Re recent posting by Squad

[pilotlight]

Reading this mornings posting by Sqad, regarding his home visits in his capacity as a GP reminded me of my mother 'sending for the doctor' if, as a child, I was ill.
I had to change into fresh pyjamas.
The radio was turned off.
A chair was placed at the side of the bed.
A bowl of water and a fresh towel were placed at the side of the bed.
A clean spoon was placed at the side of the bed ( just in case the doctor had run out of the lollypop type sticks that he used ).
She would keep an eye out for anyone parking anywhere near our front door, and told in no uncertain terms to 'move', as the doctor was coming.

Yes Squad, how times have changed.

[Sqad]

netbiza....LOL...Eastbourne.............what i remember about bodkin Adams was that the MDU (Medical Defence Union) got a Prof of Pharmacology from Guys Hospital to support his claim.

This poor old Prof was "taken to the cleaners" by a smart prosecuting Barrister......LOL........probably Barmaid.

[gness]

Sqad. I was told by my GP last week that he wasn't "allowed" to refer me to a vascular surgeon as urgent which he would have preferred. I have to go as routine but he hoped to be able to move the appointment up if he could.
Who is not allowing him to decide if I am urgent and do you know why?
Bit off topic but ties in with what you have said.....I think.

[boxtops]

There is no way that the second opinions won't be referrals to specialists, sqad, but in the new world, the services of those working in the hospitals will be commissioned directly by the clinical commissioning groups (CCGs), not the PCTs - the PCTs go in six months' time, all very much change from 1 April. If so many referrals for say hips, or specialist diabetes treatment have been commissioned by the local CCG in response to their local patient needs, then the referral can still happen. At present if a GP refers to hospital, the hospital has to do it, whether it can afford it or not, which has partly led to the current hospital overspends.

Neti - no, it shouldn't. GPs get paid for activity (by the NHS) but the fee to the private consultant is for his time and expertise, it doesn't go back down the chain.

[starone]

You had to pay in those days so we only went when it was absolutely necessary. I remember 'the doctor's man' calling on his bicycle to collect what was owed, usually in small instalments.

[boxtops]

Gness - probably funding issues - PCTs and CCGs have only so much money to spend. It's not right - in fact in many instances it's wrong - but if there is only so much work contracted and paid for, the GP can't just refer, there would have to be a special case put to the commissioners to pay for the referral. The organisation to whom the patient is referred has to be paid from the local budget.

[Sqad]

commoner.......no he wouldn't get a cut, but would probably get the use of the Consultant's villa in Switzerland or.................?the Balearics.

£150-£200 for half an hour is par for the course.

[boxtops]

^ sorry, I meant commoner not neti :-(

[gness]

Thanks Boxy. Seems very short sighted but at least I can pay for a private appointment before it gets any worse.

[commoner]

lol...not grumbling Sqad...I was very worrried about a condition in my eyes where I suddenly got dozens of floaters ...he was a lovely gent and gave mr]e a really good examination...made me feel punts better....just putting my penn'orth into the mix..:-)

[Sqad]

gness.......the doctor decided who and when to refer in my day.....but now due to shortage of money, there are protocols...Boxy is the expert.

On the plane a couple of weeks ago, I sat next to a cardiologist who told me that there were now protocols for the treatment of certain heart conditions.......in MY day I decided upon the treatment.
Talking to him, there is a lot of discontentment among hospital staff and resentment of the very narrow gap between GP salary and Consultant salaries........many of the "boys" are looking for and taking early retirement from the NHS.

[gness]

Thanks Sqad. Would have preferred the GP to have a free hand to make his decision and reading between the lines so would he.

[boxtops]

Gness, it's up to the GP then, to put it to his CCG (who will be commissioning the services of the consultants on behalf of his patients) that he wants to be able to do that. It's GP-driven from next April, the services will be commissioned (locally and nationally) based on the needs (current and anticipated) of the patient population in the local CCG area.

[gness]

Thanks Boxy.