Wednesday, 15 February 2012

A Few Thought On GPs And The NHS

I began researching this topic after reading and commenting on the always excellent Subrosa's post on Dr Philip Lee MP and discovering how many hours a week he worked as a GP (about one day a week on average). I don't blame him as it keeps him linked to the real world instead of the foetid petri dish of the subsidised restaurants and bars of the Palace of Westminster. Every MP ought to have a trade as it would make them less dependent on their MP's salary and the anti-democratic demands of the Party Whips. A political career should be an oxymoron for all but a few: the more MPs who put their constituents and country before the diktats of party leaders, the stronger would be Parliament be at holding government to account.

What amazed me was the approximate hourly rate that a temporary GP gets - about £100. That's net of practise overheads. Obviously that's peanuts compared to professional footballers and senior exectives, but it's rather pricey compared with prescribing nurses and pharmacists who offer the same service for at least 75% of illnesses and can triage more serious cases up the chain for assessment and treatment: just like GPs.

In England, the Conservative government is attempting to change the NHS to better suit the needs of patients by making GPs and other medical professionals responsible for commissioning the services required from local providers. Always resistant to change until extra money is paid (the establishment of the NHS wasn't the BMA's finest hour, despite their revised history) the Royal College of General Practictioners is now agin it as are physios But the NHS isn't perfect, otherwise £15.7 billion plus of medical neglience claims wouldn't be outstanding or GPs wouldn't send a dog to be treated in some hospitals or most GPs would prefer to die than have the treatment given to terminal cancer patients.

It's clear that there's a great deal wrong with the excellent NHS but GPs must grasp the nettle and put the best interests of their patients first and get properly involved in commissioning. The Surgery where I have been registered for all my life except when living away from Coventry has taken a lead in this area and patient care is better than ever. Things are no longer done because they've always been done like that but because they have been proved to work. Some treatments are cheaper, some are more expensive but we patients are more involved.

After the massive salary increase and hours cut  in 2004, it's only fair that GPs are being expected to take more responsibility for the holistic care of their patients that began with Practice-Based Commissioning. Numbnuts like Andy Burnham bleat on about keeping Nye Bevan's NHS (actually a very nasty man according to Clement Attlee who knew him) despite Labour reforms of it but I prefer the famous quote from Lampedusa's The Leopard, "If you want things to stay the same, they are going to have to change." Labour improved things after 2000 by doubling the amount of money spent on the NHS (but not getting anywhere near double the output) but at a time of austerity in England with much smaller annual real-terms increases, efficiency savings have to be found from within the overall budget so that money is spent where it will buy the most for patients.

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