No GPs?

Sorry, I should have added, that even if all those plans came to fruition, there will still be recruitment issues in general practice, because it isn’t, for many reasons, a popular career path for doctors now.

Doodledog

I'm not thinking in terms of pounds of flesh or punishment. They are your terms.

As I said, I would scrap the fees, so they wouldn't have student loans, and their taxes would pay for the same things as yours or mine. I think it should at least be discussed as part of a solution to the lack of staff, whether in recruitment or retention. It needn't rule out looking for other ways to reduce workloads and the stress they are under, but it would give the NHS some stability.

I know they were my terms, I feel desperately sorry for doctors in the current environment. If you adopt a no fees approach for people training to be doctors, I assume you feel that should extend to other health professionals who are also in short supply, I’d agree in principle with that rather than the current bursary system, but it would cost a lot to do of course - and other groups may lobby for similar treatment.
There has to be a robust selection process, there’s about a 10% drop out rate at the moment, and it’s likely that more people who are not suited to be doctors would apply and the dropout rate would increase. The big barrier for people from lower income families would still be the accommodation and living costs charges - are you proposing they pay for those on a similar basis to now?

Sylvia
You have accurately summed up the situation. I don’t mind if my doctor comes from Africa though, not sure why you mind. I do object to us poaching medics from abroad though, I think it’s immoral.
My daughter is a doctor and has experienced abusive patients. As you say, I wonder how members of the government would feel about their adult child being abused at work.
The government are doing nothing to resolve the GP shortage. They are doing nothing to resolve the problem with junior doctors pay, which has been eroded for about 14 years as I understand it.
My daughter has gone to New Zealand to work and to escape the working conditions in the UK. Many doctors, especially GPs are leaving to work abroad and the government apparently don’t think think this is a problem.

I'm not thinking in terms of pounds of flesh or punishment. They are your terms.

As I said, I would scrap the fees, so they wouldn't have student loans, and their taxes would pay for the same things as yours or mine. I think it should at least be discussed as part of a solution to the lack of staff, whether in recruitment or retention. It needn't rule out looking for other ways to reduce workloads and the stress they are under, but it would give the NHS some stability.

Doodledog

fancythat

To train a doctor in the Uk is expensive. Both for the government and for the student.

It is, but if we (as a society) knew that the money wasn't being sent abroad it would make sense to invest in training more (and more nurses, radiographers etc). I can't see why a contract such as I described in my previous post wouldn't benefit everyone. No debt for the medics, and a guarantee that expertise will stay here or the expense of providing it reimbursed would be a win-win situation.

The vast majority of doctors remain in training posts in the UK after qualification already Doodledog, they tend to leave in their thirties, by which time they have worked for the NHS already for around 10 years. They have large student loans because of the length of their training, which they also pay back as deductions from their monthly salary. I think by the time they do emigrate if they decide to, that the UK has already had its pound of flesh. We need to make working for the NHS an attractive option, not punish them for leaving a system that destroys them in its current form.

fancythat

To train a doctor in the Uk is expensive. Both for the government and for the student.

It is, but if we (as a society) knew that the money wasn't being sent abroad it would make sense to invest in training more (and more nurses, radiographers etc). I can't see why a contract such as I described in my previous post wouldn't benefit everyone. No debt for the medics, and a guarantee that expertise will stay here or the expense of providing it reimbursed would be a win-win situation.

www.telegraph.co.uk/health-fitness/body/junior-doctors-nhs-true-cost/

To train a doctor in the Uk is expensive. Both for the government and for the student.

I was sceptical about my doctors (within walking distance) stating if you need an appointment you have to log in to their website state what you have wrong with you and what you would like to happen but I've nothing but praise for this system now, if they think your appointment is urgent you get an appointment same day or a doctors phone call or a referral.

Mr. S. had a routine health check last week and has just looked up his blood test results on line and been told he needs to talk to a nurse. He's 'phoned this morning and been told that a nurse will call on the 14th of this month!!!

09:39Sago

Whilst waiting for his blood test appointment last week my husband saw a poster in our surgery that said “ No papers, no documents, no problem!
There was also a poster offering double appointments for people with English as a second language.

Wow probably never paid into the system either, you couldn't make it up could you😡

Places on medical degrees are very competitive, and lots of keen and capable young people are turned away. As qualifying to be a doctor takes a lot of time and requires equipment and hospital use, the courses are very expensive (although, of course, the fees are currently paid back in line with earnings in the same way as for any other course). Training is ongoing post-qualification, which again adds to the cost. Yet medics regularly leave after all of that, and take their expertise with them.

How about we look at funding the training, increasing the number of students (without reducing the quality - many with very good A levels are rejected) but introducing a contract that requires some sort of payback if they leave? The details of that would be worked out with input from the doctors themselves, of course.

I'm not suggesting that people are held in the UK against their will, but that in return for free training they should have to pay back the expense of that (maybe in instalments out of their new higher salaries) if they leave before the cost has been recouped out of tax, after normal tax contributions are taken into account.

As has been discussed before, that sort of contract is not unusual in business. My son had postgrad qualifications paid for by his employer, on the understanding that he worked for them for X years afterwards. If he'd chosen to leave he could have, but either he or his new employer would have to pay back the cost of the courses he went on, plus a penalty as he'd be taking his new expertise to another company, and the old one would need to fund someone else to acquire it.

Knock-on effects would be that medicine as a profession would open up more to students from diverse backgrounds, as the training would be free, and we could train enough new staff to plan to fill expected vacancies year on year.

I have always thought the NHS was good but am concerned with the recent GP changes. At my practice, you can get a routine GP appointment 4 weeks ahead.
Otherwise, when you phone you will get a telephone appointment with a pharmacist or a physio if it is for back or joint pain. I don't see how joint problems can be diagnosed or treated without being seen. The pharmacist can prescribe and order blood tests, which is great for some things but not for lots of more complex issues.

henetha

Absolutely no-one would like to see their child butted in the face. The situation is terrible and it lies with the government to get a move on and do something about it. I'm not sure why recruiting from Africa requires an ugh though?
I live in hope that the situation can be improved soon, somehow.

I interpreted 'ugh' as an expression of being baffled, ie. why is the UK poaching staff from an area of the world where healthcare is poor?

Doodledog The advantage of having health checks is that you do actually get an appointment. I use them to make sure I raise all the issues I want to. As you have access to your Patient Summary Record, challenge the nurse on anything you've seen in it which you don't think is true.

That was a response to Sylvia Plath's comments

Absolutely no-one would like to see their child butted in the face. The situation is terrible and it lies with the government to get a move on and do something about it. I'm not sure why recruiting from Africa requires an ugh though?
I live in hope that the situation can be improved soon, somehow.

My surgery used to be literally a few doors away from my house. It has now moved to new premises further away, which it shares with another practice. Obviously that is less convenient for me (but more so for those who live nearer the new one) but sharing the building means that they can also share things like X Ray machines, offer ultrasounds and have consultants come in for clinics to save people travelling to hospitals.

All of that is great, but you can't get an appointment easily. After diagnosis you are almost always seen by nurses and HCAs for blood checks and so on. The two practices are separate, so the number of doctors hasn't increased, and like everywhere the local population has increased because of new developments with no facilities.

Annoyingly, they do things like refuse to fulfil repeat prescriptions if you don't go for 'health checks', which are cursory at best, and involve a series of lifestyle questions. The nurses often make up the answers - I have never yet been asked about attending the dentist, yet my dental health is listed as good (nobody has looked in my mouth). Similarly, I am listed as taking 'regular light exercise' when in fact my breathing precludes that, and apparently I 'understand medication regimes' without being asked. They seem to make assumptions based on looking at you, but you have to go in to answer the questions when you can't get an appointment for something that could turn out to be important. I know this is all about funding, but it is very frustrating.

Two of my children are Doctors, A&E and a GP I have an DIL also a clinician., and another child a Pharmacist. The working conditions are terrible and unsustainable. I feel fearful for their mental health. There is a severe shortage of Doctors, pharmacists, Nurses and beds.
They are begged to undertake extra shifts. English trained Medics are leaving for Australia, Canada etc, in droves. Our Government won’t pay our Junior Doctors.
The remaining U.K. Doctors are being horribly vilified for a situation, not of their own making. Our government are recruiting Medics from ? Africa. Ugh.
I would like Sunak to go into a A&E department late on Friday night when the unconscious alcoholics and drug addicts are wheeled in for the staff to cope with, all mixed in with the sick. No beds ( or MH facilities) of course, as the nursing homes have shut. How would he like his child butted in the face, at work.

I truly don't feel that I have a doctor at all now. My old GP retired six years ago and I was assigned to a new one and I have yet to set eyes on him. On the rare occasions that I have needed to see a doctor in the last few years it's always a different one. And now it is even more difficult to get an appointment at all. So I generally don't bother. I'd rather google things and then buy medications online. Obviously I would not do this if it was something serious, but for many everyday problems it is perfectly satisfactory.
I feel somewhat cynical about the whole GP thing.

Doodledog

I use Pharmacy 2 U, Dickens. I started doing so in lockdown when there were queues outside of pharmacies and Mr Dog was waiting in the rain to get my inhalers, which, as you describe, were often not ready. The service is free and not bad at all. The GP sends the prescription to them, and they have never got it wrong or been late. My only niggle is that their reminders are out of synch and they nag me to order things I don’t need, but it’s all on email so easily ignored.

Oh thanks DD!

I will check that out today! Brilliant! (as they say)

It’s not feasible to open new GP practices for new housing developments, due to the GP shortage. The trend is towards larger practices so that GP time is better used, and so that a greater range of specialist services can be offered than small practices could do. We are going to have to get used to services operating differently, and to travelling to reach them unfortunately.

Sounds all too familiar here in the South

That is if course an issue here, massive new builds, not a single new GP practice. The existing GPs are definitely MIA, well in our practice. The practice seems to be operated remotely. Nearly 300 houses on the edge of the village alone.

Whilst waiting for his blood test appointment last week my husband saw a poster in our surgery that said “ No papers, no documents, no problem!
There was also a poster offering double appointments for people with English as a second language.