Terrorist bombings & the NHS

So it turns out that the latest bout of completely ineffectual terrorist attacks may have been perpetrated by a bunch of medics - or "Terror suspects all linked to NHS", as the Beeb put it. At first glance this may seem strange - you'd expect doctors to be fundamentally opposed to things like extensive burns, blast and shrapnel injuries, death, and irritating delays to your holidays - but it seems not.

It's nothing to do with Al-Qaeda if doctors are involved - we're all far too busy struggling against the exponentially more oppressive, reactionary, pervasive, and sadistic regime of the Great Satan as epitomised by hospital managers across the NHS and their slaveringly moronic cohorts to worry about petty East-vs-West politics.

The vital piece of information that is being overlooked in the current media frenzy surrounding the almost-bombings is this - lots of doctors smoke. The timing's perfect - more evidence that it's nothing to do with Al-Qaeda - they're just taking the ban a bit hard...

Spending more time with the family

This, from Mr. Eugenides' blog, is absolutely glorious about Patricia Hewitt, who is departing because she was a total incompetent to spend more time with her family, just as Alan Milburn left the job years back because he'd hospitalised his- to spend more time with his family:

In an ideal world, I would like to take Patricia Hewitt, tie her up, and slowly feed her into the propeller of a DC-3 - feet-first, naturally, so I could see that condescending fucking face contort in agony. I'd let the blades shear off her legs, and then hand her a mobile and dial NHS Direct, see how much fucking use that would be to her with some cretin in a call centre in Chelmsford asking her where it hurts, the patronising, incompetent, self-obsessed bitch. Later, after she'd expired from blood loss while waiting, in vain, for an ambulance that never came, I'd beat the corpse to a bloody pulp with a bound copy of one of her stupid fucking White Papers, until the only sign that this had been Her Majesty's Secretary of State for Health was the cheering crowd willing me onwards to commit ever greater acts of depravity against the lifeless body.
But I'd probably be breaking some law or other, so I won't.

NHS choices

Recently, those public-spirited folks at the department of health spent £3.6 million on something dear to all of our hearts.

A new website - NHS choices.

I can only assume from the cost that the project was started in the early 1980s before the internet existed, that they selected fifty or so destitute children at that time to do it, and paid each of them through infancy, childhood, and adulthood so they could eventually be ready for the awesome responsibility of doing things as the government like them to be done.

In this case, that means taking a website which was quite shit already and making it (a) even more shit and (b) about as embarrassing as having your auntie Mabel round for tea and realising your flatmate has scattered hardcore pornography around the livingroom.

I can't decide what my favourite bit is.

First there's the teenage sex advice section, which is hilarious in a sorry-Auntie-they're-nothing-to-do-with-me-yes-that-does-look-sore kind of way:

The test is titled:
"Reckon you have more front than Jordan in the bedroom? Take our seX-rated test to find out how much you know"

Question 1 is "How far would you go on a first date?"
Question 4 is "What would you do if you have a green frothing discharge?"

Way to keep those teenagers sucked in, fellas!

Don't the girls in the photo look a bit - well - young to you? I'm all for sexual education starting young - but for those kids to be finding the NHS choices website, they must be googling "Calum Best gonorrhoea breakfast Flopsy", in which case I would suggest they're beyond help - and know more about sex already than whatever ex-management consultant who believes he's down wit-da-kids wrote this shit.

Almost as entertaining is the "What your GP is reading" link from the same search (no, it didn't involve any of the terms above, particularly not "Calum Best") which comes up with something on family interventions to prevent smoking in children:
"The results are not quite as mixed as the trial designs but the results are not always clear or consistent. However, it is likely that some family based interventions are better than nothing at reducing the risk that a child will become a smoker as they grow older."

Believe me, your GP is not reading that, although they would certainly read it before anything else on NHS choices.

This abomination is all part of the government's drive towards "choice". If you'll bear with me while I go with that metaphor for a while, in this case the driver didn't have to sit a test
(and so believes that other specialised activities can and should be carried out by people not trained to do them) and they'll be long gone by the time you realise they've written off your car.

Buried in the pilot studies which the DoH appear to believe justify this crap (they're stuffed with terms like "building capacity", "leveraging existing capacity", and "positive attitudes towards offering choice") is the telling phrase:
"No effect on the referral pathways was shown, with most patients still opting for their local hospital."

So the government has pressed ahead with three-point-six-million quid of your money for something their own research has shown that you don't care about and won't make any difference to where you opt to go!

Doubles and trebles all round, eh? Oh, sorry - what were you drinking?

Orthopaedics: good cop, bad cop

This morning I sat in on a spine clinic, fully expecting a succession of elderly folk with slipped discs, and therefore to be bored at least to the perimeters of my mind.

I was quite, quite wrong. The first patient I saw was a man in his late 40s - not old by any means - who'd had the shite beaten out of him repeatedly while institutionalised as a kid, and had then joined the navy for several years of heavy lifting, twisting, and lots of other back-wrecking seafaring activities. Despite having been in constant pain of varying severity since he was 17, he was extremely pleasant to talk to, and willing enough to suffer an examination from me to establish just how little movement he had in his back.

Then the consultant (Mr K., a surgeon) came through to talk to him, and immediately wanted to know why he hadn't had a follow-up after an MRI scan of his back...in 2004. Mr C (as we will call him) seemed bemused:
Mr C. "Because no one sent me an appointment."
Dr K. [shaking his head] "The way it works is that you have a follow-up appointment to discuss the scan."
Mr C. "They didn't send me one."
Dr K. "Hm. Well - you should really have taken responsibility for that - you should have called the department and said, I've had this scan and I need an appointment."
Mr C. "I didn't realise I should..."
Dr K. "You just needed to get on the phone."

It then emerged that in addition to failing to send him an appointment, no one had injected him with gadolinium, which you need to make the image clearer, and the doctor couldn't access the scans anyway thanks to the abominable computer system the DoH in its infinite wisdom has forced us all to use. In this context, it's perhaps unsurprising that they added insult to injury by suggesting it was all his fault...

After a brief diversion during which the surgeon talked about surgery with such evident relish that he almost put the patient off having a second (very expensive) MRI, Mr C. expressed an interest in his outlook:
Mr C. "Really I want to know what my prognosis is so I can plan my life."
Dr K. [cheerily] "Well - you're not a winning horse."

Images of the consultant taking him outside, shooting him, and sending him to a glue factory flashed through my mind.

I should say that the doctor was evidently a phenomenally good surgeon. He told me glumly that "I get all the revisions these days", 'revision' being a polite medical way of saying 'surgery which didn't work first time'. He had one guy in his mid 30s come in who practically kissed him, having had a disc fusion 6 weeks earlier and was evidently absolutely transformed by the results.

The patients who hadn't seen Dr. K first time through tended to have a rougher time of it. There was one 18-year old kid who'd been a champion martial artist and had had back surgery at an (aptly named) Kent hospital under Mr. M; at follow-up, he and his parents had been told that his ongoing pain on any sort of exercise was unavoidable and there was nothing more to be done. Mr. M had then repeatedly refused to see them, instead sending his registrar in to do the dirty work; the poor reg had eventually apologetically suggested they get a second opinion, which they'd done privately. The private doctor had taken one look at the X-ray and noticed that one of the screws wasn't even in the bone, and referred the guy on to Dr. K "to get things sorted".

Dr. K was relatively reserved in his criticism, but it became clear that the original operation was probably the wrong one to have done, hadn't been done properly, and hadn't been followed up at all well. I should say the boy had been consented for a clinical trial on the morning of his operation while on the anaesthetic table - which is just totally unacceptable practice. Anyway - while I reckon Dr. K can probably sort him out, he's essentially lost a year out his life, has had to drop out of school, and needs a day's rest after doing a day's work.

I'm not in favour of suing the NHS - it's too often provoked by fucking ambulance-chasers because some thick clutz has fallen over - but in cases like this, hitting the trust in the pocket is about the only way to get the suits to curtail the sociopathic tendencies of folk like Mr. M.

The moral of the story? Think twice before having back surgery. Then think another dozen or so times, and go to a regional centre to have it...

Should quite possibly be Iapyx

He was, after all, a physician. However, Daedalus is a lot catchier, let's face it.