Time ticks @on@ ok .. but, depends which [vulture] :-D * What's your [Obsession] . Take an [OCD] [test]

Monday, 30 June 2008

I trust this man ...


What I understand from the report so far:

1- Medical Education for England will be established :)

2- More apprenticeship places for frontline staff (More places for the juniors? Must be)

3- Stress the importance of excellence and innovation and encourage both to flourish, therefore, unlocking talent to improve service

4- Stressing that clinicians are leaders

5- Setting fronline free from central control

6- Medical directors in every SHA

7- No New Ttargets

8- Nurses to be allowed to set up shop

9- 150 Polyclinics

10- More accountability measures for team members

Other measures to do with the provision of the service itself

NHS Next Stage Review: A Quality Workforce

Read Prof Tooke's response here and many other including the role of the doctor (Important document)

Sir Tooke: "I am pleased that this report shows the Government’s commitment toensuring that medical education and training ison the right footing for the future andacknowledges the crucial part the profession ofmedicine has to play in securing that future. ......

The proposals in this document address many of the challenges I set out in my Inquiry report.
In this regard, I am particularly pleased to see the creation of Medical Education England

During the turbulence of the last two years, trust was lost between the profession and the
Government. The strategic review offers a clear vision for the future of education and training"

:) .. So, I was right to trust the man afterall ... And, he made sure that this document is the 1st to be published on his site straight after the report.


Have your say on the NHS Constitution

High Quality Care For All: NSR final report launched


The BMA has replied to the report here


Conclusion: You 'kids' would be crazy not to rally behind Ara Darzi ... and he is going places too .. and so will you, young and old-er, if you follow him ...

:-)


Sunday, 29 June 2008

Pure Genius !

“Out of suffering comes the serious mind; out of endurance, fortitude; out of deliverance faith.”



Listen to "another Brick in the wall again."

What an awful accent! The 'kids' are uneducated and unruly, yet they are very resistant to getting an education or change (We don't need no education.) So, they voice their strong frustrations and bad wishes on the teacher ending in the use of foul language wishing him to f off at the end!

Teacher frustrated but very insistent on educating them, will only give 'pudding' when they when they have finished their work ... The teacher is frustrated but he won't give up on 'the kids' because he cares about them.

Now I understand, If it was possible, I'd say thanks for the education teacher :-)

When we grew up and went to school
There were certain teachers who would
Hurt the children in any way they could
"OOF!" [someone being hit] ... :-)
By pouring their derision
Upon anything we did
And exposing every weakness
However carefully hidden by the kids
But in the town, it was well known
When they got home at night, their fat and
Psychopathic wives would thrash them (Kids wishes)
Within inches of their lives.

We don't need no education
We dont need no thought control
No dark sarcasm in the classroom
Teachers leave them kids alone
Hey! Teachers! Leave them kids alone!
All in all it's just another brick in the wall.
All in all you're just another brick in the wall. (Never the kids's fault!)

"Wrong, Do it again!"
"If you don't eat yer meat, you can't have any pudding. How can you
have any pudding if you don't eat yer meat?"
"You! Yes, you behind the bikesheds, stand still laddy!"

For his 'favourite' disk, he chose 'Seven Seconds' and I got this wrong the first time as well! He is talking about his own skin colour and that his doctors should look beyond that and cooperate! He is also stressing that whatever time it takes, he 'insists' on change and will wait as long as he's in office. So 'Changer' is not 'Freedom', it is indeed an order but when change happens, it will become 'freedom' or liberation from the old rotten ways ..

And that Irish song Finnigan's wake .. it's land of milk and honey and no work, they're having a party and wasting and wasting ... but they are 'stupid' because 'Tim' is not dead!

... and ...there's more ... :-)

I said, "Of course doctors are a 'placid' lot ... and 'everyone' knows that ..."

... and he wants this too to change, he wants doctors to become streetwise
so that they in future can fight 'in the jungle' when they are attacked by anyone

"Streetwise folk would have been, and their lawyers, ferocious to deal with when it came to protecting their reputation and their rights .."


I till you what 'kids', you'd be crazy to fight this opportunity to get an education from this teacher! He wasn't showered in honours for nothing! .. and he's doing it all out of love, dedication and commitment!

I remember Dr Crippen saying that he was not afraid a Polyclinic will open only 3 miles away from his practice because his is one of the top 12% in the country and, therefore, it's unlikely his patients will want to leave and join a polyclinic. So, you need not fear if you are good, do you?

This man has integrity as well, if you are good, you won't be harmed! Please do not lose the opportunity, cooperate or it will be forced upon you and then, like MTAS, many an excellent GP will lose out in the massacre!

He's proud in his profession!

And he wants to save the profession, SAVE YOU! All of you! Senior as well as junior! .. and saved, you will be! .. one way or the other!

Well, I am in! Polyclinics and all! .. Because I know, I will be able to keep my GP if he is really good.

To summerise 'Desert Island Disks': The message is:

The dark Armenian from Iraq with the Irish accent is 'determined' to save YOU! (Said with best intentions)

Here's the pen and paper ... look behind the skin, UNITE, say, Yes Minister and sign! Then let's start building Jerusalem in Britain together and build it, we will! Then you will all prosper for it too.

Awesome! ... and ... how many birds can you hit with one stone teacher?! ...

why am I not a doctor?! ... I would jump at the opportunity on offer and be the first to say 'yes minister' and sign!

Thanks for the education .. 'world class!' ... sorry, I failed miserably at the first attempt ... I was never taught to that standard before ..

I wonder what more is hidden in those disks! I can't find the Armenian song either :( and I do not speak the language but do I need to ? Is it a happy but wise song? I only heard the last 7-8 minutes of the programme. I wonder what did you also say?!

There should be a copy of this audio programme on Lord Darzi's blog.

The dead line is tomorrow! ... Too late? .. 'the great teacher inspires' , what to do now?!

Then again, I no longer need that report! :-)

Time I rest my head and not worry ... we're all in safe hands at last.

Thank you


Am I right? ... Tomorrow will tell!


“I am impelled, not to squeak like a grateful and apologetic mouse, but to roar like a lion out of pride in my profession.”


Saturday, 28 June 2008

Changer ... meanz ' Freedom!' :-)


A solitaire

“Don't let anyone tell you that you have to be a certain way. Be unique. Be what you feel.”

My mother, who is now 81 years old is a retired accountant, spent all her working life working for the huge Cairo Transport Authority and retired as 'director of statistics and followup' after working for the organisation all her adult life. She also won prestigious awards for her work from the Egyptian Central Office for Statistics over the years.

When I was a university student, reading accounts and business management like my mother, I used to discuss my assignments with her. One of those assignments was to search ways to improve the service of a section of a public sector provider so, obviously, I chose Transport, concentrating on bus services ... :)

When I then asked my mother what would she do to improve the service, she said "I would dismantle it and rebuild again." She then explained that by dismantle, she does not mean discarding everything. Rather to keep the parts that work and replace that don't to create harmony within the system to aid better performance. It was also the first time for the much younger me then to become aware that the performance of the bus system is dependant on the administration behind it .. This was the part my mother would have tackled first herself.

She gave me examples of why she would tackle this first, one of those was that employees come to work only because they got paid at the end of the month and that's it, no love or loyalty. So, the result is employees arriving to work at 8am and leaving at 3pm (How it used to be in Egypt) and not bothered about what they do withing this time. Some even brought their kids' homework to mark in the office, while others sign in then find ways to pass the time talking together or going out whenever they had the opportunity to do so., hence, the rot in the system which greatly affected productivity.

I also learned that this was a known side effect to public sector work anywhere in the world. ... I got a very high A for this assignment at the end BTW, so, thanks for the cheating mum ;)

I came second on graduation and somehow convinced my parents to allow me to travel to Britain for my masters. Being an only child, I have no idea how, but I managed to convince them which was very rare for girls in those days ... That's how naive moi ended up here.

I came with two other friends and without having arranged with a university first, but with some money given to me by my parents to pay for whatever course I chose and my living expenses. To cut a long story short, the majority of this money got stolen and I ended up on my own. I did think about returning home but couldn't do it .. I do not deal easily with failure, so I didn't ... the rest is history but in my own little way, I made it ... Shame about that masters though ...

I suppose one changes the older they get and I am no longer so adaptable to such drastic change because of the risk involved. But my fear is not for myself anymore, it's for the children. I suppose this is a natural sentiment for any parent; the desire to protect their offspring. Hence, I have displayed this fear here on many occasions before, even as recent as only a few days ago. But, I am going back to my old self again .. I do not shy away from change or adventure, I have done it 34 years ago myself! And I survived against all the odds!

If the rot is really setting in Lord D, and I have to trust you on this because I do not know much about the NHS, except for the current rot in the juniors training and that is very important for me. If you will fix this as well as what you have deemed rotten, then I am in. But I am not as daring or as crazy as I used to be because I have responsibilities now. I just hope you have done your sums right and, given your track record, I will take the chance. If you have not, then throwing the kids at the deep end "For a while" will do no one no harm ... indeed, it will do the opposite .. this I know ... it's logic ..

but then, I don't have very young children anymore ...


I do trust he is able and honest enough from before, but those disks changed my mind because I now also understand the intentions .. I don't think this will increase my popularity though ...

So, let me be the first one around the blogsphere to take a chance on you .... even from before I know what's in that report ... and ... Good luck ... I feel younger already ... :-)

But I hope you're not depending on luck alone ... I don't think you are.

... It must be a sun stroke or something ... but ... let's all fight for that Jerusalem ... together :-)

.... No polyclinic still .... not that crazy anymore ...

... Let's get on this rollercoaster .... Hope it will be fun ... or .. I'll SCREAM ... as usual ... ;-)



“No matter what age you are, or what your circumstances might be, you are special, and you still have something unique to offer. Your life, because of who you are, has meaning.”

Friday, 27 June 2008

Disks, papers, pens and luxury items ...


Lord Darzi's disks, book, and luxury items

Unique and very clever! All you need to do is open your eyes and look and open your ears and hear .. all in there ... So here is my interpretations as I thought they meant :)

Rest your head. This is for the juniors, The teacher will do something good them for sure (I am your friend, more jobs? It' gonna be alright.) He will also probably find ways for those who left last year to come back. For the extra numbers graduating, there may always be a route open for them to go abroad and ability to return to training and work in Britain afterwards. I feel optimistic about this ..

Lord Darzi also definately wants a tolerant NHS free from inhibitions and prejudices that hinder prosperity and improvement and pledges to monitor this himself so long as he is in office. He probably also believes that this above is the true route to aspiring to excellence and innovation as well as improving own skills and attributes and acquiring new abilities to evaluate same, reflect and improve to lift up the whole. Remove all negatives ... Good one :-)

Unlike myself worrying about the 'kids', he considers all doctors and looks at things from a boss or 'teacher's point of view " You can't have any pudding if you don't eat your meat .. GPs in mind ;)" Hence, he possibly insists on cooperation and willingness to change which will be rewarded somehow. Will he then reward the young doctors who have just finished eating all their meat and passed all their exams? No more waste of talent? I think so but don't know how, if more and more HCP will be in place instead of doctors? Will core training be the right of all graduates? .. I sincerely hope so but .. let's wait and see.

The songs imply that his reform and change (GP +) is almost as sacred as Jerusalem for him. So, he totally dedicated to establish what he would consider an enviable health service in Britain and he intends to fight for this as if he was fighting for Jerusalem itself ... no let go ..

To establish what he may believe is an enviable system, 'contracts' will be signed and the doors will probably be opened wide, thus allowing for global competition on personal and on establishment levels, including more private sector involvement so, no let go on Polyclinics either .... even more ..

Not so sure about the sarcasm in this one though but I think it means the NHS is near dead and everybody will enjoy reviving it and that this reform will happen regardless of who is in power so you'd be stupid if you don't cooperate with me?

And what will he do about the current bullying of the juniors on the hands of others? With his pledge of zero tolorence, will this work both ways? How will nurses setting up shops in competition with GPs work then?

He wants doctors not to be afraid of this change because he would guide them through it and because they can rely on him to protect the (?) Again how? With the nurses and when you're trying to reform the whole of the the NHS! What a task and what a promise!

I believe he is an honest and hardworking man that you can depend on and feel he will do his best, especially for the juniors.

He is definately 'innovated' something for them and their training, something NEW ... :-)

Patience will be good here till Monday then I need to switch off for a while ... go somewhere in the sun by the sea ...

I do spontaneous sometimes ... :-)




This song asks and urges 'change, it does not order .. like 'changer' is good for you









Till Monday ...

... Don't give up ... hold on ... till Monday ..

In this proud land we grew up strong
We were wanted all along
I was taught to fight, taught to win
I never thought I could fail

No fight left or so it seems
I am a man whose dreams have all deserted
Ive changed my face, Ive changed my name
But no one wants you when you lose

Dont give up
cos you have friends
Dont give up
Youre not beaten yet
Dont give up
I know you can make it good

Though I saw it all around
Never thought I could be affected
Thought that wed be the last to go
It is so strange the way things turn

Drove the night toward my home
The place that I was born, on the lakeside
As daylight broke, I saw the earth
The trees had burned down to the ground

Dont give up
You still have us
Dont give up
We dont need much of anything
Dont give up
cause somewhere theres a place
Where we belong

Rest your head
You worry too much
Its going to be alright
When times get rough
You can fall back on us
Dont give up
Please dont give up

got to walk out of here
I cant take anymore
Going to stand on that bridge
Keep my eyes down below
Whatever may come
And whatever may go
That rivers flowing
That rivers flowing

Moved on to another town
Tried hard to settle down
For every job, so many men
So many men no-one needs

Dont give up
cause you have friends
Dont give up
Youre not the only one
Dont give up
No reason to be ashamed
Dont give up
You still have us
Dont give up now
Were proud of who you are
Dont give up
You know its never been easy
Dont give up
cause I believe theres the a place
Theres a place where we belong


"babies are innocent! ... “It is the nature of babies to be in bliss.”











Wicked choice of disks and that book and luxury item! ...


Thursday, 26 June 2008

Blogging ...

The influence of blogging is overall a very positive force in the media.

One blogger has been trying to stop blogging for a while and has been posting much less than before, even withdrew the majority of their previous posts. I have been urging them not to stop because I could not understand why they wanted to stop. My reasoning was that, since blogging is available to everybody, then it is legal, but, is it?

Another blogger has also stopped all of a sudden and without any warning as habitual when they went offline for a while, albeit, the blog itself is still visible and I have no idea if they will return or not or their reasons for stopping. I do wish them well whatever the reason but hope they will return. Another blog is usually loud and uses over the top language but, it does no harm although I consider some some of the language used somewhat over the top. That said, it is about a person/s expressing their frustrations and letting of steam in their own way and nothing more IMO.

(I also think I was taken for ride on one recent occasion but that's another story .. I don't think I ever want to remember .. all I can say is that boys will be boys ... :-)

I suppose anyone with a blog may unintentionally cause offence sometimes. Indeed I sometimes worry I may have done so on occasions and for that I apologise if I did.

But while I, for example, started blogging thinking I would be letting off steam as well as hoping to show feelings at grass roots level, it has always been on my mind whether some subjects/ways are a no go?

Is there some sort of an online blogging regulation? A site for this purpose for example? Are law abiding people incriminating themselves thinking that what they do is permissible while it may not be? Indeed, why is blogging allowed at all if there is a chance it may lead their authors to go against the law?! Why is there no regulations? Or, is there?

Since not all people enjoy writing about cookery, what are the limits and were do bloggers stand?

Blogging = Harmless socialising on the net and venting off steam?

Blogging was another important way of solving the freedom of expression and flow of information I was after and there was Six Apart.


Wednesday, 25 June 2008

Innovation ...



What will it be?!! ... 'Innovate'? ... Or turn into a robot that follows preset protocols to prove 'competence'?

Make up your minds ....


Me? ... I'd choose 'innovate' any time ... and the aspiration for excellence ...



A groundless rumor often covers a lot of ground.




















Has anyone seen a witch and black cat anywhere?!

Sunday, 22 June 2008

Inept ....


'Rere ring rere ring' .. 'rere ring rere ring' .. 'rere ring rere ring ......

- "Hell-oo, ... Department of Hell-th, can I hell-p youuu?"

- "Hello, is 'Inept' there pleeease?"

- " Which one?" .......

Saturday, 21 June 2008

Strength to 'reverse' change ...

“First they ignore you, then they laugh at you, then they fight you, then you win.”

I've just noticed the sign on the rostrum in Lord Darzi's picture, it says: 'Strength to change Britain.'

To what? .. and Why? Why change BRITAIN?!

You know, I am not sure if I will vote at all at the next election! Because I am puzzled and confused and this is a really uncomfortable position to be in ..

If there was a survey asking those questions below, on health only just for argument's sake, here is how I would answer:

Do you believe that our PM is a good and honest man? Yes

Do you believe that our Secretary of State for Health is a good honest man? Yes

Do you believe that the Junior Minster Lord Darzi is a good honest man? Yes

Would you vote for them at the next election? No

A true irony! .. but why?!

Because I was hoping they would have the strength to reverse the wheel of current change, regardless of the pain this may cause them and that they would do so because this is what the people want.

And this is what good strong leadership means to me ..

Our good leaders; NOTHING is beyond 'the point of no return' as your predecessor once said, .... except strength and true commitment.

You know, if I was involved in campaigning for one of your rival parties, which I am not, I would use this same sign on that rostrum and just add the word 'not' ... this, I am sure, would guarantee winning the next election! Here:


***

'Strength NOT to change BRITAIN'

... despite 'any' pressure ...

***

“If you want to take your mission in life to the next level, if you're stuck and you don't know how to rise, don't look outside yourself. Look inside. Don't let your fears keep you mired in the crowd. Abolish your fears and raise your commitment level to the point of no return, and I guarantee you that the Champion Within will burst forth to propel you toward victory.”




Friday, 20 June 2008

Behind the wheel of change ....


Only a year ago, all I knew about Professor Darzi was that he is a brilliant surgeon and Professor of medicine with international reputation for his contribution to minimal invasive surgery and his interest and work in the engineering that goes hand in hand with it. The first time I heard his name was when my eldest son chose to do a BSc in Medical Physics and Bioengineering to compliment his ambition to become a surgeon. When I asked him why this particular subject, he explained by showing me some of Darzi's work in this field .. Amazzzing!

That said, not in a million years would it have ever occurred to me that this man will have so much impact, not only on my children's but on my own life too! So, in a modest endeavour to understand why things are happening the way they are today, either in higher medical training or in health, I have decided to learn a bit about the man behind the wheel of change, both Professor Darzi, the teacher and the innovator as well as Lord Darzi, the politician.


So, here's a Lord Darzi ... MY first in the series ... :-)

Listen to Lord Darzi on his rationale for polyclinics 11 July 2007 (Guardian unlimited)

'London competes international in business; we need to have a similar profile in health.'

Health minister Sir Ara Darzi at news conference announcing his plan to reorganise London's health system. (4min)



Of course, the main reason why I, as a patient, don't like the idea of polyclinics is because it is an impersonal service that does away with a doctor/patient relationship, which I consider vital for a good health outcome and also because one may end up not seeing a doctor at all, once the initial novelty of the polyclinic idea has faded and the GPs running them are swapped for 'Dr nurses.' .. the later alone would make me run a mile ... or two .. or five ....

So, Lord Darzi, maybe the backwards and forwards scenario you describe in that podcast is actually a bliss? Because with polyclinics, I might end up not being able to see a doctor at all ... I also don't like the idea of me becoming a 'business' ...


Choice? .. “Ignorance is not bliss - it is oblivion”

Wednesday, 18 June 2008

Much Ado About Nothing ...


"Benedick: A miracle. Here's our own hands against our hearts. Come, I will have thee, but by this light I take thee for pity. "

Shakespeare wrote this play back in the 1600s. One of it's main characteristics is that it is very hard to follow who is who, who is in love with who, who did what and why and who is responsible for what ... Amazing parallel between the plot of this play and the current situation in medicine, only this current farce is not a farcical love story ... far from it .. it's about the love of 'money!' Shakespeare did not intend to confuse his audience, nonetheless, one of the main characteristics of the play is that as the plot thickens, the audience gets more and more confused ... unless one has read it several times before watching the play in the theatre , prepare to be totally lost in the plot ...

I read Prof Maynard's article in the BMJ again, then looked at what is happening to Physiotherapy then also considered the 'widening access' scheme and why the Kings college School of Medicine is dumping down ...

Was what is happening to Physiotherapy an expected outcome? Is the same outcome known and is expected for medicine?

It certainly seems so! Physio's university applications are down by around half, meaning that the required grades for entry will have to be lowered to fill the vacancies ... if the same is to happen with medicine, then this Kings College 'initiative' must be a pilot scheme to determine whether it will be possible to train those with lesser abilities and lower grades but who the college determines as having good mental abilities to a near enough standard to that of the current high achievers, then those candidates can be taught medicine just by adding an extra year to their training and providing rigorous and very intensive coaching for that year only.

Given the current thinking (by some?) that the study of medicine is equivalent to 50 GCSEs as well as MMC's emphasis on 'dissecting roles' into little chunks as well as the emphasis on 'competence' and it's view that not everybody needs to be trained to the highest possible level because those skills won't be needed for the majority of time, it then becomes clear that coaching the less able students, although may initially be expensive, will produce the predetermined outcome and the savings in the long run when the initially less able students qualify will be huge ... and, they won't even need to develop higher intellectual abilities either! Ever, they won't need them! Not in their predetermined roles of populating the middle grades ... for less money, much less money ...

So, will grades for entry to medical schools come down too in the near future?

That those students come from more deprived and more diverse backgrounds is also intended IMO because of the aim for self-suffeciency ... or the need to replace the current cheaper foreign workforce ...

With the NHS employers current emphasis on 'competition', it makes sense that it was not a mistake or just by chance that there were so many foreign applicants in direct competition with the Brits, after all, they were invited over! Therefore, MTAS and MMC were rushed in 2007 despite the warning of the medical profession because the Physio Model was already producing results and the NHS reform to strengthen an 'inner market' was already in place, so ... MTAS had to roll ... because MMC had to roll ... because everything else was already in place .. and waiting for the 'experiment' ...

Although 'competition' was sought and encouraged (as explained by Sian Thomas of NHS employers to the HSC) , no one anticipated that MTAS would fail in selecting the best candidates in 2007 This failure was due to a fault in the 'design' of the MTAS application itself, which then caused all the trouble and the ensuing farce. What happened was that the very part of the application that was supposed to be testing the 'competition' bit by annonymising all applicants went wrong. So, although it was intended that applicants couldn't write information about their nationality or where they graduated, it was a big mistake that an applicant could not list their qualifications and experience when applying ... if only this was allowed ...

The competition ratios of 2:1 were probably considered as a good pilot for the first year of introducing the new system but what they are really after in the future is, as Sean Thomas said are 3:1+ ratios and much more the higher the level ... Of course, with the return to local applications where you have more control on who gets what, things are back on track, for now ... but that is not the designed outcome if you again consider 'competition.' Will MTAS or similar be introduced again in the near future? ...

Going abroad or even immigrating is not such a bad idea either if the middle classes' children don't like 'it' .... after all, in macro management, there will always be some victims ... until the dust settles ...

See why no one in particular was blamed and/or held to account? .. Because this was, and still is ... policy ... why? I wish I knew .. really knew ...

Maynard said it all in his article .. it is the whole future of medicine in this country on an A4 paper IMVHO!

Only I wouldn't call it middle class 'furore' Prof, It's now turned into 'bewilderment' and, as they say, “Much unhappiness has come into the world because of bewilderment and things left unsaid.”

Now, one needs to consider, can something come from nothing ...


Don Pedro of Aragon: Officers, what offense have these men done?
Dogberry: Marry, sir, they have committed false report; moreover, they have spoken untruths; secondarily, they are slanders; sixth and lastly; they have belied a lady; thirdly, they have verified unjust things; and, to conclude, they are lying knaves.


Monday, 16 June 2008

Who's holding the knife?

“A sword is never a killer, it is a tool in the killer's hands”

Last year, I wondered why are nurses being trained to take over the jobs traditionally done by junior doctors. I also wondered how will those nurse practitioners be deemed as safe. I had found out that some of them were being trained and will have to pass college exams and wondered if this would be the RC of nursing or of surgeons? I then also wondered why, while surgeons training hours have been shortened to nearly a quarter of what it was before, is this being allowed to happen and where is the BMA and the Royal Colleges in all this?

I have now found out ... The BMA is still saying nothing at all about all this and The Royal College of Surgeons is training and testing the nurses to take over the juniors duties ...

Sad state of affairs!

It seems best to go abroad if one ever needs an operation! 'Medical Tourism' is the way since we now have no idea who is holding the knife when we are asleep; a minimumally trained surgeon or a quack-titioner?! If one doesn't wake up because of a mistake, who is to blame? .. no one can blame MMC .. no one ever could so far! ...

Who are we to succeed where everyone else have failed? ...

They want to cut costs .. to employ 'cheap' staff while 14 Billion pounds are being spent on an IT programme to store patient information in Britain!

Why bother! With the way things are going, there will be no patients left anyway! ...

What I know about medical tourism is that people used to come here during the 70s, 80s and 90s and up to very recently from all over the world for the best treatment possible because British Medicine used to be the best in the world! ... and we've managed to turn it into a big, big mess!

How much, while we are are running after cheaper and cheapest for our own people, have we lost in revenue from the lack of incoming, as well as the now outgoing, medical tourism because of this mess?!

... and MMC is still going from strength to strength ... like a plague ...

:-(


“My dream role would probably be a psycho killer, because the whole thing I love about movies is that you get to do things you could never do in real life, and that would be my way of vicariously experiencing being a psycho killer. Also, it's incredibly romantic.”


Sunday, 15 June 2008

A wolf in monster's clothing? ...


“In the Soviet Union, capitalism triumphed over communism. In this country, capitalism triumphed over democracy.”

Graduate Physiotherapists have been finding it very hard to find work for for the past four years. This started in 2005, then went on to 2006, then 2007 and now in 2008

Is it any wonder now that applications to study Physio at uni are down by as much as 40%?

Physiotherapy is a valued and respected discipline. It 'was' a highly regarded career favoured by very able and bright students with matching high grades at A levels. Before the current situation with unemployment, you needed at least an ABB in A levels to read Physiotherapy at university and the programme was hugely over subscribed at all universities ... no more ...

In 2005;

"A Chartered Society of Physiotherapy poll of 1,523 of this year's graduates found 805 had not secured their first physiotherapy post.

More than 90% of respondents said they had sought work in physiotherapy.

The government wants to increase NHS physiotherapists from 15,600 to 24,800 between 2000 and 2009 - a rise of 59%.

Phil Gray, CSP chief executive, said: "After months of competing with hundreds of others for just a handful of junior posts, many graduates have had to put their physiotherapy aspirations on the backburner.

"We know of first-class graduates who are working in Tesco, Topshop and TSB just to make ends meet.

"One's joined the circus, while others are working in factories to raise money for Christmas."

Of course they blamed the problem on 'bad workforce planning' :-) and Health Minister Lord Warner said:

"There is no question of wasting taxpayers' money because we recognise physiotherapy graduates are a valuable resource for NHS patients."


Then, in 2006

"Over 2,300 physios graduated this year after spending three years training.

The survey - which interviewed 854 former students - found that 68% were still not working as physiotherapists and had been forced to accept jobs in bars, shops and warehouses to make ends meet. Last year's equivalent figures were 50%."

.. and the number of graduates was 60% more than in 2005! ... amazing stuff! So, how did this happen?!

"The society said the government and NHS employers signalled in 2001 that more physios were needed, so training places were expanded.

But the positions were no longer there as NHS trusts have embarked on a year of cuts in a bid to break even."

Well, if the government wanted more physios, why wasn't the money to create jobs for them not 'fenced' to ensure the taxpayer's investment in their training is not lost then?! ... no ... this maybe is 'problematic' .... because you won't be able to raid the money if it is 'fenced' of course ...

Anyway, that year A Department of Health spokesman said:

"We are aware that newly-qualified physiotherapists are facing much more competition in finding their first job than in the recent past and people may have to be prepared to be mobile to secure a post.

"At present, we are working with the society and NHS Employers to support NHS trusts analyse their local situation, develop plans and take action to recruit the physiotherapy staff they need to deliver services."

Lol ...

So, was the problem fixed and all physios got jobs, now that the situation was analysed, plans were drawn .. then action was taken?

No! .. the trend continued for 2007 and 2008

"Half of all physiotherapists who graduated last year in England cannot find jobs, according to a survey released to the BBC."

"Of the 726 who responded only 184 had found a permanent NHS junior post and another 191 were employed on short term contracts.
Overall, the CSP estimates 1,800 physiotherapists who have graduated since 2005 have not been able to find work"

The article does not say how many physios graduated in 2007 .....

"Strategic Health Authorities in England have set up talent pools where graduates can register for information about jobs.

But the CSP said many graduates don't bother to register, and those that do often receive little more than an acknowledgement."

A Department of Health spokesman accepted that there were problems, and said work was being done to try to address them.

"There is more to be done to help existing physiotherapists to progress their careers, thus creating vacancies for new qualifiers, and improving access for graduates to opportunities across the wider health and social care sectors.

"In some parts of country, such as West Yorkshire, newly qualified physios are using their skills in new innovative roles, working as community care officers for local authorities, helping to support hospital discharge."

"This enables physios to carry on practising their skills when the availability of posts in the NHS is very competitive."

.. Is 'idiocy' and 'foolishness' criteria for employing DoH workforce planners .. or there is another reason for all this? ..

Of course ... part time work was also suggested ... to help the poor graduates of course ....

Then, the unis' admission tutors blamed the shortfall in applications on:

"I blame it on the fact that there has been a lot of press coverage of the problems physiotherapy graduates were having getting jobs and this is deterring people from applying for training places."

You don't say! It seems that unis prefer to 'con' bright kids into their schools so that they can cover themselves and fill their quotas! .. Then who cares if those same kids graduate to ruin?! This same tutor then said the the job situation was likely to be temporary! .. For FOUR years?!.. and still going strong?!

In 2008, the DoH did not bother with 'action plan' announcements, it said:

"A spokesperson for the Department of Health said the NHS employs 20,146 physiotherapists.

"The NHS in England has seen record levels of investment. The number of physiotherapists has increased by 41% since September 1997.

"It is for Primary Care Trusts to determine how best to use their funds to meet national and local priorities."


Gobsmacked!

They say there has been 'some' improvements in the job situation .. Meanwhile, I bet those without jobs will even work for 'nothing' if only to keep their skills! Then, one of the lucky ones to find a job also said:

"Samantha Haw who finished her training last July had to wait for almost a year for her first job as a locum

"It's frightening. I work full time but I have no job security.

"I don't think it's getting much easier to find work."

What can you say to Samantha? How do you explain to her that she is just being prepared for 'competition' in the market out there ..... This is just a bit of 'competition' Samantha .. The NHS employers said in the HSC that they like competition, that's all ...

It costs around £30,000 to train a Physiotherapist for the 3 years at uni ....

Now that applications to read Physio are down, of course the universities will also drop the grades they require in order to lure the students to fill the empty places. If you were an admissions tutor, financed according to the number of students you have, have a 50% vacancy rate, how much will you drop your grades by?! ... soon Physio will be up for grabs with EEE at A levels .. or, a B-TEC? ... or even less?

I wonder if Prof Maynard can let me know, how many is Physio worth in GCSEs?

.... Next!


"The fortunate must not be restrained in the exercise of tyranny over the unfortunate”






Wednesday, 11 June 2008

What does the future hold?

“The good we secure for ourselves is precarious and uncertain until it is secured for all of us and incorporated into our common life.”

Today, I accidently met with the parents of a young doctor who used to be in the same year as my son. He was not suited last year and was seriously considering leaving medicine altogether then. Today his father told me that his was on the brink of a mental breakdown last year after he was discarded by MTAS, he did not even apply to round 2 of 2007. Apparantly, at the end, he accepted an unpaid anatomy demonstration post after lots of pressure from his family and friends urging him not to leave the profession he always aspired to join. His family now questions whether they gave him the right advice ..

His parents told me that he has now secured a training post this year, albeit a few hours away from home.

.. But this is not the happy end of a sad story!

The young doctor accepted the post but he does not want to leave his family and live alone in this new far away city. He is now again considering if it would be better to leave medicine altogether instead. The parents say he has already applied to many other non medical jobs even from before and while applying for training. They say he applied to the city, pharmaseutical companies, management positions, even in the NHS, etc but to no avail. It seems that 'A' degree in medicine is not that lucrative outside of medicine after all!

His father said that his son is depressed and has been so since MTAS last year. He is also now so confused about the future, he can't decide whether to leave medicine now and retrain in something else or, stay in medicine despite being faraway from where he belongs for the sake of the job only to face a very possible career dead end two years from now?

Apparantly, the training post he has is in a surgical specialty that is really oversubscribed the higher the level. So, this young doctor now argues why take the job now only to become unemployed or pushed into dead end career when he is 2/3 years older? He questions if it would be better to leave medicine, change direction and retrain in something else now?

However, even this senario poses another problem; how competitive will he be when he graduates the new dicipline at age 30 and with not much work record behind him? How competitive will he be in the work market when most of his new fellow graduatess will be 8 years younger?

His father feels that the 8 years spent in medicine have totally ruined his son. That medicine turned him from a happy, ambitious and successful young man into a confused individal that does not have much hope in the future ... Being a very bright son, his father was wondering where would his son be now had he gone for an engineering degree instead ... I wonder too ..

I could only listen and sympathise, but I had no answers for this parent ... I couldn't give an opinion or propose a solution because I too have no idea ... and there are lots of parents in the same boat out there ... whether their children have or do not have a training post, the future is uncertain and worrying ..

When I got home, I kept on thinking about this young doctor .. and about them ... and about my own ... and about the future ...

Then I read the comments on this Dr Crippen's post ...

... What does the future hold? ...


“ It is prudent never to trust wholly those who have deceived us even once”

Help!

Help, I need somebody,
Help, not just anybody,
Help, you knowI need someone,
help.


When I was younger,
so much younger than today,

I never needed anybody's help in any way.

But now these days are gone,
I'm not so self assured,

Now I find I've changed my mind
and opened up the doors.


Help me if you can,
I'm feeling down

And I do appreciate you being round.

Help me, get my feet back on the ground,
Won't you please,
please help me.


And now my life has chan
ged in oh so many ways,
My independence seems to vanish in the haze.
But every now and then I feel so insecure,

I know that I just need you like I've never done before.


Help me if you can,
I'm feeling down

And I do appreciate you being round.

Help me, get my feet back on the ground,

Won't you please, please help me.

When I was younger,
so much younger than today,

I never needed anybody's help in any way.

But now these daya are gone,
I'm not so self assured,

Now I find I've changed my mind
and opened up the doors.


Help me if you can,
I'm feeling down

And I do appreciate you being round.

Help me, get my feet back on the ground,

Won
't you please, please help me, help me, help me, oh.





Sunday, 8 June 2008

Getting pampered sous le ciel de Paris ...


“It is impossible to overdo luxury”

Apparently, it is better to be ill in France than in Britain!

"The surgeon told me there were two full orthopaedic teams on stand-by in the hospital, even though it was a holiday weekend.

In theatre, I was offered the option of an epidural anaesthetic - then the theatre sister produced an iPod and said: "You don't want to hear us working." I listened to jazz while they fixed my hip."

"Not long after I came out of theatre, a "pain doctor" gave me Tremedol and paracetamol. "If you feel any pain at all, push the button and ask the nurse to call me. I will come right away," he said. On day three, when I did have some pain, they set up a small morphine drip immediately.

Unlike in Britain, hygiene was taken extremely seriously. Every morning, the nurses got me out of bed, stripped it down to the frame and gave the entire room, furniture and floor a thorough clean. I was in a two-bed room with shower en suite; the nurses shook their heads at the idea of lumping patients together in a large room. (This 1,000-bed hospital had only one- and two-bed en-suite rooms.)

A physiotherapist helped me to exercise daily. The food was tasty and varied (in London, I was never given what I requested because it had always ''run out"). On Sunday in France you even got a half bottle of wine with your meal.

In France, the patient's ongoing care and individual well-being was paramount. On the morning after I arrived at my French house, the district nurse came to give me the first of 15 daily injections. She asked me what time I would like her to call.

All this was free courtesy of my Europe Health Insurance Card (which gives British citizens the right to free or reduced-cost emergency treatment across the EU). Why can't we get it right in Britain, despite the billions that the Government has poured into the increasingly creaky NHS? Are there too many managers? Too much central control, perhaps? Or has the NHS simply forgotten to put the patient first?"

Don't they have Dr nurse, nurse practitioners and nurse consultants in France?! .. well, it figures! .. The French do it the old fashioned way ... with passion ...



“I always thought I should be treated like a star.”