The Tories are in sight of their goal aren’t they?

Joseanne

So you haven't answered my questions, just got personal?

Just getting personal is more polite than I would be if I replied to you

Ha ha? Which bit about my discussing the pastoral role of GPs is troubling you?

That wasn't my issue Joesanne more your comments about choosing to pay for your private health care; your choice of course.

The NHS is an overweight behemoth, that is too big to be run efficiently by anyone, state or private. It needs to be broken up into independent regional companies, much as the public utilities were before privatisation.

I was the regional market research manager for a British Gas region, and apart from taking part in occasional national research projects, I was free to make all the decisions about how the market research dept was run and what work we did, in consultation with the managers who would be using it. The variation in how market research was conducted varied hugely from region to region, according to each regions needs and agreement about what they wanted.

If the NHS was broken up, leaving each region to decide what ervices they needed and how to provide them, with very light touch oversight from a small national HQ, I think we would have a much better more efficient NHS.

As it is broken and inefficient, World rankings of health systems, the Uk is rated at 10th at best worldpopulationreview.com/country-rankings/best-healthcare-in-the-world and some years and some rankings do not put us even that high up.

We are sinking in the ratings and will continue to do so unless something major is done to our system.

Outsourcing the provision of health services does not mean the privatisation of the service, nor does it inexorably lead to paying indivdiduals paying for health care. Lots of the countries in the top 10 health systems provide medical care that is effectively free to the patient, but is paid for in all kinds of ways.

As long as health care is free to the patient on need, I really do not care that much whether the system is entirely state paid for or paid, as in France, which has one of the best health systems in the world, by a mix of free and insurance paid by those who can afford it.

What I want from a health sytem is one that works safely and efficiently to serve its patients and give them the best possible outcomes and is freely available to all that need it.

The current system fails entirely to do any of the above.

Outsourcing to private companies means that somebody is making a profit and money is not being spent on frontline services.

Don't forget that France pays considerably more for healthcare than the UK.

I do not agree that the current system entirely fails to provide safe and efficient care. I've just been the recipient of care which cost the NHS thousands of pounds. I do realise that there are huge problems, but I do not accept that the system is "per se" broken.

Everyone coming into this country gets free health care, without paying a penny in.

No, they don't.

Seasonal Marsh family video on the strikes.
www.youtube.com/watch?v=pOHEF5CjS1E

Can I also just say, GP phone appointments are inadequate. I had to have one for a personal problem and they rang me whilst I was at work and I imagine this is happening to a lot of people. How can you discuss things ad hoc over the phone. I feel it's unfair

I agree JaneJudge. Some problems just can’t be discussed over the phone! I don’t really understand why it’s still so difficult to get a GP appointment. Obviously, during the pandemic, they didn’t want queues of people in waiting rooms and telephone appointments were an appropriate substitute, but why is this still the case? Any ideas anyone???

^ It needs to be broken up into independent regional companies, much as the public utilities were before privatisation.^

The NHS was 'broken up' into Regional Health Authorities, or rather, all the historically developed hospital boards were amalgamated in RHAs, in the 1970s. It was then subject to re-organisation after re-organisation by successive governments until it has reached its present 'business focussed' state, but basically a very fragmented organisation. Which, quite frankly, I suspect that many of us find difficult to make head or tail of...

The full history of the NHS since the 1940s can be found here:

www.nuffieldtrust.org.uk/health-and-social-care-explained/nhs-reform-timeline

I'd say, read it and weep...

We were warned that this would happen if the Tories won the last election, but not enough people listened. This is on everyone, including Labour MPs and staffers who worked against a Labour win.

“I'd say, read it and weep..”

And we wonder why it’s difficult to recruit and retain staff, when the whole system is failing year after year, none of the reforms have been a success.

Katie59

“I'd say, read it and weep..”

And we wonder why it’s difficult to recruit and retain staff, when the whole system is failing year after year, none of the reforms have been a success.

The 'system' has been deliberately underfunded in real terms ever since the tories came to power in 2010. Labour left it in a reasonable condition.

The Lansley reforms (2012) weren't meant to be a success. They were about breaking the NHS into saleable units...

You are right about that MaizieD

JaneJudge

Can I also just say, GP phone appointments are inadequate. I had to have one for a personal problem and they rang me whilst I was at work and I imagine this is happening to a lot of people. How can you discuss things ad hoc over the phone. I feel it's unfair

I much prefer phone consultations and would choose one every time if I could, but I agree that it’s not always possible. As Jane says, it’s far too difficult to have a phone consultation if a person is at work, and also some people don’t like them, or are not able to book them online (my 94 year old mother for example, wouldn’t have been able to book online for a phone appointment, before she died last August.)

…I don’t really understand why it’s still so difficult to get a GP appointment….

I’ve said this on a multitude of threads before but I’ll say it again because maybe not everyone has seen it. It’s difficult to get a GP appointment because we don’t have enough GPs for the size of the population. There are a multitude of reasons why this is the case, but it is the case, and it’s not really difficult to understand. It’s really that simple, we don’t have enough GPs for the number of people who live in the country.

Maddyone it takes 10 years to train a gp. I think in the mean time, consider health tourism. My son was accurately and quickly diagnosed in Greece at 50 euros a visit after a very frustrating time with the Nhs here.

maddyone meltdown in 3..2..1..

Well maddyone isn't the meltdown kind, but you know what I mean.

To add to maddy’s post, we need t0 accept the awful pressure GP’s work under. They have huge patient lists and expectations are increasing steadily.

GP’s like every other public servant, have been treated with contempt by our government for 11 years now. Clapping for carers quickly turned to blaming them for the difficulties in the nhs.
Who could have imagined signs in every gp surgery warning staff won’t tolerate aggressive or violent abusive behaviour
I’m struggling not to go into monty python mode - we are all doomed

Welcome to 2023.

ronib

Maddyone it takes 10 years to train a gp. I think in the mean time, consider health tourism. My son was accurately and quickly diagnosed in Greece at 50 euros a visit after a very frustrating time with the Nhs here.

Actually ronib it took my daughter twelve years to become a fully trained GP:

1) Six years at university, three years mainly theoretical and three years clinical (she did the intercalated course at UCL meaning she got two degrees, so it takes a bit longer)
2) Two years as an F1 and F2 (foundation years working on different rotations in a hospital)
3) One year spent working in a psychiatric hospital
4) Three years as a GP Registrar

Then she was a fully trained GP and she has now been working for ten years as a GP.

Sadly, as I said before, there are too few GPs and that is why it is difficult to get a GP appointment.

Thank you for mentioning some of the other pertinent points Iam64. As I mentioned previously, there are a multitude of reasons why there are too few GPs, and you’ve elaborated on some of them.

You’re right volver I won’t go into meltdown, but I do at times feel wearied by having to repeat the same information over and over. But there it is, as my son would say, it is what it is.

I should have explained that a GP Registrar is a fully trained doctor who is training to become a GP.

Iam64, I have noticed they even have the abuse posters up in the opticians!

Of all the trainee doctors in my grandson’s year, not one wants to be a GP. Not enough pay, too much responsibility, not enough support. When he has finished it will be 8 years study and he has a couple of years to go. It costs a fortune to get his degree and many,many hours hard work. This is in Australia, not the UK. A world wide problem.

Maddyone it’s so heartening to hear about your daughter staying the course and qualifying with a depth of training and experience. Sadly I know of another gp who decided to stop work to look after her young family. Given the huge cost to the taxpayer of gp training, I wonder if this situation can be improved?

Also I am always thankful to any medic and I always say thank you for your help! However, I am very aware of problems that others have faced when trying to access treatments sometimes with near catastrophic consequences.

We are paying considerable salaries to top tier Nhs managers and I think it’s upto this group to put forward workable solutions.

ronib, your young friend who has stopped work to look after her family is female of course. We need more family friendly workplaces and subsidised high quality child care to keep parents, especially mothers, in the workplace.
My female GP has a two year old. She reduced to 3 days a week but it’s 12 hours and more. I don’t criticise her for working ‘part time’ ie full time hours over 3 days, for 3 days pay and associated pension reductions.