Posted by: Witch Doctor | June 6, 2007

Support Bernard Ribeiro!



On New Years Day 2006, regarding Choose and Book, The Observer reported the following.

Plans to revolutionise the way patients are admitted to hospital have been attacked as ‘Stalinist’ by Britain’s leading surgeon. Bernard Ribeiro, president of the Royal College of Surgeons, said the system would destroy the professionalism of the NHS and put people’s care at risk.”

Strong words.

“Ribeiro said the system did not allow doctors to talk to one another about patients, or for a GP to send a patient to the consultant they thought most equipped to deal with them.

He said that as a consultant surgeon himself, he could no longer find out much about patients who were being referred to him via the new computer system.

‘I simply pick a patient’s name off the list on my screen and put them on my list, whereas before a GP was able to phone and say, “Could you fit this patient in sooner, I’m a bit worried about him.” Now, if I want to bring in a patient more quickly for treatment, it would be quite difficult to do.

‘The system is in danger of destroying our professionalism. To say they will only have this limited menu of choice, and they have to book one of them, is in my view, Stalinist.’



And more.

“Ribeiro, who works as a urologist in Essex, said the system was destroying the relationship between the GP who makes a referral and the consultant who will see the patient. ‘The choice agenda has become mechanistic rather than offering individualised care. If patients feel they are treated as a number, rushed through, it doesn’t engender confidence.’ “


There are many issues surrounding “Choose and Book” that have been criticised, however Mr Ribeiro is raising the most important issue by far. The destruction of the practice of patient referral from one senior doctor to another.

Is the attempt in this, and other ways, to destroy this pattern of referral intentional?

Because of the wider implications?

The Witch Doctor is sure it is.

The Witch Doctor thinks Mr Ribeiro fully understands the importance of the independent medical practioner within the medical profession, he realises how much it is under threat, and he is prepared to speak up about it.

Does he realise how a competency based training open to all and sundry has the potential to destroy the professionalism and responsibility so important for patient care?

Does he realise that GP to Consultant or Consultant to Consultant referral is the one, and perhaps the only way, to retain this professionalism and patient responsibility in the face of the current changes that a controlling government is imposing on the medical profession in the name of modernisation?

Does he realise the dangers of MMC in this regard?

The Witch Doctor thinks he does.

The Witch Doctor thinks he is one of the few who does.

The Witch Doctor wishes his peers would pay attention to what he’s saying and stop, for the time being, diverting themselves into crashing computers and a government that has squandered billions. All very important too. But not nearly as important as the destruction of professional relationships between patients and doctors and between doctors themselves.

Do not let governments, administrators, managers interfere with direct doctor to doctor communications regarding patients.

Do not delegate responsibility for the referral of patients to members of staff who are not doctors.

The referral procedure is the last hold you have on your professionalism.

If you do not retain the referral procedures that have been used up till now, patients will eventually be referred by management teams to any Tom, Dick, or Harry, Health Care Professional who will keep waiting lists down regardless of the consequences.

And doctors won’t be able to do a damn thing about it.

It will be too late.

You will only be needed to take the blame.

Your professionalism must be retained for the sake of patient care.

Without your professionalism patient care will become shambolic.

Shambolic and unsafe.

Click on “The Secret NHS” under my Black Cats eyes to see what will happen if you do not heed.

The Witch Doctor – Link to a random page





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