To think a 6 week wait for a GP appointment is totally ridiculous

[fussychica]

Just tried to book an appointment at our local surgery to get something checked out. Not been for ages and I was expecting a 2 - 3 week wait but apparently there are no face to face appointments before the 4th Jan and they are not releasing any appointments beyond that date until the end of next week. There are also no 5 minute telephone consultations available until after 21 Dec. Apparently there is no doctor shortage at the surgery.
I am really shocked and not quite sure what to do apart from go private. It's not an emergency at the moment but at the same time I'm not happy to wait 6 weeks to sort it.
Have written to my MP advising him of the situation, for all the good it's likely to do.

So is this the norm now or are the people of this town alone in receiving such a sub standard service?

Absolutely spot on.

weetabix you aren’t being unreasonable. That is utter nonsense. And I’m frightened by it too.

Want2be's points about some GPs being put off by the cost of childcare may be irritating, but they're also probably right. Pointing out that other people on much lower salaries isn't actually a refutation to this. GPs, like other people, make their decisions based on what suits them best, not what they'd do in different circumstances and on different wages. You don't have to sympathise with them to understand this.

If we as a society decide we don't want to provide subsidies to encourage workers with shortage skillsets to do more hours when they're over a certain income, that's fine and a perfectly legitimate policy decision (although ideally it would be based on analysis rather than whether the idea sticks in people's craws). Just let's be clear about potential consequences.

And yes, of course what's being done to the NHS is deliberate. That much is incredibly obvious. One could be anti-NHS and still see that.

weetabix. You are right. Its rubbish for everyone. But the population is getting older, the mental health crisis is getting worse, the ability of people to make every day common sense decisions about their health care is rapidly declining and the limits of science are getting ever limitless. Yet the number of healthcare professionals employed per head population is only going on a downward spiral, for a variety of reasons. And the answer to that from a reasonable % of MNers is to make the remaining ones work more than full time to plug the gaps.

A few years ago these threads were complaining about a week wait, then 2 weeks,3,4 and now we are at 6. Why is anybody surprised?

And no, nobody is suggesting that you should go away and die quietly in a corner. The system as it it doesn't work for anyone - the rich (because navigating the private system is no walk in the park and if you get hit by a bus you'll be going to your local NHS A&E in any case), the poor, the middling, the staff, the patients. We as the public need to decide what we want to do in terms of ongoing healthcare provision in this country. And no-one can agree.

Maybe I'm misunderstanding your question about hourly rates. Most people work for a net profit ( i.e. don't work to end up with nothing or almost nothing at the end of the day). My Salary is X, my childcare is Y my other work related expenses are Z. What I'm left with is (X-Y-Z) =Q. Where Q is £2/hr for the hours I'm actually contracted to work ,never mind the overtime done in hospital and days like today where I'm sitting studying all day for a qualification I'm required to have.

Your consultant friend will earn an hourly wage with the NHS it will be A and in his private practice it will be B. Most consultants doing private practice do so on top of a full time NHS job.

Do most people not work out their net hourly rate?

As for How much do you think one of your nurse colleagues earns per hour once you take off childcare and registration costs and professional membership costs and training costs? .....err, nothing, which is why they leave in their thousands. And is why I would PAY my own children not to do nursing

I don't usually tend to work things out in terms of hourly rates, but I did when I was considering whether to do some extra hours that would've required paying childcare costs. Reason being that childcare would be charged hourly. I expect HCPs who are making the same calculations do the same.

I think if you asked anyone in any job to work out their hourly rate they would work out the pay received divided by the hours worked.

I doubt many people would include expenses in that.

If you asked most people to include travel, child care etc then many people would be earning much less than the £2 / hour that you claim.

What exactly are you including in that? Is that just your work related expenses or does it also include housing costs etc too?

I suspect most people with childcare costs would work out how much they'd be left with after paying all working expenses. You might factor transport costs in but obviously they don't necessarily increase by working more hours, one might do a longer day rather than take another trip into the workplace. Of course, what other people do and are left with isn't at all relevant to the question of whether an individual doctor (or anyone else) feels it's worth them working more.

And I think that we can all agree that the NHS is in a shocking state.

It isn't right though, when patients are justifiably complaining that they are suffering through being unable to access healthcare, to enter into one upmanship about how bad the doctors are having it.

I don't doubt that you are and if there were a thread about it I would support it.

My life is already very hard as it is. It isn't made any easier by artificial difficulties applied by some GP practices. If many are able to operate within the current system why can't they all? It isn't just about geographical socio economic differences either because in my area some are good and some aren't.

My practice used to be amazing. It isn't now but my condition leaves me tied to this practice.

I don't know why, if my practice is struggling so much, they don't just do away with appointments? They had a huge issue a while ago and you couldn't pre book for about 3 months. It was fantastic. No missed appointments because no one knew if you were going or not. Those who went got seen. As it is now I know of people who book a future appointment just on the off chance. If when it comes around they don't need it they cancel it. How many appointments are being blocked out by people doing this?

Of course, what other people do and are left with isn't at all relevant to the question of whether an individual doctor (or anyone else) feels it's worth them working more.

How is a consultant able to take 2 full days per week out of the NHS then to pursue private practice? Are they being paid as a full time consultant? Is 3 days a week classed as FT or PT?

If pt then they must be getting paid a decent wage in order to only work for 3 days/week.

Or have another source of income such as a working partner. I don't earn anything close to what a consultant does, but I work less than 3 days a week and I can do this because my salary isn't the only one we have to live on. There are people who earn much less than me who make the same calculation.

Though consultants do get paid a lot, obviously. Even the ones working part time would still be on a pretty high hourly rate.

Can I just clear up something about Consultants and private practice? I don’t know if it’s the same in every Trust, but in our local hospitals Consultants have to work a minimum of 11sessions a week (which is full time) for the NHS, before they are allowed to do private practice.

How do a lot of people on here think they cope in Europe?

Why does not the NHS always equal an American system.?

Im in Ireland and our public hospitals A and E are like standing at the gates of hell.
If someone told me i had an hour to live, I'd put the foot down and try to drive to a private hospital, even if it meant dying in the car. Irish hospitals are full of people just waiting.

Our GP system though is excellent. You pay €50 every time and get seen that day.

It doesn't necessarily leslie, but I think many of us think given the current political forces aimed at destabilising the NHS, we wouldn't get anything like the European systems. Actually we've got a little taste of it already with the Virgin Care stuff and with the way the UK privatised stuff like the railways and water. Pretty much all of the disadvantages of privatisation and none of the potential advantages. If it were a choice between eg our system and France, that would be a different discussion.

missyB is right. London seems to be a bit of an exception but most consultants have to work at least 10 NHS sessions (40 hours) before they can do any private work.

How Consultants fit in the private work its because when they do on call or out of hours they rack up loads of hours which then need to be taken out of the weekly average. So a consultants does a weekend on call (and there is a bit of variation), but they'll probably be doing at least 12 hours each day and then they get an 'allowance' of hours for the time they are on call, but not necessarily in the hospital. So a consultant could rack up 30 hours over a weekend, and this has to be averaged into his or her weekly practice, which is how come a 4 day week is standard in many specialities because the 5th day is essentially time owing from evening/weekend work.

Consultants in the NHS don't earn nearly as much as people think they do. Consultants basic salaries (and most of us are on basic salaries) are from£75-101k/year dependent on seniority. This works out as a take home of £24-31/hour. Our childcare costs were £16/hr. My transport to and from work in London was £20/day. My professional fees and indemnity run into thousands, never mind courses required for CPD. And no, I haven't included any housing.

I'm not trying to have a oneupmanship competition about who has the worst time (patients v HCP) but I'm totally fed up with the constant doctor/NHS bashing that goes on in the press, and on MN. 99.9% of HCP go to work to help people, not make their lives more difficult, and its extremely hard to help people when you're working with your hands tied behind your back and almost for free.

checking out now to actually study

Those saying that they would happily pay £10 to see a doctor have no idea of the costs of healthcare. Private GPs charge many multiples of that....

samedaydoctor.org/service/feeling-unwell-see-doctor-today/

www.medicspot.co.uk/pricing

www.londondoctorsclinic.co.uk/prices/

I don’t think people understand costs at all, which is ok as they don’t actually see behind the scenes. Paying £10 makes no odds if there is no GP to see. All that would happen is that locum GP’s would charge even more. Do not get me started on the locum business. They have absolutely cashed in on th NHS as a whole and brought it to its knees, although this is stopping in secondary care so much now. We have to apply to senior managers with justification of why we would need a locum and detail the reasons and they say yes/no before we can take them on so only in desperate measures. GP’s not so lucky, they probably end up forced to pay someone more than they earn themselves to do 2 sessions and patients do not even know them.

I’ve worked with consultants too and those who don’t do on calls (say they are community based) don’t get paid as much as you think they do.

Leslieknopefan - plenty of us have experienced European healthcare. We're aware of how it works there.

Plus other countries that operate social health care systems.

The reason we think it likely that IF certain govt members get their way re doing away with the nhs it will likely be an American system that's implemented is because those same govt members have "consulted" with USA private healthcare providers, some even have shares or their spouses do in private healthcare both American and British.

They're not even looking at European healthcare models! Not enough profit in it.

"Not nhs" doesn't have to mean "USA system" - can you please tell the govt this?

3luckystars - what do people who don't have a spare €50 do? And that won't just be the poor, it'll be as TM calls it the JAM people - those just managing, who are the ones who can also least afford to become ill to the point of having to quit work or being sacked as a result of ill health.

As grabem rightly points out we've been here before with essential services being privatised.

I remember when water, gas, electric, trains, phones, buses were publicly owned and run. No it wasn't perfect but if anything most of those are now worse run than they were then yet we're having to pay far more for the privilege of getting shit service.

Like hell do I trust this current shower with something so important!

Bluefolder you're absolutely right. I can absolutely see private healthcare being brought in under a promise of "affordability" - which is what happened when all those other services were privatised. The British public were told if anything the competition would drive prices down (that worked well - not!) that it would provide much needed cash for investment in those services (any regular city commuters care to say how that's worked in rail travel? Because I remember BR having its problems but it was never as bad as I'm hearing it is now. I used to travel regularly on commuter trains pre-privatisation, customers got seats on clean trains then).

The only area where prices have been driven down in my experience is telecoms. Phones and phone bills used to be extortionate under BT. But I suspect that's more due to tech advances than the glory of privatisation. (On that note it's beyond me why we don't have a nationwide wifi system. We're a small island it's entirely possible, funded by a sort of "wifi licence" similar to the tv licence - sorry way off topic.

So, based on previous experience of privatisation of essential public services in uk - no way! Instead let's vote in a govt that will invest in and support the nhs - for patients and staff.

Telecoms works because of the competition, I think. But that's just not replicable in healthcare. Oh sure, you'll get a choice of providers for your straightforward hip replacement and your smear tests. Those already exist. Stuff that's much more niche, time consuming or expensive, you won't, because it's much tougher to make money out of. There'll be one provider Crapita who tendered for a lower price than would be required to get the job done properly. You won't be able to go properly private because the private sector won't provide full coverage, so you'll be lumbered with privatised no choice NHS in name only, and won't even have the option of punishing poor performance with your vote.

Other forms of non-NHS healthcare model do exist, of course. It's just this one seems like the one we'll be getting.

Graphista I'm with you on every one of those points! I'm also old enough to remember publicly owned utilities and rail. Like you say they had their issues but they seemed more affordable and more efficient back then. Competition didn't drive down prices it gave private companies free range to price fix and fleece us all.

I can only imagine what would happen to healthcare!

Drives me mad when people try to push for private healthcare.

I worked in a private hospital. They cherry picked very carefully the surgeries that they did. Always routine of course but in very selective patients. Self caring, not obese, no other major illnesses, as low a risk of complications as they could manage. Occasionally things did go wrong. Post op complications arose. If they were serious or likely to result in very extended stays they got blue lighted back to the NHS.

Private hospitals currently work because they don't face the pressures that the NHS does - serious illnesses, slow recovery, bed blockers, complex conditions and surgeries.

As soon as everyone has to use the private system it will be just as the NHS is now only worse because somewhere profits will be taken or share holders paid. It is disgusting.

This is dreadful. We're lucky in Barnet that you can usually get an appointment in a week, but guess we're just lucky.

Grabem - that's what I really fear. That it won't be truly competitive privatisation but instead the nhs but us being charged through the nose for the privilege and STILL not getting the care we need.

We haven't had a socialist govt in almost 40 years, supposedly we've had govts that understand business, profit etc - well yes they've done bloody well in making money for big business owners but fuck the consumers! Look at the bloody mess we're in!

@Graphista you’re not comparing like for like though. Back when things were publicly run we didn’t have a living wage so essentially we had enough people on low pay to run these services, also for example in my area nearly all the jobs have disappeared locally (high streets shutting down, large companies using technologies that require less and les people) so people are forced to get on the train to travel an hour away to larger cities where there’s more jobs and we’re like sardines, I’ve seen this change on my train line in the last few years and has been privately run the whole time. 3 years ago I could easily get a seat, now I have to pick a particular train to stand a chance and even then it’s only a slim chance.

@Weetabixandshreddies in my experience private healthcare is horrendous in the uk because they have no competition and no real need to get better. You have your very few large corporations and everyone else uses the nhs. Also there isn’t really much affordable private healthcare schemes because people decided they pay taxes for the half a system nhs so may as well use it.
I wish I had the choice to not pay tax for nhs and go private. Some European models work on the basis that if you do not work or earn less then you will have access to basic care and basically what we have on the nhs and then if you work and earn more you’re entitled to pay a subsidised amount for less life threatening requirements or requirements such as ivf etc. Which the NHS decide for you that you’ll just have to be lumped with what they offer or be forced into private and suffer extortionate costs.

I’m currently on a waiting list for hernia repair. I’ve been told maybe within 5 years I might get it fixed. This is abysmal. On top of that it’s actually got worse while I’m waiting. But nhs doesn’t care because they’re holding themselves together by the skin of their teeth and just making sure people are staying alive. I don’t think that’s a sign of a good healthcare system. This system forces me now to pay for my operation as I’m now at the stage where I can’t eat properly because it hurts too much and I’ve lost a lot of weight to the extent I’m underweight and therefore suffering consequences of that as well and when I go private it will be me trying to escape hospital as soon as possible because that reduces my cost even if that’s to the detriment of my health.
So if I end up in the nhs from complications that’s because this system doesn’t allow any leeway for choice. It’s shit nhs or nothing unless you’re wealthy!