NHS Managers are War Criminals

Medicine is often compared to, and seen as, a war against disease. It is an ageless war without end, against a resourceful and deadly enemy.

It is hard enough to fight such a war without having to worry about Fifth Columnists within secretly helping the enemy. Sabotaging the war effort, and costing innocent lives in the process, who are these twisted turncoats? Well, I'll give you a clue - you'll find them in A&E departments across the country carrying their deadly arsenal of clipboards and pens....

It's called 'gaming' - politicians make up daft targets, managers 'game' the system to hit the target, and in so doing put patients lives at increased risk, and the politicians get to tell the electorate how much better everything is getting.

As described in The Sunday Times this week, the think tank Civitas has worked out what those of us on the inside have known for the last few years - that some NHS managers have lied and cheated, no doubt at the cost of patients' lives, to hit political targets. My personal favourite, and I know doctors who's patients have had to endure it, is keeping sick patients in ambulances outside A&E departments until the managers are sure the department can cope and won't breach its 4 hour target. Doubly brilliant for the cunning saboteurs-in-suits, this not only makes it much more likely that the poor punter will go paws-up in the company of the poor ambulance crews (who are not trained for this shit), but it has the knock on effect of fucking up ambulance response times, so hopefully bumping off a few more frequent flyers before they ever get within sight of the hospital.

But, isn't there a name for such behaviour? Damn right there is. It's called 'War Crimes'(1).

In the War on Disease, an increasing number of NHS Mangers are War Criminals. Let's get the Hague involved. Let's see some inditements, extradite the fuckers, lock them up and throw away the key. And if they 'do a Slobby' and have an MI in custody, then let's hold them in an ambulance outside the local hospital for a few hours just to make sure. We wouldn't want any Dutch civil servants to lose their jobs over a few worthless NHS managers....



(1) I suppose it could be called 'Crimes against humanity', or just plain old fashioned 'homicide', but War Crimes has such a lovely, emotive ring to it.

Dr Otto Chan

By all accounts from doctors who have worked with him, Dr Otto Chan is an excellent doctor. An excellent teacher, a hero even, for junior doctors, and someone who really cared about good patient care.

In fact he cared so much, that according to the Observer, when he found out that 100,000 unreported x ray films lying around for long periods of time unreported, and management's response appeared to be to lock them out of sight of inspectors, he started to get all bent out of shape.

The Royal London management, in true 'shoot the messenger', 'not a team player', 'we need to talk about your attitude' style, fired him for 30 allegations of professional misconduct. None of these allegations were clinical. They were to do with his 'relationship with management'. That would be his relationship with managers who locked unreported films in a cupboard to hide them from inspectors. Managers that did not seem to care that patients lives were being placed at risk, but did seem to care about being found out. Managers who's response to a problem appears to be not to fix it, but to hide it and get rid of the witnesses.

I can only hope that the 'problems' in the relationship were that Dr Chan poured acid over the Royal London's cheif executive's car and boiled his pet rabbit alive, but sadly since the investigation is secret (I love the transparency of NHS management) we may never know.

But no wonder he got fired, because quite frankly there is no place in a modern, caring, patient centered NHS for such doctors. I mean, how is Tony supposed to trot out all those fibs at the dispatch box about the NHS getting better and better if some pesky, jumped up doctor is going to get all worked up about a few thousand unreported xrays being locked away in a cupboard or destroyed.

Besides, as his medical director, Dr Charles Gutteridge (GMC number 2307620, in case you feel like getting a little worked up yourself) points out, the xrays were from patients with the 'lowest clinical risk'. Well, that's ok then. What exactly does he mean? That the doctors caring for those 'low risk' patients exposed them to harmful radiation just for the fun of it. Call me old fashioned, but when I arrange an xray for a patient, I like to have some good reason for it. There are actually laws in this country about ordering pointless xrays - in most hospitals these days you need to sleep with half the radiolographers (of both sexs) just to get an xray request accepted, so the idea that there were 100,000 pointless films just lying around the Royal London would be laughable if it were not so scary.

So, not only do the patients of the Royal London (and they are largely poor patients due to the catchment area) now have to suffer the loss of an excellent radiologist, but the rest of the staff have been sent a strong message about how the management of the Royal London view the toleration of bad clinical care - and the staff had better lump it, if they know what is good for them.

What do you think? Corrupt, sick, twisted, fucks? Keep it to yourself.