The Medical Press is scathing – and acknowledges the deconstructed Health Service(s)

The Medical Press is scathing – and acknowledges the deconstructed Health Service(s). In GP Magasine Exclusive 29th May 2015 Siobhan Chan reports: Thousands wasted on managed practices as recruitment crisis hits  and Exclusive: Welsh recruitment crisis forces GP partner to quit practice. Goodness knows how many more practices will be directly managed in 5y time. NHSreality has not reported the dozens that have closed in the last 3 months, mostly reported in local newspapers.NHSreality advises that only if you are a detailed, experienced, and comprehensive reader of policies should GPs change insurer. The small print will have you every time. The way out of this is “no fault compensation” as in NZ. At least Andy Burnham recognises some of the problems: ‘I offer hope the NHS can be put back together again’ (Pulse 22nd September 2015).  Perhaps he thinks of the Health Service as a bicycle ……

that needs putting back together.

Seven practices in Wales were being directly managed by health boards last year, the Freedom of Information Act investigation by GPOnline has found.

GPC Wales say the number of managed practices could double, with practices across Wales on the verge of falling over….

In Pulse under the title “A millstone around the neck of GPs”, an article derides the rising cost of insurance policies for GPs.

“Rising Indemnity costs are a millstone around the neck of General Practice. We have been told of premiums soaring by 25% this year and reaching 30K for some of the out-of-hours GPs, and for some it is simply not worth taking certain kinds of work due to the soaring cost of cover.

But there are signs that now NHS bosses are waking up to this as a “priority issue”.

In Wales they have the enlightened approach of including GPs in the NHS “risk pool” (for Out of Hours only) and others are negotiating juicy discounts with commercial insurers. Could that be n approach that works elsewhere? The issue has to be addressed if GP practices are to open up seven days a week and integrate more with secondary care. The BMA is hosting a summit today on the issue, and we (Pulse) will let you know what comes from it.

A case in point. A young patient presents with her mother and a headache. She has no lateralising signs and a long history of “migraine” without diagnostic symptoms. Mother is a “care assistant” and says she noticed involuntary movements on one occasion. Who would not refer for a CAT scan? Are GPs pilloried for missing Sub Arachnoid haemorrhages (SAH)? – YES. Are the rates of request for CAT scans or referral for headaches measured and compared? NO. So there is a perverse incentive to over-investigate in order to protect one’s own health and stress. If you miss one SAH your premium will rise…

 

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This entry was posted in A Personal View, Commissioning, General Practitioners, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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