Saturday, April 30, 2022

WEEKENDER: Doctors in Distress, by Wiggia

The last couple of weeks or so have seen the NHS pushing back on the fact its services are falling further and further down the quality ladder that we who pay for it have the right to expect.

We have had the GP on television defending the almost non-existent service by blaming overwork and burnout as being a big part of the problem; for a branch of the medical profession that has had two years of near holiday you have to have some gall to come up with that one.

And only this morning, the 29th, Dr Hilary Jones on GMB was talking about doctors saying 1 in 4 were suicidal or that they all knew someone in the profession that felt that way. I would suggest if that many doctors are genuinely considering suicide they are in the wrong profession. Dr Jones spoke of how they all love their jobs etc. etc. despite himself not practising medicine in any meaningful way since 1989, being permanently on television and spouting the government guidelines and spreading misinformation for the last two years, especially about numbers in hospital that had Covid and were unvaccinated.

Since returning to normal, i.e. the poor service before Covid, for many it has deteriorated further, yes there are (if you are lucky) still surgeries operating in a manner that benefits the patient but increasingly they are not, and one has to ask how come those can perform at a near normal level as opposed to the majority that can’t or wont.

The government statement that two-thirds of GPs are working just three days a week, confirms what many of us have observed; though there is no mention of those working just one or two days a week, and I do actually know of one of the single day variety, not every week but most: she and her husband, a surgeon, spent the best part of two years not working or just turning up now and again, and now normal service means he is away working while she does a day a week. My own designated doctor is now doing two days a week at the surgery, as against the previous one.

The same surgery has eight doctors on its books yet on the infrequent visits there by me and others only two plus a duty doctor can be physically seen to be there at any one time. The large waiting area with just three or four waiting gives lie to the phrase we are back to normal: pre Covid you could not get an appointment easily but the majority of doctors, not all, were in attendance and the waiting area full.

The same goes for nursing staff. Pre Covid they had two nurse practitioners and four nurses on duty most days; now, a visit for a blood test my wife has to have on a regular basis was with the only one on duty or working - she said it was because of Easter! And they now have no nurse practitioners.
Last time the staff were not seeing people for blood tests, health checks etc. they were out helping to give jabs to people for extra income…

We now have the BMA proposing that surgeries will only be open from Monday to Friday between 9 and 5. Ours is only open those hours now with a lunch break, so what is new?

Another doctor interviewed on TV used the 'burnout' phrase to defend the slating many GPs are now getting. When asked how that could be if they are only working three days he referred to 12 hour working days as the problem; that is still only a thirty-six hour week if true and hardly likely to create burnoout.

This all goes back to before the pandemic. Many GP surgeries, for lack of a better explanation, have used the pandemic as an excuse to cut back their activities further. Yes, we are lacking GPs on a ratio of doctors per thousand people as compared to our European neighbours; that is not the fault of the patient who still pays for an ever-diminishing service: governments are at fault for that.

You cannot have an ever increasing population without catering for it and successive governments have failed to do anything about recruitment and training of extra doctors for decades, and everything else; now that fact is coming home to roost.

But that does not give the current protectors of the infirm (!) the right to cut their hours as they already have and receive the same salaries courtesy of the same patients and tax payers. Much of this goes back to the contract that they got from Blair who just gave them everything they asked for without any questions asked or consequences.

With that in mind and the fact they are in the top flight of pay compared with their European neighbours what is the problem? It's not pay or hours any more. Being paid for patients on the books should be scrapped; our surgery with the same number of GPs on its books has an increase in patients over ten years of roughly 50% The complaint that patients waste appointment time with trivial problems or no problems is valid, but the doctors who complain of this have never pushed for an appointment fee that would weed out that particular problem; a fee like that is normal almost  everywhere else in the world and there are no problems getting an appointment.

The NHS gives the impression that it has no will to change in any way that will help the patient. It  continually blames underfunding which has been dealt with in previous articles by many who know more about it than I do. If there is no change in the areas that are continually highlighted it will simply disappear, or will it? Remember the 1.3 million who work for it.

So how about our elected representatives getting their collective fingers out of their backsides and doing something about it? Vague promises of more doctors in ten years' time does nothing for the poor sod waiting three years in agony for a knee replacement as in this area and not being in a position to afford to go private and have the operation performed by the same burnt-out doctor; at this moment in time there is something completely immoral about that.

Over the last few years I have  been able to give stories of incompetence at all levels in the NHS. The bureaucracy has increased at the expense of patient care and unneeded positions are still being advertised and filled, the money for which could be better spent. I have spelled out that side of things before, and so have many others.

The latest tale of woe came last week from a close friend of the wife who lives in north London where she has resided for over forty years. She never had a problem getting to see a GP at her local surgery until four years ago when they amalgamated with two other surgeries to create a ‘medical centre’ (oh, the familiarity!) since when she has to get through the gatekeepers in the morning and failing, try the following morning, ad infinitum.

She has been suffering from shooting pains in her back whenever she moves and can hardly walk. It has not gone away and after three weeks of this persevered on the phone and got a telephone appointment.
The doctor phones and she gives an account of the problem, he immediately says it’s arthritis; she replies I don’t have arthritis; he says oh, it is common in people who are getting old and suggests she rest, which because she can hardly move is what she has been doing anyway; and that was that, really.
No sending for examination or an x-ray which without even seeing someone in person would be the only way one could say that arthritis was the problem. This dismissive flippant dismissal with phone consultations is anecdotally becoming more common, making the process completely pointless.

Footnote to this: the pain did not go away, she went private for a consultation and was sent for an x-ray: no arthritis - a suspected trapped nerve, collapsed disc, but a scan will tell. This is the second friend who because of a useless GP has had to go private at that level to discover the truth about a problem. Not only is it not good enough and a disgrace but we who pay should be able to claim back the costs from the NHS for failing to do the job they get paid for in the first place. Once again in that same situation in many other countries they can claim because they have an insurance input; here we have to put up with whatever is deemed good enough at the time, which now is not much.

And can anyone tell me why the surgeries are still carrying on with all this mask insistence when my own experience at the local hospital and others shows many medical staff are not wearing them? We now, because of the media and endless NHS mandates, have a substantial percentage of the population that will be wearing masks forever. These same people actually believe that not wearing a mask is risking everyone else's health despite being triple/quadruple vaccinated.

Mark Steyn’s blistering opener on the results of booster jabs is worth watching. Several medical professionals and a statistician have attempted to query aspects of what he said but the essence of what he shows stands up.

And just why are young children being urged to get a jab for something that doesn’t affect them in any meaningful way with something that has no long term testing results and won't for some time?

On the same theme,  this has to be one of the scariest videos by a total waddock that I have seen, and there are plenty of them. He and the grinning selected nodding donkeys on with him are a total disgrace. This has to be one of the most insidious propaganda videos of recent times. We haven’t quite reached that level here but not from lack of trying; I have seen quite a few of our medical professionals even at the fag end of this pandemic still urging jabbing every three months into the future and mask wearing the same.

So once again the NHS rightly claims it needs more front line staff while refusing to reduce the over bloated bureaucratic areas, or consider any reforms. What with the country saddled with enormous debt and inflation now a major problem it could be that the NHS becomes unaffordable in its current form. A paring back to basic healthcare may be the only way it can survive and have any relevance to people, because in its current form it is rapidly becoming an irrelevant behemoth that still devours huge quantities of taxpayer money.


Sackerson said...

I'm puzzled by the shortage of working doctors in the surgery combined with very few in the waiting area, Have people given up expecting service?

Paddington said...

A couple of points:

As I noted in my piece the other day, it is not all roses here in the US. It can take months for an appointment, resulting in 'Minute Clinics' and mostly useless quasi-emergency facilities springing up every where in the suburbs.

As for the 'mostly useless jabs' for children, the US has seen something like 1738 deaths from Covid in the age range of 0-17. Of those, about 300 had no comorbidities, while the most common ones in the others were obesity and asthma, which are no generally considered life-threatening at that age.