Thursday, January 25, 2007

Gordon Brown Voted in top 100 sexiest men


New Women's poll voted him 97 th.

Ahead of him was Worsel Gummage, Sponge Bob Square Pants and Frank Dobson

But seriously this must be a joke! Another New Labour spin attempt to make him seem trendy. Get him a baseball cap and hoody please

GPs condemn Government

Nearly 75% of GPs say the Government is doing a poor or very poor job according to GP Magazines European Barometer.
Patricia Hewitt is considered to be doing a good or very good job by only 13% of GPs
Asked which Party GPs felt closest to
44% Conservative
22% Lib-Dem
17% Labour

Thursday, January 11, 2007

Saving the NHS


By Dr Paul Charlson
Is a GP in East Yorkshire and member of Doctors for Reform.
He was previously a member of East Yorkshire PCT executive committee.


My local Primary Care Trust (PCT) and Hospital Trust are millions of pounds
in debt, a situation that is repeated around the country. Yet the Government has said that the books must balance this year. This can only be achieved by cutting services and jobs, a process that is already underway. After several years of unprecedented spending the NHS is about to hit the buffers. It is reminiscent of the stop-go economy of the seventies. The NHS needs real reform if it is going to deliver what we all want -a safe reliable patient centred service.

In 1999 our health authority split into 4 PCGs which later became 4 PCTs and recently merged into 2 PCTs. Each re-organisation was accompanied by new strategies and management structures with recruitment and redeployment of staff. Many managers simply moved organisations or changed job titles. To avoid redundancy some managers were placed in roles that they are unsuitable for. Meanwhile the Government attempted reform by producing endless unclear and contradictory guidance. This created a management culture fearful of decision making with an innovation phobia.

The problem is that the Government has interfered too much and needed to concentrate on strategic vision allowing local managers flexibility to implement it. Local flexibility is the only way reform will be effectively achieved.

The Government recognised that without the co-operation of medical staff any reforms would fail. Sir Gerry Robinson’s television series about Rotherham General Hospital is to be shown this week. One of his findings was that management did not listen closely to the staff. It is obvious that the people working at the coalface will know what is going wrong and might know how to fix it. Rotherham is not alone. PCTs have consistently failed to listen effectively to clinicians who have increasingly become disengaged with them. My colleagues who served with me on our Professional Executive say it was frustrating and a waste of time. Our local PCT managers are generally good motivated people yet over the years they have listened less, as the organisation has become debt ridden and centrally controlled.

The first thing the NHS must do is put clinicians back at the centre of decision-making processes. This should not just be at the level of local Primary Care Trusts but in the Strategic Health Authorities and the Department of Health.

The NHS financial problems are also reducing innovation. We set up an innovative scheme for Dermatology, involving patients being seen in the community by specially trained GPs and Consultants. This has been a real success with high levels of patient satisfaction and it has been designated a DoH pilot site. Yet despite “ticking all the Government boxes” and support of the PCT we are down to bickering over a few hundred quid. The situation is that bad!

In the same service we planned to employ a part-time dermatology nurse two years ago.. Despite many meetings the nurse is still not in post . In my Practice, we decided to employ a new nurse practitioner and she was in post within eight weeks.

Without innovation you cannot have reform. Without reform the NHS will fail to achieve its potential.

Our practice trains medical students and they are fearful of unemployment. It is estimated that 9000 Doctors are unable to find training posts. When you think of the motivation and effort it takes to get a medical qualification not to mention £250000 it costs to train them, it is a scandal. The situation is even worse in nursing where about half of graduates have a job and in physiotherapy it is 20%.

The budget cuts have hit training posts hard meaning that newly qualified staff cannot get the further “on the job” training needed to become really effective parts of the workforce.

Furthermore staff are made redundant only to return to virtually the same post as agency staff at twice the cost

The NHS has failed to plan adequately producing an unbalanced and unaffordable workforce.


An urgent manpower review is required. We need to ensure training posts match the needs of a reformed NHS and an end to the contracting out of staff to agencies.

Apart from failing to control costs the Government has made some new very expensive commitments. One of these is Connecting for Health. This is the central computer system encompassing amongst other things a central medical record and the ability to book outpatient appointments from the GP surgery.

We started to use Choose and Book nine months ago.. The system is supposed to come up with appointments virtually instantaneously. The first time I used it, I looked like a real lemon staring at a blank screen for five minutes. The patient went away without an appointment and my secretary spent 30 minutes creating an appointment for her. This was repeated many times by our practice before we gave up. Even the National “hit squad” has failed to sort the problem out.


Three things seem to have gone wrong with Connecting for Health. First the time scale for its introduction was hopelessly short. Second many good systems that were already operating around the UK have been dumped. Thirdly an IT system must assist its users to do their job better. Currently this is not happening.

Choose and Book should be suspended until it can made to work properly. Current systems should be supported until they can be integrated and there should be more consultation with clinicians in future developments.

The NHS has a golden opportunity to create a safe reliable service with enhanced local services and patients as valued customers but to do this it must change. The current fiscal belt tightening will wreck the Government’s vision of reform. The think tank Reform’s latest report suggests writing off the current debts rather than forcing organisations to make drastic cuts. The new start would involve much tighter financial rigor and planning but at a local level, this time with patients and clinicians driving the changes. This is surely what the Government wanted but has failed to achieve