UK Politics: Bully for you

[Tyria]

I dunno, maybe our pharmacists are trained differently in Canada, but they've been giving vaccines for a long time. It started with the flu vaccine, I believe, then expanded to others. We got our covid boosters at the pharmacy. 

The province has also expanded some services where pharmacists can diagnose minor ailments like UTIs, sore throats, etc. It was done to relieve pressure on overworked doctors (our population exploded during covid, because a ton of people, mostly from Ontario, sold their multi-million dollar shit boxes and bought up pretty much everything in the Atlantic Provinces causing housing and rents to skyrocket. Sure, our house would sell for over twice what we paid for it in 2016, but there would be no where to go!). 

We've also kept online doc appointments, which is awesome. It was a pain in the arse to have to go to the office, because parking by mine sucks, I hate elevators, and she's always running late. I've lost count of how many times all I needed was just a prescription renewal, but I had to go in because regulations. It saves everybody time now keeping this option. She calls me on time or a little earlier now, and I don't have to sit in a waiting room with sick people.

Anyway, all of this was done in consultation with doctors, nurse practitioners, and pharmacists. I don't think I've heard of or read about any complaints. Everyone just came together to deal with the shortage of nurses and doctors. Recruitment is ongoing, but something had to be done in the meantime. 

[Raja]

Not a GP, but work with plenty & GP land and A&E are linked in a lot of ways and good pathways between both always benefit patients

1. The current system for getting appointments is terrible for patients and needs changing from calling up at X time to try and get an appointment.

2. People should do what they're trained to do and that includes pharmacists - if they can be trained up to see common thing like sore throats, UTI, earaches then fair enough - will they be getting that training? If yes, then I don't see much of an issue - if not, and Sunak mentions investing money but isn't clear if that means they will be skilled up or just have the ability to give Abx.

I'd also add that the majority of sore throats don't need anything except time as they're viral infections and antibiotics don't actually do anything for those - but

- Are they going to know which sore throats are actually not sore throats but a peritonsillar abscess that needs to be seen by an ENT surgeon? Will they get training for that

- Will they have the appropriate training to recognize the complications of earaches etc?

3. Things like this are a drop in the ocean and do not deal with the core issue that

- We have fewer GPs than 5 years ago

- GPs are seeing *way* more people than 5 years ago

- We have a government over the last 10 years that has cut funding to the NHS

- It does nothing to address that the profession is not attractive to doctors and it's much easier to just go someplace else ( Australia/ New Zealand) and get better pay and see fewer patients

[Tyria]

Yes, they are getting the training for it here. The doctors never would have allowed it otherwise. Also, the pharmacist can and will send someone to a doctor, if they are unsure of the diagnosis, and they send all info to your doctor, if you are lucky enough to have one. 

The government is recruiting hard and setting up another medical program at a university in another part of the province aimed at getting doctors into rural areas (there was only one medical school in the city, but it's a pretty well known one). Problem is finding people to teach, residencies, etc. Same with adding more seats to nursing programs in both universities and colleges. 

I know they've upped incentives too such as adding support for spouses/partners finding work, support for those who moved away to move back home, etc. Reducing or eliminating the insane cost for tests and such that doctors from some countries are required to do to make sure their training is up to standard is helping. Although it is essential, it is just another barrier for people that moved their family half way across the world only to end up driving a taxi.

eta: yes, cuts in funding over the years is what got us into this mess too. The Federal government funds it, but the provinces decide how to spend it. As you would expect, it was always worse with an Conservative Prime Minister, and Harper was the worst. Fuck that guy. The Cons are in power in my province now, and I'm shocked that they are doing so much to fix it. They are crazy Cons like the Federal ones though. 

Edited May 9, 2023 by Tyria

[Raja]

9 minutes ago, Tyria said:

Yes, they are getting the training for it here.

I actually know 3 of my med school friends that are all Canadian and now practice in Canada. One of them used to be in Sask but he's moved away to Alberta for better pay and to be less rural. He was a GP but it just wasn't worth being on call as a GP and the pay was better if he moved away.

I imagine if pharmacists can ring up GP practices here if they are unsure of a diagnosis then there is some safety netting there, but I'm not sure how much that really helps GP practices have fewer patient contacts as you're still then seeing the patient face to face or giving advice over the phone - the main thing is you need to be trained clinically, and pharmacists don't *really* have that clinical training ( unlike nurse practioners ) so you're starting from scratch in a lot of ways. It's another thing if these pharmacies already have nurse practioners but I don't think that is the case.

These are the conditions they will be allowed to prescribe for-  sinusitis, sore throat, earache, infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections - except for UTIs, most of these are self limiting and get better by themselves but you also have to consider that currently we have the lowest number of chemists since 2015.

I agree with the Royal College of GPs, when they say the following

Quote

None are the silver bullet that we desperately need to address the intense workload and workforce pressures GPs and their teams are working under - we need thousands more GPs to be able to use these measures effectively to provide the services patients need.”

Tbh, I am in awe of people that become GPs in the NHS. It is a thankless task even though you're doing *more* than you ever have for the last 10 years with fewer resources, and then you have the vilification of GPs by the press & politicians.

[Raja]

This is what the pharmacist that runs the pharmacy that used to be run by Sunak's parents has to say, and it doesn't really fill me with confidence regarding this plan

Quote

“Already there is not enough funding for pharmacies,” said Ballepu, who has run the shop on Burgess Road for two years. “Pharmacies are facing a lot of pressure in terms of providing services. We are not able to cover the cost of providing enough colleagues. There have been so many pharmacies that have closed because of lack of funds.

“We would need much more funding and definitely more staff to provide any new services. I would need another one full-time dispenser and whether you can get the staff depends if you are able to pay the right salary. We would need more trained colleagues.”

“People would have to be trained properly. In my opinion providing antibiotics over the counter is not a good idea because customers would get more pushy trying to get antibiotics. I think leaving the antibiotics with the GP would be a good idea. Contraceptives is fine – we have a protocol to follow. But customers could try to force pharmacists to provide them.”

Ballepu said he was not against the principle of pharmacies being asked to take on more duties. “It’s a good idea to get more services for the pharmacies. It will take pressure off GPs. Patients are struggling to get GP appointments. We see them coming here when they can’t get appointments. But we need to make sure the funding is in place. That is my concern.”

 

[Tyria]

4 minutes ago, Raja said:

This is what the pharmacist that runs the pharmacy that used to be run by Sunak's parents has to say, and it doesn't really fill me with confidence regarding this plan

 

Ah, ok. It is different here. Pharmacies don't typically receive funding as medications aren't covered by the government accept for Pharmacare for lower income and seniors, and for First Nations people. For the latter, if you have insurance through employment, that is billed first. Mr. Tyr is Mi'kmaw, so he doesn't have to pay for meds, glasses or dental. Mine is mostly covered through my work plan, then there is something called RxOne (I think) that also lowers the price of meds and/or the co-pay. 

Pharmacies will now receive funding for providing services (and did for giving vaccines) where I imagine it will be a similar billing system to what doctors/nurse practitioners have. 

I may have misread the linked quote, but our pharmacies are like franchises. There are some family owned ones, but most of them are just like running a McDonalds. 

[Zorral]

2 hours ago, Raja said:

People should do what they're trained to do and that includes pharmacists - if they can be trained up to see common thing like sore throats, UTI, earaches then fair enough - will they be getting that training?

That's a lot of extra work w/o additional pay -- at least here in the USA.  The pharmacists are so busy here, at least where I live, that they really don't have time for all this.

[The Anti-Targ]

Here, for COVID-19 and 'flu vaxing our pharmacy hired (mostly semi-retired) nurses to do the job, as the income from vaccinating is enough to cover the extra staff. I don't think there is a single pharmacy in the country where the pharmacists does the vaccinating.

Almost all of our prescription medicines and vaccines are close to 90-100% subsidised by the govt. COVID-19 vax is completely free. 'flu vax is free for over...60s(?), a lot of workplaces also offer staff of any age a no cost 'flu jab. Pretty sure MMR vax is also free to all-comers. I think the only non-subsidised vaxing are for diseases that don't exist here but which you need to be vaxed to travel to a country, and for those you have to go to your GP as pharmacies don't stock such vaccines.

[Zorral]

I know who the pharmacists are, I recognize them, some of whom have worked in the pharmacy where we fill our prescriptions for years.  THEY are the ones doing it, and they have not in the least felt abashed at not telling me how much they resent it, ever since they first were required to do flu shots.   I went there for one when that began -- much later, evidently than in the UK and Canada. The pharmacist did not know at all what he was doing and my arm was bruised and hurt forever.  It took him years to get any better at it, because HE DID NOT WANT TO.  The women were better, for some reason.

Now, as of the last two years or so, they have to do all kinds of vaccinations, from flu and pneumonia, to shingles, as well as covid, and they do it at all age levels.

 

[Tyria]

35 minutes ago, The Anti-Targ said:

Here, for COVID-19 and 'flu vaxing our pharmacy hired (mostly semi-retired) nurses to do the job, as the income from vaccinating is enough to cover the extra staff. I don't think there is a single pharmacy in the country where the pharmacists does the vaccinating.

Almost all of our prescription medicines and vaccines are close to 90-100% subsidised by the govt. COVID-19 vax is completely free. 'flu vax is free for over...60s(?), a lot of workplaces also offer staff of any age a no cost 'flu jab. Pretty sure MMR vax is also free to all-comers. I think the only non-subsidised vaxing are for diseases that don't exist here but which you need to be vaxed to travel to a country, and for those you have to go to your GP as pharmacies don't stock such vaccines.

That is a good question. I don't know if it was the pharmacist that gave the jabs or if they had a nurse in. I was in a horrible anxiety downward spiral at the time, so I just wanted to get out of there. I'll find out.

Here most vaccines are free. I think the only ones that aren't are ones for travel to certain countries. Blanking on naming one!

[The Anti-Targ]

25 minutes ago, Tyria said:

That is a good question. I don't know if it was the pharmacist that gave the jabs or if they had a nurse in. I was in a horrible anxiety downward spiral at the time, so I just wanted to get out of there. I'll find out.

Here most vaccines are free. I think the only ones that aren't are ones for travel to certain countries. Blanking on naming one!

Country or disease? When I first went to India I had to get a yellow fever shot. But that was in the 1980s. My sister recently went to Rwanda and had to get vaxed, not sure what for though.

[Tyria]

8 minutes ago, The Anti-Targ said:

Country or disease? When I first went to India I had to get a yellow fever shot. But that was in the 1980s. My sister recently went to Rwanda and had to get vaxed, not sure what for though.

Disease. Post menopause foggy brain doesn't word good no more sometimes. 

[James Arryn]

My wife started out in pharm…she’s a corporate big shot now but since COVID she’s been going in weekends at her old pharmacy to give vaccines. Long days. 
 

She’s not a nurse, but fully qualified to give needles for years, took the courses long before Covid. Anyways, just asked her per this discussion, and she says pharmacists are not qualified to give needles absent the course/certification. Our family is currently over the ocean, heading for a few weeks in Tuscany. Travelling with 3 year olds…they should give a course for that, too. 

[Tyria]

3 hours ago, Raja said:

I actually know 3 of my med school friends that are all Canadian and now practice in Canada. One of them used to be in Sask but he's moved away to Alberta for better pay and to be less rural. He was a GP but it just wasn't worth being on call as a GP and the pay was better if he moved away.

 

Forgot to address this part, but yeah, Canada is huuuuge. Saskatchewan is prolly bigger than all of the Atlantic Provinces combined. Area wise, not sure about population and too lazy to look it up. Also cold af in the winter. Like prairie dry cold -40C, etc. Can't blame him for leaving. Alberta at least has Calgary and Edmonton, but still Canada's Texas. We get a few cold days here, but being right on the ocean -any C hurts to the bone. 

Forgot about GPs being on call. I've mostly lived in the city, and I don't think that happens here? Could be wrong though. I do know that when I lived in a small town for a bit that the GPs had on call shifts at the local hospital. My GP is also an OB/GYN, so she does on call at the children's/maternity hospital, but she adjusts her GP hours for that. So, yeah, GPs that are also specialists do on call shifts as do specialists themselves.

[The Anti-Targ]

1 hour ago, Tyria said:

Forgot to address this part, but yeah, Canada is huuuuge. Saskatchewan is prolly bigger than all of the Atlantic Provinces combined. Area wise, not sure about population and too lazy to look it up. Also cold af in the winter. Like prairie dry cold -40C, etc. Can't blame him for leaving. Alberta at least has Calgary and Edmonton, but still Canada's Texas. We get a few cold days here, but being right on the ocean -any C hurts to the bone. 

Just want to confirm you are not claiming to live in Alberta and be right next to the ocean. Because according to Google maps those two things are mutually exclusive. I am pretty sure you're not saying that but some geographically challenged people might think your "here" is the location mentioned in the immediately preceding sentence.

-8C in Ottawa was about my limit of potentially liveable winter temps.

[Tyria]

4 minutes ago, The Anti-Targ said:

Just want to confirm you are not claiming to live in Alberta and be right next to the ocean. Because according to Google maps those two things are mutually exclusive. I am pretty sure you're not saying that but some geographically challenged people might think your "here" is the location mentioned in the immediately preceding sentence.

-8C in Ottawa was about my limit of potentially liveable winter temps.

Hahahahaha, yeah. I live in Nova Scotia. Again, foggy brain doesn't word good. 

[Raja]

6 hours ago, Tyria said:

 

Forgot about GPs being on call. I've mostly lived in the city, and I don't think that happens here?

Yeah, it's mostly because he was quite rural which is why he was on call and pretty much why he left. A big attraction for being a GP is you're done with doing nights & being on call.

[Raja]

8 hours ago, Tyria said:

 My GP is also an OB/GYN, so she does on call at the children's/maternity hospital, but she adjusts her GP hours for that. So, yeah, GPs that are also specialists do on call shifts as do specialists themselves.

Mostly how it works is that GPs in Canada can do an extra year of training in a special catergory allowing them to do more than GP work - commonly this includes Emergency Medicine, OB/GYN, Addiction Medicine and Paediatrics. It's a flexible speciality which makes it attractive but you also don't make as much money as a Cardiologist etc ( whereas in the UK all speacialities, weather you are a GP or a Neurosurgeon all earn the same amount of money - which I'm in favour of)

Then you also have people that are dual trained, like your GP where they've done residency training in both GP & OB/GYN, which can happen in the UK but is rare.

[Spockydog]

I see Prince Harry's case against The Mirror has kicked off at the High Court.

Don't know any of the details, other than the fact that Piers Morgan was in charge of a newspaper that regularly ran stories obtained by  a whole manner of illegal methods - hacking children's phones, blagging hospitals to illegally obtain people's medical records, etc.

Harry's lawyers will show that Morgan was personally aware of this.

 

Edited May 10, 2023 by Spockydog

[Spockydog]

Not sure what the statute of limitations is here, but Rebekah Brooks barely avoided prison for this shit. 

I hope Morgan is fucking shitting himself. 

----

From the Guardian live blog:

The court has seen new evidence linking Piers Morgan to phone hacking at the Mirror.

Fresh evidence filed to the court includes a claim from the journalist Omid Scobie, who claims he heard Morgan discussing the use of voicemails while doing work experience on the Mirror’s entertainment desk in 2002:

He recalls during one of those days in the office the editor, Piers Morgan, came over to talk to someone about a story relating to Kylie Minogue and her boyfriend James Gooding. Mr Morgan asked how confident they were in the reporting, and was told that the information had come from voicemails.

Former Downing Street official Benjamin Wegg-Prosser recalled asking Morgan how the Daily Mirror had obtained a story about an affair between the England football manager Sven-Göran Eriksson and the television presenter Ulrika Jonsson:

Mr Morgan asked Mr Prosser which network provider he used for his mobile phone and then told him the default pin for that network, and then explained that the default pin numbers were well known and rarely changed, which is how mobile phone messages could be accessed remotely. He then said, with a smile, that the story on Mr Eriksson and Ms Jonsson was obtained through that method.

Former Mirror political editor David Seymour recalled an incident in which Morgan obtained a voicemail left by Paul McCartney, in which the singer sang a Beatles song to his then-girlfriend Heather Mills as part of an attempt to patch up their relationship.

According to the legal filings:

Mr Seymour recalls that he was walking through the newsroom one day, likely in March 2001, and Mr Morgan was standing in the middle with a group of reporters around him holding a tape machine, and played the message to all present a number of times, laughing mockingly. Mr Seymour recalls that the Beatles song played by Mr McCartney was actually And I Love Her.

Morgan has always denied any knowledge or involvement in phone hacking.