Dr John Crippen
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Here's an idea. Let's make up tablets entirely from chalk, and sell them as homeopathic remedies. In fact, advertise them as "even more homeopathic" than normal homeopathic remedies -- after all, the logical next step after massive dilution of the active ingredients is not to put in any active ingredients in the first place.
Given the strength of the placebo effect, they'd probably still even work on some people.
(I often get the feeling that most alternative practitioners think "double blind" means unable to see with both eyes.)
I know a couple of vets, one retired and one a schoolfriend of my younger brother, now in his late 30s. I had seen a claim in some weekend newspaper about 85% of animals treated homeopathically benefitting from the treatment. Both vets pointed out that many conditions in animals are self limiting and the animal's immune system copes with them. The retired vet remarked drolly that he generally found that around 85% of his patients recovered, despite his treatment.
The NHS does indeed have many problems due to mismanagment, however GP's need to accept their share of the blame too.
NHS 24 and NHS direct exist to help reduce the load on primary care and A&E. Whilst out of hours services aren't great now I often hear doctors refer back to a mythical golden age where doctors ran the show and everything was perfect.I'm 20 so maybe this was before my time as I do not recall it.
Many cases of meningitis have been missed by experienced doctors. Where do you draw the line with patients who present with flu like symptoms.
Paul,
Perfectly fair point. Doctors, including experienced and caring doctors DO miss cases of meningitis. It is fearfully difficult to diagnose. But that is NOT a justification for the organ grinder handing over his work to the monkey.
John
John,
There are shortage of GP's willing to do out of hours work. People require health advice 24 hours a day.
I accept that in an ideal world GP's would provide more care, but demand is greater than supply. What is the soloution?
Before you attack the changes in GP contracts also bare in mind the growing need for primary care doctors. I'm a med student and many of my colleagues are now seriously considering general practice as a result of the change in work conditions.
Hi Paul
The new contract has brough huge financial benefits to GPs and a vast reduction in the amount of work we have to do.
The Government is not going to continue to pay GPs £180,000 a year or more to work a four day week, with no out of hours, no evenings, no weekends and 8 weeks holiday a year. That is was some GPs are up to, believe me.
The professionalism and the professional committment is going. GPs are increasingly becoming piece-rate workers, and, as I say in the article, many are cherry picking what they will and will not do.
The OOH service in this country at the moment is a disgrace. The government will not or cannot pay doctors to do it, and so it is dumbed down to nurses. At the same time demand is fueled and many people think it is their RIGHT to call a doctor at any time of the day or night for any condtion however trivial. The government can only provide a response to demand like that by using nurses and EMTs.
Over the next ten years I predict that most of the services now provided by doctors will be provided by cheaper resourses such as nurses and ambulance drivers. There will be fewer and fewer jobs for real GPs. The ones who are left will probably be managers of large 24 hour a day walk in primary health care centres staffed by poorly paid and poorly trained HCPs.
The great and the good will, however, continue to see doctors, just as they send their children to private schools. You won't catch Tony Blair's children being treated by an HCP or being educated by a Teaching Assistant in a comprehensive school
John
Sounds like a nice vacation-
FYI this article in the NEJM today about pay for perfromance in the UK -was your practice one of the ones studied?
http://content.nejm.org/cgi/cont...4/375?
query=TOC
Thanks for the response John. I agree the extent of the dumbing down in NHS is going to far. Although I think there is a place for allied HCPs extending their roles however not to extent that is happening.
It often makes me questions why I'm becoming a doctor. I will have spent 5/6 years at medical school, get in to a lot of debt and have to pay tuition fees and undertake years of post graduate training all to do a job a "nurse" does.
I should have been a nurse, would not have required A levels, get paid whilst studying so much less debt and no tuition fees. Then do a few courses and become a "specialist" and do the same job.
Obivously most of the basic science I have learned is irrelevant.
At work just now (summer job as an auxiliary nurse in a 20-ward DGH) and it seems that, overnight, we have two doctors on duty.
Replacing proper medical cover, we have the "health emergency care" team with an SHO and two nurses, both of whom look great in their scrubs with stethoscopes round their necks.
One SHO is covering A+E, and the other one is doing all the wards along with the nurses.
GP relative hates giving childhood immunisations - not because of any ethical/pay reason, but because the child gets the whole 'betrayl of trust' thing going on. You see them the next time they go to their GP in sort of 'You! You were the one who said nice things and then stuck a bloody needle in me!' etc. This doesn't happen if someone else gives them their jabs 
Nowadays It seems that scientists may invent any pills if they are given an absolute freedom in their actions!
The Government is not going to continue to pay GPs £180,000 a year or more to work a four day week, with no out of hours, no evenings, no weekends and 8 weeks holiday a year.
Quite.
Paul I should have been a nurse, would not have required A levels, get paid whilst studying so much less debt and no tuition fees.
1. nurses don't need A Levels? 2. A Levels are no big deal these days, sorry you found them irksome 3. you'd have been happy with a nurse's salary and social status as opposed to £180,000 a year and "professional middle class status"? (If you would, good for you!)
Glad you had a good break Doc
Anglesea eh? Good to see people supporting British tourism, which is more than our freeloading leaders ever do.
As you have demonstrated over and over again, dumbing down in the NHS is athreat to all of us. So I suspect is this idea that ill-health is largely our own fault.
And on that, what do you make of Tony's claim that by 2010, 20% of NHS spending will go on treating diabetes? Yes, I know he wants to shift the blame for his NHS fiasco onto us- or at least fatties. But is that figure any way credible?
" trying to get children to have pre-school boosters is hard and unrewarding work. Doctors used to do it because they were doctors. Because they were professionals ... doctors are cherry-picking the task list and only doing the tasks that pay well."
So does that mean doctors have become less professional? Why do doctors not slog round doing boosters now? Because they get paid more and get more holidays?
I saw your post about the Choose & Book system and hence this comment to your Blog. We (www.nhswatch.info) have been asked by some of our readers to track whether it is working or not?
Clearly in your instance it did not, but as you say, the DOH are 'looking' into this.
I have received a number of direct email comments to our web site from 'front-end users' the GP's, 'Patients' the customers! and 'back-end users' Trust/hospital staff that it is not doing a very good job.
I did a search on your Blog but only found one comment on the subject. Do you have any other comments/opinions on Choose and Book that you could share?
By the way, great blog. Keep on posting.
It may be doing a very good of giving patients appointments but whether they are actually seeing the appropriate consultant is another matter. What is the point of having specialised clinics and doctors trained in sub-specialties when patients are being sent off to other hospitals where no such facility exists even if they have cheap car parks and you can get an appointment next week.
Whilst on the subject would anyone like to own up to how much the GPs are being paid for using this system. If the private sector offered incentives to GPs for referrals I think we might hear an outcry but this apparent conflict of interests seems to be OK
to anonymous if you don't mind:
"Whilst on the subject would anyone like to own up to how much the GPs are being paid for using this system. If the private sector offered incentives to GPs for referrals I think we might hear an outcry but this apparent conflict of interests seems to be OK"
+++++++
Yes, I will. Our practice stands to get £13000 give or take for agreeing to use choose and book.
We are not legally allowed to accept brib...., sorry, incentive payments from the private sector to make referrals
John
And on that, what do you make of Tony's claim that by 2010, 20% of NHS spending will go on treating diabetes? Yes, I know he wants to shift the blame for his NHS fiasco onto us- or at least fatties. But is that figure any way credible?
Wat Tyler
Wat, I don't know the answer to that. I DO know that Bliar's agenda is nothing to do with the costs of health care in 2010 because he will have gone by then.
DM2 is on the increase for several reasons:
1. Doctors are more vigilant in seeking it out.
2. Big Pharma has bribed doctors to move the goal posts yet again and reduce the levels of so called normal limits so that they can get the population of the world on medication.
3. People are getting fatter and so the disease is getting commoner.
The best thing the government could do would be to close down all the fast food outlets and the soft drink manufactures and so stop inserting poisonous crap into children.
Trouble is though those wretched free markters do not believe in controls like that!!
John
i wouldnt ban unhealthy food i would just tax it a bit more
and at the same time make it compulsory for every govt minister to spend a few hours having a meal with a random member of the public every month
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