Tuesday, 19 March 2013

The rot continues

JD is currently bemoaning the state of affairs in general practice, but it's no better in hospitals either. I've recently been talking to a friend & colleague. He specialises in a condition that is refractory and chronic and many of his patients have seen him many times over several years. His patients, on average require eight follow up appointments before he either achieves some sort of objective, or runs out of ideas. Until recently no one told him how often he could see patients or keep them on his books. He, as the professional made the decision as to whether or not to get them back.

All that has changed. He has now been instructed that he can see a patient for a maximum of three appointments only, and then they MUST be discharged back to primary care. And the appointments they do have will have to be with a specialist nurse in an increasing proportion. That means that many of his patients he will have to discharge before he can achieve anything, and they will return to their GP in effect untreated. The management don't give a shit. They are only interested in "processing" the patients through the system so they can get their money from the PCT. The fact that these peoples' medical problem will not have been addressed does not matter to them. The idea is that if the patient still requires specialist care he will have to be referred again and the Trust can then charge the PCT again, for the patient just to be seen by some overfed harpie who calls herself a consultant but knows fuck all about it.

So what is he going to do about it. He's taking early retirement.


  1. Fast becoming the most dis-integrated health care system in the world. Sad.

  2. The agenda is to add health to the GDP by privatising and marketising the system. Hospitals are there to sell their services to GPs in order to generate money. Those services are not designed around the patient - the GP is paying for a batch of 3 appointments at a time (like 3 sessions with a massage therapist), not for the patient to be made better. Those of us who think the aim is to make the patient better, not to make money, will be driven out

  3. Thing is realistically it's not just a medical decision re. How many times you can see a patient. It is a financial one as well. I live my dog, but I wouldn't let my Vet decide how often to see it as I have to pay the bill = compromise.