A weekly commentary on
BMA News - April/May 2002
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  Saturday, 25 May 2002

FRONT PAGE

Drug Users
Once again "Doctors' Leaders" have "welcomed" something which I venture to say most GPs would not wish to do, namely, to treat drug users for their addiction.  This will, of necessity, involve supplying the drugs.   The welcome was muted because they believe the government have not got it right.  Perhaps a more sensible response from our "leaders" would be to reject the suggestion until Milburn had got it right.

Rural GPs
At this very late stage in the day "GP leaders" have set up a committee to ensure rural GPs are not let down by the new contract.  Surely a competent group of leaders would have ensured that before presenting the contract not after but they never did take country practice into account properly.  And, anyway, shouldn't GPC Rural Practice sub-committee be in the best position to do that - if, of course, it had good leadership?

Bogle
Dr Bogle has warned a no doubt trembling Milburn not to use his new QUANGO, The Commission for Healthcare Audit & Inspection as an OFDOC inspection organisation.   Again a little late.  Care to bet on the outcome?

ELSEWHERE

Those "doctors' leaders" have spoken again.   This time about "safe havens" to treat violent patients.  Milburn has been approached but has done nothing and PCTs have followed suit.   Dr Chisholm says PCTs must get their act together - or what?

"Doctors' leaders" have welcomed the government's 5-year licence plans for doctors.   Annual appraisals will feed into this system.

Negligence
Shortly HMG will reveal options to replace the clinical negligence system with a no-fault compensation system

Pharmacy prescribing
GPC supports chemist prescribing - with safeguards.    ABPI has reservations, particularly about the reclassification of a raft of drugs from POM, P to OTC.    Quite right, too.   Another case of GPC welcoming instead of rejecting until the government has got it right.    Could this be why Milburn appears to think the negotiators are a push over?

Confidentiality of records
Rather astoundingly 54% of doctors favour the use of medical records for "research" without consent. This despite the same percentage believing patients may be discouraged from discussing private or embarrassing complaints and even more that research would be hampered.   In the post-Alder Hey days one would imagine that 100% would be nearer the figure for the first question.

Blundering
On site there is an article describing the goings-on at the BMA Council meeting after "accidental" release of a discussion document suggesting that GPs should give up the gatekeeper role.  Despite much anger (now denied by Council Minutes and a refusal to my specific written request to amend those Minutes) at the Meeting, Bogle has declined to publically correct the impression that the discussion document was, in fact, BMA Policy.   This leads to the question "Was there some jiggery-pokery going on in BMA House?".   Further evidence for that is that this edition of bmanews publishes a prominent article by two academic nurses saying:  "The traditional gatekeeper role of GPs is widening to include other qualified health carers, a trend to which the BMA appears to lend support".  So, was it blundering which caused the release or deliberate intent by those, Bogle amongst them, with their own agenda for the future?   To give him his due, Bogle was astoundingly quick to wash his hands of any responsibility.   Whichever it was, the nurses certainly believe that GPs are about to hand over the responsibility to them.   Shouldn't Bogle, as Chairman, have ensured that there was a wider discussion within the profession than from Sun and News of the World readers?   Or at least a general apology to GPs from the chief servant of BMA members?

 

 

Saturday, 18 May 2002

FRONT PAGE
"Doctors' leaders" have urged ministers to regulate better and improve private involvement in the NHS.   Reading between the lines, the BMA is not overall happy with private involvement.   Odd, really when the government is content to use private services more and more to boost a failing NHS.

Oh, dear.  Bath NHS Trust has upset the government by discovering 280 patients who have waited more than 15 months for treatment.  HMG thought there was only one patient nationwide.    Hmm!   What would happen, one wonders if all Trusts were either as honest or as diligent as Bath?   A new management has been imposed on Bath Trust.

ELSEWHERE

Foundation Hospitals
High performing hospitals are to be separated out as Foundation Hospitals and allowed greater freedom to manage their own resources.   The BMA has some reservations about this as they may set their own conditions for staff.

PCTs
Dr Bogle quite correctly believes that PCTs need much more admin support in view of the tasks they have been given.  many are not up to the job and "at the very least they are unprepared".

PCTs are NOT controlled by GPs, nurses etc say 232 out of 240 PCT board chairmen, chief execs, GPs and nurses.   Number 10 says they are.  In fact GP and nurse executive chairman are not even on the DoH mailing list, are not invited to conferences and are ignored.

Buddies
A very sensible scheme has been set up in Beds and Herts.  GPs who face complaints are teamed up with a GP who has already gone through the complaint procedure.   In today's climate there should be no shortage of such buddies.

Etymological Royal College
The RCGP has offered GPs an A-Z of medical terms for their patients.   It may be seen on the RCGP web site.

300,000 contracts priced
Apparently Milburn has found the money to price a pay rise for other NHS staff.   He has not found funds to cost the GP contract.

Advertorial
Page 6 carries a blatant but unlabelled Advertorial for a BMA Insurance scheme.

Wanted !  How many doctors?
There seems to be a great controversy as to how many GPs and consultants are needed or how many the government has promised by 2004 - or was it 2008?   The figure varies from 2000 to 15,000 GPs depending whether you look at BMA figures, the NHS Plan or the Plan, version II.    GPC, completely missing the point, has given government a list of measures to attract/keep GPs in the business.  They include maternity and sick leave, family friendly policy and changes to pensions.   How aout removing some of the over-heavy regulation of the profession and the blame culture which GPC has welcomed over the years?

Letters
One correspondent wonders what all the fuss is about, MRI scanning the dead.   After all with current waiting lists most patients will be dead before their turn comes round anyway.

Contract
In a statement of outstanding naivete the author of bmaview, Tony Calland, concludes that GPC produced the unpriced contract now because they had promised to do so and, if they hadn't, confidence in the BMA GPs committee would have been lost.   And there's great confidence in them right now, is there?    A little blackmail creeps into the piece.  It will be difficult, the author says, to explain to the public why the profession might want to reject a framework which encourages and rewards doctors for a high quality service.   Young GPs, he says, increasing the pressure, will be puzzled, too.   Dr Calland says that the alternative is either to continue with PMS or the old GMS contract.   WRONG  !   Have the negotiators conveniently forgotten the alternative they were charged with?  Resignation?   You can bet they will do their damnedest to wriggle out of that one.  I recall Dr Michael Wilson, then GMSC Chairman, telling Kenneth Clarke that "Resignation is not an option" even though GPs felt very strongly that it was.

Drugs in Sport
A very worthwhile 2 page [iece which any GP interested in sport and sportsmen should read.    The BMA has produced a book under the same title.

 

Saturday, 11 May, 2002

FRONT PAGE
There is an exclusive item suggesting that consultants' leaders have almost reached an agreement for rewarding doctors appropriately for out of hours work.
Another "Exclusive" continues the saga of the Scots pre-reg HOs whose trusts are breaching new deal limits

GPC is said to be close to concluding a deal to help GPs modernise their premises without losing out financially.  They may not lose out financially but they become almost irradically tied to the NHS if it virtually owns their premises.  The, some inner city GPs may be left with old premises they cannot sell or afford to put into a saleable condiition.

ELSEWHERE

Bursary mis-selling
Fast-track medical students claim to have been misled that they would qualify for an NHS Bursary.   Now finding that they won't, they are £30.000 in debt just because they are less than 25 years old when they finish.   Their parents will have to pick up the bill.    Does the NHS want doctors, or what?   Is it prepared to cheat to get them?

CHC abolition has been blocked in the Lords.

Anaesthetists...
...are quite rightly anxious about cost-saving measures to replace them in some way by those ever useful NHS dumping grounds, nurses.

Desperate Chisholm
With signs of increasing desperation Dr Chisholm claims that GPs missing out on quality payments may be given help to raise standards.   By doing this he assumes that these practices are inferior and sub-standard by the Milburn standard of the day.   Talking of whom, we can guess what "help" he will offer !

Five fewer full-time GPs...
...as five GPs become chairmen of Welsh Health Boards.

Your contract  - your future
In a somewhat dismal admission of failure John Chisholm said that the government had refused to price the "contract" until after the June spending review had allocated funding for primary care.  It does not take a rocket scientist to work out from that that, as usual, GPs will be at the mercy of the Treasury and in a take it or leave it situation.     How many times have doctors been told the national interest comes first?   All other discussion in the full-page article is so much superfluous drivel.

John Vautrey...
...a GP in Leeds, is sold on the contract on the grounds that if he is interested in a job he considers the pay secondarily.  I wonder whether Jonathan Reggler will be given a similar half page of space to oppose?    Don't hold your breath.

Head 2 Head
This edition asks should the private sector become more involved in the NHS?   The headline of opposer Ron Singer's piece has him saying "The NHS is very efficient in its use of resources because their use os based on clinical need not a profit motive".     The NHS very efficient?

Saturday, 4 May, 2002

FRONT PAGE
Eminent cot death expert Professor Peter Fleming has been pilloried by the think last write first hacks of the national media.  They wrongfully accused him of keeping PM specimens for himself during his investigations.  It matters not one jot to these creatures, in today's vindictive anti-doctor country, that Prof Fleming's work has saved numerous infant's lives.  Prof Fleming runs a round the clock bereavement service for afflicted families.   It must be said that bookseller Milburn must take some responsibility for press opinions.

Fairly typical tactics have been used by DoH negotiators dealing with "seniors".   A 14 hour day for consultants was rejected by the doctors but it reappeared in a DoH briefing note.

ELSEWHERE

GPs are demanding more time to fill in cremation forms if they are to be done properly.   Time is not given for full consultation with other health professionals about the deceased.

Guys and Tommy's Med School has had to axe 50 medical teaching jobs to help save the Trust £3.5million a year.   The government wants 15,000 new doctors.   Are the two facts compatible?

48 hour access has been rejected as gimmicky by Scots GPs.

"Doctors leaders" are asking for even more reforms.  BMA juniors' leader told Blair that doctors would welcome reforms and that it would be better if doctors helped government get the message across.   Those statements give food for thought by over reformed GPs.

Milburn's DoH will establish a bedside manner training course for every doctor and nurse.  No doubt after psychometrically testing and replacing the Health Secretary?

DAY SURGERY
In a full-page feature the Association of Day Surgery says that all elective surgery should be day case.   The piece has a lot of self-justification but not one word about those poor buggers, the GPs, who will have to pick up the pieces for this move.

Bogle's Opinion
He's at it again!    In a very political Opinion Bogle is "delighted the government has rejected alternative methods of funding".  Chief servant of BMA members, Ian Bogle, is reminded once again that when he writes as BMA  Chairman he should stick to clear BMA Policy or make it crystal clear that the opinions are his alone.   BMA policy is not that all other methods of funding should be rejected but that alternative methods should be explored by the BMA.   In another objectionable example of political bias he calls the Tories "profits of doom" .  Apparently Labour is all good, now he and the BMA have forced them into action, and the Tories are all that's bad.   Maybe Dr Bogle would care to regale us all with his wisdom as to why all other methods of funding should be rejected?  That, of course, would mean that he would have to list those alternatives and dispense with throwaway comments.   Dr Bogle told bmanews readers last week that he held no particular political brief but, by George, he does let us know where his sympathies lie.

The rest of this edition
Most of the rest of bmanews is taken up, quite rightly, with news and features about hospital doctors.  As this is primarily a GP site, I can do no better than commend readers to obtain a copy of bmanews.

 

Saturday, 27 April 2002

FRONT PAGE

Scottish consultants are to be asked if they want to give up the merit award system.

Milburn rather unsurprisingly denies that figures for medical recruitment have been "spun". A MoH spokesman seem to agree that they had.  Dr Bogle felt that the figures had been designed to confuse.

ELSEWHERE

NI GPs say more NHS cash would ease strains.
Proposals for nurse and pharmacist prescribing have been revealed - but not in bmanews.

Overseas doctors, filling the breech in the NHS dam, are being badly treated.

Army doctors - of which there is a great shortage - have been awarded a "standstill" pay rise.  That will help recruitment no end!

The British Association of Day Surgery, presumably without asking GPs, has said that "all elective operations should be day cases".   And who will pick up the pieces?

New contract

Much comment about this has already appeared elsewhere on site.  That applies to GPC statements as well comment here.   As expected a significant amount of space was used to air the issue. 

Dr Chisholm did answer some questions.  One of them is worth repeating here so that readers may tell me whether I am being thick or did he not answer it.  Certainly it was worth asking.

Q:   Although the contract deals with the problem of supply management, how will it address the endless increase in demand for GP services?

A:  The new contract will seek to empower all patients, helping them make the best use of professionally led services and other self-help resources.  Mechanisms for building these "empowering patients" schemes into the new contract are being considered.  There are already initiatives under way across the UK, including proposals to build patient education into the national curriculum in schools.  The work of the Doctor Patient Partnership, Life Education Centres and Expert Patients Programme in England will be drawn on.

In short, the contract does damn all to address the problem.  Things will be much the same as before - as anticipated - except that patients will be "empowered" (don't politicians love their jargon?) to ask for more or to be educated - if they want to be.

Dr Chisholm answers the very obvious question as to why the contract wasn't costed, before being presented, in a New Labour political fashion.   Apparently they never said it would be costed just that the framework would be presented for approval (or not).  Not an act of great political astuteness but one which may hang them.

A final word.   The negotiators seem to think - even without pricing - GPs are in a win-win situation.   I find that a little hard to believe with Milburn on the other side.

The apparent basis of the new contract seems to be that if the GP wants to reduce stress and work-load he can - but his pay will drop alarmingly (?).   Not quite what the doctor ordered after slogging his guts out for little reward for decades.  Ergo, to keep his pay up the GP will have to work harder and isn't that where we came in?

Letters
I had a go here at Ian Bogle about the source NHS funding, suggesting there was an alternative to totally through taxation   He replied.  We differ.   Members have not been asked.  CLICK

BMA GP Poll
THis has been mentioned elsewhere and seems to confirm opinion that PCTs will not improve care.

GP Recruitment
This long piece bemoans the repeated fact that there is a shortage of GPs and that there are few if any applicants for even the most leafy, rural practices.   Anger is expressed that notice was not taken of warnings to the DDRB over many years.  Few suggestions are made as to the cause or the remedy but there were a lot of words.

Perhaps the small item from Haroon Mann, an orthopaedic research fellow says it all - or nearly.   He "places" a small ad which is very worthy of being repeated:

WANTED: 4,500 students with A and two Bs at A-level to work long hours a week for approximately £5.76 per hour.  Ability to make life or death decisions essential.   Experience not necessary - full training given (six years compulsory).  Successful applicants will be at high risk of suicide, alcoholism and divorce, but those who persevere may reach top positions after 18-20 years.

 

Saturday, 20 April 2002

FRONT PAGE

The Headline concerned the new GP contract, continuing on to the next page with the GPC wish-list.   No comment about wishing to be paid adequately or at all, even.   At the time bmanews went to press negotiations were continuing.   No doubt the subject will have exhaustive coverage next week.   Up-to-date news about the Contract is elsewhere on this site (via Headlines).

ELSEWHERE

There is a headline on page 2: "21st century doctors need strong leaders".   Quite.  But they don't have them.

Other items cover stories which have previously been posted on this site, such as organ collections, locum pensions and MRI PMs.  The latter being just one consequence of the  irresponsible and ignorant mouthings of the Secretary of State over Alder Hey which may cost lives in future.

An interesting side piece tells us that former Aussie PM Gough Whitlam has donated his brain for research.   There is a rumour that the GPC negotiators rather liked this idea but couldn't find one between them.

Scots LMC Conference is to make a call for the NHS to be freed from politics.   Seems a good idea considering the experience since 1997 when the loonies were let out of the bin.

Talking of loonies, bmanews tells us that the RCN, under its new American branding, is taking the NHS to an Employment Tribunal to bring nurses pay in line with doctors.   The RCN makes some comment about work of equal value and equal pay.   Although this is absolute rubbish one has to recognise that the RCN leadership, although being atesticular, does have balls.

In the "he would say this, wouldn't he" section, the NHS director of Human Resources (as opposed to canine, perhaps?) says that it is crucial that doctors deliver on government targets (? no matter how ludicrous) if the NHS is to reap the rewards of greater funding.

Knifeless PMs by scanner
This has been alluded to above and on-site.

National Primary Care Trust Development Programme (NatPaCT)
I still find it amazing that the doctors' trade union magazine can publish political articles without political comment.  In this case a page is devoted to the inevitable formation of another QUANGO lead by ex-GP Barbara Hakin.   NatPaCT is part of the Modernisation Agency and is intended to help PCTs meet demands from the centre without compromising local flexibility (it says).   The fact that GPs, despite all the past government promises, have little influence on all this, is glossed over on the grounds that PCTs are a good thing, anyway. "It would be unrealistic for GPs to expect quite the degree of influence they had in PCGs" says Dr Hakin - except that is just what GPs were promised in the worthless Milburn propaganda.

Sports drugs
An interesting and increasingly important dilemma is facing GPs.  Whether to offer guidance to patients who break the law in this way.   The conclusion at the end of this page-long piece is that patient confidentiality still obtains - so be careful.

Other articles
Doctors in Sarajevo, a GP who received a new kidney and making employment law work.   All these are well worthwhile items and deserve the attention of bmanews readers.

Saturday 13 April, 2002

FRONT PAGE

PM MRI scans
The magazine quite rightly carries criticism of another air-headed idea from the DoH.  Where do they get tham all from?   The department is suggesting that to avoid the problems created by their own-goal at Alder Hey (PM refusals are now the norm), PMs may be carried out by a less accurate and less informative MRI scan.   Erm, isn't there a national shortage of scanners and radiologists to scan the living?   Alan Milburn to answer, in one word, please.

PCTs
Many PCTs are not yet up to the job with which they have been landed with since April 1st.   Too few staff and many of those are not trained in primary care.   Hands up all those surprised at this announcement.

GPC on the road
...with details of the new contract but beware of CBEs bearing gifts.

ELSEWHERE

Ex-cons
It seems that ex-cons are turning up at surgeries, without medical records (like the rest of the population) demanding diazepam etc etc.   GPs are concerned about this.   Maybe some worry that the cons will complain when the drugs are not automatically handed over and that the GP will lose his job over it.

Scots non-principals
The delay in compiling the list of non-principals and the effect on superannuation worries Scots GP.  English locums are concerned because Milburn has reneged completely on their pension rights.

Northern Ireland
GPs in the province are concerned about the chaotic bureaucracy in the province.   Maybe the quaintly titled public safety minister in charge (shades of the French revolution) is not up to the job and has thoughts in other directions.

Another worry for GPs
In these extremely litigious, fast-buck-for-nothing times bmanews rightly comments about the anxieties of GPs who are asked to certify that patients are fit for this, that or the other activity.   Unless the GP has a special training, or loves living in the high risk lane, he should be very wary of such requests in future.

A later piece comments similarly on GPs and sports meetings.  An item on this very subject was posted here a year ago.  Return to Headlines and scroll down.

Bogle and the Budget
 Ian Bogle looks forward to the expected massive increase in NHS spending from Mr Brown.   He comments that we (BMA) will be interested to work to see it produces a better service to patients and doctors etc etc.   He further comments that he (Ian Bogle, because BMA members haven't been asked) favours funding the Labour party way, from general taxation.  He (Ian Bogle) would favour raising taxes for that.  Well, bully for him.  I (David Roberts, a BMA Council member) would not and my opinion is worth just as much as his although he is promoting his views on the back of his office as BMA Council Chairman - and he shouldn't.  A letter to this effect has been sent to bmanews but will it be printed?

The future of medical schools
There is unfair funding of the research system and this could adversely affect some medical schools to the extent that they may have to close.   The BMA correctly agrees.  Milburn, who needs doctors badly, should look into this urgently.  Time for a QUANGO?

Patient satisfaction
More than 80% of patients are satisfied with their GP and 51% very satisfied according to a MORI poll.

Avon Health Authority
Going out with a bang the HA says that GP treatment rooms for minor surgery do not meet new standards.  The LMC says they are unattainable and that the serrvice may have to cease.   Meantime, the LMC says, there is no evidence of patient harm coming from GP minor surgery.  The terrified HA backed off and then said the standards were a gold standard not hard and fast rules.

Two long articles...
...
on the shortage of paediatric pathology staff (post Alder Hey) and the NHS Frontline (about violence to doctors) are both highly commended reading.   

Management shuffles & Tony Calland
Tony reminisces about all the changes that he has experienced in his 30 years in the NHS and he concludes that the devolution to primary care has been round the wheel before.   He further states that PCTs are not up to the job due to cash and trained staff shortages.   The conclusion is that governments should think in ten year cycles, he believes.   The corollary to that is that major medical politicians should not be so eager to embrace incoming government's latest wheezes even if they do vote for the Party in question.  I have no idea how Tony votes but he has held a position of some importance for some years now.   The BMA eagerly dumped the Tories and jumped on Tony's waggon when they had an opportunity to put chocks under its wheels in 1997.

Second opinion
An excellent piece by John Sinclair on MMR and single vaccines and the murky waters surrounding the controversy.  He mentions the speculation about government advisers having financial links with MMR companies.   Undoubted links considering today's hidden announcement that the smallpox vaccine contract has been awarded, without good reason, to a company which funds Labour despite there being alternatives.

Head2Head
This is a short debate between professor Black, who favours the view that the NHS should be run by an independent institution and Dr Howard Stoate, who does not.   Interestingly, bmanews says that Howard is an MP but does not say he is a Labour MP - a fact that colours his views.   Although personally not agreeing totally with the professor I do find Dr Stoate's reasoning bizarre.  "Imagine", he says "an NHS under the control of a chief executive and board who are not up to the job".  It would be very little different, perhaps even better, than an NHS under the control of a third rate Labour party bookseller.

Final comment
From Winner takes All - a piece on personal injury claims:

A BMA commissioned MORI poll in February found that only politicians and government ministers scored a lower satisfaction rating than lawyers.  Doctors and nurses, meanwhile, topped the poll.

And whose surprised at that with Ministers of the calibre of Byers, Mandelsonn, Milburn, Blair, Robinson etc etc.

Saturday, 6 April, 2002

FRONT PAGE

The main topic is the anger amongst GPs that Milburn has offered a bribe of £50K to some if they joined PMS before the end of March.   GPC says this discriminates between GMS and PMS GPs.  They have "expressed concern" to the DoH.  I suppose one day they will have the courage to face Milburn and say what they really think in no uncertain terms.  "Expressing concern" invites the GPC to be ignored.  As, of course, Milburn will.

GPC and LMCs also express concern, on the front page, that, surprise, surprise GPs will have less influence on PCTs.   Surely this was blindingly obvious to a doe eyed rat when Milburn announced the scheme?  It just shows what an ineffectual lot GPs have as representatives.  The leadership was far too concerned sucking up to Blair and Co. to do their job properly in the early days.  Hence the CBE, perhaps?

ELSEWHERE in BMA News

Surgical appraisals
Milburn damands that death rates be included in individual surgeon's appraisals.  There will be no meaningful discussion about this.   The consequence will almost inevitably be that surgeons will decline to take on difficult cases for fear of being adversely appraised.  Well done, Alan.  True to form.

On the same topic, the government has reassured (it hopes) consultants that inaccurate data about them will not be published.  And the next flying pig comes by at 4 o'clock.   The BMA consultants committee has "expressed deep concern".

Telephone consultations
The RCGP says they are not an efficient use of GP time.  Having seen this report the DoH is now about to issue a directive to GPs to hold telephone consultations.

Wider range of GPs should stand for GPC election
Hear, hear, I say and, considering that the negotiators almost to a man evade regional elections and creep onto GPC through the back door of LMC Conference and BMA ARM, perhaps they should set an example.

Anti-smoking bill
At last the government has been shamed into supporting a Liberal Bill to ban tobacco advertising.   It seems they failed to find time for an identical bill last session and didn't mention it in themost recent Queen's speech.   However, its progress through the Commons has embarrassed Blair to adopt the Bill as a Labour one.  He will, of course, grab all the credit, as usual.

The right to prescribe
The BMA and the Pharmaceutical Society have got into bed to discuss the extension of prescribing rights.  Ostensibly the conference is about nurse prescribing but the chemists have a certain self-interest here in that Milburn is about to announce similar rights for chemists.   The conference takes place at the Commonwealth Institute on May 23rd.

Letters
In a very sensible letter Vice-Admiral Sir John Rawlings comments about the unecessary nature of revalidation.   As he says, doctors are very respected and there are ways of complaining about us.   Why don't the BMA and the Colleges survey members on the need for revalidation?  Answer was there none!

Bogle's boogies
This Opinion from the Editor in Chief is mainly about NHS funding but doesn't say much about it except that an increase is needed and the BMA was ignored some years ago when it said so.   He comments also that now the PCTs have been formed doctors have very little influence on how the money should be spent.   He sets his place out clearly when he says he believes "unequivocably that the NHS should be funded through general taxation"".  With all due respect he is in no position, as a trade union leader, to say that.  He should be unbiased and listen to both arguments and Council should make a decision, not the Chairman.  In this case, Bogle appears to dismiss the Opposition's view point out of hand by sticking unequivocably to the Labour line.  Why is he still sucking up to Blair on our behalf?

Off the record
Andrew Dearden of GPC recently gave evidence on bed blocking to a Commons Select Committee.  During the hearing a smug Labour member of the committee accused the BMA of overstating the problem.   Quick as a flash, as they say, Dearden apparently said that doctors could never be accused of that and perhaps the politician was joking, or at least, Dearden said, "I will take it as a humorous remark" and, if the problem weren't as serious "as we say we wouldn't be debating it here today".  Full of sharp remarks, Dearden told a triumphant Tory "I'll slander everybody equally".   Make what you like of that but BMA News devoted half a page to the exchange.

Mentally Sick doctors
A useful double page spread sets out a case for caring treatment by specialists away from the area of practice.  Apparently the DoH is not unsympathetic to the idea which is not the same as saying they will do something about it.  The piece emphasises the problems for doctors who fear being in the same waiting room as their patients and therefore are tempted to self medicate.   A mentally sick doctor is unlikely to get his own diagnosis right.   A short supplementary piece by a manic depressive doctor bemoans the fact that few GPs know much about mental illness - in his opinion.  Consequently he shops around regularly to find one who does thinking his life may depend on it one day.