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Graham, you had a JHJ moment there 🙂
docrobster - thank you. May I ask some questions and fully appreciate if you'd rather not answer them? In your experience, and since the start of austerity, has there been an increase in consultations due to patients not willing to buy their own medicines? Has there been an increase in the number of patients entitled to free prescriptions? Are patients more informed or less informed these days, or simply disinterested in their own health?
Thanks. 🙂
The proposed contract said they were changing the definitions so that working till 10pm during the week and working 7am till 10pm on a Saturday was no longer considered to be "anti-social" hours.
And the fact that anti social hours are paid more is of course an irrelevance.
Especially as that change was sold to them on the back of lies, spin and misinformation.
Well it would appears from the article that lies, spin and misinformation weren't restricted to the DofH. I personally don't have a major problem with that though, it is sanctimony as if doctors should be treated better than any other profession that I find grating.
It's almost as if the government, bitter at losing the dispute, has made a last minute effort to poison the public sympathy for doctors by releasing the GCHQ surveillance transcripts extensive message log kept by a concerned citizen to a suitably sympathetic publication so they can scrape some small "victory" from the whole sorry mess.
Oh look who has drunk the Kool Aid, you don't think that there may be some disagreement within the group itself.
And the fact that anti social hours are paid more is of course an irrelevance.
No it was/is pretty relevant as it is the entire basis of the banding system, which was originally devised to make it more expensive to have one doctor working ridiculous or illegal hours than two doctors working reasonable hours.
Well it would appears from the article that lies, spin and misinformation weren't restricted to the DofH.
It's a public negotiation. Both sides are going to have a certain amount of tactics, bluff and PR. That's to be expected really.
But the whole "7 day NHS", "work shy junior doctors kill thousands of patients by not working weekends" thing was an out right lie from the start. As was the whole "it's actually a pay rise, that is also completely cost neutral, and saves us a lot of money" thing.
All these things did was anger the doctors and rally them against the government.
it is sanctimony as if doctors should be treated better than any other profession that I find grating.
Any other profession is allowed to strike if management decide to force through a drastic change to terms in their contract that their union opposes. Most other professions are not government run monopolies.
I suspect any sanctimony or superiority is more perceived than real.
mefty - MemberAnd the fact that anti social hours are paid more is of course an irrelevance.
Of course it's not irrelevant; I don't recall many doctors saying "we don't care what we're paid. Pay is irrelevant! Pay us nothing, we don't care". The question is whether it was central, or critical, or as some outright liars would have you believe, what it was all about.
But don't forget Northwind:
That they were prepared to leave people in pain for cash was shocking. At best they seem to have misunderstood that the NHS exists for them - it doesn't patients should always come first.
Doctors should work for free if they have to, because asking for money is immoral when people are in pain.
You know, just like any other profession.
docrobster - MemberThis is for you ernie.
Thank you docrobster, however I have absolutely no idea why you think it would be of interest to me.
Yes I think it's probably a good idea that you can buy nail fungal treatment in Boots without a prescription, and no I don't think it's a good idea that someone should make an appointment with their GP so that they can weigh their holiday luggage on the practice scales.
But once again, thanks anyway. 🙂
Cinnamon girl im happy to try to answer your questions although clearly this is just my experience.
Bear in mind that where I work is in the 20% most deprived in the country according to the index of multiple deprivation.
I can't say that there has been an increase in number of appointments due to people not being able to afford to buy medication, simply because most prescriptions I write are free anyway, over 60s, kids, diabetics on medication, and of course those on low incomes all get them free anyway. There has always been an element of going to the doctors to get it for free which is why the CCG, like most, has a minor ailments scheme to provide over the counter medication to those in receipt of free prescriptions for no cost from the chemist. What worries me more is that people will stop getting their medication because they have to pay for prescriptions but can't afford them. In that case they usually just stop coming to see us as well. This definitely happens and probably more in recent years. I have no idea what gets sold in chemists shops because very few of my patients would have money for that anyway. It is a lower priority than phone credit. As above though, it's frustrating that any old crap is punted across chemists counters at times. Cough medicine for children being a case in point. Complete waste of time yet still sold in large quantities.
Regarding the second question I've no idea but I expect there are national stats somewhere. As above the majority of prescriptions are not charged for in the first place. What I have seen is a huge amount of consultations for people who have been thrown off the sick and wish to appeal so of course expect a letter from the gp. Two thirds of cases are overturned on appeal so the dwp gets the assessments wrong more than they get it right. I hear horror stories on a daily basis of people being badly assessed.
Last question is actually something I was discussing with my wife this morning. We feel there is more variation, so you get people obsessed with their health, clean eating etc all that stuff. They come with sports injuries and expect first class treatment so they can keep doing their triathlons or whatever, and are often disappointed by they 6 week wait for physio etc. Then you also get the hard drinking and smoking people with a completely fatalistic attitude of "we all die eventually of something, no point trying to be healthy". I think there are more of the second group in more deprived areas. Where I work alcohol is a huge problem. Yet the government bows to pressure from industry and won't bring in minimum pricing. 3 litre bottles of white lightening sell very well.
In your earlier post you asked about whether poor access to gps was a London thing due to overcrowding, in fact the opposite is true. The inverse care law is still very much in effect. There are more doctors per head of population in less deprived areas. The hardest to recruit areas are generally the most deprived. London deanery has the least trouble filling it's go training places. I was informed this week that the minimum standards required for workplaces based assessment by the trainees are less onerous there than in other areas ( number of learning log entries required per month to be signed off as competent) but I expect it's more to do with the pull of London.
The effect of cuts to council funding cannot be over emphasised. Apart from obvious things like longer waits for assessments for social services, councils commission public health services like sexual health smoking cessation, health visitors and school nurses etc. All these budgets are being actively reduced so "ring fenced" healthcare spending is having to be spent to fill the gaps. Not good for the health of the nation and incredibly short sighted stupid policy.
If you're interested in actual stats as opposed to my jaundiced view there is research being done on this issue in Glasgow and Leeds/Sheffield search for deep end general practice.
[url= http://www.gla.ac.uk/media/media_296141_en.pdf ]This paper probably covers quite a lot of it though[/url]
Sorry ernie I thought you questioned human behaviour and how it might impact on health services. I must have misunderstood.
Once again, for the hard of thinking, the proposed settlement was cost neutral, the actual settlement is cost neutral. Doctors overall are not getting paid any more. They are just making sure that money isn't getting taken away from the people who work in the actute specialities who deliver the 7 day NHS... And making sure whistle blowers are protected, women aren't disadvantaged, all those really bad things. AT NO ADDED COST. Yet it's all about the money?!
Interesting to see who won't last this lie...
Sorry ernie I thought you questioned human behaviour and how it might impact on health services. I must have misunderstood.
Misunderstood? I thought it was [i]you[/i] who questioned human behaviour and how it might impact on health services !!
Well there's certainly been some misunderstanding, that's for sure! Still never mind.
ny other profession is allowed to strike if management decide to force through a drastic change to terms in their contract that their union opposes
I can't think of another "classical" profession that is unionized.
Teachers?
Classically I don't think teaching was regarded as a profession but a vocation, hence I used a qualifier, that is not to demean it, just a recognition that the use of the words "profession" or "professional" have changed. After all in the context of sport, it means you are simply paid.
At best they seem to have misunderstood that the NHS exists for them - it doesn't patients should always come first.
But without them the NHS folds and then the patients will definately come last.
In my experience of working with my junior doctor colleagues "da money" is far from the first thing they worry about with Herr Hunt's meddling, but it shouldn't be the last either.
I believe we all work for the NHS because we truly believe in the ideal of a 'free at the point of use' healthcare system. That shouldn't mean we do it for peanuts though.
ENgineers- they certainly have [ a number of] unions as well
I can't think of another "classical" profession that is unionized.
Hmm.. not sure what you mean by "classical" profession there?
[url= http://www.oxforddictionaries.com/definition/english/profession ]OED says[/url] a profession is [i]"A paid occupation, especially one that involves prolonged training and a formal qualification"[/i] and gives teaching as an example.
Wiki says [i]"Medieval and early modern tradition recognised only four professions: divinity, medicine, law and Engineering – the so-called "learned professions"[/i]
Is that what you were going for? If so then pulling medicine out as one of four special disciplines seems an odd way to convince us that it isn't special 😕
But since you asked, [url= https://en.wikipedia.org/wiki/Prospect_%28trade_union%29 ]Prospect[/url] is the independent union for Engineers (of all kinds).
Lawyers have [url= http://www.lawsociety.org.uk/ ]The Law Society[/url], which is a "professional body" rather than a union but does do some fairly uniony things like making press statements on behalf of members, petitioning government etc.
No idea what divinity have, other than a really good after death package.
Lawyers have the Law Society, which isn't a union but does represent lawyers
Actually lawyers working for the Crown Prosecution Service, for example, have a TUC affiliated trade union - the FDA
I was referring to professions that have been organised in Institutes, or Royal Colleges in the case of doctors, since the 19th century or before. That said, on reflection, I think that unionisation is more a function of the nature of the employer, lawyers who work for government will be often be members of FDA so the fact that hospital doctors are unionised is a function of who employs them rather than anything else.
EDIT: Sorry Ernie, I didn't refresh so didn't see your post.
so the fact that hospital doctors are unionised is a function of who employs them rather than anything else.
Doesn't the BMA represent self-employed GPs as well as hospital doctors ?
😆No idea what divinity have, other than a really good after death package
Brilliant
Doesn't the BMA represent self-employed GPs as well as hospital doctors ?
I wasn't sure - hence I restricted my response - but if the answer is yes - substitute who pays them rather than who employs them - still doesn't cover every situation.
That said, on reflection, I think that unionisation is more a function of the nature of the employer
I guess being employed by big government might encourage people to join a union to defend themselves - but there are tons of unions for all kinds of jobs/professions/vocations and all kinds of employers:
Unite the union represents Church of England clergy, which I'm sure mefty in his role in the established church is aware of.
[quote=Junkyard ]ENgineers- they certainly have [ a number of] unions as well
TBH I dont even know what point you're trying to make here mefty
What is it - genuine question not sarcasm.
Unite the union represents Church of England clergy, which I'm sure mefty in his role in the established church is aware of.
I was not actually, but then my role is completely insignificant, my late mother probably would have known who had a less insignificant role, but hardly significant.
Oh well I knew because of tribunal cases in the news involving Church of England clergy, and I have no role at all in your breakaway anti-papist heretic outfit!
I hear you brother, I am with the working man in the Anglo Catholic branch, none of this Tory party at prayer for me.
The Holy Father says "nice one bruv".
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So what next ?
I suspect they want their slice of the £350 million pound cake
So it's all about money then ?
I thought so. Crafty ****ers.
Can't help thinking that it is a major mistake to reject the current offer.
As far as the public are concerned this dispute was over. They won't welcome its return at a time when they are now focused on the consequences of brexit and I think they are likely to lose sympathy for the junior doctor's argument pretty quickly, especially if further strike action is called.
I suspect they want their slice of the £350 million pound cake
Look, this has been explained, at no point did Vote Leave say they were going to give the NHS the 350 million that the EU takes every week:
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#posttruth
I think they are likely yo lose sympathy for the junior doctors pretty quickly, especially if further strike action is called.
Personally I doubt it. Sure they might lose some sympathy, and people who have never had any sympathy for junior doctors are likely to come along and say "well they've lost my sympathy", we've already had cases of that on this thread.
But on the whole I would say that the public trust junior doctors more than they trust politicians, and particularly in the case of the NHS, Tory politicians.
And why wouldn't they ?
I can just see it getting spun as [i]"Bloody greedy doctors. As if we don't have enough to worry about now"[/i].
I can just see it getting spun as "Bloody greedy doctors"
More like "bloody Corbyn", I suspect.
BMA agrees deal, Doctors reject. Dogs breakfast.
BMA agrees deal, Doctors reject. Dogs breakfast.
Funny that, 'cause the Tory Heath Secretary Jeremy Hunt, and his biggest cheerleader the Daily Telegraph, were both claiming that the BMA were a bunch of militants who were forcing junior doctors to take strike action they didn't want to take.
[url= http://www.telegraph.co.uk/comment/telegraph-view/12152870/Junior-doctors-are-being-misled-by-the-BMA.html ]Junior doctors are being misled by the BMA[/url]
Quote :
[i][b]Having rejected the Government's fair offer, the BMA now uses its hard-working members to hold the nation to ransom [/i][/b]
What's that all about jambalaya ? Do you know ?
Don't you respect a democratic vote, Jambas?
Leaving do last night for Jr doctor in our lab, probably the best medic PhD I've worked with, there's no doubt his work will mean a big change in how bowel cancer and IBD are treated when the regulator comes to review the guidelines next year.
he flies to Australia on Sunday.
Can't help thinking that it is a major mistake to reject the current offer.
As far as the public are concerned this dispute was over.
I completely agree with this analysis, also the BMA supported the offer, so now the government can spin it as greedy doctors with a hint of truth.
The other thing is the doctors have gambled as they don't know what the new PM's take will be, they might look for settlement again or could just impose.
Dragon one of the conditions of this contract was the BMA had to say they supported it.
So they supported it.
It's no surprise really. The BMA spent months suggesting the differences between their demands and the government's offer was massive, then agreed a deal which looks virtually identical to the one they had rejected weeks earlier.
Their members see only a marginal at best improvement from the position which had them on the picket line, so can be forgiven for still rejecting it.
Monumental cock-up from the BMA, who are now stuck in no-man's land between Jeremy Hunt and a bunch of angry juniors.
Is / has Mr Chunt Kepped his job ?
....and he's out 
Who is replacing him though ?