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MT editor Matthew Gwyther's take on the burning business issues of the day.

Editor's blog: Ex-parrot shows doctors keen to feather their nest   

The case of a (now ex-)parrot in Miami got me thinking about the caring professions and their relationship with lucre.

I do wonder about some people. Not least Anne Lowery from Florida, who spent £50,000 on chemotherapy for her 42-year-old Wagler’s Conure parakeet called Areba - who then became an ex-parrot within a year. Dr Teresa Lightfoot, the vet who administered the avian injections (and swiped Ms Lowery’s card) said, 'It was tough for Areba. But we improved her quality of life and gave her and her mom more time together.' (I don’t know what they teach them at Miami vet school, but I doubt if the prospect of homo sapiens giving birth to a Wagler’s Conure parakeet is included in the curriculum.)    

These kind of stories are ten-a-penny in our mad world. Kids starve in Africa and some nut job spends fifty grand on her parrot. But it was all brought home to me last week by my brother and his dog Sidney. Sidney is a crazed lurcher/greyhound cross with an IQ of around 12, breath like an open sewer and a bad attitude towards small furry animals such as foxes and squirrels. Last week he made the serious error of taking off across the road in pursuit of his prey and was hit by a Transit (tt didn’t bother stopping). My brother took the broken-legged mutt to the vet and they donned the mask to have a look.

After an X-ray came the bad news – the specialist orthopaedic operation required would cost £4,500. I can’t say this surprised me – when you spend eight years getting trained to acquire your veterinary certificate, you really want to fill your boots when you're finally are let loose on Satan the Rottweiler and Squeaker the hamster. I recall the bloke who used to see to our childhood cat Marmaduke when felled by fleas or feline enteritis drove a Jaguar XJS. The emotional blackmail used by vets will be familiar to any pet owner.

This got me thinking about the caring professions and their relationship with lucre. Not least because after failing to visit my wife and children on the last two occasions they were really pretty unwell - a nasty allergic reaction in the case of the 8 month old baby - we’ve just had a seriously snotty letter from the GP, saying if we don’t get the toddler in for his second dose of MMR, we're going to get slung off their list. The fact that they lose money if they don’t reach their children’s immunisation targets is the reason for this. I feel like ringing up to suggest that if they agree to visit, we’ll do the immunisation - but that would be childish. And they probably wouldn’t answer the phone anyway.  

What they need to remember is that following their contract renegotiations and the huge uplift in their salaries, the out-of-hours service offered – or rather not offered - by most GPs is now a shambles. Only one in 50 services is meeting the out-of-hours performance targets set to ensure patients get proper advice and treatment.

GPs, like vets, are not saints - they are small businesses operating in a very odd market. Many are hugely successful. Take Dr Suppiah Ratneswaren, 61, who is linked to four separate NHS practices in the south London borough of Greenwich. He’s admitted he is earning between £300,000 and £400,000 a year, 90% of it from the health service. And yet I notice today their Royal College is yet again trying to make access to them more difficult, because they don’t want to be bothered with 'minor ailments'. It seems to me that GPs have spent the last decade telling us all that they wish to do less work for more money. You can't blame them for trying; but that doesn't mean we have to buy it.

The point is a simple one. As members of the NHS resist the inevitable public spending cuts that will come after an election, they will scream blue murder about protecting patient care and why health should be ring-fenced. It should not. Many of them will genuinely be concerned about this. But, human nature being what it is, they're anxious to keep their own nests feathered too. 

Published Mar 23 2010, 07:49 PM by Matthew Gwyther

All Comments

Bob Hodges March 23, 2010

Your comment: "What they need to remember is that following their contract renegotiations and the huge uplift in their salaries, the out-of-hours service offered – or rather not offered - by most GPs is now a shambles."

Unfortunately reveals a great deal of ignorance of the manner in which primary care is organised and funded.  Firstly GP partners are not paid 'salaries'. They take home 'profits' from their business i.e the practice. The 'huge uplift' you refer to was in no small part due to the that fact that the Employer's  pension contribution of 14% was then paid to the practice, and immediately taken back  (i.e. a phantom 14% pay rise).

You might also have easily found out that the take home pay for the majority of GPs have fallen for each of the last 5 years. The increase in practice funding has in many cases failed to cover the inflationary pay award for practice staff (the balanace of which is therefore paid from money previously atributable to the GP partners), let alone provide for an inflationary award for doctors.

Finally, you lament the way that 'visiting' and 'out of hours' care has gone - basically, the government was desperate to privatise this element of practice as they though that mangers could do it better. Therefore they valued it at £6000 per year per GP. They have subsequently realised that they were wrong, and are crying foul.

The new contract keeps me very busy indeed doing preventative work and managing chronic disease like diabetes (saving the NHS billions per year in preventing hospitalisation) - I simply don't have the time or energy to field phone calls from drunks at 3am or do home visits for self-limiting illness in the fit and mobile. There is only so much time in the day - this is the argument the Royal College makes (rightfully). The NHS has limited resources, and 'demand' and 'need' are not the same in any way shape or form. We typically spend more than 90% or out time with less than 10% of our patients - these are not necessarily the 10% who are the most 'ill' either. The reason I'm paid what I'm paid (which I guarantee is less than you think I earn), is because the buck stops with ME. I'm trained to sort out a bewildering volume and variety of other peoples problems, and that's what I do.

I do make myself available for Out Of Hours work, and for this I am paid by the hour. The quality of service is proportional to the funding it receives and how much of it is spent on doctors.

You comments are doubly disappointing as it could be construed as implying that 'managers' are 'altruistic' in contrast. By and large, most of the NHS's problems are due to 'over management', 'Micromangement' and 'mismanagement' from Whitehall down through SHAs to the Ivorry Towered PCTs. They are not due to the dwindling proportion of organ-grinding frontline clinical staff and how comparatively less under-paid they are to a decade ago.

Finally, you make example of Dr Suppiah Ratneswaren (a reare case indeed), but fail to spot the irony that he's possibly the only GP in Britain that earns more than his dentist.

Marge Brown April 21, 2010

£50,000 for chemo for a parrot that vet is laughing all the way to the bank. Is this exploitation?

 
 

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