GPs to be balloted on plan B subscription service
Discussion
https://www.bma.org.uk/news-and-opinion/gps-consid...
https://www.pulsetoday.co.uk/news/breaking-news/gp...
https://www.pulsetoday.co.uk/news/breaking-news/gp...
article said:
the union’s GP committee has now confirmed it supports balloting the profession on ‘a plan B option for general practice provision’ that includes consideration of a ‘means-tested, subscription-based service’, such as those being offered currently by NHS dentists. This will be the first time the union is balloting GPs on an alternative model.
These articles are light on details, but if this goes ahead then NHS GPs would also be able to offer a paid service, which might be quicker, similar to the way dentists work. s1962a said:
These articles are light on details, but if this goes ahead then NHS GPs would also be able to offer a paid service, which might be quicker, similar to the way dentists work.
I think the key thing is that they might be able to offer that service to their existing NHS patients. They are already allowed to have a private practice alongside their NHS work, but they're not allowed to provide private GP services to their own NHS patients.That's very dangerous for the country.
A large scale disassembly of GP work in the NHS is likely.
When were the public asked about all dentists going private?
Were you asked?
When did we as a country accept that NHS dentistry was to be taken apart?
The Government doesn't care about this, for them it will solve lots of problems. Until the "can't find a NHS dentist" problem for GPs reaches their desk (and they are in opposition by then).
Most people can afford £50 to see a GP, and the GPs will survive on far more pay (from the fees) and fewer patients. Just like the dentists do.
A large scale disassembly of GP work in the NHS is likely.
When were the public asked about all dentists going private?
Were you asked?
When did we as a country accept that NHS dentistry was to be taken apart?
The Government doesn't care about this, for them it will solve lots of problems. Until the "can't find a NHS dentist" problem for GPs reaches their desk (and they are in opposition by then).
Most people can afford £50 to see a GP, and the GPs will survive on far more pay (from the fees) and fewer patients. Just like the dentists do.
People need to look at Australia to see where this is going.
When we came to Australia 15 yrs ago, most GPs were "bulk-billed" - That means the GP sends their bill to Medicare (equivalent of NHS) directly, and the patient doesn't pay. Medicare paid the GP directly.
Back then, the government set the maximum fee that the GP could charge for a standard consult and another for a long consult.
However, that maximum fee was not increased at all in subsequent years, leading the GPs complaining, then eventually starting to charge almost everyone directly, or through their private health insurance.
There are now almost no "Bulk Billed" GPs and all have gone private.
Recently, the government have finally raised the maximum Medicare payment, allowing GPs to charge Medicare more. Handily (for the government) there are far fewer GPs doing that work now, so they're able to say "look at us, we're so great, vote for us" whilst actually paying less overall to GPs. No GPs are going back to "Bulk billed" as they were 15 yrs ago - Those days are gone.
When we came to Australia 15 yrs ago, most GPs were "bulk-billed" - That means the GP sends their bill to Medicare (equivalent of NHS) directly, and the patient doesn't pay. Medicare paid the GP directly.
Back then, the government set the maximum fee that the GP could charge for a standard consult and another for a long consult.
However, that maximum fee was not increased at all in subsequent years, leading the GPs complaining, then eventually starting to charge almost everyone directly, or through their private health insurance.
There are now almost no "Bulk Billed" GPs and all have gone private.
Recently, the government have finally raised the maximum Medicare payment, allowing GPs to charge Medicare more. Handily (for the government) there are far fewer GPs doing that work now, so they're able to say "look at us, we're so great, vote for us" whilst actually paying less overall to GPs. No GPs are going back to "Bulk billed" as they were 15 yrs ago - Those days are gone.
NHS Dentistry
"Those days are gone"
Its a horror film playing out in front of me.
When the government funked up the GP contract before, many years ago (2004) and allowed them to buy their way out of out-of-hours GP work, the service started to fall apart. This is directly linked to that.
GP is a very difficult job to do. But the disassembly continues.
"Those days are gone"
Its a horror film playing out in front of me.
When the government funked up the GP contract before, many years ago (2004) and allowed them to buy their way out of out-of-hours GP work, the service started to fall apart. This is directly linked to that.
GP is a very difficult job to do. But the disassembly continues.
Edited by The_Doc on Tuesday 2nd June 20:26
The current funding model for primary care is out of date and not fit for purpose - and unsustainable in the long term.
Everyone knows this and doesn't want to deal with it. GP's are independent / private contractors anyway - so this is simply offering up alternatives that are long overdue. They will have to provide a service to match and this will have to be performance managed. The problem of course is that practices working to a different model may drop NHS work altogether, like dentists, which of course is unacceptable - given that medics are trained in and by the NHS.
That some people would have to contribute to their care over and above NI - god forbid. It needs to happen though and sooner rather than later and needs to come from the centre rather than be directed by the mercenary element of medicine.
Everyone knows this and doesn't want to deal with it. GP's are independent / private contractors anyway - so this is simply offering up alternatives that are long overdue. They will have to provide a service to match and this will have to be performance managed. The problem of course is that practices working to a different model may drop NHS work altogether, like dentists, which of course is unacceptable - given that medics are trained in and by the NHS.
That some people would have to contribute to their care over and above NI - god forbid. It needs to happen though and sooner rather than later and needs to come from the centre rather than be directed by the mercenary element of medicine.
So the GPs looked at the current state of nhs dentistry and collectively thought Yeah, seems to working well for everybody , lets have a slice of that pie!
really ??? I thought this was a spoof at first.
the gp model in the nhs has never really been perfect, they really should have been made employees from the start, the same as hospital medics, but the BMA fought against this in 1947.
The 70 s and 80 s must have been the golden period for general practice, its really gone downhill for the last 10 years or so.
In the 90 s i used to visit a fair number of gp practices as part of my role, they were excellent, they had plenty of gps , they offered loads of services, like minor surgery, screening clinics , had physios and all sorts,
really ??? I thought this was a spoof at first.
the gp model in the nhs has never really been perfect, they really should have been made employees from the start, the same as hospital medics, but the BMA fought against this in 1947.
The 70 s and 80 s must have been the golden period for general practice, its really gone downhill for the last 10 years or so.
In the 90 s i used to visit a fair number of gp practices as part of my role, they were excellent, they had plenty of gps , they offered loads of services, like minor surgery, screening clinics , had physios and all sorts,
Edited by sawman on Tuesday 2nd June 20:56
Edited by sawman on Tuesday 2nd June 21:17
sawman said:
.
In the 90 s i used to visit a fair number of gp practices as part of my role, they were excellent, they had plenty of gps , they offered loads of services, like minor surgery screening clinics , had physios and all sorts,
Sounds like ours now. We're rural, but only 5 miles from a city (with an infamous hospital).In the 90 s i used to visit a fair number of gp practices as part of my role, they were excellent, they had plenty of gps , they offered loads of services, like minor surgery screening clinics , had physios and all sorts,
Sheepshanks said:
Sounds like ours now. We're rural, but only 5 miles from a city (with an infamous hospital).
Lucky you ( and your local community)Theres a lot of variability, my daughter is a resident doctor she is planning to enter gp training after a really positive experience on her foundation rotation ( she had thought hospital based care was where she would specialise) A pal of hers who wanted to be a gp is now leaving medicine based on the grim experience on gp rotation. There are obviously some issues out there
Edited by sawman on Wednesday 3rd June 07:18
Yahonza said:
The current funding model for primary care is out of date and not fit for purpose - and unsustainable in the long term.
Everyone knows this and doesn't want to deal with it. GP's are independent / private contractors anyway - so this is simply offering up alternatives that are long overdue. They will have to provide a service to match and this will have to be performance managed. The problem of course is that practices working to a different model may drop NHS work altogether, like dentists, which of course is unacceptable - given that medics are trained in and by the NHS.
That some people would have to contribute to their care over and above NI - god forbid. It needs to happen though and sooner rather than later and needs to come from the centre rather than be directed by the mercenary element of medicine.
It's going to create another level of inequality, if you can afford a private GP you can already go to one, all this means is the tax payer keeps paying more and then has to pay again after the tax has already been taken and debt taken in their name to fund the service. Everyone knows this and doesn't want to deal with it. GP's are independent / private contractors anyway - so this is simply offering up alternatives that are long overdue. They will have to provide a service to match and this will have to be performance managed. The problem of course is that practices working to a different model may drop NHS work altogether, like dentists, which of course is unacceptable - given that medics are trained in and by the NHS.
That some people would have to contribute to their care over and above NI - god forbid. It needs to happen though and sooner rather than later and needs to come from the centre rather than be directed by the mercenary element of medicine.
Dentistry went down this path and is an utter mess, but no doubt lucrative for some, the NHS is funded by general taxation FYI...
Let me rewind to absolute base cause. Ignore the whole political positioning.
In what way, and it s a genuinely open question, are General Practices currently unviable?
I can understand the dentist case: it s a remarkably issue based service where the likelihood is that people requiring intervention require a bit more than a brief scrub and rinse. Root canals etc.
But the standard GP is ploughing through all sorts of stuff which is non intensive (otherwise it would be an A&E or hospital appt) and is routine?
What s changing? Genuine question.
In what way, and it s a genuinely open question, are General Practices currently unviable?
I can understand the dentist case: it s a remarkably issue based service where the likelihood is that people requiring intervention require a bit more than a brief scrub and rinse. Root canals etc.
But the standard GP is ploughing through all sorts of stuff which is non intensive (otherwise it would be an A&E or hospital appt) and is routine?
What s changing? Genuine question.
Sheepshanks said:
sawman said:
.
In the 90 s i used to visit a fair number of gp practices as part of my role, they were excellent, they had plenty of gps , they offered loads of services, like minor surgery screening clinics , had physios and all sorts,
Sounds like ours now. We're rural, but only 5 miles from a city (with an infamous hospital).In the 90 s i used to visit a fair number of gp practices as part of my role, they were excellent, they had plenty of gps , they offered loads of services, like minor surgery screening clinics , had physios and all sorts,
Our GP practice is superb. I wouldn't be against fees being charged for appointments though. If they're introduced, everyone should be subject to them, even if on a sliding scale. The notion of "free" services needs to end.
Wills2 said:
It's going to create another level of inequality, if you can afford a private GP you can already go to one, all this means is the tax payer keeps paying more and then has to pay again after the tax has already been taken and debt taken in their name to fund the service.
Dentistry went down this path and is an utter mess, but no doubt lucrative for some, the NHS is funded by general taxation FYI...
Tax isn't covering the service though. It's not covering any of the services we "want"/"need" fully, hence a £130bn deficit and nigh on £3tn debt.Dentistry went down this path and is an utter mess, but no doubt lucrative for some, the NHS is funded by general taxation FYI...
Everyone will pay more eventually - either in actual £s given through taxation or direct to the provider, or by not getting any service at all as it falls apart.
These are choices WE need to make, and vote for politicians accordingly.
"Inequality" is a factor of the species. We can fight against it all we like...but it will always be there.
Ridgemont said:
What s changing? Genuine question.
Risk/Reward for GPs and escalating expectations in the face of relative reduction in resources.The model of private contracting to the NHS was a fudge and flawed from the start. As Sawman pointed out, Aneurin Bevan should have nationalised the lot but chickened out.
The universal free health care model lasted about five minutes as means tested charges for eye tests, prescriptions in the 50s and later dentistry came in.
The partnership model which more or less successful and lucrative for the first 50 years has fallen apart. One of the reasons is the Govt./NHS is an unreliable business partner as it can change funding structure on a whim. A recent egregious example is the ARSS (I kid you not) scheme providing funding for a practice to employ any practitioner as long as they are not a doctor. This is no basis to commit to decades long investment in premises equipment and staff. Younger GPs are simply rejecting the partnership model and opting for salaried or locum work. This also allows flexibility in hours reducing the availability of qualified staff.
Thus the ownership of practices is falling into precarious 'last man standing' situations or being hoovered up by mega practices like the Hurley Group or private equity.
Current rules don't allow GPs to offer private services to patients on their NHS lists. It's a measure of just how expensive health care is that wholly private GP care along similar lines to the NHS, rather than a walk in internet or telephone services for sleeping pills, antibiotics, erectile dysfunction treatments and sick notes, are very rare. Even if a GP in a prosperous area of the country decided to cherry pick, say 1000, of his healthiest and wealthiest patients to set up a private service, the fees required to provide the premises and staffing would probably exceed what most people are prepared to pay as a subscription.
The_Doc said:
That's very dangerous for the country.
A large scale disassembly of GP work in the NHS is likely.
When were the public asked about all dentists going private?
Were you asked?
When did we as a country accept that NHS dentistry was to be taken apart?
The Government doesn't care about this, for them it will solve lots of problems. Until the "can't find a NHS dentist" problem for GPs reaches their desk (and they are in opposition by then).
Most people can afford £50 to see a GP, and the GPs will survive on far more pay (from the fees) and fewer patients. Just like the dentists do.
I would question your assertion that most people can afford £50 to see a doctor. Because whilst I could afford the £50 to see somebody at the health centre(actually seeing a doctor is quite rare nowadays) currently. (I currently only go once a year for a check up) what about all those who have medical needs that need constant check ups? A large scale disassembly of GP work in the NHS is likely.
When were the public asked about all dentists going private?
Were you asked?
When did we as a country accept that NHS dentistry was to be taken apart?
The Government doesn't care about this, for them it will solve lots of problems. Until the "can't find a NHS dentist" problem for GPs reaches their desk (and they are in opposition by then).
Most people can afford £50 to see a GP, and the GPs will survive on far more pay (from the fees) and fewer patients. Just like the dentists do.
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