4.Make up sentences of your own with verbs and expressions demanding Gerund to be followed after them.

To accuse of; to agree to; to approve of; to be afraid of; to congratulate on; to depend on; to dream of; to feel like; to give up the idea of; to insist on; to look forward to; to object to; to persist on; to prevent from; to succeed in; to suspect of; to thank for; to think of;

5. Read, translate into your own language and put sentences in the following order: a) Participle b) Gerund c) Verbal Noun;

1. The driving wheel of the wheelchair was broken. 2. Lying in a stretcher, the patient passed many wards. 3. Having had an accident by a passing car, the man was immediately taken to the hospital.4. Travelling is a pleasant way of improving your English. 5. It is no use crying after being injected. 6. Looking at this man, the doctor recognized having met him many years ago in this department. 7. Having passed the blood and urine analyses, the patient returned to his ward. 8. The cleaning of the wards was done by clinical support workers. 9. The students found the reading and studying of patients’ history cases rather difficult at first.

10. He spent much time on the reading and translating of English texts.

UNIT 6

Primary care

The National Health Service

The National Health Service (NHS) is responsible for health care for everyone in the UK and gives emergency treatment for visitors. Although a small number of patients chooses to pay for private care. Treatment is free but there is a prescription charge for drugs and appliances, such as a cervical collar, with exemptions for some patients, such as children and the elderly.

Primary care is provided by general practitioners, or GPs, (sometimes known as family doctors), nurses, dentists, pharmacists and opticians. Dentists and opticians usually have separate clinics. They are not parts of health centres.

GPs work in practices of 1 to 20. Practices are based in a surgery and look after the health of from 1,000 to 15,000 people in their local community. They also provide health education in areas such as smoking and diet, run clinics, give vaccinations, for example for influenza, and may perform minor surgery such as removal of warts and moles. If a patient needs specialist care, the GP will make a referral andrefer the patient to a consultant in secondary care.

Patients are normally consulted on an appointment basis. Home visits are made when patients are housebound i.e. they areunable to leave their homesor too ill to attend surgery. Out-of-hours (ООН) treatment, from 6 pm to 8 am, is provided by the local Primary Care Trust, which organizes shifts of GPs and locum GPs to cover if someone is absent.

Much attention is paid to the educational programmes. The Department of Health provides anti-smoking education programmes, alcohol education programmes, cancer prevention programmes and so on. Much attention is paid to the AIDS and drug programmes.

Great Britain pays much attention to the qualification of doctors. They are trained at 16 universities. Besides, they get practice during their work at teaching hospitals.

The practice team

A typical GP practice employs receptionists. They are responsible for initial patient contact. The receptionists make appointments, take requests for repeat prescriptions, take messages from patients and other health care providers, file and scan documents into patients’ records. The practice manager has responsibility for finance and sometimes for IT. He/she supervises reception staff, hires locums, and helps to prepare the practice development plan. Practice nurses run asthma, diabetes, and cardiovascular disease clinics as well as one-to-one clinics for those who wish to give up smoking.

In addition to practice staff, GPs work with a number of health professionals.

• District nurses visit temporarily housebound patients, those who have recently been discharged from the hospital, to change dressings, such as ulcer dressings.

• Health visitors visit families to carry out check-ups on young children - particularly under-fives - to make sure they're healthy. Special attention is paid to families in need, such as those living in poverty. They also do baby immunizations.

• Midwives run clinics for antenatal patients.

• Physiotherapists provide hands-on treatment but also teach patients exercises they can do to improve their condition after an accident or operation.

A day of a general practitioner (GP)

Dr James works in a practice in a small market town, with three other family doctors. The surgery is located in the centre of the town and is shared by three practices. This is a typical working morning when she is not the duty doctor, responsible for emergencies and urgent problems.

8.00 am. arrival at the surqery

checking the ООНemail printout

checking for urgent and non-urgent messages

8.30 am checking up emails from the healthboard and

partners

preparation for surgery

8.30-10.15 am morning surgery(ten-minute appointments)

6 pre-booked lastweek

2 booked 42 hours ahead

4bookable on the day

10.50 -10.55 am checking with Reception for messages

sign, prescription and deal with repeat

prescription request

11.00-11.20 am coffee break in the conference room with colleagues

11.20- 11.30 am checking home visit requests and dividing up visits

with colleagues

11.30 am -1.00 pm home visits