Robbie Coull wrote:
> Interesting discussion.
>
> As the NHS comes apart at the seams (could happen at any
> second, but I'm not holding my breath too hard), this could become a
> more common issue.
>
> It's interesting to consider....
>
>
> (1)
>
> -you, or one of your partners, saw the patient out of normal
> surgery times privately -assume you refused to sign the
> 'dinnae do a dentists' clause in nGMS -how would you handle
> any prescriptions arising from that consultation?

Don't think this would be legal - i.e. charging an NHS patient of the
practice for services which could be received under the NHS. If the
partner had retired from the NHS and the patient wanted to continue to
see that partner, then that would be legal, and indeed it has happened
locally. Although it kept the patient off the backs of the remaining
partners, I believe it caused some irritation around prescribing.

>
>
> (2)
>
> What is the source of the irriation over the private GP
> suggesting NHS treatment from the patient's own GP?
>
> (I find it irritating too, so this is self-exploratory...)

It's the assumption that we'll drop everything in order to translate the
prescription from private to NHS. If the patient comes to see us in the
ordinary way and allows us to make up our own minds about the
prescription, that's fair enough. When we've referred to a private
consultant we've asked for his advice, and in general we'll accept it.
With a private GP the patient has self-referred, and practice
prescribing policies may be undermined.

>
> Is it?
> -because they are getting paid more to see the patient, and
> then we are having to do more work as a result? (Equity of
> remuneration issue)

Don't think it's the whole story, but probably a factor.

>
> -because we feel if the patient can afford to see a private
> doctor, they can afford to pay for the Ixs too? (Distribution of
> resources, moral issue)

Often investigations cost a lot more than the consultation. We probably
indulge in some moralising about waiting times, though.

>
> -because the patient decided to see another doctor and not
> us? (Hurt pride)

It's usually a relief.

>
> -because private GPs are money oriented, lazy gits who have
> had the bad taste to leave the NHS? (cultist views of heretics)

Don't think that's the case around here. I think there's a danger that
private GPs will pander to patients' belief systems to the detriment of
their care.

>
>
> Other?
>

--
Michael