http://www.theguardian.com/healthcare-network/2014/jun/30/jeremy-hunt-stop-gp-bashing
Decent article on where the government go wrong in healthcare. They set unrealistic and wrong targets and then we get the blame for not carrying them out. If anyone can post out the full thing as im on my phone thanks.
Jeremy C*nt should stop GP-bashing, or hospital referrals will skyrocket
Rather than naming and shaming family doctors, politicians should invest in training, staff and practice buildingsKailash Chand
Guardian Professional, Monday 30 June 2014 11.19 BST
'Hunt wants to expose GPs who don't send patients for life-saving scans … No one misses cancer on purpose.'
I have more than 30 years' experience of being a GP and it saddens me to hear the continual denigrating of general practice by media and politicians. Jeremy C*nt, the health secretary, wants to expose GPs who cost lives by not sending patients for potentially life-saving scans quickly enough.
Missed and late diagnoses of cancer are tragic. But how does Hunt define an "unacceptable" delay in diagnosis? No one misses cancer on purpose, and we have all done it when we have only 10 minutes for a consultation. In many cases, the diagnosis is unclear at first. If some doctors consistently diagnose earlier than others then there is a case to be made, but in my experience, that is not usually so.
I can think of occasions when I have been very lucky and have detected a cancer ridiculously early, but it has always been pure luck. The health secretary has already revealed his underlying prejudices with the words he uses and the issues he is focusing on. GPs will, once again, see a bunch of academics looking for errors and poor performance, yet another factor that will demotivate GPs. I wonder if Hunt has a story lined up for every day from now until the general election next year.
Rather than political gimmicks, what we need is more GPs, more practice staff, including nurses, and a programme of investment in GP practice buildings to bring them up to scratch. Primary care receives only 8% of the total NHS budget yet it carries out 90% of patient consultations.
There is no doubt that we have variation in standards of primary care which needs addressing. However, by and large, the primary care model in the UK is undoubtedly one of the best.
Let's take a tour of general practice in Europe and beyond, where GPs spend longer with patients, such as the 20-minute consultations that are common in Holland. Or where whole chunks of clinical care aren't even done by GPs, such as in Spain, where all smears are done by gynaecologists, Hungary and the Czech Republic, where all children are seen by pediatricians, and indeed in most of Europe, where patients see specialists freely, without any reference to their GP.
Or Sweden where out-of-hours services start at 5pm, and where, between midnight and morning, there is no primary care, and patients instead attend A&E or call an ambulance. And in the whole of Europe, no nation operates targets or makes systematic data entry, nor measurement of practice performance of chronic diseases.
And forget revalidation; even continuing medical education is voluntary in Spain, Portugal, Luxembourg and France. Let's go further afield to Canada, where there are no registered lists. Only 30% of practices are computerised, and, again, no measurement of practice-specific immunisation or cytology is undertaken.
So let's return to British shores, where every single patient wanting to see a specialist must see their GP first, and where we, who are not specialists, manage 90% of patient care, as well as the continuing transfer of work from hospitals.
Where we comprehensively provide the entire spectrum of clinical care without exception, from baby checks to the elderly, managing chronic diseases such as diabetes, coronary heart disease, heart failure, epilepsy, even renal disease, which would be completely alien to the reality of GPs in other countries.
Where this information is systematically recorded with registers and exemplary standards of care, via the quality and outcome framework, that has no international parallel.
Where we have superlative trust and satisfaction ratings that tower over our hospital colleagues, and where patients see us as advocates, helping them through thick and thin, from stress at work to coping with grief, and where patients even resort to phoning us from A&E or a hospital bed, pleading with us to sort out their plight.
And when the system fails anywhere, from an ambulance not turning up, to a hospital appointment cancelled, or a disability benefit that's been refused, it's us to whom they turn to pick up the pieces. And it's the GPs' door where the buck stops. And we're paid just £70 per patient to do all this, a fixed amount for an unlimited number of consultations or visits per year, where in spite of this we prescribe more cost effectively.
Moreover, we do this with fewer GPs per head than most of Europe. I challenge any government to find a model anywhere in the world that can match the range, remit and responsibly that we take on and provide as British GPs. Now we are taking additional hospital services, such as minor operations and diagnostic services in the primary care setting.
And considering our pay after the new GP contract, one could argue that one gets what one pays for, but no, the taxpayer is getting far more from us for their money even now. Our system of general practice offers an amazingly cost-effective service with a quality of care that is second to none.
The NHS bashing, which is now an almost daily feature from politicians needs stopping. Hunt, instead of naming and shaming GPs, please invest in training, education and funding in primary care. If you continue with your mission of denigrating GPs by naming and shaming, the consequence will be that hospital referrals will skyrocket.
Fearmongering will fuel inappropriate referrals and plays beautifully into the hands of private providers who make much of their profit through unnecessary investigations and over treatment, which I suspect is already costing the NHS billions. I take some comfort from learning that the Academy Of Medical Royal Colleges is taking this issue very seriously and will be reporting on it towards the end of the year. Initiatives to undermine the NHS in general and general practice in particular would be a disaster.
http://www.theguardian.com/healthcare-network/2014/jun/30/jeremy-hunt-stop-gp-bashing