We are watching the demise of the NHS with our eyes wide open.

Having worked for the NHS with a gap of 30 years in between employment with it, I can say that once they began to run it as a business and employed chief executives with ridiculous salaries , plus their assistants and assistants assistants and making the admin side top heavy, that the troubles began.
I dread to think of the amount of money that has been spent and possibly wasted each time that EOs leave their jobs, for a variety of reasons and they leave with the "golden handshake" of a years plus salary that could have been spent on patient care.
About GPs. In my area several GP surgeries have closed often through the retirement of GPs and other nearby surgeries have taken on the patient list, therefore stretching the resources of that new surgery.
All very well for the government to throw money at the NHS, but they reduced the number of places at medical schools, so the hospitals are short of doctors and a GP must work as a hospital doctor for a number of years before training as a GP - so if there are not enough hospital doctors in the first place, where are the new GPs coming from to replace those that have retired ?
Yet another lack of planning along with the skills of HGV drivers and abattoir workers, skilled agricultural workers that are expected to appear fully qualified from somewhere!

I missed a zero! My bad.

BUT surely, the doctors are working for a large part of that time (the 9 years) so surely, although there is a cost ratio, there is also a profit ratio?

On average it costs £220,000 to train a doctor over their five-year degree.
Most of the training is paid for by the government but some tuition fees - plus rent and living costs - are paid for by the student.

The article is from 2016. 5 years ago. No doubt it will cost more today but how does 9 grand a year cover it?

Please explain because I'm totally bewildered

Kali2

''To train a doctor in the UK costs approximately £220, 000.''

where on earth do you get that ridiculously low figure??? It takes a minimum of 9 years to train a GP!

How is it a ridiculously low figure?

And if it's so low how on earth does 9 grand a year help?

Read the link.

Really? Students pay £9,000 a year in tuition fees. Looks to me as if it's covered. Unless I've missed something? Totally possible!

You've missed a very big something! Read the link. It's from the BBC. Quite safe. How can 9 grand a year add up to the 220 thousand it costs?

''To train a doctor in the UK costs approximately £220, 000.''

where on earth do you get that ridiculously low figure??? It takes a minimum of 9 years to train a GP!

I think the NHS lost its way a few years back.
It can’t decide whether it’s running a business or providing a service.

Zoejory

MaizieD

TRAIN more staff. OK, offer free training and then tie them in for a minimum number of full-time working years if you want your moneys worth.

This is another facet of Ug's strange reasoning. I don't know if she's noticed, but the country doesn't actually pay for GP's training any more. They pay their own tuition fees. Which by the working of the Free Market makes them entitled to do what they like with their qualification when they've finally obtained it.

MaizieD

Do you honestly believe that GPs pay for their training with tuition fees?

Yep, they will pay some. A small amount.

Most of the training is paid for by the government

To train a doctor in the UK costs approximately £220, 000. Tuition fees hardly covers it.

www.bbc.co.uk/news/newsbeat-37550759

Really? Students pay £9,000 a year in tuition fees. Looks to me as if it's covered. Unless I've missed something? Totally possible!

Urmstongran

I totally agree with your comments regarding your own family maddyone. You are rightly proud of what they do. And of course they work hard - over and above I expect. And are entitled to their lifestyle choices.

But sadly, not all GPs are as dedicated it seems. Once AfC was brought in by Blair and HUGE amounts of money was given out, then lifestyle choices by GPs took off good style.

Fair enough if the taxpayers felt they were getting a good service, but these days this often isn’t the case.

People aren't getting a good service because there aren't enough GPs. There's very little wrong with the ones we have.

Shropshirelass

A lot of pressure is put on the NHS by peoples lifestyle choices. A lot of illnesses are fuelled by unhealthy eating, obesity is rising and it proves this. This must be tackled at the roots and until people start looking after themselves properly then the NHS will struggle, just pumping in more money is not the answer. Incorrect dietary guidelines given by the Governments over the last forty years must be addressed. Smoking and high alcohol consumption are also a drain on resources. NHS should be for genuine illnesses and accidents, not self inflicted illnesses.

Statistics show that about 75% of over 60s are overweight or obese, so if GN posters are typical you've just told them they can't have NHS treatment.

Great! I've never been overweight or obese, don't drink or smoke and exercise as much as I can, but I can't get the treatment I need. Maybe I'll be able to, if all the people with self-inflicted illnesses are banned from seeing their GP!

libra10

It seems to me that extra funding for the NHS has been available, but I wonder how wisely it's spent!

Seeing headlines such as, 'The NHS is hiring 42 new chief executives who will be paid up to £270,000 each' makes me wonder what is going on!

Link metro.co.uk/2021/09/09/nhs-hiring-army-of-new-270000-bosses-wholl-check-how-36bn-is-being-spent-15230016/

I could be wrong, but won't they replace the current heads of CCGs rather than be new appointments? I suspect that for many it will be a sideways move.

You must really miss your family maddyone. Another casualty of our inadequate system. And NZ’s gain. They do of course have a much smaller population there. I think it is similar to Scotland - at around 5mil people. I wonder what their ratio of doctors to patients is and how they are funded & renumerated?

I wish we could have a proper rethink of the NHS. A cross-party consensus. Instead of it being a political football (or hot potato!). I also wish that said cross-party would look in depth at ‘best practice’ in other countries and emulate those.

This of course would be years in the delivery. But at least it would be an agreement by ALL political parties and binding instead of tinkering around the edges, throwing money around without due regard until the next government came in to do the hokey-cokey.

Until then ...

Many GPs have retired over the last couple of years because their pension pots were so generous, the tax on their salaries became too high to make it worthwhile to work.

At the same time, a large proportion of newer GPs found that they could live quite well on a couple of days work per week.

It’s broken. It needs fixing.
But who to tackle it?

MaizieD

^TRAIN more staff. OK, offer free training and then tie them in for a minimum number of full-time working years if you want your moneys worth.^

This is another facet of Ug's strange reasoning. I don't know if she's noticed, but the country doesn't actually pay for GP's training any more. They pay their own tuition fees. Which by the working of the Free Market makes them entitled to do what they like with their qualification when they've finally obtained it.

MaizieD

Do you honestly believe that GPs pay for their training with tuition fees?

Yep, they will pay some. A small amount.

Most of the training is paid for by the government

To train a doctor in the UK costs approximately £220, 000. Tuition fees hardly covers it.

www.bbc.co.uk/news/newsbeat-37550759

TRAIN more staff. OK, offer free training and then tie them in for a minimum number of full-time working years if you want your moneys worth.

This is another facet of Ug's strange reasoning. I don't know if she's noticed, but the country doesn't actually pay for GP's training any more. They pay their own tuition fees. Which by the working of the Free Market makes them entitled to do what they like with their qualification when they've finally obtained it.

It seems to me that extra funding for the NHS has been available, but I wonder how wisely it's spent!

Seeing headlines such as, 'The NHS is hiring 42 new chief executives who will be paid up to £270,000 each' makes me wonder what is going on!

Link metro.co.uk/2021/09/09/nhs-hiring-army-of-new-270000-bosses-wholl-check-how-36bn-is-being-spent-15230016/

GagaJo

All great, if you have private health insurance. But most of us can't afford it.

I'm with a great doc at the moment. But I no longer live in his catchment. I dread what is going to happen when he eventually finds out. The GP in my local area is awful. Run into the ground. It terrifies me.

Not even that. As far as I understand, for most serious issues, even if you go through your private provider you'll end up being treated "in the NHS". Unless the private hospitals simultaneously beef up their game then this will also hit the very people trying to force it through.

I have a friend (no really, I do this is not “my niece’s, cousin’s penfriend said…”) who works abroad and, every three years his organisation sends him for a comprehensive, but fairly straightforward, set of tests under his private insurance. He was stuck in the UK due to COVID and tried to get them done by BUPA or Nuffield. BUPA simply said that this wasn’t part of their standard offer and Nuffield didn’t even reply to him.

Unfortunately the pressures in the NHS have seen my family off Urmston. They left to work for two years in New Zealand in May. So we’re two GPs shorter now. Many are choosing to emigrate. It’s really sad for everyone concerned. I hope they will return and I hope they have a fantastic adventure in New Zealand. We are lucky in that that with today’s technology we can stay in touch very closely and still know what they’re up to, but it doesn’t make up for a real life cuddle I’m afraid.

maddyone

Urmstongran are you actually suggesting that GPs should see patients all week and then on Saturdays and through the evening? When do they see their families then? Aren’t GPs allowed time off?
We have a very good out of hours service in the UK. It’s not perfect, but it works.

Exactly Maddyone.

This echoes people who think teachers should work longer days plus offer Saturday school. When a full-time teacher ALREADY works a 60 + hour week.

TRAIN more staff. OK, offer free training and then tie them in for a minimum number of full-time working years if you want your moneys worth.

This is systemic running down of a service the country wants. Just because it goes against their party's belief system. Which as we can see at the moment, doesn't work in any way.

Not to mention of course that GPs have a hellishly high suicide rate. Do you want them worked to death?

Urmstongran

The fact remains most GPs work part time. Huge capacity that we paid to train not being used.

How are they not being used? I BET (no evidence, I don't know any GPs) their part-time hours rival full-time hours of many other workers.

I work part-time as a teacher. The state funded my teacher training. I'm still an active teacher. And yes, even part-time I work more than 40 hours a week.

I totally agree with your comments regarding your own family maddyone. You are rightly proud of what they do. And of course they work hard - over and above I expect. And are entitled to their lifestyle choices.

But sadly, not all GPs are as dedicated it seems. Once AfC was brought in by Blair and HUGE amounts of money was given out, then lifestyle choices by GPs took off good style.

Fair enough if the taxpayers felt they were getting a good service, but these days this often isn’t the case.

Covid was not a good excuse for Drs urg, but an excellent excuse for this incompetent government to lay the blame on everything (butBrexit0 and everyone. Anyone, especially our age when we need health care more than ever are mad to vote Tory.

I agree maddyone that it’s a mess. Throwing money at a bad system (not the doctors themselves!) just doesn’t make sense. Changing direction will be a mammoth undertaking. A consultant paediatrician I know said the NHS is like a juggernaut and getting it to do a 3-point turn would be impossible.

I wonder how many taxpayers actually know how GPs are being funded - as in the business set ups/partnerships/locum sessions etc? They now have practice managers for a reason!

And what is wrong with F2F consultations by doctors? The numbers of appointments carried out this way has fallen dramatically. Yet their practice nurses still have their sessions for diabetes clinics, blood tests etc.

As did front line supermarket workers, teachers etc.

A lot of pressure is put on the NHS by peoples lifestyle choices. A lot of illnesses are fuelled by unhealthy eating, obesity is rising and it proves this. This must be tackled at the roots and until people start looking after themselves properly then the NHS will struggle, just pumping in more money is not the answer. Incorrect dietary guidelines given by the Governments over the last forty years must be addressed. Smoking and high alcohol consumption are also a drain on resources. NHS should be for genuine illnesses and accidents, not self inflicted illnesses.

With regard to her husband, he worked eight sessions a week at his GP Practice, and then many hours in the Covid Hub all through Covid. He worked around 60 hours a week. Why is this not enough?