Rob49 said:
I went to my MP who passed this troubling report onto Lord Howe, the Parliamentary Under Secretary of State at the Department of Health. His response was very positive. I will paraphrase it below as all I have is a scanned copy of this letter
Our Policy is that clinicians acting within the scope of their of their clinical competence should be able to prescribe medicines in line with NICE guidance. I believe there may be some confusion in terminology : many PCT's develop lists of medicines that should be initiated by specialists rather than GP's. If we have evidence that any PCT is not following our policy then my advice is to take the matter directly to the CEO of the PCT. If the situation is not resolved then the matter should be escalated to the relevant Strategic Health Authority, which can involve the Department of Health
(the letter is signed) Earl Howe
I think this answers the question and I would be happy to provide a copy the letter to anyone who needs it
Robin Frowd
Very useful information. I'd love to see the whole letter. Can you scan it yourself and email it or post it on here as an attachment?
A question about the restrictions being imposed comes to mind. Of the medications on the hit list, are there alternative generic medications that are exactly the same but much cheaper? These become available when the brand name ( ie: the company who first developed and tested the medication and has to recover its costs) is now past it's 'it's all mine and no one else can produce it' limit? This same debate happened some years ago for the same reasons. It was not the medications that were banned but the prescription of them under the original, very expensive, brand name instead of using generic alternatives. The generics are often thought of as inferior or somehow different, but they are not. They have to be identical. The only difference is in some of the additives such as colourings as far as I am aware. Now someone who knows more is going to shoot me down and say that is not so, but I would like to see concrete evidence if that is the case. If generics are what is being proposed then there should be no problem, but I don't know if that is the case or not.
[quote="oobuc5"
doctors now are doing more proceedurs in house as they get paid money for keeping it in house.
example,if you had to have a sist removed you would have been refered to the hospital [maxifacecial] for a minor opp ,but in the warm up to the budget hand over to the gp,s the pct does not fund minor opp,s at the hospitals any more .
they will tell you to see your doctor and get a special dispensation to get it done at the hospital .
tried to get to see a perdiatrist ? good luck with that one .
![/quote]
I think you will find that this has always been the case. You have always had to go to your GP first to get referred for any hospital treatment. Also, many GP surgeries have, and have had for a long time, facilities for doing minor ops. For instance I had some rather pernicious warts surgically removed by the GP. Very simply and competently and it avoided a whole day lost attending the hospital fifteen miles away. Our GP's surgery is soon moving to new premises where they can have more facilities to do more in house. It will make them like a micro hospital and make it much easier for local people to stay local for simple and routine treatments. Why waste a hospital's precious time and resources doing things that GPs are perfectly competent to do? Let's be happy for the hospitals to do the work that can't be done by the GP. The GP will soon refer you to the hospital if he thinks the work needed is beyond his expertise or facilities. For instance...
(If you're sqeamish, skip the next paragraph.)
My warts nearly had to go to the hospital as they had penetrated the bone in my finger and the GP could not go that deep because the risk of infection was too high with his facilities. That information could not be known before he looked inside. (Although I had been fairly certain because bone pain is different - but the doctor couldn't know that my assumption was right - longer story there, but no criticism of the doctor.)
These plans for our local GP's surgery were in place long before the current government's existence, let alone their new NHS policies. They are ideas that have been ongoing for a long time and hugely encouraged by the last government. Remember their plans for the new 'super surgeries'? Perhaps these facilities are of more benefit to people living in rural areas as I do, where the hospital is fifteen miles away and a visit kills at least half a day, and a whole day for those who have to travel an hour each way on the very expensive hourly bus. Lucky us - we have a bus once an hour. Move a couple of miles out of town and there is no bus except the ring-and-ride one. A more comprehensive service from the GP will be very welcome.
