Dr Rant has very kindly given me the opportunity to write a guest column on some of the cutting edge schemes being run up in my neck of the woods, in the NHS North West. My name is Joe Rafferty and being non medically trained, I feel I am perfectly qualified to design new schemes in the area of screening and diagnostics. It has been long known by us NHS managers that we know far more about medicine that the actual clinicians who have spent years and years taking exams and studying medicine.I wrote a recent piece in the Guardian and I was pretty disappointed that it got such a cold response from some of you doctors out there. I am not terribly sure what the difference between screening and diagnostics is, but they are definitely in the same ball park, and nit picking over small details like this just detracts from the real issues. In my eyes the real issue is the fact that NHS managers are such dynamic geniuses that they should be empowered to say exactly how healthcare should be run it the future, and PCTs should have more of a role so they can become even more efficient and streamlined than ever before by arranging 'efficiency' and streamlining' meetings, and possibly employing 'efficiency' and streamlining' officers, sorry, I digress.
The whole point is that progress in the NHS is incredibly rapid, and this is because we do not modify policy on the basis of proper peer-reviewed scientific studies, we have a very different approach indeed. The clever expert politicians tell us, the managers, where they want to see policy going; we, the managers, then design some weak studies that will provide some low quality unscientific basis for these policy reforms. In this way those with any knowledge of medicine are completely ignored in forging our new cutting edge ideas such as 'polyclinics', 'WICs' and 'deep cleans'. We also bypass the scrutiny of the scientific community by only publishing our research on the DoH website, after all no journal would have it, I tried MRSA monthly but they told me to sod off. Soon there will be no experts left, as they will have all been replaced by nurse practitioners, and they only know a little bit more than the managers about medicine. The world will soon be ours. Please email me with your questions, but don't ask me what the difference between screening and diagnostics is, that is just a little bit too tricky.
joe.rafferty@northwest.nhs.uk
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Joe, it's good that you are here to defend yourself but I have to say that your article in the Guardian was the most embarrassing thing I have ever read about our NHS. It's no wonder our American friends think that the NHS has a long way to go if they judge it on the basis of the drivel you have written.
People with what might be sudden cardiac chest pain need to dial 999 and get to the hospital ASAP.
Peacemaker: You do realise that post wasn't actually written by him don't you? Ooops.
If you're just stupid you keep quiet and carry on drawing your undeserved income.
If you're spectacularly stupid you write an article in a major newspaper and let everyone know just how stupid you really are.
Do you mean to say, Michael, that Joe's not reading this? Blow!
Actually, I'm not so totally out of touch with reality as our friend Joe. While I was not taken in by Dr Rant, I do find it quite hard to believe that Joe's ludicrous article was not a spoof. I even hope it was. If it wasn't the NHS really is in deep trouble with people like him in charge. As Dr Ray implies he doesn't even know what he doesn't know. And in things to do with medicine it is very important to know when you don't know.
Sorry to hijack the thread, but could people take the time to have a quick look at this. The tinterweb is remarkably quiet on the subject and personally I believe it's something that should be given a lot more attention
http://www.telegraph.co.uk/health/
main.jhtml?view=DETAILS&grid=&xml=/
health/2008/01/28/hmax128.xml
http://21stcenturysocialism.com/
article/
who_will_have_killed_ama_sumani_01598.html
The single most terrifying article I have ever read on the NHS. Thanks for highlighting it Dr Rant!
He does read his emails and respond.
Seems to have a high opinion of himself though:
Can I suggest that you think about reading between the lines? The article is really about the WILL to move the system on from the navel gazing stage of ‘how difficult things are’ to recognise the potential to take big steps forward that will benefit end users. The lack of will is often exemplified by the content of your message, implying mass stupidity, the inability to deal with complexity and that knowledge resides only in the hands of the few. The work we report indicates the potential to create a very different deal for patients and that is the message; the learning it is transferable to the screening agenda.
You might rightly conclude that SOME NHS managers haven’t a clue about the science behind screening. This one in particular has spent many years devising such screening test – unlike MOST doctors. So take some time to think about it – you might find it edifying.
J Rafferty
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