Saturday, 17 January 2009

Honest noble Lord Darzi on the surgical checklist


One thing this government and its minions could not be accused of is reinventing the wheel and then claiming it as their own invention. For example we all know that Lord Darzi was the first man to ever use laparoscopic surgery, even though he was born in 1960, he has magical time travelling powers, the man is simply a great surgical pioneer, he would never be described as a politically minded brown noser who happens to have published a lot of papers.

This week Lord Darzi has been talking about a 'surgical checklist' that the World Health Organisation (WHO) have come up with:


"Health Minister Lord Darzi, who played a role in developing the checklist, said: "The beauty of the surgical safety checklist is its simplicity and - as a practising surgeon - I would urge surgical teams across the country to use it.


"Operating theatres are high-risk environments. By using the checklist for every operation we are improving team communication, saving lives and helping ensure the highest standard of care for our patients.


"The amazing results from the global pilot puts this beyond any doubt." "

Thanks for that honest and full description of the situation Lord Darzi, you really are a man of great integrity and honour, you wouldn't possibly be trying to spin things to enhance your own importance would you? Are you reinventing the wheel, again?

The study has many limitations and is poorly designed for one, even the paper admits a lot of this, something the media fail to mention, very strange that, the BBC just describe it as being a 'startling' phenomenon. In fact the study took eight hospitals from eight very different countries and made the assumption that this sample can be representative for any hospital in any country in the world, it doesn't stop there though, in the four hospitals from the wealthier countries there was not a statistically significant difference in complication rates in three of the four hospitals. While the hospital from the UK, St Marys, recently made on of the biggest errors in medical history by removing a women's healthy gallbladder for no good reason, I believe the great Lord is an honorary consultant there too. There are other flaws that the paper explains in the discussion section. It becomes rather obvious that drawing conclusions from this study and applying them in blanket fashion to the whole NHS is just plain stupid.

If you listen to Lord Darzi then it appears that the checklist is a revolutionary idea, in fact all good hospitals in the Uk will already be doing everything on the checklist For example where I work it would be considered bad practice to not be doing the routine checks on the WHO's list. Lord Darzi however has not been defending the fact that many hospitals are well above introducing a checklist when they already have the checklists in place!

He has been concentrating on blowing his own trumpet, pretending that this research is ground breaking when it is not, and spinning the agenda of the government that involves continually belittling what others have done well before him. He made no attempt to reassure patients that many hospitals in the UK are already doing these checks, he deliberately pretended that this checklist was revolutionary and in doing this a lot of people will get much more anxious than they should about surgery in the NHS.

Lord Darzi has gone from being a surgeon to a politician, he has no interest in responsibly getting the facts of a an argument across in the best interests of science or people's health, he is just keen to further his own political career by blowing his own trumpet whenever he has the chance. A responsible scientist would try to emphasise the grey areas and the limitations of various pieces of research, an irresponsible politician goes away from science by spinning only one agenda that is not based on the scientific evidence. Lord Darzi is no more than a politician dressed up in a fake surgical gown.

10 comments:

sam said...

"He made no attempt to reassure patients that many hospitals in the UK are already doing these checks"

He did when he appeared on BBC breakfast TV. He said it more than once, that 'all' hospitals already go through a check list for surgical procedures, only this one is simpler to use and more comprehensive than many already used by 'some' hospitals, hence, this check list will be the minimum standard for all hospitals in the UK. He also stressed the fact that this research was a collective effort between the participating countries and done through the WHO.

Anonymous said...

Lord Darzi appears to be flouting the Secretary of State's "Bare Below the Elbows" policy.

sam said...

He is not an elected politician, he is an 'expert' who was 'gotten' by the PM to devise and implement a policy to rescue the NHS and he did a brilliant job, his patient constitution is law! He has no blemished throughout his working life whatsoever and is the hardest working man you can get! Not only did he satisfy himself with the huge task of reforming the NHS as well as keeping his clinical and academic work, but he was the ONLY doctor, after Tooke, who stood with the juniors post MTAS and decided to rewrite MMC to include the opportunity for excellence and innovation thus giving every doctor a chance to prosper as well as make the application system fairer and more fit for purpose!

So, no, he's not 'flouting' anyone's policies, nothing in his history suggests that he is or accept to be this type of person. He's made his own policy and it's a good one too. The reason why I, as a patient and mother of young hard working doctors, believe he's the best of the lot, including those in that higher seat! ... not forgetting those other so called 'leaders' and the way they have been behaving recently! Cooperate and encourage then and only then, blame him if he doesn't deliver but he will, he is that type of man.

And by the way, it wasn't his team at the St Mary's who made the gall bladder error.

Garth Marenghi said...

Look at Darzi's record as a DoH stooge, it makes your comments appear rather naive.

If he did try to reassure patients then fair enough, it still doesn't change the fact that the study has several glaring flaws.

Garth Marenghi said...

ps Sam, I've chatted to other people who listened to the Radio 4 interview and they also got the overall impression that Darzi did not reassure people of how much of this checklist is routine in many hospitals

pps if you would like to explain to me how Darzi has 'stood' with juniors on their training problems then I will listen, I think you'll find it hard to justify this though with evidence or fact

sam said...

Hi Garth,

I don't blame you for being somewhat pessimistic, he knows the staff are frustrated, he said so in that lecture at the Royal Society. That said, Darzi can only do his best, given the mess that was MTAS and the desperate situation that followed. As for what he has done so far for the juniors:

1- Rewritting MMC by 2010 to allow 'every doctor' a chance to prove themselves through the inclusion of innovation and allowing those in trust grades to get into training and vise-versa.

2- MEE is in the process of being established and it will not be staffless and located in a broom cupboard but will have a real role influncing training and making life easier for the juniors.

3- His call for clinical leadership and the new National Leadership Council will not only give new opportunities to young doctors like yourself (And I believe you would make a wonderful leader, you have all the ingredients but just need to be a bit more optimistic) to get into leadership positions influencing the quality of service provision as well as policy but will also ensure leaders are held accountable for their actions .. unlike the leadership farce with regards to MTAS, Scot JR .. etc

4- His centres will employ young recently qualified GPs currently driving taxis to make ends meet.

5- If Virgin wasn't scared off, Branson would have employed more young doctors but there will be alternatives who will do the same because they will need to staff the new centres

6- Darzi, I believe, is currently reforming the student grant system so a medic with £50,000 debt will hopefully be a thing of the past.

7- His whole reform of the NHS ensures not only quality and safety in service provision but an open NHS that is transparent and is accountable to it's patients and staff. He is moving away from the delapidated NHS look to one that is younger, more dynamic and this provides real opportunity to those who want to excel

That can't be bad ... is it? Support and motivate him to do more then blame him if he doesn't .. only I trust in his integrity too ... nothing to show otherwise.

Best regards :-)

sam said...

As for the checklist, he did say when he appeared on BBC Breakfast that all surgical teams already do checks before and after operations but you never know what some do and others don't. .. the idea with this one is that it is simple to use and is 'uniform' for use by everybody and is researched, validated and approved by the WHO .. believe it or not but protocols are 'vital' in some situations and this is one of them. It has already resulted in cutting complications rates by a third and avoidable deaths by 45% .. Scientifically, this is an amazing result, agree? :-)

Garth Marenghi said...

sam,

I hope you're right.

See the latest Pulse for a rather worrying but of fuel for my pessimism though.

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