Regular readers will know that Dr No is an advocate of Auric’s Law of Causes – happenstance, coincidence, enemy action – and it so happens that Auric’s Law has been met, indeed exceeded, in four out of four recent NHS encounters by family and friends of Dr No. In each case, the care provided was either partly or wholly inadequate and/or incompetent; and, by Auric’s Law, he concludes these adverse experiences did not arise by chance, but by malevolent force. The malevolent force was the NHS, or more specifically the doctors who provided (or in some cases did not provide) the care. All four cases happened in, or were related to, secondary (hospital) care, but more often than not the GP was also involved in, or at the least complicit with, the deficient care. In all four cases, either the patient or a relative was a doctor, and so an ‘expert witness’, able to ‘read’ what was going on. How much more poor care, one wonders, goes on, but is unnoticed, because the witnesses are lay, and lack the knowledge to read the signs?
Category: Dodgy Practice
The Apothecary: You’re Fired
Once upon a time, there were no GPs, only apothecaries. These corner-shop chemists evolved over time into today’s GPs, but their shop-keeping origins are still present even in today’s super-surgeries, and all the more so in the small lock-up single handed surgery. The short appointment times (it’s usually only a shopping trip, for Heaven’s sake), and expectation that the shopper-patient will not walk away empty-handed (what shop-keeper would so disappoint his or her customer?) are two leading characteristics of today’s general practice that stem directly from its apothecarial trade roots.
A Good Day to Bury a Bad Bill
Conveniently, the Health and Social Care Bill completed its final parliamentary stage on the eve of the budget, ensuring it was in hours knocked off the top of the news pile by Porgie’s Biddy Tax. But, mean as the Biddy Tax is, it is not the erosion and loss of the Pensioner’s Allowance that will hit Granny hard in the years to come, it is the erosion and loss of the NHS brought about by the Tories’ now soon to be unleashed health service reforms that will hit Granny – and indeed the rest of us when we need healthcare – hard. So the question arises: what are we going to do about it?
Lansley’s Barking Spider
The Ollie Wright/Indy/Number 10 axis of spin has spun again, choosing today to front page a week old ‘let’s be friends’ letter from Dr Clare Gerada to the Prime Minister. Why The Indy ran last week’s news as today’s front page is quite beyond Dr No. Perhaps the wheels of spin spin slowly at the Indy’s offices these days. Those at the BBC however were up to speed, at least when it came to peddling the Indy spin. Radio Four’s Today programme grabbed the week old story and put it at the top of the day’s news, and gave Dr Gerada one of the coveted post-eight o’clock news slots: doctors in massive climb-down. In the event, the story back-fired. Humph humped, but Clare was clear: the RCGP position remains the same – the bill must go.
The Two Tier Health Service in Action
Dr No’s colleague, the Formidable Missile, who cares so much it must hurt, has been campaigning tirelessly on behalf of her PIP ladies. Whether lumping these women together as ladies is a push up too far that affords them a degree of nicety not always entirely fitting is a moot point, but on the matter of doing something to help these women, as Dr No prefers to call them, Dr No is right behind the Formidable Missile’s point. No matter what collusion of vanity and distress prompted these women to put a rocket in their tits, the fact is they presented to their surgeons in good faith, expecting a competent procedure, done using the proper materials. That the booster in their rockets turned out to be sinister industrial grade silicon, and prone to rupture to boot, is a calamity that simply cannot be laid at their door. And for this reason, Dr No agrees with Dr Coales: there is no moral justification for leaving these women to fend for themselves.
Sick Individuals and Sick Politicians
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.
Double D C*ck Up
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.
Leveson, Le Lapin Chaud and Lack of Moral Fibre
Ian Hislop spent much of last night’s Have I Got News for You looking like un lapin apeuré caught in the headlights. Kirsty Young, the thinking Jock’s crumpet, kept both hands on the wheel. The man behind the wheel behind the headlights was one Lord Justice Leveson, chief pongo at the eponymous inquiry into, inter alia, the culture, practices, and ethics of the British press. The fear is that the headlights will turn into ray-guns, and before too long Hislop not to mention other upstanding members of the Great British Press will go up in flames, to be left standing, like smouldering stumps after a bush fire, the charcoaled reminders of a once free press.
Furies and Bullies
There has arisen, it seems to Dr No, a certain class of doctor, typically female and in their thirties or forties, maybe a GP, but not in full time clinical practice, perhaps instead involved in medical education in some guise or other, or perhaps not, who number, amongst their many duties, that of patrolling the internet. They patrol other, often male, members of their profession for what they consider to be misdemeanours, great and small, and when they find such misdemeanours, they feel driven to act, in the name of decency, correctness, and the final eradication of all victimisation, bullying and harassment; and for the greater good of the name of a modern caring profession. Dr No calls them The Furies, after the Roman version of the Greek Ερινύες, the avenging goddesses of wrath, who arose, fittingly enough, from drops of blood spilt at the castration of Uranus.
The Curious Case of the Coales that Burnt in the Night
Those who follow the UK medical blogosphere will already be well aware of the curious case of Dr Una Coales, the Korean Missile currently disguised as a locum GP. A prolific, out-spoken, self-promoting and self-publishing writer, with ambitions to become the RCGP’s next president (small fry, given that she is already, according to her twitter page, ‘Conservative Health Secretary’), she has brought a world of fury upon her shoulders for – allegedly – shopping the identity of a person or persons unknown as the real Dr Rant, late of the blogosphere, to the police – or perhaps the GMC, or even both. Within hours, other bloggers started going out, like bulbs on a set of Christmas tree lights. A better known Heat Seeking Missile has weighed in heavily, and told us in no uncertain terms that it is our own stupid, indolent fault that our lights are going out. Her comments as of now lie, steaming like elephant dung roadblocks, at the bitter end of more than one post on the matter. No doubt a similar steamer will be dumped here before too long.