Further evidence has emerged that there are kangaroos loose in the General Medical Council’s top paddock.
Doctors on the GMC’s Register have been pestered over the last few months to confirm their wish to receive a licence when the new licensing system for doctors goes live later this month.
It seemed a bit pointless – why did Dr No pay his last Annual Retention Fee if he did not want a Licence? Nonetheless, he did confirm that, No, it was not a mistake that he had paid his Fee, and Yes, he would like a frigging Licence: that’s why he paid the frigging Fee.
Meanwhile, the GMC has been making a Big Noise about how successful their Licensing Campaign has been. The latest edition of GMCtoady, their six times a year propaganda rag, got all self-congratulatory with a racy news item headlined “93% and rising”, while only last week, GMC Chair Professor Peter Rubicon assured us that progress had been made, rivers had been crossed, and that the Campaign had “exceeded all expectations”.
Quite why the exercise needed to be done in the first place is beyond Dr No; why it needed a Campaign is beyond understanding, while how it managed to create expectations, be they exceeded or otherwise is, quite simply beyond the Pale. It might even be beyond the Rubicon.
Putting aside matters of time and money wasted, there are three important things to note about this non-Campaign. The first is that 13,500 – over 6% of all registered doctors currently on the register – responded by saying they did not require a licence. And so, at a stroke: 6% of the UK medical workforce has been wiped out; and so there are 13,500 less doctors to work in the NHS. These numbers are not trivial.
Now, it may be that these doctors reflect natural wastage through age. But Dr No suspects that a number, possibly a great number, of those 13,500 doctors have had enough – of the GMC, and the way things are going, and have decided enough is enough; and to the extent that is the case, they represent the first cull – there are many more to come – caused by the new regulatory system for doctors.
The second – and the first to show the kangaroos have been out to play – is the quite remarkable revelation by the GMC last week that the 3% of doctors – over 6600 doctors – who did not contact the GMC will be given a licence anyway. Which rather begs the question: why did the rest of us have to tell the GMC we wanted a licence, given they would have given us one anyway? A pointless and futile exercise that nonetheless “exceeded all expectations”…
The third – and this is the one that makes Dr No wonder whether the kangas have got little roos loose in their top paddocks – is that the default position for non-responders – that is, those who not have responded, who are out of contact, who are off the radar, and possibly even, for all we know, living on the dark side of the moon, is – wait for it – you can have a licence! Bonkers – or what?
Thought you would like to know ‘Kangaroo’ is aborigine for ‘I don’t know.’ Apparently Captain Cook saw one and asked a local what it was and he replied ‘Kangaroo’ and the name stuck..
The OED has the “I dunno” explanation as urban myth. I suspect the myth came from Python – all blokes are Bruce, all females are Shelia and the rest…
The Licensing Campaign bamboozled me too. Then I wondered if it was really an exercise to see how many were likely to drop out as the revalidation date came closer. The powers at be must surely be concerned there may be a mass exodus. Probably the Licensing Campaign could not detect this, since many doctors under 60 will anticipate more delays in the revalidation date, and so if planning to retire because of this extra burden will do so at the very last minute.
Perhaps some of the 6% on the register not wanting a licence have already retired so that might not be as bad as it seems.
Here is a link to a 2009 “Retirement Project” document by the NHS Workforce Review Team. It only considers hospital consultants since it was designed to inform WTD staffing which doesn’t relate to general practice. It is described as anecdotal rather than a comprehensive analytical study.
https://docs.google.com/fileview?id=0B9i2cGakbyaMZDRkYTIzOTUtYzU1OS00ZjYxLWIxZTYtYjVmZjMzZDA4Mzgy&hl=en
The preferred age of retirement is 60 rather than 65. Even now, ignoring any possible detrimental effect of revalidation on the workforce, they are talking about encouraging consultants to work longer or return to work after retirement.
Witch Doctor – “The powers at be must surely be concerned there may be a mass exodus” – I beg to differ. In the past they have let this happen many times. This time round, I have met some of those in a position to “be concerned” and what I have seen is not concern, but second rate doctors with over-inflated egos exercising arbitrary powers. The Government is delighted – gets rid of nuisance Nutts and paves the way for caring Noctors. Joe Public likes caring Noctors; and they are not only cheaper to train, but cheaper to run. Win! Win!
In the news this morning we heard that soon all nurses – all – are to have degrees, apparently so that they are better able to make decisions.
Dr No finds it absurd that otherwise capable but not degree level – whether through lack of inclination or calibre – candidates for nursing are to be barred from training.
Be that as it may, and putting aside (a) if one looks at our ethicist friends, it would seem that an excess of degrees inhibits decision making and (b) most of what nurses do (or, rather, should be doing) is about caring, not deciding, what Dr No suspects we are seeing here is the back door rise of a group of alternative decision making practitioners who can step into the gap when the massive cull of doctors takes place as revalidation is brought to bear on the medical profession. The problem is, the noctors haven’t been to medical school. They may learn to decide which orifice to stick the thermometer in, but they wont know how to make sense of the reading once they pull it out again…
I wonder if saving money is just a perception. Observing the “dumbing down” and “protocol effect” in my corner, I have found it causes a significant increase overall in costs and inconvenience. But this increase in expenditure is hidden across several spreadsheets and it is therefore not easily identified that “dumbing down” is the reason. One manager’s spreadsheet may look good but several others are left scratching their heads wondering why they have gone into the red and how to justify it. No connection is identified because it is obscure.
If “dumbing down” doesn’t save money, what does it do? Well, it keeps the unemployment rate from rising, and it produces a workforce that is much more malleable than most of the medical profession. Government bodies then insidiously begin preferentially to communicate with the malleable workforce and can therefore slip through agendas that might otherwise be impossible.
However, some members of the medical profession are extremely malleable also. Most of the worrying changes in the NHS today would not have happened but of the complicity of some malleable “second rate doctors with over-inflated egos exercising arbitrary powers.”
Incidentally, this term was coined by – you’ve guessed it – doctors. “Committee doctors” from The Royal College of Physicians, London.
http://witchdoctor.wordpress.com/2007/11/12/a-competent-clinical-decision-maker/
The OED has the “I dunno” explanation as urban myth. I suspect the myth came from Python – all blokes are Bruce, all females are Shelia and the rest…
I feel like the kid that’s just been told there’s no Santa!:(
Anyway, the collective nouns for kangaroo are a mob, a troup or a court of kangaroos. Sounds about right for the GMC..
Dr No would be mortified to be the one who told the kid there’s no Santa.
Whatever the origins of the phrase – who does know? – the OED is only ever “work in progress” – your observations on the names for a group of kangaroos are very to the point. Perhaps we should rename the GMC the GKC?
Meanwhile I note Rita is turning up the heat on Prof Rubicon here and here. Maybe he will be the first knagaroo in the pot?
I have been meaning to blog on the same thing but haven’t got round to it yet. As you say it is a completely pointless exercise in reinventing the wheel and making an attempt at the same time to appear that one is actually not a big fat wasteful organisation wasting millions each year in doing precisely bugger all of use.
http://ferretfancier.blogspot.com/2009/11/what-value-medical-degree.html
The aussies appear to have more sense than us but interestingly their government is also trying to shaft them as we were shafted by the dumbing down of medical training and standards.
Thanks for the good writeup. It in reality used to
be a leisure account it. Glance advanced to far added agreeable
from you! However, how can we communicate?
With havin so much content do you ever run into any issues of plagorism or
copyright infringement? My website has a lot of unique content
I’ve either written myself or outsourced but it
seems a lot of it is popping it up all over the web without my agreement.
Do you know any techniques to help stop content from being ripped off?
I’d genuinely appreciate it.