The Medical Thread
- Thread starter Didley Squat
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There’s an interesting article on General Practice in the comment section of the Times today.
Like many on here, my GP practice became a fortress to avoid contact with patients as soon as COVID struck and remains in this mode.
I do have a couple of neighbours who are GPs who I would count as friends (we have a few drinks occasionally) and they are lovely people. They both work part time (despite being considerably younger than me) like 90% of their colleagues. They do this because they can afford to on average pay of over £100k. I have no objection to this but it creates a perfect storm of **** as demand, with an increasingly old and ill population, is rising exponentially while supply is shrinking - you have to recruit and train 3 new GPs to work part time to replace one full time GP who retires - and many do retire early, in their 50s.
The British health system, this weird blend of public and private, was always a compromise with the ‘free at the point of delivery’ mantra and ‘our NHS’ slogan with public attitudes so anti change meaning that we are stuck with what we have got.
Oh, and good luck Aussie, no shame in that reaction. I’ve never had the experience of ‘full immersion’ only up to the chest including the very odd injection of contrast medium, which I could feel moving around my blood system.
Surreyhoop’s story sounds a bit fishy to me.
There's been a move in recent years towards GP practices being owned and run by private businesses, mainly US health insurance companies. I don't think it's particularly widespread yet, but could be the thin end of the wedge. They're not going to train any new GPs, but will want those they employ to have more patients on their lists, meaning fewer appointments.
Yes, I know. I meant private businesses - such as US health insurance companies - employing GPs, as opposed to the GPs contracting directly to the NHS.
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There's one thing about this I don't get. In France, it is a semi-private system, and GP's are paid for each appointment they take. The result of this is that I can see my GP Monday-Friday from 8am to 18:30/19:00. The GP's know that the more patients they see, the more they earn. The result of that, here at least, is that they work long hours and try to see as many patients as they can. Could it be that the problem in the UK is that a lot of surgeries have thousands on their books, each of which they get paid for, but there is no extra incentive for ensuring there are enough available appointments for each of the patients on the list to get appointments. I've never had any problem getting an appointment here, but that said, I haven't needed to see a doctor since the pandemic started. My kids have though, and we got an appointment with their pediatric GP without a problem.
No, a highly qualified Radiology technician, specialising in MRI equipment nowadays. It was me who called him 'Doc', just for fun, and he did not seem to mind. As I said, a top guy!
The one from me you're welcome, Didley, hope I did not bore you with my very true tale. I know you will be OK if you decide to have another go, I feel sure of that. Good luck!
Bloody idiotic structure, innit?
It's like Amazon only getting revenues from Prime subscriptions, saying everything is free, but then only shipping 20% of the customer orders after a 6-week wait.
No no, Sooperhoop, I just happen to live in mainland Europe, but I was born and raised in The Borough in the 'smoke' (12-years or more) and Kingston-on-Thames. Married to a Bavarian girl and decided to stay down here when I quit travelling and working abroad. Seems long ago, have been a long time retired. Does look like I am on a planet where QPR keep winning, although Coventry will be a real test next game. We'll see.
It is the problem, but it'd be interesting to know the figures too. To counter my own point, we pay €60 every time we see our kid's paediatrician, and that's just for a 15/20 minute appointment. That'd be around €180 per hour. According to this;
https://www.pulsetoday.co.uk/news/p...aid-an-average-of-155-per-patient-in-2019-20/
...GP's usually get £155 per year, with a maximum of £172 per year per patient...so to expect the same availability and care for far less money seems a bit unfair on the GP's.
There are loads of perverse incentives in play for primary care in the U.K. There is a headcount payment, weighted to give more for old/sick populations, but the GPs would probably prefer young and healthy people on their list, the ones who don’t go to the doctor, to balance the frequent flyers out. But they also get money as a ‘fee for service’ carrying out certain procedures like flu jabs, regular check ups on the chronically ill, managing diabetes patients to a certain target, prescribing generics etc etc.
But mostly they are just gatekeepers to specialists in hospitals,you get referred and then wait months to see someone. Where France, most of Europe and the US differ is they have community specialists - there are no ‘paediatrician GPs’ in the U.K., just some GPs with a ‘special interest’ who might not be available when you need them.
Im surprised you have to pay for your kid to see the doctor. Can you claim it back from your insurer?
We get a % of the fee back. The Government set a rate that they think is fair for doctors to charge, and the insurance companies refund to that fee. If your doctor happens to charge more than the Government rate (which most do in central Paris), you have the pay the rest out of your own pocket. It usually comes to a couple of euros per visit, so nothing major.
Presumably if you have a chronic illness, are on welfare or a pensioner there is no fee.
Most European countries work through state sanctioned insurance schemes, and from my perspective it works better than here, although we are not allowed to say that out loud. Also, health care is nothing like as politicised as it is in the U.K., and there tends to be more choice and less waiting. It’s still socialised healthcare.
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Yep, that's about it. If you have a serious/on going medical condition you are 100% covered by the state. Also, if you have something major done the insurance will cover it all. I had shoulder surgery a few years back after multiple dislocations and I didn't pay a penny/cent.
I have had a number of MRIs over the years all head first as they were scans on my brain. All fine a bit scary as it’s a small tunnel but got through it, when i had one recently and had to wear mask OMG panic set in immediately it was awful, I understand your distress. Fortunately mine didn’t last long.
Hope you okay
C x
Hope you okay
C x
I got through with eyes tightly shut until I was pulled out of the thing. But adding a mask would be that much more difficult. They like to give us a challenge.