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I’d worry

The GP system stands “on the brink of collapse” and would go the way of dentistry under another term of the Tories, Wes Streeting has said.

The shadow health secretary said a Labour government would divert billions of pounds from hospitals in an attempt to save “the front door” of the NHS and ensure patients could get help sooner.

You can just see them deciding to nationalise it all. Turn GPs into salaried employees.

32 thoughts on “I’d worry”

  1. As I’ve said before, when my father ran a pub in the late 60s and 70s he was fond of telling his customers who supported nationalisation and other Labour policies that he wished they’d nationalise pubs, then he could sell the worst beer in town. Not many got it.

  2. Conveniently forgetting that it was under Blair that the GP contract re-negotiation/capitulation happened (Jack Straw?) that has royally screwed up any chance of a decent GP service.

  3. It’s not lack of money, Streeting you berk.
    Patsy Hewitt saw to that.

    In fact that is the whole problem.

    GPs don’t need to see patients anymore.

  4. “would go the way of dentistry under another term of the Tories,”

    Chance would be a fine thing. At least you can get to see a dentist. OK it costs an arm and leg but you can see one.

  5. Despite both party’s unshakeable obeisance to the envy of the world the unsustainable and already barely fit for purpose GP system is steadily morphing towards the despised US model.

    Pharmacists are taking on more responsibility and could soon become the go-to for diagnoses and prescriptions (until it all goes online) while patients requiring simple procedures once provided by surgeries are instead directed towards the lengthy queues and exorbitant parking charges at the nearest A&E.

    For once Streeting is partly correct. It will go the way of nhs dentistry irrespective of which cheek of the uniparty bum is in power at the tipping point.

  6. Person in Pictland

    “would go the way of dentistry”: the way that NHS dentistry has been going, i.e. towards extinction for many, was a gift to us all from Tony Blair.

    As Mr Stress Wetting must know.

  7. When it became impossible to find an NHS dentist, maybe fifteen or twenty years ago now, we decided to go private. My main objection at the time was that we were effectively paying twice and that, as taxpayers, we had paid for a service that wasn’t being delivered. Since then, having an excellent service available when we want it is more of a consideration. To be fair, the GP surgery where I live is very good.

  8. “The shadow health secretary said a Labour government would divert billions of pounds from hospitals in an attempt to save “the front door” of the NHS and ensure patients could get help sooner.”

    This is such a bad idea. GPs belong with the horse and cart. Back when people lived in market towns and rarely went anywhere else, you needed a general medical bloke.

    The problem is that GPs are not adding much value, because they just do tons of basic routine shit, and a wide variety of looking at other things. So they’re either doing strep throats and the pill, or they’re looking at something and referring you. If you can’t diagnose your problem after 5 minutes on Google, a GP probably can’t either.

    You could replace all the everyday medicine with people specifically trained in the routine shit. Spend 3-6 months on this. Beyond that, you go to hospital. Have someone on a desk who asks what the complaint is and tells you which department to start with.

    Spending more money on this nonsense means less useful value being added by people who spend years in medical school. More GPs saying “yes, that doesn’t look right” (wow. thanks, Sherlock) and sending you to a hospital, less people at the hospital to actually diagnose what it is.

  9. even paying the NHS an extra £1000 per year ‘surcharge’ on top of income tax and NI, which sometimes gets us to the front of the queue, the service from our local GP is so poor and impossible to access that we have almost entirely switched to private and find the benefits in service quality, ease of access and capability/professionalism mirrors that of private dentistry that we also rely on.

  10. The problem with GPs is that most of them only do 3 days a week and they erect a barrier round themselves in order to avoid seeing patients.

    The fucking rigmarole my parents have to go through to get an appointment is appalling. Either book one so far in advance you will be either better or dead by the time it happens or sit on the phone at 8am waiting for the opportunity to plead with some miserable bitch on reception for an appointment that day.

    This is further complicated by only 2 of the doctors being vaguely competent.

  11. ‘The shadow health secretary said a Labour government would divert billions of pounds from hospitals in an attempt to save “the front door” ‘

    He’s more familiar with the back door.

  12. My private dentistry plan costs £17/month, not a lot more than a Netflix sub. For that I get two checkups and two hygienist appointments each year. I also get a discount on any remedial treatment, but luckily I’ve not needed any for years.

  13. You could replace all the everyday medicine with people specifically trained in the routine shit. Spend 3-6 months on this.
    I can see an argument against that. One I got from my optician. Who’s a proper one. He said, you can train someone cheaply to do eye test & prescriptions. But whilst doing the eye test he regularly spots things indicate a so far undiagnosed condition. And not only problems with eyesight.
    So in the same way, a GP doing a routine procedure, may detect something the patient’s not presenting for.
    Of course, since it’s almost impossible to see an NHS GP in the first place & if you do, they don’t do competent examinations, it’s not a particularly good argument. Although, no doubt, one they’d shrilly adopt if you tried that..

  14. GP surgeries are normally owned by some of the GP’s who work there. Nationalising GP’s and paying them a salary would presumably mean buying the surgeries from them at which point many would jump for joy and retire. Not letting them quit is technically slavery even if you pay them.

  15. “So in the same way, a GP doing a routine procedure, may detect something the patient’s not presenting for.”

    You’re having a laugh. The average GP will tell the average unacknowledged cancer patient (ie someone who will end up being diagnosed with cancer, but is just going to the doc with non-specific symptoms) to bugger off and take a few aspirin for at least 6 months until someone with a slight amount of medical knowledge and a conscience bothers to check whether the patient might have cancer or not. People know when they are ill, its convincing the idiot doctors thats the issue.

  16. I have recently had cause to see our GP.
    Had to go three times in a couple of weeks and in each case I rang on the morning and got in the same day.
    Are we really so completely at odds with everyone else, or is there some spin being put on this by Labour and their pet hacks?

  17. I saw the GP about three years ago, for a thing he may have got side money for. Since then I’ve been to the surgery many times. Seen a nurse or ‘practicioner’ (who seem to be totally constrained by procedural rules, no initiative allowed) and several phone convos with another GP. Who has diagnosed, prescribed and referred me for all my ills. But he has never seen me. Likewise the other staff won’t look at me or touch. It’s thoroughly useless.

  18. Interested,

    I think you’re very fortunate. Round here that hasn’t been the case for at least 15 years. Most people have given up after “you are caller number (pause) twenty six in line”.

    The alternative acceRx online system has worked well for me and friends on a couple of occasions. Patient fills in details of condition, trained person screens messages and requests additional info where appropriate. Serious issues have resulted in seeing a GP either on the same day or within 72 hours. For everything else the surgery gets in touch within 48 hours and an appointment, not necessarily with an actual doctor, is booked for within the next 2-3 weeks.

    Even the it’s only a sticking plaster over a gaping wound. There are simply too many people to cope with and the extra million or so each year, many receiving prioritised access to services, isn’t exactly helping.

  19. It is notable that all the measures proposed by the Labour manifesto are what I’d call managerial. No plans to DO anything, just get them in and they will setup a new organisation to stop the boats, magic up the dentists, drive the GPs, encourage growth by taxing the successful,you name it, no doing in the plan, just reorganisation. And create 650,000 jobs. Presumably not 660,000 or 640,000, and doing what they fail to say. Wonderful.

  20. Bloke in Spain,

    “I can see an argument against that. One I got from my optician. Who’s a proper one. He said, you can train someone cheaply to do eye test & prescriptions. But whilst doing the eye test he regularly spots things indicate a so far undiagnosed condition. And not only problems with eyesight.
    So in the same way, a GP doing a routine procedure, may detect something the patient’s not presenting for.
    Of course, since it’s almost impossible to see an NHS GP in the first place & if you do, they don’t do competent examinations, it’s not a particularly good argument. Although, no doubt, one they’d shrilly adopt if you tried that..”

    Opticians are at least a better model because it’s a shorter course with more specialism. And at the end of it they’re going to do nothing but eyes every day. So you not only get more of them, but they’re going to be more highly skilled at diagnosing their field than someone who is doing a whole load of different stuff.

    If we have people for diagnosing eyes, why don’t we do that for ears, toes, whatever? Three year course, and you can diagnose and resolve basic toe problems. You get a ton more work done. You’re still going to need some doctors for when things get really tricky, for surgery and so forth.

  21. GP surgeries are normally owned by some of the GP’s who work there. Nationalising GP’s and paying them a salary would presumably mean buying the surgeries from them at which point many would jump for joy and retire. Not letting them quit is technically slavery even if you pay them.

    Happens all the time with businesses, especially in the tech world.
    Someone sets up a company with a program. Big boys like Google decide they want it so offer to buy it for large amounts, but they don’t want the head talent just to fuck off somewhere else, so they have a clause in the contract – if they leave within a few years they don’t get the whole amount.
    Do the same with the GPs. Buyout, but put in a stretched payment. So they can retire if they want, but then they don’t get paid. Set it for 5 years or so to give time for more doctors to get trained.

  22. “… a Labour government would divert billions of pounds from hospitals in an attempt to save “the front door” of the NHS and ensure patients could get help sooner.“

    So…. since the GP is the gate-keeper for the hospital service, speeding up rate of referrals to hospitals to add to the 7 million waiting list whilst reducing the resources in hospitals to deal with it – is a good idea because?

  23. Bloke in Cyprus (in Gdansk)

    Had to go to an ENT guy in Cyprus recently… Very good BTW.

    He had two English students there training to be GPs… Apparently they just couldn’t get places (or even interviews) in the UK so opted to move to Cyprus and do their training there.

    Happens a lot apparently…

  24. Pharmacists are taking on more responsibility and could soon become the go-to for diagnoses and prescriptions (until it all goes online) while patients requiring simple procedures once provided by surgeries are instead directed towards the lengthy queues and exorbitant parking charges at the nearest A&E.

    Went to the pharmacist this weekend for something for both daytime and particularly nighttime acid reflux with occasional vomiting of stomach acid (not the most pleasant experience), spoke to the pharmacist saying I was “popping Rennies like sweeties” and other treatments such as Gaviscon were doing nothing.

    Aparently this was some huge red flag for something else (Gastroesophageal reflux disease, possibly) and I had to see my GP. This being Saturday lunchtime I was a bit screwed (GP closed until 8AM Monday).

    Come 8:00 AM on the dot, I began ringing and it took 25 minutes of ring / engaged / ring / engaged / ring / failed call to get through to the telephone queue (max 10) and then a further 10 minutes for one of the GP Rottweilers to answer the damned phone, so 35 minutes of pissing about, to be patronised by some power mad cvnt about my inner workings.

    In fairness, one of the doctors rang me back about 10 minutes later, requested an appointment for an endoscopy (future date unknown) and had a prescription for 2 x 28 capsules of Omeprazole 20 mg ready and waiting, so by 11 AM I had the drugs in hand and they’ve mostly alleviated the problem (although the cause remains to be seen).

    Overall it seems that the gateway process of actually getting through to the GP is the biggest problem. This faffing about with telephones and then having to negotiate with the GP’s staff is just dogshit.

    They have a website where you can book appointments, by providing a brief synopsis of your problem. This was ideal and worked fine for everything pre-COVID, but now just doesn’t have any appointments at all.

    Presumably too many people were just doing it online and bypassing the gatekeeping interrogation by the GP staff.

    I hate it.

  25. doing it online and bypassing the gatekeeping interrogation by the GP staff.

    I’ve found, in the past, that turning up to the surgery before/at opening (8am, when the phone lines also open) has gotten me an appointment before 9am.

    Only had cause to try that twice, however.

  26. Tangentially, I’m watching the Leaders Debate, and Starmer has confirmed that Accusation equals Guilt equals Punishment.

  27. I’ve found, in the past, that turning up to the surgery before/at opening (8am, when the phone lines also open) has gotten me an appointment before 9am.

    Yup. Tried that in the past and got told to go home and call.

    Phuqers.

  28. John Ga[t, gotta watch that omeprazole, they will leave you on it forever if you let them, and that’s not good for you and doesn’t fix the underlying cause.

  29. John Ga[t, gotta watch that omeprazole, they will leave you on it forever if you let them, and that’s not good for you and doesn’t fix the underlying cause.

    No, I’m fully aware of the problem as it happened with a friend of mine. My plan is to stick with it until Christmas and then slowly taper off for a period of 4 weeks and see if the problem is resolved. I’ve had some combination of acid reflux / heartburn since I was a kid.

    Likely the taper off will cause an increase in acidity, but we’ll see where we are at the end of the 4 week period. If it is manageable, I’ll do without as it is not a drug I want to take long term on the off chance.

  30. JG: I had similar to you, eating Rennies like sweeties. I too was put on omeyprazoley. After (I can’t remember) some months I tapered off and now can be fine for weeks on end, just need to know that I have a packet of Rennies somewhere within reach. I’ll have the odd day of a full six-pack, and then weeks and weeks of nothing.

    Also: with me it has to be Peppermint Rennies. I experimented with my drugs and that’s the only thing that works. Everything else just goes in like sweeties. Other than, out of desperation, a heaped teaspoon of baking power in a 1/4 glass of water.

  31. Surely the gate keeping issue being referred to in several posts here highlights the problem with any nationalised government funded enterprise. For a private enterprise, attracting customers and keeping them is a big part of your business model. Having a system for actively preventing customers from accessing your business would rapidly lead to bankruptcy. The NHS, in a sane world it would be out of business.

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