It was recently reported that a GP was mugged on his way to his surgery. He was left blooded and confused lying in the street while the thief made off with the doctor’s Rolex watch and Audi TT sports car. Aneurin Bevan the architect of the National Health Service is alleged to have said he had to stuff the mouths of doctors with gold to get them to stop their opposition the socialisation of medicine. Doctors have done extremely well financially over the past decades. In more recent times as they become, ever more, wealthy while the quality of care has declined often to the point of criminal negligence. The public however still hold them in high esteem. Why is this? Richard Titmuss in his book “the Gift Relationship” argues that the altruistic act of giving blood underpins a transaction from which the donator and recipient benefit. He felt this to be a universal truth in a civilised society when we expect the fireman to go into the burning building not for financial gain but for grateful nation’s thanks. I agree with Titmuss but the ethic is undermined as soon as the service is incentivised. Money has poured into GP’s pockets in recent years while the services they provide have withered. Try getting your own doctor to make a house call out of hours; but the public still think the relationship is an altruistic exchange. As shops struggle and factories close gleaming health centres have risen out of the economic ashes. Health is now a product and doctors are small businesses selling us access to it. The latest government fumble is the change to the GP contract with the removal of a minimum appointment time, targets and a reduction of red tape (less monitoring of what doctors do!) It’s a return to old fashioned medicine they say and we will have a named doctor to coordinate our care. It will also be “cost neutral”. Somehow I do not think so having once witnessed junior doctors arguing on a Ward who should sign a death certificate to get the fee. So the battered, bloodied and confused tax payer is left calling for help from their named GP while the mugger checks his Rolex watch before speeding off in his Audi TT sports car.

Hildenboy,

I can only speak for our own Doctor here in St.Catharines, she will make a house call whenever it is necessary. To be honest she is the most caring Doctor I have ever met. Last year on Christmas Day she arrived at our house just to see our son Stephen for herself, he had only recently been discharged from hospital,that is the way she is. She is in her early 50s, she is 3rd generation Ukrainian married to an Englishman.......she is one of a kind.

To all of my Forum friends, Stephen had his appointment with the Transplant Specialist yesterday and was told he is not yet strong enough to withstand the procedure, he has a follow up appointment on January 16th.. He is in a form of remission at present so he is Okay for now. Our main worry is, if it comes back in between times it will be more aggressive. All your support and prayers will be very much appreciated again. Thank you from both Doreen and myself.

I apologize Hildenboy as you are probably not aware of our son's illness, he has an aggressive form of Lymphocytic Leukemia, he was diagnosed last October, since then he has had major Lung Surgery in March, this set him back a lot. Now we have to get his strength back before they will attempt the Transplant. All the Forum contributors have been more than supportive since the beginning.

Beano

Beano

Thank you for sharing your thoughts. I wish your son well and will keep him in my prayers.

Beano, what can I say. Stephen's illness affects us all on the Forum. We have followed his illness and your concerns over the past while. We are with you in spirit, if not in the flesh. I will certainly keep room for Stephen in my prayers.

Good luck to Stephen, yourself and Doreen. Keep your chin up. You have many friends who wish you well.

God bless us all, Hildenboy, that was a tirade all right. Wouldn't like to get on the wrong side of you, eh boy?

I'm sure you have good reason for your opinion on doctors. However, personally speaking, as regards our GP practice, we have two very caring and knowledgeable young doctors. They have never given me reason to complain about diagnoses or treatment.

They are not the ones who make the rules. It's the directors sitting behind desks, and who have no medical knowledge. These are the ones who now make the decisions about health care. The doctors have no say in the matter. Their hands are tied.

I think being a GP must be the most difficult job in medicine. They have a few minutes to make a correct diagnosis from perhaps a garbled and varied account of symptoms. If they make a mistake, it could mean life or death for the patient. A tough job as far as I'm concerned.

Consultants, on the other hand, deal solely with their speciality. An easier task as far as I'm concerned.

However, what would we do without them?

Ann

Dr Harold Shipman was, by all accounts, a very kind and caring GP who just happened to also be the greatest serial killer Britain has ever known. He quietly murdered in excess of 250 people. Does that mean that I believe all doctors to be bad. No. However a system that allows such an atrocity to go unnoticed for so long is not fit for purpose. That is why doctors need to be monitored and managed. I have worked within and without the health service and I know there is good and poor medical practice. There are some who I have tremendous respect for and others who as not fit to change a plaster. My point is that financial incentives and a medical market have undermined the selfless ethic of primary care. An easy manner and charming smile is the modus operandi of most good con men.

P.S tirade? I thought it was a reasoned argument.

Beano,

Stephen is always remembered in my prayers, as are all the others who asked for them. Do remember me in yours too. We all need someone to pray for us. Just knowing someone cares is a medicine in itself.

We all are lucky we have Doctor's, just think of the Philippines at the moment or Syria, or any country where there is a shortage of doctors. Just imagine not being able to call on one when sick or injured.?

In Eire to visit a G.P. costs 50Euros, more in the cities, prscriptions must be paid for too, often costing nearly 100 Euros. Medical Card holders get free G,P.services, their prescriptions cost E1.50 per item. With the recession Medical Cards are hard to receive now. Used to be all Pensioners got one, but now it is means-tested.

No house calls here now, as Doctor's are too busy with surgeries etc. Hospital costs have to be paid even for out-patient Clinics. The Government is to bring in free Doctor visits before the next election........MAYBE?

Must say I am satisfied with my Doctor, whom I only visit when I really have to, hate surgeries & waiting. When I do go, I am amazed at the length of some peoples visit, as I seem to be in & out in 5 minutes!!!!

I do think free medical & hospital care should be for all, no private care & all things should be equal, but then it was abused in the past.

Pat

Beano. I share with you the worry of Stephen's illness.
As the song says: He's not heavy; he's my brother.

Hildenboy, I was as outraged as you over Shipman. Did he have the benefit of financial incentives in his career?

Pat
When I read your comments about Doctor´s costs in ROI then I realise how lucky we are here in the Vaterland. We pay a lot but we receive also excellent treatment and benefits. We do not have long waiting times for an appointment here in Munich, maybe in rural area where there are not so many practices that may be different. Recently I read in the Tele on-line that lots of ROI citizens cross over to NI for treatment as it costs a lot less.
donald

Dabbler

Yes he did: Dr Shipman was paid a per capita fee for each patient registered with his practice; he was able to prescribe diamorphine and other drugs for patients which he used himself or sold; he was paid a fee for signing the death certificate of each one of the 250 individuals that he murdered (that used to be £70 per signature); his position of trust gave him access to ill, vulnerable people and their bank accounts plus their Wills. In relation to this he was also charged with fraud and forgery. However my tirade was not directed solely at Dr Shipman as, thank God, psychopaths like him are at the margins of society. My point is that doctors have moved steadily away from the altruistic ethic that underpinned the birth of the NHS; and the BMA have successfully defended their small business members negotiating whopping pay packets from Governments of all political hues. George Bernard Shaw writing in 1906 thought doctors "ignorant licensed murders." In his play the Doctor's Dilemma he satirises the dubious ethics of a profession that loves to play God. He of course was writing pre-NHS. Post NHS we have a GP serial killer and doctors with Rolex watches and expensive sports cars while the inequalities in British Society have never been sharper. What would GBS make of it all?

Pat
50 euro. That was 10 euro a minute. Not bad work if you can get it.

Hildenboy, thanks for the learned reply. To be honest, I was thinking that the psychopathic doctor practiced while Labour governed, and before GPs had such power. But I agree. Health should be the top priority of any government.

Dabbler

I was not making a party political point but I will now: Thatcher (I hope she is enjoying the warm temperature where she currently resides)infected the NHS with her internal market virus when she was in power. Blair did nothing to challenge or change and probably compounded the problem with PPI funded health projects. The Con / Lib coalition removed the last healthy organs of the NHS with the wholesale destruction of the primary care trusts and stuffing even more gold into the GP cuckoo's fat gaping mouths.

Yet the public seem not to care? I am often told that "My GP is a very nice man and does his job well." If this is the reality why do the media report a constant stream of neglect cases and medical abuse. I have thought about this "I'm alright jack" attitude and come to the conclusion that most GP patients' view of the relationship with their doctor is probably based on something akin to the "Stockholm Syndrome": the patient bonds with the doctor as a response to trauma in becoming a victim of ill health. Being assaulted by disease, and the treatments to combat the disease, leaves us battered and bruised psychologically

Identifying with the doctor is one way that the ego defends itself at a time of perceived threat. Ultimately the patient adopts the same values as the doctor: "he is so busy; I should not waste his time; all these resources being used; he will save me even from myself; I am not worthy; he blesses me with his knowledge and presence."

Well I must stop as I have to dash off to a doctors appointment. As we stare at each other over his mahogany desk in the comforting glow of a flickering computer screen I may ask him the time. Just to check what sort of watch he (or she) is wearing. I am sure he will tell me as he is a very nice man (or woman).

Dear All

Just back from the GP.

This morning was the first real bite of winter with a ground frost, cobalt clear sky and stinging North by north east wind that takes the breath away. Comfortably wrapped and insulated in my snow jacket, gloves, scarf and dashing Russian faux fur hat I brandished my bus pass (don't you just love socialism) and sped off to my appointment. The surgery was semi packed and I waited my turn listening for the all powerful doctor's "buzz" indicating "I'm free." Making my way to his consulting room I passed the district nurse, the practice nurse, the cheery phlebotomist, and a lost looking locum before entering the inner sanctum. Dr X turned from his computer and greeted me (after first taking a quick look at my notes to determine who I was). My GP was dressed in a muted, sunset motif, Hawaiian shirt and aubergine coloured shorts. Shorts? All arms and limbs as he gambolled about the room searching for a prescription pad. "How are you getting along," he said over his shoulder. I began to sweat not in response to his question but due to the 31C temperature of the room. I began to unpeel my scarf, remove gloves and Leninist hat. "Good, good," he said jovially returning pad in hand "it is important at your age to keep warm. Crank up the old central heating." (I would crank it up alright if I could afford the bills) He flicked though some more papers, consulted his screen and pursed his lips. "Your annual MOT indicates you are basically (he drew out the syllables slowly then slammed in an) OK!" Adding "but you might want to consider Statins." He angled his screen where a 100 little stickmen figures shimmered; he crossed out several to indicate visually my "risk" of a heart attack or stroke (clearly he must have thought I would struggle to understand percentages). I said I would think about it. Dr X said conspiratorially that the computer thought it would be a very good idea. We both looked at the screen in silence. I thanked him for the computer's advice, and re-swaddled my perspiring body.

As I stood gently steaming waiting for the bus to lurch into view a faint, distant, gentle buzz seemed to echo in my ears.

****! I forgot to ask him the time...!

Hildenboy, I thoroughly enjoy reading all your posts. Whether I agree or not isn't the point; you have a talent in convincing me that you really care about things and people. You're not ready to "lie down" just yet. You're full of zest and life.

Did you ever think of going into politics?

Keep on writing.

Ann, If Hilden Boy is who I think he is,he was in politics.ie The Trade Union Movement.He makes me proud of the good larning he had at Hilden School.

Hilden Boy,
Keep the posts coming.Brilliant.By the way am I right???????
Pam

Hildenboy,

I agree with Ann & Pamela, enjoyable post, but you did get up a head of steam, not advisable re a heart attack.

As I tell Joe when he is ranting & raving at politicans on T.V. "What good does the outbursts do, the change will come when people get up off their asses & change things, after all there is more of us than them.

Pat

Hildenboy, I enjoy the hyperbole. It reminds me of my days as a Trade Unionist. I enjoyed a march through London behind Arthur Scargil. I was, and am, a great admirer of Tony Benn. But, looking back, I realise that, though I advocated benefits for those in need, I never in my life claimed any. Somehow, with little education, and a physique that Davy Jones would have thought twice about accepting, I managed to get by. LOL!
p.s: My Conservative MP is a very nice man.

Pamela

Partially correct: but you are thinking of the wrong brother. The trade unionist is still battling with the bosses in Dublin; but thank you for the complement.

Pat and Ann

I always keep the defibrillator handy when watching question time.



Dabbler

You are not averse to the odd splash of hyperbole yourself.

Hildenboy
Yes,indeed, I can be a bit of a drama queen.

Dabbler

Which part of the Trade Union movement did you mobilise behind Mr Scargill?

Hildenboy
I merely participated. At the time, I believed that a way of life was being destroyed by Thatcherism, so, along with fellow Trade Unionists, I hopped on a coach for London, and marched in support of the miners. I was quite proud to see my picture on the front of that month's local Union Magazine. (GMB).

Ann,Pat,Dabbler,Hildenboy,Mauri and Donald.

I am in awe of all of you on your descriptive posts. Kitchen and shopping, gardening in Clare, poems etc., Travel,G.Ps, Trade unions and seafaring tales, even the Vaterland,everyone a great read, you are all missing your calling, I look forward to the Forum every day.
Doreen and I would like to thank all our Forum friends again for all your support for Stephen, over the last year, which in fact seems like a decade, he is really fighting this thing and with God's help he will make it.

Beano

Beano
Beside the health of your son. it is all rubbish.
I am deeply moved by your family fight for his recovery.

Beano, glad to know that you and Doreen enjoy the oul chat on the Forum. Sometimes it's interesting, sometimes not, but we all have our own views which we can share.

Beano,

Compliment gratefully received.

Pat