Why can't I see a GP? The tip of the NHS crisis ~ in numbers

 It was always possible to see a GP the same day for an emergency and to make an appointment within a reasonable timescale for non-emergencies.

Nowadays... it seems the NHS is almost an emergency-only service. 

I think it is a good thing that patients are being redirected to other professionals, such as prescribing nurses and pharmacists, when appropriate. GPs don't need to see everyone.

Also, fantastic that we have Urgent Treatment Centres (UTCs) or Walk-in Centres (WICs) or Minor Injuries Units (MIUs). These offer an alternative to A&E. 

People can turn up without an appointment for urgent medical help for non-life-threatening conditions when you can't get a GP appointment, like sprains, cuts, infections, and minor head injuries, without needing an appointment.

But still, often you need to see YOUR local GP for an ongoing condition: 

• You don't need to see them that day, but that same week would be ideal.
• You don't want to see the locum who you will never see again.
• You do need to see a doctor and not a different clinical person (such as a PA or nurse)

The ONLY way this is going to be fixed is by employing more GPs. There have to be more NHS budget ringfences to employ more GPs.

It isn't that GPs need more pay (although I'm sure they would like more) it is that there aren't enough GP posts being funded. Across the country, there are qualified GPs who are unemployed. They'd love a job. They trained for years to be qualified. 

There are unemployed GPs: this is a scandal.

In September 2015, there were 50.2 GPs for every 100,000 people in England. This had fallen to 43.3 for every 100,000 people by December 2024

So there used to be 5 GPs for every 10,000 people and now there are only 4. 

It's as if every village or small market town has lost one of its doctors. 

Another way of looking at it is that every GP used to have 1,992 registered patients, and now they each have 2,309.

And that means every GP's workload has increased by 16% in theory, though, as they have a team to help them, it isn't so straightforward, but the responsibility does ultimately lie with the GP.

***

Many GPs choose to work part-time. But many would like to work more hours.

If we add them all up together to get full-time equivalents rather than the number of people, then there are actually fewer GPs working today than there used to be, even though we have a bigger population.

There were 29,364 FTE GPs in September 2015 and 28,516 today.

How Many More GPs Do We Need?

There isn't a definitive figure about how many GPs we need. 

On the one hand, the cases they see and manage are more complex than ever, and the BMA recommends they see no more than 25 patients per day. 

On the other hand, there are other professionals seeing patients (nurses and pharmacists, for example). It's clear we need to step things up, perhaps with an immediate increase of 500 GPs, with a further 500 as quickly as possible. 

***

Additional notes:

It's not all about funding. 

Attracting GPs to jobs and keeping them is an issue. 

GPs are just as frustrated by the system as patients. They want to be family doctors, offering continuous care and getting to know their patients (like what used to happen). That's what attracted them to the job.

Today's NHS offers them a poor working life, with lower job satisfaction than they expected, which is why many of them leave or want to leave.

Sky High Food Prices

 Tell me about it!

Today, I read a detailed explanation about why Orange Juice is so expensive all of a sudden.

My daughter is the only one in my house who drinks it regularly, so I typically buy a carton every two or three weeks.

Each time I buy one, I can't believe the price hike. I'm really thinking twice and looking for the best value buys.

Of course, the issue of relying on a single crop from a few suppliers and the risk of crop failure due to weather and disease is precisely what I wrote about a few weeks ago. We in the UK are extremely vulnerable because we rely so heavily on imports.

If you'd like to check out my thoughts on food Insecurity, you can find them here.

Taxis or taxes?

I'd like to see more public transport, more buses, trains, and trams. I'd like the price of public transport to be kept low and affordable. This blog post is a bit of a rant if you want to come along for the ride.

Have you thought about going to London by train recently? 

If you aren't eligible for any of the railcards, it costs an arm and a leg. Well, the cheapest return tickets seem to cost about £55, which is just too much. No wonder lots of people just get on the train and hope to get away without paying. 

There are signs saying that traveling without a ticket is theft, but the person who didn't pay (because they couldn't afford to pay) isn't taking something away from someone else -- there are empty seats. 

Someone somewhere is getting away with daylight robbery when most fares to London are well over £100. 

I want to travel from Stoke-on-Trent to London, not from one country to another. It's 160 miles. The train journey can take upwards of 90 minutes. Why should a day-return ticket cost over £100?

I want to go because: 

(a) my eldest child lives there, and 

(b) a dear old friend who I've known for almost 40 years is very ill. VERY ill. 

Unfortunately, it would be a lot cheaper for me to drive and let the train go with plenty of empty seats: make it make sense.

I'm a parent. I've spent many years doing my utmost to raise the next generation. I've also worked most of that time. I've made a contribution to society. And now I wonder how many times I can visit my friend in what is likely to be her final year, given the exorbitant cost of the train fare. She's almost 80 years of age and has worked all of her adult life, too.

Our taxes, our contribution to the country, should be enough to mean that basic essential infrastructure is functional and affordable. 

Just remind me: is the UK one of the richest countries in the world?

And I know the train fare isn't fair because if I were JUST a few years older than I am now, I could cut the cost by 1/3rd with a railcard. 

That's not based on the ability to pay, it would be solely based on age.

I know plenty of people older than me with bags of spare cash.

It's nothing to do with the capacity of the train. 

There are many empty seats on the Stoke to London trains (after 9am).

***

If I had my way, the public transport system across the UK would serve the British public. 

It would be priced so people could afford to use it. 

but Deb, HOW WOULD YOU PAY FOR IT?

I don't want to say I have all the answers, but there has to be a better way. 

• I suspect the people who work on railways and people who use railways frequently have far better ideas about how to change them than I do.
• I suspect we could learn a lot about running an efficient public transport service from other countries; many of them seem to do it better than we do.

Socialists Always Want to Raise Taxes

That's the accusation, as if all taxes are a bad thing.

Shared control and funding of public services and infrastructure for the good of us all is a good thing. Everyone benefits, even the rich and mega corporations.

I'm in favour of a welfare state and a fairer distribution of wealth.

I'm in favour of everyone contributing to public services that benefit all of us.

And things that benefit society do benefit all of us, even if we don't all personally use those things.

On the subject of TAXES: 

I've been listening to Dan Neidle a lot. On YouTube, on the Radio (BBC Sounds), and reading his website: Tax Policy Associates. It is interesting stuff and very accessible. You don't need to be a lawyer, accountant, or have A-level maths to follow along with his shows on TAX. 

 

TAXES

I'm sick of hearing that rich people would leave the UK rather than pay more taxes. 

And they'd take their money and their business opportunities with them

and they'd invest in some other country with lower taxes

and less employment rights for workers

and less protections for nature and the environment.

What kind of a shithold do those rich bastards want to live in?

How patriotic is that?

If you were stinking rich,

surely you'd want to invest in the country

that made you who you are.

That nurtured you 

and educated you.

Surely you'd want to help your country

generate wealth

generate jobs

generate happiness.

That said, I don't think being a left-wing socialist is all about raising taxes.

HERE are some thoughts on what we can do to change the tax system today. 

Who Wants Curry?

In a break from my usual content, I just want to shout out for food. 

 At the Curry Life Awards a few local eateries picked up prizes: 

• Chennai Indian Cuisine, in Leek, 
• Ali’s Kitchen, in Longton, 
• Ali’s Spice, in Blythe Bridge, 
• East 360 in Congleton.

I'm always on the lookout for delicious food.

I'd add Indian Heaven in Alsager as a personal favourite.

And a special shoutout to some special places in Newcastle:

• Sukhmani - low cost in the heart of N-u-L. Punjabi veggie food from a cafe /takeaway.
• UK Meal Club - authentic Malayalee food for the taste of Kerala
• Rose of Kashmir Restaurant 

When Essential Services are Run for Profit: eg. wheelchairs

Our taxes are often used to fund essential services provided by private companies. 

• Should a company reap a profit at the taxpayers' expense? 
• Should the provision of essential services that are paid for by taxes be left up to the private sector?

Companies supplying services ***ESSENTIAL goods and SERVICES*** that are paid for by taxpayers are generally making things more expensive because a profit has to be paid to the company owners. 

note: I'm the first one to admit that this is a simplification: there are owners of (small) companies who really don't make obscene profits. The bosses generally work in the company and only make enough to cover their own wages and company's bills and everyone's wages.

There have always been private businesses involved in providing some essential stuff and paid by taxpayers, but it proliferated from the 1980s

A clear example of where the taxpayer is paying more is when private companies are involved in building schools and hospitals. We also pay shockingly high rates to water and energy companies now, after our state-run services were privatised.

This year, wheelchair users have faced difficulties in getting their equipment repaired. 

This is essential equipment and often provided for via taxpayer funding.

I was amazed to discover that wheelchair parts and repairs are in the hands of the private sector.

When a major player, NRS Healthcare, faced financial difficulties, it was wheelchair users who had to stay in their homes and suffer the consequences:

NRS Healthcare was a leading UK provider of community equipment, wheelchair services, and technology-enabled care, but the company entered liquidation in 2025, creating disruption for thousands of users and professionals reliant on their services. 

The company is no more, and its NHS contract has been transferred to Medquip. 

 * * *

I'm sure we all find it hard to imagine things being run in a different way to what we know.

But it really doesn't have to be this way.

I don't know much about mobility aids, tbh, but I can talk to you about hospital cleaners and porters:

Back in my day...

I remember the good old days when ancillary staff were directly employed by the NHS. They were employed where they worked and had good terms and conditions.

In the mid 1980s there was a move to 

* SAVE MONEY

* contract out...

Let's say there were 2 or 3 domestic workers on a hospital ward who were all directly employed by the NHS with full rights, pensions, and holiday pay. Some access to training, etc.

Now, a private company comes along to SAVE MONEY - do the job cheaper AND make a profit for the company shareholders.

How is that possible?

Answer: It is only possible by doing one or all of these:

• Cutting the working hours of domestic staff on the ward
• Cutting staff pay or other perks (such as pensions) 
• Cutting back on equipment and uniforms

The fact is, cleaners were working hard on those shifts, and there were numerous tasks that had to be completed daily to align with the ward routine. So this money-saving exercise had to involve cutting back on some aspect of hospital cleaning.

Experienced staff left in droves.

The NHS is the nation's biggest employer. Therefore, it can offer economies of scale (cost savings) through its finance and payroll system and its human resources team. 

There is simply no logical reason for any staff member who works in an NHS setting all the time to be employed by an outside employer.

 * * *

Hiring the cheapest staff on the worst contracts may have been cheaper and may have cut costs for the taxpayer (I doubt it), but what does it say about the kind of society we want to live in? 

There are currently not enough jobs, and people can't afford to live on their wages. 

Would we all prefer that taxes were paying for an extra part-time cleaner on a hospital ward rather than the costs of having people without jobs?

Dr John Lister is one person who really does understand the consequences of "contracting out" in the NHS, a process of transferring work from the public sector to the private (for-profit) sector. Studying this has been his life's work. He has published on the failure of 40 years of the private sector being invited into the NHS.

 * * *

Wheelchair repairs and hospital cleaning staff are just two examples of where essential services are being provided by the private sector for a profit.

What about the private sector being used to provide clinical services? Yes, they do operations to reduce waiting lists and they provide other clinical services routinely. All of this is a drain on the NHS and into private profit.

It would be far better if that money were spent on the NHS, building up the NHS. It has the capacity for more work -- the buildings and staff are in place, they just need the funding. 

It has been a political decision to fund the private sector instead. 

And it is not just me saying it, the BMA said the same about outsourcing.

Is Nigel Farage a Fascist?

 

Nigel Farage, Fascism, and the Politics of Labels

Zack Polanski of the Green Party recently described Nigel Farage as a fascist. Much as I agree with Zack and the Greens on a great many things — especially on the urgency of climate action, social justice, and democratic reform — I don’t think it’s helpful or constructive to call Farage a fascist.

It’s not even especially useful to ask whether the label is true. 

Fascism features: extreme nationalism, far-right ideology, the suppression of dissent, the erosion of democratic norms, the weaponisation of fear, and the consolidation of authority around a single leader.

Throughout the 20th century, you could only say that any of the fascist leaders were fascists once they were in power. The essence of fascism is in its actions once the machinery of the state is under control: 

To call someone a fascist before they have power turns a political analysis into a moral accusation, and the discussion tends to shut down. Supporters feel attacked; opponents feel morally vindicated — but nobody changes their mind.

I'm certain many of Farage's supporters do not support fascism.

What’s much more productive, useful, and constructive is to talk concretely about policy — about Farage's proposals, what they mean in practice, and who they would hurt.

For example:

• On immigration: Farage’s rhetoric divides communities and obscures the economic reality that Britain depends on migrant labour. That he isn't just stopping people from coming in the future, he aims to expel people who've legally lived here for years and decades. He also plans to deny people the legal right to seek refuge as asylum seekers.

• On climate policy: His opposition to actions around climate change would leave Britain behind in the global energy transition and forfeit the jobs and industries of the future.

• On the economy: The nostalgic protectionism and deregulation he promotes would likely deepen inequality while failing to deliver sustainable growth.

• On workers’ rights: Farage wants to weaken protections that safeguard fair pay, working hours, and safe conditions. In the name of flexibility, what he really offers is insecurity — an economy tilted ever more toward employers and away from ordinary workers. On top of that, he wants to reduce the safety net of the welfare state.

• On private healthcare: He's long been associated with expanding private provision within the NHS — that those who can afford it should “opt out”, leaving everyone else with an underfunded public system. This is a slow road to a two-tier healthcare model that undermines the very principle of universal care.

These are the areas where Farage’s politics can and should be challenged — not on moral labels, but on the real-world consequences of his vision.

Calling someone a fascist might feel emotionally satisfying, but it doesn’t win arguments, it doesn’t persuade, and it doesn’t build coalitions. What does work is clarity, evidence, and calm insistence on the values that actually matter: democracy, equality, sustainability, and fairness.

#Reform

Food Security - The Big Issue

 I think there are some really big issues facing the UK, and Food Security is one of them.

We see significant hikes in food prices and too many people relying on food banks, but mostly, food doesn't get the attention it deserves. 

I think that FOOD SECURITY should be up there for long-term strategic priorities, along with climate change, national defence, and world peace.

Food security is a BIG problem.

Defining the Food Security Problem

Background: 

Dramatic climate change is likely to put further pressure on food production, distribution, and prices over the coming decades. 

This pressure may be exacerbated by a rapidly growing world population and issues such as war.

Imports may become more expensive and difficult to source, yet we rely on them to feed the nation.

Imports account for roughly 40% of our food.

How much we grow vs. eat (self-sufficiency): 

The UK’s food production to supply ratio was 62% (all food) in 2023. 

For foods that can be grown in the UK (“indigenous”), it was 75% in 2023.

Import reliance overall: 

The UK sources food roughly 60:40 (domestic:imports) in recent years. 

The EU supplied 64% of the volume of UK food, feed and drink imports in 2023.

How it’s changed (roughly the last 100 years)

• Pre-WWII (1930s): Britain imported about 70% of its food

• Post-war to 1980s: Self-sufficiency climbed steadily from ~47% in 1956 to a peak of ~78%

• 1990s–2000s: Gradual decline from the 1980s peak; by 2000 it was ~67%, stabilising around ~60–62% through the 2010s–2020s. GOV.UK

• 2021–2025 context: DEFRA’s UK Food Security Reports describe a broadly stable overall 60:40 split (domestic:imports).

The UK’s high import dependence today (especially for fruit, vegetables, and seafood) leaves it exposed to trade shocks, conflict, climate events, and geopolitical risk. 

How would we survive?

I think the UK should be ready and making plans for just in case the worse happens

What could realistically move the UK toward being able to endure 1–2 years with zero imports?

Let's talk about it.

Here are ideas for a plan, nothing set in stone.

1. Boosting Domestic Production (Innovative Agriculture)

Controlled Environment Agriculture (CEA)

• Vertical farming & hydroponics: Can supply leafy greens, herbs, some fruit year-round regardless of weather. High energy demand, but potential synergy with renewable power and waste heat.

• Greenhouse expansion: Heated, lit glasshouses (like in the Netherlands) could greatly expand UK-grown tomatoes, cucumbers, peppers, strawberries.

• Aquaponics & urban farms: Closing nutrient loops by combining fish farming with plant growth.

Crop diversification & resilience

• Expanding cereals and pulses: The UK already produces enough wheat in most years, but less barley/oats for human consumption, and far fewer pulses (lentils, chickpeas). Expanding pulses would reduce dependence on protein imports.

• Protein innovation: The growing demand for pea protein, insect protein, and lab-grown meat could potentially substitute for imported soy and beef.

• Perennial grains and novel crops: Breeding for UK conditions (e.g., quinoa, alternative oilseeds).

Regenerative and precision farming

• Boost yields while cutting inputs, through:

  • Drones and AI for precision fertiliser/pesticide use.

  • Soil carbon management for long-term fertility.

  • Agroforestry to increase resilience and output per hectare.

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2. Building Strategic Food Reserves

Stockpiling basics

• Cereals and oils: Wheat, barley, oats, rapeseed oil—relatively easy to store for years.

• Dried and canned goods: Beans, pulses, tinned fish, powdered milk, baby formula.

• Cold storage: Frozen meat, fish, and veg—but energy dependent.

Infrastructure and governance

• The UK currently has strategic fuel reserves but not food reserves. A national grain reserve or “buffer stock” could be reintroduced, managed publicly or with private sector partners.

• Could model this on Singapore’s rice stockpile (they store ~3–6 months of consumption) or China’s massive grain reserves.

Emergency diet planning

• In a “zero-import” year, the UK diet would be grain-heavy, root-veg heavy, with seasonal/local produce, dairy, and meat. Luxury/mediterranean items (citrus, coffee, bananas, rice, soy) would vanish unless alternatives were stockpiled.

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3. Other Strategic Levers

• Cutting food waste: Roughly 9.5 million tonnes per year wasted in the UK. Reducing this by half is equivalent to freeing up hundreds of thousands of hectares of production.

• Dietary change: Shifting away from meat-heavy diets reduces the land footprint, since feed crops often come from abroad.

• Energy–food link: Ensuring resilient energy supply is critical if relying on greenhouses, cold storage, and vertical farms.

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4. Feasibility of “2 Years without Imports”

• Possible for calories: The UK produces a large share of its cereals, dairy, and meat. With rationing, calories could be covered.

• Very hard for diversity & nutrition: Vitamins (C from citrus, A from tropical fruit, omega-3 from imported fish) would need supplements or fortified foods.

• Stockpiling + innovation combo: With large enough reserves of vitamins, dried/frozen fruit & veg, and oils, combined with a ramp-up in controlled-environment production, survival for 1–2 years is plausible—though not comfortable or varied.