If you are a GP or a
hospital doctor who has been in the game for a number of years, or a medical
student or a doctor in training you will have heard, or will hear at some point
during your career, the above statement or something similar from one of your
colleagues. Who makes such a statement?
It is usually a senior
doctor approaching retirement. Note what they say and its implications:
1) I love my job.
Most doctors' do but only
if it is just confined to providing medical care something they were trained
for, have spent years refining as a professional and hopefully getting it
2) I like seeing patients.
Most doctors like to see
patients and discover their as yet undiagnosed illnesses. It is challenging and
rewarding even though we know we sometimes cannot always treat our true enemy
3) I have had enough.
Have had enough of what?
Well lots of things each in
isolation a mere irritant but when such crap as appraisal, revalidation,
protocols, NICE, QOF, tick box medicine not good quality patient care, care
pathways, CQC, pathetic targets, yet another rearranging of deck chairs on the
NHS Titanic called "reform" etc.etc. get in the way of and make
treating patients harder not easier then something has to give.
An analogy we heard of is
that of the bamboo curtain. A single piece of bamboo is easy enough to snap and
walk through. But if you have many thousands of such pieces of bamboo arranged
around you row upon row of retarded centrally determined government policy,
locally enforced by PCT morons over many years that are medically of no use to
patients you will realize why GPs and hospital doctors cannot wait to retire.
Some retire early and use
their reduced pension to support themselves and also work as locums where they
get paid better to do less and avoid the administrative burden that hampers
their provision of good care.
Such statements are not
said the day before they leave. Often it is a few years before they do so and
by that time they have lost the urge to resist the institutionized retardation
that increasingly gets in the way of good quality patient care. So they quietly
plod on shrugging their shoulders as the next layer of bureaucratic retardation
comes along counting the days until they can get out.
Most will yearn for a
return to the past and almost all are fearful of the future for they know that
at some point they will become patients and they like not what they see being
done to their patients but they are powerless to change it. They can only
protest but no one listens for the power is no longer with the clinicians.
In a younger doctor people
would call this burnout but what would you call this pre retirement? Is a form
of Stockholm syndrome?
We have seen it many times
at ND Central over the years and also when we worked in hospital. It is like
looking at a brightly burning Olympic torch and watching the flame go out. The
torch is still there but the light has gone out.
The doctors' job is no
longer an inspiration it is a once proud inspiration which when they retire
will be put out onto NHS eBay for the next highest bidder for the job who will
go exactly the same way given time.
Praise be to the Party for
ensuring that highly experienced medics both in hospital and general practice
can't wait to get out. It is a sad reflection of how little NHS society values
its doctor's, and other workers' experience in the work place not by making it
better but by making it harder for them to do what they are good at.
And the Party wants to make
people work longer? Bet you that retirement on ill health rates due to mental
illness go up.
There has been a
very popular charity called Help for Heroes in the United Kingdom which you can
read about here. We will not dwell on it too much save to say that it seems to
fill in the gaps for those servicemen and women who are injured between what
the Forces' and NHS medical and social care provide.
On our travels we
frequently see people raising cash for them in all sorts of ways. Sometimes
even if you walk into a colleague's surgery staff there will be collecting usually
because someone they know or know off is serving or has served in the armed
forces. It was only founded in 2007 and seems to have caught the public
Well the Party has followed
this trend and come up with its own idea in he last few days and we would not suggest
that they have no imagination and are copying a successful idea but have a look
here and at the official website here.
Who would you
nominate to receive a "recognition certificate"? Will Mr. Lansley be
signing them personally and touring the troops to award them to the
"heroes" in the glare of national press coverage? Perhaps it will go
a stage further and a Lansley Star or Nicholson Cross be issued as well that
staff could pin to they uniforms for state visits?
Unfortunately he cannot, as
you have to work for, not have worked for, the NHS. So if you have nothing else
to do if you know someone who has a cup of tea, a hand to hold, a shoulder to
lean on who always goes the extra mile visit this website.
On the other hand it if you
know someone who can't hold a cup of tea because they have no hand, who has no
shoulder and who would love to walk the extra mile but cannot you may like to
consider another website we have mentioned and do something useful instead.
Praise be to the
Party for its complete lack of imagination and for taking the urinal by doing so.
In general practice all our
patients have friends and lots of them as a lot of our patients never attend of
their own volition. Someone, a friend, a relative or sometimes an anonymous
complete stranger always tells them to attend.
However a recent consult
made us think about just how many friends our patients have and how much work
these friends generate for us as GPs. Our patients' friends advise them daily
on health care surely obliterating the need for Big Party NHS (re) direct and
Take last week and a few
examples of what our patients' friends advising them:
A friend said I ought to
see you because I have had a car accident (and they said can you make sure
something is in my notes?).
Friend = money grabbing
patient/lawyer or claim's management company.
I could not sleep and a
friend gave me a couple of these tablets and suggested I have a few more weeks
of these to help me sleep.
Friend = drug dealer or
drug user who is using you to get currency. No deal.
A friend said if I get a
letter from a doctor I could get a holiday in Barbados/get a new house/a new
television like they did from the social/council etc.. . .
A friend said I did not
look well and should have a few weeks off as they thought I had (insert) name
of disease after reading (insert name of learned journal) magazine . . .
Isn't it amazing how many
friends our patients have in general practice all of whom have given such considered
opinions and worthy advice to our patients to attend their primary care physicians
urgently to address their health needs?
Praise be to the Party for
ensuring that as a result of all the friends our patients have GPs and their
staff will never ever be lonely. Best of all it doesn't cost their friends a
For those of us old enough
to remember such TV series as Quincy and MASH there was a perenniel message
of the Golden Hour whereby if a seriously ill casuality was transferred to a
trauma centre within an hour after resuscitation their chances of survival were
greatly increased. In the Korean and Vietnam wars the use of helicopters had
pioneered this before it was transferred to civilain practice.
Unfortunately the United
Kingdom is very backward in introducing new technology that works. So what was
available in Korea in the 1950s, in Vietnam in the 1970s is only now available
in the UK via charitable donations or commercial sponsorship. It is not provided
for by the Party unless in the form of the Air Sea Rescue or Coastguard
service. That is right dear reader a once first world country cannot afford to
provide air ambulances for its population charities do it for them instead.
So the story we refer to is
about how a hairy, our affection term for our biker breathern fellow road using
friends, discovered an anomaly in the way that the air ambulances provided by
charitable donations are taxed on fuel. So a Mr Ken Sharpestarted an epetition which
has attracted over 150,000 signitures and several mentions in Parliament.
charity VAT in fuel.
another charity no VAT on fuel.
Both are charities and
provide assistance to those in extremis often staffed by volunteers.
aviation private enterprise no VAT on fuel.
staff often providing excessive luxery to those able to pay.
So we thank our hairy
friends for exposing that while big profit huge consumers of fuel have 0% VAT
on their fuel a charity that has to employ volunteers to raise its income to
try and help injuried persons attempt to receive first world medical care NOT
provided by Big Dave's State are charged a VAT premium for the priviledge of
Big Dave's big society is
increasingly looking like care on the cheap and you can look after your own at
your expense unless you can go private when we will give you tax breaks.
Just goes to show you
always have to respect the hairies. As for Big Dave's Big Society . . .
Praise be to the Party for
ensuring that when when it comes to Big Society we all have to pay and pay some
more in addition to the tax we have already paid to ensure that the
"State" provides its citizens with an air ambulance service.
Thanks, call me Dave and
his little buddy hopalong Clegg, for showing how you expect the big Society to
work for your Chancellor's benefit.
There has been a lot about
the excesses of unregulated financial speculation in the last few days and we
suspect this will smolder on for a while but a lot will get away Scot free. For
those of us who daily do work on the golf course of UK general practice we have
encountered a new threat provided by some other unregulated free wheelers in
this country. While exiting the confines of Shiteton's vast sprawling urban
metropolis we encountered an as yet undiscovered hazard on Northernshire's
We are well used to early
morning pigeons, pheasants, deer, tanks, fallen trees and more recently floods
as a result of the idle Brown turd's dump on general practitioners and their
staff which is reflected daily in his work avoidance schedule but what we encountered
on a 400 yard straight recently bettered all of these hazards and dereliction
We were firing up the
Ferrari for a 0-30mph sprint when the onboard hazard proximity radar detected
slow moving incoming from 1 o'clock. The target was on a linear course which
did not deviate and at 400 yards away was on a direct head on collision course with the
Ferrari. The deflector shields were instantly activated and the photon torpedos
armed and readied.
As we approached to visual
contact we were met with a silver haired surfer preceded by a three wheeler
rollator (pictured above for the benefit of readers as a hazard avoidance
learning needs exercise for your PDP after your have filled in a SRT) who was
giving us no ground as they continued undeterred along the white line provided
in the middle of the road for the navigational assistance of elderly drivers.
You will be pleased to know that the middle wheel of the rollator was kept on
the white line in an undeviating military fashion despite the flashing lights
and horns of oncoming motorists traveling either side of the hazard.
This Ethelocet missile
topped with a dark blue all weather woolen cardigan and woolly hat tastefully
off set by a white night dress and slippers below in a torrential midsummer
downpour suggested something was not quite right. Even white van man took
evasive action most impressive as he was on his mobile at the time complying,
as did the Ethelocet with all current UK motoring and other legislation.
Now three wheeled vehicles
are traditionally the preserve of the very young in the form of tricycles or a
fad of middle-aged eccentrics or a necessity for mobility for the very old.
A three-wheeled Ethelocet
must surely be more hazardous than a rogue banker or free wheeling dealer and
is clearly a failure of the health and social care system and not the financial
regulator or the responsible politicians? Clearly we GPs need increased dementia awareness to stop this new scourge of unregulated free wheeling Ethelocets?
Mr. Speaker, it is only a
matter of time before an Ethelocet hits a white van and causes their driver
immeasurable harm and, as a result irreparable economic harm to this country.
Mr. Speaker, we need an
Ethel's law now or else. I commend Ethel's Law to the house . . .
While busy sitting in the
Ferrari that all UK GPs drive and listening to the Steps Ultimate Collection
album on a stationary downhill facing dual carriageway we did espy in our rear
view mirror the blue
flashing lights of one of the local ambulance service vehicles at full pelt
followed a few seconds later by the sounds of the sirens.
The traffic was nose to
tail and going nowhere fast as due to road works it was being channeled into a
single line and all lights were at red. Still having spent many happy hours in
the back of ambulances transporting critically ill patients between various
locations we thought we would do our bit and help create a clear passage.
As we checked our mirrors
we became aware that the two lines of stationary traffic we were stuck in had
parted to form a clear passage through the middle and the single line of cars
ahead had pulled in between the coned off section of carriageway in a organized
chevron like pattern.
As a result the ambulance
sailed through the congested roadworks unimpeded before everyone got back to
their former postions. All in a few brief seconds before the business of queing recommenced as
Now we know that this does
not always happen. With less than fond memories of ambulances and their police
escorts screeching to a halt and the air turning blue from the comments of
their crews expressing opinons about some driver's abilities while we
struggled to stay in a seat and at the same time prevent a ventilated patient from being
disconnected from their ventilator, it was a pleasure to watch as people with no
knowledgeof what the emergency was
cooperating to enable an emergency vehicle through.
We are sure the crew must
have thought all their Christmases had come at once and we certainly recall
being overseas where commercially run ambulances were frequently ignored in
congested traffic. While that ambulance was more likely than not on its way to
a non emergency like a little old lady in 5 layers of womble wear who had had a
faint due to being over heated in the muggy conditions it could equally have
been a paediatric cardiac arrest where seconds do count.
Certainly up here in
Northernshire road manners are usually better than our southern cousins but
what we saw made us proud that for a few brief seconds a group of individuals
who did not know each other acted independantly and correctly and may even have
helped someone they did not know as a result.
And then we were able to
continue listening to Steps with only the briefest of interruption too.
Praise be to the Party for
continuing to educate the Public about what to do when they see ambulance blue
flashing lights. Ignore them obstruct them at your will but remember one day
you might need them for real.
The Party loves to control and nowhere is that more
obvious than with the CQC (Care Quality Commission) whose current leader is a
failure as he comes from the same background as its former great leader Cynthia
“1200 deaths did not register on my radar” Bower in social services. If you did
not go to a Northernshire comprehensive school you will not be aware that in
order to be a social worker you have to be in the same bottom third of such a
school that they recruit NHS managers from.
So dentists and now doctors are to be inspected by a
retarded bureaucracy that is itself under performing in order to bring
standards down to their retarded level. Such professionals in order to make the
grade are usually examined by people far better qualified than they are. A
simple example of how retarded centralized bureaucracy was bought home to one
of the team who recalled a conversation from many months ago from a victim of a
CQC inspection who did not lie down and say I am wrong you are right. So look
at the image above.
This was taken by one of the team on a holiday at a
remote outpost somewhere in Northernshire’s vast hinterlands. Now if you showed
that to a retarded CQC inspector you would probably follow your own gut
reaction which is that is disgustingly dirty throw it away NO-ONE could drink
any water out of that kettle and live. Now if your holiday accommodation was inspected
by a retard unaware of local circumstances you would expect them to fail it
based on such “evidence“ and a moronic tick box mentality.
However if you think beyond the amoeba brain size of
the average tick box this kettle’s appearance might be impossible to avoid.
Large areas of the UK are covered by moor land with a peaty soil. Large areas
of the UK do not have mains water and so other sources are utilized for example
springs or water taken from streams which flow off peat moor land.
The water may be microbiologically pure but will
contain small fragments of peat - think what happens if you garden and split
peat- which even though the water is filtered will be present in the water. A
lot of people have slightly brown coloured water which is safe to drink and we
have even stayed in places where the water has been blue but in both cases was
completely safe to drink.
If you repeatedly heat water in a kettle in the same
way that lime scale forms in hard water areas you will over time get a coating hence the
picture above. Not harmful to health but not nice to look at.
Now back to CQC retardation. We spoke to a doctor in
training who was present during a CQC inspection which had failed their ward.
The reason? Not crap medical care but the CQC botmoron found that there were
clean urine bottles placed on the bedside tables of elderly male patients which
they also ate off. Disgusting you may say so the hospital management removed
The result? Not a massive drop in infection rates as a
result of removingthe clean bottles
but a massive increase in the need to wash bed linen and pyjamas, clean floors
all essential requirements of a CQC “approved” ward which pulls staff away from
real patient care to tick a botmoron’s box. Add inrelatives complaining about patients, sorry their relatives,
sorry CQC clients, who had previously been dry sitting in pools of urine and
wet clothing and think how much time can be wasted by a botmoron.
All this was the result of a CQC inspection which no
doubt improved the “quality” of the “care” provided. After all the boxes had
now been ticked and as a result of an “inspection” and a hefty fee
(page 3) onwards for the privilege of a botmorons’ visit.
the junior doctor to whom we spoke after a lot of aggravation the urine bottles
were reinstated. And all of the care “improvements“ which resulted in the
increase in “quality “of “care” which were dictated by the botmoron CQC
Now why might that be so? Well remember the top of the
tree at the CQC is a social worker and they are in the bottom third of the UK
in terms of academic ability. Their inspectors won’t be as bright and so they
could not put 2 and 2 together to make four while holding their best crayon
they just looked at the box and found it wanting so they signed with their
usual signature a great big X. and they felt epic!
The bottles were on the tables because this was a
geriatric ward full of frail old men who could only walk slowly to the
centralized toilets 2 four bedded ward bays away for there were not enough
staff there to help them. Coupled with the prostate problems they would have
they need to go frequently and with urgency but could not make the toilet in
time. Hence the positioning of the bottles.
Praise be to the Party for ensuring that whenever you
want to improve “care” and “quality” you employ a social worker to bring us all
down to their high standards.
This might be the start of a little series of CQC
watches as it is such a fit agency for purpose is it not? Just watch the news
as it tries to justify its existence but scratch below the stories and it is
No Care no Quality just another Commissariat YOPS scheme for
those who have always failed and that started when they were at school, in
their first jobs which led them to NHS management and where they are today.
Contact Northern Doc:
Northern Doc was once a blog originally written by a group of GPs in Northernshire and expressed their experiences and frustrations of working in today's NHS. The pieces were compiled at social meetings after work and published anonymously in a once free society. Following the Government's Medical Council clamp down on freedom of thought, speech and expression by doctors and our belief that the views of a few doctors DO NOT represent the views of the profession as a whole their views will now be written by and published by a journalist who has previously contributed to the blog by virtue of social ties. Any inference that the word Doc means a doctor is now purely coincidental. This is as of the 22 April 2013.