Please read this

I don't know how I chanced on this, but do please read it.

Nauseating rubbish

Patricia Hewitt was the worst Secretary of State for Health in living memory. However this is what our new prime minister wrote to her after her resignation:

The Prime Minister has thanked the Secretary of State for Health, Patricia Hewitt for her "outstanding contribution" to the government, as Mrs Hewitt announced her decision to step down from the frontline of government and accept a party political role.
In a letter released today, Mr Brown said that he wanted to "pay tribute to the progress that, as Secretary of State, you have made in reducing waiting times and driving forward reform in the health service".

So now we now.

The truth at last

I have, at the request of a friend, removed this post until Monday evening.

It will reappear then, and is worth waiting for.

(Sorry for sounding so mysterious)

Burying bad news

The news was rather busy today; to be fair, a new Prime Minister is a rare enough event. So it's a good day to get a story out which no one will notice.

Except the Save Bedford Hospital party has eyes and ears everywhere. Today was the day that the Chief Executive of the NHS released his annual report, and a day that was guaranteed to ensure that it was totally ignored by the media.

Perhaps it's time for the DoH to spend less time on spin and more on substance.

Save Bedford Hospital

I have just finished chairing an excellent meeting of the campaign committee of the Save Bedford Hospital party. I can reassure our supporters (and warn our opponents) that we are well organized and in fine spirits.

The NHS needs local hospitals, and those hospitals must be suited to local needs; they need the full range of acute surgical and medical services that are required for the local population, and they must be freed from the overbearing political interference to which they have been subjected in recent years.

I look forward to making a number of important announcements in the next few weeks and months; in particular I look forward to announcing details of our party conference. Keep checking this site for details.

Exterminate

From today's Sunday Telegraph TV listings.

BBC3, 8pm,
'Doctor Who: Part one of two. A new prime minister begins a reign of terror'.

What do they know, that we don't?


(Thanks to Iain Dale for this)

Bonkers

Have we finally gone bonkers? The answer must be "yes" if this story from the BBC is true:

Sporran wearers may need licence

Kilt owners may have to seek a licence for their sporran

Kilt wearers could face prosecution if they do not have a licence for their sporran under new legislation which has been introduced in Scotland.

It's not true

Politicians are fond of claiming that the problems of the NHS are all the fault of the doctors, because we refuse to change the way we work. This little link shows how we really have changed.

We will miss you

John Prescott steps down next week. Running his office as "deputy prime minister" has, over the past decade, cost tens of millions pounds of our money. The visible returns have been hard to identify.

The Save Bedford Hospital party believes in value for money in the public sector. We wish Mr Prescott a happy retirement, but do we really need a replacement? Perhaps not.

The power of prayer

Next week Gordon Brown takes over as Prime Minister, and many of us will be fascinated to see who takes over from Patsy Hewitt at health. He has already said that it will be his number one domestic priority, which is hardly surprising given the mess that Patsy, Reid and Milburn have created in the last five years.

Brown is obviously not terribly impressed by the talent he has available in his own party, as judged by the stories of his offering a number of posts to prominent Lib-Dem peers (such as Paddy Ashdown and Lord Carlile); according to press reports he was also keen to offer the health portfolio to the Lib-Dem peeress Rabbi Julia Neuberger. She is already the Lib-Dem health spoke(wo)man in the Lords, has been the Chairman of an NHS Trust and ran the King's Fund, so she clearly knows something about the subject.

I suspect that Gordon also saw another virtue, namely that as a rabbi she clearly understands the power of prayer, and given the present state of the NHS, that may be a commodity we will all be needing.

Getting ready

Next week we will have a new Prime Minister.

There is always the possibility that he will call a snap general election, so the campaign team of the Save Bedford Hospital party is gearing up for action. We will be ready.

PS, if you feel that you can help us in any way, do get in touch.

Money down the drain

Patricia Hewitt in a previous incarnation was a management consultant, working for Andersen's (of Enron fame); Richard Granger the shortly to be ex-head of the disastrous NHS IT programme was another Andersen's product. It is the management consultant culture (and the application of the notorious "performance management" - a concept perfected in the jungles of Vietnam) which has contributed to the destruction of the public service in the UK, and the NHS in particular.

Now even politicians are getting a bit tired of the management consultant rip off culture, as evidenced by this piece from the Guardian:

Whitehall could save taxpayers at least £500m a year by relying on advice from civil servants rather than paying nearly £2bn a year for the "profligate" services of consultants, a committee of MPs recommends today. The Commons public accounts committee found that Whitehall departments often hire consultants before establishing whether in-house staff have the skills for the job. It called for a "more intelligent" use of consultants, echoing new advice from Sir Gus O'Donnell, the cabinet secretary, to all departments, following publication of a critical report from the National Audit Office, parliament's spending watchdog.

From the coalface

I have received this e-mail from a junior doctor at a nearby NHS hospital:

Dear Dr Monk,

I'm an SHO in T&O at ******* *******, and I've seen the disaster that is CfH first hand - the Millennium CRS system. Apart from the bizarre name (or is it 7 years late!), it just does not do what it is supposed to.

It was first introduced in A&E as a patient record, and hospital-wide as a PAS system to track notes & patients, etc. In A&E, the consultants have stopped using it as an EPR, as they found that it took 5 minutes to see the pt and 20 minutes to do the computer work! It is now just being used as a PAS system, and the rumour is that this is only because the old PAS has been erased from the hospital systems.

The software is completely user-unfriendly and counter-intuitive - whoever wrote it will obviously never use it. You may remember that it featured in an article in the Times - one consultant described it as "clunky" and "not fit for purpose".

On the wards - we as doctors do not really see the chaos that is caused, but the ward clerks are all tearing their hair out. They say it's impossible to use. However, we as SHOs used to be able to get a printout of our consultant's patients, which is useful if they're spread around as outliers, and the new system won't let us do this. Seems insignificant, but it is annoying.

In clinics, it is downright dangerous. We will have a clinic list printed the day before, and obviously those notes are prepared. Few of these patients will turn up - they say they have not received an appointment. We see lots of patients attending the wrong clinic (dermatology follow-up in the orthopaedic new patient clinic, for example). Then another cohort of patients WILL attend, with a letter conforming the clinic and date, but not on the list and therefore no notes available. Finally, the "codes" for clinic that all staff, including clinic staff and ward clerks knew (eg "code" LW210 meant Mr X's knee clinic) are incompatible with the new CRS system and have been scrapped.

You read it here first

The Sunday Telegraph covers a story today which appeared on this site over a week ago.

Read all about it

Think of the alternative

"Think about the alternative." That's NHS IT chief Richard Granger's response to the mounting criticism of the 10-year £20bn Connecting for Health (CfH) modernisation programme, which has been described as the largest civil IT project in the world, already massively over budget, and behind schedule.

Well clearly Mr Granger has thought about the alternative - he's handed in his notice!

What's it all about?

There is a rather good story on that usually reliable medical blog Dr Rant

I have absolutely no inside knowledge here, and all I can say is that fairy tales do sometimes come true.

Hazardous bubbles

A clown has had to stop blowing bubbles for children to chase after being warned it could be a safety hazard.

	Barney Baloney: no more bubbles

Tony Turner, also known as Barney Baloney, will now stick to clowning and juggling after being refused insurance by several companies which feared youngsters might slip on the bubbles' residue.

Mr Turner, 47, who is married with three children, said yesterday: "The fun is being taken out of children's lives by bureaucracy.

"This whole health and safety business has gone too far. Kids eat jelly and ice cream and that gets on the floor and is slippy. Does anyone want to stop them eating that?"

Equity, the actors' union, has now agreed to insure the Sheffield clown's act but, after taking advice, he will no longer be blowing bubbles.

This is the sort of madness which we have to put up with in Britain after ten years of Nu Labour; wonderful.

Into cyberspace

I have just received this letter from a local GP:

"This gentleman has been referred under Choose and Book and has already made an appointment to see you.

I typed the referral letter today, but just as I clicked to send the letter across, the computer system crashed. The system has now "frozen" the letter somewhere in the middle of nowhere - according to messages which have come up on the screen - and is refusing to do anything with it! As the patient has already made his appointment, I am attaching a copy of the referral - it would be much appreciated if, on this occasion, you could accept this in the good old-fashioned (paper) way."

So there you are: Choose and Book is expensive, reduces choice, and wastes everyone's time, and all at the touch of a button. Perhaps it's about time that we launch it (and all the computer wizards who sold it to the DoH) into cyberspace.

New jobs for old lags

Come August 1st, who will be doing the work in our hospitals? Faced with the mess which is MMC and MTAS some of our best and brightest doctors are busy applying for jobs abroad; others are planning to give up medicine and go and work in the City. I know of one who is thinking of auditioning for the next series of "The Apprentice".

So how will we be filling the gaps? The answer might be found in a recent edition of Nursing Standard reported in The Times. Apparently prisoners in Wandsworth prison are forming part of a pilot project to train them to enable them give medical advice.

I am all in favour of teaching prisoners life skills, but when I'm ill, I think that I would prefer to be looked after by a real doctor; unfortunately, after next month I may be struggling to find one.

Situation critical

The political career of health secretary Patricia Hewitt is lying on a trolley in some dark hospital corridor, very probably labelled “Do not resuscitate”. In a couple of weeks, Dr Brown is expected on his rounds to put Hewitt out of her misery. But until then she must put up with the pain.
She’s already been attacked in recent weeks by midwives and junior doctors. Last week hospital consultants joined the fight by accusing Labour of crippling the health service.
Dr Jonathan Fielden, chairman of the British Medical Association’s consultants committee, said the service had been harmed by botched reforms. “Political meddling has brought the NHS to its knees,” he told the association’s annual consultants’ conference.

Quote of the day

"A friend has had to give up running a pub - she said the last straw was being told she had to do a risk assessment on a cheese sandwich"

Sandra Howard, wife of Michael Howard, the former Tory leader, on the menace of bureaucracy.

(Thanks to Iain Dale for this)

Nice work, Reg

I never cease to be amazed at the ways the Department of Health find to waste money.

Every Trust (community, hospital or PCT) is now required to do an annual survey of staff opinion. However, the Trusts aren’t allowed to produce their own survey, they have to employ a company (and there are just a handful of them) from an approved list, and these companies don’t come cheap, around £4000 a time (per Trust, per year) seems to be the going rate. And the questionnaires, by the way, are pretty fatuous, and no doubt designed to report back that everything is wonderful and that we are all most grateful to Mrs Hewitt.

The largest of these companies is called Quality Health Ltd, a company wholly owned by Dr Reg Race and his wife (the doctorate, by the way is not a medical one, it is a PhD from the University of Kent on the subject of bureaucracy). Quality Health claims to work for 360 NHS Trusts, although curiously, when Mark Hoban MP asked a question about the company in the Commons on 16th April, the minister, Andy Burnham, claimed that the DoH had had no contact with Quality Health in the period 2001-2007 ("why not?" you may well ask, if they are such a successful supplier of services).

Reg is a pretty persuasive chap, or so I hear from those senior managers at Bedford Hospital to whom he gave a presentation last week. What Reg didn’t trouble to tell them is that Reg Race is a former Labour MP and still active in the party. He is recorded by the Electoral commission as having given the party £10,000 in January 2007, and recently gave Alan Johnson £5000 for his deputy leadership campaign.

So here’s how it appears to work (and forgive me if I misunderstand things). You tell trusts to run questionnaires; you ask your mate to design the questions; you tell the trusts they have employ one of your mates; your mate says thanks and gives your party something in return. Oh, and by the way this is public money which could have been spent on patient care. Or perhaps I'm missing something.

Incidentally, Reg Race does have one claim to parliamentary fame; he was the first Member of Parliament to be recorded in Hansard as using the word "****" during a Common debate

Fiddling the books

The Times has an interesting article today suggesting that the government now realizes that its plan to have all patients treated within 18 weeks is unachievable.
Their answer, apparently, is to fiddle the books by preventing patients actually getting on to waiting lists. Another triumph for Nu Labour.

This is the start of the article:

Drastic cost-cutting ordered by the Government across the NHS has derailed its flagship policy to ensure that no patient waits longer than 18 weeks for hospital treatment.
A leaked e-mail seen by The Times reveals that the Department of Health is so worried that new data showing that some patients will have to wait “in excess of one year” will be highlighted by the media that it has issued special guidance on how to spin the news.
The Government is expected to announce today that the NHS has made a surplus of more than £500 million in the past financial year after an aggressive drive to reduce spending by health trusts.
The e-mail says that more than half of patients are still waiting longer than 18 weeks for treatment. It calls into question the Government’s ability to honour its key health pledge that all patients would be treated within this time by the end of 2008.

From The Times

From The Time,
June 6, 2007
Junior doctors
Sir, Last year the Postgraduate Medical Education and Training Board (PMETB) issued the laudable requirement that processes for recruitment, selection and appointment into specialist run-through training programmes should be open, fair and effective. Subsequently, the Medical Training Application Service (MTAS) has failed to achieve them. An independent judicial review branded the system flawed and disastrous, and Mr Justice Goldring accepted that many junior doctors could have an entirely justifiable sense of grievance.The chairman of PMETB has now claimed (letter, June 2) that it has no responsibility for the current crisis affecting junior doctors’ recruitment, claiming that its powers “do not encompass. . .choosing between eligible candidates”. Such evasiveness does not concur with the evidence given to the High Court, that the PMETB “was responsible for laying down the basic principles of recruitment to specialist training posts”, that it instigated the change to the new (competency-based) shortlisting process, and that they issued guidance concerning the use of CVs.PMETB is the body established in 2003 to develop a unifying framework for postgraduate medical education, and assume regulatory roles previously the responsibility of the independent medical royal colleges. The PMETB is neither directly answerable to Parliament nor independent of political control; the Secretary of State can give such directions as she considers appropriate.Many of the board members have potentially conflicting roles on other medical bodies. For example, Dame Carol Black is also chairman of the Academy of Medical Royal Colleges, in which role she has publicly supported the Chief Medical Officer for pioneering the present reforms (letter, May 17). She is chair of the Health Honours Committee, and an adviser to the Department of Health. Another member of the PMETB Board, Professor Neil Douglas, has chaired the “independent” review group set up to examine the failures of the MTAS.There are few precedents for a regulatory body with responsibility for the education of doctors not to have responsibility for equity and appropriateness of entry to that education. The general public and their doctors are left to wonder who, if anyone, will take professional responsibility for regulating the novel and previously unvalidated selection system.
LOUISE BAYNE
MATTHEW JAMESON EVANS, MRCS
JUDY KING, MRCP
RICHARD MARKS, FRCA
CHRIS MCCULLOCH, MRCP

Powerful words

This was a published e-comment made by a doctor from New Zealand in reply to Prof Morris Brown's letter in the Times:

"Professor Dame Carol Black is the President of the Academy of Medical Royal Colleges (AoMRC) and a member of the Postgraduate Medical Education and Training Board (PMETB). She is also chair of the Honours Sub-Committee for Health and a member of the Advisory Committee on Clinical Excellence Awards. She would therefore be able to reward doctors who pursue her agenda in postgraduate medical education with recommendations for honours and bonuses.
It is ironic that she is in such a position when one of the many lofty aspirations of MMC and MTAS was to rid the profession of a perceived system of patronage. May I suggest that she resign as President of the AoMRC. MTAS might then serve one useful purpose before its death in appointing a random successor who could not possibly do a worse job of defending postgraduate medical education."

Unfortunately,although Crockard and Johnson did the honourable thing, I am not so convinced about the pantomine dame.

This is how to do it

Rt Hon David Miliband MP
Secretary of State,
Department for Environment, Food and Rural Affairs (DEFRA),
Nobel House
17 Smith Square
London SW1P 3JR

16 May 2007

Dear Secretary of State,

My friend, who is in farming at the moment, recently received a cheque for £3,000 from the Rural Payments Agency for not rearing pigs. I would now like to join the "not rearing pigs" business.

In your opinion, what is the best kind of farm not to rear pigs on, and which is the best breed of pigs not to rear? I want to be sure I approach this endeavour in keeping with all government policies, as dictated by the EU under the Common Agricultural Policy.

I would prefer not to rear bacon pigs, but if this is not the type you want not rearing, I will just as gladly not rear porkers. Are there any advantages in not rearing rare breeds such as Saddlebacks or Gloucester Old Spots, or are there too many people already not rearing these?

As I see it, the hardest part of this programme will be keeping an accurate record of how many pigs I haven't reared. Are there any Government or Local Authority courses on this?

My friend is very satisfied with this business. He has been rearing pigs for forty years or so, and the best he ever made on them was £1,422 in 1968. That is - until this year, when he received a cheque for not rearing any.

If I get £3,000 for not rearing 50 pigs, will I get £6,000 for not rearing 100?

I plan to operate on a small scale at first, holding myself down to about 4,000 pigs not raised, which will mean about £240,000 for the first year. As I become more expert in not rearing pigs, I plan to be more ambitious, perhaps increasing to, say, 40,000 pigs not reared in my second year, for which I should expect about £2.4 million from your department. Incidentally, I wonder if I would be eligible to receive tradable carbon credits for all these pigs not producing harmful and polluting methane gases?

Another point: These pigs that I plan not to rear will not eat 2,000 tonnes of cereals. I understand that you also pay farmers for not growing crops. Will I qualify for payments for not growing cereals to not feed the pigs I don't rear?

I am also considering the "not milking cows" business, so please send any information you have on that too. Please could you also include the current Defra advice on set aside fields? Can this be done on an e-commerce basis with virtual fields (of which I seem to have several thousand hectares)?

In view of the above you will realise that I will be totally unemployed, and will therefore qualify for unemployment benefits.

I shall of course be voting for your party at the next general election.

Yours faithfully,

NO COMMENT

This is the sort of useless jobsworth we have to put up with in the NHS. This e-mail was received by a colleague

To: PCT Users

Subject: Madeleine McCann emails

All staff are asked not to send or forward emails containing pictures of Madeleine McCann. There are already many photographs of Madeleine in the public domain, so this is unnecessary. There is also data protection and child protection guidance which advises against this practice. If you do receive such an email, please delete it.Thanks for your co-operation; Sarah Smith Communications manager Bradford and Airedale Teaching PCT 4th Floor, Douglas Mill Bowling Old Lane Bradford BD5 7JR Tel: 01274 237386 or 07976 084773 Fax: 01274 237453 sarah.smith@bradford.nhs.uk

What would the Tories do?

We all know what a disaster the Labour party has been in relation to the NHS, but at least we know what they are doing. Does anyone have any idea what the Tory policy is, or is it like their ideas on grammar schools - no policy at all?

How to waste money

John Prescott, the deputy prime minister, has just completed a farewell tour, at public expense.

The itinerary was;

–Sunday in Philadelphia with a speech on sustainable cities and a tour of graffiti murals.
–Monday a 90 minutes trip around Baltimore harbour.
–Tuesday Kingston, Jamaica for a speech on slavery
–Wednesday visit to Jamaica’s botanical gardens
–Thursday visit to a sugar factory before flying to Barbados.
–Friday Visit to the Museum before the start of a week’s family holiday.

Travelling with Prescott were a team of 8 which included a special adviser,two private secretaries, two press officers,a speech writer and two bodyguards.
The mystery surrounds the presence of the two press officers as both the Jamaican and Barbados High Commissions were told not to put out any information about the trip.
Unfortunately for the taxpayer the local free accommodation at the Embassies and High Commissions was deemed not good enough for the tour and therefore five-star hotels at a cost of $315-$700 per night had to be used.

Victory

I recently posted a story about the Gurkha veteran who had been denied admission to the UK because the Home Office claimed that he had no connection with the UK, not withstanding the fact that he was a holder of the Victoria Cross.

Well, just for once, people power has worked, and the Home Office has changed its mind.

Public pressure is a very powerful force when properly applied - as I hope the Save Bedford Hospital campaign will show.