Monday, 23 November 2009

Clinicenta death and contract suspended

This recent story is just the tip of the ISTC iceberg. Recently another private firm's dangerous practice had led directly to at least one very preventable patient death.

It seems that despite getting paid at a rate at which the NHS can only dream of, Clinicenta is struggling to provide a safe service in London and their work has been transferred back to the local NHS providers. What a sad waste of tax payer's money.

These kind of failures seem to be largely buried in the news and the general public is not as aware is it should be of the disasters that have gone on as a result of this shady program of unaccountable privatisation. The health service's running should be completely out in the open, not hidden as a result of commerical confidentiality. Some people need to start joining up the dots.

Wednesday, 18 November 2009

What value a medical degree?

It seems that the Australians have more balls than the British, down under the Australian government is trying to force through various destructive dumbing down reforms that empower those without medical degrees to jobs that previously required much higher levels of education and training. The Chairman of the Australian Doctor's Fund is clear with his message:

"Who would subject themselves to the rigours of a medical degree when it is so much easier to obtain a nursing degree and be jumped into a medical role?

In other words Ms Roxon has to decide whether she wants doctors or nurses to be the ultimate decision maker on the care of patients. Sadly our leaders seem to be unaware of the problem or seem to think that simply by announcing it, their job is done. Sadly those driven by ideology rarely succumb to reasoned argument; backed by million dollar budgets and armies of public servants they play with their half-baked ideas and impose them on those who know better.

It is our duty and our intent to prevent these destroyers of the culture of medicine from achieving their goals. It is our duty to assert and intervene in all possible ways to make sure that a medical degree, and all the discipline required to achieve it, is given its rightful place, namely signifying leadership in medical care.

This is the model that has delivered Australians world-class medical treatment. There is no reason or compelling case to dismantle it.

When I worked in England many years ago I was appalled that there seemed no one who took personal responsibility for a patient. Let us not go down the same road here."

Ms Roxon is the Health Minister who is coming up with the half-baked ideas, the parallels to the UK are obvious, and these half-baked ideas are very much a threat to world-class medical treatment, once the dumbing down starts it is hard to stop. The Australian Government is also trying to replace GPs as the cornerstone of Australian medical practice, in a way that draws striking parallels to what the Labour government has done here in order to usher through the privatisation of the NHS. A former Australian Medical Association chief has this to say:

" If nurses want to be doctors, trained to take a history, examine, investigate, diagnose and
formulate a management plan with the depth of knowledge required for the possibility of
differential diagnoses, then they should apply to medical school…."

This quote from another big cheese shows how the Australians are trying to push through exactly the same dumbing down agenda as has been done in the UK, it matters not what education, skill or training anyone has, you can all be 'doctors'! But then what will the word doctor come to mean?

"And, interestingly, there is a push for another change – namely, that all practitioners
working in primary care, irrespective of their qualifications and expertise, be now called
“doctor”. Such a collaborative model readily brings to mind the sovietisation of health

There is a problem with bananas, this half-baked philosophy of cutting the number of properly trained staff won't even save money; it is expensive, bad for patient care but it does allow the government to push through it's privatisation schemes more easily. The NHS Skills Escalator looks like it were drawn up by a braindead slug on crack, but sadly this is a creation of our retarded overlords in government and it is being pushed through regardless of its utter stupidity.

Good luck to the Australians in resisting this destruction of their excellent health care system, it will be hard as the government have buddied up with the Australian Nursing Federation and seem determined to repeat the damage that has been done in the UK. They have established a 'National Health Workforce Agency' which may well be another prong in their attack on medical professionalism and standards.

It is sad that there are so many people out there who are too stupid to see the wood for the trees. It matters not whether people are called doctors, nurses, paramedics or monkeys. The labels to things do not matter, relabelling a useless product does not make it better. It is as simple an argument as less education and training makes for a lower quality of care. After all if the government announced plans to train doctors in about three months then I am sure everyone would be up in arms, so why do some idiots find it acceptable to convert nurses into doctors with an even shorter period of training? There isn't even any decent evidence to show that it is safe. In life you get what you pay for, less investment in training people properly will get you a poorer service, it won't magically save you money and provide as good a service.

"The Cochrane Collaboration summary on the equivalence of GP-led and nurse-led care has more disclaimers than a set of K-Tel steak knives. Most damning is the statement that these findings “should be viewed with caution given that only one study was powered to assess equivalence of care, and many studies had methodological limitations”. So, Australian policy-makers, reformers and governments beware – 50 years of general practice hard slog has resulted in international benchmarking for key health outcomes, and unsurpassed general practice patient satisfaction."
(Prof Claire Jackson, The ‘little sick/big sick’ myth of general practice, Australian Doctor, 19/10/09)

Tuesday, 17 November 2009

Junior doctors deserve no rights

According to this 'consultation' document from the Department of Business, Innovation and Skills the rights of junior doctors are to be completely ignored yet again; apparently medical deaneries, the bodies that are responsible for the recruitment and training programme of junior doctors to NHS Employers, should be 'exempt' from employment agency legislation.

It begs the question, why should deaneries be exempt from employment agency legislation when they are effectively acting as employment agencies? It is a bit like saying that one particular murderer doesn't have to be prosecuted because the law doesn't apply to him like everyone else. The pathetic justification for this is:

"This is based on evidence that the potential consequences could be to seriously hinder the recruitment and training arrangements of junior doctors with a subsequent impact upon both cost and staffing for the NHS"

This is a disgrace to put it mildly. The government are effectively saying that they want to treat junior doctors as subumans because this way it is cheaper and easier to fill the jobs up. If sticking within the law is so hard for deaneries and the government then they should take a long hard look at the shabby and substandard way in which they treat junior doctors, shepherding them around like cattle and not giving a minute's thought that they may be entitled to lives and rights like other human beings.

At least the BMA will stand up for the junior doctors, right? No, wrong, the BMA have met with the Department of Health to discuss treating junior doctors like slaves and they are to draw up a completely toothless code of conduct that deaneries will just ignore because it's not the law. Interestingly Remedy were not invited to this 'discussion forum', strange that. So much for all humans being equal, it seems in the eyes of the government junior doctors do not deserve the necessary protection of the law when seeking employment, it is just too costly to treat them as humans.

Sunday, 15 November 2009

Who will do the nursing?

Much talk has taken place in recent days on plans for all nurses to be trained to degree level from 2013. I think a lot of the chatter and debate has missed the point. 'Degree level' is just a label, it doesn't mean a great deal on its own, I think the problems with nursing training are similar to the problems with medical training that have become apparent in recent years.

Good old fashioned basic nursing has become devalued as an entity in recent years, it seems that an apprenticeship in one's trade is simply no way to learn the ropes in our current politically correct times. Basic things such as feeding patients, washing patients and attending to bedpans are beneath some modern nurses. A little knowledge can be a dangerous thing, a quick superficial glance at the science behind medicine seems to have inspired quite a few nurses to bit off a bit more than they were able to chew.

I do not wish to single out nurses, the same types of problems exist with the training of doctors. The basic science has been dumbed down, the apprenticeship has been lost and the ward hours are just not there anymore. The same is the case for nursing training, the ward hours and apprenticeship has been lost at the expense of satisfying politically correct mumbo jumbo spewed forth by educationalists. The subspecialisation of educationalism is to blame for a lot, invariably idiots who were not very good at the job end up doing all the teaching despite the fact that they haven't been on the front line for years.

This loss of the apprenticeship and the reduction of basic standards is a direct result of one thing, money, the government does not want broadly trained competent workers who have learnt the ropes adequately, they want to isolate individual competencies and shift work down to people who have had way less training than in years gone by. To see this in action all one has to do is see who does most of the basic nursing on wards, it is done by 'health care assistants' who have had very minimal levels of training, they are the modern day nurses.

Nursing is no longer good enough for modern day nurses, a lot of them now go into nursing as an easy route to becoming a quasi-doctor or 'noctor'. In life you get what you pay for and less training and knowledge inevitably results in a lower quality of service for patients. Many nurse specialists who specialise in areas which are suited to their skills and training, for example stoma care nurses, district nurses or various sub speciality liaison nurses, are a great asset.

The problem comes when nurses are promoted into jobs that demand a broad based understanding of medical diagnosis and management, for example the nurse in the Walk in Centre who practises independently or the scarily 1984-esque nurse 'consultant'. Some experienced nurses can just about get away with it, some of the time, however when inexperienced nurses are given these roles the consequences can be rather disastrous as well as expensive. One example is the massive failure of nurse-run Walk in Centres to reduce referrals to other health services.

The government cares not for quality of care, all is interested in is privatising the NHS and selling it off to private corporations. Breaking the medical profession's monopoly on doctoring has been part of this corrupt privatisation process. A side effect of this has been the devaluing of proper nursing which is sad to see. There is a real need for patients to be properly nursed and in the future we'd be better off having nurses doing nursing, rather than letting anyone with a couple of weeks training take their place and moving trained nurses into jobs that are outside of their expertise and training.

Thursday, 12 November 2009

Who will do the caring?

The BBC has reported on a government report which claims that around 2,000 people's deaths each year are contributed to by the innappropriate prescription of anti-psychotic drugs for patients with dementia. The report claims that:

"But the expert review - commissioned by ministers - said the treatment was unnecessary in nearly 150,000 cases and was linked to 1,800 deaths."

This is all well and good, but when one sees the prescription of anti-psychotic drugs in the context of a care system that has been almost entirely privatised and ground down to the very bare bones, then the government's sticky plaster of a response is nothing but pissing in the wind.

The government wants better access to other kinds of therapy, more training for care workers, more monitoring and a new national director. I wonder where all the money for this will magically appear from given the NHS' budget crisis?

Also it is strange that the government has done so very little to regulate the care industry in the UK in recent years. It used to be largely publicly owned, but after the last twenty years or so of destructive reforms, it is largely privately run for profit. This also means that the government cannot force changes upon the system anymore, as the private firms hold all the card in terms of ownership and lobbying power, they have been very resistant to proper regulation in recent years.

This has meant that many care homes are dangerously short staffed and the staff present are invariably not sufficiently trained for the jobs they do, the government watered down regulation changes a few years back that would have forced a maximum number of patients per staff member. No wonder anti-psychotics are being dished out like smarties, there simply has not been the right number of properly trained staff to adequately manage the most tricky patients with dementia.

The privatisation of a service that should be accountable to the public has led to it being run down in the name of profit. This government and previous governments have caused the care of our elderly to be so woefully neglected, they simply don't want to pay for people to be cared for properly to the grave. This report is yet another dishonest piece of spin designed to take attention away from their own failings.

Tuesday, 10 November 2009

PCT deprives NHS of cash to to council's job

I read this story in the newspaper that demonstrates how completely stupid those in charge of alot of the NHS' cash are, the Mail covered this story of Durham and Darlington Primary Care Trust (PCT)'s decision's to spend 1 million pounds of NHS money on gritting the county's roads.

"This money will be spent in a variety of ways but, in particular, on gritting extra paths and pavements which will result in improving the quality of life for the elderly who often fall and fracture bones in icy weather. It will also go towards additional road gritting as road traffic accidents have a major health impact and often cause death or lifelong disability for the individuals involved."

This is the logic of a fool. By this logic PCTs could spend money on filling in pot holes, repairing roads, checking vehicle safety, renovating old buildings, improving playgrounds, arresting dangerous criminals, policing the roads, collecting rubbish et aliter. Many other areas of policy can affect health, but this does not mean they should be funded directly with NHS money. This is plain barking mad.

As hospitals are being starved of cash by PCTs, because the uneducated morons in charge of the PCT's funds decide to fritter away money on non-health related issues and on health related schemes that have sod all good evidence to back them up, we see the banks continue to be propped up by the government because they cannot be seen to fail. Why can hospitals be seen to fail because PCTs are wasting all the money they need to provide decent local services for local people?

It has been many years in the making, but the way in which the most educated and knowledgeable are not involved in deciding where NHS funds should be allocated is a national scandal. Epidemiologists and Public Health specialists are now routinely uninvolved, while empowered general managers with no understanding of medicine in tandem with a sprinkling of uneducated idiots are literally pouring petrol on this bonfire of tax payer's cash.

Monday, 2 November 2009

Johnson and Brown: two idiots of the highest order

The Prof Nutt saga is not going away unfortunately for the incompetent duo of Gordon Brown and Alan Johnson. The disgraceful sacking of the eminent Professor is turning into quite s sh*t storm, and quite rightly so. The more information that comes to light, the more corrupt and stupid the politicians appear. Dr Grumble has pointed out yet more flaws in the government's weak line of logic.

Alan Johnson accused Professor Nutt of becoming political with his statements, in fact what he said prior to his sacking was simply a well rehearsed and well researched scientific argument that was backed up by solid evidence. All of Brown and Johnson's comments on drugs have merely shown an immense lack of understanding of the evidence and a pathetic tendency to appeal to the lowest scaremongering sections of the tabloid press.

Skunk is not 'lethal' as fat Gordo stated, in fact by Johnson's logic Brown should resign as he is clearly straying into the scientific domain with this political statement. Johnson is just as bad as Brown with his illogical statements that he has released in order to justify the unjustifiable.

This is a simple issue and it comes down to the government having no balls. Brown is a weak incompetent leader who will do anything, no matter how wrong or dishonest, to win a few votes. Brown has routinely ignored experts on issues of which he and his fellow morons in power have no clue, he is too stupid to have any insight into his own lack of knowledge, he is a first class buffoon. This affair is not going away, it is about important principles, the resignations continue and I sincerely hope that it has done some good in exposing the rank stupidity and arrogance of those leading our country.