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Saturday, 30 March, 2002
FRONT PAGE
Dominating the front page is a photograph of a scorpion but the
editor has resisted the temptation to name it after a certain government
minister.
The main item states that
most HAs and Trusts have failed to provide safe locations for GPs to see
previously violent patients.
Gordon brown will be raising taxes, he hints, tro pay for the NHS and
the consultants' negotiators are grappling with the remuneration element
of their new contract. (GP leaders are prepared to leave
that until later).
ELSEWHERE
The current Aunt Sally, bed blocking, raises its head as "doctors
tell government" about it. The Select Committee Chairman,
David Hinchcliffe, agrees that it costs the NHS at least
£750million/year in England alone.
BMANews receives the same
press releases as this magazine and mentions "bogus health
sites". See Headline page of countrydoctor for
more about this.
The dead are to be
presumed to want to give their organs to others if they haven't said
not, according to a private member's bill. I, personally, would
draw the line at mine going to Milburn but, then, they may insert a
little common sense into him!!!
Siphoning off cancer
money
Who will be surprised that many HAs are misusing funds which should
have been ear-marked for cancer care? The NHS, Milburn, said
that it was up to the HA what they did with funds but that it expects
cancer funds to be used for cancer care. £570million was
provided but £280million had been spent elsewhere.
Meantime, surprise, surprise, the government is patting itself on the
back as it misleads the public about the funds it is giving to cancer
care.
Private Care
Milburn cannot resist putting his finger into matters that do not
concern him. First locums must register with their HAs, now
any doctor working in provate care must register with the National Care
Standards Commission. It will not have escaped even
Milburn's notice that any failing doctor is answerable to the GMC, so
why the need for yet another QUANGO? Is it because it makes
our Alan feel important?
Losing their grasp
My namesake, David Roberts, Chairman of Dyfed Powys LMC, makes good
sense, as he would, when he says "I don't think that they
(politicians) know what the truth is anymore. What we hear from
politicians is very different from what we see on the
ground". Well said. In this government, and this
me writing, the major qualification is that the truth should be spun out
of all recognition lest it be inconvenient.
GPs confident of high
approval rate
Following on from the last item, the DoH is surveying patients about
their satisfaction with GPs in an 88 question leaflet. As
ever, Chisholm is confident of the outcome and, no doubt, welcomes the
poll. Have he and his negotiating colleagues learned nothing over
the past few years? If Milburn wants another rod to beat GPs
with then he will get the outcome he wants from this unaudited
poll. Naive negotiators only help him
It's 2004 again!
Alan,just as obsessed with his target date of 2004 as I am with his
incompetence, has announced through Lord Hunt that strategy to tackle
alcohol misuse will be implemented by 2004. More
unpaid work for GPs?
FEATURES
Cremation Certificates
The Coventry Cremation referee writes a very pertinent piece about
the many failures of GPs when it comes to writing out
"ash-cash" forms. He is quite scathing but, then,
I, too, have felt the lash of the Coventry officials! This
item alone is worth all doctors searching out this week's edition of
BMANews. They won't enjoy reading it but nevertheless they should
do so.
NHS Federation Chief
Executive
The new chief exec, Dr Gill Morgan, has had a varied career through
general practice, public health and finally in charge of the NHS side of
present negotiations. Let us hope that Chisholm and Co
are not misled by female charms at the negotiating table because Dr
Morgan is, first and foremost, a government employee, loyal to
Milburn. She says there is a "huge degree of trust
developing" but is that necessarily a good thing when dealing with
Milburn's minions and GPs' futures? Apparently, the BMA says
she is "good news". Oh, dear! Poachers
turned gamekeeper are never good news for the rabbits.
Northern Ireland
Health care in the province is all crapped up, seems to be the
message from Nigel Gould's item. Much will be made of the
extra £224 million going to NI healthcare but, it appears, only
£46million will go towards badly needed improvements. £1billion is
needed. Could it be that the Health Minister was not primarily
trained in the specialty of health care and, like so many other
politicians, lives in a fantasy world?
PCTs cometh
Milburn has apparently said that removing the HAs and replacing them
with PCTs (it will be fact on April 1st) is an enormous risk which will
take 10 years to assess! Then why do it? Is it
just because, like Blair, he enjoys change for change's sake or because
it makes him feel macho? The BMA primary care development
chairman, Julian Neal says that PCTs are "under-resourced and
understaffed" as "there is a flood of good talent leaving them
and the NHS". Money, he says, is going, by instruction from
on high, to bail out secondary care rather than to develop primary
care. Even Dr Morgan, NHS Chief Exec, agrees and is quoted
as uttering some nonsensical waffle, ministry-speak. But all
this is a bit late. The BMA/GPC had its chance to oppose these
"reforms" many years ago and characteristically ducked the
issue in its initial glorification of the New Labour, Blair
government. I should know, I was in Council when they did
it! They are now repenting at leisure - at your
cost. An interesting footnote is that Slough PCT has
the support of all its GPs and they are all in one committee or another
- and who works at the sharp end?
Saturday, 23 March 2002
FRONT PAGE
Psychometric testing
of GPs
Milburn's QUANGO, the National Clinical Assessment Authority, is
about to psychometrically test the suitability of
"under-performing" doctors for their profession. What
this means is that doctors who offend will have their closest personal
lives, relationships, past and upbringing examined in detail by
governmental psychiatrists. These colleagues are then
charged to determine the doctor's suitability to be a member of the
medical profession. Upon that rests the future of the
doctor's employment.
Stalinist Russia also
used tame psychiatrists to ensure that government policy was carried
out. Apparently our Health Secretary, Milburn, is
comfortable with the concept that similar actions should take
place in his name in today's NHS. This raises the
question as to whether he, himself, is psychologically the appropriate
candidate for such a high office of state.
There are, of course,
serious human rights issues to be addressed here In the
meantime one wonders about Dr Bogle who
simply commented, in BMA News, that the measures were "over the top".
Is there any fire in this man's belly? Is he still unaware what is
happening to the profession? Perhaps he, too, should be
referred for psychometric testing?
ELSEWHERE
Students and juniors
The Junior doctors committee is urging students to refuse to work in
non-compliant HO posts because of the horrors of long
hours. There is here a dichotomy between being well
trained through seeing a multitude of cases or just doing a job as a
hospital doctor, 9-5. Again, which is worse a tired HO or a
poorly trained but rested HO?
PCTs
Apparently PCTs do not have to have a medical director and, in the
absence of one, the PCT Chief Executive may ask a toady doctor to
resolve clinical decisions. Quite rightly the BMA objects to
this.
Scottish Trusts and
Juniors
All Trusts have failed to implement the accomodation standards for
junior doctors.
GP staff pay
Welsh receptionists are leaving GP work for more lucrative jobs
elsewhere.
Complaints
Following the suicide of investigated - but innocent - GP, Dr Philip
Evans Welsh doctors have called for a ban on publicity of complaints
until the matter is resolved. The Health department said
that if relatives bring a complaint into the public domain then GPs can
respond about innacuracies.
BAMS GPs
Doctors should not put up with violence when visiting patients to
examine for DSS purposes.
The 2-page spread on
art & medicine
An interesting but non-political item - much to the relief, no
doubt, of many.
AIDS
This is an article complaining that AIDS may not be getting the
support it needs. Certainly the AIDS industry has been
curiously muted in the UK these past several years.
Saturday, 16 March 2002
Once again,
Ian Bogle editor-in-chief of BMA News and BMA Chairman, has failed to
admit that there was a cock-up over nurse gatekeeping and still hopes it
will not be missed. Not a word in the BMANews about the
gatekeeper role, let alone a retraction. Readers will recall
that it was the same Bogle who put his - and the BMA's - name to an
infamous government document last year - and had to retract that.
FRONT PAGE
New Standards
The Academy of Medical Royal Colleges chairman, Sir Denis Pereira
Gray, quite rightly pointed out to BMA Council that the profession in
under unprecendented attack by this government. Both
self-regulation and medical education have been targetted by the
Blair/Milburn axis as being properly within their rightful sphere of
influence. Both parties are somewhat unknowledgeable about these
matters.
D-Day 2005
Sir Graeme Catto said the first doctors
will be revalidated in 2005.
Consultants'
deal
has yet to be announced.
Elsewhere...
GPs and MMR
Targets
Council agreed that GPs were likely to
lose "thousands" under the current target scheme and that it
should be modified. GP's should not be fined up to £1,800
because one patient exercised their democratic right.
Dr Chisholm said that patients should be counselled and advised - in
some of the free time doctors have, no doubt.
NICE
Tory MPs quite rightly believe that HAs
could be forced to cut patient services to recoup the cost of drug
overspends caused by GPs observing NICE diktats and the refusal of
Milburn to provide the necessary extra cash. Dr Bogle
agreed.
Slowdown in
complaints to GMC
Last year, 4,504, previous year 4,470,
1999, 3001. 10 years ago the figure was about
1000. Dr Bogle hoped that the number of complaints had
levelled off. Incidentally, the rate of resignations and
retirals has also increased over the same period of time. Cause
and effect? GP stress levels due to workload rises
have also increased. Somerset HA Director of Governance said
"Action is needed to relieve it" - before sending another 440
diktats down the line.
BAMS doctors and
complaints
Many of the GPB dislike not being able
to get their hands on State Benefits and, of course, the obvious people
to complain about are those evil doctors who follow the system.
These complaints go on the GP's record and he has to answer for them to
his employer. He may also be penalised on revalidation, they
fear. If that is the case then perhaps they should find work
with a better employer.
Anti-tobacco
groups...
lament four decades of early deaths and
Bernie Ecclestone's influence on Blair - perhaps.
Sperm donors
should be anonymous says BMA
Absolutely, 100% correct. No
doubt some greedy member of the gbp would seek support from the
thankless "father" many years down the line
Surprise
Many MPs questions to Milburn have
remained unanswered for around a year. Milburn blames his civil
servants.
BMA ARM changes
George Rae, RB Chairman, says there will
be changes at this year's ARM - though not many. One
is that the speaker will be centre stage, as being all-important at the
time. Permission for other changes will be sought from the
meeting.
Asylum seekers
and healthcare
Rather than put illegal immigrants on
the first plane back to await a decision on their acceptability - or
fast-tracking political immigrants - the government is allowing 5,500 to
enter the country monthly. These people are then assigned, without
further resources, to GP practices where their presence affects current
care of the population.
GP negotiations
Laurence Buckman gives an insight into
the negotiations and gives nothing away. He asks a puzzling
question: "ask yourselves why seven GPs, representing all of
you, would choose to damage the NHS they are dependent on for a
living".
Surely, the question
should be "Ask yourselves why seven GPs (etc) should allow the NHS
to damage your lives". But he didn't ask it, did he?
Nor do the negotiators want "to put a gun to the Milburn
head". It's all a question of priorities.
European ops or
not?
Head2Head debates the issue with, on the
one side a doctor who has worked in both systems saying that German
treatment is first class and patients will benefit. On the other
side is a Professor who says it is madness if the costs are greater than
in the British private sector. The professor says - almost -
that Milburn's department cooks the books when announcing new money.
Saturday, 9 March, 2002
FRONT PAGE
One would imagine that
the "abrupt change of policy" over gatekeeping mentioned
in the BMJ would rate a mention on the front page or somewhere.
Not a word nor a retraction of the error. For
details of the error.
Disabled students
The BMA's disabled students' row with GMC takes priority but I
cannot help wondering whether the campaign is
misguided. I suppose a lot depends on the disability.
Common sense surely says that there must be some discrimination.
After all, who wants a blind brain surgeon? Somebody needs
to educate me as to how the full undergraduate medical course can
be completed by every disabled person in every circumstance without
discrimination.
Supplementary lists
for locums
As a locum I object most strongly to this Milburn
measure. My contract is with the practice, not the NHS, and
it is the practice's responsibility to the NHS to ensure that I am
competent and fully registered and insured. I am a private
practitioner and the list restricts my right to practice my
profession. The GPC seems content that Human Rights issues
have been addressed. I am not.
CRaP
As mentioned elsewhere on site, CRaP may, if you trust Milburn, have
its powers reduced so that it will need the agreement of both Houses of
Parliament before it can demand changes to GMC. I suggested
in BMA Council yesterday that they should carefully examine, with a
lawyer, every phrase, word and letter that Milburn presents to the
BMA/GMC considering the deceit with which he introduced CRaP to the
world.
ELSEWHERE
Medical Education on
the government
The BMA complains that government proposals undermine the
profession's own efforts to introduce standards. The
government's proposals are described by Dr Bogle as
"proscriptive". It would be surprising if they
were not.
Insurance reports
Dr Peter Holden, professional fees committee chairman, is hopeful
that an improved agreement will be made. In the meantime,
some GPs are charging around double the old, outdated rate.
It is your choice, for the time being.
Doctor safety
The MDU says it is the PCT's responsibility to have safe places for
doctors to treat dangerous patients.
LMCs say more doctors
should go sick
GPs should not soldier on through ilness when all about them are
giving in. Government, says GPC, should recognise that in locum
payments. It should not be necessary to go to work
ill. Hear, Hear!
Nurses not trained to
prescribe...
...except under very limited circumstances and even then there are
doubts.
Northern Ireland
The cock-up by the NI Health Minister has united doctors, nurses and
midwives against the NI government.
GP clinical
attachments
GPs are paid £70/session and locums cost at least £120 for the
same period. Ergo, if the pay does not go up, then the
GPs will opt out. Government take note.
BAMS warned
Peter Holden - again - has warned BAMS to tackle its work-force
crisis and doctors' pay. Last chance.
Tobacco Advertising
...could be outlawed by June, says this piece but Dr Bogle had a
letter in The Times (7/3/02) saying nothing had been done by
government. Bogle didn't say it but I
will. How much cash is going into Labour Party coffers from
Ecclestone and Co.?
Double Page spread -
MMR
The confusion is addressed together with the anxiety that
doctor-patient trust will be damaged by GP targets.
Trevor Pickersgill
The "juniors'" leader is featured in a continuation of the
series on BMA notables.
The Bogle column
Dr Bogle says the BMA has considered many ways of funding the NHS
and they have concluded that general taxation increases are the only
way. He applauds the prime minister and rebukes the Director
General of the CBI who accuses Blair of tax and spend.
Seemingly sold on this government Dr Bogle wholeheartedly supports them
and the suggested increase in taxation. No other options are
discussed.
Off the Record
...warns Milburn that just because Byers presently occupies
the hot seat doesn't mean that his time won't come - it will.
Cambodia
A fascinatingly revealing two-page spread on land-mines and
amputations. Read it if you can.
--------------------------------------------------
Saturday, 2 March 2002
FRONT PAGE
Blair's tax top-up
"Doctors' leaders" believe Blair is to raise taxes for the
NHS and that he has put "his personal personal reputation on the
line". Judging by recent events that reputation is not
worth very much but, nevertheless, Ian Bogle believes it is and, yes, he
"welcomes" it.
Protecting GPs
Only 7 HAs have put in a scheme to protect GPs from violent
patients. Are we surprised that they don't give a
damn? However, Simon Fradd has written to Milburn, so soon
even the magic seven will be eliminated.
Fiddling the figures
Surgeons say that the last-minute cancellation figures for ops are
understated since they don't include cancellations made the day
before. Another surprise to someone?
ELSWEHERE
Staff pay
Scots GPs say they are not being properly funded for staff pay and
will have to dip into other budgets. Or reduce
services?
Surgical day cases
In a hell-for leather dash to get waiting lists down at any cost,
Milburn is putting pressure on surgeons to get as many cases treated on
a day case basis. Surgeons have expressed their anxiety over
this.
Targets & MMR
GPC says removing the target incentive for MMRs would also remove
the suspicion of patients that GPs are not impartial about MMRs.
Can't argue with that.
Appraisals
Once again GPC has warned that appraisals, whilst they say they are
welcomed, will not take place unless funded by PCTs. The DOH
has agreed and issued directions to PCTs. Meantime, there is
suspicion that the cash will be removed from other parts of the GP
budget. Central funding is essential, says Nagpaul. By
the by, how many front-end GPs welcome appraisals, one wonders?
Waiting lists
Birmingham University professor, John Yates says the government
hasn't a chance of achieving its target of a maximum 13 week wait for an
OP appointment by 2005. On the contrary, things are
worsening. So another electoral lie bites the dust.
Welsh GPC
"welcomes" something else
This time it's a package of GP recruitment measures which consists
of: a £1000 bribe or "thank you" for working after 55;
another, £15,000, bribe to fill single-handed practice vacancies
payable to practices who allow a partner to fill the vacancy for at
least a year. GPC has not explained who will pay the
essential locum costs of more than £15K for the year.
General Practice &
superheroes
A quite correctly commended article from the recent BMA competition
describes a couple of incidents in Dr John Burscough's day.
Governance of the BMA
itself
Governance seems to be the "in" word but what it really
means is that somebody wants to reform the Beem. Russell
Walshaw has chaired the appropriate committee so the ARM will whether
his committee has done a good - or necessary job. At
last year's ARM the answer was "No". This time the
Divisions have had a say.
More chambers
Even GPs are thinking of moving into chambers perhaps with
consultants and ancillary staff. The hope is that patients would
be seen more quickly. Seems all very grandiose but the
Leicester GP, Dr Khong, is not reported as saying how the GP chambers
scheme would work for Mrs Bloggs in Nether Whatsit.
Could it be that as with fundholding, the rich get richer and poor drop
off the edge?
Another
"notable" eulogy
Consultant's leader, Peter Hawker, is humbled to think he can make a
difference. Apparently he can freeze water at
twenty paces and be a bit terrifying to his staff. One has
to wonder whether a whole page is necessary for this sycophantic pap.
Northern Ireland
GPs in NI are very unhappy about proposed reorganisations and many
of their representative groups have expressed this to the, in the
circumstances, quaintly titled Health, Social Services and Public Safety
Minister, Ms de Brun. Having learned her skills at the
Milburn school she has "carpeted" and rubbished the NI GPC
chairman for his temerity. Meantime, NI is around 2,500 GPs
short and the de Brun way is not the way to get them.
Finally...
Bombay dentist Mr Kulkarni tells doctors to take their own backache
more seriously and to seek advice. He offers some sound
advice.
---------------
Saturday, 23 February,
2002
FRONT PAGE
The St Paul
The BMA is still flogging
away at the dead horse on behalf of their members and there seems to be
some likliehood that GPs will get a cash sum from the company.
Interested readers should peruse the St Paul statement on page 2 of
bmanews.
Trust me, I'm a doctor
It seems that
despite all Milburn's undoubted negative energy he has failed in this as
in so many other matters. An increasing number of patients
(now 91% as against a recent 89%) do trust their doctors.
Scots Trust fraud
Glasgow Royal Trust has asked its junior doctors to falsify their
time sheets so that managers can be seen to keep within the juniors'
contract. - not to mention save money on junior's pay. To do this doctors have been told to
"clock off" officially at 4pm even though they work on several
hours longer. This is the true state of today's NHS.
And where is the pressure to do this coming from? Good old,
name, blame and shame Milburn, of course.
Elsewhere within
bmanews
Consultants' contract
Proposals for the new contract are close and will be put to
consultants for
their opinion when ready. It appears that the contract may
have ten, four hour sessions during working hours and shorter out of
hours sessions. Increased hours will be reflected in
increased pay. My discussion with some consultants
shows that they are quite prepared to go into "chambers"
similar to barristers and make their own contracts on their own
terms. "The NHS needs us more than we need the
NHS". A later item discusses this in rather more detail.
Juniors
A couple of items show that the BMA Juniors Committee is fighting
well on their behalf. Some Trusts cannot be trusted and put
their juniors in cheaper pay bands. The BMA has corrected this.
They have also persuaded the DoH to part with more flexible training
cash.
GPs
Meantime, GPs' leader, John Chisholm has implied that the
negotiating team has proposed that it will no longer be mandatory for
all GPs to offer the present range of services because "the current
workload is unsustainable". Apparently, believe it or
not, the DoH agrees. Presumably that is why Milburn continues to
add more and more, including an increasing number of NSFs.
Lawyers
Another one to believe if you dare is that the avaricious legal
profession is "cleaning up its act" to rid itself of the
dubious, high-pressure no-win, no-fee ambulance chasers whose ads we
have all seen on the box and out-patient Appointment Cards. The Law Society has endorsed
Accident Line, a collection of recommended local solicitors set up by
Abbey Legal Protection. It would have been better if
the Law Society had done it themselves.
Privatisation
A desperate Milburn is accepting help from anybody who can give
it. German doctors are coming to work in ex-Army hospitals and
now the American Bridge Global Health Corporation is offering its
services. Roll up, roll up, Alan needs you!
We don't need you...
Milburn is advertising on TV and in the press for more doctors and
nurses. The campaign is costing £3.2million.
More effective and costing far less would be a simple poster campaign
and a letter to each doctor and nurse with a photo of Milburn with the
caption simply saying "I resign". Not many would say
they need him. Retirements and resignations would drop
overnight.
Women doctors
Women now outnumber men by 6 to 4 and 60% of new applications for
medical school are
from women. Men are no longer attracted by medicine as a full-time
job. Women, of course, leave to have families and then
return, if at all, to work part-time. So, although they
number 60% of the medical work-force women as a group do not put in 60%
of the work. Hence an exacerbation of the numbers
crisis. A further worsening is caused by young men seeing
doctors being criticised right, left and centre rejecting medicine as a
career for IT or business. It's down to
that ass Milburn again and the sycophants in all his QUANGOs.
Two extensive Labour
Party contributions
Are the editor's politics showing through? There are
two lengthy pieces by Labour activists. Namely ex-Health Secretary
Frank Dobson and current Cabinet Minister Alistair Darling.
How about something from the Opposition groups?
The failed minister gives
us all the benefit of his wisdom and, rather richly, claims that
"people who work in the NHS are fed up of re-organisation".
He believes that the government is going about things the wrong way in
the hospital sector by proposing foundation hospitals. These, he
says, will cause managers to spend funds on "management
consultants, lawyers, accountants and valuers - the uncaring
professions".
Instead doctors should
have their clerical workload cut and nurses and midwives should have a
big pay rise. Nothing here about a big pay-rise for doctors who
bear the majority of the work-load and responsibility simultaneously
with approbium from
the present Secretary of State. But it's that very approbium which
is preventing recruitment so the first step is to remove the
cause. Dobson does not say it but I do.
The removal of Milburn would a very positive first step.
Alistair Darling
is allowed column space to try to tell us we have nothing to fear from
the government's plans regarding changes to incapacity
benefit. He's convinced that there won't be any increase in
doctor workload. Well, that's all right, then. It's
not at all clear what he is trying to say except that they are trialling
a new format which sticks to clinical questions. Not sure
whether he imagines that notes won't be needed for that or how it will
reduce workload. But so long as he knows I guess that's OK.
The BMA disagrees, in
"Benefit of Burden?". Present staffing shortages
at the Benefits Agency (BA) will lead to an increased burden on family
doctors, they say. Peter Holden, who has been batting
valiantly against the BA for some years remains sceptical about
government policy - and that's good enough for me.
We learn that Chissie is
compared with Churchill, no less. Well, they both wore bow
ties and there the comparison stops. JC couldn't make his mind up
whether to be a politician or a doctor so he's doing both.
Better keep the day job, John. Oh, sorry, you've just about given
it up by now, I guess. There's not a lot else to say about
this brown nose job by senior news writer, Graham Clews, except that it
coincides nicely with the BMA Council elections in which the great man
stands - against this columnist, no less.
Peter Hawker's
"Opinion"
In contrast with the previous item, this appears to shine out as
good sense, although, not being a consultant, I cannot vouch 100% for
that. I must say, though, that I do worry when our
medical politicians "welcome" anything this government
does. Chissie has done that far too often for my
liking.
Public Health
Slightly outside this columnist's range of expertise there is a very
worthy spat in "Head2Head" between a BMA public health
committeeman and an NHS Confederation chief exec. The
BMA says the government's agenda for public health reorganisation
is rushed (as usual) whilst the Confederation says "Tough, they're
going to be implemented and you'll have to get on with it".
Where have we heard that before? The BMA bemoans the fact
that Milburn listens to no-one and rushes ahead without thinking of the
consequences. Surely they are used to that by now?
___________________________________________
Saturday, February 16
2002
FRONT PAGE
GPs fear effect of
incapacity work
This piece deals with a bone-headed directive issued by the Scottish
Executive. This commands GPs to carry out lengthy
assessments of patients to decide whether they are capable of giving
informed consent to treatment. Those who aren't will
be given a certificate. The whole useless process to be
repeated by the GP whenever the patient needs treatment from other
healthcare workers such as chiropodists or dentists. Words
fail me as to the stupidity of this order.
OFTs and anaesthetists
As mentioned in an earlier report, private anaesthetists are being
criminally investigated by the OFT on the accusation that they are
price/fee fixing. Not unnaturally the doctors are angry and
upset. It is felt that their ability to provide their
services will be compromised.
The Calderdale nudes
Obviously still
living in an era when table legs were covered by frills and fig leaves
were in vogue, the management of Calderdale hosptal have ordered that
the delicate parts of the two illustrated sculptures should be covered
up, lest they offend patients. Really !!!
Elsewhere in BMAnews
Milburn's NHS was shown in its true light recently when Oxfordshire
Healthcare NHS Trust dismissed a specialist 2 days before her 50th
birthday to save passing her 10 years of pension rights. The
industrial tribunal described the trust's action as "tawdry and
outrageous" They were made to pay compensation.
GMC President
In a full page report Sir Graeme Catto reveals that he questions the
need for Milburn to have powers of direction, in CRaP, over the GMC and
he is also disappointed that the new Medical Education Standards Board
will answer to Milburn rather than to the GMC. He feels that
the Council is being sidelined. Indeed it is, but Prof Catto
does not reveal what, if anything, the GMC will do to prevent that
happening. He fears that Milburn will give the NHS
priority over the educational standards of doctors and that that will
not be in the long-term interests of patients. OK, so the
professed signs are that he is not another appeaser. We will be
watching.
Auf wiedersehn, Sam
Council colleague Sam Everington was taken on a goodie to Berlin by
the Beeb to see the German healthcare system.
Think of a deficiency of Milburn's NHS - you know, patients dying before
surgery - and there's none of that there. Maybe one time
Labour Party adviser Sam will be reconsidering his allegiances?
Opinion Page
The main "Opinion", by BMA International Committee
Chairman Ed Borman, quite correctly emphasises that the profession
should keep and expand its international links. No argument
there.
Second Opinion
Dr Anne Savage, a retired GP bemoans the fact that admitting to
mistakes is the quickest way to the front page of the local
rag. In turn this gives ammunition to those (Milburn?)
who wish to control the profession or their own doctor. She
offers no way out of the dilemma but does advise doctors to "watch
your words". I can only quarrel with one point in
this excellent piece. Aitken and Archer may have started the
devaluation of truth but neither was Prime Minister. The
present regime don't know what truth is.
Front line by
"Charles Lamb"
Wrong target, old man. Examine the government's
part in it before blaming Dr Fox. Dr Fox did not target A
& E staff. That was government spin which many of the naive,
like Charles Lamb, or the politically motivated swallowed. Dr Fox,
if one reads transcripts, attacked the underfunding of A & E by the
government.
"Rationalising
regulation"
The writer sighs with relief. At last someone in the BMA has
taken heed of what he wrote on this site over 12 months ago, of what he
has spoken in BMA Council about and written about in more than one
publication. Doctors are over-regulated (CLICKI).
Slow thinkers at the BMA but they get there in the end.
The
piece is worth reading and keeping but the graphic is
crap. Whose 4 year old drew
it? Dr Bogle's grand-daughter, perhaps.
_____________________________________
Saturday, 9 February 2002
Lead
article
Virtually the whole front page is devoted to junior hospital doctors
whose terms of service are being manipulated and the doctors themselves
harassed so that the management can keep their hours "new deal
compliant". Other hospital Trusts are deviously reducing the
salaries and working hours of their doctors to save funds. And
where does all the pressure come from? From
Milburn who rigorously enforces targets and who could, if he
really cared about the junior doctors and the service they are allowed
to provide, come down on these managers like
a ton of bricks. But he doesn't because he doesn't.
GMC
The new President of the GMC is seeking to reconsider the
regulations which presently prevent medical schools admitting students
whose medical condition (communicable diseases - hepatitis B - or
disabilities) prevent them following the full course
satisfactorily. The medical students have been
campaigning about this but I'm not sure they are
right. You wouldn't support a blind man's wish to be a
movie critic, after all.
Psychiatric
beds
It is unknown even to the DoH how many such beds there are but there
are not enough and there are frequent crises whilst suicidal patients in
police custody, for instance, are found a bed. Predictably,
the DoH washes its hands and says it's the wrong time to audit the
situation.
GP course organisers
The cost of finding locums outweighs the allowance given to these
GPs. Dr Harris of Somerset has started a campaign to improve
pay.
Somerset
GPs are in short supply and the remaining ones have drawn up a list of
services they will withdraw if too many patients are allocated to them
by the HA. These will include ceasing to take part in PCT
etc work. Chisholm says they are wrong. However,
admin is non-clinical and that should be the first work to drop, so
Chisholm is wrong.
Insurance
Reports and the RCGP
The RCGP is suggesting to insurers and the minister that companies
approach patients first for their health details then the patients could
tell the GP to omit what they don't want the company to
know. This sounds very much like colluding in
fraud because certain conditions cause higher premiums due to greater
risk. Time for the College to think again.
Dr
George Rae
Page 7 contains an interesting filler about George and his duties as
Representative Body Chairman. I have sat alongside
George in Council for several years and the BMA is fortunate to have him
in its hierarchy. The sooner he is Council Chairman the
better.
A
few pages down the line and there is yet another filler about another
notable.
An
uneasy trust
A lovely pun on the trust between doctor and patient and hospital
trusts by a journalist, Susan Holdaway who was recently treated for a
brain tumour. Both parties are uneasy because hanging over
them all the time is the modern fear of litigation. The
media has led patients to believe that doctors can cure everything and
if they don't then there's always the litigation route stoked up by
lawyers. The doctor who fails must be incompetent and must be
punished and "I want my money". Consequently, all
doctors must tell patients all the gory details about their condition,
its possible complications and that of the treatment whether they want
to know them or not. None of the reassuring words
"It will be alright". It may not be and in slams
the writ. Wary doctor and possibly litigious
patient become at odds. Sadly, Susan Holdaway does not hold
out any solution to the problem. No more did the readers of the e-BMJ a
couple of weeks ago when I raised the same point.
Saturday, 2 February 2002
Lead Article
This is focussed on a group of anaesthetists who have been
accused by the OFT of operating a cartel over private fees. They
point out that they have operated as a group for many years and that, in
any case, there are far more colleagues working outside the group than
within it. The OFT say the enquiry is on-going.
Also front Page is a
comment that Seniors, by which BMANews means consultants, are anxious to
make a deal over their new contract. If the Treasury is not prepared to
fund it then consultants will make their minds up what to do next. Sounds
as though it might become bloody sooner rather than later.
A longer piece relates
that some GPs are so sick of being forced to treat violent patients that
some are prepared to face GMC over refusing to treat, rather than carry
on. Scottish BMA Council Chairman John Garner is supporting the
cause. The involved Trust has done nothing but, it says, is
treating the matter seriously.
Editors
The Chairman of the BMA and his wife are keeping a controlling
interest in the publication as Editor-in-Chief and Managing Editor
although there are now two "Editors". It is still unclear how
much power either "editor" has or whether Bogle and wife adopt
an appropriate "hands-off" role.
Medical student debts
The much vaunted joined together government of Mr Blair has failed
to recognise that his education policy and the shortage of doctors
conflict with each other. The prolonged course of medical students
leads them to finish their courses with debts amounting to around
£10,000 or more. The BMA correctly points out that this puts off
students from impecunious backgrounds.
GP appraisal in
Scotland
Another instance of the failure of joined up government has arisen
where the Scottish Executive have failed to agree as to who will fund GP
appraisal. Scots GPs have refused to discuss the matter
further until funding has been decided - presumably in favour of
GPs. Well done, Scotland GPC.
Also in Scotland is a
fight to win modernisation funds. Scots GPC is claiming that there
is a strong bias towards PMS practices at the expense of GMS
practices. They say that this is two-tierism "like
fund-holding". Odd that this writer did not hear many
GPC voices raised against fund-holding when the funds were good.
The Scottish Executive waffled a reply which virtually said nothing.
Milburn
A disproportionately small filler item mentions that Milburn has
started a drive to reduce waiting lists by increasing day-surgery to 60%
of operations. That, of course, means that the idle GP with
all the time in the world on his hands, will have to pick up the pieces.
Milburn's un-joined up neurones don't give a damn so long as political
targets are met. And what about GPC? Comment was there
none.
BMA Council elections
Nominationhs have closed and it is revealed that the Chairman of GPC
is actually standing for election in a contested seat - for a
change. Well done, John Chisholm May the best man win,
says the writer, who is standing against him and who has not always (!)
agreed with Chis's actions.
Bogle raps
politicians...
... over the Rose/Whittington issue.
Waiting lists
Cornish GPs have vocalised their justified annoyance over the
hospital tactic of keeping to political targets by returning hospital
DNAs to GPs without offering further appointments. They are not
alone !
The European Option
Whilst discussing whether continental treatment is good or
cost-effective the author of this feature article misses an opportunity
to discuss why it is necessary in a Labour controlled NHS some
five-years after gaining office. A number of the
shortcomings - and advantages - are mentioned as is the maybe not
surprising fact that although the scheme is up and running the DoH
hasn't sorted out its policy completely. What about league
tables (like UK hospitals and staff), litigation, indemnity.
Or even whether this is just hoped for short termism of a desperate
Milburn.
Bogle's Opinion
 This is big
stuff. The Leader writes. He begins by
decrying the "thick and fast" flow of NHS initiatives that
have continued to flow in his and our direction despite and assurance
from Milburn's special adviser, Paul Corrigan. Surely Ian
does not still believe anything coming from either Milburn or his
spinners? He wouldn't be so naive particularly after the
deceit of CRaP and the loss of self-regulation - about which Dr Bogle is
very quiet - oddly.
In a badly constructed,
or edited, sentence we are told that there is one major policy
announcement...that will have a profound effect on us all and the
NHS. It may be due to the shift in the balance of power from
Whitehall to the "frontline". Decentralising the
NHS it's called - and coming from the present Stalinist regime you can
believe that when you see it. Maybe Dr Bogle does because he
suggest that before "railroading" PCTs into all this "we
must be sure they are geared up" for it in the way of resources,
management, advice and medical input and the rest. Quite
rightly he comments that if they are denied the resources "they
will be dysfunctional". A medical way of saying they won't
work.
Somehow, Ian Bogle fails
to say what he or the BMA will do if resources are not put into the new
PCTs. One assumes he either has no plan or doesn't want readers to know
of it.
For a man who leads a
union established to protect the interests of doctors - not to protect
the NHS - and the two do not coincide - Dr Bogle then rants on
about resisting attempts to undermine the NHS. Get
your priorities right, Dr Bogle. You are Chairman of
the BMA and the doctors you represent are being insulted by the present
NHS and its political masters. They look to you to protect
them first and the NHS second and only then if it does not seriously
conflict with their interests. GPC seems to have got
this message. Why not you?
Second Opinion- League
tables
Tom Marshall, lecturer in Public Health, Birmingham destroys
Milburn's quick-fix myth of faith in league tables.
Copyright prevents us repeating his piece here but it is well worth
looking up on the BMJ web-site. His paper was produced in
BMJ on January 12.
Opinion Poll
Colleagues seem to be expecting huge changes in the way they
practice. 81% felt that they are being forced by threat of
litigation towards specialisation; 73% rejected the Wanless theory that
70% of doctors' work could be done by nurses and a mere 54% thought that
the present method of funding the NHS was still OK.
----------------------------------
Saturday, January 26,
2002
Lead article
Milburn is still
thrashing around using the Bristol case as an excuse. He is
determined to publish surgeons' performance results "providing the
data does not encourage defensive medicine". Of course it
will and that is why it is so short sighted of the BMA to "favour
the publication of robust data" as is claimed in this piece.
The RCS is also happy to publish - with the "necessary
support"
Also front page news is
that the King's Fund is proposing the NHS should be shaken up and
put at arms length from the politicians. The Report is
likely to be buried.
Another piece alarmingly
raises the spectre of GPs previously insured with Dr Lamben's St Pauls
having to pay an alarmingly high "run-off" cover of £5,770
for the period they were insured with the company. As the
MDU said about the previously cheap rates of the St Pauls, "You get
what you pay for".
Seniors in PCTS
fear...
Quite why the BMA calls consultants
"seniors" is beyond this writer. However, the story is
that they are alarmed that their careers may suffer by working in PCTs
without medical directors. They are also anxious about appraisal
and discipline in a GP orientated environment. The BMA is asking
affected consultants to contact them but one way out, of course, is not
to join PCTs in the first place.
Trust error suspends
whistleblower
The BMA has
succeeded in having a consultant reinstated almost a year after she was
wrongly suspended by her managers for whilstleblowing on a
colleague. The consultant used the correct hospital
procedure to pass on her and others' concerns. There is no
comment on discipling the administrators although it is certain that her standing amongst
colleagues and in the community has been damaged. The gauleiters
must be made to pay for their errors just as doctors are theirs.
Exam fee for GP
registrars
Quite rightly the
BMA is putting its foot down firmly over proposals for registrars to pay
fees for a new examination which will replace the free JCPTGP.
Although not decided yet, it is anticipated that the fee will run to
some hundreds of pounds. As GPC negotiator Meldrum said,
there is a crisis in recruitment and the government should pay
especially as we have no control over it.
Beware of sharks
GPs and practices
are warned that there are sharks out there charging phenomenal sums for
data registration services. Avoid them like the
plague. There is an item about Data Registration on site via
the Education index.
Waiting list
At 1,031,300 in
November 2001 there were 10,100 more patients waiting for in-patient
treatment than 12 months previously.
Low morale
Indicating his
total unsuitability for the job, primary care taar, Dr Colin-Thome can't
understand why GP morale is so low considering that GPs have so much
influence. Perhaps it's due to the undoubted fact that few doctors
peddle in politics and the vast majority have to do the, often
unnecessary, work the politicians demand of them. And then
there are all those regulatory QUANGOs - including Dr Colin-Thome's lot.
Bed blocking
More NHS cash is
to be wasted in an enquiry on this when the whole world knows that the
problem emanates from stupid government legislation causing the closure
of Residential Care Homes.
Milburn backs reforms
This major piece
tells that the Secretary of State has backed all the Kennedy Bristol
reforms especially those relating to surgical league tables.
Well, he would, wouldn't he? He even slipped in the
regulation of the medical "self-regulation" body, GMC, by his new QUANGO
CRaP. Surprisingly this has received little comment from a
misguided BMA. There are many fears that surgeons will
inevitably practice defensive medicine and decline serious cases for
fear of the effect on their careers. Others say that the
most innovative surgeons are the very ones who have high mortality
levels. Milburn says the tables will be "robust"
whatever that may mean, but that they will not be perfect. The
overall slant of the piece is that the BMA and government are in accord,
despite this. Is political correctness in action here?
Second Opinion...
...draws
attention to the fact that 10 years ago a plum practice in a pleasant
rural town would have produced scores of applicants for a GP vacancy
whereas nowadays it is most likely there will be none or just one or
two. Milburn may like to put some of his undoubted energy
into sorting that one out. If he needs any help.....
And if he won't accept mine then maybe he will accept the common sense
coming from the writer, Dr Nick Maurice.
---------------------------------------
Saturday,
January 19, 2002
Management shake-up
may hit pay
A short report about another attempt by Milburn to divide and
rule. This time by granting "successful" Trusts autonomy
from Whitehall.
Lenient action against
Trusts
The Commons Public Accounts Committee is wondering why the NHS Chief
Exec. is being lenient against the waiting list fudgers. As
mentioned elsewhere on site a couple of weeks ago, it doesn't take a
genius to understand that. If all Trusts were to reveal all
fudging God knows what the size of Milburn's list failure would
be. Hence, no pressure and no disciplinary action.
Contract talks going
well - Chisholm
Can't tell you any more, says Chis, but you'll have a choice of
contracts, The April deadline line will be stuck to.
That doesn't stop some colleagues, reported elsewhere on site, feeling
that GPs are about to be stuffed - again.
Americans offer help -
again
Private American healthcare firms have offered to bale Milburn out
of his waiting list crisis. No reply yet.
Blair's road to
Damascus
Well, he's been everywhere else recently, why not Damascus because
he's trying to kid us he's seen the light? He's
"called for an end to doctor-bashing" and Dr Bogle seems to
believe him. Sorry, Bogle old chap, but there's more than
one way of bashing doctors. Publicly - and I don't believe
that has stopped - and through the founding of more and more
disciplinary, regulatory QUANGOs. I recommend our leaders, just
for once, step back and have a look at all those. There's a
list on-site (via Headlines)
In another short piece on
page 2, "doctors' leaders" have finally tumbled to the
undoubted fact that the deceitfully introduced Committee for the
Regulation of Health Professionals (CRaP - see HEADLINES) undermines
self-regulation. Well done guys. I told you that in BMA
Council last year but did you listen? Did you heck !
And Bogle still believes Blair !
Milburn on Pages 5-6
and 7
In a longish interview Milburn claims to want to improve things for
doctors but lack of action speaks far louder than words. Morale is
low, he says with deliberate self-delusion, because of all the paperwork
so he's going to employ more administrators and the NHS will be more
family-friendly as an employer. He does understand that
there is a doctor shortage, apparently, but "there's good progress
towards recruiting more". Yes, indeed, bmanews reports
that just 130 GP out of the "2000 by 2004" have been recruited
in the first year.
He goes on to promise
more money for the NHS (ignoring the fact that managers couldn't spend
£700m of this year's cash) but only if doctors work hard for it.
He set no store on a largish pay-rise for doctors, however, so perhaps
the low-morale doctors will indicate to Milburn that no way will they
work harder for less. He has killed good-will stone dead.
And wasn't it his great leader who said, over Christmas, that the new
reforms will hurt NHS workers?
Contradicting his opening
remarks about understanding doctors and the shortage, he confirms that
those there will be reformed and will just have to work harder. He
does say he "sees the changes beginning to
bite". And how !
On the whole the
interview did not deserve the two full pages it got. He said
nothing he hasn't said before and the most important thing he could have
said to save the NHS was missing. The two, simple words "I
resign".
Mind you, I liked the
smaller of the two pictures of him. Far more in character.
On the couch
For some reason the Editor in Chief, Dr Ian Bogle, has allowed
himself to be featured in this Q&A-style interview.
There are many others out there than the Editor. However,
the preamble states that he is married to a Journalist. Indeed he
is, and she's the Managing editor of BMAnews., though the writer somehow
failed to say so. When asked what the worst thing was about being
a doctor, Ian Bogle says that it's the increasing threat of complaints
bringing more stress to a highly stressful job. Odd, then,
that the causes of that stress, the multitude of complaint mechanisms
and QUANGOs, are never addressed by the BMA. Maybe that Damascene
light will someday flood into BMA House. But can it be seen
through rose-tinted spectacles?
_______________________
Saturday,
January 12, 2002
GPs fear chemist
handling fee
The headline
piece describes GP reservations to a newly instituted £3 fee charged to
elderly patients by chemists for the time and trouble taken to
prepare medicines in the flawed-concept, unit-dose dispensing
packs.
Appraisals to be
delayed
So few consultants have been trained to appraise that the system may
well be delayed. The Consultants Committee (CCSC) seems
disappointed that so few colleagues are enthusiastic to train to be
appraisers. Could CCSC be out of touch with their
colleagues?
Consultant survey
This survey, showing consultants work an average of 54.8 hours/week
plus 10 hours during nights and weekends, may indicate to CCSC just why
colleagues won't train. Maybe, just maybe the they will put 2 and
2 together?
PCTs and NSFs
An air of realism may be beginning to creep in about NSFs because
the magazine comments that PCTs have an enormous task ahead to implement
the, so far, 9 NSFs. Hillingdon PCT pharmaceutical adviser,
possibly a local chemist, describes measures (mostly useless) taken by
the PCT. When will these jobsworths realise that there are neither
hours in the day nor hands at the surgery (let alone cash) for GPs to
implement NSFs which, a BMJ paper recently said, were depriving other
people of health care.
GP pension discussions
GPC is in discussion with health minister Hutton.
GP morale
The long piece by GP Lesley Morrison was sub-headed "What can
be done to improve GP morale". Sadly the article did not live
up to that billing too well. In fact it was a report of one of those
woolly, NHS Conferences which, apparently, said that "we must
produce graduates who are human beings first and doctors second",
medical students want this and should be listened to. Our morale
will benefit if we are inspired by the students, the writer
claimed. It will take a bit more than that, doctor.
Chisholm's Opinion
It is sad that the Chairman of GPC missed the opportunity to say
anything new in his half-page address. There was a clear
indication that the new contract will be a bit of a hotch-potch,
something for everyone, a "series of options" rather than a
uniform contract. Pity, really because governments are well
pleased with divide and rule and I would have thought the negotiators
would have learnt that lesson. Dr Chisholm mentions the
"6.8%" pay rise but failed to comment on its poor comparison
with the demands made by GPC over the past few years. On the
whole, this was a holding piece because the negotiations are far from
complete. For this he may be forgiven but the results had better
be good, my friends are saying.
____________________________________
Saturday,
January 5th 2002
GP morale
Unsurprisingly the National Survey of GP Morale showed that 40% of
young GP want reduced hours and others plan to retire early, by age
57. GPC chairman, John Chisholm said the result underlined the urgency
for a new contract and that matters were set to get
worse. Dr Bogle seems to disagree, in his column,
below.
The Bogle column
The main thrust of the column was that 2001 was a
"year in two halves". During the first half the
profession was at confrontational level with the Secretary of State (Was
that when Dr Bogle signed The National Plan?) but,
during the second half, Milburn had learnt his lesson from the BMA
ARM. Readers who check "Milburn's Year" (via
Politics Index alongside) on this site, will see what utter bunkum that
is. Milburn has continued in his unpleasant way
coming out with one doctor-regulatory measure after the other. An
example is quoted above. Indeed, reading the Bogle piece one would not
imagine that Milburn had recently introduced CRaP (See Headlines) which
removes self-regulation of the profession at a stroke. Was that
deceit not worthy of some comment?
Bogle goes on to remark
that government has recognised the "pressures doctors are
under" and how they affect their professional and private
lives. It would have been most helpful if the BMA Chairman,
Editor in Chief of bma news, had, in these evidence-based days, given
facts of how Milburn had seen the light on the way to
Damascus. Instead, there was a complete absence of anything
to back up the Bogle euphoria. Once again, "Milburn's
Year" gives plenty to contradict those rose-tinted thoughts.
Virtually the only
slightly sensible comment in the Chairman's Opinion column is his final
one where he remarks that he has only a forlorn hope that government and
opposition will cease using the NHS as a political football.
Even this is somewhat flawed because, pardon me, Dr Bogle, it has been
the Labour government over the past five years who have crapped up the
NHS, defeated morale and lied in their various NHS Plans about their
intentions to recruit ludicrous thousands of new staff.
Probably Dr Bogle could
have been better occupied watching his favourite football match or, better still,
standing back a bit to examine somewhat more carefully, the record of the man with whom, on our
behalf, he is dealing.
There is little doubt, in
any case, that doctors would prefer facts from the man who holds the
highest office in their profession rather than waffle.
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