Doctors lists

According to a recent press report some doctors’ lists are out of date and inaccurate. This is worrying in itself, as doctors do need to know who they are responsible for and to whom they should provide treatment. It is also worrying for taxpayers, if it means that the NHS is paying doctors for patients who do not exist, or who have died, or who are counted twice by being on more than one list.

I raised the general issue recently about the delays and errors taking on board the death of an individual once it is properly reported to the state’s very own Registrar. This is one more feature of the system. The Tell Us Once addition to Registration, or the act of registering itself, should trigger the automatic updating of the relevant GP’s list. Individuals registering a death are asked to take in the dead person’s NHS card, and the death is registered in full knowledge of their full name, address and National Insurance number. This should make updating the doctors records in an age of fast computers very easy.

When the Coalition looked at the topic of doctors lists in 2010 they estimated 2.8m patients registered in error.

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72 Comments

  1. Bob Dixon
    Posted September 2, 2018 at 5:22 am | Permalink

    So who should be standing in the corner with the dunces hat on?

    • Lifelogic
      Posted September 2, 2018 at 9:14 am | Permalink

      Jeremy Hunt who did nothing but apologise for the endless failures of the appalling NHS. He just chucked more money at it for nearly six years for it to waste. He was good a apologising, he had lots of practice. But did nothing at all sensible to reform the basket case NHS.

      When I left the UK some ten years back then I think our family doctor kept claiming for all of us for years. This despite the fact that I had to complete all sort of forms telling the government I had left the UK and taken most of my taxes elsewhere.

      Simply no sensible system in place, not their money so no one cares.

      I would introduce a rule that says the doctor is only paid if the patient has actually visited the doctor at least once that year. After all any decent GP should be giving you a check up on weight, blood pressures, blood glucose and general blood liver function, cholesterol and the likes.

      The solution to the NHS is to get most people to insure and go elsewhere to lighten the load on them. This with tax breaks and no IPT. The complete opposite of the idiotic Hammond agenda. Then get more control and funds to the patient and make the NHS earn the money off them.

      • Lifelogic
        Posted September 2, 2018 at 12:39 pm | Permalink

        So Theresa May says she will not be forced into “agreeing compromises on her Brexit plan that are not in the national interest”.

        Well her Brexit plan is clearly not in the national interest even before any more compromises.

        Furthermore almost everything else May & Hammond do or support are not in the national interest either. Things such as the highest taxes for 40+ years, the endless red tape, the attacks on the GIG economy and the self employed, the 15% stamp duty and attack on landlords and tenants, the misguided restrictive banking regulations, the government’s bonkers energy policy, her lack of vision and her total lack of appeal to voters.

        We need a leader with a positive, real Brexit, lower tax, smaller government, far less red tape and a cheap non green crap energy vision. Not a robotic, socialist, disingenuous electoral liability with zero vision please.

      • Colin
        Posted September 2, 2018 at 12:40 pm | Permalink

        “I would introduce a rule that says the doctor is only paid if the patient has actually visited the doctor at least once that year.”

        Even better, how about if the doctor were paid a fee for each consultation, rather than a fixed amount per year for each person on their books?

        Maybe then people who work for a living would be able to see a doctor in the evening or at the weekend. They might even go back to making house calls.

  2. Iain Gill
    Posted September 2, 2018 at 5:40 am | Permalink

    It’s not as easy as it sounds, because the public sector has messed up IT and business change projects repeatedly over the years, and what is live now is crap built on crap.

    Assumptions you make are wrong, for instance not all national insurance numbers are unique, the state has issued the same number to multiple people on many occasions.

    It’s partly the unnecessary complexity in the rules the politicians keep forcing into the system, but it’s also the clueless public school dross the public sector keeps putting in charge.

    • Iain Gill
      Posted September 2, 2018 at 5:46 am | Permalink

      Oh and the government digital service has made things worse, poor web veneer on the same old spaghetti, and preaching to local departments that often know better than they do.

    • eeyore
      Posted September 2, 2018 at 6:33 am | Permalink

      Government might find it easier to keep on top of its responsibilities to us if we were easier to identify. We all have multiple identities with government, usually expressed in numbers – an NI number, an NHS number, an HMRC number, a VAT number, a Gateway number, a passport number and so on.

      All are different. There may be historical reasons for having them so, as well as civil liberties issues; nonetheless, I suspect great efficiencies would follow from our having a single number, birth to death, to identify us in all our dealings with the great bumf factory that is Her Majesty’s Government.

    • margaret
      Posted September 2, 2018 at 6:37 am | Permalink

      Quite, Transferring in and out of the system a few times a year , travelling between Pakistan , Europe, Italy , Bulgaria , Spain etc , then back again . Technology gets confused with patients movements .Sometimes it is a case of sense in , rubbish out.

  3. Adam
    Posted September 2, 2018 at 5:46 am | Permalink

    Doctors’ systems creak with incompetence & obstructions, causing patients to wait in patience behind a queue of ghosts in their records. They need simple efficiency.

    • Iain Gill
      Posted September 2, 2018 at 8:10 am | Permalink

      It needs simple buying power in patients hands, abroad I walk in off the street and see a GP there and then. Modest fee, subaidised for those in need, gives the provider the incentive to respond to the customers needs.

      • Adam
        Posted September 2, 2018 at 11:37 am | Permalink

        Indeed. Open choice enables healthy competition to succeed & thrive, & the worthless low performers wither into uselessness, where they belong.

        • Iain Gill
          Posted September 2, 2018 at 2:18 pm | Permalink

          Yes we are not allowed choice of GP often now, they are rationed like schools according to catchment areas and other nonsense rules.

  4. Posted September 2, 2018 at 5:53 am | Permalink

    In the 18th century the oldest trick in the book was to raise a regiment with the names of all the officers and men carefully recorded. The government, usually at its wits end over some crisis or other, would give a subsidy to the Colonel who, of course, would be well known for his attendance at court in a splendid uniform.
    Only when the troops were mustered for parade would the truth be known: the records didn’t tally with the numbers of soldiers!

    Of course this is totally different because we work in the 21st century and the NHS is the envy of the world.

    • Lifelogic
      Posted September 2, 2018 at 9:20 am | Permalink

      The envy of the world only according to the BBC and some politicians. Certainly not many who actually have to use it. It delivers delays, rationing, incompetence, misdiagnosis and often death. It can takes weeks just to get a couple of minuted with a GP.

      It is a monopoly insurance system that rarely pays out on claims but you have little or no redress. You just have to wait often in pain and unable to work until they perhaps give you the op. If you do not die first that is.

      • Iain Gill
        Posted September 2, 2018 at 2:20 pm | Permalink

        Correct and suffer random government treatment withdrawal, like they have in England with trigger finger and piles operations, meanwhile these options still available in Scotland and Wales, and indeed the rest of the developed world.

  5. HenaitchS Typist
    Posted September 2, 2018 at 6:05 am | Permalink

    I agree with all that. I would add, rather than put in the typical Remoaner ‘But’ , that Microsoft Windows and other similar devices/ companies provide an ultra speedy way of increasing mistake numbers and, that Doctor’s Admin include something of health knowledge, also does not decrease their likelihood of making typos. Updating lists is necessary, though a doctor’s onboard bio-computer is good at really knowing his patient.

    • APL
      Posted September 2, 2018 at 8:15 am | Permalink

      Let it not be said that some doctors aren’t above claiming for patients that don’t exist.

  6. Nig l
    Posted September 2, 2018 at 6:42 am | Permalink

    And in the meantime Theresa May is trumpeting umpteen billions extra and taxes will go up in the autum statement to pay for it.

    • eeyore
      Posted September 2, 2018 at 4:48 pm | Permalink

      Doctors get an average £136 per patient. On JR’s figure of 2.8m erroneous registrations that makes a wastage of £380m, or 1% of what Mrs May wishes to give the EU.

  7. Fedupsoutherner
    Posted September 2, 2018 at 6:43 am | Permalink

    I wonder if its the same with dentists. We are moving soon from Scotland back to England (hurray) but are finding it difficult to get an NHS dentist. I just hope finding a doctor isn’t a problem too.

    • graham1946
      Posted September 2, 2018 at 10:06 am | Permalink

      Don’t bother with NHS dentists – get a private one, they are not that expensive and I find are good.

      My wife and I have just had our six monthly check ups and scaling – total cost £110

      Last time he took an x-ray – cost £20 – first one for years.

      For this we get our teeth looked at, mouth inspected for cancer, teeth nice and clean and fresh smelling. When it comes to treatment, a filling is currently about £80 and I haven’t had one for at least 10 years. I reckon a couple of quid a week for top notch dental care is a bargain when compared with a meal out or a few drinks in a pub.

    • The Prangwizard
      Posted September 3, 2018 at 2:52 pm | Permalink

      Frankly I didn’t we had any these days.

  8. Student
    Posted September 2, 2018 at 6:51 am | Permalink

    It is amazing how incompetent the NHS system is. A friend of mine has recently started work as a Junior Doctor for his F1 and has just had his first pay day. Apparently out of his team/department of 30, 0 people were paid the correct amount. Doubtless more money will be wasted by needing to tell people about the mistakes and get all the payments redone correctly because of this incompetence. On a national scale this kind of regular mistake must mount to some large costs. I also doubt anything will be changed to prevent it happening again.

    I’ve never seen or heard of this kind of routine incompetence amongst myself and others doing internships at private companies.

    • Lifelogic
      Posted September 2, 2018 at 12:45 pm | Permalink

      “It is amazing how incompetent the NHS system is”.

      True but it is exactly what happens in an absurdly structured dire state monopoly. Not their money after all, so what do they care about efficiency or value delivered. They already have the patients’ money so they really do not respond to patients’ needs much either. To the NHS they are nuisance to be deterred or delayed wherever possible.

    • Iain Gill
      Posted September 2, 2018 at 2:22 pm | Permalink

      Same in network rail, same public sector uselessness.

      • Iain Gill
        Posted September 2, 2018 at 4:13 pm | Permalink

        Although in both the NHS and network rail it’s half the fault of crap management, but equally the fault of crazy union negotiation positions making things way more complicated than they need be.

        In both cases they need splitting up, and customers genuinely empowering.

  9. margaret
    Posted September 2, 2018 at 6:57 am | Permalink

    The thing is you see officially there is a Registered Accountable GP employed by the NHS . Then there areother NHS staff. It must be noted that any ‘Doctor ’employed by the NHS is not solely a clinician and practitioner. If we keep alluding to Doctors this, Doctors that , the whole NHS will fall down.
    Both the NMC and the GMC talked about shared practice and information. We cannot keep putting all the responsibility on these sometimes poorly equipped Registered medical practitioners. Many of these new and old Dr’ s are not capable of working on their own.For many years we have been told blindly how clever a whole group of society is . Ok they got to medical school , but they then in their practices cannot do everything. Many Nurses take more actual responsibility and make better patient choices. Many receptionists can make better sense of IT organisation then any Nurse or Medic. Many of the Medicine Management team can keep costs down and give quick insights into not so good drugs to use.I am appealing to everyone to simply STOP saying Dr.s for everything. They are not gods and some far from it.
    It may be a good idea if the medics now practised their own physiological tests ;,like taking the boring bloods etc and reducing a layer of people to slave for them , then they could keep tabs on who is coming and going ,due to engaging more and spending more time with the patient.The consultation, like Nurses consultations could be 15 mins and the patient satisfaction would be greater.
    ( I apologise to secondary care practitioners who already do most of their own work )

  10. A.Sedgwick
    Posted September 2, 2018 at 7:52 am | Permalink

    The broader issue is how many national insurance numbers are invalid e.g. illegal immigrants.

    • stred
      Posted September 2, 2018 at 10:47 am | Permalink

      And how many have more than one NI number with different names and claim benefits such as child allowance and tax credits more than once.

  11. Bryan Davies
    Posted September 2, 2018 at 7:55 am | Permalink

    “updating doctors records in an age of fast computer makes it very easy ” Correct, but we are dealing with the systems of the NHS and Government.Far better to apply layer upon layer of complex and usually unnecessary tax rules. Complex is what politicians and civil servants understand but simple is beyond them.

  12. Stred
    Posted September 2, 2018 at 7:56 am | Permalink

    I was until recently receiving letters from the county health authority addressed to French tenant who left the UK around 1994. I used to return them marked with the correct information but gave up.She will be too old for a scrape by now so perhaps they have given up..

  13. DUNCAN
    Posted September 2, 2018 at 8:06 am | Permalink

    Duplication and error are what keep the public sector budgets expanding year on year. Waste and error are an integral part of the State budgetary system. If waste and duplication was removed and efficient processes introduced public sector budgets would shrink and our feather bedded public sector would be out in force marching with their banners proclaiming how the ‘nasty Tories’ are slashing public sector spending.

    The public and indeed the taxpayer are being conned by an efficient public sector propaganda machine who constantly pump out pro-public sector, anti-Tory crap.

    Stop pandering to Labour’s client state and reform it. If that means widespread strike action then tough. Macron was elected to reform the French public sector and he’s bottled it. We need a proper PM to fight for reform

  14. JoolsB
    Posted September 2, 2018 at 8:07 am | Permalink

    John,
    Slightly off topic. I run a b & b business in Cornwall and had an Australian lady staying last week suffering with her sinuses. She asked me to book her an appointment at my doctor’s surgery which I did and asked the receptionist if she needed to bring a medical card or insurance with her and they said no, she didn’t need to bring anything. She was given an appointment that same morning, more than many of us locals can achieve, and had to spend a couple of minutes filling in a form before hand and that was it. My doctors is the only surgery in St. Ives which has to cater for all the extra millions of visitors we get throughout the year, many of them from abroad. How many of them are charged for their treatment I wonder? It seems we really are the International Health Service. It is disgraceful the way Governments of all colours are so generous with our taxes.

    • Iain Gill
      Posted September 2, 2018 at 2:25 pm | Permalink

      Yes but the NHS never treats sinus problems properly like the rest of the world, unless the patient is a GP and they know enough to go private to an ENT consultant.

  15. David Murfin
    Posted September 2, 2018 at 8:10 am | Permalink

    My wife is undergoing a range of hospital tests. She now on the ‘system’ with three different middle names.

    • hefner
      Posted September 2, 2018 at 2:24 pm | Permalink

      I have same problem, which fortunately is not a real one: it appears the NHS number is really what is used in communicating between surgeries, hospitals or external care services.
      Which could indicate that some streamlining (as proposed by eeyore, above) might help.

    • Iain Gill
      Posted September 2, 2018 at 7:13 pm | Permalink

      Yep they cannot cope with long names either

  16. Rien Huizer
    Posted September 2, 2018 at 8:22 am | Permalink

    Mr Redwood,

    Doctors are human. They make mistakes and some of them may be corrupt, especially when getting caught is rare.

    This would probably not happen in a “for profit” (yet strictly regulated) system.

    Also, the lack of a rsident’s register (ubiquitous in all countries once blessed by Napoleontic or Prussian government or trying to imitate it, like Japan, China, etc) makes it difficult to easily spot abuse or error.

    Why do you and your party support an NHS-type health system? Even in Communist China health care is not “free”. People must pay through the nose to stay alive once they have exhausted their benefits. And they will, plus they take great care to avoid treatment as much as they can. Anyone supporting the NHS should read Solzhenitsyn’s Cancer Ward. Maybe the future of the NHS if not properly restructured.

  17. Iain Gill
    Posted September 2, 2018 at 9:01 am | Permalink

    It’s also a problem in the way the NHS system is designed. Lots of people have multiple genuine addresses, and it’s is in their interests to stay on multiple GP lists as they would in any other developed country. And people want to see a GP near work and not near their home address. So the crap system encourages people to bend the rules. Together with the waiting lists for referrals being radically different in different parts of the country, and some treatments only being available at all in some parts of the country. Of course people are going to game crap systems like this.

    • Lifelogic
      Posted September 2, 2018 at 1:11 pm | Permalink

      Is the NHS system “designed”? Certainly not by anyone with many brain cells.

    • a-tracy
      Posted September 3, 2018 at 8:15 am | Permalink

      Iain, I thought there was an nhs SPINE now that records all patients throughout the UK? one list and not multiple practice lists?

      • Iain Gill
        Posted September 3, 2018 at 6:13 pm | Permalink

        you are only “allowed” to register with GP’s within a certain distance from your “home” address.

        you are stuck with the quality of GP’s within that distance, the waiting times available at those GP’s, and the waiting times and availability of the hospital services that the Clinical Commissioning Group (new name for PCT) chooses to use (the choice is all with the CCG and not you or the GP.

        there are obvious injustices, some rather dramatic like all trigger finger and hemorrhoid operations have been stopped in England but these are still readily available in Scotland and Wales. within England the different CCG’s have radically different policies on what they will fund, the differences between Bristol and Essex are dramatic, and not based on any patient need or choice simply based on the political fashions locally.

  18. acorn
    Posted September 2, 2018 at 9:37 am | Permalink

    Usual slagging off of the public sector again, with only six comments.

    Patient lists are kept up to date by NHSBSA for each practice in England, split between prescribing and dispensing patients. It shows: Practice name, Practice code, Practice address, Dispensing list size, Prescribing list size, Total list size, GP Count, GP Practice. Updated each quarter. GPs get paid £146 per patient so the government uses every source it has to find the Ghosts in the system. (Real GP income has dropped about 10% since 2010.)

    • libertarian
      Posted September 3, 2018 at 10:50 am | Permalink

      acorn

      The public sector is slagged off for the simple reason that like all huge organisations be they public or private they are in fact useless and not focused on their customer/user/patient/client . Computer say no

  19. hans christian ivers
    Posted September 2, 2018 at 9:40 am | Permalink

    Boris was embarrassing as foreign secretary to say the least, what would be like as PM?

    • libertarian
      Posted September 3, 2018 at 10:51 am | Permalink

      hans

      He was but to answer your question about 200% better than May and 1,000% better than Corbo

  20. Dr GP
    Posted September 2, 2018 at 9:52 am | Permalink

    So lets see. Sort the lists out. Spending comes down.

    So why are there waiting lists?

    Remain say migrants are fit and young and don’t use the NHS.

    Try a visit to any GP’s surgery, A&E in London and you will see the complete opposite

    The reality and remain’s claims do not add up.

    Equally your implied claim that there are savings to be had from an ‘accounting treatment’ is just as bogus.

  21. Anonymous
    Posted September 2, 2018 at 10:44 am | Permalink

    The NHS is the new industrial wing of the Labour Party and the BBC are Soviet Central Broadcasting.

    The 70 Years of NHS ‘all employees are angels’ has been unrelenting.

    • Iain Gill
      Posted September 2, 2018 at 3:01 pm | Permalink

      Yes despite many proven cases of hospitals being little other than killing machines.

  22. Den
    Posted September 2, 2018 at 11:21 am | Permalink

    I am amazed in the days of IT and software development that the procedures suggested is not already active. Alas, such is the way of the Public Sector, way behind the times because of, I suggest, the restraining influence of the Civil service and their Unions. When are we going to elect Ministers who can actually take full charge of their departments and push the Sir Humphrey’s into solely an advisory role?

  23. Lorna
    Posted September 2, 2018 at 11:25 am | Permalink

    It is a shame that this relatively simple updating is not taking place
    Patients should have a legal NI number and the information should be registered by surgery and immediately copied into Govt database
    Illegal numbers should be immediately highlighted
    The confusion regarding registering a death is positively archaic.

    • Iain Gill
      Posted September 2, 2018 at 3:03 pm | Permalink

      As above it simply could not be done in the way you imagine.

  24. Denis Cooper
    Posted September 2, 2018 at 11:47 am | Permalink

    Off topic, my wife is not at all pleased that the Andrew Marr programme has started up again because she knows that it usually has a very bad effect on my temper, and indeed today I was left irritated that two senior Tory politicians were apparently unaware of the very limited value of most of the new trade treaties which are being negotiated.

    The transcript is not yet on the website but we had:

    a) David Davis talking up the possibility of the UK making a trade deal with the EU like CETA, the deal that Canada has made with the EU which despite all the hype will be worth a one-off addition of less than 0.4% to Canadian GDP, which is the side where we would be, and more or less nothing for the EU; and then

    b) Liam Fox arguing that the WTO terms for trade cannot be that good because otherwise the EU would not have wanted to negotiate TTIP with the USA, a trade deal which will also be worth a one-off addition of less than 0.4% to GDP on both sides.

    Table 16 on page 46 here:

    http://trade.ec.europa.eu/doclib/docs/2013/march/tradoc_150737.pdf

    Projected off-one percentage boosts to GDP, depending on the ambition of the deal:

    For the EU 0.27 – 0.48; and for the US – which is where we would be – 0.21 – 0.39.

    I don’t say that an extra 0.4% of GDP would not be worth having – after all we are glad when the UK economy grows naturally by about that amount, which it typically does over a couple of months – but rather than showing the inadequacy of the existing WTO terms of trade with the US, as Liam Fox argued, it shows the exact opposite.

    JR, please can you explain why Tory politicians in particular are always so prone to vastly exaggerating the importance of special or preferential trade deals to our economy, whether that is the EU Single Market deal, or CETA or TTIP or TPP?

    Surely it must be obvious that if world GDP is now expanding faster than world trade, as claimed, that need not be a worry as it probably just means that there has already been a lot of trade liberalisation and we are now getting into diminishing returns?

    • Denis Cooper
      Posted September 2, 2018 at 1:27 pm | Permalink

      Now on the same newspaper website we have Theresa May saying that she is sticking by the crazy Chequers plan and will make no further concessions, that is unless she thinks they are in the national interest, while Michel Barnier says that the Chequers plan would destroy not only the EU Single Market but the whole of the European project, and also a Tory MP says that he can no longer bear the humiliation of the Chequers plan and so now instead he wants to do what Michel Barnier suggests we could do and accept continued uncontrolled and unlimited immigration from the EU, and obey rules handed down from Brussels, and pay annual contributions to the EU to earn the right to run a chronic massive trade deficit with them, and all of this silly nonsense is founded on the carefully nurtured twin delusions that the EU Single Market is crucially important to the UK economy,
      an idea which Michel Barnier himself knows is not true but Liam Fox is prepared to propagate, and that because we are choosing to exercise our treaty right to leave the EU it is down to us to solve any problems that may cause for remaining member states, and in particular the Irish Republic, an absurd position which Theresa May gratuitously, and foolishly, publicly accepted in her Mansion House speech.

      • Denis Cooper
        Posted September 2, 2018 at 4:55 pm | Permalink

        https://news.sky.com/story/michel-barnier-trashes-theresa-mays-chequers-plan-for-brexit-as-end-for-eu-11488846

        “Michel Barnier trashes Theresa May’s Chequers plan for Brexit as ‘end’ for EU”

        And what’s more we could not be trusted to collect customs duties on behalf of Brussels, even though we’ve been doing it since 1973; and that also raises the question of why the EU should continue to trust us to keep the dreaded chlorinated chicken and other goods which the EU regards as illicit out of Northern Ireland, so that it could not find its way across the border into the Irish Republic and so into the rest of the precious EU Single Market.

        These are your lovely friends in the EU, Theresa May; this is what they really think of us, they regard us with quiet contempt, even as they go huggie-huggie and kissie-kissie with you, and flatter you with a gift of a customised football shirt …

  25. Marjorie Baylis
    Posted September 2, 2018 at 12:32 pm | Permalink

    In the last 11 years I have made two moves between areas and therefore surgeries. I haven’t been issued an NHS card for either of those moves… so I am not sure that the surrendering of an NHS card is relevant these days…

  26. sm
    Posted September 2, 2018 at 1:06 pm | Permalink

    In the 1990’s, hospitals were starting to cut back on admin/clerical staff to cut costs (oddly, in my experience, they didn’t cut chief executives’ pay). This has caused on-going problems of the kind you mention.

    • libertarian
      Posted September 2, 2018 at 7:23 pm | Permalink

      sm

      There are more than 250,000 admin staff in the NHS, its not staffing thats the issue its the incredibly bad systems and procedures

    • a-tracy
      Posted September 3, 2018 at 8:10 am | Permalink

      sm – all businesses cut back on costly admin staff as computer systems improved, electronic billing, e-mails, cloud storage, electronic payroll etc. all came into the mainstream. Most businesses did a much better job of managing this change and putting their resources into frontline staff instead of back office staff.

  27. Nigel Seymour
    Posted September 2, 2018 at 1:43 pm | Permalink

    So, let’s find something to kick folks…duhhh Oh I know, the NHS! I could tell you about me and my family over the past couple of years. Never had a problem them. Perhaps nearly all Labour (far) left wing socialists need to keeping whinging about the NHS as they will never ever win a GE in the next 10 years. Majority of UK voters fully support the NHS and would readily accept a 1p tax increase to help fund it! Anybody who doesn’t like the UK ‘system’ should perhaps emigrate to Argentina? Venezuala? Eastern Europe? Brazil?

    • Iain Gill
      Posted September 2, 2018 at 3:06 pm | Permalink

      No the propoganda is wearing thin.

      As more people have travelled and seen how much better care is in the rest of the developed world this argument has died in all but the lazy journalistic and political class.

      Spent a lot of time in NHS waiting rooms and there is almost universal disgust amongst the patients you only have to listen.

    • fedupsoutherner
      Posted September 2, 2018 at 4:21 pm | Permalink

      Nigel, It’s not about kicking the NHS. It’s about sorting it out so that money can be spent on health care and not mistakes and ensuring people then get the care they need quickly and efficiently. For goodness sake, we all know our health care system is better than in many countries but why put up with waste when that money could be spent better? Just saying it is better than others is not good enough when billions are being spent. It’s because of your attitude it is getting progressively worse.

      • Iain Gill
        Posted September 3, 2018 at 7:43 am | Permalink

        No most of us want to kick the NHS.

        Just like woolworths was a loved institution it didnt keep up with the times and evolve to meet customer needs so it had to go. The NHS is just the same, they hype on the brand is hillarious considering how bad the delivery of actual services is. It should not be kept going just because it is state funded.

        Real power needs handing over to patients, the NHS needs to morph into a state backed insurance company, and the state needs to get out of owning and rationing providers of care.

    • a-tracy
      Posted September 2, 2018 at 6:27 pm | Permalink

      I support the NHS Nigel but it doesn’t mean they have my blind support and that I don’t expect good systems to support our front line care givers.

      John, you could make a start by telling each GP if they have not seen a patient in the last three years they need to bring them in for a visit with their nurse for blood pressure, a blood test, weight/height to update their records accurately. Surely the Spine would throw up if someone was using two GP clinics? If they don’t see them over the following year they won’t be paid for them on their register.

    • libertarian
      Posted September 2, 2018 at 7:26 pm | Permalink

      Nigel Seymour

      Speak for yourself. I won’t pay a penny more for the NHS , its a dreadful organisation that offers incredibly poor outcomes

      I notice you listed some obscure countries , why didn’t you list the 18 countries which the World Health Organisation say are vastly better than the NHS?

      Maybe you should get out more and try the health services in France, Switzerland or even tiny Singapore ( 6th on WHO list)

  28. mancunius
    Posted September 2, 2018 at 2:26 pm | Permalink

    Not only do the patients often not exist: in the local GP practice which proudly claims to have 14,000 patients on its register (in an area boasting a total population of 11,000 people), recent frustrated attempts to see a GP have led me to the conclusion that its doctors don’t exist either.

  29. Iain Gill
    Posted September 2, 2018 at 3:08 pm | Permalink

    Any organisation which puts up posters telling customers to go away is in serious need of sorting out.

  30. Lynn Sharp
    Posted September 2, 2018 at 4:24 pm | Permalink

    About 3 years ago we moved from one Health Authority to another so obviously had to change GP. It took over a year for our notes to be electronically transferred from our old GP to our new one – we even phoned our old GP a few times to see what the delay was – can’t remember all of the answers we were given – things like understaffed, long backlog etc -I did ask surely they don’t get that many people changing GPs especially as GPs with places are hard to find and was told I would be surprised…..
    Now I know they were still getting paid [which tbh I did suspect] it all becomes very clear – can you ask the new Health Minister to look at this please? TIA.

  31. Ken Moore
    Posted September 2, 2018 at 11:02 pm | Permalink

    This is a scandal as is foreigners fraudulently applying for cards that guarantee free NHS treatment. Apparently the system is so inept that it doesn’t check that NI numbers exist or flag up warnings when multiple applications are made from the same address.
    This country is just falling apart there is a chronic lack of competence at all levels.

  32. Stuart
    Posted September 3, 2018 at 8:56 pm | Permalink

    John,
    I am of the opinion a complete review of the NHS is required.
    My wide is a GP of over 30 years who will retiring from a city practice, due in part to exhaustion, next year just shy of her 60th birthday. She recently qualified as a councillor and volunteers her services one day a week at a city centre facility that struggles to raise adequate funding to serve its community’s needs.
    Fifteen years ago we spent two years in New Zealand, where my wife was took over the running of a single doctor rural practice serving a list of 2,800. In cooperation with two other similar practices approximately fifteen miles apart from each other, a condition of the contract was she also covered out of hours on the basis of a one-in-four (the three practices had four full time doctors between them, with my wife’s practice utilising the ‘spare’ doctor one-and-a-half days per week. This doctor was paid 60% of any income generated – see below).
    We lived 5 minutes walk from the surgery and would often have a knock on the door from a patient who was worried, etc.
    As well as out-of-hours, my wife was also a first responder for such events as RTAs. The surgery also catered for minor ops, with visits from the local saw mill a regular occurrence.
    My wife often asks why we came back (since she was the main bread winner) as she left behind an environment whereby she had 15 min consultations, to what she often describes is a madhouse – most of which is government driven. Given what she went from in NZ, and the additional commitments, to a practice here in the UK with a much higher doctor to patient ratio and without out-of-hours, there is (was) no comparison.
    So what, or why should this be the case?
    Firstly, there was a payment structure, which was the principle funding stream. However, anyone who earned less than the average wage, the fee was reduced by as much as 75%, unless if the visit was deemed an ‘accident’, in which case there was no charge (but a form had to completed during the consultation). Other funding from the government came in the form of a nurse contribution, rural status, and patient number/mix (though not significant), and indirectly through the specimen route (testing companies were private and as such were desperate for your service, with turn-around significantly better than here in the UK). As my wife’s practice manager, I also took it upon myself to review the list which I reduced by circa 10% to reflect a more realistic number.
    Yes, on leaving we had a debtor’s list of several thousand dollars, but as in any business, there is always an element written off, the challenge is obviously to reduce this to zero… but at the end of the day, in tune with my wife’s wishes, a pragmatic approach is always the best route.
    Did the charging keep anyone from attending the surgery. We only had evidence of one such incident… and you’ve guessed it, a wealthy farmer kept putting off a visit, partly due to the $40 fee (£12.50) at the time and ended up losing his life.
    I should add my wife never entered the medical profession to make money. She started life as a nurse at one of London’s medical teaching schools. After spending time on the wards, she realised she was probably more than capable of becoming a doctor, and had to do six years at university, the first of which was a pre-med course… something no longer available, I believe, which is a real shame as the one fit all sizes three As at A-level is not for everyone.
    I know (or least when we were there) New Zealand had its own unique problems (retention was a big issue as newly qualified doctors would leave to come to the UK where they could earn two or three times what they could in real terms), but our experience of the health system in New Zealand from my wife’s perspective was very positive when compared to the UK.
    As a postscript, since our return to the UK, the practice my wife is a partner in, has suffered, no doubt like so many others, whereby four or five of the partners have retired and it has only been possible to replace half of them. With the local Trust forbidding them to shut there list, supply and demand has been out of kilter for some time. Where she used to see on average 26/27 patients per day in NZ, at times now, she is dealing with as many as 45 in a day. Think about that… 45 people, and with the aging population, many present with complications.
    My wife’s policy has always been to put her patients first. She will often be sat up in bed, late, completing her emails and letters.
    I started by saying my wife will be retiring next year, which I know is going to be a wrench both for her and a large number of her patients, but she is worn out… partly due as a direct consequence of our ‘beloved’ NHS, which because of its miss-management has probably cost it 10% of her work life if not more.

    • Stuart
      Posted September 3, 2018 at 8:59 pm | Permalink

      Apologies, my wife is a counsellor and not councillor.

  33. Lindsay McDougall
    Posted September 4, 2018 at 11:25 pm | Permalink

    The medical profession should be denied ANY increases in remuneration until they sort this out. And should not the CEO of NHS be fired?

  • About John Redwood


    John Redwood won a free place at Kent College, Canterbury, He graduated from Magdalen College Oxford, has a DPhil and is a fellow of All Souls College. A businessman by background, he has been a director of NM Rothschild merchant bank and chairman of a quoted industrial PLC.

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