doctors on strike

Phoned today for a GP appointment – 5 week wait. Is this normal?

Indeed @cg sadly it is, after my mum had a suspected stroke recently her GP surgery said it would be 3 weeks for the follow up appointment the hospital said was necessary, thankfully her GP saw after after “just” 2 days. The system is broken.

Just logged on to my GP’s online booking system to check. Next available appt* for me is next Weds. That’s not with my regular doctor however.

* they do seem to add free slots on a daily basis however so pays to login first thing each day to check for same-day slots.

They might have discussed the price of fish, but the only REAL red line was

which was said by 1 executive member, did the chair and the rest agree that?

jambalaya – I thought perhaps it was an (overcrowded) Southern thing. Agree that the system is broken which is why I’m having to self finance my health care that includes a number of permanent conditions. Can’t do this any more so GP will have to deal with an extremely assertive woman who won’t take any crap.

Just logged on to my GP’s online booking system to check. Next available appt* for me is next Weds. That’s not with my regular doctor however.

* they do seem to add free slots on a daily basis however so pays to login first thing each day to check for same-day slots.

That’s pretty good. Local surgery have made it clear that patients have to consult with their named doctor. No more appointments in June now.

I can always get an appointment within a couple of days with mine, Mid Sussex.

Interesting scoop for HSJ about BMA’s tactics in dispute.

All seems a bit sensationalist to me really.

They had access to over six months worth of messages, “more than 1,000 pages” (odd measure), of people talking privately about tactics and negotiations during a massive prolonged bitter dispute, and that was the best they could come up with?

I’d love to see a transcript of all the private conversations and meetings that Jeremy Hunt, David Dalton, the Dept of Health and Malcolm Tucker had during that time. 😆

(But we won’t obviously because, unlike the BMA, they work for us voters so what they say is kept secret).

the only real red line

Pretty easy to take a quote out of context and make it sound juicy. I’d like to see the full transcript there.

Don’t forget that the plain-time Saturday payment was part of the re-definition of “unsociable hours” and bandings which undermined the protection JD had from being overworked.

I notice they didn’t make a headline of the quote from Malwana that said:
” should we trying something slightly different? Offer to talk about anything he wants as long as imposition is lifted and the end result is a contract that is not discriminatory and unsafe.”

And they left this quote as a footnote: “Strongest case that we have is ensuring that all doctors are protected from working excessive hours that cause unnecessary fatigue and lead to unsafe conditions for patients. It is taking reckless risks with patient safety.”

^^^ exactly seizing onto a few lines in a discussion that went on for months and months smacks of desperation from the NHS haters

its not like they co-authored book calling for NHS to be replaced with private insurance

cranberry – Member

Well, that is a somewhat inconvenient truth. I do hope that those who said the dispute was about “saving the nhs” are blushing today.

An inconvenient truth- for you. It’s only one executive member that said it; that doesn’t make it the BMA’s position or policy. But it’s pretty obvious where you’re coming from and why you’d choose to spin it like you did.

which was said by 1 executive member, did the chair and the rest agree that?

Dr Malawana asked his executive colleagues whether any deal including Saturdays at plain time might be accepted.

Several members replied to say that it would not.

Former JDC chair and executive member Kitty Mohan said: “It is the only real red line. It’s the thing 99 per cent of juniors told us they were upset about in August.” Arrash Arya Yassaee told Dr Malawana: “Bluntly, no.”

Dr Malawana agreed and said: “If you play out each course of action. Then fundamentally it comes down to the issue over plane [sic] time. But no combination or scenario in my mind gives us a contract juniors would buy that gives you Saturday as plane [sic] time.”

So the article quotes the Chair, Malawana, and Yassaee as agreeing Saturday plain time was not negotiable.

mefty: you realise none of those quotes actually mention money?

Saturday as plain time (or even “plane” time) is a direct change to the banding system, which is a system that was put in place to try to limit the number of ridiculously long and anti-social hours that junior doctors were being asked to work in the bad old days, which everyone agreed were dangerous.

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.

So yes a 50% increase in the number of hours that were consider normal, sociable hours, did “upset” a great deal of juniors.

Especially as that change was sold to them on the back of lies, spin and misinformation.

That’s not the argument though. Cranberry is maintaining that the comment proves that the entire dispute was only about money, which of course it doesn’t remotely.

But of course with this spin story that’s the way it will be remembered.

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.

Funny that.

This is for you ernie. And for cg it might explain the long wait for appointments.

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 – Member

And 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 – Member

This 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.
This paper probably covers quite a lot of it though

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 you 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.

[Quote]At best they seem to have misunderstood that the NHS exists for them – it doesn’t patients should always come first.[/quote]

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?

OED says a profession is “A paid occupation, especially one that involves prolonged training and a formal qualification” and gives teaching as an example.

Wiki says “Medieval and early modern tradition recognised only four professions: divinity, medicine, law and Engineering – the so-called “learned professions”

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, Prospect is the independent union for Engineers (of all kinds).

Lawyers have 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:

https://www.gov.uk/government/publications/public-list-of-active-trade-unions-official-list-and-schedule/trade-unions-the-current-list-and-schedule

Unite the union represents Church of England clergy, which I’m sure mefty in his role in the established church is aware of.

TBH I dont even know what point you’re trying to make here mefty

What is it – genuine question not sarcasm.