Q. Would The Witch Doctor ever go on strike if the circumstances and cause were right?
A. Yes

Q. In some circumstances, would The Witch Doctor be prepared to go on strike over pensions or any monetary matter affecting herself or other doctors?
A. No

Q In some circumstances, would The Witch Doctor be prepared to go on strike over an attack on the principles that have underpinned the NHS?
A. Yes

Q. What form would the strike take?
A. It would cut out all the faffing about that doctors have allowed to be imposed upon them. This would involve much committee work, much reading of documents, all appraisal related work, much useless personal development exercises. Most tick box forms would be shreaded.  It would involve a refusal to take part in many activities that were designed to be a preamble to privatisation of the NHS e.g patient referral centres to name but one.

It would probably involve shutting down all emails – they are now abused and that abuse is leading a huge waste of staff time (and therefore public money) within the NHS, as well as a means of bullying staff into “doing things now because what I’m doing now is more important that what you’re doing now!”

There would be much, much more.

Q. Would patients benefit from this industrial action?
A. Yes. The time saved would be spent on direct patient care. Ensuring each patient knew and had met their consultant as part of a proper consultant delivered service. Ensuring proper time was given to the problems of individual patients. Ensuring a proper relationship with nursing staff. Ensuring patients in the wards did not go un-fed and un-watered.  Ensuring a proper relationship between GPs and the patients they refer. Ensuring proper time spent with trainees. And much more.

The definition of “proper” would be The Witch Doctor’s, not the governments.

In addition, time spent gathering stupid and contrived material in order to sell yourself so that “appraisal” and, in future, revalidation “goes well,” would be spent on “proper” continuing professional development. The kind of professional development that not only makes you a safe doctor but the very best you can be. This time would be spent only on worthwhile personal development relative to The Witch Doctor’s own personal knowledge and deficiencies. For example little time would be spent on “soft skills” such as “communication skills,” or “how and when to smile at patients” skills, or attending courses on the best way to broach patients on very private matters such as how they want their lives to end or whether they have a gambling habit. The Witch Doctor thinks she knows very well how, when, and if it is appropriate to broach these very personal concerns during the doctor – patient relationship. Further more she received no formal training on these cuddly, caring matters. She certainly would not agree to obediently following some kind of “payment by results” protocol.

In addition, time used to fill up “begging” documents such as application for discretionary points, merit awards, distinction awards, platinum, gold, silver, carbon, uranium or tin clinical excellence awards or whatever ever-changing name is given to these “obedience bonuses” would be transferred to direct patient care.

Witches don’t beg.

Even if it means they will never be rich.

Witches and doctors will always earn enough to buy the mince.

There are other kinds of riches.

The Witch Doctor – Link to a random page

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From time to time The Witch Doctor finds it necessary to sharpen her brain by casting the spell that makes her young again.

On this occasion she is trying to remember what she can with regard to industrial action among doctors and others within the NHS.

Her memory is still dim even with the help of The Book of Spells, however here are some random thoughts regarding her recollections.

She can remember some very bizarre situations.

For example, once, when the porters were in strike, senior management had to do their work and she remembers how much they moaned at having to exercise themselves into the evenings and at weekends transporting patients. Management office doors are generally tight shut and locked over weekends and public holidays in WD’s neck of the woods. They will deny it of course, but it is absolutely true. Believe me, this witch knows more about this than anyone but telling you how she knows might reveal WD’s identity.

And that would never do!

She remembers too how the medical records and secretarial staff withdrew their labour and doctors were left to see patients without case notes at the clinics. A highly dangerous way of practising medicine! However, it seemed the doctors were more prepared to take this risk than cross a picket line to look out the records themselves. Or more likely than not, they didn’t know how the filing system in medical records worked. Case notes too were hidden in all sorts of nooks and crannies in various hospitals and doctors rooms. After that strike, doctors tended to hang on to patients notes longer than necessary in case more industrial action followed.

No doubt some resorted to The Lemon Technique.

She remembers university staff going on strike but nevertheless those who were medically qualified fulfilled all their clinical commitments but perhaps boycotted some university work.

She remembers strikes among laboratory staff when services had to be cut back to a bare minimum but emergency work was usually covered.

The Witch Doctor can recollect vaguely doctors going on a massive strike in another country far from the UK. Somebody followed it up with some research demonstrating that the death rate fell when doctors were on strike! The pro-euthanasia religion, and “we-must-have-revalidation-to-address-the-Harold-Shipman-phenomenon” brigade would no doubt read far too much into this!!!

I’m sure if she racked her brains, The Witch Doctor could remember more industrial action over the years within the NHS but she is having great difficulty remembering the medical profession striking in the UK.

Apparently there was a junior doctors strike in the 70’s but the young WD has no recollection of this and whether it involved direct patient care.

However, there was some industrial action among GPs at one time. The Witch Doctor can’t even remember when or even if she herself was a doctor then. She has no idea what the strike was about. All she can remember was that the GPs decided not to do the government’s work for them. They refused to sign sick lines or something like that but surgeries and home visits continued as before.

What is interesting is The Witch Doctor can remember what happened during the strikes but has no recollection whatsoever what any of these strikes were about or whether striking had any effect on what they were about!

Perhaps that is a valid point.

Has The Witch Doctor ever gone on strike?

No.

Would she ever go on strike if the circumstances and cause were right?

She might tell you later.

On the other hand, she might not.

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Is there something you need to know about?

Then make a start by searching Wiki for information.

Right now.

If you do, you won’t find what you are looking for.

Instead you will find this:

IMAGINE A WORLD WITHOUT FREE KNOWLEDGE

And then this:

SOAP AND PIPA – LEARN MORE

Read.

Then think.

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Regarding euthanasia and assisted suicide, there are those who roll their eyes up to Heaven in exasperation when people like The Witch Doctor and other bloggers talk about “The Slippery Slope”

These clever, patronising individuals are of the view that patients who want help to die can have their way while society protects itself from “The Slippery Slope.”

We witches believe this is a load of bollocks!

First of all “The Slippery Slope” is another name for “Creep.”

Most members of The Humankind are famously susceptible to the “Creep” affliction, and so it is likely that voluntary euthanasia would follow on from assisted suicide, and murder would follow on from voluntary euthanasia.

They wouldn’t call it murder, of course. They would invent some kind of sanitised “caring” word to obfuscate and confuse.

There are many, many people in this word who, for a multitude of reasons, would be happy to see someone they know dead.

There, The Witch Doctor has uttered the unthinkable!

However, this is not shocking. These people are not necessary hard-nosed psychopaths. Most will be ordinary folks. Some would like to see others dead because of empathy for their suffering. Others would like to see others dead because of their own suffering brought on by others. That suffering might, for example, even be due to watching another suffering. There are other even less altruistic reasons and no doubt these are common too, albeit secret. Most people with these thoughts do not participate in manslaughter or murder and they have no intention of killing anyone. Their moral compass (the instrument some ethicists and philosophers question exists) keeps them from such aggressive and antisocial behaviour.

However, if the law of the land allowed voluntary euthanasia, even with all its “safeguards” whatever they might be, then a little green light gradually lights up “the moral compass” of certain individuals with the aforementioned unmentionable thoughts.

Even “The Moral Compass” can creep.

Maybe that is why some ethicists and philosophers don’t think it exists.

The green light puts a different slant on things. It becomes OK to be so “caring” about a “suffering” relative that the individual with murderous thoughts might encourage them behind closed doors to use the deadly potion prescribed by some doctor or another who does not believe in “Slippery Slopes.” Or perhaps if they can’t find a willing doctor, some other kind of health care worker will be sent to climb a few steps on The Skills Escalator so they are suitably qualified and paid appropriately to do the prescribing deed.

Other motives creep in. Society, after all, is encouraging us to think differently about death.

Death is part of life….

Death matters…….

Death should be celebrated….

Dying matters….

The elderly should make way for the young…..

Autonomy trumps all.

Autonomy?

If autonomy trumps all, then why cannot anyone be helped to die whenever they choose to do so?

What about the Kerrie Wooltortons of the world?

And what about sadness?

Why can’t the extremely healthy but lonely, grieving, individual choose to be helped to die because they want to meet their beloved relatives in Heaven?

Is that not a good enough reason to help someone die and is well within the construct of “autonomy trumps all?”

Ah, but that’s very stupid, since there isn’t such a place as Heaven they’ll say.

Ashes to ashes.

Dust to dust.

The Wise Men need to protect individuals from the concept of Heaven.

Let’s assume that everyone who believes in Heaven is as mad as a hatter and therefore not fit to be autonomous.

Let’s roll in the psychiatrists and lawyers to certify as insane anyone with a religious belief.

And so it goes on and on.

And becomes more and more tangled.

Perhaps there is no slippery slope after all.

Just a tangled mess…

P.S. If you don’t believe in slippery slopes and tangled messes, then have a look at what is happening in the Netherlands.

The Witch Doctor – Link to a random page

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If you have a look on the website of the Commission on Assisted Dying you’ll find there are some delicate frosted fern-like leaves pretending to be angels floating around.

They are probably wandering about the ether on a cold winter’s day aimlessly looking for Heaven.

Sad that, because they won’t find Heaven. The assisted dying / euthanasia outfits have seen to that. They have abolished Heaven. These missionaries who seem excessively overcommitted to the assisted suicide /euthanasia cause tend to be the far extremists of the atheist / humanist religion.

At least that’s how it seems to me and My Black Cat.

Julie has uncovered an interesting website. (I can’t link to Julie today, My Black Cat. Wonder what’s wrong)

It is a Christian site.

So it’s possible the atheist / humanist extremists do not consider it credible.

If so, that’s a pity because it is just possible that Lord Falconer’s committee is itself lacking in credibility.

CHARLES FALCONER’S BENT JURY – WHY WE SHOULD NOT BE SURPRISED BY THEIR “CONCLUSIONS”

But bent jury or not, there is always someone there to help.

Thankfully.

If for a moment you can take your eyes off the frosted fern-like leaves flying around looking frustratingly for Heaven, you will find who is helping Lord Falconer and his bent jury.

None other than one of The Intertwingled Triplets.

Demos – The Second Triplet.

And so now it seems Demos has become The Helpful Triplet.

Bless.

The Witch Doctor – Link to a random page

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A very long time ago The Witch Doctor learned an important lesson as she sat as a trainee observer during a patient’s consultation with a dermatologist.

It was an NHS consultation although the outcome would surely have been the same if the same dermatologist had been seeing the patient privately.

The patient was a young woman who came with her husband (who was a doctor in the same hospital) to the clinic. She had a big bag with her. It contained numerous bottles and jars of creams, lotions, shampoos and perfumes and she emptied them all on the desk. The consultant picked a few of them up and looked at the ingredients and as he did so, the patient elaborated on the various ways each lotion and cream was harming her skin. She pointed to the damaged areas of her face and the dermatologist examined her skin carefully.

Her doctor husband sat quietly in the background and contributed very little to the conversation. He probably had heard it many times. For all we knew, he may have been fed up hearing it. He might even have been at the end of his tether hearing it.

The patient was a pretty, young, well-groomed woman and to The Witch Doctor’s dermatologically untrained eye had a perfectly normal skin.

After spending a significant amount of time listening to the patient (for she was a patient – she was disturbed about her skin), the dermatologist quietly but firmly told her and her husband that, as a dermatologist he could do nothing to help her apart from some giving advice about some simple and cheap preparations that would do the job just as well. He told the reason he couldn’t help her was  because her skin was unflawed and the problem was that her own perception of her skin was faulty. He did not give them a return appointment.

Afterwards, the consultant explained to The Witch Doctor that cosmetic companies thrive on the discontent that patients have about themselves. Dermatologists could thrive also if they chose to. To collude with the patient risked the possibility that matters would worsen. The way this particular dermatologist operated was to ensure he did not become part of the play.

He would not collude with the patient.

He said that such collusion would be difficult to stop. Furthermore he felt it was unethical.

When Michael Jackson died, the Witch Doctor wondered how much pain he suffered due to repeated cosmetic surgery procedures.

She doesn’t know the answer to that, but she does know that chronic, severe, pain is a terrible thing and worse still when it interferes with sleep. She also knows that the drugs used to treat chronic severe pain can have a profound effect on everyday living and performance.

A doctor has been jailed for manslaughter over providing improper treatment of his patient’s pain or insomnia or both.

Was that doctor colluding with the patient?

Were there many doctors before him also colluding as the patient requested more and more cosmetic surgery?

Was Michael Jackson’s death the tragic finale of a play driven by repeated collusion like that the dermatologist all these years ago warned The Witch Doctor about?

Would that dermatologist, had he had been a cosmetic surgeon today, colluded by inserting foreign bodies into normal breast tissue unless there was a very clear medical indication to do so?

Would he have found himself caught up in the current breast implant fiasco.

The Witch Doctor thinks not.

Perhaps UK doctors were wiser then.

All these years ago.

Before the mantra of “patient choice” blurred the margins of collusion and professionalism, and sanitised commercialism within the healthcare industry.

The Witch Doctor – Link to a random page

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Once upon a time, when The Witch Doctor was very young – about the age of four, she used to sit beside her mother on a big couch in front of a blazing coal fire in the bleak mid-winter evenings. She would be drinking a cup of hot, milky cocoa before going to bed.

It was story-telling-time for the young witch child. They were usually the “normal” children’s stories like Cinderella, Red-Riding Hood, Snow-White etc. but often they were not read out of a book but were told with the addition of various embellishments in her mother’s own words.

Some of the stories that she heard have never since been encountered elsewhere by The Witch Doctor, and so she assumes they originated purely from her mother’s imagination.

There was one very brief and simple story that was a particular favourite of The Witch Doctor and she often asked for it to be repeated again and again on these winter nights.

She can’t for the life of work out why she liked this story so much because it was a bit gruesome for a child. Some children might think it even more gruesome than a wolf eating Red-Riding Hood’s granny. Since The Witch Doctor was not really into gruesome tales the fact she liked this one must have been something to do with the way her mother told it, the words she used, and the expression on her face.

Essentially, the story was about a little boy whose mother had died. One day he stepped off from the pavement in front of a car and was killed. He met up with his mother again in Heaven. So everyone was happy.

End of story.

That was all there was to it!

Now that The Witch Doctor is older and wiser, she asks herself:

“What was that childhood story her mother told her really about?”

Firstly, it was always about a little boy, never a girl. Was this because her mother did not want to personalise it in a way that pointed to the WD being that child?

Secondly, could it have been a road safety story, warning that children should take great care when crossing roads? If so this was never enlarged upon during it’s telling. Furthermore, it could be argued that it might encourage a bereaved child to walk in front of a car so that he could find himself in Heaven with those he loved.

Thirdly, could it have been a story that was handed down? Was it a family story told to my mother when she herself was very young? You see, the Witch Doctor’s mother was an orphan. Her father died when she was two and her mother when she was only six years old. Had relatives tried to lighten her mother’s burden by indicating that her parents were alive and well in Heaven and waiting for her there?

Fourthly, could it have been that The Witch Doctor’s mother thought she herself was dying and was trying to prepare the way for some kind of coping strategy for her own young daughter’s grief?

The latter is a distinct possibility, but that tale is for another day.

For some weird reason, The Witch Doctor remembered this story when she read about the current reactivation of the euthanasia debate (for the moment they are calling it “assisted suicide”)

Here we go again, thought The Witch Doctor. It’s like the Irish Referendum. This lot will come back again and again till they get the vote through.

There will be safeguards.

Of course there will……..

Then there will be Creep.

Of course there will……..

Assisted suicide should be legal, says major report to parliament.

“MPs should consider changing the law on assisted suicide to allow some terminally ill people to end their lives at home with the help of their doctor, a major report into the subject has concluded.

The Commission on Assisted Dying, chaired by the former lord chancellor Lord Falconer, says a choice to end their own lives could be safely offered to some people with terminal illnesses, provided stringent safeguards were observed.”

It has always seemed to The Witch Doctor that many of those most vociferous about a change in law in favour of assisted suicide and euthanasia are those devout followers of the Atheist and Humanist religions.

If an individual has been diagnosed with a terminal illness, or as Creep inevitably progresses, has not been diagnosed with a terminal illness, but are simply aged and lonely, or perhaps not aged but just lonely, why should they not be assisted to die or euthanased since they believe their loved ones are patiently waiting for them in that same Heaven that The Witch Doctor heard about in her tender years?

Why should an assisted suicide law not allow them die in order to be with those who care about them? Surely lonely people spending eternity with loved ones is a more justifiable reason for assisted suicide/euthanasia that spending it in the powdered ashes of oblivion?

I wonder what the most devout followers of the Atheist and Humanist religions might say about that, My Black Cat?

You think they would just say: “The Witch Doctor is a silly old Bat!”

But that would be very judgemental. We are living in a country where diversity, tolerance and choice are paramount.

Aren’t we, My Black Cat?

The Witch Doctor – Link to a random page

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A report from “Harvard Medical School via Canada :

“Statistics for 2009 compiled by Harvard Medical School and the U.S. Census Bureau show that, in the insurance-dominated U.S. healthcare system, 45,000 Americans died because they had no health insurance; 922,819 Americans went bankrupt because of medical expenses; 50,700,000 Americans have no health insurance.

The comparable figures from the Canadian health-care system are zero, zero and zero.

Which health-care system would you rather have?.”

And from Harvard Science:

“The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance,” remarked David
Himmelstein, study co-author, associate professor of medicine at Harvard
Medical School, and a primary care physician at Cambridge Health Alliance.
“Even this grim figure is an underestimate — now one dies every 12 minutes.”

The full report can be read here:

HEALTH INSURANCE AND MORTALITY IN US ADULTS

What about the UK?

Would comparable UK stats today be zero, zero, zero?

And if so, for how long?

a red apple ……………………

The Witch Doctor – Link to a random page

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In the last post, me and My Black Cat gave Her Majesty’s Government some good advice.

“A Christmas tip to HMG : You could start off by introducing a clause into the HSCB that makes it illegal for the fattening foods and drinks industry to employ PR companies. Then you won’t have to employ them yourself at great cost to undo the work they have already done promoting crisps, fried chicken and the products of the company with the revolving door that beckons folk like Alan Milburn.”

So, instead of backscratching with the Chipping Norton set and risking vertigo with the revolving doors, and instead of dumping £1m of taxpayers money into what could turn out to be a black hole, here’s another witching idea:

Mr Cameron and Mr Lansley, The Witch doctor is absolutely certain that you have picked up on the fact that the majority of the population who develop Type 2 diabetes are overweight. Doubtless you are also well aware that they will be helped tremendously if they can decrease their weight. Similarly, preventing individuals becoming fat dramatically decreases the likelihood of them developing Type 2 diabetes through time.

Now, what do the pair of you think of this idea:

Insist that the walls in the waiting rooms of all GP surgeries are lined with sweets, chocolate biscuits, butter, ham, cookies, cup cakes, Christmas cakes – you know the kind of thing – oh, and of course, crisps and Pepsi.

And in the cold weather, how about nice hot, deep fried chicken in breadcrumbs or batter to warm the cockles, before the patients embark on the cold trip home.

Or, how about the wonderful deep-fried Mars Bars (a delicacy from the Oldest Sage Witch’s Highland Granny’s part of the world).

All for sale in the surgery waiting room…….

Great.

This would be a thoughtful thing to do.

After all, it would mean that the elderly and infirm and those patients with Type 2 diabetic, could stock up on their weekly shopping while waiting to see their doctor. These people spend a lot of time in their doctors’ surgeries not only when they are ill, but for the numerous little assessments that are a necessary part of payment by results.

Ridiculous?

Of course it is.

But that is more or less what is happening.

The small independent pharmacies are wilting, because all the Type 2 diabetics with a sweet tooth are homing in on the pharmacies hidden in the hinterland of the supermarket shelves.

Unlike Type 1 diabetics, most of those with Type 2 diabetes have this condition because they have a sweet tooth. They follow the carbohydrate trail. And often the fat trail too.

Some supermarkets know how to pander to these people. They place their pharmacy counter diagonally opposite the entrance. As the population become older and more infirm they have to shuffle to the other end of the store and back again to collect their prescriptions.

This could, of course, be due to thoughtfulness on the part of the supermarkets. The long walk keeps these customers painfully mobile. Even more thoughtful – these in-store pharmacies will supply over the counter paracetamol if requested, to give the patients some relief as they shuffle the long way back to the exit again.

Is it any wonder these Type 2 diabetics succumb to their sweet tooth by stopping for a rest at all the shelves that beckon to them, on their way in and out of the store.

Yes, let’s say the supermarkets are thoughtful.

Lets not say that they will have paid some marketing or PR guru to state the bleeding obvious – that placing the pharmacy at the furthest away point will boost profits.

No let’s not say that, My Black Cat. We’ll not go there. Others can.

Instead we’ll give some more free advice:

A Second Christmas tip to HMG : Ignore the “thoughtfulness” of the supermarket pharmacies. Introduce a clause into the HSCB that makes it illegal for supermarkets to have their pharmacies at the opposite end of the store. If supermarkets MUST have pharmacies, and we witches, can’t for the life of us see why they must, then they should be situated at the entrance to the store and the customers should not require to enter the store and sneak past the shelves and the checkout in order to enter and to exit.

So there you are – a meagre little Christmas present from a witch and a black cat. It is just some free, sensible, advice that will help you in your attempts to amend the Health and Social Care Bill.

But there are conditions attached to using this advice so freely given.

First you must remove the Clause that states the Secretary of State for Health will have a “duty to promote” and return to the original wording “duty to provide.” Clear, concise, wording that has served us well for decades.

After all, without this, we might find that supermarkets and PR companies and revolving doors are running our NHS and have full responsibility for its provision – just as they have for our grocery provisions.

And they might continue to thoughtfully provide exercise for the present or future Type 2 diabetics as they shuffle past the wonderful shelves dripping with carbohydrate and fat.

And that would never do.

Would it, My Black Cat?

And so, The Witch Doctor and My Black Cat wish David Cameron, Andrew Lansley, and all the Members of Parliament that we contacted personally in 2011, a very Happy Healthy Christmas and New Year when it comes.

In 2011, we wish that you all do the right and sensible thing regarding our NHS.

We wish all our readers (especially the seven – the magic number who see that the spell is working) a Happy, Healthy Christmas and New Year also.

But perhaps most of all, we wish our fellow medical bloggers, past, present and future, a Happy Healthy Christmas and New Year because without them, there would be no medical blogosphere, and the future healthcare in this country might be the worse for that.

The Witch Doctor – Link to a random page

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You despair, My Black Cat?

Yesterday it was announced that Matthew Freud, one of the Chipping Norton set, who is also Rupert Murdoch’s son-in-law, is to roll a PR agency, largely owned by him, into the DoH to advise us all that we eat too much, smoke too much and heaven knows what else we do too much. This apparently will cost a £1m per annum of taxpayers’ money.

“Distinct strands of public health work – such as obesity and smoking – were handled as separate accounts managed by different agencies, but now all the work will be rolled up into a single account for MEC managing all the media planning and Freud Communications, the firm founded and largely owned by Rupert Murdoch’s son in law. Freud is married to Elisabeth Murdoch.”

Oh, I’m sure it will be money well spent, My Black Cat. After all, Freud Communications apparently have some “big ideas” and an “exciting pitch.”

Don’t be ridiculous!

I’m not being ridiculous My Black Cat. This is clearly a much sought after company! They are already PR advisors to Pepsi Cola, Kentucky Fried Chicken and Walkers Crisps. They will know all about fat foods. They are helping these companies keep a high profile.

And they confirm they have no conflict of interest:

“Freud PR said that the firm had no immediate conflicts of interest because the health department contract took in work about smoking and the early diagnosis of cancer in old people.
It is understood that the company does not represent any tobacco or pharmaceutical clients.”

THEY-HAVE-MADE-NO-MENTION-OF-A CONFLICTING-INTEREST-IN-FATTENING-FOODS–AND-DRINKS!

Dearie me, My Black Cat, neither they have……..

Silly old witch – that had completely passed me by.

However, My Black Cat, I’m reading something much more interesting.

It seems you can save money by giving a really, really cheap Christmas present in these times of austerity. You don’t even need to buy wrapping paper.

We can “tell our loved ones they are overweight this Christmas.”

“Christmas may be a time of indulging for many, but health experts believe it is the perfect time to tell a loved one they are overweight.

“Men find it hardest to tell their partners, while women were more worried about bringing up the issue with a friend.

But with families and friends getting together up and down the country over the festive period, the experts believe there is an opportunity that should not be missed.”

“Start by encouraging someone close to you to make simple lifestyle changes such as becoming more active, making small alterations to their eating habits and replacing sugary drinks for water.”

Can you explain, My Black Cat, why reading this makes me want to eat a very large Christmas cake, a huge plate of mince pies and a whole Christmas pudding all by myself!

Bless the experts and the New Age Charities!

They make a witch feel exceedingly hungry.

Perhaps, My Black Cat, in the new year we should take it upon ourselves to explain to the government how to help people get fit and lean without really trying, and save them £1m per annum into the bargain.

A Christmas tip to HMG : You could start off by introducing a clause into the HSCB that makes it illegal for the fattening foods and drinks industry to employ PR companies. Then you won’t have to employ them yourself at great cost to undo the work they have already done promoting crisps, fried chicken and the products of the company with the revolving door that beckons folk like Alan Milburn.

Is Pepsi the same as PepsiCo?

Dunno, My Black Cat. We witches don’t drink the stuff.

The Witch Doctor – Link to a random page

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To the tune of £1m per annum to The Chipping Norton PR machine with a “really exciting pitch”

Great.

Just great!

The Witch Doctor – Link to a random page

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So, The House of Lords is beginning to get round to it at long last.

Maybe…..

The message will get lost in the run up to Christmas.

The Commons should have sorted it out.

Why the devil do we elect MPs, My Black Cat?

The last post referred to the early medical bloggers and to Dr No’s recent post where he quotes Bob Dylan. Some my take it to mean that Dr No is about to join the other three bloggers i.e. vaporise.

My Black Cat is sure this is not the case, but time will tell.

“I don’t need your organisation……”

“I’ve moved your mountains and marked your cards…..”

She thinks Dr No is referring to the Health and Social Care Bill.

She wonders if he might be giving up on it……..

You may recollect the post in BadMed in March of this year drawing attention to the accountability of the Secretary of State for Health. If you don’t remember it, then read on……..

Not many were picking up on this key aspect of the HSCB at the time. Even My Black Cat missed it.

Once she read the post on Bad Med, The Witch Doctor thought it was important enough to do something that she has never done before.

In March this year The Witch Doctor began emailing every single MP of all parties including those in Wales, Scotland and Northern Ireland. She may have omitted a very few like the PM and the Secretary of State for Health. She can’t quite remember. If she did it would have been because she thought it was a waste of time or she didn’t want to alert them to know what she was up to (not that they would have cared much anyway, which is a pity because me and My Black Cat have an awful lot of experience of the foibles of the NHS, and furthermore we know full well where money and time are wasted. But above all, we know what is good about the NHS and how to make it better ).

Here is what she said in her email:

Dear (Name of individual MP)

I am a doctor and anonymous medical blogger. Like most members of the medical profession who are “jobbing doctors” and “jobbing academics”, I have grave concerns over the future of the NHS. I have grave concerns as a patient too.

Recently, one of my blogging colleagues, who is also a doctor, analysed the changes that had been made over the years in the sequential National Health Service Acts and compared them with the important change in wording of the Health and Social Care Bill that is currently going through parliament.

I would be grateful if you could read this blogger’s post, and consider the implications of the change in wording.

SECRET NAIL IN THE NHS COFFIN

Could I also emphasise that all bloggers have their individual writing styles. This is simply the bloggers’ way of doing things in order to gain public attention about important matters and should not detract from the cumulative years of experience they have working in the NHS, often in senior positions.

Yours sincerely,

Decrepit Witch

You will notice she didn’t use her own name “Witch Doctor.” She signed herself anonymously as “Decrepit Witch.”

As you can imagine, most of the replies were automated. These or similar words were almost always included in the reply:

“Please note that there is a strict Parliamentary convention that MPs can only deal with letters raised by those from their own constituency.”

However, The Witch Doctor was not setting a precedent by writing to every MP. It seems someone much important than The Witch Doctor did the same thing in 2003.

His name was Professor David Kerr.

My Black Cat calls him The Demi-Pied Piper’s Little Helper. You would need to have read this blog for a long time to get the gist of who the Demi-Pied Piper is. Life is too short to explain it all again. However at the bottom of the page is what we said in June of this year.

Suffice it to say that The Witch Doctor was inspired by Professor David Kerr.

She used the same opus operandi.

The only difference was that she was a witch, so she probably DID set her own precedent.

It is doubtful if any MP has ever had ever before had an email from a doctor who is a witch and a decrepit one to boot!

I suppose it freaked some of them out.

Eh, My black Cat?

More later.

If I can be bothered………..

FIRST POSTED 27 JUNE 2011

THE MODUS OPERANDI OF THE DEMI-PIED PIPER’S LITTLE HELPER

Well, My Black Cat, everyone seems to be getting their knickers in a twist about discussing the amendments to The Health and Social Care Bill.

They say there is not enough time!

They say they didn’t really listen!

You say there is much to be learned from Professor David Kerr?

One of our readers accurately identified The Professor as The Demi-Pied Piper’s Little Helper.

You say what he did many years ago might be a useful tactic to use today, My Black Cat……..

Eh? The Witch Doctor has no idea what you are talking about!

Well, the Demi-Pied Piper is, of course, Alan Milburn.

The other half of the PP is Tony Blair.

They are all knitted and knotted together in Twingles and tangles.

It is interesting that New Labour’s Alan Milburn and life-long labour supporter Professor David Kerr are both now advising the present government – a government that does not call itself New Labour.

Professor Kerr is also a “Choice” enthusiast.

“He said that he hoped to push through the ideas of choice and the empowered patient, encouraging the NHS to make more high-quality information publicly available. “People need to be able to understand how their hospital is improving,” he said.”

But he doesn’t seem to like websites that don’t engage with the government’s “choice” agenda.

“On informed choice for patients, he said that under the Government “the whole big idea ended up in the foothills of dodgy websites. No one was really engaging with it.”

He was referring to the last government.

Dodgy websites!!!

Huh!!!

My Black Cat, do you suppose it is possible Professor Kerr had been surfing around the medical blogosphere?

Wonder if he still does.

Wonder if he’s read this recent review of “The Choice Agenda.”

Anyway, My Black Cat, what is it that might be learned from Professor David Kerr?

This recent statement of Alan Milburn’s is relevant.

“The reforms I introduced as health secretary to create NHS foundation and primary care trusts started the devolution journey. GP consortiums were supposed to complete it.”

Professor Kerr, clearly supported Alan Milburn. He wrote a letter to all MPs many years ago when the Commons were divided on the foundation trust scheme.

“He was also one of the main drivers of the foundation trust scheme, offering the best hospitals the chance to become more independent, hold greater responsibility for their budgets and make clinicians more engaged in service improvement. A knife-edge Commons division on foundation status was won by 17 votes after Professor Kerr wrote to all MPs underlining the advantages that it would bring.”

In 2003, Alan Milburn referred to Professor Kerr in Hansard.

Dr Phyllis Starkey, the then MP for Milton Keynes, South West, referred to the fact that Professor Kerr “seems to write particularly good letters.”

I make no apology for quoting the much-cited Professor David Kerr, who seems to write particularly good letters. In a letter to me, he wrote: “Hitherto, the old monolithic NHS has been good at setting targets but failed completely to provide the means of achieving them. We cannot drive service improvement from the centre. Famously, Frank Dobson likened the NHS to an enormous oil tanker which took an age to turn around. Rather than let the oil tanker run aground, would it not be wiser to invest in a fleet of modern, manoeuvrable ships, which can function in a convoy without loss of individuality? As we develop national standards for cancer and other diseases, it has become crystal clear that we must support, not stifle, local initiative; that we must allow the freedom to reform; that we should raise standards so that all might benefit.”

So, My Black Cat, you are saying it is possible the Health and Social Care Reforms would never have got off the ground if Professor Kerr, a renowned cancer specialist, and staunch labour supporter, had not written to every MP giving his support for a key scheme initiating Alan Milburn’s long term plans for the NHS?

Cancer is such an emotive subject. Isn’t it, My Black Cat?

But taking all this into account, way back in 2003, the foundation trust scheme got through The House of Commons by a majority of only 17 votes!

Without Professor Kerr, where would Alan Milburn’s plan be now?

Where would the Health and Social Care Bill be now?

You will recollect too, My Black Cat, that Professor David Kerr was a member of The Future Form and sat on the subcommittee that produced this document:

Patient Involvement and Public Accountability A report from the NHS Future Forum

This is the document produced by The Future Forum that runs rings round us all by failing to clarify the role of the Secretary of State for Health.

The one where the term “duty to promote” appears to replace “duty to provide.”

But how might Professor David Kerr’s modus operandi all these years ago help now, My Black Cat

The Witch Doctor – Link to a random page

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Dr No is approaching the festive season with some words that, this time, are not his own.

It seems to The Witch Doctor that a message lies within this recent post at BadMed.

Depending on the interpretation, it is just possible the message could be related to the NHS and the Health and Social Care Bill.

For some reason it prompted The Witch Doctor to think about the first anonymous medical bloggers. She found herself looking back to the modern history of anonymous medical blogging in the UK.

Dr Crippen was the first anonymous medical blogger that The Witch Doctor discovered.

In fact, you might even say:

DR CRIPPEN BEGAT THE WITCH DOCTOR

Me and My Black Cat were great fans of Crippen’s writing style and the subjects he wrote about. His thinking was astute and confrontational and could be insulting. These insults made My Black Cat want to read it all the more. It brought in loads and loads of comments, and many led to arguments. The Witch Doctor has little doubt that he intended this to happen in his corner of the blogosphere.

He wanted to make people think for themselves.

The Witch Doctor is as sure as she can be that this was at least one of the reasons why he blogged.

He was anonymous. He always seemed to be treading where few in medicine dared to go. What he said could well have put his job on the line, although he had also trained as a lawyer and so possibly he knew just where to stop at least most of the time.

Although The Witch Doctor was pretty sure his writing style was intended to cause argument and ensure that medical blogging had a significant place in the media, she was also pretty sure that he did not speak to his patients in his blogging tongue that was carefully designed to conceal himself but reveal his thoughts.

The second anonymous blogger that The Witch Doctor encountered through a link from the Crippen site was Dr Rant. She was never sure whether he was a single blogger scrambling his identity or whether there were indeed a large group of bloggers writing in the same language. It was a new, foul, colourful, and most would say a totally unprofessional language that was now permeating the medical blogosphere. A language where a profanity or two was cleverly inserted into nearly every sentence.

Now, we witches, have been known to say things such as:

“Damn it!”

Or

“It’s bloody cold outside”

But the profanities of the original Dr Rant were in another league altogether. Rant developed a new language where swearing was the norm and furthermore it was embellished in a masterful way.

New words were created but their pedigrees could be traced to some of the worst words in the English language.

Enter the world of “Swear Blogging.”

The Witch Doctor asked herself what kind of person would blog in this way?

So she had a good look around the blog, and she convinced herself that his style of blogging was a means to an end. That end was to make brain-indolent members of The Humankind sit up and pay attention to what was going on around them.

The Witch Doctor, being a benign (but hopefully not brain-indolent) soul herself, wondered if Dr Rant might even be a gentle human being with a big cause.

It was difficult to find gentleness in Rant’s blog, but find it she did.

Sadly it has vanished.

But some time ago, The Witch Doctor posted on it.

THE SAD DEATH OF A MEDICAL BLOGGER

She came to the conclusion that his “Swear Blog” was a means of drawing attention to the medical blogosphere in its early days.

And, like Crippen, to alert The Medical Humankind so they began to think for themselves.

If that was his goal, he succeeded.

Nowadays, blogging is changing. Some may say that medical bloggers should not be allowed to be anonymous because this would force them at all times to conduct themselves in a polite manner befitting of their learned profession. They would say that they should blog with the courtesy that they give to their patients.

The Witch Doctor says: “piffle.”

If these daring, early, anonymous bloggers had not made sure they were noticed in their chosen ways, medical blogging would have been so boring in its political correctness that nobody would have noticed that the medical blogosphere existed at all in the UK.

They paved the way for a more measured approach such as that used by another of the founder medical bloggers – Dr Grumble. He has vanished off the face of the blogosphere although for some reason he is now tweeting like a bird. He better make damned (swear!) sure My Black Cat doesn’t start stalking him. We all know what she does with birds. She treats them all the same – nightingales or hawks – she deposits them at The Witch Doctor’s feet, dead or alive, on the floor The Spell Pantry.

Now, My Black Cat is very fond of Dr Grumble and would be beside herself with grief if she mistook him for a bird!

These three anonymous bloggers appeared long before The Witch Doctor and My Black Cat took to voicing our thoughts on the Internet.

The Witch Doctor is pretty sure Dr Rant has gone for ever. Indeed My Black Cat is of the opinion that the recent odd appearance of a Rant-form was that of an imposter. However, My Black Cat is notorious for her conspiracy theories and it is best to ignore her most of the time.

We hope Dr Crippen is still alive and well and enjoying his retirement. He muttered something about buying a scooter before he vanished, so that didn’t sound very terminal. Perhaps he will delight us all by wishing us a Happy Christmas somewhere in the blogosphere. Perhaps he may even metamorphose into somebody else.

And Dr Grumble? Well we hope sometime in the New Year he will fly down form the branches of the trees. It’s cold up there in winter. It’s much easier when there’s ice and snow outside to stop tweeting and to blog cosily from the fireside instead. My Black Cat is so worried that she might mistake him for a flamingo or Christmas robin one day and pounce on him with her lethal claws. Indeed she is so afraid this might happen that at this very moment casting a spell to bring him back to the blogosphere.

So what has all this reminiscing and rambling got to do with Dr No’s recent post?

The Witch Doctor will probably get round to telling you sometime.

The Witch Doctor – Link to a random page

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I suppose this is another reason for bloggers to keep the low hurdle of anonymity in place.

Yesterday there was a visitor to this blog who left the following warning:

“Might I suggest that The Witch should not put Saudi Arabia on her holiday itinerary:”

Being a curious witch she followed the link.

“A woman convicted of practising magic and sorcery has been executed by Saudi authorities.”

“The London-based al-Hayat daily, however, quoted Abdullah al-Mohsen, chief of the religious police who arrested the woman, as saying she had tricked people into thinking she could treat illnesses, charging them $800 (£500) per session.”

“The crime of ‘sorcery’ is not defined in Saudi Arabian law but it has been used to punish people for the legitimate exercise of their human rights, including their right to freedom of expression, the charity said.”

Perhaps everyone should follow the link and discover a website that even My Black Cat did not know existed.

It resulted in The Witch Doctor contemplating a few things.

Maybe she will share some of her thoughts with you some time.

Or maybe she won’t.

Doubtless you will have your own opinions on matters such as these.

No, The Witch Doctor has no plans to visit Saudi Arabia at any time. No matter how tempting many countries may be, she tends to refrain from visiting those on a recreational basis if they do not conform in some way to the Witch Doctor’s “moral compass” – that ridiculous imaginary instrument inside the brain that some philosophers don’t believe exists.

But she wonders about the holiday plans of the practising Woo Woo Wibblers who reside in the UK.

They have been warned!

The Witch Doctor – Link to a random page

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My Black Cat finds this quite amusing.

There are now pathways to lead you to the pathways.

But check out the detail.

They even tell you when it is appropriate to smile!

INTRAPARTUM CARE OVERVIEW

“Communication

“Greet the woman with a smile and a personal welcome. Establish her language needs, introduce yourself and explain your role in her care.

Maintain a calm and confident approach to reassure the woman that all is going well.

Knock and wait before entering her room.

Ask how she is feeling.”

Great tip: Start smiling before you enter her room and only after you have fixed a good smile then knock on the door.

Of course.

Notice there are no instructions about what to do if she doesn’t shout “come in”

Or if she says: “Don’t come in.”

They leave the difficult bits for you to work out for yourselves!!!!

The Witch Doctor and My Black Cat find this sort of stuff embarrassing, patronising and facile.

But then we are not of The Humankind, and so we are endowed with sensitive antennae that pick up even a whisker of patronization.

Take Note: doctors attending patients or mums about to deliver have all been well trained in communication skills during their undergraduate years.

Apparently.

The Telegraph tells you about that today.

It also tells you about what is lacking in the training of the new doctors of today.

NEW DOCTORS FEEL UNABLE TO TREAT SERIOUSLY ILL PATIENTS : RESEARCH

“New doctors feel unable to look after seriously ill patients because of greater emphasis on communication and teamwork over the basics during their training, research has found.”

“Professor Norman Williams, President of the Royal College of Surgeons, said:
“These findings about low confidence of new doctors in coping with acutely ill patients do not come as a surprise.”

“Current restrictions to working hours mean thin rotas that leave these doctors exposed and make it hard for them to build experience.”

“In recent years we have seen increasing divergence in the curricula of medical schools in the UK meaning that new doctors often have very different skills depending on where they graduate from.”

“The RCS would like to see a core national medical school curriculum and greater time spent in hospitals and other clinical care environments. The RCS recently highlighted how hospitals need to reorganise to put more consultant time at the frontline directly supporting new doctors and also run several practical courses specifically designed to build confidence in treating critically ill patients.”

Note: “Greater time spent in hospitals and clinical care environments”

That is the way it used to be when The Witch Doctor was young. She lived, even as a student, in the wards. She talked to patients, real patients, not actors and actresses. She examined bodies that were made of flesh and bone, not plastic. There was nothing false or contrived about the medicine she saw. And very quickly she communicated – without even realising she was learning to do so. The patients taught her. They taught her quickly. And they taught her well. If somebody at that time had presented her with a nice guideline telling her when to smile, she wouldn’t have smiled she would have guffawed and passed it round to her mates in the medical mess to lighten their day.

Is it possible the surgeons are suggesting The Yellow Brick Road should now go full circle?

However, the question My Black Cat is asking me right now is this.

What the devil are doctors for?

The Witch Doctor – Link to a random page

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On Sunday 20 November The Observer newspaper published an article about the agonising health problems being experienced by a particular family.

THE WORST FEAR OF MY LIFE : CANCER HAS MY FAMILY IN ITS GRIP

A little girl’s uncle wrote the article. His niece has brain cancer. In some ways the article was a celebration of the spontaneous generostiy shown by human beings when they hear about the suffering of a child. A fund had been set up and gigs were being planned to raise money to send the child to a clinic in Texas run by a medical practitioner Dr Burzynski.

Who would not or could not understand a family doing everything possible to try to save their child?

That was never in question.

Nevertheless, The Observer article opened up a can of worms.

But it is all the fault of the bloggers.

Of course……

There were some warning signs that the treatment offered by the Burzynski Clinic was at best driven by unproven enthusiasm and at worst by quackery.

These warning signs need to be investigated.

It so happens there is a cluster of bloggers who demonstrate a dedication to the exposure of quackery within healthcare. Presumably they feel it is in the public interest to expose it and furthermore they feel it is an unethical way to practise medicine.

The Burzynski Clinic threatened some of these bloggers for questioning the effectiveness of the treatment offered by this clinic.

Links to these bloggers are here:

FIRST DO NO HARM…..

Last Sunday, in response to the blogosphere, The Observer had an article asking the question:

“Is it so surprising where desperate parents will turn in the search for a cure for their terminally ill child?”

The answer is : “no it is not surprising. It is absolutely understandable.” To The Witch Doctor’s recollection that was the view taken by the bloggers.

In the article, The Observer refers specifically to two bloggers, Andy Lewis of the Quackometer, and Rhys Morgan a schoolboy. Both blog about quackery .

“Things escalated when Andy Lewis, who writes the popular Quackometer blog, received threats of legal action from a Marc Stephens, employed by the clinic to stop what it claimed were false allegations on the internet. The clinic says his “inappropriate” services have now been dispensed with, but it warns bloggers that they will be pursued by lawyers if they publish what they consider to be defamatory allegations about the treatment.”

“Rhys Morgan, a 17-year-old blogger, also received threats after raising concerns about the trials, though his recent claim that the family merely “did some research on the internet” before deciding on the clinic was not based on any conversation with them.”

The writer in The Observer seems miffed that the point of their article was being ”lost in the vitriol that is flying around the internet”

The Witch Doctor did not observe any vitriol originating from the two bloggers mentioned in The Observer.

The Quackometer has since responded to the article:

THE OBSERVER RESPONDS – COMPLICITY IN MISINFORMATION
Bloggers: “aggression, sanctimony and a disregard for the facts”

“The article fails to get to the nub of the concerns with Burzynski. First and foremost, the dubious ethics of charging parents of terminally ill children, hundreds of thousands of dollars, to enroll them in trials for a treatment that has failed to demonstrate any good evidence that it may be effective over 30 years. Burzynski is running a private clinic. He sells anti-aging creams, vitamins and supplements. He is under investigation by the Texas Medical Board. These are a few of the many red flags that ought to raise deep concerns. Even if he is on to something with his antineoplastons, he is asking the terminally ill to provide the investment funds for his research programme. His patients are taking all the risks, both with their health and wealth. He is reaping rewards whether he is right or not. Such actions go against the fundamentals of medical ethics.”

He continues:

“…….I do not know the answers. But these discussions need to be had. And they need to be had in the context that there are peddlers of miracle cures out there, that may appear genuine to a desperate eye, but offer nothing but anguish, false hope and bankruptcy.

The Observer’s response not only failed to look at these issues, but took issue with those people that tried to. Most disgracefully, they attacked the 17 year old blogger, Rhys Morgan, for saying in his Guardian CiF article about libel threats from Burzynski, that the family had researched Burzynski on the internet. The family appeared to take issue with this and the Guradian has amended the article to say “The family has asked us to make clear that members of the family completed a long and thorough period of research across a wide range of conventional and alternative treatments, both in the UK and abroad, before approaching the clinic.”

Is this the justification for calling bloggers like Rhys, “aggressive, sanctimonious and having a disregard for the facts?” You should read Rhys’s blog and articles and decide for yourself. The response also failed to note how Rhys had been threatened by representatives of Burzynski by sending him pictures of his house. This is not science and medicine, but gangersterism. Let me remind you, Rhys is still at school. If there has been aggression against children, it has not come from bloggers.”

It seems The Observer, by publishing these articles is doing everyone a favour, not only by praising the generosity of the public, but by putting the thoughts and ideas of bloggers who are dedicated to exposing quackery in healthcare into the mainstream media.

However, if it does in fact turn out that The Butzynski Clinic is feeding on money and emotions of vulnerable patients then The Observer should not be the ones to take the full credit for the exposure. On the other hand, if it turns out that The Butzynski Clinic can produce evidence that they have discovered a cancer breakthrough that will stand up to rigorous peer review in the medical journals, then The Observer should take little credit for that either.

The Observer reported, but the bloggers investigated.

Is investigative journalism in the process of migrating from the mainstream media into the blogs of a few brave individuals who rely on their brains as their resource rather than multi-million pound bank accounts?

And are bloggers to be exposed, threatened and perhaps taken to court by those with vested business interests within the healthcare industry and beyond?

And will we all sit by and watch the show, munching popcorn?

Just like we watch Big Brother?

The Witch Doctor – Link to a random page

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Sometimes, in the world of witches and black cats, bells chime out.

Sometimes we can’t for the life of us think why they are chiming.

There has been quite a skirmish following a story uncovered by The Bureau of Investigative Journalism who are running a series “Lobbying’s Hidden Influence.” They describe what they have discovered in their recent investigation as “the next scandal waiting to happen.”

It concerns the lobbying firm Bell Pottinger.

If you move in the right circles, you will have heard of it.

The Witch Doctor had heard of it even although she doesn’t move in the right circles.

But she couldn’t work out why.

It is well worth reading all about what it is that The Bureau of Investigative Journalism reveals concerning the wheels within wheels within government.

You can see a video called “Bell Pottinger exposed : Undercover filming reveals Bell Pottinger’s ‘dark arts’.

It’s all very interesting, but The Witch Doctor was still none the wiser why the Bells of Pottinger were chiming inside her head.

Then all of a sudden, My Black Cat starting jumping about in glee.

She could hear the music of the bells as they chimed out loud and clear.

She said we had Intertwingled with Bell Pottinger in The Witch Doctor’s blog way back in 2007 on the matter of healthcare.

So right now, My Black Cat is unraveling Intertwinglements.

Heaven knows what she’ll come up with.

If anything.

The Witch Doctor – Link to a random page

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There’s lots and lots of money to be made in data-mining, My Black Cat.

We saw this coming. Didn’t we?

PATIENTS’ NHS RECORDS COULD BE SHARED WITH PRIVATE FIRMS

That’s why we posted our crazy lemon post 3 years ago.

Soon you will need to be appraised, revalidated and carry a license to buy a lemon or grow a lemon tree.

A BITTER TASTE OF THINGS TO COME (2) (first posted on WD in November 2008)

Don’t be so tedious, My Black Cat.

The lemons are NOT for dunking in your tea!

They were found in the pockets of the secret writers. They are for doctors and patients so they can make case notes together.

The secret, confidential variety.

To run in parallel with the woolly public ones that don’t say much but satisfy every Tom Dick and Harry who feel “they have a need to know.”

They won’t call them case notes though.

They’ll call them An Aide Memoire, A To Do List, A Memo. Or if a witch is involved, an Addendum to The Book of Spells.

And no one else will know of their existence.

The Witch Doctor – Link to a random page

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This letter has found it’s way into the media.

You’ve probably read it by now.

BARTS AND THE LONDON HOSPITAL SURGEONS QUIT OVER “DANGEROUS” SITUATION

BARTS HOSPITAL CONSULTANT’S RESISGNATION EMAIL – FULL TEXT

HIGH PROFILE RESIGNATION AT A LONDON HOSPITAL PROMPTS SAFETY INQUIRY

There are lots of interesting bits. Here is one of them!

“He concluded: “I have been complicit in a poor standard of trauma care and am guilty of negligence by association.

“I can no longer stand idly by when patients are at best having their human rights breached, and at worst physically harmed by the care they receive.”

OK, how many consultants and GP’s know deep within themselves that they have been complicit and therefore guilty of negligence, simply because they “went along with the flow,” kept there heads below the parapet, and for some reason, not known to man or beast couldn’t find the courage or common sense within themselves to just say “NO!” when crazy tick-boxing, protocols, de-skilling, charts and inane record-keeping took over from the professionalism that was once associated with patient care.

Resignation is not the answer. It puts the expertise gained over many years into the private sector or the golf course or both, and leaves the NHS bare of experienced professionals and so patients become more vulnerable.

Why could they not have said “NO”

Altogether.

All over the country

And meant it!

Stupid, stupid, doctors of The Humankind!

Why can’t they all say “NO” now, even as the witching hour chimes?

The Witch Doctor – Link to a random page

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I suppose it would be true to say that The Witch Doctor has some things in common with HRH The Prince of Wales.

These are :

1. A love of our gardens
2. Gardening on the wild side
3. Talking to our plants

Witches always chatter or sing to their plants when they are gardening, or sowing seeds, or pricking out newly hatched seedlings. And of course we blow the seed everywhere as we sing. We sometimes dance too. It seems a sensible thing to do. Alan Titchmarsh, although not a believer in these activities, is more like that former, recently metamorphosed blogger, Dr Rant – he cruelly swears at his plants! Doubtless, that will soon become an offence in this politically correct country of ours where there are sinister moves afoot to suppress such cruelty! Just think of the uproar that Jeremy Clarkson caused yesterday. I don’t think he even swore. Did he, My Black Cat?

Don’t say we didn’t warn you Mr Titchmarsh! 

(Do click on the link and note the old picket fence and the moss in Alan Titchmarsh’s garden. That is a garden any witch would be proud of!  It is just our style!)

The other thing that we witches like to do is to observe the sky at night. We are not sure if The Prince of Wales participates in this activity, but we wouldn’t be surprised if he does. It is an activity that is becoming increasing difficult because of man-made luminescence throughout the land. It is sad that many children in the UK have never observed The Milky Way because of this.

We also garden by The Lunar Light.

We are aware that many of The Humankind think that talking and dancing to plants, gardening by the light of the moon, and searching for The Milky Way on cold frosty nights when we could be cosy inside, is a sign of madness.

We witches don’t really care what The Humankind think! They have plenty of problems of their own.

These activities, that we witches hold so dear, give us a deep association with nature. We are reminded as we look at the sky and potter about in our moonlit gardens that each one of us is less that a speck of dust in the universe and that our lifespan within it is infinitesimally less than the flutter of an eyelid.

The Humankind don’t much like to think of these realities of life, so they do other things that don’t remind them of their frailty and insignificance on this small planet.

They fight. They war. They kill each other. They kill themselves. They climb money trees on rickety ladders. They drive fast cars and sneeze at high speed. They kill themselves. They work, work, work in the futile hope of finding some self-actualisation. They kill themselves. They develop some very peculiar habits. They kill themselves.

All of this is rather odd to a witch. Nevertheless we have sympathy with The Humankind.

We can fully understand that they seek comfort in bizarre behaviour.

Some seek comfort in meditating and in religion. Sometimes they become fanatical. They kill themselves.

In some parts of the world, followers of the old religions are waning as The Atheist Missionaries seek to convert populations to embrace the logic of science.

This conversion naturally serves as a reminder to many of their frailty and insignificance.

The conversion is not complete, because many of these New World Atheists seek out and perhaps find comfort in the pseudoscience of alternative medicine.

And the more scientific the pseudoscience sounds, the better!

As we stated in a previous post, we witches have a notion that a belief in pseudoscientific alternative medicine is very, very, very common.

And that poses a problem ( or a benefit ) for doctors and scientists who are trained to follow The Scientific Method………

A problem or a benefit…..

Which is it to be?

More soon, maybe.

Or maybe not.

The Witch Doctor – Link to a random page

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It so happens that I grew up knowing that I would have had a cousin who, if she had lived, would have been much older than me.

I was told she was a very beautiful child who looked normal in every way but could do very little for herself. She had some kind of incurable brain disorder but I don’t know what it was.

I was told that my aunt travelled the world far and wide with her ill daughter looking for a cure.

I have no idea whether any doctor said they could help or whether they told her nothing could be done.

I have no idea how much money she spent looking for a cure or whether she encountered any medical quacks on the way. If she did I have no idea whether she paid them money for their quackery.

I often think about the sickness burdens that people have to bear, and how normal it would be to want, in desperation, to travel to the ends of the earth looking for a cure for your child. It often strikes me also, how vulnerable such people are when they are offered false hopes in exchange for financial gain.

Last weekend there was quite a little flurry of potential legal activity on the medical blogosphere. Copyright law, harassment law and heaven knows what other kinds of law were entering the scene.

By far the most moving of these fracases involved a child from the UK with a rare brain tumour who is attending a clinic in the USA known as “The Burzynski Clinic”

It has a website:

http://www.burzynskiclinic.com/

It looks as if it is a major, important, well-funded centre of excellence.

The child is a little girl whose name is Billie, and people are rallying round to raise money to help her travel to and from Texas to obtain treatment that they feel may help her. It is treatment that is not available in this country. The Billy Butterfly Fund has been set up.

The Observer newspaper on 20 November carried an article about her.

To be honest, The Witch Doctor was completely unaware of this establishment, or the treatment it offers. The name of the treatment sounds convincingly scientific. It is known as Personalised Gene Targeted Cancer Therapy, using certain peptides known as Antineoplastons.

If Antineoplastons are so important in the treatment of cancer, why has The Witch Doctor never come across them before?

When she first heard the term she knew what the word implied, but she hadn’t a clue what the damned things were!

Is she an ignorant, poorly trained, out of touch witch who does not read the journals and doesn’t keep up to date?

Possibly.

After all, she missed that they are mentioned on the National Cancer Institute’s website:

Why are they not being used in the UK? Has NICE stepped in and decided the treatment is too expensive?

NICE may have its faults, but depriving a child of effective treatment for a rare brain tumour is not one of them.

Has Dr S R Burzynski made a cancer breakthrough?

If so, we should all know about it, because that is the nature of research and The Scientific Method.

Or….

Is there something rotten the State of  Texas?

It seems some bloggers who are more educated than The Witch Doctor on these matters are well aware of Dr Burzynski’s antineoplaston therapy and have been keeping an eye on it for some time.

They are expressing views that are not favoured by those working in the Burzynski Clinic.

Bloggers have been very seriously threatened and, as a consequence, antineoplaston therapy has gone viral!

It is good that controversial views are being aired publically over this clinic because it is definitely in the public interest since it involves patients worldwide including some from the UK. If, as it is alleged, that a lot of money is passing from the hands of vulnerable cancer patients and their relatives, or charities set up to help them, to those making bogus claims over a useless cancer drug, information is now available on the WWW that can be followed up and any Wibblers of Woo that are around can be exposed.

Alternatively, if the clinic concerned has indeed found a treatment that can significantly help cancer patients, even if it is not a cure, and the oncologists worldwide are ignorant of it, then that is good news too. After all, ethical doctors can have no secrets when it comes to sharing cancer research that might benefit patients worldwide.

Either way, opening the conversation up in the blogosphere is in the public interest.

No doubt it will eventually become apparent whether this is a scam, a fanatical belief in the power of a useless medication, or a genuine cancer drug that offers hope to at least some cancer patients.

However, questions need to be asked about why a spokesman for the Burzynski Clinic is threatening a group of bloggers who, in the public interest, want to learn more about the Scientific Method being used to asses the treatment being offered by this clinic.

Here are links highlighting among other things, the bloggers who have been targeted by Marc Stephen, head of marketing for the Burzynski Patient Support Group.

BURZYNSKI FANATIC THREATENS BLOGGERS

THE BURZYNSKI CLINIC THREATENS 17 YEAR OLD BLOGGER

THREATS FROM THE BURZYNSKI CLINIC

THE BURZYNSKI CLINIC THREATENS MY FAMILY

SCIENCE BLOGS

D C SCIENCE

RADIOHEAD SIGNED GUITAR BILLIE APPEAL

It all makes interesting reading.

It needs to stay viral until the research surrounding this therapy has been revealed and published in the medical journals and has been thoroughly peer reviewed.

The Witch Doctor – Link to a random page

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If you are a doctor, consider your non-medical friends and relatives

How many of them believe in or have participated in some form of alternative therapy?

80% or even 90% maybe?

Then consider the nurses you know.

How many of them believe in or have participated in some form of alternative therapy?

50 – 60% maybe?

What about the doctors you know – medical practitioners or scientists with say PhDs? How many of them believe in or have used some form of alternative therapy?

5% maybe? 10%? 20%?

Who knows if these figures are correct…. They are just off the cuff. But they feel just about the right percentages for The Witch Doctor’s neck of the woods.

What does The Witch Doctor believe regarding alternative therapy?

Well, she swears by The Book of Spells and her Tussie Mussie Garden, and she has dabbled in auto-hypnosis although she has never practiced the technique on patients.

Does that make her a Woo Woo Wibbler?

At the time when it was thought that polyclinics were going to be forced on every English town and city, The Witch Doctor said something along these lines:

“The Witch Doctor has often considered how easy it would be to become a very, very, very rich Witch. Not by using The Book of Spells and The Cauldron, of course, because these are old fashioned, a bit scary, and not politically correct.

No, The Witch Doctor would have a beautifully designed consulting suite in a good area of town or maybe even a few towns, where many clients (not patients) live. The “medicine” would be dispensed in dear, dinky little blue and green miniature bottles that would contain concoctions from her Tussie Mussie garden. She would call them “The Dandelion Remedy” or “The Buttercup Rememdy” or “The Wild Bergamot Remedy,” or “The Grape Hyacinth Remedy,” This would appeal to the female variety of The Humankind who are rather more crazy than the males when it comes to alternative therapy.

The place would be pristine and there would be fresh flowers everywhere. The Tussie Mussie Garden would be renamed The Peaceful Physic Garden (organic) and clients would be encouraged to wander around in contemplation as part of their therapy.

For good measure, The Witch Doctor would do something most of the alternative practitioners cannot do – throw in a good helping of some sound medicine too when required. And even make a decent diagnosis every now and then. That would put The Witch Doctor’s practice, head and shoulders above the other alternative practitioners.

This would ensure her millionaire status.

Most doctors, if they were so inclined could cream off the alternative medicine market for themselves.

But most don’t.

Why not? Probably for the same reason that The Witch Doctor is not a rich witch.

It is dishonest, because members of the medical profession are educated in these matters and know better. They know that most of the population at some time or another dabble in woo and they know, understand and may have sympathy for the reasons why. However, this knowledge, understanding and sympathy is no reason for medical practitioners to turn their backs on evidence based medicine in order to gain a quick buck from vulnerable patients, the worried well, or clients.

If doctors become the bed-fellows of the cranks and the Woo Woo Wibblers, then it is the end of medicine as a profession.

And so, when The Witch Doctor’s moral compass stopped spinning it pointed 180 degreees away from the Woo pathway.

And that is one reason why medicine has not made The Witch Doctor a rich witch.

And it is one reason why The Witch Doctor is still contemplating whether it is wise to scan the horizon for a husband who is a millionaire.

The Witch Doctor may or may not continue with this story.

A warning:

If she does, it is liable to become serious.

Very serious indeed………

The Witch Doctor – Link to a random page

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This is the kind of news that makes The Witch Doctor squirm and My Black Cat spit!

There may be a link between concentration camps in Nazi Germany and thalidomide.

SCOTS ACADEMIC PROBES NAZI LINKS TO THALIDOMIDE

“For years, there have been rumours that Thalidomide was developed during the Second World War and tested on concentration camp inmates.

Prof Stokes was asked to investigate this by the Thalidomide Trust.

“The Nazi period is of interest to establish a pattern of behaviour,” said Prof Stokes.

“What we can establish is a background in the Nazi period of connections between Heinrich Mückter, one of the key scientists whose name is on the patent of the drug, and some other companies and other scientists who were involved in experiments on concentration camp inmates.”

Drug trials
While any Nazi links may attract attention, it is another line of inquiry which has bigger implications. Professor Stokes is investigating how much Chemie Grünenthal knew about the drug before it was withdrawn.”

There is no indication here that medical practitioners were involved in this alleged experiment in concentration camps, however, it is documented that some were eating out of Hitler’s hand during WW2

DOCTORS UNDER HITLER

When The Witch Doctor qualified, she was expected to take the Hippocratic Oath in the form of words used at that time. The Witch Doctor thought it was compulsory to do so, but maybe she is wrong about that. It is certainly not compulsory nowadays and at any medical graduation it can be observed that significant numbers of young doctors do not participate.

The Witch Doctor does not intend to debate the pros and cons of taking an oath after qualification, but she thinks the oath she took during that graduation ceremony a long time ago has served her well.  However it may be worth mentioning that the day she qualified as a doctor she knew she had to think deeply about many things. She had to set herself a bottom line below which she would not stoop regarding professional behaviour. Many things were taken into consideration as she did this, and the cumulative effect is, that The Witch Doctor simply could not possibly have become a millionaire as long as she remained practising medicine her way.

So in addition to the Hippocratic Oath, it could be said that The Witch Doctor took numerous little oaths at very personal level that would guide her through her career. You could say that they originated from her “moral compass” – that ridiculous imaginary instrument inside the brain that some philosophers don’t believe exists.

Some situations are resolved easily by this witch’s own moral compass and presumably she is no different from most doctors in this regard:

For example, she knows she would not participate in torture, capital punishment, experimentation of prisoners, or euthanasia even if she was offered a princely sum to do so. Similarly, she would not participate in the law in the land if she were required to maim an individual as punishment.

But these are easy decisions, although it would become much more difficult if close family were held hostage, maimed or killed because of The Witch Doctor’s refusal follow the directive of the state.

But for now, we will not go there.

On lesser matters, sometimes the moral compass spins a little before it settles down.

But the spinning always eventually stops, and The Witch Doctor hopes that when it does, the needle points her in the right direction……

But to date it has never pointed her in the direction of riches.

That is why she is musing over whether she needs to find herself a millionaire wizard husband.

More maybe.

Or maybe not….

The Witch Doctor – Link to a random page

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Because of the way she has chosen to practice medicine, The Witch Doctor is not a rich witch.

She is not poor either because, up till now, being a doctor who holds a full time job at any grade allows you to be clothed, fed and have a roof above your head.

Being a doctor generally allows you to have much more than that.

But ordinary doctors are usually not really, really, rich.

However, The Witch Doctor is a great believer that anyone in a capitalist society can become a millionaire if they set their mind to it. All it takes is an entrepreneurial spirit, knowing what you’re good at, the ability to live with risk, vision, attention to detail and hard, hard work. If you throw in a bit of determined ruthlessness too then success will surely follow.

The Witch Doctor does not look down on millionnaires but she does not look up to them either.

She thinks when sees, reads, or hears about a millionaire:

“There but for the grace of God go I!”

Unfortunately, The Witch Doctor’s career choice has scuppered her chances of ever becoming a millionaire.

This is because she chooses to practice medicine in a certain way that is at odds with the millionaire philosophy.

However, to be honest, she sometimes yearns to be a millionaire or even a billionaire.

Why?

Because she has a great desire to grow the most beautiful Tussie Mussie gardens scattered throughout all the urban populations in this fertile land of ours.

She thinks tending a beautiful garden makes people happy.

And think of the spells me and My Black Cat could concoct with all these ingredients available everywhere!

As she gets older, this desire is becoming more poignant.

So, recently, she considered whether she could break the medical vows she made to herself all these years ago. and become a medical entrepreneur.

She could not.

So there was only one answer.

To find a millionaire witch husband – someone who through his life had been a wizard with money.

The Witch Doctor might choose to continue with this story.

On the other hand, she may not.

Or she may just ramble on a bit.

As she often does……

The Witch Doctor – Link to a random page

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NON-STOP LANSLEY

“One man who visited an elderly relative said: “It was eerie. Everywhere you looked there was Andrew Lansley. My mother-in-law had to keep topping up the machine just to escape him.”

Hospital TV has been criticised for the high cost to patients. Last year it was reported that the cost of watching television for a 24-hour period had almost doubled from £2.90 to £5. The cost comes to £1.50 per day if you buy a 30-day package. If not you get Mr Lansley.”

Is this a kind of tax on the sick, My Black Cat?

A tax that must be paid in order to obliterate the face of Andrew Lansley?

Or is this some kind of punishment being dished out to us all because of our pesky insitance that the Secretary of State for Health retains his “duty to provide” in the new HSCB?

They are all nuts, My Black Cat.

Nuts, nuts, nuts, nuts, nuts, nuts, nuts!

The Witch Doctor – Link to a random page

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You have been very busy over the past few days collecting ingredients from The Tussie Mussie Garden.

I have been quite worried about your rather unusual enthusiasm.

And now you are boiling up The Cauldron as if your life depended on it.

What is that are you saying when you stir The Cauldron, My Black Cat?

“a, a, a, about, and, and, and, and, are, as, as, be, be, blow, broomstick, broomstick-maker, can, caring, cauldron, cauldron, charged, colleagues, comments, compassion, confirmed, continue, cyberbullying, decrepit, derogatory, detective, doctor, doctor, doctors, doctors, doctors, doctors, destress, extol, female, flame, for, for, force, harass, harassment, has, have, healthier, Highland Granny, history, humiliate, I, if, in, in, in, issuing, long, making, male, Met, mock, NHS, NHS, nastiness, nasty, noble, of, of, offensive, Oldest Sage Witch, or, our, our, out, personal, police, police, police, profession, repeat, reported, sergeant, speak, spell, Spell Pantry, stamp, support, she, than, the, the, the, the, there, these, they, to, to, to, to, to, today, trust, Tussie-Mussie Garden, two, two, up, verbal, virtuous, warning, ways, we, whistle, will, will, witch, with, writing.”

That is a very strange incantation, My Black Cat.

I don’t recollect reading it in The Book of Spells.

You should not be stirring The Cauldron without supervision.

Stop spitting at me, My Black Cat!

You must always be very careful what you say when you are stirring The Cauldron. Improvising on the well established Book of Spells often does not serve you well and can at times be quite dangerous.

Especially if The Cauldron starts to spit back at you.

The Witch Doctor – Link to a random page

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Who is Dr Fooonah Kohl?

Dunno, My Black Cat. Never heard of such a person.

Is it a male or female name?

Or an incantation?

Dunno.

Check the spelling.

The Witch Doctor – Link to a random page

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It seems an appropriate time to bring this post to the front page again. It concerns a blog which we first discovered in February 2007

IN FLANDERS FIELDS

” In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved, and were loved, and now we lie
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.”

— John McCrae

(Lieutenant Colonel John Alexander McCrae, MD (November 30, 1872 – January 28, 1918) was a Canadian poet, physician, author, artist and soldier during World War I and a surgeon during the battle of Ypres. He is best known for writing the famous war memorial poem In Flanders Fields.)

LETTERS FROM A TIME BEFORE THE POPPY BECAME A SYMBOL

This blog is make up of transcripts of Harry Lamin’s letters from World War 1. The letters are being posted on the site – each one exactly 90 years to the day after they were writtten.

The first posting was on 25 July 2006. This describes what the Blog is about and these earlier posts relate to the characters that are mentioned in the letters to follow.

A book is now available from Amazon.

A signed copy is available from the website WW1 Experiences of an English Soldier.

The Witch Doctor – Link to a random page

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Circle is like John Lewis!

Apparently…..

Or are they like hyaenas?

Or are they like hedge fund tycoons hedging their bets?

a red apple ……………………

The Witch Doctor – Link to a random page

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You had a strange dream?

You have many strange dreams My Black Cat. What was this one about?

Well, it started off with a single ewe just before the lambing season. She was pregnant with twins and every day made her way to the back door of the farmhouse and bleated incessantly.

It was cold outside.

Before long, the whole flock of sheep, being sheep, followed her to the back door and all bleated incessantly in unison.

Then the same thing started at night, so day and night there was continuous bleating outside the farmhouse. The sheep developed some kind of rota so that some slept while they others were bleating, so they did not become sleep deprived.

The farmer, his wife and children became very sleep deprived and none of the work on the farm got done properly.

Eventually, the farmer had to send for The Sheep Whisperer to find out what it was that the sheep wanted.

The Sheep Whisperer had some bad news for the farmer.

The sheep were fed up rolling about in pain outside in the cold during the lambing season. They all wanted Caesarian Sections in a warm, comfy operating theatre.

The farmer was dismayed, so he called in The Vet.

The Vet said sheep should have a choice in the way their lambs were brought into the world, and so he would book them all in for elective sections.

Now, The Farmer was a wise man and quite frugal too. He was damned if he was going to pay the vet’s bill for all these Caesarian Sections. He was aware The Vet, in the name of “sheep choice,” would become very rich while he, The Farmer, would become very poor. There was after all, no National Sheep Health Service. If he had to fork out the money and avoid becoming poor, the cost of lamb and wool would go through the roof and no-one would buy it. Eventually no farmer would farm sheep. The butchers would not buy lamb, and wool would not be sheared.

Sheep would become extinct.

Extinct. Apart form the National Collection of Sheep kept in a zoo.

So he called in another vet.

The Second Vet said the whole idea of letting healthy sheep decide to choose Caeserian Section for themselves as a mode of delivery was ridiculous. He explained the risks of anaesthesia, wound infection, a scarred uterus and a whole host of other medical and ethical reasons that the farmer didn’t understand.

Furthermore, The Vet said that, since sheep are sheep, soon every pregnant ewe in the country would be demanding a CS and there would not be enough vets available to cope with the demand, and eventually all The Farmers themselves would need to learn how to do the surgery and anaesthesia themselves.

The Sheep Whisperer was then called back to explain all these complications to the bleating sheep.

Fortunately sheep are not stupid. They understood what the Sheep Whisperer was telling them. They stopped bleating morning, noon and night and went back to their fields where they delivered their perfect little twins and triplets without any fuss. Only the occasional sheep required a Caesarian Section for medical reasons.

And so The First Vet did not become so rich that he could retire after a year or too.

The Second Vet continued happily with his practice as before.

The farmer did not go bust and continued to tend his sheep.

The price of lamb and wool did not go through the roof.

Sheep did not become extinct.

And we still see lambs gambolling in the fields every spring.

That was quite a strange dream, My Black Cat. I wonder if you are having some kind of premonition or something?

a red apple ……………………

The Witch Doctor – Link to a random page

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Dr No raised the possibility that it might have been more than coincidence that the Care Quality Commission report ordered by Andrew Lansley was released on the day after The House of Lords second reading of the Health and Social Care Bill.

Something fishy, thought My Black Cat, as did Dr No and others.

Dr Phil, in one of the comments on Bad Med, remarked:

“I was a bit disappointed that other bloggers were not interested by our recent health scandals.

Don’t be too disappointed, Dr Phil, this witch is interested, and reading, and listening. Indeed, she had something to say about it some time ago.

It seems no-one was listening to her then. It seems the consultants did not sit down with the nurses in charge of the wards and do some simple mathematics with The Abacus.

Or maybe they did.

Maybe they found deficiencies but didn’t know what to do next?

For pities sake, do you need spoon fed?

You  write letters!!!

It seems in certain hospitals together they did not write letter after  letter to those in the most senior management positions if stupid staffing ratios seemed to be the problem. (This is of course not always the problem but it is surely one of the first things to be addressed).

If a nurse who is not a manager feels too vulnerable to write or co-sign a letter, then damn it, the consultant in charge of the patients who could not be fed, or watered or toileted properly should send the letter himself or herself directly to the most senior medic and most senior nurse in the Trust. If there is no immediate written reply or they are fobbed of by the promise of “it will be put on the agenda of some future committee or another” then then you are being subjected to Yo-Yo management.  The letters then need to bypass the Yo-Yo system and be propelled further up the establishment. Letters. Not conversations, not moans, not emails. But formal snail-mail letters that are NOT on first name friendly terms and have several cc’s at the end including cc file (for lawyers if necessary).

My dear non-witchy consultant colleagues, the patients in your care cannot be expected to respond well to your treatment if they are starved, dehydrated or suffering from infected sacral bedsores.

The following was the advice this witch gave you in November 2009:

NURSE ANNE IS DOING HER NUT!

And quite right too!

Nurse Anne, in the view of the witching community, is doing an essential service for patients, in bringing to the attention of the world, the way it really is in many wards in the UK during this wonderful age of “Change” and “Modernisation” and “Diversity” and “Talent” and “Leadership” and “Contestability” and “Plurality” and now “Polysystems” with “spokes” and all the other meaningless jargon that was ushered in by Tony Blair and his “Third Way” cronies that surrounded him and followed him and are still following him.

Nurse Anne is having a go at the doctors including The Witch Doctor.

In fact, The Witch Doctor agrees with most of what Nurse Anne says in her post apart from the implication that UK doctors are a cocaine snorting bunch, and The Witch Doctor’s views on apprenticeship. The Witch Doctor has a post on the topic of apprenticeship and the creep that will follow. This post is likely to appear sometime soon during The Witching Hour. The other thing is that, as a doctor, The Witch Doctor does not feel threatened by the “dumbing down” that the Skills Escalator is intended to produce. No. It is as a patient she feels threatened by this, not as a doctor.

So, why exactly do we witches feel that The Witch Doctor thinks Nurse Anne is quite right to do her nut about doctors?

Well, The Witch Doctor frequently does her nut about doctors too, albeit not in the same illustrative language of Nurse Anne.

If you are a hospital consultant, then we witches suggest that at some point over the weekend, you pour yourself a coffee, sit down by the fire and spend an hour or so reading through Nurse Anne’s blog.

MILITANT MEDICAL NURSE

We witches think every single hospital consultant in the land should read it.

We think every single hospital administrator should read it too.

We think every member of The Department of Health should read it.

No. Forget the last sentence. That would be counterproductive.

Consultants should read it because they should be supporting these nurses who are struggling against all odds in certain pockets of the NHS.

Consultants are not supporting them.

Ask yourself whether you have seen any of Nurse Anne’s accounts happening in your ward (if you have a ward that is – your patients are probably scattered all over the place nowadays, but that is a separate issue that you as consultants should have dealt with long ago).

And then ask yourself, does it bother you that patients lie in wet beds, are undernourished and don’t get their medications on time.

Well, Does it?

If it doesn’t worry you, then let me know who you are so that all the witches will avoid you like the plague when they are ill.

If it does worry you, have you asked yourself why it is happening?

Do you know the headcount of nurses in your unit?

Qualified nurses. Health Care Assistants. Cadets.

Have you watched them in a cluster talking about Big Brother instead of attending to patients? (Some do, Nurse Anne, I have watched closely. On the other hand, most don’t.) Most are excellent nurses who are run off their feet trying to nurse to the best of their ability but can’t. They are being asked to do an impossible task much of the time. The Witch Doctor has watched carefully and has done some simple arithmetic.

As a consultant do you trust your Trust Administration in not to squeeze the last ounce of flesh out of the nurses in your ward?

Come Monday morning, here is an exercise that all consultants could do for the benefit of their patients.

Get The Abacus out.

How many patients in your ward need help with toileting?

How long does it take to deal with each patient?

How long do patients in your ward (if your have one) wait for a bed-pan or commode?

How many patients in your ward need help with feeding?

How long does it take to feed a patient?

How long does it take to do the drug round?

How many times is the nurse in your ward interrupted when doing a drug round?

Do multiplication sums.

Lots of them.

Do the figures tie up with staff numbers that are appropriate to the level of expertise of each member of staff?

No?

Then what are you going to do about it?

Let me tell you.

You sit down with the nurse in charge of the ward. Not the one who is straddling the barbed wire fence between government administrator and nurse.

You say to him or her.

These are our patients. We have responsibility for them.

Together we will sort this out.

And do it.

That is what you are being paid a consultant salary to do. To ensure your patients are diagnosed, treated, and if possible cured. If that is not possible then you ensure your patients are cared for, comfortable and safe. You know that.

The medical and nursing professions need to work as one.

Together, both of you – the “hands on” senior medic and “hands on” senior nurse, with the help of The Abacus will carry great clout.

This government wants you divided.

They do not want you to have clout.

If you do not do this as consultants, you are letting nurses and patients down.

And for pities sake, if you are a hands-on consultant, don’t go bleating to your clinical director and medical director that “something will need to be done.” Ignore the hierarchy. As a consultant you can do this. You are an independent practitioner. These people are hindered because they have chosen to straddle the painful barbed wire fence.

See to it yourself.

Do you not know that you, the hands-on consultant, and the hands-on senior nurse, are The Leaders?

If you take on your rightful role together as The Leaders, this will never happen again.

a red apple ……………………

The Witch Doctor – Link to a random page

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LINK TO UK MISSING KIDS WEBSITE

LINK TO MISSING PERSONS WEBSITE

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Long-suffering readers of this blog who read the trivial rubbish details will be aware that The Oldest Sage Witch and her Highland Granny are descendants of the Clan Mackay.

The Witch Doctor hasn’t heard from them for some considerable time.

Then, lo and behold, last night during The Witching Hour there were two very loud chuckles heard reverbating around The Witchosphere.

These old wise witches were amused at what had happened in the House of Lords.

One minute before mid-day, a member of their Clan took to his feet and started to speak as Big Ben heralded the daytime witching hour.

This is what he said:

11.59 am

Lord Mackay of Clashfern: My Lords, I should declare a non-financial interest as an honorary fellow of three of the royal medical colleges associated with the health service. One of my earliest clients was the Scottish branch of the BMA, and the first time I appeared as a counsel in this House-when the House had jurisdiction to deal with these matters-was as counsel for the Medical and Dental Defence Union. So I have had a fairly long interest in health matters, including the health service, up to the present time.

We have all had a good deal of correspondence about the profit motive in relation to the health service. It is worth reminding ourselves that the main suppliers 
to the health service, both of drugs and equipment, are powerful industries in the private sector, and therefore the health service has to be able to deal with these in an effective manner. But the main issue for me is that raised by your Lordships’ Constitution Committee. Its report, as we have come to expect, is clear, comprehensive and concise, and the Government have given a full response. What are required now are decisions.

The principal issue is the effect of deleting from the statutory duties of the Secretary of State the first part of the provision in Section 1(2) of the NHS Act 2006 that:

“The Secretary of State must for that purpose provide or secure the provision of services in accordance with this Act”.

It is the taking out of the word “provide” that is a small but extremely important amendment. I agree entirely with the noble Lords, Lord Owen and Lord Hennessy, that this is a vital matter. The committee referred to the decision of the Court of Appeal in Coughlan in which my noble and learned friend Lord Woolf, then Master of the Rolls, said that the Secretary of State,

▪ “has the duty to continue to promote a comprehensive free health service and he must never, in making a decision under section 3″-which was an issue in that case-
▪ “disregard that duty”.

What is important is that that duty in these terms does in fact remain in the present Bill. The Constitution Committee, which includes distinguished parliamentarians and very distinguished lawyers, has put that question in clear terms to us all. I do not believe, although I have the greatest possible respect for the great range of talent in this House, that any other committee could have put it better, more succinctly or more comprehensively.

Yesterday, the right reverend Prelate the Bishop of Bristol referred to this as a “foundational” matter. I agree with that, and the sooner it is resolved, the better. The problem with the proposal of the noble Lords, Lord Owen and Lord Hennessy, is that, while I agree entirely with its importance, is the method by which it should be resolved. If, in truth, this is a foundational matter, it is very unusual to leave the consideration of the foundation to the end of the consideration of the structure, and that is what is going to be involved here. My submission to your Lordships is that the sooner the sting and toxicity coming out of this issue is removed from the consideration of the Bill, the better. I have every confidence that a full debate in an ordinary Committee of the Whole House will resolve it at the beginning rather than at the end of the process. However, according to the proposal of the noble Lord, Lord Owen, the rest of the Bill is to be considered without a decision on this point. But that decision is bound to affect all of the rest of the Bill, so consideration of the rest of the Bill is subject to a condition about its foundation, which cannot be effective. Noble Lords do not need to listen to the whole of the debate, although I have listened to a substantial part of it, to know that very important issues need to be debated in order to improve the Bill. Certainly I would like to see it improved to the best possible standard because the health service is the most precious system in our country. I personally am 
highly devoted to it and have now used it for long enough to have become one of the ageing population which is threatening to be a rather serious burden, although I hope that I will not be too burdensome.

The right way for this House to deal with this matter, in accordance with its ordinary methods, is at the proper place in the Bill. Whatever wrongs the Secretary of State has done-people are finding fault with all sorts of different aspects-at least this point arises at the beginning, the foundation, of the Bill. Surely this House should not lose the opportunity of dealing with it in its place, in accordance with the full and comprehensive issue put before us by our own committee.

I do not want to say anything about the issue itself at this stage, just simply that it is one of great importance which should be decided at the beginning, not the end, of the process. I hope that we will be able to decide it in Committee. It is always open to come to a conclusion in Committee, although many conclusions are reached on Report. But I would like to see this issue decided at the beginning of the Committee stage because it has the capacity to draw out a lot of the toxicity that is affecting consideration of the Bill. A lot of people have written saying that the whole of the health service is going to be damaged, lost and so on. We need to consider that and see what we can do to deal with it. I think that the Government have indicated in the other place that they would be willing to put this beyond legal doubt. The Committee has given us one way of doing that; namely, to go back to the way it was, in which case the legal doubt is resolved. But there may be reasons for not doing it which the Committee will have to consider, one of which was mentioned by the noble Baroness, Lady Finlay of Llandaff; namely, that it is highly desirable to prevent the National Health Service becoming a political football.

I have a sad recollection of a general election in which the ear of a particular patient of the National Health Service was a political football for days. That does no good for any of us. Indeed, it denigrates our health service. I am not saying that this Bill would eliminate that for certain, but the object of this change in the early part of the Bill is to try at least to reduce the risk. Your Lordships will want to consider that, but I suggest that we do so as a matter of priority at the very earliest stage in Committee.

Of course, no one will believe a witch or a black cat if they were to say that there was some magic afoot in The Upper House at mid-day yesterday.

The Witch Doctor – Link to a random page

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LINK TO MISSING PERSONS WEBSITE

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They say that Baroness Shirley Williams abstained from voting for Lord David Owen’s amendment to send part of the Bill to be considered separately at a special select committee.

If true, it seems a bit odd.

Or is it?

Lord Owen’s amendment would have been an unusual procedure and some considered it would have had the effect of delaying the Bill to the extent it would have finished it entirely.

The Lords and Ladies of this land are much more measured and sedate than the raucous MPs residing in “the other place.” It is even possible that many of the members of the Upper House are truly honourable and they will not have approved of using an amendment to slow the progression of a Bill through parliament until it withered on the vine.

Is it just possible the Lords might still vote with their feet?

Here is an extract from Baroness William’s speech in the House of Lords yesterday.

“I turn now to the four big issues that confront us, and in doing so I pay tribute to the noble Lords, Lord Darzi and Lord Owen, and to others who pointed to them. The first was referred to by the noble Baroness, Lady Jay. It flows from the findings of the Constitution Committee, which has specifically raised concerns about the responsibility of the Secretary of State. At the beginning of his remarks, the noble Earl, Lord Howe, whose empathy and understanding is known throughout the House, spoke as if there might still be some meeting of minds on this crucial issue. But the letter he sent us all this morning appears to sound a little different. Why are we so concerned about this issue? It is because it remains ambiguous, unclear and obscure. Let me give one example. I think that I have been pursuing the issue of the accountability and responsibility of the Secretary of State for at least a year, and time and again I have gone back to the Department of Health and talked about the need to make it absolutely clear. Why is it not absolutely clear?

Those noble Lords who have a copy of the Bill need only look at Clause 4, which sets out a specific commitment to the autonomy of the bodies, the quangos -Monitor and, even more important, the NHS Commissioning Board-which now have responsibility for our health. The Secretary of State makes a specific pledge to the autonomy of those bodies in the phrase:
“In exercising functions in relation to the health service, the Secretary of State must, so far as is consistent with the interests of the health service, act with a view to securing … that any other person exercising functions in relation to the health service … that it considers most appropriate, and … that unnecessary burdens are not imposed on any such person”.

In legal language, “any such person” is very wide indeed. The autonomy clause indicates that only in the rarest circumstances would the Secretary of State interfere in that autonomy. So where would he interfere? The answer is that he would interfere if there was evidence of a significant failure. But my legal colleagues tell me that “significant failure” is a difficult bar to reach and that it is normally interpreted by the courts as meaning almost totally essential.

We all know about the danger of reactions to such things as necessary hospital closures, mergers and so on. But if the Secretary of State is unable to take any part in those until the failure becomes significant, heaven help us in making the changes that lie in front of us as effectively, cheaply and sensibly as we can. I wish very much that I could ask the Minister of State to tell the House at the conclusion of this debate that the ministry will now reconsider the autonomy clause in the light of the responsibilities of the Secretary of State. To put it simply, the expenditure of £128 billion of taxpayers’ money requires the presence of a Minister who is responsible and accountable for that huge sum.

She is concerned about the responsibilities of the Secretary of State for Health.

This came up time and time again during the debate and many are not convinced by the reassuring noises being made by Lord Howe and Andrew Lansley.

It was stated today by one of the peers and I think also by a bishop yesterday that the SOS’s responsibility to “provide” was a “foundation” element of the Bill, and that this should be considered first and foremost by all members of the house rather than have this issue hived off to a special committee that is not part of the normal procedure.

If Peers have voted against Lord Owen’s amendment on this basis then things may not be as bad as they seem. He did after all secure 262 votes. It is just possible that there are another 68 peers who might be against the Bill but want to deal with their concerns in a different way.

It may well be that pressure will be put on the SOS to change the wording back to the original “duty to provide” before further consideration of all other issues.

This witch hopes so, because it might convince her that there might be some democracy still around in the country after all, and that The Upper House retains an important role in preserving it.

The Witch Doctor – Link to a random page

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LINK TO UK MISSING KIDS WEBSITE

LINK TO MISSING PERSONS WEBSITE

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Don’t be diverted by todays news regarding Liam Fox’s best man, no matter how intriguing the relationship may be.

Don’t be diverted by the news suggesting that you might respond to the bribery nudge of having your funeral paid for by the NHS if you donate an organ.

There is something much more important going on.

You can watch the House of Lords debating the Health and Social Care Bill. They say it will go on till about 11.30 tonight and continue in the am.

HEALTH AND SOCIAL CARE BILL – LORDS DEBATE

And while you watch consider this:

Re the NHS : have we been manipulated nudged by successive governments over many years?

Have these governments been honest with the people of this country over the proposed NHS changes?

How good has the judgement of our “leaders,” the politicians, been over the years?

How good is their judgement now?

If this Bill succeeds, are we living in a democratic country?

Do you care?

UPDATE

TWO LETTERS ARE FLOATING AROUND WESTMINSTER TODAY

LETTER SENT 11 OCTOBER 2011 FROM RT HON ANDREW LANSLEY TO LORD HENNESSY

LETTER SENT 11 OCTOBER 2011 FROM EARL HOWE TO ALL PEERS

 

GUARDIAN : LORDS DEBATE ON NHS REFORMS 11 OCTOBER 2011

“The House of Lords is debating the government’s controversial health and social care bill. The debate is set to run until tomorrow, when peers will vote on an amendment from Lord Rea which would throw the bill out and an amendment from Lord Owen which would kick it into a select committee, perhaps resulting in the death of the bill. Owen said the NHS should not be opened up to “a pure market” because “health is not a public utility. Health is different” (see 2.07pm). No political party had seriously threatened the NHS – “until now”, Owen said (see 1.01pm). Rea said the plans had not been in either the Lib Dem or Tory manifestos, or the coalition agreement, so peers ought to oppose them (see 11.37am). For the government, Lord Howe defended the bill, saying it would “deliver for the long-term a sustainable NHS true to its founding principles” (see 11.32am).”

a red apple ……………………

The Witch Doctor – Link to a random page

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LINK TO UK MISSING KIDS WEBSITE

LINK TO MISSING PERSONS WEBSITE

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My Black Cat has just been reading the comments on the last post and she said she was reminded of a dream she once had.

It was the time that polyclinics were first being considered. Following her dream, My Black Cat has always maintained that The Witch Doctor could become a very rich witch if she marketed her spells properly. Very rich indeed. So rich that My Black Cat would have no need to catch her own rats or depend on the disgusting pickled variety when the big winter freeze is on. Oh no. She is of the view that The Witch Doctor would fund a whole team of rat catchers on her behalf and the rats would be served up unpickled on a golden platter as regular as clockwork every four hours.

My Black Cat reckons this would give her much more time to hunt the real rats – the ones who are hell bent on tearing the NHS into tatters and pretend the reason is something to do with that ridiculous term “Patient Choice”

This was her dream way back in February 2008:

THE POLYCLINIC DREAM

You say you feel very ill, My Black Cat?

Today you sneezed two hundred times, and coughed a thousand times. You have a sore throat and a sore head. In fact every single muscle is sore – even the ones that move your eyes from side to side.

You shivered all night and roasted all day.

You have a very bad cold, My Black Cat. Or maybe even ‘flu.

Just stay in bed. It will run its course……….

DREAMING ABOUT A CURE FOR THE COMMON COLD

Much later…….

Ah, you’ve had a nice long sleep, My Black Cat. Do you feel a bit better?

Yes?

You were dreaming about a polyclinic?

You dreamed a dream that a local franchised polyclinic appeared in our village and it looked after people well when they had a cold.

You dreamed you could phone the polyclinic any time of the day or night. They employed friendly robots from 7.00 pm until 8.00 am every evening. The robots were there at weekends and throughout every public holiday. You were never alone without robotic medical help.

You say you phoned the robot, My Black Cat?

And what did you tell the robot?

That you sneezed two hundred times, and coughed a thousand times, that you have a sore throat and a sore head, that every single muscle is sore – even the ones that move your eyes from side to side and that you shivered all night and roasted all day.

And what did the robot do?

The robot sent a message by e-mail to one of a team of schoolchildren employed on a part-time basis by the polyclinic. These children have been provided with special poly-clinic bicycles so that they can earn a little extra pocket money and at the same time provide a valuable servce for the polyclinic.

What service is that, My Black Cat?

A home visit. These children deliver a parcel of goodies to the doorstep of those suffering from the common cold.

And you got your parcel delivered. What was in the parcel?

It was an exciting parcel, beautifully wrapped. The wrapping paper had a logo. The Brand Logo. Inside was a box containing paracetamol, a hot water bottle, a lemon, some funny strong smelling ointment in a little round dark blue bottle, a thermometer, a packet of wet wipes for the fevered brow, and a tussie mussie of herbs grown in the polyclinics “physic garden.”

And a distinguished carrier bag marked with the polyclinics esteemed logo, containing a bottle of the most prestigious health giving chemical of all.

Did this make your cold better, My Black Cat?

No, but it made me realise that the robot from the polyclinic really, really cared.

Knowing that was a geat comfort.

And was all of this provided free by the NHS?

No. In the dream people with colds and flu were classified as “WW-CF” – (Worried Well with Colds and Flu) or C-CF (Clients with Colds and Flu)

Any condition coded “WW” or “C” by the polyclinics does not qualify for NHS care.

Only patients qualify for free health care. They are coded “P.”

How much did the “Worried Well Colds and Flu Parcel” cost you, My Black Cat?”

£250….

Did you not mind paying that amount of money to have a parcel delivered – just to show someone cared?

No?

Polyclinics have to make their profits somewhere from someone.

And who better than the worried well………. when they have colds or flu.

That’s true. I suppose, My Black Cat.

Hmm. Did you find out any more about the prestigious health giving chemical they sent you?

No?

But it tasted like water.

Bottled water.

a red apple ……………………

The Witch Doctor – Link to a random page

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LINK TO UK MISSING KIDS WEBSITE

LINK TO MISSING PERSONS WEBSITE

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