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Or at-least, so the rumour goes, of Professor Alan Crockard, National Director of Modernising Medical Careers & former Director of Education at the Royal College of Surgeons. If true It is one necessary step of many needed. This is in addition to him having been reported to the GMC for his various failures.

Professor Sir Liam Donaldson, said:

“With regret, I have accepted the resignation of Professor Alan Crockard.
We would like to thank Alan for his leadership over the last few years in setting up Modernising Medical Careers including the successful establishment of the Foundation Programme for the early years of postgraduate medical training.”

Press Officer - Newsdesk
Department of Health Media Centre

The list does not end here. As various documents that are slowly leaking out into the public domain show, the rot extends all the way across the top of various Royal Colleges & the BMA. And in this case I include people who claim that they privately thought MMC to be a bad idea but went ahead with it because it was policy. There is a professional responsibility involved & discharging it was & is not optional. I look forward to more of the actors in this saga being referred to the GMC.

I have only one message.

We are tired of you taking decisions on our behalf that damage the profession, based on self interest or cynicism.

Conduct your business in public with the opportunity for the profession to scrutinise your work. Do not hide behind faceless structures & pretend that you are doing the right thing when you are supine in the face of threats or worse, actively acquiesce to them.

The latest junk mail from the MMC team. The original document is here . Feel free to comment on the Wiki.

Extrapolate this will you to the work rosters of staff on shifts, which after all have a similar effect on sleeping habits. See here for how things really happen. I wonder why the same people who call for airline style monitoring of professionals & quality assurance do not have a word to say about the other airline style refinements that could be brought in.

Speaking of sleep, sedation has been used to keep aggressive patients docile in most long-term care facilities. One inadequately trained healthcare worker in charge of a dozen or more confused patients was never sustainable & sedatives have been used to maintain a semblance of order. Well, it needs to stop, but do we then have the resources to care for them properly?

Drugs commonly prescribed to people with Alzheimer’s disease are accelerating their deaths by an average of six months, a study has found.

Up to 45 per cent of people with Alzheimer’s in nursing homes are given sedative drugs known as neuroleptics to try to control behavioural symptoms such as aggression.

In severe cases, the drugs may be justified. But a five-year study by the Alzheimer’s Research Trust showed that, as well as reducing life expectancy, they were of no benefit to patients with mild symptoms and were associated with significant deterioration in verbal fluency and cognitive function.

After all, NHS staff do not want to be treated at their own hospital. And the BBC agrees as does the Guardian.

Nearly two thirds of health staff would not be happy to be a patient in their own NHS trust, a survey of more than 128,000 workers by the Healthcare Commission.

Just 39% agreed they would be happy with the care provided in their own trust, with 27% disagreeing and 33% neither agreeing or disagreeing - slightly worse than last year.

And 45% said patients were a top priority - down from 50% 12 months ago - with the rest either undecided or believing they were not a top priority.

Is that clear enough for you Ms Hewitt?

Mr Maynard, don’t let the door hit you on your way out & you can take your proposals with you. See if you can find a way to take your targets too.

Doctors should have their pay cut if they do not hit targets or increase productivity, a leading health economist has proposed.
Alan Maynard, professor of health economics at York University, said “demerit awards” were more effective at improving performance than bonuses.

And he suggested the NHS should consider taking away up to 2% of GPs’ or consultants’ annual salary.

But doctors said the proposal would “foster low morale”.

Professor Maynard said that, according to prospect theory, people value gains differently from losses as they place a greater emphasis on what they are losing.

He said the motivation to perform was not just driven by financial consequences but over the prospect of losing face in front of colleagues.

And GPs and consultants were good candidates for such measures as they were decision makers so had a great deal of control over how the health service performed, he added.

“The issue is whether this could be built into the GP and consultant contracts in order to get them to do higher levels of activity or more evidence-based levels of activity.

“But I believe it could be extremely effective at ensuring good performance.”

This from a guy who has a big measure of responsibility for the situation we find ourselves in currently. Isn’t it the evidence based levels of activity that are being blamed for the GP contract being over budget in the first place?

And remember also that before the contracts were negotiated (& I was against them because I felt that they gave too much away to the govt both on financial & professional matters) there was a very real chance of medics going on strike. Keep the talk up & you might help bring about such an outcome again.

It might be worth re-examining policies such as these:

NHS patients are officially forbidden from buying their drugs privately as this would mix NHS and private care. The Department of Health says patients must choose whether to be treated on the NHS, and accept what the NHS offers, or to go private in which case all of their care, not just the drugs, must be paid for. A Department of Health spokesman said: “You cannot be both a NHS patient and a private patient at the same time. Co-payments would risk creating a two- tier health service and be in direct contravention with the principles and values of the NHS.”

Everyone knows it happens. From patients buying unlicensed drugs on the net to visiting herbalists / Chinese medics or anyone else who can give them a semblance of hope. This in addition to the number of practitioners who have had enough of the rules & decide that their primary duty is to the patient. All of this when we quite often have the means to help them anyway, just not the money.

Writing in the Journal of the Royal Society of Medicine, Professor Sikora said the dilemma this posed for the NHS could not be ducked any longer. If it declined to pay for the drugs, patients would be forced to go without. The only alternative was to allow patients to top up their NHS care by paying privately for the drugs.

“There is now evidence of a growing use of co-payments to break through the access barriers in the NHS,” he wrote. “Cancer patients are beginning to develop sophisticated approaches to buying extra clinical services either from the NHS directly or through the selective use of the private sector to purchase upgrades to their basic NHS care.”

We already have a two tier healthcare system. To pretend otherwise is foolish. And dragging everyone down to the lowest common denominator instead of improving standards so that people benefit is rather objectionable.

Speaking of policies, I am ashamed of this one.

The JCHR highlighted one case of a destitute Rwandan asylum-seeker who suffered bowel cancer and had a colostomy bag, but was refused treatment by a hospital and could not register with a doctor.

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This entry was posted on Friday, March 30th, 2007 at 8:49 am and is filed under Clinical, Economics, Management, NHS. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.