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2017 ministerial crisis-a-day diary: key dates

 
Friday, 13 January 2017

2017 ministerial crisis-a-day diary: key dates

Exhortation of the year: it is no longer acceptable for the bottom 90% not to be in the top 10%.

We just need to bring the slackers up to the standard of the best by showing them what good looks like and shouting at them to stop slacking.

We call this spread theory.

Here are the rest of your lines to take, handily arranged by season.

Spring

That government health and social care review – full list of findings and recommendations:

1. Integration is the answer

2. Some areas are jolly good at it

3. Be more like them

Er, that's it.

Summer

Happy 69th birthday NHS! We’re very proud of you and hope you don’t mind if we take the credit. Here are some press releases with photos of Jeremy Hunt thanking smiling doctors and nurses (subject to availability). 

You'll get a proper present next year.

Autumn

Chancellor’s autumn statement:

Here’s a small front-loaded token of our appreciation. Don’t spend it all at once, because there are no more presents.

Winter

We’re going to find out why some hospitals are not pulling their weight and tell them to pull their socks up.

We’re also going to find out why Simon Stevens (subject to availability) hasn’t sorted it all out yet. It was his plan and we gave him everything he asked for – with the possible exception of the money. 

Diary editor: Julian Patterson

@jtweeterson
julian.patterson@networks.nhs.uk

 
Andrew Rix
Andrew Rix says:
Jan 13, 2017 04:23 PM

Time for a rethink
Do we need the NHS?

Patients report fewer than one in five incidences of illness and 80% of visits to GPs lead to no further action.
So for every 1,000 incidences of illness 200 receive the attention of a GP, and about 40 receive some sort of intervention. Of these 40, 90% (36) are dealt with by GPs by way of advice or primary medication and the remaining 10%, either get a second appointment with their GP or are referred to a specialist consultant.

Patients Do Not Attend between 10 and 20% of arranged appointments. 40% of prescriptions are not taken as directed (or even collected from the pharmacy).
Variation in referral rates by GPs to secondary care can be as high as 500% for the same condition in similar patients. Variation in conversion rates (those who receive treatment as a proportion of those diagnosed) has similar variation. Both signal significant levels of unnecessary treatment. Screening programmes are responsible for a high proportion of cases ‘diagnosed’ and subsequently deemed to be not needing treatment or receiving unnecessary treatment.

The number of medical school places in the UK has increased from about 10,000 to over 30,000 in the last fifteen years and the number of consultants in post has risen by over 50%.

Not a day goes by without another scare story about risks to health that ultimately will require medical intervention. Doctors instigate these stories. Despite these risks the population is living longer. True, some people fare better than others in the longevity stakes, but education, poverty and living conditions account for the majority of the difference, not medical intervention. Civil engineering and spontaneous remission deserve at least as much gratitude as medical science.

The statistics are complicated, but it does look as though supply is leading demand and that the crisis in the NHS could be solved by employing fewer, not more, doctors. Investment in spontaneous remission is the way forward.

Anonymous says:
Jan 13, 2017 05:20 PM

Doesn't matter whether Mr Rix is pulling our legs but if there is any truth in his figures then it looks like paying to see the GP is the way forward.

Figures for numbers of GPs in France and Germany are much higher than here and I never hear of anyone having to wait 2 weeks to see a GP over there.

Kassander
Kassander says:
Jan 13, 2017 11:25 PM

1.0 Doesn't matter whether Mr Rix is pulling our legs but if there is any truth in his figures then it looks like paying to see the GP is the way forward.
--------
Good thinking - also introduce a market / demand price responsive system used in areas like holiday bookings.
======
2.0 Figures for numbers of GPs in France and Germany are much higher than here and I never hear of anyone having to wait 2 weeks to see a GP over there.
-------
If there are many more GPs (per registered patient) in those countries then it's quite probable that the waiting times will be much, much lower?
Or am I missing a vital factor in the equation, such as UK based GPs are bone idle?

Andrew Rix
Andrew Rix says:
Jan 13, 2017 05:26 PM

Or educating patients?

Kassander
Kassander says:
Jan 13, 2017 11:28 PM

You'll be asking for Bibles to be un-chained and written in the vernacular next.
No-one expects the Spanish Inquisition!

Andrew Rix
Andrew Rix says:
Jan 14, 2017 10:04 AM

Google has unchained the bible of
medical information, wise doctors help patients translate this into the knowledge they need to manage their condiiton.

Andrew Rix
Andrew Rix says:
Jan 19, 2017 12:12 PM

If it was a market-responsive system would that include compensation for late delivery, cancelled appointments and dissatisfaction with the service?

Kassander
Kassander says:
Jan 25, 2017 08:51 PM

It's about time that so called 'doctors' = GPs came down from their Ivory towers and realized that their high-handed attitude to Patients as supplicants will very soon run into the brick wall of Patient and Public Power.
Treating ALL DNA-ers as if they're a cross between a naughty 6 year-old and a major criminal will not do.
What, you didn't check that the 75 year-old who missed their allotted time by 15 mins was being treated for possible memory loss, and mobility problems?
Patients logging in on time have to wait for anything up to an hour for their time booked appointment = OK.
Be more than 5 mins late to log in and you're registered as DNA.
Where's the 'give and take' in that?
And as for the
Out on your ear 8-day facility -
with no meaningful appeal.
Who exactly is paying for this lot?
We've seen the change round in relationships now H E students are coughing up £9 000 a year - it will come to a GP practice near you soon - and n ot before time.