Saturday, 28 May 2011

Bank holidays, dogs, dentists and the coming of CQC.

The recent spate of bank holidays has given a few of us the chance to travel to places new and talk to others involved in medicine. One of our travels involved a chat with a dentist.

Dentists deal with mouths and teeth and have done very well out of NHS dental reforms. This have resulted in most dentists earning far more by doing less and have created the phrase of “doing a dentist” which if GPs did the same as a result of market led NHS reform would lead to very long queues outside those GPs who could afford to work for very little for the NHS as per the NHS dentists. A clear victory for NHS market led reform in increasing provision of dental care to those best able to afford it at the expense of those who need it most. Still toothache = see NHS GP.

We chatted to this dentist who asked of us how we GPs were affected by the Care Quality Commission (CQC). The overwhelming impression we got was that this was bureaucracy gone mental. In 20 minutes of a quite in depth discussion, for dentists are ahead of GPs here, one of us was reminded of an expression that one of the team who used to help out in remedial classes recalled being shouted out loud when one of the class couldn’t spell a word one of their peers thought was easy to spell.

The word was “retard”. As we spoke it became apparant that a lot of general practice time will be spent on matters of retardation rather than anything to do with medical care. Remember retard and retardation were words used to insult those who could only just spell 5 letter words better than their fellow pupils in a remedial class. Old words were revisited in the context of what crap, nay in grunt speak sh*t, is about to be inflicted on professionals by the Care (Blair) Quality Commission C(B)QC.

As we spoke more to this dentist about the C(B)QC process the word retard got louder and louder in our brains until we were told about the section dealing with dogs when an atomic explosion of retardation gone mentally ballistic occured.

Now forgive us for being thick at ND Central but when did dentists do dogs? Err perhaps we ought to rephrase that as to when did dogs become big issues in your average dentist’s clinical practice other than blind or support dogs? But we forgot there is a war on terror and as a result in the search for weapons of mass destruction as a large government “organ” the C(B)QC may be ahead of the game.

Maybe as part of the defence of the realm all dental practices are the new Home Guard and therefore have to have a policy on provision of rest rooms for bomb disposal dogs (Armed Forces Dogs section A), enemy combatant sniffer dogs (Police Dogs section B) as well as substance misuse sniffing dogs (Drug Enforcement Dogs section C). All essential for your average dentist’s quick look in your mouth, scale and polish and charge you service.

Maybe as part of the “patient experience”, a new C(B)QC retard buzz word for the buzz word bingo card, there has to be a policy on provision of crèches for dogs at dental surgeries?

With sub sections on provision by dental surgeries for dogs’ urinary excretion needs (quality care for clients’ dogs section 1.1.a), dogs’ faecal excretion (quality care for clients’ dogs section 1.2.1a), needs with special reference to disabled dogs excretory needs (quality care for clients’ dogs section dogs 1.2.1b), and special provision for dogs with Zimmer frame needs(quality care for clients’ care for clients’ dogs section 4)?

All essential layers of retardation for the provision of “care” and “quality” assured dental services (perhaps with a little red lion mark too?) at your average general dental practioner’s surgery. Ditto the same to come for GPs?

Now GPs are not immune to the layers of retardation that have come the dentists’ way for we have already seen the 6 inches thick of ring binders full of paper that needs to be completed. We can take comfort from the fact that if all those at CQC piled their brains up we would still be able to see these ring files from space with a magnifying glass for there would be no meaningful obstruction to the passage of light as that usually travels in a straight line unless it encounters a large quantity of dense matter called a black hole in which case the light might curve and render it invisible. (In our dreams).

It would only take 4 GP’s brains to hide them from view. If the C(B)QC lost their brains they would still be able to function unhindered and deliver world-class retardation and zero patient care but completing this monster pile of retardation gone wild sh*te will lead to many GPs losing their minds in the cesspit of alleded quality and care that is C(B)QC.

No doubt for general practice the C(B)QC will be more “rigorous” and “robust” and the layers of retardation will extend to cover other areas of Linnaeian classification so no doubt hamster and gerbil policies will be de rigor to ensure a “good patient experience” and maintain alleged “quality” and “care” as per the new Soviet style commissariat?

Figures we have seen suggest that 90 hours of work will be required to complete this monsterous pile of rain forest deforestation and intellectual retardation. If you are a single handed GP that equates to almost 3 weeks less medical care in order to demonstrate “care” and “quality”. Do patients want to see a completed C(B)QC folder or a doctor when ill?

Heaven forbid if a spot CQC inspection found that little Joanna’s visit to their doctor with a minor self limiting illness was compromised because the practice did not provide gerbil wipes for little Misha their pet gerbil who happened to do a whoopse in their travel cage in their 4X4 wally wagon parked in the practice car park and poor Joanna were to be distressed as a result of the lack of provision of a rodent rest room at the practice with gerbil friendly changing facilities (red gerbil mark anyone?).

They will be in therapy for years unless the C(B)QC and it fully retarded personnel are there to maintain high “quality” medical “care” standards via the important task of completing a tick box and devising “action plans” for the provision of rodent rest rooms and all things C(B)QC led improvement.

Now the dentists seem have got their act together in contrast to the Government stooges called the BMA and are helping their members (in contrast to the BMA). The Blair Quality Commission has powers without ability (sounds familiar) but is coming our way as GPs.

It is retardation gone wild and enables all of those who failed in the UK education system to get their own back on those who were bright. For there are not enough qualified people to inspect all those even more well qualified people who provide healthcare without compromising the provision of healthcare itself.

Instead it will be the job of those who have failed. Only those who are expert in providing layers of retardation can do this and there will be plenty of people made redundant from PCTs and SHAs who will be up to the mark and they will do so to the best of their exceptionally limited abilities but at least your gerbil will be well cared for as a result. Your grandparents will die as a result as their current leader is well qualified in not registering multiple deaths on their radar.

The CQC is not about care, it is not about quality, it is merely another layer of retarded bureaucracy and in having to fill in its mind destroying paperwork it will distract those who actually provide quality care from doing just that.

For if we, in healthcare do not fill it in “properly” to retard levels of “quality” and to retard “care” levels the retards can and will shut down the asylum and be totally unaccountable but at least we can take comfort from the fact that the gerbils will be well looked after as a result of the moron generated retarded enforcement notices and action plans if you pass.

Praise be to the Party of free enterprise for ensuring that with each Party the layers of retardation increase year on year despite their increasing promises of red tape reduction.

If it carries on at this rate the weight of the (gerbil friendly) protocols and bureaucracy will crush your average GP’s practice under their weight more efficiently than any Japanese tsunami and aircraft will never fly for the weight of pilot ticked retardation will be greater than the ability of the plane to take off.

And if the plane never takes off and the patient is never treated then no-one comes to any harm but rest assured all the boxes are ticked and all the policies are there to prevent harm (or treatment?).

Now that is important, isn’t it?

(We know we missed a doggie i before you start!)

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