Guess who's back? II

Two guest blogs, 15 comments and counting! After working on this blog for almost 3 months, people are more interested in what the Guest Bloggers had to say. In the words of... me, "what a travesty!" Looking on the bright side, in the space of 3 days the hit counter went from 850 to 1050, quite remarkable.

Although I have a few more Guest Bloggers lined up this week, I felt it necessary to type again, before people completely forget about me! I think in future a good system would be for a couple of Guest Blogs per week, so again, if you would like to type a blog then let me know in the comment sections, otherwise no doubt I'll be nagging everyone to type something anyway!

Since my last blog last Wednesday I've been working on a very important blog which hopefully will be ready to publish later this week. In the meantime, I thought I'd have a rant about a few new stories that I wanted to type about last week, before giving you all the pleasure of reading the Guest Bloggers from tomorrow.

Not much has happened but there were a couple of stories I wanted to comment on. The first was the report on the court case of Sanjay Dutt, who was found guilty of possessing illegal firearms, but cleared of conspiracy in the 1993 Mumbai bomb attacks. A verdict was finally passed on an offence that took place over 13yrs ago! Only in India could a public figure get such leniency and I expect the punishment to be equally lenient, probably a fine and community service. Earlier this year another Bollywood actor, Salman Khan, was found guilty of poaching deer and sentenced to one year in prison. There is no chance that Khan will ever see the inside of a prison cell. Incidentally he is still awaiting a court case with regard to a hit and run incident in 2003 when a homeless person was killed. It wouldn't surprise me if the charge would be less than that of the deer case.

The next story was about the recent report on GP salaries rising to £106,000 annually on average, with the government coming in for criticism for such a sharp pay rise. The figure is quite a rise from only 3yrs ago when it stood at £77,000. This news bodes well for me in the future provided it remains the same, but is it actually fair? Now obviously I'm not about to complain about receiving such a pay, and in fact it's the main reason why I decided to become a GP, but having worked in hospitals I'm not sure it's a fair reflection of the amount of work done by GPs.

First of all, GP contracts were given a significant boost in 2003 because of the sheer lack of numbers. In an effort to drive more medics towards general practice the government issued a lucrative contract for the most productive GPs. The salary is mainly based on Quality and Outcome Framework points (QOF points), with each point worth a certain amount of money and the more points reached, the more money paid to the GP practice. The government predicted that 70% of targets would be met and accounted accordingly. However, 90% of targets were met which meant a gross over spend on GP salaries.

People argue that the government increased the pay for targets that should've already been met by GP practices and whilst that is true, there was no incentive to maintain those targets. A practice that was very diligent ran diabetes checks, asthma checks, cholesterol checks etc would be paid the same as a practice that did none of those things, so what was the point? This way, practices that did such activities would receive more money and hence encourage other practices to follow suit. Allied to that the removal of out-of-hours care, including nights and weekends and suddenly the job became extremely attractive. The overspend is a result of GPs meeting their targets extremely efficiently and hence as a result the contract has been modified to include harder targets in issues such as mental health, but no doubt they will be met without too much difficulty.

Therefore, a GP works less, has less responsibility and is now focused on meeting QOF points to receive more money than ever before. You could argue that it's no longer about treating the patient, but purely target-orientated. A GP once joked to me that his practice system is setup in such away that constant reminders are flashed up on the screen to include certain tasks such as smoking status, blood pressure checks etc just in order to meet targets, even if it has nothing to do with the actual problem of the patient. So instead of focusing on the needs of the patient, GPs are worrying about meeting targets. Does that improve healthcare?

As for hospital doctors, hour remain ridiculous and working conditions remain poor and the pay stays the same. A consultant once told me that if you want to make money in medicine become a GP or a private surgeon and he's right. GPs get paid much more than their hospital consultant counterparts who arguably work harder and more difficult and specialist conditions. They have the avenue of private work to make money, but in the NHS, GPs lead the way. Being as impartial as possible, I would argue that GPs deserve their pay rise, but not at the cost of hospital doctors.

At the end of the day it's all about swings and roundabouts. There was a shortage of GPs so the government splashed some cash to attract more doctors to general practice. Now competition is extremely fierce just to get on the GP training scheme with multiple steps just to get to the interview stage. I had to do 4 essays in timed conditions, never thought my English GCSE would ever come in handy again, but it did! With such an increase in interest in general practice, eventually hospital care will suffer and therefore more emphasis will be placed back into hospitals by increasing their pay and improving working conditions and by increasing the responsibilities of GPs to help patients avoid hospital admissions as much as possible.

After boring you with all that and before finishing with something light-hearted, I thought it pertinent to mention the report that Kofi Annan (the outgoing UN leader) recently spoke of the ongoing unrest in Iraq and how the situation is now worse than civil war and the Saddam Hussein regime. Does that need anymore explanation? The very purpose of the invasion was to free the Iraqi people and bring democracy to the country and 3yrs after Bush declared "Mission Accomplished," it's damning to know that the situation for the Iraqi people has only worsened.

Alongside that story is the issue of a continuing nuclear deterrent for the UK. By developing our nuclear defence further and ensuring we have the capacity to engage in nuclear warfare surely that is only sending the wrong signals to countries such as North Korea and Iran. Whilst we maintain our nuclear missiles to act as a deterrent, Tony Blair is effectively stating that it is necessary to have a deterrent and therefore when other countries are trying to do the same, then why such condemnation? North Korea maybe more likely to actually launch a nuclear weapon but that is besides that point. Whilst it sees countries like the UK and USA flaunt the nuclear Non-proliferation treaty to which they are signed upto, they will continue to do the same. Hypocrisy rules!

That's my blog for today, probably much more boring than the Guest Bloggers last week, but don't worry, they'll be returning tomorrow. I finish with a couple of amusing clips from YouTube that I found over the weekend...





Take care all,
Thoughts just flow, when do they have to make sense?