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January 2010

Why Barton Didn’t Go for a Burton

The Barton case may well come to be remembered as the one in which the General Medical Council lit the fuse of its own destruction. But the fuse that has been lit is not the one that appears to have been lit.

Unlike the Gosport relatives of Barton’s victims, and the multitude of commentators on the web, and in the press, Dr No does not think that GMC stands for ‘Gross Medical Cover-up’. He does not think this is a simple case of a profession looking after its own.

Sure, there are doctors involved. But this is not about doctors protecting doctors. It is something infinitely more troubling. It is The Establishment looking after The Establishment.

The XX Factor

Were it not for the genuinely sad nature of the case, the last few hours of Lynn Gilderdale’s life could almost have about it the air of a grotesque Benny Hill sketch. In a surreal speeded up video, complete with that memorable theme tune, one might see Kay Gilderdale rushing around their home, searching out pills and potions, furious grinding in pestle and mortar, frantic googling, over-size syringes full of air…

…and all in very bad taste, Dr No fully agrees. But sometimes he wonders whether it isn’t necessary to look a little harder at the current wave of mother-love hysteria that has risen on the back of the Inglis and Gilderdale trials for murder and attempted murder of their respective children.

Transactional Euthanasia

Thomas Harris, in his popular account of transactional analysis ‘I’m OK–You’re OK’, describes a toxic life position known as ‘I’m OK–You’re not OK’. How long, Dr No wonders, will it be before the current spate of ‘mercy’ killings mutate via ‘I’m not OK–You’re not OK’ to ‘I’m not OK–You’re Dead’ and then ‘I’m OK–You’re Dead’?

Make no mistake, Dr No has every sympathy with mothers like Frances Inglis, and the appalling predicament they find themselves in. But he also sees creep at work. And creep is nasty, sinister, very sinister…

The Rhett Butler Moment

Dr No has a close non-medical friend – a salesman - who is forever trying to sell Dr No the idea that medicine is really just like any other job. All that special pleading, all that vocation nonsense, is so much hot air, he says. Other jobs have just the same stresses and rewards. Medics have no ‘special case’.

Dr No begs to differ. Dr No suspects that most doctors have an affair with medicine, and that that adds an intensity to the relationship that most jobs lack. He is not convinced that those who sell stationery for a living – as his friend does – have affairs with selling, let alone selling stationery. If they do, then there must be an eroticism to ring binders that has quite passed Dr No by.

Going for a Barton

Language, they tell us on Radio 4’s ‘I’m Sorry I Haven’t a Clue’ is constantly evolving. If Clue should ever find itself down Gosport-way, it would find that ‘Going for a Burton’ - the WW2 euphemism for taking a shufti – has evolved into ‘Going for a Barton’ – meaning admission to the town’s War Memorial Hospital, and subsequent death while under the care of the visiting Diamorphine Queen, Dr Jane Barton.

The ongoing story of the Diamorphine Queen has been well covered by Rita Pal and others, including affected relatives. At its heart, it is one of a unfettered doctor initiating a zealous programme of ‘anticipatory prescribing’ of opiates and other powerful sedatives to patients, whether they needed the drugs or not. The disinhibitory effect of this cavalier prescribing led inexorably to unnecessary deaths. No one knows for certain how many, but the figure runs to tens of not hundreds of affected patients.

Snake Oil

Yet another study has been published showing that prescription antidepressants are no better than snake oil - that is to say, placebo, or sugar-pill - for treating mild to moderate depression. Yet in 2008 - the latest year that figures are available for - UK doctors doled out a staggering 36 million prescriptions for antidepressants to patients - almost enough for one prescription for every adult.

How can this be? To answer this question, we have to go a bit further than the usual – and highly important – profit motive of Big Pharma. We have to ask the question: why is it so easy for Big Parma to shift 36 million prescriptions a year? The answer lies in the history and nature of General Practice - which is of course where the vast majority of these prescriptions are issued.

The Tory Party at Work

Just as the Church of England is the Tory party at prayer, so is the Medical Profession the Tory party at work. Doctors, for all sorts of reasons, are natural conservatives.

But they tend – they are doctors after all – to be a particular type of conservative. They tend to be ‘One Nation’ conservatives. And that allows them to be both conservative, and, at the same time, as most doctors do, value the principles, if not the day to day practicalities, of the NHS, and all that it stands for.

Medical Armageddon

There are those who say that the Isle of Wight is one big Departure Lounge in the sea, an Island of Biddies and Gilberts waiting for their Final Flight. As it happens, Dr No knows the Island well. It certainly has more than its fair share of Departure Lounges, but it is also a very beautiful Island. Dr No has spent many a happy day savouring its special blend of peace and tranquillity.

Some time ago, Rita Pal, fancying herself a cushy number, took up a medical SHO post at the Island’s main hospital. Needless to say, all those Biddies and Gilberts meant not less but more medical work. She uses the occasion to remind us that not all GPs are paragons of virtue. Some are dreadful. She tells a gruesome tale of not four but five Horsemen of the Apocalypse, masquerading as GPs, who helped one Island Gilbert on his way.


The ever-interesting Witch Doctor has made a welcome return to the blogosphere. It seems that while she was away in the witchosphere, she spent time contemplating one of her persistent themes – that of creep. The Witch Doctor, she says, believes in creep. So does Dr No. But, it appears, not everyone is familiar with the term as the Witch Doctor and Dr No use it. A little while ago, one of Dr No’s confidants – a well read and intelligent woman - was reading a post and remarked on what she read as a grammatical error. Dr No had missed out a subject to the verb creep. She had not before come across the word creep used as a noun to describe a social process. Dr No wonders if there may be others unfamiliar with this usage.

The Cart and the Horse

Sir Liar ‘Tombstone’ Swansong, ex-CMO-elect, has let it be known that he intends to use his retirement to persuade government to impose a binding minimum price for alcohol, in the hope of curbing alcohol related harm. A figure of 50p per unit sold has been suggested – which would raise the minimum price for a bottle of 12% ABV wine to £4.50, up some 50% on today’s minimum prices.

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