“The best interest of the patient is
the only interest to be considered,
and in order that the sick may have
the benefit of advancing knowledge,
union of forces is necessary
…it has become necessary to develop
medicine as a cooperative science.”
It looks a though we are moving as far away from those ideals in
the New NHS. It is indeed most obvious with our A & E department of
hospitals in England
Government
would like us to believe that this has nothing to do with OOH
service. Perhaps there is
a belief by the average citizen that they will be seeing real doctors at A
& Es.
Guardian latest: Study says it costs hospitals more to treat accident and emergency patients than they are paid to deliver service.
Guardian latest: Study says it costs hospitals more to treat accident and emergency patients than they are paid to deliver service.
In a Market system, A & Es are run by Hospitals and OOH by
CCG/GPs; business rivals so to speak. Hospitals wants to maximize income and
CCGs did not want anyone to attend A & E if at all possible. NHS
A & E: Unpredictable, Unruly & Ungainly
Looks like the battle
is over as no doctor will want to work in A & E.
A top doctor from Somerset
Dr Clifford Mann,
registrar at the College of Emergency Medicine and a consultant at Musgrove
Park Hospital in Taunton, said hospitals were increasingly struggling to find
enough medics.
He told the Mail
on Sunday that junior doctors were unwilling to train to become emergency
medicine specialists because of the intense workload and failure of hospitals
to increase staffing levels to match the number of patients admitted.
The situation is
worsened by the fact that 10 per cent of all full-time consultancy posts in the
country's 220 A&E units are unfilled as many training in the NHS have
preferred to go abroad to work.
He said the
shortages will "undoubtedly" have contributed to the closure or
downgrading of casualty departments.
"The key
message isn't so much the vacancies out there, but that there's no one coming
through to fill them," said Dr Mann, an emergency medicine consultant.
There is
of course a solution: remove the payer system and rotate GP and other trainee
doctors through A & E as a compulsory part of training of any doctor and
have full back up of the A & E consultants.
Admission Avoidance:
GPs are facing demands to deliver
unprecedented reductions in hospital activity over the current financial year,
with NHS managers setting targets for cuts in admissions of 15% or more by next
April, a Pulse investigation reveals.
NHS North Staffordshire has called in private providers to
implement admission avoidance strategies, including
Friends moved to
They were extremely pleased with the Health Care they received
from their doctor locally. After all, not long ago, French Health Care topped the WHO ranking.
Then our lady friend had some gynaecological condition. She
consulted the local doctor who referred her to the regional hospital: a
beautiful new hospital with the best in modern equipment. In no time, arrangement
was made for her to be admitted and a key-hole procedure performed. The French
government paid for 70% and the rest was covered by insurance they took out.
They were thrilled.
We did not see them for a while and then they came to visit us
in one of our holiday places in a warm country.
They
have moved back to England
What
happened?
Four
months after the operation they were back visiting family in England London
“I
was seen by a young doctor, a lady doctor who took a detail history and
examined me. I thought I was going to be given some laxative, pain killer and
sent home.”
“No,
she called her consultant and I was admitted straight away.”
To
cut the long story short, she had acute abdomen due to gangrenous colon from
the previous procedure.
She
was saved but she has lost a section of her intestine.
They
sold their place in the beautiful wine region and moved back to England
Thank goodness for a well trained A&E doctor.
Prof Waxman in an earlier post:
The internal market’s billing system is not only costly and bureaucratic, the theory that underpins it is absurd. Why should a bill for the treatment of a patient go out to Oldham or Oxford , when it is not Oldham or Oxford
…….Instead let them help the NHS do what it does best — treat patients, and do so efficiently and economically without the crucifying expense and ridiculous parody of competition.
“The best interest of the patient is
the only interest to be considered,
and in order that the sick may have
the benefit of advancing knowledge,
union of forces is necessary
…it has become necessary to develop
medicine as a cooperative science.”
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