Sunday, 9 May 2010

Remedy vs GMC: Let Battle Commence

Remedy are taking the General Medical Council to court this week on behalfof 1600 doctors. The GMC have been accused of blocking a Fitness to Practice enquiry into Sir Liam Donaldson, days before he is due to step down as Chief Medical Officer. The case has been branded as ‘The Double Standards Challenge”.

The litigation arises over Donaldson’s management of MTASthecomputerised recruitment system for junior doctors. The Health Select Committee concluded that “Candidates and assessors alike were justifiably outraged by the sheer inadequacy of MTAS. The period between February and August 2007 was characterised by unrelenting chaos and severe anxiety for thousands of junior doctors. …

The reputation of both the Department of Health and the leaders of the profession were severely diminished”. The GMC was asked to consider whether those responsible should face a disciplinary hearing. But they declined to refer the matter to their Case Examiners. In a letter to Remedy they stated that Donaldson’s involvement could not render him unfit to practice “whatever the conduct’. This conflicts with the GMC’s own published guidance for Doctors in Management,which states ” You remain accountable to the GMC for your decisions”.

It is unheard of for thousands of doctors to take their own ruling body to court. But Remedy believes that we have been completely let down. There should be one rule for all medics, without exceptions. We are drawing aline in the sand over cronyism and lack of accountability in the upper echelons of the medical profession. This is the first time a case of deficient professional performance has been made against a doctor in management.

If you want to support Remedy then you can donate money here, or join their Facebook group here. Come on Remedy and come on Justice!

Monday, 3 May 2010

A little knowledge is a dangerous thing

The health service has been dumbed down magnificently since Labour came to power in 1997. In order to try to save money a lot of work previously done by highly trained doctors has been handed to people with much less education and training. Some people think this makes sense, but the fallacy of their arguments is obvious, you simply cannot expect those with less education and training to do as good and as efficient a job as those with the higher skill levels. This tale demonstrates just what is going very nicely indeed:

"In my locality, Transforming Community Services has actually meant Terminating Community Services.
As a result one of my residents in a Nursing home has fallen into the clutches of an "Outreach Practitioner", who this morning gatecrashed my surgery to thrust a paper into my hand, with the request to "sign this".
Fortunately I read it, & it was a request for a liver scan.WTF? Why?
"She keeps going high in the morning & low at night. I think it's her liver. Liver disease can cause hypos & I noticed she's had an ocular melanoma. We need to find out if she has metastases."
It takes about 30 seconds to ascertain that the LFTs on her last diabetic clinic with us were perfectly normal & the melanoma was treated with laser at an early stage, not by enucleation, over 10 years ago.(a) I think we'd have known by now.(b) All she needs is her bolus insulin in divided doses (as her consultant has already instructed).(c) She's 90 years old & has end-stage cerebro-vascular disease. What the Hell use is a liver scan?A little knowledge is dangerous.
When medical students reach that stage we educate - even ridicule - them into thinking "common things first, rarities last", but noctors' university training gets them diplomas without benefit of the cultural memes handed down in medical apprenticeship since the days of John Hunter & William Osler. So they think exotics first & 'simples' (such as cocked-up insulin dosage) last.So if anyone thinks they might be cheaper than real doctors, think again."

Numerous pseudo-doctors have been deployed into roles that were only previously done by doctors. This has led to a lot of patients getting a rather raw deal. Whether this be diverting Orthopaedic referrals to physiotherapists and away from the consultants, or seeing the nurse practitioner at the WIC with your chest pain, the costs in terms of patient care are obvious. This dumbing down may save money in the short term, however in the long term in may well cost a lot more to pay for the consequences of the substandard care that a lot of patients are getting these days.

The government has decimated Out of Hours General Practice in this country in the last ten years. Now instead of properly trained doctors covering patients at night, we are seeing nurses replacing doctors because they are cheaper. If they had kept GPs in charge of Out of Hours care we would not be in this mess and patients would not be dying as a result of the shambles that has resulted. The government has taken over and wrecked a perfectly good doctor led system, it has now been replaced by a numpty led shambles.

Sunday, 2 May 2010

Labour - wrecking medical training and culling training jobs

According to the Telegraph Labour have been crafting secret plans to cull large number of junior doctor training jobs if they magically win the election with Gordon Brown at the helm. This sums up the rank dishonesty and incompetence that this government have shown regarding doctors' training in the last thirteen years.

Labour have presided over a massive over expansion of medical student places at Universities. I call this an 'over' expansion because they have not maintained standards, they have stuffed medical schools too full, they have dumbed down the quality of the undergraduate medical training system in the process, much the same has been done to all University degrees under Labour.

The expansion in numbers has led to the typical boring propaganda from Labour such as 'more doctors', 'more nurses' and 'more degrees'. This may be true, but it has come at some cost and that is the standards of education, and also the fact that many of these people will have no long term career prospects in their area of training.

Modernising Medical Careers (MMC) and MTAS are two of the government's biggest cock ups, the former being the flawed dumbed down reform of medical training and the latter being a hopeless application process that wrecked many a junior doctor's career. The threat of culling training posts now could be devastating to the service with many rotas being massively short staffed as things stand.

This government simply cannot be trusted. They promised us so much and have delivered so little. The referendum on Europe never happened despite being promised in the Labour manifesto, many other promises have been broken in recent years since Labour came to power.

Medical training is in crisis despite all the money that Labour has wasted on the NHS. This government promises to protect front line services, this is a very dubious promise given these secret plans to scrap training jobs for doctors. The bottom line is that Gordon and chums cannot be trusted, they have lied time and time again. Do not give them your vote next week, they simply do not deserve it. Labour need to be removed at all costs.

Saturday, 1 May 2010

Gordon Brown misleads on health and NHS

Having watched bits of the Election debates and various interviews on TV in recent weeks, I can conclusively say that health and the NHS has been generally ignored and when talked about, the real issues have been completely skated over. All three major parties seem unable to talk about making any cuts, this is ridiculous given the amount of money being wasted on various crackpots schemes in the NHS.

We have billions being thrown away on the pursuit of the internal market when it clearly doesn't work. We have numerous layers of administrators who are not needed such as the PCTs and the SHAs, these bureaucratic layers actually spend a lot of money trying to avoid doing work rather than actually funding the front line services. We have numerous QUANGOs doing sod all of use and we have billions being wasted paying for ridiculous PFI schemes that are often run by the banks owned by the tax payer, this is beyond farcical.

There has been no open honest debate about this waste and this inefficiency, the politicians are too afraid to talk of the NHS, it is a political hot potato. The market needs to be dismantled, the way health care is funded needs to be radically simplified and transformed from the current overcomplicated shambles it is.

Gordon Brown's comments have been beneath contempt. Not only have Labour been sending out misleading leaflets to cancer patients in the most abhorrent of circumstances, but they pretend that scrapping their stupid top down targets would be the end of the world for patients, this is clearly not the case. Gordon Brown has been pretending that targets are the key for patients, actually a lot of the scientific research shows that targets are probably doing a lot more harm than good.

Targets are a waste of time. It is the capacity of front line services that is key, not the centralised targets imposed by the ignorant and uneducated bureaucrats. The 2-week cancer target is a great example of this, without extra capacity the 2-week target will arguably worsen outcomes as it will allow cunning patients a way of jumping the queue in a way that overrides clinical priority.

The old system in which referrals were overseen by the expert clinicians was far better, clinical priority was far better served. The same is true for the ridiculous 18 week surgery targets, a blanket rule such as this helps no one, it leads to ridiculous tactics in fiddling the paperwork to make money, while if capacity is not increased then no one is better off. Some people need their operations urgently, others are happy to wait for a year, lumping everyone in the same box is just plain stupid.

Targets are just one of the ways in which this corrupt abhorrent regime have tried to control the NHS from the top in a way that has not helped the majority of patients. The government's paranoid desire for complete control helps no one, it results in a system in which cooperation is dead, fear and intimidation rule. Clinical priority is now decided by medically ignorant managers and not the highly trained doctors, taking the expertise out of the prioritisation of treatment has been a massive backwards step. This government has empowered idiots because they are easier to control and rule. Gordon Brown is a liar or he does not understand the NHS, the targets need to be scrapped, we need power to be handed back to the clinicians and we need a massive cull in the layers of managers who do nothing more than obstructing patient care. And after all if those in charge think everything is so much better, why are they trying to hide the public from reality?