Thursday, 15 January 2015

You reap what you sow.

One of the most important qualifications to become the Secretary of State for Health in the United Kingdom is to have a complete lack of knowledge about the National Health Service. They introduce policies that have usually been thought up by a class of five year olds being asked how could they make a visit to their doctor better? You know the sort of things “I think if doctors had fluffy pink bunny chairs it will make me better”.

Target, after target, after target being devised to completely miss the target of most health professionals which is to treat patients not tick boxes. Current Tripartite health policies are akin to someone saying in the Second World War lets win this by taking Berlin and then deciding to take Kabul this week and Baghdad the next. Just think of another target and completely miss the point but redirect the troops in numerous different directions to achieve nothing useful.

Remember such schemes as avoiding unplanned admissions? Such a good idea say certain Party organs just like a named doctor for older patients (although patients were already nominally registered with a Dr) and QraPing.

All politically determined crap, all of which anyone who has worked in medicine on the frontline would realize would fail even before it started. The unplanned admission DES political joke has clearly worked as it has led to the current NHS “crisis” via admission avoidance via political diktat and hence there has been an increase in admissions to record levels. And did we neglect to mention the winter pressures/system resilience monies pumped in pre election? 

To paraphrase what someone who has been working on this wasting their time on this said politely “We have spent an hour with this patient writing a care plan, filling in boxes, deciding what to do if X, Y and Z happened and one chuffing phone call (can you guess to whom?) and they are admitted. What a complete waste of our f**king time for nothing”. (Sorry for the grunt word but this was polite compared with the original comment). And you can repeat this over and over again across a whole nation in every general practice. 

So a public school educated idiot felt it was far better to waste doctors’ and nurses’ time to write “care plans” to avoid unplanned admissions than for doctors and nurses to actually see and treat patients which might avoid admissions? At least there is a trail of paper to show that “something” has been “done” and the British public has been well and truly done.


And then there is the Tripartie private good NHS bad mantra. Just look at Hincingbrooke hospital. And the reasons given?

The A&E “crisis”?

So a hugely successful private, efficient healthcare organization (Party speak) can be derailed by the NHS market because a few extra patients turn up to A&E?

Most NHS hospitals will struggle because the Tripartite system of politics in the UK wants bread and circuses for the masses and they want it for free. The NHS is like a McDonalds where the great British public can turn up and eat to their heart’s content and eat for free whether they are hungrey or not. Just want and go.

The private sector are happy to provide a service but they expect people to pay for it. When they are not making money they can just walk away. The rest of the NHS has to try and live within its limited means profit or loss but the ideal is break even.

There is no crisis in the NHS for people get treated if they wait and are treated on the basis of medical need and not political want.

Yet politicians with no healthcare experience still know best as the above two examples illustrate so well and they interfere with healthcare for no benefit for the alleged consumer the patient, always their first thought after profit and self gain, before they bugger off and leave those in for the duration to pick up the pieces.

Praise be to the Party for ensuring that if healthcare professionals follow politicians and their enlightened diktats there will be no illness whatsoever. It has worked so well this winter after years of retarded, ill thought out planning and healthcare professional time wasting to deliver tick box ticking. No wonder NHS admission targets are up exceeding all centrally determined plans comrades.

Should there be a move to keep the idiots out of the National Health Service before they come up with some more bright ideas to waste other people’s time and divert those from delivering healthcare to delivering more bureaucracy instead?

Like cuddly pink bunny chairs or CQC et al?

Sunday, 11 January 2015

Vive la difference?

The doctors that we now have to act as voices for under the General Managers’ Council reporting restrictions wish to add their voices to ours and others across the world and express our sorrow at the cowardly murders of fellow human beings in France.

Terrorism takes many forms be it religious or political and suppression of freedom of speech or expression is common to both and is ultimately counterproductive as anyone who has resided in the UK for a few years will know. Remember Mrs. Thatcher’s attempts to deny Gerry Adams the right to be heard on television by using an actor to voice his words?

That worked so well as has the shooting of those at Charlie Hebdo as can be seen by the response of their fellow cartoonists.

Did we forget the widespread demonstrations worldwide?

Karl Marx wrote that religion is the opium of the people and it is said that money is the root of all evil. Perhaps it should be that religious or political dogma is the root of all evil for those who believe in it and dictate it can do no wrong for they write the rules and believe that they are above the rule of law.

We hope forlornly that there will be no misguided back lash against those of a particular religious persuasion the vast majority of whom like most of mankind will be harmless and not represented by a mindless few.

There will be no Praise be to the Party this time as their organs are doing what the murderers in France attempted to do but just use different weapons. 
A comment.

Je suis Charlie, nous sommes Charlie, vous êtes . . . ?

Tuesday, 6 January 2015

Post holiday greetings from the frontline up North.

Regular readers of this blog will be pleased to know that despite people living longer and being healthier in the United Kingdom the NHS is struggling to cope. We do not have severe cold weather, there is no flu panicdemic and yet the NHS is in “crisis”. The “crisis” is not that of record demand but of a politically generated arbitrary target not being met despite planning early and pumping money in. Indeed some politicians are starting to wake up to the fact that cuts in social care may be having an impact elsewhere.

Here at ND Central all annual leave has been cancelled, all surgeries are only for acute emergencies and all have been oversubscribed with wellness, patheticness and wasters who despite socialized education have failed to realize that health services are for illness not a pat on the hand and a cuddly RCGP hug, reassurance and there, there that must be so terrible for you.

A recent survey from earlier this year we came across showed that the commonest reason for an A&E attendance was neither an Accident nor an Emergency it was for “reassurance” not illness. A similar proportion of these attendances at an ACCIDENT and EMERGENCY department were there because “someone” told the punter “that they need to be seen”.

Just watch your average soap episode to see how long it takes someone to say “you ought to see a doctor just for a check. You can’t be too careful”. No different to general practice whereby no-one attends of their own volition.

The UK is full of such sages who are all knowing and wise about matters medical and that includes now the idiots who work for NHS 111 (dumb, dumb, dumb) who when consulted deliver advice to all with no wisdom or thought of the impact of their retarded thoughts or actions. Yes general practice also gets NHS dumb, dumb, dumb demand same day appointments becomes a call centre operative told me it was urgent.

If you want a check go to a bank. If you need a medical check (up) it is routine.

If you are ill then see your healthcare professional.

If you want reassurance ask your granny but then who knows in the UK who their grandmother is as the discovery of nuclear fission has led to the disintegration of the so called nuclear family and a “surge” for drone requests for home visits.

“I have spoken to Granny and she feels poorly can you do a visit for a “check” (on my inheritance)? No I haven’t seen Granny just spoken to her this morning, I haven’t told her I am ringing you and I am ringing from Istanbul”.

So this holiday period in the primitive cold windy snowy Northernshire surgeries at ND Central the commonest same day appointment has been along the following lines for about a third to half of all appointments:

I/my child has had a symptom.

I/they have seen an out of hours’ service doctor, or rung NHS 111, or been to A&E, or to a walk in center or even seen one of your partners – if you can get an appointment.

Most, if not all, have been told they have a (minor) viral infection which will get better on its own.

Most of these have been seen 2 to 3 times in the last 5 to 7 days for their same illness (which has not got better, pleading eyes it is so not serious) and all had been told the same thing. 

They have a virus and it will get better on its own given time. 

The most common symptoms are those of a cough +/- sore throat and in all of these consults the punters did not cough once despite telling, or more accurately lying to reception staff (that they had a really bad cough, not just a cough, and had not slept for 300 nights) and lied to their doctors that they were coughing all the time (but did not cough once in front of the doctor) such is the magical healing power of wasting another doctors’ time (again). 

All were told by the team at ND Central that they still have a virus and it will get better.

But still they came for nothing than a cheery chat with their GPs who merely told them what they had already should have known and had been told more than once already.

Remember dear reader that 90+% of medicine is done in primary care in most countries in the world so if A&E is struggling then spare a thought for what is happening in general practice. If our experience of so called medicine is repeated all over the problem is not that of illness (that will get better on its own) but of attitude.

We were reminded of this a few months back. If you give a privilege it becomes a right and what separates privilege from entitlement is gratitude.

The NHS is free at the point of abuse whether by a politician or punters and all of them believe that the NHS is a right free at the point of abuse and hence worthless.

And boy have the punters used their rights this holiday period but have we seen any real illness? 

24/7/365 no question. No charge. No comeback. 

Unfortunately the NHS was once viewed as a privilege but now is a right without any responsibility especially on the part of any politicians. Until those in charge realize who created this things can only get worse due to those in charge.

Praise be to the Party for inventing the NHS and A&E. It works so well for those nowhere near the frontline who fail to realize that they started the war and that their tactics are why the NHS is in “crisis”.