Quote

There are not enough Indians in the world to defeat the Seventh Cavalry.


George Armstrong Custer 

Death

There has been an article circulating in the media telling us that the UK death rate is at an all time low.

Funny, I thought it was still 100%

Banned! again

Federici, the ice cream company are in trouble again, and, after this add was banned recently they have now had another ad banned. The picture shown above was judged to be offensive to catholics. On the basis of just six complaints in the whole of the UK. If this is offensive what would they think of this.

The Advertising Standards Authority really has lost the plot. At least the picture shows two adults, who, whatever is inferred is about to happen, are consenting. Unlike this case which, coincidentally concerned a catholic priest by the name of Federici.

I have to say that of the images produced to advertise Federici ice cream this one does not do much for me. I much preferred that picture of the nun in the stocking tops.

Chief Medical Officer

It is now over 10 months since the previous CMO for England, Sir Liam Donaldson resigned. Although an interim, Prof Sally Davies is supposedly holding the fort she has not been exactly high profile. The Dept of Health does not appear to be in any great hurry to appoint a substantive incumbent though I have no doubt there are plenty of ambitious hopefuls.

The question is, has anyone noticed? Does anyone give a toss? If you can do without someone in this position for that length of time, without any discernible consequences, perhaps this is yet another post that could be dispensed with altogether. Certainly Donaldson was little more than a government mouthpiece, a puppet.

Scotland, Wales, and Ulster all have their own CMOs so the UK normally has four of these expensive positions to fill. If we need one at all would not one for the UK be enough?

What a waste of money on a bunch of irrelevant sycophants.

Prize winner

Following on from the most recent mystery object you may see that I acknowledged the prize of one beer to "new kind of GP" for successfully identifying the Palm Pistol.

I have done a little investigating. If my conclusion is correct then NKGP should by now have received his prize. If I am wrong, then there is a very bemused GP somewhere in South Wales wondering who on earth is giving him a bottle of Brakspears.

Future mystery objects will not be rewarded with a prize. There are far too many smartarses out there.

Clarification

When I started this blog it was intended to be simply a vehicle for me to rant about the NHS and my frustrations with it. Some may have noticed that I also have a bee in my bonnet about freedom of speech. This preoccupation with freedom of expression has led me down another path, that of religion.

A number of my posts have made clear my views on this most pernicious of human delusions. The device at the top right of the blog indicates that this blog is now registered with the atheist blogroll, just so there are no doubts about where I stand.

Quote

“History does not record anywhere at any time a religion that has any rational basis. Religion is a crutch for people not strong enough to stand up to the unknown without help”

Robert Heinlein

Mystery Object 5

Well I was wrong, New Kind of GP got this easily. It is a Palm Pistol, a .38 calibre single shot firearm, designed for those who have insufficient manual dexterity to handle a conventional handgun. A triumph of occupational therapy. As NKGP points out it is available on prescription in the US, and the cost can be claimed against medical insurance. It would without doubt be illegal to possess one in the UK.

I owe NKGP one beer.

Mystery Object 5

Now here is an interesting mystery object.

Th FDA in the USA have classified this as a Class 1 Medical Device

I would put money on nobody getting this one, and I am not a betting man.

NHS Evangelism

One of the reasons I posted the quote below of Bevan’s  was to illustrate one of the original principles of the NHS, that it’s purpose was to care for the sick.

Over the years the range of services provided by the NHS has grown out of all recognition. And with that growth there has been a blurring of what constitutes sickness, and therefore what might be obtained under the description of treatment, at taxpayers expense.

For a few examples to illustrate this;

Contraceptive services

Infertility treatment

Tatoo removal

Varicose vein surgery

Gender reassignment surgery.

I am not suggesting necessarily that these, and similar treatments, should not be available on the NHS, though I think it a fair guess that they are not quite what Bevan had in mind.

I do draw the line however at this. The active promotion of “faith and spirituality” is not in my view a proper function for the NHS. For a NHS Trust to engage in this is quite abominable, particularly when it seems to be specifically directed at those most vulnerable of patients, those with acute mental illness. No references are supplied to support the highly dubious claims made in this article. No Psychiatrist is quoted as endorsing this practice.

Richard Harlow is Sussex Partnership’s Multi-faith and spiritual care team leader, of a team that consists of 90 (yes ninety) “spirituality advocates”. Further words fail me 

Remind me never to lose my marbles in Sussex.

Quote

We ought to take pride in the fact that, despite our financial and economic anxieties, we are still able to do the most civilised thing in the world - put the welfare of the sick in front of every other consideration.

Aneurin Bevan    9 Feb 1948

Money again

I have commented before on how some of my colleagues can lose their moral objections to something if there is enough money involved. Bevan knew this, buying off the doctors who made objections to the formation of the NHS, which he described as "stuffing their mouths with gold".

This article caught my eye this morning. Wherever you stand on the issue involved, one thing is clear.
They had no problem finding a surgeon to perform the procedure.

Tredegar General Hospital

A fairly small item in the news is that a new hospital has opened in Ebbw Vale, in the Welsh valleys.

What makes this of significance is that it is replacing two old hospitals, one of which could be considered to have been the model for the entire NHS itself.

Tredegar General Hospital was built in 1904, 44 years before the NHS came into being. The land it was built on, and the money for it’s construction were all charitably donated, and it’s running was funded in part by contributions from the pay of the local mining workforce. A sort of mini, local NHS.

A J Cronin worked at the hospital in the 1920s and the experience undoubtedly contributed to his novel, The Citadel.

The Chairman of the Hospital Management Committee in 1929 was one Aneurin Bevan and his experience in this position was used later, when, as minister of health he introduced the National Health Service.

Now that Tredegar Hospital has been replaced it’s future is most uncertain. It is unlikely to continue as a hospital, and may even be demolished. This would be a great shame. 

South Wales has in the past capitalised on it’s history by making museums of it’s old buildings and industries, as at Big Pit, and St Fagans.

Wouldn’t it be nice if Tredegar General Hospital could become an NHS museum, charting the NHS history of the past 60 years.

Or maybe it’s passing and disappearance will epitomise the passing of the NHS itself, which was rooted in Tredegar.

CEAs again

More negative publicity for Clinical Excellence Awards in this article. I was aware that CEAs could be withdrawn if the holder was no longer doing the "extra" work for which it was awarded, but I was not aware that withdrawal was only on paper and the extra money continues to be paid regardless.

Professor Maynard is of the view that ”It is going to be difficult for the Government to stop the payments altogether as doctors will put up a strong fight."

I think I can reassure the Professor that this is not true. The profession has long been divided into the haves and have nots when it comes to CEAs. Why would the have nots fight to retain a system they despise? There may be a lot of vociferous resistance from the BMA and the eminent, ie recipients, but there will be far less support from grass roots. The likely halving of awards made proposed for 2011 has generated precious little interest, let alone opposition

Go on Lansley, call their bluff.

Progress?

Science and technology today have delivered all sorts of incredible devices that previous generations could not have dreamed of. Iphones, computers, 3D HD TV, and a host of highly sophisticated electronic wizardry available to all.

But if we look back in recent history we see equally, if not more exciting achievements. Probably the most exciting year in the latter half of the twentieth century was 1969. In that single year Britain & France first flew a supersonic airliner, and the USA landed the first man on the moon. Both extraordinary achievements that stretched and advanced the technology of the time beyond imagination. These feats seem to have been forgotten, and we can not even equal them today. Passengers are no longer able to fly beyond the speed of sound, and no man has walked on the moon since 1972.

Forty years ago the best minds in science and engineering were engaged in tasks to advance the frontiers of human capability. Now they are engaged in making toys for adults.

Quangos to go

Here is a list of all those Department of Health Quangos that have today been given their death sentences.
Most of these will resurface as minor committees within other major organisations such as MHRA so whether this delivers real financial savings remains to be seen. The prestige associated with sitting on these committees will however inevitably decline, and membership will presumably carry far less weight with CEA committees. Oh dear.

Is your favourite here?

DH Advisory Board on the Registration of Homeopathic Products
DH Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infections
DH Advisory Committee on Borderline Substances
DH Advisory Committee on Dangerous Pathogens
DH Advisory Committee on the Safety of Blood, Tissues and Organs
DH Advisory Group on Hepatitis
DH Alcohol Education and Research Council
DH Appointments Commission
DH Committee on Carcogenicity of Chemicals in Food, Consumer Products and the Environment
DH Committee on Medical Effects of Air Pollutants
DH Committee on Medical Aspects of Radiation in the Environment
DH Committee on Mutagenicity of Chemicals in Food, Consumer Products and the Environment
DH Committee on the Safety of Devices
DH Council for Healthcare Regulatory Excellence
DH Expert Advisory Group on AIDS
DH Gene Therapy Advisory Committee
DH General Social Care Council
DH Genetics and Insurance Committee
DH Health Protection Agency
DH Herbal Medicines Advisory Committee
DH Human Fertilisation and Embryology Authority
DH Human Genetics Commission
DH Human Tissue Authority
DH Independent Advisory Group on Sexual Health and HIV
DH Independent Review Panel for the Classification of Borderline Products
DH Independent Review panel on the Advertising of Medicines
DH Joint Committee on Vaccination and Immunisations
DH National Information Governance Board for Health and Social Care
DH National Joint Registry Steering Committee
DH Scientific Advisory Committee on Nutrition

Morale

It is hardly a revelation that morale amongst NHS staff is low, and steadily falling. Posts on various blogs reveal the frustration and resigned despair afflicting staff in all areas. One of the greatest frustrations is that there seems to be nothing we can do to stop the slide.

Some years ago I was in a NHS hospital other than the one I work. On one of the upper floors there was something you don’t often see other than on the ground floor, a door leading outside. It led on to a flat roof area only, and from there, nowhere else. Management had put a sign next to this door to inform people that they could not get out that way. It was only two words, which seem to epitomise the NHS today. It said simply “NO ESCAPE”

Music

My fellow blogger jobbing doctor has recently blogged about music. We clearly have different tastes.
Now this is music. I wish I had US$180,000 to spare.

This machine is real

A man with his head up his arse

This is a picture of Dr Mark Porter, Chairman of the BMA Consultants & Specialists Committee. His task is to represent the interests of NHS Consultants and Staff Grades.........all of them.

So, what major issue of the day is Dr Porter concerning himself with? Is it perhaps the loss of child benefit for all those families who pay higher rate tax? This is something that will affect well over a million households, but it will affect every full time NHS Consultant and Staff Grade with children in Britain. Or is it perhaps the almost certain changes to our pension arrangements, where we will be working till 65 at least, paying more and receiving less. No it is neither of these.

What seems to be preoccupying Dr Porter and the BMA is the likely loss of the clinical excellence award. I say likely. To quote the Health Secretary Andrew Lansley, who wants  “to bring the scheme “up to date” and in line with other public sector pay schemes.” Bearing in mind that no other public sector pay scheme has anything remotely resembling CEAs Mr Lansley’s intentions are clear.

Dr Porter is not alone in defending the scheme, and is supported by other prominent members of the profession, mostly of course people who are in receipt of a CEA.

These people appear to me not only to be acting mostly in self interest, but also are acting under the influence of “bunker mentality”. They appear not to have noticed what is going on outside the citadel.

The truly staggering scale of the financial catastrophe that has engulfed this country is starting to become clear in the actions of the government. In addition to child benefit loss and pension cuts every other area of the public sector is suffering, leading to desperate measures. What is happening to our nursing colleagues is a good example within the NHS. There are cogent responses from nurse bloggers here and here.

But to grasp the true enormity of our financial predicament one has only to look at how the axe is falling on our armed forces. The Royal Navy looks set to lose half its fleet, the RAF may be abolished altogether, and the Army too is set to be slashed out of all recognition. All this at a time when our armed forces are more committed than at any time in the last 65 years.

And with all this desperate economising going on Dr Porter thinks he can persuade the government to retain a bonus scheme which arbitrarily benefits a minority of the highest paid public sector workers in Britain. 

There are in my view only two possible explanations for Dr Porter’s view that NHS Consultants alone in Britain should be protected while everyone else in the country bears the financial pain. The first is that he is a man of so little perception that he has not noticed what is going on, in which case he is too small minded to be considered a fit person for his position. Alternatively he is fully aware of the circumstances and is pressing on anyway, in which case he is a man with no shame whatsoever.

Wellness

There is an increasing awareness in medical practice of the medicalisation of essentially healthy individuals. One of the best examples of this is that ultimate panacea, HRT, promoted heavily as the cure all for post menopausal women. 

It is no surprise that the drug companies feature prominently in campaigns to identify, and treat new conditions that in the past were not considered illnesses at all. A good example of this is “female sexual dysfunction” where any women who does not have the sexual appetite of a bonobo is claimed to be in some way lacking, and requiring treatment with the latest female equivalent of Viagra.

The medical profession, encouraged by the pharmaceutical industry, is starting to act like the alt med frauds, convincing the worried well that they have a diagnosis that requires “treatment”. This is reinforced by articles in the media that are little more than advertising for the drug companies.

This “pseudo medical advertising” has been criticised before by a Dr R E Dawson in a letter to the BMJ. To quote from his letter;

“.....spate of pernicious pseudo-medical advertising which daily screams at us from newspapers, placards, and television screens, telling us that we are One Degree Under.; that we need this to give us deep relaxing sleep and thus solve all our psychosocial problems, that unless we use that product our children's cerebral cortexes will never put on the spurt needed.......”

“One feels off-colour, sickly, and grumpy with the children. Unless one immediately takes large rations of "X," a product of no therapeutic value at all , one's husband will instantly pay attention to a pretty girl over the road, or an underling will win promotion over one's head, and so on. “

What is interesting is when Dr Dawson wrote this. It is from the BMJ of June 21 1958.

A miracle

Every now & then the media reports a story about some religious figure whose image or words appear somewhere unexpected, like this or this, or these.

The credulous and the simple hail these as miracles and signs to prove the existence of their particular deity.

I have recently discovered such an image on the net, which some of you may have seen before, but if not it can be found here. Funny how the faithful don’t seem to be making a song & dance over this one. I wonder why.

Mystery Object 4

Grumpy RN has pointed out that there is a link from the picture identifying the object as an Ecraseur. However the Wiki entry is not quite correct for this object which is a chain ecraseur. 

The shiny strip to the left is not a blade or a wire but a fine chain, designed to crush rather than cut.

It was used, among other things to treat haemorrhoids. The chain was looped around the piles and tightened using the screw device to deliberately strangulate. Bearing in mind this is a 19th century instrument there would have been no anaesthetic.

Mystery Object 4

Time again for a mystery object
Any guesses as to what this is, and what it was used for.

Teamwork?

Could Hamlet have been written by a committee, or the Mona Lisa painted by a club?... Creative ideas do not spring from groups.  They spring from individuals.  


  Alfred Whitney Griswold