So Clunking Brown Turd has spoken. Or rather his minion Mark Britnell has written a threatening letter. Which the redoubtable Laurence Buckmann is on to immediately.
Nigel Hawkes reports all this accurately, but picks up on the gap between government rhetoric and likely achievement.
“Picking a row with family doctors is a high-risk strategy. Poll after poll shows that doctors are far more trusted than ministers.” In Civil Service terms negotiating with the doctors is seen as being worse than negotiating with the French. Formidable!
“Yet somehow the Government has positioned itself as the aggrieved party after a contract – which it agreed and signed – turned out to offer GPs more than it had bargained for.” Excellent. GPs delivered on the contract and then the government is disappointed.
“Private companies might also be willing to participate fully in practice-based commissioning, the Health Department’s plan to make GP practices the place where NHS services are planned and ordered. This is rather like the Conservatives’ fund holding policy, but lacks enough incentives to persuade GPs to join.” The Messiah will be disappointed.
“Indeed, the Government’s miscalculation during the negotiation of the GP contract was that walk-in centres and NHS Direct could do the out-of-hours job better and more cheaply than GPs. They could not.”
Hawkes is well onto PCT incompetence, and their poor record of organising anything much.
So what we see here is Comrade Brown-Turd trying some strong arm trying to use emotional blackmail to get GPs to do something for nothing. If he persists in this he may get a medical revolution. The labourer is worthy of his hire, and there is nothing more efficient than a GPs surgery for getting through lots of patients reasonably quickly and reasonably accurately.
A combination of underpaid salaried doctors and sessional doctors will not provide a better or cheaper service to patients, but will improve Chilvers-McCrea and other businesses profits.
Which would you rather see. Efficient NHS GPs and continuity of care? Or anydoc, from anywhere? Real doctors or sessional functionaries robotically following guidelines and protocols?
The Government, and the Patients, will be on a looser if Brown pushes his hand too far here.
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43 comments:
http://politics.guardian.co.uk/homeaffairs/story/0,,2152511,00.html
I wonder if the game with GPs is a distraction from failures elsewhere in UK NHS?
From the above article:
the chief executive, Mike Sobanja (NHS Alliance), said the latest government patient survey had found that 85% of people were satisfied with GP services, but this still meant that up to 10 million people were not happy.
Now 15% of 60,000,000 is actually nearer 9 million. Well you've got to allow and error of about a million or so I suppose. But I'm guessing that there aren't hordes of toddlers out there so enraged at the service provided by GPs that they signed the tossy survey. I'm guessing the aggrieved are significantly fewer than 10 million, or 9 for that matter. Politicians and spin doctors should not be allowed to go anywhere near statistics. They'll only hurt themselves
How is this a change from current policy?
In fact, how is it a change from any previous policy? Aren't GPs practice generally private businesses in competition with each other?
http://news.bbc.co.uk/1/hi/health/6955545.stm
GPs in competition? make me laugh, if they were in competition they would be open on Saturday and their locums would speak English
Didn't the survery only take in adults? What proportion of the population is under 18?
ill tell you what we will do
we take the total amount spent on nhs GP appointments per year, divide it by the number of appontments which take place, we call this £ X
we let any patient go to ANY GP they like whenever any GP is open, and each time a GP sees a patient the patient signs a form which is worth £ X to the GP.
thus incentivising GPs to i) see more patients ii) open when the patients want to attract more appointments iii) answer the fucking phone so its possible to get an appointment in the first place
and stop all this bolloks giving the GPs money for patients on their books regardless how fucking hard it can be to get an actual appointment
and dont let the government organise anything other than the payments, certainly not how GPs choose to organise themselves
Nice idea anon...
YOur a bloody genius.
We would never get private companies employing the otherwise unemployable doctors, with strict 6 min time limits, churning through patients.
Nah it would just mean all doctors would work an extra few hours every day as they are greedy little shits...
I mean all they do now is sit about and toss they hay with the few patients they do see.
Anonymous - 'productivity' in health is not always straightforward.
Sure, some unscrupulous individuals might set up a production line, flicking on the taxi metre as soon as a patient enters the room [barely being able to stifle a yawn when chronic or complex problems arise].
On the other hand a slower but more thorough doctor might pick up something unusual or worrying [being motivated by clinical excellence, rather than a quick buck].
Accept the fact that ALL professions have a percentage of deadwood irrespective of which system they work in - as one [American] lawyer said to a colleague, it's the other 99% that give us a bad name.
"GPs in competition? make me laugh, if they were in competition they would be open on Saturday"
Have you tried to get BT to put in a new line? Tried changing broadband? Tried to get a phone line fault fixed on a Sunday?
Say it with me, children: 'anonymous is a fucking moron'.
"we let any patient go to ANY GP they like whenever any GP is open, and each time a GP sees a patient the patient signs a form which is worth £ X to the GP."
I'd love this system. Let's say you have a sore throat.
1. You'd come to see me during office hours* within a few minutes of phoning the surgery, as we do just now. The phone would be answered within three rings, as we do just now.
2. I'd look at your throat.
Just now I'd say "It's a virus" and tell you to get a fucking life. Oh, and take some paracetamol and ibuprofen that you can buy for 32p in Tescos. This is the best advice.
But with you're plan I'd do a throat swab (if I'm lucky I'll got paid more for that), and I'd order expensive antibiotics (maybe I get paid more for that too**).
Then I'd tell you that your infection could be serious, you could get a quinsy, and you could even die. Then I'd tell you to come back for a review appointment the next day. And the day after that. And the day after that. And maybe another appointment to get the swab result.
Oh, and if I got paid more for extras I'd do some blood tests. Maybe the antibiotics give you nausea. That's an expensive PPI for your stomach too (£30 a pack) and probably an anti-sickness and anti-diarrhoea medicine.
Oh, I am going to make so much fucking money from idiots like you, Anon. I can't fucking wait.
Fuckwit.
* Don't like this? Fuck off somewhere else and see if I care - there will be loads of demand from patients who are happy with office hours
ah but telecoms is not free market its a regualted market with monopoloy provision in many layers, and its not regulated that well
hardly an excuse for crap GP services is it
thanks for slagging me off makes you look big doesnt it
re "I am going to make so much fucking money from idiots like you" youre already doing OK
I dont mind you earning more money if you see more patients, when they want to be seen, in a timeline thats good for both sides, in a clean environment, and you give good advice
wow i love this you give so much free advice i feel im all qualified to deal with ear aches, and now sore throats, keep going and we should be able to list of most of the conditions GPs deal with day in day out in a few hours? what do you folk do at uni other than sit in bars? carnt be that hard
"ah but telecoms is not free market its a regualted market with monopoloy provision in many layers"
Like buses and trains. Which is how medicine is likely to be regulated too, I would think.
However, perhaps you could list a proffessional service that is private and would provide a model for how medicine would work.
Let's say accountants. Or perhaps solicitors. Yup, same day appointments and saturday opening a big draw from those two.
Opticians are the closest to what you are talking about competition- wise. But most people know if they need glasses or not before they go to the optician. With professionals you don't know what you need doing until you ask a professional.
Oh, and I slagged you off because you are a total fucking moron who's ideas will get people killed.
Fuck off and read The Doctor's Dilemma. Then come back.
re "perhaps you could list a proffessional service that is private and would provide a model for how medicine would work." not quite private but medicine as setup in belgium, new zealand or italy would do me thanks
lots of folk die due to shit health system in this country already i think the morons are the ones defending it
you dont get much feedback on here i think you need some patient input into your self centred bollocks
Anon, i think i have covered this before, i lived in Italy for years... i bet you haven’t even been to the country let alone as a patient.. you have no clue.
I don't know why you persist...so far you have never put across a comparative system (in the UK) that can be held up as a model for how the NHS (or whatever you want to call this new thing) should be run..
Your like a philosopher who thinks
communism is a good idea but can't seem to give a coherent answer to how it would run practically.
again i bow out of another thread as Anon will make me want to put pins in my eyes every time i read a comment.
Do you have memory problems as well as being a fucking moron, Anon?
We covered this already. You talked about the Italian system that you had 'experience of' and we showed that you had no fucking clue about the Italian system.
We covered waiting times in other countires, and you proved that you had no fucking clue about waiting times there (as I recall, you're view was that those countries were lying and they didn't actually have long waits).
You. Are. A. Complete. Fucking. Moron.
Now take my advice and fuck off and read The Doctor's Dilemma. You can get it on Amazon to read on the plane while you are jet-setting around to all these important jobs you have.
You are welcome to come back when you can show that you have a single fucking iota of a clue what you are fucking talking about, you ignorant twat.
http://www.theregister.co.uk/2007/08/21/gmc_rita_pal/
i worked in milan for years, i saw a GP and had to attend A & E, visited friends who were inpatients, and was impressed by all, interestingly the GP didnt take the "piss off and take a pain killer" approach the time I had an ear ache either, his intervention was somewhat different
there isnt a comparative system in the UK i would be happy with for public health provision
i already know you want a soviet style nhs?
Anonymous, where is your GP, outer Mongolia?
I'm 'just' a patient, so what do I know, but as someone with an unusual and chronic condition I shudder to think of "we let any patient go to ANY GP they like whenever any GP is open, and each time a GP sees a patient the patient signs a form which is worth £ X to the GP." this in practice might be fine for a sore throat as so eloquently described, but not for the majority of a GP's current workload.
Not that you'll listen anonymous, because I'm quite sure you won't want to hear some lowly benefit scrounger defending the current system, but you're talking nonsense.
My GP, yes as in the same doctor each time I have to see a GP (and if on occasion not, only ever one other GP) not only has to prescribe and manage my medication, but also has to keep on top of the regular hospital appointments I go to with a variety of different specialist consultants, deal with the related paperwork, deal with the paperwork the benefits system deem necessary to deluge at him whenever they see fit and advocate on my behalf with social services or any other agency determined not to give the help and support they should thus giving such tasks to GP's.
In addition to that, I can get a GP appointment whenever I need one, whether that be on the same day, or booked in advance. Having Ehlers Danlos, it's tricky for me to get around, so my GP practice will book appointments at a time I am able to get there, and when I was at my absolute worst, my GP would move himself into a closer consulting room to see me so I didn't have to struggle the extra distance, despite the extra time and trouble it caused him.
Patient input given. Bendy Girl
Anonymous - since 2004 the private sector ALREADY provides OOH GP services.
In too many cases 'standards' seem to be related to the cheapest tender instead of clinical excellence - and I have found no evidence to support the belief that standards have been driven up by market forces.
According to some reports many patients are now voting with their feet, prefering to attend A&E.
Another issue has been the suspected increase in NHS GPs who now have to pick up the pieces, or sort out problems arising from OOH.
For an interesting [and balanced] discussion please take a look at this;
http://www.saferhealthcare.org.uk/IHI/
type in OOH in the search box [top right corner] - then select the second item on the menu 'Out of hours, out of sight: how safe are patients ?
Aren't GPs practice generally private businesses in competition with each other?
not really/only in a very imperfect market (more imperfect than most markets, perhaps). I.e. (if what I'm told is true) GP practices in a given locality (probably amounting to a catchment area) have no-poaching agreements. Even if that isn't true (the person who told me is usually reliable, but could be wrong), a patient may still be unable to register at the practice of their choice.
Bendy Girl I agree continuity of care is (normally) important, I certainly prefer it, but if I had a bad GP (and yes they exist) I'd prefer non-continuous skilled care to the compulsory ministrations of someone less than useless. (BTW I think I read that something like 25 per cent of practices still can't offer 'within 48 hours' appointments, and I bet practices like yours and mine, that offer both same day and advance booking ones, are unusual.)
a & e charge nurse, I've no doubt it is cheapest tender (plus cheapskate private companies), but of course it's a private monopoly, not a true market system. (I don't like market values but thought I should point that out.) The issue is, what to do about the current OOH problem -- and clearly it is a problem.
Is no one telling the truth about Milan (I like Milan!)? Almost certainly yes. Italy has a surplus of doctors -- who are also paid far less than doctors here, hence Italy's ability to afford them -- so is more likely, ceteris paribus, to be able to meet demand for fast appointments.
Hi Jayann - yes, you are correct to make the distinction, thanks for pointing that out.
I imagine there must have been competition between providers seeking to secure a contract - perhaps we can say that this process [as it stands at the moment] is no guarantee of a better deal for patients ?
Anon, well I’m surprised, i lived in Naples and Venice...maybe Milan was just a super little area, almost an inverse of your local provision anon (weird how others who lived in Italy found it either comparable or worse than the UK..and more expensive but for you it was amazing).
Those Italian doctors and nurses... amazing how much more they love their jobs and how caring they are...again you fail to understand the difference between "here is a considered expert opinion and appropriate advice" given maybe quickly due to time pressure and "here is some touchy feely talk (in Italian which i assume you are fluent in) with more head nodding and empathising, here is some (inappropriate) antibiotics... pay on your way out".
"interestingly the GP didn’t take the "piss off and take a pain killer" approach the time I had an ear ache either, his intervention was somewhat different"
Was it, I’m so sorry you have earache... take some painkillers and if it gets worse come back.
I.e. the proper medical advice (unless you can see pus or your head is swelling up).
"there isn’t a comparative system in the UK i would be happy with for public health provision"
Well then if there is no system in the UK that works and can be applied to the NHS i do wonder where we can turn to make everything better...
Anon is telling only part of the story if the Italian system, i lived in Italy, he (the wealthy jet-setter) could afford good care..it has the problem that he says he doesn’t want in the UK (the poor falling through the gaps).
I now see he just want s system where he can afford private care and really doesn’t mind if the poor get screwed.
Jayann....lets dispel a big myth about many countries and the low pay of doctors.
Having worked abroad with German doctors and knowing a few Italian ones, they do get paid crap... by the state. However they make up for it with private work. Its like the Caribbean, the junior slog away being paid bugger all for years, then they become a partner, join a private hospital (only part time as all the doctors have to work part time for the state in many countries there) and start to earn large sums of money.
The difference i see is the proportion of state work done by senior doctors in the NHS is larger than abroad.
Oh and whats with the link anon?
funny pseudonym, I agree I'm talking only about the money -- salaries or other -- the state pays doctors. My point is simply that Italy is oversupplied with doctors (who are paid relatively little by the state) and that is (presumably) why it's easier to be seen quickly there. (I do have information from an Italian, not just from no one. One of the things she said was that tests were done faster there and if they were paid for, they cost a lot less than they would here -- she was working in Italy and here at the time.)
I'm not saying the actual care is better there, I can't tell.
Incidentally I would expect good medicine and more doctors in Milan as opposed to Naples, because of the North-South divide, you said to no one
maybe Milan was just a super little area
it's Northern, it's rich... and the Italian system is, increasingly, localised. But though Milan is in some ways not particularly 'Italian', I doubt it's an outlier.
"maybe Milan was just a super little area"
I think comparing the worst of the NHS with the best of somewhere else is classic Anon bullshit.
There are lots of super little areas in the UK.
For example, in the practices in our area patients are almost always offered a same day appointment (sometimes next day) and can easily book up to six months in advance.
re "he (the wealthy jet-setter) could afford good care" i am talking about the bog standard medical care that the poor folk of milan use
my Italian was crap, its even worse now, but then English is the language of choice in many of their office environments
Out of hours GP services in the UK are not an example of the market at work mainly because the end consumer cannot take his business to the provider of his own choice
Ah now after telling me how much bollocks I was talking about Italy, now your story is "ah well Milan does not count its the rich part of the Italy" - WTF? So by that argument the rich parts of the UK should have great healthcare? Surrey stockbroker belt etc? You been to a GP in Surrey recently? no thought not
re "here is some touchy feely talk" not really, ear ache in front of Italian docs will often end up with active intervention, such as wax syringe then local application of stuff to ear, rinsing salt water through the nose, etc, no idea how much it helps, but its sure more than soothing words
BenefitScroungingScum great you have a good GP, I am happy for you, many people do not, and many people have no abiliy to take their business elsewhere, yes the UK system can work for those lucky enough to live in the right place, this pot luck is hardly a world leading approach to improving things systematically
Still think whichever way you slice it the public are going to get Saturday access to docs one way or another, why dont we discuss how this could be best done?
Jayann, I suspect the main reason I value my current GP and practice so highly was the appalling 'treatment' handed out to me by my prior GP practice.
I'm not sure what the answer is from a patient viewpoint when 'stuck' with a crap GP, having struggled with all the problems inherent to the NHS as a system, and fallen through the gaps, I wonder if having had continuity would have forced the situation to a head years earlier, perhaps giving no alternative to push things towards complaints procedures, which in my situation would have been a positive outcome, with resolution for all, instead of having spent so many years bouncing around a large GP practice seeing different GP's all the time,which I am sure was a contributing factor to the delay in my diagnosis.
I hesitate to say this, but as Anon is right, there is going to be saturday access to GP's for routine matters, and there should be a debate about how best it should be done. My personal top irritation is the seeming lack of people to cope with minor illnesses and injuries at home, how and what to do about it. Bendy Girl
No your not anon, We have already established you have to pay in Italy, your talking about the care those who can afford to pay get, like in the uk areas with higher rates of affluence can afford better care.. that does not mean ergo care is better.
English is the "language of choice"
in Italian doctors offices? as i said before i can't comment on Milan, but i lived in Italy for YEARS and visitied the doctor a few times as a child and as a young man. If i didn't have fluent Italian speaking family members i would have been lost, again you worked in a small very cosmopolitan city. I lived in Naples in the main, but was also in Rome for a stint and just outside Venice, places with high levels of tourists and i often had problems even though i spoke some Italian.
Not my story i still maintain you have rose tinted specs on anon.
I still say Italian care may be better than soem NHS care...but it is comparable to private care in the UK. You have a good job and seem to dislike the NHS why don't you utilise more private care...in essesnce it's the same as you would be doing in Italy?
I love it... an ear ache in front of an italian Dr will get you local application of "stuff".
Dr Rant there you are...keep your ear ache patients happy with "stuff".
Anon, you are paying for your treatment, so salt water up the nose (is it going to help..probably not but who cares its "stuf!") seems a good way to me to make some money
Anon yes patients will get Saturday appointments, it will be provided by private companies, it will be used by the worreid well and there is no way it will be used well.
Why discuss how it can best be done. Do you have any sway on service provision in your area? No then i don't think giving you ideas for your nest post is really worthwhile.
Sorry but i am offski, anon i really hope we don't end up with an Italian system, i have used it and i couldn't afford to be unwell if it came here.
oh dear funny p,
re "you have to pay in Italy" well you sure dont pay for A & E, they didnt even bother taking my name as they started treating me as I entered, as for GPs yes I paid - but I'm 100% sure the poorest in Milan have access to GPs - and for the majority the system works better than it does here
language? I was talking about my work, but yes mostly the medics I came across had good English - better than many locums in the UK
rose tinted specs? maybe, but I also hear lots of stories from friends, the evidence is there for all to see, do some studies, make it rigourous, lets see where the reality is? and when its proven than they have a much better system in Milan please start learning from their best practises, cos all this excusing the nhs simply cos it gives the apprearance of being "free" to the most needy is wearing a bit thin
re "you local application of stuff" yea you might be right, i dont know, there are cetainly different fashions around the world of how medics will treat similar conditions, Italy is not the only country where ear ache routinely gets more active intervention than being advocated here, I'd love to know which is the best way, again for simple routine stuff like this you would have thought the worldwide medical community would have got its ideas straight? ah well maybe not, another good one for some blind studies
I hope Saturday appointments are not dominated by the worried well, they seemed to work quite well in my youth
re "i couldn't afford to be unwell if it came here" you might be able to afford the nhs but its going to give you shit treatment options with low chances of getting you well
Yeah i mean a couple of swift operations, endoscopy and free PPI's..i mean i can't believe i was given such shit treatment.
As i sit here with none of my old pain (don't worry i wasn't too seriously ill) i do wonder waht would have happened if i had been rich..oh wait... exactly what did happen.
My god those Drs in Italy...amazing, they started treatig you as soon as you went in. Without even asking your name! i would say unless you were an acute emergency then thats pretty bloody dangerous...when they decide you need a treatment how did they ensure you were the patiet being reffered to?
Or did they just ask "who is for the nose stuff" and hope you put your hand up.
We have covered ear ache before anon...you must not really read these comments unless they are directly at you.
Ear ache is best treated by pain relief and time (unless there is anything clinically suspicious), this is the findings that were posted on another commnts thread.
The "stuff" isn't helpfull it just makes you feel treated takes a little time.. and is billable.
Stories friends, you want me to ensure my posts are of rigerious blinded trials but your "friends" are good enough for your evidence.
Oh and the poor do have access to health provision as there is a sort of national health service in italy...funny that they have a crap version of the NHS (seems more restricted than ours with less choice as its at certain centers). Funny anon it does sound like...well a worse version of the NHS and private care. Nice lets all sign up.
Oh and by the way the national health service in Italy is going the same way as the German one, i.e. bankrupt (well unsustainable). Germany because they provided high levels of care, Italy because they have an ageing population which has become a major cost burden to the health payment exemptions (hence the cut backs).
Oh and Italy has one of the owrlds highest national debts.
No one.. i'm glad you dnever got sick in Italy when there was a doctors strike on...something that has never (yet) happened here. (oh and are not small/limited strikes, in 2004 90% of doctors stopped work.
Jayann,
I just need to ask about the lut of Italian Drs.
Even though the population of the UK and Italy is equal (58 to 60 million) Italy has 54,000 GP's compared to the UKs 42000 (and that includes the few thousand registrars).
So how is it so easy to see a GP in Milan and where is the glut?
In the UK the average GP principle carries out 8400 consultations a year, so even working 52 weeks a year and seeing over 30 patients a day woudln't get through that lot.
The average GP consultation in the UK costs the NHS £16, in Italy it costs approx 50 Euro (not that the patient pays).
I bet they Italian Drs see a whole lot less patients... i wonder if Italians are just less sickly
Now i just need to find the figures for the hospital doctors.
Funny pseudonym, I think the glut (I love the idea of a glut of doctors!) probably infests (sorry!) the hospitals, also, the North. But I guess you'll find out -- sorry but today's heat and my hay fever make me disinclined to Google a lot, maybe later.
(You made me do some research... !! Italy has one doctor per 160 inhabitants, according to this we page:
http://www.justlanded.com/english/italy/tools/just_landed_guide/health/doctors
I didn't do any research on North v. South but believe their relative wealth and number of professionals has not changed. )
So how is it so easy to see a GP in Milan and where is the glut?
I didn't do any research on Milan, I simply assumed that because it's a rich Northern city there'd be more doctors there, so no one's account was credible.
In the UK the average GP principle carries out 8400 consultations a year,
that's rather more than 23 a day assuming (what is not true) a 365 day working year! A GP who sees 30 patients a day, 8400 a year, would work -- 'work' = seeing patients, I realise GPs do more than that -- 5 hours a day, 280 days a year.)
So perhaps the Italian GPs do see more patients -- but perhaps simply Milan's better than Naples.
"so no one's account was credible" i maybe a prick but i dont lie about my first hand experiences
i dunno why the UK doesnt just open "minors clinics" especially for out of hours, similar to the "walk in centres" which are being setup - but rather staff em with docs rather than nurses, this would do a whole lot to improve the situation
I was basing my figures on working 5 days a week for 52 weeks a year. Taking into account say 4 weeks holiday (so 35 patients a day).
As yo usay this is only one part of the job -admittedly the big part-)
I know no one's accont was credible..as i said because he pays for it.
he dosn't seem to realise he can get just as good (in his opinion) service over here... its called the private sector.
No one i just don't understand you, you say the service is amazing in other countries, you pay for that service there. In those countries there is a similar system to the NHS which is comparable or worse than ours.
They even pay national insurance.
As Jayann the north south divide in Italy means one group get much worse access than their counterparts (which is not as striking here in the UK).
Looking at some info shows that the hospitals are worse in southern Italy and the access limited due to budget cuts.
Yet you rile against our NHS, why not just pay for the service you want?
Jayann
Maybe Milan is a specific area, however i didn't make it clear as anon had been reffering to Gp's i was replying to that point. I guess the hospitals in Italy must have more doctors than nurses!
Anon...go away and try again, whee would the Drs come from to staff the out of hours minors clinics?
there are plenty of docs around if the money is there to pay for them
Yeah loads og Gp's want to work nights... i mean its just a matter of offering them more money.
Oh wait a minute didn't they turn down more money to not do nights?
So you pay massive rates to get them to work nights...and then get the media for being money grabbing gits.
no one, I wasn't suggesting you might be lying, I worded my point badly, I realise that; sorry.
funny pseudonym
I guess the hospitals in Italy must have more doctors than nurses!
sometimes I think they do :D -- I did read Italy has a shortage of nurses (as opposed to doctors...)
http://www.wenr.org/DesktopModules/Articles/ArticlesView.aspx?TabID=41&ItemID=4720&mid=10547
355.000 doctors
320.000 nurses
Expenditure on health (%GDP)
Italy 8.7
UK 8.1
Spend per head
Italu $2414
UK $2560
living in a rich country means we send more per head in the uk than in italy.
Also part of the reason Italy has one of the highest national debts in the world is it's high spend on health.
the differences between the health systems in italy, belgium and new zealand to name but 3 are a lot more complex than money
i really think a good hard look at how they run their systems would show lots of lessons the uk could learn
Yes it is, they have large areas of the population with underserved, under funded, low access care.
Just because Italy has more doctors dosn't make it a better system overall.
Anon as somone who lived in Italy (and obviously not a single wealthy northern city) i thin kyour views on foreign health provision is a bit off.
I think a good look at how we run the NHS could show other counties areas of improvment. Not saying its better overall but as has been said we spend a lot more of a much bigger budget on health, when you go from Hants to Yorks i don't think you see the changes in provision you do elsewhere.
Anon, i once again leave a thread for my own sanity
Anon,
How stupid are you?
There are lots of parts of the UK that provide excellent general practice access and services. I know this because I have personal experience of living and working in many parts of the country - both as a doctor and a patient.
You have chosen to compare a good, private, service that you received in Italy to the crap end of the free NHS.
You have ignored people who have experience of living and working in Italy who disagree with your views.
You have said "i really think a good hard look at how they run their systems would show lots of lessons the uk could learn " but you have provided no evidence to back up this claim.
You are a moron. You are an opinionated moron. You are an opinionated moron who won't listen to people who have more knowledge than you trying to correct you.
The only appropriate response to someone who has all the negative qualities that you have is to say "fuck off you idiot".
Dr Rant,
I could ask the question "How stupid are you?"
Re "There are lots of parts of the UK that provide excellent general practice access and services." a number no doubt, I tend to come into the contact with the crapper end of the spectrum, I really don't know what the overall balance of service quality is, but if you keep being fed shit you tend to end up thinking all food tastes of crap.
Re "I know this because I have personal experience of living and working in many parts of the country - both as a doctor and a patient." yea well get yourself out more widely and experience it like many far too high a proportion of patients do.
Re "You have chosen to compare a good, private, service that you received in Italy to the crap end of the free NHS." not at all. The service in Italy did involve modest fee for GP access, but I wouldn't describe it as "private" rather its the way the govt and state has chosen to organise care there. It is not pure free market healthcare. Re "crap end of the free NHS" it's not free! and where oh where is the better end of the nhs scale? You lot openly admit distain for patients with earache etc - who receive much more caring concern from equivalent docs in Italy! I really don't think there is much to defend your assertion that there is anything other than a crap end of the nhs.
Re "You have ignored people who have experience of living and working in Italy who disagree with your views." no I have not, I happen to know a whole lot more people living and working in Italy than post on this board, I think I have a fair balance of informal feedback.
You have said "I really think a good hard look at how they run their systems would show lots of lessons the uk could learn " but you have provided no evidence to back up this claim. This part of your blog is titled "Post a Comment" not "Post a fully worked out, costed, and critically reviewed analysis of and proposal for a new healthcare regime". My comments are just that, and the folk on your side of the argument here come up with lots of nonsense without any great evidence. Fuck off and do your own research and reference it, then I will start listening to your informal comments, what a nonsense approach to take.
Re "You are a moron." thanks, you are a left wing nutter who clearly still lives in the dreamland of Stalin and Mao, who things that the state can do things for the greater good and is better at control that the people themselves. Well guess what it don't work anywhere else in the space-time continuum it sure aint working in the nhs. You have comprehensively failed to deliver the goods, you cannot prescribe more of the same when the medicine is killing the patient.
Re "You are an opinionated moron." yea I'm opinionated. But then you fuckers cost me a lot of money, and are responsible for a lot of unnecessary pain and early deaths amongst those I love and care for. I can think of nothing more noble to be opinionated about. "moron" aw what's a matter somebody nicked your pink crayon, you not found nursey looking out for you? get a fucking grip. if you don't want an adult debate done invite fucking comments.
Re "people who have more knowledge than you trying to correct you." ha ha more knowledge about what? I am sure I have more experience of the patients perception of the nhs than the average GP.
"fuck off you idiot" raving socialist nutters like you really should fuck off to Cuba and leave the rest of us alone.
Actually anon the state can do it better...Cuba has one of the best health care systems in the world.
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