Saturday, 21 February 2015

NICE now to reward bad medical practice.

NICE (National Institute for Health and Clinical Excellence) is becoming increasingly desparate to try and dictate by diktat how NHS doctors should practice medicine. In any first world nation it would be a joke a despotic commissariat under the delusion it is doing something useful other than lick something political but under socialized medicine doctors are told to follow NICE guidance or else. However the worms may be starting to turn and not just doctors. 

A variety of sources reported on this story which we first saw here. Others took more rational slants which you can read here (greedy GPs) or here (dob a doc). 

Now socialized medicine in the UK is becoming very similar to socialized education. In socialized education the better you do academically the less input you receive from the Party. This is the principle that all pupils are equally dumb and as such all pupils are treated equally dumbly but some pupils are more equally dumb than others.

The reverse is also true in socialized education/medicine for if you are a disruptive failure then you went into class sizes of maybe 2 or 3 pupils to a teacher in contrast to if you were good you would be rewarded with class sizes of 30-40. If you were good and turned up that was just expected. 

If you were bad and turned up say 4 days out of five or more you got a star for each day you decided to grace skool with your prescence and when you hit five stars you got a prize, every week if you got all your stars comrade. If you did well and turned up every day you got nothing for doing so (although some might argue that as a result you may have done better in life as a result of being ignored by the Party apparatus and in doing so are allowed to contribute hugh sums to the Party for the privilege). 

So applying NICE’s retarded thinking and recent Party policy to some recent ideas can you see how this approach might work in medical practice? Take the great Westminister Hunt’s £ 55 per dement bung.

We know of a few local practices that did this work off their own backs a good while before Hunt even had his great idea and increased their dementia diagnosis rates for whatever that is worth in terms of outcomes (zero?) and then comes along a great Hunt who knows best.

When the practices who had already done this work asked if they too were to be rewarded for this they were told “Oh no comrade the work you did was counter revolutionary and such acts of terrorism against the Party will be severely punished as it was not ordered by the great leader and so was of no benefit to the Party. Hale Ming! Sorry comrade we meant Jeremy we have just watched a study video all this week.” 

So while the media reports an increase in dementia diagnosis what it is acutually reporting is that people who were not doing medicine that well are now being paid for what they should have been doing anyway but did not do so until they were given the great Hunt dement bung.

Ditto antibiotics. Will practices that have low rates of antibiotic prescribing be rewarded for doing well in terms of good medical practice or those delinquent practices receive huge bungs for reducing their antibiotic prescribing? In other words will poor medical performance be rewarded for doing better while consistent good medical practice gets nothing just like at school?

Praise be to the Party for once again rewarding duff medical practice by NICE and not rewarding good practice.

PS Please Sir shood NICE be spelked NIHCE?

Saturday, 14 February 2015

CQC watch – a how to from dummies.

This week it was announced that one of the nation’s repositories for morons has published guidance on the use of covert surveillance.

Now given that in order to work for CQC the only qualification you need is to be a failure as its first head was (like the former head of the NHS she could not count due to a lack of fingers to 1500 deaths at North Staffs and therefore does quality) the thought of such an organization even understanding how cameras work let alone the word covert fills us with dread given what they are really interested in. 

It also beggers the question of how well they are actually doing their job. 

Still if you create a set of beaurocratic rules then if someone gives you some video that does not meet your rules then you only have to do what you have done for all of your working life.

Nothing useful.

Praise be to the Party for once again creating jobs for morons and failures. If they were actually doing the jobs the Party has created for them properly why would any patient’s relatives need cameras let alone guidance from failures on how to use them?

Thursday, 15 January 2015

You reap what you sow.

One of the most important qualifications to become the Secretary of State for Health in the United Kingdom is to have a complete lack of knowledge about the National Health Service. They introduce policies that have usually been thought up by a class of five year olds being asked how could they make a visit to their doctor better? You know the sort of things “I think if doctors had fluffy pink bunny chairs it will make me better”.

Target, after target, after target being devised to completely miss the target of most health professionals which is to treat patients not tick boxes. Current Tripartite health policies are akin to someone saying in the Second World War lets win this by taking Berlin and then deciding to take Kabul this week and Baghdad the next. Just think of another target and completely miss the point but redirect the troops in numerous different directions to achieve nothing useful.

Remember such schemes as avoiding unplanned admissions? Such a good idea say certain Party organs just like a named doctor for older patients (although patients were already nominally registered with a Dr) and QraPing.

All politically determined crap, all of which anyone who has worked in medicine on the frontline would realize would fail even before it started. The unplanned admission DES political joke has clearly worked as it has led to the current NHS “crisis” via admission avoidance via political diktat and hence there has been an increase in admissions to record levels. And did we neglect to mention the winter pressures/system resilience monies pumped in pre election? 

To paraphrase what someone who has been working on this wasting their time on this said politely “We have spent an hour with this patient writing a care plan, filling in boxes, deciding what to do if X, Y and Z happened and one chuffing phone call (can you guess to whom?) and they are admitted. What a complete waste of our f**king time for nothing”. (Sorry for the grunt word but this was polite compared with the original comment). And you can repeat this over and over again across a whole nation in every general practice. 

So a public school educated idiot felt it was far better to waste doctors’ and nurses’ time to write “care plans” to avoid unplanned admissions than for doctors and nurses to actually see and treat patients which might avoid admissions? At least there is a trail of paper to show that “something” has been “done” and the British public has been well and truly done.


And then there is the Tripartie private good NHS bad mantra. Just look at Hincingbrooke hospital. And the reasons given?

The A&E “crisis”?

So a hugely successful private, efficient healthcare organization (Party speak) can be derailed by the NHS market because a few extra patients turn up to A&E?

Most NHS hospitals will struggle because the Tripartite system of politics in the UK wants bread and circuses for the masses and they want it for free. The NHS is like a McDonalds where the great British public can turn up and eat to their heart’s content and eat for free whether they are hungrey or not. Just want and go.

The private sector are happy to provide a service but they expect people to pay for it. When they are not making money they can just walk away. The rest of the NHS has to try and live within its limited means profit or loss but the ideal is break even.

There is no crisis in the NHS for people get treated if they wait and are treated on the basis of medical need and not political want.

Yet politicians with no healthcare experience still know best as the above two examples illustrate so well and they interfere with healthcare for no benefit for the alleged consumer the patient, always their first thought after profit and self gain, before they bugger off and leave those in for the duration to pick up the pieces.

Praise be to the Party for ensuring that if healthcare professionals follow politicians and their enlightened diktats there will be no illness whatsoever. It has worked so well this winter after years of retarded, ill thought out planning and healthcare professional time wasting to deliver tick box ticking. No wonder NHS admission targets are up exceeding all centrally determined plans comrades.

Should there be a move to keep the idiots out of the National Health Service before they come up with some more bright ideas to waste other people’s time and divert those from delivering healthcare to delivering more bureaucracy instead?

Like cuddly pink bunny chairs or CQC et al?