People think that General Practice is the business of seeing patients. But they’re wrong. GPs are paid to keep people healthy. They don’t earn extra if their patients bother them more so there is no incentive for GPs to keep patients sick. General Practice is under a lot of financial pressure. And business people think … Read more
Extra funding for General Practice is much needed and it is is great when they start paying for extra work dumped out of hospital. But incentives like paying £20 per advice and guidance request is just plain dumb. The NHS cannot afford for GPs to be forced to make more referrals in order to earn … Read more
Yes, we spend less per capita than most developed countries. But this has been the case for decades, so why is the NHS struggling now? The reason is that spikes in activity now do the organisation permanent harm and gradually degrade its capacity. The NHS has been so successful in part because it can run … Read more
GPs need to build businesses that will survive in the world as it is. There’s no doubt that NHS GPs are having a tough time. After years of falling income and increasing expenses it seemed like the new Labour government would bring some relief. But then the rise in National Insurance has piled on the … Read more
The NHS faces many problems, and often their solutions are in conflict. Fixating on patient safety without resources can make impossible demands on staff. Pressure to make short term cuts can allow long term costs to soar. Demands to reduce waiting lists can cause aggressive triage to get rid of patients. What we need is … Read more
There is an open secret that older Doctors know but it seems like everyone else is deliberately ignoring: The industrialists have made clinical medicine so rubbish that the bright young things have all left. This is fine for us who were in the trade and have the knowledge or know people who are up to … Read more
A lot of things done for the NHS do not help people get healthier. It is easy to get lost in the weeds arguing about what healthier means or whether it should be a public good. But let’s take the simple definition of “living longer and having more fun” and go with that. Some stuff … Read more
And yet those are exactly what are being filtered off to Physician Associates. Leaving difficult and intractable problems for the Doctors but not giving them any time to recover. This is the industrialisation of medicine where short-term cost saving is all that matters. And the joy of the profession, where you can get to know … Read more
A profession is where the public is protected against charlatans by only letting people with specific training do certain things. In medicine this used to include only allowing doctors to prescribe, operate, anaesthetise or make referrals. But in many countries these rules are being relaxed, and less knowledgeable staff are being given these roles. Why … Read more
In a knowledge industry where talent is recognised as critical, why is NHS management deliberately antagonising its key staff? Are managers incompetent or are they deliberately trying to break the NHS? Or is something else going on? Every business has a job to do. The reason it exists. For the NHS, the reason is to … Read more