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February 2011


My Last Chair as Post

This is my last Chair as Postman of Council, and I write it with great joy. The last three years have been the most wonderful time; it’s been a great privilege to travel the length and breadth of the UK telling the great unwashed how to live their lives. But the real privilege has been being able to meet and suck up to politicians, journos and other movers and shakers across the country in my bid to become England’s next Chief Medical Officer. It’s been wonderful to see the great way these people lap up everything I have to say. In this, I do of course take my lead from my hero, Sir Liam Donaldson, England’s last CMO. If I can aspire to be even half as wonderful as Sir Liam, then I shall be well pleased.

Big Richard/Little Richard

RNLI crews, expert mariners that they are, often have to deal with casualties. The Institution has recently attempted to simplify first aid for crews by introducing ‘Big sick/Little sick’, an approach which reduces initial assessment of a casualty to simple question. It is a clever approach, and Dr No has decided to apply it to a question that has been ruffling him lately: whether Scot Junior was entirely innocent in his fate? He did, after all, build an impressive log cabin, and dumped it where it could be read. Might he in some more significant way have been the architect not just of his cabin, but of his own fate? In the battle between Needham and Scot Junior, who of the two is the bigger Richard? Who, when we get to the bottom line, is the ten bob note, and who the two bob bit?

Doing One's Duty of Care the Machiavellian Way

Dr No doesn’t really do duty of care. Instead, he just cares. When he sees a patient, he does what he does simply because he cares for his patient, just as he always has, and always will. He suspects – but isn’t over-bothered, perhaps even doesn’t care – that what he does in fact more than satisfies any duty of care baloney, which in the real world he steers clear of, finding it to be tedious, tiresome, distracting, legalistic, defensive, job-serving, and all about doing the minimum to cover one’s back, rather than aiming to go the extra mile and do the best for one’s patient. In all this, Dr No is no doubt frightfully old-fashioned, maybe even old-fashioned enough to trigger the crackle of snapped pencils in the legal offices of his professional indemnity society. But Dr No remains resolute. True care is always better than duty of care; for the former is human and comes from the heart, the latter formulaic, and from the law.

Eichmann Reloaded

Pandora Needham, Postgraduate Medical Dean (North Region), has recently opened her box and set loose a fury of furies. A number of medical bloggers and other commentators, wide-mouths, forum sharks, hucksters, ne’er-do-wells and other assorted busybodies, including Dr No, have asked the obvious question: why open the box at all, and why now? Had the box remained shut, the unfortunate events of a few years ago would have remained locked in the box of history, gathering dust. By publishing the article which opened the box, Pandora on the face of it shot herself roundly in the foot.

A Woman on the Verge of a Nervous Breakdown

Once upon a time, in a hospital far away, a frustrated junior doctor suddenly found himself in very hot water. Dr Scot Jnr – as he became known - had expressed himself vigorously – exceedingly vigorously - on a doctors-only forum. He had even dared to call the great and the good in his profession Richards. Even before anyone had time to cry ‘Foul!’, let alone Code Brown, red lights were flashing in Deaneries up and down the land. Deans – senior doctors responsible for junior doctors training – got on their hot-lines, and then their high horses, and before anyone could say appendicectomy – Scot Jnr was said to be a surgeon - he had been suspended.

Mary Portas: Queen of Clinic

It is a wonder they haven’t called in Mary Portas, Raptor of Retail, to fix the NHS. Nice Gerry tried a while ago, but tea and biscuits, even Nice Gerry’s 24/7 tea and biscuits, failed to hit the fan when it came to fixing the NHS. Nice Gerry’s biscuits did what biscuits do when faced with a sea of NHS tea. They got dunked - and disintegrated.

Raptor, of the other hand, would know exactly what to do. Dressed by Dallas out of Star Wars, she would stalk the wards and clinics, skewering managers. Layabout staff would be rounded up, and their nail varnish stuffed where the sun don’t shine. A wand of retail magic would be waved, dull clinics transformed in a halogen twinkle into fun interactive experiences. Freshly botoxed greeters in Thunderbird uniforms would be drafted in, and the warmth of the Mall would embrace all. Everybody would win, and all would have prizes.