I tried (unsuccessfully) this morning to get to see a doctor. Although I rang the surgery dead (no pun intended!) on the dot of 8:30 am, which is the official time at which the machine at the surgery is switched on, I didn't get through to the receptionist until 8:45 am. By that time all the available appointments for the day had been booked up. I enquired about the problem and was told that 2 doctors had retired, 2 doctors had left the practice, and 1 doctor was off sick, which left a patient to doctor ratio of 14,000 to 5.
I was told I could (a) try ringing up again next Monday (and risk an even worse result because of all the people falling ill over the weekend) or (b) queue up at the surgery on Monday ahead of the official starting time of 8:30 am and hope to be nearest the front of the queue to get an appointment. Alternatively (c) I could request a call-back from a doctor on Monday morning and take my chance as to whether he/she would assess my problem over the phone and arrange an appointment to see a doctor (the doctors have a limited number of appointments under their control) or whether the doctor would decide there and then what action would be taken. Option (c) seemed to be the most likely to get me in contact with a doctor the soonest so I accepted it. It's a good job I'm not writhing in agony.
What's your surgery's patient to doctor ratio?
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>>What's your surgery's patient to doctor ratio?
I don't know, but in Bicester they have a system where one rings up and leaves a number, the nurse calls you back in under an hour, and then she decides how quickly and who you need to see.
Works pretty well in my experience. I've been bounced to the next day or so, but equally I've been seen that morning.
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>> What's your surgery's patient to doctor ratio?
2,800:1
better than yours.
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Ours is 9000:5, four partners and one salaried GP. They often have a GP Registrar as well though as well as four nurses, two health care assistants. Peripatetic psychological counsellors, podiatrists etc also attend.
Like Mark's practice calls are pre screened and referred to the Doctors for telephone triage or to a Nurse. If an apointment is needed it's nearly always same day, they will prescribe on basis of phone call for simple stuff. Nurses see minor injuries/complaints such as my propensity to fungal infection under toe nails.
A quick google suggests that snail's 3000:1 is on the high side of average. Of course that's pretty raw data, effectiveness will vary with social age etc profile of practice area. GP's are independent contractors so how they manage vacancies and the appointment systems is up to them.
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>> A quick google suggests that snail's 3000:1 is on the high side of average.
Fortunately it's only the current situation. Before doctors started retiring or leaving the ratio was 1300:1. The problem has been exacerbated by the fact that one of the doctors who left was a GP trainer. Before he left there was always a GP Registrar as well as the regular doctors.
Two additional doctors are due to start in September, so the situation should slowly get better. But knowing that didn't help me this morning!
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Approx 1,700:1 but will change to 2100:1 later this year.
That ignores any locums.
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>>
>> That ignores any locums.
>>
I normally do.
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>> >> What's your surgery's patient to doctor ratio?
>> 2,800:1
>>
>> better than yours.
>>
Z, are you joking?
My Scots taught arithmetic reckons that 14000:5 is exactly the same as 2800:1
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>> >> >> What's your surgery's patient to doctor ratio?
>> >> 2,800:1
>> >>
>> >> better than yours.
>> >>
>> Z, are you joking?
>> My Scots taught arithmetic reckons that 14000:5 is exactly the same as 2800:1
>>
Well fancy that, what a co-incidence.
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Obviously, you live in a classy area. It's 42,000:15 here in Bucks.
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1000:1, and none of that nonsense. They see you same day, or if you stagger up there's always (been so far) an emergency appointment available that day. And no nasty triage.
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Not sure what the ratio is locally, but there is a ploy available hereabouts which generally results in being seen same day, the phone exchange with the "none shall pass" goes something like this:
"I'd like to see a doctor today, please."
"no appointment available here today... etc"
"OK. I'll go to the 'walk in clinic'."
"Oh, hang on, there's a space at xx:xx"
I understand the local Doc/practice gets charged by that clinic not providing.
Money, as always.
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Compared to other GP practices I have been to in the past, the adherence of my current practice to scheduled appointment times seems extremely bad. It is no exaggeration to say that I have always been kept waiting at least 30 minutes past my appointment time and more than once it has been well over an hour.
When I do go, the thing that strikes me is the length of time between a patient leaving and the next one going in. It seems to always be at least 10 minutes and can be much more.
Coupled with the long delays, I used to find it a bit infuriating, but I wonder if they tend to spend a long time writing detailed notes of the previous consultation.
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Our lot changed again recently. You now ALWAYS get a call from the doc (not the nurse), even if it's a standing appointment, to determine whether or not they actually need to see you. I've no idea what the ratios are here, are they published somewhere?
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1550 per full-time equivalent in our practice.
And we're quite busy at that - somewhere like rural Bucks will have far less patient attendances (probably averaging 4 per patient per year - some very poor areas will be 8+ appointments per patient per year for virtually the same income).
Current contract does nothing to encourage practices to take on sufficient staff/partners to meet demand, but increasing access to GPs ultimately leads to increased referral to hospital services and this is politically unacceptable, so don't expect much to change.
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Routine appointments with a doctor can be booked on-line, but oddly enough non-urgent appointments with nurses cannot. A visit or a phone call is needed.
Repeat prescriptions can be ordered on-line and collected by Boots pharmacy next door to the health centre, either for delivery or collection once fulfilled.
There is a walk-in surgery from 0830 Mon/Fri. at which one may see either a doctor or a nurse-practioner according to the perceived problem.
Our health centre is very efficient, with reminders for nurse's appointments being phoned through a day or so before. Reminders are posted for periodic check-ups if needed.
We are also lucky to have a hospital within five minutes of home, where a drop-in blood testing service also operates very smoothly.
Last edited by: Roger on Fri 21 Jun 13 at 20:23
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>> Compared to other GP practices I have been to in the past, the adherence of
>> my current practice to scheduled appointment times seems extremely bad. It is no exaggeration to
>> say that I have always been kept waiting at least 30 minutes past my appointment
>> time and more than once it has been well over an hour.
At our previous practice I was quite happy to wait over an hour to see one of the doctors, because I knew he was very thorough and was prepared to listen to you and didn't just rush you out when you'd had your allotted 10 minutes.
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My London surgery had an online booking system which was great.
My wife's one, within walking distance of mine, didn't...and had the ridiculous 'all try to ring at 0830' method.
The other thing was when my wife was pregnant and regularly having check ups with her GP, she couldn't book an appointment more than 2 weeks in advance...even if the GP had just told her "see you in a month's time". She still had to ring in one morning and fight the telephone system...grrr
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I'm not sure how many, or even how to work it out, but at a guess 500:1.
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It's a Le Mans style 8am start to get an appointment at my surgery - utterly ridiculous and probably rules out 98 per cent of the total number of patients being successful.
In addition the whole place shuts down from around 10-30am on a Wednesday allegedly for "training purposes" which, added to weekends as well, makes the whole setup something of a joke.
In the past the surgery's then two doctors used to see virtually everyone who needed an appointment, did house calls (including a follow up without being asked) and also automatically visited any patients who were in hospital. They allowed elderly or children to be seen, if necessary between other patients' appointments and even saw people on Christmas Day or other holiday periods if a call was urgent.
Those were the days.
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>> It's a Le Mans style 8am start to get an appointment at my surgery -
>> utterly ridiculous and probably rules out 98 per cent of the total number of patients
>> being successful.
What?
You mean you all have to park your cars simultaneously and then run across the road to the surgery door? The first one through the door is the winner? That sort of thing?
;-)
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snipquote!!
>> You mean you all have to park your cars simultaneously and then run across the
>> road to the surgery door? The first one through the door is the winner? That
>> sort of thing?
>>
>> ;-)
No that's the car park of 'spoons at 10:30am.
Last edited by: VxFan on Mon 24 Jun 13 at 01:09
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snipquote!!
>> No that's the car park of 'spoons at 10:30am.
>>
I think you will find that most 'spoons open at 8:00am, to start serving their delicious, remakably good value for money cooked breakfasts.
Last edited by: VxFan on Mon 24 Jun 13 at 01:09
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>> What? You mean you all have to park your cars simultaneously and then run across the road to the surgery door? The first one through the door is the winner? That sort of thing? ;-)>>
Something on those lines but, in this case as you've probably gathered, on the phone...:-)
The other day, seeking to make an appointment for a three month check up requested by the doctor, I actually managed to get through after just three attempts. So surprised I almost forgot why I was making the phone call...:-) :-)
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>> The other day, seeking to make an appointment for a three month check up requested
>> by the doctor, I actually managed to get through after just three attempts. So surprised
>> I almost forgot why I was making the phone call...:-) :-)
I wonder what reason/excuse Stuartli's surgery put forward for keeping this MO?
Several of us have related better experience with the triage system than FCFS.
I've rarely had an engaged tone from our surgery either. While on hold there's a regular update of place in the queue. Partly of course that's becuase patients have confidence that they don't NEED to ring on dot of 08:00.
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>> Those were the days.
>>
Almost a calling.
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I haven't needed to visit a GP for over 21 years but, it's comforting to know I'm registered with a quite civilised practice:
"Routine - Bookable up to 6 weeks in advance. Approximately 40% of our appointments can be booked in advance.
On the day - We now operate a system of doctor call backs.If you ring for a same day appointment the receptionist assign a call back time when the doctor will call you back to discuss your problem. The doctor will either resolve the issue during the call back or if necessary bring you in later in the day.
Please note the reception staff will ask the nature of the problem to enable us to best deal with all of the requests.
Urgent appointments - These are for medical emergencies only and are always available.
Extended hours - These appointments, which are available at specified times are early morning and later in the evening. These are for routine matters or for blood tests and are for booking at least 48 working hours in advance".
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>> "Routine - Bookable up to 6 weeks in advance. Approximately 40% of our appointments can be booked in advance.
One problem is no shows and longer lead times.
100-150 no shows per month at my surgery.
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No idea, but I've never failed to get a same-day appointment if I've needed one.
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>> No idea, but I've never failed to get a same-day appointment if I've needed one.>>
Exactly as it should be - and used to be in the case of my surgery without the current hassle.
Fortunately I don't need to visit all that often, but I'm not the only one who complains about the setup. Sometimes the doctor can pre-book an appointment for a follow up, but even this depends on how far ahead it is required.
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Ours experimented briefly with the Le Mans style start. There were two events. One was like buying tickets online for a concert. Start 8.30.00, all over at 8.30.10.
The other was an actual event - doors open, form a queue, unlucky ones waited all morning and then were sent away until tomorrow.
But now it works in a perfectly civilised way. One can phone up for an urgent opointment that day, or turn up and take one's turn, or book an appointment for a slot later if there is a long queue.
Obviously specifying a particular doctor gives fewer time-slots than if any one will do.
The concept of appointments is slowly creeping into local hospital too. Previously everyone got an alleged "appointment" at say 10.30, and waited until maybe late in the day as they worked through the queue. Now they have discovered how to have a series of slots throughout the day, which they allocate in advance. On notification of a particular appointment it's even possible to phone up and change it for another time/day if more convenient, or swap it for a cancellation.
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>> The concept of appointments is slowly creeping into local hospital too. Previously everyone got an
>> alleged "appointment" at say 10.30, and waited until maybe late in the day as they
>> worked through the queue. Now they have discovered how to have a series of slots
>> throughout the day, which they allocate in advance. On notification of a particular appointment it's
>> even possible to phone up and change it for another time/day if more convenient, or
>> swap it for a cancellation.
The Fracture Clinic at NGH works on timed slots but it doesn't always work like it should. Yesterday I was slightly early for 09:20 but was kept waiting until after 10 before being sent to X Ray. Usually you've barely sat down before being sent off again. Upside was a saw the Doc quickly as his queue had died down.
Discharged now so unless I have problems, which can take up to two years with pinned hips, I don't need to go again.
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>> Upside was a saw the Doc quickly as his queue had died down.
>>
Rrather than the queue died waiting? :-)
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"One problem is no shows and longer lead times. 100-150 no shows per month at my surgery."
I can't quite see why 'no-shows' are such a problem - particularly as the docs are usually running late anyway. Doesn't it enable them to catch up?
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>>I can't quite see why 'no-shows' are such a problem
Those 150 patients will rebook and take other appointments that you could have had.
>>particularly as the docs are usually running late anyway
The amount of complex guff we look at now compared to even 15 years ago is far higher than it was: diabetics, hypertensives, heart disease, chronic kidney failure, chronic lung disease... often all in the same patient...
Add in an increased expectation from patients that medicine can cure their ailments, which relate to the slow decline of years, and their awful lifestyles...
Plus hundreds more treatments that didn't exist before the Pharma companies managed to get their teeth into "Evidence Based Medicine" (usually of modest efficacy but with significant risk of side effects)...
And a never-ending stream of Benefits Agency/ATOS derived drivel (usually genuinely disabled punters who are repeatedly told they are fit to work or need to go to tribunals which they inevitably win...
and a 10 minute appointment flies past in no time.
I think 15 minute appointments will become the norm in the next 5-6 years - if this doesn't come with a whole load more GPs then don't get your hopes up that the service will get better from the patient's viewpoint.
Of course the reality will be lots more 'first contacts' with the NHS will be with nurses rather than GPs (who are basically consultants in general medicine and thus very expensive) - my friend just came back from the US having seen how their health services work first hand - she is seeing her doctor here after seeing various non-doctors for medical issues, and the doctor she did see couldn't fill a script in correctly.
You get what you pay for: considering the amount spent on general practice in the UK, the service is pretty good in my biased opinion (approximately £10 per month per person gives unlimited free access to a GP during working hours - lets see an insurance company offer that).
Last edited by: Lygonos on Mon 2 Sep 13 at 19:19
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>>>>I can't quite see why 'no-shows' are such a problem
>> Those 150 patients will rebook and take other appointments that you could have had.
Our local surgery has similar figures.
I agree with all you say!
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I think the crux of the matter is that our practice has taken on more patients than they can consistently handle satisfactorily. Dentists limit the number of patients that they'll take on, but NHS doctors don't seem to. Every time there's an increase in the population of the catchment area the situation at our practice is likely to worsen.
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One advantage of having a Doctor in the house (i.e. Mum). For informal advice anyway. About a year ago I woke up in the early hours, my back was itchy and these red patches had appeared. It wasn't particularly painful, a bit irritating, more worrying than anything else. So I woke her up, I think it was about 2am. She knew straight way what it was, I had been doing some strimming with no top on as the weather was hot and some of the hogweeds must have flung up onto my back, they are quite renowned for causing skin rashes with some people apparently. I think she said hogweeds anyway. In a day or two it had all passed although I don't think she was too pleased to be woken up by her son at 2am, official patients that's different!
Last edited by: MJW1994 on Mon 2 Sep 13 at 18:45
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>>some of the hogweeds must have flung up onto my back
You were lucky.
en.wikipedia.org/wiki/Heracleum_mantegazzianum
It's recommended not to strim giant hogweed, but to use gloves, and secateurs. Also to choose a cloudy day, as sun make the skin contact worse. Nasty stuff.
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Yeah, reading that link I think I got away with a very minor case. Always worn goggles for strimming anyway, silly not to. Been more careful since, always wear fully clothing and gloves now.
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Two new GP partners are starting this month, so that should help to ease the situation. Does being a partner mean they will have a financial stake in the practice, rather then just being employees?
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>> Two new GP partners are starting this month, so that should help to ease the
>> situation. Does being a partner mean they will have a financial stake in the practice,
>> rather then just being employees?
>>
6 equal partners
Income £1m
Costs £400K
Profit £600K/6 = £100K each
However, the world is not like that and the 2 x Senior Partners (who fund the business / own premises etc) might take 1/4 each and the remainder, the junior partners (no equity so could be deemed as "employees") get 1/8th each say £75K from which they pay their Pension /NI etc - nice but not wealthy.
Your local wealthy dentist owns 100% of his his business - premises, equipment etc. He /she will employ some dentists. There will be associates who are self employed and share the income from NHS & Private ( 1 x dentist with £250K gross income- 50% each - with the owner paying all the bills of staff/premises, materials etc).
Last week the incomes of dentists (NHS & Private) were in the papers with hundreds making excess of £300K per year - nice little earner!.
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£300k per week for this guy... www.bbc.co.uk/news/uk-23931053 - even nicer!!
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"£300k per week for this guy... "
It's all down to market forces and scarcity and, in the case of doctors, the most powerful union in the country.
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>> and, in the case of doctors, the most powerful union in the country.
>>
Whenever I received scathing comments about my life-long membership of an engineering trade union I always pointed out that, while they were giving me the scathing comments, some of the most respected professions in the UK had the strongest trades union ~ doctors, dentists, teachers and lecturers, police, fire service, to name but a few.
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>> Does being a partner mean they will have a financial stake in the practice, rather then just being employees?
Often but not always.
Last edited by: MJW1994 on Tue 3 Sep 13 at 19:19
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I wonder if your doctors surgery would get the hint if you pre-booked an appointment each month for the rest of the year. If you're ill, bingo! you've already got an appointment.
If you're not ill, cancel it a few days beforehand.
;-)
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>> I wonder if your doctors surgery would get the hint if you pre-booked an appointment
>> each month for the rest of the year. If you're ill, bingo! you've already got
>> an appointment.
>> If you're not ill, cancel it a few days beforehand.
>> ;-)
>>
Our medical practice doesn't allow pre-booking of appointments. We have to ring up (or queue up at the door) at 8:30am for an appointment on that day ~ and when the appointments for that day are all gone, they're gone.
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I can book appointments online through this place with the practice I use:
www.myvisiononline.co.uk/vpp/index.jsp
it needed the receptionist to set it up, and give me a first (temporary) password, but now I don't need to bother them anymore.
If you were bored you could probably find your practice in the (very slow) search option, if they use it.
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>> If you were bored you could probably find your practice in the (very slow) search
>> option, if they use it.
>>
I checked and it wasn't there.
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Bit of a soft marker the 'efficiency' gradings - apparently Spain and Italy are amongst the most efficient healthcare services in Europe.
Perhaps they are.
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Can we take it, Lygonos, that you are a GP? If so, maybe we should start a 'Ask Lygonos' thread!
Can I set the ball rolling by asking what you think of the 'Toenail Fungus' stuff that keeps popping up at the top right of this page?
It's called 'Zeta Clear', but I suspect that it's American 'Snakeoil' marketing at its finest! ;-)
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>>If so, maybe we should start a 'Ask Lygonos' thread!
Once I've sorted out my Paypal account I will start replying to such a thread ;-)
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www.zetaclear.org.uk/ingredients.html
No chance of any side effects.
Unless you are allergic to water.
From wiki:
Homeopathy involves a process known by practitioners as "dynamisation" or "potentisation" whereby a substance is diluted with alcohol or distilled water and then vigorously shaken in a process called "succussion". Insoluble solids, such as quartz and oyster shell, are diluted by grinding them with lactose (trituration). The founder of homeopathy, Samuel Hahnemann (1755 — 1843) believed that the process of succussion activated the "vital energy" of the diluted substance, and that successive dilutions increased the "potency" of the remedy
Umm. Ok.
Last edited by: Lygonos on Tue 3 Sep 13 at 21:18
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And some might say it's complete claptrap...
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You think a remedy that is the equivalent of one molecule of a substance in a sphere of water larger than the entirety of the Universe is claptrap?
Shirley not :-)
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Oh dear - so it looks as though my fungal toenails are going to remain ................... fungal.
How can such 'products' be promoted on an honest, wholesome website like this?
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My experience of homeopathy was a couple of years ago when I was 17 and I had pain and redness in my eye. Mum said it was episcleritis but sent me the next day to A&E for examination by the eye specialist as eyes are too critical not to be 100% certain. She was right (as usual…) and I was prescribed some drops called Voltarol Ophtha which is what she would have prescribed. They were highly effective but when the problem came back a few weeks later I thought I would try to see if there was a green remedy and contacted a homeopath since I was a bit worried about long-term use of the prescribed eyedrops although Mum thought I was being paranoid. I thought it wouldn’t do any harm, all they do is delve into your life to see if there is any underlying problem.
I remember being asked all sorts of questions such as had I any trauma in my life, recent dreams, relationships, infact almost everything short of what colour underwear I have. Anyway about an hour later and £80 lighter, you go home and a few days later some pills are sent to you which you take and then there’s a follow-up appointment (£40) where your progress is assessed. Well these magic pills did nothing at all so I went back to the proper eyedrops and in a couple of days my eye was perfect and I’ve never had the problem since. I think I can work out what caused it now, at the time I was training at a different swimming pool where I didn’t like the chlorine smell, it seemed stronger than other pools, it probably needed attention. It helps with the chloromines and the chrlorine smell if people are asked to shower before going in and kids told not to pee in it.
Homeopathy might work for some people but I am not convinced by it. Bit like religion, you either believe or not.
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>No chance of any side effects.
Antimonium, arsenicum, Nitricum Acidum ?!
Antimony, arsenic and Nitric Acid?
Last edited by: VxFan on Wed 4 Sep 13 at 01:20
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As I say - an atom/molecule of these in a sphere of water more massive that the entire universe ain't gonna cause much of anything.
Last edited by: Lygonos on Tue 3 Sep 13 at 23:00
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Ahh, just Googled the "C" scale.
200C is a ratio of 10−400.
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In all my years working for a large multinational chemical company, I have never come across the aforementioned 'C' scale. Maybe it could be used for measuring the doctor/patient ratio?
As balmy as homeopathy is, my scientific training tells me never to say "never".
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>> Our medical practice doesn't allow pre-booking of appointments. We have to ring up (or queue up at the door) at 8:30am for an appointment on that day ~ and when the appointments for that day are all gone, they're gone.
>>
Two weeks ago, I was rather concerned that a pain in my shoulder hadn't got better with the passage of time.
I phoned my GP's surgery just after eight o'clock on Monday morning, I got an appointment to see my GP at 09.10 that morning, she gave me a form to make an appointment at the local cottage hospital/day surgery unit a couple of miles away.
When I got home I phoned for an appointment. I got one for 11.20 the same morning. When I turned up at the hospital, I was seen a little earlier than my appointed time.
By 11.30 on Monday morning, I was out of the x-ray unit. All done in the one morning!
What is the problem? Or was I just lucky?
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What is the problem? Or was I just lucky?
Well obviously no problem for you Duncan but the last time I tried to get an appointment. with my GP I was advised that the earliest appointment was in 16 days time and that would not be for my own Doctor. I didn't bother in the end although perhaps I should try again as the problem persists.
I am looking around for another Doctor at the moment but most of the practices around here are either not taking any more patients or seem just as bad as my current one.
Pity I'm not a cat - Our moggy had a minor injury last week and I rang the vet ten minutes before closing time. - No problem I was told - if you can get here within half an hour the vet will see you.
The difference is of course I had to pay the vet and he had to deliver a service to get paid. I am firmly of the view that until there is a charge for visiting GPs they will continue to be clogged with patients with trivial problems and GPs will have no incentive to start looking at their patients as customers who are owed a decent service instead of held in contempt as I feel many do.
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>> I am firmly of the view that until there
>> is a charge for visiting GPs they will continue to be clogged with patients with
>> trivial problems .............
That's a heartless viewpoint. I know an ailing pensioner whose only income is the basic state pension, and unless a GP's charge was very low then she wouldn't be able to afford to see a GP.
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No its not heartless its just common sense. Make any service "free" and it will be abused. You could well argue that food is just as essential to your poor pensioner as is medical attention. If Tesco provided food "free at the point of delivery" do you think people would take just what was needed or would many abuse the system?
More importantly it would change the relationship between doctors and patients. Doctors would have a financial incentive to improve their service and patients would feel that they had the right to demand a better service rather than the "you're lucky to have a doctor at all" attitude that pervades the NHS at the moment.
Do you think that if you paid up front for treatment your Doctor's practice would adopt the system that you outlined in an earlier post. Do you think that any commercial organisation like your garage would even think of adopting such a non customer focussed system?
If GP's made a charge - say £30 to £50 to attend the demand would slump. If you were really ill would you honestly not be prepared to pay such an amount? The amount paid to the NHS throughout taxes could be reduced
Most people including many pensioners could afford such as such a sum easily although I would concede that some would need assistance.
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>> If you were really ill would you honestly not be prepared to pay such an amount?<<
Being prepared to pay it and having the money to do so are totally different.
The most common request for help to the charity I'm involved with is for travelling expenses/parking/fuel etc for regular visits to hospital for treatment after a long illness.
After seeing an income and expenditure form for the claimant it's obvious to us there isn't any money available for such things...and of course we help, but so many are to proud to ask.
Pat
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"Being prepared to pay it and having the money to do so are totally different."
Yes they are but there is no logical reason why those able to pay up front for an appointment to a GP should not be asked to do. I'm not advocating the abolition of the NHS just the payment of a one-off reasonable charge by those who can afford to do so to see their GP
At the moment those who need treatment, including the poor, are being effectively denied access because there is no incentive for doctors to improve their service, the waiting rooms are clogged with people with trivial complaints like colds and sore throats and good proportion of patients never turn up for their free appointments.
People never respect what they are given as "free". Many Doctors have little respect for their patients because they don't directly contribute to their income
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>> If you were really ill would you honestly not be prepared to pay such
>> an amount?
I guess one problem would be the tight non-hypochondriacs who don't think something is serious, so don't go, when in fact they have something that is, or at least symptoms of it. By the time they do pay up and go, it's too late.
Last edited by: Focusless on Wed 4 Sep 13 at 09:08
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"I guess one problem would be the tight non-hypochondriacs who don't think something is serious, so don't go, when in fact they have something that is, or at least symptoms of it. By the time they do pay up and go, it's too late."
Do you not think many people who perhaps should visit their GPs are not being put off by by the prospect of a three week wait for an appointment or some ludicrous booking system as outline by L'Es?
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>> Do you not think many people who perhaps should visit their GPs are not being
>> put off by by the prospect of a three week wait for an appointment or
>> some ludicrous booking system as outline by L'Es?
Undoubtedly, but that doesn't mean what I said isn't still going to be a problem.
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I guess they would have to learn not to be tight when it comes to their own medical care.
It would be a self induced and problem resolvable by the individual unlike the present ones which are imposed on the individual by the system.
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CG me ole son, why don't you consider making a private appointment with a GP so as to jump the queue, like.
Yes, I know you've paid in to the NHS for gawd knows how many years, just like my wife and I have done,
even though we've not had to visit a GP once in the last 20 years.
I agree with much of what you say btw and would be prepared to, eh, cough up for an appointment with a GP.
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Of course if they were allowed to - which according toa GP relative they are not - doctors could solve the trivial complaints issue tomorrow.
Ejected after examination and after three such trivia struck off doctor's list..
Will never happen. Here they just go to A&E and clog that up.
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It is easy to judge someone about a trivial complaint.But to them it isn't trivial bit of a minefield.
A young girl in our village had a lot of pain in her stomach.Doctor's verdict you are overweight,she had a scan eventually and a tumor was found.To late to save her.
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We have a system paid for by general taxation.
The largest contributors to the NHS are those who would be paying twice in CGN's world.
The non/low-contributors would continue to get/'abuse' that which they get for free (at the point of contact).
Of course maybe pre/early Victorian Britain was right - if you couldn't afford food you could die from malnutrition, if you couldn't afford education you could be illiterate, and if you couldn't afford healthcare you could die in agony from whatever cancer or parasite got its teeth into you.
Last edited by: Lygonos on Wed 4 Sep 13 at 13:54
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Nobody's suggesting people being left to die form malnutrition or dying in agony from cancer.
Just a reasonable up front payment to access your GP so that people are made aware that the service is not free in that there is a real cost to provide such services and the service should not be abused.
THose who are not exempt pay for NHS dental treatment at each visit - what's the difference?
I would be interested to know what proportion of your patients really have need of your services. I rather suspect that a significant proportion would be better off with a day in bed and a couple of aspirins.
I would also be interested on your views as to how long you think a practice that was at least commercially partly dependant on payments provided directly by its customers would last with an appointments system as described by L'Es or where the wait can be up to four weeks (my Doctor)
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why don't you consider making a private appointment with a GP
Funnily enough Dog I have been looking into that very thing. Don't think I should have to but it's looking like the way to go.
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It's no wonder the nation is totally confused - we are living in anachronistic times. E.g. the country is full, yet we allow more in; the bankers foul up, yet get big bonuses; MPs preach morality, yet continue to thieve; we are advised to save for retirement, yet are encouraged to spend to aid economic recovery etc.
Relevant to this thread, we are told to "see your GP" if you've a suspicious mole etc - then struggle to get an appointment/don't want to risk wasting the GP's time. And they wonder why blokes 'leave it too late'.
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> the country is full,
By what measure?
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"By what measure?"
Do you mean 'measures'?
Population per sq mile; schools can't cope; transport infrastructure clogged up; GP surgeries can't cope (see other thread); insufficient housing etc etc
I suspect that you must be living in another country???
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I can assure you that the greatest pressure on the NHS/welfare state comes from the indigenous population of elderly.
Without a constant influx of younger people (or a more rapid removal of the elderly...) the country can only regress economically.
If you honestly believe traffic congestion, school underinvestment, and a lack of housing is largely due to Johnny Foreigner coming here then you're going to be sorely disappointed with the way UK plc turns out.
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>> I can assure you that the greatest pressure on the NHS/welfare state comes from the indigenous population of elderly.
Yes I agree, I heard something on the TV that in the last ten years, the number of males over 75 has increased by 25%.
But I don't agree with your comment:
"Without a constant influx of younger people (or a more rapid removal of the elderly...) the country can only regress economically."
... because eventually those newcomers become old and dependant themselves. You can't have a continuous inflow of new people. What needs to happen is some hard decisions need to be made about what will and what will NOT be provided by the NHS. Often a subject of healthy debate in our house not surprisingly.
But no politician will go near any of this as it would be political suicide.
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As I suspect you well know I share my time amongst several countries and have done so for years.
However, when I am in the UK I do not walk around with my eyes closed desperately trying to shoehorn all issues into my chosen scapegoat.
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'Struth, chaps, you'll be telling me next that failed bankers are fully deserving of their bonuses!
Local news this evening was talking about some schools having to go onto 3-day weeks.
But, to be honest, I'd have been disappointed if there had been no response to my observations.
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>>Local news this evening was talking about some schools having to go onto 3-day weeks.
Damn, why couldn't that have happened when I was at school!
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>>'Struth, chaps, you'll be telling me next that failed bankers are fully deserving of their bonuses!
As we live in a capitalist society, and we have chosen, via our elected representatives, not to allow the status quo of financial markets to collapse, it's not easy to make banks do very much.
History, however, suggests the current financial nonsense where most countries are living way beyond their means will end in one of 3 ways:
1. War
2. Mass defaulting of debt, structured or otherwise, to clean the slates
3. Inflation devaluing debt (and unfortunately savings) to the point of evening balance sheets and deficits out.
My bet is 3, eventually turning into 2.
Hopefully not 1.
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Surely if you have three you won't need 2 . The debts will disappear. No need to default. That's how we all paid off our mortgages. :-)
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"............will end in one of 3 ways:"
Good application of logic, and extrapolation of a financial scenario. All a bit gloomy, but I concur.
Now apply the same clear thinking (as MJW did) to the 'what happens if you try and cure all ills by importing more and more young people' scenario. Is it sustainable?
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Of course it's not infinitely sustainable.
But that's the illusion of perpetual growth foisted on us over the past couple of hundred years.
Significant social restructuring will need to happen as the world's population peaks.
In 1000 years we'll likely either be self-eradicated, or more hopefully, working together in exploring beyond the confines of this rock.
If we're still "keeping up with the Jones's" and worrying about being overrun by other human beings what exactly have we managed to achieve other than the cessation of human evolution?
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Patient to doctor ratio of 14,000:5 - No FM2R
