Thursday, 21 June 2012

A summer solstice that has done no good for anyone – neither doctors nor patients.

June 21st is the longest day of the year in the Northern Hemisphere – with more daylight than any other. 8% of doctors, members of the British Medical Association, chose not to put this extra time to good use. For the first time since 1975, medical practitioners were on strike. They are striking about their pensins and the extended retirement date. They are not striking about NHS reform, patient care or the NHS budget.
The build-up to this event has been remarkably muted since it was announced a few weeks ago. Perhaps the BMA realised they had scored an own goal – and speaking of goals – maybe Euro 2012 has engaged the public more than some petulant clinicians.

To add to the PR disaster for these doctors, the comedian Jimmy Carr (for my overseas readers – a comic who, with a constantly straight face, spends a large proportion of his act criticising corporate greed and the banking community) was lambasted by David Cameron for his personal tax avoidance activity. Why one performer should be singled out for his accountants’   legal methods to protect their client’s income remains to be seen, but it is interesting to note that this was the lead story for most UK news bulletins today. (Is that why you did this David? To divert attention from the open wound that is the NHS?)

Back to the revolting doctors….. What was achieved today by this action?

Nothing. Really – nothing. Well, nothing positive anyway. To say that patients’ lives were not put at risk is frankly ridiculous. Doctors, and all related professions, are not in business just to save lives. They work to help people stay healthy, to improve their quality of life, to avoid or alleviate suffering.

I have no idea if anyone will die as a result of today’s action, but many people will have been inconvenienced, distressed, or even put at risk by the very people who purport to care for them.

According to the Department of Health, 2,000 GP surgeries were working on an ‘emergency only’ basis, 19,000 ‘routine’ appointments were cancelled and 2,700 ‘non urgent’ operations cancelled. Many cancer and heart disease diagnoses follow a ‘routine appointment’. Some ‘no-urgent’ operations such as hip replacements and cataract surgery are life changing. How can a G.P or surgeon really justify prolonging this suffering?

It was interesting to listen to a radio phone –in programme today. There was a striking G.P and a non-striking surgeon. The GP was frankly a little hysterical, suggesting that the government wants doctors to work longer, hastening an early death so the pension burden won’t be as great. The surgeon agreed that, yes, doctors who work for longer under stressful conditions do die sooner after retirement, but he was not comfortable with interfering with patient care by withdrawing his labour.  I suspect that most professions would observe similar events and I’m sure that there are many GP’s who share the surgeon’s view and vice versa.

I have enormous respect for GP’s, surgeons and physicians. I work with them often, with pleasure and sometimes even awe. I know they work hard, in difficult circumstances and under great stress. But to sit in your GP surgery or turn up to your hospital department and refuse to see patients for appointments or routine surgery seems unbelievably callous. What about the man with spinal injuries who was waiting for his MRI results today and now has to wait another week? What about the old lady who took two buses to her GP surgery only to find out that even though the doctor was there, her blood pressure problem would not be discussed? What about the man who has been waiting for 18 weeks for his cataract operation so he can see well enough to drive again to visit his wife with Alzheimer’s’ in her nursing home 30 miles away, but now has to wait another month or maybe more?

The daylight may have shone longer today – but the view isn’t pretty.


Rob Dickman said...

This is a situation that GPs have manufactured themselves over the years. The truth is that lots of people are inconvenienced by the strike because GPs have made their local populations more dependent on them than ever before. And the Government has perpetuated this by handing over a significant chunk of the NHS budget to GPs.

The big problem here is the huge amount of over-prescribing that goes on. Here are some stark figures:

In 2010, nearly 927 million prescription items were dispensed; this is a 4.6 per cent rise on 2009 AND A 67.9 PER CENT RISE ON 2000.

An average of 17.8 prescription items were dispensed per head of the population in 2010; compared to 17.1 in 2009 and 11.2 in 2000.

I imagine these fiures will rise again for 2011 and 2012. So what does this tell us? I think it tells us two things:

1. The uncomfortable truth is people these days want a pill for every ill and are prepared to ship up at the surgery at the drop of a hat to get what they want. GPs doll out what their patients want because it is very often less hassle to them than standing by what is clinically correct.

2. This practice of giving the patient what they want creates a reliance on the system (and in particular the GP) that to me is unhealthy (excuse the pun!). And it costs us a great deal of money. For example, prescription charge exemption means that nearly 90% of all prescribed medicines are dispensed free due to condition-specific and low income exemptions, which obviously affects the yield that goes towards offsetting the drugs bill.

Further, the pharmacist is paid per item on a script so in a world where GPs over-prescribe and the state picks up the tab for nearly 90% of prescriptions, there will always be a serious funding gap.

What do GPs do to help alleviate these problems that they have themselves helped make? Yes, they go on strike over their already generous pensions.

You couldn't make it up....

Finchers Consulting said...

Your astutue comments make painful reading. As you say - the government is now suffering at the hands of the monster that they, and past governments have created over the years.
Shades of Frankenstein...

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