Saturday, 10 September 2016

Greedy bastards.


The Party is as ever all wise and believes in a fair day’s pay for a fair day’s work in all commercial organizations like the Houses' of Parliament, banks, stock brokers and the like and applies its free market principle to all and sundry with one notable exception which is the NHS.
A small piece of non news caught our eyes as it shows once again how greedy bastards are getting paid extra to do extra work something that would not happen in any other industry. Can you imagine asking a builder to work on a Saturday or a Sunday to finish a job on time because they were behind schedule? We are sure the conversation would go something like this:
“Comrade customer I am so very and truly sorry that we have not been able to finish the job on time but I will forego taking my children to the seaside this weekend and my summer holiday and I will work 168 hours a week to finish the job as agreed on time. It is a privilege and honour to work for you comrade customer and I shall not ask for any tea and biscuits or even money in case the need for food and drink and the toilet interferes with me working non stop”.
Now imagine a hard pressed comrade hospital commissar manager asking an idle hospital consultant who never works weekends if you believe a certain Jeremy Hunt to do the same.
The hard pressed consultant brushes their hair back and pulls a half smoked cigarette from behind an ear before taking a few stressed puffs from it after lighting up while looking worried and concerned at the comrade commissar’s request and shaking their head from side to side, tutting and tapping the ash from their cigarette before saying:
“That’s not gonna be cheap mate. It’s gonna cost you time and some mate. I can just about squeeze you in which ain’t gonna be easy because I’ve got more jobs on at the moment than I have comrades to work them and we are in a recession you know . . .”
So once again the press point out that market forces using the supply and demand curve mean that if there is a shortage of supply but increased demand then costs usually rise but this is verboten in the NHS “free” meerkat. Costs comrades should be zero regardless of demand for all who work in the NHS.
If you put the £ 350 million overtime into context with the overall spend and these are approximate figures from various sources then this represents about 16% of total consultant pay but remember comrades compare that with estimates of the total cost paid to all locum staff say £ 3.3 billion and for those on medical top dollar salaries £ 350 million is a small percentage of total agency spend (10.6%). And curiously the same cost of the alleged weekly benefit to the NHS from brexit so why is the BBC unhappy?

It means that full trained staff can be used to plug the gaps today rather than waiting for the Party to increase supply which will take at least 15 years if they recruited extra medical students today as demand on the NHS increases unabated. Or take the chance of possibly dodgy locum cover? (Before you start we are aware that locum staff have the same good, the bad and the ugly just as regular staff do). 

And did we also say that it costs 25 times more to fill locum posts than it does to have full time posts? Clearly the meerkat is working for the meerkat not the comrade patient.

And remember some highly trained professionals choose to work as locums for the following reasons:
1) better pay
2) choice of hours to suit family commitments
3) post retirement to top up pensions and do a job of pure clinical medicine they enjoyed without the Party add on of retardocracy that they hated and resented that went with the day job.
Still there is a solution and Jeremy knows how to do this. He will just change the contract. Perhaps the consultants will agree to the same contract as the BMA got for GPs in 2004 whereby the Party only has to “consult” about changing the “contract” each year and does not even to bother doing this now knowing that they can in true Soviet style enforce it. Maybe a consultant QOF too to make bugger all difference to patients’ healthcare other than “inviting” them back to consults for nothing more than to tick a retadocrat’s QOF box.?
We are sure the Party will want any extra consultant hours to be done for a no extra pay for extra hours clause in any new contract just like they did with GPs, junior doctors, lawyers, bankers, plumbers, builders and so on for comrades when it comes to exploitation of the NHS workforce in the NHS “meerkat” we are all in it together.
And Jeremy understands a contract as a voluntary agreement between two parties enforceable by law as a contract by Jeremy and for Jeremy take it or leave it using the concept of Party NHS “Choice”.
And interestingly the same news organization has no qualms about highly skilled operatives in a different profession that people pay for when they use it being paid a mere £ 220,000 a week after tax in contrast to the salaries commanded by consultants and GPs in healthcare.

That is the equivalent per week of the total annual earnings of 2 above average paid GPs per year total income BEFORE they have to paid their tax and after they have paid their staff and expenses.
Praise be to the Party for again once explaining to those in the NHS that extra work is to be done for no extra pay for they understand this for builders, footballers et al they pay for but the NHS is completely free at the point of abuse and should cost nothing extra for politicians to misuse it even more. Seven day working anyone?
You know it makes financial sense, simples?

Wednesday, 31 August 2016

New ideas, old ideas?


You have to admire those in charge at the BMA for being so in touch with its grassroots membership and for being so in tune with those in charge of the Health Service in their endless quest to support their members for gongs that they have come up with a whizzo wheeze to solve the GP crisis and restrict workload. You can read about the wheeze here and if you want it from the ass’s horse’s mouth the link at the end of the first paragraph after the header GP Workload will take you there to a document called “Safe Working in General Practice”.

So having signed the peace in our time document with the Party to avoid a possible vote on mass resignation and loss of gongs for the BMA leaders, its leadership have agreed to promote Party policy as the means of solving the GP problem which in a nutshell is too much demand and very limited supply.

To avoid opening a second front the document and its authors lists a series of six principles that you can read in the article towards the end and if this was presented by NHS managers your buzzword bingo card would be full by the end of the first paragraph but nonetheless the language is the same as recycled flawed thinking that working smarter and IT will reduce unmet demand.

Now hubs is currently a buzzword but haven’t we had these before? Walk in centres and Darzhole centres all supposed to reduce GP workload and A&E attendances?

They weren’t called hubs then and the BMA document says that these new hubs are “not walk in centres” (pg 5) and on page 6 the hubs would only offer same day urgent appointments which is great as all unmet demand in general practice is for same day urgent appointments rarely if ever for urgent medical conditions that require immediate medical care just patient want. 

The "I want somemit now so give it to me for free it’s my right whatever" principle. 

It does not take long for Party speak to sneak in for where have some of the team heard the phrase Multi-speciality Community Providers (MCPs) and the term hub before?

This appears at the beginning of page 5 but note the fact that the BMA gong hunters have dropped the word “community” which is the C in the MCP initials and they describe it as a “multi-specialty provider”. They are either dyslexic and/or thick and confusing their C’s for S’s or they are glossing over the fact that MCPs are yet another Party vehicle to dump hospital work onto GPs albeit in “hubs” or GPs working together, "at scale" or in Federations of the sizes quoted in the document and all Party approved/determined "options".

So well done chaps and chapesses at the BMA for coming up this pile of recycled guano which will be as much use as the creeping barrage was to the troops on the front lines in World War 1. Lots of bangs and flashes to achieve nothing useful for the boots on the ground. 

One principal, and the most important the seventh, is conspicuous by its absence and that is where is the extra capacity coming from to create these hubs in terms of fully qualified GPs? 

Time for a rousing rendition of the World War One song Over There! to lift morale we thinks on the front line as the BMA solves the problem and this clip shows exclusive footage of the architects of this leaving BMA headquarters in all its modesty and selling it to the troops they have enthused to sing along and their attitude towards their members. 

Praise be to the Party and its bumchums Allies for doing everything to solve a problem other than defining and addressing the actual problem itself. With all these these hubs from Narnia comrades the war will be over by Christmas (once again).



Sunday, 24 July 2016

Baubles, beads and trinkets the new Manhattan deal for general practice.

There are some real morons at present who are medical “leaders” and false “professors” as can be seen by this latest announcement from a certain Royal “College”.
Now if you were a GP wanting to return to practice what would you want to tempt you back?
1) Not having to pay a minimum of just under £ 11,000 a year for basic medical defence insurance? Of course not patients are far more important.
2) A highly paid stress free job, free of the NHS institutionalized bureaucracy one of the reasons you left in the first place whereby seeing and treating patients was (once) an option and the reason you became a doctor in contrast to today’s box ticking for bureautards fully supported by a certain Royal “College”?
Of course not, comrades, reflection is far more important than treating patients it achieves bugger all (for patients) other than ticking another box for retards. 
3) A job with reduced workload (most GPs leave because of workload) and the opportunity to see real illness in contrast to socialized inadequacy?
Of course not comrades completing an e-portfolio each year is far more rewarding and important and so by adding to workload it merely reduces your stress after seeing the odd patient who may, or more likely not, have anything wrong with them but the RCGP does not do illness.
4) No annual appraisal or any other such crap (all for the benefit of the Party and its bum chums at the GMC et al)?
All of which are but some of the (many) reasons why you left as a GP in the first place.
So if a Scottish womble says ah way hin, that must be terrible, I feel your pain and while I am here can I explore your Ideas, Concerns and Expectations of why you wish to return (not) to practice and do absolutely nothing about your problems after pretending to listen while appearing concerned and then goes on to say I think I can help, would you like a free year’s membership of the RCGP as there is a loads of evidence of its benefits together with that of  crystal healing, quantumtouch and homeopathy? 
We suspect that most GP (even) thinking of a return to practice (after 20 pints of Old Scroty Grundge and a serious head injury) would view this in the same way as someone asking you to come and see some puppies. 
Most GPs of a certain age who actually had the option of joining said Royal “College” would think and would once have known the true meaning of the word to “ice” someone.
Currently membership of this alleged “college” is compulsory as they are the Party groomers of GPs to be to fix social not medical problems and as such the “College” has a degree of (political) impotence but most GP registrars are bright enough to realize that its methods are so flawed that they are retarded (sic the e-portfolio, reflection et al) although its alleged “leaders” think otherwise.
GP registrars also know that such reflections can screw them more than their trainers do now but none at the RCGP can see this for most believe that the sun revolves around something dark called reflection which is essentially the art of self colonoscopy with the light switched off and then saying I can see everything more clearly now to your trainer or appraiser.
So if this is aimed at GPs who have left general practice and maybe older ones we are sure that those proposing it on high think that GPs can still be bought by baubles, beads and trinkets from the RCGP when schemes offering tens of thousands of pounds have failed to attract GPs to general practice posts. 
The war on the lack of GP recruitment will, comrades, be over by Christmas by this simple, innovative intervention of the RCGP for less than the cost of a First World War rifle (Lee Enfield) today by provision of up to £ 519 of RCGP membership will mean that GPs not currently in practice will like lemmings be flooding back soon in droves to return to work.
Clearly many hours of institutionalized retardation at the Royal “College” will have led to this earth shattering idea and we are sure that they will reflect at length on its success when it achieves absolutely nothing useful like a GP returning to work. Their e-protfolio will be full of brown stuff with which to discuss with and impress their appraiser. 
The muppets retaking Manhattan perhaps by a “New Deal”? You can see Jeremy’s smile now as he knows he will meet his 5000 new GP target thanks to his friends . . . 
Praise be to the Party for understanding why no-one wants to be a GP and thinking that baubles, beads and trinkets are the answer. And that is just those that claim to represent the profession that they do not understand.