Malky3

I don't have any problem with a gatekeeper system, but I do agree to some extent with what you are saying here. I'm not sure why GP's running their practice would think that a GP receptionist who struggles with a colouring in book and crayons would be better able to diagnose how ill someone is over the telephone than they are. If the system works as it was supposed to perhaps we shouldn't worry about a shortage of GP's and just recruit more GP Receptionists instead.

Jesus, I'm sorry I missed this doozy last night. What you have just described is EXACTLY what the SNP do on BBC Question Time when they send one of their politicians down to England to appear on the show. All sorts of bizarre claims are made - like the one from Alyn Smith last time round that the Scottish NHS was all bright and rosy. It's only very recently that these claims have started to be challenged by the likes of Fiona Bruce, who pointed out the SNP had failed to hit their own NHS targets, and by Andrew Neil. I provided comparison data that shows Scotlands failing performance in education. Now you'll need to tell me which hospitals elsewhere are killing children with bird droppings in their water supply, and which countries have allowed a "typo" to go unchecked all through a build contracts lifetime, only to be spotted just before opening as a serious and dangerous flaw, so bad that the hospital can't be opened and £tens of millions of taxpayers money will need to be spent rectifying the f**k up.

It's good if they've always got availability. My current GP practice does seem better in that way too, but at the last one I was with that certainly wasn't the case. If you wanted a same day appointment and all the available appointments had gone you either had to go with a GP phone call where the GP would then tell you to come to the practice anyway, or you had to work the system and over egg your symptoms. I also suspect the reason people claim appointments are urgent is because they face a situation like I did this week where the first available non urgent appoint was the 23rd of February. A mole that has changed shape slightly and has become a bit itchy is probably non urgent in most peoples book. Just something it's better to get checked out but hardly an urgent matter of life or death. But tell them the next available appointment is one month later and you can understand why that mole has suddenly become "skin cancer". Just to be clear this is a hypothetical example.

I do that for repeat prescriptions, but I can't believe that in Dundee GP's expect sick patients to wait a couple of days to get their prescription paracetamol.

It's not an estimate - as I described earlier it was the figure that was on the wall on one day when I went in and I noticed it. Regardless though - 120 missed appointments in a month is still a ridiculously high and wasteful figure.

In Chicago do they still WRITE prescriptions? In Scotland, at least at the two practices I have been a patient of, the GP types up a prescription and prints it off. If I've wrongly assumed that GP surgeries around Scotland had made it to the 21st century I apologise.

Are you sure? At my last practice they struggled with searching Google or NHS 24 and talking at the same time. And it's a long time since I saw a GP that was trusted to write out a prescription.

Fair enough - I had a search on the web though. That 7 minutes per appointment that I remembered isn't - apparently - accurate. GPs are supposed to set aside 15 minutes per appointment. So if there are 80 missed appointments in a week that's 20 hours a week where one GP at that practice was not seeing patients. According to ISD Scotland there were 944 GP Practices in Scotland in 2018. I know it's simplistic but assuming all of the GP practices had the same number of missed appointments as my old GP surgery did on that week where I paid attention to the figure that would mean 18,880 GP hours per week being wasted by non attendees - and all because we have a wasteful system that allows people to book frivolous appointments. The "gatekeeper" method that the SNP expected to happen at GP surgeries clearly hasn't been and isn't working. ....and that is just as GP Practices. Dental practices fine patients who are late or who miss appointments so why shouldn't the Scottish NHS do the same? Why should the idea of charging to see a GP, or fining someone who hasn't turned up for their appointment so taboo? Why should our GP's be writing out prescriptions for Paracetamol and Aspirin when they cost 65p and 40p per packet at Tesco? And why should a qualified NHS doctor be telling us all that because a weeks supply of a certain type of tablet cost £10 at Boots, a patient should be encouraged to make an appointment with their GP and to get it on prescription instead? My wife recently had sensitive teeth and having tried most brands of toothpaste she eventually spoke to her dentist about it when getting a checkup. He prescribed Duraphat 5000ppm toothpaste. Now apparently this stuff is only available on prescription anyway. She expected to pay but when she went to the chemist to pick it up she discovered she'd just got 6 large tubes of Colgate toothpaste on the Scottish taxpayer. Free prescriptions were never the right way to go.

That's utter nonsense. Are you really suggesting that 200,000 extra people voted for Boris Johnson than voted for David Cameron because they hated him more? Are you really saying that 200,000 fewer people voting for the SNP this time round than voted for them in 2015 is because the party is more popular? I know that Scottish Nationalists are famous for their lack of logic but by f**k Sandy you are taking this to new levels. Not that I should be surprised. It wasn't that long ago you were telling fellow Scots who didn't agree with you to f**k off to some other country. We know what kind of Scotland you would like to see - ruled by an authoritarian zealot dictator committing acts of genocide against fellow Scots. It's alright though cause 55% of all Scots will ensure your extremist views will never become a reality

Glad to hear it. Just to pick you up though - I have no problem with "freebies" for those who genuinely need it but I've always thought it weird that people like me - who certainly can afford to pay for prescriptions - are able to get them for free. Whether or not charging for prescriptions makes a profit for the government is neither here nor there. The purpose of what I was exploring in that conversation was how to stop frivolous and wasteful demands on our health service. No doubt one of our doctors here will correct me but I seem to remember a statistic that said the average appointment time with a GP was around 7 minutes. 80 missed appointments at 7 minutes a time would be 560 minutes a week wasted where an NHS GP could be seeing patients that need them. That's just over a day's worth of appointments for one GP in that practice where instead of helping people, they are sitting round waiting on patients that haven't bothered to cancel and who aren't going to be in to see them. How many more hours per week do GP's waste writing out prescriptions for Aspirin, Paracetamol and Omeprazol that could be purchased over the counter? In the modern age there is no reason why an appointment couldn't be made using a debit or credit card where a charge is held on account without ever being withdrawn, and that charge is either completed when the patient fails to attend or released by the receptionist when the patient checks in. Christ, at my current GP surgery the receptionist wouldn't even need to do it - the patient checks themselves in on a tablet.

Maybe so but it is the most widely prescribed drug in the Scottish NHS. It's available in pharmacies over the counter at a cost of around 58p per pill. BTW if you want to know the other most frequently prescribed pills in Scotland they are Those who claim there is no "frivolous" use of the NHS is really kidding themselves on.

In 2006-7 prescription charges and PPC's raised £46.9 million. Introducing a zero rate cost the Scottish Government £57 million per annum back in 2006-7. Not my figures but that of the Scottish Government in an SPIC Briefing at the time that is readily available on the internet. In the same article those experts who rolled out the evidence to be considered said that "frivolous use of the prescribing system would cost an estimated £15m per annum in drug wastage. The response from the Scottish Government was that they believed that the "gatekeepers" were those prescribing the medicines and they expected GP's to limit wastage through improved prescribing practices - which would presumably involve more time being spent on appointments and on repeat prescriptions. Back then the total drugs outlay for the NHS in Scotland was £917.14m. By 2018 the figure stood at £1.3Bn - a 25% increase in 10 years! That's £247.79 per person in Scotland per annum! The most common medicine prescribed is Omeprozole used for acid reflux - a drug that can be bought over the counter at Pharmacies. 3.59m Omeprozole prescriptions were issued by GP's in 2018

I haven't ran off anywhere. If it were to be a constructive conversation I'd be happy to engage and to listen. But whilst he has accused me of being entrenched, he's taken the entrenched view that members of the public know f**k all. One thing I do know is that the reason we haven't re-introduced prescription fees isn't about any financial viability about doing so - it's about the electability of the party that would admit they fucked up scrapping the prescription charges for the middle and upper classes in the first place.

Aw, sorry! My mistake. I thought you said you wanted a constructive discussion. Instead I raise points and you take on the role of expert and write them off as ridiculous. I don't think there is much point in engaging any further to be honest with you.

i voted for Jim Sillars in Govan back in the late 1980s. I've never been a fan of Scottish Nationalism or Socialism, but Sillars was someone I could listen to all day long. Whether you agreed completely with him or not he was uttely sincere - something that has been missing from the SNP for decades. The Nationalist movement would do well to listen to Sillars rather than write him off as some do as an old man. In the meantime though I'll get back to my shopping

Biggest losers are the Scottish Nationalists. What was the result in 2014? Dreams shattered everywhere and an endless flood of tears from those who do grievance politics the best. Still Jim Sillars has called you all out. Independence isn't going to happen.

It is a societal matter, of course, but there are political solutions. One of the contributing factors as far as I can see it was the introduction of free prescriptions by the SNP. Those who were low paid or unemployed already got free prescriptions so the policy benefited only those who could afford prescriptions. The SNP argued that the administrative cost of managing it meant it wasn't costing much at the time to offer free prescriptions to everyone. But what is clear today - and feel free to correct me - is that we now have many GP appointments were patients are in looking for a free prescription for medication that would be available over the counter if only the were willing to pay for it. Re-introducing prescription charges would fix that issue. Another issue appears to be frivolous appointments. My last GP surgery used to have a notice on the wall that showed how many "no show" appointments they had in the last days. Now I don't want to paint a picture that I was always in, in truth I've visited the GP maybe three times in the last four years. However the worst I ever saw it was 80 missed appointments in a week. Years ago I was friendly with a former NHS manager who had spent a few years working in California. He told me that they didn't have the same problem. When people paid to see a GP they would ensure they turned up at the appointed time. That would appear to me to be one way a political solution could be implemented, either by introducing a refundable deposit system, a system of fines for those who miss appointments, or a straight forward charge to see a GP for those who can afford it. We also clearly have fitness and dietary issues in Scotland. Finding ways to boost access to facilities to get people fit should be a driver for any government. Yet the SNP in councils that they ran implemented sharp increases in the cost of booking fees for council facilities that particularly impacted on juvenile football clubs. I also have a Vitality Health Policy - interestingly they have rewards programmes for their members who actively work out and keep fit, obviously because when their members do they are less likely to become ill and to cost them money. The Scottish Government would do well to look to see if there was a way to roll that kind of reward scheme out to the broader society. There's loads more but one last one for now. You talked about the student fees in England but Martin Lewis has been at pains to point out that he believes the scheme is incorrectly named and that instead of being called a loan - which many people will never pay back in full - he says it should be called a Graduate Tax. I'd agree with the principle of charging graduates a higher rate of tax as they repay the cost of their advanced education. How many nurses trained for free in Scotland by the Scottish taxpayer are now working in England or abroad? I'd have stopped that loop hole if I was in politics. After all it can't possibly be progressive, fair, or even morally right to charge bin men and care assistants for the education of solicitors, bankers and politicians.

Better? Seriously? I wouldn't say that experience is how patients see it. Better treatments I'll give you but not better waiting times, better services or better practices. I phoned my GP yesterday to make a non urgent appointment. 23rd of February was the date I was offered - and this GP practice is millions of times better and more organised that the last one I was with. At the last one things were so bad I made an appointment to see the Practice Manager who apologised for the state of the practice and claimed it was because their practice was being "forced" by the Scottish Government to stay open for new patients when all of the other practices were closed to new patients because of the number of people moving into the area. Now I appreciate that the Practice Manager might not have been honest - people tell all kinds of lies to shut down complaints - but one thing I am absolutely certain of is that GP services have not improved in the last twelve years. Hospitals, as far as I can see, are more or less in the same boat too. We hear all sorts of stories about sick people in A&E being on trolleys for hours on end - two days I was on a trolley in Monklands in an area just off A&E reception that had been set up to handle around 20 patients like me that they couldn't fit into wards. Wishaw General was closed to patients that night - the explanation was the same. As a PFI hospital Wishaw had limits and could close when it was full. Monklands isn't a PFI hospital so they have to continue to admit no matter how full their wards are. Yet over the last 13 years we continue to reduce the number of available beds. Last time I had a stay in Wishaw General was about 5 years ago. That night one of the ward nurses told me that it had been an horrific night. They had one doctor covering 8 wards and A&E. Now you'll know better than me how common that is - but it certainly doesn't sound like a well run health service does it? We might be better than England - I've no Idea. I've no experience of what happens down there. But we certainly aren't in a better place than 13 years ago.

Jim Sillars has always been the only Scottish Nationalist worth paying attention to - and here's what he's saying today https://uk.yahoo.com/news/snp-deputy-leader-nicola-sturgeon-indyref-2-vote-123212249.html "Sturgeon is pretending there will be another Independence vote" "SNP leadership is misleading it's members" "division within the party" and "it's the responsibility of SNP members to convert those who are not behind Scottish independence, rather than marching every weekend"

I work in engineering Oaksoft. If a client comes to us requesting a quote for the installation of plant, controls and equipment we'll supply it based on what they have outlined in their specification. If they f**k it up we'll charge them for the rework. In the case of the Edinburgh kids hospital, it's been quite clear that the mistake lay with Lothian Health Board, who are now under "Special Measures" as is the QEUH. The problem for the SNP is that the Health Secretary is supposed to manage her brief and she has clearly failed. Why Jeane Freeman is still in her post is way beyond me. The same is true of education.Anyone with kids knows there are good and bad teachers, but it is remarkable how the same teachers are achieving poorer standards year after year. There is an Education Secretary who is supposed to be on top of his brief yet the slippage in performance is happening under their watch. Tell me Oaksoft, when BHS went under did you blame the individual sales assistants or did you, like the rest of the population, blame Phillip Green?

What? Aside from Theresa May's (and Ruth Davidsons) strong Scottish showing in 2017 (which handed the Conservatives their General Election win), it was the best Conservative voting figures in Scotland since 1992 when John Major proved that Conservative support was still strong in Scotland despite the Thatcher years and the Poll Tax. Ofcourse Johnson hasn't managed to achieve Margaret Thatcher levels of popularity amongst the Scottish vote yet - despite what many up here would have you believe she always polled strongly in Scotland - but he's getting there. To claim that Johnson is somehow unpopular in Scotland when his party are continuing to poll strongly across Scotland is to ignore the actual figures. And to address Jakedee's post - the SNP did the same thing with their election leaflets preferring to stick to the message of "Stopping Brexit" and "Stopping Boris" than banging on about Scottish Independence and an Indy Ref 2. The reason is that parties are looking to attract new voters with these advertising materials, not their hard core support. The SNP know that when they talk about Independence they lose votes.

692,000 Scots voted for him. Up over 200,000 since David Cameron and Cameron in 2015. A 50% increase in support of the Conservative Party in Scotland since the 2014 referendum whilst the SNP have lost almost the same number of votes since the same election would suggest Johnson IS popular in Scotland

Do you think Boris Johnson is "hugely unpopular"?

Yep, but the fact that the population has increased only serves to put the claims about the SNP's popularity under starker focus.

Just to back up what I said earlier here's a table showing Prime Ministers and the number of votes their parties got to elect them. Boris Johnson's Conservative Party win in 2019 polled the second most votes in UK history for a Prime Minister. The only PM to do better was John Major in 1992. Yet still some daft people think Johnson is hugely unpopular. 2019 - Boris Johnson - 13,966,451 2017 - Theresa May - 13,636,684 2015 - David Cameron - 11,334,226 2010 - David Cameron - 10,703,754 2005 - Tony Blair - 9,552,436 2001 - Tony Blair - 10,724,953 1997 - Tony Blair - 13,518,167 1992 - John Major - 14,093,007 1987 - Margaret Thatcher - 13,760,583 1983 - Margaret Thatcher - 13,012,316 1979 - Margaret Thatcher - 13,697,923 1974 - Harold Wilson - 11,457,079 1974 - Harold Wilson - 11,645,616 (actually won more seats with fewer votes than Ted Heath who got 11,872,180) 1970 - Ted Heath - 13,145,123 1966 - Harold Wilson - 13,096,951 1964 - Harold Wilson - 12,205,808 1959 - Harold MacMillan - 13,750,875 1955 - Sir Anthony Eden - 13,310,891 1951 - Sir Winston Churchill - 13,717,851 (won more seats with fewer votes than Clement Attlee who had 13,948,385) 1950 - Clement Attlee - 13,226,176 1945 - Clement Attlee - 11,967,746 1935 - Stanley Baldwin - 10,025,083 1931 - Stanley Baldwin - 11,377,022 1929 - Ramsey MacDonald - 8,048,968 (won more seats with fewer votes than Stanley Baldwin who had 8,252,527) 1924 - Stanley Baldwin - 7,418,983 And in Scotland the SNP polled fewer votes than 11 other general election results in Scotland. Yet the same daft people seem to think that the SNP and Nicola Sturgeons popularity is unparalleled and is indicative of a strong desire for Scots to want to leave the United Kingdom. In 2019 the SNP got 1,242,380 votes In 1997 Tony Blair bettered that in Scotland winning 1,283,350 Scottish votes In 1987 Neil Kinnock bettered that in Scotland winning 1,258,135 Scottish votes In 1966 Harold Wilson bettered that in Scotland winning 1,273.916 Scottish votes In 1964 Harold Wilson bettered that in Scotland winning 1,283,667 Scottish votes In 1959 both Harold MacMillan and Hugh Gaitskell beat that in Scotland winning 1,260,286 and 1,245,255 respectively. In 1955 Sir Anthony Eden beat that in Scotland winning 1,274,942 Scottish votes In 1951 Sir Winston Churchill and Clement Attlee beat that in Scotland winning 1,349,298 and 1,330,244 Scottish votes respectively In 1950 Clement Attlee beat that in Scotland winning 1,259,410 Scottish votes In 1931 Stanley Baldwin beat that in Scotland winning 1,385,385 Scottish votes