Khunta blames the guilty but in doing so completely misses the point.

British politicians of all of the Tripartite parties have certain things in common. Most are public school educated, rarely have worked in anything useful and rarely if ever know how the NHS works. Given their incredible qualifiacations this makes them most able to comment on anything that has happened previously for they all have Korsecofspsychosis.

So the current Secretary of State Khunta kinde has decreed that the current A&E problem is all down to the GPs. It is all down to GPs failure to provide "proper out of hours care". We presume he means that GPs no longer provide him with a trip to see "matron" ooh er missus whenever he didn't feel well?

Excuse me Khunta but who is responsible for and whose responsibility has it been to provide "proper out of hours care" since 2004?

Go on Khunta have a guess. It shouldn't be difficult you are after all the minister in charge of providing health care. Can't mange to think that hard we will give you a clue:

the Primary Care Trusts.

The PCTs were charged with this after the 2004 contract was agreed by one of your Tripartite healthcare partners using your market good, NHS bad, philospohy the idea was that GPs were bad at proving out of hours care and so the private sector could do better and improve it for a fraction of the cost it took to provide then.

It did within 3 years costs had tripled and out of hours care got worse. And that was the GPs fault for a service that they did not then commission? Excellent retardation Khunta a PPE graduate with a non degree and the ability to speak Japanese a difficult language to learn a few decades too late to be useful for your average FEPOW.   

Well Khunta doesn't know his history but he may just be right. After all the PCTs are now dead and have been replaced by Khunta Care CCGs which are meant to be run by GPs as the whole of the medical profession is behind your reforms - not.

Now given this 100% solidarity it should only be a matter of days for GPs to fix everything that the Trpartite healthcare system has given the British people since 2004. Give the GPs a break they have only been in charge 24 days when you made your statement.

What will be next a change to the GP contract to restore 24 hour responsibility that should be easy to do you only have to consult to do that? Maybe a new Dave "unaccountable" Nicholson efficiency gain sorry target to provide the out of hours for lessthan the £6000 a year your Tripartie predecessors thought that a professional with a minimum of 9 years training was worth per hour? Far cheaper than paying the National minimum wage and it gets the Tripartite health coalition off the hook too.

Come to think of it under Khunta Care things can only get better. If we could put an F between the K and C that should help market something but we can't think what?

Praise be to the Party for ensuring that whoever is the Secretary of Dtate for Health the only qualification they need is absolutely no idea about the NHS both now, in the past and the future too. 

    

Foot in mouth.

Our fellow alleged medical bloggers Dr Zorro (retired) and Jobbing Doctor (soon to retire) have both posted on the latest edicts from the Government's Medical Council (GMC) on their advice regarding social media with some very, very naughty grunt words which we suspect most doctors will echo in the same way that the GMC got it seriously wrong with their plans as the Party's thought police to regulate doctors' private lives. You can see the results of their alleged "consultation" here when most people with brains thought it was a step too far.

We suspect this advice will be the first of a series of small moves to reinstate this failed policy in a subversive way or as the Witch Doctor calls it creep (to their political masters).

Have the GMC made a slight omission and are they in fact acting in a very discriminating fashion towards certain doctors? We appreciate that totalitarian control freaks who consider themselves above all laws both British and European never make mistakes but a glance at some old GP magazines and BMJs reveals that some doctors dare to write anonymously or use pseudonyms in these journals. 

Is therefore according to GMC non-logic an article in paper format allowed to be published anonymously while the exact same content published on social media has to have the author identified if they are a doctor?

 

Of course paper is always easier to burn than the internet so maybe the GMC feels it has more control here as it can send the stasi round with some matches to a warehouse far more easily than have to observe the legal niceties that would have to be followed for phone and internet tracing/hacking and buildings do sometime burn down spontaneously, mi lud. Perhaps they will invoke anti terror legislation to track down those they do not like as there is a clear threat in their "guidance"?

 

Will medical students in the future not be allowed to parody anonymously their seniors in medical school reviews or publications? How will doctors be able to draw attention to the wrongs of a system without endangering their careers? Imagine Scot Junior and what the Deans involved would have done to every medical blogger that raised their abuse of power.

The local press is full of such anonymous criticism of local authorities and their policies but such activity is alright if you are a professional journalist. Journalists do not need any regulation. They have their own high codes of moral conduct and clearly feel that doctors need to be regulated while they need no such regulation for they are all honourable men.  

Extend the process further and will doctors when they go out in public have to wear yellow idents with the word doctor and their name written on it so that if they express an opinion in private/public for example with a group of friends it can be "trusted"?  

Will our purchase and consumption of 8 pints of Old Scroty Grudge followed by the  uttering of "All middle aged bald men are fags" or "If you want decent child protection call the Pope" or "I believe in abortion up to the age of 140 years" be construed as "may reasonably be taken to represent the views of the profession widely"? The GMC clearly feel that social media represents the profession perhaps more widely than it does? 

What about any doctor registered with the GMC who is resisting a corrupt regime and treats those injured by it who then posts about their involvement anonymously to bring injustice to a wider audience? Is the GMC either by the doctor following their guidance or by them tracking them down (allegedly mi lud) grassing them up to their oppressors?

 

So given their advice we will keep the Northern Doc blog title but remember it is a team effort based on a practice's experience of the current NHS so hence forth it is to be regarded as a blog written by a spouse of a team member who is a journalist and as such may, or may not, interview some doctors but will not have to disclose their sources.

As a result all posts appearing in this blog are fictitious. Any inference that the word Doc is a direct, or indirect, reference to a doctor, living or dead, is purely coincidental. 

We love freedom of the press. 

Praise be to the Party for allowing freedom of thought and expression anonymously to all unless you are a doctor. The thin end of what we suspect will be a very long and increasingly broader wedge if they get away with it.

    

Staffordshite. Khunte speaks.

So our newish Secretary of State for Health who after a hard night of resistance work at the infamous Café Michelle we christened Khunte kinda has finally spoken on the Francis report but he kinda didn't get it despite having weeks (months) to ham up on it. The UK headlines say that all new nurses should for a year work as health care assistants "to learn to care".

Clearly Khunte has never read the once excellent and much missed militant medical nurse's blog and her comments on the "kids" and nurse staffing levels here and in the land of the free a little point that Khunte has conveniently side stepped in an interview this evening for Channel 4 news by not setting minimum national staffing levels but leaving that to local (for profit) organizations like Staffie. The implication is that the nurses got it wrong not the local Staffie bull terriers (cough Nicholson, Bower et al).

Staffordshire was institutionalized, nationalized failure on a huge scale and but never individual failures seems to be the Party line but you can't blame the System. All three Parties want the NHS to carry on as before hence these token changes.

 

If Khunte wants to show he cares why does he not lead by example as do such humble people as Popes and wash the feet of a few patients? Perhaps we should extend his year of learning to care to all who work in healthcare from the top to the bottom?

 

Did Khunte as part of his medical degree have to wipe patient's bottoms, provide and clean bed pans on his first few days at work as a (clinical) medical student before you could learn the art of being a doctor and have your working hours dictated by a ward sister to fill gaps in her depleted work rota as cheap = free labour? 

Or maybe better as it is clear that at present no one is going to get the chop that all those involved in Staffs should be confined to a ward run at the same high standards as Staffie care for a year and see how many come out alive?

 

Khunte kinda doesn't get healthcare but he does get profit not patients. A whole year of pre nursing students working as interns will drive care standards up no end and help the private sector cut costs year on year. 17 546 HCAs @ say £ 14,000 a year = £ 245.6 million vs 17 546 newly registered trained nurses @ £ 21,176 = £ 371.5 million = a minimum potential profit (efficiency gain) £ 126 million.
 

And it was great to see Andy Burnham "in the crematorium" being the indignant one over System failures as he was one of the Tripartite leaders in health that over saw introduction of Foundation Trusts and the concept of profit before patients.
 
Praise be to the Party for always being right and politicians always being smartarses and dumping on those they dictated to to do their bidding.
 
PS apologies if Khunte's language isn't quite right for it was many years ago since one of the team was stationed in Brixton as part of our training.




 

Tales from the Darkside 003: the Dark Lord's whoopsies.

In our rapid descent into the Darkside it has become increasingly clear that GPs are being set up for a fall. The buzz words we have heard most frequently are "we want more clinical involvement" which sounds nice but it becomes increasingly clear that this means you rubber stamp what they say. 

For years NHS managers have got away with this for politicians think doctors are thick and that they know better. And the managers agree with them for they too are thick and always know better. 

So consider how you get to be an NHS manager outside of Shiteton PCT where we are blessed by Harvard and Yale MBA's from the most junior level upwards. The rest of the country gets this: 

The first dan is the comprehensive school failure who is not bright enough to get into the private sector but reads the back of the local free ads section and sees a salary (for doing nothing useful) when they realize that in order to get money you have to work something they never did at school. They do this for several years and as others go off with stress or pregnancy they are promoted because they are still there.

 

There is then a reorganization every few years and they increase the number of NHS dans on their belts not because they are good but because people leave and so they go elsewhere with increasingly longer job titles for doing less or nothing useful.

Eventually they become senior in a local Soviet and at the next reorganization "someone" suggests they move up and elsewhere. There is only one place that these otherwise unemployables can go. And that is always "upwards" for failure in NHS management is always rewarded with promotion. 

Anyone reading their CVs sees things like "I put toilet rolls into the toilets and it were epic" and immediately sees someone they can work as they are clearly gifted for they never thought of that and so they achieve Strategic Health Authority dan (Shadan) status for having done nothing ever for patient care. 

The same process continues year on year until they reach the Department of Health dan the elite Dohdan. This is rarely awarded on merit but usually as a result of acquiring several third world polytechnic "masters" degree(s) in non-subjects. 

At this level they usually have more initials than your average teaching hospital professor of medicine after their name and the complete inability to do anything useful like count. 

At this level the only level is up as the next dan is the Nicholson level dan the Cockupdan. 

To reach this you have to have done everything your political masters have wanted regardless of costs and with no interest in healthcare whatsoever. You are now an NHS Zen Master in delivering bugger all quality healthcare and you do not even need any knowledge of maffs or statistiks to get there. You only need to be an enforcer like Hitler's SA and SS. 

So our as yet brief sortie into the Dark Lord's realm has seen how this same process has evolved over the last few weeks in the following way: 

There is a problem. 

We (managers) want "clinical" involvement. 

We (then) ignore the clinical involvement (we asked for). 

We have got a promotion and as a result will bugger off and leave the issue we are supervising unresolved. 

A few months down the line we will be supervising this particular issue. So who will be criticizing the new boys and girls?

 

Those who did the whoopsies. 

Miss a Staffordshire and who can sort it out? 

Those who did the whoopsies in the first place.

 

Praise be to the Party for realizing that no-one is too thick for NHS management and for promoting everyone well and truly above their own level of incompetence. If this is happening at a local level we are sure that it won't happen any higher will it?

Did you know you CAN change the NHS? Here's how.

We have said before that the Party likes to control for in its infinite retardation about matters healthcare it always knows best. A recent use of a computer at ND Central which we rarely use allowed us access to the local Soviet's intranet home page.

 

You can take it as read that most at ND Central displaced this home page with something a little more up to date and useful like Google centuries ago but this was recycled crap via NHS IT support for a breakdown. However our chance misuse of its illicit homepage caused us to find a link to this a little gem which our naturally curious minds did proceed to explore.

Yes as President Obama said in the land of the free change is a coming and look at this website to see where in the NHS this is a coming from. If you wait long enough you might even get to read some pledges to date or do as we did and watch the little continuous rotating spokes go round and round and round. No taxpayers' money will have been spent or more likely spared on this little gem. It is clearly a worker sponsored out pouring of collaborative joy over the current NHS a la North Korea.

 

If you wait long enough you will see how many people in the NHS have so little to do at work that they have made a pledge but can you read them? The wheel is still going round and round and round. If you want to make NHS efficiency savings find each person who has so much time on their hands they can make a pledge rather than treat a patient and sack them?

Move your mouse down to bottom of the page and over the supporters of NHS change day and see how many have very similar surnames. Click on the view all section to see all and what do you get. You must be logged on to access that page. So clearly NHS Change Day is a grass roots all inclusive "change" day. Still you can marvel at the blue logo about the NHS change model.

 

Move down this page and tremble with excitement for this can be used to further your CPD (Continuing Professional Development) the current Soviet thought Police way of dictating medical practice via retardation or Continuing Professional Retardation (CPR as we call it) as you can see here. Click further to advance your knowledge here. (Link may or may not work if it does struggle to read the blue text telling you how.)

 

Clearly the new twitterati are the new intellectuals of British medicine via their CPR. So now tweet, read the chat, "reflect" on it and tweet it which means you as a doctor can pass appraisal. Excellent medical retardation. But what if you don't tweet? Will Niall send the boys round?

 

Or should we now just tweet "had my Nialls done and they look wicked", follow the subsequent chat, reflect on it and pass appraisal on the basis of tweeting? That should advance our knowledge of mitochondrial DNA related diseases by several centuries and mean we will continue to be up to date via CPR and Twitter.

 

When we tried to access this site at work we got repeated messages that we were allowing our secure NHS computer dinosaur access to a secure NHS website which meant that when we went to this page  the sentence on this page under the heading "Whose idea?" (a very good question not convincingly answered) that reads on a real computer as:

 

"One innovative suggestion can lead to a new way of thinking which could transform the way we work"

 

actually and repeatedly read as:

 

"which could transform the way we wo".

 

Is that short for woo for this site was full of it?

 

Praise be to the Party for its consistency in regarding the NHS as merely the provision of websites, call centres and now pledges as opposed to providing real time frontline healthcare. Anyone asked who actually benefits from such websites other than broom cupboards?

 

 

 

 

 

Tales from the Darkside 002: Gok does commissioning.

 

Now whenever you join a new "gang" as a NewbieCom (new GP commissioner) there is inevitably a steep learning curve which involves a trip to the ghetto to learn the new gang's language. There is also an induction process whereby all those thick kids at school who took the p*ss out of the boffs now have to tell the boffs how to do things properly (not).

 

The learning of a new language is hard and the term OD which to most doctors means overdose is now used for those of us NewbieComs to mean Organizational Development. We prefer the term institutionalized retardation.

 

Well girlfriends one of our first sorties into the murky world of clinical commissioning as NewbieComs was an eye opener for those fashionistas among us here at ND Central. We who would normally strut our stuff in a shade of green off set with a subtle hint of max factor face blackening blush were astounded at how much time the fastionistas in the local Soviet spent talking about CQUINs, darlings.

 

Don't know what CQUINs are darlings?

 

Of course not girlfriends you are mere GPs (as are we) and patients who pay for the health service so you don't need to know about these pretty, pretty sparkly things that cost you all so dear. And CQUINS are one of many of those many 'brevs (abbreviations) which those into NHS retardation have to work so hard to impress us with so pump those 'brevs hard girlfriends and work 'em ladies.

 

CQUINs stand for Commissioning for QUality and INnovation.

 

CQUINs are a classic example of NHS glitz and glamour versus old-fashioned real hard care medicine. As NewbieComs the local retards told of us how they "negotiated" many, many pretty, pretty sparkly CQUINs to "improve" local healthcare and they thought they were "epic" as they bored us with tales of daring do and how clever they were at obtaining value for money and raising care standards with their pretty, pretty sparkly CQUINS.

Until the NewbieComs read what the CQUINS were and dared to ask questions. The detail was hidden behind the briefing paper but doctors are used to reading huge quantities of information quickly and extracting useful data and using it quickly particularly when they see through the bull they are being bored with. 

NHS manager do the reverse they produce huge quantities of information and hide behind it thinking that those thicker than they will be put off by a huge pile of dung. 

We NewbieComs noted that half a million pounds had been spent to prevent a very common complication of a very common hospital procedure. We noted that what had been agreed between the local tractor plant and the local Soviet and signed off meant that the local tractor plant got paid to prevent this complication but managed to exclude every procedure that actually caused it via a pretty, pretty sparkly CQUIN. 

Remember dear reader that those who work in PCT land are in the bottom third of the UK comprehensive system while those in hospital administration are slightly brighter than that, but only just. 

The NewbieComs, after their speed read of detail that would have taken years to produce, dared to ask in a scene reminiscent of Oliver Twist where Twist asks for more, why in the agreement had the local Soviet agreed to exclude every procedure that could ever had led to this complication with the local tractor plant? 

There was a stunned silence as those in the remedial class realized that they had been done, to use a Northernshire expression, which means to have been found out by the teacher. Various excuses followed like the dog ate my homework, I left it on the bus followed by there was "clinical involvement" honest guv so it can't be our fault can it? 

The NewbieComs asked what "clinical" involvement was involved knowing full well it would have been a 20 stone 5 foot HCA whose sickness absence would have greatly exceed your average firefighter's days at work in the last 6 months and who would always appear to be the only worker in a BBC documentary on acute health care showing them serving numerous cups of tea and advising consultants on heart valve replacements and liver transplants dressed in scrubs. 

Only someone that qualified would have been available to those in the local Soviet to provide "clinical involvement" for they would never ever have done the procedure involved in the shiny CQUIN. 

CQUINs pretty, pretty useless things costing a fortunate and delivering sweet FA. What is worse with CQUINs is that after the first year where the local tractor plant gets paid for the work they don't do, the next year the pretty, pretty CQUIN gets written into the contract at no extra cost to the local Soviet. So in essence pay lots of money for nothing to improve nothing and get nothing in the following years and the tractor plant is laughing all the way to the bank.

 

Praise be to the Party for ensuring that if you exclude the bright in (world class) commissioning you get world class sh*t (sorry re grunt word). We would like to think it might get better but after our first few sorties into the dark Lord's realm we are sure there is plenty more to find.

The dark Lord is still in control as are his very thick storm troopers.  More Staffords vicar?

A trip to the doctors.

 

In Northernshire recently we have been bombarded by a series of strong gales, falling temperatures and snow on the ground causing widespread disruption which when combined creates the wind chill effect which means it is bitterly cold. To use the local term (politely) it is freezing our rocks off and there is more to come.

 

So one of the team, while on a trip to their own doctors, was amazed to watch the TV screens in the waiting room pumping out Party propaganda supplied via a massive satellite dish mounted on the surgery wall for the masses who were waiting for Party care on relevant health issues at this time of year. The team member was supplied every 3 minutes on the TV screen with information on how to deal with a heat wave.

 

Praise be to the Party for ensuring that in the same way that we were (probably not) the best prepared country in the world for the great flu Panicdemic our population via its state sponsored TV screens in surgeries will now be the best prepared country in the world to deal with a heat wave.

 

In January? In the United Kingdom in winter? You cannot make this up.

 

And people are being paid for this out of our tax pounds? What next how to deal with frostbite in the middle of a flaming (wet) June?