https://www.theguardian.com/society/2018/feb/28/gps-offered-cash-to-refer-fewer-people-to-hospital I thought GPs were already finding it hard to cope with the workload? This sounds an odd way to try and fix the system. HB

The EU has barred the NHS from checking the qualifications of EU doctors and nurse, that means thousands of European doctors and nurses will be able to practice in this country without checks on their qualifications. These new rules in the EU, mean they will be given electronic passports’ which will automatically allow them to practice in hospitals and GP’s surgeries. Europe will issue these passports to nurses, midwives and some other medical staff from January 1st, and doctors in two years’ time, without checking their qualifications or whether they have lied or been suspended. Also they will not be tested on their ability to speak English, because this would impede their ‘freedom of movement’ rights. So if you ever become ill, I would suggest you try the vets after all they will most likely be better qualified than your doctor.

An interesting story for general practice this morning. The post on the BBC website today links patient satisfaction with GP antibiotic prescribing levels. http://www.bbc.co.uk/news/health-35008128 As a practice manager I've seen this myself, people wanting to complain that their request for antibiotics (ABx) has been refused, normally accompanied by "well, Dr. X always gave them to me..." We have a nickname for GP's who prescribe appropriately, Dr. No! Because it seems they spend much of their day saying just that. You find that most younger GP's are quickly labelled as a Dr. No and they quiclky develop a whole tranche of patients who don't want to see them and would sooner see the older, 'easier' GP. Is it down to GP's who are less strong willed in the past changing public perception and expectations? I think it might be, it's far 'easier' to give someone what they want, but is it clinically appropriate? No, of course not. It was only in August this year that GP's were threatened by NICE with being disciplined for prescribing too many ABx(http://www.bbc.co.uk/news/health-33961241) So, what's your take on it? Are you left feeling short changed when you leave the surgery empty handed? Are you happy that your GP is one of the stronger, more clinically adept ones who prescribe appropriately or would you prefer one that NICE want disciplined/struck off?

I was tempted to use 'discriminate against' in the thread title but thought that may have been a bit too strong. Ok, so my mum is currently on a trip to Dubai with my dad (He's already over there for work) and so we went to take out a travel insurance policy. She's done this trip (alone and with me) several times in the past few years so we've got a good bit of experience with buying Travel Insurance online, usually from the Post Office, and just printing out documentation at home within minutes. All nice and simple. So this year we sat down (She's not at all IT-savvy, so it's down to good old Son who works in IT to do something so 'complicated' for her ) and went to go through the process as usual, but this year there was something a bit different about the questions to answer/fill in, with more details on the medical side being requested. In the past there's never been any medical questions when buying travel insurance beyond the "pre-existing conditions wont be covered" type stuff. Now, unfortunately my mum was diagnosed with Breast Cancer nearly 6 years ago. Fortunately it was caught very early and through a combination of minor radiotherapy and drug treatments, she made a complete recovery and was given her all clear last December. Previously this has never been applicable to the questions that we've been asked when buying Travel Insurance online, but the new questions, or at least the new wording of the questions, meant that it did seem to fall into the 'relevant' bracket now, so when the following question came up, Along with. We had to click Yes, wanting to give an honest declaration that she had been for treatment, but that she was now all clear and no longer undergoing any treatment. On clicking Yes we were asked what the condition was, and Breast Cancer was an option. We were then given the following questions, Available answers were, "No", "Yes - spread to lymph nodes in armpit only" and "Yes - spread to other parts of the body". Fortunately, our answer was "No". "Under 2 years" "2-3 Years" "3-5 years" "5-8 years" "8-10 years" "More than 10 years" Our answer was "5-8 years" "Yes" "No" "Still waiting for surgery to remove the cancer" Now on this one, we selected "No", as there was never any surgery. However I'm assuming here that Chemotherapy and medication don't classify as 'surgery' as there wasn't what I could consider a surgical procedure involved. For this one we selected the option of 1 to 2 visits in the last 12 months, the last one being her final check last year before getting her all clear. Well, no she's not. Treatment is complete, but there was no option for that at all. There were only options for Chemotherapy, Surger, Radiotherapy, Tablet treatment, Other Treatment or No. So we had to pick no. So as you can see, there were absolutely no options to say "I did have cancer, but it was treated completely successfully without the need for surgical removal". So we put in those details, and then got prompted that there were no policies available based on the information. Hm, odd. So next we tried a comparison site, thinking that might be a bit better. We ended up on Moneysupermarket after prompting that there was a previous cancer case involved were directed to their "Pre-existing condition" quote site. Sounded good, something a bit more specialist. Went through that only to be prompted with word for word the same questions and answers. Obviously we put in the same information....and got the same results. No policies available. In the end, she had to phone up her bank and managed to get a quote over the phone since she could actually explain the cancer was now gone and she'd received her all clear. But why not have an option for people who have been successfully treated for Cancer? Why did we have to go through all that? Are insurance companies just of the opinion that once you've had cancer, you always have cancer?

This is very worrying ? http://www.bbc.co.uk/news/uk-england-nottinghamshire-30005682

I heard someone from this association on Radio 4 this morning. There's nothing on their website and the podcast isn't up yet, but I'll post it when it is. I'm not quite clear what they do, but it seems to involve supporting patients who are having trouble getting the treatment they want, or who are getting nowhere with complaints against a hospital. And I think greater transparency was mentioned. http://www.patients-association.com/Default.aspx?tabid=41 HB