Blackmailed by my local doctor's surgery

[Mr Mackay]

I dont begrudge a nominal fee - they have enough to do as it is ,despite what we think !

I would urge folk to act on their reminders , not sure if they do a couple of reminders any more
I suppose we should make a note of these things

 

[PDE1]

My reminder came 12 weeks before the renewal date but still waiting for doctors with 5 weeks to go. Speaking to the firearms officer this afternoon at least 40% of surgeries both in town and in the countryside are refusing to fill in the forms in this area. Also the commercial companies that will do the report for you are taking 8 to 9 weeks to process them, could be they are struggling to get peoples records as well

 

[betweenthelines]

So, a bit like football and parks owned and looked after by Councils. We have paid via Council tax and Income tax, why should we pay again ?

If you took all the non essential paperwork away from Doctors, they'd have nowt to do. Local surgeries are a retirement home for Doctors. How many actually work full time ? If there's anything important they refer you to Hospital via A&E, which is one of the main reasons A&E departments were bursting at the seams.

So, as the public's taxes are paying your subsidies, does that give everyone the right to roam at will over your farm?

Your comments re GP's are simply not worth a response.

 

[thesilentone]

So, as the public's taxes are paying your subsidies, does that give everyone the right to roam at will over your farm?

Your comments re GP's are simply not worth a response.

The public's taxes are not paying me one penny.

Why are they not worth a response, please do some research.

 

[TheTallGuy]

So, a bit like football and parks owned and looked after by Councils. We have paid via Council tax and Income tax, why should we pay again ?

If you took all the non essential paperwork away from Doctors, they'd have nowt to do. Local surgeries are a retirement home for Doctors. How many actually work full time ? If there's anything important they refer you to Hospital via A&E, which is one of the main reasons A&E departments were bursting at the seams.

My surgery group has 7 full time doctors plus locums on 3 separate sites normally running clinics for 6+ hours per day. Doctors mainly aged 40-early 50s which means that they have enough experience to do the job. In ~20 years I can't recall any of the family being referred to A&E other than for one case where there was an immediate need for an x-ray - all other referrals being for tests or specialist clinics that the surgery can't host. Other surgeries may be different, but I can't fault how hard they work at ours.

 

[puppet]

"thesilentone, post:


Who owns the intellectual property rights to our medical records ?

You can apply to get your records though the practice will have duties under data protection to withhold sensitive information.

We pay for the National Health Service, we pay for the Police Service, why are we paying twice ?

I can't understand that either as I asked the patrol car to save me paying for a taxi as they were sitting in a layby and I was paying them to do nothing. Wouldn't even help me when I offered to pay for fuel.


Why wasn't private enterprise given the chance to tender to provide the vaccine ?

It was. Pharmacists and GPs are doing it

 

[Scholsey]

So, a bit like football and parks owned and looked after by Councils. We have paid via Council tax and Income tax, why should we pay again ?

If you took all the non essential paperwork away from Doctors, they'd have nowt to do. Local surgeries are a retirement home for Doctors. How many actually work full time ? If there's anything important they refer you to Hospital via A&E, which is one of the main reasons A&E departments were bursting at the seams.

wow

 

[farmerm]

Yesterday was formulating in my head the conversation I need to have with my GP.... Well Dr, its like this... if your family members continue to assume it acceptable to regularly trespass at will across our property with your dogs running wild, including roaming though pasture for which those walking them can not be sure do have not livestock in and disturbing all the ground nesting birds as they go... then I will assume it is equally acceptable for me to bring our livestock to roam and graze in your manicured gardens. Further more, such wild roaming and general lack of control greatly increases the risk of your dogs causing harm to our livestock and that greatly raises the risk of your dogs and those walking them from getting peppered with lead from the shotgun of a very irate farmer....

Whilst on the subject of shooting, I need to ask you arrange to provide a favorable medical report to the police for the renewal of my gun license...




Doh!

 

[thesilentone]

My surgery group has 7 full time doctors plus locums on 3 separate sites normally running clinics for 6+ hours per day. Doctors mainly aged 40-early 50s which means that they have enough experience to do the job. In ~20 years I can't recall any of the family being referred to A&E other than for one case where there was an immediate need for an x-ray - all other referrals being for tests or specialist clinics that the surgery can't host. Other surgeries may be different, but I can't fault how hard they work at ours.

Great, I wonder how many are full timers ?

Is it not ridiculous that in 2021 that a Doctors surgery cannot carry out such a simple task as an x - ray ? Or is the whole NHS so Unionised that they won't allow it ?

Instead of constantly sending everyone to Hospitals for x rays, why not have a x ray shop on the high street, pop in, pay your money, get an x ray ?

Being referred to a specialist Doctor via the local surgery takes weeks, or even months. So, to circumnavigate that process, the Surgeries send patients via A&E.

We then end up with a political argument about A&E Departments being overrun, Doctors working hours, and the need for a full 24x7 specialist service from our NHS.

A&E is just that, Accident and Emergency, not a back-door to the specialist services currently used by local surgeries.

 

[thesilentone]

"thesilentone, post:


Who owns the intellectual property rights to our medical records ?

You can apply to get your records though the practice will have duties under data protection to withhold sensitive information.

We pay for the National Health Service, we pay for the Police Service, why are we paying twice ?

I can't understand that either as I asked the patrol car to save me paying for a taxi as they were sitting in a layby and I was paying them to do nothing. Wouldn't even help me when I offered to pay for fuel.


Why wasn't private enterprise given the chance to tender to provide the vaccine ?

It was. Pharmacists and GPs are doing it

The question was, who owns the intellectual rights, not how do I get access.

It is ridiculous to compare a Taxi service from the Police, it is not a legal requirement.

If, the GP's were not already taking a Salary from the taxpayer, then I would agree, but they are. So, why should they make an additional charge to carry out work that is mandatory for the applicant ?

 

[TheTallGuy]

Great, I wonder how many are full timers ?

Is it not ridiculous that in 2021 that a Doctors surgery cannot carry out such a simple task as an x - ray ? Or is the whole NHS so Unionised that they won't allow it ?

Instead of constantly sending everyone to Hospitals for x rays, why not have a x ray shop on the high street, pop in, pay your money, get an x ray ?

Being referred to a specialist Doctor via the local surgery takes weeks, or even months. So, to circumnavigate that process, the Surgeries send patients via A&E.

We then end up with a political argument about A&E Departments being overrun, Doctors working hours, and the need for a full 24x7 specialist service from our NHS.

A&E is just that, Accident and Emergency, not a back-door to the specialist services currently used by local surgeries.

All the doctors at our surgeries are full time apart from the locums, other than for the chargeable services such as driving licence medicals & firearm renewals. The money from the non NHS services goes straight into the practice coffers to pay for running the whole service - the GP gets no extra money for doing the medical, or signing a certificate.

As for having a "high street x-ray service", medical grade x-ray equipment isn't cheap to purchase or maintain and requires specialist staff to operate. For it to be financially viable, either very high charges must be made for the service, or you need to concentrate the service for a locality to ensure it sees enough volume of traffic to keep costs down. Wouldn't it be amazing if there was a location for each district where medical grade x-rays were available along with the staff to operate them and sufficient volume of usage to justify the costs.... just like a hospital! As it is, there are quite a few places that you can privately obtain medical x-rays starting from ~£50, although you still need to have a medical referral; that £50 will purely cover the cost of the x-ray. If assessment is required by a specialist then the bill goes up significantly & despite what TV & films suggest, ability to fully interpret an x-ray isn't something that the average gp generally does. If fact, every consultation I have been present at involving x-ray results the clinician has referred to the notes provided by a specialist.

Around here, if a doctor sends a patient to A&E, they are assessed as to whether they require immediate critical treatment - e.g. a wound needs closing, or signs of a stroke etc, if they don't require immediate treatment they get put into exactly the same booking system that the GPs have access to; even most fractures are booked in this way! If the patient is in need of immediate critical care then the GP has followed the correct procedure in sending the patient to "A&E". The biggest clog in A&E is down to patients self referring due to either not being able to get a timely GP appointment or just being stupid for going there with a touch of Delhi Belly rather than phoning 111 & following the advice!

 

[TheTallGuy]

The question was, who owns the intellectual rights, not how do I get access.

It is ridiculous to compare a Taxi service from the Police, it is not a legal requirement.

If, the GP's were not already taking a Salary from the taxpayer, then I would agree, but they are. So, why should they make an additional charge to carry out work that is mandatory for the applicant ?

On "intellectual rights", the clinician who creates the notes/record has "first copyright" & as part of their contract with the NHS/surgery will effectively assign those bodies a perpetual licence to utilise those records. Under DPA & GDPR, the patient has a right to access data pertaining to themselves for free (within reasonable bounds), but "free" does not necessarily pertain to allowing third parties to access that data. In theory you can obtain the data yourself and pass it on, but that does not guarantee the recipient will receive a full unadulterated copy.

As noted above, generally the GP is not obtaining pecuniary advantage themselves - it will be the medical practice that is doing so to cover the costs of the practice. I guess in extreme cases enough of these charges could boost the practice income to afford the GP a pay rise, but it's unlikely to be significant!

The laws that make it mandatory to provide those records to the patient for free does not generally apply to third parties. As far as I am concerned, the purpose of the NHS is to provide health care that is free at the point of use not to facilitate either commercial or hobby activities. I suspect that this is likely to become something of a moot issue anyway as the role of NHS Digital Records expands - as it is I can already view aspects of my medical records online and can designate third party access.

 

[puppet]

As noted above, generally the GP is not obtaining pecuniary advantage themselves - it will be the medical practice that is doing so to cover the costs of the practice. I guess in extreme cases enough of these charges could boost the practice income to afford the GP a pay rise, but it's unlikely to be significant!

If you are a salaried GP then you do what is asked each day and get your pay but majority of surgeries will have partners who are self-employed businessmen, employing staff, running premises, etc. That is why GP pay structure includes the necessary stuff about seeing ill people but then a lot of NHS add-ons which are optional (and can be provided by Health Authority instead) plus external work such as insurance/driving medicals and various certificates including firearm reports. Those are not part of their core contract to provide medical services.
Just like a contractor being asked to cut 10 one acre fields for the same price as a 10 acre one, they are perfectly entitled to refuse any of the private work which will certainly affect the partners profit as they own the business.

The public cannot just order an xray as it involves radiation and needs someone to decide if it is appropriate and actually filming the correct part. Who then decides on the result-just give it to the individual to Google it?

 

[thesilentone]

Quote:

All the doctors at our surgeries are full time apart from the locums, other than for the chargeable services such as driving licence medicals & firearm renewals. The money from the non NHS services goes straight into the practice coffers to pay for running the whole service - the GP gets no extra money for doing the medical, or signing a certificate. why do they need ' extra money ' as they already get paid for being a NHS Doctor ?

As for having a "high street x-ray service", medical grade x-ray equipment isn't cheap to purchase or maintain and requires specialist staff to operate. For it to be financially viable, either very high charges must be made for the service, or you need to concentrate the service for a locality to ensure it sees enough volume of traffic to keep costs down. Wouldn't it be amazing if there was a location for each district where medical grade x-rays were available along with the staff to operate them and sufficient volume of usage to justify the costs.... just like a hospital! As it is, there are quite a few places that you can privately obtain medical x-rays starting from ~£50, although you still need to have a medical referral; that £50 will purely cover the cost of the x-ray. If assessment is required by a specialist then the bill goes up significantly & despite what TV & films suggest, ability to fully interpret an x-ray isn't something that the average gp generally does. If fact, every consultation I have been present at involving x-ray results the clinician has referred to the notes provided by a specialist. As you may know, these services already exist, but are few and far between, and are currently expensive. However, an x ray of the quality required by a specialist can be procured outside the NHS, but it has to be referred, why ?

Around here, if a doctor sends a patient to A&E, they are assessed as to whether they require immediate critical treatment - e.g. a wound needs closing, or signs of a stroke etc, if they don't require immediate treatment they get put into exactly the same booking system that the GPs have access to; even most fractures are booked in this way! If the patient is in need of immediate critical care then the GP has followed the correct procedure in sending the patient to "A&E". The biggest clog in A&E is down to patients self referring due to either not being able to get a timely GP appointment or just being stupid for going there with a touch of Delhi Belly rather than phoning 111 & following the advice!
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With the authority of your response, I assume you know your onions, however you will also be aware that in many cases the A&E department system is abused by local surgeries.

However, the issue is charging for mandatory information requested by the Police or insurance Company, or employer etc. Given the applicant has zero choice, and the information required appears to be ring fenced (our medical records) by the NHS/ Doctor.

Where any cost to the public is required, we should not allow a cartel to withhold our opportunity procure that service elsewhere.

In many cases the 'Clinician ' who created the first copy will either be dead or retired, then what ?

 

[X344chap]

So, a bit like football and parks owned and looked after by Councils. We have paid via Council tax and Income tax, why should we pay again ?

If you took all the non essential paperwork away from Doctors, they'd have nowt to do. Local surgeries are a retirement home for Doctors. How many actually work full time ? If there's anything important they refer you to Hospital via A&E, which is one of the main reasons A&E departments were bursting at the seams.

You haven't paid for the Doctors already - GPs are self employed but have a contract with the NHS to provide healthcare. This healthcare contract doesn't include signing passports or helping police with their enquiries etc - so its time spent that the NHS doesn't pay for and so needs charged for.

If the job was that great then you would find people keen to have a career as a GP and very little in the way of vacancies - the number of GP practices having to close or be taken over by the NHS due to the inability to fill jobs tells a very different story.

 

[X344chap]

Great, I wonder how many are full timers ?

Is it not ridiculous that in 2021 that a Doctors surgery cannot carry out such a simple task as an x - ray ? Or is the whole NHS so Unionised that they won't allow it ?

Instead of constantly sending everyone to Hospitals for x rays, why not have a x ray shop on the high street, pop in, pay your money, get an x ray ?

Being referred to a specialist Doctor via the local surgery takes weeks, or even months. So, to circumnavigate that process, the Surgeries send patients via A&E.

We then end up with a political argument about A&E Departments being overrun, Doctors working hours, and the need for a full 24x7 specialist service from our NHS.

A&E is just that, Accident and Emergency, not a back-door to the specialist services currently used by local surgeries.

The clue is in the name - 'General' Practitioner
They know a huge amount of medical stuff at a general level - but are not experts in any particular field unless it happens to be a speciality that they chose in their training.

The hospital consultants are the experts in each particular field - the GP just 'triages' and decides when it can be treated locally and when it needs to be referred from the generalist to the specialist.

GPs are not Radiographers or Cardiologists etc and don't have the knowledge, experience or access to specialist equipment required. * some exceptions apply in remote areas but those GPs will have additional specialist training.

 

[betweenthelines]

Great, I wonder how many are full timers ?

Is it not ridiculous that in 2021 that a Doctors surgery cannot carry out such a simple task as an x - ray ? Or is the whole NHS so Unionised that they won't allow it ?

Instead of constantly sending everyone to Hospitals for x rays, why not have a x ray shop on the high street, pop in, pay your money, get an x ray ?

Being referred to a specialist Doctor via the local surgery takes weeks, or even months. So, to circumnavigate that process, the Surgeries send patients via A&E.

We then end up with a political argument about A&E Departments being overrun, Doctors working hours, and the need for a full 24x7 specialist service from our NHS.

A&E is just that, Accident and Emergency, not a back-door to the specialist services currently used by local surgeries.

I can't work out whether you are being deliberately obtuse or are just naturally intellectually challenged.

I think you thing you fail to appreciate is that G P's are just what it says on the tin- General practice Doctors, able to deal with the more common ailments that the public suffer, but wise enough to know what is best passed to a more specialist doctor. I broke an ankle once, had an x ray taken at the local (small) A & E but had to have the x ray assessed at a main (city) hospital as the Doctor's at the local A & E didn't have the daily experience of assessing such x rays and injuries

 

[ollie989898]

Steady on guys- the vast majority of GP services are provided by private enterprise already, not many GPs are employed by the NHS directly. GP surgeries are mostly privately owned by the people working in them. They are then paid on a per patient basis as necessary.

I personally don't like the idea of a GP surgery charging for a someone to renew their firearms certificates. If I was working as a GP (as I eventually hope to), I also think I would have a bit of a problem signing a bit of paper to say this guy is AOK when I've never met the guy or not seen him in front of me in years. I know that rural people, (and in particular men of a certain vintage and beyond) are generally a nightmare to get in the front door of a surgery at the best of times for routine health screening checks, I wonder if the shotgun renewal thing could be an opportunity to get you folks in the front door so you can answer the mental health questions and, just as importantly, get the usual health MOTs done as well?

 

[ollie989898]

Great, I wonder how many are full timers ?

Is it not ridiculous that in 2021 that a Doctors surgery cannot carry out such a simple task as an x - ray ? Or is the whole NHS so Unionised that they won't allow it ?

Instead of constantly sending everyone to Hospitals for x rays, why not have a x ray shop on the high street, pop in, pay your money, get an x ray ?

Being referred to a specialist Doctor via the local surgery takes weeks, or even months. So, to circumnavigate that process, the Surgeries send patients via A&E.

We then end up with a political argument about A&E Departments being overrun, Doctors working hours, and the need for a full 24x7 specialist service from our NHS.

A&E is just that, Accident and Emergency, not a back-door to the specialist services currently used by local surgeries.

Steady on- GPs can't hand out X rays just like that and certainly may not even be trained to do one. Same is true for CT etc scans. A radiographer is trained to use the machines, and a radiologist (a doctor trained to evaluate the resultant images) will do the interpretation.

I believe in future some GP surgeries may well have an on site path lab and diagnostic imaging suite but again there is a cost to this and to be fair there is not an unlimited number of staff within the health service either- the demand for diagnostic imaging alone grows annually at in excess of 10% I believe. Of course, the government is also now making noises about taking GP surgeries back in hand and employing all of them directly on a salary. Good luck forcing that down their throats.

In France, you see the doctor, get referred and will probably see a consultant in a day or two at most if not the same day. This is because of their funding model and because their system is insurance based- the funding follows the patient and it is in the provider's interest to get you in the door TODAY so they can claim the money.

And one last thing- there is no such thing as 'The NHS'. It is not a single monolithic entity: it is segmented into various providers and 'trusts' and other businesses. Some of them are actually privately owned. Obviously many of them do not make this fact very public.

 

[thesilentone]

You haven't paid for the Doctors already - GPs are self employed but have a contract with the NHS to provide healthcare. This healthcare contract doesn't include signing passports or helping police with their enquiries etc - so its time spent that the NHS doesn't pay for and so needs charged for.

If the job was that great then you would find people keen to have a career as a GP and very little in the way of vacancies - the number of GP practices having to close or be taken over by the NHS due to the inability to fill jobs tells a very different story.

By far and away the majority of income going into a GP practice comes from the taxpayer- fact !