| Non-motoring > Naughtie was right | Miscellaneous |
| Thread Author: Lygonos | Replies: 68 |
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New Wed 26 Nov 14 12:41
Naughtie was right - Lygonos
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Without being aware of circumstances, this certainly appears on the Minister's own reply to show his level of Knobhead-factor. www.bbc.co.uk/news/health-30207608 |
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New Wed 26 Nov 14 13:08
Naughtie was right - Zero
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Whilst, based on past performance, I would happily add Berkshire to t his name, to be fair the circumstances are important here. For example if you suspect your kid has meningitis you aint gonna wait 24 hours for a GP appointment you can't get anyway. I can vouch that the NHS help line is utterly useless, so A&E is sometimes your only valid option. |
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New Wed 26 Nov 14 13:53
Naughtie was right - rtj70
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We don't know the circumstances here. But Andy Burnham seems to be saying nobody should bypass the GP service and go straight to A&E.... so why have an A&E service that you can walk in on? Even though most GPs are not open at the weekend (or out of hours), I thought all areas had an out of hours service manned by GPs. Our area certainly does and we've had to use it a few times over the years. |
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New Wed 26 Nov 14 16:02
Naughtie was right - Westpig
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>> >> Without being aware of circumstances, this certainly appears on the Minister's own reply to show >> his level of Knobhead-factor. >> >> www.bbc.co.uk/news/health-30207608 >> Why does that make him a knobhead? You have children, they become ill, you worry about them, you don't want to leave it if it was something important and you have limited knowledge on the subject matter...so you take them to somewhere that does have the required knowledge. What else do you do? If you left something important you'd never forgive yourself. I for one think 7 day a week GP cover is a positive thing. |
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New Wed 26 Nov 14 17:23
Naughtie was right - Lygonos
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>>I thought all areas had an out of hours service manned by GPs. ^ this And if the system is crap then fix the system, don't make a whole new level of nonsense. A&E is NOT the same as out-of-hours general practice - it's open 24hrs for a reason, rather than 6pm til 8am. If Hunt called 111 and was unhappy with the response, and felt his child(ren) were so unwell they needed urgent attention then that's fair enough but his beef in that case should be with 111. If he just couldn't get a Friday appointment and 'didn't want to wait' til Monday then he deserves the abuse and disrespect he is about to receive. >>I for one think 7 day a week GP cover is a positive thing. It already exists. If you actually mean "I think I should be able to see my GP/someone from my practice 7 days-a-week (does that mean 24/7 or just office hours...)" then you have to decide how you will pay for it, or what service is removed to be able to afford it. |
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New Wed 26 Nov 14 17:39
Naughtie was right - rtj70
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I think the old system where your own GP surgery covered (with a rota) out of hours was flawed. Expecting someone who's asleep to answer a phone, perhaps then get dressed and drive out to wherever. When my father died the GP insisted he'd seen him earlier in the night and he seemed fine.... Only he had an asthma attack that was in the process of killing him. He did finally arrive but too late. Ambulance wasn't in time either. The current system where you phone an out of hours numbers gets answered by a GP. At least you get to speak to one. If your symptoms sound like you need to be seen an appointment is made. If you cannot get there they would come to you. I once had to attend and was then quickly admitted to hospital. All arranged by an out of hours service GP I'd never seen before. Only potential issue is no access to your medical record - but NPfIT was meant to fix that in England but that's another story. |
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New Wed 26 Nov 14 18:24
Naughtie was right - Westpig
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>>I for one think 7 day a week GP cover is a positive thing. >> >> It already exists. Not really. GP surgeries can be very hit and miss for getting an appointment as is some out of hours cover. You can't blame some patients and especially parents concerned about their offspring, for going straight to A&E. I appreciate that A&E should be used most sparingly and only for emergencies... in which case the GP system needs to be more user friendly. I for one wouldn't wish to sit in an A&E for hours on end, why would I?...however, if I was worried about my child, off I'd go. Increase the confidence in the GP system and I'll refrain from using the A&E system... which is what Jeremy Hunt is seemingly trying to do. >> If you actually mean "I think I should be able to see my GP/someone from >> my practice 7 days-a-week (does that mean 24/7 or just office hours...)" then you have >> to decide how you will pay for it, or what service is removed to be >> able to afford it. Maybe an increase in efficiency in the current system would help. My old surgery in London had an internet based booking system for appointments...which was absolutely ideal. My wife's surgery down the road had the 8am free for all system where you could never get through. |
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New Wed 26 Nov 14 20:06
Naughtie was right - MD
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>> My wife's surgery down the road had the 8am free for all system where you >> could never get through. >> Ring the number, get the engaged tone and then use ringback, usually number 5 on your keypad (BT). If it's not included in your package you'll pay 43 pence for the privilege, but sometimes it has to be done. |
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New Wed 26 Nov 14 21:25
Naughtie was right - Westpig
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>> (BT) Sky |
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New Wed 26 Nov 14 18:53
Naughtie was right - No FM2R
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>If he just couldn't get a Friday appointment and 'didn't want to wait' til Monday then he deserves the abuse and disrespect he is about to receive. If my child was sufficiently ill that I was too concerned to wait for a GP appointment, I'd take her to a b***** brain surgeon if I thought it would help, and any subsequent "abuse and disrespect" could get shoved right out of the sunshine. My need to be fair, reasonable, honest, a respecter of rules etc. etc. goes right out of the window and down the toilet if I believe that one of my children is at risk. I'm not saying its right, but I would expect most parents to react that way if their own children were involved. That's why lawmaking needs to be objective. |
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New Wed 26 Nov 14 19:12
Naughtie was right - Lygonos
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So you see your GP at 9am on a Sunday morning. Where are you going to take the prescription? How is the GP going to get the blood test checked? etc. There's a lot more required than simply opening up a surgery 8am to 8pm Saturday and Sunday. A&E doctors are not trained GPs. Most GPs however will have worked in A&E. And all this 'please won't someone think of the children' stuff is a smokescreen. The VAST bulk of A&E attendances with sick children are better dealt with by a GP service - who can forward on patients who are possibly/obviously very unwell. And a sizeable chunk of my own patients who go to A&E (adults and children) stating they couldn't get an appointment to A&E are found not to have even tried to see us in the first place - or decided at 7pm they needed immediate attention for a problem that had been brewing for 2-3 days. The GP system ("Primary Care") accounts for around 90% of NHS patient contacts, yet attracts approximately 8-9% of the budget. Flinging cash at A&E units would be better spent on the wholy more efficient primary care system. |
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New Wed 26 Nov 14 19:19
Naughtie was right - Lygonos
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>>If my child was sufficiently ill that I was too concerned to wait for a GP appointment, I'd take her to a b***** brain surgeon if I thought it would help And this is the very reason for the existence of all forms of quackery. In that situation you don't need a brain surgeon, you need advice from someone who knows what to do. However, you are not the guy apparently responsible for the running of the Health system in the UK, and if you were I would expect you to know how to use the 111/NHS24 service. I am suspicious Hunt has misjudged his line here, thinking it strengthens the case for 7 day GP surgery opening - to those in the service it makes him look like a fool. |
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New Wed 26 Nov 14 19:27
Naughtie was right - sooty123
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thinking it strengthens the case for 7 day GP surgery opening - to those in the service it makes him look like a fool. I doubt he's trying to convince them ;) |
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New Wed 26 Nov 14 19:38
Naughtie was right - Lygonos
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>>I doubt he's trying to convince them He (or his replacement) will have sod all chance of making it work if he only has 'Yes men' and NHS managers on side. The CCGs will run into disrepute soon enough as mahoooosive levels of conflicts of interest come to light, with numerous individuals being shown to award multi-million pound contracts to their own companies. I hope to hell that guff doesn't come north of the border. |
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New Wed 26 Nov 14 19:48
Naughtie was right - sooty123
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| I didn't mean so much the internals frictions inside the NHS, mainly because I know nothing about it. I meant it was for 'external' consumption ie the public, rather than anyone in the NHS. |
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New Wed 26 Nov 14 19:40
Naughtie was right - Manatee
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Hunt: ""We have to recognise that society is changing..." (not sure what that has to do with it) "... and people do not always know whether the care that they need is urgent or whether it is an emergency, and making GPs available at weekends will relieve a lot of pressure in A&E departments." TBH I don't know the system myself, although I hope I would take the trouble to find out if I needed it. Are you saying that the correct action is to call 111 whereupon the adviser will say - don't worry about it; or - not dangerous, make an appointment with your doctor next week; or - we'll book a locum call for you, a doctor will come to you; or - take her to A&E; or - call for an ambulance? When our doctor told my wife to go to A&E with a suspected infection, it took several hours to be seen - every time she got near the top of the queue, another child came in with suspected sunstroke (it was a very hot day)! |
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New Wed 26 Nov 14 19:35
Naughtie was right - Zero
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>> So you see your GP at 9am on a Sunday morning. >> >> Where are you going to take the prescription? The chemist that has the duty pharmacy open, there is always one round here. I might, if its a bad day, have to wait till 10:00am >> How is the GP going to get the blood test checked? if its got the level where a blood test is needed then referral to A&E. >> A&E doctors are not trained GPs. Most GPs however will have worked in A&E. >> whats that got to do with it? An A&E doctor is trained to decide if I need treatment there and then, which is why I went there. >> attention for a problem that had been brewing for 2-3 days. the extra days from friday to monday morning might well be the killer. |
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New Wed 26 Nov 14 19:41
Naughtie was right - Lygonos
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Which is why there already is an out of hours GP service. >>An A&E doctor is trained to decide if I need treatment there and then Ahahahahahahaha. Mercy. Last edited by: Lygonos on Wed 26 Nov 14 at 19:42
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New Wed 26 Nov 14 20:10
Naughtie was right - MD
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| I'm all for raising income tax to pay for a proper efficient healthy Health service, but it'll never be because of too many Chiefs and not enough Indians and too much self interest. |
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New Wed 26 Nov 14 21:00
Naughtie was right - Bromptonaut
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>> I'm all for raising income tax to pay for a proper efficient healthy Health service, >> but it'll never be because of too many Chiefs and not enough Indians and too >> much self interest. You need to watch the facts instead of the press reportage. |
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New Wed 26 Nov 14 21:58
Naughtie was right - MD
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>> You need to watch the facts instead of the press reportage. You're wrong in your assumption on just how I reached my opinion. Quality isn't cheap. Also I am fully aware that throwing money at a problem is never the answer. Perhaps I didn't word it too well, but I am in favour of paying more (if necessary) to have a decent Health Service, but as with all other businesses you have to cut out the dead wood. I am also set against TTIP. The proposed Transatlantic Trade Partnership and any hint of further privatisation of the NHS. If you are not familiar with TTIP then it may be advisable to bone up on it. MD |
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New Wed 26 Nov 14 23:17
Naughtie was right - Harleyman
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>> >> You need to watch the facts instead of the press reportage. >> As mentioned below I've just experienced the facts first-hand. Like many of us, I suspect, I dislike repetitive form-filling. One thing which I noticed whilst in hospital was the amount of nurses time wasted doing this. Once you check in as a patient (please correct me if I'm wrong) your details are logged onto the hospital's central computer, every ward has a computer, so why the heck is it that every damn form they fill in for you, and there are plenty of them, they have to go through the time-wasting rigmarole of asking you your name, address, phone number, next of kin, shoe size etc? Have they never heard of bar codes or similar tracking systems? I don't get this sort of thing at my local GP surgery, it's all on computer; so why does it happen in hospitals? Last edited by: Harleyman on Wed 26 Nov 14 at 23:18
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New Wed 26 Nov 14 20:27
Naughtie was right - Haywain
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"immediate attention for a problem that had been brewing for 2-3 days." This is the patient's dilemma … brewing for 2 or 3 days; brewing for 2 or 3 months. Everybody knows how busy GPs are, goodness, we are told often enough, so no one wants to waste the doc's time on something that could well sort itself out. When it turns out to be something nasty, then the patient is told that he should have gone to the surgery sooner. |
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New Wed 26 Nov 14 20:49
Naughtie was right - Harleyman
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I have recently had good cause to be thankful that I bypassed my GP and went straight to hospital. Back in August, I was moving one of my bikes around in the garage; didn't notice that the side-stand had moved back slightly, consequently when I leaned the bike back on to it, it folded up and I ended lying up on my side with four hundred pounds of Harley-Davidson trapping my left lower leg just below the knee. Managed to pull it out, hopped about, swore and carried on; it was very sore but didn't break the skin. Over the next couple of days it bruised up around the ankle but that was it; however it didn't feel right but I put that down to being 54 not 24. Four weeks later, on a Wednesday night it started to ache; took Ibruprofen, went to bed, in the morning it was still sore. Went to work at six, it gradually got worse till about eight o'clock I was limping; a colleague asked what was the problem and I pulled my trouser leg up to see that the area was red, swollen and hot. He advised me to go to hospital; I did, and ended up in there for five days on intravenous anti-biotics as I had an infected haematoma which required surgery and washing out. I am still off work. The surgeon pointed out to me that had I not sought treatment when I did, I could well have been applying for a blue badge and I certainly wouldn't be driving lorries any more. My local GP surgery, like many others, is very busy though I cannot fault the service. Like many others , if you want to see a doctor you just have to keep ringing till you get through and there is no guarantee that you will be seen that day; which could well have been too late for me had i not gone to A&E. If you phone the surgery they do advise that if the symptoms require urgent treatment out of hours you should go to the hospital. I am glad that I did. |
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New Wed 26 Nov 14 21:35
Naughtie was right - Westpig
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>> If you phone the surgery they do advise that if the >> symptoms require urgent treatment out of hours you should go to the hospital. ...and therein lies the problem. Truly urgent = ambulance. Obvious urgent but not truly urgent = go straight to A&E via your own means Not too sure = ? Trivial or not urgent but needs dealing with = go through the dreadful faff of booking an appointment for a GP, who you might get to see next Wednesday, if you've managed to get through to the surgery in that time. So what do we do with the '?'...and as said before, if it involves your kids, you're worried and you're not too sure, you cover all the angles... and if that means on one hand going to A&E unnecessarily or having a disaster with one of your kids.. guess which option most people will take? |
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New Wed 26 Nov 14 23:39
Naughtie was right - Ted
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>> >> So what do we do with the '?'...and as said before, if it involves your >> kids, you're worried and you're not too sure, you cover all the angles... and if >> that means on one hand going to A&E unnecessarily or having a disaster with one >> of your kids.. guess which option most people will take? >> My daughter, the para, says that if anyone is worried about a child in any sort of distress they should ring 999 without any hesitation and get the child to A & E. They don't mind...that's what they're there for. It might just be indigestion...but what the hell ? In our two cities there are several specialist 24 hr children's hospital and the kid can be there in 15 minutes or so. Don't hesitate for a moment. |
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New Wed 26 Nov 14 23:42
Naughtie was right - rtj70
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>> My daughter, the para Does she jump out of planes often? You must worry about her :-) I'll get my coat. |
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New Thu 27 Nov 14 00:42
Naughtie was right - Lygonos
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>>My daughter, the para, says that if anyone is worried about a child in any sort of distress they should ring 999 without any hesitation and get the child to A & E. They don't mind "She's had earache for the past 2 hours.. crying all night she is" Not really a 999 ambulance. Have we turned into a nation of softies? Rather than National Service where we get to learn how to square-bash and shoot foreigners, what about a compulsory 3 months work experience in A&E or a medical ward upon leaving school. In fact compulsory labour ward experience for all 14-15yr old girls. No more teenage pregnancies....! |
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New Thu 27 Nov 14 09:23
Naughtie was right - Westpig
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>> Have we turned into a nation of softies? It's not a question of that IMO...it's a question of not having the knowledge when worried about something.. and.. not trusting the current system. So forget 111, there's no way I'll ever ring that. I absolutely do not trust that I'll get the right advice. That leaves A&E or GP. I don't want to be an A&E PITA....and certainly don't want to lose hours of my life for no reason waiting in there, guilty that i'm maybe* blocking up a system. The GP system works well if you've got an obvious non urgent problem (and you have the patience and fortitude to deal with the booking in system, inc the receptionist). The A&E system works well for the obvious urgent stuff. It's the bit in the middle that fails... and if you are medically untrained you often don't know what the score is and especially with kids, you worry, possibly unnecessarily..but you're not going to take too many chances with them are you? * how do I know? |
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New Thu 27 Nov 14 11:10
Naughtie was right - rtj70
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>> It's not a question of that IMO...it's a question of not having the knowledge when worried >> about something.. and.. not trusting the current system. So when we were all children our parents were more knowledgeable? So if you had earache as a child they rushed you to A&E? I don't think so. And today we've got the Internet too. |
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New Thu 27 Nov 14 11:34
Naughtie was right - Westpig
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>> So when we were all children our parents were more knowledgeable? So if you had >> earache as a child they rushed you to A&E? I don't think so. And today >> we've got the Internet too. >> Oh no, our parents weren't more knowledgeable, far from it and of course as you've said we now have the back up of the internet. What it is, is nowadays we as a society are not prepared to be told you don't count, shut up and go away (or any other variation of that theme). In the past we'd have been considerably more likely to 'just do as we are told', whether the advice was correct..or not. Nowadays, we are more likely to challenge things, ensure we are dealt with thoroughly and properly. I happen to think we have a way to go yet. When someone nowadays tries to palm me off ..they get the full broadside (polite and restrained, of course). The internet as far as medical conditions go can be a bad thing, because obviously being untrained we don't know what we are looking at and can fear the worst when we don't need to... another good reason for having trust in our systems. |
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New Thu 27 Nov 14 12:55
Naughtie was right - Bromptonaut
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>> Oh no, our parents weren't more knowledgeable, far from it and of course as you've >> said we now have the back up of the internet. >> >> What it is, is nowadays we as a society are not prepared to be told >> you don't count, shut up and go away (or any other variation of that theme). I take your point but I think we're also, ironically in view of medical advances, much more inclined to think worst of childhood illnesses now. If I'd had earache as a kid in sixties I'd have been given an aspirin and sent back to bed. Nowadays parents immediately seem to worry about meningitis. |
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New Thu 27 Nov 14 13:34
Naughtie was right - Harleyman
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If I'd had earache as >> a kid in sixties I'd have been given an aspirin and sent back to bed. >> Nowadays parents immediately seem to worry about meningitis. >> That is hardly the fault of the parents. Tis the NHS and also doctors in the media who stress how important it is for menigitis symptoms to be investigated as soon as possible; and rightly so for it can kill or maim very quickly indeed. |
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New Thu 27 Nov 14 20:21
Naughtie was right - MD
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>> If I'd had earache as a kid in sixties I'd have been given an aspirin and sent back to bed. >> Nowadays parents immediately seem to worry about meningitis. >> ....but Bromp is that because we now have more news and are more enlightened? As with Sexual offences. Are there any more per head of Pop' or are we just more aware? It's a mad mad world. Ditch the mobile and let's have plugs and points.....:0) |
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New Thu 27 Nov 14 22:35
Naughtie was right - Armel Coussine
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>> If I'd had earache as a kid in sixties I'd have been given an aspirin and sent back to bed. I had very bad earaches in the forties, early in the war in fact. If there were antibiotics then they weren't available to civilians, but I don't think they existed yet. They used to put warm olive oil in the ear, but of course it didn't do anything about my mastoid ulcer. Fortunately there was a good surgeon in town (Bath) at the time who chopped the thing out, in the nick of time it was said. God knows what it cost my parents who were far from rich. I do remember spending a lot of time recovering. These days a bit of tetracycline or similar would stop something like that safely and quickly. There's a hollow behind my left ear where all the infected bone was cut out. No smartass comments please. You're lucky to have me if my mother was to be believed. Last edited by: Armel Coussine on Thu 27 Nov 14 at 22:38
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New Thu 27 Nov 14 22:54
Naughtie was right - Bromptonaut
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| AC, my mother's one time boss and later friend Arthur had a mastoid operation in what I guess was same time frame as yours. His hearing was never right as an adult, difficult to converse with if on his deaf side. |
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New Thu 27 Nov 14 23:01
Naughtie was right - Kevin
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>No smartass comments please. You must be minus a few marbles AC. No-one here would do such a thing. |
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New Thu 27 Nov 14 12:32
Naughtie was right - commerdriver
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When I was ill as a child (1955 - 1965 say) my parents would, when required have called the doctor who then came out to do a house visit, remember them? Trip to A & E was much bigger deal as it involved a bus / taxi journey. A&E has become nore of an option at least partly because we now have a car to take the "patient" in. |
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New Thu 27 Nov 14 13:53
Naughtie was right - Westpig
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>> When I was ill as a child (1955 - 1965 say) my parents would, when >> required have called the doctor who then came out to do a house visit, remember >> them? Well you've hit the nail on the head. We are all more aware, a little knowledge can sometimes be a bad thing, we worry more and access to a doctor is worse. Well there's the problem. We are in the internet age, we all have phones and computers and tablets etc. Why can't I book my GP appointment via an internet based system (like I did in London). Why can't I talk to a doctor on the phone and if necessary Skype them or send pictures via e-mail (e.g. child's rash). All I want is reassurance that I am not neglecting something I shouldn't. I acknowledge that a remote system isn't perfect and in cases of doubt I'll hop in the car and attend the surgery... but.. I don't want the 8am mad rush to get through on the phone and then be told I may have an appointment in 4 days time ...I don't call more than once or twice a year, if that, so when I do maybe it's because I need to, even if to allay an unnecessary fear. |
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New Thu 27 Nov 14 14:05
Naughtie was right - Bromptonaut
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other point re your GP Westpig is why is contact so difficult? My GP here in Northants has a system where you ring the surgery anytime after 08:00 and speak to a receptionist. It's easier if you tell receptionist your symptoms but you don't have to if you're not comfortable with that. She/he takes basic details and a one of the Doctors, always either a partner or a staff GP, rings back in under an hour. They will then triage your problem. If it's susceptible to diagnosis on the phone, like my impetigo a few years ago, they'll prescribe something and the medicine will be at the pharmacy in short order. If they think you need seeing you'll get an appointment with a Doctor (who may be a Registrar as they're a training practice) or the nurse if that's what's needed. Almost always same day. I think this is a widespread system in the former Northants HA area. One wonders why other practices cannot make something similar work for them. |
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New Thu 27 Nov 14 14:57
Naughtie was right - No FM2R
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>>All I want is reassurance that I am not neglecting something I shouldn't. Exactly. I don't want to trouble anybody with something trivial. I don;t want to cause issues if it is only toothache, a cold, earache etc. etc. I just want a quick and easy way to gain some comfort that I am only dealing with something like that and not something where time matters. Presumably the ideal place is a GP or nurse. However, at night, bank holidays or otherwise out of hours that's sometimes quite difficult to do. I haven't used it for a while so I assume its still going, but the telephone assistance thing [NHS Direct], whatever it is/was called, was always quite good. Ring them, sometimes get told its ok to wait till morning, and sometimes a Doctor would call back and if necessary be available. One level down from that, i.e. I do not need to be seen in the night, but I do need to be seen first thing in the morning, and stuff hits whirly things. That's when being told to wait a day or two is unacceptable, even if I am over-reacting. My sister-in-law is a surgeon and my wife is a vet. This is not good. This simply serves to scare the living crap out of me whenever I ask a question. |
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New Thu 27 Nov 14 15:16
Naughtie was right - henry k
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>> >>All I want is reassurance that I am not neglecting something I shouldn't. >> >> Exactly. I don't want to trouble anybody with something trivial. I don;t want to cause >> issues if it is only toothache, a cold, earache etc. etc. >> >> I just want a quick and easy way to gain some comfort that I am >> only dealing with something like that and not something where time matters. When we had our first child, we were " concerned" that we did not miss some lie threatening happening especially in the middle of the night. We were advised to get a small selection of baby/ medical books for reference. The reason being that ( as we found out) the latest problem/concern was not listed in books 1-4 but book 5 said " No problem/ very common" . The relief was immense. Today Google is available to many but needs careful usage. In the recent past I have called the out of hours service via our GPs and been told " I cannot get to you for 90 mins so go to A & E " |
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New Thu 27 Nov 14 15:28
Naughtie was right - Manatee
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>> Why can't I book my GP appointment via an internet based system (like I did >> in London). Don't know. I suspect because it can't fully replace the phone service, and may in fact be little used by people who individually don't visit the doctor very often. In other words, at the present time it probably increases costs without an offsetting benefit. >> Why can't I talk to a doctor on the phone and if necessary Skype them >> or send pictures via e-mail (e.g. child's rash). See my comments elsewhere re improving the service. What we perceive as a clunky service isde facto a form of rationing. I never trouble the quack unless I am seriously worried or debilitated, it's too much hassle. If I could email them every time I had a pain in my left arm, or a headache that might be a brain tumour, people like Lygonos would need another 8 hours a day to answer the emails and view out of focus pictures of piles or whatever. >> >> All I want is reassurance that I am not neglecting something I shouldn't. A service that is provided by NHS Direct? Which you refuse to use :) >> I acknowledge that a remote system isn't perfect and in cases of doubt I'll hop >> in the car and attend the surgery... but.. I don't want the 8am mad rush >> to get through on the phone and then be told I may have an appointment >> in 4 days time ...I don't call more than once or twice a year, if >> that, so when I do maybe it's because I need to, even if to allay >> an unnecessary fear. It's a Catch 22, for want of a less hackneyed expression. Maintaining the funding in real terms, even if it is adequate to start with, means a deficit soon builds up - any progress in efficiency that also makes the service better (including better treatments and drugs) automatically increases demand, this is why there will be a £30bn a year deficit in a very few years, that's another £1000 or so per household. Unless the sacred cow is slaughtered, and there's a modest charge for services (even if it is reclaimable by poor folk, or there are means tested free passes) then the best bet will be to focus on efficient execution of all the underlying services but to make the actual service to patients worse, not better. In effect, by insisting on decent service levels and trying to eradicate waiting times, we are removing some of the rationing that existed for decades, for example with non-urgent operations. The better you make the NHS, the more of a bottomless pit it becomes - some sort of demand management is essential. If we don't deal with this by limiting trivial demands, we will find creeping rationing elsewhere - such as "old" patients being quietly allowed to die rather than receive treatment. Give it long enough and the maximum treatment age could be made official - like raising the pension age to balance the budget regardless of what people have paid in for. Or maybe we should deprioritise self inflicted problems, such as those caused by smoking, drinking, playing sport and being grossly fat? Take your pick:) |
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New Thu 27 Nov 14 15:41
Naughtie was right - henry k
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>> that's another £1000 or so per household.. I suspect that most folks have no idea of the costs involved in treatment.. I am in the position of being able/prepared to self fund some private hospital treatment for self and SWMBO so i know some of the costs involved. It is usually met with surprise when I say I am self funded so I assume the rest are BUPA PPP etc. It is very easy to get into four and five figure costs. I too have paid into the NHS all my working life but I am spending what the tax man will not get ( except for VAT! ). |
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New Thu 27 Nov 14 16:34
Naughtie was right - Westpig
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>> >> All I want is reassurance that I am not neglecting something I shouldn't. >> >> A service that is provided by NHS Direct? Which you refuse to use :) Are you happy for someone not fully qualified, reading from a script, taking the place of a fully qualified doctor? |
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New Thu 27 Nov 14 16:44
Naughtie was right - Zero
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>> >> >> >> All I want is reassurance that I am not neglecting something I shouldn't. >> >> >> >> >> A service that is provided by NHS Direct? Which you refuse to use :) I've used it, its poor. |
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New Thu 27 Nov 14 16:54
Naughtie was right - Manatee
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>> >> A service that is provided by NHS Direct? Which you refuse to use :) >> >> Are you happy for someone not fully qualified, reading from a script, taking the place >> of a fully qualified doctor? I'd give it a go. Now called NHS 111 apparently. Call 111 if: you need medical help fast but it's not a 999 emergency you think you need to go to A&E or need another NHS urgent care service you don't know who to call or you don't have a GP to call you need health information or reassurance about what to do next They aren't supposed to be qualified doctors, they are supposed to be qualified/equipped enough to determine the next step. They probably use an online system to prompt the diagnosis questions. You can do this on line yourself, I suspect it's the same database. www.nhs.uk/symptomcheckers/pages/symptoms.aspx I've just tried this out in relation to a sharp pain I get in my back ribs when I sneeze. It told me to go to A&E immediately, so maybe you are right - or I really should have gone to the quack's with it at some point in the last 3 years while I've had it! |
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New Thu 27 Nov 14 13:07
Naughtie was right - Pezzer
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Last edited by: Pezzer on Thu 27 Nov 14 at 13:09
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New Thu 27 Nov 14 13:15
Naughtie was right - Bromptonaut
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>> Hmm when I was young in the 60/70s our Family Doctor made house calls ! Ours still does if getting to surgery is not reasonable. So does our family friend who is a GP in North Wales. |
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New Thu 27 Nov 14 13:22
Naughtie was right - Manatee
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We all want a better service. As I have been moved to comment before, improving the service will (a) cost more, for the same level of demand (b) given that the price of treatment is zero, further increase the demand, and therefore the costs. The immovable obstacle to affordable improvements is the sacred cow of free treatment. My retired doctor friend tells the apocryphal story of a doctor, in the earliest days of the NHS, who was called out in the middle of the night by a woman with some ailment or other, I can't remember what. Doctor: "How long have you had the pain?" Woman:"About three months." Doctor: "so why have you waited three months and then called me out in the middle of the night about it?" Woman: "I know my rights!" Last edited by: Manatee on Thu 27 Nov 14 at 13:23
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New Wed 26 Nov 14 21:30
Naughtie was right - Cockle
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I consider myself very lucky that I and my family are registered patients at a remaining 'Darzi' centre. We have access to a GP service from 08:00 to 20:00 365 days a year, appointments available 8-18, walk in service the rest of the time. We have not failed to see a doctor on the same day in over 5 years. The fact that I can leave work at 5 and go to the health centre and see a doctor that evening is a major plus for us as working people. If I need a prescription then I go to my local pharmacy at the Waitrose a mile up the road opening hours 8-22 Mon-Sat, 10-20 Sun. Absolutely top service. Ironically, with all the noises coming from Government about extended GP hours, my local CCG is now threatening to withdraw funding for the general walk in service, which is open to any patients from other practices who can't get appointments in their practice and therefore reducing the pressure for those to go to A&E, to 'improve the service to the registered patients'. The centre has stated that they will have to reduce our opening hours if this happens, not quite sure how that improves the service to me and my family as we wil now not be able to see a GP without taking time off work.... or go to A&E?????? |
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New Wed 26 Nov 14 22:52
Naughtie was right - Lygonos
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>> I and my family are registered patients at a remaining 'Darzi' centre. Have a look at how much 'value for money' these provide(d). Another little beauty like PPP/PFI. www.gponline.com/exclusive-darzi-centre-paid-7-times-per-patient-gp-practices/article/1085390 Last edited by: Lygonos on Wed 26 Nov 14 at 22:56
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New Wed 26 Nov 14 22:59
Naughtie was right - Lygonos
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| (As a comparison, my practice of 8,500 patients gets pretty much the same funding each year as this one with 1,200 was getting) |
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New Wed 26 Nov 14 23:43
Naughtie was right - rtj70
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>> (As a comparison, my practice of 8,500 patients gets pretty much the same funding each year >> as this one with 1,200 was getting) But how do the workloads compare? |
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New Thu 27 Nov 14 00:45
Naughtie was right - Lygonos
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How do you think? I spend 6 to 7 hours per day face-to-face with patients, with maybe and hour to 90mins of admin required (referral letters, reading hospital correspondence, checking results, etc, etc) I doubt Darzi centre doctors each spend 40 hours per day seeing patients. |
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New Thu 27 Nov 14 08:21
Naughtie was right - MD
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| ? |
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New Thu 27 Nov 14 08:22
Naughtie was right - MD
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| What is Darzi? |
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New Thu 27 Nov 14 09:37
Naughtie was right - Bromptonaut
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>> What is Darzi? Lygonos and Cockle above give some clues. Seems to have been an attempted alternative method of GP provision, presumably based on ideas of Lord Darzi. en.wikipedia.org/wiki/Ara_Darzi,_Baron_Darzi_of_Denham#Political_career |
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New Thu 27 Nov 14 11:17
Naughtie was right - commerdriver
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Anyone actually know how widespread is the availability of walk in NHS / GP centres. Is it only large towns or does it vary by "post code". Seems the most suitable "worried parent" type facility to me. Did Jeremy Hunt have one available to him or was A&E the "only" option? Note in my view for may cases NHS direct does not cut it. Last edited by: commerdriver on Thu 27 Nov 14 at 11:19
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New Thu 27 Nov 14 14:31
Naughtie was right - BobbyG
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This is interesting for me at this moment in time. MY GP surgery is staffed by two elderly Asian Doctors who have very strong accents. Both my son and my daughter recently have went for appointments and came out none the wiser. They couldn't understand the doctor and he wasn't clear on what they had to do next. Both my wife and I have had similar issues and once I had to raise a formal complaint when one doctor continued prescribing me a medicine that I should only have had one month max of. We are most likely going to change surgeries which will mean inconveniencing ourselves as the next one is 2 miles away. However my son plays football and he injured his knee in a match. He is limping heavily and complaining about it being sore. As far as I am aware the options open to me are 1. Try and get an appt with this GP who will ultimately I am sure refer him for an x-ray 2. Just take him to A&E myself and wait the hours for the x-ray 3. Go to a private physio and pay. From previous experience, if we go down the (1) or (2) route, you ultimately just get put on the waiting list to see the NHS Physio which I believe is 12 weeks. I have told him just to hop. |
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New Thu 27 Nov 14 14:58
Naughtie was right - Zero
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> >> We are most likely going to change surgeries which will mean inconveniencing ourselves as the >> next one is 2 miles away. Do what I did, Marry a Nurse. Preferably one tho that is prepared to believe you when you say your ankle is broken "Stop making a fuss" is a poor diagnosis in my book. Still its great to say "I told you so" when you are hobbling around on plaster. |
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New Thu 27 Nov 14 15:23
Naughtie was right - Harleyman
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>> Still its great to say "I told you so" when you are hobbling around on >> plaster. >> I can well believe that you did, and not just once either. :-) |
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New Thu 27 Nov 14 15:27
Naughtie was right - BiggerBadderDave
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"Do what I did, Marry a Nurse." Or do what I did, move next door to a hot, tall, blonde paediatrician whose marriage is collapsing. |
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New Thu 27 Nov 14 15:28
Naughtie was right - Zero
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>> "Do what I did, Marry a Nurse." >> >> Or do what I did, move next door to a hot, tall, blonde paediatrician whose >> marriage is collapsing. > Sounds a bit Jimmy Saville to me matey. |
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New Thu 27 Nov 14 15:58
Naughtie was right - Lygonos
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>> hot, tall, blonde paediatrician whose marriage is collapsing. Let's take this back to first principles.... You meet a tall, beautiful, blonde lass who earns 100 grand a year and whose husband has left her. Keep running! And don't let her near your kid's pet rabbit. |
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New Thu 27 Nov 14 17:06
Naughtie was right - BobbyG
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>>Do what I did, Marry a Nurse. I did, but the difference for me is she is a palliative care nurse!! Her role therefore, as she is always willing to tell anyone who asks for her opinion, is to ensure that all her patients have as "pleasant" a death as possible. Tends not to get too many patient complaints....... |
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New Thu 27 Nov 14 17:14
Naughtie was right - WillDeBeest
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| ...and presumably you get the splinters out of your own fingers. |
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New Thu 27 Nov 14 17:18
Naughtie was right - Zero
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>> Tends not to get too many patient complaints....... Hmm I'd take care if I were you, sounds like Nurse Beverley Allitt. |
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New Thu 27 Nov 14 15:56
Naughtie was right - Lygonos
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>>1. Try and get an appt with this GP who will ultimately I am sure refer him for an x-ray Unlikely that an XRay will give the answer as most 'hobbling' knee injuries are either strains (which won't show up) or soft tissue damage such as cartlidge tears (which XRays cannot see). If any imaging was deemed appropriate an MRI scan would be first choice. If he's struggling to weightbear on the knee get him to go to the GP, especially if there is obvious swelling, the knee is sore to touch, or it has been locking. 2 miles to GP surgery? Sounds like you have little faith in the service you currently receive. If it was a law firm/dentist/accountant/plumber/mechanic would you keep going back? How far do you think the average Highlander lives from his/her GP? ;-) |
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