Is the LTA leading to a shortage of GPs?

TARDIS

jamesd wrote: »

One where the customers work nights and week days and want to be able to get at health care when they are awake and not at work. I don't really like having appointments only available during my prime sleeping hours and it's one reason why I've been in an area for a decade without having a GP. The mon-fri service isn't just struggling, it's completely failed to serve me.

I can see that a 24/7 day service is more convenient for some people, particularly people still in work (not the main users of NHS services, but that's not the point here). But if you can't staff a 5 day service trying to extend that to 6 days and hope safety/quality doesn't suffer is irrational.

Of course if continuing the current service model is not your goal...

atilla

For the new Doctors, it seems a lot go for the easy option in terms of practice. Specialise in say cardiology/Eurology etc. Far easier than trying to be a master/expert/knowledgable about all.
Hence they have such a problem recruiting GPs.
LTA won't be helping the older end either.

If the average joe in the street is looking for early retirement (funds permitting), we can hardly complain if Doctors are too.

bigadaj

stoozie1 wrote: »

OH is a dental surgeon and will not hit the LTA, even by making substantial sipp contributions which most IFAs we've spoken to couldn't get their heads round.

I think the public perception of the earnings of a profession is often just a headline of click bait.

Completely agree about clinical pressures. Austerity measures lower morale.

Would be interesting to see actual figures quoted, everything is anonymous after all.

justme111

I think she posted the actual numbers in one if her threads, you can make a search for "threads started", she was asking about pensions so given a breakdown of income/contributions in that thread.

bigadaj

justme111 wrote: »

I think she posted the actual numbers in one if her threads, you can make a search for "threads started", she was asking about pensions so given a breakdown of income/contributions in that thread.

Yes, seems to be referring to a mid five figure sum, good wage but not huge, I thought dentists would typically earn a little higher.

I think one issue here is that with depressed interest rates, low gilt yields etc then a db pension is much more valuable, as evidenced by cetv rates currently.

Whilst those cetv rates aren't available to unfunded public sector schemes, and even in funded schemes are nowhere near as generous they are an indication of the actual value when compared to annuity rates for example.

So someone with a db scheme who has hit the Lta will have a pension income of £50k. Dependent on age then the actual value of that pension could be double or more the Lta if a comparable product and to be bought.

stoozie1

happy to be proved wrong, but I have run the numbers a few times . He won't be a consultant for 4-5 years, but projecting that forward with revaluation each year until he's no longer eligible to pay into the NHS pension scheme, no chance of hitting the LTA, no.

jamesd

justme111 wrote: »

you must be lucky to be in a good health then. .

Instead I self-diagnosed and ordered prescription-only medication over the internet. And just ignore some things which would or might benefit from treatment.

justme111 wrote: »

By the way I am sure private GPs work till about 7 pm , enquire at your local Nuffield or Bupa or whatever other private hospital , they may offer private GP services.
Of course it would be better if all was free and comprehensive and of good quality and at any time in this world but it happens only either in communist society or in a dream .

Rationing care by restricting its availability to divert it to the private sector isn't really something that I associate with the objectives of the NHS.

TARDIS wrote: »

I can see that a 24/7 day service is more convenient for some people, particularly people still in work (... . But if you can't staff a 5 day service trying to extend that to 6 days and hope safety/quality doesn't suffer is irrational.

Of course if continuing the current service model is not your goal...

Continuing the current service model isn't my goal. That'd be making it more available. My employer manages to provide 24/7/365 service and pharmacists seem to manage early evening and 24 hour service. It doesn't take one doctor working 24/7/365 but getting organised to deliver it. I suppose doctors might try demanding more pay to work hours that others do for standard pay just as a routine part of work to cover things at all times. All doctors don't have to have their five days be Monday to Friday.

justme111

do you realise that if you seen gp it would not have been any better ? do you know how severely restricted are investigatiins and management of most not immediately life threatening conditions ? do you realise they have like 7 minjtes per apppointment per patient ? you have not lost much from them not working on weekends.
I second stoozie's info on income of dentists. I have looked at recruitment page of one of the dental corporates for dentists. one of the testimonies there was a letter from the dentist who was grateful he had a workplace which provided him with an income to take a mortgage and buy a house. That is a sad state of affairs and hardly helicopter flying, is it? And not my conjecture , it was on their website and meant to be something to attract applicants and something to aspire to.
your idea of evolution if NHS services has nothing to do with the reality I am afraid. Reluctance of politicians to admit it has to be private and instead trying to squeeze it by the back door harms the nation's health resulting in people like you , who could afford private services persevering with their ideas while selfdiagnosing and ordering medicines from internet.

jamesd

justme111 wrote: »

do you realise that if you seen gp it would not have been any better ? do you know how severely restricted are investigatiins and management of most not immediately life threatening conditions ? do you realise they have like 7 minjtes per apppointment per patient ? you have not lost much from them not working on weekends.

A GP who couldn't handle something like recognising type 2 diabetes and following the treatment guidelines in that sort of time might not be in the most appropriate job. No crisis in that but the long term harm from lack of treatment can be severe.

justme111 wrote: »

your idea of evolution if NHS services has nothing to do with the reality I am afraid. Reluctance of politicians to admit it has to be private and instead trying to squeeze it by the back door harms the nation's health resulting in people like you , who could afford private services persevering with their ideas while selfdiagnosing and ordering medicines from internet.

Reality can and should change. Many people can afford at least some use of private GPs if anywhere near to median income but it's not the founding principle of the NHS to restrict services to push people to the private sector. The idea is something that I assume would provoke outrage from the apparently large number of health union members who seem to want private provision banned in the belief that it takes resources from the NHS.

justme111

there you said it - folowing treatment guidelines. Guidelines are designed to maximise the benefit to society in conditions of resteicted funding, not to a particular individual. Argument that there are other groups that support your idea is not a proof that it is the correct one. Unlimited demand can not be met with limited resources - how can someone argue that it is not the case is beyond me. British fascination with free healthcare while nobody blinks an eye im spending money on their cars , nails, pets, drinks and holidays while losing teeth because they are deemed nonresrorable by dentists who avoid loss making root treatmemts and vincing in pain during injections for minor operations because it is not in the culture to put anesthetic cream on the skin for half an hour before the inhection is a sorry state of affairs.