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Negative Pressure at the Anus

Posted by Dr No on 09 August 2010

prof_field.jpgAs a medical student, Dr No was greatly impressed by a particular surgeon. This surgeon was that rare thing, a surgeon whose mind was even sharper than his scalpel. He taught Dr No perhaps the most important surgical lesson of all: that surgery is not about how to operate – any competent surgeon can do that – it is about when to operate; and it is fidelity to that decision that distinguishes the great surgeon from the average surgeon. That same great surgeon taught Dr No much else, often in the vernacular, and none more certain than that which holds that the only sure-fire way to advance one’s medical career is to apply regular and consistent negative pressure at the anus of one’s superiors.

Needless to say, neither this surgeon nor Dr No proved adept at this particular skill, and both came to languish in distant backwaters, while all around more Machiavellian colleagues dropped the mercury and mounted ladders. These habits of former colleagues were brought sharply back to mind over the weekend by a spectacular display of negative pressure applied not this time to a mere individual, but to the back door of a entire building, a building none other than Richmond House. Dr No refers, of course, to Professor Steve ‘Fattie’ Field, current Chief Pongo at the Royal College of General Practitioners, and his bid to become England’s next CMO, or Chief Medical Officer.

Fattie has been in the headlines recently for trolling up to public health minister Anne Milton by, err, telling fatties they are fat. This, understandably, upset those amongst us who, as the saying goes, have more of them to love, but is as nothing when compared to the King James I style CounterBlaste to Modern Lyffe issued by Fattie over the weekend.

Fattie’s 1200 word rant, published in Sunday’s Observer, aligns the Prof with the Cons in much the same way that a rat might align itself with a drain-pipe. One can hear the hectoring echoes of the Hacksaw years, the Decrepit orders for the out-of-work to get on their bike. Of course, it didn’t work then, and it wont work now, for the simple reason that life, as Margaret McCartney points out, is just that little bit more complicated. But what strikes Dr No most forcibly about Fattie’s rant is that it already bears that classic CMO hallmark: the loud pronouncement that looked at more closely emerges bereft of reliable evidence.

Take, for example, Fattie’s assertion that smoking in cars when kids are present is child abuse. Dr No has no trouble with the political and moral rhetoric that kippering the kids should be discouraged. What Dr No does object to – because it degrades scientific credibility, and so compromises the scientific case on the occasions when we do have evidence – is the careless use of casual evidence that does not stack up. Fattie, in support of his allegations of child abuse, refers airily to ‘evidence from the US [that] indicates that more young children are killed by parental smoking than by all unintentional injuries combined’.

Putting aside the semantic insinuation that parents are intentionally killing their children, what is this ‘evidence from the US’? So far as Dr No has been able to ascertain, it comes from one 1997 study that assessed the economic effects of parental smoking. The study of economics, we may recall, was invented to make astrology look good – and so it seems, to Dr No, that Fattie’s assertions assume the scientific credibility of astrological certitude.

The candyfloss approach to evidence is not the only factor that marks Fattie’s card as the next CMO. As we approach the head of affairs, it appears that the Prof has form on MMC, was a judge on the CMO’s Public Health Awards 2010 (which provide a number of ‘evidential examples’ routinely relied on by the Prof) and that he is full of beans for the role of public health in GP commissioning - all of which could make Fattie a tasty wager in the CMO stakes.


The post of CMO is just the sort luscious dog turd that will attract all the blowflies in our profession.
If fatty doesn't get it some other arselicker will. Only two things are certain. Firstly that the next incumbent will be a prize twat. Secondly that within 12 months he will be Sir prize twat.

Laughed my socks off at this. I'm still looking for them. Thanks for that, Dr No..

It never fails to astound me how the 'Old Boys Network' is alive and kicking.

This chap 'Stevie Field' is one of those people who seems to be doing the rounds of the NHS Heirarchical Committees, Councils and Institutions.

He is a Fellow of the National Leadership Council and I have personal experience of another Fellow of this Council who, Dr. Zorro, has his 'Sir' prize already!

One would imagine that the qualities needed to be a Fellow of the National Leadership Council are similar and so if Stevie is anything like Sir Andy, God Help us All, 'cos Andy only knows how to lead folks round in 'a merry dance'!

Mind you Stevie is already in his dancing gear!

Toms Anguish

Never had an original thought in his life

"Never had an original thought in his life"

Isn't that what being a CMO is all about? A job for life too.

...though much in common. Including MMC. And fatness

And what do we need a CMO for?! The last one stayed in office for 12 whole years, messed up junior doctors' postgraduate education and wasted 1,000,000,000 pounds on a disease that never was! And despite being branded as 'inept' by the Health Select Committee, no one could get rid of him because he had a waterproof contract for life, it was only, I think, when he could make a deal that he finally agreed to move on to an even more lucrative job!

I think now is a golden opportunity for the new gov to modernise the CMO job, maybe make it just a two year contract to be renewed depending on achievement - or even abolish the post as it stands and employee a whole part time committee instead. At least those would discuss and weigh up available evidence before they implement something like the notorious 'Swine flu' campaign, which was a disaster! And a commettee would be much more democratic and a lot cheaper too!

Whichever way, it would be crazy to get anyone else into that office for life and give them free rein too! Dave, Andrew and co don't have their offices for life, why should a mere employee like a CMO be allowed that super privilage?!

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