GPs, Your Opinion?

Sportsman

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A very good question and an almost impossible answer. The whole system has evolved differently, but at the root of it the French system is basically private, so the patient/customer is king. Having said that the private system is nothing like the American model, where profit for the insurance companies seems to be the only motivation. This system is private, but with a strong government input and regulation and is much more patient centered.
Put simply, the doctors are self employed professionals, who get paid when patients visit them. Patients can theoretically choose any doctor and so doctors are basically in competition for patients and so have to try harder to keep their patients happy. This is a great simplification, but is the basis of the system.
The average income of a French GP is probably not much more than half of their British counterpart and because of this there is a shortage of GPs. It is not always easy to get signed up with a good one.
 

Neil ofthe nene

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Let me make it clear, my issues mainly revolve around the administration, not the medical side of a practice. From a very personal perspective as an ex admin manager I feel the administration in a GP practice is poor. And there is too much "that's the way it has always been done" attitude.

Looking at the medical side I don't know how many understand that in the medical profession becoming a GP is regarded as failure. So attracting eager young doctors to become GPs is difficult, hence to some degree the high pay.

But that does not excuse poor service and a disregard for the customer. And I use the word "customer" intentionally. If patients were seen as customers that are paying for the service they receive I believe we would receive better treatment, indeed we would be more entitled and eager to demand better service. In far too many parts of the NHS patients are seen as a nuisance, not valued customers.
 

Pompous git

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I haven`t got a clue how the NHS is run or funded but my experience regarding my local practice and waiting times generally is not
good {ok covid is a factor}, so this is what I would do. First any action needs to be radical {I mean radical in the true sense not liberal`s
forming a committee}.

The entire NHS should be thrown open to the private sector.

Now you have picked up your teeth read on.

I remember a business man saying British Rail does not need privatisation it needs a good dose of private sector discipline, I think the
same could be said of the NHS. With the amount of medical procedures etc there is vast amounts of money to be made so the private
boys would not be backward in coming forward.
First though rules {rules that stick} should be put in place to protect the service itself, in other words the private mob cannot cherry
pick the lucrative bits and leave the NHS to pick up the pieces.

GP`s surgeries could be funded by local government and beyond this central government by a direct and separate tax which could go
up and down as required. I don`t think people would object because they will see exactly why money is being taken and where it is
going.

Also I have to say I feel for NHS staff, the service itself gets a lot of flack for things beyond their control. I`m sure it must sap their morale.

We need strategically placed training centres to turn out medical staff on a production line basis. If people come from abroad and become
qualified at our expense they and their immediate families can settle here as long as the sign up to work in our heath system for say five
years. Our own people should have university fees waived if they do the same.

I realise I don`t know what I am talking about so please be kind but surely the money sponge that we have at present can be improved on.
 

rudd

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Can get a GP appointment in about two weeks.
Two years to see a dentist if we are lucky.
 

PJG

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When (eventually) you are allowed to actually see a gp they are excellent. The receptionists first directive is to try to deny you access to them! Be careful, there is another grade out there called PA (Physician Associate) they are not qualified doctors, they cannot sign off presciptions. The prescription system is pathetic, it's slow, inaccurate and wasteful!
 

Robwooly

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Are GP's just physical switchboards? You see them then they either give you a mild medicine or placebo or refer you to a specialist who know's the area of concern.
 

angel

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If I call my GPs surgery at 8.00am when they open, it will probably take circa 20 mins to navigate the automated system and wait in a queue, whereupon my queue position will be counted down 5, 4, 3, 2, 3(?) 2, 1, 2!!!, 1.
The Care Pathway Navigator will request details of why I think I need to see a doctor, then proclaim... a Doctor will call you "sometime today" from experience this can be anytime up to late evening 10pm or even the following day.
On one occasion I was waiting, nipped to the loo and the phone rang, before I could reach it and before the answerphone kicked in they hung up!
It later transpired I had missed my slot.
Prescriptions take 72 hours to navigate the 1/2 mile of ether to the pharmacy. Once there, they can be ready to be collected within minutes.
 

Dave Spence

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Let me make it clear, my issues mainly revolve around the administration, not the medical side of a practice. From a very personal perspective as an ex admin manager I feel the administration in a GP practice is poor. And there is too much "that's the way it has always been done" attitude.

Looking at the medical side I don't know how many understand that in the medical profession becoming a GP is regarded as failure. So attracting eager young doctors to become GPs is difficult, hence to some degree the high pay.

But that does not excuse poor service and a disregard for the customer. And I use the word "customer" intentionally. If patients were seen as customers that are paying for the service they receive I believe we would receive better treatment, indeed we would be more entitled and eager to demand better service. In far too many parts of the NHS patients are seen as a nuisance, not valued customers.
I agree Neil, when I lived in England our GP practice had nightmare receptionists who would give you the third degree if you wanted an appointment. The doctors were very good once you got to see one but, unfortunately, they were invariably locums and didn’t know any of your history. I once saw a doctor and he told me that he wanted to see me again in two weeks time and that I should make an appointment at the reception before I left. I asked for the appointment and the receptionist told me that I couldn’t make one in advance and that I would have to ring in two weeks and see if they had any appointments for that day. When I explained that the doctor had told me to make it her reply was “he had no right to do that, he doesn’t understand the system I use” 🤷‍♂️. I was very relieved that I didn’t have to visit very often.
 

Rob F

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I'm not a frequent user of the service, luckily enjoying relatively good health. When I've had to see the doc the hard part has been just that - getting to see them. Once in the service has been good, referrals prompt and prescriptions same day.

The NHS however has become one great big administrative beast to my eyes. in my opinion this is where a lot of the problem lies. Couple this with more users, wider variety of treatments available, shortage of doctors and increased user expectations - the system is creaking badly.

I've had conversations in the pub with a retired doctor (pre covid), he couldn't believe the way the NHS has gone and he was most scathing about the bureaucracy his son, also a doctor, would tell him about. To the extent he said that if he'd known then what he knows now he would have told his son to study law not medicine.
 

Neil ofthe nene

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I agree Neil, when I lived in England our GP practice had nightmare receptionists who would give you the third degree if you wanted an appointment. The doctors were very good once you got to see one but, unfortunately, they were invariably locums and didn’t know any of your history. I once saw a doctor and he told me that he wanted to see me again in two weeks time and that I should make an appointment at the reception before I left. I asked for the appointment and the receptionist told me that I couldn’t make one in advance and that I would have to ring in two weeks and see if they had any appointments for that day. When I explained that the doctor had told me to make it her reply was “he had no right to do that, he doesn’t understand the system I use” 🤷‍♂️. I was very relieved that I didn’t have to visit very often.
I had a similar issue when a GP wanted to see my mother at a future appointment. The receptionist told us that they didn't book that far ahead. I explained that it was the doctor who was booking an appointment with my mother, not the other way round. We got the appointment.
 

tipitinmick

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Let me make it clear, my issues mainly revolve around the administration, not the medical side of a practice. From a very personal perspective as an ex admin manager I feel the administration in a GP practice is poor. And there is too much "that's the way it has always been done" attitude.

Looking at the medical side I don't know how many understand that in the medical profession becoming a GP is regarded as failure. So attracting eager young doctors to become GPs is difficult, hence to some degree the high pay.

But that does not excuse poor service and a disregard for the customer. And I use the word "customer" intentionally. If patients were seen as customers that are paying for the service they receive I believe we would receive better treatment, indeed we would be more entitled and eager to demand better service. In far too many parts of the NHS patients are seen as a nuisance, not valued customers.

Exactly Neil. How many times have I heard …. You should have come and seen me sooner. Sooner, sooner ? Do you know how long it’s took me to get this appointment after your reception staff have failed to ring me back time and time again ? If you want to hear the latest on Game of thrones, Eastenders, Coronation St go sit in our surgeries reception as that’s all the reception staff are interested in. That and playing on their mobile phone. 😡😡
 

Neil ofthe nene

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I haven`t got a clue how the NHS is run or funded but my experience regarding my local practice and waiting times generally is not
good {ok covid is a factor}, so this is what I would do. First any action needs to be radical {I mean radical in the true sense not liberal`s
forming a committee}.

The entire NHS should be thrown open to the private sector.

Now you have picked up your teeth read on.

I remember a business man saying British Rail does not need privatisation it needs a good dose of private sector discipline, I think the
same could be said of the NHS. With the amount of medical procedures etc there is vast amounts of money to be made so the private
boys would not be backward in coming forward.
First though rules {rules that stick} should be put in place to protect the service itself, in other words the private mob cannot cherry
pick the lucrative bits and leave the NHS to pick up the pieces.

GP`s surgeries could be funded by local government and beyond this central government by a direct and separate tax which could go
up and down as required. I don`t think people would object because they will see exactly why money is being taken and where it is
going.

Also I have to say I feel for NHS staff, the service itself gets a lot of flack for things beyond their control. I`m sure it must sap their morale.

We need strategically placed training centres to turn out medical staff on a production line basis. If people come from abroad and become
qualified at our expense they and their immediate families can settle here as long as the sign up to work in our heath system for say five
years. Our own people should have university fees waived if they do the same.

I realise I don`t know what I am talking about so please be kind but surely the money sponge that we have at present can be improved on.
I fully agree. The NHS has become a poor administrator's/manager's playground. I am convinced that I could save millions were I allowed to critically examine my local hospital's structure and practices.

First step would be to redesignate 90% of managers as supervisors and team leaders. Adding the title manager to any role increases the salary by thousands.

I would also draft in managers from successful commercial organisations on a temporary basis to bring their knowledge of process and economy to bear. And one radical idea would be to borrow senior managers from the likes of McDonalds, KFC and Pizza Hut. Does no one ever wonder how McDonalds manages to get their young and not overpaid staff to produce a consistency of product and service? It is through strong and firm management that does not take a step back or accept second best. Yet we look at the NHS and with all their highly paid staff they cannot achieve the same.

Whenever I go into hospital I play "The Coffee Cup Game". How long does it take to spot a member of (admin) staff wandering around with a coffee cup in their hand? My record so far is 45 seconds. Don't get me wrong, people are entitled to a coffee break. But an example from my own management of a team explains my position. When I first moved to take over a new team in Northampton I spotted that some staff were getting themselves a coffee from the machine in the department just minutes after our 8:45 start time. I soon called the supervisors together and asked that if peoople wanted a coffee to start their day that they do do this before 8:45. I further explained that I had no issues with people getting ready to go home at 4:35. But to balance that I didn't expect to see anyone at the machine getting a drink before 9:15. My request was followed without issue.

When I worked in branches for Barclays we did not know what a tea break was. We were too busy serving customers.

I often joked with The Boss that whenever I want to the doctors while she was working I never saw her without a coffee or tea on her desk.

A friend once worked for a while in an NHS department. She told me that the culture was such that new staff expected to be a manager after two years. In the bank it took me 20. Such is the difference between a company that has to make a profit and the NHS that expects to be bailed out from a bottomless money pit.

Another friend, an ex banking colleague, worked for a few years in a hospital's stationery supply office. He is scathing about the way money is wasted and the poor standard of management.

And finally, from my own experience. I was told by a nurse that the NHS pay £25 per 50 for blood sugar monitor test strips. At the time I was buying my own for £6.99 for 50 including delivery. The NHS should be dictating the price to the supplier given their size, not the other way round.

Until someone in Government is brave enough to really take control of the NHS it will remain an inefficient and costly drain on public finances.
 

Neil ofthe nene

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Exactly Neil. How many times have I heard …. You should have come and seen me sooner. Sooner, sooner ? Do you know how long it’s took me to get this appointment after your reception staff have failed to ring me back time and time again ? If you want to hear the latest on Game of thrones, Eastenders, Coronation St go sit in our surgeries reception as that’s all the reception staff are interested in. That and playing on their mobile phone. 😡😡
As I say, The Boss was a receptionist for 21 years. Even she is critical of the current staff in that role.
 

tipitinmick

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As I say, The Boss was a receptionist for 21 years. Even she is critical of the current staff in that role.
As you might know Neil my missus is a midwife and she says to me …. “ I don’t know how they get away with it. We’d face disciplinary if we didn’t answer the phone like that “ The missus will sit in reception with me shaking her head. She’ll say ….. “ We can’t get away with anything like this. Wish we had time to cal about what was on TV last night “. In our surgery it’s definitely the receptionists that are the problem. They simply do not give a s##t. Simple as. 🤷‍♂️
 

Zerkalo

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I haven't had to see my GP for years thankfully so can't really comment, but having GPs in my family, I do know that they will often only be working a few days in the practice and sidelining with other work such as medical checks for different professions, tribunal cases and things like that. One thing they say to me is that they don't want to work as locally as they could as it would mean they would end up bumping into patients in the village and being hassled on the street.
 

62tucker

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Is a doctors receptionist a minimum wage job. Or have you got to have qualifications.
The ones at my doctors are all big lipped big breasted young lasses who look as thick as mince.
Hope on. Need to make a few appointments 🤣
 

Sportsman

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My GP doesn't have a receptionist, or a nurse or an adminstrator or an office manager. She has two rooms, a waiting room and her office/clinical area. She shares a phone answering service with other doctors.
When I phone I will be asked if is urgent, if it is I will probably get an appointment same or next day, otherwise I may have to wait two days. Once I am in with her we can talk about as many problems as I like, my visits last on average 30-45mins.
If I need a blood test, she writes a request. When I leave I take the request around the corner to the laboratory where they take the blood If it is before lunch I will get the results online by 6pm that evening. My Dr will be copied in, but they are my results.
If I need a referral, etc., the Dr phones and makes the appointment.
Of course, all of this has to be paid for. Prices are set by the government and a GP consultation is €25, payable at the time. If you are registered on the system and carry a smart card, then €18 will be refunded directly into my bank account within 2-3 days. This is covered by my earnings based social security payments. If I wish I can take out voluntary private insurance to cover the difference between the cost and the refund. If I couldn't afford to pay the Dr would see and treat me just the same. It's the law.
I don't pay anything anyway, because I am diabetic.
It is a very complicated system, but not for the patient.
 

Arry

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Our local surgery is pants... you cannot get an appointment for days if at all and you are at the whim of the lass on the end of the receptionists telephone, on two occasions I have been cut off when I insisted I needed to see a doctor... and with multiple GP'S at the surgery you take pot luck who you get seen by so there's no continuity of treatment... the joys of a GP'S trust I s'pose
 

Keith Sparky

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Very interesting thread this. It seems most don't get the service we think we should be but mention that the NHS may need reform and not just endless pots of cash then we get the leave our precious NHS alone cries. Maybe we should be open to other models and take on board the good bits other countries do
 
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