[Closed] doctors on strike

Well it certainly seems to be a part of it.

From Auntie http://www.bbc.co.uk/news/health-34775980

Yeah they're wrong.

Ah I see. The BBC are incorrect.

Riiiight.

Fact or supposition ?

Let's just call it foresight.

Jamablaya:
As I posted on the other thread the Tories won the election with a higher nhs spending pledge than Labour (+£8bn pa vs £2bn)

and

Tory Health Minister Jeremy Hunt
"Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain"

Doesn't take a genius to understand where the Tory ideology will take them.

On page 31, I posted this:

The dispute is categorically NOT about pay for weekend working. It's barely about pay at all.

In no particular order, here are some of the things that I disagree with on the imposed contract:

1) No financial penalties for Trusts that allow their doctors to work unsafe hours
2) More weekend working with the same number of doctors means less cover during the week, when most of the day to day work is done (due to everyone else doing elective work M-F)
3) Thin end of the wedge with regards to other doctors and allied health professionals having their pay cut
4) "Creative" rotas that have doctors working random shifts with absolute minimum length of breaks, meaning tired and disorientated doctors looking after patients that have no continuity of care
5) Widening of the gender pay gap due to:
a) no pay progression whilst on maternity leave,
b) no provision for how less than full time training (LTFT) will work in the new contract
c) a pay structure that could mean that 2 female junior doctors on 60% contracts (ie doing a total of 120% of a full time job) could together earn less than the equivalent male doing 100% of a full time job
d) no pay progression for the final 5 years (full time) of training, which could mean that female doctors in their 30s could work for 10 years (gaining experience and skills) without any hope of a pay rise
6) Disincentives for doctors to do academic research, further diminishing our status in the worldwide scientific community
7) No pay progression in the final 5 years of training, which is where the biggest gains are made in terms of experience and skills.

Junior doctor rotas are already at breaking point. My own place of work has 7.6 people working a rota meant for 12. Next weekend, we don't have any doctors covering the day shifts on Saturday and Sunday. Imposition of this ridiculous contract will mean that the exodus of doctors from the NHS will accelerate and I suspect we are in for a very hard decade or so in the NHS (if the NHS survives at all).

It's still true.

In fact, we don't have any doctors to do the weekend day shifts AGAIN this weekend. It's like groundhog day.

@JT - yup that's the French system, a proper mix between private and public - we have a right dogs breakfast and it's not working - our expectations of it are nowhere near what we fund though state. The French have much higher taxes, vat on food etc and they still have greater use of private health service provision via personal insurance. We need a serious rational discussion.

Put simply - if it was purely about money then Junior Doctors would welcome privatisation due to the vastly inflated pay cheques that it would bring.

They don't. It's not.

No financial penalties for Trusts that allow their doctors to work unsafe hours

On 4 January Daniel Mortimer, chief executive of NHS Employers, wrote that a system of financial penalties for trusts who abuse doctors’ working hours had been proposed.

He said trusts who breached working time protections would have to pay fines to a “Guardian” who would spend the money on “supporting the working conditions or education of doctors in training in the institution”. He added: “The BMA seemed unwilling or unable to discuss this major development with us.”

Creative" rotas that have doctors working random shifts with absolute minimum length of breaks, meaning tired and disorientated doctors looking after patients that have no continuity of care

Without being a fly on the wall in the negotiations, it’s hard to know what the real sticking points are. The BMA has made no secret today that it sees status of Saturdays as the main obstacle.

At the same time, the doctors’ union is not conceding that all the other areas of disagreement in these complicated negotiations have now been completely settled.

If it is the case – as the government claims – that earlier fears over unsafe working hours have now been allayed, this message has not trickled down to striking doctors on picket lines.

They are still telling the public, perhaps wrongly, that this industrial action is still at least partly about unsafe hours.

[url= http://blogs.channel4.com/factcheck/factcheck-doctors-strike-patient-safety/22458 ]Source[/url]

Remember, BBC reporting is very heavily skewed towards the London 'Establishment', especially now that Cameron has one of his pals as editor in chief of news...

The BBC has just done their lunchtime report, they've concentrated on 'pay rises' 'unsocial hours' but never mentions the unsafe practice. 🙄

@Drac - I agree.

I think it's got very muddy and emotional that some of the orginal concerns are struglling to get through. They interviewed a doctor on the picket line and her reason for striking didn't come across well either...although you do have to be media savy to sum up your concerns in a minutes soundbite on the radio..

Maybe that's why they used her footage.

allthepies - Member

Ah I see. The BBC are incorrect.

Riiiight.

The BBC are reporting what they say are doctors' reasons for the strike. It's not a big reach to say that if this reporting doesn't tally with doctors' reasons for the strike, it's probably not the doctors that are wrong.

Or maybe the doctors should tune into the BBC to find out what they think, and then act accordingly.

we need no discussion tories and there apologists need to learn that the people want the NHS to be in the public sector rather than engineer shit like this so they can then argue its "not fit for purpose" then make it more expensive so their chums can make more money.
There is no public support for a privatised NHS except amongst Hunt and a few other loons.

My apologies - the details regarding financial penalties for breaches of the contract appeared after my initial posting on page 31. In the previous version of the contract, there were no financial penalties for Trusts.

However, on the point of penalties for Trusts for breaching the contract:

1) Junior doctors do not have any protection under whistleblowing law (recently tested in court)

2) Breaches of the contract must first be reported to the junior doctor's educational supervisor, the person that decides whether or not a doctor progresses in their career

3) In the case of doctors working longer hours because of sick patients, they will have to get "permission" from the consultant in charge before working any time over and above rostered hours - hardly likely at 9pm on a Friday evening when you are dealing with a patient that is dying

3) The educational supervisor (another consultant) will then decide whether the breach meets criteria to be reported to the Guardian

4) The Guardian will be a senior member of that consultant's Trust, potentially the person who decides whether or not the consultant progresses in their career

5) The Guardian will take direction from the Department of Health regarding what actually constitutes a breach of contract

This system is wide open to abuse and manipulation.

The current system involves mandatory (ie breach of contract if you don't do it) reporting of hours by every junior doctor on a rota for a 2 week period every 6 months, which is collated by an independent administrative person and published publically. Trusts are fined a set amount per doctor that breaches the EWTD hours regulations.

You missed out the bit about the BMA still holding out for more of the fine to be paid to the doctor who has been "overworked" - even though it is the patients who theoretically suffer. Nothing to do with money this dispute, not at all, oh look a badger.

There is no public support for a privatised NHS except amongst Hunt and a few other loons.

There is a very big difference between a fully privatised health service and what we have now, in fact pretty much every other successful developed nation has a different system

There is a very big difference between a fully privatised health service and what we have now, in fact pretty much every other successful developed nation has a different system

You missed out the bit about the BMA still holding out for more of the fine to be paid to the doctor who has been "overworked" - even though it is the patients who theoretically suffer. Nothing to do with money this dispute, not at all, oh look a badger.

I think one of the problems with the Guardian proposal is that the fines are paid into the trusts' educational budget, and that the fines may well work out cheaper than employing a locum for the same shift. I'm not entirely sure if the current version of the contract still has these problems but perhaps someone could enlighten me.

Enforced moving of money from one part of the trust budget might be a fine but it doesn't really seem like a penalty.

You missed out the bit about the BMA still holding out for more of the fine to be paid to the doctor who has been "overworked" - even though it is the patients who theoretically suffer. Nothing to do with money this dispute, not at all, oh look a badger

To be fair, I agree with you on this point. I don't give a toss where the money goes, as long as it acts as a deterrent to Trusts taking the piss out of their staff. We certainly don't get the money now (IIRC, around £5000 per doctor that fails "monitoring") and I don't care if we get it in the future.

FWIW, although I'm a junior doctor, I'm not (and have never been) a member of the BMA due to (IMO) their total mishandling of multiple issues over the years (Modernising Medical Careers, pensions, whistleblowing case to name but a few). I would like to think that I'm capable of looking at the evidence, weighing it up, and coming to a conclusion by myself and have certainly not been "misled" by the BMA (their emails, like those from Health Education England, are deleted immediately on principle).

Enforced moving of money from one part of the trust budget might be a fine but it doesn't really seem like a penalty.

You are right, smaller fines should be paid but they should come out of operational and clinical senior staff's remuneration - sorry, got to go, flock of pigs flying outside.

Enforced moving of money from one part of the trust budget might be a fine but it doesn't really seem like a penalty.

Sorry, should have read "Enforced moving of money from one part of the trust budget [i]to another[/i] might be a fine but it doesn't really seem like a penalty."

Once again those that disagree are "loons" and its a fact no one is suggesting privatising the NHS. This is a perfect example of how a rational discussion is currently impossible

I am happy to discus show much funding is fair but not the model of delivery. As I said only right wing loons, you, Hunt, Farage, want to discuss that sort of issue.

jambalaya - Member

its a fact no one is suggesting privatising the NHS.

Well of course the Tories won't talk about "privatising the NHS", it would be political suicide for them to do so.

But they are quietly getting on with it anyway.

And if they mention it at all they refer to it as "denationalisation" rather than the dreaded [i]privatisation[/i] word.

Although it of course means exactly the same thing.

jambalaya - Member

I understand that, however it's worth noting my neighbours include a surgeon and a dentist with with very nice houses, top end Mercedes and nice yachts. Nothing against any of that of course, they deserve it.

The fact that some surgeons and dentists are rich is not the point. You suggested that doctors were in it for the money. I doubt many of them actually entered the profession with the ambition to become the Warren Buffett of healthcare.

There are people who think money is everything, and those people will tend to assume everyone else thinks the same. Even when told otherwise, they'll assume it's a lie or self-deceit or naivety. It colours everything they say and do, and you can't argue with it. Anyone who doesn't have money is jealous, anyone who gives money away is only doing it to feel good. And of course they'll believe that this strike is all about money, too. And every time anyone mentions money even as an aside or a denial, they'll go "ah hah! I knew it- they're thinking about money"

Free at point of care?

Oh can I call this bullying like you do when it happens to you?

@ernie increasing provision of care via direct payment and/or private insurance is inevitable. What we have cannot work in my opinion. You are quite right it's electoral suicide to discuss this so no one does and the can just gets kicked down the road, but it doesn't change the reality.

And every time anyone mentions money even as an aside or a denial, they'll go "ah hah! I knew it- they're thinking about money"

But as that Fullfact piece I linked to earlier, it is not really about patient safety either as most of those issues have been largely resolved, of the remaining issues money does figures pretty highly.

jambalaya - Member

What we have cannot work in my opinion.

When I point out that Hunt talks about "denationalising" healthcare you respond by making the case for privitisation.

So is it fair to assume that you now fully accept that the Tories are committed to NHS privitisation and that your [i]"its a fact no one is suggesting privatising the NHS"[/i] comment is just meaningless twaddle?

.

EDIT : Btw since your comment [i]"You are quite right it's electoral suicide to discuss this" [/i]betrays your recognition that NHS privatisation would be extremely unpopular with the British public you need to ask yourself why that is.

Why would the British electorate never vote for a party which openly said that it would privatise the NHS? Isn't privatisation a good thing? Why the public hostility to it? Can you explain?

mefty - Member

But as that Fullfact piece I linked to earlier, it is not really about patient safety either as most of those issues have been largely resolved,

It doesn't say what you think it says.

This may have been a sticking point for a while, but it would appear that substantial progress was made – i[b]f statements by the government’s negotiators are to be believed.[/b]

But crucially, he did claim that the government had “reached agreement” with the BMA on the broader package of measures to protect junior doctors from unsafe hours.

[b]If that’s true[/b], all those placards warning about tired doctors and patient safety must be redundant. [b]According to the government[/b], these are issues that have now been resolved to the satisfaction of the BMA.

At the same time, [b]the doctors’ union is not conceding[/b] that all the other areas of disagreement in these complicated negotiations have now been completely settled.

If it is the case – [b]as the government claims[/b] – that earlier fears over unsafe working hours have now been allayed, this message has not trickled down to striking doctors on picket lines.

They are still telling the public, perhaps wrongly, that this industrial action is still at least partly about unsafe hours.

My bold. The factcheck doesn't state that these things have been resolved; it states that the government says they've been resolved.

On the subject of fines for excess working; yes, a "penalty" system has been developed, whereby trusts would have to pay fines... to themselves. (the Guardian can spend the fines on education for doctors in training, something they already have to pay for)

I propose a new system where every time I call someone a * on STW, instead of getting banned, I have to pay a £10 fine. That fine is to be paid from my bank account, to my paypal wallet, and the Guardian will make sure I only spend it on bike bits. I think this'll discourage me from calling people *s, don't you?

No the Tories are not remotely committed to Privatisation of the Health Service, they won the election not least because of the economic credibility which protects the NHS and a commitment to spend £8bn more vs £2bn from Labour.

What I say is health service provision needs a radical overhaul. It just cannot work in today's world with today's expectations and it was never intended to, it was setup to provide universal basic health care. Modern medicine and longer life expectancy it simply cannot cope with.

EDIT : Btw since your comment "You are quite right it's electoral suicide to discuss this" betrays your recognition that NHS privatisation would be extremely unpopular with the British public you need to ask yourself why that is.

Why would the British electorate never vote for a party which openly said that it would privatise the NHS? Isn't privatisation a good thing? Why the public hostility to it? Can you explain?

No the Tories are not remotely committed to Privatisation of the Health Service

Well that ignores the fact that increasingly large amounts of the NHS budget is being handed over to private companies. And that Hunt, the Tory health minister, has said :

[i]"Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain."[/i]

So it is very clearly completely untrue.

I think that the truth and you jambalaya, is a bit like oil and water - you don't mix very well. Would you say that's a fair analogy?

On the subject of fines for excess working; yes, a "penalty" system has been developed, whereby trusts would have to pay fines... to themselves.

...and the doctors, you missed that bit out.

Personally, I think the government negotiators, who are officials rather politicians, do have credibility - the BMA appear to have been less forthcoming with Fullfact about what is outstanding.

mefty - Member

...and the doctors, you missed that bit out.

No agreement's been reached on what level that would take, so yes, I missed it out- it could be 100%, it could be 0.00001% more than what the doctor is owed for the work done, which hardly constitutes a penalty. Also, Danny Mortimer was clear that the fine was only applicable where rules are "consistently breached".

Thoroughly bored with this - there is a huge difference between modernising health service provision and wholesale privatisation - there will always be state provision of fundamental basic healthcare. Whatever happens with the JD strike is totally irrelevant to solving the health service funding crises we face.

@ernie because people will not accept the economic reality we face....etc, etc, etc,

Yes I understand what you are saying, but you have not explained why you think the British people wouldn't support privatisation of the NHS.

Is privatisation considered by most people to be a bad thing? If so why is that? Why don't they think that it would be a good thing?

Thoroughly bored with this - there is a huge difference between modernising health service provision and wholesale privatisation - there will always be state provision of fundamental basic healthcare. Whatever happens with the JD strike is totally irrelevant to solving the health service funding crises we face.

So. How far are the Doctors going to make this stand?

Lives are now being played with by both sides.

I've no sympathy for either side.

Lives are being played with? Read any of the rest of the thread?

Now? Yes.

How far are the Doctors going to make this stand?

Hopefully until they win.

Right now the junior doctors and the BMA are the only people standing up to a Tory government which is committed to dismantling NHS England.

What I say is health service provision needs a radical overhaul. It just cannot work in today's world with today's expectations and it was never intended to, it was setup to provide universal basic health care. Modern medicine and longer life expectancy it simply cannot cope with

Essentially it needs more money. That is not radical overhaul its just appropriate funding.NO health system copes as well as ours, with such outcomes for so little money

Never in the field of human healthcare have so many owed so much to so few

I accept the electorate are a bit daft in both wanting tax cuts and better services. A grown up debate about how we only get what we pay for , with the clear acceptance private is more expensive, is indeed worth while.

There is no chance this "grown up debate" will win over the UK public to a private NHS.

It was not set up for basic health care - some more oil[facts] for your water[opinion]

In February 1941 the Deputy Permanent Secretary at the Ministry of Health recorded privately areas of agreement on post-war health policy which included "a complete health service to be available to every member of the community" and on 9 October 1941, the Minister of Health Ernest Brown announced that the Government proposed to ensure that there was a comprehensive hospital service available to everyone in need of it, and that local authorities would be responsible for providing it.[6] The Medical Planning Commission set up by the professional bodies went one stage further in May 1942 recommending (in an interim report) a National Health Service with General Practitioners working through health centres and hospitals run by regional administrations.[7] The Beveridge Report of December 1942 included this same idea.

The only basic thing here is your understanding which, clearly, needs to see a doctor.

For now they are but there's rumblings a foot with other health care professionals facing the same issue that similar action may be needed.

Lives are now being played with by both sides.

I've no sympathy for either side.

Junkyard - lazarus

Essentially it needs more money.

There appears to be plenty of money.

The problem is that it isn't necessarily going into patient care.

Example :

[i][b]The scandalous Private Finance Initiative (PFI) is saddling hospitals with enormous debts. The original capital cost of more than 100 PFI hospitals was around £11.5 billion; the repayments on those hospitals will end up costing up to £80 billion. This differential of tens of billions will be siphoned off to banks, financial companies, construction and facilities management firms, instead of being spent on patient care.

.

Funding is a fundamental issue, but it can only be tackled once privatisation has been halted for good - otherwise the health budget is merely diverted as profits for private companies masquerading under the NHS logo.

.

The crisis in the NHS is real, but it is a manufactured crisis due to deliberate policies that have stripped the NHS of funding. We spend significantly less than France, Germany or Holland on our health service, less than the EU average and well below the US. [/b][/i]

http://www.independent.co.uk/voices/jeremy-hunt-heres-how-to-call-off-the-junior-doctor-strike-and-save-the-nhs-in-five-easy-steps-a6862901.html

Fair point ernie
Fair point.

@ernie the British people already welcome private healthcare, plenty of STWers have had private ops and Steve Peat openly said he could not have gotten the level of care and rehab for his ACL without private medical. However what we have is a dogs breakfast as the two systems have grown up separately, as such neither really complements the other. Sooner or later people will figure this out themselves. It's not party political thing as after 13 years of Labour government the NHS was in worst shape and it will continue to deteriorate as the amounts of money required are simply beyond reach not least as spiralling medical costs, raging and expanding populations will outstrip any additional spending which is forthcoming.

You yourself have posted the reason above, we don't spend enough and haven't done so under any government. The fact is the electorate are not being told the truth about how much the health service we want actually costs and as it stands they certainly don't want to pay for it. All my French friends with half decent middle class jobs pay for private medical insurance on top of their already high taxes.

The fact is the electorate are not being told the truth about how much the health service we want actually costs and as it stands they certainly don't want to pay for it.

Interesting theory.

Why do you think the government isn't telling the electorate the truth jambalaya ?

Mefty, you are naughty. Two sensible posts in a row are too much for a subject that can only be dealt with in the context of hyperbole and misinformation. Please stop it.

Hope everyone was ok today and no grizzly headlines. Not having to wait for the senior physician in A&E must have been a novelty.

the British people already welcome private healthcare

The issue is whether they will accept a fully privatised NHS - or your totally erroneous claim it was only ever basic

That post does not address either issue.

Just for clarity, is this the person in whose hands the NHS has landed?

http://www.liverpoolecho.co.uk/news/liverpool-news/fury-sports-secretary-jeremy-hunt-3405374

He said: “I was incredibly encouraged by the example set by the England fans, I mean, not a single arrest for a football related offensive and the terrible problems that we had in Heysel and Hillsborough in the 1980s seem now to be behind us.”

Why does no one propose a fee for going to the Doctors similar to what the French do? 15quid for a GP visit, 50quid for A&E, 250quid if you negligent (drunk etc).

I can't see why anyone would disagree with this and the amount of unnecessary trips would be significantly reduced.

LHS - Member

Why does no one propose a fee for going to the Doctors similar to what the French do? 15quid for a GP visit, 50quid for A&E, 250quid if you negligent (drunk etc).

I can't see why anyone would disagree with this and the amount of unnecessary trips would be significantly reduced.

Because plenty of people don't have £50 in their pocket to pay for essential healthcare? Because treating things quickly is cheaper than dealing with the consequences of having people not seek help?

SRSLY.

Ok, so 20quid /10quid pick your point. A nominal fee that will make people think twice about going to the doctors because they have a sore throat. It won't stop people seeking help if they need it, yet will stop the serial offenders who abuse what the service is there for. If you want a non-privatized service, it needs to be adapted to reduce waste.

[quote=LHS ]Why does no one propose a fee for going to the Doctors similar to what the French do? 15quid for a GP visit, 50quid for A&E, 250quid if you negligent (drunk etc).
I can't see why anyone would disagree with this and the amount of unnecessary trips would be significantly reduced.

Where do you stop then? Pay up front for attendance of Police, Fire, Ambulance?

Lets go back to the good old days of this [url= https://en.wikipedia.org/wiki/Fire_insurance_mark ]https://en.wikipedia.org/wiki/Fire_insurance_mark[/url]

Pay by Paypal? gift only obviously cant have you lodging a dispute later on once better.

I would say that is a knee jerk reaction, you don't get people phoning the fire service or visiting the police station for a chat. The NHS is without question not-sustainable in its current form, why not make some small adjustments that will cut waste.

LHS - Member

Ok, so 20quid /10quid pick your point. A nominal fee that will make people think twice about going to the doctors because they have a sore throat. It won't stop people seeking help if they need it

Any amount that's enough to act as a deterrant, will act as a deterrant.

That isn't the case in other EU countries who have this system.

[quote=LHS ]I would say that is a knee jerk reaction, you don't get people phoning the fire service or visiting the police station for a chat.

Ha ha ha you'd be surprised what the public do and expect from their public servants. I've lost count the number of times I've had the phrase #Ipayyourwagesdontchaknow screamed in my face. 🙄

I must have missed that report.

Ok I am out, carry on. But without compromise and willingness to address the issues, the NHS is doomed to failure, and no one wants that.

....stop the serial offenders who abuse what the service is there for

Ah yes that's the crises affecting the NHS in England, not PFI or UnitedHealth Inc. siphoning money from the NHS budget, the billions being wasted on that is inconsequential, what's really screwing the system is wasting money on people who aren't ill.

LHS - Member

That isn't the case in other EU countries who have this system.

It's exactly what happened in Germany when they introduced co-payments, and exactly why they abolished them, less than 9 years later. You don't get many unanimous votes in politics.

They also failed to yield the incomes expected, to the surprise of nobody.

In Sweden, when copayments were abandoned for children's medical care, it the increase in outpatient visits was small but overwhelmingly from lower income families, and clear evidence of underuse of care was found in those low income brackets.

Now where's your evidence that no genuinely ill people are deterred or delay seeking medical help in other countries?

France and Ireland are using them.

50million wasted GP visits a year at last estimate. At probably 100quid a visit. I would say that was considerable cost.

Anyway, as per my previous, I am out. Carry on.

LHS - Member
Why does no one propose a fee for going to the Doctors similar to what the French do? 15quid for a GP visit, 50quid for A&E, [u]250quid if you negligent (drunk etc)[/u].
I can't see why anyone would disagree with this and the amount of unnecessary trips would be significantly reduced.

As someone who works as a nurse in Emergency Medicine I'd love to see the amount of people brought in drunk reduced but, if someone can't consent to being brought to hospital (too drunk/unconscious), how could a hospital charge them £250 for attending?

Also, how drunk are we talking? Tipsy or steaming? What would be the legal definition, after all there would be legal challenges to such a charge ("I pay my taxes dontchaknow!")

LHS » Why does no one propose a fee for going to the Doctors similar to what the French do? 15quid for a GP visit, 50quid for A&E, 250quid if you negligent (drunk etc).
I can't see why anyone would disagree with this and the amount of unnecessary trips would be significantly reduced.

You're not trying to solve the right problem there. You want people to stop *not* attending, not stop people attending altogether.

Probably best to fine those who don't attend, rather than charge those who do.

you don't get people phoning the fire service or visiting the police station for a chat.

You've not worked with emergency services, or are a regular news reader, are you?

"999: Someone stole my Snowman..."
http://www.bbc.co.uk/news/uk-england-kent-11908583

"999: Cold Kebabs, and rip-off prostitutes..."

http://www.bbc.co.uk/news/uk-england-35162700

A woman called to say she had bought a cold kebab and the shop would not replace it

Callers who missed their alarm and were going to be late for a flight wanted officers to take them to the airport

A woman who had seen a clown in London selling balloons for £5 each, which was much more than other clowns were charging

Callers in distress because their low fuel indicator light had come on
A man called to say his 50p coin was stuck in a washing machine at his local launderette and wanted police to retrieve it

A man who did not have change for a parking machine claimed staff at a car park had kidnapped him because they were refusing to let him out for free

A caller dialled 999 at 04:00 on a Saturday morning and asked: "Where is the best place to get a bacon sandwich right now?"

A man called 999 as he was advised to call 111 but did not know the number

A woman wanted police to deal with a couple of noisy foxes outside her home as they were preventing her from sleeping

A woman dialled 999 to say there were men in her house trying to take her away. The men in question were police officers who had come to arrest her

Let's not forget the total waste of organs that call the fire brigade, just to try to either beat them up, set them on fire, or just generally abuse them.

What you are doing there is distracting from one issue with a another. I don't think there were 51million unnecessary fire brigade call outs last year? If there are then yes we should apply the same methodology to that too.

Agree on the fines for not attending appointments.

EDIT: 45GBP for a 11minute GP visit so 2.2bn GBP on wasted trips
Missed appointments estimated at 200million GBP a year. so 2.4bn GBP in waste. (2% of annual NHS budget / an extra 12,000 doctors)

I'd love for an ambulance to cost the same or maybe £5 more than the cost of a taxi to ED. You'd see our workload halved almost overnight, with the remaining patients most likely being the sort that actually require ambulance assistance. Honestly, if the public knew just what the am I that they have just pulled over to let through a busy road was actually going to, they'd probably think twice about giving way!

But the ambulance service is NOT representative of the whole NHS. The complete waste of time users are deflected from costing the NHS a major fortune by a small army of paramedics, ED nurses and docs, and obviously GPs. The ones that get through to actual ongoing treatment, by and large need to be there.

What you are doing there is distracting from one issue with a another.

Nope. Just responding to your deflection.

A nominal fee that will make people think twice about going to the doctors because they have a sore throat. I

The problem with putting off people with a shoe throat is that you also put people off who've got rectal bleeding, which, believe it or not, your GP would really like to hear about. The problem with putting off people with a bit of a cough is that every so often the person with a cough has TB, or lung cancer, or something else you don't really want to see 6 months too late.

As the NHS does pretty much next to nothing in terms of preventative medicine I think that is a pretty weak argument. The French and Ireland systems have not seen any correlation between people not going to the doctors with genuine concerns. Also the effective use of the phone system (111 is it) would not change.

Rectal bleeding believe it not has different symptoms than a sore throat. It is not that common to get rectal bleeding. A cough usually disappears in a week, if it is persistent for a few weeks you would go to the doctors.

Side note - a mate of mine was working in a GP practice in a deprived area of Doncaster and was really shocked by the late presentations he saw there. Rarely a week went by without someone coming in to tell him about their severe central crushing chest pain that they'd had constantly for a week or two now, or the fact that they've been weeing blood for the last six months and had just decided that it was probably not entirely normal.

As the NHS does pretty much next to nothing in terms of preventative medicine.

Well that ain't right. All those statins and smoking cessation services don't prescribe themselves you know.

The problem with putting people off...

Surely instead of saying that 'free at point of delivery' is completely sacrasanct (which it evidently isn't, see; dentistry) maybe we could have a list of 'core conditions' that are free to see the [i]appropriate[/i] service for, like chest pain, stroke, RTC etc, no charge from Ambo, but call us out to change your bedsheets (like last night) then no probs, the bill is in the post. Free to see your GP for almost anything, but decline to see the NP first when triaged as appropriate, well no probs, how about a contribution towards the cost of providing ten years of medical training at your beck and call.

I don't know. I desperately BELIEVE in the NHS as an organisation and as a concept, but I despair as to the lack of value placed on it by large segments of society.

*All in my entirely anecdotal experience, of course. But a valid observation nonetheless, I can't help but feel.

It is not that common to get rectal bleeding.

Agreed, but it is relatively common to delay going to see a doctor about it because of fear or embarrassment. Your 15 quid probably wouldn't help neither.

http://www.pulsetoday.co.uk/clinical/prescribing/government-accused-of-letting-pharmaceutical-industry-dictate-drug-prices-and-nice-approvals/20009850.fullarticle

The French and Ireland systems have not seen any correlation between people not going to the doctors with genuine concerns

As the NHS does pretty much next to nothing in terms of preventative medicine

?
Statins
Breast screening
Smear test
Poo test
Sexual health clinics (seen a huge reduction in funding, lots of closures)
Etc

No doubt much more needs to be done but with the present funding and staffing crisis don't see that changing much, and can't see this cluster ****ing of a contract change doing anything good

Besides which the government transferred the responsibility for public health to local councils 2 years ago, ya know the local councils that have seen their biggest ever reductions in funding......

Meanwhile the government could've done what doctors have been asking for instead they caved to industry pressure on minimum alcohol pricing, traffic light labelling etc etc

But without compromise and willingness to address the issues, the NHS is doomed to failure, and no one wants that.

In many respects you are right, trying to make these points is a waste of time and best not to bother

trying to make these points is a waste of time and best not to bother

Why not take your own advice instead of giving it to others?