But the point is they cost nothing.

Unlike GPs.

Thank God the state does not yet see providing them as part of it’s role.

Anything that is free, like the GP service, is not properly valued. There is no opportunity cost to not having it

Things that are free – in the sense of having no opportunity cost – include love, friendship and the beauties of nature.

I take it you don’t value them, either, Pagar.

First of all it it is impossible for me to comment on your situation because I do not know all of the circumstances – I was talking about general principles.

Also because I work for the NHS it does not mean that my family are not health consumers in exactly the way that your step-mother is.
As it happens my Dad was a type II who died (not that long ago) after suffering end organ failure associated with his diabetes (heart/kidneys) – so I do have some insight into the flip side of the coin from both a primary and secondary care perspective.

Monitoring of diabetes should involve hospital specialists (such as an opthalmologist to check the progression of retinopathy, etc) as well as a GP – so would you advocate that the location of hospitals should have to be more convenient as well?
But let’s say GP boundaries ARE extended – how far beyond the current 3 miles should we go?
If a patient cannot make it to the surgery and wishes to call out the GP round trips might end up at 10 or 15 miles (if Lansley’s daft proposals are implemented) – how many other patients will be disadvantaged by such arrangements because consultations are obviously going to take much longer (since the GP will be spending a great deal of his time on the road listening to radio 4 or perhaps Handel’s Messiah?).

Alternatives (to GPs) do exist for workers – for example it is estimated that around 2.5 million consultations take place in Walk-in- Centres (which deal with minor injuries or illnesses). NHS-direct also fields millions of calls, and can often provide sensible advice on self management of a whole host of self limiting conditions. A&E’s now see 19 million patients annually (I think that’s a third of the population by the way)

You conclude with an accusation – “but no, we patients should be damned grateful, apparently, that you and your ilk deign to serve as at all. And stack up problems for yourselves along the way”.
Obviously I cannot alter your perception of the motives of NHS staff but I can tell you that many of us feel frustrated that the consumerist mindset is very damaging to other patients – patients that may be less vocal because they are old and frail or very ill.

Or put another way I suspect there will ALWAYS be a percentage of people who are never satisfied if services provided by GPs, walk-in-centres, NHS direct, and A&E are still not enough for them – curiously the number of patients using these services is increasing year on year, now why is that I wonder, it’s not because we getting sicker that’s for sure?

The GP system might be slightly more effective if so many people didn’t take the piss.

But it has been designed so that people will take the piss. Anything that is free, like the GP service, is not properly valued. There is no opportunity cost to not having it.

So the bored OAP faced with the choice of buying some cream for their piles or going to the GP where they can have a pleasant chat with a nice young man and get the ointment FOC is clearly going to take the latter course.

Why wouldn’t they?

And the GPs?

If someone is willing to pay them in excess of £100 a year to listen to stupid people talking a load of drivel and for prescribing occasional doses of antibiotics, why wouldn’t they?

The answer would be to have a basic flat rate charge of say £10 for a GP appointment. The waiting rooms would empty in an instant and we could save half of the current cost.

Ha!

you’re not suggesting that people abuse a service they perceive as “free”, are you?

heaven forfend!

Consider the working type-2 diabetic, needing regular checkups, prescription renewals and likely to suffer various co-morbidities.

Currently rules say that she (my step-mother as it happens) cannot belong to the GP practice convenient for her, but one determined by the postcode she lives in.

If I could use one where I work, I would not always be demanding the first appointment slot of the day, but could be flexible throughout the day.

But no, we patients should be damned grateful, apparently, that you and your ilk deign to serve as at all. And stack up problems for yourselves along the way.

No, we need a democratic voting system first, i.e. PR.

She’d hardly have been made Home Secretary if she wasn’t an authoritarian. It’s been a prerequisite for the job since 1983.

John Meredith:
They could hardly be more authoritarian, could they?

Of course they will. The only thing that restrained them from being quite this authoritarian under Thatcher and Major, or even more so, was a Labour Opposition ardently sticking to a libertarian line. As with, for instance, the creeping privatisation in health and education, New Labour has only been able to get away with it because there was no Labour Opposition to seriously oppose it. It took a long time for the Tories to shift direction against authoritarian civil policies and and they have never put their full hearts into opposing authoritarian legislation (even ID cards – and why would they, why would they fight tooth and nail against legislation that used to the stuff of their dreams?).

What we will end up with is a Tory government that won’t hesitate to revert to type at the first opportunity, to use the first terrorist attack or upturn in crime figures as an excuse to drop libertarian positions that it has adopted purely for the sake of opposing the government; and a Labour Opposition that will (at least until its second defeat) be sticking to a Blairite line and reject any proposed return to libertarian civil policies as dimly as it views any proposed return to socialist economic ones, and so won’t be doing any serious opposing. We’re going to be completely screwed until at least 2014 (when, following that second defeat, Labour will hopefully start shifting back towards its traditional platform).

What, the Douglas Hurd who oversaw the introduction of Section 28?

loony libertarians would be celebrating that the UK was a free state, just like Somalia.

LMFAO!

Yes, we have government in that there is a central body that directs the central bank, law enforcement bodies and the armed forces, with varying degrees of efficacy. The same body also collects taxes that provide for roads and education and income benefits. Government is still in control of core activities, otherwise the loony libertarians would be celebrating that the UK was a free state, just like Somalia.

We don’t have a government that can make significant changes. That is not a result of the MPs’ allowances scandal; New Labour was an unambitious project, unreviewed when given stomping parliamentary majorities, and it has simply fizzled out.

Phil Woolas is the next former NUS President in line as Home Secretary, to follow on from Jack Straw and Charles Clarke. Unless Trevor Phillips or David Aaronovitch is given a peerage.

As Sunny notes, there is something terribly corrosive about the job of Home Secretary. When appointed, Charles Clarke was perceived as a decent managerialist, but in office, he turned into an authoritarian. To his credit, he appears embarrassed about it, but his personal failure confirms that there is something wrong with the Home Office. While we campaign for parliamentary reform, reform of that government department demands special attention.

The last civilised Home Secretary was Douglas Hurd 20 years ago, and the last progressive was Roy Jenkins, 33 years ago. So in the last 33 years, authoritarian Home Secretaries have held the office for 29 years. Even if it isn’t Woolas, my bet is that the appointment will be someone equally inappropriate.

Gordon should have done what Cameron did the other day and give a State of the Nation type address. Without grinning. Explain himself to the country, sound like he understands what the public are feeling, that he “gets it”, that he’ll punish errant MPs.

He should also subject himself to a phone-in on 5Live, as Cameron, Clegg and all the other party leaders have done.

Watching PMQs tomorrow will be like watching a slow motion car crash; someone needs to put Gordon out of his misery…

As to the GP question, well if you are fit enough to go to work then it sounds unlikely that you need to see a GP urgently (and if there was an emergency then go to A&E). Convenience medicine (in other words pandering to the worried well) comes at a very high price, and detracts from those with more serious health problems (cancer, multiple sclerosis, etc).
The GP system might be slightly more effective if so many people didn’t take the piss.