8 Comments »

1. It is deeply disappoiinting that so little of the extra funds spent in the NHS is not used on the people who provide the service rather than those who like to watch.

   Sadly, the debacles that are the new doctors’ contracts have further eroded trust in the DoH. What about a bit of honesty for a change? So many areas cannot recruit GPs; and if a GP resigns to take up freelance or locum work he is counted an an "extra" doctor!!

   Waiting lists! We all have patients waiting much longer than 9 months for treatment; but they are not counted as being on the "waiting list" until a few months before beimng sent for.

   Truly newspeak at work.

   Comment by ciaran wasson — 18 May 2004 on 12:23 am | Link

2. How would it improve NHS services if all the extra money was simply spent raising the salaries of doctors and nurses?

   Comment by David Boothroyd — 18 May 2004 on 12:51 pm | Link

3. David,

   because it would attract more, and better qualified, people to become doctors and nurses

   because it would show that we do value public servants

   because it would go some way to reversing the obscene situation where someone who sits in an office making more money for already rich people gets paid more than someone who saves lives

   because it would better than raising the salaries of business consultants in the NHS

   etc.

   etc.

   etc.

   (your response is also a rather obtuse interpretation of what ciaran said – why not address the issue instead of twisting it?)

   Comment by Uncarved Block — 18 May 2004 on 2:20 pm | Link

4. Doctors are already paid extremely well, Consultants even more so (and have had obscenely lax conditions for many years). The problem with attracting staff to the NHS is at the lower levels and here I agree, but it seems to me that it will not alter patient care one iota that their GP is on \xA365,000 and not \xA355,000.

   As for NHS managers, the NHS has historically been woefully undermanaged, which means wasted resources and an inability to cope with varying demand levels. It’s very easy to make a populist headline out of employing more managers but if you ask anyone in the Health Service (and my mother was a District nurse, and a good friend is a GP who works in A&E sometimes), they will know that better administration means more and better patient care.

   For a counter-example of more money + bad NHS management = fewer and worse patient care, see NHS Wales.

   Comment by David Boothroyd — 18 May 2004 on 2:40 pm | Link

5. The issue is, as always, that the government is trying to push work down the ladder – things traditionally done by surgeons into GP offices, things traditionally done by consultants into junior staffers, things traditionally done by your GP into the nursing world.

   This directly affects the cost of care of the specific item; it also means that people who are further up the ladder are freed to do more of the work that only they can do well.

   It also means that everyone further down the ladder has to do more jobs. This is the bone of contention – whether we’re talking about a junior doctor taking on additional workload in his poorly paid 60 hour work week, or an already overtaxed and underpaid nurse picking up things that the GP used to do.

   This isn’t necessarily a bad thing – but it’s the kind of change that doctors, nurses, and consultants will argue over, and it’s the kind of change where, if there aren’t enough well paid staff at the bottom of the ladder, things can go horribly wrong in.

   We’re just seeing those groans as the workload shifts – it’s not that it’s necessarily the wrong thing to do.

   Comment by Gregory Block — 18 May 2004 on 3:44 pm | Link

6. The NHS has improved out of all recognition. Of course everyone wants more pay. But this is about providing a good service for the patient. Its great that we now have more doctors, nurses and beds with waiting lists reduced from 18 to 9 months. Lets hope that things continue to improve at this accelerated rate.

   Comment by gary gatter — 18 May 2004 on 4:06 pm | Link

7. Gary,
   One problem is that there aren’t more doctors. Certainly not nearly as many as the DoH claims. If a GP resigns from a practice and is not replaced, and takes a part time salaried post, and registers with a locum agency for other part- time work, he is counted as TWO EXTRA doctors.
   How many NEW Whole Time Equivalent doctors haave taken up post? I work in a practice which had 5 GPs looking after 10 000 patients, now has 3 and has been unable to attract applicants.
   And very few of my patients wait less than 9 months for traeatment

   David
   I agree that better administration will help improve the service. But what we get is more, not better, management (not the same as administration), and a management that does not seem to realise that their ultimate function is to support the front line professionals

   Comment by ciaran wasson — 18 May 2004 on 9:48 pm | Link

8. One argument is that we shouldn’t need more doctors – we just need to free up their time from the things that others can do. That’s not an entirely unworkable premise – and it’s one that the government is, in principle, trying to get people to agree to.

   That’s not to say that more doctors aren’t needed – merely that trying to solve the problem purely with numbers isn’t necessarily the best approach.

   I think that’s been pretty successful so far – it’s certainly worth a shot.

   Comment by Gregory Block — 19 May 2004 on 2:11 pm | Link

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