The last thing I did before my summer break was write an article on the appalling Neil Bacon and his even more appalling website on which he attempts to categorise doctors in the way one might categorise washing powder. Rita has not taken a summer break. Armed with the Freedom of Information Act she has been extracting information from the GMC about their relationship with Bacon and in particular has accessed and published some fascinating correspondence and emails. Full details here
Uncharacteristically for Rita, she has made one factual error, an error she will I know be only to happy to put right. She has referred to him as a “nephrologist”. The man on the street might take that to mean that Bacon is some sort of medical specialist. In fact, despite having qualified as a doctor as long ago as 1990 Bacon does not seem to have achieved any recognisable status in medicine. Looking at his picture, I wonder if he is applying for a job modelling clothes from M & S? May I just remind you all of Bacon's status, such as it is, in the medical world:
General Medical Council : Registration check on Neil Colin Michael Bacon
Results of search on: 16 Jul 2008 at 17:18:30. The details shown are valid at the date and time of the search only.
GMC Reference Number: 3332531 Given Names: Neil Colin Michael Surname: Bacon Gender: Man Registration Status: Registered
Primary Medical Qualification: BM BS 1990 University of Nottingham Provisional Registration Date: 11 Jul 1990 Full Registration Date: 01 Aug 1991 Specialist Register entry date:This doctor is not in the Specialist Register GP Register entry date: This doctor is not in the GP Register
The truth is that, 17 years after qualifying, Dr Neil Bacon is still a junior hospital doctor and he is not currently working within the profession. Has anything changed since July?
Well, all the dentists in the USA call themselves "Doctor", and that's fair enough. Their qualification is DDS, Doctor of Dental Surgery. But can anyone afford to go to an American dentist? Take one poor boat owner from Seattle. Here is his boat:
How can this be in the land of the free? Do they not have Pepsodent? But just a minute. I see Mr Allen hoists the Union Jack on his motor boat. Perhaps he attends an NHS dentist. Or, more likely, maybe he can't find one. I shall ask my American dental colleague to investigate.
I am, I suppose, somewhat old fashioned. Regular readers will not be surprised to hear that. I believe in being polite to patients. I do not routinely use first names. I always detested the madwives who assume that, because a women whom they have never previously met is lying on her back with her legs apart trying to push out a baby, they have the right to call her “Mary” rather then Mrs Jones. Hospital doctors are at it a lot these days. I have written about it before. It disgusts me. I tend to call male patients “sir” and female patients “Mrs Jones”. There are a few patients, mainly ones who have grown up with me, with whom I have not dropped the first name usage established in early childhood but they are the exception to the rule.
Part of my old fashioned good manners (as I see it) is not being intrusive. My job is to provide advice on request. No more. No less. I only help old ladies across the road if they ask. I don’t much care for the “health hazard appraisals” (as the American’s would say) that we do on new patients but I accept that they make sense. So, yes, we record height, weight, BP, family history and smoking and alcohol history. I particularly dislike taking the alcohol history.
Which brings me to today’s publication
Department of Health Reducing Alcohol Harm: health services in England for alcohol misuse
REPORT BY THE COMPTROLLER AND AUDITOR GENERAL | HC 1049 Session 2007-2008 | 29 October 2008
It is not difficult to summarise. A very large number of people are drinking a very large amount of alcohol and it is damaging their health. Nothing profound there. The question is, what should we do to about it?
My job as a doctor is to pick up the pieces. I am also prepared to advise people who wish to be advised about the dangers of alcohol, and advise how best to deal with their problem drinking. I will go one step further. If they present to me with an illness that is clearly alcohol related (and they frequently do) I will talk to them about their alcohol intake even though they have not asked me so to do. But already I am approaching a line that I do not wish to cross. A line drawn by good manners, by respect for individual rights and for my patients’ personal privacy.
The Devil expresses my feelings on this in his normal fashion. Those of nervous disposition can skip the next box.
I do wish doctors would shut their fucking mouths and get back to concentrating on what they are supposed to be doing—patching people up. Who elected these sanctimonious cunts to a place wherein we should listen to them? Oh, yes: no one. It's bad enough that the evil, corrupt, venal bastards that we do elect want to micromanage every aspect of our lives (whilst illegally filling their boots at our expense), without these unelected medico fuckers trying to control how many times a day we can go for a shit.
What particularly angers me about this latest bit of control freakery from the government is the hypocrisy. First of all, they suggest that my profession is rather letting the show down by not identifying problem drinkers. If only I were better trained, I would know how to identify them, and all in the world would be well. And what, pray, am I supposed to do when I have identified people with serious alcohol problems? They suggest that I should then refer these patients on for hospital treatment
Inpatient treatment and residential rehabilitation Includes:
Comprehensive assessment for complex cases
Psychiatric therapy to address alcohol misuse and co-existing conditions
Medically assisted inpatient withdrawal
Delivered in: Specialised service inpatient facility, residential rehabilitation units, hospital
That sounds plausible. Trouble is, these so called resources are few and far between. There is no residential treatment for alcoholics in my area. There are no NHS detox units in my area. The local psychiatrists, who are not la crème de la crème of the speciality, take no interest in alcohol problems and indeed refuse to treat drunks whatever their psychiatric problems may be. I reckon that in excess of 50% of problem drinkers have underlying psychiatric problems and these problems will be ignored whilst they continue to drink. As most do. The general physicians are no better. If they get a whiff of alcohol on a patient they lose interest. I have said it before. It is worth saying again. Never, ever go to see a doctor smelling of alcohol. You may only drink one glass of wine a year, but if the doctor detects it, there will be a pompous note thereafter forever on your medical records saying, “smelt of alcohol at 11.30 am”.
How much is it safe to drink? I have not got a clue. It varies from person to person. Twenty-eight units a week, or three to four small drinks a day, are current “recommendations” but there is no underlying scientific basis for these precise limits. Someone made them up on a "sounds reasonable" basis. The government now wants me to summon all patients who drink more than that, and give them a good ticking off. Sorry, that’s not how they phrase it. They talk about “brief advice”
Brief advice ‘Brief advice’ is defined in the Department’s guidance as short advisory interviews, often delivered after screening identifies alcohol as a potential problem. Brief advice sessions have been shown to be effective in reducing people’s drinking, as well as cost-effective, in a variety of settings (see Appendix 6). They are provided by a ‘competent practitioner’ such as a GP, nurse or trained non-medical professional, in about five to ten minutes. The advice given may include
the risks a patient is running by drinking too much
setting goals to reduce alcohol consumption and
providing written materials such as advice leaflets.
The Department has funded a £3.2 million pilot programme of identification and brief advice, the Screening and Intervention Programme for Sensible Drinking (SIPS) in order to provide more evidence on the delivery, effectiveness and cost effectiveness of a range of alcohol identification and brief advice approaches across settings in England. The programme, which was launched in autumn 2006, will report in 2009.
This is the sort of egg-sucking pomposity that percolates down from this government in multi-million pound initiatives that may sound good for their focus groups but are of no practical value other than providing a tick-sheet protocol for dumbed down health care professionals who are so stupid and illiterate that they do not know what "brief advice" means in the context of heavy drinking. Such advice, we are told, may include "the risks of drinking too much and setting goals to reduce consumption." Well, as my old Aunty Jenny used to say when given such advice, "I'll go to the bottom of our stairs." ***
I’m not going to do it. I am going leave it to the "trained non-medical professionals" including nursey if she so wishes, though I would prefer she got back on the wards and resumed her nursing duties. So, you can come to see me about any problem you like, secure in the knowledge that I will not badger you about your drinking, unless it is strictly relevant to the problem you bring. This is not a job for doctors.
How then do we approach the problem? I have no easy answers. Government proposals to humiliate the poor housewives who buy two bottles of cheap wine a day in the supermarket are offensive. Why are they not going to humiliate the Royal topers who stack up on their booze at Berry Bros & Rudd?
Increasing the tax on alcohol is even more offensive. Do you really think Andrew Lloyd-Weber, a well-known oenophiliac, is going to be bothered about the cost of his next bottle of plonk? Once again, it’s the poor housewife who will suffer. Perhaps our leaders will take a lead for once by closing all those subsidised bars in the Houses of Parliament. Let’s breathalyse every MP as they walk into the House of Commons and publish their alcohol levels on the internet. That would be fun.
Drinking is part of our culture. Drinking to excess is also part of our culture. Perhaps it should not be. But the only way to change it is by education and persuasion, and by example. People enjoy, even celebrate, the antics of Dean Martin. Whilst that attitude prevails, it is hard to be censorious. Let us try to educate people to drink less. It can be done. The businessman’s long liquid lunches are no longer fashionable. It is acceptable to drink soft drinks, even the appalling designer fizzy water. By all means let us have draconian penalties for drunk drivers. It will take time to change attitudes, but it can be done. It probably should be done. But, please, not by me. Don’t make people nervous about going to the doctor for fear of being chastised about their drinking.
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*** Does anyone know the derivation of this odd expression, much used in days gone by in Lancashire?
Mrs Crippen’s sister lives just outside Dallas in a comfortable middle-class area. Both she and her husband have signed on with Uncle Sam and so will be voting next week. Mrs Crippen’s sister – and her husband – are atheists. They do not go to church. Ever. They reckon they are the only people in their neighbourhood who don’t. There has been the occasional raised eyebrow at the local school PTA meetings but mostly nobody minds or, if they do, they do not say anything.
They have just received the following email from one of their neighbours. A neighbour who, until now, they regarded as entirely normal. OK, Texas is a deep red state, but the area in which they live is not the boonies. They are surrounded by educated, normal people, most of whom are University graduates. One might expect a dose of the Bradley effect, but would you expect this:
There comes a time in all our lives that our faith is put to the test. Do we have enough faith to stand firm and take a stand for God or we will deny him also? I believe this election is one of those times.
" God puts each fresh morning,
each new chance at life,
into our hands as a gift
to see what we will do with it."
:) Blessings to you,
Mary-Jane Rogers
Let's treat this like a prayer chain and GET THE WORD OUT!
Being dismayed recently when a family member of mine said to me with great resignation that Obama will take the presidency. These words came from someone who in the past has been a great prayer warrior.
What is happening was my question???
Why are we Christians settling and not issuing a battle cry and falling to our knees and taking our country back?
We allow ourselves to be stripped of the right to pray at school functions and in school, we have the 10 commandments removed from government places and are told we cannot pray in school, all the while providing public prayer places for Muslims. What in the world is going on and why are we being apathetic? Why aren't we praying? Our God is a mighty God who is waiting patiently for us to raise our voices to heaven to stop the tide of the anti-Christ actions in our world today.. Now we find we have a charismatic candidate for president who does not respect our flag and refuses to wear one on his lapel except when it becomes politically expedient and whose own wife and pastor that he loves profess to have strong anti-white feelings, and we sit back and say "it is a given, we can do nothing."
There has never been a time in 2000 years that we can do nothing, never a time that we must sit back and allow the evil in men's and women's hearts to take over our world. We should be very afraid because our apathy is leading us to perdition.
It is time for all Christian Americans to raise the battle cry and take our nation back. Maybe McCain on his own cannot defeat Obama, but our God can and He will if we take to our knees in prayer and raise a mighty cry to the heavens to "Save us O Lord." We have the power to change the course of this election and to keep a man as suspect as Barak Obama from leading our country to who knows where with his message of "change" - a change which I fear will be away from our Christian ideals and away from Christ and further away from one nation under God.
We are great at passing stories and pictures around the internet, but where are our prayers and prayer warriors praying to stop this tide of Barak Obama? God parted the Red Sea, Jesus raised himself from the dead, and we can bring our country back to its Christian roots and stop the move to the rise of Muslims in our country. We can stop our country from being "under Allah," but we must begin to pray, to pray as if our country and our lives depend on it, because they do. We can stop all these atrocities against God's commands that have taken root in our country through something as simple as sincere prayer, a call to God to deliver us, to forgive us our sins of apathy and to protect us from the evil that is upon us.
Okay prayer warriors, here is your challenge, start those prayer chains. Get the spiritual power working on our behalf and stop Barak Obama the proper way, by calling on our God to save us from the deception that charismatic preaching is using to lead us on the wrong path. Stop those who would take God out of our country and our government. Raise up good men to lead us and protect us.
George Bush is being buffeted because he has fought a holy war against the evils that attack us and we should not be surprised because a prophet is not honored in his own country. But we should not rest on our laurels and allow ourselves to be taken further off the path of Christianity and to have God removed from our presence in our schools, courts, government and businesses.
Invite God into the fray. Ask that His power rest upon us and give us the victory. Ask him to raise up a mighty army to defend us and to protect our country as he did in days of old. Let us be victorious beginning NOW. The battle is His but we must call on Him without ceasing and unite our voices and hearts in prayer and fasting.
Please pass this around to all people of prayer that you know and maybe, just maybe a more eloquent person of prayer will write something better and more inspiring and even the rocks will shout that Jesus is Lord and our Mighty God is with us, bringing the victory for us and ultimately for Him.
"Be joyful always, pray continually, give thanks in all circumstances, for this is God's will for you in Christ Jesus." I Thess 5:16-18
....Continuous Prayer is the answer to this attack on the USA....
Please pray the Will of God will prevail through our continuous prayers to HIM....
Remember Prayer Can... Move Mountains!
No, it is not a spoof. I print it verbatim (I have changed the name) including the spelling of Barack. How representative is it? Who knows. But add this on to the Bradley effect and whatever the opinion poles may say, to coin a phrase, it's not over until it's over.
The wall up against which I shoot journalists is becoming overcrowded this week. Today’s nonsense revolves round tomatoes. Purple tomatoes if you will. Don’t like tomatoes much myself, but I enjoyed the film. Today, reports are featured all over the mainstream media suggesting that “purple” tomatoes are so jam packed with anti-oxidants that they can cure cancer.
Because, as we all know, antioxidants do cure cancer.
Don’t they?
Sadly, there is not much hard evidence to back this up. Yes, yes, I know all about “free radicals” and the damage they do; and the antioxidants mop up all the “free radicals” and we achieve life eternal, forever free of cancer. It’s the same intellectually flawed argument we see with vitamins. Vitamins are essential to life and are therefore good for you. So the more you eat, the better you feel. It does not work like that with vitamins, and it probably does not work like that with antioxidants
Trials are being done on antioxidants, and the results to date are equivocal and prove nothing. The jury is still out.
Considerable laboratory evidence from chemical, cell culture, and animal studies indicates that antioxidants may slow or possibly prevent the development of cancer. However, information from recent clinical trials is less clear. In recent years, large-scale, randomized clinical trials reached inconsistent conclusions. USA National Cancer Institute
So what should we all do whilst the jury is out? A balanced diet seems reasonable and there are lots of sensible if more mundane reasons for including a wide range of fruit and vegetables.
Meanwhile, Dr Crippen will take a back seat as those usual purveyors of wibble, the nutritionists, flog their patented antioxidant cancer cures. As regards purple tomatoes, there will be one small pleasure; watching the fight between the “right-on” antioxidant brigade as they clash with the anti-GM crops brigade. For those purple tomatoes are genetically modified.
There are not many books on Amazon that get 25 unsolicited reviews from the general public within a few weeks of publication, and none (to my knowledge) that gets a consistent 5 star rating from all the reviewers.
Bad Science is by Dr Ben Goldacre, well known to Guardian readers for his regular column, and also within the medical blogosphere for his leading blog of the same name.
Ben graduated from Oxford with a 1st class degree in medicine and still found time to edit Isis. He has picked up a qualification in philosophy somewhere along the way, and is currently a research psychiatrist at the Maudsley Hospital. It’s an impressive career to date, and there is more to come.
The book is a joy. It is easy to read, at times very funny. But do not be deceived by the humour for, underneath the humour, Ben is the scourge of medical fraudsters, and is not afraid to name names. He may not be up there with Ian Hislop in terms of the number of writs he has attracted but he must have some good lawyers. He has already seen off a particularly offensive quack who was flogging patent medicine as a “cure” for HIV infection.
Readers of the Daily Mail, wearers of copper bracelets, homeopaths and nutritionists (to name but a few) may not enjoy Bad Science. The doyenne of nutritionists, the “awful-poo lady” herself, “Dr” Gillian Mckeith “PhD”, will not be gruntled to find that she is summed-up in a one-liner which in itself justifies the price of the book.
My seventeen year old son took a break from his science "A" levels to read Bad Science. It made him “very happy” (I quote). It will make you happy too.
Dr & Mrs Crippen are just getting to the age at which, not infrequently now, the phone will go in the evening and we will learn that a friend has “got something.” As like as not, because we are both doctors, it will be the friend him/her self who phones wanting what they perceive to be some “inside information”. It is a salutary thought for doctors advising patients that, however good their relationship with patients may be, if the patient has a friend or a friend of a friend who is a doctor, that friend’s advice will be more valued.
“My brother-in-law’s uncle’s cleaner works for – insert name of any eminent teaching hospital doctor – and she says….”
Woe betides the doctor whose advice differs from informal advice gleaned in this way.
Last night, Alice phoned. We have known her for years. As we went through the usual opening chit-chat, I could tell from her voice that there was a more serious agenda. Alice has just been diagnosed as having breast cancer. She saw the family doctor ten days ago, and she has had her one-stop visit to the breast clinic: mammogram, ultrasound, biopsy. She is due to go into hospital next week for surgery. She had all sorts of questions about options, radiotherapy, adjuvant chemotherapy and so on, none of which I could answer properly as I didn’t have enough information. I made lots of reassuring noises about national protocols. Thank God that the days of the general jobbing surgeon who “does a bit of breast work” have long gone (not so long that I cannot remember them) and by and large the breast cancer patient will get the state of the art treatment, guided by international protocols, wherever she goes.
Alice was worried. Her husband changed jobs recently and, for various reasons, she no longer has private health insurance.
“It’s nearly three weeks since I went to the family doctor, and the surgery is not until next week. David wants to pay for me to go privately.”
Alice is highly intelligent. She is an architect. Pushy middle class sort of person, I suppose, like the Crippens. I sketched out the timescale. In 17 working days she has seen the family doctor twice (once for the original presentation and once yesterday to talk through all the options), a radiographer (twice), a consultant radiologist (twice), a consultant breast surgeon (twice), a breast oncologist (once), a breast care nurse (once). Behind the scenes there has been a Multidisciplinary Meeting during which her case has been discussed by the three consultants involved. The NHS is delivering for breast cancer. I wish I could say the same for all cancers but I just do not see how it could be done better, or quicker, any other way than the way it is done for breast cancer.
“But how do I know that the consultant will actually do the operation if I don’t go privately?” asked Alice.
At that I paused. That, I suppose, is the one flaw. “OK boys and girls” says Sir Lancelot to the assembled junior doctors “which of you has not done an axilliary dissection?” I noticed Mrs Crippen shaking her head. She took the phone and reassured Alice that the operation would be done by the consultant and then she walked to the fridge, poured herself a glass of white wine, all the time holding the phone in the crook of her neck, and disappeared off to another room. I have to put the phone down to do that. It’s a female thing, I suppose.
She came back half an hour later. I said I wasn’t sure it was good to flannel friends about who did operations. Mrs Crippen was firm. It will be the consultant. None of the junior surgeons is experienced enough to be let loose unsupervised on cancer surgery. When I was a surgical houseman, most of the surgery was done by the Senior Registrar. (SR) The boss was away on the Yellow Brick Road. At that time I felt I would prefer to have an operation done by an experienced, lean and hungry SR than by the consultant who might be over the hill.
There are no senior registrars now. They have been abolished. Consultants do all the jobs that, in years gone by, would have been done, and done well, by senior and middle grade registrars. Not any more. The government led destruction of medical training means that the juniors are not getting the experience they need. The consultants have to do the demanding surgery themselves and so, for the time being, all is well. But give it ten years. The properly trained surgeons will have retired. The new breed of inexperienced consultants will be functioning at middle-grade registrar level, and operating under the watchful eye of the nurse-specialists.
I hope you enjoyed the video. Surgery taught by Nintendo. Ho! Ho! Very droll. But truth is stranger than fiction. We are going to teach surgery by using the Nintendo Wii. No, really. It is being pioneered in the Third World which, medically, is where the NHS will soon be**. And you thought I was joking:
New Scientists Tech are reporting that two “developers” from a hospital are designing Wii software that will accurately simulate surgical procedures. A training platform based on the console, which costs about $250, might be more practical for trainee surgeons in the developing world than traditional virtual training tools, which typically cost a great deal more. To test how the Wii affected surgical skill, the researchers asked eight trainee doctors to play it for an hour before performing a virtual surgery. They used a training tool called ProMIS, which simulates a patient’s body in 3D and tracks the surgeon’s movements as they operate. They fed the movements to an algorithm which scores the virtual surgeon on a range of factors. Wii-playing residents scored 48 per cent higher on tool control and performance than those without the Wii warm-up.
It will not matter. No one will remember how it used to be.
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** And if you don't believe me when I suggest that British hospitals are descending into the Third World, read this tale of nursing care, reported by a midwife.
It was well over ten years since the General Dental Council decided to allow its members to use the title “doctor”. This followed a long campaign by “Dr” Douglas Pike, who drills teeth somewhere in Suffolk:
Dr Douglas Pike - the General Dental Council's decision to permit use of the title is effective immediately - said that his sole aim was to bring Britain into "harmony" with the rest of the world. Dr Pike, who practises in Sudbury, Suffolk, said: "We are primary healthcare workers just like GPs. We prescribe drugs, take biopsies and X-rays, and our training is very similar." The Independent
Mr Pike was of course talking bollocks. Dentists are dentists. No more. No less. They are no more doctors than the chiropractors and other practitioners of mystic alternative arts that masquerade as medicine. Most quacktitioners would love to call themselves "Dr" but are not prepared to go to medical school to get the training. Chiropractors in particularly have long since coveted the title. Earlier in the year, the irrepressible David Colquhoun of DC’s Improbable Science took the chiropractors to task:
Who should use the title ‘doctor’? The title is widely abused as shown by Gilbey in this issue of the NZMJ in an article entitled Use of inappropriate titles by New Zealand practitioners of acupuncture, chiropractic, and osteopathy. Meanwhile, Evans and colleagues, also in this issue, discuss usage and attitudes to alternative treatments. Gilbey finds that the abuse of the title doctor is widespread and that chiropractors are the main culprits. An amazing 82% of 146 chiropractics used the title Doctor, and most of them used the title to imply falsely that they were registered medical practitioners. DC's Improbable Science
I feel ashamed and embarrassed by the British dentists. They are not quacks. They are neither chiropractors nor acupuncturists. They have a real scientific training. Why they are not proud of their own independent profession is beyond me. The crowning irony of course is that in the UK it is traditional for surgeons to call themselves “Mr”. By fraudulently calling themselves “doctor” the dentists are not only being dishonest; they are denying their own training.
But now a breath of fresh air. We can always rely on the Advertising Standards Authority for some commonsense:
Dentists not doctors
Dentists must not use the title doctor unless they are medically or academically qualified to so, the ASA has ruled. A dentist in Knutsford, Cheshire was rebuked for calling a dentist “Dr” in an advertisement.
I prefer to start my day by shooting a journalist. Up against the wall today is Mark Henderson, the normally reliable science correspondent of the Times
A step change in the treatment of multiple sclerosis is heralded today by the first study to suggest that a drug can stop the disease in its tracks and even reverse its progress. Mark Henderson
Could someone please tell me what exactly is meant by a “step change”? I can tell you what, in this context, it does not mean. It does not mean that suddenly we have a proven cure for multiple sclerosis.
A trial of the medicine, known as alemtuzumab, has found that it offers benefits that are “better by a country mile” than other treatments for MS, and that it is effective for a much wider cross-section of patients. (Mark Henderson)
By this stage in the article, many MS sufferers and their families will have thrown the newspaper in the air and broken out the champagne. Some will be on their way to the family doctor to ask for a referral to the Alemtuzumab clinic. I have had one phone call already today. There will be more.
Do not get me wrong. This may be good news and, in a few years, we will be in a position to say more. But it is early days as yet. The conventional treatment for the relapsing-remitting form of MS has been b-interferon. This trial was a comparison of alemtuzumab with b-interferon. It was carried out in double-blind conditions (in other words, neither the doctors nor the patients knew which drug was being given to whom). 334 patients with MS were assigned to treatment with either b-interfon or alemtuzumab. Approximately a quarter of the patients on alemtuzumab had serious side effects and one of them died.
Patients treated with alemtuzumab appeared to regain some of their lost function; they had significantly fewer lesions (P=0.005), and significantly improved brain volume from month 12 to month 36
However, nearly a quarter of the alemtuzumab patients (22.7%) had an autoimmune-associated adverse event compared with 2.8% of the controls (P<0.001).>
And alemtuzumab treatment was halted early because of reports of immune thrombocytopenic purpura in three patients, one of whom died.
In an accompanying editorial, Stephen Hauser, M.D., of the University of California San Francisco, described the efficacy findings as dramatic. But, he said, "the toxic effects associated with alemtuzumab considerably dampen any enthusiasm for its routine use in patients with multiple sclerosis until more is known about its long-term safety and sustained efficacy. (MedPage Today)
For a rational report on the trial, you can read an abstract of the research at the New England Journal of Medicine or buy a copy of the on line full article for a small sum. Or, if you don’t want to spend the money, you can read a good summary here.
The news is thus not as good as the Times would have you believe. And, on a depressing note, there is bad news from this research. Conventional treatment with b-interferon is deeply disappointing.
Who was it who said that these days "The Times is just the Daily Mail in a suit"? So I checked out the Daily Mail coverage of the story (here) and found that it was bordering on sensible. Wonders will never cease.
Just caught up with another excellent post from Mike Denham over at Burning our Money. He has been taking a look at the latest annual report from the Healthcare Commission. Or, to lapse into today’s mandatory quango-jargon, and use the official title, the “Annual Healthcheck”.
Mike Denham’s anger about the Healthcare Commission is primarily motivated by the flagrant waste of taxpayer’s money. £70 million a year may be a drop in the ocean of the near £2 billion a week NHS budget but it’s still a lot of money. Money that is wasted on this Stalinesque “Good news, comrades, tractor production is up…” PR exercise.
Problem is, a lot of people are taken in. British citizens want to believe in the excellence of the NHS, the excellence of their NHS. The government has poured more money into healthcare ergo healthcare has improved. It must have, mustn’t it? And so, when NHS BLOG DOCTOR says that it is all dishonest propaganda, that the NHS is providing a level of care worse than it has ever been, worse beyond all imagining, there are howls of anguish and disbelief. How dare you suggest that the NHS is anything other than wonderful? How can a doctor who purports to believe in the ideals of the NHS dare to criticise it?
Junior doctors are not getting the experience they need. Real nursing care has disappeared. Elderly patients are dying of malnutrition or hospital acquired infections because there is no one to feed and clean them. Paramedics are pressurised into not taking critically ill patients into hospital. GPs are to be “incentivised” to keep sick patients at home. The de-skilling and dumbing-down gathers momentum. It is, I suspect, already unstoppable. The protocol-driven target culture “empowers” (as the government would say) unskilled workers to appear to do jobs which are in reality beyond their competence.
And so it goes on.
I have been “round the houses” so many times on so many issues that I lose the will to live. Hence the prolonged blogging break.
Meanwhile, the boxes continue to be ticked, the targets are hit, and so all is well in the world of healthcare.
Dr John Crippen's weekly diary. The trials and tribulations, the pleasures and pitfalls of family medicine in the modern British National Health Service.
The pathogenisis of Multiple Sclerosis : Dr Alastar Compston, University of Cambridge 
