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Source: (consider it) Thread: New Junior Doctors' Contract
Ariston
Insane Unicorn
# 10894

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And, for once, the comment section doesn't make me hate humanity more.

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“Therefore, let it be explained that nowhere are the proprieties quite so strictly enforced as in men’s colleges that invite young women guests, especially over-night visitors in the fraternity houses.” Emily Post, 1937.

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Sioni Sais
Shipmate
# 5713

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quote:
Originally posted by Alan Cresswell:
That's a very big exclusive. I would be surprised if the average Sun 'reporter' had the intelligence to troll Facebook. Though, maybe the collective mental ability of four of them ...

The Daily Mirror once used "Lies, damned lies, and Sun exclusives". It could have done so, accurately, every week.

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"He isn't Doctor Who, he's The Doctor"

(Paul Sinha, BBC)

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Doublethink.
Ship's Foolwise Unperson
# 1984

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I enjoyed this http://www.buzzfeed.com/laurasilver/buying-waitrose-toilet-paper-because-yolo#.egzgKjOqz

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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell

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Anglican't
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# 15292

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quote:
Originally posted by Sioni Sais:
quote:
Originally posted by Alan Cresswell:
That's a very big exclusive. I would be surprised if the average Sun 'reporter' had the intelligence to troll Facebook. Though, maybe the collective mental ability of four of them ...

The Daily Mirror once used "Lies, damned lies, and Sun exclusives". It could have done so, accurately, every week.
There are many who could offer a good critique of the Sun, but the Daily Mirror...?
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alienfromzog

Ship's Alien
# 5327

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Today's Matt Cartooon in the Torygraph.

As usual, Matt is clever and funny but the thing is, here is where I park for work (100 miles from where I currently live).

Staff Parking, just one more thing from the list of perks that I don't get. I AM NOT complaining here. Not about the lack of perks, that's what I signed up for - but when the government tries to paint us as lazy wasters, I think the facts matter. So here's a list of things I don't get that might surprise you:

1. The right to decide where I work
2. My (required) professional fees paid for (£1500/yr)
3. My (required) professional exams paid for
4. Essential training courses paid for
5. Necessary conference attendances paid for
6. Annual leave for on-call work. (We have to swap our nights and weekends around any leave we take)
7. Any control over what rota I work
8. Routine overtime payments in addition to my contracted on-call work (unless it's an extra shift to cover sickness or absence)
9. Extra money for working Christmas or Bank Holidays
10. To walk away at the end of my shift and not worry about the patients I've seen.

(Ok, so 10 isn't a surprise)

I do not want to be lauded, I do not want more money, I do not want to be thanked.

All I want is to not be insulted while I do my job and for an employer to treat me as the dedicated professional I am; providing me with a work environment that is safe for me and my colleagues and most of all for my patients.

AFZ

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Everyone is entitled to his own opinion, but not his own facts.
[Sen. D.P.Moynihan]

An Alien's View of Earth - my blog (or vanity exercise...)

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Baptist Trainfan
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# 15128

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quote:
Originally posted by alienfromzog:
Dan Poulter, former (Conservative) Health minister writing in the Observer.

Interesting...

As it happens, he's my local MP and I have briefly met him. My politics aren't the same as his but he's a decent man.

What you may not realise is that he left his Health post last year so he could go back to part-time doctoring (GP, not hospital) while remaining an MP.

Now you may or not may think that that is a good idea, but it's at least suggestive of a disagreement with the way Government policy was going.

Or else he's planning to get out of politics altogether at the next election ... something he wouldn't have to do, as this is a very safe Tory seat.

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alienfromzog

Ship's Alien
# 5327

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Fuck.

[Mad] [Mad] [Mad] [Mad] [Mad] [Mad] [Mad]

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Everyone is entitled to his own opinion, but not his own facts.
[Sen. D.P.Moynihan]

An Alien's View of Earth - my blog (or vanity exercise...)

Posts: 2097 | From: Zog, obviously! Straight past Alpha Centauri, 2nd planet on the left... | Registered: Dec 2003  |  IP: Logged
Doublethink.
Ship's Foolwise Unperson
# 1984

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Seconded, thirded, quadrupled, quintupled.

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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell

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Kelly Alves

Bunny with an axe
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This sucks. Standing in sympathy with the Britmates.

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"Take your broken heart, make it into art"-- Carrie Fisher (1956-2016)

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mdijon
Shipmate
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I thought this captured the lunacy of Hunt pretty well.

But not as well as this.

Only it doesn't look like the second one is satire.

The whole thing is a textbook case of how not to handle a dispute. Aside from being in the wrong to start with, even with the right reform this would be the most deliberately provocative way of dealing with it.

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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon

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alienfromzog

Ship's Alien
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quote:
Originally posted by mdijon:
I thought this captured the lunacy of Hunt pretty well.

But not as well as this.

Only it doesn't look like the second one is satire.

The whole thing is a textbook case of how not to handle a dispute. Aside from being in the wrong to start with, even with the right reform this would be the most deliberately provocative way of dealing with it.

Nope, amazingly enough, the second one is not satire. I'm pondering a pithy enough response - I mean we all know how Mr Hunt could improve morale instantly.

AFZ

[ 12. February 2016, 06:59: Message edited by: alienfromzog ]

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Everyone is entitled to his own opinion, but not his own facts.
[Sen. D.P.Moynihan]

An Alien's View of Earth - my blog (or vanity exercise...)

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Frankenstein
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# 16198

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This is confrontationalism pure and simple.
He wants to put the junior doctors in the wrong.
Then he Jeremy Hunt will ride out on his charger and save the day!

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It is better to travel in hope than to arrive?

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alienfromzog

Ship's Alien
# 5327

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Sir Bruce Keogh is the head of NHS England (the chief medical officer in old money) who apparently advised the government that no deal with the BMA was possible.

YouTube clip - This is him talking about weekend working a few years ago...

Make of that what you will...

AFZ

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Everyone is entitled to his own opinion, but not his own facts.
[Sen. D.P.Moynihan]

An Alien's View of Earth - my blog (or vanity exercise...)

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ExclamationMark
Shipmate
# 14715

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quote:
Originally posted by alienfromzog:
Today's Matt Cartooon in the Torygraph.

As usual, Matt is clever and funny but the thing is, here is where I park for work (100 miles from where I currently live).

Staff Parking, just one more thing from the list of perks that I don't get. I AM NOT complaining here. Not about the lack of perks, that's what I signed up for - but when the government tries to paint us as lazy wasters, I think the facts matter. So here's a list of things I don't get that might surprise you:

1. The right to decide where I work
2. My (required) professional fees paid for (£1500/yr)
3. My (required) professional exams paid for
4. Essential training courses paid for
5. Necessary conference attendances paid for
6. Annual leave for on-call work. (We have to swap our nights and weekends around any leave we take)
7. Any control over what rota I work
8. Routine overtime payments in addition to my contracted on-call work (unless it's an extra shift to cover sickness or absence)
9. Extra money for working Christmas or Bank Holidays
10. To walk away at the end of my shift and not worry about the patients I've seen.

(Ok, so 10 isn't a surprise)

I do not want to be lauded, I do not want more money, I do not want to be thanked.

All I want is to not be insulted while I do my job and for an employer to treat me as the dedicated professional I am; providing me with a work environment that is safe for me and my colleagues and most of all for my patients.

AFZ

The Tory Agenda is finally coming home to roost. They consider themselves strong enough to take on anyone or anything - even something they've waited a lifetime to dismantle (yes an element of anti NHS and social support is ingrained in the Tory psyche for what it represents).

I have a certain amount of sympathy for Junior Doctors but it's tempered by the fact that they said nothing, when the Govt were selling off bits of the NHS, simply because it didn't affect them.

I didn't see Doctors whining when nurses contracts were changed nor did I see them on a local picket line when cleaning and ancillary staff struck over wages and conditions. There's a case, sure, but the Doctors action (inaction on behalf of colleagues in the past) does rather smack of protectionism and selfishness.

Don't forget the people who will be helping you on the ground both Mrs M and Miss M have letters from Junior Doctors on their first wards who have been thankful for their help and support.

It's a kind of bullying - or rather use of the ability and power to strike. Who will really suffer?

By the way, numbers 2 and 7 would send a lot of people in the NHS into paroxysms of laughter. Fat chance they have of getting that.

[ 14. April 2016, 08:00: Message edited by: ExclamationMark ]

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Doc Tor
Deepest Red
# 9748

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Bearing in mind that secondary action has been illegal for quite a while now...

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Forward the New Republic

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quetzalcoatl
Shipmate
# 16740

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Rang the surgery last week to see a doctor. Told I had to wait two weeks, or I could go to A and E. I guess this is the future, gradually grind the NHS down, so people will either go private, or go to A and E, which will also grind to a halt. See, the NHS doesn't really work.

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no path

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L'organist
Shipmate
# 17338

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Two weeks? You were lucky.
My local surgery will only go so far as to say you can be given an appointment with a doctor (unspecified) on a date 3 weeks from your call but won't confirm the time of the appointment until the day before - and that is only if you're prepared to tell the person on the appointments line why you want to see a doctor.

They do have (so I'm told) same day appointments but I've never met anyone who managed to get one.

The best thing IME is to ask to speak to the triage nurse who will then decide whether or not you either need to speak to a doctor (probably not same day) or be given an emergency appointment (usually next day).

By way of contrast, I can call a vet for a friend and they will come out to see her horse same day.

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Rara temporum felicitate ubi sentire quae velis et quae sentias dicere licet

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Alan Cresswell

Mad Scientist 先生
# 31

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The last few times I've needed to see the GP, I've called up and the reception staff have said something like "Non-urgent? OK, how about the day after tomorrow?". I guess that's what happens when the Scottish Government decides to provide more (but, not all that much more) funding to the health service.

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Don't Brexit if you haven't a scooby how to fix it.

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M.
Ship's Spare Part
# 3291

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I'm in England and have never had much of a problem getting an appointment either. In fact, last time I went to the doctor, having heard about how busy doctors are, I was saying to the receptionist 'it's not urgent, a couple of weeks time will be fine' as she was getting very confused and saying, 'I can fit you in tomorrow'.

M.

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Leorning Cniht
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# 17564

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quote:
Originally posted by M.:
I'm in England and have never had much of a problem getting an appointment either.

When I lived in England last, my GP's office didn't offer appointments. On the single occasion I needed to see a doctor, I called to ask for an appointment, and was rather surprised to be told that they don't do appointments, that I should turn up at the surgery in the morning and wait, and I'd be seen in rough order of medical urgency. Explaining that this wasn't an emergency - it was a skin condition that wanted treatment, but I'd be happy to wait for an appointment didn't make a difference - the things just didn't exist.

I was rather surprised by this - the receptionist told me that they used to do appointments, but that a very large number of people failed to keep them.


I wasn't very impressed, needless to say.

So I suspect that ease of getting an appointment might be something that shows strong local variations.

[ 16. April 2016, 15:04: Message edited by: Leorning Cniht ]

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Curiosity killed ...

Ship's Mug
# 11770

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My local GP surgery has a daily phone in and call back system for emergency appointments. Other appointments can be booked in advance. I usually have to book 6 weeks in advance for my regular asthma check ups.

An emergency request needs to be made by 10am and if the triage system / doctor think that the problem warrants an appointment that day you're called in. (Last time I felt ill enough to fight the system I had a pretty bad chest infection and was called in for an appointment. It didn't clear with the first course of antibiotics so when I called in again I was issued with a second dose of antibiotics with a phone appointment. If I'd needed a third course I would have had to go back in for further investigation.)

Basically to use the local GP's surgery you have to be ill with something that will wait 6 weeks, or you're really sick. Otherwise don't bother.

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Mugs - Keep the Ship afloat

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M.
Ship's Spare Part
# 3291

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Actually, Leorning Cniht (if I've spelt your name wrong,sorry), my doctor used to do open surgery, which I much preferred. I could rock up at 8 am for 8.30 opening and be seen in order of turning up. So when I discovered a lump in my breast one morning when I was in the shower, I saw the doctor at 8.30 and was on my way to work knowing it was a cyst by 9.

Booking an appointment is much less efficient from my point of view. And quite a recent innovation in the scheme of things - I can't remember ever having bookings for general 'I want to see the doctor'-type things until about 15 or 20 years ago.

M.

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Leorning Cniht
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# 17564

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quote:
Originally posted by M.:

Booking an appointment is much less efficient from my point of view. And quite a recent innovation in the scheme of things - I can't remember ever having bookings for general 'I want to see the doctor'-type things until about 15 or 20 years ago.

I suppose it depends both on your lifestyle and on the busyness of your doctor's surgery. I know the consequence for me was that I spent all morning hunched over a laptop in the doctor's waiting room in a vain attempt to prevent the morning being a complete write-off, so an appointment would have worked out much better for me.

If you offered me a choice between a nearby doctor with a "turn up and wait" scheme, or one that was a little further away but offered appointments, I'd take the second one every time.

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anoesis
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quote:
Originally posted by Leorning Cniht:

If you offered me a choice between a nearby doctor with a "turn up and wait" scheme, or one that was a little further away but offered appointments, I'd take the second one every time.

It really does depend on what you're going to the doctor for, and how efficiently they run their practice. It's all very well to say you'd rather have an appointment time because that way you don't have to waste all your working morning, but in my experience there is absolutely dreadful slippage throughout the day with appointment times and if your appointment is after lunch it is likely to take place at least half an hour after the scheduled time anyway, possibly more, but given you're not in a drop-in scheme, you can't really take that risk and have to turn up at the correct time and still waste a load of your time. The great benefit of drop-in type centres, from my point of view, is that they tend also to be open longer hours. So if you have been up with a sick kid from the small hours, you can wrap them in a dressing gown and get down there at 6.30am for opening and be seen pretty soon, and conversely, if you just need another prescription (as I do, every three months), and there is not a thing in the world else wrong with you, you can head down there in the evening after the working day and after the kids are in bed, with a book, and just wait in line as long as needed, without getting all hot under the collar about how you've managed to allocate your time in such a way as to make your appointment on time, but, once again, others haven't.

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The history of humanity give one little hope that strength left to its own devices won't be abused. Indeed, it gives one little ground to think that strength would continue to exist if it were not abused. -- Dafyd --

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anoesis
Shipmate
# 14189

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quote:
Originally posted by L'organist:
[snip]

They do have (so I'm told) same day appointments but I've never met anyone who managed to get one.

[snip]

By way of contrast, I can call a vet for a friend and they will come out to see her horse same day.

I don't in any way mean to trivialise what you are saying here, and I do think that a two-week wait for an appointment is excessively long, but you're not comparing apples with apples with the vet analogy, surely? The vet is more comparable to fully private healthcare provision, in both service and cost terms. I know I have spent more money getting my cat stitched back together* than I've ever had to spend on a human member of my family with a health problem.

*Hmm, trigger phrase...just realised that the obstetric costs for my second child were more than any single vet bill, but still the total of vet bills will have exceeded this...

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The history of humanity give one little hope that strength left to its own devices won't be abused. Indeed, it gives one little ground to think that strength would continue to exist if it were not abused. -- Dafyd --

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L'organist
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# 17338

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A 2 week wait would be a massive improvement: if you read my earlier post you'll read that at my surgery it is a THREE week wait. This wait holds good regardless of any long-term condition(s) you may have. When my late-lamented had terminal cancer we still were told there was a 3 week wait for regular appointments and that we couldn't book for a specified doctor: this made an already ghastly situation ten times worse. Our local hospice were so appalled they advised us to change surgery.

As for comparing apples and pears - the GP gets paid regardless of whether or not they see patients and regardless of easy or difficult they make it for their patients to see them. A vet only gets to see animals if there is a need so healthy patients with no ongoing need equals no one to see equals no income.

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Rara temporum felicitate ubi sentire quae velis et quae sentias dicere licet

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mdijon
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# 8520

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quote:
Originally posted by L'organist:
Our local hospice were so appalled they advised us to change surgery.

I guess on the positive side at least that indicates they thought this was not "normal for the NHS" or there would have been no value in changing.

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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon

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quetzalcoatl
Shipmate
# 16740

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Well, I used to be in a small surgery, where you could get next day appointments fine. Then some small ones were combined into a big one, in the name of efficiency, I guess, and the result (rather predictable), is that I had to wait two weeks. What seems really daft is that this will put pressure on A and E, as many people will be forced to go there, if they can't wait two weeks. I saw an old lady at reception, and they told her, you can't see a doctor today or tomorrow, go to A and E. Madness.

[ 17. April 2016, 14:41: Message edited by: quetzalcoatl ]

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no path

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Zacchaeus
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# 14454

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quote:
Originally posted by mdijon:
quote:
Originally posted by L'organist:
Our local hospice were so appalled they advised us to change surgery.

I guess on the positive side at least that indicates they thought this was not "normal for the NHS" or there would have been no value in changing.
It's normal around here a 3 week wait is very usual. it's not even unknown for there to be no bookable appointments at all.
i've been known to phone every day at 8 for a week and still not get an appointment.

We'd change doctors but research tells us it would frying pan to fire......

we are fortunate to have a walk in close by - we tend to use that

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anoesis
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# 14189

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quote:
Originally posted by quetzalcoatl:
Well, I used to be in a small surgery, where you could get next day appointments fine. Then some small ones were combined into a big one, in the name of efficiency, I guess, and the result (rather predictable), is that I had to wait two weeks. What seems really daft is that this will put pressure on A and E, as many people will be forced to go there, if they can't wait two weeks. I saw an old lady at reception, and they told her, you can't see a doctor today or tomorrow, go to A and E. Madness.

It does indeed seem like madness, especially as presumably both the surgery funding and the A & E funding come out of the NHS pot. I know that here in NZ, there was a point some years ago where A & E departments were under absolutely enormous pressure with overloading from people either turning up because A & E was free, whereas docs appointments were not, and they needed another inhaler, or their kid had a temperature, and their financial situation was such that it was preferable to sit and wait literally all day than pay for a docs appointment. Also there were those who were not managing chronic conditions adequately, also due to a reluctance to go to the doctor regularly, ending up actually needing A & E services, which they would not have otherwise. I don't know what the whole suite of policy decisions to deal with this were, only what I've observed as a user of health services, but these include: doctor's appointments for children under ?13? or ?16? (both my kids are under 13 still so I'm not sure), are free, which is a start. Also, in Auckland where I lived until recently, the 24 hour medical clinics (drop-in centres) were funded by the hospitals so that appointments were free during what you might call the 'small hours', when ordinary day/evening surgeries were not open, in the hope of making the 24-hour clinics a viable alternative to A & E for those who were not immediately dying, as it were, and it is my understanding that during these hours, people were encouraged away from A & E and to the clinics, the exact opposite of the scenario you have described...

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The history of humanity give one little hope that strength left to its own devices won't be abused. Indeed, it gives one little ground to think that strength would continue to exist if it were not abused. -- Dafyd --

Posts: 967 | From: New Zealand | Registered: Oct 2008  |  IP: Logged
Alan Cresswell

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# 31

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quote:
Originally posted by anoesis:
quote:
Originally posted by quetzalcoatl:
Well, I used to be in a small surgery, where you could get next day appointments fine. Then some small ones were combined into a big one, in the name of efficiency, I guess, and the result (rather predictable), is that I had to wait two weeks. What seems really daft is that this will put pressure on A and E, as many people will be forced to go there, if they can't wait two weeks. I saw an old lady at reception, and they told her, you can't see a doctor today or tomorrow, go to A and E. Madness.

It does indeed seem like madness, especially as presumably both the surgery funding and the A & E funding come out of the NHS pot.
Indirectly the same pot. But, doctors surgeries (and, indeed most hospitals) have been made into trusts with their own budgets, with an emphasis on "fiscal efficiency" rather than patient care. Which effectively means the GPs surgeries employ the least number of people they can get away with and are hence understaffed much of the time.

A&E departments are (generally) adequately staffed to deal with genuine emergencies. But, are under pressure from a combination of people who don't really need A&E but can't get to see their GP at one end (because GPs are under-resourced), and often a lack of space on the general wards preventing them from moving patients who do need hospital care out of the department at the other end (because other departments in the hospital are under resourced, and quite often because social services are so chronically under resourced that provision can't be made for the care of patients at home when they no longer need to be in hospital).

Put simply, the NHS (and related care services) needs more resources across the board - from primary care GPs and pharmacies, through hospitals, and out the other end of the system with social services and care at home. More resources means more doctors, nurses, pharmacists, radiologists, social workers, care home workers etc. It needs ending ridiculous working hours and conditions. None of which is helped by replacing a junior doctors contract that was designed to reduce long working hours and improve conditions with one that appears to be designed to save money by increasing working hours and making conditions worse.

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Don't Brexit if you haven't a scooby how to fix it.

Posts: 31967 | From: East Kilbride (Scotland) or 福島 | Registered: May 2001  |  IP: Logged
mdijon
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There is another area of fiscal madness in social care provision. It is not unusual to find patients waiting in hospital for "social care packages" to be ready before discharge.

What this means in practice is that because the social care budget can't yet provide a carer to go in once or twice a day to assist the patient with daily living in their home (cost 150 pounds) they remain in a hospital bad on a waiting list (cost 350 pounds per day).

Because these are separate budgets the system leaves one individual with the incentive to fix the problem and another individual with the power to fix the problem.

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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon

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Huia
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Goodness - I didn't realise how lucky I am. I use a small medical centre with 4 doctors who don't all work full time. I can usually get to see my own Doctor within a day or two. If she's away I can choose which other doctor I see. Once when I had a migraine I was seen immediately by a nurse who called in a doctor to prescribe the medication which was injected by the nurse.

The opening hours are 9am until 5pm and after that there is an after hours clinic which is a drop in arrangement and charges like a wounded bull (compared with the usual costs). Fortunately the time I needed to have something attended to urgently was after the Feb 2011 earthquake, when the Government picked up the tab for all doctor's visits. (much and all as I don't support the current government here they had some helpful responses during the immediate aftermath of the worst quakes).

Huia

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Charity gives food from the table, Justice gives a place at the table.

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quetzalcoatl
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The other point I forgot to make, is that to see my own doctor, who I've seen for 20 years, meant a 4 week wait.

In effect, if this carries on, I will not see the same doctor except by accident. It seems a mad way to run a health service to me, but as I said earlier, if you are cynical, you will say that the Tories want to run the NHS down.

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no path

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TomM
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quote:
Originally posted by quetzalcoatl:
if you are cynical, you will say that the Tories want to run the NHS down.

Call me cynical, but it is something the Right Honorable Secretary of State has previously said.
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quetzalcoatl
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quote:
Originally posted by TomM:
quote:
Originally posted by quetzalcoatl:
if you are cynical, you will say that the Tories want to run the NHS down.

Call me cynical, but it is something the Right Honorable Secretary of State has previously said.
Ah, but you see, he was misquoted there, and anyway, he is a different man now. He doesn't want to run the NHS down, he just doesn't see why private health can't be expanded and expanded and expanded ...

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no path

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North East Quine

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# 13049

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We have a completely bizarre system where you phone for a "backstop" appointment to see a GP, any GP - this may be a couple of weeks away. You then phone back the next day to see if it can be brought forward, which it usually can, and also if you can swap to a different doctor, if there's one you'd prefer. If you're still not happy then you phone again the next day, and get it brought forward / swap doctors again. Once you have your back stop appointment, you're into the system. And as you cancel appointments as you shuffle forwards, those appointments open up for other people shuffling forwards.

Mind you, last time I wanted a GP appointment, I got a next-day appointment as it was potentially serious. I'm confident that if I needed a GP appointment I could get one.

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Alan Cresswell

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There are a variety of potential systems for patients to see their GP, even if they seem bizarre. I don't expect there to be one size that fits all, and therefore each surgery should assess which system best suits the needs of their doctors and patients.

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Don't Brexit if you haven't a scooby how to fix it.

Posts: 31967 | From: East Kilbride (Scotland) or 福島 | Registered: May 2001  |  IP: Logged
Sioni Sais
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quote:
Originally posted by Alan Cresswell:
There are a variety of potential systems for patients to see their GP, even if they seem bizarre. I don't expect there to be one size that fits all, and therefore each surgery should assess which system best suits the needs of their doctors and patients.

There's certainly not one recipe. Some places can't attract GPs and some practices with a high proportion of high-use/high-dependency patients. Down-at-heel seaside towns must be in a perfect storm.

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"He isn't Doctor Who, he's The Doctor"

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Leorning Cniht
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quote:
Originally posted by Alan Cresswell:
There are a variety of potential systems for patients to see their GP, even if they seem bizarre. I don't expect there to be one size that fits all, and therefore each surgery should assess which system best suits the needs of their doctors and patients.

And/or possibly patients should be able to select the surgery with the system that suits them. The rules on what surgeries you are permitted to register with have changed over time - I don't know whether they're the same nationwide, or there's local variation in that too.
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no prophet's flag is set so...

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quote:
Originally posted by Alan Cresswell:
There are a variety of potential systems for patients to see their GP, even if they seem bizarre. I don't expect there to be one size that fits all, and therefore each surgery should assess which system best suits the needs of their doctors and patients.

A good money saving one is to have physicians as second tier health care providers, and generally not seen at all unless required. See a nurse first. Nurses are cheaper here by quite a bit. I imagine cheaper there as well. The hourly works out to be 1/4 or 1/5 the cost. This works quite well in many parts of Canada for things like chronic condition follow-up, hospital emergency triage, various medication checks, renewals and reviews. The health system saves on the physician fees and the nurse practitioners do the work. If the nurses need help, they call in for consultation by video call, and can remotely apply the recommendations from the consulting nurse or physician.

We've also dispensed with the need for physician referral for physiotherapy, occupational therapy, psychologist, chiropractic, speech therapy, audiology, eye care, several others. These people can refer or consult as primary practitioners without physician involvement.

Part of this has been necessity. In many places in the north we can't get physicians to agree to do other than short call-in periods of 1 week to 3 months. The other is the clear cost savings with no negative impact on health outcomes. And more rapid access to care, thus patients are happier.

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Maybe I should stop to consider that I'm not worthy of an epiphany and just take what life has to offer
(formerly was just "no prophet") \_(ツ)_/

Posts: 10844 | From: Treaty 6 territory in the nonexistant Province of Buffalo, Canada ↄ⃝' | Registered: Mar 2010  |  IP: Logged
Alan Cresswell

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I see the government has decided to invest more money to boost the number of GPs in England.

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Don't Brexit if you haven't a scooby how to fix it.

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alienfromzog

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quote:
Originally posted by Alan Cresswell:
I see the government has decided to invest more money to boost the number of GPs in England.

Much needed.

I am sure, though that you'll forgive me for maintaining a degree of skepticism until we know this isn't old money being promised again.

AFZ

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Everyone is entitled to his own opinion, but not his own facts.
[Sen. D.P.Moynihan]

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Alan Cresswell

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Or, just budget shifted from another cash-starved part of NHS England.

And, they want 500 more overseas doctors. How does that square with their immigration policy?

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Don't Brexit if you haven't a scooby how to fix it.

Posts: 31967 | From: East Kilbride (Scotland) or 福島 | Registered: May 2001  |  IP: Logged
alienfromzog

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This is really interesting.

I don't believe that Mr Hunt believes what he says but that's me. I may be wrong.

However the striking part is that apparently there is 'nothing' Mr Hunt would take in return for not imposing the contract.

That is an extreme arrogance. I thought the point was to improve the NHS. Apparently saving face matters more.

AFZ

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Everyone is entitled to his own opinion, but not his own facts.
[Sen. D.P.Moynihan]

An Alien's View of Earth - my blog (or vanity exercise...)

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Sioni Sais
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# 5713

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Within that measured and calm article by Alex Murray appears the crucial line "if Jeremy genuinely stands for improving the NHS, surely we should be on the same page?"

Isn't it obvious that Jeremy Hunt doesn't and never has stood for improving the NHS, whether for the clinical staff, the clerical and support staff and certainly not the patients or the taxpayers, but only as a cashcow.

I'm sure some will disagree, and that improvements can be made to the NHS within its existing budget, but this is a sharp-end change and back in 2010 the government stated that services affecting the public would not be affected by austerity measures and reforms.

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"He isn't Doctor Who, he's The Doctor"

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Posts: 23903 | From: Newport, Wales | Registered: Apr 2004  |  IP: Logged
Anselmina
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# 3032

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quote:
Originally posted by Leorning Cniht:
quote:
Originally posted by Alan Cresswell:
There are a variety of potential systems for patients to see their GP, even if they seem bizarre. I don't expect there to be one size that fits all, and therefore each surgery should assess which system best suits the needs of their doctors and patients.

And/or possibly patients should be able to select the surgery with the system that suits them. The rules on what surgeries you are permitted to register with have changed over time - I don't know whether they're the same nationwide, or there's local variation in that too.
In our part of Northern Ireland it might vary with GP practice. I think you're supposed to transfer to a practice in your new location when you move. But I do know many people who still travel back to their former surgeries.

With our practice - which has about at least six doctors, and a number of regularly visiting nurses - covers a huge populous area, which also has a fair number of similar sized practices. Nevertheless, the average wait if I wanted to see my 'own' GP I'd have to wait at least three weeks. If I wanted an emergency appointment the form is to phone first thing in the morning when the switchboard opens to see if the operator will invite you into the surgery later in the morning, either as a possibility to be squeezed in, or to take up a cancellation. To be fair, you would normally be told to come in and be seen that day, but you would have to phone up first and organize it.

You just have to resign yourself to it! And I must say it works well enough, by and large. They're a good, hard-working bunch, and I often think that the workload must be oppressively overwhelming at times, and the flack they take from frustrated patients very unpleasant.

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Irish dogs needing homes! http://www.dogactionwelfaregroup.ie/ Greyhounds and Lurchers are shipped over to England for rehoming too!

Posts: 9930 | From: Scotland the Brave | Registered: Jul 2002  |  IP: Logged
Albertus
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# 13356

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Twenty years ago my GPs in Tooting ran their first surgery of the day, every day, on a no-appointment, first come first served basis, and it was much appreciated.*
As the man said when the receptionist asked him if he had an appiontment, 'what do you think I am, a prophet? I didn't know I was ill until this morning...'
*The senior partner was very widely and AFAICT rightly respected as a skilful and caring GP. But I suspect that she may have had a fairly brisk way with obvious malingerers- which probably helped keep the drop-in surgery manageable.

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My beard is a testament to my masculinity and virility, and demonstrates that I am a real man. Trouble is, bits of quiche sometimes get caught in it.

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alienfromzog

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Some excellent work by the University of Manchester has shed some light on the weekend effect.

As many of us suspected, the 'increased death rate' is nothing of the sort but a statistical result due to the fact that the patients admitted a weekends are sicker.

As most of us suspected.

I look forward to Mr Hunt's climb down...

What do mean he's reiterated his claim of excess deaths(Sky News report on this paper)? [Eek!] No, really? Colour-me not remotely surprised. [Disappointed]

This is a particularly scathing analysis...

I come back to something I said a few months back:
http://tinyurl.com/jeremyhunt

AFZ

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Everyone is entitled to his own opinion, but not his own facts.
[Sen. D.P.Moynihan]

An Alien's View of Earth - my blog (or vanity exercise...)

Posts: 2097 | From: Zog, obviously! Straight past Alpha Centauri, 2nd planet on the left... | Registered: Dec 2003  |  IP: Logged
ExclamationMark
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# 14715

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The Government is beginning to bottle it under the premise of reflection.

Who will they give into next? Doctors, Education .... any prizes for the next one in the list?

Respect can't get any lower

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