Eastwood
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Post by Eastwood on Apr 13, 2021 21:53:49 GMT
But many patients really don't like these larger practices where they end up seeing a different doctor every time. And if they have ended up there by default it's going to cause some irritation That's fine as a preference but you try and recruit young, newly qualified GPs into a two GP practice. It just isn't possible. That's the reality of the situation. You need at least a 3FTE practice to have a sustainable recruitment policy (which is really 4 GPs these days as many will be working a 0.8.) So councillors and politicians can take part in campaigns all they want but there is no point in protesting to try and keep an unsustainable delivery model that falls apart as soon as an old-timer GP retires.
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Merseymike
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Post by Merseymike on Apr 13, 2021 21:57:58 GMT
But many patients really don't like these larger practices where they end up seeing a different doctor every time. And if they have ended up there by default it's going to cause some irritation That's fine as a preference but you try and recruit young, newly qualified GPs into a two GP practice. It just isn't possible. That's the reality of the situation. You need at least a 3FTE practice to have a sustainable recruitment policy (which is really 4 GPs these days as many will be working a 0.8.) So councillors and politicians can take part in campaigns all they want but there is no point in protesting to try and keep an unsustainable delivery model that falls apart as soon as an old-timer GP retires. I entirely agree. Even more so in dentistry where the corporate sector has virtually taken over in many areas. However, it means that older patients in particular are often unhappy with the arrangements. It's the same with having larger regional centres of excellence. Could be argued that producer rather than consumer interests are being prioritised.
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Eastwood
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Post by Eastwood on Apr 13, 2021 22:08:41 GMT
That's fine as a preference but you try and recruit young, newly qualified GPs into a two GP practice. It just isn't possible. That's the reality of the situation. You need at least a 3FTE practice to have a sustainable recruitment policy (which is really 4 GPs these days as many will be working a 0.8.) So councillors and politicians can take part in campaigns all they want but there is no point in protesting to try and keep an unsustainable delivery model that falls apart as soon as an old-timer GP retires. I entirely agree. Even more so in dentistry where the corporate sector has virtually taken over in many areas. However, it means that older patients in particular are often unhappy with the arrangements. It's the same with having larger regional centres of excellence. Could be argued that producer rather than consumer interests are being prioritised. I think it's about balancing consumer interests versus consumer preferences. Patients are better served by having a sustainable model. They don't like it as much as the unsustainable model right up until the point where all the doctors leave and they end up in a surgery staffed entirely by locums which they like even less.
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Post by Disgusted Of Tunbridge Wells on Apr 13, 2021 22:33:23 GMT
That situation is precisely how some Independents get elected, and in many cases, deservedly so. Good luck to her. OK I may have been a bit knee jeek harsh, so I’ll enquire a bit further - if you know the detail. Were these main or branch surgeries? Were they the same practiceand two building or two practice and one building or two of each? how big were the practices? Were there any practice mergers or retirments involved. One was a surgery run by a husband and wife (Peppard Road surgery, if you're interested) who unfortunately retired, which can't really be helped. The second was a practice with 6000 patients (my old practice, Priory Avenue) which had struggled to recruit GPs, but all the nearest practices are badly oversubscribed and they had to expand the nearest surgery to become a very large GP practice, which now has long waiting times despite the expansion. As a result of the oversubscription, some of the patients now have had to sign on practices at the University or in Tilehurst (which are 3 - 4 miles away, with no direct public transport links). All this time, Caversham is growing and we'll need a new practise soon, when we've just closed one right in the (Cav) town centre.
I understand it's not the council's decision, but the councillors could have lobbied the CCG to hold a more thorough consultation on the closure, at least. It's part of a pattern of the councillors not listening or fighting for services for residents and we're sick of it.
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Post by Disgusted Of Tunbridge Wells on Apr 13, 2021 22:51:22 GMT
Second closure was another suburban house based surgery run by a husband and wife team who were retiring. Again seems obvious that the delivery model was not sustainable and no replacements would be recruited into such a practice: www.berkshirewestccg.nhs.uk/media/3270/110-_pccc_pm_oct_peppard-road-closure-review.pdf There may be a case for capital investment in the remaining two surgeries in Caversham but I can't see any incorrect decision making in the two closures. Problem is there is barely any capacity in those remaining surgeries, patients are being sent to the other side of town for services, a big problem for the large elderly population of Caversham and Emmer Green, especially during Covid.
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Eastwood
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Post by Eastwood on Apr 13, 2021 23:05:06 GMT
Second closure was another suburban house based surgery run by a husband and wife team who were retiring. Again seems obvious that the delivery model was not sustainable and no replacements would be recruited into such a practice: www.berkshirewestccg.nhs.uk/media/3270/110-_pccc_pm_oct_peppard-road-closure-review.pdf There may be a case for capital investment in the remaining two surgeries in Caversham but I can't see any incorrect decision making in the two closures. Problem is there is barely any capacity in those remaining surgeries, patients are being sent to the other side of town for services, a big problem for the large elderly population of Caversham and Emmer Green, especially during Covid. So your campaign should have been to invest more in the remaining, sustainable surgeries rather than against closure of the failing surgeries.
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Post by Disgusted Of Tunbridge Wells on Apr 13, 2021 23:06:33 GMT
Ah, yeah, I get that, it's just it feels like Caversham is always an afterthought to Reading Borough, the relevant Labour MP (Matt Rodda) tried to stop the closures, but no councillors to be seen. They could have at least spoken to NHS Berkshire, but, no, they're very rarely seen for the most part when it comes to local campaigns (all of the councillors north of the Thames, not just the Labour ones.)
Labour seem to see it as too rich, the Tories or Lib Dems don't have really enough councillors to do something about it and didn't when they ran Reading Council in coalition around 10 years ago now, the Greens don't really have the base this side of the Thames to take them on.
Not a personal attack on the LDs or Greens, I approve of their administration on South Oxon where I am registered currently, but no party has really served Caversham well and we've decided it's time to turn that around.
That situation is precisely how some Independents get elected, and in many cases, deservedly so. Good luck to her. Thank you very much for your kind words, there is precedent with the Henley Residents Group down the valley, who started as a pressure group opposing overdevelopment in the town centre and hold the Town Council, all the district council seats for Henley and the Oxon CC seat as well.
It's not gonna be some big new party to start with, but we want to show Reading residents how Independent governance can be elected.
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Post by Daft H'a'porth A'peth A'pith on Apr 14, 2021 7:01:42 GMT
I entirely agree. Even more so in dentistry where the corporate sector has virtually taken over in many areas. However, it means that older patients in particular are often unhappy with the arrangements. It's the same with having larger regional centres of excellence. Could be argued that producer rather than consumer interests are being prioritised. I think it's about balancing consumer interests versus consumer preferences. Patients are better served by having a sustainable model. They don't like it as much as the unsustainable model right up until the point where all the doctors leave and they end up in a surgery staffed entirely by locums which they like even less.
And who decides consumer interests and how?
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Merseymike
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Post by Merseymike on Apr 14, 2021 7:17:53 GMT
I entirely agree. Even more so in dentistry where the corporate sector has virtually taken over in many areas. However, it means that older patients in particular are often unhappy with the arrangements. It's the same with having larger regional centres of excellence. Could be argued that producer rather than consumer interests are being prioritised. I think it's about balancing consumer interests versus consumer preferences. Patients are better served by having a sustainable model. They don't like it as much as the unsustainable model right up until the point where all the doctors leave and they end up in a surgery staffed entirely by locums which they like even less. It's only unsustainable because of the growing corporate model, though. And the expectations the public have of what doctors should do, which does not match what they are willing to pay. The faceless health centre may be sustainable, but it has a lot of drawbacks. What is presented as "progress" is often far from beneficial
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Merseymike
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Post by Merseymike on Apr 14, 2021 7:22:52 GMT
That situation is precisely how some Independents get elected, and in many cases, deservedly so. Good luck to her. Thank you very much for your kind words, there is precedent with the Henley Residents Group down the valley, who started as a pressure group opposing overdevelopment in the town centre and hold the Town Council, all the district council seats for Henley and the Oxon CC seat as well. It's not gonna be some big new party to start with, but we want to show Reading residents how Independent governance can be elected.
I think the truth is that a lot of local issues are not particularly tied to party politics, anyway.
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Post by greenchristian on Apr 14, 2021 8:40:42 GMT
I entirely agree. Even more so in dentistry where the corporate sector has virtually taken over in many areas. However, it means that older patients in particular are often unhappy with the arrangements. It's the same with having larger regional centres of excellence. Could be argued that producer rather than consumer interests are being prioritised. I think it's about balancing consumer interests versus consumer preferences. When did they stop being patients and start being consumers?
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Merseymike
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Post by Merseymike on Apr 14, 2021 8:44:50 GMT
I think it's about balancing consumer interests versus consumer preferences. When did they stop being patients and start being consumers? When the internal market was established.
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Post by Disgusted Of Tunbridge Wells on Apr 14, 2021 8:47:25 GMT
Problem is there is barely any capacity in those remaining surgeries, patients are being sent to the other side of town for services, a big problem for the large elderly population of Caversham and Emmer Green, especially during Covid. So your campaign should have been to invest more in the remaining, sustainable surgeries rather than against closure of the failing surgeries. Both have been hugely expanded reasonably,but Caversham is 36k as it is and we're heading for 45k. We're going to need a third surgery as those surgeries can only be expanded so much.
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Post by Disgusted Of Tunbridge Wells on Apr 14, 2021 8:49:57 GMT
Thank you very much for your kind words, there is precedent with the Henley Residents Group down the valley, who started as a pressure group opposing overdevelopment in the town centre and hold the Town Council, all the district council seats for Henley and the Oxon CC seat as well. It's not gonna be some big new party to start with, but we want to show Reading residents how Independent governance can be elected.
I think the truth is that a lot of local issues are not particularly tied to party politics, anyway. That's true, but some are strongly linked to internal party factions and an Independent alliance can get rid of that.
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Eastwood
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Post by Eastwood on Apr 14, 2021 15:39:13 GMT
I think it's about balancing consumer interests versus consumer preferences. Patients are better served by having a sustainable model. They don't like it as much as the unsustainable model right up until the point where all the doctors leave and they end up in a surgery staffed entirely by locums which they like even less.
And who decides consumer interests and how?
I think it's about balancing consumer interests versus consumer preferences. Patients are better served by having a sustainable model. They don't like it as much as the unsustainable model right up until the point where all the doctors leave and they end up in a surgery staffed entirely by locums which they like even less. It's only unsustainable because of the growing corporate model, though. And the expectations the public have of what doctors should do, which does not match what they are willing to pay. The faceless health centre may be sustainable, but it has a lot of drawbacks. What is presented as "progress" is often far from beneficial GPs are businesses, always have been. The same factors in practice sustainability apply in Scotland where the market element is much reduced. As GP partners in small practices reach retirement age the likelihood of recruiting replacements is strongly related to working conditions in the practice. Small GP practices are inherently less flexible for new GP partners than larger ones and less likely to attract applicants. GPs in converted residential units have three additional disadvantages. Their facilities are likely to be inferior to neighbouring practices, there is likely to be a larger buy in cost for new partners compared to a practice that rents from a health board or CCG and their facilities have more resale value so the retiring partner will be less willing to sell on the premises below market value. If no new providers are willing to offer the 1-2 GPs in a practice model (they're not, primarily because employees don't want to work in that model) then what the consumer prefers becomes irrelevant. It's about choosing what is in the consumers interests out of the available models being offered by producers. And in this case to looks like investing in the remaining practices has resulted in additional capacity which is greater than that lost in the closed practices and leads to a more sustainable and better service in the long run. Good result as far as I can see.
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Merseymike
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Post by Merseymike on Apr 14, 2021 16:02:39 GMT
I think the core point you make is 'what consumers prefer is irrelevant'.
Is that 'progress'?
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Chris from Brum
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Post by Chris from Brum on Apr 14, 2021 16:18:17 GMT
Consumer preference can sometimes be suboptimal, and is susceptible to influence by often invented "tradition", in this case nostalgia for the friendly neighbourhood GP with the personal touch, who would pay a house call at the drop of a hat and prescribe aspirin for everything.
Thanks, but I'll have my local health centre-based doctors anytime.
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Eastwood
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Post by Eastwood on Apr 14, 2021 16:34:42 GMT
I think the core point you make is 'what consumers prefer is irrelevant'. Is that 'progress'? What consumers prefer is irrelevant if no producer is willing or able to deliver it. You might want to plant your roses in Unicorn dung but you'll just have to make do with horse shit!
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Post by East Anglian Lefty on Apr 14, 2021 16:54:49 GMT
Ultimately the problem is that not enough doctors wish to become GPs, and that those who do do not particular want to be partners in a practice. It doesn't matter if there's a demand for traditional GP practices if the supply isn't there.
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peterl
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Post by peterl on Apr 14, 2021 21:08:01 GMT
I think people with long term heath conditions probably do benefit from seeing the same doctor. If you have a complex medical history, seeing someone who is used to you and you are used to probably helps. Similarly for people who have difficulties communicating for one reason or another.
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