27 November, 2002
New contract - latest
It will seem
incredible to our readers but the leader of the GPs Union (GPC), John
Chisholm CBE, has now, somewhat belatedly, admitted that the contract
could not be priced because neither the government nor GPC have the
figures to do it. Now is this incompetency and negligence or is it
not? Fine, so Milburn thinks he can manage without GPs , does he?
Pensions
Entirely as a
consequence to the negotiators' incompetence, the pension agreement also
cannot be priced.
Recruitment facts from
the DoH
The number of
unfilled GP practice vacancies more than doubled last year from 147 to
322. Over 100 have been vacant over a year. The
average number of applicants to each post has fallen, in the same
period, from 6.0 to 4.4 The growth in GP principals in
Scotland between 2000-01 was just 1%. And the clot who
still, God help us, runs the NHS maintains he will find 2000 new GPs
within 13 months i.e. by 2004. Not the way he punishes
general practice with an ever-increasing workload, he won't.
Increased work load
GPs are to be put
under increasing pressure to meet political targets for chronic diseases
and immunisations. 48 hour access is still a political
demand. The diabetes NSF will be demanded by
Christmas. GPs are to be told to enter more consultation
data whilst also attempting to diagnoses and treat patients within the 7
minutes permitted by the crush attending. Whilst all this is
going on, together with the existing work-load, of course, the
government is preparing to launch an NSF on "long term
illness". Milburn has warned GPs that that NSF will
entail more work than earlier NSFs.
Golden hallo/handcuffs
GPs have shown
themselves resistant to bribes and have not taken up the
hallo/handcuffs. Apparently the job, for that is what it now is,
is so unpopular that the government isn't rich enough to attract doctors
into general practice. And a lot of that is due to the intellect
of the individual in charge.
GPs in control?
Apparently not
because a survey of 35 LMCs showed that they face resistance if they
attempt to become involved in PCO affairs. In addition to
that ex-Health Secretary Dobson says that GPs will be losing power on
PCTs.
Plan ahead for new
contract?
Articles are
appearing in the medical press/comics telling GPs to prepare for a Yes
vote. A bit presumptuous, isn't it? I accept that
writing these articles earns a crust from the comics for the writers but
colleagues would be ill-advised to do anything at this stage. As
things are going the vote is likely to be a resounding NO.
19 November, 2002
GPC and old tricks
Negotiator
Lauence Buckman is quoted in today's PULSE as warning the NHS Federation
that messages about delaying the contract would not help
"sell" it. That implies that GPC and the NHS are
to unite to sell the contract to GPs. It is not GPC's
business to sell anything. I would have thought they would have
learnt that lesson from the consultants' fiasco where their leader had
to resign because of the hard sell techniques they adopted. The
new roadshows must not pressurise, denigrate opponents but simply
inform.
New pay hurdles in
contract
Pay will be
related to whether GPs hold patient questionnaires. The GP
negotiators want three levels of pay: the first for having a
patient questionnaire, the second for acting on the result and the third
for sharing the results with patients.
10 October, 2002
Botched
Milburn has lost
the battle over Foundation Hospitals as Blair chickened out of
supporting him. They will exist but only so far as the Treasury
will let them. Chancellor Gordon Brown has demanded that
they should only spend the same as the rest of the NHS Hospitals.
In effect, instead of being answerable to the DoH they will be
answerable to the Treasury. Some freedom.
7 October, 2002
More Bogle nepotism?
bmanews reported
last week (28/9/02) that the BMA was to undergo reform. In
charge of the project team is one Julie Coulson a.k.a. Mrs Ian Bogle (I.B.
is Chairman of Council). M/s Coulson-Bogle was recently listed
as Managing Editor of bmanews.
4 October, 2002
Foundation Hospitals
Flagship
foundation hospitals will be granted freedom from NHS restraints and
will be able to generate funds from wherever they choose. It is
anticipated that they will be able to pay staff more and attract the
best. Meantime, "failing" hospitals will have
funds removed from them and will, one assumes, fail even more.
This, says the venerable Health Secretary, bookseller Milburn, will not
create a two tier service. Say no more!
28 September, 2002
Frankie's world
After making
something of an ass of himself attempting to criticise the Prince of
Wales the other day, that arch intellectual, Frank Field
MP has turned his ire on hospital consultants. Completely
failing to understand the health system he accuses them of
"protecting their own business" by making parachuted-in
foreign consultants unwelcome. Readers will recall that a
desperate Milburn, too dim to understand why British consultants can't
be retained, is trawling the world to plug the gap. A plane
load of German consultants have just returned home disgusted with the
NHS whilst attempts are being made to recruit others from France, Italy
and South Africa - to name just a few sources.
26 September, 2002
Appraisals
GPs must not
undertake appraisals unless the PCT pays for them to do so and provides
a locum. The GPC has taken legal advice and
reported two PCTs to the DoH for refusing to pay yet ordering GPs to
place themselves under appraisal. GPs in similar situations should
instantly report their PCT to the GPC. For once it's
behaving like a trade union.
Countryside March
Nearly 500,000
countrydwellers marched peacefully and tidily through London last
weekend whilst the "President" was holed up in Chequers too
busy to bother about such trivia. With supreme arrogance the
Countryside Minister (or whatever title he goes under) said the
government was taking country matters very seriously. After
all, he said, we've had a weekend conference about it and we've got 180
members from rural and semi-rural areas. And there,
precisely, is the Blairite Achilles Heel - and he'd better remember it.
24 September, 2002
Latest access target
"We have already met the target set for patients to receive appointments with primary care professionals or GPs.
A new target has been set out in the Rural Services Standard 2002, which will mean that by March 2003, 90 per cent of patients will have an appointment with a health professional within 24 hours.
"A network of 6,000 UK online centres will also be in place in England by the end of December, 2002. This will give people living in disadvantaged rural communities with limited transport greater access to the Government's services online, such as nurse-based health advice provided by NHS Direct."
14 September, 2002
Bogle winces
Dr Ian Bogle
writes in bma news today (qv) that he and his colleagues "wince
every time our friends in the media describe us dismissively as
"the doctors' trade union" ". Apparently they think
are something grander. That sums up in a few words why
doctors have done so badly over the years.
21 July, 2002
Wicked whisper
Which Trade Union
leader recently e-mailed all the professional Directors of his company
saying he would "not tolerate such behaviour in
future"? The mind boggles. And which editor
asked him if he really meant to come over like that?
The Natural Menopause
Advice Service - NMAS
In the light of
recent, possibly over-hyped developments over HRT some readers or their
patients may be interested in a menopause alternative
treatment. The NMAS has been rather quick off the mark by
creating an information website <www.nmas.org.uk>
11 July, 2002
Dohhhhhhhh !
God knows
what qualifications are needed to work in government other than a head
measured in units of wood but it has taken years for the Audit
Commission to state the bloody obvious. In a 110 page report
published this week they conclude that too much is being asked of GPs
too quickly. Now that light has dawned upon that august body one
wonders how long the head concho whose head is measured in units of
stone will come to the same conclusion. And, more to the point,
perhaps, how long Chis & Co will arrive at the conclusion that this
may help in pay discussions and pricing the contract.
Blair
Following his
recent insult to single-handed practices all the President and his merry
spinners can come up with to "support" his nonsense is a 10
year old report which, in its body, does the opposite. An
apology would have been more appropriate and more acceptable but the
President is never wrong. Is he?
6 July, 2002
NICE slammed again
The pro-Milburn
QUANGO NICE has again been slammed. This time by Hugh Goslin,
editor of Pharmaceutical Marketing for callousness.
NICE recently reviewed Novartis' Visudyne for the treatment of wet
age-related macular degeneration. The review found that Visudyne
"was found to improve the chance of avoiding appreciable loss of
vision over a period of two years" but a chill was sent down
Gosling's spine by the section "cost effectiveness" which
demanded that the drug should only be used after the vision had been
lost in one eye. Typical of the Milburn regime, one is
tempted to say.
Patient harm
Figures recently
released show that almost 1 in 10 patients admitted to hospital will
suffer some accidental harm during their stay.
The worst system
A two year
research project into the NHS by the OECD has shown that Milburn's NHS
ranks alongside Hungary's as one of the worst in the West when dealing
with key measures such as heart disease, stroke and breast cancer.
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