I wouldn't get to worked up about GP's folks because
they are going to be phased out! Having listened to
George Alberti talk have glimpsed the brave new world
which the politicians are aiming for and the plan is
to do away with any distinctions between docs, nurses,
physios, OT's etc. First to go will be GP's. I expect
them to be a thing of the past within my lifetime.
Here's how it works. If you look at a GP's core
activities they break down into:-
(1) Diagnosis/treatment of minor illnesses.
(2) Assessment/diagnosis/referral of major illness.
(3) Routine chronic disease management.
(4) Screening/health checks - eg. children, elderly,
maternity.
(5) Emergency diagnosis/assesmet/tratment/referral of
acute illness.
If you look at those roles currently practice nurses
are being trained to do (1) & (3), Health visitors and
community midwives can do (4), leaving only (2) and
(5) to sort. With GP's opting out of emergency work
this is being taken over bu nurses and paramedics (at
least in our area) so you don't need GP's for that!
That only leaves assessment/referral of major illness.
Not hard to envisage a suitably trained nurse taking
over that role. Think it won't happen!? Think again.
In our area one practice has already replaced retiring
partner with additional nurse support. In the short
term with no on call and most of the income coming
from capitation, item of service and target payments
makes a lot of sense. One less £6,000 to deduct too
for out of hours. But it is the slippery slope. GP's
are doomed!
Fred.
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