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Saturday, 29 June,
2002
FRONT PAGE Milburn is preparing to cook the figures of consultant shortage by introducing a sub-consultant grade. Naturally the consultants committee of the BMA is angry and will resist. It is typical of the character of Milburn - and this government -that the BMA has learnt of the plans from lobby correspondents rather than directly from the bookseller. In another panic book-cooking measure to "achieve" the ludicrous NHS Plan bookseller Milburn is encouraging foreign medical companies to set up in business in the UK. Dr Bogle says that the BMA would not wish to stand in the way of the measures unless they stand in the way of long term measures to build capacity in the NHS. So, it seems that Dr Bogle does not have a closed mind after all on funding the NHS. The Consultants' committee is to attempt to persuade colleagues to accept their new contract. According to postings on doctors.net.uk there is an overwhelming feeling that they have been stitched up. Dr Peter Holden, after advising government on "red tape" has said it must be cut. The government committee of which he was a member has suggested that GPs write long-term prescriptions for stable conditions. Wait till the chemists hear about that one, then! One prescription = one dispensing fee. ELSEWHERE A BMA "snapshot" belies what medical newspapers and web-sites seem to show by indicating limited approval for the consultant contract. For another view doctors should visit www.doctors.net.uk. Academic medicine is in jeopardy, says a BMA Report. No it isn't, says Milburn, we've committed resources for it. Let's see who's right. In another fairly typical stick reaction, rather than carrot, this autocratic government is planning to fine social services departments which fail to meet delayed discharge targets. The consistent and rather stupid attitude of the Blair government seems to be, to hell with recruitment and morale, just so long as you all know we're the bosses. LMC Conference A full page and a half is devoted to the Consultants' contract in a question and answer form. The misleading statement is made that "most doctors representatives have welcomed the new consultant contract". Councilo has yet to be asked, GPC has yet to give its verdict and who knows who else has yet tp speak. If, however bmanews means most consultants reps have supported it, then, of course, they would because they negotiated it. However, the next generation, who the consultants committee will ignore at their peril, have rejected it. Half a page is devoted to leading members of the "Juniors" committee explaining why. Rural Practice Elsewhere Geirge Rae gives a eulogy on next week's BMA ARM. A report will appear on site shortly afterwards. In Second Opinion physician Philip Welsby claims it is a brave fool who criticises government publications. I disagree. Government publications are there to be criticised by all but the sycophants and fellow travellers. If the critic has to be brave then that implies some sanction by government and if that is the case the editor of this site must be on a Milburn hit-list. Dr welsby continues his piece and shows that he, too, is brave but not a fool. ARM again
Saturday, 22 June, 2002 FRONT PAGE The Lead item is a eulogy about the consultants' contract about which the Juniors have reservations not supported by the consultants' committee. There is a small piece claiming that NHS Direct provides a poor service out-of-hours for GPs. Independent, retired consultant, MP Dr Taylor took on Milburn telling him that GP co-ops were better. ELSEWHERE In the latest way to cook the figures GPs in south Wales have been told that their patients will be removed from hospital waiting lists unless the doctors inform the hospitals that they should remain on them. The LMC objected. This year's BMA ARM will be reported on-line by bmanews staff but readers prepared to wait until it's all over will find an independent report on this site, as they did for the past two years. In a no-news story Simon Fradd says he is pressing government over locum pensions. He said that some weeks ago so the item must be a filler. Those "GP leaders" have been at it again. This time Chisholm has added another wish to his list, that there must be parity between GPs and consultants. I believe one insurance company presently has an advertisement on television featuring pigs - one of them is called John. The Juniors' conference rejected a sensible suggestion that the training of consultants should include a period as a GP registrar. So they will continue to pontificate in ignorance about what life is like in general practice. Consultants contract His grin is even wider because even after seven years consultants must work an extra 4 hour session before they may see their private patients. In effect, Milburn has screwed a 48 hour week out of young consultants and a 44 hour compulsory week out of older consultants. No wonder the Juniors dislike it. The almost equally unpleasant Mr Kenneth Clarke did something similar to GPs in 1989 and many of us played him at his own game and rigidly worked the set hours and no more. The voluntary work in our own time vanished. If young or elderly consultants want to see their families and have a social life they are advised to do the same. On another point, is there not a human rights issue here? Contract or no contract. Should
targets
be met? GP Contract Dr Louise Warburton (GP) has published an admirable piece on the nonsense of promoting nurses to do the jobs of GPs when there aren't sufficient nurses to do the caring job of nurses. Sadly, your editor says, just as pharmacists no longer like their core profession, dispensing, nurses don't like nursing and both want to be doctors without, of course, having put in the years of hard graft first. They are supported by a careless, thought-bereft Milburn who thinks a quick fortnight at the Poly is sufficient to bring them up to scratch - and hang patient safety. Consultants' contract There are no other features directly relating to general practice in this edition. Next week, however, will be a different matter as the negotiators crow over their victory at a rather sycophantic LMC Conference. CLICK HERE for the report Saturday, 15th June, 2002 FRONT PAGE Headlines are given to the consultants' contract which had not been announced when bmanews went to press. After publication the Juniors rejected the contract. A comment about the GP Roadshows said that they told "family doctors how the new contract would affect them." Not a word about any of the spin from the negotiators and fellow travellers. Nothing about the dire threats following a NO vote. How many of the Roadshows were simply an explanation exercise? Violent patients and
PCTs ELSEWHERE Med School job cuts Another example of
poverty of thought processes £111million for
Nottingham Northern Ireland GPs
reject primary care plans More reality Waiting lists
Spinning the contract Will it reduce workload? Trust me, I'm a negotiator. We will monitor "creep". (Tony Blair had better watch out, then). What about allocations? We are negotiating on that. Where is clinical responsibility? Where it's always been - with you. What about statutory certification? We'll pass it to nurses and chemists - if there are enough of them. Patients come too often. We are working on schemes to educate them. Oh, and nurses and chemists can help (if there are enough etc.) What about increasing consultation times? Go on, you can manage it! We are looking to put this in the quality framework so you'll have to. What about temporary residents and asylum seekers? Well, we've cocked the TR system up but you'll manage, believe me, I'm a negotiator. Treating AS's is an opt-in so you won't have to do it (oh, yes?). What about out-of-hours? It will be the PCOs problem not yours - unless the PCO can't find anybody. Then it's your problem. Are we not handing control to PCOs? Funny you mention that but we don't have a clear answer but you can opt to provide out-of-hours cover. Can all practices opt out of out-of-hours? Yes, if there's an alternative - otherwise no. We think PCOs will be able to do it but we don't know but we do know you will if they won't/can't. What about 48 hour access? Well, um, we don't accept it but government isn't giving way. Anyway, this is such a wonderful contract that you'll be able to do it. Trust me, I'm a negotiator
BMA View - Peter Holden Peter Holden's piece exhorts GPs to stop underselling themselves. Does that mean that as a negotiator he will go for a very realistic pay scale? The BMA has valued GP time at £100/hour. Even I would vote for a contract which paid that and allowed me to opt out of all the crap. However, no such luck. The item is disappointing in its vagueness. Peter says that some colleagues argue that patients might suffer. In a burst of characteristic bluntness he replies "not as much as they will with current retention and recruitment trends". Telling politicians to put their money where their mouth is he instructs doctors not to be "so feeble. Stand up and be counted and stop underselling yourselves." Start by voting NO to this contract, I say. MAJOR ARTICLES WORTH GOING ON-LINE TO READ 2 pages on Bed-blocking
Saturday, 8th June, 2002 As this was Jubilee week bmanews is rather a small edition. FRONT PAGE The Headline piece, not surprisingly, covers the vote on the GP contract and urges GPs to vote Yes. Being very fair to Dr Chisholm he does not tell GPs to vote for the contract but he does suggest that a No vote will not be helpful. Which almost comes to the same thing considering he stresses that the importance of voting cannot be overestimated. So, is telling GPs that a No vote would be bad, the same as commending a Yes vote? That, however, is what Dr Chisholm has said many times he will not do. Contrast with the abilities of GP negotiators and Consultants' negotiators is well demonstrated by the very simple fact that they are going to their members at their conference, this week, with a priced contract. The GP negotiators' excuse that they had to present a contract in April is pure patronising crap unworthy even of them. They have failed in that they have produced only a skeleton contract with no indication of its worth. ELSEWHERE Apparently doctors' leaders are "angry" that the private sector regulatory body has the power not only to regulate and control private health premises but, also, it has now been found out, the doctors who work there. How can this be? Dr Bogle and other "doctors' leaders" welcomed the National Care Standards Commission when it was announced - just as they have shot from the hip and welcomed just about everything from Milburn. As your editor told Council a couple of months ago, anything from Milburn or this government should be sent to the legal department of the BMA and examined carefully paragraph by paragraph and word by word for hidden meanings. Then it should be sent for a second opinion and only if there are none should the Chairman or GPC Chairmen open their mouths and comment. You'd think they would have learnt that by now. BMA view, on the following page consists of John Chisholm commending a vote but carefully not saying outright, vote Yes. Letters
Saturday, 1st June, 2002 FRONT PAGE The lead article discusses the fears over Foundation Hospitals. These, readers will recall, are the super hospitals which reach all government targets and which will be given total freedom from Whitehall interference over their expenditure - just so long as they continue to meet targets (which Milburn has set). A kind of ersatz freedom, indeed. Doctors believe that they may be paid more to work in Foundation hospitals, thus creating a tow tier system over colleagues not in the ersatz hospitals. Bogle does not want a two-tier system although he also says, about incentives to work in these hospitals "Any local incentives must be in addition to national agreements on pay and conditions". Surely, Dr Bogle, "additional incentives" will create that very two-tier system you dislike. Is it very painful to sit on the fence? ELSEWHERE Milburn and foreign
input NHS cash for surgery
improvements Near miss system Scots standards board
not punitive PCTs and the Contract Self justification? Signposters not
gatekeepers Negotiators answer
questions on contract What about smaller
practices? Capitation based
practices will benefit large ones? We will have to work
harder to stand still? How much will come
from "quality"? UK bio-terrorism
protection needs reform. "Second
Opinion" "The way we
were"
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