In pride of place, the BMA - for being an all-round disappointment, though I must say that the new team is better than the old one by a minute degree. Or maybe not as recounted by Private Eye in their “Medicine balls” column. Brian Butler has been mentioned here before and he is joined by colleagues in the IT & legal departments.
The DoH - for being a mixed bag of contradictory policies but with the worst predominating.
The Royal Colleges - for being asleep on the job & now looking to pass the buck.
The medical establishment, to wit the Deaneries & associated networks including those involved in training - for their callous cynicism.
Connecting for Health - for their singular lack of sense.
I am sure that they will be joined soon by other deserving candidates. I must really add a scoring system to keep a running tally of the level of cluelessness of the above players.
Nothing much to report today either except for stupid commentary given voice in the Telegraph from the likes of Patrick Mercer, Andrew Green & Andrew Pierce. Reminds me why I didn’t read it very much before the MTAS debacle. And some fact-checking before going to print wouldn’t have hurt.
For all the speculation & rumour mongering about the weeks events, just one person has been charged so far. So what has this flap been doing to other overseas doctors? The other papers are full of the same but reading them just makes my blood pressure rise, so am not bothering to link to them.
And more ill-informed speculation from a free-market advocate in the Times claiming that the NHS is more expensive than US health insurance.
Next year’s NHS budget will be about £104 billion. That’s roughly £1,733 per man, woman and child. Multiplied by four for a typical two-child family, then divided by 12, that equates to median monthly family healthcare expenditure of £577, or $1,155 in American money. I can buy some very respectable US health insurance for $1,155 a month.
But does he use the standard dollar to sterling conversion ratio that things cost double here in the UK compared to the US? Or the fact that the figure he quotes is the average cost of healthcare for each person in the UK, including the severely ill & not just the young fit & healthy? The cost of private healthcare in the UK would be a fairer comparison & has already been done. Not to mention the deductibles, the lack of public health cover & the increased administrative headaches. The fact that the Us spends close to 25% of GDP on healthcare while the UK makes do with just 8% (maybe 12% if you add the private sector) does not seem to make an impression. The stupidity & selfishness of those presenting this argument is breathtaking!
We are told often enough that those working for the NHS have it good & that terms in the private sector are worse. Somehow not many have been convinced. Sandra Parsons appears to be having some trouble at home & has this to say in the Times:
The professionals with real grounds for grievance are doctors. The current jobs fiasco, presided over by the newly resigned Health Secretary, Patricia Hewitt, means that with less than a month to go before new training posts start on August 1, 11,000 junior doctors don’t know whether they have a job.
The term junior doctor refers to anyone not yet a consultant. Of those who do have posts, hundreds will have to relocate to take them, moving homes, uprooting children from schools and forcing spouses to change jobs – all for a position guaranteed at most for one year and often only six months before the merry-go-round begins again.
These are people who were the brightest and hardest working at school; you don’t get to study medicine with much less than three A* these days. They then endured six years of medical school before taking their first bottom-rung jobs, working relentless hours with little sleep. They are now embarking on their chosen speciality, for which they will have to pass two or three stages of gruelling and demanding exams, and for which they must study while also working long and antisocial hours.
Those who survive will then be told by the chattering classes and the media that they should be grateful to have a “job for life†(until they make one mistake and kill someone, that is) and that they earn ludicrously “good†money (although not by lawyers’ standards, obviously). In most other countries in the world, a child’s ambition to become a doctor is greeted with pleasure and, frequently, proud rejoicing. The fact that the same cannot be said of Britain owes much to our increasingly cynical attitude.
I think cynical is the wrong word. The disenchantment is simply a reflection of the loss of status & of the low value society appears to place on the profession, measured by the standard currency of this capitalistic age i.e. money.
How many of us can imagine a normal working day that might include, as my husband’s did not long ago, treating two horrifically burnt children who die despite your best, most sustained, efforts? Which ends with your having to tell their mother, who is incoherent with grief, that her children are dead? Where the purpose of showering, when you eventually get home, is to rid yourself of the lingering smell of burnt flesh? I happen to think that’s worth the £70,000 a year a new consultant earns.
But back to our unhappy lawyers. Of the one in four who wished they had other jobs, the majority wanted to be journalists or writers (only 2 per cent fancied working for the NHS). The most popular reason for not switching careers? “The possible drop in salary.â€
News of the review, unveiled at Mr Brown’s first prime minister’s questions, caught the Home Office and the Department of Health off guard, suggesting it was a last-minute decision.
The prime minister’s spokesman later said the government would also run checks on the migrant’s sponsors, whether they are organisations or individuals. In most cases in the NHS, the sponsor is a hospital so it is not clear what purpose a check on them might serve.
Health professionals were sceptical that Sir Alan is going to be able to find any loophole in the law, or obvious remedies. Vetting is currently undertaken by employers, in most cases hospitals.
It is possible Sir Alan will examine whether the intelligence services could be given access to details of doctors seeking employment. Few or no questions are asked on the political leanings of potential medical recruits.
I have to apologise for the recent lack of activity here. A sudden attack of ennui, in addition to personal issues caused me to take time out from this blog for the past month, triggered by the bullish unwillingness of people to listen. Frustration creeps in occasionally at the brazen shamelessness of the lies.
A lot has been said & done over the past month including the resignations of Richard Granger & Patricia Hewitt. There are some however who cannot be helped & the only thing I can do is to try to hold them to account in whatever way I can.
The NHS & the Dept of Health are public service organisations & should be run to deliver benefit to us all. Any part of this machine that deviates from those ideals needs corrective action to being it back into line. Poor decisions taken by people with questionable motivation & those made by following poor directions rigidly certainly fall under this category.
Since it appears that the normal checks & balances that would act to govern such acts of omission or commission are being ignored and there seems to be no appetite for effective supervision of rogue departments, the public are entitled to know just what is going on.
I am being driven to the conclusion that linking individual names to the action under scrutiny is one of the few tools available to the public. Let us see if it makes a difference. This lady for one seems to be doing well with this strategy.
But on the first day of the new administration & with changes expected at the top, I hope to resume regular service & keep an eye on the movers and shakers.
I try to look at motives, the behind the scenes machinations why a position is taken & make it a point not to be influenced unduly by any personal consideration or gain. Well, I try anyway but not always successfully. Claiming to be holier than thou is not realistic.
I am sure that my outspokenness on here has put off a few potential clients but there is only so much I can compromise on. Wired goes into it in a little more detail.
Radical forms of transparency are now the norm at startups - and even some Fortune 500 companies. It is a strange and abrupt reversal of corporate values. Not long ago, the only public statements a company ever made were professionally written press releases and the rare, stage-managed speech by the CEO. Now firms spill information in torrents, posting internal memos and strategy goals, letting everyone from the top dog to shop-floor workers blog publicly about what their firm is doing right - and wrong.
“You can’t hide anything anymore,” Don Tapscott says. Coauthor of The Naked Corporation, a book about corporate transparency, and Wikinomics, Tapscott is explaining a core truth of the see-through age: If you engage in corporate flimflam, people will find out. He ticks off example after example of corporations that have recently been humiliated after being caught trying to conceal stupid blunders.
No, this post is not brought on by any major crises of faith or ethical dilemmas & I am not aware of the location of a smoking gun.
But just how far will people go to hide negative opinions, especially if personal gain is involved?
I recently posted a few comments on a major newspaper’s website, nothing libellous or close to but pointing out mistakes / economies with the truth of one of their star columnists. None of the comments made it past moderation. Once is possibly an error, twice less likely to be so. More than that & there is likely to be something going on.
Today, I posted on a site that takes in quite a bit in industry sponsorship. The comment questioned the value of a particular transaction & drew attention to its poor record of performance. No show. I can only think that the fear of offending an advertiser was greater than the commitment to telling the truth.
Hiding from the truth doesn’t make it less correct or even go away. Intellectual honesty is a pre-requisite.
The co-founder of iSoft, the embattled IT company at the heart of the government’s troubled £6.2bn NHS IT upgrade project, was sacked yesterday after being suspended since the beginning of August.
The company said Steve Graham, former commercial director, had been “removed as a director” and had “ceased to be an employee of iSoft.” This move follows his suspension on full pay of £385,000 from August 8, “following an initial investigation into possible accounting irregularities in the financial years ended 30 April 2004 and 2005.” Another employee was suspended alongside Mr Graham, but the company refused to disclose their identity. A spokesman for the company said the financial terms for Mr Graham’s departure had not yet been agreed, but added: “It is not our intention to pay any compensation.”
As I do for the BMA or the Royal Colleges, especially after their behaviour over the years.
I am not capable of the cognitive dissonance, the moral bankruptcy of the position that “I’m al-right jack” & that other peoples problems are of no consequence.
The MDU guidance on the Electronic Patient Record is worth considering fully. It is difficult for me to understand how anyone who considers fully the positions being eluded can go along with current CfH plans.
“GPs will need to consider, therefore, whether they can rely on implied consent, or whether they need to seek express consent from their patients in order to upload their data onto the summary care record.
“GPs will need to consider a number of things. They will need, for example, to satisfy themselves that the CfH [Connecting for Health] publicity campaign had indeed reached all their patients, that all their patients had read and understood the leaflets and, if the GP had not heard from them, had decided not to seek an appointment with the GP to ask any questions, and not to ‘opt out’.â€
In clinical medicine, these are the current ethical transgressions that are being ignored. Is a life in the “Third World” any less sacrosanct than one in the West?
Tens of thousands of elderly Americans have received life-prolonging care as a result of their long-term-care policies. With more than eight million customers, such insurance is one of the many products that companies are pitching to older Americans reaching retirement.
Yet thousands of policyholders say they have received only excuses about why insurers will not pay. Interviews by The New York Times and confidential depositions indicate that some long-term-care insurers have developed procedures that make it difficult — if not impossible — for policyholders to get paid. A review of more than 400 of the thousands of grievances and lawsuits filed in recent years shows elderly policyholders confronting unnecessary delays and overwhelming bureaucracies. In California alone, nearly one in every four long-term-care claims was denied in 2005, according to the state.
“The bottom line is that insurance companies make money when they don’t pay claims,†said Mary Beth Senkewicz, who resigned last year as a senior executive at the National Association of Insurance Commissioners. “They’ll do anything to avoid paying, because if they wait long enough, they know the policyholders will die.â€
I have just received a very insulting response from Brian Butler, Director of Communications at the BMA to my request for comment regarding the email from the RCOG and the issue of IMGs.
I have been told that they will not deal with my current and future media-related requests as I am not a “bona-fide” journalist in their “terms”.
This from a person who does not see the irony in self-aggrandising comment. Put your money where your mouth is Mr Butler.
BRIAN BUTLER, Director of communications, British Medical Association
Opinion masquerading as fact really annoys me and we see more of that now. You find yourself hunting for the fact, but getting to the bottom of the story without discovering it. In terms of TV journalism, I get very annoyed with journalists interviewing other journalists, for want of finding another source. It’s an American thing and we seem to have imported it. You get journalists reviewing the papers, which is cheap and easy but also bizarre. If a businessman was commenting they might give some insight.
This pre-historic attitude is part of the reason why I have given up my membership in the organisation, seeing that they do nothing for the profession, provide no support to members & can’t even respond to a simple request for comment. This was after I had identified myself fully including the fact that I was a doctor who wrote about medical issues, explained the circumstances and waited all day for a response. I had to call back just before 5 p.m. to find out that my requests would be ignored.
I have received far better responses from pretty much every other organisation including even the RCOG.
The implication therefore which has not been refuted is that the BMA have no problem with the original statement from Professor Templeton and also that they are happy to let Mr Butler decide BMA policy.
For an organisation that has an unhappy history with reference to discrimination & indeed has had to pay out large sums of money as damages to members whom they had served poorly, it is not a strange attitude to take and exemplifies why better representation is needed. They have become fat & complacent with too much of a stake in the status quo.
If this is not the case, they would be better advised to improve their communications team as it is currently “not fit for purpose“. It would in fact make an ideal case study for how not to run a PR division. I am happy to provide consultancy in this regard. I have given them enough suggestions on IT matters over the years though they have not made much use of them, abdicating the discussion forum part of the website to DoctorsNet & losing leadership in medical jobs postings to the NHS jobs website. Listening between 1999 & 2002 might have made a difference.
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A website has been set up to collect signatures for an Extraordinary General Meeting of the BMA to hold a vote of No Confidence in both the chair of the BMA, Mr James Johnson, and the chair of the JDC, Dr Jo Hilborne.
Following on from the NAO report on the Dr Foster Intelligence contract, I have another criticism to make.
Is it right for the public sector to squirrel away for internal use only the data collected with our monies? How can they justify making the information available to a limited number of commercial entities to profit from? Why should it not be available to all, for free?
Google mash-up’s are a case in point. The data has long been available to commercial users but it took the arrival of Google Maps & the map API to unleash a flowering of creative energy & hundreds of innovative applications for the maps when overlaid with other information.
I have long been a supporter of the Free our Data initiative & am working on a public health application utilising healthcare statistics & OS mapping / post-code data. The software is derived from work done by My Society & is intended to be free. But I have to pay Dr Foster Intelligence for use of the DoH data & the Ordnance Survey for the maps in addition to the Royal Mail for the post-code database. All this while Dr Foster’s are my competitors & get this information for free.
“Public sector information holders (PSIHs) are usually the only source for much of this raw data, and although some make this available to businesses for free, others charge. A number of PSIHs also compete with businesses in turning the raw information into value-added products and services. This means PSIHs may have reason to restrict access to information provided solely by themselves.
The study found that raw information is not as easily available as it should be, licensing arrangements are restrictive, prices are not always linked to costs and PSIHs may be charging higher prices to competing businesses and giving them less attractive terms than their own value-added operations.
The report has also found that much of the legislation and guidance which aims to ensure access to information is provided on an equal basis, lacks clarity and is inadequately monitored. As a result the full benefits of public sector information are not being realised.”
So Isoft is on the block & one of the bidders is Cerner. So after all the chest beating about promoting a choice of systems & a wider ecosystem of suppliers which was the rationale given in the early days of the NPfIT for the numerous disastrous choices they made, we are now in a situation where one LSP controls the implementation plan for the acute sector in the entire country with the other players in supporting roles.
And we have ended up with the worst of all worlds. with a poor modification of an off the shelf system instead of a solution that suited the requirements on the ground. Whither diversity?
With the new mantra of local ownership of the CfH programme, I hope that the clinical community are involved more than they have been so far or we might as well just write off the billions still to be spent & return to writing on pieces of slate.
The whitewash of the NAO report & the oratory at the Parliamentary standing committee aside, does anyone seriously think that this programme is still the best deal we can get?
To readers from far & wide:
The server logs make for interesting reading, telling me just who is visiting the site & the topics that interest you.
So can I invite you to participate in the discussion, by telling me why I am wrong if indeed I am so & generally shedding a little light on this brave new world we inhabit.
It is more fun that way, honestly!
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