Crockard Shit

Crockard has resigned!

So the Crock 'o Shit has hit the fan, so to speak.

mmc360 is reporting that the MMC national director has resigned a day after taking a pasting from the Mums4Medics.

mmc360 are delighted. Dr Rant is more interested in the damning comments in his resignation letter (see below).

• From my point of view, this project has lacked clear leadership from the top for a very long time.
• the overriding message coming back from the profession is that it has lost confidence in the current recruitment system.

Damning stuff. The real question is whether nutters like Pat and Tony really give a fuck. They want control, and the destruction of good health care is a small price to pay for them. Thankfully, bad publicity that they can't spin their way is the one thing Patzy seems afraid of. Which is why she has a string of Lords to roll out as cannon fodder for bad news, while she hides in the bunker. A sort of fair-weather minister.

Here is Alan Crockard's resignation letter to Liam Donaldson, the Chief Medical Officer:

Dear Liam

I wish to resign from my position as National Director for Modernising Medical Careers with immediate effect. I am increasingly aware that I have responsibility but less and less authority.

I care deeply about medical education and training. In 2003 I moved from the College of Surgeons where I was Director of Education to join the MMC team. At the College we developed a competency based curriculum. These ideas rolled over into MMC where the team put together the Foundation Programme which was launched in 2005. It also involved coordination of the stakeholders in curriculum development, training the trainers and carrying out numerous road shows to set the scene for consultants and trainees. It is now considered successful and fit for purpose. In addition the doctors completing the Foundation Programme this year seem as if they will match well into the new Specialty Training Programmes.

As a prelude to new Specialty Training, MMC worked closely with PMETB and all the stakeholders to facilitate the new competency based curricula and set the scene for such a radical change in training.

Manifestly, specialty training is an order of magnitude more complex than Foundation, but it became obvious that the MMC team¹s expertise
was less used in planning of specialty rollout. MTAS was developed and procured by DH outside my influence. An email (12 October 2005) to our team made it abundantly clear that Debbie Mellor has been tasked with delivering a recruitment system to recruit junior doctor posts specifically FP1s and ST1s.I am not clear how far you should (or want) to be involved in this. We don't want to tread on any toes, but equally we need to be clear about what level of autonomy this Programme has.

The MMC programme has been the subject of an OGC Gateway Review in September 2006 (DH331), they concluded "that the programme has made
significant progress since the OGC health check in August 2005". The report overall was supportive of MMC, but there was one serious red risk. This was to identify a clear break point for the MTAS project beyond which the contingency arrangements should be activated. It
also commented on the unclear leadership between DCMO and two senior responsible officers. From my point of view, this project has lacked clear leadership from the top for a very long time.

Moving to the last few weeks, I have become increasingly concerned that the well intentioned attempts to keep the recruitment and selection process running have been accompanied by mixed messages to the most important people in the whole process the young doctor applicants. I realise that the service must continue to allow patients to be treated and I know little of the law, but it seems to me basically unfair to advertise the possibility of four interviews and then suggest that these might not be honoured. Equally devastating would be the suggestion of some stakeholders, that the completed interviews be discarded and the process be rerun. I accept that in many areas and in many specialties, this round of recruitment and selection has been acceptable. But the overriding message coming back from the profession is that it has lost confidence in the current recruitment system.

With my very best wishes.

Alan

The story has also made today's Telegraph and Times. The Telegraph also has an excellent Back our Doctors campaign.

Put yourself in your doctor's shoes

Our darling New Labour government has been intent on centering health care entirely around the patient over the past ten years. There is a 'slight' problem with creating a patient-centred market based approach to running the NHS; this is based around the fact that the NHS is a nationalised system which has to ration healthcare and if this rationing is to be fair then it cannot be driven by patient demand. Unfortunately either New Labour didn't understand this simple little conundrum or they are deliberately trying to privatise the NHS, you can decide this for yourself.

As the NHS has rather limited funding, part of the system has to give; it is certainly not Gordon's purse string that relent under the pressure, they only relax to fund management consultants, QUANGOs and other hare brained centrally funded initiatives. Gordon would never release extra funds to pay for essential frontline services, he is modeling his regime on Kafka's castle after all; so if you have varicose veins, an inguinal hernia or a joint needing injection then you might as well forget it on the NHS. However if you want to complain about this situation then there is certainly no shortage of agencies who will listen long and hard, before telling you to f*ck off with you hernial sac between your legs. This is Gordon's brave new NHS.

So who do the patients vent their anger and frustration on when they have to wait unacceptable lengths of time for scans, operations or appointments? Who has to put up with untold rudeness, verbal abuse, racist abuse and physical abuse when they are trying pretty damn hard to do as good a job as possible for their patients?

The doctors, nurses and other health care workers on the frontline have to, that's who.
Undoubtedly society has changed since the NHS was founded, but care is now 'demanded' and 'an indisputable right'; whereas it used to be more appreciated and gratefully received. The current situation is clearly unworkable as the government loves to build up the public's expectations and demands for health care; but at the same time this very same government is enforcing crippling deficits on trusts up and down the country. The government's 'patient is always right' motto is creating an American style belief that they have a 'right' to whatever they want out of the NHS; and this only encourages a very selfish, obnoxious and unpleasant attitude in patients.

Symptomatic of this shift is the focus on 'patient led care' as opposed to 'physician led care'; this politically correct shift to one extreme lacks common sense, as it encourages patients to demand care and it reinforces their feeling that a strictly rationed state system must respect their 'right' over everyone else's 'rights'. There is clearly a happy medium between the two extremes, despite the government driving for votes with one politically correct extreme. However the government increasingly listens to the manufactured propaganda trotted out by various patient's organisations which echo their belief that 'the patient is always right'.

Bizarrely NHS staff who have to make these necessary rationing decisions are being regulated in an ever increasingly authoritarian manner by the state, which makes their situation over more unenviable. There is only a fixed amount of resources to go around and by allowing staff to be intimidated by patients into practising in an increasingly defensive manner, these resources will be used even more ineffectively.

The politicians have achieved exactly what they set out to. They take credit for any NHS successes which are put down to their expert leadership, while any blame is pinned locally at a nice safe distance from Whitehall. Meanwhile the government's ministries of propaganda spend millions of tax payer's cash trying to smear doctors as greedy money grabbers who want to exploit patients for cash when nothing could be further from the truth. Doctors and the NHS staff in general are trying to provide the best care possible with very limited resources; and these resources are limited because the government has placed artificial financial constraints on the trusts running frontline services, as part of quite deliberate and undemocratic attempt to privatise the NHS.

We have a government here that shells out billions of tax payer's cash on management consultants with nothing to show for it. We have a government that is constantly espousing the benefits of private equity and PFI despite an abundance of evidence to the contrary. We have a government that thinks any combination of 'private' and 'competition' will improve our public services. We have a government that does not show its face in public and that does not respect the views of the electorate. We have a government that has repeatedly lied, deceived and cheated the people it claims to represent.

This government has gone back on pretty much every single promise that it made back in 1997. We now have a state infrastructure that is motivated solely by the pursuit of targets and the acquisition of dubious data, that can be used in the never ending propaganda campaign designed to suppress the real evidence and a proper open debate. Endless cliches about improvement are repeated ad infinitum, while any real evidence of failure is ignored e.g. literacy rates dropping, highest maternal mortality in the EU, science as a subject dying, rising inequality over the last ten years.

So please don't believe them when they pretend to give a monkeys for patients by harping on about a 'patient-led service' and 'patient choice'. They don't give a flying fuck about patients. They only care about one thing; themselves. The 'patient-led care' trick is yet another in a long line of cynical moves designed to catalyse their fast track privatisation of the NHS; while the undermining and disempowerment of the medical profession is all part of the same plan. The NHS is most definitely being led by the authoritarians at the top, do not let them try to convince you otherwise; as then you will be their unwitting instruments:

"For those who stubbornly seek freedom, there can be no more urgent task than to come to understand the mechanisms and practices of indoctrination. These are easy to perceive in the totalitarian societies, much less so in the system of 'brainwashing under freedom' to which we are subjected and which all too often we serve as willing or unwitting instruments."

Noam Chomsky

Call For A National Debate

Dr Rant is today calling for a national debate on politicians 'calling for a national debate'.

• Have you already decided what you're going to do, no matter what rhyme, reason, sanity or the settled will of the people you represent have to say to the contrary?

• Do you have absolutely no personal experience or competence to recommend you for the lofty position that you currently occupy?

• Are you someone who just can't get enough of seeing the smarmy, self regarding, puddle of colchicine-induced diarrhoea that passes for your own face, on the television?

• Is your name Tony, Gordon or Patricia?

The solution to all your problems is a simple one:

Call for a National Debate!

Why not? It would seem that every other fucker's at it!

Does one your American friends want to invade a Middle Eastern country and says that 'if you don't come along too then you're a pussy'? If you 'Call For A National Debate', then you don't have to listen to anyone, especially a few hundred thousand protesters. After all, a democracy mustn't cow to the mob!

Want to privatise your country's healthcare system but other people in your party have the temerity to cling onto outmoded concepts like 'principles' when they should in fact be blindly promoting 'dogma'? Simply 'Call for a National Debate' and ignore the bastards; because anyone who doesn't actively oppose you must be wholeheartedly in agreement with you!

Do you want to introduce ID cards despite everyone else, in the whole country, and their domestic pets, being able to construct a detailed and irrefutable argument to prove that you are wrong and why ID cards won't achieve any of their stated aims? Yes, you guessed it. I can see that most of you have got the message by now............

Call for a National Debate!

With such impressive dialogue between the populus and our elected champions, its no wonder that Britain has become a nation of mass debaters.

Some cynical people have in fact claimed that the government hired Paul McKenna to hypnotise people into oblivious disinterest upon hearing the phrase 'call for a national debate' on BBC news programmes, and to snap out of it on hearing the words '...and finally' or 'here's Carol with the the weather'. Dr Rant would like to refute this suggestion and explain that this phenomenon is due to normal human biology - the remnant of a primordial survial instinct - rather than mass mind control.

To illustrate the point, we appended the term 'national debate' to some famous names and ran it through Google.

Here’s The Dr Rant National Debate Google Hit-Parade® for 2007:

5. Michael Barrymore - 89,300
4. Patricia Hewitt - 345,000
3. David Cameron -1,110,000
2. Gordon Brown -1,150,000
1.Tony Blair -1,170,000


It's a mighty close run thing, but yet again Tony Blair, the least sincere man in Western Europe® 1996-present, triumphs in a bullshitting competition. However, Michael Barrymore's (inset - pictured yesterday) suprise entry at number 5 came as a bit of a shock to everyone, not least Michael himself who declared the result 'alwight' and immediately called for a national debate on Dr Rant's call for a national debate on politicians calling for a national debate.

The bastard.

(Dr Rant would like to commend and validate his own research techniques as being beyond reproach, and much better than the old techniques employed by others in the past. The methodology and findings of this research will be put even further beyond the realms of doubt and cynicism fostered by the forces of conservatism, by an independent review panel that has been commissioned by Dr Rant. The panel will be co-chaired by Dr Pink and Dr Mustard and will include Michael Barrymore. Let that put an end to the matter, anyway it's not like I'm trying to do something trivial like 'Modernise Medical Careers' is it?)

Off target, off message - Missing the Bullseye

From a withdrawn distance politicians glance at the statistics and it appears that everything is going swimmingly well. Target X is being met, Target Y is on track et cetera. Not all is as it first seems.

In quantum physics the Heisenberg uncertainty principle ensures that it is not possible to know the values of all of the properties of the system at the same time; meaning that as one increases the accuracy of one measurement, the accuracy of another is decreased. It is also another well known phenomenon in physics that one cannot observe a system without having unwanted effects on that system.

I can hear our regular readers muttering 'the stupid bastard's going off on one about physics again'. But no, Dr Rant is fact applying logic in a slightly abstract and lateral manner to solve the problems that New Labour are obviously too dim to appreciate.

As soon as a target such as the 4hr A/E wait is applied to a system, the dynamics of that system are changed completely. Priorities and motivations are drastically altered as the target is absorbed into the system, and this adaptation results in the target being a far from perfect measuring tool. Again our political overlords have no appreciation for complex interactions like this, and are very quick to assume perfection in their creation. It's yet more evidence that physics A-level should be made complsory for all politicians.

In context this means that in A/E the manager will be extremely upset if a patient 'breaches' (is in the department for more than 4 hours) even if the case has been handled perfectly from a clinical point of view and the 'breach' was completely unavoidable; this is because their seniors need to meet the targets to keep their jobs. The manager however does not care when a patient dies thanks to being inappropriately transferred to the ward too soon, in a quite deliberate attempt to avoid the patient 'breaching'.

In this way targets imposed obsessively from the top result in a ludicrous and dangerous state of affairs whereby clinical need is ignored in favour of harvesting more political propaganda. In this way the motivation of gathering target based propaganda for spin gets passed down the NHS food chain from the filth at the top.

There is no uncertainty about targets, they should be clearly marked as health hazards. If something doesn't get given a target then it just gets ignored, take the unacceptable waits that patients are currently enduring for radiotherapy for example. The top down control freakery means that managers end up killing patients thanks to their lethal prioritisation of political gains ahead of clinical need.

This is Tony Blair's and New Labour's real legacy. Their thirst for power has lead to patients being sacrificed just so that they can get reelected. It's hard to find the words to sum up just how low these putrid gerbil gropers have sunk. They have instilled a culture of fear and intimidation into all the public services, just to ensure that they are able to collect their propaganda material. Good managers are sacked and replaced with agreeable 'yes men', as quality services are replaced by a network of propaganda factories. And what is their answer to the overt failure of targets? Why yes, more targets! even the under fives are monitored by targets these days.

It's getting worse. No, it's getting better. It's bloody worse. No, it's bloody better. It's fucking worse. Have a control order. It's still worse you know. Right, have a flight to Egypt free on us. I'm no idiot, it's still awful. Enjoy this hot rectal probe for a second. Oh, I see now, it's all getting better, it's our best year ever. Why yes, it is, it's out best year ever!

Like fuck it is. Heisenberg would certainly have had no uncertainty that our government are lying deceitful cunts.

BMA bail from MMC review

About fucking time, the BMA Junior Doctor Committee have pulled out of the review group.

Of course the usual line up of DoH suckups, ivory tower fuckwits, quisling -I'm-just-being-a-good-Nazi bastards, and gong divers have come up with the brilliant plan of making each applicant pick just one interview. After the interviewers were told to keep jobs back for round two, so the candidates don't even know if the job they are going to pick was held over or not.

Stupid tossers.

Here is the BMA press release:


For immediate release, Friday 23 March 2007

BMA junior doctors leave ta=ks on recruitment system

The BMA’s Junior Doctors Committee (JDC) has withdrawn from the review group trying to resolve failures of the Medical Training Application Service (MTAS). The decision was made because the latest solutions proposed in the group were unacceptable to the JDC.

Under the proposed solution doctors would be restricted to one interview. BMA research indicates that this could disadvantage over 11,000 doctors who have been offered more than one interview.*

The JDC believes there are now only two acceptable solutions – for all doctors to be interviewed for all the posts they applied to, or for the whole system to be replaced.
Dr Jo Hilborne, chairman of the BMA Junior Doctors Committee, says:

“We have worked hard wit= the review group to find a solution which would select the best doctors for the right jobs in a fair way. However, we cannot sign up to what has been proposed. Restricting doctors to one interview would not be acceptable to the11,000 applicants who have already been offered more than one, and would now see these opportunities taken away.

“Anything that is not fair on junior doctors will crush morale and drive many away from the NHS. We will continue to express to the government the urgency of a solution that is acceptable to 33,000 increasingly angry doctors whose careers have been jeopardised by this shambles of a system.”

In view of the decision of the BMA Junior Doctors Committee, the chairman of the BMA Consultants Committee will also cease his attendance at the review group meetings.

*Notes to editors
1433 junior doctors who had applied for posts through MTAS responded to a survey on the BMA website. 526 (37%) had been offered no interviews, 388 (27%) had been offered one, and 519 (36%) had been offered two, three, or four, and would therefore lose opportunities under the review group proposals. Extrapolated on the basis of the 33,000 total MTAS applications, this would equate to 11,880. However, it is likely that the figure is higher than this as doctors with no interview offers would be most likely to respond.


Why don't the selfish, cowardly twats in the review group just tell Spewit MMC is dead and get it over with.

Come on, you know you want to.

Honour and Glory

At last, proof positive (if ever it were needed) that, contrary to the age old adage, swearing is indeed both Big and Clever.

Dr Rant is gushing with pride with his latest accolade: The Devil's Kitchen Bloody Devil Award.

"The Bloody Devil Award is for people who fisk objects of public derision but who also pepper the post with gratuitous but intensely satisfying insults."

It's always nice to receive the recognition of one's peers, but especially so when it comes from someone who could rightfully be described as an even bigger miserable bastard than one's self.

If you fancy a view of the world outside of the NHS through similar coloured spectacles to the ones worn by the Dr Rant Team, then you could do alot worse than keep an eye on Devil's Kitchen and it's profane bunch of foul-mouthed ruffians.

Gin-Soaked Journo-Hack Watch

The BBC lead this week with a very shoddy piece on nursing home residents in 'pain'. The evidence of this 'disgraceful' situation is taken from a patients group survey of just over 70 patients, that's solid concrete scientific fact then; my hairy old arse it is. No one wants to see old people suffering, but the BBC doesn't encourage sensible debate on these issues by presenting them in such a flagrantly biased and warped manner. In fact the survey was paid for by NAPP pharmaceuticals and guess what these people make? Yes, they stand to profit from encouraging the use of their BuTrans opiate patches, funny conflict of interest that. In fact the BBC have amended their original article so that it now mentions NAPP funding the survey. However the BBC still do not mention the conflict of interest of NAPP and they do not point out the gaping methodological flaws in the study; the sample of elderly people were not selected at random, they simply went around finding old people who told them what they wanted to hear; truly gutter level 'research'.

The BBC again can't keep away from reporting about NHS staff getting paid properly for the hours they work :"Large pay increases were granted without adequate steps being taken to ensure increases in productivity in return."

Funny how the BBC are very good about going on and on about staff salaries while they very rarely mention the billions being squandered on management consultants, PFI, ISTCs, CFISSA et al. This excellent piece of research by the Manchester Business School shows that PFI is costing the NHS almost half a BILLION pounds more than conventional public sector borrowing would cost!

It turns out that private equity providers, those lovable guys who do so much good for the economy by generously employing people, are making 58% returns on their investment; surprisingly this is nowhere to be found on the BBC. This piece is also on issues you won't find the BBC reporting on either.

What's that I hear you ask? ISTCs providing a shoddy low quality dangerous service? ISTCs are not audited or regulated properly? ISTCs undermining the NHS? No, not on the good old BBC.

"But this is not simply a tale of woe. The unprecedented levels of funding in the NHS have led to real achievements such as reduced waiting times, better cancer services and better treatment of coronary heart disease."

Here's some proper journalism desribing the thousands of cancelled operations thanks to our lovely government, would the King's fund call this a real achievement?

Yep, I've heard those radiotherapy waits are so long now that patients will be dead before they get their treatment, but there is no target for this so it just gets swept under the carpet. Is the King's fund a sub branch of the DoH press office? How on earth can they claim to be experts on the NHS' financial woes, yet they never even mention things such as PFI, ISTCs, CFISSA et al. This next article demonstrates how the financial deficits imposed by central government have inevitable consequences for patients on the ground. See here, here, and here.

The above piece blames doctors for the financial woes of the NHS. May I ask the journalist who wrote this piece what drugs they are on? Doctors are damned if they do and damned if they don't these days. If a doctor doesn't provide a 'patient led' service and tries to ration services, then criticism reigns in from the politically correct 'patient centered' establishment while the patient may complain and the doctor may be sued. On the other hand if the doctor is forced into practising defensively by giving the patient the particular treatment they want, then the doctor is criticised for wasting money by the powers that be; even though doctors have to work under an ultra authoritarian regulatory system thanks to Sir Liam Stalin. You can't have it both fucking ways you amoeba brained weasels! The logic by which all blame is pinned at the doctor's door is utterly incoherent.

This is another hunk of faeces that has emerged from the dark passage otherwise known as the BBC's slimy rectum. Undoubtedly 140 hour weeks should be a thing of the past, however has anyone bothered to think how many mistakes will be made as a direct result of the lack of experience of junior doctors, which is it turn a direct result of cutting their hours massively? No, the focus is purely on how tired the poor dolls are. The negative impact of 48 hour weeks upon junior doctor training and consequently patient care are being ignored at our peril. Just to finish on a quick message for those educationalists who think MMC form filling rather than hands on experience creates good competent doctors.

'I ran out of toilet paper the other day, just a few hours after a rather spicy curry; I needed to think quickly otherwise my favourite tracksuit bottoms would be ruined for ever. I needed something paper-like but that something also had to be 100% expendable and capable of wiping a rather loose motion without any seepage. The answer was obvious, I had a pad of mini-CEX forms close by and they had been developed specifically to withstand copious amounts of nauseating shite being delivered over them. It was also true that these forms were of absolutely fuck all use for anything else, having spoken to thousands of foundation trainees who had unanimously declared them to be about as useful as a white flag in Gaza. They were indeed up to the job and I now have my DOPS and CBD forms piled up next to my Armitage Shanks just in case of another emergency situation. "

Finally, I was nice to see 10 minutes of BBC News 24's 'News Watch' this morning devoted to why the BBC news programs failed to mention 12,000 junior doctors and the biggest protest much in British Medical History. Shame nobody watches 'News Watch', but what the hell. 10 minutes was more than BBC terrestrial news managed in the whole of last Saturday.

Thanks for our 'best ever year'. Here's your P45, now fuck off.

The NHS continues to enjoy its 'Best ever year'. Our beloved leader, Patsy, continues to bask in the glory of an excellently run health service. As we all know, it is so efficient, that we don't need any beds! Medical procedures developing at such a rate that the numbers of bed required to treat British tax-payers has fallen by 31% in the last 20 years.

The latest news is that the NHS is so very good, that it doesn't need any staff! Last year, the number of people working for the NHS fell by over 11,000. This amounts to millions of pounds worth of savings, which can be invested back into patient care. Over 13,000 nurses are set to lose their jobs. And now Modernising Medical Careers will ensure that at least 8,000 (and possibly 16,000) superfluous doctors will be removed from the NHS wage bill. The NHS should be proud of its progress.

Progress my fucking arse. What a monstrous pile of twat.

Patsy is an utter gobshite. She is a soulless, vapid, harridan of a woman, with neither wit nor guile, who, as Secretary of State for Trade and Industry, destroyed what was left of the British Car industry. Now, as Secretary of State for Health, she is destroying what is left of the National Health Service. She has been massively over-promoted. Even her colleagues think that she is 'out of her depth'. She thinks that progress is determined by a reduced number of beds. Doctors and nurses know that a bed reduction means that your post-operative patient is going to be lying 36 inches away from an MRSA+ve dement who is covered in shit.



Dr Rant has a better suggestion. Rather than put 11,000 NHS employees out of work, why not just giver Patricia Hewitt her P45? Better still, why not sack all 419 members of the corrupt, lying government, and stop their underhand destruction of what is left of the health service.

Will the Lying Bitch Hewitt Ever Apologise?

Secretary of State for Health, Rt. Hon. Patricia Hewitt, not apologising to Parliament, 19th March 2007.

Dr Rant does not often read the small print of Hansard, but he was interested to read the report of the debate in the House of Commons on the 19th March 2007 on Modernising Medical Careers. It is fascinating to see some of the responses that the Secretary of State for health gave to some of the questions put to her during this debate.

---------------------------------------

Mr Andrew Lansley (South Cambs, CON): [Regarding MTAS and junior doctors]...will she say sorry to them?

Secretary of State for Health, Ms Patricia Hewitt: It's all the fault of the Medical Royal Colleges, the postgraduate deans, the BMA, junior doctors and hospital employers. The old system must be bad as Simon Eccles says it was. It's not my fault.

Mr Frank Field (Birkenhead, LAB) : Will the SOS for Health agree that the old system was jolly bad for women and Dr Johnny Foreigner.

Ms Hewitt: Oh, yes, definitely. But I refer the Rt Hon Gentleman to the Templeton-Black letters which show clearly that MTAS is designed to make it even easier for bigoted old boy network consultants to keep Johnny Foreigner out of the plumb jobs in the NHS.

Sir Nicholas Winterton (Macclesfield, CON): What assurance can the SOS give that [junior doctors] will have a job next year? The simple thing for her to do is apologise.

Ms Halfwitt: There are most doctors than ever, because we've increase the numbers training [Point of Order! Even though there will be no jobs at the end of training. - Ed]. It's not my fault.

Mr Stewart Jackson (Peterborough, CON): When will the Secretary of State apologise for [this] state of affairs, admit that the Department got it wrong and move on?

Ms Halfwitt: Its the fault of hospitals, not me.

Mr Andrew Tyrie (Chichester, CON): This is an absolute shambles. Cannot the Secretary of State see the scale of it? Will she now, as numerous people have asked, just say sorry?

Ms Halfwitt: It's the fault of the review group, not me.

Mr Tobias Elwood (Bournmouth East, CON): I am astonished to hear the Secretary of State continuing to defend the system when she should be apologising for it. Is the Secretary of State willing to meet [junior] doctors so that she can hear their views directly, and does she agree that of all the cock-ups that the Government have caused in the NHS, this has to take the biscuit?

Ms Halfwitt: I've met loads of junior doctors. And the BMA and royal colleges. And they agree. It's not my fault.

Mr Shailesh Vara (North West Cambridge, CON): One question that has been asked repeatedly this afternoon remains unanswered. I will repeat it, for the sake of good order, and I hope that the Secretary of State will answer it. Will she say sorry?

Ms Halfwitt: We've established an independent review group. Maybe they'll say sorry. Because I'm fucking well not going to do so. In fact, it's a miracle you managed to even get me down here to answer questions, because I always go into hiding whenever the shit hits the fan.

---------------------------------------

Dr Rant would like to point out that a whole section on the MTAS form was about probity. Probity is all about knowing when to say sorry, especially when you've made an almighty fuck-up. And, Ms Secretary of State for health, you have made a colossal fuck-up of huge proportions.

Also, Dr Rant would like to point out the following statements that you made in your answers to the House of Commons:

• The number of training posts available is 23,000
• MMC and MTAS were quality assessed by experts in the field
• The MTAS IT system did not crash
• Candidates applications were not lost in the process
• MMC has been subject to formal quality assurance
• You have met up with junior doctors (other than Simon 'Judas' Eccles)

All of these are incorrect, as can be demonstrated by figures collected by the BMA. At best these points show gross incompetence in collecting your data. At worst, you are deliberately misleading the House of Commons. If Dr Rant made mistakes such as this, he would be struck off or fired.

If you are not capable of doing the right thing by scrapping MTAS in entirety, then will you at least attempt to apologise?



See also Dr Rant: Patricia Hewit is a lying liar and here are the lies she told

The ‘independent’ MTAS review panel

Gordon Brown addressing the New Labour Party Conference in Bournmouth, 27th September 2007

‘Independent’ is another word that has lost its meaning thanks to its butchering by political spin merchants. It is put in front of other words in order to give a false impression of fairness and objectivity; take ‘independent’ think tank, ‘independent’ report and ‘independent’ review for example.

The ‘independent’ review panel was created by the DoH for starters! And guess who has created MMC and MTAS? Why yes, the very same DoH. Do I detect a slight lack of independence here, just an incy wincy bit maybe, just maybe? Then have a look at who is on this review panel; virtually everyone on the panel is either employed by the DoH directly or has openly helped create MMC and MTAS from the very beginning. Only one member of the panel has actually voiced concerns over the implementation of MMC, I would imagine he is just a token dissenter for mere show.

There is no way in the world that this panel can possibly be labeled ‘independent’ to what they are investigating, namely the farcical MTAS. Does anyone seriously think that this group, made up largely of the cronies who came up with the idea of MTAS, will want to destroy their own ugly child? Will those employed by the DoH, therefore angling for peerages and promotions, really want to bite the hands that feeds them?

http://frontpointsystems.co.uk/weblog/2007/03/05/industrial-unrest/

It is very unfair to single out one man, but Alan Crockard is the architect of this whole mess, and if anyone should be resigning it should be him. His single minded drive to force through his mollusc brained love child MMC has rightly earnt the contempt of many doctors throughout the UK. His idiotic ideology is forced upon us via the shiny DoH propaganda production machine and it is done no matter what the cost. He has consistently demonstrated utter contempt for the process of consultation, engagement and reasonable debate that should be obligatory for someone in his position. There are many others on this panel who should not be able to sleep at night for similar reasons.

Depressingly nothing ever surprises me at the overt corruption in politics today. It wouldn’t surprise me if Tony Blair were to assemble an ‘independent’ panel to investigate the Iraq war scandal; it would consist of the ‘neutral’ attorney general, Tony himself and probably an administrator, maybe he’d allow a lay person to sit in and just observe the democratic process in action. These high lords need to brought back down to earth with a big bang. At the very least MTAS should be investigated by a much more genuinely ‘independent’ body, for example the health select committee. Otherwise there may be a rather sharp rise in gun powder sales………..

The Donoughtson Diaries - Week 1

Sir Liam Donoughtson, Chief Medical Officer, yesterday.

'The Secret Diary of Sir Liam Donoughtson - CMO of Cloud Cuckoo Land'

Trouble at Home- Week 1

I’m a pretty busy chap at the moment; work has been especially busy recently, the shiny pamphlet factory is reportedly publishing at its highest rate ever while my attempts to take over the medical world are gathering apace. I’ve even heard that some rather overpaid, arrogant and impudent doctors are refusing to go along with my plans of making the country a safer and better place for us all to live in. It really is a rather typical act of selfishness from a profession that cares only for itself, and if they choose to ignore my brilliance then they will have blood on their hands; just to add that if they did get blood on their hands, then doctors wouldn’t bother washing them and there would be the potential for some patient safety issues there (God, I’m just so switched on to patient safety these days, hard to think of me as a doctor, isn’t it). That makes me think - I must get cracking on that new legislation which aims to lock up all doctors before they get the chance to murder their patients, just think how this brilliant pre-emptive action will make patients safe for ever! Anyway I didn’t want to chatter on about work, I have a more pressing problem a bit closer to home.

The wife, Mrs Donoughtson, has been spending far too much money on the shopping for quite some time. After some hard deliberation I thought of the perfect soltion: one of my colleagues at work has given us our best year ever by using some rather clever thinking, and I have applied this at home to give the perfect solution. I have now hired a few managers who form a network of command that plans and organises my wife’s daily activities, including her cash spending. The new management structure is guaranteed to help my wife work towards greater shopping efficiency. I have also hired a new ‘safer shopper’ who does the shopping instead of the wife, she is however under my wife’s direct command; of course there are checks in place to monitor the content of my wife’s orders (just in case you know, can’t trust anyone these days). The idea behind this is that the ‘safer shopper’ will not get tempted by luxury items at the supermarket, such as extra soft quilted toilet paper and hair dying treatments, hence the spending will be kept to budget. The ‘spending safety’ (lovely title isn’t it) scheme has only been up and running for a few weeks so far, so inevitably there have been some minor teething problems. Initially there were so many different management agencies in place that I couldn’t afford to fund them all for their invaluable work; but having re-mortgaged the house, this problem no longer exists. These financial problems did also mean that the entire family Donoughtson had to go without food and mineral water for two entire weeks; luckily I managed to smuggle plenty of supplies home (from the canteen at work), but unfortunately this was not quite enough to save the family hamster. There was also a slight problem in that none of the management agencies knew who was in charge, so no decisions were being made as to when the shopping should be done; I don’t wish to speak more of this other than saying that this has since been remedied.

Comedian Jim Davidson yesterday

Anyway, there were bound to be troubles with such a complicated and brilliant plan, there always are, people always try to resist genius reform; but I am convinced that this structural reform is the only way forward and we must persevere, we really must, if we are to solve this spending problem. The wife has not been keen with the plan either, especially when the FSDP (final shopping decision panel) gave her only 3 pence for her first week’s budget; but I have assured her that things can only get better (as my favourite D:REAM song goes!). In fact the wife packed her bags and threatened to leave me the other day; I responded by appointing a new management committee to oversee the chaining of the wife to the kitchen sink and as the sink is a safe distance from the phone, there is currently no chance of her scuppering my masterplan for ‘spending safety’. Sometimes a price must be paid for progress, and unfortunately for the wife it is she that must pay the price by sacrificing both her freedom and dignity for the good of the family. I will keep you posted, but sorry have to go now, just got a call saying that my expertise is needed for a certain independent review; when duty calls I always try to ensure that my strategic brilliance gets spread around fairly evenly, the wife may indeed be upset.

Call To Arms!

This Saturday, the 17th of March there will me two protest marches. One in London, the other in Glasgow.

The medical profession has had enough!!

We are protesting about the introduction of a computerised lottery for junior doctors job applications that will see significant proportion of our colleagues unemployed, and a severe degredation of the type and quality of training that those lucky enough to be selected by the computer will receive.

This isn't just about 'protecting' jobs.

No one is asking for more money.

It will affect every one of us who falls ill in the future, and threatens to destroy the one area of health care in which Great Britain still leads the world - medical training. If we don't succeed, there will be no alternative other than emigration for up to 10,000 young doctors who have so far been trained at great expense to the taxpayer.

The government's heavy handed and ill disguised creative destruction of an entire generation of the medical profession is part of a cynical attempt to tame and control 'the doctors' in whom the public rightfully place so much trust. The malignant incompetence and micromanaging control freakery of New Labour and their DoH admindroids must be confronted.

NOW IS THE TIME!

Please join us. Dr Mustard and Mr Salmon, as senior doctors, will be there to give support to our junior colleagues. It's not just for doctors - if you would like to support our struggle to stop this disaster of a government and its handful of traitors from destroying the medical profession as well - you are most welcome. You'll also be in close proximity to several thousand doctors so it's reasonable to assume you'll be safe!

Here are the details.

The march starts at 10.30am, and it is organised by Remedy UK, a newly founded and rapidly growing organisation for junior doctors. The same junior doctors who have been shamefully sold out by quisling medical establishment*.

The revolution starts on Saturday.

*The grass roots are on fire you collaborating bastards, and you can kiss your arses and that knighthood goodbye.

Where's my bloody AK47?

The fucking retards that claim to be our government are off howling at the moon again. This time the target is not doctors, who are marching this weekend in protest at the way the moronic fuckers at the DoH have destroyed medical training. No, this time the target is a group that have so far escaped the target driven culture that is the deluded home of the tiny brained tick box monkeys that the British public keep voting for.

Yes, it's babies! Babies apparently don't have enough targets. Not enough check boxes for them to tick. This needs rectified, runs the thinking at the highest levels of our government.

Wonder why childhood depression is on the increase? Could it be all the stress of the constant exams and assessments? Of course it fucking is.

Noticed how students don't protest at totalitarian government control any more? Is it the secret police having the ringleaders killed? No. Is it because they put something in the student union water supply to fog their brains? No. Is it because they have mind controlling rays beamed at them from Whitehall? No. It's because they are in so much debt to the Capitalist Pig Banks and they spend so much time jumping through fucking hoops just for the chance to get a job with those self-same multinational bastards that they might be able to pay off their student debts and mortgage by the time they are 120 years old.

So lets extend it to babies. You know, the way American immigration policy is that they have to ask a 2 year old if they are or have ever been a member of the Communist party.

Yes, not happy with totally corrupting and fucking up every other public sector, with nurses, doctors, probation officers, police officers, social workers and so on not actually having time to do their fucking jobs because they spend all day ticking boxes to say they are doing their jobs. Not happy with forcing every public servant to lie about how they have done their job on a form that lets Tony Lying Fucker to stand up at PMQs and say how everything just keeps getting better.

But things are not getting better. They are getting worse. They are getting worse because these evil fucks are out of their minds and destroy everything they touch.

I mean, just how the fuck is a four year old supposed to demostrate that they 'respect other religious beliefs'. Do you get to tick the box if the teacher has never seen you torch a Mennonite in the playground? For. Fucks. Sake.

And then they say it's ok to have one teacher for 13 children. So, apart from getting repetative strain injury from ticking 13x500 boxes, the poor twat is going to have absolutely no time to spend with the children. Why not simply put them all in a big padded cage and have people with clipboards watch them via CCTV.

To make matters worse, they are insisting that all teachers teach a certain way. Phonetic reading skills. Not all teachers feel this is the right way to teach reading. Dr Rant thinks diversity in a culture is a good thing, and to bar funding based on an ideological approach is wrong, wrong, wrong.

Where is my fucking AK47? I need to shoot some politicians before it is too late.

Let's Get Physical

en·tro·py

• For a closed thermodynamic system, a quantitative measure of the amount of thermal energy not available to do work.


• A measure of the disorder or randomness in a closed system.


• A measure of the loss of information in a transmitted message.


• The tendency for all matter and energy in the universe to evolve toward a state of inert uniformity.


• Inevitable and steady deterioration of a system or society.

Dr Rant is a child of a different time. A time, if you can imagine it before GCSE media studies and A-level psychology, when studying physics was not regarded as a breach of a child's human rights. Physics seeks to explain the world around us, and illustrate the ways in which humans are able to manipulate the physical world. Physics describes the principles by which 'systems' work and predicts how they behave. The NHS could be described as a system, even a 'closed system', so what can physics tell us about the NHS?

You are probably thinking that given the list of bullet points above that I'm about to make some smart-arse comments about the way in which the NHS is administered - and you'd be right.

Entropy as a concept is central to the second law of thermodynamics. It describes the way in which energy is distributed within a system, and its tendency to spread itself evenly throughout that system. It can be summarised as;

When a system's energy is defined as the sum of its "useful" energy, and its "useless energy", i.e. that energy which cannot be used for external work, then entropy may be (most concretely) visualized as the "scrap" or "useless" energy whose energetic prevalence over the total energy of a system is directly proportional to the absolute temperature of the considered system.

So it would appear that high ENTROPY is bad because it reduces useful energy. It also implies that if a closed system is left alone the energy will become distributed evenly throughout the system, and a lower proportion of that energy will be 'useful energy'. For example, water behind a dam has useful energy, but it wants to flow down hill to the lake below. This useful energy can be removed from the system by turning a turbine to create electricity as the water flows down hill. If the system is left alone, all the water will form a single body of water (with high entropy) and no electricity can be created - therefore the dam is a good idea.

Applied to the closed system of the NHS, it would imply that unless the system is actively managed to separate the 'useful energy' and reduce entropy, then the system will become increasingly inefficient over time. Therefore what is needed is dams everywhere, controlling the flow of water and creating useful energy. Right? Therefore, what the NHS needs is more managers to construct the dams that keep the useful and bad energy separate. Yeah?

If you agree, then you could be a management consultant. You are exactly the type of person needed by McKinsey and Accenture to 'dynamise' their NHS egg-sucking facilitation and assesment programme for grannies. In a few years time you could even be a New Labour Health Minister, providing you don't let common sense, awareness of the limits of your own competence or reality get in your way of course (this seems to be the natural 'career' progression).

Let's face it; those holding the reins of the NHS are either on drugs, or they subscribe to the type of psuedo-scientific bullshit that I've just concocted about entropy. Let me let you in on a little secret.......

I'm talking out of my arse!

I don't know the first bloody thing about the application of the laws of thermodynamics to systems like the NHS. I just have to deal with day to day bollocks and fuckwittery of the never ending reconfiguration of the latest reorganisation of the last reform that the government swallowed hook line and sinker off some day nursery for workshy pseudo-academic adolescents that calls itself a think tank.

Bollocks to entropy! Here's what I really think; every time those of us on the front line manage to make a small silk purse out of the last pile of sow's ears we were given, it's back to square one with the next round of management job justifying shake ups and a even bigger pile of porcine pinnas to work on.

Why not treat the NHS as a biological system. As Jeff Goldblum declares in Jurassic Park;

"Life will find a way."

The NHS isn't a 'closed system', it's a living breathing organism with a beating heart and a pretty good central nervous system in the form of the healthcare professions.

And here's another fucking analogy for you - That living organism called the NHS has been fattened up, and is currently being lead to market by it's substantially less intelligent master. But it's OK, the private sector has got lots of magic beans to swap for it......

MMC update.

This weekend has seen the system unravel. I’m not sure it has been stopped totally but that cannot be too far away now.

Here’s the announcement reported in the Guardian

Lord Hunt apologises "I'm certainly very sorry if junior doctors have been affected adversely in this way and that's why, when it became apparent from the meetings that we had with doctors early in the week, we set up this review."

But this seems rather little, rather late for people who have had their careers torn apart by management incompetence. Vicki Woods in the Daily Telegraph gets the true picture.We’re training doctors for Australia

Jenny McCartney gets the true measure of New Labour folly and incompetence in the NHS in this superb article.

Now if she, and the rest of Fleet Street, follow through, and get their teeth into the other just as incompetently managed NHS reforms then the NHS has some chance of success.

Oh, and it looks like Patsy's been telling porkies. That's a suprise isn't it?

mini-CEX Pest

Modern medicine is all about ticking boxes, meeting
targets and achieving deadlines. So are many professions,
but medicine in the NHS has the unique attraction of
rewarding people who jump through hoops by dumping a huge
amount of shit upon them. Patsy’s modern NHS loves its targets,
and likes shitting on the little people even more.

Look at the recent plight of GPs. The new GP contract was
created and approved by New Labour. A large part of it was
meeting targets, called QoF. These targets were supposed to
be beneficial for the health of the nation, targets such as
reducing the numbers of smokers, placing 95% of the
population on statins, and so forth. The contract was designed
for ‘payment by results’, that is, if targets were met, the GP partner
would receive more money.

This year, over 90% of QoF targets were met by GPs.
So, Patsy et al should have been happy, shouldn’t they?

Erm, no. New labour ran a huge campaign to persuade the
public that GPs were vastly overpaid. This week, GPs were
rewarded by a colossal zero percent pay rise, even with
inflation on the rise. Out of this pay rise, they have to pay
their own staff, their business costs, and their own salary.
So a rise of zero percent is in fact a huge pay cut.

Targets, hoops, pile of shit…

The lost tribe of MMC candidates are starting to feel what
it is like to be given hoops to jump through. Previously, a
surgical candidate has to complete a series of relevant jobs,
get their end of job forms signed off, complete a few mandatory
courses and complete the amazingly difficult MRCS exam. The
current candidates, having passed through all of these hoops, now
have to pass through a series of new ones. Applicants who
have successfully been given MMC interviews have been told
to bring along a series of recently introduced documents, with
snappy acronyms like 'mini-CEX', 'mini-PAT', 'DOPS' and 'CbD' - a revelation that was not immediately obvious or available when MTAS forms were completed. These are all documents that are part of the foundation course, for the new generation of ‘house officers’, or foundation year officers, as they are now called. They have to spend most of their time asking people to sign
these forms to prove that they are able to 'make tea' or 'be nice to nurses' or 'wash their hands' or 'wipe their own arses'. Having these forms signed is now regarded as robust evidence that a doctor is competent.

Now the lost tribe candidates, already having completed their basic surgical training and proved their competence by actually 'doing the business' time after time, are now told to collect new certificates all over again.

Recent candidates have been given interviews with five days notice. Foundation year officers are given around 4 months to collect the certificates.

So, once again, the rewards for jumping through hoops are a crock of shit. Unless the lost tribe SHOs were psychic, utterly anal or had insider knowledge, most would neither have known to, nor had time to complete them. Already, excellent candidates are coming away from MMC interviews, feeling like utter failures, as they thought that the MRCS and PhD would count for something, but were expected to have a 'mini-CEX' instead.

How much evidence do you need of the failings of 'Modernising Medical Careers', and it's sinister intent to make a whole generation of young doctors unemployed, at the expense of the more recently trained 'foundation doctors' who cannot be seen to fail for political reasons.