Monday, 30 July 2007

The empowerment of the ignorant

Progress can be described in many different ways, and when it comes to medicine it is undoubtedly true that different people have remarkably different takes on what 'progress' actually consists of. Typically common sense would lead one to assume that progress should consist of improving education and training standards so that a better standard of service can be delivered. However the Department of Health does not buy into common sense; it buys into illogical nonsense that cannot be justified by rational argument, hence the DoH tends to hide away from public debate or engagement with anyone who dares to criticise their holy stance.

Those working in the NHS have seen an ever creeping erosion of professional standards and training over the last few years, an erosion that common sense would say 'flies in the face of progress'. Properly trained professionals have been dis empowered by clip-board wielding managers, who have very little medical knowledge at all, in a rather dangerous way that threatens the decent medical management of patients. These ignorant non-medically trained managers have been blocking GP's referrals to specialist services to try to save cash. One would think that the dangerous empowerment of managers so that they can overrule the decisions of experienced clinicians would be unjustifiable, nevertheless the DoH has a crack:

"A spokesman for the Department of Health said referral management centres should only be set up where they would benefit patients, by ensuring they saw the most appropriate health professional."

How on earth can someone with no medical training safely decide where patients should be sent against the direct wishes of someone who is specifically trained for years to be able to do this job? This is the kind unaccountable dangerous quackery that has become the government's trademark over recent years.

A rather brave surgeon has risked a DoH beating by telling it how it really is in the NHS, he describes quite brilliantly how the ridiculous payment set-up of the internal market actually incentivizes bad medical care. Money and paperwork are shuttled around by idiots and the important person, the patient, is forgotten; while the clinicians are left fuming as they are stopped from doing what they are specifically trained for, that is providing a high standard of medical care for their patients.

The multi-million pound wasting NHS direct is never out of the news, and it is not surprising given that so much money has been spent on providing a significant net harm to patients. NHS Direct has again empowered those who are simply not adequately trained to do the job they have been given, incidentally the job they have been given would actually not be safely done by an experienced medically trained clinician; no wonder there is carnage when protocol-led nurses are handed an impossibly hard job. It is also not hard to find examples of nurses being empowered beyond their means, simply have a browse though NHS jobs and one is sure to find a few remarkable examples of this malaise.

It seems that training and education are no longer important in our Brave New NHS. Clinical decision making can now be handed down to anyone who wants to have a crack, simply call that person a 'Health Care Practitioner' or 'Manager' and this approach is suddenly magically justified despite the overt dangers that are rather obvious to anyone who possesses a small portion of common sense. Less and less training and education are needed for jobs than ever before, there is also no need for these new forms of HCP to be assessed by traditional means such as the 'examination'; who needs exams when one has the wonder of competency based learning which allows anyone to be let loose on anything that their employer chooses! It truly is depressing that the blind are leading the blind in this destructive anti-scientific manner. It is strange that if a doctor wanted to do a nurse's job then they would be told that they have not been trained to do it, however when a certain breed of nurse wants to do the job of doctor the DoH has no problem with it; it couldn't be anything to do with the fact that it costs more money to provide a decent service led by professionals that it does to provide a shoddy service run by quacks?


Advanced Practitioner said...

Are you taking over where Crippen left off?
Quacktitioner bashing has become a national sport he! he!

Dr Brown said...
This comment has been removed by the author.
Garth Marenghi said...

just happen to believe in maintaining educational/training/professional standards

I am all for some types of specialist nurses as I have stated a few time, I am also very happy for non-doctors to be able to be fast tracked through medical training if they want to change careers,

however what I am not for is for people to be handed roles for which they have not been adequately trained,

If 'quacktitioner bashing' is the criticising of when medical standards are being dumbed down to save cash, in the process reducing the quality of service, then I am happy to do it!!