I think the same problems exist in many other countries. We certainly have blame bingo, mainly women who get breast or cervical cancer who haven’t had their screenings, “naughty, naughty”, never mind these tests are elective and not without their risks. Cervical screening benefits very few, while over-detection and over-treatment are far more likely, especially with early testing and over-screening. Breast screening, I don’t think there is any benefit, it seems the risks exceed any small benefit.
I was reading a health forum recently and a woman mentioned she’d just been diagnosed with breast cancer. The next few posts were from women, “didn’t you have your mammograms?”…
A No often triggers a blame fest and yes…confusion and fear or see a lawyer.
Honesty has never been part of our programs and we don’t follow the evidence or respect informed consent.
Women are dropping out of our excessive non-evidence-based cervical screening program so we have a new “naughty girl” campaign and I hear the powers above are thinking of introducing a UK style call and recall system to give them greater “control” over women.
It’s bad medicine and so harmful. It really is quite frightening when you know the evidence and it can’t help but affect your trust in and respect for the profession.
Hi Margaret – and well put. It now seems we have a health service where GPs are responsible for everything and taking the blame for everything that is wrong with the service.
Something that vexes me is the complete lack of understanding out there among the press, politicians and public about (1) the world-leading and almost unique nature of UK primary care (i.e. general practice); and (2) how UK general practice actually works.
No-one seems to understand that GMS GP practices don’t belong to the politicians or the NHS. They are private businesses which chose to contract themselves to the NHS. As such they have to make a profit to pay their doctors. And, at the same time, it is the doctors (not the politicians or the NHS) who pay for the staff and the equipment and the letters they send out to patients and the phone calls they make to patients and the miles they drive to do house visits, etc.
Idiotic tabloid papers and politicians simply look at the amount of money going into a practice then divide it by the number of doctors and then say that is how much the doctors earn when of course it is not. That is the sum the doctors have at their disposal to pay their staff, pay their bills, and, hopefully, pay themselves. But their income is not protected and, in theory, they could end up “earning” nothing some months.
Then there are also the added costs even once they have paid themselves a salary – defence fees (effectively compulsory) £3000 per annum, locum insurance (compulsory) £2000 p.a., the GMC (compulsory) £400, and so on.
Then we have the calls for GPs to return to a 24/7 service because people want their verrucae looked at 8pm. But we never had a service like that. Prior to the new GP contract of 2004 out of hours was for emergencies only. The fact that large numbers of people abused the system pre-2004 was the reason it started to become an intolerable burden for most GPs. No wonder they couldn’t believe it when the Government told them they could opt out and they jumped at the chance.
If the press, public and politicians want GPs to go back to doing OOH the “traditional” way that’s fine – if they are prepared to pay a professional rate for the job and not the £2 an hour they used to pay. After all why should a GP coming to your house at night be paid less than a plumber for being there?
Ultimately what it boils down to is a society which wants everything for nothing. But we don’t live in the Never Never Land – everything has to be paid for. And you cannot have low taxes and free healthcare. It’s really that simple.
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