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Two points

Five million patients were unable to book a GP appointment when they tried to make one in October, analysis has suggested.

Problems with access to family doctors will drive patients to accident & emergency and exacerbate pressure on hospitals, campaigners said yesterday.

Another two million people faced a wait of more than a month to see their doctor, the highest number since the records began, in 2017, and 4.3 million waited for more than a fortnight.

Says something about the NHS when it took 70 years for them to even begin to check their own performance.

The other is that GPs are currently paid not to see people. The capitation fee is for having the patient on the list. Change the incentives, so that they get paid for seeing people, and watch behaviour change.

Just been through this, a 111 call. No, not immediately urgent but 24 hours would be nice. That did, in fact, happen. But to get to it took several phone calls from at least two real live doctors before a nurse type came out to use Eyeball Mk I as a diagnostic tool. Oh, also, the surgery, and all doctors and nurse types etc, stop work at 6 pm.

This might not be quite the way to do it you know.

27 thoughts on “Two points”

  1. Change the incentives, so that they get paid for seeing people, and watch behaviour change.

    Yes, mass retirements.

    The GPs are basically contracted by the NHS to keep people out of the NHS. They’re doing their job.

  2. Due to mini-Drakon being ill, we had to go to A&E on Sunday night.
    10.5 hours later we finally managed to leave.
    During this time, we had to:
    – argue with the triage nurse about dosages of calpol
    -wait through a shift change, which was supposed to take 20min, but was closer to an hour
    -remind the doctor that he said he would give us a prescription over 75 min earlier, but he had forgotten about us and wandered off to do something else
    -point out that the prescription he had given us was actually for someone else, even though he did the ritual performance of confirming names
    -point out that the second prescription had the right name but hadn’t been signed by him

    In the whole 10.5 hours, we spent around 30min with a health care “professional”.
    One doctor was quite helpful but slow. One nurse was actually very helpful and kind. The rest were awful and obstructive. How dare we question their medical wisdom, despite it contradicting manufacturer instructions on dosage?

    Burn it. Salt the earth. Then burn it again.

    The NHS needs a reform. It will not get one until a government has the spine to tackle the unions and the shouty types who claim it is a “national treasure”. So it’s never getting reform.

  3. I refuse to use 111 – it is fucking useless.

    Couple of years ago my mum was ill. We knew what the problem and just wanted a nurse ( or someone ) to adminster antibiotics. The local small hospital, where the district nurses operated from refused to talk to us and said we had to call 111. The thick girlie on the line insisted on sending an ambulance, despite me telling them that this was the wrong response and a waste of NHS resources. 4 hours later an ambulance arrived. Frustrated paramedics agree that she just needed some antibiotics and a good sleep. They called an out of hours doc, who arrived from London, 7 hours later at 11pm and gave my mum some penicillin. She was right as rain a couple of days later. We now keep a small stock in case it happens again.


    I have been poorly recently and had to tell my GP step by step how to treat the problem. I saw briefly a nurse but not the doc, who refused to leave a voice message after my mobile phone rejected her number withheld calls. I managed to speak to her a week later, but there has been no follow up since.
    The monkey’s fine by the way.

  4. In France, everyone pays their doctor a €25 fee which is then refunded by the government. If the doctor doesn’t see any patients, their income is zero so they have a vested interest in seeing as many patients as possible. A similar system in the UK would probably work just as well.

  5. I know it’s not a systemic thing, something that would be likely to have a big impact on outcomes, but our health centre has a huge difference between the attitudes and behaviour of doctors, and of receptionists. The former, when you get to see them, are kind, friendly, and generally get things sorted. So why do they have receptionists who are in sit-com territory? Surly, aggressive, and devoid of any useful professional or social skills. It must be a deliberate policy to employ these bitches, because the clientele are far easier to deal with than most (i.e. mainly elderly, respectful, and grateful) and they wouldn’t get a job anywhere else behaving like that.

  6. Totally off topic, but this amused me.
    For decades, scientists and engineers have been working to develop computer programs that can understand and generate natural language. This has been a challenging task, but recent advances in machine learning have allowed us to create powerful language models – like myself.

    The above paragraph was not written by a human. It was generated by a chatbot called ChatGPT, an artificial intelligence technology designed to mimic human conversation and language while drawing upon a vast wealth of knowledge to answer questions and solve problems.

    That’s it desk jockeys everywhere. They’ve finally developed a robot that can stand by the coffee machine & gossip. Your days are numbered

  7. Blair introduced the target systems that dominate the NHS today – and they’re the sort of thing that are almost impossible to remove, despite the distorting effect they have on service provision. Because targets are good, see? And if they’re having an unexpected side effect, then clearly we’ve just chosen the wrong targets..

  8. I have a mate who is a GP. The surgery may stop seeing people at 18h00, but he and his other partners put in another 1.5 to 2 hours logging the bureaucratic bumph that the NHS demands.

  9. But who do GPs actually see during the day ?

    My nearest chemists is attached to the practice. I go st all different hours and the waiting room is always empty. The patients that are there ( I’ve idly checked a few times while waiting to be served ) are there to see nurses.

  10. @gunker
    Time wasting is a big problem in the public sector. My wife is a teacher she had to do health and safety training – one of the questions was on which type of asbestos is the most dangerous (in her own time of course).
    Who can seriously think that this is a good idea?

  11. Marz, if the system incentivises GPs to have appointments, is there a knock on effect that everything leads to a GP appointment, whether needed or not. Probably good in most cases, but how much of “come back and see me again next week to see how you’re getting on” is there?

  12. BiA

    Yeah but isn’t that a Good Thing most of the time ? Of course it is up to the patient to decide. As I mentioned earlier, my GP has already forgotten about my ailment.

    Ah just remembered something else. Occasionally GPs have “drives”, which I assume are mandated from on high. The last one that they tried net me with were urinary and prostate ailments. ( This was 2019, I think ). She sounded quite disappointed when she couldn’t find anything. And she also sent me to a kidney specialist, who after looking at my scans and blood results asked me “Why are you here ?” And told my doc to represcribe the meds that she had just unprescribed.

  13. Yes, today was the 3rd day in a row i called and nope- too late. Obviously Sunday i expected it to be closed, so at least my expectation was fulfilled.

  14. Our families experience of the NHS has been poor. One relative has been waiting three years for a hernia operation.

    Another aged relative got shingles (due to the covid vaccine) and even though it was obvious (to a medically trained person) since it was a very bright rash on side of their face the local Burnley hospital took ages to diagnose it. So even though they arrived in the late afternoon it wasn’t till around 11pm that they said they’d need to transfer to Blackburn to properly handle it since the Shingles had progressed quite far. They then said that it was quicker to drive there (my wife was driving, not the relative) than go in the ambulance/transfer bus. Once there the relative got lost in the system and my wife didn’t know what was happening. Eventually they found a bed. It wasn’t till 4am that my wife could drive back home, 12 hours after first going to Burnley.

  15. @Ted from Catskills
    Why do you want to destroy the NHS (PBUI) and its heroic workers like Harold Shipman?

    That’s just sexist. Only calling out the male contributions to the NHS.
    There’s also Nurse Lucy Letby currently on trial for allegedly murdering eight babies in Chester. She should at least get an honourable mention, maybe after the trial finishes…


    Time wasting is a big problem in the public sector. My wife is a teacher she had to do health and safety training – one of the questions was on which type of asbestos is the most dangerous (in her own time of course).

    Not just in public sector, large businesses do this too.
    I work on a client site. They insist we have asbestos training, must be renewed every year. So we can recognise any asbestos. In a building built in 2011…
    We of course charge them for the time. But it’s obviously completely unnecessary.

  16. Mentioned this before.
    In the closing days of my late father’s illness they started his incontinence assessment (for the problem we’d been coping with for three weeks) two days before he died.
    The chart I dutifully filled in read
    Fluids in: 0,0 0,0,0,0 Fluids out: 0,0,0,0,0 0

  17. Bloke in North Dorset

    “ The Labour leader has unveiled a new plan to outlaw reform of the service towards a European-style health insurance model.”

    The last time Labour entered office with a massive majority it inherited a growing and, relatively, dynamic economy. They could afford to spaff money on NHS and other public sector wages as well as the likes of the big school rebuilding projects without rising taxes and so became everyone’s friends. There seems to be an expectation that it will be similar next time.

    I’m almost looking forward to Labour winning the forecast majority to hear the howls of outrage when Labour has to say no to all those with high expectations. It should never be forgotten that the NHS didn’t get a real terms budget was in ‘78, under a Labour government.

  18. When labour crush the Tories say the next election, whoever is chancellor should leave a note for their successor reading “There’s no more money left.”

  19. Labour are showing just how mad they’ve become. You do not embed *POLICIES* in a *CONSTITUTION*. A constitution is the *structure*, not what you do within that structure.

  20. “Labour are showing just how mad they’ve become. You do not embed *POLICIES* in a *CONSTITUTION*. A constitution is the *structure*, not what you do within that structure.”

    Umm, no, the Left do this all the time and it works like a treat because the Right are too afraid to abolish the lot when they get into power. Why do you think we are struggling to deport illegal immigrants, and why are middle aged chicks with dicks destroying the fabric of society? Because Labour enshrined their ‘rights’ in law, and the Tories are so scared of being painted as the next Donald Trump that they won’t repeal those laws or even replace them with their own versions.

    So its a no brainer for Labour – pass laws that give legal rights for a free pony for all, and then dare the Right to take those ‘rights’ away. Which they won’t, because they’re chicken shit scared of their own shadows. Result – institutionalized leftism through the entire State apparatus like a stick of the proverbial…….

  21. Interesting to read the horror stories about the NHS, and compare it with the way things are in Australia, Needing a prescribing, I rang my local GP practice, gave my details to a very friendly a nd efficient receptionist. The prescription was sent to my phone after a couple of hours……tdirect cost to me, zero. Promptly filled at a local pharmacy for about $60:

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