Surgery appointments

[Davy]

Last week I read about a man who called his doctor's surgery and was placed over 30 in the queue. He had enough and found a surgery with a better way of processing enquiries. This week my brother felt really unwell and took 2 nights off work (which is unusual for him, also to feel cold)) He tried calling the surgery and was placed over 30 and later told there was no appointments left. I said to play the diabetes card and that might get him to the head of the queue. He said that actually he had a sore foot last week and was told to call again if it got worse and it had. H e tried the surgery the next day and same again. So he called the podiatrist who saw him and sent him straight to A& E who then admitted him to hospital with a foot disease which I read later if untreated spreads through the blood and infects the rest of the body and can lead to death. Anyway it got me thinking of the old SLF song "Is that what you fought the war for" and particularly the lyrics " Where free health care can save your life, but queue until you die". And if he never went to the podiatrist he might just have! I don't believe the NHS pressure is now from Covid, but wonder why is it our doctors after getting qualified. piss off to Australia, New Zealand, Canada etc. I like having free bridges, prescriptions, bus passes etc but wonder if it is worth it if we cant get an appointment to see the doctor! Thoughts please?

 

[Jack K]

It's hellish now trying to get a GP appointment and most dentists are trying hard to get rid of NHS patients.
It all gone wrong in the last five years.
A race to the bottom.

 

[Forzahibs]

I went to my doctor , he arranged for blood tests , by the time he phoned me with the results i'd had a heart attack and was in hospital

 

[Hibee Kev]

Been waiting 4 years on a minor surgery (hernia) albeit covid and switching from NHS England to NHS Scotland hasn’t helped (they don’t speak to each other).

 

[Greenmachine]

Why has this happened ?
A few years ago you could get a doctors appointment without too much trouble.
Now it's a nightmare.
Is it the fall out from Covid, or Brexit or what ?
I hear loads of people going on about this and I have been very fortunate that I have not had to get a doctors appointment in the last three years or so, but it's clear something has went massively wrong in the NHS in recent years, I am just asking the question of what is it that has went wrong, and far more importantly why has it went wrong, and how the hell can it be fixed ?
It's pretty clear to me the NHS in it's current form is no longer fit or able to support the population of this country in the way it used to.
It badly needs reform. I just don't see the political will, talent or bravery required to initiate this reform i'm afraid.

 

[egb_hibs]

The system is mental. Five or even six A passes at higher can be insufficient to get into medical school such is under capacity. This at a time when half the population are funnelled into uni, many gaining nothing more than a worthless degree and four years of indoctrination in anti social nonsense.

The NHS is, meanwhile, a dysfunctional mess that no doctor or nurse heroics can compensate for, because it’s not a medical problem it’s a structural one that no amount of flinging good money after bad is going to fix.

It needs rethought, but too much dinosaur dogma stands in the way. It could be the making of Kier Starmer if he takes it on, because it has to be labour that does it I think.

 

[hibbybilly]

I don’t think there’s enough Doctors tae cope with the demand. Population increase and A lot of newish conditions tae like Covid and mental health that weren’t around years ago. The Tory cvnts trying tae sell off the NHS isnae helping either.
That said I got an appointment with a doctor a few weeks ago nae bother.
Glad I did.

 

[Archie]

The system is mental. Five or even six A passes at higher can be insufficient to get into medical school such is under capacity. This at a time when half the population are funnelled into uni, many gaining nothing more than a worthless degree and four years of indoctrination in anti social nonsense.

The NHS is, meanwhile, a dysfunctional mess that no doctor or nurse heroics can compensate for, because it’s not a medical problem it’s a structural one that no amount of flinging good money after bad is going to fix.

It needs rethought, but too much dinosaur dogma stands in the way. It could be the making of Kier Starmer if he takes it on, because it has to be labour that does it I think.

I'll ignore the hyperbolic dissing of higher education.

The Scottish Government sets the intake targets for medical schools based on workforce planning requirements. Not say these are right, but it could be addressed there (albeit with a long lead in time).

What are the structural problems you mention that throwing money at won't solve?

I think one issue is that primary care is seeing a withdrawal from service by practitioners. Dentistry is an obvious one, but most GPs are also independent contractors. My GP practice had a difficulty retaining young doctors because they didn't want to take on liability for the lease that was about to be renewed. Why is that even an issue? I think we should move to more salaried GPs.

 

[Purple & Green]

Where do you start?

In Bonnyrigg ten years ago it was a 6 week wait to get an appointment. I moved through to Inverclyde and I could get an appointment next day. Could even go online and pick a time. Covid killed that. I think the gps played up on not having to do face to faces.

Most GPs seem to work part time, do consultancy in their free time and retire ridiculously early.

Nursing seems to be an altruistic career choice whereas Doctory seems to be a very well paid career. That’s maybe systematic of the society changes in our lifetimes, doctors were part of the community when I was a child now they are gatekeepers to getting access to medical services.

 

[Purple & Green]

Reminds me of a story from Jason Langford, involving a stand-off between a doctor and a paramedic at one of his gigs.

What kind of doctor are you?

GP

Oh, yeah, what you going to do? Google it?

Which is really funny because I’ve been sat in a doctors surgery with a sick child where the doctor did exactly that.

 

[egb_hibs]

I'll ignore the hyperbolic dissing of higher education.

Yes I’m sure you would, inconvenient truths and all that

The Scottish Government sets the intake targets for medical schools based on workforce planning requirements. Not say these are right, but it could be addressed there (albeit with a long lead in time).

Given the NHS fundamentally depends on looting the poorer parts of the world of their desperately needed medical expertise because we don’t have enough of our own, I’d suggest target setting is somewhat broken.

What are the structural problems you mention that throwing money at won't solve?

Monolithic operating model the main one. It’s far too big and unwieldy. Bad target setting one outcome out of countless.

I think one issue is that primary care is seeing a withdrawal from service by practitioners. Dentistry is an obvious one, but most GPs are also independent contractors. My GP practice had a difficulty retaining young doctors because they didn't want to take on liability for the lease that was about to be renewed. Why is that even an issue? I think we should move to more salaried GPs.

A lot of them are salaried I think. Depends on the arrangement in any given practice. I’m not sure why this would be disincentivising as being part of a partnership vs salaried is to their financial benefit I would have thought. Perhaps I’m overlooking something but seems to be the case in other professions.

 

[Westside Green]

According to the text message I get there's an unprecedented demand at least once a week for the last 3 years

 

[Archie]

Yes I’m sure you would, inconvenient truths and all that


Given the NHS fundamentally depends on looting the poorer parts of the world of their desperately needed medical expertise because we don’t have enough of our own, I’d suggest target setting is somewhat broken.


Monolithic operating model the main one. It’s far too big and unwieldy.

I think one issue is that primary care is seeing a withdrawal from service by practitioners. Dentistry is an obvious one, but most GPs are also independent contractors. My GP practice had a difficulty retaining young doctors because they didn't want to take on liability for the lease that was about to be renewed. Why is that even an issue? I think we should move to more salaried GPs.

A lot of them are salaried I think. Depends on the arrangement in any given practice. I’m not sure why this would be disincentivising as being part of a partnership vs salaried is to their financial benefit I would have thought. Perhaps I’m overlooking something but seems to be the case in other professions.

The hyperbole with this quote isn't 'truthful' it's just noise:

"This at a time when half the population are funnelled into uni, many gaining nothing more than a worthless degree and four years of indoctrination in anti social nonsense."

But moving on, the point I was making about GPs being independent contractors is that there is risk as well as reward. So that means that the provision of primary care through GPs will be distorted by factor other than population and need.

As for dentistry, changes in what the SCottish Government will fund is leading a withdrawal from NHS dentistry.

 

[egb_hibs]

The hyperbole with this quote isn't 'truthful' it's just noise:

"This at a time when half the population are funnelled into uni, many gaining nothing more than a worthless degree and four years of indoctrination in anti social nonsense."

Which bits aren’t truthful ?

Half of young people in England went to uni as of 2019, I expect Covid has dunted it since . Maybe it’s less in Scotland but I’m talking about the UK, of which England is the bulk.

The symbolic target of 50% at university reached

Tony Blair's ambition for half of young adults to go into higher education is reached, 20 years later.

www.bbc.co.uk

Around 30% of that intake will fail to graduate if trends continue

How many students fail to graduate?

About 70% of students who enter a tertiary programme graduate with a first degree at this level on average across OECD countries with available data.

www.oecd-ilibrary.org

Of those that do, (figures are English again). 25% of males and 15% of females won’t earn more than non graduates (source is the economist but that is paywalled, this blog reproduces the piece). But that is skewed by degree - basically 100% of medical and stem graduates will get a ‘return’ and far lower in ‘softer’ subjects.

Was your degree really worth it? – The Passive Voice

www.thepassivevoice.com

Earning is not the only measure, but it’s pretty central not only for the individual but in the economic value society gets out of our approach.

For the indoctrination point I’m not sure you’ll get figures like this, but you only have to look around at the lunacy, the chilling of free speech, the mental health crises etc…

But moving on, the point I was making about GPs being independent contractors is that there is risk as well as reward. So that means that the provision of primary care through GPs will be distorted by factor other than population and need.

Risk and reward is the nature of life. I’m not persuaded this is material to an NHS where roughly a third of doctors are from overseas and new recruits from overseas outnumber trainees in British medical schools

NHS hires more foreign doctors than total medical school intake

Ministers have been urged to boost medical school places after figures revealed that more foreign doctors joined the NHS last year than the number of medical

www.thetimes.co.uk

While as recently as 2021 only 37% of new doctors in the UK had a British qualification

NHS hiring more doctors from outside UK and EEA than inside for first time

Jeremy Hunt questions ‘morally dubious’ recruitment as thousands hired from poorer countries

www.theguardian.com

As for dentistry, changes in what the SCottish Government will fund is leading a withdrawal from NHS dentistry.

Don’t pay attention to dentistry but that’s regrettable

 

[Jack]

Which bits aren’t truthful ?

Half of young people in England went to uni as of 2019, I expect Covid has dunted it since . Maybe it’s less in Scotland but I’m talking about the UK, of which England is the bulk.

The symbolic target of 50% at university reached

Tony Blair's ambition for half of young adults to go into higher education is reached, 20 years later.

www.bbc.co.uk

Around 30% of that intake will fail to graduate if trends continue

How many students fail to graduate?

About 70% of students who enter a tertiary programme graduate with a first degree at this level on average across OECD countries with available data.

www.oecd-ilibrary.org

Of those that do, (figures are English again). 25% of males and 15% of females won’t earn more than non graduates (source is the economist but that is paywalled, this blog reproduces the piece). But that is skewed by degree - basically 100% of medical and stem graduates will get a ‘return’ and far lower in ‘softer’ subjects.

Was your degree really worth it? – The Passive Voice

www.thepassivevoice.com

Earning is not the only measure, but it’s pretty central not only for the individual but in the economic value society gets out of our approach.

For the indoctrination point I’m not sure you’ll get figures like this, but you only have to look around at the lunacy, the chilling of free speech, the mental health crises etc…


Risk and reward is the nature of life. I’m not persuaded this is material to an NHS where roughly a third of doctors are from overseas and new recruits from overseas outnumber trainees in British medical schools

NHS hires more foreign doctors than total medical school intake

Ministers have been urged to boost medical school places after figures revealed that more foreign doctors joined the NHS last year than the number of medical

www.thetimes.co.uk

While as recently as 2021 only 37% of new doctors in the UK had a British qualification

NHS hiring more doctors from outside UK and EEA than inside for first time

Jeremy Hunt questions ‘morally dubious’ recruitment as thousands hired from poorer countries

www.theguardian.com

As for dentistry, changes in what the SCottish Government will fund is leading a withdrawal from NHS dentistry.

Don’t pay attention to dentistry but that’s regrettable

What's the situation(s) in Scotland?

 

[egb_hibs]

What's the situation(s) in Scotland?

You tell us, i think you are more qualified.

 

[Archie]

Which bits aren’t truthful ?

Half of young people in England went to uni as of 2019, I expect Covid has dunted it since . Maybe it’s less in Scotland but I’m talking about the UK, of which England is the bulk.

The symbolic target of 50% at university reached

Tony Blair's ambition for half of young adults to go into higher education is reached, 20 years later.

www.bbc.co.uk

Around 30% of that intake will fail to graduate if trends continue

How many students fail to graduate?

About 70% of students who enter a tertiary programme graduate with a first degree at this level on average across OECD countries with available data.

www.oecd-ilibrary.org

Of those that do, (figures are English again). 25% of males and 15% of females won’t earn more than non graduates (source is the economist but that is paywalled, this blog reproduces the piece). But that is skewed by degree - basically 100% of medical and stem graduates will get a ‘return’ and far lower in ‘softer’ subjects.

Was your degree really worth it? – The Passive Voice

www.thepassivevoice.com

Earning is not the only measure, but it’s pretty central not only for the individual but in the economic value society gets out of our approach.

For the indoctrination point I’m not sure you’ll get figures like this, but you only have to look around at the lunacy, the chilling of free speech, the mental health crises etc…


Risk and reward is the nature of life. I’m not persuaded this is material to an NHS where roughly a third of doctors are from overseas and new recruits from overseas outnumber trainees in British medical schools

NHS hires more foreign doctors than total medical school intake

Ministers have been urged to boost medical school places after figures revealed that more foreign doctors joined the NHS last year than the number of medical

www.thetimes.co.uk

While as recently as 2021 only 37% of new doctors in the UK had a British qualification

NHS hiring more doctors from outside UK and EEA than inside for first time

Jeremy Hunt questions ‘morally dubious’ recruitment as thousands hired from poorer countries

www.theguardian.com

As for dentistry, changes in what the SCottish Government will fund is leading a withdrawal from NHS dentistry.

Don’t pay attention to dentistry but that’s regrettable

I'm going to be blunt here. I think that it's really important that impressionable young people reading this don't get put off tertiary education. From my personal experience tertiary education was transformative for me, as a person, career terms and in my earning capacity. You say yourself that 75% of males and 85% of females earn more than people without a degree. That’s a good strike rate.

And it takes no account of the other positive aspects of tertiary education.

You do have a really negative view of tertiary education. I don't know what that's about. But maybe listen to people who have experienced it rather than just reading blogs.

 

[egb_hibs]

I'm going to be blunt here. I think that it's really important that impressionable young people reading this don't get put off tertiary education. From my personal experience tertiary education was transformative for me, as a person, career term and in my earning capacity. You say yourself that 75% of males and 85% of females earn more than people without a degree. That’s a good strike rate.

And it takes no account of the other positive aspects of tertiary education.

You do have a really negative view of tertiary education. I don't know what that's about. But maybe listen to people who have experienced it rather than just reading blogs.

Ok that’s ‘your truth’, I’m talking about the evidenced picture. And not from blogs either.

You don’t seem to place much weight on evidence over what you feel about something and it keeps coming up. Is this what tertiary education instils? That would certainly chime with concern over the worst aspects of contemporary campus lunacy, but you aren’t young enough to have been caught up in that (I think).

I rather doubt this exchange is going to have an impact on people choosing university - this is a forum mainly composed of middle aged men, and this jury you keep wanting to address doesn’t exist. But if you do feel that strongly, pick some of the points evidenced above and counter them.

Finally, and yet again - you seem to ignore things that don’t fit your viewpoint - I am not negative about tertiary education, indeed that would be absurd. I’m negative about the way aspects of it are approached today, from indoctrination over rational enquiry, to the swizz of pointless degrees that leave people in debt for no obvious benefit other than plumping the education industry, and the way the system favours those who can afford it over academic ability.

 

[Jack]

You tell us, i think you are more qualified.

I retired more than 10 years ago. I know when I'm not an expert.

What I will say though is what is happening now is a version of what was trying to be achieved back then. It would seem covid has provided the opportunity.

That is seeing the healthcare professional most appropriate to what the patients need is. If there is even a need!

GP surgeries were full of people demanding a doctor to prescribe hay fever pills, removing a skelf, even just for a wee chat while they could be helping someone through their cancer diagnosis.

Over 60% of those rocking up to A&E should have been rocking up elsewhere or maybe just sleeping it off.

I don't know what the plan is now. Maybe we're going through a period of tough love and once it all settes down people will become more used to not seeing a doctor where a nurse or some other healthcare professional is more appropriate and the casual A&E visitor will take a paracetamol for that stinking hangover or take the weight off and rest that sprained ankle for a day or two.

 

[Archie]

Ok that’s ‘your truth’, I’m talking about the evidenced picture. And not from blogs either.

You don’t seem to place much weight on evidence over what you feel about something and it keeps coming up. Is this what tertiary education instils? That would certainly chime with concern over the worst aspects of contemporary campus lunacy, but you aren’t young enough to have been caught up in that (I think).

I rather doubt this exchange is going to have an impact on people choosing university - this is a forum mainly composed of middle aged men, and this jury you keep wanting to address doesn’t exist. But if you do feel that strongly, pick some of the points evidenced above and counter them.

Finally, and yet again - you seem to ignore things that don’t fit your viewpoint - I am not negative about tertiary education, indeed that would be absurd. I’m negative about the way aspects of it are approached today, from indoctrination over rational enquiry, to the swizz of pointless degrees that leave people in debt for no obvious benefit other than plumping the education industry, and the way the system favours those who can afford it over academic ability.

Why are you belittling my experience? You know - my actual experience with this nonsense about 'my truth'?

You posted evidence that showed that 75% of males and 85% of females earn more than those without a degree. That’s me putting a lot of weight on evidence. Hard practical benefits for individuals.

And who are you to say that people are doing 'pointless degrees'? Pointless to you maybe, but you are not the only arbiter of this. The idea that people don't have any free will in their choices is laughable.

How do you know that education favours indoctrination over rational enquiry? Where have you experienced this?

As for those who can afford I over ability, I agree with you. One of the paradoxical issues with tuition fees being scrapped was that it was partly funded by scrapping financial support for poorer student and capping the number of Scottish students who could attend university.

 

[egb_hibs]

Why are you belittling my experience? You know - my actual experience with this nonsense about 'my truth'?

Exactly. Your experience is not irrelevant but it doesn’t overturn the evidence base vis a vis student populations

You posted evidence that showed that 75% of males and 85% of females earn more than those without a degree. That’s me putting a lot of weight on evidence. Hard practical benefits for individuals.

That’s after a thirty per cent drop out rate, so 52.5% of males intake gain from it. And this is not going into the fact that because of the volumes now going, a lot of those people will be getting jobs that don’t need a degree but from which non graduates will now be substantially excluded. So 50k of student debt to get back to the start line. Harder to metricise this but it’s undoubtedly at work.

And who are you to say that people are doing 'pointless degrees'? Pointless to you maybe, but you are not the only arbiter of this. The idea that people don't have any free will in their choices is laughable.

What are you on about free will? People are perfectly free to do things heroic, good, worthwhile, pointless, venal, bad … this is irrelevant. (Well Richard Dawkins et al would disagree but that’s another topic)

And yes, pointless is subjective. If people want to acquire a sack load of debt for something of no obvious benefit to them, and to the taxpayer who contributes to it all, that’s up to them. If you recall, the point was that against this backdrop I believe we should be devoting more of our tertiary sector efforts to under scaled medical schools.

How do you know that education favours indoctrination over rational enquiry? Where have you experienced this?

I know of plenty examples first hand, but you only have to look at the endless documented examples and not close your mind because you don’t like it. Or indeed be aware of the canonical texts of this new cult which emerge from the (predominantly US) university system.

For example, consider the fate of Kathleen Stock or people trying to screen feminist films at Edinburgh.

As for those who can afford I over ability, I agree with you. One of the paradoxical issues with tuition fees being scrapped was that it was partly funded by scrapping financial support for poorer student and capping the number of Scottish students who could attend university.

It’s more than that; grants are affordable when the truly academically gifted are the principal intake. When you extend to half the population, they aren’t. A compromise I would favour is providing grants based on subject and academic achievement, and then disqualifying some based on means testing (rather than qualifying people based on means testing). This may even go on in some highly limited way, but I’d be looking to get back to the levels it used to be, and if that means trimming back elsewhere, so be it.

 

[Archie]

Exactly. Your experience is not irrelevant but it doesn’t overturn the evidence base vis a vis student populations


That’s after a thirty per cent drop out rate, so 52.5% of males intake gain from it. And this is not going into the fact that because of the volumes now going, a lot of those people will be getting jobs that don’t need a degree but from which non graduates will now be substantially excluded. So 50k of student debt to get back to the start line. Harder to metricise this but it’s undoubtedly at work.


What are you on about free will? People are perfectly free to do things heroic, good, worthwhile, pointless, venal, bad … this is irrelevant. (Well Richard Dawkins et al would disagree but that’s another topic)

And yes, pointless is subjective. If people want to acquire a sack load of debt for something of no obvious benefit to them, and to the taxpayer who contributes to it all, that’s up to them. If you recall, the point was that against this backdrop I believe we should be devoting more of our tertiary sector efforts to under scaled medical schools.



I know of plenty examples first hand, but you only have to look at the endless documented examples and not close your mind because you don’t like it. Or indeed be aware of the canonical texts of this new cult which emerge from the (predominantly US) university system.

For example, consider the fate of Kathleen Stock or people trying to screen feminist films at Edinburgh.


It’s more than that; grants are affordable when the truly academically gifted are the principal intake. When you extend to half the population, they aren’t. A compromise I would favour is providing grants based on subject and academic achievement, and then disqualifying some based on means testing (rather than qualifying people based on means testing). This may even go on in some highly limited way, but I’d be looking to get back to the levels it used to be, and if that means trimming back elsewhere, so be it.

I'm not going to get sucked into your culture war stuff, but some observations:

- As an example Edinburgh University has way over 40,000 FT and PT students
- Just over 1% don't complete their degree at Edinburgh
- Number of students
- Many of your examples are from England, where students pay fees. So the cost is bourne by the individual. That's surely their choice, unless you think the 'globalists' are somehow making them do it.
- I don't approve of the Adult Human Female censorship, but this was maybe 100 people involved - it's like saying the person who stickered Ibrox is representative of all Hibs fans. You can't just generalise from some high profile examples.
- Kathleen Stock's experience was awful. But should I extrapolate that all retail is a sex trafficing operation because of Abercrombie and Fitch?
- The evidence that you posted shows that, of those who graduate, 75% of males and 85% of females earn more than they would have. I suspect the variation is that men are more likely to have higher paying jobs through apprenticeships than women. But it's a great strike rate.
- I think it's really interesting that you frame this as me having a closed mind. As it happens I think the lived experience approach has it's limitations, but that you are so dismissive of my experience and that of young people in my ambit of higher education is telling. I'm sure the blogs you read are interesting, but there is a wider perspective that you can't loftily dismiss.
- You make some interesting points about access. I will remind you that the Scottish Government has a key role in controlling access to courses, especially medicine. So maybe take it up there.

 

[egb_hibs]

I'm not going to get sucked into your culture war stuff, but some observations:

- As an example Edinburgh University has way over 40,000 FT and PT students
- Just over 1% don't complete their degree at Edinburgh
- Number of students
- Many of your examples are from England, where students pay fees. So the cost is bourne by the individual. That's surely their choice, unless you think the 'globalists' are somehow making them do it.
- I don't approve of the Adult Human Female censorship, but this was maybe 100 people involved - it's like saying the person who stickered Ibrox is representative of all Hibs fans. You can't just generalise from some high profile examples.
- Kathleen Stock's experience was awful. But should I extrapolate that all retail is a sex trafficing operation because of Abercrombie and Fitch?
- The evidence that you posted shows that, of those who graduate, 75% of males and 85% of females earn more than they would have. I suspect the variation is that men are more likely to have higher paying jobs through apprenticeships than women. But it's a great strike rate.
- I think it's really interesting that you frame this as me having a closed mind. As it happens I think the lived experience approach has it's limitations, but that you are so dismissive of my experience and that of young people in my ambit of higher education is telling. I'm sure the blogs you read are interesting, but there is a wider perspective that you can't loftily dismiss.
- You make some interesting points about access. I will remind you that the Scottish Government has a key role in controlling access to courses, especially medicine. So maybe take it up there.

@Archie you are not getting sucked into anything, you are charging in screaming banzai and starting it. You have dragged the thread into all this stuff because of my - topic relevant - mention of our failure to produce sufficient doctors in the context of a huge education sector supporting lots and lots of ‘less valuable things’ (perhaps we can meet there).

I suggest we revert to the NHS.

 

[egb_hibs]

I retired more than 10 years ago. I know when I'm not an expert.

What I will say though is what is happening now is a version of what was trying to be achieved back then. It would seem covid has provided the opportunity.

That is seeing the healthcare professional most appropriate to what the patients need is. If there is even a need!

GP surgeries were full of people demanding a doctor to prescribe hay fever pills, removing a skelf, even just for a wee chat while they could be helping someone through their cancer diagnosis.

Over 60% of those rocking up to A&E should have been rocking up elsewhere or maybe just sleeping it off.

I don't know what the plan is now. Maybe we're going through a period of tough love and once it all settes down people will become more used to not seeing a doctor where a nurse or some other healthcare professional is more appropriate and the casual A&E visitor will take a paracetamol for that stinking hangover or take the weight off and rest that sprained ankle for a day or two.

Nothing to disagree with there. This seems like a cultural problem though, which is yet another thing the NHS has to grapple with. There is not a shortage!

 

[Archie]

@Archie you are not getting sucked into anything, you are charging in screaming banzai and starting it. You have dragged the thread into all this stuff because of my - topic relevant - mention of our failure to produce sufficient doctors in the context of a huge education sector supporting lots and lots of ‘less valuable things’ (perhaps we can meet there).

I suggest we revert to the NHS.

I will remind you that you started this with a rant about tertiery education!

Failure to produce numbers of doctors is a directly related to Scottish Government decisions. So your critique is with Government.

On to the NHS - what are the structural weaknesses that need fixed and, more importantly, how are they fixed?

I suggested starting with primary care.

 

[egb_hibs]

I will remind you that you started this with a rant about tertiery education!

Yes, with specific reference to the topic at hand

Failure to produce numbers of doctors is a directly related to Scottish Government decisions. So your critique is with Government.

OK, so? If its their responsibility to determine what universities allocate resources to, they should fix it. I'm not convinced it wholly is though.

Do they specify the number of media studies grads we need for example ?
 

On to the NHS - what are the structural weaknesses that need fixed and, more importantly, how are they fixed?

I suggested starting with primary care.

We have one the worst healthcare services among comparable countries for health outcomes. Big uplifts in funds seem to make no difference. Unsurprising to me because while I am no healthcare expert, very fews organisations work at that scale. Bureaucracy, unwieldiness, sprawling decision making chains, inability to effectively manage resource allocation- it doesnt matter what line they are, huge monoliths almost always become unresponsive and inffective.

I'm talking UK level btw; maybe Scotland can he different at smaller scale but it doesn't seem to be.

 

[Ryan69]

Probably got something Todo with alot of Doctors and Surgeons also working private.

So they do bare minimum hours...then get big bucks from private.

Turning into The National COVID Service didn't help too.

At that time....Hospitals were dead.
I went visited a couple of times...was like a ghost town(That was Bristol).

 

[Archie]

Yes, with specific reference to the topic at hand


OK, so? If its their responsibility to determine what universities allocate resources to, they should fix it. I'm not convinced it wholly is though.

Do they specify the number of media studies grads we need for example ?
 

We have one the worst healthcare services among comparable countries for health outcomes. Big uplifts in funds seem to make no difference. Unsurprising to me because while I am no healthcare expert, very fews organisations work at that scale. Bureaucracy, unwieldiness, sprawling decision making chains, inability to effectively manage resource allocation- it doesnt matter what line they are, huge monoliths almost always become unresponsive and inffective.

I'm talking UK level btw; maybe Scotland can he different at smaller scale but it doesn't seem to be.

So what do you propose?

 

[egb_hibs]

So what do you propose?

A restructure of health care provision based on better performing models elsewhere in the G8.

I'll leave the shape to the experts but I would have little in terms of starting constraints other than it remaining free at the point of use. I would anticipate they'd come up with a disaggregated model of mixed public and private providers under regional authorities, with service financed through a proper national insurance. Instinctively i would also keep GPs in the public sector as a check against unnecessary and commercially motivated referrals, but I defer to the experts.

 

[Gareth]

My partner is a GP, so I can talk about this with I hope I wee bit of knowledge, and possibly a bit of defensiveness. I think one of the big issues is that the role of the GP was stretched to breaking point, mental health, social work etc. You add this to the increased elderly population and the additional health needs they have, the rise in mental health problems and you place them with a massive shortage of GPs and it’s a major circular issue. My partner does 11-hour days without a break and is constantly worrying about patients to the detriment of her health. So when its said she works part time, she works more hours than is good for her health and a day is much more than a normal day and neither she, nor any of her GP pals, do any ‘consultancy’ or any extra curricular work, they’re too done in to even if they don’t have a moral position against it, which most of them do. She sees as many patients today as she ever has, maybe more, and has constant extra work in addition to that. And getting to another point, she is a partner, the reason lots of young GPs are salaried or locums is that they can earn the same money with half of the stress and responsibility. It’s a ‘sellers market’, so they can’t say, for example, that they won’t do house visits, or paperwork, or out of hours, meaning there is even more slack to pick up.

And add to this, my partner went into GP to be useful, not run a feckin business. So the model of private GP practices, where accountancy and staffing levels become a massive part of the job is hugely problematic. She would much rather be a directly employed GP, meaning staffing problems and general HR wouldn’t be a huge part of her day and stresses and she could spend her time being a GP. So back to the circularity, lots of people are not staying as GPs here because of the stress and working conditions, and the working conditions won’t get better without far more staff. . I read that over 50% of GP practices are one resignation or retirement away from being unviable. I think we need more rather than less centralisation. I think all GPs in Greater Glasgow and Clyde should be directly employed under standard central contracts and only in exceptional cases are locums employed. And better funded social provision in other areas would also help.

Incidentally, i've never had an issue getting an appointment when i needed one, and quite like the triage and phone consultations

 

[egb_hibs]

My partner is a GP, so I can talk about this with I hope I wee bit of knowledge, and possibly a bit of defensiveness. I think one of the big issues is that the role of the GP was stretched to breaking point, mental health, social work etc. You add this to the increased elderly population and the additional health needs they have, the rise in mental health problems and you place them with a massive shortage of GPs and it’s a major circular issue. My partner does 11-hour days without a break and is constantly worrying about patients to the detriment of her health. So when its said she works part time, she works more hours than is good for her health and a day is much more than a normal day and neither she, nor any of her GP pals, do any ‘consultancy’ or any extra curricular work, they’re too done in to even if they don’t have a moral position against it, which most of them do. She sees as many patients today as she ever has, maybe more, and has constant extra work in addition to that. And getting to another point, she is a partner, the reason lots of young GPs are salaried or locums is that they can earn the same money with half of the stress and responsibility. It’s a ‘sellers market’, so they can’t say, for example, that they won’t do house visits, or paperwork, or out of hours, meaning there is even more slack to pick up.

And add to this, my partner went into GP to be useful, not run a feckin business. So the model of private GP practices, where accountancy and staffing levels become a massive part of the job is hugely problematic. She would much rather be a directly employed GP, meaning staffing problems and general HR wouldn’t be a huge part of her day and stresses and she could spend her time being a GP. So back to the circularity, lots of people are not staying as GPs here because of the stress and working conditions, and the working conditions won’t get better without far more staff. . I read that over 50% of GP practices are one resignation or retirement away from being unviable. I think we need more rather than less centralisation. I think all GPs in Greater Glasgow and Clyde should be directly employed under standard central contracts and only in exceptional cases are locums employed. And better funded social provision in other areas would also help.

Incidentally, i've never had an issue getting an appointment when i needed one, and quite like the triage and phone consultations

I’m sure I speak for us all when I say we are grateful for people like Mrs Gareth and the good work she is doing.

People like her are being failed by the wider ecosystem, and hell by our society too. This is the thin end of the wedge of what I mean when I talk of our social choices destroying welfare by multiplying demand and choking supply.

She and her colleagues are picking through the rubble of all the social damage incurred, acting as social workers come psychologists when they should be dealing with physiological complaints, as they are trained to. Meanwhile the supply side is crippled by the cost of dealing with this, and with insufficient additional labour coming in to defend the pass.

And on top of that doctors are working under the auspices of a failed and unwieldy monolith.

The latter needs wholly rethought, what we can do about that ‘social triage’, fuck knows.

The business side is a double edged sword, being part of a gp partnership brings financial rewards as I understand it, and a degree of autonomy, but it obviously comes with an overhead. There should be salaried options but I would have thought a shared practice could hire an accountant ? I assume they’ve thought of that though and it’s not a goer. (I don’t mean a permanent employee, there are accountant services).

 

[Hibee Kev]

Been waiting 4 years on a minor surgery (hernia) albeit covid and switching from NHS England to NHS Scotland hasn’t helped (they don’t speak to each other).

Finally got my op today and all went well!

 

[joethehibby]

If I can’t get an appt, I just say it’s an emergency and they do see you
Thing is anytime I do get an appt, there are a max of 2 parients in the waiting room. Not exactly run off their feet . There is a major problem with people not turning up . Easily solved by fining them or striking them of their patient lists

 

[Forzahibs]

If I can’t get an appt, I just say it’s an emergency and they do see you
Thing is anytime I do get an appt, there are a max of 2 parients in the waiting room. Not exactly run off their feet . There is a major problem with people not turning up . Easily solved by fining them or striking them of their patient lists

A nightmare if you work trying to spend an hour on the phone , agree about the waiting room situation

 

[emerald green]

Finally got my op today and all went well!

Quality Kev. Hope you have quick recovery

 

[Stu]

If I can’t get an appt, I just say it’s an emergency and they do see you
Thing is anytime I do get an appt, there are a max of 2 parients in the waiting room. Not exactly run off their feet . There is a major problem with people not turning up . Easily solved by fining them or striking them of their patient lists

I've noticed this, there never hardly any patients waiting. It used to be a gurning-faced moshpit of people coughing their guts up, kids running around shouting and wailing with waiting room toys. Eight year-old, well-thumbed magazines about 'country living' or motor caravans and an asthmatic sounding PS system calling out your name whenst you'd smugly look around at all the other suckers with their 45-minute waits to come while you stalked through into Room 101.

Seriously, where did they all go?

 

[hibbybilly]

Finally got my op today and all went well!

Mikey got a hernia op when he was a bairn Kev. Done himself a mischief crashing intae things in his baby walker. A trait he would also put into practice later in life as a radge centre half.
Hope for a quick recovery bud

 

[emerald green]

I've noticed this, there never hardly any patients waiting. It used to be a gurning-faced moshpit of people coughing their guts up, kids running around shouting and wailing with waiting room toys. Eight year-old, well-thumbed magazines about 'country living' or motor caravans and an asthmatic sounding PS system calling out your name whenst you'd smugly look around at all the other suckers with their 45-minute waits to come while you stalked through into Room 101.

Seriously, where did they all go?

Most get successfully dealt with via the phone. Punters then picking up prescriptions at some point that day then passed into the pharmacies. (those that get through, and get thru the feckin monsters on the reception , to book a call back from an actual medically trained professional that is)


Personally think GP surgery are worse than bad. Theyre brutal.

 

[Cavalier]

Most get successfully dealt with via the phone. Punters then picking up prescriptions at some point that day then passed into the pharmacies.


Personally think GP surgery are worse than bad. Theyre brutal.

I have to get bloods taken every 6 months at the hospital.
I asked if I could use the surgery thinking the hospitals could do with the pressure off. I was told the opposite.

Not been in my local surgery in 5 years.

 

[emerald green]

I have to get bloods taken every 6 months at the hospital.
I asked if I could use the surgery thinking the hospitals could do with the pressure off. I was told the opposite.

Not been in my local surgery in 5 years.

..and yet Cav, to get bloods taken its by a phlebotomist. That is (or was) a grade 2 in Scotland. Its not a highly paid post in the slightest. Its a nonsense the local Doc surgery cant deal with that. I suspect your surgery doesnt wish to pay for sending the samples.

The great GP steal. A wee part of rip off britain.