Do we expect too much from our GPs ?

AndBreathe said:

It would be fascinating to know if people's opinion of their doctors changed, in the light of their diabetes diagnosis, and subsequent interactions.

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Mine certainly did. Generally very happy with them until I met the diabetic nurse who couldn't answer my questions and became aggressive followed by giving me the silent treatment and told me not to bother coming back when I told her that I wanted to low carb and test. Had to battle with doc over strips and meter. Finally he admitted that it was a cost issue.

Scandichic said:

.................... The bottom line is, a larger proportion of the budget needs to be spent upon the NHS so that staff receive the most current training and people receive the care and meds to which they are entitled. Perhaps the likes of Cameron and all those other greedy MPs could practise what they preach instead of voting for huge pay rises for themselves at a time when most people's salaries have taken a significant dive.

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The NHS budget is around £100 billion, Parliament costs less than £1 Billion , from figures on the internet, so it wouldn't make much difference in the grand scheme.

AndBreathe said:

It would be fascinating to know if people's opinion of their doctors changed, in the light of their diabetes diagnosis, and subsequent interactions.

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Yes! My doctors opinion of me changed and then I started to get better service from him. For years I have tried to lose weight and each time I went to ask for help they gave me various diets. All of which I stuck to, and none of which worked. The GPs replies were always, 'well you couldn't have followed it properly, are you sure you wrote everything in your food diary.? Well YES always. I am fat, not stupid. Now I am diabetic (diet controlled)and they can see from the blood tests, that I am eating the right things. They respect me more, and therefore I respect them more in return.

But I do agree with luceeloo who says 'The very least we should expect is that our GP's listen to us and take us seriously. In my opinion, that is the very minimum expectation, but many aren't even meeting that.'

douglas99 said:

The NHS budget is around £100 billion, Parliament costs less than £1 Billion , from figures on the internet, so it wouldn't make much difference in the grand scheme.

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With a rising population then the budget is clearly not enough. I wonder how much revenue has been surrendered by giving our top earners a 5% tax break?

I have nothing but praise for my GP, and her predecessor. Nothing is too much trouble for her. During my chemotherapy treatment she rang me weekly to see if there was anything I needed, and on the only occasion when there was she came to my house rather than have me go to the surgery (which I could easily have done). She also called round once to check on me because she happened to be passing my house on another call. My diabetes was picked up on an annual routine blood test following which I received a letter asking me to make an appointment with her. Before I did this I had an oncology outpatients appointment with an oncology consultant, and it was she who told me I have diabetes, so when I saw my GP I was fully armed with everything I had read on the internet about it. My 10 minute appointment turned into 30 minutes, during which she listened to me, checked me over, arranged for me to have a 12 hour BP monitor, discussed statins as my cholesterol was raised and the diabetes had put me into the 20% high risk zone, made me an appointment with the practice DN specialist and for further blood tests. She was just lovely.

I expect and get a good service from my gp, although he has now left the surgery there are others that I would go to see and others I wouldn't, I don't see them that often anyway as my diabetes checks are carried out at the hospital clinic.

Scandichic said:

With a rising population then the budget is clearly not enough. I wonder how much revenue has been surrendered by giving our top earners a 5% tax break?

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That's another trap for politicians though.
Increase tax, and all the assets simply move out of the country, and the revenue goes down, not up.

douglas99 said:

That's another trap for politicians though.
Increase tax, and all the assets simply move out of the country, and the revenue goes down, not up.

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They do that anyway! Big business always goes to where the workforce is cheaper - usually a developing country where every poor b***r is a university graduate working in appalling conditions for a pittance.

Andy12345 said:

this is so very important to us but just a job to them im sure

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"I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug."

This is part of the oath they swore yet these are its most widely ignored elements.

Before the days when students paid money to get their degrees, if anyone applying to study medicine told the interviewers that it was just a job, they wouldn't get into medical school. Every student was asked, 'why do you want to study medicine?' It was seen as a vocation.

Yorksman said:

"I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug."

This is part of the oath they swore yet these are its most widely ignored elements.

Before the days when students paid money to get their degrees, if anyone applying to study medicine told the interviewers that it was just a job, they wouldn't get into medical school. Every student was asked, 'why do you want to study medicine?' It was seen as a vocation.

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It's nearly impossible to get onto the degree course now. Personal statements, then straight A at A level, and A* at O level, and massively over subscribed. And a lot of years of debt to pay for later.

Would you be prepared to pay more? The UK is unusual in that on the whole NHS costs are paid through general taxation. Most other countries have schemes that involve some form of social insurance but also part payment. Wiki describes quite a few of them. Very few are as cheap to the individual as the UK.http://en.wikipedia.org/wiki/Health_insurance

.We pay contributions based on taxed income and also contributions for any test, visit, pill etc that is non diabetes related .(you can get extra private insurance to cover some of these costs.) Most chronic or serious conditions are covered at (almost) 100%. Dental and optical coverage is poor
I've calculated that it amounts to at least £2500 a year more than we would pay in the UK. ( hard to estimate exactly because we have to pay our income tax in the UK not France).
What is actually covered is listed so, if, as a diabetic with '100% reimbursed for diabetes, I wanted to see a podiatrist I still would have to make a 40% contribution to the cost unless I had a diabetic ulcer. A T2 on most medications or diet won't get more than a possible 50 strips 'in the context of education'. The government legislated on that a couple of years ago. As a T1, I don't get an unlimited amount either (adequate at 6 per day)

Outside the' in patient' hospital setting, doctors are essentially private. You pay for them directly and you get reimbursed according to the scale. Doctors certainly seem to have far more time to discuss things. If you don't like them it is easier to go elsewhere but some doctors may charge more than the basic state decided cost. Since they are private, it means that you normally have to write a cheque at the conclusion of your visit. (refunds are quick but paying upfront can cause some problems if lots occur at the same time or you've just had some other high expenses)

Paying upfront makes you very aware of the cost of your health care as does the itemised 'bill' we receive from the state every 2 months. Reimbursements are paid direct to bank accounts after charges have been deducted.

To reiterate : Would people be prepared to pay relatively more for their health care to get more time more choice and time with the doctor they see?

douglas99 said:

It's nearly impossible to get onto the degree course now. Personal statements, then straight A at A level, and A* at O level, and massively over subscribed. And a lot of years of debt to pay for later.

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That's the case with many courses thesedays. Even a university like Sheffield requires 3 As to study a subject like history. The government has managed, very effectively, to get people to borrow large amounts of money to keep themselves off the unemployment register.

phoenix said:

To reiterate : Would people be prepared to pay relatively more for their health care to get more time more choice and time with the doctor they see?

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No party standing on an election promise to increase general taxation has ever been elected in my lifetime.

The NHS has just over 1,600,000 employees and is the 4th largest employer in the world. Of that 1,600,000, about 550,000 are involved in healthcare, doctors, nurses, heamatologists, radiologists, physiotherapists, biochemists, microbiologists, phlebotomists, podiatrists, histologists, dieticians etc etc. The remaining 1,050,000 are in administrative, managerial, clerical and secretarial posts. This figure has grown by 40% since the year 2000.

"work expands so as to fill the time available for its completion"

Cyril Parkinson derived this dictum from his extensive knowledge of the British Civil Service and it formed the basis for his essays on The Persuit of Progress. He explains that the growth in numbers of bureauocrats is governed by two forces: (1) "An official wants to multiply subordinates, not rivals" and (2) "Officials make work for each other."

Whatever the rights and wrongs, good and bad with our NHS, it is still a hell of a load better than it used to be.

phoenix said:

Would you be prepared to pay more? The UK is unusual in that on the whole NHS costs are paid through general taxation..........

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A good post phoenix and one that has made me at least realise how lucky we in the UK are for our NHS I hate to think what would have happened to me a 7or 8 years back when my medical problems started, had it not been for the free intensive care unit I was admitted to for 14 days at an average cost of around £2K to £3K per day/night I hate to think what might have happened. Had I lived elsewhere and not had the very best insurance I doubt I would have survived.

I am also lucky in that I have a very good GP who I am able to discuss pretty much anything and everything with, given the short time allowed for appointments of course but if I have several things to discuss he is always OK to run over the allotted appointment time a little. I have always sent him a Christmas card every year since my respiratory and arthritis problems started, thanking him for his help over the past year, its a simple thing but I feel it helps build a relationship which I am grateful for which is why I can never understand why some people are so anti their doctors and/or the NHS. I fully appreciate that not all doctors are equal and there are a couple who I always try to avoid seeing at my local surgery but if I felt my GP wasnt doing a good job I would look for another, just as I would with any other professional or tradesman alike. I wouldnt see a bad plumber more than once any more than I would a bad doctor.

Andy, in your op you appear to suggest that no one really cares about anyone else in business or everyday life any more, I prefer to see the best in people unless they show me otherwise and if someone gives me bad service I go elsewhere, I always assume that I will get good service and you know what I usually do, I wonder why that is? Perhaps I'm just lucky eh?

In my personal opinion Dr's are just people that get paid a shed load of money for doing their job ... Therefor I think we have a right to expect a good service from them. If they don't want to listen or help the people they see then they should find another job. After all it's our taxes that pay the Dr's wages.
If I did my job as badly as my Dr then I would be quickly out of work. (I am retired now, so have time to tiptoe around my health problems)


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Sid, you would still get the treatment in France (same basis as I get my diabetes care,)T he principal is still socialist even though it's an odd mix of private and state. As in the UK, you contribute according to means (just that it's a bigger slice here) , the sicker you are, the more the state pays . The poorest don't contribute at all.
Of course there are many parts of the world where no money means no or very little health care.

Actuall I would rather pay more tax if it meant that I got a better quality of care! I do agree with Sid up to a certain point - treat people well and generally you will be treated in kind. However, there are good, bad and indifferent in all professions and sadly some doctors are not always prepared to treat their patients with the same level an courtesy which they deserve.sometimes it is due to cost. Sometimes personal opinions get in the way. I believe that T2 diabetes is often regarded as the fault of the individual and that can colour the response which we receive. It also depends upon which diet you want to follow.

I spend a lot of time in a country with no social healthcare, or even part funded health care. There is rarely a week goes by without some sort of appeal for someone who has some critical health issue or the other.

Now, there, although funded directly by the patient, some things seem quite reasonable. For instance, I could walk into a very smart medical bio lab and request a full diabetic panel, including all the stuff we get here and including the phlebotomist taking the samples I would be charged US$100, or about £60. A friend recently had to have their elbow rebuilt, having slipped on a damp bathroom floor, and that came to US$15,000. Healthcare seems to be charged in USD in many places.

In the US a different friend has an adult son who is very unwell and needs a liver transplant to survive. Fortunately, he has insurance, and they will pay for the transplant – provided he has a particular test beforehand, but they will not pay for that test. The cost of the test? US$250,000. (Yes, all those zeros.) Leaving aside the insurance company's morality; what a way to live? He will probably have to sell his home, and our friend will probably have to make a contribution to the test. How do you tell a son they can die?

Are we lucky to have the NHS? Is it imperfect? Oh yes, to both. Imperfect as it may be, we all know if life changes, as it can, in a moment, we have a safety net.