Past Posts...

Trust Me, I’m a Trust

The Orwellian coup of calling the corporate bodies that run the NHS ‘trusts’ – with the comforting overtones of propriety and trustworthiness - hides the fact that underneath the surface they are like any other corporation: selfish, secretive and psychopathic.

Dr No was brought to this cheerful observation by a dull but worthy documentary aired by BBC2 last week. Fronted by a man with a puffy dial whose every alternate sentence started ‘I wanted to find out…’, Why Did You Kill my Dad? was an over-scripted attempt to, err, find out ‘the true scale and [human] cost of killings by the mentally ill in Britain today’.

Virgin Shags Assura

Big business is all about big branding, and nobody does branding better than Branson. His red logo is just about everywhere – travel, banks, media, mobiles, you name it – except healthcare. Until now, that is. Earlier this week, the Virgin Group bagged a three quarter share in Assura Medical, the company that runs the Khazi Klinics.

Virgin have been sniffing the panties of healthcare for some time, but, like most novices, were for some time unsure about how to proceed. “For us, this is the culmination of what has probably been five years of knowing we wanted to be in this space but really not finding the right entry point,” said Gordon McCallum, chief executive of Virgin Management. Now they have found the ‘entry point’, the shagging can begin in earnest.

Why Revalidation is Wicked

In its proper form, the doctor-patient relationship is not unlike a marriage. It is founded, above all else, on trust.

The essence of trust is an implicit assumption of the benevolence of the other. Good marriages do not rely on annual appraisal folders, multi-source feedback or revalidation to stay on course; instead the partners simply trust each other. Indeed, the very concept of needing to re-establish trust periodically would be laughable. Why then do the medical revalidatchiks – the Obersturmführer Marshalls of this world – insist that we must replace implicit trust with explicit checking; and that revalidation is now a professional imperative, a ‘core professional activity and responsibility’ that we doctors ignore at out peril?

The Varring and Betting Scheme

We are seeing the first blowback from the introduction last autumn of the Government’s absurdly over-egged Vetting and Barring scheme. Children scheduled for surgery are having their operations cancelled by zealous apparatchiks blocking surgeons who – despite CRB clearance in one trust – are being refused entry to others, where they would otherwise be able to operate. The var, one might say, between stooge and surgeon is on, and all operation bets are off.

On a benign view, this is an example of goal displacement – a triumph of process over outcome. One could leave it at that, were it not for the fact that this triumphant process has trumped real kids needing real operations by real surgeons. And so we have a scheme designed to protect children perversely achieving the opposite result – harm to children.

Nobody Expects the Revalidation Inquisition!

GMC Revalidation pilots have started. Dr No’s agents have been secretly filming progress, and a transcript of a recent ‘revalidation event’ follows.

A Responsible Officer’s plush office suite. The RO sits at his desk, holding a long sharp pin of the type favoured by neurologists in one hand, and a wax effigy in the other. He prepares to stick the former into the latter. There is a knock on the door.

Murder via the Orient Express

For many of its long and illustrious years, the Orient Express travelled across Europe from Calais via Zurich to exotic Eastern destinations. Were it still running today, it might well have found itself doing a brisk trade in one-way tickets to Switzerland, following the DPPs final guidance on prosecuting cases of assisted suicide issued today.

The final guidance has shifted its position significantly from that found in the interim guidance issued last year. The focus has moved away from factors associated with the suicidee (the best term Dr No can come up with to describe the ‘victim’) towards the motivation of the assister. If the assister can show that he or she was acting wholly out of compassion – that they acted with ‘love in their heart’ – then he or she is unlikely to be prosecuted.

Desperate Doctors

BMA Press Office

For Immediate Release

BMA Launches Sexy Doc Show

London, UK February 2010 – Britain’s leading medical association has launched a new TV series starring sexy young docs in a bid to boost trainee numbers.

Modelled on the recent BBC drama Desperate Romantics, the six part Desperate Doctors portrays junior doctor training to be a racy romp through the wards and clinics - far cry from the dull round of failed job applications and endless assessments depicted by many of today’s junior doctors.

Revalidung macht frei!

One of the more striking and duplicitous bits of Nazi propaganda was their use of the slogan “Arbeit Macht Frei” – ‘work makes you free’. It was widely used, but never with more cynical and chilling effect than over the entrance gates to the death camps. Dr No cannot help but notice that the Obersturmführers of medical revalidation have already started a creep towards similar twisted propaganda.

Snuffed Goose Recipe

We shall probably never know whether Ray Gosling was an inspired stage name, or the portentous real name for a lad who, after a TV life rich in sauce and stuffing, would spend much of his later life stuffed and trussed, before – in a final defiant gesture – spatchcocking himself on camera in a lonely graveyard.

Last Monday, early evening BBC viewers in the East Midlands region were greeted by Gosling, decked out in a fetching overcoat, ambling through the tombstones. Speaking in his best bus driver documentary voice, he mused: ‘Maybe this is the time to share a secret that I’ve kept for quite a long time’. Viewers expecting a homely confession that he rigged a past documentary were in for a shock.

No Man is an Island...

Unless, that is, you happen to be one of Ray Gosling’s unidentified lovers who happens to be seriously ill. Then you are very likely to find not only that you are an island, but a very small island; in fact a mere clod, about to be washed away by the sea – or, since it is more practical, smothered, while an obliging and obsequious doctor – would you Adam and Eve it - steps outside for a gasper.

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