Thursday, 27 August 2009

Liars, scammers, blaggers and Blue Badges.

We have all been accosted many times recently by our new senior head receptionist who has asked us if we had done some Blue Badge forms. These forms have been deemed, by the patient, to be “URGENT”. They had been on someone’s desk for at least 2 days in the midst of an alleged flu pandemic. Hence the patient used their God given right to abuse reception staff and chastise them for them not having got these forms completed to their satisfaction for no cost to the patient.

For those who do not know what a Blue Badge is, it is explained here. Normally Blue Badges are best seen in supermarkets in the parking slots closest to the entrance usually occupied by teenagers who have nicked their Grandma’s Blue Badge who are playing their 700W stereo systems in their Scoobys while their mate goes for 3 X 24 can packs of lager that they carry out to their car on their shoulders (unaided) and bare chested with tattoos on display.

There is even a possible black market for them if you read here. Why pay the London congestion charge when a nicked Blue Badge could let you in for free? There is also another market to help protect your tresured Blue gem if you look here and here. We love free enterprise.

The standard that is usually thought to qualify for a Blue Badge by the “applicant”, our patient(s), is that:

1) you are a whinging elderly patient who feels they are important as they claimed to have worked a lifetime
2) you have your state pension, bus pass and get free prescriptions so you automatically must qualify for a Blue Badge, and
3) your next door neighbour, who is a veteran world champion decathlete, has one so I must also be eligible for one as well.

GPs across the land are asked to confirm applicant’s “disabilities” by local councils who send out Blue Badge forms and yes, we do get paid for completing them by the local councils, but much less than a mere solicitor’s letter costs.

A simple little earner you might think and so helpful for “infirmed” and “aged” patients who run marathons and travel the globe on back packing expeditions? Remember, dear reader, this is Northernshire.

The average Blue Badge applicant is old and a lifetime liar. Examples include people who attend on numerous occasions fully mobile, seen in public and able to walk miles, who never need a wheelchair to go to California to visit their relatives but do need a little help with parking to get their cases of whisky to the car before they are off on the local hunt.

These same people, if their God given right for a Blue Badge is rejected, suddenly turn up in surgery wearing callipers, clutching crutches with a exaggerated Herr Flick limp that no one has ever seen them with before. Ever.

How dare their GP deny them a Blue Badge by asking them a question and honestly reporting their answers to the local council? At their calliper enabled protest appointment, usually an emergency, they will insist that they made a mistake about being able to walk miles without stopping and insist that the only way they can get to surgery is via their teleporter system after saying “Beam me down Scottie”.

We, who wrote this piece, did not realize how much a Blue Badge could help until you have seen how complicated it is, and how long it takes, to move a patient with a severe spinal injury into a restaurant from a purpose adapted vehicle. The person concerned had only limited arm movements and can just about manage a few yards on the flat in a wheelchair using the palms of their hands as propulsion as they have no finger grip. A kerb is impossible and they cannot drive.

While we were watching the friends concerned move the Blue Badge holder with the spinal injury out of the vehicle we were also watching the couple in the next door “disabled” slot in their 40s in a dinner jacket and long evening gown in high heals park and unaided walk across the road to a Rotarian function after getting out of their sports coupe, a low slung open topped Mercedes, proudly displaying its Blue Badge.

Without the Blue Badge our friends would have would have been knackered and what took 15 minutes of manoeuvring would have taken a lot longer. This was after getting someone out of a specially converted van to take a specially adapted wheelchair using a powered lift not a low slung Mercedes with no lift.

Most people with Blue Badges don’t do this, we mean they don’t have severe spinal injuries or are in wheelchairs. They are old miserable and think society owes them something for a lifetime of doing nothing.

Society owes a duty of care to those who are genuinely ill not to those that are just genuinely old. The hassle we have had as a Practice recently over Blue Badges from the pathetic old, as opposed to the genuinely ill, has been enormous.

The old scheme was the Orange Badge (of incompetence) that used to warn other motorists of the disaster on wheels coming in their direction but this highly visible warning seems to have been replaced by the less visible Blue Badge of European Patheticness.

Blue badge applicants hassle our staff more than patients with terminal disease. Sometimes it is the genuine younger patient with disabilities that don’t get them, as they have not yet mastered the art of how to lie, unlike their older forebears, and play down their disabilities. In contrast to the old who play down and lie about their abilities.

The old are those who voted for the National Health Service out of self interest, although at the time it may have seemed like a good idea. This idealism when young has been replaced by a cynical and manipulative abusive of a service for personal gain namely the Blue Badge.

If your car is nicked by a joy rider do not blame necessarily blame them. The old always blame the young. When it comes to lying, thieving and cheating the system the old have a head start. You need look no further than the Blue Badge scheme to see this in operation on a daily basis.

Any GP knows this. The patient “knows their rights” after all after a lifetime of not paying for anything related to health they are all automatically entitled to a Blue Badge.

At what ever cost. They take no prisoners.

Praise be the Party and its Blue Badge scam, sorry scheme. Can’t be anything wrong with that as when did our MP last get a parking ticket outside Westminster? They may well be, given their “age” and financial “infirmity”, entitled to a Blue Badge as well as all pigs are equal comrades. Are they not?

Tuesday, 25 August 2009

The Best Prepared Country for Flu in the world - a possible oops?

One of us was driving en route for a little late lunch (all our lunches are late) last Friday at about 14.00hrs and heard during the journey a Radio 4 news bulletin as we flipped the channels to help pass the huge distances involved in home visiting in Northernshire. A similar article appeared in one of the national papers too.

Swine flu seems to have died a death here in Northernshire, perhaps because the media have found, or been fed, other “stories” to concentrate on.

In informal discussions in the mess we did speculate if there might still be a few slight “increases” due although these speculations may have gone before we publish.

The start of the final Test Match and of the football season for the “I don’t feel well, boss. I have some Tamiflu do you really want me to come in . . .?” crowd might just cause a few slight blips of “swine flu”independent of media hype but related to sporting fixtures.

The news item says that so many doses of Tamiflu have been given out which, dear reader, DOES NOT equate to GENUINE swine flu cases. Estimates put the diagnostic (in)accuracy of swine flu as between 1 in 4 to 1 in 10 of prescriptions being given to patients who ring them who actually have swine flu. Based on our own personal experiences of patients not better after the magic wand of Tamiflu has been waved suggest that almost all of the swine flu line diagnoses are wrong.

This will of course be of great comfort to someone given Tamiflu with meningitis as if they tossed a coin they would have a better chance of getting the right diagnosis (using the coin) not the Swine Flu Panic Line. Heads you live, tails you die.

But still we all know that call centres and protocols are the way forward in medicine here in the UK as they are cheap, far better than (any form of) learning from (any) experience. In fact to use the newly discovered American expression this is true “Socialized Medicine” aka the current NHS.

No wonder the Americans who can afford private medicine are worried. They are like the British who cannot afford private medicine who are worried also. They know how crap the NHS can be. And is. Given a choice of seeing a doctor or ringing a call centre operative to make a diagnosis without seeing you, who do you think some of the most affluent and educated people in the world would opt for even if it meant paying a bit more?

You can see the first British moon landing being done by a gerbil with a protocol from a call centre in Watford rather than a highly trained astronaut who also happened to be a pilot. We believe the later was done by the Americans we doubt the British could do anything like it so the call centre, and the gerbil, will have to do, comrades. This is after all what the NHS does best care on the cheap.You may be able to fly a supersonic jet comrade doctor but the Department of Health insists you throw a paper airplane for your patients and call it world class aviation. They are so much cheaper than real aircraft or treatments.

Oh we must mention this.

A colleague has been asked to provide a note for a patient asked for by the patient’s employer to say he does not have swine flu. This is because another worker has been given Tamiflu and the patient’s boss does not want to run the risk of catching Tamiflu, sorry, swine flu, from any of his co-workers.

Nice little earner for any doctors here especially as we can’t test for swine flu if they wish to play this silly game for this particular employer. Will the airlines or the coach companies or railways be next? We have been asked to provide this type of letter for other severe life threatening illnesses like chickenpox by travel agents.

Remember this is the United Kingdom the worst prepared but best panicked country in the world to deal with a mostly mild viral illness.

Praise be the Party and all its plans. How could the “best prepared country in the world” have got it so wrong just like a lot of other but easily fixable things wrong in the NHS? No wonder the Americans are worried. If “socialized medicine” comes in the USA the UK could face a brain drain of NHS managers.

Would we be prepared and able to cope? Probably.

How have we managed without them thus far?

Monday, 17 August 2009

History does not repeat itself. Or does it?

For those who read the Mail on Sunday we are sure you will have been scared by their lead story about the proposed Swine Flu vaccine. The blogosphere has had this information for several weeks, nay months. This article here was found in June from this source from a link from this excellent site which we like alot. We liked the cartoon too!

If the story is true then it would appear that someone has alerted neurologists to a slight problem with a swine flu vaccine that was identified a mere 30 years ago when the US of A decided to panic and produce a vaccine that seemingly killed more than the disease itself.

The Party, being all wise, does not do history but does do panic par excellence. Those of us here at ND who do research feel that the prescription of Tamiflu, by the National Pandemic Flu Service, for a quinsy, otherwise known as a peritonsillar abscess, the treatment of which is usually surgical or high dose IV antibiotics, should be written up as a case study to pad out a CV but as far as we are aware there is NO formal audit of the Swine flu line’s effectiveness i.e. politicians being unaccountable for panicking.

So while the Party wants a huge vaccination program for what is at present a relatively minor disease whose mortality is less than that due to automobiles and is trying to divert the Public’s mind by pointing out that healthcare costs of vaccination of some £ 700 million for those evil idle GPs to vaccinate the Public, it seems to have ignored history completely.

Read the above links and make up your own mind. To panic, vaccinate and possibly kill more than the disease itself or to learn from history?

Praise be to the Party and all who ignore Fort Dix and the lessons learnt in 1976. We shall not say anything about history possibly repeating itself else re this and politicians acting in a similar way to those back in 1976 for these truths are self evident?

History will tell us the answer but at what cost and to whom? And who, if any, will be accountable if there is a repeat?

NHS Employers opt out

A lot has been written recently about the possible detrimental affect that the European Working Time directive (EWTD) may have on the training of junior doctors by an enforced reduction (by Europe) of their working hours. Not much on the effects of sleep deprivation which is a standard form of torture unless applied to junior doctors when it is called “training” or “experience”.

We are sure that most senior doctors would be happy if the pilots that fly them to their holidays were working the same hours as they worked as juniors in order to gain “experience”. Tired pilots are not a problem which is why their hours are so tightly regulated.

While trawling the net we stumbled across an item on the Remedy UK website about the NHS employers introducing a “voluntary” opt out form for the extreme crisis that is the current flu panic, sorry, pandemic. The form is here.

Now why would people at this stage even be thinking of such a form? Are we not the best prepared country in the world for flu? We are sure that those planners who have had many years to prepare for the ETWD, sorry flu, who were granted an opt out for several years to allow them to prepare for the ETWD,sorry Flu pandemic, are ready. Indeed, given our best prepared country in the world status for the EWTD (sorry Flu), Alan “Postman Pat” had to prepare an urgent review of the situation even though his Party had been in power for the last 12 years and knew it was coming.

We like advanced planning here at ND Central. See a hole in your tyre and NHS management will plan for weeks on how to repair it rather than actually do something useful like repair the tyre before it bursts. When the tyre bursts it is never their fault as they had lots of plans about this situation so we are all right aren’t we comrade? Flat tyre going nowhere = NHS management in inaction with Flu and EWTD.

We liked the wording of the form. Given that it is most likely to be introduced in a period of panic (sorry pandemic) we suspect that clause 2 will be modified to never give you notice about ending this agreement and clause 3 will become and work for free.

We know that local F1 doctors, who used to be called housemen aka housedogs, are now being asked to “voluntarily” sign disclaimers saying that they “don’t want to work a mere X hours a week please let us work even more hours oh please, please can we?”

We are sure these forms will be “voluntary” along the lines of if you don’t sign you won’t get a reference and hence might as well give up your medical career now. In the same way that Nazi SS guards would have said to their victims in a Sgt Wilson like voice “Do you mind awfully stepping into this gas chamber? It is, after all, for your own good.”

No hidden agendas here comrades the EWTD, sorry Flu, opt out form is for the good of the Party and its efforts to fight the Great Patriotic War against Pandemic Flu.

Given the state of the economy, should not EVERY person in employment be signing such forms? For example MPs should “voluntarily” sign an opt out form to forego their 82 day break. After all it is clearly a good Socialist principle to stop the exploitation of the working classes until that is you become the employer.

Absolute power corrupts absolutely. Remember the junior doctor who sees you in hospital gets 82 days off each summer. The politicians who dictate this sh*t* don’t. Or did we get this wrong somewhere?

Praise be to the current Party that was born out of evil employers taking advantage of their poorly paid overworked workers. La plus ca change la plus c'est la meme chose?

Friday, 14 August 2009

NHS Electronic Record Security

The supersecure NHS Smartcard prevents any unauthorised access to the system and provides positive proof that the holder works for the NHS.

Some of us here at ND Central are really sad.

Yes, we admit it, some of us enjoy computers and, yes, some of us read computer magazines to which we have subscriptions but we do also see and treat patients. We have done so for many years and amazingly this was once possible without the aid of the ubiquitous desktop computer. We still can but listen to any Party member and this is heresy as it is clearly inferior care especially when your pockets are lined as a result of NHS IT expenditure.

A small item caught our eye about the fact that the “super secure” and unhackable NHS Smartcard which restricts access of all but a few million to your medical records, if the Party has its way, might have been compromised in that someone has managed to hack the chip. Unfortunately we are unable to give you a link but if you have access to our source GP magazine more details can be found in 7th August 2009 edition pg 12.

It would appear that a court in one of the more liberal European countries called the Netherlands has ruled that details of how to do this can be published. If the article is to be believed it might have disastrous consequences for the smooth running of the health service. Imagine a PCT chief executive finding that their barrier controlled car parking space were to be taken by a hacker who has hacked the smartcard controlled barrier.

Of course they have been the official denials that security has not been compromised but it seems that more and more holes are appearing in the security of the ill thought out and expensive failure that is the leaking sieve of NHS computing confidentiality. We hacked it a couple of years ago after reading an article in the GP press and more recently another GP reported how easy it was to get into the demographic database. (The stasi know all about it before you get excited).

We suspect at some point he will be up before the GMC for a breach of patient confidentiality rather than being hailed as someone who drew attention to one of numerous flaws in the NHS computer policy. True Party members know that it is all perfect and that GPs who criticise it for being too slow, unreliable etc are all underworked, overpaid GPs who actually use the crap unlike those singing its praises who do not.

Still in this time of gloom there is a news item that the Conservatives, if elected, would ditch the NHS computing plan but read deeper, dear reader, and it says renegotiate the contracts which might mean an end to wasteful, needless, expenditure on computers but a wasteful, needless, expenditure, on contract bailout penalty clauses instead. Still we can live in hope.

Praise be to the Party who invented security and Burgess, Maclean, Philby and Blunt and have built security further on these leading lights. Must be time to start learning Dutch . . .

Wednesday, 12 August 2009

Tales from the Flu Line

Today we had some instances of how well the use of medically untrained call centre operatives are having a huge impact in the phoney war that is the current swine flu “crisis”. We saw our first patient who had successfully completed his free flu Tamiflu after ringing the Swine flu line service. He had seen one of us a few days before who had made the correct diagnosis (viral upper respiratory tract infection) and they had been given the correct advice (paracetamol, fluids and it will get better on its own).

However, because all patients here in Northernshire are more qualified than their doctors, as his minor symptoms did not get better after 2 curative doses of Lemsip Max strength flu cure and it was clearly a case of severe Swine Man flu he rang the Panic line and despite a constant temperature of 37 degrees he got a box of the magic Tamiflu and an instant week off work to watch the cricket, sorry, recouperate.

So in a controlled study of one, Tamiflu does nothing as he was still coughing although slowly getting better as one would expect from a simple but very common viral upper respiratory tract infection that most GPs will be seeing at this time of year.

The widespread use of Tamiflu in such people will almost certainly accelerate the development of resistance in virus(es) due to its indiscriminate use.

The second case yesterday shows how Tamiflu seems to be given out without any consideration of other medical matters. We tell our students that before they prescribe they must always ask about allergies and also is the patient on any other medicines to prevent drug errors. A patient had rung the swine flu line and was debating whether to take Tamiflu as he was on anti epileptic drugs so rang to ask.

There is very little information on drug interactions with Tamiflu (certainly none we could find in the prescribers’ bible the British National Formulary) and the Summary of Product Characteristics thinks that interactions are unlikely. We often joke that if a drug has no side effects it doesn’t do anything so does that mean a low risk of interactions is similar?

We do not know if swine flu line operatives ask about other disease and medications or allergies but it is a bit worrying that patients are thinking to ask these questions of their doctors before taking a drug that has not be prescribed by a doctor.

Praise be to the Party for its contribution to medical science by conducting one of the largest clinical trials of a drug not being prescribed by a doctor to unseen patients over the phone. Bet they got that one past an ethics committee in a couple of days?

Saturday, 8 August 2009

You could not make this up – could you?

We were here at ND Central were hoping to break the large amount of swine flu posts with something different but today institutionalised incompetence reared its ugly head again.

Readers may recall an earlier post about what the mask issued to our Practice to protect us would actually protect against.

One of our Practice nurses informed us 2 days ago that an Infection Control person was coming to collect the masks as there was a “problem” with the filters.

We shall keep you posted as to what this “problem” is, if we ever find out, although we suspect we know the answer as it might have been in our previous post.

Still the team will be on the phone to technical support at 3M the manufacturers and onto our colleagues at Porton Down and Atlanta CDC to find out if just perchance the local Thickerazzi have cocked up? After all given the option of a scalpel to do an operation versus a flint knife they would opt for the later as it is cheap and they would not know the difference as they still walk on their knuckles.

May be someone mentioned the “Health and Safety” word or asked a question like “do the masks work”? Imagine the commissioning process that must have gone on in a well prepared “world class” commissioning PCT.

Once again a top “world class” commissioning PCT in the “best prepared” country in the world sends out masks to protect us that now have a “problem” with the filters. And they want them back.

Why? To conceal the evidence of institutionalised incompetence?

We haven’t been given any replacements either.

It’s a bit like sending a soldier to war with a rifle and giving them ammunition that does not fit the gun. Yes, you have a rifle but it can’t do anything useful. Can we have it back please?

Praise be to the Party and all its wise planners. Did we also tell you that Tamiflu has already surfaced at local car boot sales? We are so well prepared it is unbelievable.

Thursday, 6 August 2009

Yoeh fellow educationalist dudes, the Dean dudes give us an update on medical education.

Deans Bilious and Tedious have been a walking near San Demonsville in the Waitrosa hills and have discovered certain organic medicines called Port and Stilton (most excellent for all Dean dudes’ health).

As keen most excellent dude Dean scientists they wished to pursue these substances - purely for academic purposes only.

Some other dude Deans have tried Crystal MTAS which is well good gear as it screws up the lives of thousands of young enthusiastic junior doctors but we Deans think we can try better to improve things educational here in San Demonsville, Arizona and have come up with a great idea called Choose and Book, sorry man we must have over consumed on our new discoveries, and come up with the new E-Portfolio (excellent air guitar moment).

(Remember children drugs are bad for you and our respected Dean dudes here in San Demonsville do not condone illegal use of drugs. A most excellent public health message from our esteemed Dean dudes for the safety of our younger readers).

Our learned most excellent Dean dudes, Deans Billious and Tedious, present their most esteemed thoughts about this revolution in education and other new matters around current modern medical education.

Please remember dear readers these are the thoughts of our Dean dudes who almost went to military academies and so any hidden meanings are those in your heads not in our esteemed Deans’ heads as they are airheads, says Dean Tedious’s dad, Captain Logan, a respected Police Captain, who approves this message.

So read, and party on, fellow dude readers:

Dean Bilious: Excellent port Dean Tedious! Your thoughts thus far, my most excellent Dean dude friend?

Dean Tedious: Thanks Dean Bilious. I thought the port was a little immature, Stilton excellent but that aside I would ask does that now mean that every junior doctors’ personal and sexual details will be on the World Wide w**k, sorry web, this Stilton, is most excellently cool? Did you say it had an organic herbal origin or did it come from a cow?

Dean Bilious: Tedious you know that Stilton comes from the Waitrosa hills no where else, I think, as does Port which is short for Porto Tesconia which is where the name Port came from dude.

Well of course Tedious it is yet another great New Labour social experiment in sharing everyone’s personal information so you know it will be most excellently secure in the same way after Port and Stilton your fly is always secure!

Dean Tedious: Whoa Bilious! I am most awesomely impressed with the security of my fly so this is most excellent news!

Is it undone?

I have my Smartcard that ensures that my fly is always most excellently secure as I think I am the only one with a password to my fly apart from my wife, mistress, all my post grads, the under grads, the faculty admin staff all of whom love to read about my cases but this is academia and things intellectual should always be freely shared . . . as I do with my most excellently secure Smartcard.

After all, if you need a pee, you have to go then and now and sod the password.

What are we actually taking about Bilious? I think I went off on one there, dude?

Dean Bilious: Well Tedious, had you not been drinking so much Port, we were talking about the fact that your caring family GP, Doc Northern MD, has now been asked to do an E-Portfolio on their current junior doctors in training. But hey this looks a little dodgy?

Dean Tedious: Bilious I take offense!

Despite us taking Doc Northern out to a meeting that must have disabled most of the A&E, anaesthetic, nursing and training GP departments at the San Demonsville Community General Hospital for the Criminally Insane and Pensioners for an hour for a five minute training session by some dudes from a real military academy called a Deanery (snigger) this E-Portfolio will be a great Government time saver as no one in training will have to keep paper records ever again.

Dean Bilious: Not entirely Dean Tedious. You seem a little confused over this and the detail, more herb, sorry Port, dude to clear your mind?

Yes and not only do their trainers and themselves have to do everything electronically like NHS (re)Direct, Choose and (re)Bookit but because it is a Party excellent idea (air guitar moment) they also have to print off the same information on paper for their trainees (and referrals) as well.

Dean Tedious: Do they need a password?

Dean Billious: Yes, but we haven’t sent any of them out to increase security and avoid your fly security problem.

Dean Tedious: Most excellent logic fellow Dean dude we like security. I like electronic things too especially if they buzz or crackle or vibrate. Can I have another glass to clear my head?

So trainees now have to spend hours doing everything on line like porn and then, when they have finished, print off the pictures, sorry assessments, on paper as well? Excellent a double wa**y!

Dean Bilious: Tedious do not discuss our most awesome on line teaching seminars with our undergrads in public. At least spare paper has a use for wrapping up certain things when you are a fully qualified Dean and exploring the science of combustion!

Dean Tedious: Whey Bilious I hadn’t thought of that dude! What is combustion? I just thought we were just being Government stooges again Bilious?

Dean Bilious: Tedious I take offense as we, as true excellent (air guitar moment), academics are impartial and would like to be recognized for our most excellent bogus scientific work if I could only think if we had done some.

Now regarding over producing UK medical graduates what are you proposing to do with this?

Dean Tedious: Easy we don’t employ them!

We make them apply for jobs they don’t want! If they get a job offer they have to accept the job within 24 hours as they are automatically excluded from any other job application. Take it or leave it Doc dude! Excellent!

Dean Bilious: What happens then?

Dean Tedious: We still don’t employ them!

Dean Bilious: So how do we fill jobs?

Dean Tedious: Easy Bilious, we employ doctors as “service posts” from overseas who meet the bare minimum qualifications for any UK military academy, that is not the most excellent Sandhurst, and send our excellent well qualified graduates overseas so spending a fortune in training them to benefit less fortunate countries like Australia, Canada, New Zealand, Singapore . .

And the trainee Doctors dudes have mountains of debt that no current Dean dude here down in San Demonsville would ever have incurred when they were training.

Shaft them and leave them dude as you would at San Demonsville High when you were a hot pre Dean dude?

Dean Bilious: I wish Tedious. This makes most excellent sense Dean dude after this serious stuff, more port Tedious?

Over produce doctors here, don’t employ them and when jobs aren’t filled after a head full of Crystal MTAS employ doctors from overseas in dead end jobs?

Dean Tedious: Excellent you have it in one just like being a Dean dude! More port and Stilton?

Dean Bilious: Finally Dean Tedious what is the 360 degree feedback and why does it take 6 weeks to do? Doc Northern MD was asking about this and I did not know?

And I was, Tedious my dear dude friend, sober and not stoned, sorry under the influence of Stilton, with him as we were talking serious haemorrhoids and I was in a compromising position. He was, however, wearing a glove with gelo on it!

Dean Tedious: Woey Bilious that is certainly a most professional Dean dude thing to be engaging with your family physician about educational matters and I am pleased he used gelo and a glove. Are they back in now?

360 feedback is where you get a doctor to turn around and around several times like we do after some port and charge them a fortune to prove they are still most excellent doctor dudes.

Dean Bilious: Bit like the GMC fee?

Dean Tedious: Most excellent analogy Dean dude but I don’t know if it is tax deductable but like the substances we use it is probably good sh*t*. More Port and Stilton fellow Dean dude?

I tried to do it once and the password and log in details didn’t work so I think it must have been a 320 feedback. Another great electronic failure costing the country, or the Docs stupid enough to do it as part of appraisal, dear fellow dean dude. It is most excellently bogus. Did we have anything to do with appraisal?

Deans Tedious and Bilious (in unison): Thank you for watching. Be excellent to each other and your trainees and Party on Dean dudes.

We are doing a most triumphantly excellent good job, we think?

Catch you later fellow dude Deans and all our trainees at our next most excellent educational seminar.

Praise be to the Party and all its most excellent Dean dudes.

With thanks to our many previous students, F2 trainees and registrars whose individual experiences and sense of humour inspired this piece. It is based on what they have told us about their experiences after leaving us many of whom have left medicine or gone overseas to continue their training often in specialties that did not wish to do but any job is better than no job. Crystal MTAS ruins lives. Good luck to Remedy UK.

Monday, 3 August 2009

NHS Flu Resource Desk. A vital component in healthcare in a “crisis”?

The world’s best prepared country to counter swine flu has just got even better. One of our team, the on call doctor no less, went to an “emergency meeting” to brief local GPs about how the plan is coming together even though it should have been seamlessly rolled out due to the advanced knowledge of all those involved in its implementation like we GPs on the frontline.

We were told that there was a Flu Resource Desk that had been operating ever since the pandemic was declared. This would cease its vital and well valued operations when the Flu Lines opened on the 23rd of July somewhat earlier than October when they were expected to be available so no panic here just excellent forward planning by the Party.

Flu Resource Desk? Must have been a closer guarded secret than the Manhattan Project but even the Russians knew about that one and they were several thousand miles away before the Internet. How come despite Connecting for Health we did not hear about this valuable resource?

Their exact terms of engagement are unknown locally and whether they could issue Tamiflu prescriptions is also unknown. But nonetheless it was there and with the advent of the Government’s Flu Line Service the “excellent” local planners who set it up can now shut it down happy that it has served its purpose. Whatever that was?

There will now be appointed by the local Politburo thickerazzi a group of 4 wise dickweeds, sorry Party stooges, sorry wise GPs (remember here in Northernshire we have more GPs than we ever need and that was before Lord Darzi) to ensure that the local underworked, overpaid GPs have come up with a contingency plan or sorry “a business plan” to cope with the Flu pandemic.

So taking 4 local GPs from a heavily “over” doctored area out of medical practice to individually visit practices and check that they have a flu crisis “business plan” is an efficient use of resources? What about in under resourced areas?

Now tell us dear reader, if people do not pay to use a service is there any need for a “business plan”? Or is it NHS failed management speak for we have a problem Houston get us out of it. Lets pretend to do something (useful?).

Listen up soldiers while managers have to develop business plans we just have to cope. Did their flu plans and flu “crisis” plans offer any help to us when every Tom, Dick and Harriet who was mildly unwell decided to phone their GP?

NHS managers flu plan = panic.

GPs flu plan = cope as best you can even if you are ill yourself.

Some more observations from the frontline of the phoney war against Swine flu which is still a relatively mild and self limiting illness in most people who have it although a small number will die. More will die on the roads each day at present. Should we be panicking about this and ringing our local Volvo dealers for their toughest tank just in case we have to go on a car journey?

Praise be to the Party without whom we would never have coped. They did so much to generate a crisis when there was none and so little to help with the problem they created. The grunts just worked on.

If the big one happens this winter we know we will be able to cope don’t we? 1919 the sequel, if it happens, will just be a re run with a few minor plot changes for example 1919 no intensive care units, 2009 no intensive care beds. And so on.