Lord Mancroft is right and wrong

Lord Mancroft is right when he describes those who cared for him in hospital as 'dirty, drunken, and promiscuous'. I'm sure they were dirty and I'm sure they did talk over him about innappropriate topics: this is standard in much of the NHS today.

However, he was wrong about one key thing. They were not nurses. He was almost certainly descibing 'Health Care Assistants' - what we used to call Auxilliary nurses. They used to provide support care under the direction of ward nurses. Now, of course, they do all the nursing while the real nurses are chained to their desks filling out forms.

The Managers are not happy, though:

Chief executive James Scott said ... no complaint had been made at the time of the stay, last August.

Mr Scott said: "I believe it is wrong to make allegations like this without putting any evidence before us or giving us the opportunity to respond."

NHS managers are so fucking predictable. They always come out with the same shit.

Oh, and the 'evidence' for the poor care is the testimony of the thousands of patients every day. Fuckwit.

Daytime GP visits cost £33 per worker

It costs more to insure your Guinea Pig.

51 million patients are happy with GP opening hours!*

So the main pressure for extended GP opening is coming from the CBI.

It is the CBI's members who are making it difficult for workers to take time off to see their GP during office hours.

The figure trotted out in media stories is that lack of extended opening is 'costing' the British economy £1 billion per year.

But, since there are 30 million working people in the UK, that's works out at a paltry £33 per year for each worker.

And it's a false cost anyway, because you can't simply eliminate health care costs - extended hours clinics cost at least 50% more than daytime one.

Another piece of classic New Goebbels propoganda.



* Using the New Labour technique of expanding the result of a survey to the entire UK population - 85% of patients are happy with GP opening hours.

A reply to the National Audit Office.

The Dr Rant Team's favorite type of cash.

Another day, another round of GP bashing. The BBC report with glee the 'findings' of the National Audit Office that GPs are making more money than they used too. Nicky Fucking Campbell, the Fivelive gobshite, was in semi-orgasmic paroxysms as he read out a text message this morning. It was from 'Dan from Coventry' and stated that 'I work a 69 hour week, and make £250. Why should GPs make so much money?'

I'll tell you:

When I was a teenager, I was working every hour of the day to get decent A-levels. My friends were all out playing football.

When I went to university, I was attending hundreds of lectures and studying on the wards. My friends were smoking dope and getting laid.

When I was in my twenties as a junior doctor, I was working 100 hour plus weeks in a London shithole hospital dealing with heart attacks and strokes, for 'class 3 ADH' payments, i.e., half what the cleaner earned per hour. My friends were out having early afternoons and long weekend breaks.

When I was in my thirties, I was starting out in GP land doing a 1 in 2 on-call, with responsibility for patients on my list for 24 hours per day, 7 days per week, for no extra money beyond the 9 to 5. My friends had dinner parties, and wondered why Mrs Rant frequently came on her own.

And a few years ago, when no junior doctors in the UK wanted to become GPs, the government introduced better wages, for performance related pay. And my friends read the bullshit in the media that stated I was 'overpaid'.

So, the answer, 'Dan from Coventry', is that I am paid what I am because I fucking deserve it. If you wanted to be paid as much, all you had to do was give up your football, smoking dope, getting laid, most of your twenties and thirties, and your family life. You now spend, 69 hours a week doing something a monkey could be trained to do if you only earn £250. Simple, eh?

The National Audit Office can go and fuck themselves. If 'Dan from Coventry' doesn't like how much GPs are paid, then he shouldn't be surprised when we all 'do a dentist' and fuck off to work privately.

Oh, and Dan mate - you must be a fucking thick wanker if you haven't worked out that you only earn £3.62 an hour - that's less than the minimum wage. 

Stupid cunt.

Antidepressants don't work - in Hull

Researchers from Hull University are claiming that antidepressants only work for patients who are severely depressed.

Whilst Dr Rant is perfectly willing to believe that placebo is just as good as antidepressants for mild to moderate depression, I think we do need to point out a glaring problem with this research. It's from Hull. I mean, have you been to Hull? Fuck, if I lived in Hull I'd be depressed and I don't think antidepressants would help. The 1960s didn't happen in Hull until about 1985.

Here's a suggestion: next time compare the effects on depression of taking placebo against simply moving to somewhere that isn't Hull.

A Reminder

What Darzi actually said:

BBC News rewrites history

Ara Darzi: Still a lickspittle rent-a-gob wanker.

If someone said to you : ""We need to separate that fantastic relationship between a patient and a doctor.", would you think that it meant the same as ""We need to support that fantastic relationship between a patient and a doctor."?

Well, that's what the BBC seem to think. Recently, health minister, and gong-junky fuckwit, Professor Lord Sir Ara Darzi was all over the BBC espousing his ivory tower 'polyclinics' as an improvement on traditional general practice. Dr Rant wasn't impressed at the time, and he heard the slimy bastard in question say 'separated' with his own ears.

However the BBC, despite initially reporting correctly that he said 'separated', have seen fit to 'correct' the the quote to say 'supported'. Have a look at this article on News Sniffer for the details.

What the fuck are the BBC doing changing verbatim quotes to radically alter the meaning of what was actually said? 

He said what he said on BBC morning television, and he was heard by millions - there was no ambiguity in what he said, yet the revision of the online news report significantly improves the image of what a government minister said, without acknowledging the change. Why has a public service broadcaster done this? The George Orwell coincidences are coming too thick and fast for my liking.

There is only one context in which the words 'support' and 'separate' have even remote equivalence:

Women's underwear! 

Was that a Freudian slip there Lord Sir Ara? Are you trying to tell us something?

Stop the NHS spine

It's Day 4287 in the Big Brother Health Service....

The government has spent £20 billion of your taxpayer money on a useless, ineffective and insecure computerised NHS IT system. It has been a top down imposed disaster from day one led by the aggressive and obnoxious Richard Granger- truly a man for the world of new Labour bullshit projects. The fight back against this dangerous project is growing.

If you as a patient want your medical records uploaded onto a leaky information database do nothing.

If  you as a patient want anyone and everyone to have access to your medical records then do nothing.

The government has set up the system on the assumption that everyone thinks the NHS spine is great and safe and trustworthy and so why would anyone raise any objections to it.

So if you think that the Government has no concept of confidentiality, and no idea about data security then you need to ACTIVELY OPT OUT.

If you want secure medical records, kept safely then write to your GP and ask him or her to add these codes to your medical records.

• 93C3 Refused consent for upload to national shared electronic record

• 93C1 Refused consent for upload to local shared electronic record

• 9Nd1 No consent for electronic record sharing

If enough of us do this then the whole of the CfH strategy will be scrambled, and the government will have egg on its face. More importantly doctors and patients will be able to communicate confidentially with each other.

Trial uploads have already happened in Bolton. They will be coming to other towns and cities very soon.

Dr Rant has already asked his GP to add these codes to his records.

If you need more convincing the links below give excellent evidence:-

Ross Anderson excellent article in February BJGP

The Big Opt Out

Dr Neil Bhatia and his colleagues. A Caldicott guardian who takes his responsibility to patient confidentiality with due seriousness.

Remember also that “prominent people” such as senior politicians will not have their data uploaded onto the NHS spine. Apparently they are worried it might fall into the wrong hands.

So are we at the Ranting House.

So too should you be!

OPT OUT NOW.

David Fuckwitovitch - Moron of the Year!

A Monstrous Pile of Cunt, yesterday.


Apologies for the slight delay in posting this fisk of Wankovovitch's 'article' in the Times, but Dr Rant's head exploded whilst reading it and I have only just managed to scrape what is left of my brain back to the computer.

"When I saw [the GPs provide holistic care] claim, I thought long and hard about it. And decided that this “holistic” approach, is, in fact, code for “inexpert”."

Incredible. Tossovovitch types and shit appears on the page. You know, I may just be a blogger, but don't you think that having some vague knowledge of a topic would be a good starting point for an article? Perhaps having read some research. Or having spoken to people who, you know, actually have some fucking idea what they are talking about. But not our Davy. Oh, no. He just vomits up un-informed, illogical, thought spunk.

Let me make this quite simple: generalists are experts. They are experts at sorting problems, and picking up the odd serious problem from the sea of self-limiting illness, and at dealing the uncertainty.

(What is it with big-name MSM columnists? Do they train to be this arrogant or stupid, or are they just a self-selected group born uniquely gifted in this regard.)

"What I increasingly want from a practice is accurate and fast diagnosis and screening, combined with the best possible advice about my condition. At the moment I tend to use my GP's practice as a way of getting referral to specialists and accessing prescriptions that I have already decided that I need."

Oh, I love it. Notice the use of 'I want'. Not 'ill people need', or even 'most people would like', or even 'some people would like'. No, it's 'I want! I want! I want!'.

No Arseovovitch may be just as clever as he claims to be. He might be able to self-diagnose. But I doubt it. Doctors avoid self-diagnosis, because research shows that even highly trained professionals are likely to misdiagnose themselves. Of course, if the diagnosis in question is Oligoneuronia and the prescription Fuckoffovitch has decided he needs is arsenic, then he has my full support. Carry on. Otherwise, he's just a selfish, stupid, ignorant, narcissistic, NuLabour stooge.

Interestingly, for someone who started off as some kind of pinko commie, Lurchrightovitch does not seem much bothered that the frail and infirm (ie: sick people) might not share his Thatcherite vision of what makes good General Practice. The fact that all the research shows that a system of primary care doctors makes health care safer and more efficient is also, presumably, besides the point.

One question Arseovertitsovitch? How do you know which specialist to see? And, assuming you pick the wrong one, how will your specialist know which specialist you should actually see?

Actually, who cares. You're clearly too stupid to live. Fuckwit.

NHS IT rushed by 'deluded' Tony Blair

Another shock 'who would have guessed it' story, this time from Computer Weekly (the last bastion of investigative mainstream reporting by the looks of things).

Aparently, Tone (who can't tell a computer from Gordon Brown's arse from what I've heard, but I could be wrong) wanted the timetable for the Electronic Patient Record to fit in with the 2005 General Election.

Paul Cundy, GP IT spokesman for the British Medical Association, said it appeared that the Department of Health had been "wildly, even delusionally, optimistic about the timetable for the NPfIT in order to secure funding".

New Fuckwits? Deluded? Say it isn't so, say it isn't so....

Corrupt NHS Targets Harm Patients 999 Shock!

I know this will come as a terrible shock to regular readers, but the Guardian has 'discovered' that A&E departments up and down the country are keeping sick patients in ambulances for hours to meet their '4 hour targets'.

Who would have guessed it?

Well, I suppose if the Mainstream Media (MSM) had actually bothered to read the medical blogs A YEAR AGO, they might realise that this is NOT NEWS.

Still, better late than never.

Fuckwits

The BritMeds 2008 (07)

Welcome to the Dr Crippen BritMeds. Dr Crippen has kindly asked for the Dr Rant team to take turns with him hosting the BritMeds, so please send all of your BritMed suggestions to BritMeds@DrRant.net.

Apologies to regular readers: it's been a while since we had the BritMeds - Dr Crippen and Dr Rant have both been too busy to keep them up.

++++++++++++

Golden geese

It's great to see Dr Grumble back on form.

How things have changed. GPs used to argue passionately that they were the ones that knew their patients and that they should be the ones if one of their patients fell ill to go out at night. Cradle to grave - that was the mantra. They knew each one of their patients as a person. It was a wonderful ideal but it was exploited. The government unwittingly exploited it with the old 24/7 contract that required too much of GPs. Even a doctor's spouse had responsibilities if the doctor himself was ill. Then the patients started exploiting it whipped up on a grand scale by a government unwisely increasing rather than damping down expectations.

++++++++++++

The truth about GPSIs

Dr Grumble has republished his spot on piece regarding GP's with special interests schemes:

GPs have been very effective gatekeepers between primary and secondary care. It's one of the reasons why the NHS used to be the most cost-effective healthcare system in the world. But the government thinks that GPs have been wasting taxpayers' money by sending patients to hospital unnecessarily. After all, what could the hospital possibly have to offer that a GP couldn't deliver? Plainly, so government thinking seems to go, GPs have been just a little bit idle and have been offloading their work to the hospital. Just maybe, of course, GPs are not confident in every area of medicine. But that can be dealt with by a little extra training. And then you can call the specialist GP a GPSI (general practitioner with specialist interest).

The NHS Service Delivery Organisation Research and Development Programme has funded two separate studies which assess the cost effectiveness of GPSIs.

The results come as no surprise to Dr Grumble:

The introduction of GPSIs did not reduce waiting times at the hospital clinic
The cost of GPSI clinics was always higher than the hospital (up to twice as high)
GPSIs were paid more than the hospital doctors
One consultant saw twice as many patients as the GPSI (a chance finding when a consultant replaced a GPSI temporarily)

Grumble also reposted the excellent article on Giving GPs a break, which is worth it just for the gratuitously pretty photo of Lochgoilhead.

++++++++++++

Is there a doctor in the house

The Junior Doctor has this piece on lack of medical staff while thousands of junior doctors are unemployed or emigrating:

I wrote before about the bizarre state that we find ourselves in regarding staffing. Despite the ridiculous shambles of MMC 2007 that left the majority of junior doctors in specialist training either displaced or unemployed, we now find ourselves in a position where there aren’t enough doctors in the hospital to staff a rota.

The situation has now been picked up by Channel 4 and The Telegraph (the BBC, as always remain silent).

To put into perspective how bad things have become, in February 2007 (pre-MMC) there were 12 junior doctors (SHOs) on the anaesthetics rota at NewTown Hospital, today, there are five. Five doctors are doing the work of twelve.

++++++++++++

Ask a silly question

SHP made us laugh with this:

In these touchy-feely days of politically-correct medicine, where we must not allude to the fact that we are giving people drugs for illnesses by calling them 'patients', where daily nursing entries forgo the hackneyed observations of mental state and whether or not major organs appear to still be functioning in favour of 'no spiritual or cultural needs identified', we have endless boxes to tick and reams of clerking proformas to fill in, to ensure a holistic approach.

Some would say it's 'political correctness gone mad'.

I'd be inclined to agree with them.

But if you want me to fill in your patronising, euphemistic, dumbed-down check-lists, there are times it is almost enjoyable, viz:

What is the client's perspective of need?

"I want to get out of this fucking shit-hole, you cunts!"

++++++++++++

Jack's Eye


The Monk has this interesting post that shows what is happening to patients as the NHS disintegrates.

This is a posting from Dr Martin Rankin,a GP in Devon; he is trying to get some media coverage for the story, so do pass it on to any journalists who might be interested:

Below is an open letter that I propose to put in the public domain

Dear Mr Brown,

We need your help to save the vision of an old man.The case of Mr Herbert "Jack" Tagg * a Pit Boy turned WW2 Sergeant Pilot typifies the incompetence of your labour government in managing the NHS."Jack" has developed Wet Macular Degeneration - a condition which will mean he will almost certainly become blind within a couple of years. The good news is that there is a treatment for this. The bad news is that he has to go blind in one eye before the NHS will pay for treatment in the remaining eye. "Jack" is not a wealthy man but his wife has, without any hesitation, decided that they must sell their house to pay for the treatment. You have never met Jack or his lovely wife but I can tell you they are a wonderful couple. He risked his life for us, you are in charge of the NHS, we believe that our patients would prefer you to spend a few thousand pounds on Jack in his hour of need than bailing out an incompetent bank. The doctors who have added their names to this list will all post on a cheque for £5 payable to Mr Gordon Brown. Of course we don't expect you to get Jack his treatment on the NHS - we already know you are not up to the job of running the NHS, we simply would simply ask you to cash our cheques and then forward on the lump sum to Mr Tagg.
Yours sincerely


The Doctors of Great Britain.

*I have Jack's consent to use his name. Please sign your name below and send your cheque for £5 to Mr Gordon Brown (his address is 10 Downing Street, LONDON).
Let's see Brown spin this.

edit:
Please send the cheque payable to Mr Gordon Brown to me at Plym River Practice, Plympton, Devon PL7 1AD. I will get a photo and supply it with a photo of myself and Jack and the bundle of cheques next to a post box.

++++++++++++

The fall out of MMC

The Ferret, meanwhile, points out that the Awkward Squad were, as usual, right all along:

Rabid doctors like myself have been predicting the massive service shortfalls that would result from the rushed Modernising Medical Careers reform of medical training. The media have started to take notice.

(Note to Ferret: could you provide your entire posts via RSS rather than just a teaser - it would make my job a lot easier!)

++++++++++++

Old enough to be your doctor?

I'm A Medical Student Get Me Out of Here is worried about looking wet behind the ears as a 'house officer' [I think that's 'F1' now, but the young whippersnappers keep changing their job titles and I can't keep up. - Ed, feeling very old]

So come August (pending finals) I’ll probably be one of the youngest out there, there is a high probability that I’ll be the youngest in the SW deanery what with 6yr courses, intercalation etc etc. Personally I think that’s quite cool, I’m not sure the patients will though. I think I look about my age so I’m certain I’ll get plenty of comments about being too young to be a doctor, behind my back mostly I expect. It doesn't bother me, they're probably right. Who would you want to be treated by? The 35 year old doctor who spent 10 years as an accountant before deciding on a career in medicine or fresh faced me who'll still be 22.

++++++++++++

Blogtitioner Alert #1

Mental Nurse, as mentioned on Crippen this week, has a piss take piece about freedom of speech being wasted on amateurs...

There has been a disturbing rise of ill informed comment masquerading as serious Journalism on what has become known as the “blogosphere” in recent months. These Blogtitioner lead “walk in centres” for news and current affairs are springing up all over the place and are a symptom of this Governments obsession with dumbing down and saving money. First it was our schools, then it was our health service and now it is our newspapers.

++++++++++++

All about control

Life in the NHS sums it up here:

It is becoming clear that the UK government would like to control every element of our lives. There is no doubt that there are some great ideas going on there in the various government departments. Ideas about better parenting, opportunities for children, the variety of education, the food that we all eat, our lifestyles and the amount of exercise we take, the way we live our lives as adults, the food and alcohol we consume, our moral lifestyles and the way we spend our money. The trouble is they are not happy with just offering up ideas and schemes, they are not happy with giving guidelines, making policies. No they want to tell us all how to live every aspect of our lives.

++++++++++++

Stupid Bitch Matrons

Militant Medical Nurse has a photo of Luc Besson's Nikita and is not afraid to use it!

Bring Back Matron you say? Oh they are back all right.

At my hospital we always had a saying..."Matrons are like ghosts...we know they exist but we never see them."

Who are the modern matrons? They are highly trained and highly educated nurses who take on clinical specialist/ management roles. Highly trained and highly educated nurses are great at the bedside. Research has shown that patients have a higher survival rate when they are receiving total care by a degree educated RN. Even better if she has a manageable number of patients.

Many of our modern Matrons, however, are as useless as tits on a bull. They have no soul. They have no interest in patients. I would rather eat c-diff positive shit than bestow the honourable title of "Nurse" onto one of these people.

More on matrons and nurse patient ratios here.

++++++++++++

US view of problems with the NHS

The American site Hot Medical News has their take on the problems with the NHS:

Imagine that you are seriously, even critically ill. You are in a dirty, rundown, understaffed hospital. The nurses, doctors, and other employees are rude, inattentive, and incompetent, and you can't get out. What could be more terrifying?

Although government mismanagement is without question part of the problem, the UK spends much less on health care than the US. Still, the British government nationalized the health care system in 1948 and has had over fifty years to work the kinks out of the system.

The British people deserve better.

They also have an excellent image of Seattle police with masks on during the 1918 Influenza Epidemic as their archive picture of the month:


++++++++++++

And finally...

Funny Things


The Girl with the Blue Stethescope (still Dr Rant's favourite blog-title) asks...

What funny things have you noticed that have changed about yourself since becoming a medical student?

I now understand more of House. It makes even less sense than before. ;)

Medstudentitis. Feeling tired? Leukaemia! That spot on my brother's back? Could be melanoma! Feeling down? SAD! Unwell after drinking spirits? Must be early diabetes!

At least I am enjoying it.

++++++++++++

Please send your recommendations for next week’s BritMeds to: BritMeds@DrRant.net

The BritMeds are usually published from Saturday morning to Sunday evening, so please let us have your recommendations by Friday evening latest.

Fuck off Darzi, you slimy opininated fucking freak!

Who the fuck is 'Lord' Darzi? Who the fuck does he think he is? The BBC report on his plans to replace single-handed GPs with polyclinics has some incredible quotes from him. Even for the lying, government suck-up, wankrag that he is, these are incredible.

For example:

[Darzi] praised the "fantastic" relationship between doctors and their patients, but said it must be distinguished from modern practices, where there were now often several GPs working under the same roof.

Isn't that just like a New Cunt? Single handed GPs have very high patient satisfaction ratings on the whole - better than group practices. But does Darzi give a fuck about patient choice or satisfaction? Does he fuck. He thinks we should replace this with 'modern' unpopular, disjointed, tickbox-monkey, bums on seats, never mind the quality feel the width, New Lies bolloks.

FUCK OFF, FREAK!

Really, Darzi. You look like a fucking alien, you fucking freak!

FUCK OFF, TOSSER!

Want' to replace good continuity practice with McDoctor shit?

FUCK OFF, WANKER!

I can't express how much I hate this man. He's a fucking surgeon politico-wannabe tosspot, for fuck's sake.

But don't let good care get in the way of New Shitty's plan to privatise the NHS and give lots of money to themselves, the corrupt lying scum. They move from management consultant jobs to ministerial posts, give contacts worth billions to their old bosses and then move back to their old jobs once they leave!

Can you say 'corrupt overflowing faecal cesspool of New Labour lying scum'?

Fucking evil bastards. Let's round them all up and torture them. Let's pull their fingernails off. Let's gouge their eyes out with a blunt spoon. Let's cut their ears off. Let's amputate their limbs, cut their tongues out, and remove their fucking bowels while they are still alive.

Of course, that would be illegal. Morally justified, but illegal. Unless you are someone who possibly might at some point have seen the word 'Iran' on a map and you have dusky skin, in which case it's 'alternative interrogation'.

Fuckers.

Rant Under Construction

Right, let me get this straight. Some part time surgeon, and Government arse-licker who got a peerage for playing tennis with Tony Blair, is announcing the end of traditional General Practice.

Two points to make for the edification of the Darzi Fuckwit:

1. Not every area can support a 'polyclinic' - there aren't enough patients to make it viable. 

2. What the fuck happened to choice? Every fucking thing that Labour have done to screw up the NHS has been done in the name of 'Choice^TM'. How about letting people decide which GP they register with - i.e 'choose', rather than be pontificated to from on high by a micromanaging control freak politburo.

All I can say is thank fuck they didn't make Lord Darzi the Minister for Breweries.......I'd have to go through all of this sober.

When I've calmed down a bit, Darzi's going to get both barrels. Until then, I'll leave you with some apt lyrics:

"You do nothing but socialise, and become a menace.

 Put on your Reeboks man, and go play fucking tennis!"

The Reverend Black Grape

An Alternate Reality

Patient expectations of us are rising. Here is a letter from Friday’s Telegraph :

"My father was a GP. Not only did he have a busy work schedule, but he was often seen in his spare time mending patients' gutters, bringing in their coal and doing minor repairs. He would never have expected to be paid for out-of-hours work. Can you imagine today's GPs doing anything similar ? "

Let's sincerely hope she's not a member of a focus group in a marginal constituency.

Dream Sequence....

Imagine this:

The reality of the Prime Minister's golden incompetence, and the cost to the UK taxpayer starts coming home to roost. He’s between a Northern Rock and a hard place. He needs a smoke screen - a bit of a fight that he knows he can win. He needs to demonstrate how tough he is and then be able to shout his success from the rooftops........

Cue the GPs, and it begins....

Phase 1: The Government instigates a softening up campaign in the pliable sycophantic printed media.

'Lazy GPs earn more than plumbers !!!'

'Hospital manager diagnosed as brain dead by lazy GP is back to work the next day' etc.etc.

Phase 2: £11m survey commssioned by HMG includes the question: 'Is there the remotest possibilty that you might like your GP to repair your gutters, out-of-hours, free of charge, at a time convenient to you ?'

84% say No.

16% say Yes, and the bastion of democracy that is Her Majesty's Government uses this minority view to batter those who remain sceptical of it's Gerrymandering access mantra.

Phase 3: The BMA's GPC negotiates to clean the gutters of those with heart disease, osteoporosis and Peripheral Vascular Disease. However, at the 11th hour, the Prudent One decides to scupper the deal in a fit of pique that it starting to resemble a habit. He needs thicker smoke and for a longer period, and a mutually agreed deal, accepted by the GPs, won’t do this.


Phase 4: Ayatollah McClunkjaw therefore 'negotiates' 'Imposition C':

58.5 QOF points are taken out and recycled into gutter cleaning. When the DDRB announces a third successive 0% pay increase there will be a 1.5% uplift available to be earned by doing extra work - all utterly pointless and clinically unproven, but soundbite-friendly and potentially vote catching.

Phase 5: ‘Imposition C ' is not accepted, therefore the Prudent One blackmails with ‘Imposition D' :

135 points are removed from QOF, and the thresholds are increased by up to 20%, making the points harder to earn. No inflationary uplift is given for the 4th succesive year

“ Gutters’R’Us^™” are appointed the Government's favoured private contractor. £1bn, taken out of the GP contract budget and given to Gutters’R’Us^™.

One year and one day after leaving office Postman Twat, by complete coincidence, gets appointed to the board of Gutters’R’Us^™.

Six months later our favorite Postie has saved enough money to become Sir Pat.

Of course this scenario is all fantasy.

All characters are fictitious and any resmblance to anyone living or dead is purely conincidental.

This sort of thing doesn’t happen.

Does it?

Why is NHS net soooooooooo shit?

Being an NHS GP, Dr Rant has access to one of the most highly developed IT systems in the world. If you think a Sinclair ZX81 is 'one of the most highly developed IT sytems in the world'. Or, in other words, Dr Rant has access to the kind of technology that a 1982 teenager would have considered obsolete.

Having decided to spend somewhere in the region of £20 billion on an NHS IT system (the brainchild of that well known technovirgin, Tony Blair) Dr Rant now have access to an email system that is marginally better than the stone-age NHS email system it replaced.

Yes, for 'security' the NHS has shut out most systems that normal IT people would take for granted (Skype, VPN, browser-independent websites and so on). I have to use Internet Explorer and NHS.net email for some key NHS stuff to work at all.

Let's look at two emails I received today from NHS net. The first was a warning that I was near my storage limit for email. Yup, that's right: I have used nearly 80MB of storage. Forget Google's unlimited storage (at least 2.8GB last time I checked) - the NHS only gives you 80MB. That's equivalent to an entry level PS3, so I'm guessing that the NHS's £20 billion did not go on a google-style farm of servers. More likely it went on a gaggle farm of management consultants with the left over pennies being spent on a BBC micro computer and wobbly RAM expansion pack from eBay.

The second email concerns an email I sent to my practice manager from my gmail account. Apparently NHS.net is not happy with this and bounced the email back to me 'Reason: Server rejected MAIL FROM address.
Diagnostic code: smtp;501 Sender domain must exist'. Whatever the fuck that means. In ten years of using email, I've never seen any other email system bounce email with this error message.

Exactly how much wank can you buy for £20 billion? And how much storage space does it take up?

Asylum Seeker gets NHS treatment and dies

Immigrants should also be concerned.

The Guardian reports that an asylum seeker died during treatment and investigation at the hands of the NHS.

The inference is that he died as a result of being given poor care because he was an illegal immigrant.

Of course, we all know better. He died for exactly the same reason that all the other patients die: the NHS is falling apart.

Sadly, his story will sound all to familiar to any GP.

The only good news is that the NHS is an equal opportunities service - it kills everyone, regardless of race, gender, or creed.

Fuck off, BBC

No sooner is the ink dry on the BBC's headline claim that the BMA had 'backed down' by recommending their members choose to butt-fucking #1 over butt-fucking #2 than they come up with the following peice of cuntbastardary:

Iraqi medic detained over blasts

What? More murdering doctors? Hang 'em all! I hear you shout. But wait. What's this; the 'medic' is in fact an administrator at the hospital.

Not a doctor. Not even a noctor, but a fucking manager.

Managers are all lying evil cunts (why should the Iraqis by any different?) so the real question is: how do the lying bastard, anti-doctor, post-Gilligan, government-suckups at the BBC sleep at night?

Fuck off, BBC.

Stop Fucking Around, Mr Brown

The following letter from a GP to our dear PM made Dr Rant laugh:

Dear Mr Brown,

Stop fucking around with General Practice, the most efficient part of the NHS with an 84% patient satisfaction rating on access, and sort out NHS Dentistry before I have remove my own teeth with a clawhammer.

Signed

Everyone

Thanks to Dr Beard for letting us publish it here (first posted on DNUK 16th January, 2008)

I'm a GP

This superb video was posted on YouTube yesterday by it's maker. It's a parody of the Apple Mac advertising campaign highlighting the difference between the type of GP most people have now, and the type of GP brown and Darzi are going to give most of you in the future.

It's not exactly laden with special effects, but it's truthful. The only inaccuracy I can spot is that a real GP would be wearing a cardigan......

All animals are equal

Dr Rant was highly amused by a recent comment by his chum Dr Paul Baird:

"I received my letter today, and having just seen my last patient, read it, and thought I'd give Mr Johnson a call.

His phone number is on the letter.

I spoke to a very nice chap and explained that having received Mr Johnson's letter there were a couple of things I'd like to discuss with him.

He asked me to hold and then came back on the line to say that Mr Johnson wasn't available and in fact there was no one at all at the Department of Health who could discuss this letter with me, as there is no one in the offices after 5pm.

I'm delighted that at least everyone at the DOH finishes early enough to be able to see their own GP in a normal evening surgery without the need for extended opening hours."

George Orwell would have laughed his socks off. The above has also been published in the Daily Telegraph's letters section today. Well done Paul.

Public services on the cheap

This story is the perfect case study of our darling government's dumbing down of just about everything in the public services. Dr Rant is not a fuckwit and knows that you only get out of something what you put in to it. The ferret fancier has also decontructed the lack of common sense in the government's dumbing down of health care.

Less education, less training and less experience gives you someone who cannot adequately do the job that someone with more education, more training and more experience can do. Whether it be PCSOs as policeman, nurses as doctors, GPwSIs as consultants, HCAs as nurses, classroom assistants as teachers; these new roles are not improving the public services and they are not ost effective. The government would have been better off keeping job boundaries well defined, letting the professionals do their job without being bogged down by paperwork and the need to satisfy short termist political needs, investing extra money into training more of the professionals that we need and treating them well.

Where was that consultant expansion that the government promised? Oh I forgot they must have put it in the drawer with the stable economy folder, the referendum file and the honest trustworthy behaviour video. Cunts.

The Postman Always Rings Twice

"Super Darling! We'll be able to get of bunions seen to on a Saturday! We'll never miss Jeremy Kyle again."

As promised by Mystic Meg, Alan Johnson has written us G.P.s a letter. You can read it here. I would love to have seen what Alan himself would have done if the government had written to post office workers behind the back of their union when he was in charge of it. Putting brazen hypocracy aside for a moment, here's my considered reply:

Dear Alan

Fuck off.

Yours with the deepest of admiration and respect

Dr Francis X Rant BSc (hons) MB BS DRCOG MRCGP

p.s. You may have noticed that there are more letters after my name than in it. The closest you have come to letters is delivering them. Don't tell me how to do my fucking job. I'm not going to vote for a pay cut that will mean I get to spend less time with my kids just so you can get a few votes.

What next? The Secretary of State for Egg-Sucking will also be writting to all grandmothers in England to explain how it's done?

Mystic Meg Speaks

Right! It's Sunday evening - here's what's going to happen tomorrow.

The Government will try to claim that the BMA's uncharacteristically tough stance on the Government's attempts to unilaterally impose their whimsical changes on our legally binding contract is 'out of touch with what GPs think' and is 'misrepresenting' the 'offer'.

Three things will happen:

1. The oily twat Ben Bradshaw will have his nauseating mug all over the sycophantic BBC breakfast time rubbish that passes for news. Chris the Sports Guy at some point will try to get into Carol the Weather Girl's knickers on live TV, again.

2. The cuntfaced Bradshaw will also slime his way onto Radio 4's Today Program where arch Labour support Jim Naughtie will let him get away with it. John Humphreys will attempt to break the world record for cramming the words GP, golf, lazy and 'quarter of a million pounds' into the same sentence.

3. Postman Twat will write a letter to GPs telling us why doing more work for less money without benefiting patients is a good deal, and that we are being lead astray by the callous BMA.

It will happen - I'm giving you 12 hours warning, so get onto William Hill now.

Basically, the shower of cunts are rattled. They are incompetent, corrupt, dishonest, RATTLED cunts.

Oh, and someone with four limbs who knows someone called 'Dave' will win the Lotto on Wednesday.

KY Jelly and GPs

GPs are facing a vote this month. We learned about our options at Rantingshire Local Medical Committee where our chairman valiantly led us through the options available to us. It’s a really appealing choice:-

Would you like to be shafted gently, (with KY Jelly) (Option A)?

Would you like to be shafted, (without any KY Jelly) (Option B)?

Now be a good boy and bend over and take what’s coming to you!

The PCT Chief Executive bravely attended and promised to rub it all a bit better once it was all over. How nice of him. But he’s still the DH’s Gauleiter in Rantingshire, and still paid to implement DH policy. And his job security is less than that of a premier league football manager…so how long will he be around for us to work out if we can trust him or not?

That’s about the level of Gordon Brown’s negotiation with GPs at present. Even Devil’s Kitchen is showing us some sympathy we have been so badly treated. The issue is not the hours row, it's the government's BAD FAITH in negotiation.

Now the apparent causus belli is the government’s wish for GPs to extend their surgery opening hours. Now there’s no real objection to this, and it’s fair enough for the government to want us to provide longer opening hours. And if the negotiation was just about GP opening hours there would be no major row, and an agreement would have been reached already. (As NHS employers and GPC were about to reach back in November).

OK extending opening hours will cause us some discomfort, and need some reorganisation, but the idea of evening or weekend surgeries is not objectionable in itself.

Medically it’s unnecessary, and it will take time away from the sicker patients, and make life easier for basically fit patients such as commuters. But this government will pander to whims and wants, rather than medical needs and this is such voter rather than patient centered behaviour.

There’s also safety issues around female staff working alone late at night in poorly protected health centres.

But actually GPs think this dispute, which has been provoked personally by Gordon Brown (and to Postman Alan’s horror. The new SOS for Health is a pragmatic ex-union man, and if left to himself would have sorted out a deal already), is about far more than a few more hours of surgery opening. It tells us a lot about the Scottish control freak, and his bad faith, and sheer lack of ability, in negotiation.

The government is acting to destroy the clinically based (about important chronic diseases) and evidence rooted Quality and Outcomes Framework (QOF) and use the money on cheap, politically motivated, targets about access for anything and everything. In other words, sod the quality, just see the patients. Quantity is what the Clunking Fist wants, not quality. We’d agree with him and say we’ve had too much of him, and the quality’s been crap. The changes are being imposed unilaterally, by executive fiat, rather than in negotiation. In other words the government has given up on the GMS2 contract, and will do whatever it bloody well feels like, provided it “consults” for 13 weeks beforehand. The GMS2 contract now feels worth as much as Neville Chamberlain's 1938 “piece of paper.” Now this is no way to get a happy, contented and effective workforce, and Dr Rant feels very free to damn this government at any turn face to face to patients. The government loses no opportunity to rubbish my work and I’ll return the favour. It’s also no way to get what you want out of people. Sullen acquiescence perhaps, but no more.



Perhaps this is what the government wants, to destroy British General Practice. It cannot stand GPs becasue we are independent and think for themselves. We are the one bit of the NHS that Nye Bevan never got around to nationalising, and the service we provide is all the better for that.

Gordon Brown thinks he can get primary care for patients more simply and cheaply than by using GPs. Hence an endless stream of ideas such as “skill mix” and “practice nurses could do a lot of the GPs work.” Speak to any practice nurse and she’ll admit she cannot.

And Gordon Brown wishes to get rid of GPs surgeries and load us into either Lubyanka or the Polyclinic. He wants his mates at Virgin, and from those ever so ethical USA HMOs to come and replace existing surgeries.


The issue for patients is going to be “are you happy with a cheaper, dumbed down, cut price service?” Or would you prefer to be able to see a real doctor, who you know and recognise, when you need one?”

If you want a real GP service in the future you may have to pay privately for it.
If you want Medicine for Idiots (to go alongside Perfect Financial Idiocy) then keep voting Labour into office. If you want to see the destruction of British General Practice vote Labour. If you want to keep on paying taxes to get nothing, vote Labour.

But if we want functional general practice delivered by real doctors, and appropriate support staff, then the public need to support their GPs vocally, and oppose this destruction.

Oh, and vote against Labour whenever you have the chance.