The failings of medical training

The 'new and exciting' broad based training program is a sad indictment of the rushed reform of UK medical training that has taken place in the form of Modernising Medical Careers (MMC).  The fact that such a program is needed says more about the lack of consistent training value of many Foundation Year jobs than anything else, with the lack of a proper robust regulatory process overseeing medical training being a key factor in this failure.  There are also several significant flaws in this broad based program, including the obvious potential for a lack of medical experience for those wishing to pursue a career in hospital medicine.  

Key elements of MMC continue to be jettisoned in the dustbin; these include run through training in several specialities including Orthopaedics, the misuse of minimally validated workplace based assessments and shortened GP training.  It is just a great shame that the robustly regulated PRHO year of six months medicine and six months surgery cannot be resurrected.  What medical training really needs is the proper robust regulation of all training posts, not the reinvention of wheels.

Dear Dr Dan Poulter

In your most recent piece of spin you bravely claim Pete Deveson's New Statesman article is "factually inaccurate" but fail to explain why this is so?  Interestingly you also fail to answer any of Pete's simple 3 questions.  

It seems Dr Dan has been compelled into a response:

"Although in theory, until the full introduction of the EWTD, the maximum number of hours a doctor could work in a single week was 91 hours (7 consecutive 13 hour shifts). The process of ensuring proper continuity of patient care through patient handovers to colleagues and being present on the morning consultant-led ward rounds for handing over patients admitted overnight meant that the reality for doctors like me, in some specialities was a working rota pattern involving regular 100 hour weeks.

A typical obstetrics and gynaecology rota (as it appeared on the official rota) which I performed as a doctor as recently as 2009 was; 12 days of consecutive day shifts (including 7 days of 11.5 hour on call shifts) followed by two days off, followed by 12 further consecutive day shifts (including 7 days of 11.5 hour on call shifts), followed by 2 days off, followed by 7 consecutive 13 hour night shifts, followed by 6 days of compulsory rest and a week of training/annual leave (then working pattern repeats in a cyclical nature).

This was a gruelling and tough medical work rota by anybody’s standards, notwithstanding the fact that patient handover meetings and required attendance on post admission patient ward rounds were not ‘counted’ as officially timetabled hours on the rota. The demands of ensuring proper patient care and continuity of care, required junior doctors, like me, to work 100 hour weeks as recently as 2009."

Dr Dan is digging himself into a hole in my opinion. His claims of regular 100 hour weeks are based on a slightly dubious use of the word 'regular' and some rather interesting hand overs.

Interestingly Dr Dan also probably worked regular zero hour weeks if we take his argument to its logical conclusions. Strange he didn't spin this line in Parliament.

At best Dr Dan has been caught engaging in some blatant spin that is arguably highly disingenuous. Dishonest? Well, we simply don't have the facts to make this judgement but it wouldn't surprise me knowing most Tory politicians.

A successful day of Industrial Action

Despite certain biased media outlets including the BBC/Telegraph/Mail et al deliberately seeking negative views on our industrial action and despite the constant stream of dishonest propaganda from the Department of Health press office, I think today has shown anyone around a GP surgery or a hospital that there is a fair bit of support for doctors in our battle against the lying dictators in government.

A majority of our fellow workers and many patients were very much behind our decision to stage this day of protest and personally speaking, I was heartened by what many people had to say.  Of course there were a few people who did not agree with us, however this was inevitable and these people are entitled to their opinion, even if some of them were more motivated by petty jealousy than anything logical.

If this battle is to be won then we need to dig ourselves in, it will take repeated days of protest to make this corrupt regime listen to our calls for fairness and negotiation, not yet more unilateral arrogant dictation.  Well done to all the doctors and all those who supported us, for doing things in such a sensible and caring manner.  

Also please make the effort to sign this E-petition that calls for Lansley et al to pay the same % that doctors are being asked to pay.

Doctor pensions - stick it to Lansley!

Whatever you think of doctors, if you believe in fairness then you should sign this E-petition.  Doctors do not expect special treatment, all they want is fairness, and the fact that government are unilaterally forcing doctors to pay far greater percentages of their income into their pensions than other workers in the public sector is grossly unfair, there is no credible argument against this I'm afraid.

Unfortunately large sections of the media have swallowed up a lot of Lansley and the DoH's lies.  Well, if Lansley and the DoH think doctors should be forced to pay 14.5% of their incomes into their pensions, then Lansley and his DoH cronies should also pay the same amount.  Currently MPs like Lansley, civil servants like those at the DoH, teachers, judges and many other public sector workers pay nowhere near the 14.5% that is being unfairly forced on doctors.

Please sign the E-Petition, post it on Twitter and Facebook, let's help force Lansley and his cronies to pay the same as doctors, let's see if they are happy to eat their own pudding.  I doubt it.

Dear Joe Public - the doctor strike facts

There will be a lot of disingenuous and dishonest information spread by the government and various biased sections of the media in the forthcoming weeks ahead, and it is vital that you, the public, are informed of the facts so that they can make up their own minds as to whether a strike is justified.  Just remember that this is the same media that is being shown to be rather free of honesty and morals in the Leveson inquiry.

First and foremost a strike is completely safe and ethical, any strike will not involve emergency services, it will only affect anything that is non-emergency, in fact ironically emergency patients may well get better care than normal during a strike as all elective work will be cancelled.

Secondly there are several key facts that you will not hear in certain sections of the media, certain journalists and newspapers have massive vested interests, they cannot be trusted with their propaganda.  The facts that no one from the government can deny are as follows:

1. Our pension fund is in surplus of about 2 BILLION pounds per year.  It is sustainable and it is simply being raided by government to subsidise losses and deficits elsewhere.

2. Doctors have had numerous pay cuts and freezes over the last 20 years or so, compared to their peers from equivalent backgrounds and levels of education, doctors earn significantly less money over their careers.

3. Doctors agreed a new pension deal in 2008 which the government wants to tear up, this already increased contributions hugely, the new proposals which have already been enacted involve doubling the current contributions.

4.  Strangely the pension contributions of politicians and civil servants are not being plundered in the same manner, I wonder why this could be?  Surely the whole public sector should be treated in the same manner and doctors, who already pay a good chunk of their salaries, should not be selectively robbed.

I am biased, I will not deny this but a line in the sand needs to be drawn now and a strike is utterly essential for numerous very solid reasons.  The government is privatising the NHS as we speak and they have no democratic mandate for this.  They now want to steal money from the pension funds of doctors to pay for their errors, of note from pension funds that are accruing about 2 billion pounds of surplus cash per year.

We, doctors, need the public's support and we need you to ignore the dishonest bile that will be thrown in your direction from the likes of the Daily Mail and the BBC.  The vast majority of doctors feel this way.  I love being a doctor, however I am relatively poorly paid in comparison to most of my peer group who did not go into medicine, and all I ask is that our reasonable pensions are not plundered by the incompetent and dishonest fools in government who will tell you numerous porkies in order to make you think that I am greedy or selfish.  This is not the case, I just don't want the government to steal from my pension fund to pay for their negligence and incompetence.  Thanks for listening.

Risk-free profits for the vultures begin

This excellent article from Allyson Pollock sums up the disaster that Lansley's terrible NHS reforms are.  It is clear that the market is fake and that many private sector vultures are set to make massive profits at the expense of the tax payer.  It is an utter scandal.

There is no accountability or transparency, meaning that the market is a sham, there is no real competition.  This Bill has been created with the help of the private sector for the private sector, the conflicts of interest are a disgrace.  This is the Lansley and Cameron's idea of open accountable democracy:

"The public cannot make a fully informed judgement about the contract, because both the Treasury and Department of Health have refused to release key information, despite repeated requests under the Freedom of Information Act. "

Pollock sums it all far better than I can:

"The speed at which contracts have been let and the lack of public consultation inevitably seeds suspicions of corruption; but it is politicians who have seriously misled the public over the NHS.......The current lack of disclosure is a public scandal."

It is good to see the current corrupt government paying for their sins in the local elections, the problem is Labour are not much better, the real disgrace is that our democracy is but a sham, voters have no real choice and this will result in reducing voter turnout in elections, increased apathy and a rise in the extremist far right vote.  Thanks Cameron and Clegg, you are a disgrace to this country.

Dr No - nail on head? Can of worms exploding

I stumbled upon this excellent piece by Dr No on the proposals for extra years of training for GPs, I have to agree with Dr No, I do not trust the Royal College of GPs and suspect some cynical motives may be at play:

"There are of course those who see the extension of training as a cynical ploy by the general practice establishment to extend the pool of sub-GPs (and so cheap GPs) available for exploitation by the establishment. While this may indeed happen as an unwelcome side-effect, Dr No suspects the primary motive of those who wish to extend GP training is to enhance professional standing and status, and so distance the profession from its trade roots; and in this objective, Dr No believes the College proposals will fail."

I am not sure Dr No is right on this, however in the comments it is abundantly clear that there are major problems with medical training that continue to be ignored by the powers that be.

Medical training has been taken over by educationalists in Ivory towers, many of whom reside at the GMC, the focus is now barmy, it is all about paperwork and reflective practise.

There is no decent regulation of training.  There is no focus on hours and experience.  It is a joke.

The problem is that this situation is getting worse, there is a huge disconnect between those involved in training on the ground and those in the Ivory towers who are telling them what to do.  A key part of John Tooke's review talked about this disconnect and the lack of involvement of those on the ground in running training.

The GMC is not democratic, the Royal Colleges are not democratic, the BMA is not democratic, and all this combines to result in the continued disastrous reform of training.  It is nothing but a shambles.

Andrew Lansley - popular compared to Hitler

So the antidemocratic farce that is Andrew Lansley's 'Health Bill' has not yet been scrapped.  Today the deeply unpopular and arrogant health minister needed a police escort to visit an NHS hospital.  This really should tell the government and Lansley himself that things have gone far enough, if these cretins cared one iota for democracy they would have chucked Lansley's  deranged manifesto of privatisation firmly in their privatised dustbin.

If the NHS Bill does end up going through it will only prove just what a complete lack of democracy we now have in this country.  The wealthy people in power can push through terrible legislation that shafts the average man on the street but furthers their own selfish interests, it is such a sad indictment of the state in which we live.  Lansley need a police escort and a media blackout, yet even with this his every move is still a PR disaster, such is the idiocy of his Bill.

I hold out a lot of hope that Lansley's toilet roll will be flushed down the bog where it belongs.  The momentum appears to continue to gather, the Royal Colleges look close to full blown opposition, the public are getting angrier and some of the media are taking more notice.  It is just a great shame that so much of the mainstream media is so unable to call a spade a spade, there is too much corrupt conflict of interest around for the truth to be broadcast far and wide as it should be, even so lying Lansley has been found out, we all know that his bill is a dishonest piece of privatising filth designed for one thing, making the rich richer and the poor less healthy in the process.

Lansley on the run - write to your President now!

Lansley's disastrous Bill appears to drifting towards the rocks, the BMA, RCN, RCM, Unison and Unite already oppose the Bill.  The Colleges are not covering themselves in glory with their failure to oppose the Bill.

Now is the time for them to stand up, be counted and represent their members and the people of this country by openly stating their opposition to this destructive and incoherent Bill of idiocy.

It will not take long to email the Acadamy of the Medical Royal Colleges and your specific Royal College President to pressure them into opposing the Bill, so get emailing and do it now:

Everyone:(AOMRC) academy@aomrc.org.uk

Medics:     enquiries@rcplondon.ac.uk

Surgeons:   president@rcseng.ac.uk

GPs:        president@rcgp.org.uk

Anaesthetists: president@rcoa.ac.uk

Psychiatrists: cchurchill@rcpsych.ac.uk

Here is a brief letter template:

"Dear President

I am writing this email to complain about your abject failure to oppose Andrew Lansley's Health and Social Care Bill.

If you fail to publicly oppose this Bill then I feel you are failing your members, your patients and yourself.

Yours."

Lansleys lies some more

So Lansley is now claiming that nurses' and doctors' unions are opposing the health bill because of pay and pensions, what an illogical and incoherent view from this cockroach of a man.

The pension reform is part of the package that is the whole scale privatisation of the NHS, the white paper and the pension reform are all part of this antidemocratic privatisation campaign.  The pension looting is a quite deliberate part of this privatisation, as private firms will not take staff on if they have decent pensions.

We are against the NHS and what is stands for being destroyed, we are against patient care going down the toilet, and privatisation will do both of these things, and this privatisation is being catalysed by the white paper and the pension reform.

If a doctor had lied and lied in order to privatise the NHS in such fashion there would be a good case to strike them off for their rank dishonestly and lack of integrity.  Sadly this kind of malignant weasel-like behaviour has become standard for all politicians of all three major parties who have joined in the NHS privatisation in recent years.

The public do not want it, doctors do not want it, nurses do not want it, only Lansley and a few rich people with vested interests want the NHS sold off and it is quite disgraceful.  While Bevan is remembered fondly, Lansley will be remembered in quite the opposite manner and this will be thoroughly deserved.