Primary Care Health Changes The Health Service has seen unprecedented spending in the last decade mainly in secondary care ( hospitals ). Consultant numbers have increased by at least four times, which has resulted in faster referrals, investigations and treatments which is all a good thing. Primary care, through General Practice manages over 80% of the health care of the UK. The public satisfaction for this service is rated the highest of any public sector and yet the government wish unilaterally to change this service which will probable be irrevocable and detrimental to patients. If a system isn’t broken why fix it, is the adage that rings true. There have been many recent schemes initiated directly by government which have not been trialled and in economic terms have been of unproven value. NHS Direct the telephone triage service was initiated at a time when the Out of Hours doctor services was well and efficiently established. This service duplicates an existing service without providing the doctors expertise and so 22% of all calls result is a re-direction to their own GP. A similar proportion of patients are referred directly and often inappropriately to hospital. Walk in Centres, duplicate existing General Practice services rarely providing the medical input that is frequently required. General Practice in the UK has an enviable record of providing ‘cradle to the grave’ healthcare which can probably only be fulfilled where patients are registered with one doctor who know the families with which he/she practices. This personalisation of healthcare stimulates a mutual trust and a willingness of the doctor to pursue their patient’s health issue well outside the alledged ‘9-5’ time frame of General Practice. The benefits extend to more appropriate referrals, earlier identification of illness and more methodical prescribing.
June 2008. More than 100 GP representatives rallied outside the LMCs conference in London in support of Pulse’s Save Our Surgeries Campaign,( photo opposite) as practices across the country took part in a our Week of Protest.LMC chairs and GPC negotiators stood shoulder to shoulder with grassroots GPs to show their backing for our campaign to stop the Government enforcing its polyclinic model on general practice and save surgeries from closure We have also won the support of the BMA itself, the RCGP, the Family Doctor Association, the Patients Association and Londonwide LMCs as well as the Conservatives and the Liberal Democrats. http://www.saveoursurgeries.co.uk/ GP’s have been clearly out manoeuvred in the press as erroneously earning alarmingly high salaries as a prelude to the government rescinding on their contracted working hours. Practices we will have to nominally have to open longer hours for routine surgeries ( without the essential back up of pharmacies, and routine hospital services). This is likely to have little benefit for patients at the detriment of scrapping of proposed health screening quality care with conditions such as osteoporosis. |
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The General Practice contract of 2006 insidiously expunged the direct registering of patients with the doctor in favour of the practice, and led the way to the gradual fragmentation of primary care. These changes have occurred in many forms from the increased dispersal of medical skills to pharmacists and community matrons to unrelenting move to walk-in instant health care. The most notable recent change is the introduction of ‘Polyclinics’ throughout the inner cities, which is the brain child of Lord Darzi. These practices with their proposed longer hours will more further away from personal lists.