Saturday, 16 June 2007

The death rattle

There seems to be no end to the dumbing down of medicine in the NHS, a great example of this is the empowerment of ambulance staff in a way that both defies logic and threatens to result in many unnecessary deaths. I use the term 'ambulance staff' as there are so many new varieties of Health Care Practitioners who ply their trade in ambulances these days, many of these workers are endowed with less training than ever before.

One of New Labour's great gifts to the grim reaper's flourishing business has been the unprecedented handing of clinical responsibility to medical staff who are simply not adequately trained for it. Any punter can have a crack at medical diagnosis these days, in the eyes of our clip board wielding protocol obsessed managers anyone with the appropriate numpty diploma, short training course and fisher price stethoscope should be able to have a crack. This frankly lethal empowerment process is often justified by pointing out that doctors make mistakes and are not perfect, of course this is true; however one could claim that fighter pilots make mistakes, hence why not let anyone loose as a pilot after watching Top Gun a couple of times. This logic can obviously be used to justify the overtly unjustifiable.

There are many tales of ambulance staff being empowered to try to prevent patients coming to hospital in a way that can only be described as completely reckless. Do not make the mistake of assuming that these are isolated examples, it is worryingly becoming standard practice in our brave New Labour NHS. I personally have seen several examples of extremely sick patients being refused transport to hospital by ambulance staff, even when their GPs had seen them and quite rightly recognised the critical nature of their conditions. I have heard of cases concerning ruptured ectopic pregnancies, diabetic ketoacidosis, unstable angina, and serious head injury. All these patients had obvious symptoms and signs that would not have been missed by anyone half decent medic.

I do not solely blame the ambulance staff for the inappropriate dirty work they have been handed by the state. The culture of trying to force patients away from hospital comes straight from Whitehall, in trying to save cash the politicians in control are knowingly supervising this wanton slaughter; the money wasted on ineffective schemes that try to prevent unavoidable hospital admissions would be better spent ensuring A & E departments had the capacity to safely manage the workload. As it is the government is living in a state of dangerous denial that forces the sick to stay at home, and the ambulance staff are used as the government's agents of enforcement.

Medicine cannot be practised by protocol. It takes several years at medical school, lots of tough exams, several years of supervised practice and even then after years of experience of practice medicine is still bloody hard. So imagine the potential for disaster when less educated, less trained, less skilled and less experienced staff are suddenly handed roles far beyond their station. Some of these staff have enough insight to realise that they are not sufficiently trained to overrule the decision of an experienced GP, however others lack this insight and become an arrogant disaster waiting to happen. When this dumbing down is combined with management forces that push the under trained to act beyond their station, and an unaccountable NHS management system that leaves managers free to kill tin order to satisfy the political needs of their psychopathic masters; you have a real recipe for disaster.

This dumbing down is not confined to the ambulance service, it seems to be infiltrating every sinew of the NHS. It may indeed by safer to call a Taxi to get into hospital, but unfortunately even having got to A&E you still have to somehow be seen by a good medically trained doctor. This proves difficult at times in the NHS, as the 4hour target means that the patient with the stubbed toe who is about to breach will often be prioritised ahead of a genuinely sick patient; while there is a proliferating array of non medically trained practitioners who are keen to dust off their fisher price diagnostic equipment. Add to this the fact that many of the best UK trained doctors are quitting medicine or emigrating thanks to New Labour's incompetence; while the GMC allows these well trained UK grads to be replaced by any old EU medical graduate, no matter how suspect their medical training or command of the English language.

On second thoughts you'd probably be better off having a go at repairing your own aortic aneurysm on the kitchen table with a big sharp knife, a pair of scissors, some garden twine and a bit of plastic. After all patients just want to stay at home, don't they? Who needs doctors.

post scriptum:

due to several tasteless and offensive comments I have withdrawn comments on this post, if people wish to debate in the future I suggest they at least remain civil, it seems however that this is beyond some people