Saturday, April 14, 2007

RCPath talk tough

I have obviously happened on this issue rather late, but I noticed this document on the RCPath website the other day. It’s a response to another document I hadn’t heard of before, a discussion paper called ‘The future of the medical workforce’, published by NHS Employers.

I read the RCPath’s response first and it’s quite a strong-worded response considering pathologists often hedge their bets with phrases like ‘suspicious but not diagnostic of’ in histology reports. I wondered what had provoked this and read the offending document. This is a piece of writing supposedly about the recent ‘reconfigurations’ in the NHS, the European working time directive (EWTD) etc and the effects these things have had, and will have, on how doctors work, how they are trained and how many are needed. To me it looks like a load of vague waffle written by somebody who uses the buzzwords but doesn’t really understand the issues. It talks about ‘mergers and closures of some smaller units’, the reduced training time for doctors due to MMC and EWTD without any hint that the authors have considered the effect of these things on patients and doctors and whether these are a good thing or not. The document is full of ‘key questions’ and I’m glad to see the RCPath have answered many of these in their response. Here are a couple of examples:

‘Is there a need for a new specialist grade below consultant?’ ask NHS Employers.
RCPath response: ‘No’

What will the doctor of the future look like?’
RCPath response: ‘Here is a likely distinction between expectation and reality. The doctor of the future should be fully competent in the clinical management of patients through a deep understanding of the scientific and pathological basis of disease. The reality is that he/she will be a politically-correct apparatchik who responds to clinical situations in a protocol-driven and codified manner. If such an event occurs, it will be highly detrimental for the medical profession and patients alike as well as being severely damaging for society as a whole.’

The RCPath’s conclusion says: ‘Overall, this is a naive document that exposes many errors and misconceptions currently held by employers and managers within the NHS. There continues an inherent advocacy of a ‘top-down’ directive approach without an acceptance that medically trained doctors are probably best suited to develop the environment necessary for good clinical care within society. Obvious lack of appreciation of fundamental constraints such as time and money do not engender confidence in the proposed discussion or consultation process as advocated at the beginning of this document.’

Neither of these documents is very long and they make interesting reading, particularly if you’re careful to read between the lines. I think the RCPath is pretty spot on in the majority of what is said, I just wish they’d shout about it more.


At 11:18, Blogger Shinga said...

It really is time that some professional bodies asserted their autonomy more vigorously.

What would a good follow-up be?

Regards - Shinga

At 18:26, Blogger Dr Andrew Brown said...

Wow! Go, RCPath!
If I ever thought that pathologists were dusty academic types, I was surely wrong. This is stirring stuff: blunt and entirely correct.

At 18:22, Blogger Dr K said...

Hi guys

I think the RCPath do their best (and sometimes succeed) in standing up for pathologists when it comes to things like organ retention, the human tissue act etc but their efforts don't seem to be very well publicised. Unfortunately the RCPath website seems a bit pro- 'the principles of MMC' and they don't say much about MTAS other than the Association of Medical Royal Colleges statements. Personally I wish they'd take a stronger and more public stand against MMC and MTAS. There was an email floating round on doctorsnet which the RCPath had sent (only to consultants, I think, I didn't get it) and somebody had posted, which was more scathing about MTAS.

At 22:34, Anonymous Anonymous said...

wish someone would expose the crappy labs they try to work in - all have 'cpa accreditation' haha, but the cpa never investigate anyway - the rbch in bournemouth only has 'full cpa accreditation' because it counts poole nhs hospital labs as a 'sattelite site' - this obscures the fact that it is 5 miles away, that their on site labs are only open ~9-5 monday-friday, and that at all other times , even routine samples have to be sent BY 4 HOURLY AMBULANCE SHUTTLE ACROSS TOWN - the lab reports only show the time the sample was received/time result issued, not times ruddy samples were taken. On paper, they are allowed to order a taxi for 'urgent samples', but when asked in an FOI how many had been ordered in the past year, there were 'no figures available' -
the labs are a total shitheap..


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