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July 2015

Breaking Bad

Like a pair of blind impotent bulls, Humph and Jimbo crashed about the Today studio this morning, breaking bad, but not much in the way of news. The programme reverberated to the dull thud of blunt horns getting stuck in wooden stories. Humph deployed his standard technique of exclaiming ‘Ha!’ every time an interviewee started to answer a question, to put the interviewee off balance, while Jimbo has extended his extended question technique by inserting…long…pauses. More crotchety than ever, Jimbo has even started to avoid questions altogether, preferring instead to crochet together a long series of statements…and pauses…and…assertions, more waffle, more saccharisms, more Jimboisms…before delivering a final semi-triumphant statement, leaving the by now stunned hapless interviewee little to do except to agree.

Deaths In Custody

News last week that there were 17 deaths in or following police custody in 2014/15 in England and Wales has rekindled outrage at the scandal and led to the usual political wails. Theresa May, announcing an inquiry into the deaths, said they ‘represented failure’. Well, that’s one way of putting it. Others rallied round ‘one death is a death too many’. Had Stilton been asked for comments, he would have said the deaths ‘absolutely represented failure,’ and that ‘one death absolutely is a death too many’. Sotto voce, he may have added, ‘we absolutely have been here before,’ because of course the GMC has had a hand in the death of similar annual numbers of doctors under FTP investigation, but from a far smaller population at risk. We should also note Stilton does not count year-and-a-day deaths, ie those occurring after FTP investigation. As a killing machine, or if you prefer a negligent machine that allows deaths, the GMC is far more lethal than the police. For once Stilton would be in error to say the GMC absolutely is more lethal, were he ever to admit such a thing, because in absolute published numbers the police are equal to, or slightly ahead of the GMC, but in relative, pro rata, terms, the GMC’s FTP processes are more lethal than police custody processes. If the police’s grim reaper is a scythe on open land, the GMC’s grim reaper drives a combine harvester down narrow streets.

Zombie Patients

Writing in the well-known Blue Top, the BMJ, Margaret McCartney, a fellow scourge of Bad Medicine, recently described the 16% higher chance of death if you are admitted to hospital over the weekend as a zombie statistic. The essence of a zombie statistic is not necessarily that it is wrong, but that it won’t go away, even when it is shown to be at least spurious, possibly wrong, and almost certainly misleading. Zombie politicians, who tend likewise to be at least spurious, probably wrong and almost certainly misleading, but still wont go away, love zombie statistics, as does the zombie press, which attracts zombie stats as a dunghill attracts flies. Shortly before the election, David Cameron, increasingly the zombie party leader as BJ hots up the mustard, pumped up the 16% higher mortality statistic, and true to form it just won’t go away. Today the zombie minister Jeremy Hunt will use the 16% zombie statistic to prop up his case for seven day zombie working in the NHS.

Prolapsed Participles

Good medical practice, perhaps, but bad English. Absolutely Stilton’s announcement of his latest hair shirt guidance for doctors, absolutely jointly produced with the Nursing and Midwifery Council so that it applies to nurses and midwives as well, is focused, if that is not too strong a word, on the duty of candour, more generally understood as the duty to be honest. It tells clinicians, with a ringing third degree participle prolapse, that ‘When something goes wrong with a patient’s care, doctors, nurses and midwives should: speak to the patient, or those close to them, as soon as possible after they realise what has happened.’ Wily clinicians, and those liable to be bent by their learned friends, are thereby provided with a useful loophole. So long as the patient hasn’t realised something went wrong, there is no need for the clinician to embarrass themselves. Piling Pelion on Ossa, the next point reverses the prolapse. Clinicians, the announcement says, should ‘apologise to the patient – explain what happened, what can be done if they have suffered harm and what will be done to prevent someone else being harmed in the future’. From where Dr No is sitting, it seems they absolutely don’t know who they are, and if they don’t know who they are, the what hope can there be for the rest of us knowing who we are, let alone what we should do?

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