Monday, 30 June 2008

Little Red Riding Hood

Little red riding rood once had to deliver a parcel of food to her poor sick grandmother. She had to negotiate her way through the woods in order to get to her grandmother's house, but there was a big bad wolf that wanted to digest her, however he was afraid of doing so in public, so he approached her to find out where she was going, she naively spilt the beans...

The wolf beat her to the house, tricked little red's grandmother into letting her into her house, ate her and dressed up in the grandmother's clothes, then lay in wait for little red riding hood. Little red arrived a little later and was swallowed whole.

Luckily for little red a hunter came to her rescue and cut the wolf open to free both little red and her grandmother, all ended happily with the wolf being killed off by some large stones.

Incidentally Darzi's review was released today proclaiming 'Change – locally-led, patient-centred and clinically driven', maybe it's just me, but the very same government that has been wasting billions on centrally controlled, politician centred and politically driven health care reform appears to be very much in control of this one, while the calls for more 'personalised' care driven forward in an 'accelerated' manner looks like a wolf hiding in a 'quality' sheepskin jacket to me.

I fail to see how any of the following will improve 'quality': undermining high standards in medical training, allowing more private sector cherry picking, allowing more money to be wasted by PCTs on healthy lifestyle guff, more quangos, more reorganisation with no accountability, more inaccurate measurement of care quality by the use of patient satisfaction surveys (remember the botched ISTC jobs) and more care delivered by workers with lower levels of education and training than ever before. I could go on but you get the picture of our hairy and rather toothy bedfellow.

The medical profession is in the woods. The big bad wolf is ready and waiting, our grandmother is long gone and probably in the terminal ileum by now. Do we naively believe all we are told or do we get ready to hunt our wolf, the choice is yours.

Sunday, 22 June 2008

A blogging rut, happy 60th NHS

If I knew the secret to writing inspiring masterpieces week in week out I'd be a billionaire by now, and if I could just intermittently write the odd masterpiece I'd be content. Finding the drive to write is difficult in the ruts, sometimes one thinks its better to just write nothing when there's no creative spark, at other times one thinks it would be better to grind through regardless.

I can't find the inspiration at the moment and I have no idea why. Work has been fairly busy, but then work is always busy, so that's no decent excuse. The NHS is 60 years old this year, so I should be celebrating this great landmark, but for some reason I do not feel like celebrating.

It is not the NHS that should be celebrated in my opinion, the system and the structure leave a lot to be desired in my eyes. From my few years of practice it is the humanity of the staff and the patients that should be celebrated, and this is frequently in spite of the system.

No matter how the government grind us down there are some things that they cannot take away from us, no matter how hard they try. The satisfaction and sense of achievement that one experiences at a job well done makes the daily grind well worth it. The variety and complexity that a career in medicine brings to one's life cannot be converted into pounds and pence.

I'm sure the government will try to spin the 60th birthday into some propaganda peddling extravaganza, luckily the majority of us stopped listening a long long time ago. Despite all the negativity and gloom, working in the NHS gives me a faith in humanity that stops me falling off in the ruts. Even though the government want to turn us all against each other in order to further their own short sighted self interest, through my daily contacts I see that they will never break us down.

Wednesday, 18 June 2008

Child dies

A sad story has emerged in which paramedics elected not to bring a child into hospital following a head injury, the child died a few hours later after another ambulance had been called.

Whatever the facts of the case, it is clearly unfair to put paramedics in this decision making position given their minimal levels of training in medical diagnosis and treatment. In the NHS these days managers frequently pressurise paramedics to leave patients at home.

This is a high risk strategy to say the least, these kind of decisions are hard enough for fully trained and highly experienced doctors, so it is not safe or fair to put paramedics in this position.

This is a familiar tale in the NHS today. Those without sufficient knowledge and training are routinely empowered to make decisions outside of their so called 'spheres of competence', the system is set up to encourage this dangerous practice. It's very sad indeed and it just isn't good enough.

Monday, 9 June 2008

R-UK goes live

The one flower to have blossomed following the MTAS explosion has been that of Remedy UK. The only group that showed the courage and determination to represent the opinion of doctors was Remedy, and as others floundered Remedy was strong.

Remedy have launched a new online Magazine and it's a site that's well worth popping past. Anyone can read the magazine, while everyone is also free to register and join the online Remedy community.
I would therefore urge everyone to be part of Remedy's solution, this is no time for apathy, admittedly many of us are feeling the strain after many months of unrelenting grinding against the system, however if we do not stand up now and try to make ourselves heard then we never will.
Darzi, Johnson et al are currently pushing through their antidemocratic reforms which promise to reduce the standard of care while privatising what is left of our National Health Service. We need to unite against this common evil, we need to believe that we can make a difference as individuals combining to destroy this malignant growth.
The power of public opinion is potentially huge and enough to stop any tyrant in their tracks, so it is up to us to find more ways in which to educate and engage the public, so that they can unite with us against this common enemy. We have the truth on our side, so despite our relative lack of finances and propaganda merchants, we can hit the bastards for six if we believe in ourselves a little bit more.