Posts tagged with Dodgy Practice


Regulators are from Mars, Doctors are from Venus

It is a truth universally acknowledged that a regulator in possession of a dodgy report must be in want of a cover-up.

–Attr: Austen, Miss J.

Yesterday on Newsnight, the Chief Stoat was worrying another victim, on this occasion the Chief Pongo for the time being at Can’t Quite Cope, the body charged for the time being with keeping an eye on the quality of health and social care in England. The story is that CQC had given a certain NHS Trust a green light when it should have flashed a red. On finding the error, senior staff at CQC ordered all lights off, all shredders on, and folk who should have known better started wall-papering their arses. But wall-paper is no match for the brown stuff. As the skid marks appeared, the CQC leadership panicked, turned to its lawyers, and received the extraordinary advice to hide behind the Data Protection Act. It was the absurdity of this advice, not to mention that it was followed, that caused Paxo’s eyes to enlarge in visible increments. Mr Behan, the Chief Pongo for the time being at CQC, responded for the time being by talking up his leadership, but the vigour his assertion was compromised by the fact he spent most of the interview looking like a goldfish about to lead the escape from a wet paper bag.

Toothless Wonder

Dr No gazed in open-mouthed if not toothless wonder as the first episode of Frankie (BBC1) unfolded last night. Not content to be the life and soul of the party, Frankie, a SuperNurse for the time being on the district beat, is the life and soul of the known universe. In a script that pasted it on like a bricklayer mortaring a wall, Frankie was given lines to assist even the dimmest viewer to a full comprehension of Frankie’s awesome powers. When cutbacks have ordinary doctors and nurses quivering, what does Frankie do? Why, she laughs at the cuts! When a cut of a literal sort threatens to come her way in the hands of a demented war veteran, she turns the other cheek. Nothing is beyond the toothless wonder’s extraordinary powers. When a child arrests in her car, Frankie becomes paramedic and then emergency ambulance driver; later, she turns her hand to a spot of midwifery. Dr No suspects Frankie has a fold-up operating theatre in the boot of her car, and in later episodes will turn her hand to a spot of surgery. Nothing is beyond Frankie for, as she told at least one gagging viewer, ‘the world is her patient’. When not fixing the world, Frankie likes to turn up the stereo, and dance, turning the show into a musical: Frankie Goes To Bollywood. Truly, nothing is beyond Frankie, but then, Dr No supposes, that is what happens when you have done Torchwood. Even Captain Jack has been turned into a shadow of his former self, a hapless plod who’s always got the wood, but never gets his way, because every time he gets his pecker out, Frankie’s away.

Raising the Bar

Justin Wood, the Today programme’s Useful Idiot, was let out of his play-pen this morning to tackle a story with real numbers in it. He promptly crashed and burnt. So spectacular was the crash and burn that the erudite Prof McManus’ erudition flat-lined and later all but crashed and burnt too. At issue was the distinction between pass mark and pass rate for the Professional and Linguistic Assessments Board test used to assess clinical and English language skills in the - as the media would have it - foreign devils more formally known for the time being as International Medical Graduates. In Woodie’s upside down world, the great secret was to up the pass rate, the better to weed out those with forked tongues. In the real world, of course, upping the pass rate, rather than the pass mark, would have the effect of letting though not fewer but more IMGs.

The Curse of a Fortunate Man

Over the years Dr No has encountered a number of single handed general practices. His first encounter was on a Scottish island, as a student, in a practice made memorable by two things: the sweet malt smell from the oil drum sized barrel of beer that brewed beside the kitchen range, and the loan of the practice Land Rover, with a licence to roam the island. Later, as a locum, he found single-handed GPs on leave a reliable source of work: he could be transported, as if by a revolving door, to the seat of a single handed GP. For a week or two, he had eyes-only access to almost every aspect of the practice. He saw the intimate details first hand, not as a squinting sociologist might, but as a living participant. And living practices they certainly were, but pretty rum many of them were too. Too often for comfort, opening a drawer in search of a prescription pad, Dr No was greeted not with a jumble of papers, tongue depressors and broken tape measures, but with the clink-chink of bottles of high proof but non-surgical spirit.

Normal For Norfolk

In the Good Old Days, NFN (Normal For Norfolk) was medical shorthand used to describe a patient who appeared peculiar, or odd. It now appears that NFN may apply not only to patients, but to other goings on in the good county of Norfolk.

Poldark by Gaslight

Dr No approached last Sunday evening’s Lady Chatterley’s Lover (BBC1) in a bad mood, having just had his computer freeze up in the last moments of an ebay auction he was particularly keen to win. Maybe there’s an app out there baddies can use to freeze up other bidders’ computers at the critical moment. Any road, he hoped some good old fashioned rumpy pumpy would distract him from his ebay woes, all the more so as the BBC’s adaptation was by Jed Mercurio, once upon a time a doctor, and known more recently for dramas such as Line of Duty. He was up against stiff competition, not just in the trouser department. For Dr No, Ken Russell’s Women in Love is the defining big or small screen adaptation of DH Lawrence’s work, with a none too bad 1980s BBC adaptation of The Rainbow definitely in the running. How did Mercurio do?

Tick Box Medicine

Dr No’s mother, a fit 80-something year old, recently attended an ophthalmology clinic, on the advice of her optician, and was told – out of the blue, by a nurse – she hadn’t even seen a doctor - that a bed had been arranged for her to come in two days later to have her cataract removed. The nurse was most put out when Dr No’s mother – who knows her mind very well – said she had no intention of coming in for an operation she neither knew about, nor did she need. Yes, she does wear reading glasses – but otherwise her eyesight is fine.

Gluganomics

Today’s announcement by Scotland’s Minister for Emesis, Nicola Stugeron, that the Scottish government intends to set a 50p minimum unit price for alcohol reminds Dr No that a similar bell is set to toll South of the Border. Forty-eight hours after Porgie’s boomerang budget, the one that keeps on coming back to tap the Tories where it hurts, Theresa May was pushed on to the floor of the Commons, in a reckless bigger-the-pushed’un-the-better-the-cushion move, to zap hostile media coverage of the budget, by announcing the Westminster government’s own Alcohol Strategy. Needless to say, that strategy also contains proposals for minimum unit pricing, and, needless to say, both governments are equally deluded in their expectations that this daft policy will do any good. In fact, Dr No predicts it may even do harm.

Sick Individuals and Sick Politicians

Hoping no doubt to capitalise on New Year temperance sentiments, David Cameron chose last week to announce a review of alcohol pricing. Westminster officials have been ordered to develop ‘a scheme in England to stop the sale of alcohol at below 40p to 50p a unit in shops and supermarkets’, akin to similar but further advanced Scottish plans. The idea behind these neo-Prohibitionist proposals is the so-called ‘single distribution theory’, expressed rather alarmingly some time ago in the title of a seminal BMJ paper as ‘The population mean predicts the number of deviant individuals’. The notion is that, not only can the tail wag the dog, so too can the dog wag the tail. Reduce overall alcohol consumption, and the number of deviant (i.e. heavy) drinkers will also reduce. Like most neo-Prohibitionist clap-trap, it is pure poppy-cock.

Staggering Catastrophes

As a doctor who has dabbled in epidemiology, Dr No is not unaware of the siren song of care.data. Greater minds, including epideiology’s Einstein, have frothed at the prospect of the data orgy to be had, only to have it dawn that theirs was a premature cigar. Yet even when left staggering at the catastrophes revealed, a hard core group still want care.data to happen, the idea being that if enough corks are inserted, then nothing will leak.

If only! Dr No remains persuaded that the call of care.data is indeed the song of a siren balanced on dangerous rocks. However alluring the song, the rocks remain; many rocks, but four stand out as especially dangerous.