Thursday, 19 September 2013

The true worth value and benefit of the GMC’s appraisal to the NHS is at last revealed.

Most doctors in the UK realize that the Party’s General Managers’ Council (the GMC) has become an organ of Party control as it completely missed a doctor called Harold H. Shipman’s failings in the 1970s. The GMC let him continue to practice for a good few years and get more kills (250+) than the highest UK fighter ace of WW2 but far less kills than the current ober killmeister of the NHS its head who has got away with Staffordshire et al but then there is no real GMC for those not bright enough to become doctors. Only knighthoods.

So a slightly confusing piece in GP online magazine caught one of the cynical GPs with whom we socialize eyes saying that GP appraisers will only get paid so much.

Look at the range of incomes for appraisers who are in effect the GMCs enforcers of (low) medical standards via, and excuse the grunt word, its p*ss poor system of doctor evaluation (humiliation) called appraisal and its little extension called “revalidation”. This is via the GMC’s new one man one commissar vote based system of approval for revalidation called “responsible officers”. So Soviet comrades how did you ever think of it all on your own (think Soviet, think Nicholson)? At least at medical exams you had at least 2 examiners some of whom would be external from your own medical school.

But ask yourself who becomes an appraiser? Is it a highly qualified well motivated always up to date doctor you would be happy to see? Based on a totally unscientific study on what has happened locally appraisers all happen to be: 

Dodgy doctors. 
Doctors who like money in large quantities £500+ on average for wasting another doctor’s time to do an appraisal in half an hour.
Rarely female. 

So the indirect conclusion is that to be a GP appraiser you only need to do a 2 day course, accept low health standards in your practice populations while self reporting exceptionally high health standards via QOF and do an annual update. Sounds suspiciously similar to the likes of Nicholson and Bower? Large amounts of money for missing the point and rewarding and sustaining institutionalized inability. 

A hugely skewed group of doctors especially regarding higher qualifications (or more often the lack of) given the local population and these doctors’ QOF scores far exceed their own patients’ population health statistics. Look elsewhere other than Northernshire and you may well find something similar. However can you find a list of who local GP appraisers are? Doubt it for even doctors are only offered a couple of names per appraisal and those are usual the ones no one wants to appraise them (ever) again. 

When appraisal was introduced GPs used to get paid to undertake this retarded piece of shite but within a year this cost of wasting all GPs’ time disappeared into the “global sum” a sum you cannot find in the Carr Hill formula (because you cannot find or see the formula) so any GP who feels that their time is wasted by appraisal can instantly see how this time was renumerted (not). Bet your appraiser, an alleged super doc, can’t tell you this either but they know exactly how much they get paid for being a Party stooge? 

What is worse is that locums will not get paid to do appraisals according to NHS England. Just think what happens if another unappraised doctor gets into the country or locums go underground? Earn money or be appraised which comes first? What an excellent way of maintaining standards equally for all doctors.

Most appraisers locally have their own problems, poor practice being the main one and saw appraiserdom as a way of ensuring that they would escape true scrutiny as they would be viewed by their fellow appraisers as “damned good fellows” for who appraises the appraisers? Unfortunately locally a fair few fell foul of people brighter than they and were removed. And hence there is a shortage of Party stooges, not good doctors, for we would argue that the two are mutually exclusive called appraisers. 

This latest attempt by NHS England whose leader is a certain Sir Neil Davidson “I am not responsible” is echoed by Niall “in your coffin of doctors’ freedoms” Dickson which between them mean that you have 2 bald headed elderly men who have never succeeded in anything dictating how those individuals with at least 3 A level grade points each better than they ever achieved collectively between them (allegedly) should perform. 

Think about those who have seen previously what was not there and think Gordon and Tony QOF, WMD and isn’t it about time the NHS got better than a load of Jeremey Hunts who think tick boxes and appraisal good?

They now think nurses should have something similar which will of course not stop another Beverly Allott but lots and lots of boxes will be ticked and there will be piles of paperwork to prove how good everyone is until the next maverick. Hang on comrades did not the nurses give doctors the flawed concept of appraisal and in return you want to give them the equivalent of revalidation in return? Most excellent retardation where will it end? 

The more frigthening thing is that in another article it is suggested that NHS managers, those in the bottom third of the UK's educational system, “appraise” those in the top 1% about whose job they know nothing and could not do. Can you see how this might work and the doctors at ND Central jest not for one of them had a similar appraisal a few years ago: 

Sir Dave “N” (appriaser): Harold S, I am a bit concerned that you are not meeting the Shipman target of 2 deaths per month per GP can you explained why you are not meeting target trajectories for GP deaths in practice? Being off target is not acceptable! 

Dr Harold H. (appraise): But I am Dark Lord for I set the target. 

Sir Dave “N”: Rubbish! The target has been reset we expect a much higher minimum death rate per healthcare professional to meet the high standards of appraisal and revalidation that I, we, expect. Have you any excuse why for the last 9 years you have not had a 1200 minimum death rate per NHS practising clinician like me or a single kill per year? 

Dr Harold H.: I don’t work in hospitals? I worked in general practice and have been dead for the last 9 years? 

Sir Dave “N”: Hmm. Nice try Shipman, thought you could fool me? Can I add you as another kill to my list? 

Appraisal completed Shipman you are now revalidated and licensed to kill again as per GMC mandate just sign here. You said you were dead let me sign it for you to get my fee. If you are truly dead then you can return to work at Staffordshire and we will turn a blind eye you rank amateur. Doctors they think they know it all, next . . .

Can I have my 500 sovs now I have completed the paper work? This appraisal work is much easier than claiming NHS expenses and so much quicker to do can I do some more say 6 an hour?

Our doctors jest not.

Praise be the Party for not realizing that if you pay peanuts you get monkeys but at least they will all be better for an annual appraisal and a quick revalidation won’t they?

(Apologies for not posting for a while some technical issues with blogger have prevented this).





1 comment:

Molan Parker said...

The things you have pointed out about the GMC appraisal and revalidation are right to some extent and the whole system needs improvements. As far as proper training and consultation is concerned get in touch with