Not sure how to do this. Ive upgraded my account by payng the but cannot change the category to what we are and what we are looing for
Help appreciated
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Rising
Over 90 days ago
Bi-curious Male, 60
Bi-curious Female, 67
0 miles · Kent
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Sexpert
Around 19lbs in 10 weeks here, I bought a book about GI foods, the food in there is traffic light, green, amber, and red. Only bought Green Stuff, 3 meals a day, inlcuding breakfast, lunch, and a main meal, all eaten at around the same times of the day. Working here at moment.
Sexpert
Peter Mendelson is the most despicable Politician of his era, a nasty piece of work, whom I have met. He typifies the New Labour movement more than most, a person more interested in his own self, than that of his government or indeed his country. Peter Mendelson cares about one thing and one thing only and that's himself. Brown's appointment is probably the most ridiculous thing ever done, by a sitting Prime Minister, if he thinks that Mendelson is going to turn the country and his government's fortune's the words cuckoo, living and cloud come to mind. It's handed the next election on a plate to the Conservatives, and Cameron will be laughing all the way to Downing Street.
Political Rant over.
Political Rant over.
Sexpert
Quote by Bbw4umen
LOL
I don't wank on cam, don't see the point, unless personally requested that is.
Women look far better on cam as you have more to show and can dress up nice, cams can't really keep up with the movement of a wank..lol...plus, you have so many cocks to look at, can't be
I'm a memeber of xxxxxx, and on there on average there are 35 women ad 500 guys ffs, all wanking away, well most.
A cock is a cock, a face is what is most likely to get you noticed, and it's what most women are going to be attracted to.
uhuh
I go for the face.. if they've got a big cock it's a bonus but not a requirement
somewhat disheartening, given you have no face on your profile, but then again Ive been here long enough to know that for the most part, the lady calls the shots
Sexpert
Quote by Peanut
Just a couple of points re this thread, in regards to opening times, people need to actually take this 'out of the box' so to speak.
What has happended recently is that new diretives have been introduced to extend consultation hours, now this is different from the actual times a surgery is open, we for instance are providing 2 and a half hours additional consultation (appointments) per week.
These have to be provided 'outside' of the normal times that your surgery has its appointment's, therfore if a GP finishes his surgery at , he/she may well decide to add that extra time on to his afternoon surgery, and therefore may not need to extend their opening times to compensate.
Again, it's all about what the GP decides and it is usually what is convenient for the GP not what is best for the patient.
On the issue of 'out of hours and weekend care' well this stopped years ago, the new contract ( a direct result of Tony Blairs NHS Plan )gave GP's the option of opting out of these services at the weekend, it was only signed by GP's on that basis, and I dont think there were many GP's who opted to continue to provide that service.
90% of doctors opted out. In many ways it demonstrates the changing loyalties of the doctors towards their patients and veering it to their own convenience. After all they do need more time off to spend all that extra moolah.
It must be realised that since that contract started, it became the responsibility of Primary Care Trusts to provide that care, not GP's, the responsibility ended for GP's at the end of surgery.
Now there's so spin if I ever saw some. Yes it became the responsibility of the PCT and no it didn't "end for GPs", it was rapidly given away en masse. It wasn't like the responsibility was ripped from them. They gave it away at the first chance they got.
When that happened, Practice's had their budgets decreased to reflect that level of finance that was previously in that budget,
Yet more spin. yes the practices had their budgets cut, but the GPs wage itself rose by almost 25%.
so what happened is that many GP's formed locally co-operatives to provide that service, and would (and still do) work in after hours co-operative, maybe once/twice a week, but less than what they would have done in their own practice,
What you mean is that they became their own locums and attracted additional wages for what once came under their original responsibility and original pay grade.
this was particularly appealing to small practices, where GP's were small in number, as they wouldnt have to provide surgeries as well as after hour care on a 24 hour basis, that wasnt good for the GP, and it certainly wasnt good for the patient.
If the GPs can do it as a cooperative how come they couldn't do it as a practice? Again, it's all about the filthy lucre. Why do something as one job and one wage when you can do two things and get two wages?
As for accountability, well General Practice receives much of its income from what are known as enhanced services, which are add on's to the contract that the GP has (with the local PCT). The PCT doesnt give the money over lightly, to give you an idea of what we get funded for over and above the contract, we get money for Access, Choose and Book, the new extended consultation times, and we also have to do an annual patient questionnaire, that does ask questions about levels of satisfaction, these are made public, and are available to you whether or not your a patient or not under the FOI.
I do like the way you choose to use practices as examples when it comes to finances, when it's actually the doctors themselves we are discussing.
No one i know rests on their laurels in General Practice, and yes it is a business, you have to remember that GP's are self employed independant contractor's and are responsible for their business in the same way anybody else is, that's fact, and it is clear that this government have moved Primary Care nearer and nearer to the Private Sector.
yes they are businesses and yes they are self-employed, but they are doing it with public funds. This alone should make them accountable to the public who are funding them.
Next time you need any vaccinations prior going on holiday, check some of the Private surgeries that are out there for their prices (in some places twice the fees that our GP's will charge you).
These are private sales using public funds to subsidise them. Is it any wonder they can undercut the private sector? Private surgeries have to fund all the outgoings themselves from their profits, NHS practice surgeries don't.
Primary care, and providing care for patients is not about privatisation, its about trust in people that you know, and I for one would strongly fight for the role of local GP's and surgeries to be enhanced and strengthened, at the moment the road is one of division, scaremongering, and deep mistrust.
And who is to blame for the mistrust? Could it be that the profession (which actually I admire greatly even though it doesn't appear so) who has been revered and put on pedestals for so long have started fighting back for their own interests and in doing so have shown that they are just as much self-serving as any other professional group. When the reality of that hits Joe Public it's hardly surprising that there's blowback.
For example it doesn't take a maths genius to understand that the pressure in the surgery could be cut in half overnight (metaphorically speaking) by the simple expedient of paying GPs 50k and having twice as many of them. Let's face it 50k is no pittance for a trained professional and is far higher than most people's incomes. 100k is ridiculous for a public employee in such a cash starved environment as the NHS.
My you do have a bee in your bonnet dont you? Well your entitled to your opinion, and its quite clear that you have little time for GP's and you make some valid points, all I know is that the GP's and staff in my practice are working as hard as ever, and are not nearly earning the sums you suggest. I know because I pay the salaries, and manage the budget.
I also know based on the strength of patient questionnaires, targets that we consistently hit, feedback from patients, a happy staff with absolutely no manpower turnover problems whats so ever, a good reputation, an excellent appointment system, a first class recall system, a modern surgery, a forward thinking manager, a great team of Nurses, on site Physio, on site Health Visitors, on site counsellors and midwifes, that we as a surgery provide a first class service to our patients, and I am very proud of that.
I hope you get well soon, perhaps you should move abroad for your care, and see if you can get a Doctor at 9am to see you, let alone anytime after
Sexpert
Just a couple of points re this thread, in regards to opening times, people need to actually take this 'out of the box' so to speak.
What has happended recently is that new diretives have been introduced to extend consultation hours, now this is different from the actual times a surgery is open, we for instance are providing 2 and a half hours additional consultation (appointments) per week.
These have to be provided 'outside' of the normal times that your surgery has its appointment's, therfore if a GP finishes his surgery at , he/she may well decide to add that extra time on to his afternoon surgery, and therefore may not need to extend their opening times to compensate.
On the issue of 'out of hours and weekend care' well this stopped years ago, the new contract ( a direct result of Tony Blairs NHS Plan )gave GP's the option of opting out of these services at the weekend, it was only signed by GP's on that basis, and I dont think there were many GP's who opted to continue to provide that service. It must be realised that since that contract started, it became the responsibility of Primary Care Trusts to provide that care, not GP's, the responsibility ended for GP's at the end of surgery.
When that happened, Practice's had their budgets decreased to reflect that level of finance that was previously in that budget, so what happened is that many GP's formed locally co-operatives to provide that service, and would (and still do) work in after hours co-operative, maybe once/twice a week, but less than what they would have done in their own practice, this was particularly appealing to small practices, where GP's were small in number, as they wouldnt have to provide surgeries as well as after hour care on a 24 hour basis, that wasnt good for the GP, and it certainly wasnt good for the patient.
As for accountability, well General Practice receives much of its income from what are known as enhanced services, which are add on's to the contract that the GP has (with the local PCT). The PCT doesnt give the money over lightly, to give you an idea of what we get funded for over and above the contract, we get money for Access, Choose and Book, the new extended consultation times, and we also have to do an annual patient questionnaire, that does ask questions about levels of satisfaction, these are made public, and are available to you whether or not your a patient or not under the FOI.
No one i know rests on their laurels in General Practice, and yes it is a business, you have to remember that GP's are self employed independant contractor's and are responsible for their business in the same way anybody else is, that's fact, and it is clear that this government have moved Primary Care nearer and nearer to the Private Sector.
Next time you need any vaccinations prior going on holiday, check some of the Private surgeries that are out there for their prices (in some places twice the fees that our GP's will charge you).
Primary care, and providing care for patients is not about privatisation, its about trust in people that you know, and I for one would strongly fight for the role of local GP's and surgeries to be enhanced and strengthened, at the moment the road is one of division, scaremongering, and deep mistrust.
What has happended recently is that new diretives have been introduced to extend consultation hours, now this is different from the actual times a surgery is open, we for instance are providing 2 and a half hours additional consultation (appointments) per week.
These have to be provided 'outside' of the normal times that your surgery has its appointment's, therfore if a GP finishes his surgery at , he/she may well decide to add that extra time on to his afternoon surgery, and therefore may not need to extend their opening times to compensate.
On the issue of 'out of hours and weekend care' well this stopped years ago, the new contract ( a direct result of Tony Blairs NHS Plan )gave GP's the option of opting out of these services at the weekend, it was only signed by GP's on that basis, and I dont think there were many GP's who opted to continue to provide that service. It must be realised that since that contract started, it became the responsibility of Primary Care Trusts to provide that care, not GP's, the responsibility ended for GP's at the end of surgery.
When that happened, Practice's had their budgets decreased to reflect that level of finance that was previously in that budget, so what happened is that many GP's formed locally co-operatives to provide that service, and would (and still do) work in after hours co-operative, maybe once/twice a week, but less than what they would have done in their own practice, this was particularly appealing to small practices, where GP's were small in number, as they wouldnt have to provide surgeries as well as after hour care on a 24 hour basis, that wasnt good for the GP, and it certainly wasnt good for the patient.
As for accountability, well General Practice receives much of its income from what are known as enhanced services, which are add on's to the contract that the GP has (with the local PCT). The PCT doesnt give the money over lightly, to give you an idea of what we get funded for over and above the contract, we get money for Access, Choose and Book, the new extended consultation times, and we also have to do an annual patient questionnaire, that does ask questions about levels of satisfaction, these are made public, and are available to you whether or not your a patient or not under the FOI.
No one i know rests on their laurels in General Practice, and yes it is a business, you have to remember that GP's are self employed independant contractor's and are responsible for their business in the same way anybody else is, that's fact, and it is clear that this government have moved Primary Care nearer and nearer to the Private Sector.
Next time you need any vaccinations prior going on holiday, check some of the Private surgeries that are out there for their prices (in some places twice the fees that our GP's will charge you).
Primary care, and providing care for patients is not about privatisation, its about trust in people that you know, and I for one would strongly fight for the role of local GP's and surgeries to be enhanced and strengthened, at the moment the road is one of division, scaremongering, and deep mistrust.
Sexpert
Doctors have to undergo annual appraisals each year, there really isnt a need to put Doctor's to the test, anymore than what is already out there to do so. Patients have sufficient choice mechanisms in place to go elsewhere if they are not happy.
GP Practices are surveyed by both the DOH and local PCT's on a number of things relative to Primary Care, in some cases, the patients responses are fundamental to funding that practices receive (Choose and Book and the Choice Agenda) is an example of that.
Since 1997, the Labour Government have challenged General Practice quite vigorously, and it should be realised that at the heart of this government's policy, lies the will and desire to force GP's out of Independant Contractor status, that's really the bottom line.
Hence we now see the onset of polyclinics, which will actually threaten GP Practice as it stands now, Im angry that having implemented many, many changes over the last decade, this government still feels the need to undermine one of the best things about the Health Service in the UK today. Im not saying we are perfect, but we are for the most part extremely good at what we do, and have first hand knowledge of our patients, more so than the locum Doctor who you will be able to see at at night.
A recent development has seen us extend our consultation hours, this has been forced upon us (financial incentives were available, but they are not funds that we could re invest) this was based on the sort of survey's that the initial post states, in that survey only 7% of our Practice response said that they were unhappy with our current opening times.
What I suspect will happen is that the direction of General Practice will continue to be threatened under this Government, in my area we are about to open a Polyclinic, that is right in the middle of about 5 practices, soundly run, with good profiles, and good reputations, I genuinely do not understand that.
Polyclinics are no good if the support services are not there to support them. What really needs to happen is a full look at the secondary care sector, the costs of your hospital admissions, the costs of your operations, the costs of going to A/E, because if you ask this Government, the only problems are in Primary Care.
GP Practices are surveyed by both the DOH and local PCT's on a number of things relative to Primary Care, in some cases, the patients responses are fundamental to funding that practices receive (Choose and Book and the Choice Agenda) is an example of that.
Since 1997, the Labour Government have challenged General Practice quite vigorously, and it should be realised that at the heart of this government's policy, lies the will and desire to force GP's out of Independant Contractor status, that's really the bottom line.
Hence we now see the onset of polyclinics, which will actually threaten GP Practice as it stands now, Im angry that having implemented many, many changes over the last decade, this government still feels the need to undermine one of the best things about the Health Service in the UK today. Im not saying we are perfect, but we are for the most part extremely good at what we do, and have first hand knowledge of our patients, more so than the locum Doctor who you will be able to see at at night.
A recent development has seen us extend our consultation hours, this has been forced upon us (financial incentives were available, but they are not funds that we could re invest) this was based on the sort of survey's that the initial post states, in that survey only 7% of our Practice response said that they were unhappy with our current opening times.
What I suspect will happen is that the direction of General Practice will continue to be threatened under this Government, in my area we are about to open a Polyclinic, that is right in the middle of about 5 practices, soundly run, with good profiles, and good reputations, I genuinely do not understand that.
Polyclinics are no good if the support services are not there to support them. What really needs to happen is a full look at the secondary care sector, the costs of your hospital admissions, the costs of your operations, the costs of going to A/E, because if you ask this Government, the only problems are in Primary Care.
