Clare Gerada: influence on UK medical practice and ME/CFS management

[Cheshire]

I have no doubts that some patients are "difficult", but the answer offered by Clare Gerada is so... hum, don't even know how to qualify it. But sure, coming from her, it is not surprising, and quite telling.

But she added: 'If we are going to improve the health and wellbeing [of GPs] we also need a new kind of patient… I don’t think we can let patients off the hook.

'I think now, if patients want to have authority - which they are quite right to have authority over their own health – they need to also start having accountability…

'Because part of the problem at the moment is that all the accountability lies with the doctor… and the authority lies with the patient “I want this, I want that”, but if it goes wrong then if bounces back to me.'

http://www.pulsetoday.co.uk/your-pr...ggests-gp-mental-health-lead/20035805.article

ETA: Clare Gerada is Simon Wessely's wife.

 

[Valentijn]

This whole thing is so fucked up, I don't even know where to start. I can only speculate that Dr Gerada assumed what she was saying wouldn't go beyond the room it was said in.

Apparently the focus isn't to keep patients healthy, it's to protect GPs from the patients:

The lack of accountability among NHS patients is contributing to making GPs ill, the medical director of the national GP mental health service has suggested.

It sounds like the organization she's running isn't capable of dealing with the problems GPs are having so she's shifting the blame to the patients:

Professor Clare Gerada, medical director of the national GP Health Service, argued that while GPs have to give up their 'nostalgia' and adapt to the changing NHS, patients also need to take more responsibility.

Speaking at today's Westminster Health Forum on the future of general practice, Professor Gerada said nearly 1,000 GPs with issues such as anxiety, depression and addiction have now come through the service which was launched in January.

Based on what I hear from patients in the UK, they have no options and accordingly no authority. Doctors have tight control, and there's little accountability when they make a mess of things. The NHS seems to support their lack of accountability by giving them a lot of ways to pass the buck, such as crappy guidelines and tolerating widespread psychogenic diagnoses:

'Because part of the problem at the moment is that all the accountability lies with the doctor… and the authority lies with the patient “I want this, I want that”, but if it goes wrong then if bounces back to me.'

It's pretty sickening that people like Dr Gerada have any authority in the NHS. No sane person would want someone with that attitude as their own GP, so why is she making any sort of policy decisions or recommendations?

 

[Adrian]

The NHS seems to support their lack of accountability by giving them a lot of ways to pass the buck, such as crappy guidelines and tolerating widespread psychogenic diagnoses:

From what I see too many GPs default to doing nothing and dismissing patients (hence the desire to push for psychogenic diagnosis). We have had years of patient blaming from people like Gerada talking about the 'worried well' leading to late diagnosis. We see this continuing with a push on MUS which is again about dismissing patients symptoms.

 

[Hoopoe]

Of course GPs are stressed out. The NHS is collapsing due being starved of funding. The policy of treating complex or unexplained illness as psychosomatic, promoted by Gerada, Wessely, etc is a good way to poison doctor patient relationships. A little more humility would be easier for everyone.

 

[arewenearlythereyet]

They will continue to blame patients while they cut funding. Its a great cop out when it comes to funding at Westminster to feed in to the patients wasting valuable NHS resources ...similar to "cheating people who sponge off the state by living off of benefits" narrative.

Personally I think these narratives are pretty close to other more sinister methods of breeding contempt and hate. Its quite contradictory that on one hand breeding hate is seen as terrorism yet on the other hand the right wing politicians find no problem in breeding hate when it comes to benefits and "bed blockers" in the NHS.

No wonder people who have studied psychology are making great careers out of feeding the governments propaganda machine

 

[Snow Leopard]

There is a big problem when medical systems (funding, teaching etc) do not consider human nature as central to their practise.

A system that expects doctors to provide perfect advice and patients to always follow that advice is pure fantasy.

 

[Esther12]

Just about everything I read from Gerada makes me cringe. I don't think that she'll ever be able to understand the harm she's done.

 

[large donner]

ETA: Clare Gerada is Simon Wessely's wife.

I don't know who I feel more sorry for, I guess when it comes to it they are well suited.

 

[Jonathan Edwards]

Of course GPs are stressed out. The NHS is collapsing due being starved of funding. The policy of treating complex or unexplained illness as psychosomatic, promoted by Gerada, Wessely, etc is a good way to poison doctor patient relationships. A little more humility would be easier for everyone.

Indeed, and on a more general note the policy of treating complex disease when you are not qualified to do so, as GPs like to do, is simply unethical. It is people like Gerarda who are responsible for GPs continuing to fail to treat people for conditions that require specialist expertise to look after properly.

GPs are totally unaccountable. They do bugger all and nobody does anything about it. It might not have been their fault but it is because they have wanted to go on doing things their way.

 

[large donner]

GPs are totally unaccountable. They do bugger all and nobody does anything about it. It might not have been their fault but it is because they have wanted to go on doing things their way.

Basically this is because the Blair government gave them enormous pay rises as a bribe to put up and shut up as a means to starve the NHS of money overall, and now the current government is finishing of the job so that they can sell it all off privately to their mates and corporate masters.

When you push for a private health service using the logic that we cannot meet the health expenditure per capita any longer its a warped logic to think it would be cheaper by introducing the profit motive on top as the per capita need does not disappear, except that's how it will happen. Treatments will just disappear.

Hence CBT for everything as a means of changing patient expectations and blaming the failure to apply a scientific approach on stupid citizens who spend all their time watching "fake news".

Its no coincidence the government is pushing a "destigmatising of mental illness" agenda.

Scary times!

 

[Luther Blissett]

Of course GPs are stressed out. The NHS is collapsing due being starved of funding. The policy of treating complex or unexplained illness as psychosomatic, promoted by Gerada, Wessely, etc is a good way to poison doctor patient relationships. A little more humility would be easier for everyone.

To add context using Office of National Statistics Data,

Human health & social work activities

Unfilled Vacancies

• July - September 2012 - 60,000
  
• August - October 2017 - 120,000

The range from 2001 - 2012 was from approx 50k - 80k.
The 120k + level started in 2015.

https://www.ons.gov.uk/employmentan...employment/datasets/vacanciesbyindustryvacs02

 

[Jonathan Edwards]

Basically this is because the Blair government gave them enormous pay rises as a bribe to shut up and put up as a means to starve the NHS of money overall, and now the current government is finishing of the job so that they can sell it all of privately to their mates and corporate masters.

Yes, I blame Milburn. But the GPs had the option of refusing. They could have resigned on the grounds that they could not fulfil their responsibilities - as I did in 2010.

 

[Guest 3]

Just about everything I read from Gerada makes me cringe. I don't think that she'll ever be able to understand the harm she's done.

That hits the nail on the head.

 

[FreeSarah]

When I was teaching we used to have conversations like this about the students. Then by the morning we’d be sober.

 

[Valentijn]

When I was teaching we used to have conversations like this about the students. Then by the morning we’d be sober.

Good point. "My job would be so much easier if it weren't for the customers and having to do my job," really is on par with a drunken rant

 

[TiredSam]

The lack of accountability among NHS patients is contributing to making GPs ill

The lack of accountability among BPS-cult members is contributing to keeping M.E. sufferers ill.

Professor Clare Gerada, medical director of the national GP Health Service, argued that while GPs have to give up their 'nostalgia' and adapt to the changing NHS, patients also need to take more responsibility.

I blame Peppa Pig:

http://www.bmj.com/content/359/bmj.j5397

And while the BBC News website has studiously ignored M.E. for years, their Health Reporter Ian Westbrook is on the case of Dr Brown Bear within 24 hours:

http://www.bbc.com/news/health-42322216

You couldn't make this shit up, it is beyond parody. Clare Gerada is just another one of the lunatics running the asylum.

 

[TiredSam]

With regard to the BBC article, there are some great comments, if you put them in order of highest rated first.

 

[Luther Blissett]

With regard to the BBC article, there are some great comments, if you put them in order of highest rated first.

Holy moly, you are truly a fearless explorer of desolate and inhospitable lands.

Please stay tethered to your nearest sane person.

 

[Arnie Pye]

'Because part of the problem at the moment is that all the accountability lies with the doctor… and the authority lies with the patient “I want this, I want that”, but if it goes wrong then if bounces back to me.'

This is simply not true for me. Over the last 40+ years I've been to doctors with many problems (mostly related, directly or indirectly, to one triggering event which happened when I was a teenager), and doctors have had absolutely no problem saying No to me, over and over and over again.

If I ever try and push for treatment they look down their noses at me and usually suggest in some way that I, as a mere patient, could not possibly know what is best for me. Or they shout at me and throw me out of their office. Or they accuse me of being depressed, a hypochondriac, or tell me I have a functional condition for which there is no treatment.

....

Another piece from Gerada, but I didn't think it deserved a thread of its own :

http://blogs.bmj.com/bmj/2017/12/05...-medicine-become-such-a-miserable-profession/

Clare Gerada: Why has medicine become such a miserable profession?

December 5, 2017

Medicine has always been a hard taskmaster, yet more and more we hear about the unrest and dissatisfaction of doctors across the world

“Devalued, demoralised, and depressed” read the placard held high above the heads of junior doctors during their 2016 NHS strike. These three words perhaps best sum up the prevailing mood of many doctors, not just in the NHS but across the world. We continually hear about the growing malaise among medics—a phenomenon that is often reported as self-evident. The question is are doctors objectively unhappier than in previous years, and if so, why?

Continued at BMJ link above...

 

[Sarah]

Former RCGP chair named in GMC manslaughter review panel

By Nick Bostock on the 21 May 2018

"Former RCGP chair Professor Clare Gerada has been named in an expert panel set up by the GMC to review gross negligence manslaughter (GNM) in healthcare following the Bawa-Garba case.

"Terms of reference for the independent review commissioned by the GMC - to be led by orthopaedic surgeon and former Royal College of Physicians president Dame Clare Marx - were announced in March.

"The review will consider whether GNM cases properly take account of the role system pressures can play in cases when patients die, and look at how GMC guidance and communication around reflective practice could be improved. It will look at what happens after a fatal incident; the impact of criminal investigations; inquiries by a coroner, procurator fiscal or sheriff; and the regulatory process and GMC fitness to practise procedures.

"The equivalent offence of culpable homicide in Scotland will be scrutinised by the review; along with findings of the Williams Review on GNM in healthcare announced by health and social care secretary Jeremy Hunt last month. Findings from the Marx review will be published early in 2019."

"... Professor Gerada is one of 10 experts appointed to help Dame Clare lead the review. Speaking exclusively to GPonline earlier this year, the former RCGP chair revealed that 1,100 GPs had sought help for stress and burnout-related problems from the GP Health Service she helped to establish during its first full year in operation.

"She said at the time: 'We have many cases similar to that of Dr Bawa-Garba. Doctors who have made errors and been erased and not made the headlines. She has come at a tipping point. We have pointed out the disproportionate nature of some of the cases.'"

"... 'As a group we are committed to exploring every avenue to promote a no blame culture and encouraging a renewed focus on reflective practice and learning. It will be a difficult challenge, but I am confident that my colleagues on this working group are the ideal team to achieve this.’"

https://www.gponline.com/former-rcgp-chair-named-gmc-manslaughter-review-panel/article/1465366