My health ... My way :-)

“All personal breakthroughs begin with a change in beliefs.”

Personal Health Budgets: First Steps

Lord Darzi has just launched his policy for personal health budgets. This is a way of giving people greater control over the services they use and who provides them.

The document itself is 59 pages long and leaves no stone unturned. It is that good, really .. I read 46 pages of it and left the rest because the remainder was intended to PCTs and service provides giving them directions on how to implement the pilot. .. but I will return to read the whole thing again later because it is a very thorough piece of work and I believe this is a really good idea; giving patients lots more control over their own care through three types of personal budgets, depending on a given patient's needs - read it :-)

A personal health budget can be:

Notional or 'virtual' where a budget is allocated but is held and managed by the PCT and caters for a specific plan as agreed with an individual therefore allowing risk to be pooled

Real budget which can be held by third parties such as voluntary organisations, etc and those would therefore be responsible for 'risk' prediction and management thus reducing the pooled risk for PCTs

Direct budget, which following the social model, can be paid direct to the individual - conditions attached.

However, the pilot which starts from Sept 2009 and runs to 2012 will only run for the first two types. He emphasises the need for risk management and necessity of 'indemnity' for all. This piece of work is currently being looked at by parliament with the intention of having it included in the 'health Bill'

Personal budgets are designed with the aim of:

1- Upholding NHS values

2- Ensuring Quality in the form of Safety, effectiveness and experience

3- Tackling inequalities while protecting quality.

After a budget is agreed with a patient, a 'care plan' designed to meet the individual's 'agreed' health and well being outcomes is drawn. All budgets are purely voluntary and are not suitable for either 'emergency services' or 'Primary Care assessments' including GPs, who remain providers of clinical care through registration. For this vision to succeed, Darzi, again, talks about the importance of leadership as well as 'change of culture' with a far reaching vision of integrating health and social care to achieve best outcomes for patients and the NHS. Hence, not only does this policy reduces and hopefully eliminates inequalities while ensuring quality but it also has the potential to greatly control cost and reduce waste ..

This policy is a brilliant idea very well set on the road to success ... no doubt! :-)

From a patient point of view, this is a 'quality' piece of work that will improve the quality of care as well as quality of life for so many people. Especially those, as mentioned in that report, with special needs or long term conditions. A brilliant and very comprehensive piece of work ... again ... produced at the 'speed of light!' ... It's becoming a 'marathon' trying to keep up with this minister .. But .. I am enjoying the learning ..

World Class!

Respect :-)

"The most essential thing for us was to get the business model right, then put the world-class technology under it to support it. That meant not doing what people expected, but much much better. "

Wink, wink ... wink ... ;-)

“The only honest art form is laughter, comedy. You can't fake it... try to fake three laughs in an hour -- ha ha ha ha ha -- they'll take you away, man. You can't.”

I have just read the post on Dr Crippen's blog. It's about a GP whose husband is a hospital specialist . Apparently their daughter was not well and it seems they were unable to get an appointment with another GP at a 'health center' and were offered an appointment with a nurse practitioner instead.

The first thing that came to my mind was, didn't that woman GP betray the 'GP cause' by registering with a 'health centre' for her 'own' family?! Doesn't she know about 'la resistance'?! If I were Dr Crippen and I recieve this e-mail, I would have replied, straight away, and, of course, wished the child was better first then went absolutely berserk with those two doctors! Totally out of my mind! I mean, first, we have the head of the BMA signing a contract for one of those centres! Then you have GPs registering as patients! What atrocity and what utter betrayal of 'the' cause! ..... Grrrrrrrrrrrrr :-(

What message are those 'militant' GPs sending ordinary patients then? They must be stopped AT ALL COST, eh?! ;-(

Then again, I don't think a seasoned woman GP and her consultant husband can be that daft, can they?! It doesn't make much sense, does it?! No! So .. could it be that someone was playing a 'prank' on Dr Crippen? Of course this is possible in our twisted, conspiracy ridden day and age, isn't it? But then, how can such a stupid prank get past someone so intellectual like Dr Crippen?! .. who also happens to be an Oxbridge graduate?! .. I suppose the best of us do get fooled sometimes ... never mind dr C ;-)

Dr Crippen does not say whether the e-mail mentioned if the two docs were able to get an appointment for this ill daughter with a GP at the end or not? Or, what they did next if they were not able to do so? It is just that I am wondering whether the little girl was put at risk by the action of that centre ... stupid receptionist, isn't she?! Hasn't she heard about 'patient safety' and the consequences, for herself as well as that centre, for jeopardising that these days?! ... That 'incident' could have escalated really bad, especially because her parents are doctors themselves and did say that her condition had deteriorated to the point where even them needed help! .. I sincerely hope this little girl is fine now ... and ...

I'd love to know what happened next .. is the little girl ok Dr Crippen? ;-)

And, if this story is true, isn't that the best proof the GPs should not be afraid of their patients leaving them for those 'extra provision' centers? Who wants to leave 'a good' GP for a nurse practioner?! I wouldn't!

And BTW, I am still of the opinion that the GP representation let it's members badly down. It is the 'first' rule of diplomacy that if you are in a 'needy' position, it is the best approach to start matters by 'negotiating' calmly and with reason to get the best deal possible. If you disagree, show me 'one' diplomatic effort that had a successful outcome while following the opposite route to this rule, like you lot did? Just the ONE .. please!

Your representatives decided to take an opposite route .. with belittling and sarcasm too! Where did this get you?! I truly do wonder now how much you lot lost out because of this?!

Time to open up these talks again and try and salvage whatever can be salvaged, don't you think? ... 'he' did say he'd be waiting ... ;-)

Let's hope the little girl is ok now ...



“If you haven't got it. Fake it! Too short? Wear big high heels, but do practice walking!”

Look who's talking ...

He can score, he has great confidence, he's got great creativity, and I get criticized heavily for it, but I let him go. When you've got a thoroughbred, you've got to let him run. It's a green light for him. It's bright green.

Just not to let JD down, here is my 'write up' on clinical leadership, which will of course be on Lord Darzi since he is the current leader as well as one pioneering the call for clinical leadership to ensure greener pasture for all users of the NHS .. :-)

And JD, why do you never give me 'reason' to make me change my mind about the current leader and his reforms?! Despite me asking for same on numerous occasions?! Convince me with proper debate and I will change my mind. Otherwise, to quote you " he is the frontman for a criminal conspiracy and monumental fraud of the taxpayer".. is just hollow as it doesn't explain anything let alone 'your' own reasoning for this statement! I am sure you can do much better than that for I am also sure you have the ability and the intellect to convince an amateur like me if you tried enough .. so please do so and I promise, once convinced, I will no longer support Darzi .. I am 'eagerly' awaiting your 'reasoning'. Incidentally, who do you think is a better leader out there who is more able and can do a better job? The GP VIPs? :-)

And so, ... back to the topic at hand .. In that Royal Society lecture that has now disappeared, Lord D said that clinical leadership is 'critical' if positive change concentrating on 'quality' and 'safety' is to take place. I happen to believe the same too and have asked before very early on this blog, although I can't remember which post, I asked, why isn't the Secretary of State for Health a doctor?! .. I still ask the same question and sincerely feel that this will happen soon. Of course our current leader has a track record of learning at the speed of light :-) so, I don't think it will take him long to learn the art of politics since it is just about 'logic' or the deliberate evasion of same, right JD? ... mastering GP is, of course, very different ... again, right JD? ;-)

The reason why I believe clinical leadership should be encouraged at all levels and will hopefully soon reach the highest possible office is precisely because of why the current reform is taking place .. to ensure Quality as well as safety .. to rejuvenate an otherwise dilapidated establishment that is falling at the seems. To bring this precious establishment into the 21st century where it should be ... a new NHS that is younger, more vibrant and able to provide what Bevan believed when he established it; 'quality' care for all .. and ... satisfaction and opportunity for it's staff. ... I believe we are on the road to that aim now.

The very fact that Lord D topped the list for the 50 most powerful people in health for the second year running again even topping his boss for the 2nd year running tells volumes about why clinical leadership in the NHS is so important. Of course, this particular 'junior' has a habit of always topping his boss. The fact that he was able to take centre fold position for the second year running again proves the point. This in itself shows what clinical leadership can and will do to ensure improvement all around for patients and staff. It shows how effective it can be for driving positive change.

Watch the clip below, filmed while touring the country gathering evidence for the Next Stage Review. There is just one clinical leader touring with two non clinical ones ... watch who is doing all the talking and how convincing he was too .. and who is doing all the listening and whether they made any difference overall .. then form your own opinion, who is best positioned to lead public health as well as the NHS into the 21st century ...

Clinical leadership in Health can not be equalled because it is the 'Thoroughbred' of leadership .. this is why it is 'vital' for the success of an NHS fit for the 21st century

Clinical leaders will 'always' have the best 'vision' because they will always have the best 'breeding' and therefore the best 'gallop' to success .. because they have the best 'eye' and so, best 'direction' ...

Just like a 'Thoroughbred!' :-)



“There can be no two opinions as to what a highbrow is. He is the man or woman of thoroughbred intelligence who rides his mind at a gallop across country in pursuit of an idea.”

Learning ... :-)

“What moves those of willingness to learn, what inspires their work is not new ideas, but their obsession with the idea that what has already been said is still not enough.”

I am reading quite a bit these days because I have decided to learn more about the NHS. It is amazing the amount of information one can get on the net ... lots and lots but I prefer hard copies and so I visited many websites and got ordering. It really is very easy to get hard copies by just simply phoning relevant organisations like the National Patient Safety Agency, any trust's annual and strategy reports, complaints procedures, patient support bodies, the current reforms .. etc .. etc .. etc ... and all those organisations! And their abbreviations .. zillions of them! How do you guys get to remember them all!

I got a few bits and pieces last week but, I've just had about 10KG worth of stuff delivered today .. all for free!

Amazing! ... and .... overwhelming :-)

The kids know that I'll read anything ... but seeing all these packets delivered today, they now think I am becoming a bit obsessed with the NHS ... see, before MTAS, I had no idea ... and looking at all the reading material I recieved during the past week and today .. and I am still expecting more to arrive, it seems that I still have no idea ...

Well, I have always wanted to become a doctor ... this is the next best thing I suppose ... and I want to protect my investment in the NHS, my four children .. and our health so .. what better way than to learn .... Time to make a cup of cocoa, sit in bed with my pile of paper .... and get reading ... and reading ... and reading ...

And ... I have ordered lots more stuff too .... ooooh! :-O


“Your ability to use the principle of autosuggestion will depend, very largely, upon your capacity to concentrate upon a given desire until that desire becomes a burning obsession.”

Now you see me .. now you don't!

“I can avoid being seen if I wish, but to disappear entirely, that is a rare gift.”

Lord Darzi's lecture is no longer online!

I wonder why it was removed?! Such an important for everybody lecture ..

I think that lecture 'was' a great education on why 'things' happen the way they do .. one was hoping for lots more online 'stuff' like this .. afterall, the current trend is to prevent disease where possible and improve on quality, thus making patient safety the numero uno priority now deeply embeded at the heart of the NHS and clinical practice! The trend is to empower and involve the patients in their own health .. and what better way than to educate us, the public, on public health using lectures by our best doctors and scientists, like that one just removed? Of course that lecture had been available for anyone to see online for more than a year now! Judging by the packed room and the use of another for spell overs, this lecture must have been very popular online too!

So, why was it removed now?!

We want to know .. Actually, in this day and age of the global village and the information explosion, things can not be hidden anymore ... and so, we demand to know! ..

So ... please let me remind the medical profession of the 21st century, you have a duty to educate the public on matters that concern the public and their health ... in the 21st century!

Because we now have the right to know ... by LAW!

We want more ... not less! ... Please :-)

Prevention is better than cure ... and for that we need more public education. Maybe the Royal Colleges and all the medical societies .. etc should dedicate a special public space on their websites making available 'all' lectures .. or a special site where all public health lectures are pooled in and are made available for anyone to see and learn from .. Innovation in medical practice and delivery of same ... in the 21st century

To all of you 'Enablers' out there ... center on us, 'your patients!' .. our health as well as our health education, including policy .. and not on other 'things' ... 'change' your culture .. open up! ... Empower your patients ... Transparency ... Accountability ... Education ... Teamwork! One BIG, BIG happy team! Working 'together' ------- > Quality, Safety, enhancing your patients' experience .. and cutting costs too .. a winning formula, eh? ;-)

Working together to preserve and advance an NHS fit for the 21st century ... I did say it was a brilliant lecture ... ;-)


Maybe that site was temporarily ... one thing or another .. Maybe I should check again later ... you never know ... let's hope for the best ... as always ... :-D




“When we remember we are all mad, the mysteries disappear and life stands explained.”

Free .. :-)

“A dreamer is one who can only find his way by moonlight, and his punishment is that he sees the dawn before the rest of the world.”

I believe the simple dictionary is the biggest and most comprehensive book of wisdom ever written. I like looking up the definitions of words I think I know the meaning of .. for every time I look up a definition, I always find a new meaning .... here is one I looked up today ... Of course the longer and more complex the definition, the more time it took wise men to find .. the bigger the wisdom ...

Free:

1. (adj)	free , at large, at liberty, escaped, loose, on the loose, at liberty, unconstrained, autonomous, independent, self-governing, sovereign, available, uncommitted, aweigh, atrip, clear, discharged, released, disentangled, extricated, freed, emancipated, liberated, loose, out-of-school, unconfined, unimprisoned, unhampered, free of, unrestricted, footloose, independent, unbound, unconfined, unrestrained, unrestricted
2. (adj)	free , liberated, unbound
3. (adj)	complimentary, costless, gratis, gratuitous, unpaid
4. (adj)	unoccupied
5. (adj)	detached, unfixed
6. (adj)	free , emancipated, freed, liberated, freeborn, free-soil, slaveless
7. (adj)	spare, unoccupied
8. (adj)	loose, liberal, inexact
9. (noun)	free people, people
10. (verb)	liberate, release, unloose, unloosen, loose
11. (verb)	rid, disembarrass
12. (verb)	dislodge, remove, take, take away, withdraw
13. (verb)	exempt, relieve
14. (verb)	release, issue, supply
15. (verb)	discharge
16. (verb)	disengage
17. (verb)	absolve, justify, forgive
18. (verb)	release, relinquish, resign, give up, pass, hand, reach, pass on, turn over, give
19. (verb)	unblock, unfreeze, release, issue, supply
20. (adv)	loose

Then I looked it up in the thesaurus ... overwhelming, isn't it .. free

Isn't it amazing how some people interpret the meaning of 'free'? They think it is all about saying and doing what you want whenever you want .. or getting something for nothing! .. I think it is one of the most restricting definitions ever ... and the duties and responsibilities attached .. but then the liberation ... phew!

Let's all 'strive' to be Free ... for there is no absolute freedom ... and so the endeavour never ends ... till the end of time ....

Look up the meaning of a word you think you know today ... and ..

Enjoy the song ... and have a peaceful day ... :-)




“Slow buds the pink dawn like a rose From out night's gray and cloudy sheath; Softly and still it grows and grows, Petal by petal, leaf by leaf.”

History in the making ... :-)

" I am an academic, I meet deadlines" Professor Lord Ara Darzi

"We are made wise not by the recollection of our past, but by the responsibility for our future."

NHS Constitution is launched

"Today sees the launch of the first ever NHS Constitution

The Constitution, viewed as a "bill of rights", defines what staff, patients and the public can expect from the NHS, emphasising both rights and responsibilities."

Just recording a piece of British history ... :-)

"Our Constitution is color-blind, and neither knows nor tolerates classes among citizens. In respect of rights, all citizens are equal before the law. The humblest is the peer of the most powerful."




The Constitution is the sole source and guaranty of national freedom.











"The history of the world is the world's court of justice."

Working at the speed of light! .. :-)

"Strengthening leadership across the service is vital as we enter this new stage of reform. " Lord D

My my ... here comes the National Leadership Council ... ;-)

"The NHS will introduce a new leadership council to help nurture the next generation of senior management.

It will aim to:

• Gather intelligence and evidence on leadership skills
• Set standards for what makes a good leader
• Commission relevant leadership development programmes and
• Ensure leadership capacity is improved across the NHS

Improving leadership across the health service was a key commitment in High Quality Care for All, Darzi's review of the NHS, published last summer."

Emphasising Clinical Leadership again! In the lecture , he stresses the need for future leaders' accountability and again spoke about transparency .. and there you go!

... sooo ... was that a premonition I had then? .... It seems that I can read boss's mind ... :-D

Way to go minister!

Boss -------> Forward ------> Always -------> At the Speed of LIGHT! :-)


"We have a responsibility to learn continuously, seek development and career opportunities, and spot talent. This is where the National Leadership Council comes in. The council will act as a guardian for leadership in the NHS, setting standards and campaigning for change." Lord D

Educate the patients ... :-)

"The public and the patients have a greater respect and believe in what the clinicians say than what politicians and managers do"

Last year when Professor Lord Darzi published his interim report it was followed by what I now understand to be an unjustified GP scare! A campaign that stressed that polyclinics must be avoided at all cost because they are as bad as can be for everybody! I had no idea what that meant or why reform was happening but if the doctors on the net say so, then they must be right! They are doctors after all, one must 'always' believe a doctor, otherwise, if you doubt those, who else can you believe?! And so, I displayed a yellow 'save your surgery' logo on this blog and ran to my GP to signed to 'save the surgery' for myself and on behalf my whole family, without their consent. I have a good GP and to me, what I heard the doctors on the net were saying made it seem that the government, through Lord Darzi, was hell bent on closing my practice as well as every practice in the country and herding all GPs into huge under staffed new buildings really far away from where anything is .. Then, a little later, the intention was to sack all the GPs and replace the lot with nurses to cut down costs! Below standard everything!

Oh, NOOOO! What a predicament .. Has our government gone mad! .. maybe :-)

Then you think, what a deceitful and kniving government! But then, how did they brain wash Professor Darzi of Imperial College, a world renown doctor, surgeon, academic , teacher, scientist, innovator and now decision, policy and law maker and expert of the highest possible caliber into doing all this to all of us helpless patients as well as his fellow hard working doctors?! Then you say, well .. it's government, isn't it? They are capable of doing anything, aren't they?! And so .. it was WAR! .. and I felt I had a duty to show solidarity with my comrades, the doctors ..

As I am a fighter by nature .. :-) I too felt I must take up arms and fight ... Ara, Alan .. and Gordon ... here we come! .. WAR! :-()

And so, as well as fighting on this blog, I too ran to a doctor rating site that gave really negative rating to Lord D in everything .. but then I had prior knowledge about the professor through my eldest son who considers him a role model and knew of this professor's achievements and contributions to British and world medicine soooo .. those 100% negative ratings seemed weird to say the least so I hesitated .. because it made no logic, no common sense and so, I decided to go 50/50 and gave him a neutral rating instead despite feeling somewhat uneasy still. It was the only neutral one amidst all the 100% negative ratings with sad green faces .. then I felt I had to write a 'reason' for why I rated him a s such but since I couldn't say I was part of la resistance, I wrote "Your life is safe in his hands but not your GP surgery" which I thought it made more sense and justified my action ... given the war situation, you know. But ... I was still wondering, what did they up there do to him to change a man like this from being a doctor and a scientist of the highest possible honour and integrity and with a totally unblemished career to match, to suddenly make a U turn to a completely unreasonable and unpredictable man who became totally bent on the unrelenting and systematic total destruction of the whole of the NHS! Then you think, how did 'they' convince 'him' to 'co-ooperaaate'?! Well, Lord D did describe how he was 'recruited' in this lecture. Apparantly the PM sat at the back of a room full of members of public for 3 hours! Quietly watching Lord D mingling while he wrote lots of notes .. @@ .. Then .. from KBE to KGB overnight! ... Frightening stuff, eh?! :-D

That's when I started reading more .. Because things did not add up!

If I had the information that I have now, that reform is aimed at improving quality for all, through existing service provision and/or getting rid of failing GP practices, what we all know do exist. That those centers are extra capacity because the NHS can no longer cope with the spiralling out of hand increase of patients use of A&E departments and for equally huge unsustainable cost as well as treating ailments that do not warrant the specialised care that such departments provide. If I knew that these centres will provide extra services such as X-ray, physio .. etc and that it is proposed that federated GP practices will be allowed to use those extra facilities those centers as a substitute, where possible, for the now struggling A&E departments as well as provide walk in and out of hours care for patients who need it .. and the trend of more care in the community and the demands for extra capacity to cope with same, otherwise current GPs will be overwhelmed and will not be able to cope .. as well as employing the currently jobless doctors, nurses, physios .. etc, etc, etc ..

I would not have taken part in that 'save your surgery campaign!' .. Because as well as all the reasons above because it is a good idea to have extra facilities that are designed to properly meet local needs. And, I KNOW my GP surgery will be safe! .. My current doctor is that good .. not the one before though

I would also not have taken part, not because I now think the doctors were out to deceive the patients on purpose but because I feel now that the docs themselves were decieved! They were made victims of the 'scare campaign'! A campaign intended to cause a stampede amongst doctors as well as patients! .. This campaign was started by the GP VIPs at the RCGP as well as the BMA! .. I find this A M A Z I N G now! ... Because I know better. And now that I do, I wonder 'why?' again, only this time, I wonder why did those two prestigious representative of GPs institutions act the way they did? Only for the head of one to go on to sign the contract for one of those new health centres himself!?! And to the other VIP I ask, why did he, as well as join to devise and support the scare campaign, did those 'leaders' join efforts to launch an equally viscous campaign to belittle the only fellow doctor in a ministerial leadership position through the 'he knows nothing about GP' campaign ... as well as all the sarcasm .. etc, etc ... to me, they don't look very credible now that his report is law!

'A Pantomime villain! .. How dare you?! And what are you if you allow yourself to brand anyone, let alone one of our best , a villain?! .. I ask that to 'whoever' initiated then allowed this sad 'article' to run of course ...

Funny that because I always was under the impression that negotiations were the best route to agreement and I still think so .. I am also under the impression that 'leaders' have a duty to recognise excellence when they see it. That before they make any move to attack, they have a responsibility and a duty to justify why attack? .. giving valid 'reasons!' for their decision... so maybe those VIPs now need to explain; why they took the stand they did? Why didn't they properly evaluate the Next Stage Review report before they went blind folded for that hunt?! Did they read that report at all?! ..

Because I now feel they let their members, as well us patients down, wasted valuable time and an opportunity to cooperate with the 'doctor' in office for the benefit of their members as well as us patients! .. and this time I also want to ask .. how much did their ill sought actions cost their members?! If those institutions are so rich money has no value to them, maybe it is time they improved their performance somehow and/or gave much reduced joining rates to the financially limited juniors instead of that waste, spending on useless campaigns then shelve them at the end and apply for the 'fruits' themselves?! And for those who pay memberships to those 'prestigious' institutions, isn't it time you asked how 'your' hard earned money is being spent? As well as what are the 'worthy' achievements of your VIP leaders since they took office?

And, to oneVIP: Leadership is about protecting those you govern; as in not supporting an unvalidated recruitment system that proved to be the biggest black hole in medical history or running a 'scare' campaign for 'unknown' reasons! And, it would be nice to know; on what basis did you judge those two 'causes' to be worthy of your approval?! Of course leadership is also is about raising standards for patients and staff, including fighting for the right of young GPs to proper jobs and a right to a bright future. It is 'definately' not about how many media appearances one makes since coming to power! ...

As a mother of young doctors who may decide to become GPs in the future, I still wonder who is fighting for the young fully qualified but jobless GPs currently despairing because of lack of opportunity? and why aren't you doing so Prof Field and Dr Meldrum?! And .. what was the aim of the opposition to the health centers campaign? Why? What was gained by following it? Were they value for money? What other solutions did you put forward to solve ALL the problems that warranted the creation of those centres in the first place?

What happened recently and is still happening makes me feel that there is an essential need to educate the public on health as well as health policy. Patients need to know about policy before things happen. Otherwise, like me, they will end up without having the ability to make a decision based on real choice. Of course, I am still a beginner and may have mistakes in judgement above so, please correct me anybody where I went wrong for now I can and will change my mind if I feel there is a 'valid' reason to do so. But next time, I will need to be convinced based on knowledge and proper debate first.

I honestly feel that in this day and age of the information revolution, we need transparency and education. Because it is 'dangerous' to leave people out when decisions that affect their lives are being made. It makes no sense to anybody when they read in the papers that doctors are on the golf course or the not so nice exchanges with the government that followed without explanation of why all this was happening. This make people make uninformed decisions just like I did before. People now want to know where and why as well as 'how will policy affect me?' .. youtube is not enough ... and you need to aim to reach everybody and not just a certain class or a selected few.

Educate 'the patients' .. help them make real choice, the 'right' choice :-)

That said, I like to stress that I will still always believe in what a doctor says more than any other professional. Because I do firmly believe that most doctors have higher integrity and moral standards than most others .. but perhaps if I had better knowledge about the 'health centres' issue a few months ago, I may have been able to help my doctor, where his representatives have failed miserably, to see the reality of the situation so that s/he can get over the unfounded fears they now suffer due to that scare'em campaign ..

Isn't that what people are for? .. take good care of each other while striving for better standards for all?



“Our knowledge can only be finite, while our ignorance must necessarily be infinite.”

Cracking the 'NUT!'

“A few clowns short of a circus”

How do you crack the specialty training 'nut?!' Well, it seems that part of specialty training 2009 is to put young doctors on an endurance course with crazed 'machines' then wait and see what happens! .. Are 'they' having a laugh .. two years on from the MTAS catastrophe!?! .. You betya! There are still hitches with the potential to ruin many an excellent young doctor's career yet again! Haven't those systems been tested and validated before they were unleashed on the young doctors?! It seems I was too optimistic here ... for ..
Two years on from the MTAS circus and still, the 'machines' can not get it right!

"This year three medical royal colleges have been running their own online national application system where junior doctors can apply to train in their speciality.

A glitch in the computer system meant trainees filing in the forms at the same time could see each other's answers and at least one candidate had his qualifications and experience swapped for someone else’s.

The problem was spotted 'within minutes' and the system was taken offline. Deadlines for applications have been extended. Around 3,500 doctors had registered with the system.

The Royal College of Psychiatry system is now back up and running, but the Royal College of Paediatrics and Child Health system has still not been reinstated.

The Royal College of Obstetricians and Gynaecology was also affected for a short time but has now solved the issue."Amazing stuff! .. then ...
"Experts said it is on nowhere near the scale of the failure of the Medical Training Application Service (MTAS) two years ago"


E X P E R T S !!! .. Oh PLEEEASE! Are they the same 'experts' of MTAS 2007?! .. or is it that everybody is now an 'Expert?!' .. A new lot of 'EXPERTS' perhaps?! Where do 'they' find all those EXPERTS with the same 'high' performance calibre from?! ... Ah well, at least 'it' is not on the same scale as hurricane MTAS 2007 .. that's alright then, isn't it! The 'EXPERTS' said so, didn't they?! .. The 'Experts' said ..

Tell that to the doctors who may lose out because of this .. the application to speciality training of 2009 blunder ...

AND .. while we're at it .. talking about 'blunders' .. please tell the 'Experts' there is something wrong with the Royal College of Physicians 'core training' application 'machine' too! REALLY!

Albeit small-ish in comparison to the above but 'valid' nonetheless! You see, there are questions requiring answers that allows a maximum number of words to be used. Those are on experience in audit, research, commitment to specialty .. etc. Of course this takes time and lots of effort for a young doctor to get what they want to say within the permitted allowance for each question .. Then you press the submit button .. but the system won't accept your application if you have used all your allowance! It will tell you that your word count is over the limit when you know that it isn't because you counted AND counted! ..

But then, you do go back and count and recount and count and recount .. to find out where you went wrong but you didn't .. It seems that the 'machine' may be configured somewhat different to whatever word package you may be using and hence, the word count may differ by just a few words .. and you can't submit! Meaning, you have to go back to one question, try to omit a few words from your 'perfect' answer , then try to re-submit again but .. again, the 'machine' won't accept! Then you go to another question and remove a few words from your 'perfect' answer .. then another .. and then the machine will finally accept your application .. but, were your submitted answers as perfect as you wanted them to be?!

Of course, the deadline for applications to core training have now passed. But, for the sake of those young doctors, why didn't those who devised the system allow say 10 or so words extra per application to allow for the variation of word packages used by the applicants .. if indeed this was the cause of this 'glitch'? .. because this reasoning is only my guess ... Of course the 'Experts' know better ... yeah .. maybe! ;-(

And now that most applications to specialty training have been submitted. How do we know that the 'machines' will be fair in marking same? Will they be using an MTAS style 'buzz word' system to mark?! .. how else can 'machines' mark applications?! How do we know those 'machines' won't 'spit out' a few applications here and there while they are in the midst of their marking convulsion .. munching and crunching?!

We await the 'EXPERTS' reply to this question .. soon please!

AND ...

God help all young doctors applying this year to 'Cracking the NUT!'



“If we are all bouncers, who is going to get beaten?! .. Only the children left ...”

Thrilling! .. :-)

“True genius sees with the eyes of a child and thinks with the brain of a genie”

Gripping lecture given by Lord Darzi at The Royal Society of Medicine in 2007. The lecture theatre was so full, they had to open another room and link the two together. It was also mentioned that this was the first time the society had such amazing attendance! (You need to register with 'any' email and name to view) In this lecture Lord D speaks about his vision for the future of the NHS and the necessity for clinicians to take leadership roles as well as about innovation .. etc .. watch the lecture ...

He said that while at The Health Select Committee in 2005, he was asked:

"Why do you want a clinician leading a piece of work in the heart of government and what the impact of that would be for the NHS and its future? (meaning the Next stage review)

And

what makes you think that clinicians should lead on policy in health care?

To which Lord D replied:

"There is plenty of evidence that we know that if you want change and you want reform in the health care system you need to empower clinicians in leading that change and there is no two doubts in my mind about that."

And .. to the 'dislike' of the chair and the rest of the members, he said:

"The public and the patients have a greater respect and believe in what the clinicians say than what politicians and managers do"

These are such strong replies, they are 'statements!' If that's not one committed doctor to his fellow doctors, I don't know what is?! And, I remember someone saying that he refused the idea of a regulatory body for managers. While I have no idea if this is true or not, I can only guess that if indeed this was true, then he may have refused because when you regulate any group of people, you actually also give them power .. so you don't regulate if what you're after is reform. It makes more sense to get the docs into the leadership, or rather, the most influential managerial positions and ensure they are not met with resistance from a regulated lot and their 'specialist' representatives, which will always be the case if you allow this regulation. This way, as well as getting the docs into the top as well as middle leadership positions, you also do regulate those managers but without giving them extra powers, right? .. Think about the benefits of that for the docs! .. I told you, the man IS a genius! Thrilling! :-)

And thank you Angus Dei for finding this treasure ... I feel you enjoyed this lecture as much as I, and the packed audience did ... Nobody can talk like him and this is a well known fact! He has this amazing ability to simplify really complex matters so that anyone sitting in the audience can understand. Watch out for the bit where he integrates medicine and engineering talking about how a 'static' image is achieved in the operating theatre using modern robotic and other equipment that measures the speed of a moving organ and equalises or sybcronises it with the surgeon's gaze. Or equipment that measures the surgeon's gaze or fixation point then helps him decide the depth of the tissue they are looking at! Mesmerising stuff! and pardon me if I put it somewhat, you know .. but I understood, ya :-)

And, I don't know why don't doctors, academics and scientists like him, .. although .. ahem .. ;-) Anyway, why don't they let us ordinary people into those important as well as very informative to everybody lectures or, as they call it, address. Please allow and include us patients, those who do need and would benefit from the education on making policy and why 'things' are done. Invite everybody and not just fellow doctors. .. Maybe it is time Lord D gave a lecture in the Hyde Park ... of course, he can always use Kensington Park for the spill overs ... or maybe an online lecture on an own website? Or on TV? We're talking about the NHS in the 21st century after all .. Innovation for the sake of the health of the whole nation. What better way to educate the public than to get our best 'professionals' in health to talk about things that matter; obesity, alcohol, smoking and sexual health? Not forgetting 'the aging population', end of life, prevention, care in the community, ... etc .. etc ...

Innovate in a true campaign addressing the health of this great nation in the 21st century .. using 21st century tools :-)

Oh yes! .. he was on BBC breakfast time TV today .. at 7.30am .. complete with red eyes due to lack of sleep .. me thinks one can only juggle so much .. but then, I am no genius :-)


“Enthusiasm is the yeast that makes your hopes shine to the stars. Enthusiasm is the sparkle in your eyes, the swing in your gait. The grip of your hand, the irresistible surge of will and energy to execute your ideas.”

Time for beating the Congas ... ;-)

“But hark! My pulse like a soft drum. Beats my approach, tells thee I come.”

Where did Glen Burley, the Chief exec of one after another lucrative NHS exec post, get the money to keep Dr Mattu at home for 5 years from?!

According to the Mail online, Mr Mattu, the suspended Cardiologist was paid around £75,000 a year to stay at home, the total for 5 years is £375k! What a waste! But then the paper says that the total cost to the NHS for those 5 years he stayed at home was £5000,000,00! Nearly a staggering 14 times the amount of money paid to Dr Mattu over the same period! The rest are for legal and other fees to do with keeping the Cardiologist at home, then for the same Cardiologist to win his case and be re-instated! Forget how much will it also cost to train him on what advances he missed in his field for that's 'nothing' .. in comparison!

How many patients could have been treated with this money? How many lives could have been saved? How many, say, MRI scanners could have been bought and placed in where needed?!

The 5,000,000.00 used by Mr Burley to pursue the hunt for that Cardiologist could have built THREE new health centers and employed so many people including young, fully qualified but despairing jobless GPs! How many needy people would have benefited from the better use of this money?!

Don't Chief Execs at the NHS get audited?! How did this Mr Burley get away with this?! How many others like him are getting away with 'it' too? And, How many more health centres could have been built?

What a cheek! .. What a waste!

I am an incurable eternal optimist! I firmly believe that the call for 'quality' is also a LOUD call for transparency and accountability too .. for everybody .. including those who fail to manage.

Let's wait and see ... for only time will prove me right!

This is the amaaazing Cesaria Evora singing Esperanca Irisada ... enjoy!

And ... I used to play the Congas ... They are the loudest of latin drums ... and the most hollow too ...

E s p e r r r a n c a amigos .. E s p e r a n c a! :-)




“There's a moon in my body, but I can't see it!
A moon and a sun.
A drum not touched by hands, yet it beats, and I can hear it!”