Saturday, 21 February 2015

NICE now to reward bad medical practice.

NICE (National Institute for Health and Clinical Excellence) is becoming increasingly desparate to try and dictate by diktat how NHS doctors should practice medicine. In any first world nation it would be a joke a despotic commissariat under the delusion it is doing something useful other than lick something political but under socialized medicine doctors are told to follow NICE guidance or else. However the worms may be starting to turn and not just doctors. 

A variety of sources reported on this story which we first saw here. Others took more rational slants which you can read here (greedy GPs) or here (dob a doc). 

Now socialized medicine in the UK is becoming very similar to socialized education. In socialized education the better you do academically the less input you receive from the Party. This is the principle that all pupils are equally dumb and as such all pupils are treated equally dumbly but some pupils are more equally dumb than others.

The reverse is also true in socialized education/medicine for if you are a disruptive failure then you went into class sizes of maybe 2 or 3 pupils to a teacher in contrast to if you were good you would be rewarded with class sizes of 30-40. If you were good and turned up that was just expected. 

If you were bad and turned up say 4 days out of five or more you got a star for each day you decided to grace skool with your prescence and when you hit five stars you got a prize, every week if you got all your stars comrade. If you did well and turned up every day you got nothing for doing so (although some might argue that as a result you may have done better in life as a result of being ignored by the Party apparatus and in doing so are allowed to contribute hugh sums to the Party for the privilege). 

So applying NICE’s retarded thinking and recent Party policy to some recent ideas can you see how this approach might work in medical practice? Take the great Westminister Hunt’s £ 55 per dement bung.

We know of a few local practices that did this work off their own backs a good while before Hunt even had his great idea and increased their dementia diagnosis rates for whatever that is worth in terms of outcomes (zero?) and then comes along a great Hunt who knows best.

When the practices who had already done this work asked if they too were to be rewarded for this they were told “Oh no comrade the work you did was counter revolutionary and such acts of terrorism against the Party will be severely punished as it was not ordered by the great leader and so was of no benefit to the Party. Hale Ming! Sorry comrade we meant Jeremy we have just watched a study video all this week.” 

So while the media reports an increase in dementia diagnosis what it is acutually reporting is that people who were not doing medicine that well are now being paid for what they should have been doing anyway but did not do so until they were given the great Hunt dement bung.

Ditto antibiotics. Will practices that have low rates of antibiotic prescribing be rewarded for doing well in terms of good medical practice or those delinquent practices receive huge bungs for reducing their antibiotic prescribing? In other words will poor medical performance be rewarded for doing better while consistent good medical practice gets nothing just like at school?

Praise be to the Party for once again rewarding duff medical practice by NICE and not rewarding good practice.

PS Please Sir shood NICE be spelked NIHCE?

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