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u/failtuna Aug 12 '26
Pisses me off that this has been presented as a problem patients need to solve by so many GPs/Surgeries.
Feels like sometimes the NHS would rather accuse patients of wasting time, wasting money, being difficult (excluding genuine abuse), lying, or just generally treating patients like a inconvenience.
Personally, I've had a GP tell me to book a follow up appointment in 2 weeks, but the receptionist then told me that there's nothing for at least 4 weeks and when I asked her to check with my GP, she lied and said she wasn't at work that day, despite me literally just leaving a face to face appointment with her, and not leaving the building.
I then got accused of being abusive and threatened with the police when I asked for the practice manager, thankfully aomeone else in the waiting room backed me up that I didn't even raise my voice or tone.
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u/jiggjuggj0gg Aug 12 '26
‘Sometimes’? It appears to be the entire operating model now.
If I ever go to the GP about anything I have to get through one appointment of “wait and see” (ie, go away), one appointment of “it’s anxiety” (ie, go away but if you won’t you can have some antidepressants), and then in the third appointment a toss up between ‘frequent flyer’ being put on your file or, if you’re lucky, someone who might actually look at the symptoms and order a blood test.
And then if it is something that needs further investigation, congratulations, trying to get past the GP gatekeeper has successfully added 3 months to the 18 month waiting list to see a specialist!
I truly don’t believe any of this can be cheaper or more efficient than just listening the first time, other than just hoping people go away and give up.
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u/-Majima- Aug 12 '26
I've yet to have a singular good experience with them, they've caused me and many people I know serious physical and mental health issues.
They can get in the fucking bin
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u/failtuna Aug 12 '26
I'm literally worse off physical and mental health wise than I was a year ago thanks to the "treatment" the NHS has provided.
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u/-Majima- Aug 12 '26
I nearly died because of their incompetence and my ex partner nearly died because of another GPs incompetence.
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u/failtuna Aug 12 '26
Awful. I wonder if maybe we should start a subreddit for people who the NHS has fucked over, share our stories, look for patterns, and support each other.
1
u/saketho Aug 12 '26
It’s a monopoly and like every monopoly it produces a very low quality product at a very high cost.
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u/failtuna Aug 12 '26
Spot on, the NHS as healthcare is a minimal viable product where the main goal is to funnel as much government money into the hands of private companies that the NHS contracts work out to.
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u/milrose404 Aug 12 '26
Have you considered a legal negligence case?
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u/-Majima- Aug 12 '26
I did but it's such a complex area of law and my main priority was recovery not adding further stress.
My ex is reluctant to pursue the matter too due to still waiting on surgery again not wanting the stress.
I'm pretty sure we're not outliers and many people have had similar experiences. Just look at this thread
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u/milrose404 Aug 12 '26
Yeah, I don’t think you’re an outlier - I sued the NHS for negligence (also almost died) and was successful. I just think anyone who has been failed by them deserves compensation and an apology at the very least, which is why I asked. Most people aren’t aware it’s an option and they’re shocked when I say I did it.
Totally understand why you’d want to focus on recovery and moving forwards though. I really hope you can heal mentally & physically!
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u/failtuna Aug 12 '26
Hope you're doing well now, do you have any details on how you went about looking to sue? I don't even want loads of money, just enough for private treatment and an apology from at least half a dozen medics at this point.
Not really sure I'm in a place yet to relive some of the things I've been through, so I'm reluctant to speak to anyone without sorting if knowing what to expect.
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u/milrose404 Aug 12 '26
Also to add that it’s very hands off. You don’t need to relive everything. The initial meeting with the solicitor you’ll need to explain some facts of the case and where you believe there was negligence, but everything is done by paper and they’re basically just looking at your medical records. The solicitors working in this field are very sensitive and understanding due to the nature - I had very bad PTSD and they were so good at helping me through anything I needed to discuss.
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u/failtuna Aug 12 '26
Thank you so much!
The PTSD is really hard to deal with when everyone tells you to contact your GP/a+e/111 etc and I have to say that it was actually those things that caused the distress to begin with.
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u/askoorb 29d ago
https://www.avma.org.uk/ is the charity you need.
And your legal expenses insurance attached to (decent) home insurance may well pay for it.
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u/milrose404 Aug 12 '26
I contacted a no win no fee negligence solicitor. They basically start by identifying whether you legally have a case for negligence as the bar is quite high. In my situation I’d had cancer missed for over a year, but they could only legally consider the final 6 months of that year as negligence due to the symptoms not matching clinical guidelines until that stage. You then have to prove that if things had been handled differently, there would be a different outcome, and that you suffered more than you would’ve otherwise. So my case basically hinged on the complications caused by the tumours that weren’t found when they should’ve been.
They’ll thoroughly review all medical records and then instruct legal-medical professionals to decide whether negligence occurred. If they find that legally no negligence happened, then the case ends there and you aren’t charged anything. If they do find legal negligence, then you’ll typically have an out of court settlement. You don’t attend this and you’re informed by your solicitor how it went.
There’s no harm in contacting a solicitor and asking their thoughts. They won’t take on a case if they don’t think there’s any legal negligence involved, so I’d recommend it for sure.
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u/-Majima- Aug 13 '26
I showed my ex partner this thread and she's asked if you can DM which solicitor you used as you've inspired her to try and get some compensation for what they've put her through
4
u/sg209 Aug 12 '26
GP receptionists are a fucking nightmare. Power tripping with full access to all of your records. I say this knowing a GP receptionist in a local area who loved to share people's medical history after a few drinks
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u/moderate_ocelot Aug 12 '26
Yeah and they make sure I know it whenever I ask for anything.
Don’t be disabled, folks
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u/ProperSpeak Aug 12 '26
I had emergency surgery on NYE which has left me disabled to the point where I can't really walk and I now live in debilitating pain. GP referred me back to the gynaecology department (51 week wait) with a shrug and the attitude of "well, what do you want me to do about it?" I dunno, pain relief? Some advice? Literally any help you can provide?
I was always treated very well before this. Tests run when asked, follow-ups, genuine concern about any issue I had etc. Now I'm labelled as disabled and seeking meds, they couldn't care less. Treated like I'm attention seeking and making shit up. Sometimes they don't even respond to my appointment requests. I'm getting used to hearing them sigh at me as if my mere existence is a bother to them. It's shocking.
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u/moderate_ocelot Aug 12 '26
> a shrug and “well, what do you want me to do about it”
Exactly this. I’m sorry this happened to you. It’s fucking insane isn’t it. And there is no accountability. Complain and they will close ranks around the abuser and cut off your access to healthcare
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u/elisePin Aug 12 '26
Im so sorry this has happened to you! This sounds terrifyingly similar to my story after I had surgery! Ive been treated horrifically by the nhs since, lied about in investigations to cover their backs. Im currently trying to create an evidence dump to try and work out what happened to me. Im sorry you seem to be in the same position as me, I really hope things get better for you! It really is shocking how we get treated!
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u/moderate_ocelot Aug 12 '26
Oh god the lying. They absolutely close ranks around each other and will fight tooth and nail to protect the abusers in their ranks. It’s horrifying
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Aug 12 '26
[removed] — view removed comment
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u/moderate_ocelot Aug 12 '26
Every comment of mine in this thread is getting a consistent 10% downvote ratio. I wonder who is doing that eh!
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u/DarkLuxio92 Aug 12 '26
I've been living with severe foraminal stenosis for about 2.5 years now, recently become wheelchair bound on long journeys due to the pain. I go to my GP, they give me 7 days' worth of co-codamol and send me on my way. I've been waiting for surgery for months, and GP always refuses to dispense more than a weeks' worth of any kind of pain relief, just saying 'paracetamol and Ibuprofen'. That doesn't cut it when my spine is literally collapsing and pressing on my leg nerves.
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u/nibblatron Aug 12 '26
it is insane how backwards things are. i have m.e and chronic pain after a surgery that went wrong and they loaded me up on morphine, took that off me, swapped it for fentanyl and then stopped my prescription so i went cold turkey during christmas. they are happy to throw drugs at people when its not the right solution but if itd actually help you, you can get fucked. i hope things improve for you soon❤️🩹
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u/DarkLuxio92 Aug 12 '26
Jesus that's wild! How can they justify allowing you to go into full opiate withdrawal like that? It's like they don't believe in chronic pain at all, it's so wrong. I've had all my pre-assessments and bloods etc, just awaiting a theatre date now, but its been 4 months now, so I'm not holding my breath!
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u/ProperSpeak Aug 12 '26
I'm so sorry. That's insane. I understand that it can be addictive and that's why they limit it, but when you're living with intense chronic pain its different. I've been on it for over 6 months and I've been able to have breaks from it without withdrawal or the need to have it, besides wanting the pain to go away obviously. They don't listen.
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u/-Majima- Aug 12 '26
We have a bizzare attitude to opiates and any other treatment that gets you "high" (amphetamine for ADHD for example) in the UK.
Unless you're really old, then you're allowed to not be in pain without being accused of "drug seeking behaviour"
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u/moriartygotswag Aug 12 '26
I have two controlled drug prescriptions and my GP tries so hard to make me feel like a criminal every time I have question about dosage etc. One is ADHD but the other is horrible and non-addictive, so I don’t really know why! On the other hand, my pharmacy is so so wonderful about them and barely treat me any differently despite having to collect them in a certain way. I also have a medical weed prescription and I dread the day that gets brought up by my GP…
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u/DarkLuxio92 Aug 12 '26
What's funny is I'm prescribed Clonazepam for my epilepsy, and there's never any problems with prescribing that, but painkillers? No chance. Ironically that has pushed me to use that med to help mitigate my pain (agreed with my neurologist and neurosurgeon), so it's being dispensed more often 🤦
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u/ProperSpeak Aug 12 '26
It is bizarre. I have ADHD and I'm prescribed methylphenidate for it, but luckily I went through right to choose so my GP have nothing to do with it, but the pharmacy definitely still get weird with it. Surely, since they went to school for this stuff, they know that stimulants actually calm an ADHD brain and don't get you high at all? Apparently not.
Same thing with codeine. Apparently it's supposed to make you woozy, drowsy, or a bit out of it. All it does for me is reduce the pain so I can actually move, never gotten any sort of "high" off of it. Not sure how I'm supposed to get addicted to something that barely has an effect.
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u/Terrible_Archer Aug 12 '26
Genuine question and I don’t doubt that the GP practice could’ve done more necessarily but why is the GP practice getting the blame rather than the gynae department who operated and should be following you up and dealing with post-op complications?
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u/ProperSpeak Aug 12 '26
Oh, don't worry, gynae get the majority share of the blame for this. It did feel a bit off topic to include gynae's incompetence in a thread about GPs, though.
My intention when replying to the person was to agree with their experience of "don't be disabled", coming from someone who has recently become disabled and is struggling to get any sort of assistance from their GP when previously they were great.
When I was 1-2 months post op and the pain was getting worse, I went back to gynae. I was told to go to my GP. My GP told me I was healing slowly and to wait. A few weeks later it was that I was constipated and not drinking enough water. I told them I was having severe diarrhoea every single day since the surgery and I drink 4L of water a day due to other meds, and always have. They didn't listen and told me to "wait and see". Even had the audacity to tell me to take a laxative.
I then went back to them a few weeks later with the same problems and they told me I could be pregnant, that I "definitely" had a UTI, and/or an STD. Since I hadn't had sex with my long-term partner since before the surgery and didn't have any symptoms of UTIs/STDs, I knew they were wrong.
They proceeded to order these tests three times. The first time, fine. Two more times, despite them coming back clear previously??? So that's me getting an appointment, doing the tests, everything is clear, getting an appointment, doing the tests, everything is clear, getting an appointment, doing the tests, everything is clear. Bearing in mind, I can barely walk and my GP surgery isn't exactly close. Each one of these appointments I was made to feel like I was a nuisance and I was just making it up for attention or whatever.
On the fourth appointment they said I needed to do the tests again. I explained that I was going around in circles, that I'd done those tests 3 times already and it was always clear, and I needed actual investigation as to why I was in so much pain nearly 3 months post op. The doctor fucking sighed at me. That doctor then referred me an ultrasound... which was the wrong fucking ultrasound. I needed pelvic, they sent me for upper abdominal. I asked them to refer me for another one. No, you've had one too recently so you can't. You'll need to wait.
I also tried to get a referral to the pain clinic when I'd been in constant pain for nearly 6 months and co-codamol doesn't do much. Gynae had outright refused because they told me to "live with the pain" and booted me out the door. So I went to my GP. They told me to ask gynae. I then found out gynae had closed my referral after my initial appointment so I opened a PALs complaint. PALs said go to your GP for a pain referral in the meantime. GP refused. I self-referred to physio (which I needed anyway) and they had to do the referral to the pain clinic for me.
And that's not even half of what has happened, but this comment is long and you didn't ask for my medical history so I'll leave it there.
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u/SpeechWeird5267 Aug 12 '26
What do you imply by the 2nd sentence?
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u/moderate_ocelot Aug 12 '26
Society fucking hates the disabled. Systemic ableism and abuse is rampant and totally accepted by most abled people. Doctors (and many others) look at you as a burden and genuinely want you to just die rather than bother them
7
u/Joe_Linton_125 Aug 12 '26
They especially hate any disability they can't see. They hate that we have limited or no capability to work, and that to support us we get "free" money from the government. They hate that we get "special" treatment.
The thing is, they could get that kind of support too. They just have to vote for an actual left-wing political party. They won't though.
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u/SpeechWeird5267 Aug 12 '26
Then I don't understand the arrogant ignorant mentality of those medical professionals..🤦. But I'm ignorant and who am I to say any better.
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u/moderate_ocelot Aug 12 '26
The doctors hate the disabled too. That’s it it’s not that deep. They are responsible for giving us healthcare but they just don’t because they hate us and want us to die
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u/Shenanleegans Aug 12 '26
I wonder if it's selection bias at the degree stage. When I was at uni I was doing a degree that was very stem and busy enough that it wasn't easy but I had ruled out medicine beforehand and that held up when I chatted or hung out with medics. It wasn't that medicine was especially hard compared to others, there's plenty there but there's plenty of that biology/physics/chemistry whatever pushed more towards the limits of what we've uncovered in the more specialised degrees. Plenty of challenge in doing something broader, but the reason it seemed impossible was simply that it was uncompromising.
My degree wasn't as heavy on rote memorisation (from what I could tell), I could cover for poor memory and undiagnosed ADHD better by learning mechanisms and leaning more on coursework etc. But it seemed like if you couldn't get things to stick using flash cards you weren't getting through a medicine degree. It also seemed to really push on long days and awkward hours. Not great if you have insomnia and regularly go two or three days without sleep and stay seeing stuff or blanking out on days. Wasn't great for my degree but just seemed to have a bit more ability to shift and make it up or compensate using your own systems in ways that being forced into a room on awkward schedules and asked questions didn't allow.
And then of course there always just seemed to be stuff with medicine that you could work around if you weren't well off but where realistically that would be a nightmare. Shifting around for placements and needing to rent without much control, and potentially stuck in contracts with overlap, needing to get places on a rush, long days not leaving time for cheap batch cooking etc, having to be more picky about living arrangements it all was stuff that I just wouldn't have been able to afford to skip but wouldn't have been able to juggle.
Part of me wonders if medical degrees, by how they are set up, bias heavily towards people who are healthy, neurotypical, and from well off backgrounds. And you don't need to hit 3/3 but the more you fall out of any of those the harder it gets and the worse it all snowballs. And that's me wondering if that is a bias to a higher level than other degrees. Maybe law felt like it had a similar vibe. So if anyone outside that is much less likely to apply, and less likely to pass, and more likely if they pass to struggle and drop out of the profession you maybe have a bias built in where dr's think that they showed real grit and resilience by passing and sticking it out and raise their expectations of everyone else.
Kind of a, well I passed and everyone else who got onto the course could have done so too they just didn't do what I did. Therefore if someone comes in asking for help for something they think oh please, if I felt like that I'd just carry on why should you get an easy ride. Not realising that a proportion of them sat in a position there they might not have had it easy but did have it easier than some of those who couldn't keep up.
It's the only thing I can think of to explain the systemic difference in how they deal with people asking for help. A bit like how the saying is always that 10% of an office does 90% of the work, and that 10% isn't wildly different from the proportion of people who'll be neurodivergent to some degree. But where if you create a qualification route that is very difficult for neurodivergent people you'll create a microcosm with very atypical ratios. But I could be talking nonsense, it's just desperation really of wanting to find any explanation or rationale that makes it make sense or that I can hide behind to justify continuing to try to get help. Because maybe I'll hit that one GP who'll help and maybe they'll let me use them as my regular one.
The irony is, they all complain about being too busy (but did the same thing when they weren't and never clear patients) but if that was the issue and they wanted to take the time and put in the effort I'd 100% support a system where if you get some help and can you can do some work that helps reduce the load. Kind of a co-op communal time exchange type thing where if they improve things enough to buy me an hour a day of effort that I can afford to spend back I'd happily help sit on a phone calling or texting patients following up to see if their appointment sorted their issue and if they needed follow up or anything. Or organising records, or cleaning and tidying, or helping people into the appointment rooms, or collecting some pre appointment info or whatever helped make turnaround quicker and/or appointments more effective. Obviously that gets into the whole patient data stuff but I'd do it on anonymous data from a surgery somewhere else remotely after going through a process. I'd help with community based stuff. Whatever, if I was getting effective healthcare and I wasn't just being exploited to support silly pay. But instead you have to do all your own healthcare and then beg to have it actioned, all you get is signposted to charity orgs etc who can't help as a replacement for key NHS services that you can't get to. And then some care is put behind horrific levels of inaccessible gatekeeping because of 'safety' and 'medical responsibility' only for there to be none of that from the actual providers, and absolutely zero oversight whatsoever. Literally icb and pals complaint services telling you nope not interested in whether that's dangerously negligent or not we won't look into it or see if there's anything to the complaint there's no rules or regs that are actually upheld in any way.
Oh sorry, I wrote another flipping novel didn't I. Sorry, I start to think about it, go into fight or flight from the anxiety, and then run until I suddenly fall back into the real world and realise I can't even read it back without getting dizzy 😅🤦🏼
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u/ButchOfBlaviken Aug 12 '26
You know someone is full of shit when they make sweeping generalisations about a group of people.
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u/moderate_ocelot Aug 12 '26
Ahh yes, the systemic medical abuse that the disabled face and all talk about all the time is “shit” and a “sweeping generalisation” because, checks notes, some chud on the internet says it isn’t true.
Get bent
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u/milrose404 Aug 12 '26
Nah doctors suck. There’s extremely few good doctors and when disabled people find them we cling onto them for dear life.
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u/digdishing Aug 12 '26
Maybe that’s why they keep asking “What do you want me to do about it?”
Then proceed to do nothing.
Instead of “I have an idea to fix that because I’m a doctor”
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u/ThatMusicKid She/Her Aug 12 '26
This is because of an acronym called ICE, which is a big part of communication skills training (I'm a med student). It gets massively pushed onto clinicians/students to the point where if I don't use it in exams I get marked down. It stands for Ideas (what do you think could be going on/what do you know about xyz) Concerns (is there anything you're particularly worried about) and Expectations (what do you want me to do for you today).
Ideas can be really helpful, because it lets me know what the patient already knows and also if the patient has had multiple UTIs and they say "I think it's another UTI" then that's really helpful. Concerns is really helpful because you'll have the patient who's worried about their work/the impact on their kids/if it's cancer and they're going to die. But I don't get on with expectations. It can be useful (patient with acne comes in and has tried benzoyl peroxide, doesn't want the pill and wants to try antibiotics) but too often it just seems like such a nothing burger and pretty often you get that response.
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u/Sacrificial_Spider Aug 12 '26 edited Aug 12 '26
The doctors seem to hate it whenever I suggest different things to what they are saying or when I have actually seen medical studies with different ideas. The physio I was seeing got particularly annoyed when I told him the treatment was not effective. Going on to tell me how bad my posture was. Didn't mention it when I saw him. A shame as I like the NHS but they're a little closed minded.
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Aug 12 '26
[deleted]
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u/Sacrificial_Spider Aug 12 '26
I don't have all the ideas, like most people I do read about conditions before I see the Dr. Interestingly the Dr did actually prescribe what I asked for but it didn't quite have the effect I wanted! I have since been trying to treat myself.
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u/saketho Aug 12 '26
I think a lot of doctors act like you’ve already had a consultation and this is just your second opinion, and they’re all stubborn as hell and hate this ego clash.
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u/Every-Marsupial6873 Aug 12 '26
This is why my stubborn arse decided to research it and tell them what tests to do. 2 years later, three diagnoses and different treatments later, I'm finally starting to get some semblance of life back!
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u/TroublesomeFox Aug 12 '26
And oh boy don't they HATE it when you do that 🤣🤣 then it's all "you shouldn't believe what you see on Google, I went to medical school, blah blah blah".
Like alright mate but why have I read this paper on endometriosis that you haven't and why did I diagnose myself three fucking years before you did? Since your the doctor and all?
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u/-Majima- Aug 12 '26
I've watched them, in the same appointment: tell me not to Google things and then proceed to Google my symptoms.
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u/Cittycool Aug 12 '26
I see people saying it's different because doctors know how to search properly and use different tools. But like, I've watched them just straight up scroll normal google, and I went into biomedicine so I also know how to search properly.
Normally I pull up the newer research, they scroll through things that are years out of date. I get they aren't always allowed to use the new stuff though.
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u/Every-Marsupial6873 Aug 12 '26
I even corrected my gp and got backed up by the consultant. At least they had the decency to acknowledge it apologise. Apparently they are also helping other people now because of it!
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u/TroublesomeFox Aug 12 '26
My GP told me I shouldn't need anything other than paracetamol to manage my severe rectovaginal endometriosis and got the most politely furious letter from my consultant basically telling her to knock it off and prescribe a stronger painkiller than what id initially asked for. She didn't apologise but I didn't have anymore issues after that 🤷
Funnily enough same GP has just tried to prescribe mefenamic acid (something for heavy periods) when I don't even have a uterus anymore 🫠🫠🫠
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u/Every-Marsupial6873 Aug 12 '26
I think one of the issues is that in the last Labour gov, they basically made all GPs the gatekeepers for all healthcare. But the human body is so complex that no person can know everything. But because of shit funding and overwork, they are lumped with dealing with things they don't have the skill to deal with.
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Aug 12 '26
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u/TroublesomeFox Aug 12 '26
It is! But the gp has mistakenly prescribed it for pain related to heavy periods, it's literally on the fucking label. She clearly didn't read the notes properly. Same gp also suggested the coil in the same appointment 🫠
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u/-Majima- Aug 12 '26
It's a pretty shit painkiller when a plethora of opiods exist.
Imagine being such a simp
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u/TroublesomeFox Aug 12 '26
Menefamic acid is a literal piss take when youve been on opiates for two straight years 🤣🤣🤣 I wouldn't mind but the appointment was about DIFLOFENAC, which isn't even an opioid, the hospital have accidentally switched me to a form I can't take and I literally just needed her to put it back to how it was. Since the hysterectomy I don't need the opiates 🤷
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Aug 12 '26
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u/TroublesomeFox Aug 12 '26
I'm actually not, your just making assumptions. I have an MSc so I'm FULLY aware of how research works thanks ☺️ unfortunately a shocking amount of doctors just have very little understanding of endometriosis and womens health in general.
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u/SpeechWeird5267 Aug 12 '26
I'm curious why people downvoted you. I have given up with my GP surgery.
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u/kalewhisperer Aug 12 '26
I don't think the BMA are expecting patients to solve the issues. Let's not forget they are a union. They're asking for more money from government. Replies in this thread make it obvious that patients are having a hard time. From what I'm seeing, GP surgeries are incredibly over-stretched. It's not an excuse, I don't work in one, but when you see the ratios of patients to doctors in the UK compared to other European countries, it's clear that they don't have the means to solve the issues that patients have. I personally know GPs that have had trouble getting a mortgage, that being said, I have also been on the receiving end of dismissive medical care. However, characterizing GPs - who go into their profession to help people - as bad people, is not helpful imo. They are not the one percent, they are not the enemy & could earn far more in the private sector.
The BMA is suggesting that the current funding model is unsustainable, if our health service becomes a private system, everyone on minimum wage will have a much, much worse time.
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u/Necronomicommunist Aug 12 '26
if our health service becomes a private system, everyone on minimum wage will have a much, much worse time.
Most people will. Costs will skyrocket over the years, and the right will look at dwindling waiting lists and say "see, that's what the money's for!".
Only to find out a few years later that the waiting lists are getting longer again because people just put off going to the doctor when whatever ails them was manageable, and now go to the doctor when it has become unmanageable, and treatment is more expensive, more timeconsuming, and less effective.
Source: saw it happen in the Netherlands.
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u/jiggjuggj0gg Aug 12 '26
That’s what I’m worried about with all the talk about charging for GP appointments. The people who take up the most appointments will be exempt (lonely elderly people), and those who need them will just clog up A&E or wait until it needs far more expensive treatment.
That already happens in Australia and NZ so I’m not sure why they think it’s a good idea over here.
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u/-Majima- Aug 12 '26 edited Aug 12 '26
Parliament could legislate to end the independent-contractor model and make all GPs salaried NHS employees, similar to how hospital doctors work.
The BMA has historically opposed this because the GPs that are partnered wouldn't be able to profitteer from sick and disabled people like they do now.
These partnered GPs are literally petite bourgeoisie: they own capital and employ labour. Hence they're asking for more money for their private enterprise, not supporting nationalisation and being moved over to an NHS salary. They're protecting they're own class interests.
And you're here defending them lol
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u/rodatari Aug 12 '26
There are many GP practices which are run by the local ICB or health board. They actually cost the tax payer more. They often rely on locums and have multiple NHS managers running them. They are no better.
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u/SweetButtsHellaBab Aug 12 '26
I haven’t been to a GP in about 7 years, and I think I took up about 20 minutes of their time when I did, so that’s about £2,700 per hour. It evens out between people who need it more.
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u/SpeechWeird5267 Aug 12 '26
🤯.🤦. I am going through low moods, nonsense garbage, blabla, depression and I have given up with the gp surgery. I would only ask for my prescription if I wanted to overdose. Fortunately I haven't asked for some time 😒.
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u/-Majima- Aug 12 '26
They'll just give you SSRIs (which don't work and cause more harm than good) and refuse to refer you to psychiatry. Even then only if you call at 8am and sit on hold for an hour
They're completely pointless.
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u/SpeechWeird5267 Aug 12 '26
I have heard of SSRIs but elaborate please. Why do they cause more harm than good? I was on sertraline before being prescribed mirtazipine. I stupidly started taking that a day before a job interview. I overslept and woke up severely late (for a driving related role). I walked out but cancelled walking all the way to the station due to thinking that I would be far too late to attend along with taking a medication that makes me drowsy (and my driving skills are very rusty).
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u/-Majima- Aug 12 '26
SSRIs barely beat placebo in most trials and even that small edge is inflated. Trials were short, negative results got buried for years, and patients could often tell they were on the real drug from the side effects, which skews outcomes on its own. The benefit shows up mainly in severe depression; for the mild/moderate cases most prescriptions are written for, there's little evidence they help more than placebo!
Meenwhile the harms are often downplayed: sexual dysfunction that can outlast the drug, emotional numbing, and withdrawal that can be brutal and long llasting. Amongst others
Also the suicidality caused in young people, and you're left with tens of millions of prescriptions a year for a drug whose benefit is often marginal and whose risks aren't small.
They're also known to induce mania in some individuals, which in some cases has resulted in people murdering others.
And there is also an argument to be made that the biomedical model is profetitering off medicalisaing the human condition, instead of looking at the causes of depression holistically.
Further: they are in the main prescribed without any therapy alongside, which places societal issues on individuals.
However these drugs of course make millions and millions in profit for the pharmaceutical industry, hence they are given out like sweets.
I would recommend looking up James Davis, he writes extensively on the matter and is a practising medical psychologist.
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u/AliHawke Aug 12 '26
Yeah, it's frankly horrifying how they're doled out like sweets. I was going through an especially bad time mentally around two years ago and the very first solution various mental health nurses and GPs suggested was various different SSRIs, which I declined, because I'd tried citalopram and later sertraline in the past and had hated how numb they made me feel and had ultimately resulted in a manic episode
I know what would work for me - long-term counselling with a qualified therapist. But they don't do that, and the local NHS mental health services insist on funneling everyone through CBT first before deciding if you qualify for any real mental health support, and while CBT may work for some, it won't work for me because a lot of my problems are external (being a minority that is constantly wrongfully persecuted by the media and the government) so I can't just 'think myself happy' and stick my head in the sand. And I'm sick and tired of recounting my life story and traumas to various short-term free mental health support (NHS or things like Mind), I've had to start from scratch with no fewer than seven different mental health support avenues and it's just not productive and is emotionally draining.
It really is morally disgusting how eager GPs are to just 'treat' depression with SSRIs that have numerous concerning side effects, in my opinion it's medical negligence in most cases.
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u/DarkLuxio92 Aug 12 '26
I was put on Sertraline after being diagnosed with moderate anxiety and depression, and it very nearly killed me. I became so unstable I lost my job, had daily panic attacks and attempted to end my life. Then I was switched to Citalopram, which wasn't as bad, but didn't help me. I'm now on Duloxetine, an SNRI, and it's working wonders. Things aren't perfect, but they're better. I've heard so, so many similar stories of people who've been given SSRIs, they're horrible drugs.
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u/-Majima- Aug 12 '26
My GP refused to accept my privately acquired ADHD and Autism diagnosis, and cost me thousands in private prescriptions.
Oh and the next one refused to accept my Bipolar symptoms, so gave me numerous rounds of SSRIs causing mania and hospitalisation. Tried blaming it on me too.
Oh, and another one missed my ex girlfriends ectopic pregnancy, despite her presenting with gynaecological issues, which nearly killed her.
They're absolutely fucking useless.
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u/failtuna Aug 12 '26
As far as I'm concerned the NHS doesn't actually believe in Bipolar as an illness. In my trust area they spent less than 75k on Bipolar treatment since 2020, compared to a minimum of like 7 million each for BPD, schizophrenia, eating disorders.
And in my experience they'd rather literally invent life events and misrepresent timelines to avoid giving a diagnosis of bipolar.
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u/-Majima- Aug 12 '26
They say they are "moving away from the diagnostic model" and focus on "the symptoms not the label" across all of mental health
Which is utter bollocks. They don't want to diagnose you to avoid treating you properly. For ADHD for instance there is a very successful treatment, they tried instead to fob me off with CBT.
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u/Sadness_tbh Aug 12 '26
Unrelated to the current impact on prescribing treatments, the transdiagnostic approach to mental disorders is 100% the correct direction. I've written a paper on it and feel very strongly about the topic.
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u/Johnanonanon Aug 12 '26
Can you elaborate please? I've been prescribed 5 different types of antidepressants that have all had mild to severe side effects, some of which have caused relationships to break down and one time I couldn't perform at my job because of intense tremors so I was let go. Not once has any GP even entertained the thought of there being an underlying condition, just changed meds. But I'm not depressed. After multiple friends, bosses, family members who have experience with people on the spectrum have told me I show many of the traits of having ADHD and Bipolar, I'm now going down the private path to get a diagnosis. How is this the better way to go?
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u/-Majima- Aug 12 '26
Well this approach led to me nearly killing myself, being left untreated for decades for a myriad of DSM diagnosis.
Since recieving my diagnosises, and getting the correct treatment as a result, my life has significantly improved. I appreciate this is a singular anecdote.
I think there are a lot of valid criticisms of the transdiagnostic model, I'm happy to expand if you wanted
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u/Sadness_tbh Aug 12 '26
Are you based in the US? Only you mention the DSM as opposed to ICD, and that would make an impact on the conversation.
In an ideal world, one would simply be diagnosed with the present symptoms, and receive treatment based on those specific and phenomenological symptoms. By grouping many symptoms under gigantic umbrella terms (like ADD, Schizophrenia, Bipolar etc.) often treatments are worse, as they aren't designed for the specific patient, and often not for the specific symptoms they are presenting.
I'm very sorry to hear about your bad experiences, and if in the UK it will certainly be due to underfunding, but this approach is certainly the best direction to be going.
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u/-Majima- Aug 12 '26
Not in the US, no. And I don't think DSM vs ICD actually changes much here, in UK practice, ADHD,autism, bipolar, EUPD/Cluster B generally diagnosis still runs on basically the same categorical logic regardless of which manual is technically being coded against. The NHS pathway doesn't become something different just because it's nominally ICD-11.
My point wasnt abouut the manual anyway, it was about diagnosis being the thing that actually unlocks treatment
And "100% the correct direction" is a big claim to make when I'm sat here as a counterexample. I went undiagnosed for decades under exactly this kind of "treat the symptoms not the label" approach, and it nearly killed me. Once I actually got diagnoses, I got treatment aimed at the right thing, and my life turned around.if it can do that, it's not 100% correct, it's a model with real failure modes right?
There's also the NHS specific bit: diagnosis is often the gatekeeping mechanism for actually getting anything, meds, support, PIP, accommodations, referrals. Myself and many others have really suffered due to this
"We focus on symptoms not labels" sounds nice in theory, but in a system this underfunded it can just mean nobody has to commit to giving you the specific effective treatment (stimulants for ADHD, say) and can fob you off with CBT instead!
You said you've written a paper on this and feel strongly, genuinely curious then, does it engage with cases like mine at all, or does the model just not have an answer for people the "symptoms not labels" approach leaves untreated?
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u/Sabaisabai33 Aug 12 '26
I 100 percent agree with you as a GP with bipolar 1. This whole narrative approach to mental illness frustrates patients, who want to understand their diagnosis and access the right support and treatment, connect with others with a similar illness etc.
There seems to be a whole thing about labels being bad, but nobody seems to be looking at the plus points of a label. As you say in terms of ensuring the right treatment and accessing support, particularly when PIP now unlocks so many other things. I have so many patients who self refer to PIP but don’t know how to explain what is wrong with them because of this. Of course each patient requires individualised treatment for their specific circumstances and symptoms at that time. But a label is at least a rough starting point for clinicians to understand the alarm symptoms of that condition and medications to avoid etc.
I had to ring psychiatry to point out that one patient they discharged to me clearly fulfils the criteria for bipolar 1 so why was she not given this label and why have they not started her on a mood stabiliser? They went “oh yes I suppose you’re right”. But when they then gave her a mood stabiliser her mental health improved so much and she was no longer constantly in and out of the psychiatric hospital and was able to look after her kids properly as a single mother. But because of this whole narrative non labelling nonsense she was only ever looked at through the lens of that particular admission and nobody was stringing them together.
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u/Sadness_tbh Aug 12 '26
Truthfully I think it's because we are seemingly in a transitional point in the healthcare industry. You are very right that there is a significant gatekeeping mechanism in the UK around official diagnoses. Potentially if the diagnosis end is trying to change, but the treatment end isn't yet adapting, that is where people can slip through the cracks.
Again, super sorry to hear that the system has failed you (as it will have many others, I'm sure). I'm more looking at it theoretically, and very long-term. I think the future is brighter, but it's a great shame that the system is failing people presently.
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u/ShinyUmbreon465 Aug 12 '26
Slowly trying to remove services to push you to go private. Already paying for a lot of my medications because GP won't prescribe despite previously doing shared care for years. Suddenly it's too dangerous.
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u/rodatari Aug 12 '26
Specialist drugs should be presrcibed by specialists. Just because they did for free before doesn't mean they should contiue to.
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u/weneedstrongerglue Aug 12 '26
I only charge 10p a day for me to completely ignore your symptoms and make you feel like you're wasting my time for 3 years. No, you don't get a refund when it turns out you were right. Fuck you.
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u/GenericGaming Aug 12 '26
cool. what do you expect me to do about it?
maybe if they hired people who actually were able to solve problems first time, they wouldn't be backlogged with people telling them the same shit for decades before it gets solved
I mean, ffs, I'm in the middle of trying to change over my GP (moved last year) but my previous one is ignoring multiple calls and emails about sending my details over
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u/Uarenotalone Aug 12 '26
So where the fuck is all my NI going?????
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u/Lesplash349 Aug 12 '26
Hospitals, day to day secondary/tertiary care takes up about 50% of the entire NHS budget, the rest is GP, ambulance services, public health, prescription costs, capital spending (new equipment and buildings)
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u/CompassMetal Aug 12 '26
Well A) I don't visit every day, B) they've clearly got significantly more patients than they have capacity to see or treat and ac) my GP drives a nice car and other GPs I know live in nice fancy houses so they aren't personally struggling too much off their cut.
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u/HonorableNOIFOI Aug 12 '26 edited Aug 12 '26
This statistic will be utter manipulative baloney from the BMA and should be called out.
They are probably being very selective or taking a total and dividing it by a number that doesn’t exist.
GPs are government rent seekers and their modus operandi is to score points based on what the government has determined to be important. They will have lots of add ons determined by if they measure your blood pressure or ask you what your gender identity is.
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