Saturday, March 24, 2007

Gone but not forgotten

Apologies to my regular reader(s) for my recent lack of posting. I've been suffering from bloggers' block. If I was more organised I'd have a small stash of pre-written and uploaded drafts so all I had to do was log in and hit the 'publish' button and nobody would know the difference.

What are the causes of bloggers' block? Well in my case it's partly down to a bout of illness compounded by some bad news.

During the week I heard that an old colleague who I used to work with and chatted to sporadically since, is no longer with us. I wish I'd spoken to him more often.

It's made me think about two things. One is the the effect that the sudden death of a colleague has, creating shockwaves through the hospital. It's something I've observed after the sudden death of senior doctor in my hospital a few years ago and the suicide of a fellow house officer a few years before that. The second thing is that we have to carry on. Death and disease carry on in the hospital and the world and we must carry on too. We have a quick cry into a coffee in the hospital canteen and then get on with the ward round. We all look normal and the patients, and sometimes our other colleagues, can't tell the difference but inside we're weeping.

Sunday, March 11, 2007

Light relief

If it's all getting you down and you want a laugh, the little black duck has found something to amuse. It made me laugh.

The nightmare continues

So MTAS is unravelling. For the uninitiated what is going on is that in August all junior doctors of SHO or equivalent grade are having their contracts terminated and they are having to re-apply for what were their own jobs. These are doctors who qualified around two to eight or more years ago and since then they’ve been training, gaining clinical experience, passing tough exams, getting advanced life support certificates, doing PhDs and many other things that will help them provide better care for sick patients. They are applying for training jobs that will train them to consultant level.

MTAS is the system through which they have to re-apply for their jobs. Over the past few weeks flaws in the system have been coming to light at an appalling rate. They include:

Unvalidated selection criteria being used

The majority of marks are awarded for creative writing exercises rather than experience and qualifications

Some applications have been marked by unqualified shortlisters

Some applications have been ‘lost’ in the system

Candidates who are ineligible for jobs have been shortlisted

Candidates have been offered interviews for jobs they did not apply for

Shortlisting consultants have been offered interviews for junior doctor jobs they didn’t apply for

Some shortlisting consultants have been able to see the names of candidates because applications were not always anonymised

Some shortlisting consultants have been able to see and potentially alter marks given to applications by other shortlisters

Some applicants were made aware of shortlisting criteria before applying

There are only two rounds of this system to allocate jobs for the NHS for a whole year – so doctors left jobless will be in trouble as junior doctors can only train in the NHS in this country, they cannot set up in private practice

In some areas consultants have refused to conduct interviews as they felt the selection process was grossly unfair. It is obvious to anybody that the system is a shambles. It is obvious it is incapable of selecting the best junior doctors for the jobs. This system is supposed to help produce well qualified, well trained consultants for the NHS. It will not do that. Yet the Association of Medical Royal Colleges (AoMRC) recommend continuing with round one interviews (the RCPath has the documents here). This is ridiculous. I can’t express how angry, disgusted and despondent I feel about this.

The AoRMC (and that includes you RCPath, show a bit more gumption!), the BMA and anybody who thinks they might need treatment from the NHS in future (and that’s pretty much all of us, me included) should make a strong stand against this disaster. Please visit the excellent mmc360 site to learn more, write to your MP (and ask them to sign these early day motions - 737 and 1059), march in London or Glasgow with RemedyUK, sign the petition and email your royal college. Please help.

Saturday, March 03, 2007

Writing therapy

Imagine the person closest to you has bowel cancer. Horrible isn’t it. Obviously you want them to have good treatment. Who do you want them to go and see?

An expert on bowel cancer. Definitely.
Somebody who really knows what they’re doing. Oh yes.
Somebody with plenty of experience of treating the disease. Absolutely.
Somebody who is well trained in their field. Spot on.
Somebody who can care for them properly if they have complications. Nothing less.

Somebody who is good at creative writing. No? Are you sure?

Well you could go and see Miss K Scalpel. Even when she applied for higher surgical training she’d already done 5 years of basic surgical training and 1 year of training in anaesthetics and intensive care medicine. She’d got a PhD from a prestigious university for studying bowel cancer. She was an instructor on Basic Surgical Skills and Advanced Trauma Life Support courses.

She sounds ideal.

Or maybe you’d rather your loved one went to J K Rowling for treatment?

Don’t laugh, tomorrows consultants are now being selected mostly on the basis of their creative writing ability rather than their qualifications and experience.

Welcome to MTAS.

Thursday, March 01, 2007

Liam Halligan I love you

If you watched Dispatches this week you’ll know why. Liam Halligan brilliantly explained how so much money has been poured into the NHS and where it has been wasted/siphoned off into the private sector. If you didn’t see it find somebody who taped it and if you can’t do that then read the pages on the Channel 4 site.

If you’re feeling up to it, read his interview with Patricia Hewitt in the Sunday Telegraph. The interview was shown in the programme and for the very first time I experienced an urge to eviscerate somebody who wasn’t dead. I had to bite my fingers to stop myself bludgeoning the telly with a frying pan. Here’s a quote from the Telegraph interview which was shown in the programme:

I put it to the Secretary of State that she is desperately trying to rein in the deficit, in an unrealistic time-frame, to save her own political skin. For the first time, she loses her cool, and the interview comes alive. "That is an absolute insult to thousands of NHS staff across the country," she retorts, her eyes wide with anger. "That is an insult to NHS staff across the country who have worked their socks off this year to make difficult decisions."


I’d love to see Liam doing a programme on the UK chainsaw massacre that is MMC and MTAS (this is the second of 5 posts so far, have a look at the others too) soon.