The I Pay Your Salary brigade, such as our very own resident IPYS acolyte, No-One, are well known to public servants throughout the country. Presumably every country has them, but the British ones seem to be the most rude and extreme ones in my experience. Perhaps that's because rudeness and mistrust are so endemic in Britain. France has the highest levels of mistrust of public figures in a recent study.
Mistrust and public rudeness are very negative things for an economy, business climate, and social structure. Modern economies are founded on systems of trust and when either that trust breaks down or is perceived to break down the economy suffers badly.
Tony 'Scars on my Back' Blair did not trust public servants. Neither did Thatcher. In fact, mistrust and systems-of-control (financial in the case of Thatcherism, structural in the case of Blairism) are central to the Blatcherite ideology.
We see this, in the NHS and elsewhere, expressed as a constant Reform culture. The NHS keeps getting worse, and the current ideology says that this must be due to public servants that are selfish, lazy, and/or stupid. The intuitive solution is: more management.
And yet, as more management is applied, things continue to get worse. So, of course, more management must be the solution. The promised land is just over the next rise! More management! Like the cultists who stuck with their leader even after he falsely predicted the end of the world over a thousand times, the failure of reform to work is seen as a sign that we did not reform enough. The ideology allows no other solution.
And yet, it seems obvious to me that the more reform is applied, the worse things get. Sure, there are some positives - for example, the four hour target has put more resources into a chronically underfunded A&E system. But, on the whole, these positives are accidents. You could have had a far better effect on A&E waiting times, without the dangerous corruption of the service, by simply providing more funding to professionals who were working flat out to keep times down all along.
Meanwhile, the percentage of the NHS budget spent on management continues to climb. And the percentage of time spent by highly trained professionals - GPs, consultants, and senior nurses - on management continues to climb. And climb. And climb. Bear in mind that the NHS budget has shot up so the amount spent on management, as the percentage of that budget climbs, is huge.
At it's inception, the NHS spent 2% of it's budget on management. The Tories never trusted the professionals, and started an enquiry aimed at showing that better management was required and that the professional-led service was inefficient. That enquiry showed the opposite. The NHS was efficient. Nonetheless, the politicians have never been able to believe this. When Thatcher introduced her reforms in the 80s it climbed to 12% of the budget.
But simply trusting professionals to get on and do the best job possible for patients. It is counter-intuitive for people like No-One. They will never accept it. They will continue to blame the 'professionals' for all of the problems. Will the No-Ones of this world every grasp the truth? Will they ever be forced - screaming and kicking - to look into the mirror of their own guilt and folly? History would suggest they will go to their deaths convinced they were right.
I once had fun driving a reverse-stearing Land Rover on an off-road course. The No-Ones, Tony Blairs, and Thatchers are driving a reverse-steering NHS: no matter how often turning the steering wheel left results in the car going right, they refuse to accept that they might be getting it wrong.
In the meantime, I'm going to dream of an NHS utopia with no managers. No targets. No intrusive distrust. A utopia where doctors and nurses get on and do the best for their happy patients.
I'll leave you with one interesting thought: the most efficient health care system in the world is arguably the Japanese one. It's hospitals are almost bankrupt, and it's doctors don't earn much, but it is efficient and popular. Japanese patients beam with delight at being able to simply turn up at a GP clinic during office hours and wait to be seen. They may wait a couple of hours, but they think this is a great system. The GP only sees them for an average of three minutes, but the Japanese love it. I knew a single-handed GP that ran a similar system. His patients loved it, but they were a self-selected group (there was another practice next door that ran a more traditional 10 minute appointment system). I wonder how No-Oneites would feel about such a system? Would they be as gushing about it as the Japanese patients I saw were?
Dr Rant
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Ms Scarlet
Dr Informed
39 comments:
The founding principles of the NHS (comprehensive/universal provision, etc) were only ever sustained thanks to:
* Hospitals being propped up by junior doctors routinely willing to work 100+hrs per week - this changed after the ETWD, of course, but instead of being rewarded, MTAS was foisted onto them.
* GPs who see everybody, and everything and then try and make sense of what is significant and what isn't.
Any NHS detractor would do well to remember the herculean effort put in over the years by these groups, for example, I cannot think of any other profession(al) expected to work twice the number of contracted hours, FOR NO PAY.
I do think NHS managers get a bad press though ?
Some are actually pretty good at providing an overview, getting things done, linking the different specialties together, etc - the problem is they are constrained from implementing ideas locally because of the depressing tendency of the DoH to micromanage everything.
Admittedly, a fair few are crap as well which may be a result of employing too many of them ?
The cultural reference (to the Japanese) is an interesting one, but given NuLabs obsession with rampant consumerism we cannot be surprised if a perctenage of demanding patients confuse NHS clinical settings with the complaints department of a retail outlet.
"Look at the Japanese, they are ALL sheep, why can't you be more like them?????" (Rant the ranter 2008) They did follow their leaders blindly into a war, massacre millions of people, and why? Because they were TOLD to.
That would be typical of you picking one of the most closed, authoritarian cultures on the planet as an example of how the rantletts would like to see healthcare delivered. Congratulations. I also hear that there were few complaints in Nazi Germany about healthcare as well. You should study that system rant, they knocked people off routinely if they complained, would imagine that would be your "final solution" might want to check copyright on the phrase however, seems as though I have heard it before.
The reason we go through continual reforms here is because the service never changes it just says that it will. Many professions work under government rules and regulations, fill in forms, have to account for their actions, and get their jobs done in a timely, orderly, and professional manner. The politicos don't trust you because you LIE to keep from changing, thwart them at every turn in the road, make sure that "we're okay mate!"
When Thatcher and Blair finally called your bluff, saw that the taxpayer would get to a point where they didn't tolerate the opaque way you did business would begin, because even we lower class people travel, to understand that our system is broken and actually crap in comparison to most others and start to ask why. They would have to reform an antiquated system. The patients are starting to ask those questions, your profession is becoming even more insular, reactionary, and unwilling to engage as you protect turf that is not yours, it ours. The rantletts charachterise it as "ungrateful patients and taxpayers", I'd say it's the people paying the bills, and we do rant whether you like it or not, asking why now that we spend more than 10% GDP on health do we still have a crap system? Well, through successive governments the civil servants (that's you rant, notice it contains the word servant) have had the upper hand. They knew that if they dug their heels in used anecdotal threats like "foreign doctors might not be safe! Change could put patients lives at risk" With little or no evidence to support the statement, you could delay, drag your heels, kick, scream and cry long enough to see through a change in government. You have! Congratulations!
The public has every reason to see you as prime suspects in the murder of reform. The evidence supports the fact that you want NO CHANGE what-so-ever. Read this site! It would appear this deflection defence where you try and put the blame on our 1960's style system on everyone but yourself is coming to an end.
Delusion amongst control freaks is not uncommon. Hitler and his regime sat in the bunker until the day Hitler killed himself trying to convince each other they were not the problem, still in control, and the war could be won. Just as you sit in the rantlett shelter and try to convince yourselves that you are not the problem, and the patients will remain sniveling little worms who should be grateful that you and yours would see them for more than 3 minutes, because "as you know you sniveling little waster that's all the time you would get after waiting hours in a GP's surgery in Japan." Patient, "you can tell he's a doctor, he's not covered in shit."
This is a power struggle between you, your 'profession' and badly needed reform. You have a problem however, even the thick, dumb, fuckwit, shit-for-brains patients are waking up to the fact you and your followers are not value for money, its hard to measure your performance (because you don't want us to), and the self-policing of your profession has gone badly wrong, and we are paying with our lives because you as a 'profession' won't drag yourselves into the 21st century.
You are not a patient advocate rant, you are a status quo merchant. Willing to sacrifice lives to hold back needed change.
But you and the rantletts are okay right? You know who the good doctors are, who might screw up a surgical procedure, maybe even kill you on the table. You know which hospitals to avoid, which procedures should be avoided with a specific consultant and that you should seek out the better trained and leave well alone the neanderthal who has not taken the time to become current. The rantletts are okay.
For the rest of us, we should use a dart board since you and the rantletts would rather keep the lid on data, make all the medical decisions for us. Why? Because you don't want to lose control, people might discover that there are wide variations in doctors abilities, even discover where you are hiding the murders you have failed to turn in.
But that's okay. I am off to study a country and it's healthcare delivery that until the 1960's killed children of mixed race, and to this day remains one of the most closed of the democracies where woman are stilled viewed as second class citizens. Please let all of us patients know when you would like us to start using the nazi salute and doing the funny walk. I will start now; I WILL OBEY RANTLETTS, I WILL NOT QUESTION THEIR SUPREME AUTHORITY, DEATH IS LITTLE TO ASK OF ONE SO UNWORTHY OF THEIR ATTENTION, LONG LIVE RANT...............
Charge Nurse - All this idealistic flag waving behind the "founding principle" etc, etc, is just a smoke screen. People used to drive model 'T' Fords 80 years ago, but you don't see any on the road today.
You always try and shroud the delivery of medicine in this wonderful fuzzy cloak that is hard to touch, easy to use as a defence because it has little or no substance. But to use it to defend the status quo is not appropriate.
I commend you on your defence of your system, but think it is slightly misplaced at times. Having said that, I find you to be the most sincere of the bunch. You debate with out calling names and appear to come from a place where you care deeply about your patients.
"In the meantime, I'm going to dream of an NHS utopia with no managers. No targets. No intrusive distrust. A utopia where doctors and nurses get on and do the best for their happy patients."
Does he really mean this? Amazing what you find on a Saturday morning surf. Used to go and see my GP and not really worry too much.
After reading this blog, if you are representative of the profession, I'm worried.
I agree with the Japan post. Having worked there for a number of years, it's not a pleasant place when you dig a little deeper. Would hate for the UK to start and resemble that society.
Little like stumbling on Disney Land for GP's. Will leave you to it.
Very interesting. The only thing I said about the Japanese system was that it was 'efficient'. I think NHS GPs provide a far better service (although, as I said, I have seen NHS GPs that provide a similar type of service to the Japanese and had very happy patients).
What interested me was that No-Troll says the NHS is the worst system, is so innefficient, etc. etc.
Yet, when I bring up the Japanese system he launches into a bigoted diatribe about them.
If the government orders a doctor or nurse to do something (reform) that will directly harm the patient in front of that doctor or nurse then:
1. The doctor/nurse can be a good little nazi and harm the patient.
2. The doctor/patient can refuse and continue to treat the patient as best they can.
To describe the latter as 'lies', 'status-quo' and all that other psychotic bullshit, while SIMULTANEOUSLY ranting about Japanese mindless mass murderers I think shows you up nicely, Nut-One.
As a mother of four children who have needed NHS treatment over the course of their lives, I have found it very much a mixed bag. There are some who clearly enjoying what they do and do it well, the majority who see it purely as a job which is to be expected. Some who just don't want to be there. Reflects life I would say.
I must say I don't recognise either the idealism or the outright pit of disappear that seems to be reflected here by opposing groups.
I will close by saying that my husband and I lived in the US for 10 years, and I found the staff there to be more friendly and attentive than they are here. Also, the hospitals appear to be much cleaner, and I say that from first hand experience of having three children in US hospitals and one in the UK. On those two measures there is a noticeable difference.
Well no one anonymous rant - you out do yourself I see! First you seep across the page with this sickly sweet idealistic view of what the NHS should be. An ideal that can NEVER be achieved, so you have set us up for immediate failure. That positions you to continue the "rant", perfect, well structured. "Oh we should have doctors accountable to no one, and patients who are happy to blindly follow them". The only thing missing are a few lines of cumbyya!
Typical non-reformer rant offer a solution that's not achievable, blame the establishment and quietly put the rant subliminal message in the piece. "patients should always blindly obey."
Your contention that the Japanese system is efficient and bankrupt is bullshit by the way. If it was efficient why would it be bankrupt? I might be psychotic, but I'm not delusional.
Bigoted? No. just statement of fact, but of course you should know that since you have been there.
I'm not the one calling everyone who dares be different from what you imagine life should be like names. That would be you rant. Every once in a while you try and step out of character by writing a piece like to today in a vain attempt to persuade people you are not an abusive bully, but the real you still shines through.
You should stick to the consulting room for conversation where, in most cases, you have the upper hand and don't have to worry about encountering opposing views. Much safer place for a bully. It is interesting how bigots are the first people to label others. Another great tactic, call the fellow some choice names, label him as a bigot. You should be in politics rant. Well maybe not, people would know who you are and I suspect you would cower in a dark corner in case someone stood up to you. Bullies can't stand people who confront them, they would much rather hide in places like this.
the only thing that is 'fuzzy', no one, is the inevitable sensation of jet lag some doctors must have felt after working another 100hr week, most of it unpaid.
Both my parents died under the care of the NHS, my three children were born into it.
No complaints from me, even though my folks had significant ailments (in the end) - I can't tell you how important it was that they both had a GP keeping an eye on things.
By the way I'm not into name calling, the NHS stands or fall by the standards we deliver - I'm sorry that your family has found it so problematic but I have no reason to manufacture compliments about some of the incredibly skillful people I have worked with ;o)
"Your contention that the Japanese system is efficient and bankrupt is bullshit by the way. If it was efficient why would it be bankrupt?"
The Japanese system is efficient.
It is the hospitals providing the service that are close to bankruptcy because the government controls how much they are paid for each procedure
You can be as efficient as you like, if the cost of providing the service is greater than the fee you receive then you go bankrupt.
(Are you really as stupid as your question made out?)
No-Troll,
I find it interesting that you repeatedly accuse Dr Rant of being a bully.
From Wikipedia:
Norwegian researcher Dan Olweus defines bullying as when a person is "exposed, repeatedly and over time, to negative actions on the part of one or more other persons." He defines negative action as "when a person intentionally inflicts injury or discomfort upon another person, through physical contact, through words or in other ways."
Dr Rant certainly abuses public figures, however your posts on here (and the other medical blogs) clearly meet the definition of bullying behaviour.
I'm often amazed at how often bullies cry to their mommys about how they are a 'victim' when someone turns round and give them the good kicking they deserve.
"The Japanese medical insurance system has a unique combination of characteristics that has led to the overuse of tests and drugs, unconstrained demand from patients, and an explosion of costs."BMJ 2005;331:648-649 (24 September), doi:10.1136/bmj.331.7518.648
Doesn't sound very efficient to me rant.
Also, I like how you take a definition turn it around and then arbitrarily exclude yourself! "If you exhibit bullying behavior towards PUBLIC figures , it's not really bullying, or anyone on this site since they are all too stupid to understand what is really going on"
Not sure about the guy from Norway, but the Oxford English dictionary defines a bully as someone who, is "a blustering, quarrelsome, overbearing person who habitually badgers and intimidates people."
Your very powerful position as a medical professional in our society gives gives you the ability to be that overbearing person. You defend that overbearing position everyday by constantly asking the patient to "trust me I'm a doctor". Most people who walk into your surgery are worried, afraid, frightened, intimidated. By controlling the information flows, not allowing appropriate outcome data into the public domain, you keep you position and your ability to bully.
When a person disagrees with you here, you use your status as the author of this blog to badger intimidate and bluster by calling names, calling into question their intelligence, their right to question you or any of your professional mates and getting your "mates" to join in in the badgering, name calling. Does it remind you of a school yard? Were you the victim then rant? Maybe you are using this to get back on all of those you feel have "wronged" you over the years? You're a bully rant of the worst order. You have to hide behind the Dr. Rant name and are too afraid to break cover.
If what you have to say is of such relevance, and it is clear you spend a great deal of time on it, why aren't you in the public forum taking the same abuse as the politicians and civil servants, patients, anyone really who disagrees with you is? At least they have the guts to stand-up publicly for what they believe in. You? You sit here call names from behind the bike shed and giggle when the teacher walks by. I wonder what they call that in Norway?
No-Troll,
Dr Rant lives here. It is the Dr Rant blog. Dr Rant is a fictional character who does exactly what he says on the tin. Rant. If people are going to be offended, then they know how to avoid it.
You are not forced to come here. No-one drags you here at gunpoint and makes you read the posts.
You visit here several times a day and post nasty diatribes on OUR site. We can't avoid you. Your vitriolic posts attacking us arrive in the Rant HQ in tray several times a day.
You obsessively choose never to use a handle to identify yourself, so we can't screen out those emails. You have always posted 'anonymously'. (You call us 'anonymous', but we use nomes de plume to identify ourselves).
It is another feature of your incredibly, nasty, narcissistic, ignorant little personality to think that going round to someone's house and then shouting abuse at them day after day without them every being able to do anything about it makes you the victim.
You nasty, slimy, little fuck.
Nice rant. Abuse, name calling just what one would expect from you. This isn't your house. It has an open door. "I use a nom de plum so I'm okay. You only use anonymous so you are ignorant and not fit to be here"
Rant, you choose to do this in public. Be nasty, call everyone a "cunt" who you don't like or who would dare to challenge what you say. You have chosen to hide behind a "nom de plum". So what. I don't call you names, just describe what I see as the problem with the service, point out when I think your attitude and prejudices potentially inflame the situation or continue the status quo.
You have little regard for anyone except yourself. If you don't want "trolls" like me telling you you are full of shit, get off the airwaves! Go back to whatever rock you crawled out from.
The problem with you rant is that when you have ignorant people who think that rules are for everyone except them in a position like yours, lives are put at risk. The polarisation and hate you display for others cannot be as directed as you state. You hold most people in contempt. Unfit to even think they might have as much right as you to hold an opinion, god forbid, one different from you.
Go on rant publish your real name. Come out from behind the bike shed, stop hiding behind your profession, get some balls rant. Buy a backbone, tell everyone who you are.
I thought you were good at this. You are a rank amateur who can only get a message across with abusive language, bullying and the tactics of an eight year old. Okay, let me come down to your level for a moment. I dare you.
re Anonymous
I wonder what fantastically vital job Anonymous does that he/she can be so dismissive of highly trained members of the workforce. Care to enlighten us?
Sad NHS supporter
Dear Anonymous - mate - the rants take the piss out of public figures who are in turn taking the piss out of you - although you aren't seeing it.
You seem to be taking all of this really seriously and from the sheer volume of posts and PERSONAL negativity you're expressing, you've a lot invested in the replies you get back.
In a Karmic sense this is going to come back to haunt you big time. I think you should back off, re think and save your ass in the long run. I'm worried for you man...
anonycunt
you are a bigot. not to mention a cunt of epic proportions
the japanese are a respectful people. the caricature you deliver serves only to reveal that you are a malignant being
let us hope that as all malignancies do, you too will burn yourself out, choking on your vitriolic cocktail of mendacity and self delusion
and did i mention that youre a cunt
Hmmm.
Let's see. Dr Rant. I wonder what kind of chap he could be? Sounds like a mild-mannered sandle-wearer to me.
Poor Anon. What a shock it must have been to find out that 'Dr Rant' was in fact quite an angry chap who was tearing into politicos. Who would have guessed it?
Feel pity everyone for poor Anon. What an unimaginable trauma it must be, being forced by external mind-control to come here ten times a day and be subjected to abuse by that awful chap.
I mean, it is not like Anon in any way provoked a response. A totally innocent chap, our Anon. He humbly and quietly states his simple views, without any attempt to upset anyone, and is set upon by Nasty Doctors.
See, Anon, you were right all along! Those 'professionals' must be evil because they were nasty to you. You, who has only shown them Love.
Ah, my poor anon. There, there. Hugs and cuddles for poor Anon. Bless.
Ah, the rantletts. Each with his own form of turrets. Big word big word, CUNT!
I had not realized that rant-o-matic grouped you together by mental age, about eight as far as I can tell.
No pink I don't sit here and believe every hate filled sentence that rant writes and immediately break into chords of "hail rant, hail rant".
The posts here speak volumes about the immaturity, lack of respect for others, complete lack of professionalism and disregard for the people who you are supposed to serve and the ones who pay your bills. I suspect the problem is much wider than this blog.
Walk into any part of the NHS and the patient might as well be invisible. It is becoming increasing clear to me that the doctors are the problem. Whether you admit it or not, and won't because you will have to accept responsibility for something, you are the leaders of the medical community. Go on hide behind the government and it's rules, hide behind people you label cunts and trolls, don't take any responsibility what so ever. The government and the users of the system have finally called bulllshit on your behavior.
Have you noticed how the attitude in the last few years about doctors has changed? Until recently 90% of people followed you blindly, supported you 100%. Now a majority, think you are a bunch of self-interested money grubbers. Why do you think that is? The government? The troll, cunts, bastards? No rant it's you and your mates and your attitude. You are an entrenched bunch of dinosaurs. The fact you are fighting on all fronts, patients, politicians, nurses, face it, most other segments of society and the fact you write this rancid blog is proof that you have lost it.
If you don't want to change, have an easy life, create that idealistic place rant outlines in his latest post, buy an Island, take one of those jobs you spoke about in the US. Quit the profession, you can be one of the 30% of doctors the BMA has been saying are going to quit for the last 5 years, and haven't. They badly need someone to quit so they don't look like such huge liars.
Hide behind your nom de plums,continue to harass, and bully those who don't agree with you. That's most people really.
Face it boys and girls, the reason you fight so hard for a way of life that has its roots in the 1948 NHS is because it is easy, you don't have to worry about being measured, you answer only to yourselves. the problem is not Blair, Thatcher, the list goes on.... It's you!
If you really had compassion for the patient, a spinal chord, any commitment at all, why didn't you create the rantletts in a public forum? Disclose your real names? Why do you hide behind your "nom de plums"? Is it because you might lose your job? I would imagine that would be your prayers answered since things are so bad for the poor doctors! With his ability to drive a range rover with the steering the wrong way, rant could go to Africa.
On the Japanese, I have a Japanese wife and lived in Kobe for 6 years. The Japanese are very polite on the surface but as a society, not far under the surface you will find bigotry. They tolerate foreigners but rarely allow them to integrate fully into the society. They still treat mixed race children badly or ignore them. My wife and I moved back to the UK 4 years ago so that our children could get away from the abuse they were experiencing in Japanese schools as they were mixed race. The Japanese you meet in the west typically move here to get away from the oppressive nature of the Japanese society. It is like the UK of the 60's and 70's. You would always have people stare in disbelief if you walked down the street as a mixed race couple, in some parts of the UK that still applies, it wasn't done and you were kept at the periphery of our society. So, who ever you are, once again your idealistic bullshit is well off the mark, I would call you an "ignorant cunt" as it would apply but that would be immature so I won't.
Anon, I hope your children have found respite from persecution in the UK. But is there any chance that YOU could fuck off back there?
"Have you noticed how the attitude in the last few years about doctors has changed? Until recently 90% of people followed you blindly, supported you 100%. Now a majority, think you are a bunch of self-interested money grubbers. Why do you think that is? The government? The troll, cunts, bastards? No rant it's you and your mates and your attitude."
Personally I'd have thought such a dramatic (and arbitrarily determined) shift in public opinion is unlikely to have occurred spontaneously. Have doctors suddenly become more obsessed with money/prestige? I doubt it. What then precipitated this shift in opinon? Sorry I'm going to have to go with the meedja. Certainly not irksome trolls such as yourself. You're merely a nuisance that (seemingly) must be tolerated. I don't say this because your views are different, it's because you're a fanatical wind-up merchant.
You can't argue or reason with malignant stupidity. I give A&ECN credit for trying, but frankly you'd do better trying to reason with a toddler.
No-one is a troll and will post anything to try and get a rise out of someone.
He's a grade-A, ocean-going, copper-bottomed prize dunce who is illiterate for the main part, paranoid, deluded and bit of a sad case. He thinks that armed with information that he doesn't actually understand he is a savvy healthcare consumer, rather than the sort of ignorant prick who holds court in the corner of the pub putting the world to rights.
Tragic, really.
www.youtube.com/watch?v=X3Hg-Y7MugU
Well well rantletts - it is apparent you can't stand opinion that does not reflect your point of view. Just as the child does who has no real basis to avoid what he or she has been told to do, you fly off the handle, go into uncontrollable rages, call names, insult, try and manipulate. Why? Because your reasons for not doing what is asked of you are baseless, immature, self-interested.
The reason you are not held in very high regard by the public? Generally people are starting to see through the "we need more money argument", or "the government targets and red tape keep me from being a good doctor". The people you are preaching to have to live their lives within their means, can't blame all their problems on money, come out with baseless arguments like "it might put patients lives at risk". On a daily basis, put up with the red tape and get on with things without calling everyone who disagrees with them a "cunt".
You do, just did. What I say is true and you know it that's why you can't defend the behavior or even try to, and the reason it stirs such emotion. Your intransigent stance against the system is one of the reasons it is the way it is. Why waiting times are higher here than in any other western country. Why outcomes for stroke, heart disease and cancer trail most western countries with the exception of some of the new soviet entries, even though we have doubled the amount of money into the system, 70% of which went into the staffs pockets. That would be you.
I am tired of the woe is me I'm a doctor act. Tough shit folks, life's a bitch, deal with it get on with your job, grow-up and take some responsibility for the system that you exert so much control over. The patients are the losers here and you know it but seem not to care.
The ranletts were the ones who decided to have this debate in public, call names, question intellect, family heritage, bully, and badger. All "regimes" who had little moral authority or were merely there to take advantage of peoples fears and needs through keeping them ignorant act the same way. Hitler, Stalin, Moa, rant .......
Oh my god your a bore.
Do you think anyone on this site will agree with your views?
So what your saying is, on the one hand we are making it all up and pocketing money that should go to patients.
On the other hand, lifes a bitch we all get screwed so get on with it.
Which is it?
You never replied to many of my posts when i challenged you and posted stats to disprove your little lies.
Your now comparing Dr Rants site with hitlers regime?
What a super cock you are.
Please tell me how the medical profession is screwing you over and then we can talk.
How are me and those other working class people who worked hard to get into medical school are screwing you? Tell me again How us evil little money grabbers are taking all yor money and your my boss.
Tell me how the 40 k of debt medical students have means we should't want to get a decent wage so we can pay it off (apart from the extra years at uni we had and thus lost earnings on).
And before you tell me it will be ok long term and i will become a wealthy consultant rememebr i am of the unbabded 21 k a year generation. With unemplyment expected to be 15-20% for my cohort long term and many in sub-consultant posts.
So tell me againi am doing this for the money and to screw people over you litter fucker.
I work my ass off to earn a lot less than you i bet (as your mental illness probably gives you a decent payout from the gov).
I put my heart anf fucking soul into medicine because i love it, i feel a better person for doing it and believe people appriciate me when i do my job well.
Fuck it you re-inflate the old dears lungs and disimpact the old boy while he tells you about the war.
You don't have the fucking stomach.
Tell you what, put your money where your mouth is.
Name and shame yourself first and others may think about doing it too.
As for me, well i will be doing the extra 10-20 hours a week (i'm not paid for) work hard and still fucking study into my 30's so i can keep my job.
Pointless ranting at you really as a) i don't care about your views (just nice to have a rant) and b) your probably a bit dim and thus unable to see 2 sides to an argument.
ah the rantlett tried and tested attack method
1. Tell everyone how much work you do and how hard done by you are and that it is ALL because you love your job and we should all fall at your feet and worship you for JUST DOING YOUR JOB. You choose to be a doc not me. Just another nothing is ever my fault rant.
2. Since we are by definition far more intelligent than the average human being, call into question their intellect. Tell them they don't have the intellectual right to spar with us or challenge our thinking. That's okay here but that attitude as you go forward in your profession will kill people.
I really don't care about all the idealistic bullshit you tend to spew, what I do care about is what you are doing to make it better for patients. It would appear that nothing would be the answer to that question, as all I hear about is how many "unpaid hours" By the way that's how it works in professions you get a salary not an hourly rate. There are a lot of professions out there who work a lot of hours. You wouldn't notice cause you are so wrapped up in yourself, "oh look at me I am lower class Doctor (that makes me really special) and work a lot of hours".
Whoopee shit, so you re-inflated a lung. Think that's a big deal? Want a medal, note from the teacher, pat on the back, large sign on the M4 saying what a great person you are? You did your job, the one you chose to do go paid for it. That's what most people do, and they don't get on a blog and start the woe is me routine, throw their toys out of the pram and act like a pre-Madonna. Grow-up or get out of the profession YOU picked, you might save more lives by doing that.
You seem to have forgotten Keith Joseph as Health Secretary under Heath had McKinsey turned loose on the NHS.
Anyone who knows McKinsey knows they did a major organisational study of Royal Dutch Shell and used it as the template for every other organisation they analysed whether BBC or NHS
If i just did my job more people would die or at least be a lot sicker.
Actually doctors get a salary for a certain number of hours. We do extra due to dedication.
I don't want you to worship at my feet, unless your a hot 25 yr old female with a penchant for medical staff? Worth a try.
I can almost guarantee my intellect is higher than yours, if don't need to question it, all sorts of other people wondered about mine so I got tested at a young age and again for a job i did...turns out I’m pretty smart...even for a medic :)
Being clever and dedicated is what stops me killing people in the main.
Please tell me how my attitude is even close to what you think it is and how it shows any tendency towards harming patients and I would actually consider leaving medicine.
Erm the unpaid hours, the extra study etc IS how i make it better for the patient. Dumbass, how hard is it to realise that by being a good little worker ant i keep the patients alive.
Yes i do my job, but I could refuse to do lots of the things I do every day (without a problem anymore as references don't get you a job).
Actually re-inflating the lung is a big deal, i picked it up on x-ray, i proved all that medical training was worth it and as such a little old lady got better.
Hurmm, nope no medal but the M4 sign would be nice.
What do you get for a job well done? Do you get a bonus? DO you get thanks from your boss? Do you get any sort of recognition? I bet you do ...even if you work at Mcdonalds.
What do we get for doing a job well?
I don't think woe is me, i think ...people look up to me, people want to do my job, people think i'm a nice guy and i'm also pretty good looking.
I do think, what a twat who thinks if i leave medicine more people will stay alive! what a twat who derides the very people who do put the patients first and generally try to dent the optimism of a new generation of medics when he could maybe have an influence on them.
All i think now is i wonder if most patients secretly think like him? Maybe working the extra hours isn't worth it?
nah he is obviously pretty twisted so lets keep doing it.
Please tell me what i should do to make the NHS better? Bar people like you would actually be a start, the small minority who demand more than their share.
As for being lower social class, I do think it does help me. I relate to many patients i see more than some people I graduated with, I worked harder to get through medical school than some (as I needed to earn money) and I did it with idealism in mind not really thinking about reimbursement.
But i guess you have never felt like that so can't understand.
I feel like going back to the random abuse in the profiling post as your trollish ways just make me feel sorry for you which i don't think you want.
I bet it winds you up that we all have a picture in our heads of a man sat in a dark room all alone ranting against the world on various blogs in his y-fronts.
I'm seriously impressed with No One's postings. Even on the mental health boards I inhabit, I rarely encounter someone quite so obsessed with taking his personal issues out on complete strangers. I think a few pills might help. What about olanzapine? Useful for mania, psychosis and aggressive behaviour.
Keep ranting, Rant team.
Nothing personal. I just don't like self-interested obstructionists who made an informed choice to follow a career in medicine, and then once they are there anonymously attack the system they made the choice to join. I assume that with your extensive intellect you were aware that there was only one employer here that would use your services. Let's take that as a given even though many here are good at missing the bleeding obvious. I would agree that from a leverage standpoint having only one place to go in a market is a bad thing for both participants. But all you do here is call the system "failing", admit that people are dying because it is so bad in the NHS, call the people who try and make changes names, insult them, question their intellect. So what does that make you? Far worse people than those you attack.
Your idealistic solutions of "leave us alone to all live happily ever after" is a pipe dream and you know it. Also, for you to suggest that you can run the whole £104 billion system is a farce. Just in the same way you goad those who would dare to even suggest they might have the right to comment on their healthcare, doctors for the most part are crap businessmen, politicians and managers. Someone will get on here and rant about that as most of you are convinced you can do anything better than anyone. Diagnose that.
Again, nothing personal, but all I hear on this site is what are the problems as they relate to you, never hear a realistic solution, never hear how you are going to engage in a meaningful way to effect change, never hear any criticism of you and why you might be a part of the problem as well and how YOU can change, engage, become more positive and work WITH the managers, politicians and others to improve the system.
This place is like an AA meeting where none of you will admit you have a problem. Talk about psychotic behavior!
Ah the diagnosis is correct.
He may well be a paid troll!
Starting ranting when he gets into work and as has been said no posts by him in the evening (watch this change tonight to "prove" he is a proper troll).
Ah well funs over, time to ignore him.
As predicted, the rant rule of ranting number 3 - when all else fails IGNORE THEM!
Re Anonymous
You maintain that we are all ignoring what you say. Just as you continue to resist telling us what YOU do that makes the world such a better place, and allows you to dismiss the views and concerns of the trained and experienced.
Or are you continuing to ignore that which doesn't suit you?
Just curious
Sad NHS supporter.
**TROLL WARNING**
The Troll identified as 'ANON' or 'NO-ONE' has now been studied closely and has been CLASSIFIED AS A PROFESSIONAL RENT-A-TROLL.
HAVING IDENTIFIED THIS PROFESSIONAL TROLL, WE NO RECOMMEND THAT ALL READERS SYSTEMATICALLY IGNORE HIM. (The fun bit will be watching him escalate things to try and goad people into ignoring this advice!)
This professional troll is being depoloyed against a range of blogs critical of New Labour NHS privatisation policy. Employing professional trolls to damage a progressive blogs message is increasingly common.
HIS MODUS OPERANDI IS TO MIMIC A CONTRARIAN TROLL.
We don't know who The No-One Troll's Employer is, but Nu Labour themselves must be considered a suspect: they have created the greatest political propaganda unit since seen since the Nazi glory days of Goebles and their attempts to control the media agenga include manipulation, coersion, isolation and exclusion of non-compliant journalists, threats of legal action against media companies that run negative stories, and the systematic degredation of the BBC's ability/will to perform investigative political journalism.
There are technical limits to tracking and blocking trolls through blogger, but we are looking at our options.
THIS AUTOMATED ANTI-TROLL WARNING WILL BE REPEATED REGULARLY.
Ah rant is at work. You can tell he has plenty of time to blog. Now he has pushed the deathcon 4 rant blog "ignore the troll" button, the following message will be placed on this blog at regular intervals:
"fellow ranters, you must ignore him, don't let him goad you are draw you into discussing our indefensible, hypocritical position, as you know our argument that nothing is ever our fault is crap. Continue to destroy the NHS from within. Call into question its viability, tell all our patients how shit it is, but remember rants, NEVER offer any solutions! Things might change and we might find our power-base erode even further."
"as you will see rantletts the TRUST ploy where I didn't use ANY bad words was a failure. I will now revert to calling everyone, with the exception of rantletts, CUNTS, BASTARDS, INTELLECTUAL PYGMIES. Has always worked in the past. Let's get back to what we do best follow me!
1. Dig hole
2. Insert head
3. refill with sand
THIS MESSAGE IS REPEATED EVERYDAY JUST READ ANY OF MY RANTS!
This has been a party political broadcast on behalf of the "doctors for no social reform even if it kills people"
Just noticed I have been branded a privatiser. The fact that you have a private practice sitting next to the NHS work is one of the most perverse and destructive of the NHS structural failures. All GP's are private providers. 40% of French healthcare is provided by the private sector. And you have commented recently on the fact that docs leave in droves to work in the US, a private health system. I guess all they care about is the money! Considering you make more that US doctors now I guess that can't be the reason. Since all of your fellow docs are not interested in the money, I can only guess then that the US private system is better than the NHS model.
Won't get an answer to that questions you have me on supper secret ignore and only those with a secret decoder ring will be listened to in the playground, very mature.
What question? You didnt actually ask one!
Oh, and as regards your previous posting, are you on crack?
"I just don't like self-interested obstructionists who made an informed choice to follow a career in medicine, and then once they are there anonymously attack the system they made the choice to join."
Right, so what would you do if you had the brains, stamina and skill to get through medical school?
Would you carry on with the system as it is? Or would that that make a mockery of all your postings about the need for reform? Well?
"I assume that with your extensive intellect you were aware that there was only one employer here that would use your services. Let's take that as a given even though many here are good at missing the bleeding obvious."
Most doctors are self employed GPs or work for the universities or private healthcare companies or is that too obvious a point for you to grasp?
"...all you do here is call the system "failing", admit that people are dying because it is so bad in the NHS, call the people who try and make changes names, insult them, question their intellect. So what does that make you? Far worse people than those you attack."
How have you reached that conclusion? So if you were an airline pilot and the new management consultant in your company thought it would be a great idea to save money by deciding not to buy any wings for the aeroplanes do you think they should be championed and applauded for "fighting to make things better" or should they be derided as fucking imbeciles who have no idea how a plane flies?
"Also, for you to suggest that you can run the whole £104 billion system is a farce."
What is a farce is that the system (when it was run by us) was producing pretty much the same outcomes for about half the running costs it is now. You can throw even more reforms and money at the problem but productivity will continue to decline even faster than it has been doing because your analysis of what the problem is is completely wrong. Sadly you will out of time, money and willpower before you comprehend this (if you ever do).
"Just in the same way you goad those who would dare to even suggest they might have the right to comment on their healthcare, doctors for the most part are crap businessmen, politicians and managers."
Interesting - the GPs seem to be fantastic businessmen to me, see the above paragraph to see how efficient our management has been aginst your alternative. I do however agree with you that we are crap politicians.
"Someone will get on here and rant about that as most of you are convinced you can do anything better than anyone. Diagnose that."
I dont think its hard to diagnose. A UK trained doctor will almost certainly be brighter than you are, will have proved his commitment to work harder than you do, have more social and management skills than you and also have the benefit of acruing a great deal of wisdom that only peer-led medical training can give you. That's why I think in a straight competition I will do better than you. You don't like the thought of that? Live with it.
Oh I'll give you one thing - I can't juggle. I'll give you juggling. Enjoy your minor victory.
"Again, nothing personal, but all I hear on this site is what are the problems as they relate to you, never hear a realistic solution...."
And, nothing personal, but all i hear from you is you bitching about reform is needed without any clear cut ideas or policies to do this apart from some vague rambling about producing mortalithy figures for operations.
So is that it then? Is that your big idea? As we carefully tried to explain to you in the other thread the most likely outcome of this will be doctors and surgeons changing what they do to obtain the best figures - ie - rejecting complex and demanding cases in case they drop down the league table. This will not improve standards - it will just improve the figures the same way it has with the police or teahcers or any of a hundred other examples.
So, bright spark, what other brilliant ideas do you have? Or is that really it?
"..how YOU can change, engage, become more positive and work WITH the managers, politicians and others to improve the system."
Well I think the point is that we understand how the system works - it will only be improved by listening to people who know how it works. Engaging with managers and politicians to facilitate stupid ideas will not improve the system. of course - if they have a good idea like paying Doctors more and restoring more of our previous control over budgets etc. we will be more than happy to engage on such a positive and noble quest.
"This place is like an AA meeting where none of you will admit you have a problem. Talk about psychotic behavior!"
Never been to an AA meeting. What I have come to realise about you though Anon is that you really do not have the first clue about what you are trying to talk about. In your frequent posts you may occasionally touch upon a worthy idea or argument but you can never develop it because you dont understand the topics that you are rabbiting on about.
I myself can get quite worked up on some of the football forums I frequent and I can tell you I havent been impressed with the way Liverpool have rotated so much this season or how we havent given Peter Crouch enough support from out wide or even through the middle.
But guess what? I'm not Rafael Fucking Benitez and thats why my opinion doesnt fucking matter.
There's a lesson in there somewhere. Nothing personal ;-)
interesting points here. clearly there is one nut on here, but i'd think that if he cares so much, rather than criticising he should either get constructively involved in medicine or politics or shut up.
anyway, the interesting point is what is the question of the worth of a doctor (or any professional for that matter)? how do you judge the sum total of good done and sacrifice made by the doctor vs the moral benefits of the job enjoyed by the doctor. i'd suggest that's impossible and that the only way to get that information is to let a perfect market show you. clearly, the nhs/academia can't do that (as they're very far from perfect markets). private medicine is closer but of course private healthcare is expensive. i guess anonymous would feel that i'm a money grabbing doctor to suggest that private medicine has anything good but private medicine reveals what the market will support- and that is expensive doctors.
many nhs consultants look on nhs work as lawyers look at pro bono work. you could argue as nhs consultants they should be spending 100% of their working time on the nhs, but then you'd need to pay them a market (i.e. private) rate- which politically is unaffordable or unpalatable.
the simple truth is most doctors are good people who could get more money by working in a different way. but they recognise that that would mean many patients would go without and so they work harder for less just so more can benefit from them. it's a shame some people can't for whatever reason believe that. it's more of a shame other professions don't work like that either- i could do with an altruistic mechanic/plumber....!!
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