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


Anonymous said...

Unfortunately often management sits on the Senior Staff Committees and it is difficult to be lucid.

It is true that all consultants should unite and in fact with GPs and speak with one voice.

Dr Zorro was probably right about cowardise.

Anonymous said...


You are right, they are there in our hospital as they are so afraid of what consultants only committee will do.

I agree that we should speak up.

Anon Consultant

Doctor Zorro said...

Management presence on the SSC meetings is wholly unacceptable. Even the Medical Director should only be there by invitation, for specific issues within his remit. If management insist then meet off NHS premises, outside NHS time. Take control.

The Shrink said...

I don't want to be depressing since as you've kindly suggested, I'm normally genuinely up beat and positive.

But it's only sensible and realistic to critique cultural and organisational practice that's unhelpful/wrong.

I've met with our Chief Exec and several Executive Directors and our Medical Director to challenge what's wrong in our Trust, with remarkably positive responses. So I remain upbeat that, although the world can't change to instant perfection, progress can be made, one step at a time.

Cockroach Catcher said...

Thanks for the comment.

No wonder they want to move near Lake Cocytus.

We did the same when I was working and had really positive results: our Finance Director wanted to spend more time with his family and our trust was eventually gobbled up by one of these huge Things that did not call patients patients unless you are in hospital and the new CEO (later) also wanted to spend time with the family after a few suicides.

Perhas we were not that lucky. But treasure what you have and perhaps let Andrew Lansley know.

I am pleased that more top guys in management since Andrew Lansley value time with their family, even if for a few days.

Cockroach Catcher said...

Dear Doctor Zorro

Your posts had been picked up by The Witch Doctor and a link was added.

See, you are in!!!