The Good Doctor’s Blog
"With all due respect Mr Woodbridge…."
The ongoing exchange of views between Dr Emil Shehadeh and the boss of Thurrock Lifestyle Solutions continues over the question of health checks for people with learning disabilities.
I admire people who are passionate and tenacious about what they believe. May I therefore begin by doffing my hat to Mr Woodridge. Mr Woodbridge said he had read my blog with sadness. However, judging from his reaction, I can say that sadly he misread part of my blog whilst not reading the other part at all.
What he has not read: I have already acknowledged that people with learning difficulties are at increased risk of mortality from cardiovascular disease, amongst other conditions. Yet he spent a large part of his response repeating that fact. Perhaps he did not read it because emotions have got in the way. He also totally ignored the fact that not all GPs are equally funded.
Therefore not all GPs will provide the same services. He also failed to deal with the fact that there are numerous other services that are offered only by some GPs. Why should health checks for people with learning difficulties be different? He has also failed to read the fact that DES’s are optional. He has no right to demand these services from GPs, let alone assail them for not providing them.
He indicated the presence of “much Scientific Study” on the subject, but quoted none to support the efficacy of such health checks. Because none exist, as I have already stated. He also indicated that he himself, and others, have “really really pushed” for these checks. Exactly my point! Which services are provided by the NHS is totally irrational. It is who shouts most. Which pressure group has better access to decision makers is the determining factor. It should be sound evidence that determines which services are offered. We should offer services that are proven to yield a positive change, an improvement in life and the quality of life, not services that well-meaning pressure groups not armed with any scientific evidence of efficacy, demand.
What he has misread: He also failed to understand that just because a group of vulnerable people are at risk, it does not mean that risk can be reversed by any means, let alone by specific medical interventions that have not been tested. I believe most of these needs are social in origin, and should be solved by the right people, not GPs. Just because he is concerned about vulnerable people does it mean that those who disagree with his solution are less caring than he is?! That sort of thinking is unhelpful.
What I find sad is the sort of thinking that is more suitable in a communist society. So now apparently, doctors have to reduce their income to Â£100.00/week! Of course, were born GPs. We did not have to study for 10 years.! The qualification just dropped into our laps from high heaven! There are lawyers, and I have them in my family, who would not get out of bed for less than Â£350.00/hour. There are pop stars and footballers who earn 100 times more than that. This is capitalism. I deplore the sort of thinking that stems from the bitterness and envy.
As a Christian, I believe in helping the poor and vulnerable. I believe in trying to better society. We Christians invented trade unions, and put an end to child labour and slavery. We invented socialism, the early church sharing all their worldly goods. It was John Calvin, in his excellent work “The Institutes of The Christian Religion” who provided the western paradigm for most caring civilised societies today. But I also deplore the attitude of envy which rewards underachievement and seeks to punish hard work and excellence. This is part of Britain’s ailment and lack of success.
This is why we are losing our ranking in the world, which is also why we cannot afford a better NHS. We, in modern Britain, encourage a calculating devious attitude to work and income. It is financially better for some people to be on benefits than to work; so they feign illness and demand benefits. Self-respect, honesty and the Protestant work ethic does not come into it anymore. We expect to sit at home and earn a decent salary, have a world class NHS and public services!
Mr Woodbridge deems it appropriate to shift attention from the people he cries for to GP earning, which I find distasteful. This is the sort of attitude that puts potential doctors off, and increases the temptation for GPs to retire early. He is aghast at the Â£100.00 per hour. Firstly it is not Â£100.00 in the GP’s pocket. It is Â£100.00 in the surgery’s account. By the time that money finds its way into the GP pocket it would have dwindled to little more than Â£20.00, as a large part of it would go to the tax man to pay the poor people who do not earn Â£100/week. Secondly, the first encounter may take an hour. There is follow up to discuss test results.
There may be treatment and further follow up. But of course the NHS takes its doctors and nurses for granted! Does the public ever wonder why we have a shortage of both doctors and nurses? If the money were so good, why are we failing to recruit GP trainees?! This reprehensible envy of doctors’ income will only exacerbate the acute shortage of those who save lives day in and day out.
Whilst we are on the subject of cost, GPs offer a phlebotomy service at a significant loss. So not only do we not earn Â£100.00/hour, but we actually lose money. My children are actually sponsoring the NHS! Most principal GPs sponsor the NHS. We do not have 8 hour days. We work till we are exhausted. We are also tired of being taken for granted.
Mr Woodbridge needs to accept that GPs are human beings with saturation points. The saturation point for most GPs has long been surpassed. There is no more capacity for more services to be crammed into general practice. Emotional reactions such as calling failure to deliver “scandalous” just proves my point about the emotional aspect of this service.
These GPs are scandalous for being exhausted, stretched to the limit, working 12 hour days in their fifties and sixties, being underfunded and under-resourced! Insults like these can only hinder and not help. This is an unhelpful, immature, irrational, emotional, response to a general practice at breaking point. It is not very mature to scream insults at people when you do not get your own way. No one thinks it is scandalous that GPs cannot start diabetics on insulin, and refer them to a nurse-led diabetic team. No one calls this scandalous, nor should they. GPs cannot meet all the demands of society.
Mr Woodbridge described many problems that people with learning difficulties have, which clearly do not require GP input, such as the inability to read. They require social care not general practice. GPs have enough to do. To go on burdening them with tasks for which they are not equipped, would harm them and the people we are supposed to be helping. Who wants to be looked after by an exhausted, harassed, GP, who is constantly being told what to do by all sorts of pressure groups?!