Bruce Keogh and doctors' pay freezes

I didn't know much about professor Sir Bruce Keogh until today, but I read his proclamations on doctors' pay and thought I should find out about him. It turns out from his puff-piece on the DoH website that he is NHS medical director.

My reason for looking him up was an article on the BMA website which I'm afraid is subscription only (but see how you get on with that link). In it he says that doctors should consider accepting a pay freeze to help the NHS through the financial crisis, and presciently warns of "tough times ahead" thanks to the "recession's fall-out", presumably while popping down to his local stables to bolt all the doors he left open midway through 2007.

He goes on to say:

"We need to see doctors stepping up to the plate in terms of leadership roles and recognising their financial responsibilities. They need to take control of budgets and accept pay restraint. Doctors have to recognise that they are not above the rest of society. There are all sorts of people out there who are not getting pay rises at the moment, and there would have to be very particular reasons why doctors were [exempt from] that."

Given Prof. Sir Keogh's confusion about the timing of the recession, it's no surprise that he hasn't noticed the phenomenally large amounts of money that other bits of society are paying themselves, and in so doing has aligned himself with such economically-savvy luminaries as the Duke of York and Boris Johnson. Are we quite sure someone who's only just noticed the recession, and hasn't noticed bankers' plans to pay themselves billions of pounds, is genuinely a professor? This isn't some new-Labour reward for brainlessly toeing the party line via statements that appear to have been ghostwritten for him by the Daily Mail, as his knighthood presumably was, is it?

There is a wider point at play here. What we have here is a doctor already in a leadership position, who has by definition presided over the disastrous financial mismanagement of the NHS over the past decade, the leeching of doctors and nurses away from the public sector and the country, and the rock-bottom morale which comes from people like Bruce making imbecilic pronouncements about things they know nothing about. He can afford to take a pay freeze - based on publically available information about what medical directors of individual NHS trusts make, he's might be on 120k or more. But why should I, as one of the thousands of doctors who for years have been telling the leaders of our profession exactly what they should do to save money and have been totally ignored, take a pay cut because the government has screwed things up so royally? If you want me to take a pay cut and to show "leadership", that's fine - but I won't bloody do so until I get some power to affect spending decisions locally so that the same idiots who've got us into this state can't carry on screwing things up.

Let me put this more simply, Bruce: don't witter on about 'leadership' unless you're willing to devolve some actual responsibility with it.

Virtual Learning Environments

This weekend I have had the unbridled joy of preparing for a 2-day course. This has involved a decade of hours plowing through an utterly turgid "virtual learning environment" or "VLE" which makes repeated utterly token attempts at "interactivity". This has made me want to submit examples of genuine multimeejah by e-mailing videos of myself swearing at the course designers to those responsible.

This particular bout of fury was brought on because I dutifully stopped listening to the background music which was keeping me sane because the VLE told me it was very important I had my sound on when I looked at the powerpoint. The sum total of the "multimedia experience" in the presentation was a single ambulance siren on the second slide. That was absolutely the only thing there I needed headphones for.

So. Farewell then Ara Darzi

So. Farewell then
Ara 'Lord' Darzi
Polyclinic-exponent and Grand High Reviewer.

You wanted to put
quality
at the heart of the NHS

and you told us that
as ideas go
this was "radical"
which was
pretty insulting, if you think about it.

Data protection

The hospital trust where I will be working from August has just sent me the reams of paperwork I am required to fill in to demonstrate that I am safe and qualified to do the job. It contains exactly the same questions, and requests all the same paperwork, that I sent in about 12 months ago to demonstrate that I was safe and qualified to do the job this year. Hundreds of people are being paid by the taxpayer to do this.

Best of all, though, was the document on patient confidentiality, which was a mixture of bland statements of the obvious, stern caveats about talking to the media ever, and a wonderful section on "Use of Internal and External Post" which appears to have been written by someone at the department of health purely to remind us of all the ways in which imbecile government officials have sent the personal details of thirty thousand drivers to some organisation in Texas, or left 120 patients' medical records on a train, etc.

I should say at this point that the Trust I'm working for is one I have enormous respect for, and which has not to my knowledge made any such crass fuckups. But again, someone in government has spent time and money writing this patronising nonsense when if I spent my entire career wilfully distributing patients' personal information to as many people as I possibly could, I still wouldn't get near the breaches in confidentiality that a single civil servant can manage after one too many bottles of claret with lunch.

Snake ateronon

I want to know who these unspecified "scientists" are who are besmirching the name of their profession by claiming that some wonder-pill can "stave off" heart disease and stroke? Because whether the drug works or not is so far from being proven I can't begin to explain - but suffice to say that so far as I can make out these snake-oil salesmen have precisely one study of 150 people in which they measured not heart disease or stroke, but instead "the oxidation of harmful fats in the blood".

So a more accurate description of this pill would be something like:
"A new pill is being hawked around to fat, worried people everywhere by a private company looking to make a quick buck. They have demonstrated that it reduces one blood test result at one point in time in a laughably small sample, and are hoping you will pay thirty-five pounds a month just in case it thereby prevents illnesses they haven't demonstrated any reduction in. For thirty-five pounds a month you could buy just under 20kgs of tomatoes at ASDA, or just over 10kgs of organic cherry tomatoes at Tesco. Every month. That way, you'd get lunch as well as the health benefits."

Newsflash, boys and girls: eat sensibly, exercise more, see a doctor if you're worried. Don't buy this crap until and unless someone has proven it'll help you. So far, they're nowhere near.

Here be Swine Flu

It was today reported in the 'ouse of Commons, by none less than the Health Secretary, that there have been twenty-five (25) possible cases of swine flu in the UK since the start of the scare.

One such occurred in my hospital this weekend. Basically, it was total bollocks - the woman in question came in with a straightforward pneumonia, but because she was eight months pregnant the medical team looking after her shipped her on to the obstetricians, on the basis that she was doing reasonably well and at that stage in a pregnancy the priority if she went off would obviously be getting her baby delivered.

As far as I can make out, the obstetricians spent the entire weekend trying to convince the poor lady that she would die and that if she didn't she'd need to be put on a ventilator for them to deliver the baby. In amongst all this they realised that she'd been to Mexico and so called the local Health Protection Agency about her querying swine flu. The only problem, of course, was that she got back more than two months ago - not really consistent with the incubation period - and had a far, far more likely diagnosis already in place.

In the end the weekend team took her away from the panicky obstetricians and put her back on a medical ward, where she is doing just fine, and it looks like despite the hullabaloo that the baby will not be born with a pig's head this time. I wonder how many more of the 25 cases were utter bollocks...?

Saints preserve us....

God bless Jade Goody for what she's done for screening.

But a musical of her life? Spare us that, please - spare me the pound signs in Clifford's weaselly eyes... I feel nauseous just thinking about it.