A couple of days ago Wes Streeting, Labour’s shadow health secretary, attacked GPs, saying their finances are murky, in the process obviously seeking to blame them for NHS failings. In the process he threatened to take away the role they have in primary health care.
Mrs. Murphy is a GP.
As to their finances. Currently we have a system where a GP is paid not to see a patient – capitation fees. Perhaps a change to being paid for seeing a patient would have a useful effect upon incentives?
The role they have in primary health care is as high priest and gatekeeper to the treatments you actually need, and I wish somebody would hurry up and actually strip them of that role. I don’t need a gatekeeper to refer me to my dentists, I don’t need a gatekeeper to refer me to my optician, why the hell must I persuade a GP to refer me to an ENT specialist when I know I have a recurrance of an ENT problem that needs to be dealt with by an ENT specialist. My latest GP didn’t even know what I was talking about until I showed him photos I’d taken.
Too many perverse incentives from on high! Too much bureaucracy! Rusty clinical skills unless patient has something really obvious! Go back to the drawing board
The GPs have contracts with the NHS, not with patients. If the problem the NHS is having* is too much demand on its services, then it isn’t going to incentivise the gatekeepers to increase the demand.
*which is different to the problem with the NHS
The role they have in primary health care is as high priest and gatekeeper to the treatments you actually need . . .
We talking about the doctors or the receptionists?
I thought Mrs.Murphy retired early on health grounds? She is presumably in receipt of a good NHS pension which again raises the question of why Ritchie is continually hustling for cash.
It was quite the thing to witness with my GP surgery when they were being paid to do Covid boosters. Suddenly all kinds of evening and weekend opening hours were available…
Contrast with the text message this week saying that no in-person appointments are going to be available (because unprecedented pressures etc.), and if you want to see someone, find a walk-in centre or go to a pharmacist
I disagree weith jgh – for the vast majority of primary healthcare the GP (or just a nurse) is sufficient (within that there is a significant minority that can be self-treated by anyone who was a Brussel Sprout). Consequently there is a tiny minority of ENT/cancer/cardiac/kidney/UTI/… specialists to deal with the tiny minority of cases in their specialities. In these rare cases the GPs act as a signpost rather than a gate-keeper. Of course there will be 1 in a thousand GPs who fail to recognise a ratre symptom but does he think that he will get so see his ENT specialist quicker is he has to queue behind 999 other would-be patients who cannot tell whether they have a bad cold or are in need of a laryngectomy?
@Sam Jones I believe they are “permanently separated” , but not divorced cuz Reasons. Quite possibly tax-related.
” Of course there will be 1 in a thousand GPs who fail to recognise a rare symptom”
Its my experience that its rather akin to 1 in a thousand GPs who can recognise and diagnose serious and not particularly uncommon symptoms. I’ve lost count of the number of people who I know of who have been fobbed off by GPs for months if not years who turned out to have serious health issues that should have been diagnosed at the outset. In some cases they have died, many have suffered life threatening and debilitating issues because of the failure of GPs to diagnose correctly. The way most GPs diagnose you’d think their only qualification was a postal course in medicine from Ladybird books.
The latest case I know of ran along the lines of:
‘You have a great pain in behind your eye, your face is drooping on one side, you are losing weight rapidly and keep collapsing. You must have an eye infection. Have some antibiotics and stop bothering us’
That turned out to be a brain tumour. Only diagnosed when the repeated collapsing and inability to walk resulted in an ambulance trip to A&E and some real doctors had a look at him. GPs are utter scum and fraudsters, taking 6 figure salaries to behave like concentration camp guards. I could do better with a PC and Google.
“Quite possibly tax-related.” Oooh, dodging inheritance tax on money left or gifted to a spouse? Anything else spring to mind?
I take it that the “permanently separated” are allowed to have separate principal residences just as if they were divorced? Otherwise a house sale might generate a bit of CGT.
I could do better with a PC and Google.
On one of the few occasions I’ve actually decided it was worth wasting my time and saw the GP, the useless bint actually sat there googling my symptoms. Wasn’t even subtle about it.
F*kin useless.
This is why I mainly try to go and use medical facilities abroad. You know, where they aren’t actually
the wonder of the worldshit.Gotta say that my experiences with my GP (and the nearly a doctor nurses in his practice) here in the hurt of Tejas don’t match any of the reported horror stories from Blighty.
Quite the opposite. My GP is well-read, enjoys a discussion (both on specific symptoms, and general issues) and seems to keep up with Stuff.
Jim,
“That turned out to be a brain tumour. Only diagnosed when the repeated collapsing and inability to walk resulted in an ambulance trip to A&E and some real doctors had a look at him. GPs are utter scum and fraudsters, taking 6 figure salaries to behave like concentration camp guards. I could do better with a PC and Google.”
I had a situation many years ago where a GP couldn’t figure out my problem and at one point diagnosed me something they had already done. “But we tried that before” “well, it might work this time”. Absolute unscientific quackery.
But I realised that really, you can do as well with Google. The problem with GPs is that their experience never goes deep. They’re doing so much routine crap for so much of the body, they never get to see enough ENT or whatever cases to build their experience in it.
It’s like you don’t go to one bloke to do things to your home. Plumbers, tilers, plasterers, painters and decorators, glazers, electricians, carpet fitters. Because if someone is fitting windows all day, every day, they’re going to become really great at it.
GPs are a waste of talent. Most people should be channeled into a specialism earlier. ENT, feet, arseholes. Opticians are a 3 year degree course, because beyond some basic medical stuff they learn about eyes and not much else. Which is why it’s not hard to get an appointment at Specsavers.
Which is why it’s not hard to get an appointment at Specsavers.
Also, there is plenty of competition for Specsavers. Boots, etc. So if Specsavers is full, you can go somewhere else. Even my local Asda has an opticians in it. Plus there are numerous small business opticians.
NHS? Not as much competition. For those lucky enough to have private insurance or afford private healthcare, there is competition and it’s very telling how much better it is than the sainted NHS.
“I had a situation many years ago where a GP couldn’t figure out my problem and at one point diagnosed me something they had already done. “But we tried that before” “well, it might work this time”. Absolute unscientific quackery.”
I once had a GP (senior practice owner) say to me (when I’d suggested I might have complaint X) ‘You can’t possibly have that, I’ve never seen a case of it’.