A New Labour Propoganda Poster promoting changes to the General Medical Council, circa 2008
We are now in the last days of of the age of doctors and nurses as Patient Advocates.
The State, and I mean here the Thousand Year NuLabour Third Reich [Surely, Third Way? - Ed], does not like professionals. Professionals are self-regulated groups that operate to a code of honour. Professionals do their best for their patients, not because they are paid well, or because they are 'appraised', or 'monitored', but because they are professionals. Should they fall short of their professional code, they they will lose their honour.
The clash is essentially an ethical and philosophical one. Professional codes are, in essence, Kantian. Something that is wrong is always wrong - such as killing patients. Politicians, however, are basically Utilitarians: things are wrong or right based on circumstances. If killing patients will lead to another term in office, then it is The Right Thing To Do.
The State has had plans in motion for some time now to neutralise these problematic professionals. Firstly, it has reduced the Burden of Proof in professional fitness to practice cases. The General Medical Council and the Nursing and Midwifery Council are already prosecutor, judge, jury, and executioner. The new rules on a 'sliding scale' of proof, now also allows them to decide how much proof is required on a case by case basis. Basically, they can just make it up as they go along.
The second part of the plan is to remove professional self-regulation. Previously, the members of the professional court were elected by the professions. In future the NMC and GMC are almost certain to be run by State-appointed members.
Now, some people will point out that if the GMC had done it's job in the first place none of this would be happening. And you are probably right. Dr Rant has seen two GMC 'investigations' into dangerous doctors up close, and the only thing I can say is that the GMC are utterly useless. Both 'investigations' consisted of writing a couple of letters to managers - the first doctor continued to practice for another two years until someone unrelated to the GMC actually visited the doctor's practice (ie: what I'd call an 'investigation). The second doctor is, to my knowledge, still practicing. You could say that the GMC is lowering the burden of proof because it is too lazy or useless to raise the standard of its 'investigations'.
However, whatever the faults of the GMC and NMC - and they are huge faults - they are less frightening than what we will soon have: The State in control of the professional bodies. The State will control who is prosecuted, for what, and what standard of evidence is required. The State will act as sole Judge, will appoint the jury, and will decide on the punishment.
Leaving aside the fact that lowered burden of proof means that any psycho now gets a 50:50 chance of success from a free shot at any doctor of their choice (and paediatricians involved in child protection are already subject to a co-ordinated barrage of malicious complaints from a small number of individuals), basically if you are a Good Nazi then you will be allowed to practice and if you are not, then For You The War Iz Over.
Agents of The State do not put patients first. Agents of the State put their Political Masters first.
Long Live New Labour!
Dr Rant
Dr Cardigan
Dr Blue
Dr Brown
Rev Dr Green
Dr Mustard
Mr Orange
Dr Pink
Dr Purple
Mr Salmon
Dr White
Mr Beige
Ms Scarlet
Dr Informed
27 comments:
Great code of honor you have. Let's run the waiting list up as far as people will tolerate, then move the ones who can't tolerate the pain anymore (and can afford the bill), no two tiered health system here) onto your private list and pay for the holiday and private health insurance 33% 0f you take out.
Yeah whatever, great code of conduct. the days are over when you can hide behind the government, hospital managers and everyone else you have on your "I hate" list.
And stop complaining about anonymous! YOU ARE ANONYMOUS. Typical two faced twaddle.
Boo hoo hoo, oh woe is me...............
You refer to two doctors who have been "investigated" From your comments I would assume they are a danger to the public. It would appear that you and your colleagues did nothing to stop them from seeing patients.
You have just condemned the system you have spent three paragraphs defending. You have proved that as a profession you are not self-policing. In fact, you will avoid conflict with other doctors to have a quiet life or insure that you continue to receive referrals.
It was a very subtle way to point out that as a profession your code of conduct is worthless. Could it be the government is reacting to a dysfunctional professional structure that routinely outs patients at risk?
no one - unsurprisingly, you are deeply suspicious of professional codes, perhaps you have reason to be ?
But I believe that doctors and nurses are honorable in the main - and don't forget a fair proportion of them use the NHS themselves.
A colleague is being treated for breast cancer to cite just one example.
Maybe you would prefer to turn an imperfect system over to the bureaucrats & politicos ?
Did you see "Taking Liberties" on telly last night ?
NuLabs 3,000 laws infringing some of our most fundamental liberties.
Would you prefer it if they had more of a say in the regulation of professionals as well ?
This lot are willing to frog-march an 82 year old man (and lifelong socialist) out of a political meeting for having the temerity to hold a different view to the platform - bastards.
I charge to be a nurse - I have a real problem with the large pile of shit that was recently dumped on this site by the no one anonymous rant. "If I mess up as a doctor i lose my HONOUR". And the flip side is that we patients lose our LIVES!!!! Typical elitist clap trap. I guess Shipman lost his honour? Did everyone associated with the massacre in Maidstone lose their honour? I am sure the family members are overjoyed that justice was done.
The people on this blog live in the twilight zone. Human life is but a commodity to someone who could lose their HONOUR. Just to let all of you know, the year is 2008, not 1864.
Professionals have nothing to lose by outside scrutiny, if they are not incompetent.
Lay persons have everything to lose with self regulation.
Good riddance to it.
Well put. These people must be incredibly incompetent to fear it so much......
We try to keep our house in order here is a link to current NMC hearings:
http://www.nmc-uk.org/aArticle.aspx?ArticleID=193
You are right to say that some patients will lose their lives as a result of a medical or nursing screw ups - such errors occur in every health system in the world, the NHS is no different.
I dare say you have made errors at work but the consequences are probably different ?
I agree that enquiries (after cock ups) should be as open as possible, but create a climate of fear and doctors/nurses will become increasingly defensive.
Do you really want the sort of litigatious culture that the Americans are so familiar with ?
Professionals have nothing to lose by outside scrutiny, if they are not incompetent.
Lay persons have everything to lose with self regulation.
Horse shit!
If the regulation is incompetent, and politically motivated then you also have everything to lose.
dear dear dear, such rancour !
the problem here is that the examples used - both in this blog and elsewhere - are extremes. using shipman as an argument against self regulation is like using hitler as an argument against elections !
a number of things ought to be reasonably obvious to most people
1
most professionals - note 'most' - are honest and decent people doing their best for the client/patient. no system will protect against genuinely intelligent and informed psychopaths
2
well paid, self regulating professional bodies are inevitably going to attract unwelcome scrutiny from politicians, especially if the state is paying them (excessively?)
3
the issue with outside regulation is that it is potentially open to external manipulation. it also risks not understanding the details and circumstances of the cases in question - and i mean that not as a criticism, rather as an observation of a number of medicolegal cases i have been closely involved in. self regulation potentially works well because the regulators have an intimate, working and detailed knowledge of the regulated. also 'trial by peers' must be respected
4
unless the professional is truly practicing alone - which is nowadays rare - most professional groups will intuitively know who in their number is 'good', who 'bad', who 'dodgy' and so on. harnessing this knowledge is, i think, key in any regulatory system
so ...
full on self regulation of the old-style is gone, both for political and (sorry to say) competency reasons. however, a fair balance must be met, otherwise any new system will fall into disrepute and simply trade one set of problems for a new set
and at all times we must remember that there is a huge difference between incompetence or wilful negligence on the one hand, and bad luck coupled with poor communication on the other
anonymong
"elitist clap trap"
can we safely assume you are a labour voting work dodging benefit seeking class warrior
just because the concept of honour and doing the right thing is an alien concept to you, dont lets judge others by your own gutter standard
This troll is really running himself into the ground.
Covering all the main blogs so quickly!
Funnily enough now with maximum waiting list times the people i know doing private work are as busy as ever.
there is no need to run up a waiting list to generate private work, it is and always will be in demand.
Doctors will no longer be able to hide.
I can;t wait for the day that your turned away from hospital by a triage manager for not fitting into a protocol and see the mess that devaluing the people working on the front line has caused.
Actually M Thatcher began the attack on professionals but backed off when it came to lawyers.
Labour is a Marxist Party that simply wants to eradicate centres of resistance and to impose Gramscian hegemony and Marxist homogeneity by commoditising all professionals so they are certified by The State rather than being qualified by training.
It is remarkable that a bunch of Fremasons like the GMC was not toppled by doctors earlier, but they are a conformist bunch who in the main behave like employees rather than practitioners.
It is not as if many doctors don't simply prefer the regulated lives instilled by medical training in hospitals to actually having to recruit patients who can pay their fees.
The simple fact is that people in this country are slow-witted. complacent bordering on lethargic and assume the ostrich-position whenever sand is available.
Actually GMC is improving.Soon local clinical governance will get more teeth.
The probem is that the outliers eg high prescribers, high referrers, low referrers are rarely the bad doctors. They may be unbalanced, but they usually are making care of the patient their first concern.
I have seen GMC from both sides, having had to respond to a complaint,(dropped after preliminary enquiries) and then having been a specialist advisor on occassion. Most doctors will have to answer 2-3 GMC complaints over their career now.
As far as I can tell most GMC work is about bad behaviour in doctors, and rarely about pure clinical incompetence. Negligence settlements rarely lead to GMC review. It doesn't matter if panellists are lay or not. The lay panellists I met were lay only in that their degree was in something other than medicine. Otherwise they were high achieving professionals often with personnel/business or magistrate experience.
Remember GMC is like a court, not like the police. Courts judge cases, they don't act proactively to prevent cases.
The key thing is that GMC defines the terms of good medical practice. At the moment "Making care of the patient your first concern" is our deontological mission.
When the utilitarian managers make "care of the patient...within budgets" our priority then medicine is lost. It's not yet.
"If the regulation is incompetent, and politically motivated then you also have everything to lose."
The regulation is not "incompetent", nor is it "politically motivated". This is simply the paranoid ramblings of Dr Rant who would like to be obeyed by all and questioned by few.
Well that approach has gladly gone. The GMC have acted bravely and with notable success with regard to child protection and the individuals involved in renowned cases. Their decisions have been models of restraint & erudition and easily show how comprehensive judgments can be made by informed lay persons acting to guide Doctors.
I think the GMC is working and working well & it is hardly subject to political interference.
Self regulation has always been suspect and now is no more. It is quite correct that Doctors should be accountable to an independent body with a majority of lay persons on it.
If you don’t like it Rant piss off somewhere else.
Now that is very interesting, Anon. That you focus on the witchunt against paediatricians involved in child protection.
Could it be that our very own Anon is a member of the small, highly organised, group that have been attacking paediatricians involved in child protection?
If you have had your kids taken off you, then blame The State and its Secret Family Courts, not the medical profession.
As for Dr Rant not 'stopping' the dangerous doctors, what exactly do you suggest Dr Rant should have done? Kidnap the 'dodgy' doc? Have them killed? If the GMC is uninterested, as they were with Shipman, then what can be done?
As for undermining self-regulation, I thought that was one point of the piece: we have had the Old Boys Club regulation, and soon we will have The Agents of The State regulation.
As Dr Blue points out, this is happening for political reasons at a time when the GMC is improving (child protection aside).
Actually, No-One being an child abuser who has lost access to his children would explain a lot. For example: pathological hatred of doctors....lots of time on his hands....poor access to his GP ;) .
Does anyone know what internet access is like in prison these days?
no one anonymous rant - i suspect you will have first hand knowledge of prison soon now that allowing quacks to keep practicing won't be an option. Just the attitude I would have expected from you regarding your quack "colleague". "Not my problem, but by god self-regulation is the only way this will work! Jesus, those docs are killing people! Can't trust those @&@^@%@@ regulators they are all SHIT!"
And you are right, the days when patients will put up with your arrogant attitude, let you treat them with contempt, and hang on your every word is over. Grow-up or get lost.
Fucking hell, Yawnonymous, you're such a ginormous twat. And stupid. Did I mention that you're stupid?
Laypeople have NO business on a medical council, or a lawyer council (if there were one) or anything else that deals with things they don't fucking understand. No it's not fucking arrogance. There are cases I hear of that I could not presume to judge, so complex and grey area are they. How the fuck could someone with NO medical or medicolegal knowledge be able to make an informed decision as to negligence etc? Seriously?
All that would happen is EVERY time someone made a complaint, rightly or wrongly the doc would be struck off because they idiot masses fuelled by the even more imbecilic media would want it. Not because it was necessarily justified. And guess what?
Any chance of having a non-adversarial, open disclosure system where patients actually get some answers and doctors operate under transparency would be lost, forever.
I work in New Zealand at the moment. You cannot sue a doctor or nurse here. There is a government body called ACC that pays out "no-fault" compensation in the event of a medical mishap. This way, the patient always gets an appropriate amount of compo, without having to go through hell and the courts, and the doctor does not have to work in fear and practice defensive medicine and constantly cover his/her ass.
This is common sense operating. Your emotive and cretinous "Lynch the bastards, they shouldn't be afraid if they have nothing to hide" is absurd and makes me laugh at your low IQ. Get a brain and a life.
Oh and incidentally, waiting lists are long because of the NHS, not because evil doctors stroking bald cats are sitting behind desks lengthening them to charge people more. You don't even understand how systems work, do you. Muppet.
Oh Dr Rant, No I'm not a member of the mythical "witch-hunt" against Doctors nor have been to prison, but your posts beautifully confirm the deluded nature of your "professionalism".
And you are a nasty little "professional" aren't you rant? How quickly the façade of “professionalism” falls flat when questioned. A “highly dedicated professional” accusing others unknown to him of child abuse because they disagree with him.
If ever anyone wanted proof why individuals such as you should be kept in line, the previous few posts suffice.
drjanedoe, you grossly over-estimate your abilities and underestimate the abilities of lay-persons to comprehend medical facts. I suspect there is little in the field of negligence which cannot be grasped. The GMC now has lay people on its board and do not strike off Doctors after “every” complaint.
I don't think anyone has claimed Doctors should by “lynched” although your obviously high IQ has not noticed that.
HE is still too stupid to think of a name so we don't just think he may well have multiple personality disorder.
Strange little one this "Anon" is...are you going to keep me inline little one?
Lets see you try, maybe i should stay in line.
Fuck working exstra hours to make sure patients have things they need before i go home, bugger doing extra skills i will probably never need just in case some cock like you need them, beware self directed life long learning...i can hand you over to the nurse specialist a few hours after it would have been of any use anyway because i "didn't do the course" (i don't do most of them yet funnily enough i still am expected to do the hard procdures).
Tell you what if i (and my peers)were kept in line you would loose out more than we would.
Do you notice that even the little wankers like you and those drunken idiots who are clogging up A&E still get treated well? Thats because we care and want to do our jobs well.
You on the other hand must take great pride in staying within the lines when you colour in your book.
Let's face it rantletts. You are the most unreformed group of medicos on the planet. Even the Pharma co's will tell you that when it comes to taking up new drug therapies, the UK doctor is the worst, and that's nothing to do with NICE before you blame them. Until recently patients were left in bed for weeks after short stay surgical procedures because you were too lazy to learn new and improved techniques. Hip surgery UK average length of stay? 14 days. Rest of the western world? 3-5 days. MRSA rates outside UK? Significantly lower. Why? Because the rest of the world is not concreted in a 1960's medical provision model because the medical staff are so entrenched and noncompliant.
You hate politicians because some have started to shine a light in the dark little recesses where you hide. It is only going to get more uncomfortable as more data becomes available about your performance. That will piss you off. Until now you have controlled the information flow to keep your patients ignorant so you go on rants about how thick we are and could never understand your complex world. Arrogant elitist crap merchants. Leave the profession now before you end up on the new BBC programme "Let's expose the quack".
On your point that the NHS is the reason for waiting lists, just let me say that the number of Phaco's done by eye consultants in the NHS was 1/3 the number they did in the same amount of time in their private practice and that's across the NHS. Why did they allow people to suffer? MONEY MONEY MONEY.
People die every day in the NHS because you won't reform and there isn't any meaningful measurement of what you do and the outcomes you achieve, or don't.
I don't respond to Trollonymous to try and educate him - after all, he is simply a loud stupid little fuck -but just to rebut the rubbish he spouts in case anyone else should be taken in by him.
"You are the most unreformed group of medicos on the planet."
I'm not sure what you mean by 'unreformed'. If you mean 'not having gone through reforms', then we are in fact probably the most reformed group of doctors in the world.
ie: You are a stupid lying little ignorant fuck that just makes stuff up all the time.
"Even the Pharma co's will tell you that when it comes to taking up new drug therapies, the UK doctor is the worst,"
Er, why would you want to do what Big Pharma wants?
"and that's nothing to do with NICE before you blame them. "
Actually, it has everything to do with NICE.
ie: You are a stupid lying little ignorant fuck that just makes stuff up all the time.
"Until recently patients were left in bed for weeks after short stay surgical procedures because you were too lazy to learn new and improved techniques. Hip surgery UK average length of stay? 14 days. Rest of the western world? 3-5 days."
I don't have the figures to hand for this, but since you are known to be a lying, stupid, little fuck who makes stuff up I'll assume that these figures are made up as well. Feel free to link if you feel this is unfair (you stupid, ignorant, little fuck).
What is wrong with a longer stay per-se? Perhaps the shorter stays are to save money but have worse outcomes.
"MRSA rates outside UK? Significantly lower. Why? Because the rest of the world is not concreted in a 1960's medical provision model because the medical staff are so entrenched and noncompliant."
Er, no (again, sigh). MRSA rates are higher in the UK because bed occupancy rates are higher, because all the beds have been closed by tax-cutting scum in power.
ie: You are a stupid lying little ignorant fuck that just makes stuff up all the time.
"On your point that the NHS is the reason for waiting lists, just let me say that the number of Phaco's done by eye consultants in the NHS was 1/3 the number they did in the same amount of time in their private practice and that's across the NHS."
Again, you just made this up.
ie: You are a stupid lying little ignorant fuck that just makes stuff up all the time.
However, as I have said so many times, we will all be getting the type of Health Service that Trollonymous so psychotically wants.
It's a shame that tens of thousands need to suffer and die simply to prove Trollonymous wrong, but that's democracy.
"Oh Dr Rant, No I'm not a member of the mythical "witch-hunt" against Doctors nor have been to prison,"
I knew it was too good to be true!
Still, it was a nice image while it lasted.
no, no one anonymous rant - everything you just said is a lie! two can play that game ass wipe.
LOS on total knees and hips is a FACT. Look it up you have the superior intellect.
We have more hospital beds per thousand than anytime in our history, will concede on the wards issue but that is mainly because all your consultant mates insisted on "their own space" in the new hospitals. Recreated the 1960's hospital ALL over again. Ignorant rant.
Eye surgery figures are a FACT you lay in your link to PROVE they are not you over paid lazy quack.
1) Could anonymous either set up his own website so that he can more easily be ignored, or learn to be concise?
2) The G.M.C. are a bunch of wasters. Do they think we are thick. The few who do not instantly bin their areswipe junk-mail will see the standard format for lying propaganda:-
"Your licence to practice" ; "Your Racist database"; "Your G.M.C," and so on. No gitface it's not mine it's the Fucking Governments. Just like "Your M&S" isn't yours it belongs to the shareholders. The G.M.C. is part of the Fucking Government and belongs to them, the liars. Fuck them.
The most deluded part of our scociety right now are the doctors. They still beleive that people will idealistically folow them blindly even if you, the quack, lead them to their death.
Well quack, the party is over. The internet has changed your "profession" forever. Patients now have the information they need to make informed choices. I know you don't like it because the docs who are crap then start to standout. Might lose their job, not be guaranteed an income anymore.
It is too bad that it has turned out many of you are insecure, self-interested, non-caring, money grubbing, elitist, arrogant little shits. We all have our crosses to bear.
I love this blog, enjoy being able to inject a little truth into the constant bullshit that you spread. Wouldn't expect anything less form a bunch of docs. You treat your patients with the same dismissiveness and arrogance.
Wait till they take away your lists. You might even have to sell the third home.
Dr Rant love the posts gave a few grins.
Start to take away the lists?
How are they going to take away private practice? Surely any changes to doctors (as you say making them leave the NHS etc) would drive up demand for private work no?
Ah well your clearly not too clever, in our shiny new hospital there are 200 beds less than in the old one. This is because the new hospital was designed to be "more efficient". However now we have a real bed issue becuase (and i promise us juniors don't have long lists of private work so we really do try and get people well and out asap) its not as "efficient" as expected.
As for number of beds per 1000, we don't have more than at any time in the past (as has been said you do lie so no surprise there).
http://www.nationmaster.com/graph/hea_hos_bed-health-hospital-beds
Number of hospital beds is down by a third in the last 20 years.
http://www.nationalschool.gov.uk/policyhub/news_item/hospital_beds.asp
Oh dear, being proved wrong again.
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