Thursday, May 27, 2010

NHS: Two Consultants & Freedom of Speech

The Shrink:
The Shrink is highly respected and I remembered that there were patients wanting to find out where Lake Cocytus really is and move there. The Cockroach Catcher would not miss a single entry by The Shrink. He is the typical understating educated British Consultant. Then some weeks back something changed and in his recent posting he was not pleased. Not pleased with the Tick! Tick! Tick! approach that is everywhere in our NHS.

“…….I do work on medical and surgical wards, covering liaison psychiatry for older adults in the acute hospital. 

Things ain't great.

Medication is accidentally omitted (oddly, never reported to the NPSA despite their alert on this issue).

People are left lying in urine.
People are left unfed.
This happens every day.

…….How will the Trust be sure that things are in place? Nurses will check. Except the senior nurses, who 2 years ago were seeing patients, now don't. They now "support the governance framework" through checking things on clipboards are ticked off and done. This drives them to distraction, they're band 8 nurses, not band 3 clerical support, but that's what the Trust requires of them. Tick, tick, tick.”                                     More>>>>

Then a little while back:

“A couple of patients a day are seen within the acute Trust down the road by our liaison psychiatry service. I am involved in all of them, managing all referrals and seeing many folk on medical and surgical wards.

All is not good.

Again I've had a week of misery and depression and despair. Mercifully, that's not my patients. Nor my team. Nor myself. The low mood and low morale and consequent, ‘f**k it all!’ attitude is increasingly pervading the acute Trust's wards. Staff are desperate.

This is bad.”

I know.               More>>>>

Dr Zorro:

Dr Zorro is a consultant in the NHS, probably for some years but young in blogging terms. He started in April 2010:

“Every day out there things happen in our health service that should get more publicity, but don’t. There are a number of reasons for this, including apathy, resignation, practicality and others, but I think one of the major ones is fear. Many of us remain silent because we fear what our employers will do if we stick our heads above the parapet and criticise or express adverse views. Such fear is not unjustified.”

“Doctor’s are often labelled as ‘challenging’, for having sufficient independence of thought to challenge politically driven diktats which on occasion are unhelpful, or even compromise care. As Shaw said ‘all change is achieved by the actions of the unreasonable man’”

Today he talked about a group of doctors he knew: the consultants.

Accountability, part three

“Having posted my last rant about the managers at Stafford hospital, it hit me that I have completely failed to mention one other group of people who should take some responsibility for what happened there.
He went on:
“The medical Consultants must have known full well what was happening at the sharp end. Unless they were blind and deaf they can not have been unaware of the avoidable suffering and death being inflicted upon their patients. Patients to whom they owed their ultimate loyalty. They as much as anyone let their patients down.

“It could be argued of course that they were, like other staff, intimidated into silence, knowing full well what would happen to any individual who spoke out.”

His final verdict:

“Cowardice. Craven, inexcusable cowardice for which they should be thoroughly ashamed.”

More: here>>>>
Previous posts: here>>>>:here>>>>
Also covered in:  The Witch Doctor

Tuesday, May 25, 2010

Tate Modern at 10: Louise Bourgeois & Insomnia

Tate Modern©2010 Am Ang Zhang

I was at the Tate Modern with my wife the other day for their 10th Anniversary celebration.

When Tate Modern first opened 10 years ago Louise Bourgeois was the featured artist with her famous spider.
 Tate Modern
Then a couple of years back I saw the Crouching Spider in San Francisco.

Insomnia is bad for health: not so it seems for Louise Bourgeois who has been an insomniac since 1939 and she will soon be 100.

Louise Bourgeois en 1990 avec sa sculpture en marbre Eye to Eye (1970). 
© ADAGP, Paris, 2008.

© Photo: Raimon Ramis, D.R.

Kate Kellaway
The Observer,    Sunday 27 April 2008

The Queen of Insomnia (if she will permit the title) is the 96-year-old French artist Louise Bourgeois. Hers is a heartening case. She has been an insomniac since 1939 and, even in old age, has fierce things to say about it: 'I am insomniac, so the state of being asleep is paradise. It is a paradise I can never reach.' Yet, between November 1994 and June 1995, she produced a remarkable body of work, The Insomnia Drawings. Some are soothing abstracts - Bourgeois described working on them as 'a kind of rocking and stroking and an attempt at finding a kind of peace'. Others are sharper, more figurative (of water, houses, the figure of a woman). These are a way of dealing with traumatic experience (she had an abusive father, a traitor of a stepmother and, in her youth, tried to drown herself).

Curator Ann Coxon of Tate Modern believes insomnia is crucial to Bourgeois: 'She has to keep herself in that traumatised place to keep creating such amazing work.' What I find most interesting is that for Bourgeois art is an alternative to sleep: her drawings process trauma as dreams are supposed to do.

Art is a guarantee of sanity.
Louise Bourgeois

Tate Modern at 10: Guardian

Louise Bourgeois:PBS, Observer, Telegraph, San Francisco

Friday, May 21, 2010

NHS: Polyclinics & Sense

Jobbing Doctor in Sense:
Most Jobbing Doctors thought that "Lord" Darzi's ideas were a crock of shite. Seems like some politicians agree with that.

But in fact it was not just some politicians, it was our new Prime Minister:

April 21, 2008
David Rose
But Mr Cameron condemned the plans, announcing the start of a week-long offensive against the Government’s health policy.

As many as 1,700 local surgeries in England would have to close or merge in order to form the clinics, he said.

“The NHS has suffered hugely from fads driven from Whitehall. And my worry, and why we’re launching this campaign, is that this is the latest fad. The Government has already tried to bring about the end of the district general hospital. Now ministers are trying to abolish the family doctor service.

“Communities which have lost their Post Office, their local shops and their local police station, are now going to lose their doctor.”

In a speech to the King’s Fund, the charitable foundation, in London this morning, he will urge doctors to sign-up to an online manifesto which declares general practice to be “the foundation of the NHS”.

The petition adds: “We want to be free from central Government interference and bureaucracy; able to control our own budgets; rewarded for working in socio-economically deprived areas; free to reinvest for our patients’ benefit and able to innovate in contracts with healthcare providers.

It continues: “We also believe we should be free to determine the opening hours, size and locations of our practices, in response to our patients’ needs, and object to being forced into polyclinics against our will.”

Cameron: Speech


Wednesday, May 19, 2010

Faking: Harvard & MIT

Survival is instinctual and in an earlier post I reported:
In Tortuguero National Park of Costa Rica, we were fortunate enough to observe a catch by the Anhinga. A seven inch fish was the latest victim……… The fish looked truly dead. In normal circumstances, one flick was enough. It had two. Or was it three?
The bird was now relaxed. Why rush when you can wait till the previous fish is fully down? Spread your wings a bit – there is a huge audience of tourists. It was a beautiful sight – a female Anhinga spreading out its wings. 

Suddenly. Very suddenly. The little fish came to life. Made a couple of strong wriggly movements, slid into the water and swam off. By the time the Anhinga realised, it was a split second too late. The fish disappeared into the mangrove roots.                                          

Then we find a pilot falsifying his qualification and flew for 13 years. More>>>>

Now the Harvard Crimson reported on a student applying for Rhodes and Fulbright scholarships:
May 17, 2010

A former Harvard student was indicted Monday for falsifying information in his applications to Harvard and for several scholarships.

Adam Wheeler, 23, was indicted on 20 counts of larceny, identity fraud, falsifying an endorsement or approval, and pretending to hold a degree. Wheeler was allegedly "untruthful" in his applications to the University and in scholarship applications, according to a statement released Monday by Middlesex District Attorney Gerry Leone.

As a senior in September 2009, Wheeler allegedly submitted fraudulent applications for the Harvard endorsement for both the United States Rhodes Scholarship and the Fulbright Scholarship.

The University Diaries called him:
Everyone’s talking about Adam Wheeler, the incredibly enterprising, incredibly precocious confidence man who lied and faked his way into Harvard University, and, once there, got tens of thousands of dollars in various money awards.
Read all about it here.

But Adam is an amateur by comparison with Marilee Lee, the admission dean of MIT, Marilee Lee did the same and it took 28 years for her to be found out.

When Jones applied for a job at M.I.T. in 1979, it would have been perfectly reasonable for the university to pay attention to her academic record. School officials had little else to judge her by. Twenty-eight years later, the situation is different. They know she's good at her job. She has demonstrated real merit. Why should her employer care about the paper stuff? But, of course, they did care, and she did lie. And she maintained the lie for 28 years until she was outed by anonymous sources. And this wasn't just any lie. It was a lie in the very area in which Jones' job requires her to expect the truth. The dean of admissions, of all people at a university, has to be pretty firm on the question of résumé padding.

February 5, 2008

Jones was also well-respected among administrators, faculty, and her colleagues in the Admissions Office. She received a 2001 MIT Excellence Award for Leading Change, given for her ‘visionary’ approach to college admissions.

Faking Posts:

Tuesday, May 18, 2010

Mt. St. Helens--30 Years

On May 18, 1980, at 8:32 a.m. Pacific Daylight Time, a magnitude 5.1 earthquake shook Mount St. Helens. The bulge and surrounding area slid away in a gigantic rockslide and debris avalanche, releasing pressure, and triggering a major pumice and ash eruption of the volcano. Thirteen-hundred feet (400 meters) of the peak collapsed or blew outwards. As a result, 24 square miles (62 square kilometers) of valley was filled by a debris avalanche, 250 square miles (650 square kilometers) of recreation, timber, and private lands were damaged by a lateral blast, and an estimated 200 million cubic yards (150 million cubic meters) of material was deposited directly by lahars (volcanic mudflows) into the river channels. Fifty-seven people were killed or are still missing. 

USGS Photograph taken on May 18, 1980, by Austin Post

Alaska and Yellowstone: Predicting Earthquakes and Volcanic Eruptions.

Monday, May 17, 2010

House M.D. : Canon 5D Mk II

At the WPPI show in Vegas, I heard something that I thought was just sales talk. The Canon speakers said that the Canon 5D Mk II is better than any of the video cameras at the show.

No way, I thought, they were about 10 times the price.

Canon WPPI 2010 ©2010 Am Ang Zhang

Well, tonight's House MD (US) is filmed entirely with Canon 5D MkII, a digital camera.                 Sneak Peek >>>>  See a clip of Canon 5D here>>>>.   Blog Critics
One of the problems of Digital Camera for motion picture taking is the sharpness, not the lack of it, the opposite: too sharp. There is a built in software that will take care of that. 

Now surgical operations can be filmed with the much cheaper ‘still’ digital cameras!

I also heard that BBC and Reuters only allow their photographers to take video with DSLRs and no single shots. I think the editors wanted control. Not too good for the future Magnums.

NHS: Andrew Lansley on Hospitals, Doctors & Nurses.

Thank goodness for the internet as we can easily track what politicians have ever said. Are they as happy as we are, only time will tell.

By Kate Devlin, Medical Correspondent Telegraph
12 Jan 2009

Britain has fewer hospital beds per head of population than almost any other European country, with half as many as Lithuania and Hungary, according to official figures.
The figures show that while Britain has 389 hospital beds per 100,000 people, Germany has 829, the Czech Republic has 817, Lithuania has 801 and Hungary has 792.

Prague, Czech Republic©2010 Am Ang Zhang
Britain is ranked 25th out of 32 European countries, and only Cyprus, Portugal, Denmark, Spain, Sweden, Turkey and Malta have fewer hospital beds.

Andrew Lansley, the shadow health secretary, said that it was "madness" that the number of beds had been cut under Labour.
"The objective of the NHS is to deliver world-class healthcare, not to maintain a certain number of hospital beds," he said.

"The Government needs to explain why our hospitals have so many fewer beds than hospitals in other European countries."                Read More>>>>

Now The Cockroach Catcher do not subscribe to the view that more is necessary better but:

By Rebecca Smith, Medical Editor Telegraph
18 Feb 2010

Around 500,000 patients are readmitted to hospital within a month of being discharged which the Conservatives claim shows they are not getting proper follow-up care or are being sent home too early.
Emergency readmissions have increased by 52 per cent between 1998/9 and 2007/8, the Conservatives warned.

The number of hospital beds has also been cut by 12 per cent in the last five years, the Conservatives said, compounding the problem.

Andrew Lansley, Shadow Health Secretary, has announced that under a Conservative government, hospitals would have to pay for patients' support care at home to avoid them requiring admitting again.

Mr Lansley said: “Labour have let down hospital patients. For thirteen years they have ignored the serious problem of patients being sent home from hospital without proper care and support, resulting in a huge rise in the numbers having to be readmitted.

                                                                   Read more>>>>

 Numbers and fines are dangerous as we have seen with the A & E waiting target. A father of a young patient of mine once threatened to chop his boy’s hands off if he continued to stay quiet at school. It did not work!!!

Before the election: a survey of English hospital trusts, conducted by the Conservatives, reveals that over the next parliament there will be a net loss of at least 650 doctors and 2,000 nurses:

April 25, 2010 The Sunday Times
Jonathan Oliver

Andrew Lansley, the shadow health secretary, said: “Gordon Brown promised voters that he would protect the National Health Service and protect frontline services. But these figures reveal that Labour is planning secret cuts. They will cut the number of nurses, the number of doctors and the number of hospital beds. It does not get more frontline than that.”

Lansley insisted the Tories would be in a better position to guarantee clinical services because of their commitment to ring-fence health spending.

Lansley said the reductions in hospital staff could not be excused by ‘restructuring’ or ‘moving care into the community’. He added: “There is no evidence that extra staff are being recruited to replace these roles in the community. In fact the number of district nurses has gone down. The big increases in primary care trust staffing are coming in administration not frontline workers.

“Under Labour the number of managers has risen five times faster than the number of nurses. Our NHS has been weighed down by a bloated bureaucracy which means precious resources aren’t being spent on helping patients.

“We will cut bureaucracy by a third and we will make sure that frontline patient care comes first.”                                             Read all>>>>

Saturday, May 15, 2010

NHS & A Conspiracy Against The Public Interest.

On Wednesday, September 2, 2009 I posted:

Can the minority sometimes be right?

"In life, should one maintain a narrow focus and stick to one’s own field, leaving the rest to the so called experts? Or should one have a broader outlook, as one can often learn from the mistakes of others."

I quoted near the end:

Seumas Milne 1 July,2009
“……In England's health service creeping privatisation is turning into a full-frontal assault as the government strains every nerve to give health corporations a bigger slice of the action: not only in buildings and maintenance, but diagnostics, elective surgery, GPs' surgeries, district nursing, health visiting and trust commissioning – regardless of the views of staff and patients; the evidence on cost, inefficiency and lack of accountability; and the corrosive impact on the NHS ethos.”

In the same article:

“……But corporate capture goes much further than lobbying. The revolving door that propels civil servants into the arms of companies for whom they previously set rules and signed off contracts was well established before New Labour came to power. But the process that saw Tony Blair's former health adviser Simon Stevens effortlessly transmute into European president of the US company UnitedHealth, or his foreign policy adviser David Manning collect a clutch of directorships, from Lloyds TSB to Lockheed Martin, has now become the norm.
What's new for Labour is the stampede of ministers for the revolving door. Since 2006, 37 former members of the government have been given permission to take private sector jobs within two years of leaving office. As with their Tory predecessors, many of these jobs involve working for companies directly bidding for government contracts and privatised services. They include Blair himself, of course, whose £12m annual income now includes multimillion contracts with banking groups JP Morgan Chase and Zurich Financial Services, in a sector lovingly protected during his time in office.
“But there are plenty of others. The ex-transport minister Stephen Ladyman took a job with the traffic information company Itis, pitching for Whitehall business. The former defence minister Adam Ingram signed up as a consultant for EDS, whose major clients include the Ministry of Defence. One-time home secretary John Reid works for G4S security services, which also does business with his old department.”

More to follow:

“Interestingly, former health ministers have done particularly well. The ex-health secretary Patricia Hewitt earns more than £100,000 as a consultant for Alliance Boots and Cinven, a private equity group that bought 25 private hospitals from Bupa. After leaving the department, her predecessor, Alan Milburn, worked for Bridgepoint Capital, which successfully bid for NHS contracts, and now boasts a striking portfolio of jobs with private health companies.”


A culture of corruption pervades the links between government and business, fuelled by and fuelling privatisation. These relationships are – as Adam Smith put it – a conspiracy against the public interest.


Free Advice: Abandon! Abandon! Abandon!

NHS: Pass the Patients Back