Wednesday 21 February 2007

Trust me I'm a politician



Today is indeed a dark day for the medical profession. The current administration continues its attempts to grab as much power as possible, while apologists in the media look on in a rather accepting manner. I am not pretending the old system was perfect, but change for the sake of political power grabbing is not in the interests of patients or doctors, it is in the interests of politicians and their puppet masters.

Doctors will have their abilities and skills tested against a set of unvalidated and meaningless criteria in the name of political expediency. Doctors will now be judged by people who have been appointed by politicians. There will also be a sliding scale for the level of proof against which doctors are tried.

The government wants our trust and claims we should go along with this for 'patient safety'.

I do not trust their record on patient safety so far, do you? Here are some examples where patient safety has been jeopardised by:

- PFIs - bankrupting trusts meaning they have no money to provide basic investigations and treatments

-ISTCs - unregulated and poorly audited surgical centres where foreign surgeons, with less training and unknown/unassessed competency, are allowed to operate away. These centres are also paid significantly more than the NHS for the same work.

- Nurse and pharmacist prescribing - extending prescribing to staff who have not had sufficient training to be able to safely diagnose and prescribe. The medical profession's opinion was ignored during the consultation.

- Extending roles of Nurses and other non-medically trained practitioners like Physicians Assistants. There is a virtually non-existent regulation process for these workers and their introduction has not been adequately assessed from a safety or financial point of view.

- Walk in Centres - another wasteful cost-ineffective scheme where unless you present with something simple like a blocked nose, you will be referred on to a GP or A&E department

-Hospital at Night - a scheme introduced around the whole country without any monitoring of its impact on patient outcomes/safety. This is despite a large amount of anecdotal evidence which suggests it is very dangerous for patients.

-National IT scheme - we've seen that the early pilots of choose and book and certain computerised systems have failed miserably, resulting in patients missing appointments and operations

-Cutting bed numbers and more power to unregulated managers - as hospitals are made more shiny, beds mysteriously go missing; this results in a desperate bed shortage and consequently managers unfairly put pressure on medical staff not to admit patients whose clinical state neccessitates admission. Surprisingly these managers are never held to account for their reckless and dangerous actions.

I could go on. Not a great record is it though? Add this to other policies where there is an increasing trend towards centralised power building and the never-ending erosion of civil liberties, and you have a rather worrying picture. This is a situation where politicians are trying to win our trust but all the objective evidence proves they do not deserve our trust; a situation where politicians claim we need to protect our democracy by bringing in draconian new laws to combat terrorism; a situation where politicians want to create increasingly centralised surveillance systems and bureaucracies.

Has anyone heard of this happening before?

This white paper must be vigorously opposed. The BMA must stand up and be counted. Actions will speak louder than more empty rhetoric. If Greenpeace can beat the government on nuclear power, then the medical profession must do the same.

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