Saturday, 6 February 2010

Polysystems, NICE killing, Mike 'O'Brien et al

There is just so much moronic drivel spewing forth from the government and its cronies that it's hard to know where to start. I shall start by the drive in London to decimate primary care there. The government is trying to make primary care cheaper and privatised, the problem is that all the changes to service delivery along with their new associated bureaucracies end up costing more money than just leaving the old system in place. Then when it is realised that the reforms are very expensive, the service ends up being cut and patients end up suffering as a result.

This is Lord Darzi's legacy in London. The 'polysystem' madness current being rushed through is exactly the politically driven policy disaster that doctors expected. There is simply no logic behind plans to centralise GPs into these poly-shambles centres, it is a massive waste of money and highly inconvenient for patients to have to travel far greater distances. In reality polysystems are just a shallow excuse for dumbing down the standard of primary care even further, more patient consultations will be handled by those without proper medical training (nurses), while the quality specialist led care of district general hospitals will be eroded by shutting these hospitals and dishing out the work to less trained doctors and other quacks. This is all about cheapening medicine and pretending it's in the best interests of patients when it quite clearly is not.

NICE is a another government organisation that is about as useful as a bullet in the head. Their guidelines are not only overly simplistic and frequently wrong, but they are also a hazard to patients. NICE's drive to lower the blood sugar levels of diabetic patients to such low levels that it actually increased their chances of dying was just one example of this. Another great example of this is NICE's drive to give everyone drugs to thin the blood to prevent the incredibly rare and infrequently fatal pulmonary embolus (PE). The danger of thinning every one's blood is obvious, you get more problems like thrombocytopenia and other bleeding complications. In fact there is a lot of evidence emerging that the blood thinners do very little to prevent clots, but they do increase the risk of some very nasty complications. First do no harm should be NICE's motto, alas it is not, many of their guidelines seem to have been written by those with some rather glaring conflicts of interests, as a result the guidelines end up serving pharmaceutical firms and not the patients that they are meant to help.

A fascinating exchange between a rather thick government minister and David Colquhoun has taken place in the BMJ this week:

"Secondly, and far more importantly, he is wrong to say I was mistaken to claim that "you cannot start to think about a sensible form of regulation unless you first decide whether or not the thing you are trying to regulate is nonsense." If it were irrelevant that the subject you are trying to regulate was nonsense then why not have statutory regulation of voodoo and astrology? The Pittilo proposals would involve giving honours degrees in nonsense2 if one took the minister’s view that it doesn’t matter whether the subjects are nonsense or not. Surely he isn’t advocating that?"

In my opinion the government minister, Mike O'Brien, comes across as a thick plank of the highest and densest order. His idiocy is well demonstrated in his illogical rambling. The government's policy making invariably ignores the actual scientific evidence, the people making these decisions seem barely able to tie up their own laces, let alone decide how to create new laws that should best serve the public interest. It is perfectly summed up by Gordon Brown's completely ill informed comments on cannabis while his own government completely fail to tackle the most dangerous drug in this country, alcohol.

Liam Donaldson also seems to have forgotten his science and has become rather too political with his swine flu exaggerations. The global warming nonsense is another good example of how what should always have been a scientific debate has become completely wrecked by its politicisation, the way in which this bullying bandwagon has been created on dodgy foundations reminds me a lot of the MMR scandal, hopefully bloggers will continue to dismantle the rubbish that our mainstream media and governments try to feed us.


Anonymous said...

HMG wish "health care practitioners" instead of doctors, the end of the "consultant/principal GP" grade, and, the authority of the bureaucrat over the responsibility of the clinician - within ten years.

Proletarianisation of the profession!
- predicted in the 1980's, brought about by Milburn, Blair, Harman, etc in 2000-10.

Polyclinics are just one of the tools to undermine GP's.

Demetrius said...

Does anyone "know" what is going on and why? My family doctors is now becoming more and more like Fantasy Island.

オテモヤン said...