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Everything posted by uro_who

  1. Unsurprisingly I totally agree. A medical secretary is actually an extra member of the team (a PA rather than typist) so the letter gets the her up to speed, who will then ensure that the patient gets that extra OPA with cardiology before the operation date, books a bed, looks out to remind me when the serum rhubarb result is back and then ensures that the patient is listed for admission, booked on our theatre scheduler, pre-clerking booked and finally appears on an op list. At the last minute she reminds me that the patient is the the boss of the local engineering firms mum. Very rarely actually do they type these days. I love technology, when I'm not being a surgeon I'm the MD of a medical IT company part time, I'm always searching out the next bit of tech to make the job more efficient but in the busy outpatient department I simply haven't found anything precise enough to do the job, yet. The biggest problem with VR is not that it will not recognise cystectomy or hypothalamo-gonadial axis, its brilliant at that sort of thing but its the little words like 'not' that seem to be missed out just a bit to often. I'm pleased to tell you that the lump we removed is cancerous. Is very different from the alternative and my PA will have the histology result when the letter is typed, India will not and the computer (at the moment) will not either. I remain however open minded, not some sort of machine breaking Luddite but a practical pragmatic surgeon who is looking for the best and most efficient way ahead for the patient, NHS and tax payer. Its not mindset or fixed ways that gives me my opinion but the misery of having tried all this sh1t and seeing our departments and patients suffer. Edited for typing errors!
  2. Er, because it took 18 years to train a consultant surgeon and the NHS pays about £45 per hour, whereas a secretary takes a couple of years to train and is on £15 per hour. Should the doctor be treating patients, removing cancers etc or typing? The average medical letter is a page an a half of A4 which is equivalent to halving an outpatient clinic or doubling waiting time for patients to 32 weeks. And as for asian doctors I'm afraid you're all out of date. I have a colleague who is Indian, trained in the UK for 10 years and when it came to getting a consultant job he went back home. The absolute salary (converted to pounds) was higher than in the NHS and the cost of living and room for economic expansion made it an easy decision. The Daily Mail 'UK doctors the highest paid in the world' stories are total rubbish. I've felt for years that unless we do everything we can to build up our manufacturing (in the broadest sense, industrial, software, technology) we'll have UK graduates moving to China and India to work as taxi drivers, nannies, cleaners one day.
  3. This is spot on. Many retired people are paying huge amounts in to private schemes not realising that they at paying for the equivalent of major surgery every couple of years. It always amazes me that people are happy to spend £5000 on a cruise but worry about private care costs. It's also incredible when I see people in my bursting NHS clinics with 5 month waiting time who eventually admit to having private cover but not wanting to use it in case the premium goes up! I note that for once BUPA didn't blame the doctors, they usually do, despite the fact that since the last monopolies committee review, fees for doctors have remained capped. That was 1991. So not even a reflection of CPI for the last 21 years. Pay as you go is the way ahead. BUPA are the worst insurer to deal with in my experience trying to wriggle out of covering their patients. if you are not one of their partners (ie accept their fixed fees and not charge a supplement to their patients) they lay it on super thick telling the patients that they could be thousands and thousands of pounds out of pocket despite the fact that for most it would be a couple of hundred quid after a 4 day stay for surgery and all would be informed before receiving care anyway.
  4. That's how the better hospitals used to work, for the wealthy, the poor had to go to charity hospitals often evolved from the poor house and run on donations. One of the reasons for the NHS was to provide equity of care for all. You have ingeniously re-invented the failed model of 59 years ago!
  5. Can you do the same for consultants, GP's have a different scheme from consultants, nurses etc. I agree with this as a part motivation! Most doctors however are much more worried about their pension than their salary so if you wanted to wind them up its certainly the right button.
  6. There is a list at the DoH which last time I heard had 28 hospitals that they wanted to privatise. The feedback from private providers is that they are happy to take over those hospitals and the others when the NHS pension scheme and national pay have gone. I heard this 3 years ago and have watched the news unfold since. This is about the privatisation of the NHS as much as about a great chance to bully more cash back from healthcare workers.
  7. As I said above, quite simply that the deal is only 4 years old. The scheme is in great shape. We understood the need for public sector reform and felt it best to just bite the bullet. Before all this started we urged Hutton in our formal evidence to review the schemes together to ensure equity across the public sector. This, he said was too complicated.So we now have a situation where judges will be paying 1.28% for a 20th accrual 50% final salary scheme, desk driving policeman can retire at 50. But surgeons etc pay nearly 15% for a 60ths scheme and cant retire until they are 68 (probably 70 by the time I get there). We feel that our scheme is reformed Sustainable Good value for money funded entirely by contributions promise that all increases will be met from scheme members Agreed in 2008 an ratified for the above in 2011 So the NHS pension changes are an opportunistic theft. Our aim is for the government to sit down and have real negotiation and to put the damn effort in to providing equity across the public sector. The 'strike' is not really a strike. We are seeing emergency and urgent patients only for 1 day. Most hospital work fits that anyway and because most hospital doctors can't handle being idle we have mostly booked many more of these cases to make up for the cancelled ones. Hospital doctors are furious however and if this warning shot doesn't work it may well be escalated. Cheers (am I allowed to say that?)
  8. Nope say 20 patients weren't seen on Thursday afternoon. Normally I do admin on Friday afternoon. I'm now going to see the patients on Friday afternoon instead and the 4 hours of admin that still needs to be done will be done by me on Saturday, at home, with no hours claimed. I've not done any work on Thursday afternoon but I've shifted two things around, worked on Saturday morning instead and not claimed any extra money. The works still been done just postponed. Does that make sense? Edited, I think I misunderstood you, I said cost neutral, they are being paid in advance for the shifting the work to another time, its not extra work, but its not less work so no loss in pay.
  9. No the letter signing, results checking, dictating outcomes, letters etc will be taken home and done in the evening or weekend and they will use the time that was for that in the working week to catch up. This will be cost neutral for the tax payer. No spin, we are not politicians but standard issue human beings like you. We are being vilified and set up, marginalised, lied about, do you see a pattern in that manipulation?
  10. This is total nonsense! £25k of my salary is deducted per year (excluding the 50% I get taxed on the rest of it). Look at it another way. I pay in £25k per year for 40 years. I then retire and live for 20 how much can I take out? As for effort I calculated the average person works 76,000 hours during their working life. I've worked 78,100 so far and I'm 44. Do you really think when I had 16 years more to go after all that its far that the government unilaterally says, hold on we know what we agreed 4 years ago but now you need to work for 26. Do you think I'll make it? And do you think you'll make it if I operated on you in the middle of the night? I don't fly a desk!
  11. Nope some doctors are being paid in advance for an agreement that they will catch up the work in their own time. Its payment for advance work. Anyone who refuses will be losing pay. What's more, most of us are working just seeing urgent or cancer cases rather than routines. The second sentence is spot on however.
  12. Might I contribute a fact or two? Doctors are paid by the state. !00% of our earnings are from taxpayers. We recognised that the country was stuffed in 2008 and sat down with the politicians, treasury actuaries and all the health unions and renogotiated the NHS pension scheme (which we are in). We (doctors, nurses, porters etc.) accepted a 40% increase in our contributions. A retirement age increase to 65. And a very important deal that if the scheme ever came out of the black that only the members would contribute the extra cash needed. This was reviewed in last year by the all party public accounts committee and said to represent good value for the tax payer and 'sustainable into the future'. 25% of my salary is withheld and used to pay existing NHS pensioners. this works so well that after the pensioners have been paid there is £2billion left over that the treasury just wastes (sorry spends). You don't believe the spin on house prices, don't accept the spin on this.
  13. As some are suggesting methods of building land expansion I'll outline my plan! Most hamlets and villages grew heterogeneously at cross roads. Its why new town blobs of almost identikit slave boxes look so weird. Solution: Allow planning permission for self build houses on a proportion of rural cross roads. Each house must have a different architect / plan so that they are different. We could stash untold houses all around the country using this simple principle almost without noticing.
  14. Me too. I had to look it up. Thought to come from Pall Mall which was named after a forerunner to croquet. First used for covered arcade in 1967. If used in the first sense it means shaded avenue for promenading and some of Buxton's streets are like that. I have never however heard it used before in that sense only the Americanised 'shopping mall'. Its a shopping arcade, High Street, Shopping Centre (not Center). Keep Britain Angle, Saxons go home.
  15. I'm not sure of this but you might be confusing undergraduate and post graduate study. Doctors across Europe usually have 5 years of preclinical and clinical training. Followed by post grad training. I'm a surgeon and had 5 years undergrad and then continued as an apprentice basically with multiple post grad exams and assessments making a total of 20 years training, although paying tax for 15 years. GPs in the Uk have a 5 year undergrad period, two years as foundation doctors and then 3 years on a GP traing scheme. So there, 10 years training, making them more than 10% better than your average French GP (only a joke, honestly)
  16. Its an old paper and its been posted before but a great bit of work. Graphs for the UK ireland etc. All modelled but the curves fit nicely. With all this more downsizers than upgraders news it seemed right to post the link again. Apologies if I'm boring you! http://www.federalreserve.gov/pubs/ifdp/2005/847/ifdp847.htm The a downloadable pdf to send to your friends, admirers and recalcitrant nagging family members.
  17. In most hospitals cleaning and feeding the patients are contracted out to facilities management companies like ISS/sodexo etc,. They traditionally employ recent immigrants from Pakistan/Poland etc. As NHS funding to hospitals is cut (all of the increase in funding you hear about is in efficiency gains of 5-6% per year) many Trusts are putting the squeeze (in their usual amateur way) on the FM providers. No doubt this has lead to the new wheeze of 'what could be cheaper than minimum wage recent immigrants?'. Ah yes, free unemployed people. Look on the bright side, at least the PFI bondholders are still getting their cash.
  18. I've only tested my 'landlord', Burton bridge top dog stout, bass, 6x, wherry, black sheep etc. to 3 pints as I normally only drink 1/2 pint or a pint. No hangover whatsoever. Avoidance of sugar in brewing and nitrogen in serving makes a big difference, as does being able to leave the beer to ferment for 10 days at 18 degrees rather than having to push it at a higher temperature for 3 to get it out of the brewery. The kits are good (the Wherry after 10 weeks is indistinguishable from a pub pint) but all grain / full mash brewing is just amazing, much better at 15p a pint than the £3.30 pint in my local pubs. Its like cooking, I have to go to a damn good restaurant for the food to be better than home (and therefore hardly bother), same with the beer really. Watch out, wait for home brewing to be outlawed or heavily taxed for 'health reasons'. You read it here first!
  19. The easy answer is to brew your own. I'm drinking a wadsworths 6x clone I made 5 weeks ago at the moment. Grain, hops, yeast etc £4.72 for about 35 pints. Nicer than any pint you'll get in the pub. Once made you've got about 4-6 months to drink it. Although in my experience once your friends discover that home made craft beer isn't the same as Boot's homebrew circa 1985 it doesn't tend to last the full 6 months.
  20. Can I suggest you search for ' a survey of public spending in the uk ' by the IFS its a good document. the details of pension costs come from the Huttom report which is googleable. I tried to attach them but they're too big.
  21. Yes and we lobbied for Hutton to do just that, reform the schemes one by one. Some had already been reformed and others hadn't. Too complicated said Hutton. Now we are going to get a situation where I'm paying 14.5% contributions for the same deal as a civil servant on 6.5%
  22. He's already been injected with cash by the government. His last outfit the work foundation went bust, couldn't quite keep up his £180,000 pa salary. http://registrarism.wordpress.com/2010/11/19/interesting-acquisition/ Now oddly enough he's been made Chairman of the new civil service pension scheme which is owned 25% by him and the other administrators! http://www.bbc.co.uk/news/uk-17890248 I tell you this pensions stuff is propaganda! Don't listen to what they say watch their actions.
  23. Its in the Hutton report so it must be true! The average NHS pension is £4,200 not 20K
  24. I've read the actual report although not for a while. Its not stated in the report. Maude said it was including the changes but the mandarins that compiled the report (as Hutton's only qualification was running several failed business and has as much grips of economics as me) stated categorically that it was with no changes. This was all 12 months ago.
  25. Who says its a pittance. Not me. What I am complaining about is that I pay in to a scheme which is £2 billion a year in profit and my contributions are going up and I'm going to be given less back. Anyone who wants to earn the same as me is quite welcome to train for 20 years, pass a load of post grad exams, take all of the real stress of telling people they are dying or doing you best to stop them dying. You only need apply.
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