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'Only one in four' backs GP reforms
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Amnesia10
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Joined: Fri Apr 24, 2009 2:02 am Posts: 29240 Location: Guantanamo Bay (thanks bobbdobbs)
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http://www.google.com/hostednews/ukpres ... 400462185A |  |  |  | Quote: Only one in four people support GPs using private companies to provide NHS services, one of the key planks of the Government's health reforms, according to a new poll. A survey of almost 2,000 adults for public sector union Unison showed that half were opposed to the move, including 56% of Liberal Democrat voters. The results have been published on the eve of the second reading of the Health and Social Care Bill, which will attract fresh criticism from unions. Unison said the YouGov poll showed that only 46% of Conservative voters supported private firms providing NHS services, with 22% registering a "don't know" response, and half of those surveyed were against GPs employing private management groups as part of the move to hand over £80 billion of the NHS budget to GPs. Unison general secretary Dave Prentis said: "This Bill is heading for trouble. The YouGov poll shows a clear split between Lib Dem and Tory supporters. There is very weak support from Tory voters and clear opposition from Lib Dems. "The fact is there is very little support for this Bill from anywhere. Many GPs are opposed to it, as are patients, NHS staff, clinicians, charities, think tanks, MPs and unions. The Government's vanity project is undemocratic, unaffordable and unnecessary. "The NHS is already under severe financial pressure because of Government demands to make £20 billion in so-called efficiency savings. This titanic reorganisation threatens to sink the NHS. The Government should step back from the brink and pronounce this Bill DOA - dead on arrival." Health workers are to stage a demonstration outside Parliament, carrying estate agent signs bearing the message 'NHS, Not for Sale'. Meanwhile, Unite, the country's biggest union, said it will provide "new and forensic analysis" of the legislation for MPs, amid claims that the Government is "rushing through" the 280-clause Bill. The union said it understood that the Bill could begin its Standing Committee stages as early as Thursday, leaving little time for MPs to get to grips with the "enormity" of the proposals. |  |  |  |  |
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Sun Jan 30, 2011 4:44 pm |
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cloaked_wolf
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Joined: Thu Apr 23, 2009 8:46 pm Posts: 10022
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The figure is a lot lower in the medical profession and even lower amongst GPs.
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Sun Jan 30, 2011 5:25 pm |
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Amnesia10
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Joined: Fri Apr 24, 2009 2:02 am Posts: 29240 Location: Guantanamo Bay (thanks bobbdobbs)
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I can imagine GP's getting very rich out of this, so no wonder they are in favour, though the impacts will be at hospitals and A&E will become very expensive, without many of the routine overheads being covered by a bigger organisation.
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Sun Jan 30, 2011 6:43 pm |
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paulzolo
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My concern is that the NHS is being opened up to market forces. This is a problem, as with any company the goal of providing health care will be lower on the list of priorities than the share holders for those private companies. The best deal will not necessarily be the cheapest tender, but you know that the cheapest option will be the one chosen. The Tories are going to screw up the NHS as well. 
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Mon Jan 31, 2011 11:35 am |
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Amnesia10
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Joined: Fri Apr 24, 2009 2:02 am Posts: 29240 Location: Guantanamo Bay (thanks bobbdobbs)
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I suspect that the prospects for fraud by GP's will be immense. They will be tempted to bring as much into the practice as possible. Only contracting things that are too costly to set up, like pathology labs and testing facilities. Minor surgery will be done within the practice. The end results is that many hospitals will close because these basic functions will have been take away. It does not look like it was thought through well. It will mean that private hospitals will benefit from access, though if anything goes wrong the NHS hospital will be ill prepared to cope.
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Mon Jan 31, 2011 2:32 pm |
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cloaked_wolf
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Amnesia, the GPs aren't gonna get rich out of this. In fact, the entire thing is set up to discredit GPs and the NHS. The entire thing is a prelude to privatisation. If GPs were gonna get rich, why the hell do most GPs not want to be part of the reforms?
At the moment, PCTs control the money. They don't care about patients, medical staff, or (it seems) the running kf the NHS. At the moment, things like treatment for varicose veins and herniae are considered cosmetic and hence not funded by the NHS. Basically, they keep moving thr goalposts. The end result is that patients suffer. In the olden days, GPs did have some control and the result was that they had better contacts with secondary care, health care was better. Then PCTs were brought in and things have suffered to the way it is now because of it.
The future as I see it is that you'll have medical consultant overseeing a group of nurses who will be looking after patients. After all, privatisation is about making money and doctors are frikkin expensive to train and employ. When you can employ cheaper staff, you can make more money.
Right now, I thinking whether I should switch tracks and retrain in a different profession. A lot of medics are moving abroad.
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Mon Jan 31, 2011 2:52 pm |
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Amnesia10
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Joined: Fri Apr 24, 2009 2:02 am Posts: 29240 Location: Guantanamo Bay (thanks bobbdobbs)
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I would suspect that you have more info on the changes than I do. Though my understanding is that GP's will get say £1000 per patient per year. 2000 patients will mean that they get £2000 000 into the practice account. Now many people will barely see their doctor in years so will mean no outlay. If they can deal with many conditions in-house they could keep the money instead of paying it out. Hospitals could lose many low cost treatments and without their contribution to hospital costs they will mean that other operations will cost more.
I have no bias towards any system. I would like to see an end to league tables and allow every hospital to solve their local problems be it MRSA or something else.
I am all in favour of efficiency and giving doctors the power to do much more, but the whole league tables meant that they had to appoint tens of thousands of unproductive administrators. It tied the doctors up with excessive paperwork. Most people do not want extra choice they just want their local hospital to be good.
Yes this is a way of privatising the entire NHS but if it does not work the Conservatives will be toxic for decades.
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Mon Jan 31, 2011 4:06 pm |
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cloaked_wolf
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Only a little. Most doctors (incl GPs) have no idea what's going to happen. Let's start with this bit: Okay, let's go with your figures. Only half of that will be paid to the practice. The remainder has to be "earned" by meeting targets. Example: all people with a new diagnosis of diabetes need regular kidney tests, regular checks with the practice nurse etc etc. If you don't meet a minimum eg 95% of the target, then you lose points. Points mean prized (well cash). So a practice could receive between £1-2million. Very few if any will receive the full amount. Out of this, costs must be paid to: property (rent or mortgage), utilities, staff (practice manager, receptionists, secretaries, cleaners etc), equipment (new and upkeep of current incl things like blood bottles), drugs (vaccines, emergency drugs etc), practice insurance etc. If there are salaried GPs (basically, non-partners), they must be paid (just like receptionists). Whatever is left over is then spread between the partners. They can choose to "draw" whatever there share is. The rest can be put back into the practice for future use eg building an extension/more staff etc. General Practice is essentially a business. So in a way, GPs will try to maximise their income. 95% will behave in the best interests of their patients. The remainder are greedy. This small percentage will get reported in the news, and spindoctored.
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Mon Jan 31, 2011 4:22 pm |
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paulzolo
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I would also imagine a lot of incentives going the GPs’ direction as companies vie for contracts. Free holidays, cars, etc.. It’s dreadful, and terrifying. We know how the “free market” has failed us. Look at the railways. Look at the power companies. Sure, there are a few successes, but there are crashing failures. A late train is not a tragedy on the scale that botched operation or a poorly planned programme of treatment can become. When you start to introduce private business, you lose the focus of the real objective as it will invariably turn to maximising returns for investors and share holders.
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Mon Jan 31, 2011 4:34 pm |
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cloaked_wolf
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Next bit: The problem with the NHS is rationing. There is not enough money to treat everyone for everything. This is why you can't have some procedures on the NHS. Cosmetic procedures used to be things like tummy tucks and liposuction. Now even things like varicose veins are considered cosmetic. This is because there just isn't enough money to fund them. The cost-cutting is already going on. Even things like hip replacements are being rationed. Transferring control the GPs isn't going to make it any worse than it already is from this point of view. Some doctors see the NHS as a train-wreck waiting to happen, but instead of the Govt (as PCTs) at the control, they're sticking GPs in their place. Cost cutting will have to go on. Part of the hope is that the huge cut in administration will help save the NHS. If I told you some of the stuff that consultants in hospitals do, it may be an eye opener: Patient has chest pains when walking (angina), sees GP who arrangings some tests (ecg, echo, stress test) which come back positive. Patient is referred to cardiology. Cardiologist sees in clinic (bill). Arranges for an angiogram to show blood flow to the heart (bill). Review in clinic (bill) and inform need for angioplasty. Patient has angioplasty (bill) and is reviewed in clinic again (bill). Cardiologist wants another angiogram to ensure everything is okay (bill). May also warrant further tests like stress echo or cardiac MRI (bill). The cardiologist is paid for the six or seven events that happen. Why can't they do angioplasty at the same sitting? Why the repeat angiogram if the patient is no longer symptomatic? Why do further tests after the patient is well? This happens up and down the country in other departments. Each wants money and has to justify their need for this money. The problem is now the doctors in secondary care are now worried about whether they will get money/jobs etc.
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Mon Jan 31, 2011 4:40 pm |
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cloaked_wolf
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I agree with the "patient choice" bit - most patients just want to be seen and sorted. Offering patients choice doesn't really work. They can't get the appointments in hospitals when they want, often where they want. The "choose and book" scheme is one of those big white elephants - looks impressive but ultimately worthless and a waste of money. (Nearly) all doctors want good care for their patients. Govt control has rarely improved things. It didn't stop them from wreaking havoc the last time!
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Mon Jan 31, 2011 4:44 pm |
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cloaked_wolf
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There will be competition for services. However, incentives like holidays/cars etc would easily be banned. Drug companies used to take doctors out for expensive lunches to incentivise them. Then a limit of something like £5 per person was applied so tends to be freebies like pens/highlighters/torches etc. Completely frikking agree. You're not the only one in that state. At least half of the medical profession are with you on that one, including me!
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Mon Jan 31, 2011 4:48 pm |
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Amnesia10
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Joined: Fri Apr 24, 2009 2:02 am Posts: 29240 Location: Guantanamo Bay (thanks bobbdobbs)
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As a non graduate I do not mind a doctor getting free education and training to be a doctor or surgeon as long as they could get a nice long contract in the NHS. I doubt that doctors will mind that. No debt and a long contract to get experience. Perfect for most I would imagine. Yet the government think that we object to it. Wrong. They want to get university education off the governments books so they can cut taxes. The same with NHS reforms, create a bigger private medical business and so they can lower taxes.
As for my rough example of a medical practice I do appreciate they are a business and have such costs. Though private enterprise is no more efficient than a well run workers co-op or similarly well run state enterprise. I just think that the Coalition are completely wrong to think that a market based system will work. The US has an excellent system for the rich but for the majority it is expensive and results in more bankruptcies than practically any other endeavour.
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Mon Jan 31, 2011 5:25 pm |
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cloaked_wolf
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The problem with a long contract is that it won't work. Job security for doctors was a sure thing. Despite issues with pay, hours, stress etc, the one thing you could rely on is job security. Given that it's no longer the situation, you cannot hold anyone in a long contract.
As for "free education" my student loan is in the region of £20k. Until/unless I hit the higher end of the Paypacket, I won't be able to get rid of it in the next five years. I've been working for four years. Given that student fees are set to rise. The average medical student could land with a £100k debt. With no job security, possible longterm unemployment, who wants to be lumbered with that much debt?
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Mon Jan 31, 2011 5:34 pm |
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paulzolo
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I speak as someone who is approaching the phase in his life when things are more likely to start to go wrong. I’m not a big fan of medical stuff anyway, but the idea that any treatment I’d get would be decided with so many non patient focussed variables is cause for concern. I dread to think how my dad’s treatment at the end of last year would have gone if there were market forces in place. It’s funny, isn’t it? In the USA, they get all tetchy because universal healthcare is deemed necessary, yet here we’re getting all steamed up because it appears that it’s being taken away.
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Mon Jan 31, 2011 6:14 pm |
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