Sheffield GP Super Surgery Polyclinic NHS Healthcare Centre
Local / Sheffield Oct 19, 2009 - 12:18 AM GMTBy: N_Walayat
Sheffield, Britain's fifth largest city saw its own GP Polyclinic or Super Surgery open earlier in the year that aimed to fill the gap in delivering competent GP healthcare services, 7 days a week from 8am to 8pm, which after initial teething problems it is hoped that the Super Surgery will deliver quality and timely healthcare to many of the people of Sheffield that remain deprived of good quality healthcare.
The new Polyclinic is situated in the centre of Sheffield on the corner of Rockingham Street and Broad Lane, which allows any member of the public to walk in and see a doctor without the need to be registered with the health centre that offer a wide range of healthcare services. This is an important development as the traditional surgery staff have a procedural tendency to lose patients of their lists with the result that a patient attempting to make an appointment is told that they cannot do so because they are no longer registered with the surgery and have to complete a form and wait for a week or longer to be registered with the surgery. Off course, the GP surgery profits from the process of re-registering patients that the surgery themselves have removed so perhaps an Department of Health investigation is in order as to how widespread this practice is of generating extra revenues for surgeries from existing patients being forced to re-register.
The wide gap in the quality of healthcare is not just a case of patient experience but being borne out in the huge gap in life expectancy in the city between affluent wards and deprived wards as voiced by the Lib Dem Leader and Sheffield MP Nick Clegg :
"It is an outrage that social mobility has slowed, not increased, under the Blair-Brown years. It is an outrage that in Sheffield, where I’m an MP, life expectancy in the poorest wards is a full 14 years below the life expectancy of those living in the wealthiest wards. Your life chances are now set by the circumstances of your birth as never before."
This is inline with the Market Oracle's own research over the past 3 years as seen in the most recent on-going Market Oracle opinion poll of Patients experience of GP services across the city of Sheffield:
The difference in the quality of health care is not so surprising given that those that reside in affluent areas tend to be from the higher educated professional middle classes that would not stand for incompetent healthcare services and hence put pressure on the local PCT's to channel funds into these areas. Whilst those in deprived wards have a greater tendency to suffer in silence in the face of under resourced and a barely competent health service.
Further analysis of official data from the Office of the Deputy Prime Minister backs this up for Sheffield as the below table illustrates, that deprived wards (red) come bottom in terms of health care provision.
Whilst affluent wards of the city are in receipt of a series of new initiatives towards improving healthcare, patients of deprived wards are witnessing cut backs in the quality of service as illustrated in numerous local press stories, where GP's scrape the bottom of the excuses barrel for failure to deliver i.e. Dad's fury at GP snub.
Sheffield, as is the case with most large cities has suffered from a wide disparity in the quality of GP health services which is mainly split along the lines of the affluent wards and deprived wards which has come to be more widely known as the postcode lottery. However this lack of quality of healthcare was worsened by the 2003 GP Pay Contracts as the new contracts that came into force for the year 2003-04 saw GP Pay soar during the following 3 years by as much as 35% per annum. If GP Pay had grown in line with average earnings then the current average GP salary should be £68,000 against the actual average of over £125,000. The consequence of the surge in pay has resulted in a sharp drop off in the amount and quality of GP hours worked to especially those living within deprived areas of the country.
The reason why this amounts to a betrayal of patients is due to the fact that GP's fought tooth and nail during much of 2008 against the governments plans to implement Super Surgeries that would aim to provide 7 days a week, 8am to 8pm GP walk in services for patients. This brought the threat of real competition to what amounts to an old boys network operated by GP's that has seen GP Pay soar by as much as 35% per annum whilst cutting hours worked. If GP Pay had grown in line with average earnings then the current average GP salary should be £68,000 against the actual average of over £125,000.
According to the National Audit Office, the number of NHS GP's has increased by 15% from 26,833 to 30,931 since 2003, this is as a consequence of the GP contracts debacle, at the same time GP's are working on average 7 hours per week less, therefore a cut in productivity of 18% on a normal working week and thus on balance resulting in little improvement in patient healthcare despite a tripling in costs, with the National Audit office reporting am actual continuous year on year loss of overall productivity.
Since the birth of the NHS in 1948 your local GP was contracted to come and see you out of hours, but following the Labour governments incompetent GP contracts that they were perhaps hoodwinked into signing upto, GP's in effect pulled a trick on the government by means of on the one hand giving up £6,000 in pay for opting out of our of hours services whilst on the other hand being handed a £60,000 pay hike on top of which they would have earned if pay had risen in line with average earnings. Which has resulted in the debacle of NHS trusts being forced to fly in doctors from mainland Europe that has resulted in unnecessary deaths and cost.
The Labour government recognising the disparity in GP services in many areas of the country during 2008 embarked upon a programme of introducing poly clinics or super surgeries in the face of much resistance from GP's which included the British Medical Association (BMA) delivering a petition of more than 1 million signatures to Downing Street against the implementation of 150 ‘Super Surgeries'.The then Health Minister, Ben Bradshaw lashed out at the scare tactics accusing the BMA of "misleading and mendacious" behaviour in getting patients to sign up to the petition.
"I am not surprised the BMA has collected so many signatures, given the misleading and mendacious nature of its campaign.
"If I were to run a campaign making false claims that something terrible was about to happen, a lot of people would sign my petition too.
"We have received widespread anecdotal evidence of patients feeling pressurised to sign the petition as well as practices telling their patients blatant inaccuracies about local plans." he said.
MP's Blame Greedy NHS GP's for Expense Claims Abuse
British MP's were humiliated during May and June across all parties as public outrage and indignation oat the abuse of the MP expenses system with MP's responding with how MP pay has failed to keep pace with that of NHS GP's which is one of the key reasons as to why they had resorted to what amounts to legalised theft from the electorate.
MP - NHS GP Pay Comparison
The Labour government's recent ANY GP choice announcement is to be implemented during 2010 (after the next general election). On face value this smells of pure electioneering i.e. so as to buy votes from people fed up with an NHS that could not care less of the patients that it purports to serve. Typical experiences (especially in deprived wards) are disinterested GP's that treat patients as ATM cards to swipe in and out of surgeries so as to maximise surgery earnings, where it can take as many more than 5 visits before a patient receives a competent diagnoses, and then has to go through the Hospitals waiting lists where appointments can be arbitrarily cancelled without noticed and the patients made to wait several more months the consequences of which are thousands of unnecessary deaths and minor illnesses which result in permanent loss of quality of life for thousands more annually.
The new initiative will at least start to deal with the estimated 30% or so of incompetent GP doctors that will face real competition and therefore need to either start doing the job they are paid to do or lose ALL of their patients to more competently run GP surgeries. It will also enable private healthcare providers to introduce surgeries in more relevant locations for patients such as near the patients workplace or even within shopping centres or super markets.
Systemic Ms-diagnoses of Patients
Another report in a long line of studies into the lack of GP competence suggests that 15% of GP consultations result in misdiagnoses, where patients with serious illnesses are systemically brushed aside with near worthless shoulder shrug diagnoses, again the answer is to bring market forces to bear onto GP practices so as to ensure that there exists a real incentive for GP's to do a good job rather than go through the motions of performing General Practice which also extends to hospitals and other medical institutions where lack of competition feed the culture of disinterest in performing competent diagnoses.
Doctors were making mistakes in up to 15 per cent of cases because they were too quick to judge patients’ symptoms, they said, while others were reluctant to ask more senior colleagues for help.
While in most cases the misdiagnosis did not result in the patient suffering serious harm, a sizeable number of the millions of NHS patients were likely to suffer significant health problems as a result, according to figures. It was said that the number of misdiagnoses was “just the tip of the iceberg”, with many people still reluctant to report mistakes by their doctors.
There was a call for better reporting methods to ensure that each misdiagnosis was recorded and monitored properly.
NHS Needs Market Forces
A recent BBC opinion poll on the NHS revealed that 66% of the population fears deadly NHS infections which claims thousands of lives every year because of failure of basic hygiene measures. As many as 1/3rd of people polled would avoid surgery in an NHS hospital for fear of getting an infection. The NHS routinely KILLs tens of thousands unnecessarily every year, with the number estimated for 2009 put at 35,000 with many more thousands disabled.
It may now be lost in the mists of time but there was a missed opportunity during the Thatcher years with regards market orientated reforms of the NHS with a view to putting the patient first, unfortunately of the two remaining objectives for reform during Margaret Thatcher's third term of either reform of the NHS or local government taxation, Margaret Thatcher sought to reform local government taxation by means of the community charge which became to be known as the poll tax and resulted in the downfall of her premiership. Had she chosen reform of the NHS then how things may have turned out differently for both her premiership and for the healthcare of Britain.
It is a fundamental truth of today's NHS that the patient does NOT come first, this was made clear in an opinion poll amongst 156,000 NHS staff that found that patient care is not a top priority for the NHS.
The government having so far only paid lip service to market orientated reforms and that mostly on the supply side rather than demand side. True market reforms have never been an real option as that would in effect put the power in the patients hands rather than the doctors / consultants. The NHS needs to resemble the private market place where the GP or hospital have to compete to attract patients through a record of delivering good competent healthcare. The medical profession in response to such suggestions state that the patient is incapable of making the decision of choosing who is best to treat them. Instead today patients with serious illnesses have to do far, far more than consult a few league tables and GP / hospital reviews to get competent healthcare, routinely patients have to fight tooth and nail to get effective medical treatment that is denied to all but those with the loudest voices and persistence despite their serious illnesses.
Patients are demanding of a more competent and professional health service as the patient is more or less left out of the decision making loop. The key to successful reform of the NHS is to introduce market forces into the NHS, where the money follows the patient right from GP surgeries to hospitals. Thus the healthcare provider is forced to provide competent / good healthcare otherwise the patient will go elsewhere. More so in that GP surgeries / medical institutions reviews and rankings will funnel patients and therefore money towards the better providers of healthcare, and that in essence is the benefit of patient driven market forces. Rather than the present day system where GP surgeries and facilities are maintained whether or not they provide effective healthcare.
The NHS in its present form is a funding black hole with falling productivity that is sucking in ever increasing amounts of cash in real terms. Real reforms are urgently required otherwise Britain will be heading for a health service crisis as the GDP share of health spending continues to expand from 3.5% in 1948 to 8% today to above 11% by 2020, all without any real improvement in patient healthcare.
In conclusion the money MUST walk with the patient to ensure the patient receives competent healthcare. Otherwise the system is maximized to yield the most money for the least amount of work as we have witnessed with the GP contracts.
Therefore a form of health credit card system MUST be implemented where the Patient CHOOSES which hospital or GP surgery to PURCHASE healthcare from regardless of whether it be a government run NHS institution or a privately run hospital, only then will the patient come first and receive the treatment that they deserve rather than the current half way house that costs more and repeatedly fails to deliver the price of which is unnecessary illness and early deaths.
GP Choice Conclusion
It is my opinion that it is the objective of the Labour party to implement a policy of enabling real choice of GP practice for patients, however as the Poly Clinics have demonstrated it is something that if it begins to materialise will be met by much resistance from the GP establishment that are expected to embark up on an even more alarmist campaign of scare mongering than that witnessed during 2008. However the GP doctors also understand that it is highly unlikely that Labour will win the next general election and therefore there is little to be gained by forcefully objecting to the policy ahead of the next General Election.
Sheffield GP Surgeries League Table
My next article will seek to analyse Sheffield GP services from the data generated by the Department of Health funded GP Patient Survey conducted by Ipsos MORI. The questionnaire is being sent out on a quarterly basis at the rate of 1.4 million per quarter and expected to target a total 5.7 million patients during 2009 and therefore present an accurate dataset from which to generate a league table of Sheffield Surgeries. Recipients have also had the option of completing the survey online at http://www.gp-patient.co.uk
Source: http://www.marketoracle.co.uk/Article14321.html
By Nadeem Walayat
http://www.marketoracle.co.uk
Copyright © 2005-09 Marketoracle.co.uk (Market Oracle Ltd). All rights reserved.
Nadeem Walayat has over 20 years experience of trading derivatives, portfolio management and analysing the financial markets, including one of few who both anticipated and Beat the 1987 Crash. Nadeem's forward looking analysis specialises on the housing market and interest rates. Nadeem is the Editor of The Market Oracle, a FREE Daily Financial Markets Analysis & Forecasting online publication. We present in-depth analysis from over 400 experienced analysts on a range of views of the probable direction of the financial markets. Thus enabling our readers to arrive at an informed opinion on future market direction. http://www.marketoracle.co.uk
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