The BritMeds 2007 (18)
The MMC/MTAS round up is as usual at the end of the BritMeds but let’s start with Patricia on Question Time on Thursday night.
And an important point at the end about New Labour’s destruction of higher medical training. We covered this before:
Ten to fifteen years ago, the average orthopaedic surgeon would have had approximately 36,000 hours hands-on experience before he was appointed to a consultancy. Dr Andrew O’Brien, a specialist registrar in orthopaedics will have had approximately 8000 hours experience when he becomes a consultant.
In a nutshell (nutcase you might prefer) the new consultant will have three hundred per cent less experience than his older colleagues. So the next time you go into hospital make sure your consultant is aged at least fifty.
Then let’s compare Patricia at leisure, and Patricia under stress:
Patricia “at leisure” stars in “Hi, I’m Patricia Hewitt":
Patricia under stress:
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Following up from the story two weeks ago, it appears that
it is acceptable professional conduct for doctors to punch each other in the face even if a nose is broken.Good old GMC
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Getting it off my chest
How it all beganAnd later
Thursday night I discover a lump.
Next day finds me gabbling incoherently at a GP I’ve never clapped eyes on before. Sadly he agrees. There is a lump. Maybe, just maybe, it’s a harmless little fibro-adenoma or cyst or something.
I screw up every ounce of courage I possess. My mouth is so dry I can hardly speak.And later
‘The lump’s malignant, isn’t it?’
He briefly touches my arm. ‘I’m sorry’ he says. ‘I’m afraid it is.’
I come home from the unit clutching a pile of booklets. Even Husband is issued with one of his own. I devour them from cover to cover and studiously avoid the internet. There’s only so much I can take in at a time.My breast cancer and me
It seems a complicated business, this breast cancer, (the understatement of the year?) but I think I’ve got a Peter and Jane version sussed.
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We used to trust this man. Ten years ago Dr Crippen trusted him and, indeed, voted for him. Remember, it was "24 hours to save the NHS" and "Education, education,education."
So, yesterday, we looked at what effect ten years of Blair has had on health and education.
The Blair Legacy
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Looney tunes “treatment” for autistic children
“I have personally been told that because I am not chelating my daughter, I am a child abuser. That I am a murderer. I have had threats of violence made against me, and a few people have even sent personal hate mail to my seven-year-old autistic daughter.”Kevin Leitch is angry.
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It used to be major surgery having your gall bladder removed. Nowadays it can usually be done laparoscopically. But I had not heard of this:
a surgeon in Strasbourg has just carried out a vaginal cholecystectomy.
A vaginal cholecystectomy?! Why ever would you want that?
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Oh Brave New World
Under the new Bill, it is proposed that doctors, psychologists, nurses, occupational therapists and social workers could receive training that would enable them to have overall charge and be the responsible clinician for a patient who is sectioned. This could mean that for some patients there could be the possibility of no medical input at all.So now nursy and the occupational therapist can lock you up if they think you are mad.
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May is mental health month
One of every three people you know will be treated for a mental illness sometime in their lifetime. If you know someone in your family who suffers from a mental illness, chances are there are others struggling as well. As many as 60% of those who suffer from mental illness self-medicate with alcohol or drugs.Dare to Dream
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Whistle blowing
The integrity of medical research is under threat. Many cases have arisen which have demonstrated the inclination of our profession to act in a way that damages both science and the interests of the patients we serve. In many instances, organizations charged with maintaining integrity have colluded, almost routinely, to pervert science, to bully those raising concerns, and to obscure problems. These organizations include our medical Journals, professional regulatory bodies, drug regulators and even formal bodies devoted to maintaining "integrity".More Scientific Misconduct from Dr Aubrey Blumsohn
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Of legacies and history : bye bye Blair
I am sorely tempted by the claims made by Tony Blair today to bring non-medical politics into this blog just this once. Like his fellow head of state George Bush, Blair is fatally wounded by Iraq and is now in search of a legacy to burnish his image for the history books. Somehow, I doubt that history will judge either of them so kindly.Frontpoint systems
Today’s event at the Kings Fund had a number of soundbites. Let us take a closer look at them.
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Where is Dr Grumble taking us with this?
One of the joys of the take is that you are surrounded by bright, everchanging (shiftworking) young doctors. This week's were excellent. Today's were all were female.Hands up all those who have never heard of Takotsubo syndrome
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Eat well, exercise…but die before you are thirty.
You can't make people happy by law. If you said to a bunch of average people two hundred years ago "Would you be happy in a world where medical care is widely available, houses are clean, the world's music and sights and foods can be brought into your home at small cost, travelling even 100 miles is easy, childbirth is generally not fatal to mother or child, you don't have to die of dental abscesses and you don't have to do what the squire tells you" they'd think you were talking about the New Jerusalem and say 'yes'.Tony Plant has, sadly, been silent for a while, but take a look at this post from January.
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Rita Pal’s fight with the GMC continues. And, as a result of it, she has just been sacked:
RE: Fired from my locum postBut, unabashed, Rita continues her campaigns:
At 16.14 today, I was contacted by my NHS Trust. They stated that medical staffing had contacted the GMC and been told that I was "under investigation". I was subsequently asked to leave. I therefore have no psychiatry post from today onwards.
Today children we are about to enter the dark corridors of the GMC litigation bandwagon. The dark tower where they all sit is situated in the top most turret in London.NHS Exposed
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Children at risk
The Children's hospital promised by Labour has failed to materialise. This has left the children of Leeds exposed to unacceptable levels of danger; as with several major specialties split between the two sites there are significant problems with transferring extremely sick childrenHewitt puts childrens’ lives at risk in Yorkshire
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In at the deep end
A chap comes to see me with "painful orgasms". Now, as the new female doctor I have to be on the look out for "those kind of patients" (said with a knowing nod) but he seems genuine.Junior Doctor Spot
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An irritatingly naïve belief in the “magic” of MRI scans.
He was obviously in pain and unable to work properly, but struggled to get any meaningful treatment from his GP, despite several visits - just a prescription of anti-inflammatories. He really needed an MRI scan to properly assess the damage. In exasperation, Greg returned to his native Hungary to get an MRI scanThe Handyman
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The British have always cared more for their pets than for each other, and so this may make them take Lyme Disease more seriously.
Parasitology experts Bayer Animal Health is issuing a reminder message to all dog owners as the spring 'tick season' nears. During spring, blood-sucking ticks can be amongst the most common problems for the family dog – particularly in prevalent areas or 'tick hot-spots,' such as the New Forest, Salisbury Plain, The Lake District and Exmoor where tick-related diseases are so common that one local vet has termed them the 'Exmoor Syndrome'.Yes, it can affect your dog too.
And Lyme Disease may have some more …er… practical uses. We may not be able to afford to renew Trident, but we always have nasty old germ warfare up our sleeves. Over now to Porton Down:
In an article I wrote entitled "Lyme is a Biowarfare Issue", you will find a large umber of facts linking the Lyme epidemic with biowarfare research, and which cannot be explained by "incompetence", nor even by coincidence. For example, Porton Down, the UK's main biowarfare research facility, has been studying Lyme and related tick-borne pathogens. This is nothing to do with "incompetence." Nearby New Forest area has the highest Lyme incidence in Britain, even by Steere camp figures.More on Lyme germ warfare here.
I do not know what the British Lyme Disease Association will make of that.
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Dr Rant is turning his hand to medical biographies.
...he is an unelected hand-picked yes-man who gives the government's health policies a veneer of medical approval; the archetypal NuLabour apparatchik.Who on earth is he talking about?
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A school - Lutterworth Grammar School if we want to ID it - has, through its medically-staffed surgery (a doctor and nurses), been supplying on request to those female pupils that ask what society chooses to call "the morning after pill".
or
Family and Youth Concern says that "schools should teach abstinence and not offer pupils contraceptives".Take you pick. “A sometimes blog” takes his.
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You may think that “Care in the Community” for the mentally ill in the UK is appalling but let us be thankful that we do not have to consider this sort of option:
The American Psychological Association has teamed with the National Alliance on Mental Illness and the American Psychiatric Association to present a brief as Amici Curiae to the U.S. Supreme Court, providing expertise on appropriate standards for determining the level of mental illness that should preclude execution.Dear God.
Arguments on the case, Panetti v. Quarterman, will be heard by the court today.
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How should we deal with paedophiles? We certainly cannot leave it to the organised churches, who consistently ignore the problems. The police are more robust. Operation Ore gave the credit card details of thousands of alleged paedophiles. Thirty have committed suicide. Not all were guilty.
Read about the extreme risks of being online.
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Thirty people have been arrested for alleged animal rights extremism in raids across the UK and Europe. About 700 police officers and support staff were involved in the early morning operation at 32 addresses in the UK, Belgium and the Netherlands. Police say the raids were one of the largest operations against animal rights extremists in the UK.Animal writes
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Inserting crap into medical students
My med school has a compulsory exercise called "Reflective Practise," where they force us to reflect on our experiences and write about them. This task is not one most of my year look forward to, it is more of a chore than a learning experience. We spend the afternoon before the deadline knocking out some story, saying how something made us feel and what we learnt from the experience. It all sounds rather like the questions on the MTAS/MMC application forms.Skipping and Singing
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Didn’t we do well…
…the NHS is producing health outcomes that are poor by international standards. Fatalities from strokes, for example, are near or above 100% higher in the UK than Australia, Canada, Japan, Sweden, Switzerland and the US. Between 1999 and 2003, only four out of 26 developed countries performed worse than the UK in terms of deaths before the age of 70 that were potentially preventable by good medical care; the UK's absolute ranking on this measure actually fell from 17th to 19th.The NHS goes from bad to worse
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Doctors get more stupid by the day:
Riley said it usually takes between five and seven years to train a doctor to carry out abortions. She expressed concern that in the future, women who want abortions may have trouble finding doctors.Abortion rights advocates are calling for changes in the law to allow nurses to perform abortions in pregnancies up to 13 weeks' gestation.
Thank god there are professionals around who can do the job after three years training.
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Critical illness insurance is all the rage, but…
Critical illness cover, the insurance that pays out if you are diagnosed with serious illness, has been heavily criticised for not paying claims that policyholders believed were covered. Historically, insurers have turned down about 20% of all claims made on critical illness policies…It seems, though, that it may be getting better
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Lyme Disease: did you know it was Tick Alert Week?
DOCTORS and the public are being warned to be aware the dangers of diseases being spread by ticks in the UK and abroad. The warmer weather is starting to tempt more people into the countryside where they may find themselves prey for the tiny blood-sucking arachnids. Tick Alert Week, which starts next Monday, hopes to inform people about the risks they may face from tick-borne diseases either in the UK or if they travel overseas.++++++++++
Most doctors continue to bury their head in the sand.
Dr Crippen is baffled. What on earth does this mean:
Doctors and Nurses: "Supermarkets only sell eggs because the manager is being held hostage by chickens as part of some dreadful pecky protection racket"
Scary Duck – not scary, not a duck : A riddle wrapped in a mystery inside an enigma, stuffed up a dog's bottom
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Did you do the Marathon this year
Watching the tail end of the runners come past I saw Dawn from Eastenders (looking immaculate and fully made up), Santa Claus pulling his sleigh, several people dressed as giant fruit and some guys pulling a giant stone (who apparently didn’t finish until Sunday morning!) There were also people twice my age, twice my size, and people with serious disabilities merrily strolling past.Nee Naw reports on the London Marathon
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Please do not assume that it is just the MTAS computer that has problems.
A computer containing the bank details of thousands of hospital staff has been stolen from an NHS building, it has been revealed.PJC Journal
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If you don’t agree with Ben Fenton you may be in trouble…
If those doctors don’t want to do so, they should consider going to work in pathology, where most of the human beings they come across will already be past giving a damn about a doctor’s precious prejudices or their religious hang-ups.Full article here
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Torture by man-made laws
Yes, Ireland and the abortion law again:
A pregnant 17-year-old in state care in Ireland began a court battle yesterday to be allowed to travel to England for an abortion, as the country’s failure to resolve the ambiguities in its abortion laws threatened to erupt into a constitutional crisis.The government agency has overruled her wish for an abortion in Britain.
The teenager, who is four months into the pregnancy, is seeking an abortion because the baby has got a rare brain condition and will not live more than three days after birth, she has been told…
Philobiblon
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A medical student argues that the selection of doctors may be flawed before they even get to MTAS
"With regard to academic score use, should we be allocating our-best' students to our-best' jobs, assuming that we can identify either group, or should our-weaker' students be placed in our-better' jobs?" The use of academic scores may motivate students, and this may be the strongest argument for doing so, he added.StudentBMJ
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Tom Reynolds reports on the Hart Team going in
There is a double cordon in place, our HART team are there (The HART team are Paramedics who are trained up to use breathing apparatus and can go into the 'hot zone' of a situation. I think that they also run into burning buildings...).
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Dr Michelle Tempest looks at why psychiatric services are deteriorating in Cambridge.
Has this also happened in your area? She asks.Yes it has. Can you persuade your profession to stand up and do something about this dumbing down to the CMHT?
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These two should have been in last week, but I missed it. Thanks to the ever vigilant aging Greek commentator for drawing my attention to them.
And so, a little competition. Which well known journalist was responsible for each quote:
First:
(NHS) spending has trebled, heart deaths are falling, waiting times for inpatients are at just an average 6.6 weeks and 90% of hospital patients report that their treatment was "excellent". By almost every indicator, ask any expert, there is no doubt things are very much better.Second:
Doctors are in a fury at being ordered about, despite massive pay rises, better hours and 32,000 more jobs…..Correct answers here. The first quote, and the second quote.
…..Feelbad Britain thinks the NHS will kill it with MRSA, deny it life-saving cancer drugs, refuse treatment by postcode, tip schizophrenics on to the streets, close local hospitals to cut debt and make it impossible to phone GPs for an appointment.
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Last Journey
I knew exactly what I was going to from the scant details we were sent by control. A 95 year old lady who has fallen over and sustained injuries to her arm and leg.A moving post from “I like curry”
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May, the most expensive month of my life
A medical student is very hard up
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What has this:
'Fertilising the ovum of a cow with the sperm of a human isn't new! Since the discovery of IVF they have been testing the viability of human sperm by fertilising Guinea Pig Ova.'Got to do with this:
'My brother-in-law went into hospital for a simple procedure during which it is expected that the patient will become unconsious. When my brother-in-law did become unconscious they immediately sedated him and wrote DNR (Do Not Rescitate) on his notes. If I hadn't discovered this and demanded the removal of the DNR threatening them with immediate national newspaper coverage I wouldn't have enjoyed a skiing holiday with my brother-in-law last month.'It is all here.
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My case was a woman whose mum was in a nursing home, aged 86, and had had a recent attack of pneumonia, and she wanted her mum to be allowed to die next time she was ill. The matron had refused to allow this. The mother was confused since her hospitalisation for pneumonia, and I as GP* had to explain about 'powers of attorney', 'legal duties to preserve life' and was supposed to check what other family there was (I forgot this one). I am convinced that in the OSCE I will probably wash my hands before and after the communication skills sessions as well as the examinations.By the time this medical student has communicated the patient will have succumbed. Maybe that is the idea.
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More free at the point of entry tales
When asked how long it will take to get a scan on NHS…he almost laughed…will be a matter of months, as in 3plus…so…have decided to go private…reduces the hassel and means i dont have to pull out of PGP etc just yet!What happens in my head gets written in my blog
still scared….because well…you know…big machine etc…but at least now i know it is getting checked!
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Surgeon demotes medical student
My colorectal surgery rotation has come to an end, and now I rotate back to my original team, the breast and general surgery team starting Monday, tomorrow. Back to the consultant who thought I was a work experience girl three weeks into the placement.Short white coats
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Contain your excitement. Dr Crippen has discovered gpcontract.co.uk. It doesn’t come more interesting than that. And this week they are looking at:
QOF News: measuring prevalenceStuff like this makes life worth living.
One of the questions often asked by GPs about QOF data is there prevalence data should be. There are three ways to measure the prevalence of a condition. First you can ask doctors, second ask patients and thirdly you can get out there and thoroughly examine a random group of people.
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Primary Cicatricial Alopecia: Clinical Features and Management
The primary cicatricial alopecias are an uncommon, complex group of disorders that result in permanent destruction of the hair follicle, usually involving scalp hair alone. Prompt diagnosis and treatment are needed to help thwart continued hair loss and the distress that often accompanies this hair loss. Nurses can facilitate the diagnostic and treatment process and, through educational and emotionally supportive measures, have a meaningful, positive impact on the patient's well being.It’s all in Stop Hair Loss – Now
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A medical student watches Panorama and gets his first taste of dumbing down in the NHS
As a doctor-wannabe I find it utterly bemusing as to how there can only be one midwife in a birthing suite in which she is expected to look after all the mothers on that particular ward. What I found more unreasonable is that there seemed to be no doctors of any sort on the ward unless it was an emergency. Being an outsider from the NHS I have no idea if this is a regular occurrence, but I'd be grateful if someone could enlighten me.Dr Crippen can enlighten you. Midwives are cheaper than doctors.
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Depressed scuba divers
Would you certify someone with a history of depression who is still on medication as fit to go scuba diving. Dr Crippen has never been asked that one.The answers are here.
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Choose and Book goes mad
The GP in question obliged and presented the parents with a list of names; when pressed to pick one, the GP demurred on the grounds of neutrality and apparently refused to say why he had listed the consultants that he had. The parents picked the most geographically convenient consultant with the shortest waiting-list.Some GPs are declining to recommend particular consultants.
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Bad Medicine
One of my moments of fun at the end of the week is getting my ‘Friday dose of woo’ ……Pathologist Anonymous review the best of quackery
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Safety in numbers
I am not alone. The number of new mothers suffering post-natal depression has risen to 20% - double the number reported in 2000, a recent survey from the Royal College of Midwives has revealed. Terrible birth experiences are being blamed for the increase, with 41 per cent of mothers with postnatal depression reporting a bad birth.Mummy wars
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Patricia says, “Push of, fatman”
"Patricia Hewitt, the Health Secretary, said yesterday that it was "perfectly legitimate" for NHS trusts to refuse some treatments to heavy smokers or patients who are obese.+++++++++++
The MTAS/MMC week
NHS BLOG DOCTOR hit the news on Channel 4 after passing on details of the second MTAS security breach.
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The DK must be lost for words as he has opened up the Kitchen to one of his medical colleagues, who produces a pithy summary of MTAS and MMC:
“HMG and the DoH have yet again proven that they are incompetent cretinous fuckwits of the most malignant order. I wouldn’t trust them with my email address, let alone my confidential medical records on the NHS SPINE or yet more personal data on the national ID database. This affair is symptomatic of a quite contemptible Blairite regime that I wouldn’t even waste my most festering saliva on. Corrupt ideological reform hides behind their allegedly ‘noble’ motives as they railroad their through policy that benefits only themselves.Great stuff at the Devil’s Kitchen in “MTAS – as powerful as a ZX Spectrum?”
Conflict of interest: I am a doctor and I fucking hate this government.”
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Privacy fascists?
Richard Granger, the director general of IT for the NHS today (26 April) told the House of Commons Health Select Committee that he blames the two year delay in delivery the electronic patient record system at the heart of the NHS IT programme on ‘consultations’ taking longer than anticipatedPrivacy facists? You mean people who do not want details of their sexuality available to the general pubic? You mean people like hospital doctors? Like RemedyUK?
“The main problem we are facing are two extremities – waiting patients and privacy fascists and we are trying to find a pathway for the middle of the two.”
Some aspects have been delayed by 24 months because the consultation schedule on these aspects has gone on far longer than was originally scheduled. Significant further work was necessary in the task of creating an environment where the necessary specification was stable.
Full report on Granger’s nefarious activities here.
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Lord “rhymes with”. Love it. And henceforward I shall use it.
… I am too angry to write coherently about the MTAS website leaks and the way that Ms Patronising “soon-to-be-shuffled” Hubris and Lord “rhymes with” Hunt are talking about them.Brilliant analysis from Aphra
Here instead are a list of adjectives and a picture.
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A short except from Patricia Hewitt’s c.v.
The rest is here in The Midas Touch
- 2003: Accenture awarded £1.9 billion contract to provide NHS IT infrastructure
- 2005: Britain’s last major car manufacturer (MG Rover) goes bust. Hewitt precipitates this by saying company had gone into administration while directors were still trying to work out a rescue deal. First airing of phrase “Hewitt Blewit”
- 2005 Appointed Secretary of State for Health
- 2005-6 NHS goes into deficit by £623 million
- 2006: Loses confidence of nursing profession: Heckled at conference after 7,000 redundancies announced
- 2006: Accenture pulls out of NPfIT citing losses of 1.1million per day (thanks Patsy)
- 2006-7: Loses confidence of medical profession: Attacks GPs for daring to hit government targets, hospital consultants for not working hard enough
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As always, the Ferret Fancier can be relied on for detailed analysis of the MTAS week.
A leaked email which proves that Hewitt was being ..er... flexible with the House of Commons about MTAS security
This was an E-mail sent from John Black - the chair of the SAC in general surgery, to Sarah Brown in February 2006. It ominously warns of the potential problems regarding MTAS and suggests the practical alternative of selecting on a regional basis. These warnings were spookily predictive of the problems that actually occurred.Hewitt gets scared and tries to silence the opposition with veiled threats:
The performance of the service, the details of which I have already shared with you clearly do not warrant the criticisms that you are making of it. In order to protect the commercial interests of our supplier, I must insist that you do not make any further claims about MTAS without providing evidence that can be investigated."The truth : Patricia’s flexible friend
Patricia Hewitt has yet again been rather generous with the truth in the House of Commons. This afternoon she tried to deflect attention away from herself, the government and her useless department by blaming other people for the MTAS disasters.And Lord Rhymes-With is at it as well:
The 'minimal impact' that Lord Hunt claimed and the 'up and running by Monday' seem to be more than slight stretches of the truth. I have stopped getting angry now, the incompetence and delays have become the norm.+++++++++++
On a lighter note:
The jobs on MTAS go round and round,More at MMC360
round and round,
round and round.
The jobs on MTAS go round and round,
all day long.
The money wasted on MTAS goes Clink, clink, clink;
Clink, clink, clink;
Clink, clink, clink.
The money wasted on MTAS, Clink, clink, clink,
and adds to the debt.
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The doctors go to court.
A judicial review has been applied for in the Administrative Court between Legal Remedy (the Claimant) and the Secretary of State for Health (the Defendant).Dr Grumble reports
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A new psychiatric disorder is sweeping across the nation at an alarming rate. Officials have not yet been able to control the epidemic of a new condition that has been named Medical Training Anxiety and Stress (MTAS) disorder. The disorder, which appears to be affecting primarily junior doctors, is characterised by a previously unseen cluster of symptoms including thought disorder, hallucinations, escalating paranoia and obsessive behaviours.The psychiatrist takes a look…
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The crisis that is leading highly qualified junior doctors to head abroad is the result of one of the National Health Service's all-time great administrative cock-ups. It is has left 30,000 junior doctors bitterly disillusioned and angry. But it also has big potential implications for patient care.Health Direct- NHS advice and news on Labour's spin
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Please send your recommendations for next week’s BritMeds to: thebritmedsATnhsblogdoc.wanadoo.co.uk
The BritMeds will now be published on Saturday morning, so please let me have your recommendations by Friday evening latest.
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