"As the Count leaned over me and his hands touched me... a horrible feeling of nausea came over me, which, do what I would, I could not conceal." Chapter 2, Dracula
I was just reading the new "Medical students: professional values and fitness to practise" guide. It is compiled jointly between the GMC and The Medical Schools Council.
Of course we all desire that doctors abide by the rules of professionalism and the very vast majority of medics and young docs do, but .. will this guide 'help' aid a sense of professionalism in medics? Is it the 'right time' to impose this on young medics? .. why was it thought of and imposed in the first place? Any special incidents or deeds that were out of the ordinary? Or is it because of ' Dr Shipman'? .. again?! ... Yaaaaaawn!
I haven't finished reading the whole guide but I have an idea of what young medics think of it so far ... and they are 'scared stiff', there is already talk amongst the medics who have little things in their past that dooms day is upon them and that it may be worth it to run away from medicine! Especially after enduring the de-motivation of early this academic year, this guide is now also perceived to be an attempt, by the Medical schools AND the GMC to get rid of as many of them as possible in order to reduce their numbers .. because 'there are too many of us' .. or that's what they think especially because some schools told their students that the GMC was commenting that certain medical schools, and I now know from the comments on other medical sites that this school was not the only one, were not failing enough students! And that marks for pass/fail in exams will be revised without prior notice!
Well, young medics are not big and strong, are they?! That's why there is a 'special' GMC set of rules for them .. and a 'special' set of rules for those at the top!
'you are untouchable if you have already made it!'
Page 2 gives a brief discription of "The duties of a doctor registered with the General Medical Council"
The last bit on that page states:
"Be honest and open and act with integrity
- Act without delay if you have good reason to believe that you or a colleague
may be putting patients at risk
- Never discriminate unfairly against patients or colleagues
- Never abuse your patients’ trust in you or the public’s trust in the profession.
You are personally accountable for your professional practice and must always be prepared to justify your decisions and actions."
While I totally agree that all of what is written so far is what we all want to see how a doctor should behave, I wonder why don't these rules also apply to the seniors who were responsible for MTAS 2007? And, the non-aspiring 'fit for the bin' MMC? And how are younger doctors and med students are expected to adhere to this guidance if they can see for themselves that no one is setting them an example?! But are actually getting away with whatever they did/do scot free simply because they are powerful seniors?
Again, what is meant by "professional Practice" here? A doctor practicing as a clinician only? Or, does this include a doctor practicing in an admin, managerial and/or leadership capacity? And if 'professional practice' means all of those, then, why are some high rank seniors getting away when this rule is broken?
Then, on page 6, rule 3 says:
"Medical students have certain privileges and responsibilities different from those of other students. Because of this, different standards of professional behaviour are expected of them."
We all know the responsibilities of doctors as well as those medics who 'chose' and worked very hard to get into medicine only to face the on-going effects or increasing medical school numbers then train nurses to do doctors work to reduce cost .. add the long number of study years only to graduate to earn way below the average national wage with other graduates earning nearly £25k. Those same graduates who only spent half the years of study at uni, ie, only 3 years .. and endured maybe less than half the content! Or a nurse of the same age, who graduated and earned a wage three years ealier than a doctor and who now, age for age, earns maybe £10k more than a young F1, lots more in real terms given the costs of being a young doctor! Ironic and a 'very' disgraceful way to treat such high achievers!.. and nurses don't advertise their pay on job sites anymore! ... and there is the up to £50,000 weight of the dept the juniors have to carry on their young shoulders too .. etc, etc! Even I 'now' do not know what those 'privileges' are?
Can 'someone' list those 'privileges' please? Can you include those 'privileges' in that guide please?
As for the responsibilities, one is aware of doctors being responsible for their patients but since the emphasis is currently on 'teamwork' then, I can not understand why single out doctors to be responsible and not the other members of the health team such as dentists, nurses and HCPs? Is there a similar guide with exactly the same terms for those too?!
Then the rest of that same rule says:
" Medical schools are 'responsible' for ensuring that medical students have opportunities to learn and practise the standards expected of them."
Which of course happens 'most' of the time, but since there is now a charter or guidance on how a medic is expected to behave, then surely a contract, which is what this medics guide is, needs two hands to sign it so, shouldn't there be another guide or 'charter' stating 'exactly' how the med schools themselves should operate and behave to ensure they too abide by their 'responsibilities?' .. and give a copy of same to every medic in the land? Surely, incidents like schools not providing adequate learning or hands on opportunities, de-motivating students or not properly investigating allegations of racial discrimination or when a school refuses failed med students access to their marked exam papers or setting the pass/fail marks to a higher percentage without prior 'reasonable' notice and with 'valid' reasons especially but not exclusively during finals .. etc. And what procedures are available if medical schools break a clause in their own charter? if such a thing really came into being because, as far as I am aware, there isn't such a thing now!
The bit that those whom I spoke too are most afraid of is the idea that stupid incidents from their past, even before the went to medical school, can be taken against them and registration with the GMC can be denied as a result! Meaning, you can study your head off for six years and pass the tough finals then be thrown to the wolves because the GMC won't grant you registration despite all this! .. Is this for real Count Dracula dear?! Count Dracula - Chapter 4
First, I can't think of what such incidents may be nor that that guide give examples! Nor can the medics I spoke to understand what is considered an unforgivable offence! It is not that medics are murderers and rapists roaming the streets in search of an opportunity, is it?! .. and to those who 'think' that medics are more boisterous than other students I say, it is exactly the contrary! Medics are usually more responsible AND they do not have the time .. or the money!
So, what is this 'astounding' rule all about then and how will it be applied?!
Can the GMC and/or anyone else give an example of an 'unforgivable' offence? please?
While I know of no one with past criminal records, as a parent I find this particular bit 'draconian' to say the least, the very fact that it hit the papers is proof! For who has the right to punish anyone for 'spent' minor offences anyway and why weren't would be medics asked about those before they were allowed to study medicine?! .. how legal is this rule? Will this guide be given to would be medics before they are accepted into medical school in the future?
Shouldn't the New Medical Education for England be responsible for the medics too instead of that scary GMC?
As for the GMC, I do not know much about this establishment, except that if 'anyone' charges the same membership from young and 'very' poor F1s on £21k per annum and lots to spend on exams, accommodation (Now that F1 docs are no longer allowed a room in the hospital and no money to compensate them for what is in effect a 20% pay cut!) etc, as it does a consultant on £100k plus, then that establishment is not fair or just to me! Indeed, we are all waiting to see what will happen to Remedy UK court case re the GMC's decision not to go after anyone for the 2007 catastrophe! .. and .. what happened to those who were involved in the 'Scotgate' affair? Any news?
This guide came at the wrong time when all medics are already disillusioned because of the effects of plan 2000 which increased the numbers entering medical schools by 70% only to train nurses on doctors duties straight after! And hurricane MTAS and it's forever lasting effects. This guide, and I haven't finished reading the whole thing yet, contains at least one bit that induces fear .. this is no good for no one can aspire and achieve while being afraid!
This guide does not help restore confidence in medical careers! And ... Let's see if medical schools will also be bound by a similar charter stating their 'responsibilities' ...
.. and , we need more doctors .. and, even if we don't .. young medics should not pay for messed up work force planning with their careers and livelihoods!
I hope popular medical bloggers with large audience like Dr Crippen, Dr Rant, JD and Dr G will have the chance to read this guide or at least the newspaper article and give their opinion and maybe post to get young medics to comment. We need to find out more about the effect of this guide on the ground nationwide.
"I am here to do Your bidding, Master. I am Your slave... and the wind blew .. wooooo, wooooo ... " Chapter 8, Dracula
Tuesday, 31 March 2009
"As the Count leaned over me and his hands touched me... a horrible feeling of nausea came over me, which, do what I would, I could not conceal." Chapter 2, Dracula
Sunday, 29 March 2009
“If I look confused it's because I'm thinking”
This morning a friend called at 5am to ask if I can take a change of clothes for her because she was going to be admitted to a central London Hospital after injuring two of her fingers on a piece of wire. When I arrived to the hospital, she was still in the A&E dept. She told me that she sustained the injury late yesterday evening and went to our local hospital, which is a large postgraduate teaching hospital. There was only one young doctor in the 'minor injury unit' and loads of people were waiting for him as he was rushing around working as best as he could. But, she was left bleeding in the towel she wrapped her hand in for hours and then she herself asked a passing by nurse and had the wounds cleaned and covered, nice nurse. When eventually the young doctor was able to see her, he decided to refer her to another hospital so that she can be seen by a hand surgeon because he thought her wounds were quite deep, they may have cut a tendon. He offered an ambulance transfer but her husband had the car and so, he took her to that other hospital's A&E dept. She was still bleeding and in pain when she arrived about half an hour later.
After another long wait, her husband went to enquire at the desk of when would she be seen and if she can be given a pain killer, especially that she was still bleeding and by that time she was also shivering from exhaustion but the 'person' in blue scrubs behind the desk just spread her hand in his face and went 'shush!' and he replied 'excuse me!' and that person just repeated again in the same manner, spreading her hand very close to his face this time 'Shuuuush!'! .. I think that is when the husband lost his temper and started shouting himself!
To cut a story short, another senior 'person' in blue scrubs interfered and called security and the husband was removed to the A & E waiting room where, as he said to me, two more people, one of whom had a towel wrapped around his head, were fighting with the reception staff .. he had no idea why :-)
By 6am, nobody was giving him any information about his wife and he was still not allowed to leave the reception area so .. he just went home and left the wife in the hospital on her own!
It was the reception staff who told the wife that her husband had gone home because he wasn't allowed to use his mobile to call his wife, who was only a few meters away behind a pair of swing doors, and that he was going home!
Apparently, when she complained to yet another person in blue scrubs, that person told her that she was the patient and not her husband and that she was old enough to take care of herself without him! :-)
They gave her another x-ray because the first hospital only sent copies of the x-ray they done with her to the second hospital, those where just copies done on normal A4 papers! The two x-rays were within less than 3 hours! My friend is a pharmacist and knows this should not have happened ... that's why she called me, because her husband refused to return to the hospital when he found out she was still in A&E, instead, I picked him and her hospital bag up and he waited in the reception while I was allowed to go behind those swinging doors and see her. There were loads of staff, a sea of identical blue scrubs ... and not many patients ... and those blue scrubs looked somewhat like pyjamas to me! :-)
Oh yes, and there were signs as well as leaflets everywhere saying that there was a bout or an outbreak of vomiting and diarrhoea in the hospital!
Anyway, by the the time we arrived, the staff in blue scrubs had told her that she was to go home and return for a hand operation on Monday to have the wounds professionally stitched by a surgeon in the hand unit. .. So, I took her .. and her husband home ... and ... was she exhausted .. and him too!
While I was behind those swinging doors, I noticed that there were loads of staff, all wearing blue scrubs, even the radiographers pushing patients into x-ray rooms were wearing blue scrubs! You couldn't tell, at all, who was who! Which one was doctor and which one was nurse! The ID badges they wore were either obscured by worn out writing or just too far to see. The majority had stethoscopes! .. and there were loads of everybody sitting behind their station desks. I then heard one person in blue scrubs ask a young woman, in blue scrubs , if she was a student nurse? to which she replied, no, I am doing sociology! ... hehe :-)
When my friend was told to go home, she went to that person in blue scrubs who was rude to her husband, me with her, to ask for her name and the young woman simply turned around and did not answer! ... I went to the other side of the station and politely asked her for her name and her occupation .. she was a nurse. I convinced my friend not to complain despite the fact that my friend told me that the dept was not busy at all for the whole time she was there.
It was nice to see a couple of police officers in their black uniform there with an injured patient! .. and the ambulance staff in their greens too ;-)
This made me wonder, how can 'quality' and 'confusion' co-exist?! :-)
Here is a bit of 'confused' nostalgia .. enjoy :-)
“It's a good thing we have gravity, or else when birds died they'd just stay right up there. Hunters would be all confused.”
Thursday, 26 March 2009
“Before the reward there must be labor. You plant before you harvest. ”
When my children were young, I always used encouragement and reward to motivate them to excel and that has always worked ... that's how they achieved high enough to be able to become doctors. I used to also remind them that a reward is a privilege because not everybody gets rewarded for what they do but only the best do. Indeed, although they take it with a laugh now, I still reward them whenever they succeed at doing something and they do accept whatever I reward them with jokingly repeating the words I used on them when they were younger; 'make me happy, I make you happy too' :-)
I have never promised a reward and went back on my word, ever .. because children, especially the really bright ones do interpret this for what it really is, pure 'hypocrisy!' And hypocrisy and 'quality' can not co-exist. Hence hypocrisy must never be part of the vocabulary of good parenting. For me and now that my children have grown up, they do the same with me, I get rewarded when I am perceived to have done something good too .. occasionally ... and that's good because they have already formed a habit; that excellence 'must' be properly rewarded .. I am now sure they will follow that philosophy with their own children one day .. :-)
Educating high achievers like medics and young doctors must also follow the same rule of 'reward' or the whole endeavour will lose it's purpose. And that's where MMC 2007 with it's monster MTAS failed so miserably .. it was hypocritical! It did not reward when reward was due! And it doesn't encourage! It took away the percieved 'privilege' of following a medical career and was very evident from the Remedy survey as young doctors can no longer feel there is any privilege in studying or following a career in medicine! That the only 'privilege is graduating to an income similar to that earned by others way below their level of ability and achievement levels. When you also add the debt of up to £50,000 on top, there is nothing else to call a 'privilege'!
Indeed, I too have no idea anymore of what those 'privileges' are?
And that's why the effects of this hypocrisy are still with us today and will remain for a long time unless the wide spread feelings of disillusionment coupled with the current feeling of lack of appreciation and the resulting injustice are corrected. So far, no body paid for the criminal masacre of medical careers of 2007 and the aspirations of the affected young doctors that were inhumanely squandered by MTAS. So it comes at no surprise to me that when Remedy UK conducted it's survey, the results came so bad!
Remedy UK did not even need to conduct that survey for the very idea that it was able to collect a relatively large amount of money from cash strapped young doctors to take the GMC to court for it's hypocritical decision not to pursue the architects of MMC and MTAS catastrophes speaks volumes on it's own. There is now a widespread sense of 'justice has not been done' feeling amongst the juniors and the frustration and anger that accompanies that .. that's why they handed Remedy some of what precious little money they have. Catastrophe MMC/MTAS 2007 did not only hurt those affected but it caused unspeakable damage that still lasts to this day. The 2007 fiasco is the reason why so many young doctors became so disillusioned, they either left medicine or left the country, why so many young doctors believe that their training is so watered down to the point that some have lost confidence in conducting operations on their own (As per an interview with some young surgeons on Channel 4 recently.) The reason why we have junior doctor shortages and the resulting gaps in rotas leading to more and more watered down training opportunties as young doctors struggle to concentrate on service provision to protect the safety of their patients. One dreads to think what will happen when the European Working Time Directive will do to patient care when the 48 hour rule is fully in force!
The results of the vicious hurricane MMC/MTAS are unprecedented. They are still rippling through upwards, to the seniors who quietly speak their opinion to their juniors about how disgraceful the whole episode was and how more disgraceful it is that the culprits got away scot free ... and downwards to the youngest medical students who are currently so disillusioned, they can't find a good reason why they are following a career in medicine, they no longer have a sense of purpose. All this is because of what happened in 2007 and because the lack of encouragement and motivation they feel, as I heard from some medics and the many comments I read on Dr Crippen's site when he posted about that same subject. It seems this demotivation, lack of appreciation and reward is happening to young medics everywhere around the country!
This comment from one of those young doctors surveyed by Remedy, it says it all, either for the juniors or the medics:
“Last year was the worst year of my life. I suffered severe depression for the first time. A lack of control was no doubt the main trigger. Having always been a high achiever it was a shock to have the door slammed in my face. It has taken me a year to get back on an emotional even keel.”
... and this from another:
“I have absolutely no bloody idea any more why I bothered to go through the amount of sh*t that I have had to put up with to then be left on the career scrap-heap.”
“I have no confidence in the medical leadership, and have seen a huge change in medical training and morale.”.. and that's how most juniors and medics feel at the moment! Not an environment suitable to produce excellence, is it?!
Some experts keep saying there is a good side to MMC, but young doctors can not currently see that and therefore consider this claim as part of the ongoing hypocrisy. We all know that 'MMC' is currently being re-written and that's good. This process is due to be completed by next year in 2010 and one hopes that this will mean a return to motivation, to encouragement and to reward for achievement and excellence. That 'aspiring to quality' will be an essential part of the new product. We also know that this rewriting is being done by proper top professors under the auspices of Prof Darzi. Brilliant professors like Prof Tooke and Prof Sowden are involved as well as many others. All real hands on good professors who do have regular contact and real teaching responsibilities, unlike those who were involved in devising the original less than adequate MMC who seem to have had no clue of what they were doing thus ending in the spectacular failure of their 'endeavour!'
All very good but, there is no confidence in that failed brand name 'Modernising MedicalCareers!' .. and that's why, unless the new version gets a fresh 'fit for purpose' name, no one will trust it and the good professors who are currently re-writing the new curriculum's efforts will probably be wasted! .. for young doctors will never trust the brand name 'MMC' again!
Please recognise this fact ... MMC is dead! ... Whatever you do, you can't revive the dead! ... Hence, do the right thing ... BURY IT!
This will restore Confidence in Quality Medical Careers which will then return to be how it should be 'Aspiring Medical Careers'! .. to produce quality doctors, high achievers who will always want to aim higher for the benefit of their patients and themselves too!
And .. no 'reward', either emotionally and/or financially, as is the case now meanz no achievement .. no innovation and no excellence ... no reward means stagnation ...
Please reward excellence and innovation if only to restore confidence in a career in medicine .. the most 'noble' of professions should be noble to it's own first if it is to continue to be of world-class standards!
“You get what you reward. Be clear about what you want to get and systematically reward it.”
Wednesday, 25 March 2009
.. and all her friends at the hospital have either got offers too or are waiting for interviews!
No moreTchycovski's 'nut cracker!' ... She's done it!
Calls for a 'vulgar' celebration!
This is 'Laila' .... especially for 'my' b e a u t i f u l Laila with all my love :-)
And .. congratulations on your 'fantastic' win NHS! ....
What an achievement! ... what a gain! ...
Tuesday, 24 March 2009
“All good things arrive unto them that wait - and don't die in the meantime”
Two young doctors I know of, both were casualties of MTAS but got saved last minute, albeit, they had to accept really far away posts to save their careers. Both have now decided to change region/specialty and applied this year and were able to secure offers in the first round.
I hear that the reason for wanting to change is not just to be nearer to family and friends but because of what they consider as serious issues to do with where they currently are. They both currently have run through posts. One is also an academic but has decided now to leave academia because he was very disappointed with the quality of his academic training for the past two years since 2007.
I hear another academic that although his professor is a really nice person, he probably does not have the time for regular contact so, that young academic does not see his teacher for months on end. Despite that, he still did his research but was not able to publish because of the same problem of communication. He knows he can push for having someone read his research and try to publish on his own but without his prof's name, he knows that the percieved quality of his work will be jeopradised 'you are only as good as your teacher!' .. and there is no teacher! This is such a shame because I hear that this young doctor is really an academic at heart! A well educated, very well cultured, a dreamer with an inquisitive mind and a practical and logical approach too! I hope with the new academic centres now being established all over Britain, this young academic and those like him will have the opportunity to return to academia in the future!
I also hear from many young doctors, and I know many, that because of shortages, they now have to just work to provide service but their training does suffer as a result. They do not get enough training and, as they say, the quality of whatever training they get has also suffered. They estimate the reduction of proper training opportunities to be around minus 30%.
As for the academics, some were not able to work on their research for many months now because of service provision and gaps in rotas because of junior doctor shortages. I also hear that despite not having their set time for their academic work, some deaneries are still trying to make all academics repeat their ST2 years to 'ensure enough clincical exposure!'
Some doctors who were displaced during 2007 have been able to change region and/or specialty this year. Some of whom do not mind starting at ST1 level again since this way, it will be better on the long run than being stuck in posts that they do not like or believe will probably go nowhere. Changing for another specialty was also a preference for doctors with two years post F2 experience or more. This experience was helpful in securing new better offers.
The problem is, some got e-mails confirming their new job offers but despite e-mailing the deanery concerned on many occasions, they have not received anything to confirm that these new posts are guaranteed nor where they will be working or any further information at all. Of course, during MTAS 2007 many offers were later withdrawn and I hear those young doctors are afraid to give notice to their present jobs only to end up with nothing if the new offers are withdrawn. I hear from some of the young doctors I know that there are more doctors in that same situation, one of whom has to give a three months notice to his present job before they can move to the new post in August beacuse the current deanery contracted them as a 'registrar' instead of an ST1, which is what they were back in 2007 ... and no, that's no joke! :-)
Deaneries should really pay particular attention to doctors who are in this situation and give them 'solid' confirmation of their job offers before they give notice to their present employers. They should also have more information on their new jobs, including where they will be working as well as an idea about their pay too.
I personally think that doctors in that situation should then be allowed to either accept or decline the new posts based on this information .. that's only fair!
And why do deaneries take so long before a contract is issued? This, as well as information about where and for how much should be made with the job offer or within a short period afterwards to allow doctors to choose properly and to also allow the current deaneries to fill those jobs again in time IMO
“Waiting is a trap. There will always be reasons to wait. The truth is, there are only two things in life, reasons and results, and reasons simply don't count.”
Sunday, 22 March 2009
It's mother's day today and the 'kids' have made sure they are all here, which is reeeeally nice! I have just come back from late lunch at a famous Lebanese restaurant .. and yes, I have eaten to the point of needing to be physically lifted off the table by my two eldest sons! :-)
And .. I've just found out! We're off again! to an Ihab Tawfeeq's concert in the Savoy! .. A surprise concert! .. and I like 'happy' Tawfeeq!
I am being spoilt rotten! :-)
And I love it! .. and I do need the excercise after that enooooormous meal!
Excusez moi! .. Buzzzzy! :-)
Happy mother's day all mums out there :-)
Posted by Sam
Thursday, 19 March 2009
"The head of a hospital trust where at least 400 patients may have died because of appalling emergency care is understood to have received pay rises totalling more than £30,000.
The salary of Martin Yeates, chief executive of Mid Staffordshire NHS Foundation Trust, increased from a pay band of up to £140,000 to one of up to £180,000 over two years, while standards at the trust deteriorated.
A report by the Healthcare Commission found “shocking and appalling” standards of care for patients admitted through A&E from 2005 to 2008. Investigators estimate that between 400 and 1,200 more people died than would have been expected."
And now this 'chief', according to BBC 24, has been suspended on full pay! ... Instead of having criminal proceedings started against him for 'deliberately' avoiding to put his patient's at the centre of his attention for a period spanning three whole years, no less!! And, after being found to be at fault by the Health Care commission! .. What can a chief executive do to get the sack in the NHS?! .. It seems that whatever you do, including causing the death of up to 1200 people, won't even just get you the sack! .. I don't usueally care who is paid what, if they deserve it, but this is fantastic stuff!
Then you think, why didn't any member of staff raise the alarm?! For a whole 3 years?! Even anonymously? Or, could it be that staff tried but were not listened to? .. We may never know. The hospital was not properly staffed, not properly equipped and not properly managed! So, why did it take the Health Care Commission 3 years to find out about it's failings?! How do we know this was an isolated incident?
I don't believe this hospital failed because it was trying to save money to gain foundation status because lots of hospitals around the country are trying to do the same but we don't hear that patients in their thousands are being killed as a result! This hospital did not only let it's patients and their families down but it let it's staff down too! Allowing roles to blur to very dangerous levels when it allowed 'receptionists' to act doctor! And then you wonder how much will it cost this hospital now to pay in compensation for the lives it has wasted? Surely, more than the ten million that chief executive was stupidly trying to save. So, his 'ability' as an 'economist/accountant/whatever' is in question here too since 'he' too does 'waste' .. of both life as well as money! How did he ever make it to chief exec?!
And, blurred roles will never work and this incident is proof! .. And this goes to show how badly we need every doctor, every nurse and every other allied to medicine professional we train in this country! Employ those for patients' sake instead of letting them drive taxis for a living! Get priorities right for best effect and best value for money too;
Doctors to doctor and nurses to nurse! The best way to ensure quality, safety as well as cost effectiveness .. and eliminate 'waste'!
If anything, this also highlights the urgent need for medical and clinical leadership in the NHS, for I don't think this sorry event would have happened had there been doctors in charge. Their ethics would not have allowed them to put money before their patients, let alone on that grand scale! The 'incident' also highlights the importance of the current reform to improve the service, including 'The new Constitution' to protect patients and staff in the future, to introduce transparency and accountability in the system so that staff are not afraid to report failure but instead, make it their duty to do so in order to avoid repeats of this sad event. So that mess ups like this don't go unnoticed for three whole years causing the unneccessary deaths of innocent people as a result. This also highlights the reason why there need for reform to put the patient at the centre of the NHS business, to ensure quality as well as safety for every patient in Britain.
This was a disaster, a ticking time bombs waiting to happen while that way below standard chief exec was left in charge unchecked ... The lesson here is that economists and accountants can not run hospitals without clinical supervision, or even banks as it seems ... it seems the only thing they are good at is running their own affairs or rather, developing the expertise to have their own cake and eat it ... many times!
Those who mess up big timy say 'sorry' then get away with it these days and bag a few millions on the way! ... and that's the end of that! I bet that chief executive will come out soon and say 'sorry' too and bag a few hundred thousands on the way too before he is 'allowed' to leave his post? .. and that will be the end of that too?
What do you do with a 'sorry'?!
But, forget about money for you can't buy 'life'! One feels for the poor families whose loved ones died as a result of this mess!
Tuesday, 17 March 2009
“world-class research, teaching and patient care in one place”
Ferret Fancier once asked me, what did Darzi do for the juniors? and I replied in a comment. But forgot to include a few more things that Darzi has done or is in the process of doing, either for the juniors or of for British medicine thus also benefiting the juniors as well. Here is my reply, in brackets is what I forgot to include:
"1- Rewriting MMC (Modernising Medical Careers) by 2010 to allow 'every doctor' a chance to prove themselves through the inclusion of innovation and allowing those in trust grades to get into training and vise-versa. (with emphasis on excellence and innovation, the new MMC will not only be about ticking boxes to prove competency as was the case with MMC a la CMO, but the sky is the limit to what you can do with your brains .. and your own career. Undergraduate medical education will also be reformed to include teaching on Quality, safety and management)
2- MEE (Medical Education for England) is in the process of being established and it will not be staff less and located in a broom cupboard but will have a real role influencing training and making life easier for the juniors. (MEE will be in charge of training not only doctors but dentists and allied professionals too, hence, this will be a powerful and well organised establishment deciding also on future workforce planning and this omitting the possibility of the workfarce planning that led to Hurricane MTAS 2007)
3- His call for clinical leadership and the new National Leadership Council will not only give new opportunities to seniors as well as young doctors to get into leadership positions influencing the quality of service provision as well as policy, but will also ensure leaders are held accountable for their actions .. unlike the leadership farce with regards to MTAS, Scot JR .. etc
4- His centres will employ young recently qualified GPs currently driving taxis to make ends meet. (And with the move to care in the community, those centres will also employ lots of consultants and doctors in training too.) If Virgin wasn't scared off, Branson would have employed more young doctors but there will be alternatives, the majority now are consortiums of GPs, who will do the same to staff the new centres
5- The application to specialty training system has been improved, although is still a bit crude, hence the blunders and the glitches we hear about but the system is now fully online so, no more up to 9 paper copies of 30 page applications to post to individual deaneries who each also had it's own format and own questions. The 'white' boxes have been reduced to a minimum, they are mainly about being committed to the specialty a candidate is applying for, experience of audit and research and current duties and responsibilities ... no more fictitious scenarios at 4 points each. An intercalated degree is also now awarded points on a sliding scale according to achieved grade, 5 points for a 1st, 4 for 2/1 and so on. This This year, young doctors applied to some specialties separately and directly to the college concerned, surely the system will improve further for 2010 and one hopes there will be no more blunders and/or glitches
6- Darzi, I believe, is currently reforming the student grant system so a medic with £50,000 debt will hopefully be a thing of the past. (I am optimistic about this one since I hear that MEE will be in charge of everybody so I am hoping study grants and bursaries will be uniform in the future ... I think we will hear some good news soon :-)
7- His whole reform of the NHS ensures not only quality and safety in service provision but an open NHS that is transparent and is accountable to it's patients and staff. He is moving away from the dilapidated NHS look to one that is younger, more dynamic and this provides real opportunity to those who want to excel"
All this was done in less than a year. I also forgot to mention how young doctors' progress in training will be assessed, which will be through 'modular credentialing.' I don't know know much about what that means, but I think it means that once one part of 'basic' training is completed, a young doctor can sign that off. Then be free to go abroad for a while to gain more valuable experience but still be able to come back to training in Britain. Be able to relocate, even move deaneries and, with your training monies following you wherever you train, this will also be an introduction of 'competition' to all deaneries to provide quality services to their trainees or lose them if they don't! ... So deaneries, provide a good training 'experience' or else! BRILLIANT move!
And now 'the bearer of good news' turned his attention to the forgotten by MMC 2007 academia and academic innovation and excellence; one of the reasons why British medicine 'was' considered to be the best in the world until the arrival of MMC in 2007. In 2007, those who wanted to follow an academic career felt dismayed and frustrated at how MTAS and MMC treated the academics returning to clinical work. Not only was a PhD awarded only 2 points and a ist degree 1 point regardless of grade obtained by MTAS but many an excellent academic was rejected outright despite a shining record of achievement! But Professor Darzi, as he says in the video below, took academia with him when he went to whitehall. In one of his lectures, he said that there was a 'valley of death' or an unnecessarily long time taken between making a medical discovery and the time it reaches the patient. Hence, brand new health centres to bridge this gap from the 'Bench to bedside' .. and this is the result!, and here .... One of those first Academic Health Science Centres is in Professor Darzi's own trust since 2007, even from before these academic centres were officially agreed, a process that started in late 2008 and is still ongoing.
However, following the MTAS 2007 disaster, many young academics have either now already left academia or are trapped in positions that do not provide them with proper opportunity to excel. With the establishment of these new academic health centres, one hopes that doctors who are not currently in academic positions but have academic potential, will have the opportunity to do research, to move in and out of academia in a way similar the that new MMC movement from trust grade to training and vise-versa .. ie, opportunity and flexibility all around.
.. and I must have forgotten other things too .... can't keep up with this boss's speed! ... and I whole heatedly believe he does not do waste ... thank god he's not an economist ;-)
On 30 June 2008, I said in a comment on one of Dr Rant's posts:
"Ara Darzi is 'committed' to saving British medicine! And he will!"
And I was right, he did!
Forward teacher .. to excellence as always ... and take us all with you :-)
Video date 11 December 2008
Sunday, 15 March 2009
“The future belongs to those who believe in the beauty of their dreams.”
I've just come back from the seaside after spending a few days just staring at the sea, mesmerised by the beauty of looking at the infinity of the horizon. I needed this recollection of myself, the hope that looking at infinity has always given and inspired me .. and it has done me wonders. So, here I am .. all charged and ready ... for whatever :-)
This winter has not been a very nice one for everybody considering the 'credit crunch' and all the associated doom and gloom we are bombarded with on a daily basis. And it seems that I wasn't alone in feeling a bit or a lot under the weather, the government is even giving more money to provide free 'therapy' for those who are feeling a bit blue. But .. WE lot here do not need the government's therapy ... nor its allotments for US, the docs and there families .. are a resilient lot! .. and we have each other .. and that's plenty .. and a privilege!
Junior, senior .. and their families .. we're 'The' best! .. and I AM being 'very' modest here ... We are good enough, equipped enough and brainy enough .. to ride over the highest of waves while our eyes are enjoying the 'infinity' of the horizon! :-( )
You know, I don't care how many 'common purpose' or 'conspiracies' are out there trying to get us, if indeed there are any. The very idea that we are all here in the blogsphere says that 'we are leaders!' .. the type that does NOT need courses! .. The type that will always be watching what those who do need courses do! ;-)
And ... I've just been to the Remedy forum, it seems that I am not the only parent enduring a child's application to specialty training for the second time. Levans is waiting too like me and to her, I like to say, please do not doom your daughter's application a rejection yet for the system has been improved. Yes, there are blunders and glitches still and I do know a few of those but I also feel within my heart that there will be no waste this year ... I have no idea yet of what will happen to my own child but I am more hopeful than I were during last month .. because I applied some reason while I sat inside that bay window by the sea .. and reason tells me that there will be no waste! .. So Levans, please remain hopeful .. :-)
We have faith in old proverbs full surely
For Wisdom has traced what they tell,
And Truth may be drawn up as purely
From them, as it may from "a well."
Let us question the thinkers and doers,
And hear what they honestly say;
And you'll find they believe, like bold wooers,
In "Where there's a will there's a way;"
The hills have been high for man's mounting,
The woods have been dense for his axe,
The stars have been thick for his counting,
The sands have been wide for his tracks,
The sea has been deep for his diving,
The poles have been broad for his sway,
But bravely he's proved in his striving,
That "Where there's a will there's a way."
Have ye vices that ask a destroyer?
Or passions that need your control?
Let Reason become your employer,
And your body be ruled by your soul.
Fight on, though ye bleed in the trial,
Resist with all strength that ye may;
Ye may conquer Sin's host by denial;
For "Where there's a will there's a way.
Have ye Poverty pinching to cope with?
Does Suffering weigh down your might?
Only call up a spirit to hope with,
And dawn may come out of the night,
Oh! much may be done by defying
The ghosts of Despair and dismay;
And much may be gained by relying
On "Where there's a will there's a way."
Should ye see afar off that worth winning,
Set out on the journey with trust;
And ne'er heed if your path at beginning
Should be among brambles and dust.
Though it is but by footsteps ye do it.
And hardships may hinder and stay,
Walk with faith, and be sure you'll get through it;
For Where there's a will there's a way."
And now the Sunday song, a bit of a goldern era nostalgia that refuses to be 'embeded!' ;-)
Paddy's dog: Chirp, chirp? .. no! ... Mooooooooo? .. No! ... Meow, meow? .. No! ... Ah! I remember now! ... Baa .. Baa .. Baaa
Saturday, 14 March 2009
“I know only that what is moral is what you feel good after and what is immoral is what you feel bad after.”
When John major was PM, he was attacked without mercy for saying that British society needs to 'go back to basics' , install some morality by encouraging and protecting the family unit whenever possible. I don't think that meant forcing couples to stay together in misery when a marriage breaks down. I think what was meant is helping couples overcome difficulties whenever possible but also install some moral values in those who decide to live a totally unchecked life style and expect support from society at the same time. Like individuals who have multiple relationships and multiple children as a result for example.
I couldn't understand why was he attacked so strongly when all he was trying to do was to install some values to protect society from the problems that are now top of the agenda for many government depts, especially health. That tory MPs were themselves accused of 'sleaze' at the time should not have distracted our politicians from the important message John Major was trying to put forward and this was that society can not afford to continue supporting totally unrestricted life styles with such alarmingly rising levels for teenage pregnancies, sexual diseases, etc and the resulting pressure on the welfare system, the health system, education ... etc .. etc ..
Since 2006, there has been a revival of John Major's idea .. at long last! While that is not an indication of which party I support, if any, would matters have been different if the Labour Party of the time had taken a more positive stand while in opposition and supported rather than attack John Major for wanting to 'go back to basics'?
Going back to basics means protecting the rights of women and children too ...
This is a taboo subject that needs to be opened wide for debate ... me thinks :-)
“It is curious - curious that physical courage should be so common in the world, and moral courage so rare”