Sunday, 28 December 2008

Now we all have to be NICE?

What inspired this piece is an article in the GP magazine Pulse:

where a Party organ has said that doctors must now follow NICE guidelines or face prosecution. An interesting phrase “guidelines” as the Shorter Oxford English Dictionary defines them as “a directing or standardizing principle laid down as a guide to procedure policy etc”. It would appear that if the Pulse article is correct that guidelines have now become a Party diktat.

A lot of doctors ignore NICE as they feel they are politically and economically driven rather than scientifically driven. In Northernshire they are opened, the front cover scanned and then binned by and large and reference made to a variety of other sources journals, books and colleagues opinions before deciding on a particular treatment.

This is called being a doctor. As a doctor, rather than a Party organ, one considers the various options and applying what one thinks is best for a particular patient and their condition. However the Party knows best and if this idea is followed through patients will have any “choice” of treatment as long as it is black and NICE.

An example from the ND’s past experience may illustrate how this ill conceived idea would work in practice.

When ND was in the military, ND was stationed at a hospital that took part in the ISIS2 trial looking at clot busting drugs for heart attack patients. The trial was stopped early because the use of clot busting drugs was so much better than the existing treatments.

The senior medical officers at the base read the results of the trial and decided that it might be a good idea to stop the trial and treat all heart attack patients with the clot busting drugs. They went to see the commanding office at the hospital who was also a doctor, not a manager, and presented their view that the hospital should change treatments and he agreed after a short meeting and a review of all the evidence.

Thus within days of a major scientific trial being published this particular military hospital was one of the first in the State to use clot busting drugs long before many other neighbouring civilian hospitals did. This treatment has been is use now for almost 20 years throughout the world.

This is an example of doctors acting independently, considering the research and coming to a considered opinion before changing treatment for the better.

Now let us look at what would happen if NICE was the only treatment. We know that NICE considers things at a pace slower than a crushed slug can move so it would take months or years for them even to consider new research. Even if it did consider new research it would look at the economics probably have a political slant all of which could mean that something that worked might not be approved because of cost or Party interference.

So the result would be that the Party would approve and ration drugs even more than at present and medical innovation would be stifled by the fear of prosecution.

The Party and its comrade commissar managers rarely learn from history. Someone has not told them that the Berlin Wall has come down, the Cold War has ended and Communism in Europe is virtually non existent. Someone hasn’t told them that once centralized Party driven control was removed from the Eastern Bloc then countries with some of the worst health care systems in the world have risen up the league tables while the increasing centralisation of the NHS is one reason that it has slipped down health care leagues to be almost bottom.

We implore anyone reading this to think carefully about what the effect of Nicentralization would be on the NHS’s ability to offer cutting edge health care. We suspect it would end it and set back NHS care years at a single political stroke.

Let us hope that our faith in democracy and reason will over come the Party’s ill thought out centrally dictated policies that will ultimately harm patients and deny them “choice”.

Praise be to the Party for Gordon’s Little Green Book knows best.

1 comment:

Jobbing Doctor said...

Dear Northern Doc,

Its lovely to discover your blog.


Jobbing Doctor (North of Watford Gap as well).