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Is the government trying to break the GP service?

(272 Posts)
JessM Sat 14-Jan-17 08:39:15

Shocked to read these proposals for forcing GPs to offer a 7 day a week 8am- 8pm service.
Are they not aware that some GP practices, in rural areas, are just not big enough to cover all these hours?
Do they not know that there is a shortage of GPs? And that medical students are not queuing up to choose this career.
Do they not think that this might push many of the 1 in 3 that are considering retirement in the next 5 years to go early?
Claiming this will significantly reduce pressure on A and E is not fair. People like Jeremy Hunt that take their kids to A and E because they don't want to take time off work are not the main cause of the problem. A lack of beds and a lack of social care - both deliberately inflicted by Jeremy Hunt, are the major problems in A and E..

www.bbc.co.uk/news/health-38620935

GracesGranMK2 Thu 19-Jan-17 12:14:23

Are you suggesting that we only employ full-time doctors Yogadatti? How would that help with the shortage? If we cannot replace leaving and retiring doctors where do you think the hours would come from to cover weekends - perhaps you are a trained doctor and would like to volunteer?

Do you really believe that a particular doctor should be able to see you as and when you turn up with an issue be it big or small? What would you suggest they do when you don't need them? I think this sort of grumbling comes from the nearly well not the ill. If you are ill you are happy to see anyone who can help; if you are a nearly well you can wait to see a particular doctor. Have you ever managed a business - you seem to have very little idea of the practicalities of making it work to the budget you have.

Once you are 75 why should you have an early appointment unless your needs (which could be the same as someone of any other age) require it? This just sounds like excessive grumpiness to me. I have two relatives with complex and life-threatening conditions and they have always had an excellent service as I am sure you would get in the same position. However, I am sure they would swap with the nearly well so they didn't have to ask for these services and the nearly well - now with the life threatening condition - could get immediate attention.

A lot of this is just shear grumpiness and grumbling because people have nothing better to do (in my opinion)

Anya Thu 19-Jan-17 15:11:45

However continuity of care is important, especially as you get older and have more complex conditions and needs.

I have plenty to do and am just sitting down for the first time to grab a cup of tea before the GC arrive back after school. And if I want to grumble then I will hmm and so say all of us.

Ana Thu 19-Jan-17 15:17:01

Carry on grumping, Anya - why not indeed, if the mood takes you?

daphnedill Thu 19-Jan-17 15:19:25

I have to see my GP regularly, so I make advance appointments and see the same GP every time. I'm not sure how many days she works, but I know she's not full-time. I know she has youngish children and I'd rather she's alert rather than totally wiped out from juggling childcare with working full-time.

Anya Thu 19-Jan-17 15:21:21

Thank you Ana smile

GracesGranMK2 Thu 19-Jan-17 16:14:25

I'm in the same position daphne although I notice my GP makes the appointment ahead before I leave her office these days. If I need to see her for something that comes up and I can book ahead and have never had a problem and if it is urgent I tend to get a locum. The last one was telling me I could get all my prescriptions free because I am hypothyroid. As I am 67 it made my daysmile

I don't even go to the surgery for my blood tests - I go to Sainsbury's. It works brilliantly. More innovation for the current day, not for the 1950s suits me.

Ankers Thu 19-Jan-17 16:32:26

A particularly unwarranted and quite nasty post by GracesGranMK2, to Yogadatti in my opinion.

Completely unnecessary, with Yogadatti making some good points too.

durhamjen Thu 19-Jan-17 16:59:54

Anyone seen that Surrey council are going to have a referendum on whether to put up council tax by 15% to cover social care?
Both Hunt and Hammond have constituencies in Surrey.

whitewave Thu 19-Jan-17 17:03:05

Yes saw that this evening. I honestly think that it should be a national decision. Our county council are raising the tax by 5% but ,imposing 17 million worth of cuts.

JessM Thu 19-Jan-17 17:04:08

I think in fairness the quality of service varies a lot in part because UK trained GPs who want full time jobs have the pick of the nice areas. You'd have to have a seriously heavy duty sense vocation if, as a young GP, you chose to live the rest of your life and bring up your family in a deprived area if you could choose from places with better facilities/scenery/air quality or whatever. So the best of the bunch get the pick of the jobs and other areas are struggling to get enough GPs, and having to use locums etc.
My MIL lived in a depressed part of the midlands and generally received adequate but not very impressive care. (very unimpressive the day she nearly died... and when she did die a few years later it took over a week to get a death certificate signed).
When she spent several months recuperating in leafy Solihull there was a tangible difference in service.
However if the UK fails to train enough medical students and then fails to attract enough of them into general practice you are going to end up with struggling GP practices in the areas with the most need - i.e. where the population is poorer and therefore on average sicker. I used to live in Milton Keynes which has many positives as a place to live but tends not to be top of the list with young graduates looking for full time roles (across the board, not just doctors). It also has an expanding population due to continued house building. When I left 4 years ago it was almost impossible to get an appointment unless you had an urgent need to see a doctor. No bookable appointments available. Phone line continually engaged from 8a.m and by the time you got through all today's appointments taken. They used to open their doors at 7.30 so people could sit there and queue to get an appointment that day when reception opened at 8. At one time they had no female doctor available as the only one was on maternity leave.
Workloads are higher and group practices are much more efficient ways to run a service in todays world.
In the 1960s I went to a 2 doctor practice (Dr Claude Davies and Dr Colwyn Thomas - who knew instantly who I was, what my mother's name was, and my grandmother's and remembered how my father had died) where you just went and sat and waited without an appointment. They had minimal paperwork and no clerical staff. They had the time to do antenatal care and to supervise home deliveries. Those days are long gone.
However politicians like Jeremy Hunt often talk as if we lived in a parallel universe where everyone still has a family GP who knows their history. I guess if you are a famous politician your GP will know who you are. But for most of the people, most of the time, I think it is a "nice to have" but not a realistic expectation.

durhamjen Thu 19-Jan-17 17:15:39

Hunt still had to take his children to A&E when he couldn't get an appointment with his GP. Exactly what he tells the rest of us not to do.

GracesGranMK2 Thu 19-Jan-17 17:20:42

Interesting Ankers. You think Yogadatti is allowed to put an opinion forward but must not be challenged on facts.

I really do believe her perspective on the way the GP service can be run, on the budget the government has decided to allow, just does not fit the pieces together. I don't think she is the only one with an opinion of how to run a 21st Century GP Service with a government seeming determined to destroy the NHS that is simply not a feasible way but if you put forward your ideas you must expect them to be challenged

How would you propose they work a seven day week when we cannot get enough doctors for the five and a half days many run? If you say they "won't work 7 days" when it is rather that they cannot get enough staff I will challenge what you say as that appears to be a 'nasty' attack aimed personally at doctors as individuals.

If you say "every doctor in my practice works 2 days.....mostly they are women with young children and only work part -time." I would have to ask why doctors in particular should be forced to work hours that are not of their choice. So far we haven't turned into China when we are told what to do. I would ask you as I did Yogadatti what you think would happen if all doctors jobs were only full-time. It was a sexist and unhelpful comment.

If you, like Yogadatti, were to say "Maybe everyone on this website has wonderful doctors,...I do not.....and anything that improves the system is ok by me." I would question your reasoning in putting more pressure on an already sitting on the edge service and then expecting it to be improved.

If you said that "most don't know who you are and spend 5 mins looking through your notes." I would question if you had ever done a job let alone worked in a pressured system where the person in front of you is one of a huge number the GPs are now expected to care for and surely, surely, whether they remember you or not you would want them to check your notes - and then write them up when you leave - and then write to any specialists you may need to see, etc., etc., or then call on you when you cannot get to the surgery, so that a 10 minute appointment can, on average, take 40 minutes.

I make no apology for questioning someone who is sounding off about GPs with little or no fact to support their complaints aimed at doctors as individuals.

Wheniwasyourage Thu 19-Jan-17 17:35:05

Good post GracesGranMK2!

whitewave Thu 19-Jan-17 17:37:02

Good post gg

Ankers Thu 19-Jan-17 17:56:50

I couldn't care less about the questioning. Question all you like.

But saying the following
perhaps you are a trained doctor and would like to volunteer?
^ I think this sort of grumbling comes from the nearly well not the ill.^
This just sounds like excessive grumpiness to me
etc

Actually I gave up up with the copying and pasting of your post,and if I have to point them all out, there is really no point.

GracesGranMK2 Thu 19-Jan-17 18:17:30

If someone makes a personal attack on the people who are doing their best and more so in a system under attack, who have no way of replying to the thoughtless who do this Ankers they must expect curt replies. Cut and paste all you want but you will not change my mind on Yogadatti's post although I would think that she may be pretty fed up by now that you keep dragging us back to it.

If Yogadatti or you would like to discuss how this could actually be changed I would be quite happy to do that; picking off groups of people who take all of the responsibility but are no position to change things is more than 'nasty' in my book.

whitewave Thu 19-Jan-17 18:19:42

Wonder what the vote will be re the 15% rise. Be interesting

durhamjen Thu 19-Jan-17 18:26:06

Half of them say yes, half say no; that could just be the BBC trying not to show bias.
Haven't seen either Hunt or Hammond on the news yet. Corbyn said it's a national problem and should be treated as such.
They appear to have got rid of the statement from someone who said they have been given 1.7 billion, that's with six zeros. Hope he has nothing to do with accounts.

whitewave Thu 19-Jan-17 18:29:14

Yes I saw thatgrin that was the Mole Valley Tory. Not the brightest spark

GracesGranMK2 Thu 19-Jan-17 18:36:06

I wonder if any other councils will follow their lead? Am I right in thinking it is a Conservative council?

whitewave Thu 19-Jan-17 18:37:37

Yes gg

Iam64 Thu 19-Jan-17 20:04:46

Yes it is a conservative council. 15% is a lot and I don't know whether it's a borough with more wealthy inhabitants than the one i live in.
I'm not sure how I feel about the suggestion that 15% is put onto council tax in order to improve social care, in one area.
The problems with social care are national, not confined to one region. I expect the residents of Kensington and Chelsea, for example, could easily afford an extra 15%. Many of them could probably afford to buy in social care for themselves. That wouldn't be the case in many other areas would it.
The austerity argument falls at the first fence for me because its being used to decimate public services, including the NHS
We need to invest in a combined health - social care system, which is properly funded, managed and staffed. It can't be beyond a country like ours to actually do this. We have the staff to do it, what seems to be lacking is a government committed to do so.

GracesGranMK2 Thu 19-Jan-17 20:28:16

Couldn't agree more Iam. The idea that we get into difficulty because of an international banking crisis and then the NHS and systems designed to help the poorest and least able are slashed while the bankers get away with no repercussions has never struck me as right in any way whatsoever.

This idea sounds like either an attack on the government - unlikely as it is a Conservative council - or an attempt to stop a combined system being formed. The council tax is already the most regressive tax we have and I can see many being in great difficult with rises like this.

whitewave Thu 19-Jan-17 20:47:57

I agree with you both. smile

Rigby46 Thu 19-Jan-17 23:28:14

I'll have a vote in this referendum and I'll be voting against it for a variety of reasons. Partly because of the regressive nature of the council tax, partly because it's absolutely no way to address such a fundamental issue, partly because if it goes ahead, the government will wash its hands even more of social care funding and just blame SCC for any future failings in the provision of such care. My take on why it's happening is that the councillors are simply fed up with all the flak they are getting as a result of huge cuts to their budget and have thrown the gauntlet down. On the average band D property, it will be an increase of about £5 a week. No idea at the moment what the result will be but it will probably increase the turn out at the May local elections.