Sunday, 27 April 2008

Expensive half baked quackery

The NHS really is the envy of the third world, as doctors in training see their pay slashed and free accommodation withdrawn, the under trained are being rewarded with huge salaries given their minimal levels of training.

Physician's assistants only have to train for a fraction of that of a doctor, while entry is far less competitive and rigorous. However after a couple of years training and a dumbed down diploma one of these PAs can be earning well over 40 grand. It beggars belief.

This is while patients on the wards are left short of basic nursing care because proper hands on nursing is undervalued in comparison to clip board wielding managing and playing with fisher price stethoscopes on dumbed down quacking courses.
Whatever happened to having different training for different roles? Why is there this ridiculous need to merge all health care workers into one pseudo fabric of competency based mincemeat?

It seems that many people without the necessary knowledge and training feel happy to have a crack at the role of a doctor these days. Bizarrely the most highly trained of the health care workers, the doctors, are not allowed to apply for these nurse practitioner or physician's assistant posts. Why is this bizarre and nonsensical one way street being constructed? The Witch doctor explains this situation nicely:

"There is A New Cult being generated by this government: A cult that attacks professionalism: A cult that undermines intellectual capacity: A cult that is attempting to sway this nation into worshiping competency rather than the excellence that professionalism continuously strives to grasp: A cult that is attempting to turn health care into a commodity in order to generate a market share. The government has complex reasons for promoting such a cult. The Witch Doctor believes what this government is doing is very short-sighted and in the long term will be very damaging for the future health, knowledge base, and ultimately the freedom of this nation."

Indeed there is, and this new cult is a massive danger to the progress of our society. Short termist power grabbing and economics are the motives for policy that is spitting on the professions. Dr Grumble highlights some salient John Tooke quotes that make for some rather interesting reading:

"The results of role substitution experiments are not particularly well publicised, but when they have been conducted they’ve tended to reveal that the role substitutor for the doctor is no more cost effective and indeed in some cases less cost effective than the doctor doing that role. And the real reason for that is that a role substitutor may be able to follow a protocol, but unfortunately human beings and human disease don’t conform very neatly to protocols and that gets forgotten."

There are pressures from Europe to change our training in a way that meets dumbed down European standards as regards consultant level standards, this is dangerous as our health system is very different to other in Europe and by trying to conform a lot of damage will be done. This top down megalomania has gone far enough, it is time that we, the professionals, rallied against this catastrophic erosion of high professional standards.

The public need to be educated to these evils before it is too late, health is not a simple commodity like coal; doctors require large amounts of knowledge and a lengthy training for very good reason, their job is complicated and if it continues to be farmed out to the ever growing army of quacks, then the service will continue to be dumbed down and reduced in quality. What is the good in producing more and more coal, if the coal is of lower and lower quality? Not much I reckon, but this is the end result of a top down system motivated by pure greed.

1 comment:

Henry North London said...

Protocols, compliance, They make the rules and we have to follow them


Tell me if the rules said you should jump off a cliff would you?