Posted by: Witch Doctor | March 3, 2008

The role of the doctor – the decision makers?



So, My Black Cat, you’ve decided to tell me what the shopping list is about.

You are going to trawl Google to find out as much as you can about all these people.

Why, My Black Cat? Are they very important people?

I suppose there are a few well known names among them including our Red Apple Award winner.

Do they have something in common?



You think they are the chosen ones who will define the role of the doctor, My Black Cat?

This is what they have to do…..

• “To develop a long term strategy to ensure that the NHS has the right clinical workforce available and deployed effectively to deliver high quality services for NHS patients and service users.

• To ensure that the investment in workforce education and training for clinical staff equips them with the skills, competences and expertise they need to deliver our clinical vision of a fair, personalised, effective and safe NHS and provides best value for the taxpayer.

To identify and describe the future roles of clinicians in the clinical team, their career pathways and how they can take on broader leadership roles to transform services.

• To ensure workforce planning mechanisms deliver trainees and a future workforce of the right size and structure and is sufficiently flexible and sustainable to meet the changing needs of patients and service users and changes to the way that care is delivered.

• To ensure education is commissioned in a way that offers flexibility in delivering changing needs and can be measured in terms of quality of output, and funded to deliver suitable numbers of high quality trained staff to meet local needs and patient expectations.

• To ensure that the appropriate operating model for workforce planning and education commissioning is developed and that education selection, curriculum design and regulation are modernised in line with our clinical vision.”

This is a very grand committee, My Black Cat.

Do you suppose they are just deciding what English doctors do?

Do you suppose the doctors in Scotland, Wales and Northern Ireland will all have different roles?

Are there any Scots, Welshmen or Irishmen on the committee, My Black Cat?

What proportion are doctors?

What proportion are patients?

Patients. Not clients.

What proportion are doctor-patients?

Their opinions would be very valuable.

I don’t think you’ve got this right. A committee of that size will squabble or fall asleep.

And another thing – we don’t know the meaning of the word “clinican” any more.

Who are these people?

The word “doctor” or “medical practitioner” is not mentioned.

Perhaps these terms are now politically incorrect.

Perhaps everyone on the skills escalator is a clinician.

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  1. Hi witch doc,

    I heard you got a new broomstick so I hope you won’t take more time putting the tired old feet up after an uncomfortable flight on the old one.

    … and, Well done black cat finding this list. Of course there are 2 good names that I know will do their best to properly define the role of future doctors, Tooke and Hamish Meldrum, but you don’t seem hopeful the rest will do a good job Witch doctor or maybe are you worried they may get overwhelmed by others including the Tesco and Pepsi Cola lady herself (She did Quaker Oates too) She, of course, firmly believes in the skills escalator and the leveling of all heads and will push for both but I don’t think Tooke and Meldrum will allow her, too much to lose … so, she will bend a bit and so will Tooke and Meldrum. The result will be ‘some’ redefinition but not what you would hope for IMO. It’s going to be one tough battle this one.

    I do not know why but the word ‘clinician’ sounds like ‘technician’ to me …someone who is somewhat less than a ‘full’ professional, so, like you, I do not really like it at all. Let’s hope

    BTW, Fidelio’s site has been off air for weeks now.

  2. Hi Sam,

    I’m keeping a hopeful eye on Ribeiro too.

    We’ll see.

    Hadn’t noticed Fidelio was down. Wonder what the problem is? Hope it’s just technical.

  3. You are right, Ribiero will always do his best as usual. We can only wish them well then wait and see.
    (The list is so long, I hadn’t noticed his name was there)

    All the best

  4. Hi,
    You can set yourself up to be sick, or you can choose to stay well.

  5. Sam’s worries are well founded!

    Did you (or your feline friend) notice that there was a ‘Director Workforce Capacity Analysis and HR’ at the DoH?

    I assume her analytical talents will be up to matching numbers exiting the Medical Schools with available training posts! Or is this not her job? If it isn’t, what is? Who did the sums in 2005 and 2007?

    Such advanced rocket science is bound to command the usual massive salary – she is a Director after all – and I assume London weighting!

  6. Yes David,

    Flora Goldhill I think you are referring to. She seems to be a very senior member of the civil service and has been around a long time. Unlike Clare Chapman who was brought in just as MTAS was erupting. I suspect FG was focusing on the non medical members of staff but may be wrong about that.

    I find it very difficult to enter the mind-set of very senior civil servants. Presumably they advise, and if the advice is not taken they do what they are told. Maybe that is too simplistic. That is the reason why I tend to point a finger to the drivers at the the very top – Tony Blair and Alan Millburn and now Mr Brown himself.

    It all depends whether it’s the incompetency or conspiracy side of the fence you’re on. I tend to veer towards the latter in this case and think civil servants have been a bit helpless in recent years because the big picture is so etched in stone. Hubris again!

    It will be up to the senior medics on this committee to fight, really fight for their profession for the sake not only of those coming after them but for us all as patients.

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