Healthy Conversations
(now titled The Talking Cure)
We know that the doctor-patient relationship is changing. Sources of health information have multiplied and the GP’s monopoly on knowledge is wobbling. But as we move from paternalism to ‘patient-centred’ how should we think about professionalism and expertise? What are the advantages and challenges of patients and the public playing a more active role in their own healthcare? As the questions patients ask of their doctors become more complicated, how do conversations with doctors need to change?
GP hours - Time for change?
at 12:23pm on Monday, 10th September 2007
According to the Times today Alan Johnson is set to challenge some of the terms of the GP contract by proposing that GP’s open surgery out of hours and on weekends. This has met with some criticism from the BMA, who argue that other professionals don’t have to work weekends, and that out of hours work would mean a reduction of normal hours service.
There are genuine questions to be asked around how to shape our current model of GP care to best suit the healthcare requirements of a 21st century working population, especially within the context of a need for an engaged, self-managing ‘patient’ population. The importance of early intervention and prevention places an emphasis on both access to, and effective relationships with, health professionals.
Although a recent DH survey showed that most existing patients were satisfied with their GP services, I argued in my letter to the Guardian that healthcare responses will need to work within the reality of our wider population’s social behavior to maximize the opportunities for health conversations.
Obviously, any reconfiguration of GP working practices will need to take account of optimum clinical delivery and GP working conditions but these are not inherently obstacles to accessible, continuous GP care.
We hope to discuss some of these issues further in an upcoming workshop as part of our Healthy Conversations project. If you would like to know more about either the workshop or the project drop me or Jack Stilgoe a line.
There are genuine questions to be asked around how to shape our current model of GP care to best suit the healthcare requirements of a 21st century working population, especially within the context of a need for an engaged, self-managing ‘patient’ population. The importance of early intervention and prevention places an emphasis on both access to, and effective relationships with, health professionals.
Although a recent DH survey showed that most existing patients were satisfied with their GP services, I argued in my letter to the Guardian that healthcare responses will need to work within the reality of our wider population’s social behavior to maximize the opportunities for health conversations.
Obviously, any reconfiguration of GP working practices will need to take account of optimum clinical delivery and GP working conditions but these are not inherently obstacles to accessible, continuous GP care.
We hope to discuss some of these issues further in an upcoming workshop as part of our Healthy Conversations project. If you would like to know more about either the workshop or the project drop me or Jack Stilgoe a line.
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Comments
The BMA is kind of wrong about other professions not having to work evenings and weekends. Hospital doctors are required to work all sorts of hours, as are lawyers, journalists, even some think tank staff. If anything, the arguments for requiring doctors to work less social hours are stronger, given the importance of what they do.
A system that demands that the individual take time off work to attend a surgery amounts to charging individuals (in terms of holiday time) or employers (in terms of lost work) an extra fee to use a service they've already paid for.
The GPs should suck it up.
First yes I'm a GP one of those greedy work shy £110k a year bunch
However lets look at this a bit more critically; yes GPs have done well out of our contract, we now earn an average £110k a year from all sources. Remember that's all sources not just our NHS work. Many GPs do work outside their practices eg police surgeon, insurance work, training new GPs etc. We also pay both the employees and employers superannunation pensions costs of 7 and 14% respectively. Finally not all GPs are self employed partners, many are salaried and earn substantially less. For the past 2 years GPs have had a zero percent pay rise and yet no one talked of industrial action.
So yes we are well paid but at an average 55 hours a week and a cost to the tax payer of around £25 a patient consultation we are very cheap compared with NHS Direct or out patients.
Roughly half of all GPs are happy to consider opening for longer than their current 8.30-6.30 hours and at no extra profit.--compare that with Tesco's or Boots who wouldn't dream of opening unless there was money to be made.
All that GPs ask is that the costs incurred in opening longer hours are properly taken into account.
We also strongly feel that the the existing Quality and Outcomes Framework (QOF) which rewards practices for excellence in their clinical care remain just that. QOF is supposed to be an evidence based pot of money rewarding practices for providing effective interventions. It is not a pot of cash to be raided to suit the Governments latest agenda.