Plus ca change

 I've written a number of posts here on the subject of bullying and harassment in the NHS. If you're interested just type "bullying" into the search box top left.

Various politicians through the years have claimed to have introduced initiatives to address this, and to ensure that whistleblowers are protected. None of these have had the slightest effect, as a recent case illustrates.

In 2020, not one, but three neurosurgeons at the Queen Elizabeth Hospital Birmingham were judged by independent assessors to have been performing surgery "incompetently" for some time. Yet another case where the appraisal/revalidation process proved completely ineffective.

Concerns had been raised by a senior nurse as early as 2017. They were not only ignored, but the nurse was disciplined by the Trust. 

I wish I could say I was surprised, but sadly I am not.

Par for the course really.

Stupidity

 DZ is still trying to come to terms with the extraordinary fact that a majority of Americans voted to put Donald Trump back in the White House, where he poses a very serious threat, not only to the USA, but to the whole world.

It could be of course that the degree of racism in the USA population is far deeper and broader than we had imagined. The same could be said of their mysogyny. 

Or is it just rank stupidity? 

I think the late George Carlin had it right.

'Think of how stupid the average American is, and realize half of them are stupider than that.'

Royal Army Medical Corps

 

Today, the 15 November 2024, marks the end of a British institution that has lasted over a hundred years, and yet does not seem to have had a mention in the media. Even the Wikipedia entry for the RAMC makes no mention of it’s end as yet.

The Royal Army Medical Corps was formed in 1898. Since then the RAMC has attended to the health of Army personnel through peacetime and numerous conflicts, in the UK and throughout the world. It’s members have won 27 Victoria Crosses including two of only three recipients ever to win it twice.

It has undergone many changes. Of nearly forty military hospitals throughout the world not one remains. The last one, Princess Mary’s Hospital in Akrotiri closed in 2013. My own son was born at the Louise Margaret Maternity Hospital, part of the Cambridge Military Hospital, which, despite it’s name, was located in Aldershot.

The Army obviously is not going without it’s own dedicated medical services. The RAMC is being amalgamated with the Royal Army Dental Corps and the Queen Alexandra’s Royal Army Nursing Corps to form the new Royal Army Medical Services.

The thousands of us who have served with the RAMC over the years are sad to see it go, and wish it’s successor all success.

DZ. Belize 1988

Drinking on duty

 

DZ was interested to read this article about a nurse who was struck off the Nursing register for consuming alcohol at work.

Now, I’m not going to condone or defend her conduct. Drinking on duty is most definitely frowned upon for medical and other professionals in the UK and I think that that is understandable.

But it wasn’t always so.

My first ever job as a pre registration houseman was at an inner city hospital. There was a pub literally next door. It was not at all unusual for entire teams of doctors on duty to take advantage of the odd quiet spell and meet up in the pub for a beer. The landlord graciously allowed doctors to use his personal landline phone (There were no celphones in those days) to contact the hospital when they were bleeped. There was even a suggestion that a hospital phone be laid on for this purpose, but though considered, it did not materialise. But the management were perfectly aware of, and unconcerned about the practice.

And then there was Christmas. Through the year grateful patients would often donate small gifts to the staff when they went home. The two commonest gifts were chocolates, or a bottle of some alcoholic beverage.

It was remarkable how quickly a box of chocolates could disappear in the presence of nurses. Some things don’t change. But alcohol was locked away. At Christmas it would come out, and a small number of bottles would be available in the sister’s office for ward staff and doctors to sample. Again this was common knowledge, and tolerated.

Not by everyone it has to be said. One teetotal ultra religious consultant one year took all the bottles on his ward and emptied them down the sink!

And in France, until relatively recently, wine was available to hospital staff having lunch in the hospital cafeteria. This now appears to be coming to an end however.

DZ will certainly confess that throughout his career, when on call from home he would often have a beer or a wine, though always careful to stay well below the driving limit.

In all my years I never saw anyone abuse the privilege. I never once saw anyone drunk on duty.

Ads

 Advertising is a strange aspect of modern life. From the moment you wake and interact with the world you are bombarded with messages trying to persuade you to part with your cash in return for some overhyped item or service. Often it's never occurred to you in your life that you would want what's on offer.

What DZ considers ethical advertising simply describes what is on offer, and the ad may have the advantage of not taking itself too seriously, and or being entertaining in it's own right.

But all too often advertisers stray into practices that are less than ethical. False claims abound, particularly for slimming products,  medical devices, tooth whiteners etc, and some of these DZ has highlighted on this site.

And then there's hyperbole, and I've recently come across a glaring example of this. An ad that waxes lyrical about what they call "vertical room storage" functioning as both "decor and storage" and "a perfect example of how thoughtful design can transform functional elements into striking focal points....deepening the sense of coziness and connection to nature."

Or as DZ likes to call it, "Shelves!"

Akusoli scam

 I haven't done a scam post for some time, though they seem to be my most popular. Akusoli are insoles with magnets in, purported to reduce various aches and pains, and also reduce body fat, by acupressure. A pair will set you back £30 to £90 depending on whatever offer they are offering at the time.

Interestingly trustpilot reviews are generally favorable. Until you read them. It looks as if they get their customers to write a review as part of the ordering process, meaning that the review writer hasn't actually tried them yet. Reviews from those who have received and used them are, unsurprisingly, not so positive.

And there is no reason why they should be. Acupuncture, and acupressure are both alternative medicine practices with no credible or reputable research showing any benefit. Oh, come on. Does it sound feasible that magnetic insoles would have any effect. Get real!

But the sellers know full well how slimming and pain relieving products appeal to the desperate. The advertising blurb for these things is bullshit, with numerous pseudoscientific claims, all fallacious, and the product itself manifest garbage. 

Save your money. Don't be taken in.

Appraisal fails yet again.

 Great Ormond Street Hospital has long been regarded in the UK as providing the very best in NHS paediatric care. So this story about one of their former orthopaedic surgeons is exceptionally worrying. Like the case of Ian Paterson, Mr Yaser Jabbar seems to have been performing botched and mutilating surgery for some years, before finally being stopped. Sadly, as soon as the shit hit the fan Mr Jabbar decided he didn't want to face the music, and fucked off sharpish to Dubai.

It's clear that he had been underperforming for some time, and concerns raised with the Trust from unhappy parents were ignored by management. And once more one of the guilty is the Medical Director. What is it with Medical Directors?

Finally the Trust asked the Royal College of Surgeons to review the problem, prompted by the sheer volume of complaints from parents and staff.

Notice if you will, one glaring absence from the list of those who apprehended this guy. The General Medical Council. I thought they were supposed, through the appraisal and revalidation system, to pick up these problems early on.

It couldn't be could it, that appraisal is totally ineffective in this, or any other objective? Surely not. That would mean it was a total, complete and utter waste of time and resources

Mystery object answer

 

No suggestions on this one. It's not actually medical. It's a hand held device for dispatching chickens quickly by breaking the neck in the approved place. Not approved by the chickens obviously.

Mystery object

This popped up on DZ' news feed today. 

Any guesses?

Out of touch

 A few weeks ago DZ highlighted the case of Dr Sarah Benn, a climate activist, and that the GMC had sanctioned her, in defiance of several articles of the Human Rights act.

Despite her having been retired for 2 years now they suspended her registration for five months. A totally vindictive, spiteful, and pointless act, but totally in character for the GMC and MPTS.

The reason that they ignored her very valid arguments was that they asserted that they knew better what the general public might consider unprofessional behaviour.

Enter the Doctors' Association UK, who decided to fact check this stance, by polling 2000 members of the general public. Only 3% of those polled agreed with the MPTS! A perfect illustration of how out of touch, patronising, arrogant and incompetent the GMC are.

I'm not sure why Dr Benn is still registered with the GMC at all. Taking voluntary erasure is an easy process and frees retired doctors completely from their malign attention. 

And using logical arguments in her defence was another waste of time. They're deaf and blind to anything but their own preconceptions. Why did she even bother turning up? What can they possibly do to a doctor no longer practising.

In her shoes I would have gone to the tribunal. And I would have relished the opportunity to express my opinion, and told them to fuck off!

Sisters

 DZ has been highly critical over the years about the GMC. But this article reveals that the General Nursing council is just as bad. Compare these two phrases;

“the council causes distress to doctors over trivial complaints while tolerating poor practice in other cases”. Sir Liam Donaldson.

"Good nurses find themselves investigated for years over minor issues, while some bad ones escape sanction."  Independent review.

In fact, reading the review you could be forgiven for thinking that it was about the GMC, with references to bullying, racism, and suicide among those being investigated.

The GMC, GNC, and all the other specific regulatory bodies should be abolished totally, and replaced with a proper, independent, professional body covering all health professions. Staffed by properly qualified people, instead of the incompetent amateurs we all have to put up with.

Flower

 No suggestions on that last post. It's Papaver Somniferum. The Opium Poppy. The one grown to produce Morphine and other opiates. It's not illegal to cultivate this flower in the UK, and it's seeds can be grown cheaply and openly on the internet.  

Doing anything to the plant to obtain the raw opium however is strictly illegal. DZ's plant has now shed it's petals to reveal the seed head which will distribute it's seeds like a pepper pot. Like all poppies they self propagate easily And DZ anticipates more of these flowers eventually.

Mystery Flower

 

There’s a bit of rough ground behind my back garden fence. It normally just grows ferns and nettles, but this year I decided to try and brighten it up a bit. I bought a large bag of wild flower seeds and scattered them over the fence. Inevitably some of the mix fell on my side, and one of the plants that grew from it is this rather lovely flower. I know what it is. Do you?

Lucky escape

 The UK left the EU in 2020. That move has attracted considerable criticism ever since, with many yearning to return. 

2020 was also the tenth anniversary of the accession to power in Hungary of Viktor Orban. Orban has ushered in form of government that DZ finds worrying. Autocratic, right wing, and theocratic, Hungary stood alone in the EU, dominated by democratic socialist governed countries. Until recently. 

Orban's type of politics have been spreading throughout the EU, and gaining ground. Orban has recently announced collaboration in the EU parliament with right wing parties in Austria, and the Czech Republic.

In another event there was an attempted right wing coup in, of all places Germany. An episode that the media devoted surprisingly little attention to.

And in France the far right are ahead in the first stage of the general election.

And this is a trend throughout Europe. A trend which could see the entire EU eventually taken over by Nazis. Plus ca change, plus c'est la meme chose.

It seems to DZ that those who wish to reverse Brexit are not paying attention.  It is true that we have our own fascists, in the Reform party. Their support, estimated at 16% is disappointingly high, but they are already beginning to show signs of infighting and disarray. Their leader, Nigel Farage, a right winger himself, was instrumental in getting the UK out of the EU. It would be a delicious irony if, as a result of this the UK were able to distance itself from the right wing advance in Europe.

Maybe Brexit was not such a bad idea after all.

Spot the difference.

Oswald Mosely

Nigel Farage

New Friends

 As DZ came up to retirement, he wondered if he would find himself at a loose end. Twiddling his thumbs with nothing to do, and getting under Mrs DZ feet all day.

But I needn't have worried. I've found myself busier than I thought possible, and have a never ending to do list. 

One of the things I've found an interest in is my long neglected garden, now transformed beyond recognition, and as I've spent more and more time out there I've found a new friend. he appears almost every time I'm out there with a spade in my hand, keeping me company.

Meet my new gardening buddy.

Death

 Earlier this year DZ lost his older brother. His death was sudden and unexpected. He was a strong, fit man and his passing was a huge shock. Though it is now several months since, I still find this hard to write. I was lucky in that we maintained contact through our entire lives.

I have many fond memories of the shit we used to get up to as kids. Our relationship is perhaps well summed up in this picture.

Being two years older than me he, to a certain extent, looked after me, and I looked up to him and I miss him hugely and the laughs we had until just a few weeks before he died. 

My Brother and me, circa 1958.

Villain

There is no doubt that bullying and harassment of NHS Staff is still rife, in every role and at every level of seniority despite various initiatives intended to address the issue. It even affects those in management as this case shows. And what this, relatively recent case, also illustrates is just how corrupt, dishonest and mendacious some senior management can be. 

At an employment Tribunal hearing a former employee of  Norfolk and Waveny Clinical Commissioning Group sought redress for unfair dismissal. The case revolved around a grievance document  prepared by a CCG employee, Steve Stavrinou. Despite Mr Stavrinou being present in court he kept quiet when the Judge was told that the document didn't exist.

But Mr Stavrinou is not the real villain of this piece. He was probably under instruction. His actions however attracted a comment from the Judge that "Mr Stavrinou is a man who finds the truth an alien concept,"

This is John Webster, Director of Strategic Commissioning at the CCG, described by the Judge as "disingenuous and unconvincing". Webster lied about the document, and then allegedly had it altered, prompting the Judge to state "Clearly, there had been a conspiracy all along going on behind the scenes,"

As if this catalogue of mendacity and dishonesty were not enough the CCG even tried to have the Judge removed once it became clear which way the wind was blowing.

The Judge has called for a full investigation and for guilty individuals to be disciplined. But Webster isn't hanging around. He's jumping before he gets pushed. Which means he'll be looking for a new job. And I have no doubt, in today's NHS he will find one. Coming to a hospital near you soon?

Tipped scales.

 DZ thought that he knew all of the machinations used by the GMC to make it easier to screw over doctors who come before a Medical Practitioners Tribunal.

Such as the original idea that the MPT should be independent of the GMC, which never happened.

Or the change in burden of proof from the criminal standard, (beyond reasonable doubt) to the civil, (balance of probabilities).

Or the fact that the only appeal against the penalty set by a fitness to practice hearing is to the High Court, an expensive, daunting and difficult path making appeal almost impossible for most doctors.

But what I didn't know was that, if the GMC themselves are dissatisfied with the judgement of a FPH and want a more severe punishment, then they themselves do have an appeal system for that. An appeal pathway not open to the accused doctor. And who gets to adjudicate this appeal of the GMC. Why the GMC themselves of course. 

The government noticed this and recommended abolition of this unfair practice over six years ago but nothing happened.

I din't know why the fuckers bother with a FPH at all. It's so biased against the doctor that it would be laughable if the consequences weren't so devastating

Be nice.

 Like most people, DZ has occasionally opened the door to evangelising individuals, purporting to be concerned for your welfare, and offering salvation. Usually, but not exclusively Jehovah's Witnesses. DZ, until recently, has turned them away in a polite and civil manner, but he is aware that many people give in to their irritation and respond rudely or even abusively.

But I have recently read something that points out that this in fact plays into the hands of the cult. That the visit of the faithful is not actually intended to convert you, but to reinforce the brainwashing of those unfortunates on your doorstep.

The whole process is explained here, by Doug Robertson.

So the next time this happens, be nice to them. Offer them a cup of tea. Sit them down. It might actually counter very slightly the brainwashing they are enduring. You could even print off some copies of this article and, when they offer you their leaflets, you offer them a copy of yours. If they accept, suggest to them that every time they endure abuse on the doorstep they should remember what Dr Robertson has written. Make it politely clear you don't share their beliefs but express sympathy for their predicament. I've actually done this once with a middle aged pair of JW's and explained how they were being brainwashed. They actually lost their temper! And left. Result!

Earth Day

So yesterday, 22nd April, was "Earth Day". DZ is aware that various climate activist groups are not popular in the UK. But despite the disruption they undoubtedly cause, no-one can doubt their commitment, sincerity, and commitment to protest in a peaceful manner. Those familiar with DZ blog will know he is almost obsessive about the Human Rights Act 1998, and there are a number of articles of the act that protect those who wish to protest peacefully.

• Article 5: Right to liberty and security
• Article 6: Right to a fair trial
• Article 7: No punishment without law
• Article 8: Respect for your private and family life, home and correspondence
• Article 9: Freedom of thought, belief and religion
• Article 10: Freedom of expression
• Article 11: Freedom of assembly and association

All of the above are invoked to a greater or lesser degree by those who protest. The present government has demonstrated an antipathy to the act, and even suggested it's abolition. It's an ambition that, for the time being seems to be on the back burner. However two recent very disturbing  cases illustrate that it's observation seems to be under attack. 

The first is the case of Trudi Warner.

 who faced a charge of contempt of court for simply holding up a placard outside a court. Fortunately the high court judge threw the case out. What is really disturbing is that the high court judge drew attention to the actions of the Attorney General, and the Solicitor General, which were described as "significantly mischaracterising the evidence". Let's translate that. They lied! The most senior lawyers in government fucking lied to try and charge this lady for doing something she had every right to do!!!

 

The second case is that of Dr Sarah Benn.

The Medical Practitioners Tribunal Service has ruled Dr Sarah Benn's fitness to practise was impaired and said it must consider whether a sanction should be imposed on her registration. For participating in a peaceful protest, in defiance of a court injunction.

Let's leave aside for a moment the idea that the human rights act can apparently be over-ridden by the courts, something I find highly questionable. What is astounding is that she could face suspension, or even erasure for "Obstructing a private road." The GMC, and the tribunal service have a long history of disdain for the human rights act, and seem to think it doesn't apply to them. Also these tribunals are usually made up of complete amateurs who know nothing about the law. And as well as their arogance, they are inconsistent. 

"In January 1999 the Standards Committee of the GMC met to consider issues involving the behaviour of doctors who comment in the media. It was their view that the GMC should not attempt to curtail doctors' rights to express their personal opinions. Doctors, like anyone else commenting in the media, are subject to the same constraints imposed by media regulatory bodies, and the libel laws. Furthermore, the committee considered that the professionals reputation depends principally on the standards of care and conduct provided by doctors to their patients, and not on personal opinions as put forward in published letters or articles. Whilst you may disagree with the comments Dr Y has made, we cannot take action against a doctor who is expressing a personal opinion".

Dr Benn's actions have absolutely nothing to do with the standards of care she provides to her patients. I anticipate that, in view of the publicity this case has attracted, and the involvement of the BMA, that the GMC will back off. I expect that they will offer Dr Benn a warning. Dr Benn should be made aware that has the right to refuse a warning. The GMC should be told to fuck off.

Turbo cancers???

 DZ has had a long career in medicine, and while there are plenty of areas where he has very little knowledge, it's not often that he hears of something completely new to him. So it is with "Turbo Cancers". Apparently questions about these have been raised by politicians in the USA. You would have thought that those raising the subject might have taken the time to inform themselves before opening their mouths. Alas not. To quote a former wiser US politician, Abraham Lincoln. "Better to remain silent and be thought a fool than speak and remove all doubt."

A very brief google search reveals Turbo cancers to be a figment of the imagination, perpetuated by the anti vaccination loons. As if they haven't done enough damage with their insane misinformation campaigns, which have caused the resurgence of Measles. The USA now has up to four million cases a year, of whom 500 die. Nearly all of these cases and deaths are in the unvaccinated.

The UK figures are not as bad, but are still on the increase.

Most Doctors have the satisfaction of looking at their hands and being pleased with what they have achieved with them over the years. A small number look at theirs and see only blood.

Rapture

 Well, the world didn't end then. But the doom mongers never give up. One characteristic of the prophets of armageddon is they never admit defeat. They never admit they were wrong. Their approach is to claim they simply got the date wrong. And true to form we already have another date. 23 April. I wonder what they'll say on 24th.

Turds

 A small number of you may have noticed a small error in my last post where I put up a pic of Steve Bannon instead of Alex Jones. Now rectified. In my defence I can only say that the mistake was easily made. They are two turds cast in the same mould.

End of the world

 DZ has written before, as long ago as 2011 on predictions that the end of the world is imminent. Despite many hundreds of failed predictions humanity doesn't appear to have learned, and there still seems to be a steady flow of nutters exorting us all to repent before it's too late.

On 5 March there was a relatively minor, (Magnitude 4.8) earthquake affecting New York state, and in two days, on 8 May there will be a solar eclipse visible over much of the USA. This has sent many in the USA to view this as a portent of...... well anything you can think of really. A simple internet search reveals a plethora of disasters predicted to be just around the corner But in particular the religious evangelical loons are predicting that it's finally time for the rapture! Again.

But to put things in perspective. There are 55 earthquakes every day on the planet, mostly minor. There are still however 16 earthquakes a year of magnitude 7 or more. hardly rare enough to be a portent of anything. Solar eclipses occur at a rate of up to 5 a year, and are entirely predictable. Hardly a surprise if you know it's coming. It doesn't stop neo nazis like Alex Jones from predicting "“Major Events Surrounding The April 8th Solar Eclipse, Masonic rituals planned worldwide to usher in New World Order."

Jones is particularly fond of various outlandish conspiracy theories, despite having been successfully sued because of it.

He always reminds DZ of one particular "peanuts" character.

Pigpen.

Guess who

 Over the last few years DZ has developed an interest in politics, both UK, and USA. He has even joined a political party, though I'm not going to say which one. 

But as far as the states is concerned I have a firm preference, which you can probably guess, by my choice of today's pic

Ads

 In the ten plus years that DZ has maintained this site he has persistently refused to have advertising material feature on his pages. As a NHS consultant he was not underpaid, and was able to afford the luxury of avoiding advertising as a matter of principal.

Now I'm retired I find that, every little helps, so I've dropped my resistance and will now allow ads on my pages. I'm sorry if any of my readers find this detracts.

Please be aware that I have have no control over what sort of ads appear. And also any ad that does appear should not be taken as an endorsement from me.

You never know, some of them might be quite funny.

Sit on this

 DZ has had a very busy year. He finally and definitively retired, for the third time, and is still getting used to the change. 

But it occurs that, although he no longer has his professional experiences to fuel his musings, that doesn't mean he has nothing else to talk about. There's a lot going on in the world. There's a lot going on in my life.

And despite my age, I'm now 70 years old, things still happen that are worthy of sharing. What follows is a true, and recent story.

I recently took my vehicle to a kwik fit for a new tyre. While waiting I was engaged in conversation by an elderly but sprightly gentleman who asked if I played golf. In fact I consider golf to be a very tedious game, and I'm not geriatric enough to consider it yet, but I replied simply that it wasn't my thing. We did however find that we had a common interest in motorcycles, and he showed me a picture on his phone of his machine, a Kawasaki, in much the same way that people will share pictures of his grandchildren. 

By now his vehicle was ready and he left. Mine was ready just a few minutes later, and I retrieved my keys and went out to the car park and got into the car. The elderly gentleman was still there and he walked over to me motioning for me to open my window. He came up to my car and said. "I wonder, would you care to come to my home, and sit on my Kawasaki?" 

Yup, I was being hit on.

I politely declined. Mindful that my interpretation may have been incorrect I recounted the exchange to Mrs DZ on my return home. Considerably amused she confirmed that she agreed with my suspicion. 

Sadly for the gentleman I have never blown that way, but on the other hand I'm left with the ego boosting thought that DZ has still got it.

And the phrase, "sitting on the Kawasaki" has become a new euphemism for us.

I'm back

 In the clearing stands a boxer and a fighter by his trade,

And he carries the reminder of every glove that laid him down,

or cut him till he cried out, in his anger and his shame, 

"I am leaving, I am leaving!"

But the fighter still remains.

                                                    Art Garfunkel and Paul Simon