A Deafening Silence Waiting to be Broken

I read with disappointment the downright malicious article written in the Daily Mail by J Meirion Thomas.

In many ways it reminds me of something we are more used to Nick Griffin spouting than an esteemed and highly educated colleague (it is interesting that NG came out on twitter to defend JMT – who needs enemies when you have friends like him!).

I sat down to write some cathartic reparté on behalf of my entire GP fraternity when I realised that mine is not the voice we should all be hearing.

This, therefore, is a challenge to all the ‘Powers That Be’ to do the right thing and publicly sanction JMT. Their inaction would be yet another example of their indifference to the public denigration of our hard work and very existence that appears in the media on a daily basis.

To the GMC……

JMT is clearly in breach of the ‘Duties of a Doctor’. This article is a brazen challenge to your authority and (in) ability to act. The GMC receives the bulk of its funding via GPs (40000 GPs paying £400 per year) and is duty bound to not just put out a statement condemning JMT but owes it to its members to act in a show of strength and support. Do your job.

RCS and RCGP……

I don’t know how these two organisations would choose to respond to such hate. However, the RCS should be feeling very, very uncomfortable about their colleague essentially upsetting every doctor in the UK who is female, non UK in origin and now also GPs. Anything other than condemnation in the strongest strength fundamentally undermines the ‘linear integrated primary / secondary care’ approach the next five years is meant to bring. Dr Maureen Baker – this is your MTAS moment, a failure to act will set college relationships back a decade.

Mr Hunt……

I laugh at him even bothering to comment. However, his views would be facinating!!!

The NHS trust and the Private Hospitals (x 3) that he works at…….

Your patients all come via their GP. You rely on positive working relationships with all of these individuals to provide the level of care that we all aspire to. It is the community teams we lead that gets a patient home and appropriately supported, to try and avoid bed blocking, our admission avoidance efforts that stops you breaching all of your targets. Is this mouthpiece someone you want to be representating your organisation? A lack of response would suggest you think he is, or you just don’t care.

The BMA/Londonwide LMC….. I would suggest you send copies of this and JMTs other article in the Daily Mail about Female Doctors to every one of your member practices, stand back and wait to see what happens.

Ben Davies

One thought on “A Deafening Silence Waiting to be Broken

  1. I read the article written By Surgeon Mr Thomas.
    I would propose a forward of letter to Mr Thomas and Daily mail as a retort.
    Hopefully resilient GPs can read it and correct any mistakes or add anything they want to and it be published under the name of resilient GP rather than one particular gp
    Dear Mr Thomas.
    we read your lovely article and were happy to know that you consider GP as part of the problems. Of course this seems to be a widely held view by Daily Mail and some politicians.
    We would like to go threadbare and discuss every point raised by yourself and Daily mail regarding this and see if we can agree with you on all points
    Dr Finlays casebook , never ever having watched it , but going by your judgement of it, lets agree he was the most warm GP and gave all aspects of personal care for his patient doing Home visit in Glens in his wolseley car. Lets also assume he was gentle compassionate.
    Lets also assume too many GPs no longer try to provide remotely personal care personal, to offer appointments at convenient times or offer continuity of care.
    Now questions that arise in this are
    Is Dr Finlay real or is he fictional. Same as Causalty and Holby city being fictional and not truly representative of real Drs
    do real Drs need Time off to update their knowledge to keep abreast of latest and best care they can provide? Do they need sleep to be safe and to provide best medical cares? Do real Drs need time off at least of few weeks to recharge their batteries?Do specialist take time off for updating themselves? Do specialist need sleep to be safe to work for best patient care?Do specialist need specialist take time off to recharge their batteries
    Is it ever possible apart from in reel life for the same Dr to be able to see the patient every time they need it? Do specialist see the patient every time they come to clinic or do they spread the work with registrars and junior Drs and decisions are taken without a case conference?
    Real problem is the time people have to wait to see specialist and if the specialist are able to see the handful of patients each GP needs to refer then the system might be more efficient as people might be able to get right care at the right time. If a GP needs to refer a patient then that patient while waiting for specialist cant be dealt by GP otherwise they wouldnt need to be referred in the first palce anyway, right? oh sorry I forgot we are talking about ficition over here and in Dr Finlays time the suregons and other specialist used to be working 24 hrs a day as well and not to european time directives and hence were able to see patient faster and there was less no of people waiting for specialist review
    Now 2 other programmes on TV Casualty and Holby city show major complex procedures being done by AED Drs including complex cardiothoracic, neurosurgical, medical management. I presume that is very true to the real situation. Investigation offered in AED and requested by AED Drs , Junior staff or Senior staff to be similar to Medics or Surgeon. Most cases being handled and stabilised and almost treated by AED before specialist taking over.
    There are probably more interesting points showed about Surgeons and Medical Drs as well, but as we dont always get to catch the situation as even though we don’t provide personal care and convenient care as per patient wanting it we still end up being in the surgery from 8 to 8 dealing with among things request or orders by specialist to start a medication which could have been done easily by consultant but they think it is more appropriate to ask GP to do it, or request or orders to request investigations for which we have to contact hospital and specialist sitting in the hospital instead of asking for it deems it better for gp to order it, aed letter regarding needs for referrals, specialist letter requesting/ordering referrals to other departments, or in some cases picking up the pieces when a specialist had a confrontation with patient or patient not satisfied with specialist wants another referral for another opinion or specialist overlooking certain medications or in some cases completely overlooking why the patient was actually referred in first place. There are many other situation which arise. GP end up being on the firing block and instead of blaming specialist ends up pacifying and defusing situations
    Anyway
    Next point Private GP demand increasing.
    Agreed. it probably is increasing. But lets look at this in this way. The demand for private specialist consultation is increasing as well. Should we take it as a decline in provision by NHS specialist. Inability of a patient being able to see specialist when he needs them or at their convenience. Could it be that they end up being on waiting list for months for different specialist to resolve their problems while privately they are able to see the specialist in a day or 2 when needed. should we says the specialist system needs to be overhauled as it is causing the major clogging or narrowing of the system. Shall we stop private practice by specialist so that they can have more time to devote to NHS patient? The waiting time will decrease and so will backlog of patients and NHS might become more efficient and less reliant on private providers for the same service by the same specialist who do private procedure and consultations
    The actual statement should be confidence in state funded system is in decline and request for private consultation with specialist is on the rise. Am I right or is there some other situation going on
    The worsening performance of GP surgeries within the NHS was graphically illustrated this week by a new report from the Care Quality Commission, the health standards watchdog, which found that no fewer than one in six practices could be putting patients at risk because of their inadequacies.
    Crucially, the review of nearly all of the 8,000 GP surgeries in England used a new Ofsted-style ratings system based on 38 categories and uncovered failings including poor care of the elderly and overly long waits for appointments.
    The report is a telling indictment of the current system. Despite the massive increases in health spending over recent decades, patients are simply not receiving the care they deserve.

    Right.
    Did we have similar report on the Hospitals as well. Are the surgeons going to have their ranking etc measured various mean published as well.
    GP surgeries are usually small unit compared to hospital the more no of people come to GP surgeries the more chances that GP surgery will become dirty. should we send the some appeal that try avoiding coming to GP surgery unless absolutely necessary.
    GP surgery turnover in a day is about 180 distributed among 3 GP’s approximately not counting the no of patient seen by Practice nurses and HCA’s. yet most GP surgeries are able to see certain no of emergencies, children, elderly, patients sent back by Hospital, chronic disease patient’s, worried well, sick notes, apart from about 6 home visits distributed among 3 gp’s minimum.
    with a small support structure of 2-3 reception staff and a practice manager and a nurse doing her own clinic and HCA in some surgeries doing their own work, along with juggling the call from patients, Hospital specialist, Social Services, OT’s, and all sorts and then workload of prescription, paperwork generated from each hospital visit, to letter from job centres, social services, housing, and all sorts of agencies including the place people work or courts etc for 1000’s of people in a day, the amount gp surgeries manage is commendable i would say.
    That is the workload on average in a gp surgery shared between people.
    SO some of the Hospital were having higher rates of MRSA and other hospital infections and superbugs. Some of the hospital were failing and have been censured.
    Now hospital are big structures and have various people managing it. Including Hospital commissioners, various kind of managers and have input of Specialist. should we take failure of hospital as part failure of consultant and every worker in the hospital. In response to hospital superbugs etc the answer was the people who shouldn’t be in hospital shouldn’t be there and various kind of calls for less admission etc.
    Specialist clinics have long waits for appointments including poor care of elderly.How many people are seen in a specialist clinic in a day. my guess is the patient turnover in a specialist clinic is not more than 40 in a day and it is distributed between at least 3-4 Drs
    The fact is modern Specialist structure is still behind times in technology as they still don’t have the best computer systems and cant even send a consultation letter in 1 day and also have to deal with a secretary somewhere having to type a letter to be sent to GP and take minimum 2 weeks. The specialist dont type consultation on the computer screen whereas GP consultations are on the screen minutes from patient consultation.Hospital work in isolations in ivory towers so they are completely out of sync with the community and patient requirements and provisions in the community. They would do well to serve their time in community from time to time doing home visits and seeing home conditions and doing community clinics in GP surgeries and come to terms with real patients and community issues

    sorry wil type some more when i get a chance

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