Posted by: Witch Doctor | January 12, 2011

Hell mend you all!!!


The Witch Doctor is of the firm opinion that the NHS will perish on the rock that deliberately puts what is effectively a gigantic shark infected moat between the “pathway” from GP to consultant and between consultant and consultant.

This can be translated into between “patient and consultant.”

The creeping path the Witch Doctor can see along will ultimately lead to between “patient and GP.”

But right now I won’t take you to the end of that path because it is not a place you will want to go.

These dangerous waters are called GP Referral Centres. However, for some years now, long before they existed there have been little local puddles with minnows still to grow teeth swimming around in them.

If you are a patient and your GP tells you that you cannot be referred directly to a named consultant but he has to follow “rules” relating to your referral “pathway”, then just ask him what exactly are these rules, who made them, and why they were made. And go home and think about the pathway you have “NO CHOICE” but to follow and what this might mean for your care now and for the future.

When Dr Crippen was around he used to get very hot under the collar about “Quacktioners” the derogatory name he invented for “Hospital Practitioners” from various backgrounds. In the early days they were usually nurses. He ruffled a lot of feathers and offended quite a few. But The Witch Doctor thinks what he saw was the beginning of Creep, although he never used that name, but he was well aware where it would end.

We are now about to see where it will end.

Enter United Health UK the multinational health care system based in the USA.

They, God-Like, are going to improve the “quality of referrals” in the Hounslow Primary Care NHS Trust.

The management – speak has already entered.

They are calling it “a referral facilitation service”

“NHS Hounslow said that the “referral facilitation service” had been developed with local GPs—with the blessing of all the area’s 57 general practices­—and would handle all referrals, including consultant to consultant referrals, from February 2011. It will act as a first port of call for GPs or hospital consultants when making an outpatient referral.”

And then, of course, they’ll come out with the speil:

“Right place, right care, right time”

The jargon of the bullshit!

What a lot of plonkers the Houslow GPs are!

What a lot of plonkers the Houslow consultants are!

What a lot of plonkers the Houslow patients are!

As thick as mince! The whole damned lot of them!

Of course, they’ll be “reviews and feedbacks…”

Of course….

Of course……

And “peer review” too…

Of course….

And who the hell is Nicola Burbidge?

“Nicola Burbidge, a GP in Chiswick, west London, and chairwoman of the Great West Commissioning Consortium, said, “The referral facilitation service will make sure patients are seen directly by the right service, as agreed by local clinicians.

“The new service will help improve understanding of what services are available locally and how to use them, and we are pleased to be working with UnitedHealth UK, who can give us expert support to help us deliver better information about Hounslow patients and their use of hospital care will help GPs become effective commissioners.”

Note the term “local clinicians”

Always, always, always when something stupid happens in the NHS sheep-like clinicians somewhere approve.

But do the majority?

Of course they don’t!

Dr Zorro to gives a clue to one of the ways that the system is used to get the approval of consultants. Carrots in the mince! There are others.

Margaret McCartney has a different way of saying things. She says:

“The mainstay of the current referral system is not designed to benefit patients or doctors but targets. I’m disappointed that GPs have chosen to make it worse.”


Margaret McCartney says she is “disappointed.”

The Witch Doctor says “Hell mend them all” and she made this point before in November 2008 and again in September 2009


If you can access the BMJ here is the full story:


Very sorry, that should read:




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  1. ‘Who the hell is Nicola Burbidge?’

    Don’t know, but she’s got a funny name, which always means trouble..

    I’m just hoping that Labour don’t get back in in Scotland at the May Holyrood elections, otherwise this nonsense will cross the border. Wish I could help you guys. And what a bunch of quislings the Hounslow GPs are. Mark my words, though; they’ll soon be whining when United Health hollow out their practices and sack half of them and put the others on a salaried basis. They’re a bunch of lemmings as well. Quisling lemmings..

  2. WD – like you, Dr No has been watching this creep, which is now gathering alarming momentum, for some time: one of his earliest posts was It’s the Right Care, the Right Place, It’s McKesson!. Maybe they drink a lot of martinis in these places.

    These referral centres are the necessary infrastructure for managed care – and as you so rightly point out, it wont be long before ‘feedback’ will make it clear you can have any colour (sorry – color) you like, as long is it black. And any drink you like, as long as it is a martini. Perhaps that is what United Health dispensed to the Hounslow clinicians to seal their pitch!

  3. How are referral centres and patient choice compatible? you can have any colour that you like as long as it is black…

    Ah well, there is always little Harley Street.

    Dr Phil

  4. […] The Hell where patients have been “reframed” to believe they have “Choice” when they have NO CHOICE at all about which “person” employed by the huge multinational outfit, United Healthcare, based in the USA, reads their GP’s referral in order to make a “Choice.” This person or committee, who does not know that patient from a womble, will chooses for them whether they will be seen by a doctor, nurse, other healthcare worker or not at all. One of the “choices” the patients may have imposed upon them is that the referral will be completely turned down by the, person /committee employed by some outfit like United Heath and bounced back to the GP’s desk. […]

  5. Julie,

    Here is another excitable funny name for your collection:

    Dr Luke Twelves, director of clinical commissioning at UnitedHealth UK, said: ‘I’m really excited about this project.’

  6. Yes, Dr No and Dr Phil, black is the colour (sorry color) of Hell once the fire burns to ashes and the patients discover that the only choice that is left for them is Little Harley Street and for most it doesn’t turn out to be the gateway to Heaven.

  7. […] Hell! “The Hell where patients have been “reframed” to believe they have “Choice” when they […]

  8. […] was intrigued that Houslow was getting into bed with United Health UK, whose parent company is a giant in the USA. She wondered what was going on in NHS Hounslow, and she […]

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