Agree - there are huge numbers of clipboard holders who do no clinical work but instead use a whip to rush the clinicians around. I've had patients who have not been declared fit for discharge by a doctor being discharged by managers, only to be readmitted because of a deterioration. It drives me nuts.

As stated above, the aim of the move to GP-led care is so you have doctors in charge, rather than managers and clipboard holders. The idea is that your local group of GPs will know lots about the local population and the clinical care/facilities that need to be in place. If you have an area with lots of elderly people with heart failure, then you can set up special heart failure clinics, rather than waste money on antenatal care/midwives that's not required. If you cut out the middlemen (and there's tiers of them), then in theory you save money.

Because they count as two separate admissions. Even though it could leave the hospital liable to a case for negligence.

It's been changed to "failed admission" if it's within 24 hours.

Sometimes it's a pain having to justify why you're keeping patients in hospital to non-clinicians.

It should be 7 days. Clinicians should be the final arbiter because it will be their insurance that takes the hit if they are sued.

It does not have to be at the same location. So if family circumstances force a move somewhere else then it can be transferred. Under my scheme you would not have that debt at all.

What if it's for a different problem, unrelated to the first? 48hrs is fine and if the patient is readmitted for the same problem they should go back to the same consultant. If it's a different problem, then to the appropriate specialty.

Also, it's the hospital trust that gets sued, not the clinician. Clinician only gets sued if they did something which is negligent.



When I was talking about job security, it was more about the UK in general. If all vacancies are filled, what do you do with the doctors who have no jobs? At the moment, I'm in a training post so as long as I jump through the hoops and don't do anything stupid, I've got another 18 months of employment. After that, I have to look for suitable posts for my specialty. If there are none, I have to keep looking until I find one, meanwhile trying to do say some locum work. That's the insecurity bit.

NuLabour decided to create more doctors. This was partly because there weren't enough and partly because the doctors who had comes from overseas in 60s and 70s are due to retire. The problem is then that you have too many doctors and not enough jobs. This is partly an effort to create cheaper labour. What do you do with the surplus doctors? Either they sit around, or they retrain into other specialties, or they leave/go into other professions. Either way, you'll have wasted a lot of money and time training doctors.

Maybe so but I do think that the public will still support free education for doctors if it mean that there was surplus of doctors. Having doctors take the risk does not mean that it has gone away. It just means that doctors have loads of debt and no work.

I do understand the insecurity aspect. That does need to be addressed otherwise doctors end up on agencies costing much more.