Monday, January 29, 2007

And in further news...

Patients will be able to boycott opt out of the uploading of their medical records.

Report in the Register here.

Well, that is a result.

The Information Commissioner's report can be found here. Astonishingly for a governmental report, it is only 4 pages long.

I especially like the following excerpt, with my own highlighting:

NHS Connecting for Health has confirmed that people living in areas
introducing Summary Care Records will be contacted before any of their
medical records are uploaded on to the NHS Care Record Service. They will be given information about their options to limit the future scope of the
information on the Summary Care Record or the option not to have one at all and they will also be given the opportunity to make arrangements to view their information before it is uploaded. They will have a specified period before
their information is uploaded to consider their options.

The initial upload will take place without explicit consent on the specified date unless you choose to utilise one of the options mentioned above. Explicit consent is only one of the conditions for processing sensitive personal data referred to in schedule three of the Data Protection Act 1998 and NHS
Connecting for Health are confident they are able to meet the requirements of
one of the other conditions.

Once the basic health information referred to above is uploaded on to the
NHS Summary Care Record:
• you will be able to choose to remove some or even all of the
information initially uploaded
• you will be able to keep the uploaded information but make the
Summary Care Record invisible.

Any further information will not be added to your Summary Care Record
unless you have agreed to it in discussion with your GP. The
Commissioner understands that these types of discussions will take place
at the next consultation you have with your GP following the initial upload.

Later on, you will have another choice. Instead of the whole record, you
will be able to choose to prevent specific information from being visible
without your consent by utilising what will be called a ‘sealed envelope’

Please note the highlighted bits. If you are in one of the pilot areas and you share my concerns about what might be termed information governance I suggest you make use of these options. As far as I am aware, I will not be in an area of "early adoption". But they can't have my info if I am.

Thank you to the BMA who were lobbying hard behind the scenes to get this sorted. Your efforts are, as always, appreciated.

More Spinal Privacy problems

As if we haven't got enough to worry about with our own national scheme, now someone in Brussels wants us to share all pour medical problems with most of Europe as well! According to the report, there are 5 million health workers across the EU, so if there is anyone who won't be able to access medical records at the drop of a hat, could they raise their hand now please?

No? Oh.

I've already posted about this twice (and on a related matter here, here and here).

Its bad enough that billions are being wasted on the UK scheme which, after £12 billion (at least) and several years, is still charitably describable as an insecure waste of money with a long term usefullness rating that most health professionals aren't convinced about.

How much will a pan-European scheme cost us and who is going to make the most money from it?

Oh, yes.

Who will benefit from the scheme?

Sorry. Forgot that one.

"The data that will be shared will include some kind of emergency care records and patients' medication histories. The aim of the scheme is that if, for example, a UK citizen falls ill while in Spain, doctors there will know what medication the patient cannot take or what existing conditions they already have."

Right. So instead of asking the patient, they can Google the patient. Great.

Still, what do I know?

Sack Patsy

There is a petition here to urge the Prime Minister to get rid of Patsy.

I urge you to read and consider whether to sign (I have).

My only slight concern is who would replace her...

(With thanks to Dr Ben Taylor for starting the petition, and Dr John Crippen for bringing it to my attention.)

Friday, January 19, 2007

Its all our fault (again)

Patsy is at it again.

Apparently, my pay should have been capped. I earn too much.

Given how the GP contract was negotiated, that of course implies that the quality of care which I am providing is of an excessively high quality. I will not however desist from providing good care. Its what I was doing before, and I see no reason why I should stop.

Ms Hewitt said: "I think if we anticipated this business of GPs taking a higher share of income in profits we would have wanted to do something to try to ensure that the ratio of profits to the total income stayed the same and therefore more money was invested in even better services for patients."
Right. So, as a self-employed, independent contractor, I may not take as much profit as I wish from my business. I have to reinvest the money into services which are otherwise inadequately funded, I have to effectively bung the DoH a sub.

"Now it is quite true that neither the government or BMA anticipated how much GPs would do in response to performance-related pay."

Well, not quite, Patsy. If you check the memo's from your negotiating team, you'll see that Dr Fradd et al did warn you that we would strive to maximise profits and do as well as we could. We are business people you see. Our business is health and illness management. That's what we do.

And then there's someone called Joyce Robbins, from Patient Concern:

However, Joyce Robins, from the health watchdog Patient Concern, told BBC News that the new contract did not represent "value for money".

"I do think that the doctors' unions took the government to the cleaners with that contract because, I mean, nobody's mentioned that in fact they do a great deal less work," she said.

"They no longer do evenings, no night work, weekend work - this has all got to be paid for somewhere else.

"And yet their money has gone up quite enormously.

"In fact, I understand that far more GPs are actually retiring early because their pensions have gone up so much that they can afford to do that."

Well, she's obviously speaking from a position of knowledge about these issues then, isn't she?

Ms Robbins, we still work about 50 hours a week, we are doing more and more during the day, and we didn't get paid for doing out of hours work before the new contract, indeed we used to pay for the privilege of working, and since the advent of nGMS, the government take 6% of our core budget off us if we opt OUT of providing out of hours services.

(Quite who Patient Concern are, I'm not sure. According to their site, they've been going for 6-7 years, but I've not heard of them before now. I'm also not sure that their agenda is as transparent as they would wish. Certainly to my mind some of their "Campaigns" are a little naive, though I agree with the principals behind some of them.)


If the Government aren't happy, they should try to renegotiate the contract with our representatives. All this spin is not helpful. Patients (and voters, lest we forget) don't believe it anyway, from the comments I've been getting from my patients.

In the mean time, I will continue to maximise my income to the best of my ability by caring for my patients to the best of my ability.

If its all the same to you, Patsy...

Sunday, January 07, 2007

Safe Arrival

I am delighted to announce the safe arival of our new daughter Willow Rose on December 28th, at 0742, born at home (about which more in a future post), weighing in at 7lb 10oz.

My wife is doing well, so is Willow and we're smitten.