Comments on Dr Rant: PCTs and gunpowder

"They are top heavy bureaucratic structures staffe...

2007-11-29T23:45:00.000Z

"They are top heavy bureaucratic structures staffed by many people with very little brain or talent."

Here we see laid bare the 'team working' values of an average medic.

I've met plenty of useless incompetent doctors - and if we're going to use the same logic why not add Harold Shipman's 'skills' into the mix and just surmise that all doctors are useless incompetent murderers?

Cunts Cunts Cunts Cunts McCunts

2007-11-21T21:14:00.000Z

Cunts Cunts Cunts Cunts McCunts

... What about 'mc medicine?!' ... next?

2007-11-20T22:58:00.000Z

... What about 'mc medicine?!' ... next?

fucking hypocritewe all know medics and their rela...

2007-11-20T22:20:00.000Z

fucking hypocrite

we all know medics and their relatives queue jump, as do senior politicians, why should an nhs manager be any different?

its the poor public i feel sorry for

The most abuse I have ever received on the job cam...

2007-11-20T22:12:00.000Z

The most abuse I have ever received on the job came from a PCT manager whose relative was being assessed in my MAU.

There was a 23+ hour wait for a medical bed (courtesy of the ED 4 hour target overflow). We'd run out of chairs in the 'walking wounded' section and I was running around like a headless chook trying to convince people with positive troponins not to self-discharge.

This particular patient had to wait (shock, horror) for 40 minutes to have blood taken and were to be treated as an outpatient if the blood test was positive. This clearly wasn't good enough and I was told this by said admindroid. I politely explained the current waiting time, clinical priorities and the fact there was only one doctor on for the area. This was answered with a 'yes but...' then a huge spiel on how inadequate I was.

As I walked off, I had several other patients follow me to tell me that they thought I was a good doctor, that I was clearly very, very busy and they were sorry for the relative's behaviour.

The PCT manager's lack of grip on reality and sense of entitlement over other patients says it all really.

Hello dr rant. Actually, I thought Llandough (whi...

2007-11-20T18:25:00.000Z

Hello dr rant. Actually, I thought Llandough (which is a nice hospital) was in Penarth till I found that page!

Shame there's no A&E unit there isn't it?

the lack of A & E except at the Heath is a disgrace.

Actually I live fairly near the Heath, the Trust seems to cover rather a large area.

Thanks Rahere - I have been venting for some time ...

2007-11-20T18:14:00.000Z

Thanks Rahere - I have been venting for some time now: I find the medical blogging community incredibly therapeutic [and much cheaper than analysis].

But despite the apparent semblence of external calm I sometimes experience Rant-induced surges of sympathetic nervous activity combined with extreme serotonergic excitibilty when certain posts hit the blogsphere.

We, the grunts, are like a persecuted religious minority who hold an unswaying conviction that we are arbiters of the real health truth - we are probably right as well, if we take the original tennets of the NHS as the cornerstone for our oft repeated mantra of letting professionals get on with the job they were trained to do.

But the NHS is in the grip of privitisation by stealth and it is this covert agenda that has set the scene for so much of the conflict between staff on the ground and the policy makers - sad but true IMHO.

And breath out............

Llandough is near as damn it in Penarth! Shame the...

2007-11-20T18:08:00.000Z

Llandough is near as damn it in Penarth! Shame there's no A&E unit there isn't it?

Looks like its the Heath, Royal Glam or Bridgend for you!

The first Google hit for my Trust (which isn't act...

2007-11-20T17:58:00.000Z

The first Google hit for my Trust (which isn't actually called a PCT) begins

"There are no hospitals in Penarth"

which says it all, really....

A&E charge nurse - this is not winding up the grun...

2007-11-20T17:42:00.000Z

A&E charge nurse - this is not winding up the grunts, it's "venting", and I view it in a very positive way. How else can those of us mired in the stinking cesspit that is interaction with those PCT managers ["strong"? - stubborn possibly, but "strong" has undeservedly noble connotations] possibly avoid sinking below the faecal waves unless we can feel that SOMEONE is on our side? Most of my partners think I AM Dr Rant (Oh to be that worthy etc!), but note that I am calmer and better able to cope with the idiocies inherent in my job when I have enjoyed working up a good lather of righteous indignation over the good doctor's latest posting and a strong cup of coffee. It really is good to know we are not alone....

Anyway, Cottage hospitals: a bloody good thing, but NOT "in" any more, it would seem...

In the case of Savernake that is mentioned by Dr Rant, and I alluded to in my first post, it looks like they are SO "not in" that the PCT is bent upon covertly running it down so they can shut it and if it is not a nursing home in 12 months time I'll be abso-fucking-lutely amazed.

In an attempt to stop it, however, there are two applications for judicial review before the high court. One is for over the closure of the Day Hospital, which was handled in a way that makes Attila the Hun look like a "good people manager" (never mind the removal of a terrific clinical resource). This aplication ahs been granted, and the judge granting it pointed out that he did so despite the reams of "evidence" the PC submitted, and said it should be dealt with before Xmas, as well as refusin the PCT leave to claim their costs from the plaintif (a local health campaigner assisted pro bono by a local barrister) - the grunts may be weak but they can still stick it to the man!

the second is for review of the illogical, perverse, boneheaded decision to shut the Minor injuries Unit in the hospital. This has produced a blizzard of statistics and numbers from the PCT in their submissions to the court, none of which make sense. If one tries to question the cost, one is told that it's not about cost, and presented with the truly surreal argument that closing the unit and expecting punters to travel 20 miles to a (worse) one where the nurses can do less is somehow a "service improvement"! We await news of the review application's success with hope but little expectation - the PCT is spending money for patients on flocks of £300/hr barristers.

I realise I'm going slightly off topic here, but the PCT involved exemplifies the quality-deficient, bullying, common-sense free, politically motivated, one-synapse-between-them management that Dr Rant rails so eloquently against. There is but one PCT manager that I have met (and we all know there are hundreds of the bastards - multiplying every time a new pot of money appears and mutating their job-titles to meaningless drivel) who I have any respect for - and she has been nobbled by her over-promoted, talentless fuckwit bosses!

Feel much better now...

Rahere

Dr Rant - please stop winding up the grunts: I fou...

2007-11-20T16:19:00.000Z

Dr Rant - please stop winding up the grunts: I found myself frothing at the mouth after reading this post.

They [the PCT and their ilk] will still be there tomorrow, and the next day, etc, etc.

They [the managers] are strong - we [the grunts] are weak: it seems to be an immutable law of the NHS I'm afraid.

Have seen a few judicial reviews - any analysis yo...

2007-11-20T16:16:00.000Z

Have seen a few judicial reviews - any analysis you have made would be interesting to us.

we thought that that cottage hospitals were the 'in thing' again now - that obviously only lasted 15 minutes!

Just say the word, and I'll fill you in on everyth...

2007-11-20T15:38:00.000Z

Just say the word, and I'll fill you in on everything I know...I assume you're up to speed on judicial review's etc?

Rahere

Mission Statement indeed!Savernake hospital is on ...

2007-11-20T15:23:00.000Z

Mission Statement indeed!

Savernake hospital is on Dr Rant's Radar by the way, so thanks for the tip!!

Nail on the head, Dr Rant. My local PCT (Wilts)wou...

2007-11-20T14:28:00.000Z

Nail on the head, Dr Rant. My local PCT (Wilts)would appear to have taken your rant as a mission statement, not a critique, and given that they are financially embarassed to the tune of 20million plus, I can almost hear them becoming erect at the thought of shafting us troublesome and expensive GPs using the "McMedicine Franchise fuckwittery" you mention. PLanners have stopped Tesco from trying to get a foothold in my town for years, and now it looks like they're likely to be invited to set up shop...probably on the site of the cottage hospital recently rebuilt at £10million plus (PFI, of course) and now all but shut by the wankers who run things Health down here in safely Tory (not a coincidence, I suspect) Wiltshire.

Oh Joy.

Rahere

The lunatics have certainly truly taken over the a...

2007-11-20T13:11:00.000Z

The lunatics have certainly truly taken over the asylum.

Welcome to my world ;-)

Our PCT gave us pots of cash and aren't wanting to mess with my service at all.

I love them :-)