Over on Paul Corrigan’s blog, we learn that Dr Smith has been updated. Whether the update was achieved by a Freeview over-the-air broadcast, or plugging Dr Smith into a USB port isn’t clear, but, following the update, Dr Smith is now crystal clear on how the new NHS commissioning structures will work. This put him way ahead of Mr Corrigan, who in more normal circumstances understands more about healthcare than the entire medical profession put together. But then, it’s amazing what you can do with a bit of IT these days. We shall just have to wait until Mr Corrigan gets updated, and perhaps then he can explain it all to the rest of us.
Dr No started his medical career in a surgical specialty (O&G), and in many ways, he still thinks like a surgeon. Physicians, with their pills and potions, and frock coats and baffling cardiac murmurs, were and still are quite beyond him. So he naturally expected that he would understand the Royal College of Surgeons stance on the Health and Social Care Bill. But instead he finds today it is the RCS’s position that is baffling him. If ever surgery was called for, it is a for a wide resection of the malignant tumour that is the Health and Social Care Bill. Yet the RCS wants to not just leave the tumour in place, it wants to encourage its growth. Dr No is indeed baffled.
Not so long ago, a misguided government, aided by Collegiate lackeys, ruined medical training, in the disaster known as MMC/MTAS. The anger amongst junior doctors was as justified as it was palpable. One particular junior nailed his colours – those colours being rich and brown – to the mast, in a doctors’ only forum. Snooping eyes started, smarted and then popped, and ordered that Scot Jnr – as the doctor became known – be taken out. The ensuing scandal was dubbed Jobbygate, and has continued to rumble on. More widely, a group of juniors formed Remedy UK, but, sadly, Remedy has so far achieved little in the way of a remedy. Today, four years after MMC/MTAS was unleashed, medical training remains in tatters, morale blown, and the contempt for and loathing towards Collegiate lackeys as potent as ever.
“The hottest places in hell are reserved for those who in times of great moral crisis maintain their neutrality”
–Dante, via JFK
So – Dodders has produced his report, and, despite the best attempts by the media to whip it up, it is predictably doddery. The general gist is that the Nicholson challenge, that the NHS achieve £20 billion efficiency savings by 2015, isn’t going too well. La La’s response – that the report was unfair on NHS staff, because they are all doing a spiffing job – baffled everyone. At some point, Dodders may have suggested the Health and Social Care Bill might be something of a distraction, or words to that effect. Whatever it was the report said, it was not the rocket up the Bill’s backside that many hoped it would be.
Reporting on the latest DYI enthusiast headed for the English High Court, a New York newspaper describes – without irony – the legalise euthanasia bid as ‘arguably a long shot’. More close call, or perhaps even parting shot, it seems to Dr No: but then we are two nations separated by a common language.
The case concerns a fifty-seven year old man who finds his life intolerable after a stroke seven years ago left him with the locked-in syndrome. An active capable and intelligent man before his stroke, he now sums up his life as ‘dull, miserable, demeaning, undignified and intolerable’, and, understandably, wants out. Being, he says, unable to do the deed himself, he has applied to the Court for a declaration that any doctor – in passing, Dr No does not see why the application has been limited to doctors – terminating his life will have a ‘common law defence of necessity’ against any possible murder charge.
There is a variant of Dennis Healey’s Law of Holes which says: when you are in a wet paper bag, stop pissing. Most folk who spend much time in wet paper bags appreciate the importance of this law to their survival, but it seems those folk who inhabit the wet paper bag more generally known as the British Medical Association have yet to turn off the tap. At a time when there is overwhelming and very visible professional opposition to the Health and Social Care Bill, and so a real prospect of nailing the bill, the BMA has turned on a golden shower of pension reform objections. There is even talk of industrial action.
Ever since The Incredible Dement described an on screen Dignitas death as ‘a result’, much as parent might comment on the inspected contents of a toddler’s potty, Dr No has been somewhat less impressed with the ID’s own ‘results’. The ID’s latest ‘result’, a cooked report, produced on his behalf and at his expense, by an assembly of pro-snuffers, pipes the payer the tune he wanted. The ID has now moved on to his next project, which is grow daily in appearance more like the Archbishop of Canterbury. On latest sightings, it appears that this project too may soon produce ‘a result’, and we shall no longer be able to distinguish one from the other. Reporters and organisers of conferences on assisted snuffing might care to take note, lest they find the talking beard before them delivers ‘a result’ rather different to that which they were expecting.
The fallout from the sorry tale of the PIP implants that went pop in the night is starting to settle. We have calls for the MHRA, the agency who green-lighted the PIP implants, to pull its finger out of its prostheses, and get some dentures with edge. What else, it is now asked, has the agency, which green-lighted breast implants filled with a Vulcan’s brew of fuel-additive enriched industrial grade rubber, also endorsed? Mobile phones recycled as pace-makers? Mild steel hips that will rust before time? Could it be that, far from entering the bionic age, we are instead in an ironic age, where that which pretends to improve turns out to do quite the opposite? Will we, indeed, ever know? We shall have to wait and see.
Hoping no doubt to capitalise on New Year temperance sentiments, David Cameron chose last week to announce a review of alcohol pricing. Westminster officials have been ordered to develop ‘a scheme in England to stop the sale of alcohol at below 40p to 50p a unit in shops and supermarkets’, akin to similar but further advanced Scottish plans. The idea behind these neo-Prohibitionist proposals is the so-called ‘single distribution theory’, expressed rather alarmingly some time ago in the title of a seminal BMJ paper as ‘The population mean predicts the number of deviant individuals’. The notion is that, not only can the tail wag the dog, so too can the dog wag the tail. Reduce overall alcohol consumption, and the number of deviant (i.e. heavy) drinkers will also reduce. Like most neo-Prohibitionist clap-trap, it is pure poppy-cock.
It was, of course, Batman who back in the eighties first let the Tory notion that the health service should be not a service but an industry out of the bag. This quaint right-wing notion is still very much alive and well today. Lambo’s Health and Social Care Bill, with its recently highlighted provision that NHS trusts can now devote up to (just one percentage point shy of) half of all their activities to privately funded work, is part of the cold steel of this reckless policy. Those who doubt the extent of Tory industrial intent need look no further than Cambo himself. Only last November, he told us – during a speech that was meant to be about exports and growth – that he wanted to ‘drive the NHS to be a fantastic business’. No doubt that will include some token assurances about the importance of customer service, but there, plain for all to see, the emphasis is on business.