JOIN CDA NEWS INDEX POLITICS DISPENSING EDUCATION FEATURES BOOKS SMALL ADS GP FEES LIGHT BITES
|
IT WOULD BE HELPFUL TO KNOW WHETHER VISITORS WOULD LIKE THIS SERIES TO CONTINUE. IF SO PLEASE LEAVE A SHORT MESSAGE ON FEEDBACK May 31, 2003 FRONT PAGE The lead item is given to the new consultants' negotiators who are behaving exactly as trade unionists should. They have sought the advice and support of their members and are carrying out their wishes. An overwhelming percentage of consultants will be resisting Milburn's threats and blackmail and will not agree to local implementation of the rejected contract. The committee has also sought the support of other hospital medical groups, the "juniors" and the Staff & Associate Specialists' committee. These groups have confirmed that should CCSC take industrial action they will not be able to cover to pull Milburn's fat out of the fire. The GPC meeting this week is trailed on the front page. All that is worth saying about it is that the negotiators have bungled again. They have decided to rush to the polls with an unwritten and un-priced contract which they expect GPs to accept. They must think GPs are idiots. Watch this space for how many idiots there are. ELSEWHERE The first double page spread is devoted to the consultants and is headed "With us, anything is possible". This may be a rallying cry to the "troops" but is also a warning to Milburn that he cannot continue to have an NHS without the co-operation of the consultants. The consultants' leader, Dr Paul Miller commented "As soon as doctors are subject to the same line-management political pressures that turn decent people into waiting list fraudsters then the NHS is finished". Yet the thrust of Milburn's campaign is to do just that. The strength of the consultants' feeling is adequately shown by the fact that not one consultant has signed up to Milburn's scheme. Other indications of this strength was shown by one delegate to the consultants' conference who referred to Milburn's "Malign tactics". The whole national consultant body is to be sent a ballot paper asking them, amongst other matters, whether they want Milburn's local implementation scheme. To date the results show and overwhelming NO. Further "assertive action" is being demanded by members of the conference of local negotiating committee representatives. Contrast all that with the "action" of the general practitioners' negotiating body !! Later. At this time of crisis within the medical profession a key ARM debate will focus on poverty. Dr Derek Wilkins who qualified some 50 years ago writes a very pertinent letter emphasising the fact that when he qualified the profession was "happy and proud. Today we are sad, divided and almost whimpering under bureaucratic enslavement" with angry consultants looking forward to retiring and GPs overworked and disatisfied. He bemoans the fact that decades of medico-politicians have "caved in" to faddish politicians and a malignant media. "We have ceased to be an honourable profession and have, in the eyes of laymen become little more than tradesmen. It is not too late for us to shrug of this oppression but I doubt whether today's doctors have the courage". (Now do you understand why I go on so much about Dr Chisholm and his crew? - Ed.) BMA View is written by a chairman of the Junior Doctors' Committee (JDC), Simon Eccles. He asks why the Doctors and Dentists Review Body has ignored all the evidence they have presented to it and done what the government asked it to do. Dr Eccles, that's what they always have done and always will do. Yes, we know they are supposed to be independent, although that word was dropped from their title many years ago, but they are not. They are appointed by government and are a QUANGO. Need any more be said? The double page spread on general practice consists of a full-page cartoon and a dissertation about general practice. It has little or no political content but is worth a glance. Other
pieces of interest: The second of these describes how juniors doctors are now being compelled to fund their own training. That just goes to show how thick Milburn is considering the enormous shortage of specialists today.
May 24, 2003 FRONT PAGE Maybe Mr Milburn should take note when he reads this edition of BMAnews. The headline reads "Contract impasses threatens NHS reform, pay body warns". Our dear Secretary of State is besieged on all fronts. The consultants have rejected his advances, the GPs are about to and the registrars are presently being annoyed by the failure of Milburn's mob to give evidence to the DDRB. They "forgot" and if you believe that you'll believe anything. Another item reveals that the GP contract will be decided by the expediency of the legislative timetable not whether it's worth having. Mind you, BMAnews tells porkies in trumps when it says that "GP leaders set their negotiators a 14 day deadline" to come up with improvements. It was chief honcho Chisholm and the negotiators who gave themselves that time limit against LMC Conference wishes. It is becoming more and more mysterious who these "doctors leaders " BMAnews constantly refers to are if they are not Chisholm and company. ELSEWHERE The late GMC President, Donald Irvine, knight of this realm, appears to have written a book about his time in office to which only he can relate. Apparently he describes a conspiracy between several governments and the profession leading to a fall in trust in doctors. Er, he was in charge for a period of that time and doctors still rank as most trustworthy professionals.. As Sir Alex Macara says, there's been some editing of history going off here. Scots juniors are demanding that their leaders get tough on Trusts which continue to flout regulations. Night work for juniors is to be examined in the light of the effects of the European Working Time Directive. An A & E department ground to a halt due to staffing shortages just a month after Milburn's infamous waiting time fixing fiasco survey. Craigavon paediatric A & E has stood idle since its completion eighteen months ago. GP contract is focussed upon in a double page spread writing up the special LMC conference 10 days after it was reported on this site. The spin is negotiator orientated - of course. Indeed Dr Chisholm did win applause but it was luke warm rather than the standing ovation he would usually have obtained. Three acolytes stood and it was all over in less than 30 seconds. A featured BMA View by negotiator Meldrum indicates that they are still intent on settling an NHS friendly contract even if it's not GP friendly. He also raises the fear of losing an 11% pay rise in favour of 3.2% leading to the conclusion that his team believes that the properly negotiated satisfactory future of general practice is only worth a short term 7.5% this year. Surely it's better to lose that than wreck family practice for ever for our successors? This contract will not be changed for many years once accepted. Meldrum then goes on to lard the doom and gloom as thickly as possible in an attempt to frighten colleagues into accepting what is a very bad contract. Trust me, he seems to say, I'm a negotiator. Thank you, Dr Meldrum, but after all the blunders, we don't. The lay make-up of GMC is discussed as it has risen from 25% to 40% following the weak leadership of previous years. The profession failed to stand up for itself in all the crises and permitted all doctors to be tarred with the Shipman brush. Donald Irvine's GMC seemed to relish in supervising its own downfall and that of the profession despite it being the most trustworthy of professions. Mind you, that ass Milburn stirred the pot as vigorously as he could not realising (well he wouldn't, would he?) that he was creating a recruitment and retention crisis as doctors fled the profession in despair. Yep, I reckon that he's doing a damn good job - for the Tories. Nizam Mamode, joint deputy leader of the consultants' revitalised committee comes from this planet whereas the GP leader, it was said at LMC Conference, comes from Uranus. Mamode at least understands that this government is not intent on helpful reforms as he lashes into government Foundation Trust policy. He also draws Milburn's attention to the fact, which that man always ignores, that the NHS has always run on the goodwill of its staff - and not only nurses, as the media would have the world believe, but also the much maligned doctors. Following the rejection of the consultant contract Milburn first took his bat home, then sulked and now is trying to fix local contracts. As Mamode says, the response from consultants has been "awesome" in its unity against Milburn. Tony, don't sack him, we want him because he'll have you out of number 10 next time. Opinion debate is whether managers should be regulated like doctors. It comes as no surprise that a NHS Confederation manager thinks not and a consults thinks so. The managers somewhat weak reasoning is that managers are not professional and there is no controlled entry. OK, then control it. Can't, he says, it's impracticable. Nonsense, says I, my father was an administrator in the good old days of the 60s and he had to take exams before being allowed to work in the NHS. Why not now? On the other hand, if managers were under the same strictures as doctors and daren't falsify figures and the like, then maybe Milburn would have nothing to crow about and we would all see what a parlous state the NHS is really in. Yes, let's regulate them.
May 17, 2003 FRONT PAGE The headline item concerns doctors who have been drafted/volunteered for the British Army in the Gulf. They are becoming very restive and may well up sticks and come home if the tour of duty lengthens. The critical time is four months and the reasons concern problems with future careers. It's a case of watch this space. Contracts: Consultants do understand their opponent and are beginning to flex their muscles by telling colleagues how to get the best out of their present contract even if that means cutting down their working time from their actual to their contracted. then we'll see what happens to the waiting lists and The NHS Plan. DDRB has completed its report but not for GPs because they are negotiating still.
The negotiators' version of enhanced services payments has been published. Already GPs are complaining bitterly. There was a motion for the negotiators to stand down, at the LMC Conference last week - but it failed as Conference fell into line despite all Chisholm and Co's failings. And Dr Bogle was asked by Council to take a direct interest in the contract by holding Chisholm's hand. The juniors' committee is publishing details as to how their constituents can get the most out of the European Working Time Directive or, more importantly, stop themselves being done down by NHS managers. Surprise, surprise 2/3 A & E departments drafted in extra staff and other measures to meet government targets on measurement day. So the whole exercise was a cock-up apart from the fact that it helped dear old Milburn to lie once again about reality in the NHS today. Another criminal offence will be added as the BMA agrees that removing organs without consent should be punishable. Water fluoridation is defended by the BMA despite criticisms that it would remove the freedom of choice. Dr Bogle supports CHAI's Chief Inspector (what a title) Peter Homa following Homa's resignation recently. Reforms for the BMA will be ready for the membership to discuss at the next ARM in July in addition to all 127,00 members. Divisions are likely to be abolished in favour of "Regions" which cover a much greater area. Your editor has severe doubts as to whether this will make the Association a. more democratic or b. more sensitive or appealing to members locally. He was outvoted. Ulster GPs have been terrorised and have asked to be moved from their premises to a local hospital for out-of-hours work. Doesn't that go with the territory in NI? Chemists say they are good at sex or, at least, spreading the word about it, according to the Pharmaceutical society. A retired GP has won election to the Scottish Parliament. Dr Jean Turner campaigned on the "Stop the Stobhill closure" issue. Continuing its expedition into reality the new CCSC is "calling time on the long hours culture". In short, Milburn has killed, stone dead, all the goodwill which kept the NHS afloat. In future consultants are to be advised, as is HMG, that any hours extra to contract will either not be done or will be paid for - handsomely. Milburn is, indeed, a fool for causing this to happen. Other items of interest: Are we prepared for
SARS? The writer thinks not but there may still be time.
May 10, 2003 FRONT PAGE The lead item concerned the government's flagship Foundation hospital policy which the BMA correctly opposes on the grounds that a two-tier system would develop. Oddly, this is the same BMA which went along with fund holding. However, despite BMA opposition and that of a number of Labour rebels the government got its way in the debate in Parliament this week, so it#s all rather academic. GPC told GPs that their new, M-PIG computer calculator was ready. Unfortunately for GPC when GPs attempted to use it they found that as with every other facet of this contract it just didn't work and had to be removed from the BMA site. It transpires that GPC had accepted it on trust from the NHS Confederation without testing it. Now where did we hear that before? Milburn in his wisdom, does he have any, is getting his way over cardiothoracic surgeons following the Bristol affair. They are to be listed on a star rating table according to their patient death rate. This wheeze of the great man is intellectually bankrupt, as one would expect, because it does not take into account risk factors. It will, however, cause several surgeons to avoid risky cases and, therefore, increase the death rate from heart disease. ELSEWHERE A retired GP has ousted a sittng Labour candidate in the Scottish Elections. She was campaigning to save Stobhill Hospital. The results for the GMC elections has been announced and Dr Chisholm and Dr Fradd have failed to be re-elected. Although there are fewer seats it is highly likely that their recent performance over the GP contract was largely responsible. Whilst BMAnews announces the results it somehow failed to mention the above facts. It did, however, mention that Dr Alex Freeman had been elected as the youngest member. She will be an asset to the Council. Overseas recruitment is roundly criticised as the BMA ponders its cost-effectiveness. Just 250 doctors have been recruited in a campaign that has already lasted 21 months. Somebody should try telling the idiot in charge of the NHS that if he made it a more attractive environment British doctors may be tempted to work in it. As it is he seems to delight in making it as unpleasant as possible. He is now reaping the whirlwind and lightning will strike twice when the GP contract is rightfully thrown out. Tony, lad, get rid of him, friend or not. He's your biggest NHS enemy. That about sums up the medico-political content of this week's paper. That is not to say that there are not any other items worth considering. Charles Lamb writes
his usual inspiring piece from A & E. And that's about it, folks. If you hoped to be kept up-to-date about the GP contract by BMAnews then, tough luck. The news is all bad so it won't be aired by BMAnews. They don't even have the will to say that Chisholm and Fradd failed to retain their GMC seats. Worthy of a line or two, I would have thought.
May 3 2003 FRONT PAGE The lead article covers the consultant contract and is demonstrating that under its new leadership the consultants' committees are beginning to show backbone. In a way which would not have been considered under the previous leadership the law is being brought into use. According to the front page item the new contract, as offered and refused, is guilty of breaking the sex discrimination act. Newly qualified consultants would be treated adversely in comparison with existing consultants and as 42% of registrars are female, against 25% consultants, that makes the contract guilty of indirect discrimination. In addition, not mentioned in the article, the contract breaks European laws in a number of ways and CCSC is seeking a case to use to sue the Secretary of State. Would GPs were so lucky in their representatives. Graduate selection for the fast-track course (to pull Milburn's fat out of the fire) is being made at random by Barts and The London Medical School. BMA Academic Staff Committee chairman, Colin Smith declined to condemn the method but his joint deputy went some way towards that. ELSEWHERE Medical School funding is losing out despite Milburn's need for more medical graduates i.e. doctors. GPS want timewasters to pay. A little extreme since they would have to collect the cash for government. Now, if the contract is rightfully rejected, and we enter the realms of private medicine in one form or another, then that is a totally different matter. Until then, one GP here, is grateful for those who don't come as it gives him time to catch up. Blair is going to battle on with Foundation Hospitals. Other papers tell us that the figures are being manipulated so that hospitals can become foundation trusts. The BMA expresses its very serious concerns as its Chairman seems to be developing a noticeable anti-government stance. For which we should be grateful. Scottish LMC Conference ducked out of censuring the negotiators despite their appalling blunder over the Carr-Hill formula and other matters. Every Scots practice was given the wrong information to calculate their income. Scotland has decided not to ask to be dealt with separately. For once Dr Chisholm got something right as her applauded this. Apparently, the Scots GP workforce is in a state of "meltdown" - and still we have this foolish and controlling contract proposal which helps government more than general practice. GP funding fears are expressed over new roles for GPs and nurses. Dr Fradd, in a fit of blinding common sense, has just realised that government has not entered into negotiations about paying these specialist GPs. Paediatrics has, as this article says, long been the Cinderalla of the NHS. It is now being hoiked up the importance scale and not before time. Children are our greatest asset, we are told, and there is to be (yet another) NSF on Children's diseases. Some details of the NSF are discussed. They include different management for younger and adolescent children. The young will have play areas and the adolescents will have privacy. Education will be catered for whilst in hospital and there will be special A & E for children and children's menus. Hi-tech GPs are inevitably the way forward and the DoH is putting in large sums to ensure it happens. Multi-split screen PCs with investigations, consultants, GPs and patients all on- screen together will become the norm. The advice at the start fo the article was that technophobic GPs should stop reading at once. There will be a few of us around. The Letters page has another posting from a GP who doesn't like the contract placed just to be shot down by that, oh, so irritating, BMA GPs committee spokesman who fears to reveal his name. A consultant, writing in similar vein, is dismissed in an identical fashion by another anonymous representative - and, wow, the editor. The human cost of doctoring is covered in an excellent double-page article by Mark Radcliffe. Far too rarely do patients and politicians consider the health and well-being of those upon whom they off-load their own problems. Dr Bogle relates the time when as a younger doctor with a baby of his own upstairs a patients brought her cot-death child to his home. This inevitably affects the physician. Only recently have there been "doctor support" services. The GP contract was notable for its absence but, largely, we were spared homilies from the ubiquitous and self-effacing "doctors' leaders". They didn't say much this week. |