Desert Island Dick

Darzi: Lovely bunch of coconuts.

Dr Rant has just had the nauseating, but frustratingly gripping, experience of listening to this week's Desert Island Discs. This weeks 'castaway' was Lord Darsehole of Islington.

Once again, thanks must be extended to the BBC for making the situation so crystal clear. I think I've got this right;

A bloke who grew up in Baghdad with his Armenian family, moved to Dublin to study medicine where he met and married and Irish woman and trained to be a surgeon. After becoming ever more specialised as a surgeon, he ends up getting the gig to destroy the least shite bit of the NHS - General Practice in England.

Well that make perfect sense doesn't it?

Guess what he chose as his 'luxury'? Go on have a guess!

A PENCIL

Yes, that's right - a fucking pencil. What a guy!

If anyone has any suggestions for what Lord Darzi can do with his pencil, answers on a postcard to the usual address........

50 ways to kill your GP

Thanks to Crippen for pointing out an excellent US medical blog Covert Rationing.

There, Dr Rant was unsurprised to find a reference to a New Scientist article about research that revealed that between 1:50 'normal' patients and 1:20 sick patients have homicidal thoughts about their GP.

That's around 50 patients per average GP.

Ah, the joys of being at the front end of a shit system that does not want to treat people because it costs money....

You just can't get enough.....

Dr Rant has been putting himself about a bit. Britain's second most popular medical blogger ^TM is delighted to announce that he has joined the Remedy UK Magazine as a guest columnist.

Remedy UK is a truly extraordinary achievement considering it was conceived by junior doctors staring over the edge of the precipice of the abyss that Modernising Medical Careers was throwing their careers into. The fight continues, but now with a degree of slickness and professionalism that is truly staggering considering that they all have medical jobs and a fraction of the funding available to the BMA.

Dr Rant is proud to support them and play a small part in their endeavours.

Remember, it's free to join......

^{CLICK HERE for RUK magazine.}

Frank has gone missing........

This latest entry of Dr Rant was smuggled into Rant central offices by someone calling himself only ‘Mr Davis’. We have no idea where Frank currently is.

Property of HMP. Now wash your hands

Cuntslime. Utter, lying, vexatious cuntslime. That what Nu fucking Labour are. I don’t know where I am, save for the fact that two Nu Labour stormtroopers have thrown me into what looks rather like a cell. When I demanded to see my lawyer, they murmured something about a 41-day wait. So, here I am, dressed in Guantanamo orange, with an arsehole like a hula-hoop, having had a cavity search from someone with bigger hands than the local orthopaedic surgeon. And all I did was sign a petition.

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Property of HMP. Now wash your hands

So, the BMA have finally grown some balls. Tiny ones, almost like shrivelled-up sultanas, but testicles, never the less. They have organised a petition to campaign against polyclinics, a proposal by Lord Darsehole so monumentally fucking stupid that even capitalist groups such as the King’s fund recognise that they won’t work. The argument is astonishingly simple. With a finite amount of money available, and a limited number of trained GPs, if you build a large number of brand shiny new buildings, and fill them with GPs, then the GPs and the money are going to have to come from somewhere else.

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Property of HMP. Now wash your hands

So, unless the government suddenly finds a huge sum of money from somewhere (it ain’t going to be the national gold reserves, or Northern Rock), or finds a large number of foreign GPs willing to work for peanuts (maybe, but they’ve all pissed off following MTAS), then something is going to have to give. Yup, local GP surgeries will be shut, and the money used for polyclinics. So, with their newfound bollocks, the BMA organised a campaign : Support Your Surgery. This audacious campaign made the following wild and outrageous demands : Spend money on improving existing GP services rather than polyclinics, and to stop private companies taking over GP surgeries.

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Property of HMP. Now wash your hands

In just two weeks, the BMA collected well over a million signatures from patients. One in sixty people in the UK signed it, in only 14 days. One would have to assume that means that the public recognise polyclinics for the crock-of-shite that they are. And what happened when the BMA released the results of the petition? Well, the government moaned like a French whore taking it up the arse. Rent-a-gobshite Ben Bradshaw, of whom Dr Rant has written plenty about before, was wheeled up to come up with the typical Nu Labour spin that we are all sick to the back teeth of.

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Property of HMP. Now wash your hands

And that spin showed that Nu Labour are frightened. Bradshaw said that the BMA campaign was ‘misleading and mendacious in nature’, as he shat his Y-fronts. He told the BBC that he was disappointed that the BMA was ‘opposing investment and painting a distorted picture of what it would mean’ as his bladder dribbled piss down his leg. And he pointed out his concern over the ‘misleading and inaccurate statements’ that the BMA had made, as he quivered in the sort of terror that bullies get when they realise that the whole school playground is about to give them an utter fucking kicking.

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Property of HMP. Now wash your hands

And eventually, Gordon Brown, the clunk-jawed dictator was wheeled out, clearly annoyed that his plans to turn Britain into a police state had been disturbed by a million people writing to him. The corpulent Cyclops chortled his disapproval. ‘The issue is about increasing access to primary care, not replacing GPs’, he grunted. Right. So just where the fucking fuck are the polyclinic staff going to come from? ‘We want GPs to be open for longer hours and at weekends’ he demanded petulantly. Who does? Not 86% of the electorate, Gordo. ‘And if that is not possible, we want to provide other source of care’ he postured. Which is, dear reader, known as privatising the NHS.

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Property of HMP. Now wash your hands

The state-run media, know as the BBC (Bradshaw’s former employer) was happy to blast out that ‘Brown bashes GPs’ on the airwaves, in between announcing that some thick, ugly bloke had won the Apprentice. However, everyone who isn’t brainwashed realises that this shameless dribble of cuntphlegm is a transparent scheme for back-door privatisation. Even the Times newspaper realised just how utterly crap the scheme is. But will Nu Labour listen? Will they pay attention to over a million people, to a hundred thousand doctors and even the King’s fund? Of course not. In fact the only public body to support the existence of polyclinics was the NHS confederation, a body of NHS managers, whom if told by Gordon Brown ‘I am going to shit a massive steaming turd up your nostrils’ would reply ‘certainly Sir. Would you like to use my left one first?’

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Property of HMP. Now wash your hands

Nu Labour are out to wreck the country. They are out to privatise the NHS. They will ensure that large parts of the NHS are run by private companies. And this will be their retirement plan. Because you can bet that for every private company who runs part of the former national health service, there will be an ex Nu Labour minister on board. The current government are evil control freaks. They will take away your right to free health. They will call the most trusted profession in the country liars. They will take away your liberty. They will imprison you for 42 days without telling you why, while they tell the public that you are a terrorist. And all the time, they look for more groups to accuse of being such ‘terrorists’. And I would like to write more, but I really need a shit, and am running out of paper. So, lots of love, and yours truly,

Frank. x

Please tear here

Common Sense Centred Medicine

The Dr Rant Foundation is please to announce the imminent publication of its seminal report on guidance to the medical profession entitled:

'Common Sense Centered, Reality Based, Organ Grinder Delivered Medicine.'

This new doctrine is designed to supercede and consolidate the recent splurge of dogma driven Grandmaternal Egg-sucking guidance dictats from on high such as 'Evidence Based Medicine', 'Patient Centered Practice', 'Reflective Practice' 'The Duties of a Doctor' and 'Good Medical Practice'. Furthermore, it is anticipated that interested parties will be able to read it without becoming comatose through boredom or contemplate self harm half way through the second paragraph.

The authors note with dismay the tendency for these earlier attempts at guiding doctors to become subject to high-jacking by fundamentalists who seek to push their individual interpretation of the texts in a pseudoreligious manner. Specific concerns were raised about self-flagellating 'Reflective Practitioners' who seek constant criticism in their quest for enlightenment, and 'Evidence-Based Ayatollahs' who haven't yet worked out the difference between failing to prove that something does work, and having proof that it doesn't.

Potential readers can also rest assured that neither Sir Liam Donaldson nor Dame Carol Black have had anything whatsoever to do with its inception, and we can categorically deny that they were consulted at any point during the process leading to publication. The DRF hope that guidance created with reference to doctors who actually see patients will be sufficiently uncommon to prick the enthusiasm of our colleagues at large.

The lead Author Dr Francis X Rant, a common or garden variety type General Practitioner and social and golf secretary of the Rantingshire Division of the BMA, describes the overriding aim of the report as "Stating the bleeding obvious as clearly and concisely as possible so we can all get down the pub".

The key points outlined within the report are:

1. The patient is your first concern, not the electability of whichever shower of shite is in government, nor the knighthoods of the upper echelons of the medical establishment.

2. Try to imagine that the patient is a member of your own family - would you treat them differently if they were?

3. Try to consider the possibility, no matter how remote, that you might not be right.

4. None of the World's major religions believe that God is a doctor. They may have a point.

5. You don't have to take any crap from anyone. Self-respect and dignity are also important for doctors as well as patients. No one is right all the time, and few people are wrong all the time.

6. If you are not very good at something then don't confuse the words 'practice' and 'practice'. Ask someone who is competent to help or take over.

7. It is both your right and your responsibility to enjoy your job. If you do not enjoy your work, your job is either wrong for you, or you're wrong for your job. You can't do your best at something for 30 years otherwise, and that's not fair on anyone, least of all you.

8. You do not have the option to 'not do politics'. Your ability to care for patients is a pure function of politics, and it is your duty to understand the wider issues concerning your practice, to form an opinion and act accordingly.

(Note to Editors - The Dr Rant Foundation is a not for profit think tank that aims to improve patient care and maintain the sanity of doctors though the employment of invective, bile, sarcasm and cathartic apoplexy via the medium of the blogosphere.)

Toothless Wonder

Well. Yet again gaping holes in Gordon Brown’s brain, sorry NHS dental services, emerge.

Patients don’t get regular dental check ups. They get dental abscesses and then need to bother GPs and A+E departments and hospitals. The documented the extra work here.

Totally needless suffering. Totally wasted resources, and misdirection of patients. Yet another success for new Labour and national contracts.

This government is soon to be come a Shakespearean tragedy, Sans teeth, sans eyes, sans taste, sans everything…and sans any professional left able or willing to do anything about it. A nation fit only for the unemployed, the incapacitated, or managers in meetings.

Not as we like it at all.

Ministry of Missing the Point?

Buses? What all that about then?

I've already blogged about the 'cancer co-payment' scandal. Jayann's objected in the comment's section that this terrible policy is no different than paying for a knee op. But it is different, because if you chose not to have a private knee op, you will still get an NHS one eventually. Furthermore, Dr Rant recently paid for an MRI scan of his knee during his NHS treatment so he could get back to his patients faster. No one suggested that I would have to then have a private op because I'd had a private MRI scan, and neither should they have. So the idea that you can draw a parallel is total bollocks.

No, I agree with DK in one of his best medical posts ever when he says:

This woman has spent her entire working life paying National Insurance which, I might remind you, is supposed to pay for medical treatment (amongst other things). It isn't your money to withhold, you cunts; it is her money that the government was supposed to invest in an insurance fund.

However, Crippen then pointed us in the direction of this post by the excellent Ministry of Truth. MoT spends a very long post suggesting first that the main story should not be people who want to co-pay being denied treatment, but the peddlers who sell the stuff.

Now, no fan of quacks and peddlers of false hopes is Dr Rant. However, that was not the main point of this story at all. And compared with the magnet-sellers, I'd take my chances that £17k on a drug that has a reasonable chance of buying me an extra 150 days of life. That's not snake oil. Snake oil is when you pay £17k for a drug that has no chance of helping you at all. There was some hint that the treatment being 'denied' was in fact combination treatment that would not have been given without the private drug, but this was unclear, only mentioned in passing. I would have liked to have heard more about that.

There is more, but not about the bit I thought was interesting. Instead MoT went on to have a go at Doctors For Reform. I was around when DfR were formed. I wasn't actually involved in setting it up, and I don't know the people involved in setting it up personally, but I remember their early flyers.

The fact that the people setting this up are largely entrepreneurs who have private as well as NHS business interests is hardly sinister. It is to be expected. Who else has the time and money to do this kind of good work? It is hardly sinister that they come from a range of politically active backgrounds either (unless you think that not having a New Labour parliamentary candidate in your group makes you automatically suspect).

MoT also mis-represents DfR's stance on the NHS. It is hardly a surprise that Doctors for Reform are a group of doctors who want the NHS to be reformed. You hardly need to by V for Vendetta with a google-map to work that out from their title. However, the reform they are aiming for is a European-style mandatory insurance system, not a US-style insurance system that MoT suggests they are looking for. I know, because they told me. To link DfR to US health insurance is a strawman fallacy. MoT should have dug deeper and looked at the DfR website:

What is social insurance?

Social insurance is the type of health system used in countries such as France, Germany and Switzerland. The systems differ but all have the same key characteristics. All citizens receive health insurance in return for contributions usually made from salaries or, in the case of the worst off (in some countries) from taxation. Insurance cover is guaranteed and everyone pays a fair price. Standards of healthcare in these countries are higher than in Britain.

“Social health insurance systems tend to be associated with high levels of satisfaction in the population. The sources of this satisfaction are interesting, including a combination of solidarity and transparency. To some extent, social health insurance may make every patient a private patient” (Funding health care: options for Europe, LSE authors, European Observatory on Healthcare Systems, Open University Press).

Personally, I think the NHS does not need that kind of reform. It simply needs to be cut free from the management and DoH dross that paralyses and corrupts it, but I can see where DfR are coming from. The Swiss system in particular has a lot to recommend it (and is not bankrupt and paralyzed by repeated strikes the way the French, and to a lesser extent, the German systems are). [At least two members of the Dr Rant team have given donations to DfR because they believe that such a social insurance system is the best way forward - Ed.]

Perhaps I am wrong, but I think MoT has well and truly missed the point. Now, Dr Rant gets things wrong from time to time, exaggerates, swears a lot. But when you call yourself 'Dr Rant', you kind of imply that is what you are going to get. When you call yourself 'Ministry of Truth' you don't give yourself much leeway. You need to get it right.

I'm disappointed.

Trust Me, I'm A Doctor. Ignore him, he's a lying fuck politician.

A 'prospective parliamentary candidate' for a major political party yesterday.

Thanks to our regular reader [Is that meant to be singular? - Ed.] for pointing us in the direction of this YouGov poll.

Apparently people really trust doctors but think that politicians are lying scum.

Would someone from Fuckwits Anonymous now like to explain how they became such a bunch of twisted freaks?

National politicians %:
Trust a great deal 1
Trust to some extent 24
Do not trust much 44
Do not trust at all 28

To a greater or lesser extent:
TRUST - 25%
DISTRUST - 72%

Local politicians in your area %:
Trust a great deal 2
Trust to some extent 38
Do not trust much 35
Do not trust at all 19

TRUST - 40%
DISTRUST - 54%

Public officials (civil servants / administrators) %:
Trust a great deal 2
Trust to some extent 39
Do not trust much 37
Do not trust at all 16

TRUST - 41%
DISTRUST - 53%

People who run large companies %:
Trust a great deal 1
Trust to some extent 32
Do not trust much 41
Do not trust at all 19

TRUST - 33%
DISTRUST - 60%

Journalists%:
Trust a great deal 1
Trust to some extent 19
Do not trust much 41
Do not trust at all 35

TRUST - 20%
DISTRUST - 76%

University professors%:
Trust a great deal 19
Trust to some extent 62
Do not trust much 8
Do not trust at all 2

TRUST - 81%
DISTRUST - 10%

Judges%:
Trust a great deal 16
Trust to some extent 55
Do not trust much 18
Do not trust at all 7

TRUST - 71%
DISTRUST - 25%

Your neighbours%:
Trust a great deal 23
Trust to some extent 52
Do not trust much 12
Do not trust at all 6

TRUST - 75%
DISTRUST - 18%

Doctors%:
Trust a great deal 34
Trust to some extent 55
Do not trust much 7
Do not trust at all 2

TRUST - 89%
DISTRUST - 9%

Zanu-Labour 'having a laugh' bankrupting cancer patients

Health Secretary Postman Pat laughing yesterday when Dr Rant confronted him with evidence that that for the first time since the NHS was created, cancer patients were being pushed to bankruptcy by his inhuman policies.
'Fuck em! I've always hated sick people. Besides, these fuckers will be dead before the next election, and dead people don't vote. And you can quote me on that!' he scoffed.

Like watching a train crash in slow motion, the morally bankrupt free fall of NHS standards just continues to facinate, astonish, and horrify in equal measures.

Free at the point of need.

That's was the NHS's mission.

When PBS Frontline recently did a program in the US on health care systems around the world, one question that the anchor asked of health officials in all the countries he visited was: "How many people go bankrupt each year in your country from health care costs". The responses he had ranged from amusement to bemusement, and all said 'None'. 'It does not happen'. 'It is unheard of'. In the US a third of all personal bankruptcies are due to medical expenses.

Well, the UK may very soon be able to add itself to the very short list of developed nations in which people go bankrupt because of health care costs.

Yes, Postman Pat - that champion of the working class - has issued guidance that patients who dare to buy in private provision for a portion of their care (say, unfunded cancer drugs) forfeit their right to NHS care.

Several PCOs around the cuntry [Not a spelling error - Ed.] are billing cancer sufferers tens of thousands of pounds for their NHS care.

Even seasoned Dr Rant readers may need that bit repeating. If you buy a drug yourself, you will have your NHS rights stripped from you. No matter that you are a tax payer. Not even the morally dubious argument aimed at smokers and alcoholics that they 'brought it on themselves'. Just the utterly inhuman decision to bill patients for all of their cancer care costs if they dare to pay for drugs that the NHS won't.

Think about this. If the patient then runs out of money, in theory they will receive no care at all. They will have to beg for care or simply be turned away at the door to die in the street.

I'm totally, fucking, speechless.

Short of simply marching people out and having them shot, could those Zanu-Labour cunts become more despicable?

Anyone?

Update:

Doctors for Reform, are mounting a legal challenge as we speak.  Thank fuck someone has some in the NHS has a backbone about this.  [Oops - initially mixed up DfR with RemedyUK - Ed.]