Tuesday, 30 December 2008

Empowering the ignorant and intimidating the intelligent: Labour's NHS

It's that time of year again when everyone tends to feel a bit under the weather, it's cold and miserable, the germs have been multiplying over Christmas and people are just waiting for winter to bugger off, so it's been no surprise that numerous hospitals up and down the country are packed to the rafters. Labour have intelligently cut the number of beds in the country steadily over the last ten years, this is despite the fact that our population is expanding and becoming more elderly in its make up. GPs have been receiving emails similar to this one from their lovingly patronising local PCT monkeys:

"Dear Colleagues

Unfortunately the hospital is on red alert which means that they have no available beds at present and they are doing everything that is possible to free up any available capacity. As a result of this, any referred patient may well have an extended wait on a trolley before a bed is found for them.

We fully appreciate that GPs are working very closely with their PBC consortia in order to work as effectively as possible in order to manage more patients safely within the community. At this time we would ask you to re-consider the following before a decision is made to refer any patient for an admission:

Please inform the patient of the likely delay on a trolley so that they are prepared and that it doesn't come as a shock to them"

This kind of message is completely pointless, it's as if managers think GPs deliberately send in patients to hospital for no reason, yet when bed pressures are greater they can suddenly cut down on these unnecessary referrals, what patronising idiotic twaddle.

Then again it's very much the New Labour mantra that patients should be treated in the community, however it doesn't really go alongside improving the quality of care because hospitals are very much necessary for managing sick patients, doing this in the community is either dangerous or incredibly expensive in comparison. Have Labour ever heard of economies of scale?

GPs and doctors in general are also being bullied by their lovely managers into following NICE guidance, which sort of makes a bit of a mockery of it being 'guidance'. Given that NICE guidance often works against the best interests of patients and misinterprets the scientific evidence, it's not as if we should be following a lot of NICE's crap little protocols anyway. It's just another example of doctors becoming less like independent professionals and more like agents of a sinister bureaucratic state.

Medical training is another thing that's going awfully well too, good old MMC means that everything is amazingly so much better than before. It's almost like alchemy, as even with less hours and experience doctors are now magically going to be better than ever before. Once PMETB said that training was now competency based and not time based, it's as if magic came to town and all those training problems went away, unfortunately common sense also went out of the window and we're all doomed, doomed I say. Apparently the GMC don't think that those who forced through the destructive and dangerous training reforms should be held to account, I just hope Remedy can force them to do their job properly, rather than protecting their buddies in their ivory towers. The GMC's logic appears sadly lacking, no surprises there then.

God medical blogging can be depressing, I'm naturally not a pessimist by any means, it's just everything that this government does is so negative and destructive. They have no intention of working with people, all they want to do is bully people and force through their corrupt agenda of privatisation. The doctors are their enemy because they are independent intelligent professionals whose autonomy threatens the government's reform agenda, the government wants a compliant cohort of worker drones who will do as they are told, follow the government protocols and let big business tuck into the NHS pie. Nothing else could possibly explain the drive to empower the ignorant and put patients at risk, while obstructing the hard working professionals who hold the system together. Ho hum and happy new year.

Sunday, 28 December 2008

Bad Science and a merry christmas to all

I was fortunate enough this year to find a copy of Ben Goldacre's Bad Science on my stocking, since I've had the misfortune of working for a portion of the Christmas period I've found time to turn a few pages of this fantastic book. It really is a pleasure to read.

His analysis of Gillian McKeith is reason enough to buy the book on its own, there's no doubt as to the danger that this kind of ignorant pseudoscience poses to the general population who are often not informed enough to know any better. Take this little extract from Gillian McKeith's website, her symptom of the day is:

"Backache or low back pain

Low back pain invariably involves a degree of dehydration and extra water helps most people in a few days. It is also a call for more Boron and Magnesium in the foods you eat along with Vitamin D and the B Vitamins; B1, B12 and B6."

Personally I find Gillian McKeith to be remarkable stinging pain in the rear end, almost like an anal fissure, it's nothing personal Gillian, I just find you brand of pseudoscience particularly offensive.

Interestingly if you search the medical literature for 'magnesium' and 'back pain' then one gets one paper of interest. Interestingly this study found that 'Plasma magnesium was slightly reduced after the supplementation', so I wonder where this talk of more magnesium comes from? Gillian McKeith's derriere perhaps?

Also if anyone gets inspired to drink lots of magnesium containing antacids a a result of reading Gillian McKeith's advice then I suggest they think again, this may be rather bad for your bones. As regards Boron there is nothing in the literature on this bizarre McKeith claim. In fact Gillian when you say 'You are what you eat', things couldn't be further from the truth, millions of year of evolution mean that we can break down what we ingest and convert it into much more useful bits and bobs.

Anyways I digress, Ben Goldacre is a rare example of someone writing about science who actually has a scientific education and background; sadly the media is full of arts graduates who who have no scientific background or education who feel sufficiently empowered to comment on all matters scientific as if they were experts, they lack the insight to be able to see just how foolish they appear to those with some scientific knowledge and understanding. In fact I remember debating this very point with a broadsheet journalist last year, he/she insisted that a science correspondent didn't need to have any scientific education, something that only an arts graduate with no understanding of science would have the nerve to say.

The BBC's shoddy journalistic standards continue to astonish in this manner, only a few days ago they were presenting a case of 'cortical blindness' as being a new undiscovered phenomenon, it may sound exciting to the lay person to present the old as new, however it's just lazy journalism not to research a story properly and to present something that was discovered over 30 years ago as being discovered this year. This is hardly a one off example, it seems to be routine for the BBC to misinterpret a poor quality study from a dodgy journal in order to spin their own agenda these days. Anyways I am ranting, I'll leave you in peace for now, happy new year and here's to the greater exposure of quacks and bad bad science.