For help, advice and discussion about stuff not related to aviation. Play nice: no religion, no politics and no axe grinding please.
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By johnm
FLYER Club Member  FLYER Club Member
#1854075
Pete L wrote:Not that I have much time for Harding as an over-promoted fast-tracked toff but what's wrong in principle with a social insurance based healthcare system?


At the risk of heading to politics that isn't what's in the frame. The ideas being discussed in the background are equivalent to getting everybody to fund healthcare through BUPA and PPP with means tested exceptions and that big US healthcare companies would be allowed (even encouraged) to take over hospitals. The NHS would effectively cease to exist and a body also involving dear Dido and hubby would then become the replacement for PHE and the regulator of healthcare...
#1854082
I can see a system in which there is a charge for seeing your GP. That works in Jersey and I personally (as long as it isn't an unreasonable amount) wouldn't object. It may cut out some of the time-wasters thereby reducing queues and might actually encourage GPs back to the workplace rather than remote video and photo diagnosis. I know some GPs have stepped up but to judge from my experience recently with a skin problem and the number of complaints on social media about it, they would seem to be the minority.

Yesterday I went into my surgery for a shingles vaccination by the practice nurse. If it is safe to see her then why not the GP? The current situation is a disgrace and GPs in general have lost lots of respect from the public.

PW
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By Flyin'Dutch'
FLYER Club Member  FLYER Club Member
#1854096
Propwash wrote:I can see a system in which there is a charge for seeing your GP*. That works in Jersey and I personally (as long as it isn't an unreasonable amount) wouldn't object. It may cut out some of the time-wasters** thereby reducing queues and might actually encourage GPs back to the workplace*** rather than remote video and photo diagnosis. I know some GPs have stepped up but to judge from my experience recently with a skin problem and the number of complaints on social media about it****, they would seem to be the minority.

Yesterday I went into my surgery for a shingles vaccination by the practice nurse. If it is safe to see her then why not the GP*****? The current situation is a disgrace and GPs in general have lost lots of respect from the public******.

PW


* studies in the 90s suggested that a £1 charge would reduce 'demand' by 20% - unfortunately that would mostly be by those who are the most vulnerable; however it would only increase the inverse care law, those who need it most are least likely to get what they need as they are not as able to sort out their care needs and make healthy life style options

** few people waste time and a charge is unlikely to make that any difference, something certainly a first hand experience from working in a (social)insurance multi tier system myself it is not the amount of contribution made that determines the behaviour of people; it is als my experience that those who use services inappropriately is extremely small indeed.

***Few GP/GP services have not been available throughout the pandemic, indeed many have gone to great lengths to offer services safely (for patients, staff and GPs themselves) and it might have been been better if they only had known there was no apparent shortage of PPE as we were all told the other day by the SoS for health.

****Social media, the pinnacle of true truth.

*****I am pretty sure that should there be any requirement for a hands-on procedure the GP would have been available too; the suggestion that GPs would be happy to leave physical to their staff and sit in their office shielding is non-sense.

******So far we are still ahead of the pack, the graph found under the link below shows doctors and nurses still respected by the public, ahead of other respectable jobs such as fire-fighter and police officer.

Interestingly enough there was no mention of politicians.

https://yougov.co.uk/topics/internation ... d-professi
#1854100
Sorry, FD. That has not been my experience recently. I have been extremely disappointed with the service offered by mine and friends at different local surgeries report very similar problems. You can discount social media all you like but it can be an indicator of widespread problems. Something is not right at the moment with a large number of GP practices. There is no logic in being able to see the practice nurse in person but not a doctor. The sheer effort of getting even remote access is mentally and physically exhausting. I have a nasty feeling that it isn't going to get better any time soon.

PW
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#1854101
johnm wrote:
Pete L wrote:Not that I have much time for Harding as an over-promoted fast-tracked toff but what's wrong in principle with a social insurance based healthcare system?


At the risk of heading to politics that isn't what's in the frame. The ideas being discussed in the background are equivalent to getting everybody to fund healthcare through BUPA and PPP with means tested exceptions and that big US healthcare companies would be allowed (even encouraged) to take over hospitals. The NHS would effectively cease to exist and a body also involving dear Dido and hubby would then become the replacement for PHE and the regulator of healthcare...


That could not possibly be worse than the NHS hospitals I have experienced.
By johnm
FLYER Club Member  FLYER Club Member
#1854111
JAFO wrote:
johnm wrote:
That could not possibly be worse than the NHS hospitals I have experienced.


All things are possible :D and it's worth remembering that a quite a lot of things are already outsourced to the lowest bidder, notably cleaning and catering! Some medical services like minor injuries and ambulance services are already down that same road too.
#1854112
Interesting piece that echos the experiences of my wife in Emergency Departments.

https://www.independent.co.uk/news/heal ... 68711.html


Lots of patients turning up for non-emergency ailments such as an aching arm because the GP surgeries are refusing face to face appointments.

Increase in people terrified that their hay fever is Indian/Delta variant (was the same hassle last year).

The usual of people faking illness to try and get free morphine (although that’s normal)

Increase in people terrified that a headache is the side effect of their vaccine.

The usual of overdoses/drinking to unconsciousness. Typically followed by a demand for an ambulance back home because “well you brought me here”.

In the past month they’ve also seen people lie to get blue lighted in with a headache or because they feel sleepy. Certainly doesn’t help with the ramping issue and lack of ambulances available. Many see paramedics as a taxi service.

And of course, on top of the joke admissions you have the usual emergency issues (stroke,falls, heart attacks, accidents etc) plus serious cases from people who’ve missed diagnosis and treatment due to the NHS pretty much shutting down for the past year.

The abuse from patients is disgusting, although they’re obviously annoyed at waiting. One of her colleagues was bitten by a lady last week who was angry at not getting a hot meal, another was punched yesterday because the patient refused to accept a paracetamol was enough for her headache.

Add to this that the media is inciting abuse against staff who’ve chosen to not be vaccinated, and morale is getting lower with many having quit, or planning to quit and go elsewhere. My wife is now one of the more experienced nurses having only worked there for 18 months. She’s thinking of packing it too. New recruits are lasting about three months before deciding “bugger this, I get the same pay for an easy job on the wards”. The department was already understaffed, it’s now understaffed and under experienced with many thinking of leaving. I’m not sure people realise how bad this is with the same scenario repeated in Emergency Departments across the U.K.
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By Flyin'Dutch'
FLYER Club Member  FLYER Club Member
#1854126
Accident and Emergency departments, Ambulance Services, Police are all services of last resort and never close so they have more than their fair share of the edge of society where people who have nowhere else to go end up going, that includes those with behavioural issues as your post, and for a great many of us, experience, confirms.

A large part of societal safety nets has been cut back over the years; the services may not exist anymore, the users of them remain.
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By Flyin'Dutch'
FLYER Club Member  FLYER Club Member
#1854127
Propwash wrote:Sorry, FD. That has not been my experience recently. I have been extremely disappointed with the service offered by mine and friends at different local surgeries report very similar problems. You can discount social media all you like but it can be an indicator of widespread problems. Something is not right at the moment with a large number of GP practices. There is no logic in being able to see the practice nurse in person but not a doctor. The sheer effort of getting even remote access is mentally and physically exhausting. I have a nasty feeling that it isn't going to get better any time soon.

PW


I am sorry to learn that. Most practices will now offer a telephone consultation first with face to face consultation follow up if clinically indicated. But from my GP jobbing colleagues I hear that this is what is done at a great many places, clearly there may be a mismatch between perceived needs between those of the patient and the provider. It no doubt took some time for 'the public' to accept that a burglary report would be done on-line or the telephone rather than result in an officer visiting the address to do their Sherlock Holmes work and apprehend the culprit.

Over here, in Germany, we also offer telephone and video consultations, as alternative for face to face consultations but after a slight increase over the winter months we are back to normal levels of that. People (and certainly I as a clinician) prefer to see people in the flesh so I can do a physical examination, give a prescription as required, way over a telephone or video consultation. For follow up they can be very good but the initial interaction is much more satisfying from a face to face consultation.

We only do consultations* after an appointment has been made and everyone with symptoms which may indicate a viral infection is told to stay in car or outside until they have had their temperature checked and if necessary having a lateral flow test. Luckily 7 day numbers are now in single digits and indeed it has been weeks since we have had a positive case in our surgery.

Your fear that things will not change in the near future is well founded, there is a historic shortage of enormous magnitude of clinicians in the UK at present; and that is not going to get better anytime soon.

I read that the new likely incumbent as CEO of the NHS wants to reduce the reliance of non-UK staff, probably a smart move given the changing position of desirability of working in the UK, but to train a nurse is 4 years and a medic 7 years plus and with the Covid induced increased workload both now and in the future it will be difficult to see how needs are going to be met until these new recruits are finished and ready for the get go.

*Medical Emergencies obviously excepted

PS you also get two officers and a flashy car here when there has been a minor bump or burglary, and although that gives a warm fuzzy feeling of 'taxpayer money well spent' I doubt it increases rates of resolution of minor crimes; nor did I ever feel not safe in the UK.
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By Flying_john
FLYER Club Member  FLYER Club Member
#1854128
Certainly the Police are expected to deal with all sorts of societal issues, from Aunt Maud who is being "cared for in the community" and decides to go missing on a long walk, to the longer term younger members of society who drink or drug themselves into oblivion.

All these modern pressures a result of cost cutting of other avenues of care or rehabilitation (most institutions having been sold for housing) just send the problem towards other agencies, medical and policing who have also seen numbers cut or are just too snowed under to deal with them.

Money could be thrown at it, but it really needs another branch to the emergency services to replace the ones that have been cut by various governments over the last 30years.
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#1854138
Just to be clear, FD, I don’t seek to tar all GP practices with the same brush, but my experience certainly doesn’t appear to be even close to unique. Maybe it is a more prevalent in London and other big cities where practices seem to have morphed in many cases into businesses above service-based practices that they traditionally were. Mine has expanded so that I don’t even know any of the doctors now my old one has retired; I haven’t been allocated a new named one and never seem to speak to the same one twice under this new system. The surgery has moved to a large, posh new building which I suppose has to be paid for. For some context, I have been lucky only to need the service of the surgery 3 times in the last 25 years, the previous 2 being in respect of injuries initially treated at A&E, for removal of stitches or dressing changes. This third time of need has been exasperating, pandemic or not, and I still don’t know exactly what the problem was although hopefully it is now all but gone. Even the doctor(s) didn’t appear to know, the first prescribing anti-biopics, after viewing a photograph, which did nothing and the second, also from photographs, an “experimental” topical treatment which helped but still hadn’t fully sorted it by the end of the course. Frankly I then despaired and couldn’t summon the will to jump through all the hoops again and hoped, as seems to be the case, that it would sort itself out without further intervention. I suspect it might have been an allergy, but who really knows. A blood test would have been nice but apparently not available. :roll:

As for policing, it was always in my experience the last resort for any out-of-hours problem, mainly because it was always open. The list of things I had to sort out which were a million miles from my job description would fill a book, but we all viewed it as part of the service to help desperate people. Thanks to modern leadership ideas and budgetary cuts much of that ethos has largely now gone too. Today even things which clearly are police matters, like domestic burglary and shoplifting, no longer command police attendance, at least from my old force. It leaves me ashamed to witness and very sad. Perhaps I am just a grumpy old man at odds with today’s world. I need a G&T!

PW
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