In message <[log in to unmask]>, Declan Fox
<[log in to unmask]> writes
>George wrote
><<You may be a doctor but the NHS bit is a job as well. If you're going to
>put in extra time, extra commitment and extra energy you will be subject
>to the same stresses and needs as anybody else, be it politician or
>dustman, and respond to the same rewards. The extent of people's needs
>will vary, however, and it seems that more and more are being unmet. If
>the medical part of the NHS is to continue then those needs should be
>met for the doctors and nurses involved or they will take their skills
>elsewhere, and the part of the NHS dependant upon them may very well
>collapse, which I feel would be a tragedy - yet so easily resolved.>>
>And some more good stuff.
>
>Right again George--as usual!
>
>The biggest problem I see is when the "system" actually makes the job of
>tending to the sick more difficult; when the NHS structure becomes a
>major impediment to us providing what we are supposed to provide under our
>T and C of service.
This is a major issue - and I'm not sure that it can be solved.
Look at the *additional* clinical workload imposed since 1990 - minor
surgaery, CHS and a lot of family planning (savings to the DHAs..not
general practice). add to this the increased administration - monitoring
targets , inhouse complaints proceedures, and the inclusion of GP staff
in the NHS Pension scheme (these are only the obvious examples - I'm not
suggesting that the extra administration is done by GPs in person...) -
take account of the fact that there are 1000 GP vacancies (with loss to
the pool of UKP 68,000,000 ;-<) - and what *time* is there that is not
taken from patient care? *Costs* are contained (how big do you expect
the clawback to be for this year?) - but what is the price?
Suppose I get a "distinction award" for additional administrative
responsibility.. it's a gamble; experience seems to show that some
groups are favoured well above their representation in any workforce
with this system.
Wouldn't it be better to press for adequate pay for the additional work?
Not just locum expenses and a chance at the Lottery?
> Contradictory, non? Maddening and frustrating?
>Ultimately enough to drive us away.
I'm stuck - I've got a surgery loan to support - and a practice short on
doctors...
> I am reminded this minute of RD
>Laing's work on the schizophrenigenic family---families driving people mad.
> I think the NHS drives clinical staff mad.
Isn't that a structural problem.. which needs a structural solution?
Mary
>Declan
Mary Hawking Kingsbury Court Surgery Church Street Dunstable LU5 4RS
tel:01582 663218 (surgery)fax:01582 476488 (surgery)
Member of British Healthcare Internet Association
Dunstable and Houghton Regis Locality Commisssioning Pilot
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