Quoting ARLO J BENSINGER JR <[EMAIL PROTECTED]>:

> I recommended this before, but since its now directly related to the thread
> thought I'd mention it again. "Sick: The Untold Story of America's Health Care
> Crisis - And the People Who Pay the Price", by Jonathan Cohn. Excerpt from
> book's website (http://sickthebook.com/) follows.

Just in case anyone gets the idea that socialized medicine is the answer to
providing quality health care, the following is from the Scotsman newspaper 
dated
April 15:

Headline: "Patients turned away as crisis looms"
 
"At least 11 GP surgeries in Scotland have shut their doors to new patients, 
despite
record levels of pay and investment.

"But GPs' leaders blame the closures on lack of resources and say the family 
doctor
service north of the Border is heading towards a crisis.

"The list closures mean inconvenience and delay for patients because they will 
have
to travel further to find medical help.

"The revelation is politically explosive because of the new contracts recently 
signed
with GPs that gave them substantial pay rises and removed much night-time and 
weekend
work.

"The surgeries affected are in Edinburgh, Glasgow and Dunfermline. In Edinburgh 
alone
seven surgeries are refusing to register new patients.

"But Dr Dean Marshall, chairman of the British Medical Association's Scottish GP
Committee, said the move was unprecedented in his 13-year career and that it 
marked a
worrying new turn in the row over NHS funding.

"He said: "This is the first sign of the problems with the new contract. GPs 
will
decide to close their lists for a variety of reasons, such as not having enough 
room
in their premises for the extra staff they would need in order to take on more
patients. There may also be recruitment issues. But the other likely cause is 
the
financial aspect of it."

"He added: "The bottom line is that practices need to consider if taking on new
patients is going to adversely affect how efficient they are."

"Two surgeries in Glasgow, the Guthrie Practice in Dumbarton Road, and the 
Kelvin
Medical Practice in Napiershall Street, are officially closed, which means they 
are
not taking on any new patients, and seven in Edinburgh and two in Fife say they 
are
"open but full".

"If GPs tell health boards their list is closed they enter a formal 12-month
agreement and are not allocated any new patients but are not allowed to provide 
any
extra services, such as minor injury or surgery clinics, which means they cannot
receive extra funding.

"When surgeries say they are "open but full" they can refuse to take on any 
patients
who make personal inquiries but will take on new babies born to existing 
patients and
family members of existing patients who fall ill while visiting. The situation 
is
reviewed every three months and they are still allowed to provide extra 
services for
which they would receive extra funding.

"Duncan Miller, general manager for primary care contracts at NHS Lothian said: 
"All
GP practices in Lothian operate open lists.

"There are practices whose lists are currently full. However, I would like to 
clarify
these practices are still accepting patients on a limited basis, but are nearing
capacity level."

"There are serious concerns about the impact of closed lists on patient health. 
The
situation can lead to a vicious circle because once one practice closes its 
list,
others in the area often have to do the same.

"Some of the most vulnerable patients can be the worst affected. Health 
problems may
be ignored and trips to the doctor postponed, and critics predict the problem 
will
worsen."

"Dr Anthony Halperin, chair of the Patients' Association, said: "I am very 
surprised
that lists are being closed.

"Doctors have been given substantially more money with the new contract.





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