You are hereArchive / March 2011

March 2011

The Secret Nail in the NHS Coffin

Sometimes a picture is worth a thousand words, and the photograph on the left – taken covertly last weekend at a top secret boot camp for Tory operatives soon to be charged with ‘fixing’ the NHS – tells us only too clearly what the Tories have in mind for our health service. But illuminating as such images are, to gain a fuller picture we have also to look at the legal framework on which such proposed activities hang, and the legal framework on which the National Health Service hangs is the National Health Service Act 1946, and its derivatives, temporal and spiritual, including the National Health Service Acts 1977 and 2006, and most recently the proposed Health and Social Care Bill, currently at committee stage before Parliament.

The first notable change is the name: gone are the references to ‘National’ and ‘Service’; instead we now have ‘Health’, conveniently bundled with that great Tory fiscal irritation, ‘Social Care’. At a stroke, the National Health Service has lost its special status, and been teamed up with just another drain on the public purse.

Laughing at Democracy

After a quiet few days, there have been some yelps squeaks and barks from UK medical bloggers about the British Medical Association’s SRM (Sham Representative Meeting) called earlier this week to decide the Association’s position on the government’s proposed NHS reforms. Dr Grumble meanwhile has adopted an “I’ve been telling you for years, will you believe me now” tone under a reckless headline on the ways of parliament. Or perhaps it isn’t so reckless after all – for who knows how many tens of thousands will die unnecessarily if the Tory health reforms become reality.

The trouble with all these yelps squeaks and barks (and Dr No has been at it too) is that they are faux-outrage at what is in fact inevitable. It is the inevitable result of what many of us call democracy, but which is in fact nothing of the sort, being instead something which Dr No called Sham Dem eighteen months ago; and the thing about Sham Dem is that it is anything but democracy, by any accepted definition of the term. It is, to give it a more descriptive but less snappy name, serial, or perhaps more accurately, interval, oligarchy. If that sounds a bit technical, Dr No apologises, but hopes to make all plain.

Mildew and Mayhem, Churchill and Chamberlain

Lord Mildew of That Ilk, Chief Pongo at the British Medical Association, is worried about his eggs. Speaking at the Association’s Special Representative Meeting yesterday, the first such meeting in nearly twenty years, he implored his delegates not to put all their ‘negotiating eggs in one basket’. To Dr No, the pleas of The Lord of the Ilks sounded more in line with a foolish game-keeper laying out all his eggs individually, the better that the foxes might easily pick them off later, one by one, than a fighting chief calling his clan to arms.

The reason for the exceptional SRM was that the BMA wanted to vote on a number of motions to do with the government’s proposed changes to the NHS. As is BMA way, the agenda was pre-loaded with motions deploring the decline in the standard of NHS biscuits, but in amongst the chaff there was no mistaking the wheat. The BMA mill was spinning for none other than the government’s chief architect of, and ambassador for, its ruinous Health and Social Care Bill, Secretary of State Andrew ‘Ribbentrop’ Lansley. The crux of the meeting, to be decided at the final vote, was whether to oppose this architect of doom by gentle jaw-jaw, or by the husk shattering steam hammer of war.

Today Interviews Bennett

Once again, the BBC proves how far ahead it is of the competition…not to mention Al Jazeera…


Scene: The Radio Four Today programme studio, on air. HUMPH sits at a desk, chewing a carrot. JIMBO sits on a bean-bag, reading an upside down copy of the King James bible. He is muttering to himself.

JIMBO: You say Naughty, I say Kno’ch’oty. What’s in a name? Quite a lot, I suppose, if you are that b*rstard H*nt. F*cking ar…

PRODUCER (within): Shut it, Jimbo.

HUMPH (on air): Earlier today, Jimbo talked to Dr David Bennett, the new Chair of Monitor, the NHS Regulator.

Ain’t Turning No Machine Off

“I ain’t turning no machine off” said Kelly, as if she was a teenager talking about shutting down her Playstation. In fact, she was a mother talking about turning off the life support for her very premature baby.

And so it was that last night's BBC2 documentary 23 Week Babies: the Price of Life exposed one of the central dilemmas at the heart of the medical and ethical minefield that is whether to resuscitate very premature babies. Kelly was clearly up for not turning no machines off. Whether she was up for understanding, let alone navigating, the medico-moral minefield was another matter altogether. She hadn’t even in fact been asked to turn no machine off, only what her views were on aggressive resuscitation should her baby take a turn for the worst. The program’s presenter, Adam Wishart – a thoughtful cove whose brief onscreen appearances featured averted eyes, even if the eyes of his cameras probed mercilessly – asked: is it right to place such a burden of responsibility on the parents?

Apples and Oranges

Following some excellent posts by the medical blogosphere’s resident Pest Control Officer, Dr No has been learning two new words. Both get flagged as misspelt by his spelling checker, and only one has so far made it into the OED. The one that has made it into the OED is ‘commodification’, and the dictionary defines it thus:

“The action of turning something into, or treating something as, a (mere) commodity; commercialization of an activity, etc., that is not by nature commercial [emphasis added].”

At a stroke, Dr No has stumbled on the word that perfectly describes the core malevolence at the heart of Tory’s proposed healthcare reforms. And on this they have form.

U-Turn If You Want To…

In a shock U-turn yesterday, Sports Minister Mr Andrew Lansley removed all references to bare-fist fighting in the ‘free-fights-for-all’ Boxing Bill currently before Parliament. Earlier drafts of the Bill had allowed ‘any willing contestant’ to fight ‘with or without gloves’. Critics of the Bill, including the British Medical Association, had pointed out that the wording ‘or without gloves’ provided an opportunity for contestants to fight bare-fisted if they so wished, a practice known to increase serious injury and fatalities.

My Lansley has insisted he never envisaged bare-fist fighting. Speaking in the House of Commons yesterday, he said: ‘I understand that references to ‘or without gloves’ in the Bill can be taken to mean that we want to allow bare-fist fighting. This was never the intention. I have therefore removed all references to ‘without gloves’ from the Bill.’

The announcement comes only days after Gordon Bennett, head of national fight regulator Monitor said: ‘an amount of bare-fist fighting will be appropriate’.

Jobs for the Boys

It is said British general practice is a broad church, and indeed it is. No branch of medicine collects under its wing such a panoply of talent and motivation. While most GPs sit somewhere near the centre, the tails of the bell shaped curve contain a diverse collection of crackpots, duds and no-hopers at one end; and at the other a rare collection of the exceptional – the exceptionally talented, the exceptionally compassionate – and the exceptionally greedy.

Despite the fact that general practitioners are adequately remunerated (we will leave the remuneration bun-fight for another day) for the work they do, a percentage – Dr No estimates perhaps fifteen to twenty percent – want more. Some of these individuals have an over-inflated opinion of their value to society, and consider that value should be reflected in their bank balance. And others – lets not beat about the bush here - are just plain greedy. Their primary purpose in practising medicine is to make money – lots of money.