[Politics] Sunak's benefits shake up

[Harry Wilson's tackle]

Well, there’s an additional problem that NHS surgeries can no longer afford to employ doctors. Appointments are being taken by unqualified Physician Associates. There are qualified GPs who can’t get NHS jobs despite wanting them, and many others f***ing off to Canada, New Zealand or Australia for better pay.

Yep. A 'young' medic (only 7 years experience, early 30s, on about £40K, FFS) who did a research project with me moved to Victoria in BC to save his marriage (by being paid much more for fewer hours).

As for physician associates....they simply don't have the skills of an experienced GP. One prescribed me colchicine to clear inflammation in what she diagnosed as gout and left me housebound for weeks owing to the severe gastrointestinal adverse effects. I explained to her I don't have gout and the pain isn't in my big toe. When I went back weeks later, an experienced GP popped in and saw me and immediately diagnosed a march fracture. Bosh.

It isn't just poor quality service using physician associates. It is potentially dangerous and certainly prone to avoidable errors.

 

[drew]

It's not surprising that Sunak wants to use unqualified people to diagnose whether someone is fit for work, afterall, they've been using unqualified people to fill ministerial roles for years!!!

 

[Goldstone Guy]

Well, there’s an additional problem that NHS surgeries can no longer afford to employ doctors. Appointments are being taken by unqualified Physician Associates. There are qualified GPs who can’t get NHS jobs despite wanting them, and many others f***ing off to Canada, New Zealand or Australia for better pay.

There's a thing called ARRS (Additional Roles Reimbursement Scheme). The government are offering money for practices which they can use to employ certain staff such as PAs, but it can't be used to pay for a GP. It started in 2019 I think. So essentially they're providing financial encouragement for practices to employ PAs and not GPs. As the "contract" for GP practice income is gradually squeezed tighter this is turning from encouraging practices to forcing practices to employ PAs (and some other roles as well).

 

[Guinness Boy]

There's a thing called ARRS (Additional Roles Reimbursement Scheme). The government are offering money for practices which they can use to employ certain staff such as PAs, but it can't be used to pay for a GP. It started in 2019 I think. So essentially they're providing financial encouragement for practices to employ PAs and not GPs. As the "contract" for GP practice income is gradually squeezed tighter this is turning from encouraging practices to forcing practices to employ PAs (and some other roles as well).

I’ve pressed “like” because you’ve put factual meat on my bones. I do not, of course, ‘like’ this at all.

Just another example of the Tories running down the NHS and then going “see - it’s not fit for purpose.”

Meanwhile vulnerable people die,

 

[Cotton Socks]

Maybe have his heart of stone transplanted with a human one?

What about a pigs heart? They have feelings, the surgeon could give the pigs head to Rishi's mate Dave.

 

[Goldstone Guy]

I’ve pressed “like” because you’ve put factual meat on my bones. I do not, of course, ‘like’ this at all.

Just another example of the Tories running down the NHS and then going “see - it’s not fit for purpose.”

Meanwhile vulnerable people die,

It seems to be the direction NHS primary care is going and I don't think Labour are going to reverse it (might be wrong). To be fair there are probably some PAs who are really good at their job and pharmacists I work with can do various things well which reduces the GP workload. When I worked in hospital doing an obs and gynae rotation, there was (and still is) a thing called the early pregnancy unit. It's where patients go if a miscarriage or ectopic pregnancy is suspected or a possibility. It was run by a nurse who'd been there years and knew far more than the junior doctors like me working there and that worked really well (pretty sure it's still nurse-led now). Seeing patients with undiagnosed, undifferentiated illness is a different matter I think. Doctors will make the occasional mistake but having non-doctors dealing with it will be a lot worse in my opinion. We'll see.

 

[Cornwallboy]

Article in the Mail about it today:

Benefits scroungers in town boast they 'chill out and enjoy life'

EXCLUSIVE: The unemployed in Jaywick, Essex are claiming 'thousands of pounds' a month of taxpayer's cash - while locals complain there are jobs, people just don't want them.

www.dailymail.co.uk

 

[Swimboy64]

Good man.

All the best

You too

 

[Swimboy64]

Glad you at least apologised because those other posts are completely unacceptable. Please don’t repeat that behaviour.

Understood completely GB
Won’t be repeated

 

[Harry Wilson's tackle]

It seems to be the direction NHS primary care is going and I don't think Labour are going to reverse it (might be wrong). To be fair there are probably some PAs who are really good at their job and pharmacists I work with can do various things well which reduces the GP workload. When I worked in hospital doing an obs and gynae rotation, there was (and still is) a thing called the early pregnancy unit. It's where patients go if a miscarriage or ectopic pregnancy is suspected or a possibility. It was run by a nurse who'd been there years and knew far more than the junior doctors like me working there and that worked really well (pretty sure it's still nurse-led now). Seeing patients with undiagnosed, undifferentiated illness is a different matter I think. Doctors will make the occasional mistake but having non-doctors dealing with it will be a lot worse in my opinion. We'll see.

Very measured, from someone who has been there.
I agree that Labour aren't likely to do much about much, at least immediately, but I hope they bin the idea of having lay people assessing whether sick notes issued by physicians are acceptable.
As for non-doctors doing the work of doctors (with which I disagree) how about non-doctors dealing with the paperwork of doctors?
Judging by my experience as a university 'academic' the chance of your admin load diminishing is slim to none.
We have banks of administrators in charge of such things as telling us to write responses to student assessment of our teaching (which I did this morning - two responses out of 60 odd students complained that I was rude to them. Come on - nobody could imagine that* as being remotely possible. )
And we have administrators to take our exam papers, put them into a different format, cut different elements up, plop them into clunky bespoke web portals for online assessment, then tell us to check it all and take ownership and responsibility.
It would of been quicker and more grammatical to of done it all myself in the first place. FFS.

*What?

 

[sussex_guy2k2]

Why put illegal immigration in quote marks like that as if it doesn’t exist? It does exist. The majority of immigrants arrive perfectly lawfully with visas and by prearrangement, to rejoin families or take up job offers etc. No problem whatever. People who arrive unofficially, including those in small boats, do so illegally. Yes, plenty will later be granted the right to stay and acquire legal status. Again, no problem. But there is such a thing as illegal immigration and it creates significant problems. As with the minority playing the welfare system, they create problems for those who genuinely deserve support and finance. You need to acknowledge that not everyone has good intentions, just as you rightly complain about the negative consequences for those who aren’t treated fairly by the system. Play fair and be treated fairly. That should be the principle to unite behind, and to strive for.

The bigger issue with the boats is how we’re dealing with them, or not dealing with them, as is the case with the Tories.

As for the people on the boats, they aren’t illegal immigrants, which is a Tory coined phrase. They are people whose status is yet to be decided.

 

[Goldstone Guy]

Very measured, from someone who has been there.
I agree that Labour aren't likely to do much about much, at least immediately, but I hope they bin the idea of having lay people assessing whether sick notes issued by physicians are acceptable.
As for non-doctors doing the work of doctors (with which I disagree) how about non-doctors dealing with the paperwork of doctors?
Judging by my experience as a university 'academic' the chance of your admin load diminishing is slim to none.
We have banks of administrators in charge of such things as telling us to write responses to student assessment of our teaching (which I did this morning - two responses out of 60 odd students complained that I was rude to them. Come on - nobody could imagine that* as being remotely possible. )
And we have administrators to take our exam papers, put them into a different format, cut different elements up, plop them into clunky bespoke web portals for online assessment, then tell us to check it all and take ownership and responsibility.
It would of been quicker and more grammatical to of done it all myself in the first place. FFS.

*What?

Yes I agree with you - if you want something done properly do it yourself. That's not to say I don't need admin and reception staff. I'd be completely lost without them. They help make sure referrals go on the right forms, get sent to the right place, make sure they've been received at the other end etc, and I read and action hospital letters etc. Basically they do their job and I do mine. Someone else doing my paperwork jobs without taking responsibility for them will mainly just create more work - same as you.

With regards to the recent sick note news, it looks like some doctors are quite enthusiastic about it, thinking it's one less job to do when they've already got too much to deal with. I agree ultimately it won't happen and it's just words in some political game. However let's say it does go ahead - I'm fairly sure what would happen. The person who's sick and claiming benefits would be assessed by someone using some sort of protocol who's done a 3 month course. (Personally I don't think it matters whether the assessor has a lot of training or not. If someone tells you their depression or back pain is severe and they're not able to work it's impossible to know whether this is correct or not, unless you secretly film them during their day to day lives. Or perhaps if they come down the corridor to the consultation room doing cartwheels that might give me a clue, but it's never happened so far). The assessor uses the protocol and tells the person they've been assessed as being fit to work. Uproar ensues and the person repeatedly appeals against the decision (ultimately at great expense). The assessor doesn't have a pathway on their protocol to deal with this so they tell the person to see their GP. Or even worse they send the GP a 10 page proforma about the person which has to be completed. I start the proforma and after the first paragraph steam is coming out of my ears and I've developed a strong tendency to complete the form in "doctors' handwriting". A year later the government announce extra staff (which costs money of course) to help GPs deal with this extra paperwork - "so that they can focus on seeing patients which I think we all agree is the right thing to do" would be roughly what Sunak, sorry SUNK, would say if he's still in power. At about the same time someone in some right-wing shadowy pressure group like the taxpayers alliance or something (apologies if that's incorrect, it might be) will say something like "we've got to stop pouring money into the black hole that is the NHS", which to be fair, it is. And that's why.

 

[Harry Wilson's tackle]

Yes I agree with you - if you want something done properly do it yourself. That's not to say I don't need to admin and reception staff. I'd be completely lost without them. They help make sure referrals go on the right forms, get sent to the right place, make sure they've been received at the other end etc, and I read and action hospital letters etc. Basically they do their job and I do mine. Someone else doing my paperwork jobs without taking responsibility for them will mainly just create more work - same as you.

With regards to the recent sick note news, it looks like some doctors are quite enthusiastic about it, thinking it's one less job to do when they've already got too much to deal with. I agree ultimately it won't happen and it's just words in some political game. However let's say it does go ahead - I'm fairly sure what would happen. The person who's sick and claiming benefits would be assessed by someone using some sort of protocol who's done a 3 month course. (Personally I don't think it matters whether the assessor has a lot of training or not. If someone tells you their depression or back pain is severe and they're not able to work it's impossible to know whether this is correct or not, unless you secretly film them during their day to day lives. Or perhaps if they come down the corridor to the consultation room doing cartwheels that might give me a clue, but it's never happened so far). The assessor uses the protocol and tells the person they've been assessed as being fit to work. Uproar unsues and the person repeatedly appeals against the decision (ultimately at great expense). The assessor doesn't have a pathway on their protocol to deal with this so they tell the person to see their GP. Or even worse they send the GP a 10 page proforma about the person which has to be completed. I start the proforma and after the first paragraph steam is coming out of my ears and I've developed a strong tendency to complete the form in "doctors' handwriting". A year later the government announce extra staff (which costs money of course) to help GPs deal with this extra paperwork - "so that they can focus on seeing patients which I think we all agree is the right thing to do" would be roughly what Sunak, sorry SUNK, would say if he's still in power. At about the same time someone in some right-wing shadowy pressure group like the taxpayers alliance or something (apologies if that's incorrect, it might be) will say something like "we've got to stop pouring money into the black hole that is the NHS", which to be fair, it is. And that's why.

"A doctor writes..."

Yes, much as I imagined. With bells on.

If the Sunk gang have the brains and honesty to imagine what a beta test outcome would look like (they won't beta test it).....one has to assume this is the planned outcome.

And yet....millions will applaud the 'attempt' to Stop the Scroungers.

Sad.