GPs' pay and surgery hours.
What do you think?
Eddie Mair | 17:29 UK time, Friday, 21 December 2007
What do you think?
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I am a little fed up of doctors complaining, they are on a pretty good wage now!
All Primary school teachers have to do 'Parent Consultation evenings' at least once a term, staying on after a busy day at school until 8 or 9 pm to see parents. Often without a break. We can't do appointments in the day because everyone else is 'at work!' So why can't doctors be available out of working hours now and again? And don't start on long holidays please!!!
Until the disastrous PCT's were set up, our GP's provided the 24hour cover. Now, they & the government are arguing at the level of jobsworth.
We had a Gloucestershire Area Health Authority, then local PCT's and now, Lo! We have a Gloucestershire PCT. Over the period of this mis-administration, the complete and ethical care formerly provided by our GP's has been replaced by an anonymous and unknown 'Out of Hours' service. I think Doctors have been forced into the current undignified argument by the government's administrative incompetence in constantly reorganising the NHS without regard to what works.
Doctors and surgery staff are working people as well. Why should they work 'unsocial hours' any more than anyone else? Would the people who demand the surgeries open longer hours be prepared to work extra hours in their job as well?
Yes, some people would find longer surgery hours convenient - but it must be properly funded and staffed without coercion.
Regarding the news that children have access to guns in a rural area i would like to say that i feel that any policy of law requires a degree of common sense, it seems alarmist on an infantile level to come out in a cold sweat because guns are being used in legitimate functional ways.
A different approach should be taken to the use of firearms dependant on the situation, this thoughtless knee jerk reaction is symptomatic of the reckless stampeding of law dependant on the latest media braying.
I would support extra pay for teachers as well, Ms Roly, for parents' evenings etc..
And no, I don't think teachers have ridiculously long holidays - I know how much of the holiday and their term time evenings is spent on school work.
Hope you have some time off over the holiday period!
All foreigners who abuse our hospitality by breaking the law should be deported regardless of sentence. There are exceptions available in the Human Rights Acts and other treaties which can be invoked to allow this.
This policy should include EU citizens and any withholding their nationalities should simply be assumed to be Somali or Zimbabwian and sent there . (they'll fit in well)
Doctors and teachers aren't the only ones who work long hours, but I absolutely agree that any such arrangement should be appropriately remunerated. However, as patients, we have to take time off work in order to see the doctor, especially for routine and non-urgent appointments.
It's another of those situations where as consumers we are either time-rich and cash-poor or cash-rich and time-poor. The only way I can see a GP without having to take half a day's holiday off work and book two weeks in advance is to pay at a private clinic. At the same time, my own GP, who knows me and has my full notes, is being remunerated for having me on their books.
GP surgeries are very busy and provide an excellent service to those who need a great deal of attention, such as the elderly, seriously ill or young children. But why do the rest of the population have to wait until we are at death's door before we can get any primary health care?
How about GPs across different practices within the same town/city get together occasionally and work out an after hours rota?
It needn't be 24/7, but perhaps occasional weekday evenings until say 8pm, or more likely Saturday surgery. If its done on a rota basis, then all GPs are treated fairly - no-one's doing more or less OOH care than anyone else, and obviously, the more GPs are recruited to the scheme, the longer the time interval between individual GPs performing OOH care.
Perhaps in the early stages of implemention, they could accept pre-booked appointments only, made a few days in advance so the local PCT (or whatever its calling itself now) can work out how many GPs to allocate.
I think they messed up big time a couple of years back (when GP's pay was upgraded dramatically) and now the Government are trying to claw something back. Sorry I didn't hear the relevant bit of the programme, I was singing for the Bishop!!
The government wants GP surgeries to open for an extra 3 hours per week, in the evening, or on Saturday morning, to provide routine services to patients unable to attend during 'normal' working hours (ie 8.30 - 6.00). GPs are now reasonably remunerated for what they do, so what is the difficulty in them providing the extra hours? Well, the reality of providing routine primary care services is that GPs do not do it in isolation: they need reception staff, dispensary staff, practice nurse colleagues, local high street phamacists, social services and hospital services all to be working and available at the same time, otherwise the GP can only provide emergency primary care, which is a very different thing. Put all of these services in place, properly funded, and extended hours might work; force GPs to open their surgeries without the allied services, and the scheme will become yet another New Labour farce.
(DOI - yes, I'm a GP, and yes, I do know what I'm talking about)
Simon
Unfortunately, many commentators, especially the politicians, seem to confuse 'extended hours' (ie routine services provided outside of 8.30-6.00 Mon-Fri) with 'out of hours' (ie emergency care).
The governmenr wants GP surgeries to open for an extra 3 hours per week, in the evening, or on Saturday morning, to provide routine services to patients unable to attend during 'normal' working hours (ie 8.30 - 6.00). GPs are now reasonably remunerated for what they do, so what is the difficulty in them providing the extra hours? Well, the reality of providing routine primary care services is that GPs do not do it in isolation: they need reception staff, dispensary staff, practice nurse colleagues, local high street phamacists, social services and hospital services all to be working and available at the same time, otherwise the GP can only provide emergency primary care, which is a very different thing. Put all of these services in place, properly funded, and extended hours might work; force GPs to open their surgeries without the allied services, and the scheme will become yet another New Labour farce.
(DOI - yes, I'm a GP, and yes, I do know what I'm talking about)
Simon
Unfortunately, many commentators, especially the politicians, seem to confuse 'extended hours' (ie routine services provided outside of 8.30-6.00 Mon-Fri) with 'out of hours' (ie emergency care).
Why can the doctors not go back to the system where, if you needed to see a doctor urgently, then you simply went to the surgery and queued between nine and ten o'clock, knowing that the last person to be seen was at ten. There was, I must admit, a fair number of people there but everyone was seen. The same situation happened at two till three and five till six.
Presently they seem to have 10 or 15 minute appointments and if you are out in 5 they must sit with their feet up as nothing happens in between time. 15 minute appointments for a blood test that takes three minute from beginning to end is laughable. After all if you can actually make it to the surgery by car, bus or even walking then you are not actually totally incapacitated that it should take a long time to have the problem looked at i.e. some people will need longer than others but it is swings and roundabouts and I bet a lot of sore throats and infections are seen that surely do not take a lot of diagnosis!
The point I am trying to make is that if they quickened the process up they wouldn't need to open late at night. If they cannot quicken it up then there is a problem in some other respect that needs to be looked at.
Simon Blake (11) " ...they need reception staff, dispensary staff, practice nurse colleagues, local high street phamacists, social services and hospital services all to be working and available at the same time."
I think you're laying it on a bit thick, there. When I arrive at the surgery, a machine checks my gender and DOB, then tells me to sit as the Dr. knows I'm there. Reception staff only needed for security. Pharmacists operate their own rota, and medicines are not always needed immediately. Hospitals are open 24x7 anyway. Social Services - what do they do?
Having said that, on 11/11/07 I was in agony and my wife called the surgery number. The emergency Dr. arrived c 2320 and administered a catheter. Excellent service. BTW, she had a male escort. Shows what things have come to, doesn't it?