|
CLICK
the PIC
|
25 January, 2003
FRONT PAGE The lead article is devoted to the plight of overseas doctors who are having great difficulty in having their applications to work processed. This contrasts starkly with those from virtually the whole of the European continent whom our European political masters demand we allow to work here even if struck off in their own country. Whilst this application matter is a very serious problem and once again highlights the fact that Milburn can't get his act together, it is not the most serious problem consulting the BMA today. That is starting an initiative to reform the NHS so that British doctors want to work in it again. Under the leadership of Milburn whose IQ does not seem to have burst through his glass ceiling of 50 yet, there is little chance of any improvement. CCSC, the consultants' "union" is taking professional advice about how to confront said gentleman. Will GPC take the hint? Doubtful, doctor, doubtful. In his pell-mell political dash to increase the number of consultants - as promised in the ludicrous NHS Plan - Milburn is promoting the shortening of consultant training. Another example illustrating the glass ceiling of the Secretary of State. Dumbing down for the sake of increasing numbers is OK and perfectly safe, he thinks. Well, so does his master and friend Blair over education. ELSEWHERE Scots GP locums will now have pension rights under a new supplementary list system. Hospital juniors have been urged to join American juniors into the effects of sleep deprivation and extended working hours on road and workplace accidents. Interested juniors - and they should be - can contact the study through the web-site <info.jdc@bma.org.uk Northern Ireland GPs seem a little happier with their health politicians following feelings that a compromise on primary care service plans may be in the air. At least they are talking again. Prison doctors are using European working time regulations in an attempt to gain back-dated holiday pay. The article says they "could" gain this advantage although the heading is somewhat more euphoric. This editor could get the Nobel Prize for literature but it is unlikely. "Hello's work says the government - spinning again - as 100 Welsh doctors have returned to the NHS and 378 others have been persuaded, they say, to stay. The BMA dampens down all this by emphasising how many are leaving. Attacking government on four fronts the BMA rightly condemns policy over A & E care, foundation hospitals, PFI and early discharges. The latter again demonstrates the glass ceiling. Milburn is fining the local authorities for not having places to put early discharge patients into, then providing money to pay the fines. Queer. Women GP registrations last year came to 60% of the total. At the risk of, and not really caring, being called sexist I wonder whether this is the best way to plug the yawning GP manpower chasm. Can the feminists tell me how many of this 60% will work full time and for how much of their careers? Admittedly, the best way is to sack Milburn. Education muddles are causing crises in medical recruitment as potential students wonder if they will ever be able to afford to repay the £40-50,000 bill they will leave medical school with. In order to afford his dim-witted plans for 50% of school leavers to go to university Blair has dumbed down the universities by recreating 'techs as universities and forced universities to massively increase the number of places for students even though they cannot afford to do so. Who will pay for this stupidity where universities have Mickey Mouse degrees in golf course management and the rest? All students, of course. Certainly the government won't pay for its own policy. GPs unhappy about the contract may shout at the negotiators, in polite terms if possible, on the GP section of <www.bma.org.uk> Wasting more NHS cash Milburn has had full page ads inserted into newspapers here and abroad in an attempt to recruit "GP returners". There has been a proliferation of these, costing over £5 million as his desperation increases. After all, he said he would have 10,000 more GPs by 2004 and by my diary that is 338 days away. A target of 30 additional GPs each and every day. Last year he managed to recruit 0.049315 GPs a day (18/year). It's time he fell on his sword. GMC elections will be in April, so if you are thinking about standing for one of the sparse seats, there are now just 19 for doctors for the whole UK, then get busy. Nomination forms are to be returned by the end of February. The CCSC leadership triumvirate is featured on page 7 under the heading "A triple taste of tenancity". One of the three, Nizam Mamode, points out that Milburn is in a fix. The European Working Time Directive will take juniors out of hospitals into bed, the Agenda for Change package dealing with pay and conditions and the GP contract. All these need the cooperation of consultants and the glass-ceiling man needs to climb down a peg or two to get it. Chairman Miller says that there must be some confidentiality during negotiations but there must be regular feedback to members. The writer of the piece, a BMAnews staffer, says, that's new because even BMANews couldn't get anything out of the old CCSC. And GPC? More quango interference in local health came into force recently as OSCs are created to empower local councillors - health experts all - to call local health providers to account. Now, if some of the other quangos had been assassinated first then, perhaps, just perhaps there may be some justification in this. But the glass ceiling man's intellect tells him that creating quangos gives the impression that he's doing something. Killing quangos and their empires only offends the sycophants and "important" New Labour people who run them. It goes without saying that "the BMA is in favour of such bodies - despite earlier calls for the plethora of regulatory organisations to be rationalised and streamlined because of the sheer number to which doctors are now accountable". That comment, from the leadership of the BMA, just goes to demonstrate how many loons there are in the BMA leadership. Is it too much to expect the BMA to represent those who pay their subs? GP Chris Nancollas, in Second Opinion, bemoans the murdering of NHS loyalty by the politicians and wonders whether the suggested response by consultants of chambers is the right way forward. He believes that it would be a big step for GPs but it just might be the right one of GPs are ready to break free. The stupidity and viciousness of consultant suspensions by management is discussed at length. At present there are 100 on suspensions, with an unknown number taking "gardening leave", whilst their cases are decided. It doesn't take much for this to happen, just a disagreement with a colleague or management about government policy. The the doctor has a gagging clause forced upon him and is denied the right to either visit the hospital or talk to colleagues whilst the, sometimes, years drag by. Lay people have no idea how Stalinesque Milburn's NHS is today. This well written piece goes some way to redress the balance but, of course, it will not see the light of day in any lay organ. Suspension is unfair, expensive, illegal often and malicious in the vast majority of cases. Any Secretary of State worth his salt, particularly in a time of recruitment and retention crisis would sort it out pronto but, of course, we have Milburn. Mind you, he may create a quango to look into it. His quango the NCAA should be doing it but has failed so why not a quango to examine a quango? The BMAnews staff are to be congratulated on a stimulating edition this week.
18 January, 2003 FRONT PAGE The main story rightly condemns the latest idiocy to be dumped upon us by the EC. Whilst we are all striving hard to keep up the standards of medical practice in the UK the EC demands that any European doctor be able to work unchecked in the UK for 16 weeks a year. And they do mean any doctor, even those struck off in their own country. Last week the chairman of GPC was saying he was prepared to present the contract without details of pensions or forced allocations, two vital not to say essential elements. This week bmanews says there has been a breakthrough on pensions. All GP work will be superannuable. Apparently all this was said at a special LMC Meeting. Odd that the entire medical press reported the opposite. Rather unusual shenanikins are going on over the consultants' contract. In a fit of national independence the Scots voted in favour of the same contract which the English rejected. And said they had no regrets and were sticking to it, so there. However, second thoughts have stirred and they have decided that if the English get a better contract by opposing Milburn, then they will have the same one. Senior Scots BMA men found a form of words to avoid the volte face seeming to be just that. ELSEWHERE That bastion organisation of democratic principles, Sinn Fein, is accusing the BMAs NI GPs' committee of threatening the future of primary care. Well, they should know all about threatening, I suppose. The crime of the GPC was to suggest that if the contract isn't right many NI GPs will resign or retire. Consultants are becoming more and more angry about extra urgent and routine work being dumped upon them out of hours and unpaid. One consultant said that in his case it amounted to 11 unpaid sessions in a month. Quite what they expect having rejected the contract agreed by a sadistic SoS I cannot imagine. CCSC is following the suggestion of many consultants and is taking outside advice on how better to represent their colleagues. Welsh birth targets have been instituted but far from an attempt to raise the birth-rate they apply to home deliveries. Without a thought as to who will back up the midwives, the Welsh social services secretary wants a 10% increase in home confinements over the next decade. Welsh GPC chairman, Dearden threw his hands up in horror and said he hadn't done a delivery in over ten years and that went for the majority of his colleagues and as the midwife would call on him for help, need he say more about the foolishness of the target? Departing from common sense again, Milburn is to reward hospitals which by fair means or foul, convince him they are beating targets. Those who don't succeed will get nothing and carry on the spiral to oblivion. Without mentioning the Mental NSF, GPs have warned they they have no resources in time or money to carry it out properly. Medical reservists may not be compensated fully for being called up for service in the Gulf. Many served at their own cost last time and promises were made - and forgotten. Too many targets says the Audit Commission, agreeing with the BMA. The Chairman of the Commission said there was a paucity of people involved in target setting who had real experience of delivering targets and this was being exposed time and time again. He might well have said it was a case of sheep being led by a donkey. Two more quangos have been created by the Milburn regime so that more cash can be diverted from direct patient care and so that more A&E chairs can be designated as hospital beds in order to spin the figures favourably. The purpose of the two working parties (if they do work) will be to tackle bureaucracy in the NHS. Like all the rest, the poodles who head them will, no doubt, empire build a workforce suitable to their own importance. The quangos are called; the GP Implementation and Monitoring Taskforce and the Hospital Implementation and Monitoring Taskforce. Does anyone need to ask where Milburn's millions migrate? The Welsh Health Secretary, Jane Hutt, has realised that Wales is 525 consultants and 175 GPs short as well as a deficit of 6000 nurses and 2000 ancillary staff. She says they (Welsh Assembly) have to "take every measure and try everything within our means to attract and retain our doctors". Following that, everything else in the page-long piece is not relevant. Her performance in those very laudable aims will be watched very, very closely by "our doctors". The drug strategy announced by our glorious Home Secretary involves a greatly increased number of (inexperienced) GPs issuing heroin etc. to addicts. The Secretary of State remained mute on the matter. Thereby adding his support to the idiot suggestion. The BMA very reasonably objected claiming drug misuse was a specialist province. The expert on the matter, Dr Gerad of the RCGP drug misuse unit says GPs wouldn't have the time to treat them. The National Treatment unit is keen to see shared care with a GP backed up by a substance misuse specialist (if one can be found when needed). Charles Lamb has a good go at nursing homes who abhor patients dying in their "care" and who 999 them to A&E if there's any likelihood of such an untidy occurrence. And, he's right, too. BMA View is provided in robust form by CCSC joint deputy Chairman, Nizam Mamode who bluntly tells Milburn to "ask for our help - or get out of the sunlight" after taking medics for granted for too long. Well done, sir. Michael Apple lashes out at specialists who take GPs to task for not having their level of knowledge about their own subject whilst, themselves, telling patients "I'll treat your wart but go and see your GP about your blindness". Again, well done. Are these specialists not capable of in-house referrals, anyway? Is it too much bother? The Opinion Poll section reveals this week that 24% of medical graduates do not go into clinical practice when they graduate. 86% of them say it is because of the way the government treats doctors. That is precisely why for nearly two years this magazine has been wanting rid of the incomparably incompetent Alan Milburn. Nearly half of doctors would not recommend medicine as a career (and that goes for this editor, too). The PMS/GMS debate is exercised in two full pages starting with the very strong suspicion that Milburn has delayed the contract so that more GPs will join PMS in desperation. Various influential GPs say that the system is in chaos and Dr Chisholm claims that GMS is the way forward. It may all be irrelevant after the vote, anyway.
11 January, 2003 Another short edition but none-the-less welcome for that. FRONT PAGE The main feature relates the sorry state of the armed forces medical service which successive governments have deliberately savaged. Now that they want to go to war the government suddenly finds there are not enough medics to see to the casualties. The result is that the already hard pressed NHS has to fill the gaping gaps. For instance, there are just 195 army GPs out of a full quota of 416, with just 96 volunteer reservists; 23 out of a necessary 120 anaesthetists; 11 out of 28 orthopaedic surgeons and 18 out of 43 general surgeons. In utter desperation the MoD has inserted a full page advertisement for medical recruits within this edition of bmanews. In another story consultants are being urged not to accept government bribes aimed at breaking CCSC and getting the rejected contract in by the back door. Any so-called offer from local Trusts is nothing more than a Milburnian bribe and should be treated as such. The announcement of the ?deliberately truncated discussion period over the GP contract is mentioned in a small clip on the front page. Government scheming has meant that the full contract will not be issued for discussion until February 21, yet the ballot will be just 4 weeks later. There are many GPs who doubt their own negotiators' good faith in this. Have the negotiators never heard of backdating? Apparently not for they wish to railroad their contract through at the earliest opportunity before opposition can develop. They are wrong. Did they learn nothing from the CCSC debacle and Dr Peter Hawker's demise? It seems not. The Chisholm team just know they are right and there's the rub. Their handling of this contract has been abysmal. ELSEWHERE Medical students are continuing, with some success, their campaign against tuition fees. A Labour MP, supported by 70 other MPs, has put down a motion condemning student fees. A & E conditions have been shown to be worse than governmentally spun figures claim after some of the tricks managers get up to to please Milburn are revealed. For instance, ambulances with patients are compelled to queue outside A & E for hours until there is a space for them. These patients then do not adversely affect A&E trolley wait figures. The prestigious Oxford John Radcliffe Hospital caused the loss of 700 hours ambulance time in November 2002 alone by adopting this tactic. Staff medical tests are discussed as the BMA raises objections to testing new staff for HIV and Hepatitis B and C. This despite the result of the failing Milburn recruiting heavily from the parts of the world where these diseases are endemic. It is a plain common sense measure that where staff may be involved in possible close, blood contact they should be tested before employment where they may expose patients to a disease which they may carry. A staff member with smallpox would not be permitted to work within the service so what, apart from political correctness, is different about HIV etc.? Should PC to spare someone's feelings be allowed to kill patients? Another quango has been created by a Secretary of State who wonders where all the NHS billions go to. Somebody should wean him off this obsession. This one goes under the title of the Commission for Patient and Public Involvement in Health. A grandiose enough title for somebody to empire build upon and to feed their own egos. It duplicates the efforts of Milburn's Section 11 of the Health & Social Care Act, 2001 and Local Authority powers to scrutinise the health services. Whoever the self-important head of this latest cash-waster is, perhaps he/she should stand back for a few seconds to ask themselves whether they are really necessary before diverting untold millions from direct patient care. There are plenty of little old ladies out there who would prefer a new hip to a lecture from Sir Andrew Bloggs, labour sycophant. BMA view is predictably provided by Dr John Chisholm who seems to show that he has heard the problems but has not listened carefully enough. Nowhere in his overlong piece is there any suggestion about delaying the contract vote even for a few weeks to allow full discussion. No inlking is there of a possibility of the back-dating of the outcome if the vote is taken later. His team seem quite content to plough on with their version in the sure certainty that they are right and that the previously promised adequate discussion period is irrelevent. You know, sometimes returning from a night call in the fog I take a wrong turn but when I realise it I just don't plough on to Watford, I turn round and find the right turning to lead me home. This is not a strategy which Chisholm would recognise as GPs head for Watford under his teams' leadership. And so ends the political content of this week's BMA News
4 January, 2003 The BMA is to be congratulated in beating all the other "medicals" by being able to produce an edition in the dead period when most are still on holiday. But, then, doctors always did work harder than hacks. FRONT PAGE The government has failed (deliberately?) to produce essential financial evidence to cost the new GP contract. Consequently details will not be released for another six weeks. bamnews believes that many elderly doctors just won't bother waiting any longer and will retire. In the BMJ this week Dr Chisholm said there was "cock up not conspiracy". Countrydoctor is aware that there is a strong feeling that that underestimates the deviousness of the Milburn regime. If there is cock-up then it also applies to GPC negotiators who should have anticipated the need for the figures much earlier. GPs are suspicious that shortening the time scale for their consideration of the complex contract could result in them being bounced into an acceptance. Once upon a time the military used NHS facilities to help. Nowadays the failing Milburn NHS is desperate to use what it can to prop it up and is now grasping the help of the few remaining military medical facilities at home and abroad. ELSEWHERE The BMA seems to be taking a little more notice of the Tories if the item claiming that 1 in 4 medical graduates never practice is an example. Shadow Health spokesman, Liam Fox whose department collected the evidence, believes it to be alarming. The high level of debt (£12,915) is believed to be a reason. Medical graduates, highly trained, highly intelligent and adaptive graduates are poached by bankers where there debts may be paid off much more quickly by realistic salaries. It is felt that the top-up fees proposed (up to £15,000/year) would exacerbate the issue And still the dim Milburn sails serenely on in his own ignorance. Northern Irish doctors are being consulted over the future of the Province's health care. Final date is March 28th. There appears to some medical scepticism. A full page item discusses what GPs need to tell insurance companies about their patients. Apparently details of sexual history, even if known and noted, are not essential unless there has been an effect on the patient's health. If the company asks about HIV testing then only positive results are relevent otherwise the question may be ignored. A completely new form will be issued later this year. In a thin period for medical politics, that about sums up this week's bmanews but nevertheless, it was a welcome sight.
|
