16 February 2008

Golden geese

How things have changed. GPs used to argue passionately that they were the ones that knew their patients and that they should be the ones if one of their patients fell ill to go out at night. Cradle to grave - that was the mantra. They knew each one of their patients as a person. It was a wonderful ideal but it was exploited. The government unwittingly exploited it with the old 24/7 contract that required too much of GPs. Even a doctor's spouse had responsibilities if the doctor himself was ill. Then the patients started exploiting it whipped up on a grand scale by a government unwisely increasing rather than damping down expectations.

Mrs Grumble (now an eco warrior) used to be a GP. The phone used to go at the Grumble home all evening and much of the weekend with helpful comments such as: "I want the doctor out." Sometimes it was 3 a.m. House calls in some countries are almost unheard of but in the NHS it was provided for free by individual GPs working very long hours. Mrs Grumble would go in the depth of night into the heart of Brixton (at the time of the riots) carrying a bag full of drugs. There was never any trouble. The doctor was known and respected. But it was tough with two young children at home and a husband who was working alternate nights (plus normal days) in intensive care. The government essentially got this service from GPs for nothing. With the new GP contract they killed a goose laying enormous golden eggs. Once you have killed your goose that's it.

This was originally published on 26th May 2007. Dr Grumble has republished it today following Lord Darzi's amazing comments [See addendum] about the doctor patient relationship. He says: "We need to separate that fantastic relationship between a patient and a doctor...." They've killed one golden goose. It seems the government is hell bent on killing another. It's quite extraordinary. But if you ask a surgeon how to organise general practice what do you expect?

Addendum (added at 14.10hrs)
Within hours of this being posted the comments correctly attributed to Lord Darzi have been inexplicably completely altered. How can that happen? The BBC accurately reported what Lord Darzi said but now they have fundamentally changed the meaning of what he said.


BenefitScroungingScum said...

Funnily enough my last two posts have been on this subject, a mix of the importance of community and GP access.
These proposals are horrifying, and I suspect not wanted by the wider public. What are the govt playing at, and who is Darzi?
Bendy Girl

Anonymous said...

Darzi is a government stooge. He did not train in this country so he does not really know the NHS. He is a surgeon so he knows nothing at all about British general practice. He is being used by the government so that the public is duped into thinking that doctors are in favour of their plans. The plans are heavily veiled so it is difficult for those outside the NHS to understand what the intention is. The intention is privatisation of general practice. To do this the government has to break the affection that patients have for their GPs. The government argument is that you don't want your GP to be like an old-fashioned grocer whom you know; you want your GP to be like a modern supermarket. Drop into Asda and see any old MacDoctor who will have your records online so that a personal relationship is not needed and who will receive a fee each time you drop in. Now is that what the voting public wants? I think not. But do they know that that is what is happening? We shall see.

Dr Grumble said...

"We need to separate that fantastic relationship between a patient and a doctor..." is what Lord Darzi actually said. And that is what the BBC accurately reported until, mysteriously, they altered the meaning of his words altogether.

Anonymous said...

Government warned: Keep your hands off our doctors. Perhaps there's hope.

Anonymous said...

The BBC said Darzi wanted to extend the network across the country.

"This is not the end of small GP surgeries, many of which provide an excellent service to patients across the country," said a Department of Health spokeswoman.

Patients Association Chairman Anthony Halperin told BBC television there had been no consultation over the plans.

"We are the largest patient organisation in the country. We have not once been approached about what we think the patients that we represent actually want."

What a mess! They are not listening to doctors and they are not listening to patients. That can only mean that there is a hidden agenda.

Surely a surgeon should know that if it ain't broke you shouldn't be fixing it. The only explanation for all this is that the changes being forced through are all about privatisation and nothing whatever to do with patients.

The two weeks on a trolley team said...

This rubbish is right up there with the dept of health foisting a contract on GPs, then telling the media that greedy GPs were ripping the govt off with the contract.

The mind truly boggles.

Dr. Thunder

Anonymous said...

Privatisation is happening right now. It can't be stopped.

Anonymous said...

The government has had to recant because Khazi went completely off piste.

How extraordinary that they sent Dawm Primorola out from the bunker. She knows even less than Khazi.

I suspect his days are numbered.