In the UK, health is in danger of becoming a valuable commodity to be bought and sold.

Oil, gold, copper, data are all valuable commodities.

Health Data could prove to be a very, very valuable commodity to be bought and sold.

VALUABLE HEALTH DATA?

“Health records could be transferred to Google or Microsoft under a Tory government, The Times has learnt.

Patients will be given the option of moving their medical notes to private companies after the Conservatives said that they would replace Labour’s “centrally determined and unresponsive national IT system”.

Do Patients opt in or opt out?

Nobody seems to know.

There will, however, be no monopoly. It seems there will be competition in the marketplace for the acquisition of health data.

“The Conservatives have not worked out what would happen to the data of those who do not want their medical records handed to the private sector. The source added: “We are 100 per cent certain there will not be an exclusive deal with one provider. We fully expect multiple providers that will almost certainly be free to users.”

MORE HERE

Now the sweetener……

This is being packaged as part of a new “Post-Bureaucratic Age,” of ever diminishing quangos.

The punters will like that, won’t they My Black Cat?

Then, surely, surely, they won’t opt out…..

Goodness gracious, The Witch Doctor takes her eye off the ball for six weeks and comes back to discover A New Age is being born.

Whatever next?

a red apple ……………………

The Witch Doctor – Link to a random page

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The Oldest Sage Witch is a pig ignorant cow!

She really is.

She cast a spell that made all the witch doctors in the land ill for weeks.

Every single witch doctor became ill.

Simultaneously.

Just like that.

THE WITCH DOCTOR JUNE 2009

These were not little illnesses. They were the kind of illnesses that require home visits from GP’s or hospital admissions. Some of the witches even became moribund for a while.

So, if you are a GP or hospital doctor who has been tending a patient with symptoms that somehow didn’t square over the past few weeks then ask yourself a few key questions. Did you make a firm diagnosis? No? Did the patient’s anatomy and physiology seem a bit bizarre? Yes? Did the symptoms follow any known NHS protocol? No? Was the patient female? Yes? Could you swear you saw a black cat lurking about under the bed? Yes? Was this female patient one of the most difficult you have ever met? Yes? Would you go as far as to say she was the patient from hell? Yes? Then the chances are that you were treating a witch who had fallen foul of this, the most ridiculous of the The Oldest Sage Witch’s Spells.

Why did the Oldest Sage Witch Cast this crazy spell?

She said witches were far too healthy and it is high time they experienced the NHS first hand and report back on their findings.

Her stupid spell nearly propelled The Witch Doctor off the face of the earth!

Permanently.

So, don’t expect to hear much from The Witch Doctor very often. She now has a mountain of e-mails and an Everest of work to catch up with while she is convalescing. Furthermore, The Oldest Sage Witch can’t remember whether she put the relapsing ingredient into this witless spell or not.

Silly old bat!

a red apple ……………………

The Witch Doctor – Link to a random page

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THE TROJAN HORSE – PART 2

So, leaving aside the reasons why, and whether it is good or bad, it is a fact that in the foreseeable future the female sex will be the predominant one in medicine.

Medicine historically has followed a male working pattern. If women were to reach the top of their specialty they usually had to adapt to a way of life where it was necessary to distance themselves from domestic matters for long periods.

Basically, a woman doctor with family commitments needed a wife.

Apart from the retainer scheme in general practice where it was possible to work 2 sessions a week and after a few years come off the scheme to increase the sessions to say half time, no other part time system was easily accessible. The retainer scheme was quite popular in general practice because the sessions were subsidised and the retainee was already fully GP trained so was a very useful pair of hands. There were very few hospital retainees, and although a part-time supernumerary training system existed, places were few and far between. Most conventional hospital training posts were on a full time basis. Job sharing never really got off the ground. In essence, there was no satisfactory career structure in keeping with what would have been considered to be a female working pattern.

It could be argued, therefore, that the concept of MMC heralded a major change from a male to a female working pattern for the medical profession ie quicker access to CCT, the option to exit and re-enter training, and, for those who would not make it to consultant status, the ability to capture a collection of competencies in the way that could give a satisfying career.

It could also be argued, that with 70% intake of female medical students, the introduction of MMC or something like it was a necessity.

The Witch Doctor admits she could be totally wrong about this, but she feels this initially was one of the important forces behind MMC before it was turned, by somebody somewhere, into a rogue form.

There were clues that a rogue form of MMC was being created. Firstly, the word “consultant” was completely omitted from the diagram that was published explaining the new structure. The Witch Doctor was surprised how few doctors picked up on this. Perhaps it was not considered credible that a consultant workforce could almost disappear. Secondly, the selection and appointment process ie MTAS was the antithesis of female friendly. In fact, in the early days of this blog, The Witch Doctor felt that the selection process discriminated against women. See “LETS TALK ABOUT SEX” Thirdly, there were serious dumbing down activities going on in the background involving “national practitioners” and The Skills Escalator. At that time few medical staff had heard of The Skills Escalator. The Witch Doctor certainly hadn’t but when she stumbled upon it, she realised it was closely related to Agenda for Change and she reckoned that MMC was designed to fit into the various steps on the escalator. Medical graduates were to merge into the structures other “practitioners” were following. She tried to find some evidence of this. She eventually found it in Australia of all places. The original document has since been removed from the Australian website but there is reference to it in the tab above – “THE SECRET NHS.”

The Witch Doctor therefore believes that MMC became integrated into a very complex plan. A political plan.

A plan that some senior members of the medical profession must have bought into and then remained silent. Or perhaps they were very blinkered.

I would like to know what the CMO thought of all of this – how closely the final MMC related to his original concept and whether he was party to the version that was eventually rolled out. If he did not approve, I often wonder, as a civil servant, what he could have done – apart from resign. And that would have changed nothing. He would just have disappeared off the horizon.

The Witch Doctor has not been so hard on the CMO as other bloggers because:
a) he consistently said this country needs more doctors.
b) he seemed to be given a bit of a hard time in government committees before MTAS surfaced
c) he refused to be drawn into the extended role of nurses
d) he seemed to be a bit frustrated by the blinkered views of the College of Physicians.

But then, The Witch Doctor was only reading between the lines. She does not really know his views or whether they have changed with the passage of time.

It is time for Sir Liam Donaldson to replace his civil servant hat for a medical one and speak to the medial profession clearly and honestly regarding whether MMC changed from his original concept. If it did, he needs to explain how and why it changed and whether he was behind that change.

One A4 piece of paper in the form of a letter, free from political embellishments or influence, to every medical practitioner in the land would be a start.

a red apple ……………………

The Witch Doctor – Link to a random page

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THE TROJAN HORSE – PART 1

One of the problems with the Female Variety of The Humankind is that they are unpredictable.

Especially when they have a partner who may have to move around the country to follow a career.

Especially when they have a partner who is financially secure.

Even more so when they have a partner and children to consider.

Even more so when they have a partner and children and aging relatives to consider.

Even more so when they have a partner and children and aging relatives and exams and all sorts of other hoops to go through to further their own careers.

There are just not enough hours in the day.

And they don’t want more hassle.

Nowadays, 60%, 70%, sometimes 80% entrants into medical school are female?

The Witch Doctor would really like to know why this is so.

One of the comments on a previous post remarks that where he is, 80% females are admitted to medicine because that is the proportion of females applying to get into medicine.

If this is so, it is very worrying.

We need to know if males are choosing other careers. In The Witch Doctor’s opinion this would be a disaster for patient care as well as the profession.

Regarding most female doctors with family commitments, The Witch Doctor can tell you what used to happen.

1. A few female doctors would have a clear plan of their career path shortly after they graduated and they would stick to this with tenacity whatever hurdles came their way. If they wanted to be a consultant brain surgeon, then they became a consultant brain surgeon and that was that!

2. The majority of women, however, decided for a broad base to their training – one that would allow them mobility in the future and the potential for part-time work if necessary. This usually consisted of going through GP training or obtaining an MRCP as soon as possible. An anaesthetic qualification was also popular from time to time.

3. Most women continued to work full time until they had children, they then took a break, perhaps joined the retainer scheme and kept ticking over on a part-time basis until they were ready to increase their sessions. Women went into general practice in droves because the route to being an independent practitioner there was shorter than in the hospital specialties, and GP qualifications meant they could pick up work in any part of the country. Many never took up full time work again and the majority of hospital doctors with children picked up sessions as Clinical Assistants, Staff Grades, Hospital Practitioners within various specialties. Some resumed work as full time registrars and continued to a consultant post. Once appointed some decreased their consultant sessions to become part-time.

4. A few gave up medical work completely and never returned.

5. Of the women who built up some kind of “work portfolio” for themselves, many would have been put off by the hassle of administration. Sessional work with minimal administrative responsibility, and minimum requirement for any more examinations suited them just fine.

It has to be remembered that full time in medicine used to mean just that – there was no respite. Even you were off duty there was reading, teaching preparation, exam marking, writing research papers, keeping up to date, thinking about an elusive diagnosis. A consultant or GP had 24 hour responsibility for his/her patients and family and personal life had to be worked round that.

That was the way it was.

How is it now?

The European Working Time Directive may enable more women doctors to work full time without all the crippling extra hours that were necessary before.

However, a longer time to train as a GP might not appeal to women doctors so much. Conventional practices are reticent about taking on new medical staff while the effect of polyclinics is being determined. Polyclinics will welcome a few female GPs on a sessional basis particularly if they are cheap to employ eg “competency qualified” rather that fully fledged GPs.

Litigation is becoming commoner. Defence fees are going up.

Silly sites like Iwantgreatcare may prove to be demoralising.

Control freaks reign in some trusts.

Will suspensions and GMC referrals increase as a result of revalidation?

Are there, at this very moment, precedents being set that will result in a formal complaint on any matter that is unrelated to medical practice being taken up by the GMC?

Is the door now wide open for vexatious complaints?

Childcare is expensive and women worry about the safety of their children when they are working.

Is it all worth it?

Women are unpredictable.

Women who can afford to, may get fed up going through all the bureaucratic hoops of ticking boxes for CPD, appraisal and revalidation and may leave medicine for ever.

The problem is that no one knows the effect of having nearly 80% intake of women into medicine in the current climate.

The current medical climate is oppressive.

Women do not like to be oppressed.

So how can a medical workforce be planned?

In The Witch Doctor’s opinion, at the present time, it can’t.

a red apple ……………………

The Witch Doctor – Link to a random page

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The post below is from April 2007. It was called “An MMC Reminder – something’s missing.”

You have found the answer……..

You think consultants are a dying race?

And you think patients should be very, very worried, My Black Cat?

What exactly are you talking about?

……………….

A link to a reminder of the “MMC Career Map” including the dreaded yellow box.

Interactive version of the MMC Master Plan

The term “Senior Medical Appointment” is used as the “ultimate goal”

Yes. GP’s gets a mention even if its only incorporated into “GP registrar.” However, the word “Consultant” is conspicuous by its absence.

And here?

“the end product of the training process, whether a hospital doctor or a general practitioner, should be a high-quality, well-trained and accredited doctor”

GP’s – OK.

Consultants???

Not there either.

Maybe the Witch Doctor is being a bit too touchy about this.

Well, my black cat, who can see in darkest of places, can you find out where the consultants have gone? Nope ? Keep looking! Maybe they just forgot.

Or maybe………

Surely not!

The Witch Doctor – Link to a random page

WELL? ARE YOU WATCHING THIS SPACE?

If not, then it would be a good thing to do.

If you don’t find anything, then it may be here:

JUST KEEP VISITING UNTIL SOMETHING IMPORTANT HAPPENS!

 

a red apple ……………………

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One of the witch children is just off the phone.

He is in Pitlochry in Scotland and has completed the Etape Caledonia cycle ride this morning. Nearly 4000 cyclists took part in the 80 mile cycle.

No, he didn’t win.

He was phoning to tell me that the race had to be halted because someone had spread thousands of carpet tacks over the road at a place about 40 miles into the race.

Many cyclists came off their bikes and there were many more punctures but apparently no serious injuries.

Someone in that part of the island does not like having any roads closed on a Sunday.

The unintended consequences of his / her / their action was that the roads were closed for very much longer than intended, and a court case will probably follow.

What were the intended consequences?

Fractured legs, fractured spines, fractured skulls, brain haemorrhages?

Does this criminal(s) know the speed these bikes reach when they are racing?

Sure enough, there it was reported on the BBC Scotland website.

TYRE SABOTAGE BRINGS RACE TO A HALT

I read the report out to The Witch Child.

And then he went off for a shower.

a red apple ……………………

The Witch Doctor – Link to a random page

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You would think that Tim Berners-Lee would know a thing or two about the internet.

Apparently, his views are along these lines:

“According to Tim-Berners Lee, inventor of the World Wide Web, Net Neutrality is simply defined as follows: if I pay for an Internet access with a certain QoS, and you pay for an Internet access with the same or higher QoS, me and you can connect. This is the basis of the end-to-end connectivity capacity of the Internet. Providers have so far furnished the end-to-end connectivity under a legal regime of “mere conduit”, as stated by Directive on the Electronic Commerce 31/2000/EC, which means that they are not held responsible for the contents which flow in their network. They are not responsible because they do not select the services they give access to, they only transport signals. This is the basic principle of the Internet as we know it.”

However, apparently there is an MEP whom My Black Cat thinks must be losing the plot. This gentleman seems to hold the view that internet providers are like bookshops and should not be expected to “stock” all the information on the internet. Presumably this because he thinks all the information on the WWW is contained in discrete volumes on shelves somewhere out in wonderland. He has conceptual difficulties, I fear. This is what he said:

“”You might choose to have a service-limited package; nobody has ever suggested that we have a general rule that if you buy an electronic communications service package you will have access to everything. That’s like saying that if you have a bookshop you are legally obliged to stock every book.”

What might happen without “Net Neutrality?”

“Without Net Neutrality, we would not even have the World Wide Web, not to talk about even more advanced technical features like distributed boards and p2p technology. It’s Net Neutrality which allows bloggers, anywhere in the world, to compete on an even playing field without any editorial impositions. Net Neutrality grants freedom of information and freedom of speech and allows start-ups to play on an even playing field with giant media companies. Net Neutrality does not mean that providers are obliged to give users the highest QoS and bandwidth regardless of price. It simply means that providers must guarantee end-to-end connectivity regardless of price.”

Now, The Witch Doctor cannot get her head round European Law. There are just not enough hours in the day. My Black Cat has a theory that no-one in Europe including those running the countries of Europe, can get their head round European Law either for the same reason.

Anyway, the quotes above are from the following:

BLACKOUT EUROPE

This is the response of the MEP concerned, Mr Malcolm Harbour:

INTERNET HAS TO BE FREE BUT NOT REGULATION FREE

Here is the index of information on “The Telecoms Package” from the European Parliament website. It is not for the faint-hearted.

TELECOMS PACKAGE

Doubtless the motives of The American Stroke Association, and The Men of Color Taskforce are completely honourable, but this sort of thing makes The Witch Doctor bristle.

Opportunistic?

No. It is an intrusion.

It is rubbing salt in the wound that The Humankind are mortal.

BARBERSHOPS OFFERING FREE HAIRCUTS, HEALTH SCREENINGS

“Research presented at the American Stroke Association’s International Stroke Conference shows that the beauty shop is an effective place for women to learn the stroke warning signs,” said Moacir Barbosa, chair of the Men of Color Taskforce based in Cambridge. “Beauty salons and barbershops are places where African Americans talk about everything from world news to family issues. That makes them perfect places to reach consumers with important Power To End Stroke health messages and get them to start doing something about a disease that is killing too many African Americans.”

This will creep.

A hairdresser/beauty shop is a place of pretence. A place to go if a woman wants, for an hour or two, to get away from the worries of the dying mother she is caring for, the child who has recently been diagnosed with diabetes, the anxiety she herself has when awaiting the results of her latest cervical/breast/bowel whatever screen.

A place to make greying hair black or brown or orange or blonde again.

A place where she can pretend the clock is not ticking.

There is nothing wrong with pretence in the right context.

SHE-WANTS-TO-GET-AWAY-FROM-IT-ALL!!

OK?

They will be infiltrating The Chocolate Shops next.

And a barbers? Do men want to be reminded that their father died at a young age from a coronary or stroke when all they wanted was a haircut and some banter about football teams?

Please believe this old witch. This will creep. It will creep to the UK. We copy the USA. The nature of the screening offered will escalate. Glory be, the barbers might start extracting teeth and amputating toes again. Why not? The dentists are dabbling in botox.

If these and similar groups driven by altruistic motives, want to “reach out” into the community, why do they not visit some other outlets where people will not feel that health prevention is an intrusion.

These are the little Hubs of Pretence scattered all over the place especially designed for those who are happy to put their health and well-being under a very fuzzy microscope.

The Alternative Medicine Shops……..

a red apple ……………………

The Witch Doctor – Link to a random page

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It is always worth keeping an eye on the top right corner of  Dr Grumble’s blog. This is a feed of some of his reading.

And while you’re at it, read this post. It’s good for a laugh.

Anyway, Dr Grumble is reading George Monbiot today.

The article is called “Captive Knowledge.” The key message is short and sharp.

“The funding for academic research has been taken over by business.”

He asks:

“Why is the Medical Research Council run by an arms manufacturer?

“Why is the Natural Environment Research council run by the head of a construction company?

“Why is the chairman of a real estate firm in charge of higher education funding for England?

George Monbiot then gives his answer to these questions.

“Because our universities are being turned by the government into corporate research departments. No longer may they pursue knowledge for its own sake: now the highest ambition to which they must aspire is finding better ways to make money.”

And he goes on:

“At the end of the month, unremarked by the media, a quiet intellectual revolution took place.”

Yes. The silence of the media was loud.

Funny that.

It is unlikely the media professionals didn’t know about this end stage creep. And it is unlikely the important consequences were not understood by them.

Even this old witch managed to pick up on it.

But then, I suppose, since she started wondering about the reasons why MMC turned into a rogue form, The Witch Doctor has been waiting for this news breaking. Especially after she read The Leitch Report.

God help you if you suffer from a condition so rare that research into it could never bring in a commercially viable income.

This is, of course, unrelated to the current recession. This was planned long before the recession. It seems to The Witch Doctor that this government will use the recession opportunistically to justify anything they do that may seem unsavoury to voters.

Many years ago, The Witch Doctor remarked to colleagues that the day would come when it would be necessary to buy yourself into a permanent university post: you would need money in the from of a substantial grant. This would be tagged on to your name in invisible ink after the letters indicating the qualifications you have earned.

The sum of a £ sign followed by six figures would be most acceptable.

“In fact a £ sign followed by six figures or even more may be all that is required. The other information such as MB ChB, MD, PhD, DSc etc would become an embellishment. It would be the grant money or the high likelihood of forthcoming grant money that would cut ice, “ The Witch Doctor said.

They laughed.

After all, witches are the most eccentric of beings.

Who is laughing now?

When you have to buy yourself into a university post, and funding essentially originates from commercial interests, it is a chicken and egg situation. “The Haldane Princlple” becomes irrelevant.

Indeed, the The Haldane Principle was interpreted in various ways over the years and in 1971 The Rothschild Report was published. This resulted in 25% of the funds of the Medical Research Council being transferred back to HMG. The government of the day, for whatever reason, could decide on what type of research was to be funded with this 25%.

Fair enough.

HERE IS A HISTORICAL OVERVIEW OF GOVERNMENT HEALTH RESEARCH POLICY

Now, in 2009, the figure is 100%.

End stage Creep, slowly, by stealth.

Game, set, and match to this government or rather those who pull the strings.

Wall Street and the London Stock Exchange are now in control of the academic brain.

And you didn’t really notice it happening. Did you?

Read all about it here.

CAPTIVE KNOWLEDGE

And, you indolent Humankind, as you read it, will you pay particular attention to the bits about Lord Drayson, Sir John Chishom, and Lord Sainsbury!

And ask yourself this:

“Did I vote for these people to run the country?”

a red apple ……………………

The Witch Doctor – Link to a random page

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There may be several reasons for the nurse practitioner skipping up the steps to the very top of the skills escalator. The Witch Doctor has always felt that political expediency and the economic “requirement” to generate a market in healthcare is largely responsible for nurses being used to do work that was always considered to be within a medical practitioner’s job description.

Yes “used”.

In the same way she thinks that pharmacists are being “used” to create a market in health care.

By using nurses and pharmacists in this way there is an added advantage of clipping the wings of the politically powerful medical profession.

Many changes that are introduced in the UK have their origins in the USA where the “Dr Nurse” is now gathering momentum.

The woman behind the rise of the Dr Nurse movement in the USA is Mary Mundinger.

Here is a list of some previous posts regarding Dr Mundinger.

Now, when the Witch Doctor awoke this morning she found that a visitor from the USA had added a comment to an old post on this blog relating to Mary Mundinger. Since it is well hidden, here is what was said.

“Mary Mundinger, who recently resigned from her position as dean at Columbia School of Nursing where the doctoral program for nurses began, has arguably been the most aggressive advocate for replacing physicians with nurses.

There is more to the story. Over the years, there have been a number of conflicts of interest. Mundinger is entwined with corporate interests in the healthcare industry. She is on the Board of Directors of UnitedHealth Group, Welch Allyn, Gentiva Health Systems (nationwide provider of home health and nursing services), and Cell Therapeutics.

Mundinger has pushed for more power for advance practice nurses at the same time she has had a fiduciary duty to UnitedHealth Group and its stock-holders, and the similar duties to stock-holders of other companies.

Mundinger, a Director of UnitedHealth since 1997, HAS RECEIVED OVER 1 MILLION DOLLARS IN COMPENSATION FROM UNITEDHEALTH SINCE 2006 alone. As of December 2007, Mundinger held 32,000 shares of UnitedHealth stock.

How much of Mundinger’s aggressive advocacy to replace physicians with nurses is related to her duties to UnitedHealth insurance company and other healthcare corporations? Mundinger is a highly compensated director of organizations that could profit from her recommendations to replace physicians with less expensive (though not equivalently trained) nurses.

This issue is especially relevant given the U.S. Institute of Medicine’s recent report on conflicts of interest in medicine with its recommendations to remove industry influence from medical education and the development of practice guidelines.

Of concern is that Mundinger has not mentioned these important conflicts of interest in her academic articles and research reports. These reports have propelled the ‘nurse doctor’ movement. One wonders how much of Mundinger’s work reflects her professional and academic research and beliefs, and how much reflects her fiduciary responsibilities to commercial organizations.”

The original post is here.

a red apple ……………………

The Witch Doctor – Link to a random page

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We witches always like it when The Jobbing Doctor puts up a new picture of his garden throughout the seasons. This week he has two new ones as well as a photo of some bluebells he passed when walking. His garden looks like an interesting place to be and he seems to appreciate the beauty of plants. There may be a witch tending his garden for all we know.

Now, Sam once said she wished the bloggers, even although they are anonymous, told more about themselves. When she found out that The Witch Doctor had been to ballet and other dancing classes, she put up a very beautiful picture of a witch flying on a broomstick and then told us about the use that her mother had for broomsticks!

My Black Cat is at this very moment sawing off the broom from an old broomstick to see if the advice Sam’s mother gave works for all the old stooped hags of witches that frequent our coven.

Clematis montana – “Elizabeth.”

The Witch Doctor does not give very much information away regarding her personal life. However, after looking at The Jobbing Doctor’s garden, she has decided to relax that rule a little. All witches love gardens and woodlands and hedgerows and and marshes and bogs and ponds and riversides. We love anywhere that plants grow. We love plants of all kinds. There are no exceptions. We even love the plants that The Humankind call weeds. Indeed so much so, that we never ever do any housework until we have filled all our vases with flowers (sometimes weeds) and then we are ready to start.

So, The Witch Doctor has decided to treat you to some of the corners of her garden. It is a very interesting place because, you see, it has had almost no work done in it for about five years. There are some very good reasons for this which I am not going to tell you. If I did, however, you would understand.

Anyway, this garden has become a haven of a wildness. The time has come to tame it a little and work with nature in a wonderful way. So, today when the sun was out, My Black Cat and I have been wandering around the garden looking at what has been virulent enough to survive the years of neglect.

I decided today to keep a photographic record of the transformation which will probably take about three years.

Above is the first picture. It is of a clematis that was planted about 30 years ago. It now has a will of its own and during the neglectful years it was found wandering around inside the eaves of the house. It looks like any other virulent clematis montana, but it is really very special. This particular plant has the strongest vanilla-like scent I have ever come across in any clematis. (The scent is even more beautiful than vanilla but that is the nearest description). I have another clematis in the garden which I think is also “Elizabeth,” but it came from separate stock and does not carry the same overpowering scent.

I have special plans for this particular clematis. I might tell you what they are if I can be bothered.

a red apple ……………………

The Witch Doctor – Link to a random page

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So, the figure is £350 million.

The Nursing Times after using the The Freedom of Information Act, reports that the government, in England, payed consultants £350 million last year. Just England.

No, My Black Cat, not consultants but “consultants.”

External management consultants.

So layers upon layers of managers within the NHS structure are paid to manage, but that is not enough.

It is necessary to pay ANOTHER £350m out to external consultancies.

THE NHS BUCKET

It has been calculated that:

This equates to the cost of 330 fully staffed medical wards each with 28 beds, or 9,160 experienced staff nurses.”

It gets worse:

“nearly £273m of this was not related to direct patient care.”

However, My Black Cat, you need to remember the name of the game.

By collecting taxpayers money, putting it in the health bucket with holes in it, it leaks quietly but relentlessly into the business community and so eases the economy.

Do you suppose that is admirable My Black Cat?

Do you suppose it is for The Common Good?

Do you suppose they know better than we do?

Do you suppose there is a Common Purpose we do not fully understand?

Eh?

a red apple ……………………

The Witch Doctor – Link to a random page

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In 2007, The Witch Doctor published a post entitled “China is the Reason for MMC.”

It is reproduced below.

Things have moved on since then in the form of a publication:

NEW INDUSTRY, NEW JOBS. BUILDING BRITAIN’S FUTURE

” As well as delivering on this and other Innovation Nation commitments:

- we will work with the research funding bodies to create a stronger framework to drive up the economic impact of the research they fund. From April 2009, grant applicants to all Research Councils will have to set out the economic impact of their proposed research;

- the Higher Education Funding Council for England will consult later this year on a new Research Excellence Framework (REF) that will take better account of the impact research makes on the economy. Decisions on the REF will be announced early next year and will create incentives for changed behaviour from that point;

- the Technology Strategy Board has had a successful start and will continue to spearhead innovation in areas where there are business opportunities for future growth, including advanced manufacturing, clean technology, life sciences and the digital economy. “

So Universities as they once were, will be no more.

Intelligence is now under control.

Thank you Lord Leitch.

……………………….

THE LEITCH REVIEW REVISITED (Published December 2007)

There is fear the The Wall Street Bull soon will metamorphose into a Bear.

Gold is waxing.

The Dollar is waning.

Permanently?

THE WALL STREET BULL PREPARING FOR ITS METAMORPHOSIS

China and India are waxing too.

Is The West waning?

Permanently?

Is this the big fear, My Black Cat?

“The world economy is undergoing its biggest economic restructure since the rise of of the United States. By 2015 the Chinese economy will not only be as large as that of the United States but larger than all 27 EU Member States combined.
(Skills for Business)

Demographic change has the potential of decimating the workforce of the west.

We have to become more competitive.

Sandy Leitch has proposed the skills escalator as a means of addressing this.

LISTEN TO A VOICE TELLING YOU ABOUT THE LEITCH REVIEW (It seems this link no longer exists)

And if you browse around the site below you can download a powerpoint presentation, and several PDF’s relating to the Leitch Review.

SKILLS FOR BUSINESS – THE LEITCH REVIEW (It seems this link no longer exists)

“Strengthen employer voice. Rationalise the existing bodies. Strengthen the collective voice and better articulate employer views on skills by creating a new Commission for Employment and Skills, accountable to Government and the devolved administrations.

Increased employer engagement and investment in skills. Reform, re-license and empower Sector Skills Councils, with an emphasis on the Sector Skills Agreement process. Deliver more economically valuable skills by allowing public funding only for vocational qualifications approved by SSCs.

Expand skills brokerage services.

Increase adult skills across all levels and all ages.

Route all adult vocational skills funding through Train to Gain and Learner Accounts by 2010. Streamline the role of the Learning and Skills Council to become a funding body and market maker.

Improved higher level skills: Change targets and funding to encourage employer / university collaboration, seeking hard-edged employer commitments to increase investment in high skills through Sector Skills Agreements.”

The Witch Doctor thinks this smacks of government control of learning, aspirations and brains.

We witches would not tolerate that. Would we, My Black Cat?

But then, humans are a funny lot.

So, the government wants a skills development system that is lifelong, demand led, with an emphasis on meeting the requirement of employers and is only funded from the public purse if it meets the needs of the employer/government.

The fashion industry can boost the economy, says the voice.

So can health if it is turned into a commodity.

Health with a Rotund consumer group but Lean workforce.

And presumably clients will be more cost effective than patients.

Clients who are not really ill.

That seems to be the plan doesn’t it, My Black Cat.

Already there are a number NHS partners benefiting financially from The NHS Plan.

Do you suppose they are boosting the economy, My Black Cat?

Yes, education driven by the marketplace is the name of the game.

God help you if you want to be a historian, a philosopher or a geologist (unless you can divine for oil.)

Eh, My black Cat?

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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© Dlundin | Dreamstime.com

Dr Crippen today publishes a letter from Dr Joanne, a newly qualified doctor in a London teaching hospital.

If you are a patient, you need to read it.

If you are a consultant, you need to read it.

It illustrates how pernicious a doctor’s portfolio can become – how the NHS is attempting to make doctors of all grades, ice cakes using pretty regional meetings, poster presentations, publications, audits, appraisals, gathering CPD points, 360 degree feedback, and soon – revalidation. All written “evidence” of being seen to be “doing the right thing.”

It is called “playing the game”

It’s OK if the cake underneath is made of soggy cardboard.

Joanne had spent a lot of time baking a delicious cake but it was spat out by her consultant because she didn’t have time to ice it.

This consultant was also “playing the game.”

A PRETTY PORTFOLIO CAKE

Now, The Witch Doctor has a consultant colleague who is of the opinion that consultants only become consultants if they “play the game.”

Up to a point, The Witch Doctor agrees, but is of the opinion that many consultants do not want to “play the game”

Why then do they continue to do so, once they have the security of a consultant post?

Why are they complicit with much of the craziness that is going on within the NHS just now?

Why cannot they just say: “No. I’m not doing that, because it’s daft and I have patients to look after properly”

Or if they are not up to the direct approach say: “Do you want to pay me to go through your pointless unproven time-consuming hoops, or do you want me to look after my patients properly? Which do you want me to do? I can’t do both!”

Either way will work. Try them.

I have.

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

You don’t realise what’s going on.

Well, do you, you gormless Human Kind?

MMC, Remedy UK, North-Staffordshire, Mid-Staffordshire, GMC, The London Deanery, The Highland Deanery, The Department of Health, the legal system and more, are all becoming intertwingled (a witching word) in a strange, complex way.

It will be difficult for any doctor in this land who does not read the medical blogosphere on a daily basis to understand what is going on, and what are the connections and implications. This information is not easily available anywhere else.

It would be well to remember, that the medical bloggers, as far as I can see, are not just letting off steam. They are trying as hard as they can to change a system for the better because nothing else they have tried kicks in until there is a major crisis of some kind.

Blogging is the last resort for The Witch Doctor as it probably is for many other medical bloggers.

But all doctors should avail themselves of what is going on, because legal precedents are now being set although the fog has not yet completely lifted.

But it will.

And the changes may affect every single doctor in this country.

But they do not know it yet.

In the meantime, consider this:

“It is like a totalitarian regime: anybody who criticises it is said to be prima facie mentally ill – what used to happen in Russia.”

I may be mad, you may be mad, we all may be mad. However making a complaint, whistleblowing, blogging, challenging the system, using the language of a swear blog, is unlikely to be a symptom of madness.

It seems nowadays if those in authority hear or read anything that displeases them, the diagnosis of “ill health” immediately springs into the mind.

That is how distinguished people in authority creep into becoming autocrats.

My Black Cat would say it is some kind of conspiracy.

We witches say it is CREEP.

Sorry, all creeping autocrats. You need to take a case history and examine a patient before you can diagnose “illness”

Just the same as you need to take a case history and examine a patient before you diagnose septicaemia.

Don’t you remember the very first clinic you attended as a medical student?

Nothing has changed.

Even doctors who have carefully planned their careers in such a way that they have climbed into positions of authority, need to remember the order of things when diagnosisng “illness.” Case history, examination, then investigation.

Simple.

After considering that, read the following:

This…

And this…..

And this……

And this……..

Then remind yourself what those in Remedy UK are doing.

While all this is going on, The Witch Doctor will fil in the gaps and record ongoing events relating to:

THE HIGHLANDS IN THE EYE OF A STORM

And

YO-YO MANAGEMENT – THE STAFFORDSHIRE STORY

The Witch Doctor is of the opinion it is worth recording these key events in detail as they continue to unfold because of the precedents that are being set concerning all doctors and all patients as well as society in general. When things go badly there always comes opportunities to change things for the better.

But you’ll have to work out these opportunities for yourselves.

You’ll never find them if you keep your heads down.

We witches can’t do everything, for pities sake!

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

Once upon a time, when The Witch Doctor was a very young witch child, she was sent to The Dancing every Saturday morning. It was just called “The Dancing.” It was not “the dancing” that older girls go to. The Dancing was really quite a sophisticated dancing school although it was held in the bowling green hall at the other end of the park. Almost all the little girls where she stayed went there too. It was “the done thing.” That was because there wasn’t much else for the little girls to do in that part of the world on Saturday mornings.

Yes, The Witch Doctor can still ballet dance, tap dance, do an Irish Jig, the Highland Fling and the Sailor’s Hornpipe. At a push. This, you see, was a very serious little dancing school run by a whole family of dancers who passed down their skills from generation to generation to generation. This is how this family served this small community. They kept all the girls (and a smattering of boys) slim, fit and healthy. And their “deportment” was good. “Deportment” was considered to be very important in those days.

For a few months each year, Saturday afternoons were taken up as well as the mornings. This was in order to rehearse for “The Show.” It was always called “The Show.” It was never called a concert.

Come to think of it, what on earth did the bowlers do for a hall on Saturdays?

Anyway, there were many changes of costume required and the sewing machines scattered throughout this little community trundled along as fast as they could go for weeks on end.

The Witch Doctor’s mother even saved up to buy a sewing machine specifically for “The Show.” The day it arrived was a big event.

Here it is here, The Sewing Machine, being looked after with affection in its old age.

Note The Broomstick.

The Show was a very grand affair. It did not take place in a little village hall, a community call, a church hall, or a school. There were plenty of places The Show could have been held in the local community. Oh no!  This dancing family always took us into the spotlight of a grand theatre in the city centre. Indeed there was a proper spotlight, proper stage, proper scenery, proper dressing rooms, proper greasepaint, proper stage hands, (we called them roustabouts), proper wings.

Yes. The wings!

It was Gordon Brown’s recent appearance on You Tube that brought on all these fond reminiscences.



Thanks for the memory, Mr Brown.

Now, some people thought Mr Brown was quite dotty on this video. Others thought he had seriously lost his marbles.

This is not the case. If you had performed at “The Show” year after year, you would know that our Prime Minister was playing to “The Wings.”

Now, when The Witch Child was singing and dancing on this big city stage, like all the other children, she smiled incessantly. It was a false, stupid, inane, obedient smile because ALWAYS there was someone in the wings jumping up and down telling us to keep smiling.

Just like this. One on each side of the stage. All through The Show.

They thought the punters in the audience wanted us all to smile.

Maybe they did.  Or maybe they wanted to watch our feet dancing.

Now Mr Brown, it is clear to The Witch Doctor, that a woman just like this is in the wings trying to make you smile.

It is very difficult to smile all the time.

You are not good at it.

You can’t do it.

You are A Dour Scot.

And that’s that!

You can’t help it. You should just be what you are. There’s nothing wrong with that.

As long as you are sincerely dour!

Why are you obediently following the advice of all the spinners, the make-overers and the marketeers that you have employed using our money?

The “consultants.”

Come to think of it, why have you employed them at all using our money?

This behaviour is the antithesis of leadership.

You say you are going to continue using YouTube.

That is your decision in this free country of ours.

But if you do, first sack all the people in the wings. All of them. Save us some money.

Sit down when you talk.

Find yourself a nice desk and chair or something.

Maybe clasp your hands in front of you as if you are praying.

And for pity’s sake don’t smile!

If you want to convince us all we have a sane PM instead of one who has looped the loop!

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

The Witch Doctor appears to be doing nothing very much at the moment.

Not so.

When witches go silent, it means we are thinking – usually because we are deeply perturbed about something.

Soon I will recommence updating the Mid Staffordshire saga and when I do the post will float up to the top of the blog.

In the meantime, The Witch Doctor is reading the material below:

THE UNIVERSAL DECLARATION OF HUMAN RIGHTS

MEDICAL PROFESSIONALS’ ROLE IN TORTURE IN SECRET PRISONS WAS “GROSS BREACH” OF ETHICS, SAYS RED CROSS

MY COUNTRY, APPARENTLY

DOCTORS UNDER HITLER

“In this history of medicine and the medical profession in the Third Reich, Michael Kater examines the career patterns, educational training, professional organization, and political socialization of German physicians under Hitler. His discussion ranges widely, from doctors who participated in Nazi atrocities, to those who actively resisted the regime’s perversion of healing, to the vast majority whose ideology and behavior fell somewhere between the two extremes. He also takes a chilling look at the post-Hitler medical establishment’s problematic relationship to the Nazi past.

Michael M Kater is Distinguished Research Professor of History at the Centre for German and European Studies at York University in Toronto. He is a Guggenheim Fellow and a Fellow of the Royal Society of Canada and has published widely in the area of modern German history.”

No conspiracy.

Just Creep.

Creeping by The Vast Majority.

Leading to the outcome of End Stage Creep.

And now reading this too. Thanks to The Cockroach Catcher for pointing to it.

WHY WE ARE ATTRACTED TO DR HOUSE

“It is instructive to consider how and why autonomy came to be declared, by universal consensus, the predominant principle of medical ethics. It happened after World War II, as a direct result of the Nuremberg Tribunal. During that Tribunal the trials against Nazi doctors revealed heinous behavior – generally involving medical “research” on Jewish prisoners – that exceeded all bounds of civilized activity. It became evident that under some circumstances (circumstances which under the Nazis were extreme but which were by no means unique in human history) individual patients could not rely on the beneficence of society, or the beneficence of the government, or the beneficence of their own doctors to protect them from abuse at the hands of authority. Thusly was the ethical precept which asks patients ultimately to rely on the beneficence of others starkly revealed to be wholly inadequate. The precept of individual autonomy, therefore, won by default.”

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

UPDATE 26April 2009

QUADS, not triplets!!

…………………..

Does anyone remember “The Triplet Saga” on DNUK?

Well, I have real triplets.

An here’s the proof.

Taken at the crack of dawn this morning by a witch child in the “nature conservation” corner of the garden.

Click on it to make it big.

Message to The Jobbing Doctor:

Bet you don’t have a corner of your garden that looks as messy as this!

But that’s what it takes if you want triplets  at the bottom of the garden…..

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

Witches need The Book of Spells and all the weird and wonderful ingredients of their Spell Pantries to keep them in business.

Black Cats find The Book of Spells cumbersome. Although we dabble in it at times, we make much more use of Our Senses.

Witches do not really appreciate their black cats enough.

We have many more senses than The Human Kind. We even have more senses than the witches we serve although we are too clever to flaunt this fact to them.

Take The Witch Doctor.

She is wittering just now. She says she is looking for the final bit of The NHS Jigsaw.

The final piece of The Jigsaw is staring her in the face……

For some serious thought, read this:

MEASUREMENT MADNESS

For some less serious thought, read this:

THE METRICS OF A SMILE

And remember this:

THE COMPULSORY VOLUNTEERS

It is not only The Black Cats that are thinking “Orwell.” It seems members of the medical profession may be too. Read this:

ORWELLIAN NEWSPEAK

Enter The Future Builders:

Read this:

FUTUREBUILDERS – INVESTING IN THE THIRD SECTOR – IMPROVING PUBLIC SERVICES

And this:

FUTURE BUILDERS CONSOLIDATING

Can you make the connection?

You probably won’t be able to, unless you are a witch’s black cat, of course.

A connection that has the potential to fundamentally change The Whole Structure of Society as we know it.

If you DO understand the connection then you may also begin to understand why, unlike the dithering witches we serve, The Black Cats are all studying current conspiracy theories very carefully.

If we confirm that they are true, then all the black cats are ready to pounce!

This page will get forever longer……. It is the page of the record of the failings of the NHS with particular reference to Mid Staffordshire NHS Trust. However, it seems appropriate to start the story many years before. Not in Mid Staffordshire, but in North Staffordshire. THE PREAMBLE A resume of the failings in North Staffordshire and what happened and what did NOT happen thereafter can be found here:

NORTH STAFFORDSHIRE NHS TRUST – THE EVIDENCE

“I raised concerns regarding the current government policies of underfunding and rationing resulting in a serious risk to patient safety.”

MEDICINE BALLS

“At Mid-Staffordshire Foundation Trust, as many as 1,200 patients may have died due to poor emergency treatment. Health secretary Alan Johnson has ordered an inquiry going back to 2002, when the problems seem to have started. So why did it take the Healthcare Commission until 2009 to publicise such ‘shockingly poor care’?…”

WELL DONE RITA

“Rita has constantly been a thorn in the side of the authorities for pointing out what was happening in North Staffordshire NHS trust 10 years ago. She has been completely justified in her comments, and should have been listened to. She only ever wanted to do this to protect all those elderly patients who died. She has sacrificed her career to a relentless expose of the truth. I am full of admiration.”

________________________________

THE REPORT

INVESTIGATION INTO MID STAFFORDSHIRE NHS FOUNDATION TRUST

“The Healthcare Commission carried out this investigation into apparently high mortality rates in patients admitted as emergencies to Mid Staffordshire NHS Foundation Trust since April 2005, and the care provided to these patients.”

I will gradually track down all the related documentation. The articles are arranged chronologically, the most recent at the foot of the page.

________________________________

MARCH 17 March 2009

HELLO, IS THERE ANYBODY THERE?

“Words fail me when I consider the monumental incompetence in the higher reaches of the Department of Health.”

HELL IN STAFFORDSHIRE

“They admit too many patients for the staffing levels to cope with and then everyone acts all surprised when people suffer and die. I have been overwhelmed and tried to refuse admissions to my ward. They came anyway. They dump them anywhere. The make us wake stable patients up at 4AM to move beds so that they can admit an acute patient from a&e onto my ward. Targets might get breached otherwise!!! Bastards. Listen. Staffordshire is not the only place where this stuff is happening.”

FAILING HOSPITAL CAUSED DEATHS

” A hospital’s “appalling” emergency care resulted in patients dying needlessly, the NHS watchdog has said. About 400 more people died at Stafford Hospital between 2005 and 2008 than would be expected, the Healthcare Commission said. “

IT COULDN’T HAPPEN IN BRITAIN

“So why did the Staffordshire doctors not complain? Once upon a time, one of them did. A courageous doctor then working in a hospital a few miles away in North Staffordshire NHS Trust complained about the appalling medical care she had witnessed in her hospital. Look what happened to her. She was treated by the GMC in the way that Stalin used to treat political dissidents, including being accused of being mentally ill.”

MID STAFFORDSHIRE NHS TRUST REPORT – MAIN FINDINGS

“Assessing the priority of care for patients in accident and emergency (A&E) was routinely conducted by unqualified receptionists. One patient with an open fracture of the elbow waited for more than four hours covered in blood with no pain relief.”

MID STAFFS INVESTIGATION

“Dr Grumble has witnessed junior doctors being pressurised. It is so endemic that the pressure continues even when Dr Grumble is present. There is no insight into the fact that hassling a junior doctor into making a decision when he is not ready to do so is plain dangerous. Does this sort of thing happen in your hospital?”

18 March 2009

PONTIUS PILATE

“These people have set the framework for this to happen. The hospital had to ’save £10,000,000.’ They were 120 nurses short. A & E had one consultant, and receptionists were acting as triage nurses, and a broom cupboard* was used as a clinical decisions unit, getting people out of A & E according to targets.”

INDIVIDUAL MANAGEMENT FAILURES

“Alan Johnson and Gordon Brown are living in cloud cuckoo land. While some hospitals do manage to provide high standards of care, it is despite the government’s central megalomania, not because of it. The problems in Staffordshire General stem from No 10, the DoH and the top. The government’s top down control freakery and brutal imposition of various brainless reforms is the cause of problems like this. The management structure of the NHS is centrally driven and top down, there is no room for feedback, no room for local decisions, it is do as the government says or die, quite literally in some cases.”

CENTRAL CREDIT, LOCAL BLAME

“Well it’s just about enough to get the old bile flowing again. I have just watched the oleaginous (former Marxist) SoS for Health lie fluently to give a classic demonstration of central credit and local blame. He was absolutely clear that the failings at Stafford Hospital were nothing to with any government policy whatsoever, and everything to do with poor local management. Yes, all the blame is already being directed straight at the chief execs, who will of course nobly take the hit for the DoH.”

MID STAFFORDSHIRE – UNBELIEVABLE

“This may sound like the opening of the film Rashomon when the woodcutter came back from the court hearing of the murder of a Samurai: Unbelievable! Unbelievable! Unbelievable! Nobody is telling the truth. Not even the ghost of the killed Samurai.”

MID STAFFORDSHIRE NHS TRUST – THE KILLING FIELDS

“What the hell happened? Monitor that seemingly piss poor “independent regulator” paid millions of our money to provide “effective regulation-better patient care” (their words) failed miserably. They decided that the North Staffs Hospital was meeting all the criteria to become a “Foundation Trust”, they believed the information the “hospital” submitted, they didn’t talk to the Healthcare Commission (another piss poor institution). The Hospital itself decided that meeting targets were more important than patients, but nobody noticed.”

19 March 2009

THREE BRASS MONKEYS

“So the mighty leader spoke to his three acolytes, who were in charge of the hospitals of the people and knew how they were run.”

IT WAS A TICKING TIME BOMB

“Then you think, why didn’t any member of staff raise the alarm?! For a whole 3 years?! Even anonymously? Or, could it be that staff tried but were not listened to? .. We may never know. The hospital was not properly staffed, not properly equipped and not properly managed! So, why did it take the Health Care Commission 3 years to find out about it’s failings?!”

MID STAFFS: THE FIRST BIG CASE OF DEATH BY EMPTY WORDS

“Incompetence was an accomplice – it always is – but the main culprit was the cloak of evasive language. The entire health service floats on an Orwellian sea of newspeak strategies, policies, stakeholders, parameters, benchmarking, outcomes, actioning, pathfinding. Third-rate jargon, that great weapon of the inadequate, has become the accepted way to con the public – sorry, service users.”

20 March 2009

BEING CHASED BY SARAH HARMAN

“The ink has barely dried on the report from Stafford Hospital, but that does not stop a certain sort of solicitor touting for business. I was appalled to see this appear today:”

22 March 2009

DEMOCRACY R.I.P.

“For all that apparent encouragement, whistles were not blown by doctors or nurses in Stafford. Instead of independent professionals with the confidence to defend the public interest, the Healthcare Commission described sullen staff, bullied by managers and neglectful of patients. Doctors told its investigators that they had been “proletarianised”: turned from professionals with their own codes and standards into employees who must obey.”

REASONS FOR STAFFORD HOSPITAL

“This is one of the reasons why I shall continue to blog: to point out the weaknesses of the current NHS, the way in which our leaders are slowly kicking the life out of (potentially) one of the best and fairest healthcare systems in the world, and why I and millions of others cannot nor will not vote for any of these second-rate politicians ever again.”

23 March 2009

CYNTHIA BOWER: APRIL FOOL

“One should perhaps not hold Cynthia Bower completely responsible for all the deaths in Stafford. It takes several years for hospital services to become as bad as they were in Stafford. Cynthia Bower only took over that position in 2005. Some of the blame must fall on her predecessor, who was David “ex-communist Thatcherite” Nicholson. He has moved on from West Midlands Strategic Health Authority too. He is now Chief Executive of the National Health Service. Onwards and upwards, comrades.”

24 March 2009

COULD FUTURE DEVELOPMENTS IN NURSING PREVENT ANOTHER MID-STAFFS?

“There is a growing international evidence base that links staffing levels not only to quality of care but also to patient safety and mortality rates,’ he said, adding that the potential power of metrics to highlight both staffing levels and skillmix can be exploited to ensure that senior management address this.”

THE CANCER CLOCK TICKS PAST 60, LITHUANIA DOES BETTER, AND THE EVENTS NEAR THE POTERIES

“(We wrote this few days ago and this appears to be confirmed by a post in Dr Crippen’s blog post 23/03/09. Barely has the stink cleared and failure seems to be rewarded with the chief poacher(s) being promoted to chief gamekeeper(s) so it won’t happen again will it?) And they will (continue to) get away with it. To paraphrase a famous Party humanitarian from the past “one breach of confidentiality is a sackable offence, 400 deaths is a statistic and to be rewarded”.

MID STAFFS, THE VIRGIN AND THE WHISLEBLOWER

“The rest I think we all know by now, management cocked up, the Healthcare Commisssion’s predecessor cocked up,Monitor cocked up, the Healthcare Commission took too much time (as usual), the patients died, chief executive Martin Yeates cocked up but was only “suspended on full pay”, at least the chairman, Toni Brisby had the nouse to resign, the GMC cocked up (as usual) and the patients died. The “reason” propounded for the death of hundreds of patients is “the target culture”, wrong; the reason for the deaths of hundreds of patients is the lack of management, the lack of care, the lack facilities, the lack of trained medics, the lack of common sense, the lack of truth and the lack of honesty.”

25 March 2009

IT’S A FUNNY WORLD

“Bizarrely, given our recent economic woes, freeing organisations to do as they please is still seen as a success. Yet we know that as the reins were eased in Stafford the management focus was instantly transferred from patient care to matters of money. It may seem odd but it is a sad truth that organisations generally value money more than lives.”

DEBATE ON MID-STAFFS HOSPITAL REJECTED

“Calls for an emergency debate to learn lessons from the hospital where 400 patients may have died due to poor care have been rejected by the House of Commons.”

26 March 2009

ON BLAME FOR MID-STAFFORDSHIRE

“Among the rather under-reported issues was the Healthcare Commission having issued the Trust with respectable, pass-level ratings during the whole period in question. HC chair Ian Kennedy responded to this in a letter to The Guardian, rather spectacularly missing the point. The Healthcare Commission is on stunningly shaky ground, because it was the regulator.”

27 March 2009

RIOJA OR RANT?

“The list of half-baked and half-witted ideas goes on and on, with very little on the positive side. I shall now return to the joys of the Tepranillo grape, and try to forget these idiots for 2 days. But all the time, vulnerable people are dying in places like Stafford as a result of their ‘initiatives’. I am losing patience with the lot of them.”

29 March 2009

AND THERE ARE MORE

“It seems that there are 10 hospitals with worse death rates than Mid-Staffordshire, and they are as follows (with their Hospital Standardised Mortality Rates in brackets (higher is worse)):”

MID STAFFORDSHIRE – MEDIA, MEDIA, MEDIA

“Time was when our newspapers can be relied on to expose great scandals and injustice. Remember Thalidomide and The Sunday Times? Mid-Staffordshire as far as I could work out could have been exposed a good deal earlier in the good old days of the Thalidomide affair. What has happened to the media in the new Millennium?”

30 March 2009

HOW SAFE IS YOUR HOSPITAL

“The guide was the first time that comparative adjusted death rates for all NHS hospital trusts had ever been published in the UK. Dr Foster information tools are used by over 70% of the NHS and comparative information for the public is now also published on Dr Foster’s consumer-facing website: www.drfosterhealth.co.uk.”

31 March 2009

REMOVE FEAR FROM NHS WHISTLEBLOWERS

‘The NHS must change. When two constituents came to see me about the state of the hospital in which they work – not Stafford – complete with a dossier of photographs, they were terrified to leave it with me as they believed their jobs would be in jeopardy. It left me impotent to take any action.”

HITTING THE TARGET : MISSING THE POINT

“You’d have thought the NHS might have learned by now. Targets cause problems, and make things worse. The Stafford case proves this.”

APRIL 1 April 2009

STICK TO CDs

“As I was driving in to work, I happened to hear an interview with Baroness Young on Radio 4. The leader of this new Quango starts work today: it is called the Care Quality Commission. This is a merging of the Commission for Social Care Inspection, the Healthcare Commission and the Mental Health Act Commission. Suffused with smug authoritarianism, this uber-quangocrat had no difficulty batting away a number of questions about what has gone on in Stafford and Cannock Chase hospitals (see posts passim).”

8 April 2009

IS YOUR HOSPITAL OK? – DON’T ASK

“National Health Service staff are no longer being asked whether they would be happy to be treated in their own hospitals. The question, seen by some as one of the most revealing pointers to underperforming hospitals, has been dropped from an annual official survey. The Healthcare Commission, which conducts the survey, cited employees’ unhappiness with care standards as one of the concerns at Mid-Staffordshire NHS Trust. A subsequent investigation concluded that patients there died as a result of poor quality care.”

9 April 2009

WHAT WENT WRONG AT MID STAFFS?

“Whilst what was happening at Mid Staffs was extreme, milder aspects of the same issues are occurring all too often on wards up and down the country right now. Unmonitored.”

10 April 2009

WHO DARES BLOW THE WHISTLE? WHO DARES, LOSES

“How does the government deal with comrade whistleblowers? It purports to “welcome” them with open arms. Here is Alan Johnson, the Secretary of State for Health, discussing the health care crisis in Stafford:”

CAN THE NHS BE CURED?

“The “old Lady” can be cured, but it will take enormous effort on the part of the Dept of Health to listen and understand what we want, to stop telling us what we need, to ask us which way the NHS should progress, to invest in the things that matter-nurses, equipment and resources, a mind set that makes the patient the most important people and allows the medics to provide the treatment we deserve and that doesn’t include overpaid, under worked clipboard carrying “managers” that are bleeding money and resources away from the NHS. The NHS is “under the weather” at the moment but with the right treatment the “old lady” will be up and around, and able to continue the mainly excellent care provided before the illness struck. “Age is only a number, a cipher for the records. A man can’t retire his experience. He must use it. Experience achieves more with less energy and time.” Bernard Baruch

11 April 2009

“STAFFORD HOSPITAL – MANAGERS SPENT MORE THAN £1,000,000 ON REDUNDANCIES DURING SCANDAL”

“More than 160 nurses left Stafford Hospital and were not replaced – as patients died in conditions later described as “appalling” by inspectors. The nurses actually left at a time when the hospital had vacancies for nursing staff. Decisions about treatment for emergency patients were left to receptionists and dehydrated patients were left to drink from flower vases during a crisis in which between 400 and 1,200 patients may have died needlessly in three years.”

ANDREW LANSLEY: WHY LABOUR CANNOT SAY “NEVER AGAIN” OVER HOSPITAL SCANDAL

“Two issues go to the very heart of the failings in Stafford General Hospital. Patients knew what was going terribly wrong but they had no means to make their voice heard, and no power to do anything about it. Those with the power on the board seemed oblivious to what was happening on the ward. This has to change The Healthcare Commission found that patients were often treated as numbers rather than people in a tick-box, target-driven culture. I regularly receive letters from doctors and nurses who are deeply frustrated that they are browbeaten into prioritising targets over clinical need. “

DR ANGRY SPEAKS OUT

“Already we have seen in Stafford, and lots of other hospitals not mentioned in the press, what happens when managers and targets take precedence over professionals. How long will it be I wonder before we see a Panorama programme on poor general practice being delivered by a private company.”

14 April 2009

MID-STAFFORDSHIRE REDUNDANCIES UNDER SCRUTINY

“Mid Staffordshire hospital trust paid out £1.3m in redundancy payments between 2006 and 2009, figures disclosed under the Freedom of Information Act have revealed.”

DAVID CAMERON TO MEET STAFFORD HOSPITAL CAMPAIGNERS

“The Leader of the Opposition is meeting Julie Bailey, one of the organisers of the Cure the NHS campaign, at its headquarters in Stafford. Mrs Bailey is among a number of people who are calling for a public inquiry into the hospital scandal.”

QUEEN’S BLUNDERS ARE NOT ALARMING

“Queen’s figures compare well with other West Midlands hospitals such as Stafford’s Mid-Staffordshire NHS Foundation Trust, which was recently the subject of a damning report from standards watchdog the Healthcare Commission.”

STAFFORD – UNEARTHING THE REASONS

“They will of course try to take credit (if you can believe this!) for unearthing their own cock-ups, they will blame the underlings, use this process to propose even more power for themselves. They will appoint placemen to investigate this process badly (you know they are placemen, because they have been to Buckingham Palace). They stand righteously saying that this will never happen again, as they conceal the metaphorical dagger dripping with blood behind their corporate backs. This group above others share a big responsibility in this whole wretched episode. If you read the dissembling of the whole process by Allyson Pollock and George Monbiot, you will get a clearer view; but they will all walk away from this terrible episode, like Pontius Pilate, washing their hands.”

15 April 2009

DAVID CAMERON MEETS CAMPAIGNERS AT STAFFORD HOSPITAL

“Mr Cameron said: “I am standing here in front of a hospital where there was the most appalling set of circumstances and people being treated incredibly badly. That is the priority for me, the NHS. That’s the priority for the British people.”

REVIEWS FOR 43 PATIENTS WHO DIED AT “APPALLING” HOSPITAL

“The case notes of 43 patients who died at a hospital slammed for its “appalling standards of care” are to be reviewed in a move dismissed by an NHS protest group a “publicity stunt”.

RCN BACKS INDEPENDENT INQUIRY INTO MID STAFFS

“Peter Carter, general secretary of the RCN, said: ‘We feel it is in everyone’s interests if there is a full independent inquiry. ‘We do not think it needs to be held in public, because people can often be more forthcoming if they are not appearing in some kind of ‘star chamber’, he added.”

A BIG THANK YOU TO PRIVATE EYE

“I would just like to thank Private Eye and MD for their kindness in featuring the material below. They are the only mainstream publication to feature a summary of the evidence.”

“There has been a recent debate about the rise of bloggers. Without the medical bloggers, there would be no accountability in the NHS. It is those few medical bloggers who raise concerns on a day to day basis who are the real heroes in the NHS. I also know that blogging provided me with a platform to raise concerns in a environment where the media and the government silenced the vital issues of Ward 87. Had the issues been addressed in 1999 and lessons learned and applied to the rest of the NHS, 2000 people would not have died at Mid Staffordshire.”

16 April 2009

TORIES WOULD END MONOPOLY OF NHS CHOICES

“The Conservative Party would remove NHS Choices from Department of Health control and force it to compete on the same terms as other healthcare information providers. In a document promising An NHS Information Revolution to Save Lives, the party says NHS Choices is failing to get adequate information to managers, clinicians and patients and that it is not sufficiently independent.”

HOW TO COMPLAIN ABOUT THE NHS

“Comrades will recall the activities of ex-comrade Dr Rita Pal who, despite re-education, continues to spread scurrilous rumours about comrade patients dying unnecessarily in the Midlands. Comrade Pal has been deemed to be mentally ill. Her views are not to be taken seriously. Comrades caught reading Private Eye will be shot.”

THIS IS WHAT I MEAN

“The problem is that confidentiality has always been a relative concept, and the numpties on the ‘panel’ could not see the bigger picture. So once again the authorities criticise the messenger, and ignore the message. The usual channels are hopeless for raising concerns. Ask all the previous whistleblowers.”

MID STAFFORDSHIRE? NOT JUST MID STAFFORDSHIRE!

“Perhaps the Health Secretary should go and look at the Third World hospitals, they may not indeed be as bad. They really do not have ridiculous targets and despite poor financing the doctors and nurses do the best they can. Also in the Third World, there would be riots if things like this happened.”

NO. NOT JUST MID-STAFFORDSHIRE – A MESSAGE TO ANGRY RELATIVES OF HOSPITAL PATIENTS IN ST. ELSEWHERE

“There is never a time during most of these shifts when the nurse is left alone, free of interruptions to go around and check on ALL his/her patients and make sure that they have everything that they need. Every single minute of many of these shifts are overbooked with multiple jobs that could get a nurse struck off and a patient harmed if they are missed. No matter how badly you (as the nurse) want to get around to everyone I can guarantee you that it isn’t going to happen and that it will be out of your control. Most shifts are like this. And even though it is out of your control you are still responsible for any bad outcomes. All I can do is work hard, prioritize, skip meals and push push push myself. We are not oblivious, uncaring, and thick. We are overwhelmed. It is triage people. Triage. Not holistic care.”

NHS PLAN – TEN YEARS ON

“This year the Commons All Party Parliamentary Group on Primary Care and Public Health is running an enquiry with the title? “Was the NHS Plan really a blueprint for the NHS – 10 years on?” You can contribute via this link.”

“Bullying is rife, with passive aggression the preferred option. But managers are so wonderful they need no regulatory body, and a quick golden parachute out of trouble, and a sideways move sorts out any problems. From such attention to detail we get the new chief exec of the Care Quality Commission from the SHA which turned a blind eye to failings in Staffordshire. Expect floggings to continue till staff morale improves.”

DOCTORS MUST ROOT OUT BAD CARE

“NHS staff – and in particular doctors – must do more to tackle bad care, the head of the new health regulator says. Care Quality Commission chairman Barbara Young said there was a culture of silence among health staff, as shown by the Stafford Hospital scandal. “

MY TEARS AT APPALLING A AND E WARD

“”I would come home literally in tears sometimes because I felt I couldn’t deliver the standard of nursing care that I wanted and that patients should be getting and indeed have the right to expect,” she told The Report. “There just physically wasn’t enough nursing staff available to go and attend to them and get a commode, help them get changed, change the bed – anything like that – and patients would be left for any amount of time before that was seen to. “It used to literally break my heart.”

NHS DRAFTS BBC BOSS GREG DYKE AS TROUBLESHOOTER DESPITE LACK OF RELEVANT EXPERIENCE

“Former BBC director-general Greg Dyke has been drafted in to improve leadership in the NHS.”

“Ministers are concerned about the poor quality of leadership in the health service, which has led to deaths in Stafford and in Kent, where 270 died in a C. diff outbreak.”

17 April 2009

MORE NONSENSE

“Who is this woman, ‘Baroness’ Young? Has she been reading the papers? Does she know what’s going on? Her ability to get herself publicity and to get her new organisation on the map is commendable. The problem is that we’ve had new organisations and new labour quangocrats coming out of our ears in the last 12 years [See Dr Rant for a measured assessment of the NHS Plan - 10 years on]. She is yet another person who has the temerity to spend her time telling people what to do, and – frankly – I really don’t care what she, and her lousy commission, has got to say. They come over as arrogant, overpowerful apparatchiks with plenty of power but no authority.”

20 April 2009

WHISTLEBLOWING – WHY IT’S DANGEROUS

“The no blame culture, and the organisation with a memory, that makes amends, and learns from mistakes is a total fiction. In the NHS there are vicious blame games afoot, and shooting the messenger is one strategy the management use to get unwelcome information off their patch. And professional bodies such as GMC and GTC will not stand up for whistle blowers, nor allow a public interest defence.”

MARGARET HAYWOOD

“What this decision means is that all bloggers that have a professional registration are now skating on thin ice. Nurse bloggers, Doctor bloggers, Paramedic bloggers – all these are on a professional register and all end up writing about situations that trusts would rather were kept under the carpet. Might I also suggest that in the cases of hospital trusts wanting to get rid of a ‘troublesome’ staff member they may well turn to organisations like the NMC, HPC or GMC to do their work for them. I know I could point you to HPC rulings that appear to do that, not evidential to be sure, but it does look very much like that.”

SHOCK AT HOSPITAL DEATH FIGURES

” According to figures compiled last November and published in a Sunday newspaper, the Royal Bolton Hospital is seventh out of 10 trusts with higher mortality rates than Mid Staffordshire. Cllr Andy Morgan, chairman of Bolton Council’s health overview and scrutiny committee, said: “I am shocked by these figures and a full investigation into the circumstances behind these statistics is needed.”

THE BLAME GAME

“The role of clinicians in when the system fails the patients highlights the distribution of power and responsibility between managers and clinicians. The interaction between the two is complicated – if a doctor feels disempowered, does that give him an excuse to abdicate responsibility?”

NURSE FROM STAFFORDSHIRE TALKS

“Incident forms are getting used as toilet tissue by managment. Being caring and hardworking is just not enough. If I am in one bay I cannot see what is going on in another. People might fall. Their relatives accuse you of not caring and being lazy. I hate it. Love nursing, adore the patients but hate the bullshit.”

30 April 2009

MID STAFFS HOSPITAL MUST HIRE MORE NURSES

“Referrals from GPs always go through the A and E unit, Sir George says, contrary to good practice that allows them to be referred straight to the unit to speed the patients’ journey through hospital.”

CONFED PROPOSES PEER REVIEW TO AVOID MID STAFFORDSHIRE REPEAT

“The NHS Confederation has called on hospital trusts to invite others trusts’ directors to inspect their services to help prevent failures such as those at Mid Staffordshire foundation trust and Maidstone and Tunbridge Wells trust.”

MONITOR RESPONSE TO PROFESSOR SIR GEORGE ALBERTINI’S REPORT ON MID STAFFORDSHIRE NHS FOUNDATION TRUST

“As the independent regulator of NHS foundation trusts, we are very clear that this Trust will not be allowed to slip backwards. Monitor has already used its formal powers of intervention once at Mid Staffordshire NHS Foundation Trust to appoint an Interim Chair and direct the appointment of an Interim Chief Executive. If the Trust fails to deliver the planned actions to address the issues identified within agreed timescales, Monitor will take whatever further regulatory action is necessary to deliver improved patient care.”

PROBE ORDERED INTO EAST LANCASHIRE A AND E HOSPITAL SERVICES

” “In Staffordshire, small but basic problems added up to disaster. “This is so important we should be able to take action immediately.” The board agreed to organise investigations, including visits to the department and requests to GPs for details of how their patients felt about emergency treatment.”

MID STAFFS REPORT: NEW DUTIES ON NHS TO PRVE PATIENT INVOLVEMENT

‘The government has announced that NHS organisations will have to publish information that proves they are involving patients to prevent a repeat of the failures at Mid Staffordshire foundation trust. A report for the Department of Health by national director for primary care David Colin-Thomé, published today, found that a significant reason that such poor care at the trust continued for so long was that patients were not listened to.”

MID STAFFORDSHIRE NHS FOUNDATION TRUST – REPORT BY DEPARTMENT OF HEALTH, DAVID COLIN THOME, SIR GEORGE ALBERTINI

1 May 2009

A MISSION TO PUT THE NHS ON THE RIGHT PATH

“There have been the damning criticisms of ineffective managers and care failings at Stafford Hospital (Mr Barnett is a member of the new National Leadership Council); concerns about the NHS’s inability to foster talent and innovation while overpaying executives (he has 20 years’ experience in human resources and organisational development); and fears of how the system will cope with a flu pandemic (he chaired the government group on pandemic workforce planning). “

2 MAY 2009

DEATH RATES VICTORY AFTER STAFFORD SCANDAL

“Mortality rates for all NHS hospitals in England have been placed on the health service central website, NHS Choices, helping patients to assess the quality of care offered before they are admitted for treatment. The move, introduced in the wake of the Stafford Hospital scandal which claimed hundreds of lives, is a victory for patients groups and The Sunday Telegraph, which has urged the Government to publish the data as part of our campaign Heal Our Hospitals.”

PETER CARTER RUCK. WHAT HAVE YOU DONE WITH THE STAFFORD WHISTLEBLOWER?

“Rumour has it that libel law firm Peter Carter Ruck may be representing Stafford Hospital. Apparently, a medical whistleblower was due to raise concerns about the hospital in a prominent Sunday paper but the raptor law firm has been circling around and oddly the story isn’t running.”

3 May 2009

ALL TANGLED UP

“MMC, Remedy UK, North-Staffordshire, Mid-Staffordshire, GMC, The London Deanery, The Highland Deanery, The Department of Health, the legal system and more, are all becoming intertwingled (a witching word) in a strange, complex way. It will be difficult for any doctor in this land who does not read the medical blogosphere on a daily basis to understand what is going on, and what are the connections and implications. This information is not easily available anywhere else.”

4 May 2009

WOMAN WHO EXPOSED STAFFORD HOSPITAL FAILINGS IN LINE FOR AWARD

A CAMPAIGNER who has fought tirelessly to expose the appalling conditions at shamed Stafford Hospital could clinch the Inspirational Woman of the Year title. Julie Bailey, who formed Cure the NHS campaign group to expose failings at Mid Staffordshire Foundation Hospitals Trust which caused at least 400 unnecessary deaths, is one of ten semi-finalists in the national award.”

5 May 2009

CNO ORDERS EXPERIENCED NURSE LEADER TO BE SEN TO MID STAFFS

“An experienced assistant director of nursing is to be deployed to Mid Staffordshire NHS Foundation Trust on the orders of chief nursing officer for England Dame Christine Beasley. The trust has also been instructed to recruit extra frontline nurses, a night matron and a professional development nurse in response to a review by the Department of Health’s emergency care tsar, published last week.”

6 MAY 2009

HOSPITAL BOSS’ FUTURE UNDECIDED

“Stafford Hospital has finally advertised for a permanent new chief executive – although the fate of suspended boss Martin Yeates has not yet been decided.”

THE FAIURE OF THE FOUNDATION TRUST MODEL

“she (Julie Bailey) is clearly an effective campaigner, and it is hard to believe that any of the well paid regulators would have intervened even now if it was not for her efforts. She runs a cafe on the main street in Stafford. Probably on about a quarter of the money of the people who run Monitor, the Healthcare Commission and the various parts of the NHS who reckoned that Mid Staffordshire was doing fine. None of them have lost their jobs”

999 MERGER NOT WORKING SAYS AMBULANCE SERVICE EX BOSS

“Then there was the Healthcare Commission’s recently published report on Mid Staffordshire Hospitals NHS Foundation Trust, in Stafford, which found that stroke patients were waiting all weekend for a CAT scan whereas before, ambulances automatically took them to hospitals where such facilities would be available immediately.”

GOD BLESS NURSES

“There is a major shortage of nurses worldwide. This is not surprising. This shortage has existed for a long time for lots of reasons. Despite the worldwide economic crisis, the shortage continues. This is due, in part to the spiraling costs of health care and the need for a skilled health care delivery work force that often compromises pay increases for new equipment.”

7 MAY 2009

HOSPITAL MANAGERS ACT ON MID-STAFFORDSHIRE FAILURES

“Around half of hospital managers and other staff believe elements of poor standards found at Mid Staffordshire foundation trust exist at their own organisation, a HSJ straw poll suggests.”

8 MAY 2009

DELAYED MANAGERS WHISTLEBLOWING CANARIES SING MID STAFFS NHS

” Health Service Journal (HSJ) in the UK deserve some credit for helping NHS managers at Mid Staffs NHS Trust to open up about the appalling standards of care . Does this mean NHS whistle blowing, though delayed beyond saving real lives previously is developing shrilling and thrilling biceps ? “

12 MAY 2009

THE NEW FACE OF NURSING – WHAT WILL THE CQC MEAN FOR NURSING

“The new super-regulator, the Care Quality Commission, took up its powers at the start of last month, marking the beginning of a raft of changes in healthcare regulation. Alastair McLellan talks to its chief executive, Cynthia Bower, about what the commission has in store for nurses”

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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© Mpz@sapo.pt | Agency: Dreamstime.com © Ijansempoi | Dreamstime.com

While The Witch Doctor is concentrating on Mid Staffordshire, My Black Cat will bring you a few items of news that are taking her fancy.

As if by magic, she will make this post float to the top of the blog every time a new entry is added.

17 April 2009

WHY DID SO FEW STAND UP TO THE SPIN MACHINE?

“I have long felt like the little boy who dared to point at the naked lobby and was laughed at on live TV by Jeremy Paxman for this unworldly naivety. As you read the many reviews of the years of terror and spin by the journalists who were on the receiving end, remember their shameful complicity. I was too far below the salt to join the lobby or to be privy to the favoured briefings from Downing Street. Nevertheless I won’t ever let lobby journalists forget that they sleep safe in their beds tonight because a rough blogger was prepared to do violence on Damian McBride.”

SACKED WARWICK HOSPITAL CONSULTANT SHIRINE BOARDMAN TO TAKE FORMER BOSSES TO TRIBUNAL

“A sacked Warwick Hospital consultant is taking her bosses to an employment tribunal.”

The Witch Doctor is about to risk having his/her identity exposed.

In the filing cabinets of NHS managers in The Witch Doctor’s neck of the woods, there exists some correspondence written by The Witch Doctor’s fair hand/typewriter/wordprocessor/computer over the years.

These documents incorporate the term “Yo-Yo Managment.”

This is a term which was coined by The Witch Doctor some years ago.

If you are an NHS manager and you have these documents in your possession, and you read this blog, you will now know the identity of The Witch Doctor.

The reason I have decided to mention this is because of today’s excellent article by The Jobbing Doctor as he returns refreshed from his break:

STAFFORD – UNEARTHING THE REASONS

What a blessing was The Jobbing Doctor’s holiday!

Er…

You’d better read this too!

WHAT. THE. F___!!!

The Witch Doctor believes the problems in Staffordshire are happening to a greater or lesser extent elsewhere and are largely the consequence of an endemic Yo-Yo Managment System within the NHS.

It is important therefore, for the safely of every patient in the NHS, that the problems associated with Yo-Yo Management are thoroughly documented and addressed.

Patients and staff alike, even if they recognise it for what it is, find it very difficult to deal with a Yo-Yo Managment System.

The Witch Doctor has observed this system at work over many years and has tried to intervene locally – sometimes with success, sometimes not.

Whether successful or not, when attempting to challenge a Yo-Yo Managment System, a cold calculated tenacity is essential. So also is the ability to take risks. But above all the timing has to be just right.

The Witch Doctor believes that the tragedy of Mid-Staffordshire indicates that the time is now right for the medical profession to tackle the problems associated with Yo-Yo Management within the NHS.

Yes.  The Medical Profession.

The Witch Doctor, therefore has decided to suspend all blogging apart from documenting the Staffordshire tragedy as it unfolded and will continue to unfold in the media and the blogosphere.

Once this is complete she may then give some accounts of how she has tried in her own way to address practically, some of the problems associated with Yo-Yo Management in her part of the NHS world.

As you know, My Black Cat is a great one for Conspiracies.

She is sure we are in the midst of a huge black conspiracy now.

We witches on the other hand are great ones for Creep.

We believe The Human Kind is quite capable of creeping into black holes and continue to do so until they waken up.

Then they are perfectly capable of reversing The Creep.

However, there is one thing that My Black Cat and The Witch Doctor agree upon completely.

It is this:

When strange news breaks over a holiday weekend, you can be pretty sure there is an ulterior motive.

We have seen this so many, many times before, that we almost find it amusing!

GORDON BROWN’S EASTER EGG

My Black Cat was therefore very excited to hear about the BBC’s message that there were to be young “COMPULSORY VOLUNTEERS”

Seems like a great idea, you say.

Responsibility. Empathy. Citizenship.

Why not?

Well, My Black Cat tells me she has been waiting for an announcement about COMPULSORY VOLUNTEERS for several months.

She says it is all part of The Great Big Conspiracy.

I have no idea what she’s talking about.

I’m sure nobody else does either.

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

Another must-read from Northern Doctor…….

HOMEOPATHIC CLAIRVOYANT DOGS. ER, BARKING

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

It’s a pity you don’t listen to witches, Mr Brown.

It really is.

We ancient women have a much gentler approach than others you may cross.

We warned you way back in 2007 you would come a cropper if you didn’t remove the spin from British politics.

We warned you here:

LIE SPINNING

And here:

MORE ON LIE SPINNING

For the life of us, we witches couldn’t see the difference between spinning and lying.

Witches never vote for Liars.

Or Spinners.

And we loathe the words “Spin Doctor”

It is an affront to the medical profession and to witch doctors!

A blogger was taken to his local police station, had his house searched and now thinks the police may be attempting to remove his blog.

He wrote this on Monday:

ARRESTED

I’VE ESCAPED FROM THE COPS

“Well, they let me go in the end – after 7 hours in a police HQ cell.

To those of you who don’t know what I’m speaking of – I was arrested in a raid on my home this morning.

Apparently – alleged breaches of the data protection law merited me being seized as I stepped out of my home – with 4 unmarked police cars and at least 8 police officers proceeding to turn over my home.

And just think – some people don’t believe me when I say the Jersey oligarchy are corupt, abusive and out of control.

I’ll write more later this evening.”

He wrote this on Wednesday:

BLOG UNDER ATTACK

“For this evening I just wanted to alert all my readers to the fact that the cops are trying to hack my blog in an attempt to take it down or remove certain postings and comments.

They’ve been too thick to quite get there yet – but I imagine it’s only a matter of time. I expect they’ll have to get someone in who knows what they’re doing.”

He hasn’t written anything since.

Whoops! Wrong!

He’s just posted this!

JERSEY FINANCE

Tuesday 14 April 2009

EMERGENCY STATES ASSEMBLY MEETING

JERSEY – AWAITING ITS DUNBLANE

STRAIGHT POLICING IN JERSEY

Who is the blogger?

He is none other than the ex Minister of Health and Social Services in Jersey, Senator Stuart Syvret.

He has been very vocal about the alleged child abuse cases on that island.

He does not seem to say “the right thing” nor behave in “The Jersey Way”

My Black Cat, as always, thinks there is a conspiracy and has fished out this document which she is pouring over just now in a very, very excited state for a cat!

THIS IS WHAT MY BLACK CAT HAS FOUND

Heaven knows what’s going on here!

Here’s some background from a while back.

HOME TO SOMETHING EVIL

FORMER HEAD OF JERSEY INQUIRY ATTACKS ISLAND’S LEGAL SYSTEM

Now I’ll have to start all over again and try to convince My Black Cat and all the other witches cats she has in tow that life is NOT one great big conspiracy!

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

FORMER LOCUM HANDED SUSPENDED JAIL TERM FOR DISPENSING ERROR

A pharmacist has been given a suspended prison sentence for a dispensing error that has been shown NOT to have been responsible for a patient’s death.

It seems therefore, that the act of making an accidental error, rather than the consequences of that error is enough to decide whether or not a health professional is jailed.

Now read this, My Black Cat

PROSPECTIVE STUDIES OF THE INCIDENCE, NATURE AND CAUSES OF DISPENSING ERRORS IN COMMUNITY PHARMACIES.

Ashcroft DM, Quinlan P, Blenkinsopp A.

School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK. darren.ashcroft@man.ac.uk

BACKGROUND: “Each year over 600 million prescription items are dispensed in community pharmacies in England and Wales. Despite this, there is little published evidence relating to dispensing errors and near misses occurring in this setting. This study sought to determine their incidence, nature and causes. METHODS: Prospective study over a 4-week period in 35 community pharmacies (9 independent pharmacies and 26 chain pharmacies) in the UK. Pharmacists recorded details of all incidents that occurred during the dispensing process, including information about: the stage at which the error was detected; who found the error; who made the error; type of error; reported cause of error and circumstances associated with the error. RESULTS: 125,395 prescribed items were dispensed during the study period and 330 incidents were recorded relating to 310 prescriptions. 280 (84.8%) incidents were classified as a near miss (rate per 10,000 items dispensed=22.33, 95%CI 19.79-25.10), while the remaining 50 (15.2%) were classified as dispensing errors (rate per 10,000 items dispensed=3.99, 95%CI 2.96-5.26). Selection errors were the most common types of incidents (199, 60.3%), followed by labeling (109, 33.0%) and bagging errors (22, 6.6%). Most of the incidents were caused either by misreading the prescription (90, 24.5%), similar drug names (62, 16.8%), selecting the previous drug or dose from the patient’s medication record on the pharmacy computer (42, 11.4%) or similar packaging (28, 7.6%). CONCLUSIONS: This study has demonstrated that a wide range of medication errors occur in community pharmacies. On average, for every 10,000 items dispensed, there are around 22 near misses and four dispensing errors. Given the current plans for reporting adverse events in the NHS, greater insight into the likely incidence and nature of dispensing errors will be helpful in designing effective risk management strategies in primary care. Copyright (c) 2004 John Wiley & Sons, Ltd.”

They say there are about 600,000,000 prescriptions dispensed per year in England and Wales.

Could you get the abacus, My Black Cat and work out just how many errors are made per year in England and Wales.

When you have done that, work out the number of extra prison cells that will be necessary to accommodate all the jailed pharmacists.

After that, you might give a thought to all the medical errors that are made.

And all the nursing errors.

And all the administrative errors.

And all the errors made by the various employees on the rungs of The Skills Escalator who are being supervised by professionally qualified staff.

Do you suppose we should turn all the nice brand new Polyclinics, Darzi Centres, Health Centres or whatever they are currently called into jails?

Yes?

But you think all the hospitals in the land will need to become penitentiaries too, to accommodate all the criminals infiltrating the NHS?

eh, My Black Cat?

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

As a witch child, I remember a van with a loudspeaker going round the streets where I lived at a time when there were no elections. It turned out to be some kind of pharmaceutical emergency. The wrong drug had been dispensed and the authorities, the police presumably, were trying to contact the patient concerned before the tablets were swallowed. I have no idea of the outcome. However, it did make its mark on The Very Young Witch Doctor that a pharmacist’s job was a responsible one and that losing one’s concentration for a moment when dispensing could have serious consequences.

Errors do happen in pharmacy as they do in medicine.

As they do in all walks of life.

Sometimes they are very bad errors.

There was a time The Witch Doctor used to have to calculate and draw up doses of a drug to be injected into a patient. The circumstances were such that the wrong dose could have been fatal. The patient had to be seen first before the decision was made to proceed. Some patients ramble on incessantly. The Witch Doctor always asked every patient receiving this drug to go back into the waiting room and explained it was because she needed all her concentration so that no errors were made during the calculation. Funnily enough the patients understood this approach and seemed to welcome this safeguard. No phones were answered and no-one else was allowed in the room while that reagent was being prepared. Patient or staff jibbering away in the background, however well-meaning, could have caused a mistake to be made.

It is easy to put a mistake down to carelessness.

The Witch Doctor believes there are three main causes of careless mistakes as a result of lack of concentration.

1. Lack of time.

2. Lack of peace.

3. Lack of sleep.

Included in lack of sleep would be prolonged shifts without a break.

Pharmacists need to have a high degree of concentration throughout their working shift. I wonder how many community pharmacists find it difficult to achieve the degree of concentration they require.

Often there will be only one qualified pharmacist in a shop. If that pharmacist has a break the shop has to be shut so they may be expected to go without a proper break for hours on end.

Some pharmacists double as the shop manager. This means for example, they have to deal with staff problems, absenteeism, shoplifting, displays etc as well as all the administrative hassle from on high.

Have you noticed the little consulting rooms that have sprung up nowadays in pharmacy shops up and down the country? These professionals are now are being asked to do the nerve-racking job of making a diagnosis without proper training.

Now, The Witch Doctor is well aware that even with the help of The Book of Spells and millenniums of experience, she could not do all of this safely all of the time.

So, who is to blame if something goes wrong?

Is it the system?

Of course not!

It is the professional negligent pharmacist.

Yes.

But where exactly is the negligence?

Is the mistake the negligence?

Or does the negligence reside in the fact the pharmacist did not refuse to work under these circumstances?

Yesterday Dr Crippen drew attention to a pharmacist who was given a deferred sentence of three months imprisonment because of a serious error where the wrong medication was dispensed.

It is not clear if the pharmacist herself dispensed the prescription although the error took place within her watch.

It seems the patient did not die due to the error but from unrelated causes.

This case is worth studying because it surely sets a new precedent for all pharmacists as well as for many other health care professionals who make a negligent mistake for whatever reason.

The precedent is prison.

All witch children are fascinated by The Moon.

Often they look up in the sky and look sad.

The moon is broken, they say.

No, My Witch Children, the moon is not broken. It is still there. “Hidden in the shadow,” they are told.

Sometimes, when they point to the moon they smile. Then they chuckle.

The moon is mended again!

Children like the big round mended full moon better than the broken ones.

There is a society dedicated to The Moon in Birmingham.

It is really a Think Tank, although Wiki has missed it out in its huge list of UK Think Tanks.

They call themselves The Lunatics. Or sometimes Lunaticks. Or other times Lunar Men and Lunar Women.

Truly.

They invited Sir Liam Donaldson to talk to them.

CRYING FOR THE MOON

Probably they wanted him to help mend The Broken Moon.

(to be continued sometime when the spirit moves me…..)

a red apple ……………………

The Witch Doctor – Link to a random page

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LINK TO UK MISSING KIDS WEBSITE

The European Union have passed a law that requires EU internet service providers to store details of e-mails and net calls for a period of 1 year.

NET FIRMS START STORING USER DATA

The reason for this?

“In a statement, the Home Office said it was implementing the directive because it was the government’s priority to “protect public safety and national security”.

It added: “Communications data is the where and when of the communication and plays a vital part in a wide range of criminal investigations and prevention of terrorist attacks, as well as contributing to public safety more generally.”

However, there was some slippery footwork used to get this law passed.

“Mr Killock said the directive was passed only by “stretching the law”.

The EU passed it by “saying it was a commercial matter and not a police matter”, he explained.

“Because of that they got it through on a simple vote, rather than needing unanimity, which is required for policing matters,” he said. “

So, in European parlance,

COMMERCIAL MATTERS = POLICE MATTERS

It seems as if the EU want to have their cake and eat it, My Black Cat.

Just watch this creep……

Incidentally, if you happened to look at The Home Office Website to obtain more information about these new regulations which were introduced today, then you would likely have been directed to a porn site.

HOME OFFICE WEBSITE LINKS TO PORN

But no matter, the BBC have clarified that there is no Data Mine of web visits, so no-one will know you were there.

Watch that creep too, My Black Cat.

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

On May 19 2008 we said goodbye.

We said he’d be back!

Didn’t we, My Black Cat………

We almost missed his return.

WELCOME BACK SLEEPY BEAR

“You think of course, you who dream of touching hundreds of lives and doing good in this bad old world of ours, that this is a good trade but I assure you that medicine as a profession will not love you back. You can solve the medical problems of a thousand grateful patients but a few hours after they leave the department or are discharged from the hospital they won’t remember your name or even your face. You will be just another bucket of medical care that they received from the tap like any other public utility.”

_________________________________________________

19 MAY  2008

TILL WE MEET AGAIN

My Black Cat, when relaxing, spends time reading Panda Bear MD, a medical Blog from the USA.

You don’t read Panda Bear MD for a quick fix. You settle down with a cup of coffee and allow half an hour or so. Then you read the latest post quickly to get to the factual material. Then you read it again – slowly this time to enjoy the excellent prose. Then you read it once more to savour the prose and the message together. Then again – to decide if what he is observing in USA health care can be extrapolated to the UK today – it often can. And then finally, you surf through his site because by now you are hooked and you need to read some more posts in this exceptional blogging style.

Now there is sad news.

Duty calls. Panda Bear needs to stop blogging.

PANDA NEEDS A REST

“My Good Friends and Patient Readers,

I’ve decide to stop blogging.

Although I have enjoyed writing this blog and mightily appreciate all of you who have taken the time to read and comment upon my many articles, keeping the blog going has taken an appreciable toll on my sleep, studying, and even on my family time. As I am about to enter my last year of residency I will have many new responsibilities to my program competing for my time. Additionally, I have signed a contract for my first job and, as I need to devote my last year of training to ensure that I am completely ready to take care of you, your family, and your friends if you ever end up in a gurney in my trauma bay, I won’t have time to update this thing and I’d rather just end it than let it fade out.”

My Black Cat says Panda Bear MD is the Shakespeare of the medical bloggers.

She might be right.

Sooner or later he’ll be back.

For The Gifted Ones write because they have to. Not because they want to.

_________________________________________________

MARCH 6 2008

ATCHOO!

“Panda Bear MD” is an ever articulate, ever controversial medical blog from far far away.

One of My Black Cat’s favourites.

Panda Bear MD has had flu.

He’s happiest if he has flu while on annual leave.

Sad that!

THE SNEEZE

Here is another Panda Bear with flu.

Poor thing.

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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© Mpz@sapo.pt | Agency: Dreamstime.com
© Ijansempoi | Dreamstime.com

The two questions My Black Cat is asking regarding Common Purpose are:

What is THE conspiracy?

What is the evidence for THE conspiracy?

The two questions The Witch Doctor is asking regarding Common Purpose are:

Why is there A conspiracy?

What is the evidence for A conspiracy?

Do you remember, My Black Cat, the year we flew over to Toronto on The Broomstick?

it was a long time ago, and you discovered A Huge Conspiracy over there.

There was something funny going on with the squirrels.

The squirrels had taken on the colour of witches cats!

And it was a secret. There was nothing on UK radio, TV or Newspapers about The Black Squirrels. You had never come across a book in the bookshops about The Black Squirrels.

Worse still. we knew lots of The Human Kind who had been to Toronto before us and they had talked about their trip to us and showed us their photographs.

But no-one ever talked about The Black Squirrels.

No-one had a photograph of A Black Squirrel. Or if they had, they had to keep it in a secret place. Well away from black cats and witches.

Do you remember how you thought there was A Huge Conspiracy designed to overthrow all The Black Cats of the witching world?

And replace them with vaguely similar squirrels.

You are still a bit wary of squirrels of any hue.

Aren’t you, My Black Cat?

a red apple ……………………

The Witch Doctor – Link to a random page

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LINK TO UK MISSING KIDS WEBSITE

DIGNITAS IS TESTING THE LAW

“Minelli said there should be virtually no restrictions on helping people to kill themselves, describing it as “a marvellous possibility”.

“I have a totally different attitude to suicide. I say suicide is a marvellous, marvellous possibility given to a human being. Suicide is a very good possibility to escape a situation which you can’t alter. It is not a condition to have a terminal illness. Terminal illness is a British obsession.”

A grieving spouse.

How caring.

How dignified.

Extreme togetherness.

“Ludwig Minelli, whose Dignitas group has helped more than 100 mostly terminally ill Britons to die, told the BBC he planned to test the legality of helping a healthy person end their life alongside their dying partner.”

For now……….

And later?

What situation will be tested later?

A grieving son?

A grieving daughter?

A grieving sibling?

A grieving grandchild?

Children can grieve so very much.

And it is so painful to watch the sadness of an orphan.

Children have rights too……

And the sick cost the taxpayer so much money………

Your money. My money.

“Minelli said assisted suicide made good sense financially for the NHS because many people who failed to kill themselves required expensive long-term care.

“For 50 suicide attempts you have one suicide and the others are failing with heavy costs on the National Health Service,” he said.

“They are terribly hurt afterwards. Sometimes you have to put them in institutions for 50 years, very costly.”

No, Mr Minelli, Lawyer of Human Rights. Of the 49 failed suicides, many are simply a transient cry for help.

And no. It is unlikely they will be in institutions for 50 years.

“As a human rights lawyer I am opposed to the idea of paternalism. We do not make decisions for other people.”

God forbid that paternalism might ever get in the way of suicide.

Or murder.

Will the law creep too?

Probably, My Black Cat.

Probably.

Because The Human Kind eventually display their  inate thirst for power in many, many ways.

History has told us this is so.

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

Common Purpose (CP) is an organisation concerned with the development of leaders and was founded in 1988 by Julia Middleton. She became Chief Executive in 1989.

“Common Purpose began in 1989 with four staff, a small office off Oxford Street and a big idea.”

CP Website

Julia Middleton is British, and educated in London, France and the USA.

It is stated in the blogosphere that The Office of the Deputy Prime Minister was associated with CP. John Prescott was the Deputy Prime Minister.

It is also claimed that Julia Middleton was Head of Personnel in the Office of the Deputy Prime Minister (ODPM). The Office of the Deputy Prime Minister  did not come into existence until 2002, long after CP was founded. It was disbanded in June 2006 when it reverted to The Communities and Local Government Committee. Hazel Blears is the current Secretary of State for this Department.

I have no evidence of the claim that claim that Julia Middleton was employed in the ODPM but this information would be easy to confirm or refute from that department.

There is reference in a 1995 article in “THE INDEPENDENT” to a £500,000 donation to kick start Common Purpose.

The article was entitled: “WHICH OF THESE WOMEN WILL BE RUNNING THE COUNTRY?”

JULIA MIDDLETON

Chief executive, Common Purpose

“A communitarian before the word was invented: born in London, comes from Bolton, educated in France, lived in a string of European countries and New York as a child and took a BSc in Economics at the LSE. She is 37, married with four small children and reckons to speak better French than English. She started off in employee relations with the Industrial Society before moving to Petrofina, British Home Stores and back to the Industrial Society, where she launched the Head Start inner cities programme, training unemployed young people. In 1988, she founded Common Purpose, persuading Government and business to stump up pounds 500,000 for the launch of a project that links potential leaders and managers from a range of public and private sectors within cities, and now across cities, through educational training programmes. She has that rare talent to persuade the great and the good – from permanent secretaries to politicians and business managers – to contribute time and effort. Nominated Visionary of the Year in 1992. Frequently head-hunted by the private sector, but not willing to sacrifice her lifestyle and children for money. “What makes me burn is that my own generation must not just drop out of community life and assume that everyone will do it on their behalf,” she says. Obvious next job: head of a major charity.”

Presumably that part of the £500,000 start up money from HMG originated from The Taxpayer.

Presumably HMG felt this money was a good investment for The Taxpayer.

The Website “CP exposed” carries photocopies, which look genuine enough, of documents dated 19 August 2005 replying to a Freedom of Information Request relating to expenditure authorised by ODPM with respect to Common Purpose.

2004/05

ODPM

Central Unit – £3730

Regional coordination Unit – £54,293.38

2005 – August 2005

Regional Co-ordination Unit – £23,406.25

Presumably this was money spent for staff to attend Common Purpose courses.

Presumably the money originated from The Taxpayer.

Presumably the Office of the Deputy Prime Minister felt it would be good for The Taxpayer if some of its employees attended these courses paid by The Taxpayer.

Common Purpose and Common Purpose International are Registered Charities:

1023384 – THE COMMON PURPOSE CHARITABLE TRUST

1056573 – COMMON PURPOSE INTERNATIONAL