Quote:
Originally Posted by Chrysalis
One could argue the UK needs to do the same if it is not prepared to increase public spending to fix the shortfall then we could adopt the french policy of making it income dependent, a good friend of mine told me of some of the better things about the french health system, e.g. in the UK if you need an X ray, you get sent to the hospital to have one, in France they have X ray machines at the GP surgery, thats just plain common sense, it makes things faster and more efficient.
To me I would adopt the following to improve workload on the system.
Grant extra powers to pharmacists to issue prescriptions.
Make some drugs not require a prescription when used in low dosage. So e.g. antibiotics, you can get issued one set without prescription per year, more require prescription which can be issued by either GP or pharmacist.
Implement more stuff to be carried out at GP surgery, such as X rays.
GPs open 7 days a week and 12 hours a day.
Ban doctors from doing private work if they wish to pull in a NHS salary.
Let HC1 cert owners reclaim travel costs to see GP (currently they dont). This can reduce home visits required.
Add video conference facilities. To reduce people needing to attend surgery for physical examinations.
Add email contact mechanism between patients and their GP, a GP can take 1 minute to respond to single query over email vs allocating a 5-10 min booking slot for someone to come in to ask the same question.
There is more but these I thought of off the top of my head quite easily.
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Having looked at the various health care models in use around the world I would agree that as a nation we probably should consider moving to more of a insurance top up based system or hypothecated tax system, which is what much of the rest of the world uses. My fear is we are heading more towards an American based health insurance based model with all the problems that this can entail to the individual.
With regard to the other points pharmacists already have more power than most people realise with regard to issuing medication, it is a myth that you need a prescription to get a prescription medicine. As long as you have already been prescribed that medicine by a doctor previously and it is reasonable that you would require that medicine on a long term basis a pharmacist can provide you with an emergency supply if you are unable to obtain a prescription from a doctor.
Making it possible to get some drugs without a prescription is looked at regularly and is generally based on the perceived benefit of making some medicines easier to get for example it is now possible to get PPI medication as an OTC medication without a prescription. Antibiotics are perhaps a bad example of a medicine that could be provided in this way as they are already possibly the most over subscribed class of medication. If you look at countries that do have a more relaxed attitude towards provision of antibiotics (Greece springs to mind) the associated incidence and prevalence of resistant infections is massively higher.
X-Rays in a GP surgery is something I like; however until we move to an alternative funding system I don't think it would be practical for every surgery to absorb the capital cost of the equipment plus the provision of qualified radiographers of which there is already a big shortage of.
In principle 7 day GP working is a great idea; however the big issue at the moment with this is there simply are not enough GPs in this country to make it work. There is also a growing body of evidence that suggests that when weekend appointments are available they are not always used. Personally I would prefer increased numbers of GPs working during the week when we do know that demand is massively out stripping the supply, hence why surgeries appointments are all fully booked within 5-10 minutes of opening!
How do you propose stopping GPs from doing private work? As far as I am aware the vast majority are not Technically employed by the NHS they are employed by their surgery which is an independent provider and is paid a sum per patient that is registered at that surgery.
As far as I am aware a lot of GPs already offer telephone consultations and some even use video conferencing for this as well. It is also already possible to email the surgery I am registered at with non urgent queries.