Tuesday, 30 March 2010

Dying for a drink

For the second time in as many weeks, I’ve heard a story involving a very sick patient having to use a mobile phone to call for help from their hospital bed.

Derek Sauter, 60, had been taken into hospital with a chest infection and then died for lack of care. Mr Sauter’s condition wasn’t life threatening when he was admitted to St Mary’s Hospital, Sidcup, in Kent. He was given intravenous antibiotics and oxygen. He telephoned his wife later in the evening in distress claiming that nurses were refusing to give him any water because he’d accidentally knocked over his first glass.

A note scrawled by Mr Sauter and discovered by his family after his death said: 'Asked for a jug of water at 6pm and again at 8.30, told to wait for handover. Said I knocked cup of water on floor.'

Some time between 9.30pm and 11.30pm Mr Sauter was moved to a side room where there was no monitoring equipment and, although he was supposed to be checked every four hours, no observations on his condition were made. At 11.35pm Mr Sauter, who had still not had any fluids, made his desperate call to the switchboard. The following morning, at 6.51am, a distressed Mr Sauter telephoned his wife to ask her to come back to the hospital. But he died of pneumonia brought on by the chest infection less than half an hour later - before his wife arrived.

Mrs Sauter had not been able to see her husband before because the events had happened outside of visiting hours. An investigation by the hospital revealed Mr Sauter's oxygen levels, which should have been routinely monitored, were not checked for 11 hours and had dropped 35 per cent below the recommended level.

The self-appointed disciplinarian masquerading as a nurse in this case was one Caroline Lowe. Ms Lowe was found to be responsible for Mr Sauter’s care and the investigation concluded that Mr Sauter would have survived if Ms Lowe had been doing her job properly. She was sacked from St Mary’s but not struck off as a nurse. So, she’s now free to punish some other poor sod in the care of the NHS.

You’d think this sort of cruelty couldn’t happen in today’s NHS, wouldn’t you? Wrong. I experienced the punishment routine from a very gobby sister when I was in my local hospital. I was taking a fair amount of morphine and unbeknown to me, my femur had developed an abscess. I asked for a bottle in order to avoid walking to the toilet and was told I couldn’t have one and that I was ‘lazy’ and ‘difficult’ for not walking to the lavatory. I too called my family to complain about the harsh treatment and total lack of care. A few hours later I collapsed and was taken to the operating theatre close to death.

Doctors and nurses are universally portrayed as caring angels ministering to the sick and the vulnerable, but that isn’t always the case. I’m sure the vast majority do work hard and do care about their patients, but too many poorly trained and frankly vicious individuals manage to besmirch the profession by remaining in the employ of the NHS. I’m sure that good nurses are sick of these lazy and incompetent colleagues. Perhaps it’s time that a ‘Shop a Bad Nurse” hotline was opened before any more patients have to use their mobile phone to summon help. However, I won’t hold my breath. I think a ban on mobile phones in hospitals is more likely.

Thursday, 25 March 2010

Tip of the iceberg

Three pence in every pound spent by the NHS is wasted… and that’s according to official government figures. If that’s what the men from the ministry are owning up to then I think we can assume that the real figure is closer to 30 pence in every pound.

Even if we accept the 3p figure as being true, that still represents a staggering £3billion pounds down the sluice every year. However, from my experience visiting my local hospital yesterday I can imagine that the amount of money wasted is far higher.

The hospital’s showy atrium was positively groaning with smarmy management types, sat at the café tables tapping into their laptops, no doubt wasting a bit more time producing even more pie charts to show how the local Trust is winning the battle against hospital acquired infections. Incidentally, my local hospital only has ten wards closed to visitors due to various viral outbreaks this week.

Not only were there armies of administrators sipping on their cappuccini in the atrium, I also noticed during my clinic visit that the number of receptionists has ballooned alarmingly. I waited for almost five minutes for one of the two receptionists to greet me and book me in for my appointment. One of the two ladies was chatting away on the telephone while the other one was attending to the far more important task of making the tea and sorting out the biscuit situation. Occasionally other members of staff would bustle past with pieces of paper in their hands, carrying chits back and forth to the consulting rooms in what looked like some sort of Dickensian paper trail. Overmanning in parts of the NHS seems absolutely criminal in terms of waste and ineffectiveness. Mind you, I wouldn’t say no to a nice cushy job sitting behind a desk and gossiping while drinking is much NHS tea as I want.

The good news is that when I did get to the consultant after an hour of waiting, I was treated with great respect, courtesy and professional competence. It goes to show that parts of the NHS do function well and if we had fewer managers and paper pushers it could be even better.

This morning I’m off for my hydrotherapy session in a department where there are no receptionists, no one carries around paper and people simply get on with their job. Unfortunately, the hospital is considering closing the hydrotherapy pool on cost grounds.

Wednesday, 24 March 2010

Classic Clarkson

Jeremy Clarkson does have a certain way with words. His current take on the British Airways strike is a classic:
"I like Virgin. And I flew Singapore Airlines recently, which was out of this world. But there is nothing quite so joyous as leaving the hustle and bustle of a superheated Third World hellhole and being greeted on the big BA jumbo by a homosexual with a cold flannel and a refreshing glass of champagne. Take that away from us and we may as well all be Belgian."
You can read the whole column here

Holy smoke!

A group of ‘leading doctors’ is pushing the UK government to ban smoking in cars. The mad medics are asking for this highly illiberal measure to be introduced ‘for the sake of the children’. However, the ban would apply to anyone in a car even if it were empty of children.

Now let me make it perfectly clear… I’m not a smoker and I detest cigarette smoke. However, as long as people don’t blow their smoke over me I’m quite happy for them to smoke as many cigarettes as they like. Obviously, if they're stupid enough to asphyxiate their own kids then they probably shouldn't have any children. What’s wrong with educating people and getting kids to ask their parents not to smoke in front of them? Why compel lone drivers to fall in line with everyone else? Is there no personal liberty any more?

As a libertarian, this alarming and increasing propensity to ban anything that the doom-mongers don’t like really scares the bejesus out of me. I’m certain that the bansturbators of this world won’t stop once they get a taste for banning things. It’s like a wild animal that’s tasted blood for the first time.

Next the good doctors will call on a smoking ban in people’s homes. After that they’ll turn their swivel eyes towards alcohol, sugar, fat, meat and anything else the pious gits consider to be bad for us. These people are not protecting the public; they’re merely exercising their taste for bossiness and fascism.

In a similar vein, I noticed in yesterday’s papers that the taste for banning things has now reached the masses with a call yesterday for the looped cords used on window blinds to be banned. A small child managed to hang himself while his mother was out of the room. The family claim the blind manufacturer didn’t warn them that such a thing could be dangerous. It was, of course, a tragic accident but hardly the basis for a total ban on blind cords. The family is now calling for the introduction of ‘Harrison’s Law’ (their child was called Harrison) and they are selling yellow wristbands for people to show their support for this proposed law. Apparently, Harrison’s favourite colour was yellow.

As I said, it's a sad tale but evidence, if evidence were needed, that the country is absolutely barking and that the grief industry has gone into overdrive along with the bansturbators.

I’m off for a lie down.

Tuesday, 23 March 2010

Monday, 22 March 2010

Filthy lucre

Having experienced the health service at close quarters for some considerable time, I have often wondered about the sanity and ethics of the politicians who preside over this envy of the world. We pay our politicians a handsome salary and, until recently, we’ve showered them with expenses, privilege and gold-plated pensions. You might expect that in return they would offer us honesty, hard work and integrity.

As is so often the case, reality offers a different picture. The news that four Labour MPs have been caught in a sting operation where they boasted at being able to influence government decisions and policy in return for cash.

Is it me or does the image of MP Stephen Byers demanding daily fees of £3000 - £5000 bring on a feeling of nausea? What sort of socialist is this man? Clement Atlee must be spinning in his grave to know that such vermin are sucking on the public teat.

It’s often said that Tories go for sex while Labour opt for money when it comes to scandals. Either way, they’re all crooked and have far too much time on their hands. What is it that stops us having decent representatives or do we get the politicians we deserve?

Friday, 19 March 2010

Mr Benn scraps slop buckets

The acrid smell of burning rubber and Ferodo hangs in a pall of smoke floating over Whitehall today following the emergency application of the brakes by Hilary Benn, the Minister for the Environment. Farming and Rural Affairs.

 Following his pronouncement that all householders would have to use a slop bucket for food waste or face punitive fines, the son of the former Lord Stansgate made a hasty U-turn and thankfully withdrew the ridiculous proposal.

The volte-face comes just days after Mr Benn executed a perfect U-turn on the proposal that all dog owners would have to insure their pets and have them microchipped. There was even suggestions that owners would have to undergo compulsory hound training and suitability tests before being allowed to take ownership of a pooch.

Yesterday, speaking at 8am at a London recycling plant, Mr Benn proclaimed: ‘The vast majority of people will say, “Yes, we don't want this stuff to go into landfill, we want to play our part so we can get the value out, help reduce some of the costs, save the planet and re-use materials.”’

No… I’ve never heard a normal person talk to themselves in that way either.

However, by lunchtime, when Hilary’s consultation paper was made public, the minister had changed his mind. The paper said: The intention is that any obligation to sort would fall primarily on the waste collection authority.

It’s hard to imagine anyone working for a local authority being prepared to comb through our rubbish bins and separate half-eaten apples and odd scraps of food in order to achieve Mr Benn’s targets. Mind you, it would be fun to see them try!

Thursday, 18 March 2010

It's all greek to me

I didn't know whether to laugh or cry when I saw (thanks to Rod) that the Local Government Association had published a list of 250 words that local councils and officials should avoid using in public lest they frighten the horses.

New into the Hot 250 this year are the following pieces of gobbledygook:
  • Trialogue 
  • Wellderly 
  • Goldfish bowl facilitated conversation 
  • Tonality 
  • Webinar 
  • Under-capacitated 
  • Clienting 
  • Disbenefits 
These newbies join the following old classics on the proscribed word list:
  • Taxonomy 
  • Rebaselining 
  • Mainstreaming 
  • Holistic governance 
  • Contestability 
  • Predictors of beaconicity 
  • Synergies
What worries me is that local government officers are still using these words in private with each other. If you want to bore yourself to death with the full list of 250 words then click here


For God's sake go... now!

Imagine that you’re a government trailing in the opinion polls and deeply unpopular. Now, what would you do? Be nice to the people or just carry on irritating them with bossy and unnecessary new laws with the constant threat of punishments and fines?

The latest bit of stupidity from the government’s Department of the Environment and Rural Affairs (DEFRA) is a proposal for new and complicated recycling laws that will require households to have up to five separate bins for their household waste. Placing a used teabag in the wrong bin could result in a £1000 fine. And if you don’t think it could happen, bear in mind that local councils up and down the country have been using emergency powers granted under the Terrorism Act to spy on householders and prosecute them for inappropriate handling of waste. Whatever happened to Britain’s treasured tolerance that the government is so fond of telling us about?

The new proposals are the ‘brainchild’ of environment secretary Hilary Benn (son of that old Socialist warhorse Tony Benn), who wants to banish all food, cans, paper and glass from landfill sites to increase recycling rates and slash greenhouse gas emissions.

Slop buckets, already used to collect food scraps in millions of homes, would be extended to the whole country, adding another bin to the three or four already parked in many gardens and drives.
Councils would be under greater pressure to enforce recycling rules, and to use fines to punish those who refuse to cut down on their waste. But even councils are warning that compulsory slop buckets would go down badly with the voters.

Gary Porter, chairman of the Local Government Association Environment Board, said: “DEFRA must not create a situation where every householder in the country is forced to have a separate bin for their food waste. It must be up to councils, working with their residents, to find the best ways of cutting rubbish going to landfill.”

With only weeks to go until a General Election, the government is spewing new initiatives like a teenager after too many alcopops. Perhaps the ruling party genuinely believes it’s set to rule for the next 1000 years. Gordon’s Reich clearly doesn’t know when the game is up. Won’t someone pass the man a cyanide capsule and a pearl-handled revolver?

Tuesday, 16 March 2010

If Liam ruled the world

Parents of fat and unhealthy children could be receiving a letter to warn them of their child’s lack of fitness if a plan for a new MOT for school kids gets the go ahead.

I was about to launch into one of my libertarian rants railing against the encroaching nanny state… but I don’t know whether it’s the painkillers or the fatigue from fighting the pain, but I simply can’t summon up the enthusiasm to have a real go.

Okay, I can’t blame the pain entirely; I think it’s the nanny state that’s worn me down, coupled with the bovine stupidity of some members of the public. I mean, the government has got a bit of a point about unhealthy children. Why are there so many fat and unhealthy children these days? I suppose fear of paedophiles has stopped many kids from enjoying a healthy outdoor lifestyle, and the weather doesn’t help much either. Secondly, schools seem to have dropped competitive sport in favour of diversity lessons and global warming propaganda. Then there’s the scandalous sell-off of school playing fields for yet more rabbit-hutch housing. Is it any wonder that kids resemble lard buckets?

Maybe children do need to be tested for fitness if their parents won’t keep an eye on their body mass index. But even if the unhealthy ones are picked out, what’s the government going to do about it? Take the kids off to fat camp? Withdraw the parents’ fat-ration card?

I note that it’s the government’s chief medical officer, Liam Donaldson, who has floated this idea. Mr Donaldson, a pasty-faced and slightly overweight character, has previous form in nannying and is due to retire very soon so is making the most of his exit by spouting as much illiberal crap as he can possibly manage. It's fair to say that Mr Donaldson isn’t a natural libertarian. If he ruled the world there would be no alcohol, no tobacco, no slouching and no meat. And yet, in a logical world, he has a point. And yet I can’t help thinking what a bloody miserable world it would be if Donaldson and his ilk were in complete charge.

Now if you’ll excuse me I’ll have to get up for my cold shower followed by a five-mile run and a lovely bowl of gruel for breakfast.

Monday, 15 March 2010

NHS wastes £487m on consultants

From this morning's Daily Wail...

"The Department of Health has spent £478million on management consultants and accountants over the last five years, figures reveal today. That works out at more than £260,000 a day, including weekends. It is the equivalent of the annual salaries of around 17,000 nurses. The spending splurge will shock taxpayers and infuriate cancer sufferers whose life could be extended if they were given drugs which are rejected as too expensive.

The winners are well-paid consultancy firms such as Accenture, Pricewaterhouse Coopers, Deloitte, McKinsey and Ernst & Young. Individual consultants and accountants can earn up to £1,000 an hour.

Between April last year and January 31, the Department spent nearly £44million. By the end of the tax year next month, the bill will be even higher.

LibDem Treasury spokesman Lord Oakeshott accused the department yesterday of having 'a long-term consultancy addiction problem'. And it is the smallest amount they have spent in any of the last five tax years. In 2005-06 they spent nearly £198million.

He said: 'They must get a grip and kick their consultancy habit now. 'For any organisation, spending vast sums on consultants year in and year out is a sure sign of spineless management. Managers are paid to manage, not carry on consulting.'

The figures are revealed just weeks after Labour pledged to halve its spending on consultants by the 2012/13 tax year. Yesterday the Health Department insisted that the consultants' work is vital. A spokesman said: 'As a Department with complex responsibilities, we require a multi-skilled workforce. 'Where there are gaps in this resource we seek short-term expert consultancy support. Work is being undertaken as part of the engagement of firms to ensure that, where appropriate, skills are transferred from consultants to the Department.'

Thursday, 11 March 2010

What's so wrong with McDonald’s?

We can expect an torrent of public outrage to greet the news that ten days spent working in a McDonald’s restaurant will soon count as one GCSE and could help boost a school’s rankings in the examination league tables.

McDonald’s has been accredited by Ofqual (the national exams watchdog) and the fast food chain is now able to serve up its own certificates to teenagers who successfully complete a ten-day work placement at McDonald’s. Each participant will earn a ‘BTEC Level 2 Certificate in Work Skills’ endorsed by the exam board Edexcel. It will be the equivalent of a B or C grade at GCSE.

Educationalists complain that the certificate in work skills will be awarded for young people who’ve merely spent their time flipping burgers, serving customers, handling cash and cleaning tables. They condemn the McGCSE for ‘devaluing the currency of the GCSE’.

Putting aside the argument that the government has already devalued GCSEs by lowering the pass rate year on year and dumbing down the curriculum, I know which qualification I’d value more. Working in a fast food outlet, dealing with Neanderthal diners, cleaning filthy tables and still remaining cheerful is one hell of a skill to acquire. One McGCSE must be worth five ordinary GCSEs in child minding, psychology, media and tourism studies… or whatever silly subjects today’s exams are taken in.

The UK is still a very snobbish country while pretending to be a beacon of equal opportunity. And perhaps none are more snobbish than the Guardian-reading liberals who sneer at McDonalds and supermarket workers while steering their own kids into the safe haven of teaching, social work and other public sector managerial positions. And we all know how wonderful and efficiently run public services are compared to the likes of McDonalds and Sainsburys… organisations that must give their customers what they want or else face bankruptcy.

I’d like to speak up for the people who do work in McDonald’s or Sainsburys workers. At least they know how to put in a hard day’s graft and the skills they pick up are invaluable to today’s employers. There’s no shame in working within the service sector.

Roll on the McGCSE… and let’s hope there will be many more employers willing to offer young people a proper taste of the world of work and a bite at the opportunity to be usefully employed.

Tuesday, 9 March 2010

From the horse's mouth

My thanks to reader Hazel who alerted me to this marvellously lucid account on the NHS from today's Telegraph... from an insider.

The hell of finding myself in a hospital bed

My life and career had been blessed. I was appointed a Senior Lecturer in 1987 and a Professor in 1998; in 2002, I was almost at the peak of my career. I had been an adviser to the World Health Organisation twice, I was Sub-Dean for examinations of my primary Royal College and was also an elected Fellow on Council, and had just been appointed to sit on a United Nations committee. My long-term partner had just proposed marriage to me. We had a good year, attending operas and dinners, had travelled widely and enjoyed tennis and sailing together. Then everything changed so very suddenly. I felt a lump in my right breast and at 11.30am on Wednesday November 27 2002 I was told that I had breast cancer: a five-centimetre stage 2 “ductal carcinoma”, which was invasive. I now began my second career – as an NHS patient. Little did I know that my medical CV would soon be almost as long as my academic CV.
My cancer treatment was arduous. I had eight chemotherapy sessions, lasting five months; I then had a partial mastectomy and radical lymph node clearance, and then six weeks of daily radiotherapy. My second and final oncologist advised me to have two “extra chemos”; despite the side effects – septicaemia, continuous nausea, plus vomiting blood because of the pressure on the veins in the throat, undiagnosed restless feet and legs and, naturally, complete hair loss – I agreed. The desire to live and get better was huge.
All this meant that I passed through numerous hands and numerous shifts of staff. Most of the professional staff and particularly the medical teams in the NHS are great: the cancer staff seem particularly caring, as they spend much time talking with, listening to and really caring for their patients.
Since cancer I have been diagnosed as having a “syndrome” – too many dark spots on the skin, which has an association with breast cancer; I have had no fewer than 20 biopsies (thank heaven – none malignant); then I had a total hip replacement (THR); and I also attend various other clinics including the asthma clinic, the lipid clinic (for a blood disorder) and a complementary cancer clinic.
I have, on the whole, been treated very well, especially by the doctors looking after me – and the cynic would say, “Well, of course, she is a doctor”. But I have not always been treated so satisfactorily. I began my cancer treatment with chemotherapy at a London teaching hospital. The side effects were ghastly, the worst of which was the septicaemia. I had to be admitted to hospital in a blue-light ambulance and do not remember two full days: I am lucky to be alive.
Apart from the consultant surgeon, who I thought was really super, the hospital staff were not very kind to me. A junior doctor asked me if I knew “my diagnosis and prognosis” and the oncology consultant appeared off-hand and failed to turn up to an appointment. I subsequently left the hospital, and my GP then transferred me to “my” hospital, where I completed the rest of my treatment and at which I am still an out-patient.
When I felt better in myself and stronger, I wrote to the CEO of the first hospital and received a complete white-wash of a reply. I felt aggrieved, but was too ill to “fight the system”. At my hospital, the doctors and consultants have been fabulous to me, but the same cannot be said for all of the professional groups there.
For instance, nearly all the nurses on the ward when I had the hip replacement a couple of years ago adopted “assumed intimacy”, calling me by my first name when not invited to do so. In fact, one of my visitors asked the nurses where Prof Robertson was – only to be assured that there was no one there by that name on the ward. I was only known as “Mary in bed 10”.
I have always called my adult patients Mr Smith or Mrs Jones; I even ask the youngsters and children what I should call them. This is, I discovered, not always the case in the NHS, particularly in some disciplines. Many a time, while having an X-ray or MRI, I have been called “Mary”. Once, when I did not reply to that, the radiographer asked “Aren’t you Mary?”. “No,” I replied. “To you I am Professor Robertson – I am your patient, not your friend.” Another time in the same department I complained and was told that using first names was their policy – this was despite the fact that the radiographer had not introduced herself, nor was she wearing a name badge.
While some of the nurses are really outstanding (my specialist nurses for breast cancer, lymphoedema and dermatology), others are far from good. Again, when I had my hip replacement, some of the nurses, in particular some Health Care Assistants (HCAs), let me and other patients down. For example, I vomited and was left for half an hour before being cleaned. Once when I used the bed-pan I was left alone and one of my visitors (who is a doctor and physiotherapist) actually took it upon herself to take the bed-pan away. I was left without a wash for two days.
There was also a shortage of nursing staff, which had repercussions for patients. An HCA challenged an 85-year-old woman as to why she could not walk to the lavatory, and everyone could hear her, which was unacceptable. A second HCA told the same 85-year-old – when the patient said she “was bursting and wanted to go to the toilet and would end up wetting her bed” – “That doesn’t matter”.
All of this was in sharp contrast to the female night staff nurse who virtually manned the ward herself, put up and changed my IV drip for a blood transfusion, gave all of us our night medications, changed my bed-pan and once, when it had spilled over on to the sheets, even made my bed. She greeted every patient when she came on duty with a warm smile. Yes, thank heavens, there are still the real “Florence Nightingales” like her, who actually want to be nurses, but then there are others who appear merely to want a job, and a job in the NHS is secure – it is quite difficult to be fired.
I can see now, as a patient and a doctor, that, in contrast to 30 years ago in the NHS, managers have much more control. Many of my doctors (with me as the patient) and also my colleagues (with me as a doctor) are frustrated, and morale is lower than it used to be. In the days when I started in the NHS, matrons in blue uniforms and starchy white hats ruled the roost, and consultants were held “on high”: everyone worked hard and loved it. People called the professor “Professor”. Now it seems that Professors and doctors are being side-lined: a friend of mine is a senior surgeon and has a midwife as boss and line manager.
There is now no dedicated doctors’ canteen in many hospitals, and complaining about this is not me being elitist – much work used to be done over lunch, obtaining an opinion on a difficult problem. Doctors, in the main, no longer have their own offices either, so many of them have to dictate patients’ letters within hearing of other folk who have nothing to do with the patient.
With all this new management come new rules and conditions, not really made by senior doctors. And then, of course, we also have the European working time rules. When I had my hip operation, the junior doctor (house-man or intern) was rushed off her feet. She was pleasant and, I am sure, competent. But all I saw was her running around like a headless chicken, greeting patients briefly, checking if they had a variety of pains, whether they had had a “pee or poo”, whether they had walked, whether or not they were in pain, whether or not they had had their bloods taken.
“No” was my answer to all: she looked aghast at the last – “Oh, that means that I will have to come and take it”. The rest of the time she seemed to be writing up the drug/medication charts or filling in forms: surely that brought little job satisfaction. I remember as a house-man working endlessly but doing everything and being a proper doctor involved in my patients’ care. I undertook draining of pleural effusions (taking water off the lung), reducing ascities (similar, but taking excess fluid off the abdomen), doing endless lumbar punctures, initiating emergency treatment and so on. We all also made time to talk to and listen to our patients. Even now, I still remember some of my patients’ names from those days, nearly 40 years ago.
A new language has insidiously crept into the medical world. Patients are increasingly called “clients”. I am not a “client” when I am ill – I am a patient and want to be treated by doctors and nurses. I am a customer in a shop and a client in a legal firm. “Breach” and “targets” are also very important new “medical” words. A breach means that a patient misses being allocated an appointment within a specified time, and the target is that specified time (heaven forbid – heads will roll and/or salaries drop).
I have had this happen to me as a patient, illustrating just how crazy it is. My previous GP referred me for a community para-medical appointment: I was offered an appointment within three days (the target) at a centre many miles away – necessitating two bus rides. I declined and asked for one at a clinic within easy walking distance from my home. No – for that appointment and clinic I would have to telephone again next day, or else I would “breach the community practice target”. When I did phone, all appointments were full, and so I was given a place on a waiting list for an appointment within six weeks. I wrote to the manager, pointing out the absurdity, and was given the appointment within three days: but imagine if I could not type and was not articulate – I might still be on the waiting list!
I took early retirement because of my cancer and work one day a week pro bono, so I am not bothered by many of the changes – for example, I almost never go to management meetings. But with the NHS changing so much, many of my academic and NHS colleagues are now taking early retirement, and continuing with academic sessions; that is what doctors love – their work.
Recently, I had the privilege of observing the entire process of deep brain stimulation (DBS; functional neurosurgery – like a “pacemaker” to the brain) for a patient with a movement disorder. The whole day was a pleasure. “Happy hierarchy” ruled and almost all called me and my senior colleague “Prof”. Everyone got on with their jobs and there was a huge esprit de corps.
DBS is probably the most amazing medical development in my 39-year career as a doctor. The day brought out everything that is fabulous about medicine – apart from the fact that in a target-besotted NHS, the operating theatre lacked a pillow for the patient and an appropriate trolley to take her to theatre, so the sister and registrar had to go searching for them.
The NHS is an absolute treasure – my thought is that we should not abuse it. This goes for both staff and patients. NHS staff should act professionally and courteously all of the time and so should patients, by turning up for their appointments (much NHS time and money is lost through missed appointments). All of this makes the NHS, according to some, an inefficient system. Let us at least try to cure that. Long live the weird and wonderful system that is the NHS.
Mary Robertson is Emeritus Professor of Neuropsychiatry and Visiting Professor and Honorary Consultant Neuropsychiatrist at two London teaching hospitals and universities.

Sunday, 7 March 2010

Damn lies and statistics

There's very little I can add to this other than the suggestion that every Prime Minister and Health Secretary since 1997 should be locked up for the murders they've sanctioned.


Saturday, 6 March 2010

Words fail me...

Is it really possible for someone to die of neglect in a public hospital for want of a glass of water? Let me assure you that it is.

The case in question involves 22-year-old Kane Gormy who was incarcerated in St George’s Hospital, Tooting, London. Kane was suffering from a brain tumour and his medication’s side effect caused his bones to soften and as a result he required a hip replacement.

After Kane’s hip replacement he was obviously immobile and had to rely upon nurses to give him vital hormone medication to keep him alive. Despite knowing how important his medication was, Kane was not given it. Kane’s mother discovered him one day in a delirious state. Kane had been ignored and was dehydrated. He died just an hour later. In the run up to his death, staff had marked Kane down as a troublemaker because his behaviour was odd… it was odd because he was being denied his medication.

I can easily believe that this story is true because the same thing nearly happened to me just a year ago. I was left virtually untended in hospital, drugged up to the eyeballs on morphine that affected my behaviour. An outbreak of the Noro virus then ran through the ward and all visits were cancelled. Like Kane I was left to rot for almost two weeks by staff that seemed indifferent to my welfare.  I was punished for being uncooperative by being left in isolation.

Fortunately, one kindly soul noticed that I was extremely ill and I managed to make it to the operating theatre with about two hours to spare. I then spent five days in ITU with only a slim chance of pulling through. I was luckier than Kane but I can easily see how such a thing could happen. There is a culture of punishment, harsh behaviour and a lack of compassion on certain hospital wards.

I don’t know how such a tragedy can occur in a health service that’s been hosed with public money for the past decade or so. There are some very good and caring burses, but equally there are some slapdash and cruel people masquerading as nurses and health care assistants. There’s a culture of sloth and indifference in some parts of the NHS that borders on the criminal.

Apparently, in Kane’s case, his nurses were traumatised by what had happened and were offered counselling to enable them to get over the shock. Poor Kane was admitted to hospital with a brain tumour and yet the NHS killed him by denying him medication and hydration. How many more deaths will it take before someone is held to account and the system is overhauled?

PS: The poor lad even phoned 999 to try to get some water as he was being ignored!

Tuesday, 2 March 2010

A dragon strikes

A LARGE, terrifying dragon is threatening the magical kingdom of massive pensions where no-one ever gets fired.

The fearful citizens of Council Worker Fantasy Land say they will surely be burned to a crisp by the fire-breathing monster unless they receive urgent anti-dragon money from the people of the Real World that exists beyond the buttercup meadow and the four star country house hotel where the magical training days are held.

Since 1997 Council Worker Fantasy Land has been the happiest place in the world, where grade two fairytale princesses and thousands of badly educated left-wing elves live happily alongside magical dwarves who are not allowed to move your wheelie bin more than 38.3cm.

But now the fearsome dragon that has eaten more 300,000 townsfolk who actually had to work for a living, could ravage the blissful community and its enchanted ability to tell other people what to do.
Roy Hobbs, the £225,000 a year chief executive of Council Worker Fantasy Land, said: "Help us o good and generous people of the realm where bad decisions have actual consequences.

"We have spent all our money on magical diversity training and surely now the dragon will eat many thousands of us for his tea, which by the way does not contain five portions of fruit or vegetables and leads us to question his ability to raise young dragons."

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The piece of cod that passeth all understanding

Okay, so it’s not cod, but spangled perch doesn’t quite have the same ring about it. What am I babbling on about? Well, the exciting news is that it’s been raining fish over the small settlement of Lajamanu in Australia’s Northern Territory recently despite the fact that it’s 326 miles from the nearest river.

It appears that the fish, some of which are still alive when they hit the deck, were emptied on to the town from the sky during a rainstorm. Mark Kersemakers, the senior forecaster at the Australian Bureau of Meteorology, said: “It could have scooped the fish up to 40,000 to 50,000 feet in the air. Once they get up into the system they are pretty much frozen. After some period they are released.”

This isn’t the first time that Lajamanu has been rained on with something other than water. The same phenomenon occurred in 1974 and then again in 2004.

A local man from nearby Jabiru said: "Usually fish are in the water, now they are falling out of the sky. What if anything bigger falls out of the sky next? It could be crocodiles, that would be real scary."

Now the people of Lejamanu just need a storm of chips to finish off the meal followed by a quick shower of beer.

Monday, 1 March 2010

Expanding north of the border

A propensity to scoff deep-fried Mars Bars and battered pizzas appears to be taking its toll on the collective Scottish waistline. According to the Scottish Executive, a massive 40% of Scots will be obese by the year 2030. The growing problem will cost £3 billion per year to slim down, according to the SNP party, which is currently ruling Scotland under the heavyweight leadership of the lithe and lissom Alex Salmond.

So serious is this weighty problem that the Scottish Executive has vowed to intervene and use legislation to forcibly reduce restaurant portions if chefs don’t agree to voluntarily cut down on the amount of food that’s being piled on to diners’ plates. That’s right… politicians are actually thinking of restricting portion sizes by statute. Presumably people will just have to order two of everything if they want to carry on gaining weight or else take a friend with them who will order the extra portion and then pass it on to them.

In order to enforce the law, I imagine that waiters will have to start snooping on their customers to see if any of them is stealing food from their neighbours’ plates. Won’t dining out be fun? I can imagine a whole new frisson of excitement being introduced to a night out north of the border. “Quick! Taste this before the waiter comes back from the kitchen!”

Other helpful advice coming courtesy of the interfering Scottish legislators includes advice for Scots to walk upstairs instead of using a lift. There’s also the vacuous suggestion that people should vigorously vacuum their carpets or jig around to some lively music before popping out for a jog or some other more ‘strenuous’ activity.

There’s something touchingly naïve about politicians, isn’t there? Don’t you just love the way they think that they can sort the world right by banning a few things and introducing a new law? They don’t really get humans, do they?