Month: January 2011

Captain Mainwaring’s Commissioning

dads_army.jpgThe government continues to push its quaint vision of local GPs doing local healthcare commissioning. Many who know rather more about the National Health Service than the government do have pointed out this is a non-starter. But let us imagine for a moment what might happen if all GPs did take on commissioning. It might go something like this:

Scene: Walmington-on-Sea Church Hall. Platoon drawn up, Mainwaring and Wilson face them.

MAINWARING: Right, Men. I’ve a very important announcement to make. (inflates chest) We’ve orders from the ministry to fix the NHS. Its going to be the next big thing. (inflates chest further, taps swagger stick on flipchart for emphasis) Its called Home Guard Commissioning. We’re going to show these Johnny-come-lately American chaps how it’s done.

A Nod’s as Good as a Wink…

bung.jpgNot content with just nuking the NHS – so last year, my dear - it now appears that Lang-Ho and the Con-Doms – fresh from turning a blind eye to city bonuses – are lining up to offer their private healthcare pals an eye-watering billion dollar bung to ‘ease’ their entry into the post-NHS healthcare market.

The proposals – buried deep in last week’s Health and Social Care Bill Impact Assessment – have arisen because a management consultant (KPMG) report estimates that Lang-Ho’s non-NHS provider buddies are at a financial disadvantage compared to NHS providers:

Not Quite Tannochbrae

tannochbrae.jpgThe Tories, it seems, have the hots for Big Bangs. In 1986, they famously blew open the Stock Market, deregulating the financial markets, arguably paving the way to a rather different kind of bang, more crash-bang than Big Bang, twenty one years later. Today’s Tory Big Bang target is none other than our National Health Service. Agent Lansley has been charged with blowing it to smithereens. Even before the debris settles, any willing cowboy will be welcomed to ride off with rich pickings, the drear and dross discarded, as dust on the desert floor.

Ross Kemp Keeps Out

keep_out.jpgMedium shot of Kemp standing, arms folded across chest, outside a Nissen Hut.

KEMP (to camera): I’ve been given exclusive access to one of the most feared gangs in the country. A gang responsible for mayhem and misery on a colossal scale, a gang so powerful that it can and at times does hold the country to ransom, but, at the same time, never shirks from bank-rolling its pals. A gang so heinous that few dare speak its real name. Instead, it is the gang simply known as (dramatic pause) The Cabinet.

Camera pans to Nissen Hut, then back to Kemp who walks towards hut. Shaky handheld camera follows. The door has a dilapidated sign nailed to it which says ’Keep Out’.

ISIHAC NHS Special

clue_nhs.jpgIn the light of the BBC’s blackout of news coverage of the NHS revolution, certain insurgents within the Corporation have been making their own programmes to cover the shortfall. Dr No was lucky enough to be given access to I’m Sorry I Haven’t a Clue’s NHS Special – and has kindly been given permission to publish a short extract.

Chairman Dee: NHS managers have been getting a lot of flak recently, being blamed with ruining the once efficient running of the national health service. There is talk of mass redundancies. Would any of the team like to suggest films that might appeal to hospital managers who have fallen on hard times and are stuck at home with nothing but a DVD to watch?

Jobs for the Boys

freemasons.jpgSo – this is the day that Cambuffoon and his Lillie Langtry are to sprinkle drops of NHS blood on the oceans of commerce; and already the corporates are circling, to devour the NHS as a shark does its prey. Rich fat and valuable flesh will be stripped from bone, and all will go, save the profitless indigestible carcass of the weak, the poor, the chronic and the incurable.

These are the headline notes of the grim fate our government has in store for our health service. Already the rabble of the right is roused; and already the cry has gone up: The NHS is a wasteful and bloated sacred cow that should be slaughtered! The steely knife of market forces will excise all waste and all inefficiency on the trading floors of the agoræ, where ‘any willing provider’ can and will step up to the mark.

SuperRube

supermac.jpgMany doctors in the United Kingdom will have recently received a copy of Count Rubin’s New Year round-robin ‘Be Ye of Good Cheer’ letter. Dr No can reveal that Count Rubin has also recorded a New Year message, shortly to be made available to younger members of the profession who either can’t be bothered to open GMC letters, or if they do, lack the motivation to read them. In keeping with the Council’s new media-rich interactive way, this message will be made available as a podcast. For older members of the profession who can’t be messing with all that new-fangled stuff, Dr No is pleased to present The Official Transcript of Count Rubin’s New Year Podcast to the Profession:

Good Evening. I have recently been travelling around the country on your behalf, and at your expense, visiting some of the chaps with whom I hope to be shaping your future...

Medical Truants

doctor4.jpgDr No has Boots down as an otorhinolaryngologist - an ear nose & throat surgeon, but then the Greek always sounds better in the plush of private practice. These are the chaps who mount CDs on their foreheads, the better to peer into your orifices. Quite why the tonsil baggers need to mount a CD on their forehead to see what they are doing baffles Dr No. Gynaecologists seem to manage very well, without resorting to shining Abba’s Greatest Hits up the old hoo ha.

One might suppose all that peering through CDs might narrow both mind and vision, but Boots has clearly escaped a constricting fate. He has cast his surgical presence wide on the Borsetshire stage; and few indeed are the pies that have escaped the Boots finger. He is very bright, reads widely, and has the natural gift of synthesis to Boot. And so it is that when we come to survey his blog, we find well crafted posts, always finely written, invariably most interesting.

Unnatural Selection

monkey.jpgBy way of a reply to WD and Dr Boots' latest comments on Dr No's last post.

In Dr No's medical student days, most medical students were WASP males. There was a lot of rugger, and high jinks, à la Daily Hail, only in those days, having studied Latin and so Roman habits, we knew how to throw up properly.

About fifteen years later, about ten years ago from now, Dr No had already noticed a shift away from WASP medical students towards more BME and more female students. He even remarked on it during a tea and biscuits break on a ward round - and a health service fattie, a psychologist of all things, all but exploded, but thankfully didn't, because all the tea and biscuits inside her would have made a terrible mess.