Sunday, 27 January 2008
BOM readers will recall Rose Gibb (see this blog). She's the ex-CEO of Maidstone and Tunbridge Wells NHS Trust ("Kent and Snuff It") who presided over the deaths of 90 patients from C difficile. Following a damning enquiry she was exited, but not before the Trust very nearly paid her £400 grand "compensation".
It was a particularly outrageous example of the public sector rewarding failure, and there was a huge public outcry. Commissar Johnson was forced to step in, promising he'd stop it.
Predictably enough he's failed: last week we learned Rose is still getting £75K, a lot more than the C diff victims of Kent and Snuff It will see.
Even more jaw dropping, she has now set up her own company - Resolve Healthcare Consulting Services - "to tell doctors and administrators how to give a better service to the public".
Her partner in this venture is her partner in life, one Mark Rees, "who also quit a senior NHS job with an £170,000 payout amid claims of weak leadership after the trust he ran accumulated debts of £30million."
Advice on how to fail. Surely even our blinkered self-serving management consultant sucking health bureaucrats wouldn't be stupid enough to buy that.
We need to be vigilant. Very vigilant.
One of Johnson's largest (legitimate and declared) donors was Reg Race (ex labour MP).
We wrote about Reg on this blog on 7th June 2007 (Nice work, Reg). Interesting how the worms keep turning.
Thursday, 24 January 2008
The appointment does not seem to have unqualified approval, to judge from this letter in today's Daily Telegraph:
Sir - Our local branch of Boots the Chemist provides a vital service to the community and I have no problem with it.
However, Boots has recruited Patricia Hewitt as an adviser. Frankly, she was the most appalling Health Secretary we have had to endure. It is a scandal that she is rewarded for her incompetence in this way.
I now refuse to shop in Boots.
Dr Mark McCartney, Liskeard, Cornwall
If other NHS employees follow Dr McCartney's excellent example, Mrs Hewitt's appointment may not have totally the desired effect.
Sir, Your report (Jan 9) on the inquest into a mother’s death associated with a hospital’s diversion of her GP’s request for a specialist opinion rings loud bells with any consultant who has watched recent governments vandalise established referral patterns.
One of the most valuable roles of the family doctor was always to know who might give his or her patient the best opinion and treatment, but successive governments have made this increasingly futile. In the “new NHS” climate where almost the entire health budget goes to primary care and hospitals get funding strictly according to referrals from the community, patients frequently have to negotiate the equivalent of an assault course.
First, there are exclusion lists for a host of conditions and any exercise of medical discretion is patrolled by expensive panels which vet cases. Next comes the diktat to GPs that they may not name specialists on referral letters. Hence such “generic” referrals become the ownership of the hospital rather than the specialist. At a stroke, the ability of the GP to find the best opinion rather than the shortest appointment time is damaged. Hospitals living in fear of DoH diktats on waiting targets can deal with these referrals as they choose, switching clinics, using nurse specialists, or even “selling on” the case to another provider hospital.
This pernicious process has nothing to do with quality and everything to do with targets. One wonders if the Southampton coroner is fully aware of the extent to which these mechanisms impinge on so many of the cases he is called to deliberate upon.
Peter Mahaffey, FRCS
Wednesday, 23 January 2008
As markets plunged yesterday George Bush convened a White House summit to push an emergency $150 billion growth stimulus package through Congress in weeks. He called in heavyweight politicians for a bipartisan effort. Elsewhere in Washington an emergency meeting of the Federal Reserve slashed interests rates 75 basis points in an effort to shore up global markets fearing recession. What does Gordon do?
He takes time out to appear on Blue Peter to wish Konnie Huq good luck in her next job. Yes, the Prime Minister has his own weird sense of priorities
Tuesday, 22 January 2008
Dr. Vincent Cable (Twickenham) (LD): I congratulate the Chancellor on brilliant originality. The Government, through their bond guarantees, are solemnly undertaking to repay the Government. The taxpayer is standing behind the taxpayer and we have a private sector solution without private money as well as nationalisation of liabilities and losses and privatisation of profits. It requires a special sort of genius to dream up such an idea and I hope that the Government’s financial advisers have been well rewarded.
I am tempted to recall the Danish economist, Hans Christian Andersen, who told the story of the two conmen who visited a particularly credulous king to sell him an imaginary suit of gold to cover his nakedness. We have a naked King Gordon, desperately trying to cover his embarrassment over the “n” word “nationalisation”.
It was said this morning in the City that the financial value in the insurance markets of the guarantee of the bonds was £2 billion. Since the private buyers are not providing that money, where will it come from? Are we talking about a guarantee of a guarantee? How else will it be funded?
The Chancellor said that there would be a profit-sharing arrangement between taxpayers and the private owner, but no numbers were given. Is it true, as the Financial Times reported this morning, that the proposal is likely to be for a 5 to 10 per cent. Government equity stake, with 95 to 90 per cent. of the uplift going to the private owner? If the proposal is of that order of magnitude, what is the position, if there is to be profit sharing, of the Northern Rock Foundation? The Chancellor mentioned it in the context not of profit sharing but of nationalisation.
Since we have heard from the north-east of England, the Chancellor will know that the Treasury’s private sale document made not a single, solitary reference to jobs or the future of the region, so what is its role under the proposals?
This morning, the BBC’s political correspondent described Mr. Branson as the “cat what got the cream”. I do not know what that is, but Mr. Branson appears to be the Government’s preferred bidder. Can the Chancellor tell us what Mr. Branson is going to contribute? My understanding is that he is proposing to put in £250 million in kind, not cash, to acquire a bank worth £100 billion, or 40 times that value. He has never run a bank, and I believe that the profits will be routed through a Caribbean tax haven, so what benefit does the taxpayer derive from his participation?
Finally, as the Conservative spokesman has already noted, Northern Rock shares have soared, while the British and other international stock markets have fallen. The only cheerful faces this morning were those of the two equity fund investors who made a speculative punt on Northern Rock a few months ago and have now recouped their investment. Meanwhile, the taxpayer is being taken for a very big ride. That will continue until the Government adopt the honest, transparent solution of taking the bank into public ownership.
Friday, 18 January 2008
This (from the BBC) is the latest data loss story:
Hundreds of documents containing sensitive personal data have been found dumped on a roundabout in Devon.
Details of benefit claims, passport photocopies and mortgage payments were included in the confidential data.
The documents were found on Thursday at a roundabout near Exeter Airport by Karl-Heinz Korzenietz, from Dawlish.
At the same time the MoD said a latop containing the details of 600,000 people was stolen from a Royal Navy officer in Birmingham last week.
I was shocked and surprised that sensitive papers like this would be lost like that
Mr Korzenietz said two months earlier he found similar documents to those found in Exeter. The Department of Work and Pensions said it was urgently looking into the matter.
Dr Monk said " I am honoured and delighted to have been chosen for this position. I will be the 102nd President, and there are some very august names amog my predecessors. This is the pinacle of my career."
Wednesday, 16 January 2008
The Telegraph reports this morning that Lord Digby Jones, the trade minister, has disclosed a 5 per cent shareholding in I-Clean, a cleaning company involved in Gordon Brown's deep cleaning of NHS hospitals. This appeared in the Lords register yesterday after being entered on January 8. An "administrative error" meant his interests were not registered sooner, his spokeswoman said. There is no conflict of interest, she added, and the shares are in a blind trusteeship.
This is odd. Last September, The Times found Lord Jones, the former CBI chief, was listed as a director of I-Clean in its Companies House-registered accounts and on the website. When asked how this conflicted with his role as trade minister, his spokeswoman said that he had in fact resigned but I-Clean two months before but the company had not yet submitted the documentation. "He resigned as a director of I-Clean on taking up his position as a minister. It is a matter for the company to file a form to update the registration." But should they, at this point, have mentioned the shares in the interests of transparency?
In 1999, against all advice, he decided to sell off 60% of the Bank of England's gold reserves. But being an idiot, he announced the sales well in advance, so that the price of gold was at a historic low when he sold. Indeed he sold at a price that was actually below the price of production of gold ; in consequence 80,000 South African gold miners were made redundant.
The current price of gold is four times the price at which Brown sold it.
(Oh, and by the way, it wasn't Brown's gold, it was OUR gold - yours and mine)
Tuesday, 15 January 2008
"Listen," said Mr. Hain, "this is important, and my secretary has already left. Can you make this thing work?"
"Certainly," said the secretary. She turned the machine on, inserted the paper, and pressed the start button.
"Excellent, excellent!" said Mr. Hain as his paper disappeared inside the machine. "I just need one copy."
Thursday, 10 January 2008
"If you go into hospital you will get screened by next year for MRSA or for C.difficile.
Gordon Brown, Sunday AM, 6 January
"Screening for colonised patients is inappropriate."
Alan Johnson's Clean, safe care report, 9 January
"We will also examine how all these changes can be enshrined in a new constitution of the NHS setting out for the first time the rights and responsibilities associated with an entitlement to NHS care."
Gordon Brown's New Year Message, 1 January
"Johnson discloses that he does not want the constitution to be enshrined
Interview with Alan Johnson, The Guardian, 9 January
If you need a thought-provoking speaker for a meeting, Dr Monk is happy to oblige. If you are a charity, there is, obviously, no charge. If you are a medical society, then all that we request is the fare money. If you are a commercial organization, Dr Monk is open to offers (but is cheaper than William Hague, and has better jokes).
Tuesday, 8 January 2008
Monday, 7 January 2008
No complaints about that,it's what we all want; but how is a personalized NHS compatible with downsizing district general hospitals (like Bedford) and centralizing services into giant superhositals? And why, if the service is to be more personalized is the NHS trying to prevent GPs referring to individual named consultants?
More spin, I suspect
Sunday, 6 January 2008
"I will provide a Public Service not a Public Convenience"
I will not open all hours, happily available to be dumped or pissed on by any passing, pissant politician or patient with the inclination. I will not have pennies, or anything else, shoved in my mouth, smile cheerfully and open my doors or my legs to order. I will certainly not pretend that I like it. I will not be handily available to deal with any and all bodily fluids man or woman may be heir to. Friends, I will not swallow.
I will not provide hand-washing facilities. It is not my problem to supply solutions, soapy or otherwise, to every grubby member, be these Members of Parliament or MRSA-ridden nether regions. Pontius Pilate can find another scrubber.
I will not provide sanitary disposal devices. The elderly may well take up a lot of medical care but so they should. They are old. They are owed. They are people not bed-blocking tins of beans. I will not help dispose of them nor help them dispose of themselves. BMA Ethics committee take note.
I will not provide a mirror for morons. I will not reflect and reinforce their pathetic, self-pitying views of themselves in the bogus name of empathy. I will not provide medical validation of their assumed victim-status at the expense of the sick. I will not be society's sympathy-sump. I will monotonously remind anyone ducking under my radar who isn't patently ill, that they can choose to get a life. Maybe not the exact life that they feel their uniqueness deserves, but a life.
I will not provide or become a Speak-your-Weight machine. Fat people have generally noticed they are fat. Telling them the obvious, in the absence of any effective medical intervention short of bariatric surgery, is not my job. Lifestyle dictation and regulation are not my reasons for being. I will not weigh and turn away the overweight in need of surgery any more than I would deny them antibiotics. I am not God, or more secularly, the external locus of control for an entirely screwed-up Western world.
I will not allow Bill Posters to stick anything up, in or on my pristine surfaces. In particular, I will not allow him to advertise services that cannot be, should not be, or are not provided. Unless of course this is a strictly private arrangement between me and my conscience. French classes after dark, maybe. An inadequate replacement for yet another trashed Genitourinary Medicine clinic or supervising DIY abortions at home? No.
To summmarise and comprehensively flog an analogy to death; I will not provide, or be a shoe or soul-cleaning apparatus. Wipe your clay feet on me and I will wipe the floor with you.
I will not be dumped on.
I will not clear up your every mess.
I will not be used or abused.
I am a doctor. It takes the best part of twenty years to make a good one of me. And there's a New Year's message the MMC mafiosi might like to ponder as they competently grind Junior Doctors into the dust. I am the ONLY person qualified to define and delimit my remit. I am certainly the person best-placed to decide how this remit could be fulfilled in a resource-limited system.
The rest of you, peasants, politicians and pseudo-managers can piss off(somewhere else) and die.
Love and Kisses,
A Public Servant.
DISCLAIMER : The fact I have been on-call since December the 8th has not in any way coloured my world view. That was Comrade Brown, in the library, with broad sloppy brushstrokes and great big buckets of hogwash.
Saturday, 5 January 2008
I watched with admiration at the professionalism and dedication of the doctors, nurses and other health professionals at the Royal Marsden Hospital this week. The way they coped with the unbelievable chaos surrounding them, gives the public at large a more accurate portrayal of the work doctors and nurses do within the NHS rather than the one often relayed. The selfless and dedicated manner in which they ensured that some of the most vulnerable people in society where protected and guided to safety shows the real face of the heart of the NHS – the heart of the doctors and nurses on the ‘shop floor’.
I also watched with interest at the entirely appropriate visit of Mr Brown and Mr Johnston to the Brompton Hospital to meet the patients, and workers involved in the evacuation from the Royal Marsden Hospital. As they shook the hand of the junior doctors, I wondered if they glanced into the eyes of the professionals in front of them. I doubt they will have any idea about how many of the doctors in front of them had agonised over the possibility of unemployment or the lack of training places in the previous year. The same doctors that now are rightly being hailed for their professionalism.
Indeed, the dark cloud of the 2007 medical recruitment fiasco has never really shifted, even though it has not been in the news headlines – people leaving medicine for good, emigrating to the southern hemisphere in droves, doctors displaced across the country…. the list goes on and on. You can’t blame the overseas doctors for this one – this is years and years of poor workforce planning by managers and politicians who I guarantee will be paid way in excess of any junior doctor or nurse.
The recruitment process has changed slightly this year, and yes, the multimillion-pound computer system is gaining dust somewhere, but again the numbers just don’t add up. A ratio of at least 3 doctors to every post means that the already despondent profession will have its morale burnt to a cinder.
Enough to set the fires burning in the hearts and minds of junior doctors…I think so. I have a strange feeling of déjà vu.
Dr Philip Smith
Sent to anyone that will listen
Friday, 4 January 2008
This little gem comes from his website:
ANYWHERE IN EUROPE !!
Whatever Mr. Brown says !!!
'Border Restrictions' on Health Care Treatment will be scrapped, under radical new laws being drawn-up in Brussels .. .. whatever our "Two Chancellors" government wants !
Britons will be able to travel ANYWHERE in Europe to access ANY treatment - from dental work to open-heart surgery; paying only for travel, accommodation and any top-up charges if their work is more expensive than that back home.
So there are hospitals in 27 different countries to chose from.
And if we travel abroad and enjoy our convalescence in warmer climes - and take our funding with us - what will that do for the calculations of our hospital 'managers' - who will be staring at empty wards ! empty coffers !! but full staff canteens !!!
Last year's court case, where pensioner Yvonne Watts won her right (and ours) to have her hip operation in France seeing that she was experiencing an 'undue delay' in this country, is the final piece of the jig-saw falling into place on this issue.
Over the past 5 years, some 3,000 patients have exercised this 'right' without having to resort to law.
It may not help 'ex-pats' living abroad; being designed for people making explicit trips in order to obtain health-care.
Well there are two main reasons:
Firstly, thanks to general cutbacks in the hospital sector, hospitals are running at occupancy rates of close to 100%. They were never designed for this, and it means that when a infectious case arises it is almost impossible to isolate it, with inevitable consequences.
Secondly, what does a poor patient lying at home, in pain and vomiting do? There is no longer an out of hours GP service, so they end up going to their local A and E; once they are there they have ample opportunity to spead the wretched bug to everyone else.
So, the government didn't cause this outbreak, but they certainly created the opportunity for it to cause chaos.
Wednesday, 2 January 2008
Has anything actually happened or was this just the usual Brown piffle?
Tuesday, 1 January 2008
It smacks of a degree of desperation - all rather like the magician who borrows an expensive watch from a member of the audience,smahes it with a hammer - and then, after much anguished brow-furrowing, confesses that he has forgotten the rest of the trick.