Tuesday, 22 September 2009

Supermarket medicine

I apologise for my recent lack of activity, unfortunately life has dealt me a busy hand of late and far too much time has been spent working and in my car. Currently a porcine sore throat means I am feeling rather pathetic and tired, my energy levels are flagging.

It's hard to keep up with the news, there is just so much utter rubbish spouted from various media orifices that it is very hard to know where to start one's dismantling from. Certainly Andy Burnham's recent disingenuous ideas are as good a place as any to start, Dr Crippen has hit the nail on the head yet again:

"The demand is insatiable, and the only way the government can cater for it is by dumbing-down the service and moving towards a 24/7 "medical supermarket"."

The sheer nonsensical nature of the continued NHS reform beggars belief, the same failed ideas continue to be tried out again and again and again. It is no surprise that they continue to fail miserably. With the recession rolling on and debt levels high, cuts will inevitably be made in the places in which they will be felt the most. The real motives are hinted at here by Dr G.

The weak reporting of the the poorly explained entitity of 'misdiagnosis' really got my goat this week. The 'BBC investigation' was dramatic and breathtaking in the BBC's minds, in reality they showed nothing new but were rehashing and sensationalising the work of others. Strange that the beeb didn't mention how anyone can have a crack at diagnosis these days, just a few weeks with a toy stethoscope can give you the power these days.

I bet the useless NHS empire of bureaucracy that is made up by the DoH/SHAs/PCTs will not be trimmed, the front line services will be the ones to suffer as the aforementioned lame duck organisations waste money hiring management consultants and employing more idiots in trying to increase efficiency. Idiots will always try to improve efficiency by hiring efficiency officers to oversee efficiency reforms, a better management strategy would be to cut the ineffective rot out of the system. The problem is that the inefficient rot is running the show and as a result the NHS is doomed.


the a&e charge nurse said...

Good to see you back Ferret - anyway, enough of the niceties.

According to a recent stud there is a 6% increase in mortality risk amongst patients treated by the August cohort of junior doctors - the so called 'killing season'.

No such risk has ever been associated with the quacks yet they are characterised (by you) as charlatans with toy stethoscopes.

I share many of your concerns about mis-management of the NHS but when are doctors finally to wake up to the fact that quacks are (in the main) safe and reliable?

I suspect trends on independent (non-medical) prescribing will demonstrate a similar level of safe and competent practice?

the a&e charge nurse said...

Recent 'stud' - perhaps this is taking 'stats-porn' a little to far?

Should say study

Garth Marenghi said...

there are numerous flaws with that study.

even if one assumes that there is a rise in the death rate then it's most likely because all new doctors spend about three days off the wards attending ridiculous politically correct induction sessions and not attending to sick patients

you can find whatever you want with a study

Garth Marenghi said...

common sense is much better than some very flimsy evidence

give me some decent randomised controlled trials then you have a point, you won't be able to i'm afraid

less training equals poorer care i'm afraid

it's true for doctors with ewtd and it's true for quacks trying to be gps with no decent training in medicine

the a&e charge nurse said...

'common sense is much better than some very flimsy evidence' - agreed, Ferret, so why can't doctors finally acknowledged that ten years of quackdom have hardly resulted in the bloodbath predicted by the medical Jonah's?

I can accept medics are opposed to the quack model on the basis of role demarkation, etc but there is no evidence (however imperfect the studies may be) proving allegations of ineptitude that I'm told surface most days on the doctors secretive website.

In other words this is a trades union matter rather than a case of inferior care standards - don't forget quacks generally see bread and butter stuff leaving docs more time to deal with complex pathologies.

The quack model is well established in the States and uptake in places like Australia is growing as well - so perhaps we could reframe this as another NHS success story?

Garth Marenghi said...

in one word 'no'

many quack roles are just plain expensive and dangerous

to argue that they are proven in utterly nonsensical

shocking bad practice is virtually always hidden in the NHS, there is the odd exception like Stafford, but 99.99% of stuff is never out in the open

to claim some of the new roles for HCPs are safe is this light is utterly fantastical and plain barmy

the pathetic thing is that lots the reforms have resulted in new roles/people employed (for example dodgy foreign surgeons in iscts) and nothing has been done to assess the impact of these reforms

it is also virtually impossible to assess their impact unless you want to, ie you need a very well designed prospective study for assessing the quality of care in general practice for example, these have never happened,

the government has never wanted to assess their impact because they know these reforms are by and large dangerous

i completely disagree with you on this, no amount of your incessant rambling will change my mind i'm afraid

your argument cuts nothing for me

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