Doctors: Diagnosis By Phone

[ratty]

People must make their opinions on this know. As outlined above my missus made a complaint about this new system and was contacted very quickly by the chair of Melbourne Grove. The phones system is only as good as the people managing it, and in the case of my wife's incident with them this was appauling! She missed the call back because the baby was being fed and was up to his nose in pureed spag bol and then could not get through to them. She went down there on foot straight away and was confronted by rude and unhelpful staff so she left in tears. She complained and everything got sorted pretty quickly.

So I emplore customers (patients) of Melbourne Grove surgery to relay their experiences of this back to us all, and to complain when the system falls down - they do seem to listen to their patients!!

[Boris Karloff]

No it's not the way all doctors surgeries are going - it may have passed you by, but Melbourne Grove Medical Practice was taken over by Concordia Health (private company), and if you read my previous messages on this forum, you would see that they are making GPs redundant there so that they can provide 'more' appointments with nurses (cheaper!). Now this telephone thing because I heard that they were at cracking point using nurses. I'm voting with my feet as this is a dangerous system. Loads of stuff on the internet about Concordia and the dubious way they were awarded the tender for Melbourne Grove and how they're only in it to make money

[lozzyloz]

I dnt undstnd a wrd tht kk. Cn u trnslte 2 txt spk pls?>:D

[Brendan]

Thanks for tha Boris. Very enlightening. I didn't know that.

[david_carnell]

Excellent post KK.

Bendan - ah, I see. You mean because you pay tax it is not free at all, and I suppose you are correct. How about 100 families/households get together in a co-op and each pays ?1000 per year? For this you get unpriviledged access to your GP 24/7 with no waiting for an appointment. The doctor gets an appropriate salary and we all live happily ever after. No? Too much money? Some can't afford it I hear you shout. Hmmm....so really a free-at-the-pint-of-use NHS is the best way to go isn't it?

Isn't it? Perhaps if you had to pay a ?50 flat fee everytime you went to your GP it would stop most of the bloody timewasters and hypochondriacs going in the first place. It could be tax deductable. Any takers? No?

[KalamityKel]

?50? I didnt think you had to pay that much privately! ::o (of course I'm likely to be wrong what with not having gone private before) :p

[david_carnell]

Oh, and whilst we're all here can I point out the elephant in the room when it comes to the Melbourne Grove Surgery. Who the bloody hell started allowing private companies to run GP centres?

Concordia Health!?! - who the feck are they?

See what the Southwark News reported in January if want a reason why you can't get an appointment. It's because all the GPs have been laid off.

*stops typing as spit and bile have obscured monitor*

[Boris Karloff]

Yep - it's been REALLY controversial, and local GPs think Concordia are basically having a laugh. The PCT [which is the Southwark 'governing' body which gave out the tender to run the practice to Concordia] has a lot to answer for and yet has done nothing - same for the Southwark Patient forum. Sad really.

[Brendan]

david_carnell Wrote:

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Hmmm....so really a

> free-at-the-pint-of-use NHS is the best way to go

> isn't it?

I fully agree but it doesn't in any way make it unaccountable to the tax payer.

[david_carnell]

How can you make it accountable?

[Boris Karloff]

David - nicely put - note in teh articel it says:

Dr Jane Fryer, Southwark?s Health and Social Care Medical Director, said: "We have now met with Concordia Health, who have given their assurance that delivering the highest and safest quality of care to their patients is their first priority. We will continue to monitor the situation and meet with Concordia Health to make sure that this remains the case."

You may not realise that they had to meet in the first place because 1) they were laying the GPs off 2) there were issues surrounding patient satisfaction!!!

[KalamityKel]

Incident reports?

[david_carnell]

Boris - do I sense a personal involvement somewhere down the line?

Nice pseudonym btw.

[macroban]

> "We have now met with Concordia Health, who have given their assurance that delivering the highest and safest quality of care to their patients is their first priority. We will continue to monitor the situation and meet with Concordia Health to make sure that this remains the case."

???

As a company the first and legal priority is shareholders' profits.

[david_carnell]

Just the type of people you want running a health service - those interested in profits, not patients! I think not.

[lozzyloz]

Perhaps also the case against private health schemes/insurance too. I've experienced both with mixed results both here and abroad. I still maintain that the UK has the best 'free*' health system in the world. It is a behemoth and as such it's inefficient, lacks proper investment, run down and over abused. However, the vast majority of the staff are excellent and well meaning if a little overworked, demoralised and underpaid. Perhaps if we adopted a system that limited treatment to people that didn't do much to look after their own health, then it might go some way to reducing the stress on the system.

*free in the sense that although it's funded by taxes but our effective tax rate is comparable with countries that don't have a free health service for all.

[bawdy-nan]

Interesting discussion about the practice here

[????]

The health services' unreliability and crapness has had a fundamental impact on my life and as someone who used to have some misguided principles about its 'value' I am kicking myself for believing in it. Any serious health matter asnd my family and me are going private out of my own pocket which I resent enourmously as a taxpayer and yet some kind of incentive to help me to do this is deemed politically unacceptable to the detriment of all users of healthcare whether paid for or not. Socialisms' lowest common denominator effect strikes again. (also see education).

[SeanMacGabhann]

It has it's problems for sure quids.. but if the alternative is "survival of the fittest" and I MUST choose one over the other I'm taking the lesser of two evils

If there is a happy medium I would like to know what it might be ....

[She'llsurvive]

its obvious to everyone (i think) that the new privately-owned melbourne grove practice has been consistently worse than the previous publicly-owned melbourne grove over the last year or so.

so whatever is needed to solve any problems in the nhs, the evidence from ED is that a simple move to private accountability isn't it. it's generally quicker to take your children to king's a&e than try to get them seen at mgmp now.

[bignumber5]

it's generally quicker to take your children to king's a&e than try to get them seen at mgmp now.

Which is a great solution - puts A&E under a butt-load of additional unnecessary strain, which reduces the quality of that service for those trying to use it appropriately. This is why privately owned GPs are never held to account for their service failures, because A&E picks up the slack.

What if A&E depts could bill GPs for any care needs that were primary-care?

[Marmora Man]

annaj Wrote:

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> Can we have some more of our NHS employees input

> on this one?

>

AnnaJ - I'm far from knocking Doctors or any clinician. My own experience of joining thew NHS as a manager in 1993, after an earlier managerial career in a very different environment was just how pointless most of NHS management was. In my previous life the aim of the managerial level had been to make the life of those actually delivering, and receiving, the service easier. This did not seem to be the ethos of the average NHS manager. Diversity awareness programmes, gender equality programmes, endless committee meetings, delegation upwards, lack of initiative, responsibility or decision making were endemic. I left, after 4 years, to manage private hospitals and found I could help make the consultants, nurses and patients life easier by taking sensible, pragmatic decisons within my own, little (100 beds) hospital and subsequently 17 such hospitals.

I found most docs regarded their time in the private sector as a respite from the drudge of NHS bureaucracy - tho' the fact they were supplementing their income was no doubt an added attraction!

I believe that making NHS hospitals genuinely independent of politicians, the DoH and its centralist bureaucracy could create a similar ethos, save money and improve service levels. At a recent think tank breakfast the BMI, presidents of several colleges and other respected NHS managers / thinkers were of a similar accord.

This does not mean they have to "go private" - the free at point of service can remain, thus meeting Sean's desire for a middle way, but reducing management levels (sounds an easy target but it would be bloody difficult) should be the aim and can only be achieved by taking the provision / management of (as opposed to the funding) the NHS away from politicians.

[spadetownboy]

bignumber5 Wrote:

-------------------------------------------------------

> it's generally quicker to take your children to

> king's a&e than try to get them seen at mgmp now.

>

>

> Which is a great solution - puts A&E under a

> butt-load of additional unnecessary strain, which

> reduces the quality of that service for those

> trying to use it appropriately. This is why

> privately owned GPs are never held to account for

> their service failures, because A&E picks up the

> slack.

>

> What if A&E depts could bill GPs for any care

> needs that were primary-care?

do the gp,s still not come in ,in the evenings to take all the primary care stuff in minors and paeds?

[buggie]

They do Spadetownboy, and they work their socks off for us - esp in paeds alot of the families coming in can be seen by them. "Inappropriate attendance" to A&E was the basis of my dissertation a few yrs back - will resist the temptation to write it all here!!

Often the families coming in ingnorant to the existance of SELDOC and often admit not even having tried to contact their GP first - have even had families who have made an app with the GP but decided they couldn't wait another 2hrs to go there (in a child who's been vomiting since 7am, app made for 4pm - child very alert and jumping round but want to be seen NOW).

When I ask "what is the emergency that's brought you here today?" I often get a slightly bemused look back from them.

My own take on it is that understandably given the amount of low income families we see the thought of having to take time off work with a poorly child isn't attractive - the impression given is that they feel by attending we can give them an instant solution - often have to explain how while they really don't need admission they will be poorly for a few days and that they won't be able to attend sch/nursery in this time.

They also seem to attend so that they can vaildate to their employers - attendance to A&E = genuine reason to be off (?employers won't believe them otherwise).

I love my job but at times feel like we're a GP overflow than Emergency Dept (as we're called now).

[spadetownboy]

been there,seen it,done it.