tag:blogger.com,1999:blog-354361182023-11-16T13:47:36.525+00:00Medicine Down the PubGrab a pint, pull up a chair and join in the discussion.
A no holds barred chat about politics, health and any other topics which spring to mind.Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.comBlogger30125tag:blogger.com,1999:blog-35436118.post-30775392119227718122007-12-26T22:56:00.000+00:002007-12-26T22:57:39.292+00:00Got bored with bloggingI find blogging hard work. So on April 1st I stoppedPaul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-33443537820540470952007-04-01T17:30:00.000+00:002008-11-13T16:48:32.157+00:00Butcher in Botox Arrest<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhk9sLWf7AAmE7Ea8VqknBUDbuTyQif-tVA7X4POXK_M-pi0RRqCx6NbuINHymUYaXLvI-s8twUBS_N_lw1XQZE7WMPpqV5wK-TTQCeQuPsDezvblhaTfSXI3ajdejnfCYAtpH1eQ/s1600-h/wrinky.jpg"><img id="BLOGGER_PHOTO_ID_5048514000432093810" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" height="107" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhk9sLWf7AAmE7Ea8VqknBUDbuTyQif-tVA7X4POXK_M-pi0RRqCx6NbuINHymUYaXLvI-s8twUBS_N_lw1XQZE7WMPpqV5wK-TTQCeQuPsDezvblhaTfSXI3ajdejnfCYAtpH1eQ/s320/wrinky.jpg" width="116" border="0" /></a> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNWmxvJJ7aSp-TBC9eRAXmONECJvP4Bc3t3RrYt9ZHJ80JrdQak6eEpJAr5Dt67ylvbyisyrO38pDIeA8oPic_edyZbF1BfEYUMLA9RuNll4Dh52HOUMPElzghju1QP2DhbilxJA/s1600-h/smooth+dog.jpg"><img id="BLOGGER_PHOTO_ID_5048514124986145410" style="FLOAT: right; MARGIN: 0px 0px 10px 10px; WIDTH: 129px; CURSOR: hand; HEIGHT: 110px" height="104" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNWmxvJJ7aSp-TBC9eRAXmONECJvP4Bc3t3RrYt9ZHJ80JrdQak6eEpJAr5Dt67ylvbyisyrO38pDIeA8oPic_edyZbF1BfEYUMLA9RuNll4Dh52HOUMPElzghju1QP2DhbilxJA/s320/smooth+dog.jpg" width="129" border="0" /></a><br /><div><br /><br /><div>A Swindon butcher has been arrested for giving his pet dog Rover Botox.</div><br /><br /><div></div><div>A neighbour noticed Rover looking odd and called the RSPCA.</div><br /><br /><div>The butcher was quoted as saying "anybody is legally allowed to do botox now, Rover looked tired so I thought I would pep him up a bit"</div><div> </div><div>From Swindon Advertiser</div></div>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-197032378239530182007-04-01T17:00:00.000+00:002008-11-13T16:48:32.516+00:00BAE again<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiywiKJg4XzIO3ps9nMbL26AgGMBMFGu3PbeZlU3beGBWV2UFgjAiHwYni-GSDbu9z54Mc8bxD9_o_ACp8YmziXSPBlD_NH5UdNWJLL8tufPvidLfZYdcbfNiGCRa2UOr6FkOAn5A/s1600-h/sunday+times.jpg"><img id="BLOGGER_PHOTO_ID_5048506510009129538" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiywiKJg4XzIO3ps9nMbL26AgGMBMFGu3PbeZlU3beGBWV2UFgjAiHwYni-GSDbu9z54Mc8bxD9_o_ACp8YmziXSPBlD_NH5UdNWJLL8tufPvidLfZYdcbfNiGCRa2UOr6FkOAn5A/s320/sunday+times.jpg" border="0" /></a> <div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div>From the Sunday Times<br /><br />A SECRET slush fund set up by BAE Systems, Britain’s biggest defence contractor, was used to pay tens of thousands of pounds to two British actresses while they befriended a senior Saudi prince and his entourage.<br />Confidential documents seen by The Sunday Times reveal that money from the £60m fund went on the mortgages and rent, credit card bills and council tax of Anouska Bolton-Lee and Karajan Mallinder. It even paid for language lessons.<br />BAE channelled the cash through a London travel company which financed “accommodation services and support” for Prince Turki bin Nasser and other Saudi figures responsible for the desert kingdom’s involvement in the £40 billion Al Yamamah arms deal.<br />The revelations are bound to reignite controversy over the deal, which sparked a bribery inquiry by the Serious Fraud Office (SFO). Documents giving details of the payments were handed to SFO staff.<br /><br /><a class="link-666" href="http://www.timesonline.co.uk/tol/news/uk/article1596756.ece"></a><br />The investigation was terminated in December when Lord Goldsmith, the attorney-general, told parliament that it was not in “the national interest”.<br />At the time of the payments Bolton-Lee, a former lingerie model-turned TV actress, and Mallinder regularly attended parties at the Carlton Tower hotel in London hosted by the prince who, as the then head of the Royal Saudi Air Force, was responsible for the purchase of 150 Hawk and Tornado jets from BAE.<br />A senior government official, speaking on condition of anonymity, said that the inquiry had been trying to establish why the women were paid through the BAE fund.<br />It is likely that both would have been interviewed later this year had the inquiry not been aborted.<br />Goldsmith’s move followed a series of threats made directly to Tony Blair by the Saudi government. The Saudis warned that they would halt all payments on the contract and cut diplomatic and intelligence ties with Britain unless the criminal investigation was stopped.<br />The SFO had been investigating claims that BAE had set up the fund to support the extravagant lifestyles of senior Saudi royals as a way of ensuring that what was Britain’s biggest arms deal survived.<br />The SFO established that BAE used Travellers World, a travel firm, to run the slush fund and channel payments to Turki and others.<br />The prince, who is married to a niece of King Abdullah, the Saudi ruler, was the key player in the deal because of his role within the military.<br />The documents relating to the actresses refer to Turki as PB – a code for “principal beneficiary” – BAE’s description of him.<br />They show that during 2001 and 2002 Travellers World paid the £13,000-a-year rent on Bolton-Lee’s flat in west London. One document reveals that she received “expenses” of £1,275 in cash. Bolton-Lee, 29, who has appeared as a hostess in the BBC’s The Generation Game, declined to comment.<br />The documents also show repeated payments made to Mallinder during 2001-2. In July 2001, a sum of £1,002.67 appears as being paid to “Associates-Mallinder”.<br />Other documents refer to payments for “Mallinder mortgage (£448)”; “Mallinder expenses (£1,000); and “Mallinder language course (£326).” Karajan Mallinder, who changed her name from Karen after a 1988 conviction for possessing cocaine, said she knew nothing about any slush fund companies but admitted that she was a close friend of Tony Winship, a BAE manager and former RAF wing-commander who was arrested in 2005 over allegations that he ran the fund.<br />She ended a telephone conversation with The Sunday Times abruptly when asked if she had met Turki and his party in the 18th-floor penthouse at the Knightsbridge hotel.</div><div></div><div></div><div>There is a fine line between schmoozing a client and paying a bribe. It's not clear that this deal fell the wrong side of that line, but for as long as attempts to investigate are blocked it will remain controversial. More pointedly (but sadly less thrillingly for the papers), this deal involves the transfer of significant jet fighter intellectual capital to Saudi Arabia. While Saudi is not hostile to British interests it is very possible that this will end up in the hands of countries that are. £40Bn over 10 years is a tiny percentage of Britain's total exports. HMG should not be propping up any public company, especially not the defence industry which is horribly inefficient, and especially not BAe Systems which is in rude health and whose majority interests now lie outside the UK. Al Yamamah stinks and we should drop it like a hot potato. If the French want to step in and apply a lower moral standard then that is their decision; Britain should know better.<br />Anthony Charlton, Swindon,</div><div></div><div></div><div></div><div></div><div></div><div><strong><em><span style="font-size:130%;">I live near a big BAE factory, it employs lots of people in an area where jobs are increasingly hard to come by. So a Prince allegedly received some hospitality? Is it such a big deal?</span></em></strong></div><div><span style="font-size:130%;"><em><strong>The world turns on hospitality amd we in Britain seem to be pathetically</strong></em> <strong><em>puritanical about it all. If we dont watch it all our work will go elsewhere. It is all about moderation and harm caused to others.Does allegedly appealing to a Prince's more basic instincts harm anybody? No</em></strong></span></div><div><strong><em><span style="font-size:130%;">Are the "actresses" allegedly involved bovered? No</span></em></strong></div><div></div><div></div><div><strong><em></em></strong></div><div><strong><em>How do you like your coffee black or white?</em></strong></div><div><strong><em></em></strong></div><div><strong><em><img id="BLOGGER_PHOTO_ID_5048505895828806194" style="DISPLAY: block; MARGIN: 0px auto 10px; CURSOR: hand; TEXT-ALIGN: center" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj2chpU0FXZP7fETd7wslrWCccq7AT5Ybjp2nIQJr3k6Ja6z3i9ISmbPv-Ind-wqnHS-HqG6e57T2Cuusvr9paeXdV5MQ39EBlaluYGpiBVfpVD-a-5IRLoT0l-nWZj_l4EdYtTdA/s200/sunday+times.jpg" border="0" /></em></strong></div></div>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-88072398067791344232007-04-01T16:47:00.000+00:002008-11-13T16:48:32.624+00:00Nurses Struggle in New Prescribing Role<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgwEiCMTTMfVpfCfPN7CzRM0WKR_YX0Oawwh17a_ZjAg9pDYu5iPfO5epRBuz8tfkM8U6wLSlFUlEB25aafU0ELQ2iIqJ_sMbM6-WL2dooBrsNx-73mio0xXw5M5W-IhOmbt4EpQ/s1600-h/prescribing.jpg"><img id="BLOGGER_PHOTO_ID_5048503383272938018" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgwEiCMTTMfVpfCfPN7CzRM0WKR_YX0Oawwh17a_ZjAg9pDYu5iPfO5epRBuz8tfkM8U6wLSlFUlEB25aafU0ELQ2iIqJ_sMbM6-WL2dooBrsNx-73mio0xXw5M5W-IhOmbt4EpQ/s200/prescribing.jpg" border="0" /></a><br /><div><a onclick="window.open(this.href, '_blank', 'width=116,height=70,scrollbars=no,resizable=no,toolbar=no,directories=no,location=no,menubar=no,status=no,left=0,top=0'); return false" href="http://healthcarerepublic.typepad.com/.shared/image.html?/photos/uncategorized/2007/04/01/nurse_prescriber.jpg"></a><br />A <a onclick="window.open(this.href, '_blank', 'width=116,height=70,scrollbars=no,resizable=no,toolbar=no,directories=no,location=no,menubar=no,status=no,left=0,top=0'); return false" href="http://healthcarerepublic.typepad.com/.shared/image.html?/photos/uncategorized/2007/04/01/nurse_prescriber_2.jpg"></a>study of 18 qualified nurse prescribers and 7 nurses undertaking a prescribing course were presented with 4 clinical scenarios such as "A 65 year old man asks if he can take some Aspirin for his severe pain due to gout.How would you proceed?"<br />The majority were "unable to identify the issues" involved in the 4 scenarios and "failed to provie an acceptable solution to the problem"<br />In interviews one nurse critisied her training on pharmacology as "really awful" .<br />About 50% of study participants scored zero in all scenarios.<br />The study was lead by Dr Maxine Offredy, reader in Primary Care at the University of Hertfordshire.<br />This raises further doubts about the scope and skills of nurse practitioners. One of the problems is the basic training of nurses in subjects such as biochemistry, physiology and pharmacology is superficial. This leaves them vulnerable when they start to practice independently. Of course many nurse prescribers only complete the course so that they can prescribe in a very narrow area of expertise.This is sensible. It is difficult to see how current nurse prescribing courses adequately equip them for work in more generalised diagnostic and therapeutic area such as primary care </div>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com2tag:blogger.com,1999:blog-35436118.post-88605120310897177692007-03-25T16:27:00.000+00:002008-11-13T16:48:32.687+00:00Global Warming<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjEGua8rFzCUaaeRWP0m0hvtgPEjd0gX8i4GAv__FfutpsMBZaAxLW2bJM5gHuoWKExVa1sUrpdfvKc_TaUIN62V-Tt9Cf-pVYX6SI9E2LMKDwD-RA31Co6vaAiFXDO35u3PLkYBw/s1600-h/warming.jpg"><img id="BLOGGER_PHOTO_ID_5045900714635225730" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjEGua8rFzCUaaeRWP0m0hvtgPEjd0gX8i4GAv__FfutpsMBZaAxLW2bJM5gHuoWKExVa1sUrpdfvKc_TaUIN62V-Tt9Cf-pVYX6SI9E2LMKDwD-RA31Co6vaAiFXDO35u3PLkYBw/s200/warming.jpg" border="0" /></a><br /><div><strong>This article from the Washington Post I think sums it all up!</strong><br /><strong></strong><br /><strong>Global Warming's Real Inconvenient Truth<br /></strong>By <a title="Send an e-mail to Robert J. Samuelson" href="http://projects.washingtonpost.com/staff/email/robert+j.+samuelson/">Robert J. Samuelson</a>Wednesday, July 5, 2006; Page A13<br />"Global warming may or may not be the great environmental crisis of the next century, but -- regardless of whether it is or isn't -- we won't do much about it. We will (I am sure) argue ferociously over it and may even, as a nation, make some fairly solemn-sounding commitments to avoid it. But the more dramatic and meaningful these commitments seem, the less likely they are to be observed. Little will be done. . . . Global warming promises to become a gushing source of national hypocrisy.''<br />-- This column, July 1997<br /><br />Well, so it has. In three decades of columns, I've never quoted myself at length, but here it's necessary. Al Gore calls global warming an "inconvenient truth," as if merely recognizing it could put us on a path to a solution. That's an illusion. The real truth is that we don't know enough to relieve global warming, and -- barring major technological breakthroughs -- we can't do much about it. This was obvious nine years ago; it's still obvious. Let me explain.<br />From 2003 to 2050, the world's population is projected to grow from 6.4 billion people to 9.1 billion, a 42 percent increase. If energy use per person and technology remain the same, total energy use and greenhouse gas emissions (mainly, carbon dioxide) will be 42 percent higher in 2050. But that's too low, because societies that grow richer use more energy. Unless we condemn the world's poor to their present poverty -- and freeze everyone else's living standards -- we need economic growth. With modest growth, energy use and greenhouse emissions more than double by 2050.<br />Just keeping annual greenhouse gas emissions constant means that the world must somehow offset these huge increases. There are two ways: Improve energy efficiency, or shift to energy sources with lower (or no) greenhouse emissions. Intuitively, you sense this is tough. China, for example, builds about one coal-fired power plant a week. Now a new report from the International Energy Agency in Paris shows all the difficulties (the population, economic growth and energy projections cited above come from the report).<br />The IEA report assumes that existing technologies are rapidly improved and deployed. Vehicle fuel efficiency increases by 40 percent. In electricity generation, the share for coal (the fuel with the most greenhouse gases) shrinks from about 40 percent to about 25 percent -- and much carbon dioxide is captured before going into the atmosphere. Little is captured today. Nuclear energy increases. So do "renewables" (wind, solar, biomass, geothermal); their share of global electricity output rises from 2 percent now to about 15 percent.<br />Some of these changes seem heroic. They would require tough government regulation, continued technological gains and public acceptance of higher fuel prices. Never mind. Having postulated a crash energy diet, the IEA simulates five scenarios with differing rates of technological change. In each, greenhouse emissions in 2050 are higher than today. The increases vary from 6 percent to 27 percent.<br />Since 1800 there's been modest global warming. I'm unqualified to judge between those scientists (the majority) who blame man-made greenhouse gases and those (a small minority) who finger natural variations in the global weather system. But if the majority are correct, the IEA report indicates we're now powerless. We can't end annual greenhouse emissions, and once in the atmosphere, the gases seem to linger for decades. So concentration levels rise. They're the villains; they presumably trap the world's heat. They're already about 36 percent higher than in 1800. Even with its program, the IEA says another 45 percent rise may be unavoidable. How much warming this might create is uncertain; so are the consequences.<br />I draw two conclusions -- one political, one practical.<br />No government will adopt the draconian restrictions on economic growth and personal freedom (limits on electricity usage, driving and travel) that might curb global warming. Still, politicians want to show they're "doing something." The result is grandstanding. Consider the Kyoto Protocol. It allowed countries that joined to castigate those that didn't. But it hasn't reduced carbon dioxide emissions (up about 25 percent since 1990), and many signatories didn't adopt tough enough policies to hit their 2008-2012 targets. By some estimates, Europe may overshoot by 15 percent and Japan by 25 percent.<br />Ambitious U.S. politicians also practice this self-serving hypocrisy. Gov. Arnold Schwarzenegger has a global warming program. Gore counts 221 cities that have "ratified" Kyoto. Some pledge to curb their greenhouse emissions. None of these programs will reduce global warming. They're public relations exercises and -- if they impose costs -- are undesirable. (Note: on national security grounds, I favor taxing oil, but the global warming effect would be trivial.) The practical conclusion is that if global warming is a potential calamity, the only salvation is new technology. I once received an e-mail from an engineer. Thorium, he said. I had never heard of thorium. It is, he argued, a nuclear fuel that is more plentiful and safer than uranium without waste disposal problems. It's an exit from the global warming trap. After reading many articles, I gave up trying to decide whether he is correct. But his larger point is correct: Only an aggressive research and development program might find ways of breaking our dependence on fossil fuels or dealing with it. Perhaps some system could purge the atmosphere of surplus greenhouse gases?<br />The trouble with the global warming debate is that it has become a moral crusade when it's really an engineering problem. The inconvenient truth is that if we don't solve the engineering problem, we're helpless.</div>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com3tag:blogger.com,1999:blog-35436118.post-43331744442412642562007-03-05T21:34:00.001+00:002007-03-05T21:37:19.499+00:00Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-18638219828506299752007-03-05T21:34:00.000+00:002007-03-05T21:36:11.737+00:00Lack of local engagementLocal MP, Graham Stuart, has written to every Parish Council in the Beverley & Holderness Constituency asking for their support in his campaign against the local PCT’s plans to close every bed at Withernsea, Hornsea, Beverley and Driffield Community Hospitals.Graham has asked each Parish Council to write to the PCT to oppose the bed closure plans and to confirm with him that they have done so.Graham said:“We need to show unanimous and overwhelming public opposition to these plans and if Parish Councils show that they are all opposed to the closures then this is a powerful argument against the PCT which is supposed to make changes with people and not just for them.“If the PCT refuses to listen to the people, then the evidence of overwhelming opposition from Parish Councils and other voluntary groups will give me a strong case to put to the Secretary of State to ask her to intervene.”Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-85236078722614390992007-03-05T21:29:00.000+00:002007-03-05T21:32:55.427+00:00What is going on with our local hospitalsProtester's blanket rejection of bed cuts<br /><br />Alexandra Wood A town councillor took to bed – to highlight the plight of the East Riding's community hospitals.<br />Brent Roach was wheeled in an old hospital bed to the side entrance of the headquarters of East Riding Primary Care Trust yesterday in a demonstration that drew more than 200 protesters.They are angry at the PCT's plans to axe 14 NHS beds at Driffield's Alfred Bean Hospital – and those at three other community hospitals in the region – and replace them with 60 beds at hospitals in Bridlington, Goole and a third unspecified location, and 40 others at private care homes.Coun Roach said: "Today's turnout shows what a huge strength of feeling there is in the community against these cuts, which we don't believe make sense. We badly need to retain all these beds in community hospitals throughout the East Riding. They are vital for recuperative care of patients after they come out of the main hospitals and before they return home."We believe shifting beds into the private care sector is totally uneconomic, because the beds will have to be paid for even when there are no patients in them.<br />"On the other hand we've seen little evidence of the savings that were meant to be made when the two trusts merged last year to form the new PCT."Unfortunately in the NHS too much money is going on personnel and not enough on patient care."We would question why the PCT is still operating from two headquarters if they are under so much financial pressure."The PCT's interim chief executive Claire Wood, went out to meet protesters who handed her a letter.She said: "We are encouraged by the interest that local communities are taking in their local health services and offer assurance that all views received will inform the final decisionon the proposed model of care." Another demonstration is planned for early next month.Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-18369419803174147392007-03-04T14:58:00.000+00:002007-03-04T15:37:10.892+00:00Doctors chaos 'is worst crisis to hit NHS'Doctors chaos 'is worst crisis to hit NHS'<br />By Celia Hall, Medical Editor Daily Telegraph<br />Last Updated: 12:49am GMT 04/03/2007<br /><br /><br /><br />The chaos created by a new training system for young doctors is the "biggest crisis to hit British medicine", a leading surgeon said yesterday.<br /><br /><br />Prof Gus McGrowther: 'This is the biggest crisis to hit British medicine since the start of the NHS'<br />The new system, being investigated by the Royal College of Surgeons, has left thousands of junior doctors without jobs as trainee consultants.<br /><br />Their current posts will end in August and fears are growing about how hospitals will cope.<br /><br />The despairing and increasingly angry doctors have set the date for a London protest march and are taking legal advice about the equity of the new system. A fighting fund has been set up.<br /><br />On Monday all the medical royal colleges will meet to discuss the crisis.<br /><br />Hundreds of junior doctors, who have spent many years and thousands of pounds on training, have inundated The Daily Telegraph website to tell of their despair.<br /><br />Rob Henderson, a senior house officer, said: "Hospitals run because of the goodwill of the doctors, evidently this has now been shattered and with it patient care."<br /><br />Sarah Cregan, wrote: "I have spent 10 years training to be a doctor and have invested not just my own time and money but that of my family's including grandparents. I feel very let down."<br /><br />The fury of scores of young doctors came as Prof Gus McGrowther, professor of plastic and reconstructive surgery at Manchester University, said he was profoundly concerned about the effect of the new system on patients as well as on medicine.<br /><br />"This is the biggest crisis to hit British medicine since the start of the NHS," he said. "We are sacrificing thousands of young doctors who are partially trained and committed to a career in the NHS.<br /><br />"We have 200 doctors who would like to be plastic surgeons and 50 jobs. Of these 150 are already very well qualified and already members of the Royal College of Surgeons.<br /><br />"They have spent an enormous amount of money creating this new system and the whole thing is spiralling into chaos. It is quite immoral to inflict this on motivated young doctors. I cannot find a single doctor who is happy with this flawed process and ultimately it is the patients who will suffer."<br /><br />Bernard Ribeiro, the president of the Royal College of Surgeons, wrote to all members on Thursday listing five "fundamental difficulties" in the system.<br /><br />There have been 30,000 applications for 22,000 consultant training jobs under the Modernising Medical Careers scheme, accessed by the website called the Medical Training Application Service.<br /><br />"For 18 months I have tried to get this system modified and the number of surgery places expanded," Mr Ribeiro said. "I have not succeeded. This system must be reviewed urgently.<br /><br />"One problem is the website, which is open to the whole world. Anyone can apply. But the application forms are designed to be so unbiased that you could quite easily get an EU candidate offered an interview when a better qualified, British trained doctor is ignored."<br /><br />In the new structure doctors do two years of "foundation" training and then apply for consultant training to become specialist registrars. The first foundation trainees are now ready to move to the registrar stage but they are clashing with the senior house officers from the old system.<br /><br />There is also an unknown number of EU and overseas doctors in the mix. Mr Ribeiro said the heavily criticised application forms might be suitable for the foundation trainees but took no account of the experience and qualifications of the older SHOs.<br /><br />"We need a different system for the SHOs as the new system is phased," he said.<br /><br />Problems listed by the royal college are: "woolly" questions on the application forms; concern that qualifications have not been taken into account; concern about the adequacy of training for assessors; inconsistent rating and errors in reporting the results.<br /><br />The fury of scores of young doctors came as Prof Gus McGrowther, professor of plastic and reconstructive surgery at Manchester University, said he was profoundly concerned about the effect of the new system on patients as well as on medicine. "This is the biggest crisis to hit medicine since the start of the NHS," he said. "They have spent an enormous amount of money creating this system and it is spiralling into chaos."<br /><br />A spokesman for the Department of Health said: "It would be irresponsible to halt the interview process at this late stage. We cannot know whether the wrong people were invited for interview until they are interviewed."<br /><br />Tony Blair's official spokesman sought to play down the crisis, saying: "The main thing is the overall number of doctors, as with nurses, has gone up."<br /><br />A DOCTOR COMMENTS<br /><br /><em>I have a medical degree from london, a "golden london SHO rotation" disctinctions throughout medical school, 100% in my medical and surgical finals (i joke you not), all my postgrad exams, posters, papers in progress, a pan-london audit etc etcAnd I have sat in front of the computer all day - waiting to see whether this incompetent system has granted me a future in medicine. I'm still waiting.All day the website had been plagued with problems, doctors rushing from one computer terminal to the other trying to pretend their looking at blood results when in fact they are looking for a glimmer of hope that they still have a career, or job in the NHS come August.Do you want to hear the biggest joke. In 2009 the EWTD says doctors have to reduce their hours. A year ago official figures predicted hospitals wouldnt have enough doctors. When they make 6000 of us unemployed this summer and we all pack up our lives and move to america or australia - within a year they will be "flying in SHOs" from abroad to meet the staffing crisis. For a huge price no doubt. Not very smart.And now I will continue to stare into my computer screen to see if a dedicated intelligent doctor has to "sign on" in August.Well done Blair.Well done Patricia Hewitt.How are you going to spin this one to the patients?????SHO soon to be unemployed. </em><a name="122222"></a><br /><a name="122223"></a>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-31157664654981183292007-02-07T17:02:00.000+00:002007-02-07T17:04:23.158+00:00Ministers dont believe in health strategyThe minister in charge of maternity services was accused of hypocrisy after he failed to turn up to the launch of a Government report proposing a major shake-up of maternity care. Ivan Lewis, who has campaigned against cuts in maternity services in his Bury constituency, did not attend the launch of the report by Sheila Shribman, the children and maternity tsar. His absence prompted the Tories to taunt Labour by claiming: "Labour ministers don't believe it."" - <a href="http://news.independent.co.uk/uk/health_medical/article2245136.ece">Independent</a>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-77716655437647274332007-01-25T20:45:00.000+00:002008-11-13T16:48:33.020+00:00Gordon Brown Voted in top 100 sexiest men<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwqnaYWpiE7UlXI5t34ESsY2SwchPiETBlPqzvt3KKXena4XrdByBDIr5M7t8NL79zNSk6SJbZxUEQy83T5sgv3fA_iNrZmKTJkouSYQPEna997W7xkFq4Qw60b4eP0GK3S0N1rw/s1600-h/gb+and+baby.jpg"><img id="BLOGGER_PHOTO_ID_5024073888303839650" style="DISPLAY: block; MARGIN: 0px auto 10px; CURSOR: hand; TEXT-ALIGN: center" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwqnaYWpiE7UlXI5t34ESsY2SwchPiETBlPqzvt3KKXena4XrdByBDIr5M7t8NL79zNSk6SJbZxUEQy83T5sgv3fA_iNrZmKTJkouSYQPEna997W7xkFq4Qw60b4eP0GK3S0N1rw/s320/gb+and+baby.jpg" border="0" /></a><br /><div>New Women's poll voted him 97 th.</div><br /><div>Ahead of him was Worsel Gummage, Sponge Bob Square Pants and Frank Dobson</div><br /><div>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</div>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-28208138026731376562007-01-25T20:18:00.000+00:002007-01-25T20:20:00.350+00:00GPs condemn GovernmentNearly 75% of GPs say the Government is doing a poor or very poor job according to GP Magazines European Barometer.<br />Patricia Hewitt is considered to be doing a good or very good job by only 13% of GPs<br />Asked which Party GPs felt closest to<br />44% Conservative<br />22% Lib-Dem<br />17% LabourPaul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-86254294363982028492007-01-11T17:28:00.000+00:002008-11-13T16:48:33.114+00:00Saving the NHS<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjeswFczyKfhstg4Ozp8So6LzyeE0I0KILYbZP66MtgSxZRVJ-hecu21p8NuEgfUX54B3EqRvu0HNN1pZP_koa3HSmvxSOyxlL-IxCKk0x_3aQlWvz_8bedbDwaf8ih9muDss6oJQ/s1600-h/save+nhs.jpg"><img id="BLOGGER_PHOTO_ID_5018828000196214082" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjeswFczyKfhstg4Ozp8So6LzyeE0I0KILYbZP66MtgSxZRVJ-hecu21p8NuEgfUX54B3EqRvu0HNN1pZP_koa3HSmvxSOyxlL-IxCKk0x_3aQlWvz_8bedbDwaf8ih9muDss6oJQ/s320/save+nhs.jpg" border="0" /></a><br /><div>By Dr Paul Charlson<br />Is a GP in East Yorkshire and member of Doctors for Reform.<br />He was previously a member of East Yorkshire PCT executive committee.<br /><br /><br />My local Primary Care Trust (PCT) and Hospital Trust are millions of pounds<br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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!<br /><br />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.<br /><br />Without innovation you cannot have reform. Without reform the NHS will fail to achieve its potential.<br /><br />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%.<br /><br />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.<br /><br />Furthermore staff are made redundant only to return to virtually the same post as agency staff at twice the cost<br /><br />The NHS has failed to plan adequately producing an unbalanced and unaffordable workforce.<br /><br /><br />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.<br /><br />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.<br /><br />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.<br /><br /><br />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.<br /><br />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.<br /><br />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</div>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-16674856841002527942006-12-30T19:58:00.001+00:002006-12-30T20:03:15.948+00:00Just give it to GPs they have lots of time for routine check upsThe proposal has been recommended by David Colin-Thomé, the national clinical director for primary care, who has been charged with reviewing primary care services and whose report will be published in January. Dr Colin-Thomé says that most patients concerned about their recovery already see their GP within two weeks of surgery, rather than waiting six weeks to raise the problem with a consultant.<br />The inefficiency in the NHS's present arrangements, he claims, is compounded by the fact that 11.9% of patients fail to attend their routine check-up. A total of 4.2m appointments were wasted in 2005/6 at a cost of £378m. "The system needs a complete rethink," he told the Guardian. "We waste consultants' precious time and expertise if we force them to spend hours sitting in a room simply telling patients they're recovering fine ... It is like asking a Michelin-star chef to cook microwave meals all day.<br />"Patients don't need specialists to tell them they are fighting fit. Most will know this themselves, and those who want extra advice and reassurance would get this from their GP. We are finding that most patients who are concerned about their recovery actually contact their GP within two weeks anyway."<br />The Department of Health calculates the move should save £1.9bn. Government advisers hope that shifting the check-ups to more convenient locations would cut the number of missed hospital appointments. Last night the department said there might be rare instances where consultants might want to see patients after complex operations. A spokesman said: "In the vast majority of cases, routine follow ups would be done by GPs." If patients demanded appointments with a consultant, these would be at the consultant's discretion<br /><br /><strong>I would agree that following each patient up routinely by a consultant at 6 weeks is probably unnecessary. I would suggest that routine follow up by GPs is also a waste of their precious time and expertise.<br /><br />There is good evidence that patients with post operative complications will consult their local practice in any case and the rest with no problems are probably quite happy to be left alone. The best system would be for GP practices to provide a nurse trained in post operative care who would have direct access to urgent specialist follow up if required. This could be funded by shifting some of the money currently being paid to hospital trusts for post operative care to GP practices. I would also suggest that 6 week follow up should be optional giving the patient choice and responsibility and at the same time reducing costs</strong><br /><strong></strong>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-50711358741497452062006-12-21T19:53:00.000+00:002008-11-13T16:48:33.344+00:00Cheeky Opik<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjDhaWulsLD7YUD8pM24HFs4YfGoBgphSlCEsEGRSOoA5KpOhWsH-X173ItOCsxqOrKJvBM5YLFyXtAce1gvO49MYnLNswYwvI8aQ6w5LWwSz4GY7qryaq7uD-T2kbH_EUv_7ptw/s1600-h/cheeky.jpg"><img id="BLOGGER_PHOTO_ID_5011071868853291762" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjDhaWulsLD7YUD8pM24HFs4YfGoBgphSlCEsEGRSOoA5KpOhWsH-X173ItOCsxqOrKJvBM5YLFyXtAce1gvO49MYnLNswYwvI8aQ6w5LWwSz4GY7qryaq7uD-T2kbH_EUv_7ptw/s320/cheeky.jpg" border="0" /></a><br /><div>Liberal Democrats are best known for winning by-elections; the Cheeky Girls are best known for the exhortation "touch my bum". How on earth did this happen? ...His family is from Estonia; hers from Romania. Mr Opik and Ms Irimia must have bonded over their mutual interest in European Union enlargement. So perhaps not such an unlikely love story after all. Only one question remains: is it too late for a cheeky Christmas duet single?"<br />Do we care?</div>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-19774360521587576692006-12-21T19:08:00.000+00:002008-11-13T16:48:33.512+00:00Yorkshire Post letter 18 Dec<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhKDnK3g3FiI5VQQ06BBmOYj0S9NqNvXVJAa_jDVdYrYsLoXpqqAeyRBlcBOQMY_ecsMKz9OTNooJXl7fGJPtKSg33hMAqPc1WHL5DbserqJmKbzDTmMcJEH4SSvj7hFuztz1hBSg/s1600-h/yorkshire.jpg"><img id="BLOGGER_PHOTO_ID_5011068450059324130" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhKDnK3g3FiI5VQQ06BBmOYj0S9NqNvXVJAa_jDVdYrYsLoXpqqAeyRBlcBOQMY_ecsMKz9OTNooJXl7fGJPtKSg33hMAqPc1WHL5DbserqJmKbzDTmMcJEH4SSvj7hFuztz1hBSg/s320/yorkshire.jpg" border="0" /></a><br /><div>Dear Sir<br /><br />Your editorial highlights the very real problems occuring within the NHS. The cuts will affect front line services, training and staff morale. All of these factors will affect the patient experience of healthcare in the coming years.<br /><br />Having working in the NHS for many years and sampled NHS management, I make the following observations.<br /><br />The has been much talk about engaging clinicians, in particular Doctors in the shaping of services. This has largely been talk. Doctors are now disengaged and disenchanted with the whole process.<br /><br />PCTs have spent more energy organising and re-organising their structures than developing services.<br />There are more uncompleted projects than completed ones. PCT managers often lack the skills required to develop a working service. They are paralysed by Government guidance which is often unclear and changes frequently. This has resulted in indecision causing immense frustration and wasted opportunity.It is demotivating to anyone involved.<br /><br />Targets whilst improving some aspects of patient care have lead to money being diverted from areas of care which are not included in targets. The targets have not been properly costed out leading to debts.<br /><br />Financial management and IT development have been frankly shoddy at times.<br /><br />Now to cap it all the Government has decreed that suddenly the books have to balance.It is like a bank threatening to forclose on a poorly run large business and panic has set in.The results are plain to see.<br /><br />The NHS is complicated and changing it for the better will always be difficult but this Government has made a hash of it</div>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-88537626312110285872006-12-21T17:50:00.000+00:002006-12-21T17:51:01.539+00:00General Practice Works by Jonathan SteeleGeneral Practice works<br /><br />“We’re off to see the Wild West show…” you know the song, “… the elephant and the kangaroo...” it goes on to exhibit the F’Kawe tribe who live on the grasslands of Africa. They are very short and the grass is very long, so you see their heads appear as they jump up and down shouting “We’re the F’Kawe”. I know how they feel. The grass is getting longer around us in General Practice. You’re not alone if you feel totally lost. It’s tempting to disappear back into the practice and wait until the grass is cut. Trouble is that no one is cutting the grass and we’re running out of energy to carry on jumping up and down. In a rush to balance the NHS books, there is a danger that General Practice will be lost forever.<br /><br />A few words here cannot be truly representative nor comprehensive. I briefly attempt to draw a map of the GP journey so far in the hope that we will not be steered off course in the future.<br /><br />Medicine is practised in a context of the society it serves and has always found a way of adapting to social changes. The Foundation of the RCP in 1518 is a good example as was the need for a College for General Practitioners in the 1950s.<br /><br />Medicine is also practiced in a system, ours is the NHS. An understanding of the relationship between GPs and the NHS may help explain some of our current difficulties.<br /><br />The National Insurance Act of 1911 allowed working men to be on the “panel” of a doctor and receive free medical care. Those doctors who listed patients under the Act were the first recognisable GPs, they established themselves in towns and villages and became the gatekeepers of referral to specialists.<br /><br />GPs owe their existence to the 1948 NHS Act which extended the panel to the entire population. The NHS owes its survival to GPs who have kept the costs down by providing well trained, comprehensive and cheap health care close to home. The long term relationship between a GP and the patient is the bedrock of medical practice in the UK. GPs are independently minded, we refused to be “employed” in 1948 and we run our businesses on a self employed basis. Our entrepreneurial independence has allowed us to adapt, a look at the GP computer systems compared to those of our hospital colleagues is a good example.<br /><br />95% of NHS consultations occur in General Practice, but we are much more than a mass service for trivial medical problems. The General Practitioner has a unique understanding of the patient as a person, in a family and a community. Our long term relationship provides trust where there is clinical uncertainty with the passage of time as a diagnostic tool. General Practice operates at levels beyond individual patient care. As a business it provides social capital to the community it serves. General Practitioners have always advised their local NHS on service developments and taken an interest in the direction of the NHS nationally.<br /><br />General Practice works as a diverse self critical system evolving through clinical excellence and altruistic social awareness. Over the past few years the NHS has been stifled into a managed mediocrity, at the front line we are struggling to cope.<br /><br />Given the freedom, we have the tools to deal with the chronic disease management of an ageing population, we have the ability to adapt to pharmacological advances, we have the experience to manage the better informed “consumer” of our care, we have the desire to improve our knowledge and practice through appraisal and revalidation. I believe that GPs can cope with the demands of our patients and of society. It is the demands of the system that distract us.<br /><br />The Quality and Outcomes Framework (QOF) has impersonalised chronic disease management into a tick box process that could be “sold” to non GP providers. The current DoH consultation around urgent care does not recognise the day time urgent care role of a GP. This thinking questions the value of General Practice. Increasing managerial intrusion into clinical practice creates an impression of a lack of trust in the abilities of GPs by their PCT.<br /><br />Whilst apparently trying to undermine General Practice, confusion arises as we are being asked save the NHS through Practice Based Commissioning and care closer to home, with neither time nor resources to do either. The worsening financial crisis implies that all initiatives are financially driven. The merger of PCT’s has created organisational chaos when clear policy interpretation and leadership is most needed.<br /><br />NHS Direct, walk in centres and Community Matrons, are an expensive range of new models of access for basic medical care. These ventures have not cut hospital admissions nor costs. The NHS is failing to serve some of our most deprived communities; it is no coincidence that traditional General Practice no longer exists in those communities, illustrating the symbiotic relationship between the NHS and General Practice.<br /> If we are living through a managed redefinition of comprehensive General Practice, the unintended consequence could be the destabilisation of the NHS. Amongst the current policy and organisational chaos, GPs know where we are. Through our professional values, we have to demonstrate that General Practice works.Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-33887642819613892442006-12-17T16:51:00.000+00:002008-11-13T16:48:33.732+00:00Aesthetic Nurse Prescribers<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVuXNPNbBkPahr5VrVpSVYqNjneXw8WwfZ_akpp-Z7r2wqTjZsiQ1VUNLomPQxoC1BeW_pRHJjVwwTX8vTox7kjxKYhRz33-W0pL00jhYVn5WaTjFW3j4t-ariuelBYUz0oAy7Vw/s1600-h/bad+botox"><img id="BLOGGER_PHOTO_ID_5009541889833306834" style="CURSOR: hand" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVuXNPNbBkPahr5VrVpSVYqNjneXw8WwfZ_akpp-Z7r2wqTjZsiQ1VUNLomPQxoC1BeW_pRHJjVwwTX8vTox7kjxKYhRz33-W0pL00jhYVn5WaTjFW3j4t-ariuelBYUz0oAy7Vw/s320/bad+botox" border="0" /></a><br /><div><span style="font-size:85%;">Bad Botox</span><br /><br /><div><strong>A Colleague Writes</strong> </div><br /><div></div><br /><div>NURSE PRESCRIBERS<br />Currently Nurses are not permitted to write prescriptions. The MHRA are currrently "Updating their advice on this". We can expect the worst. Nurse Prescribers will be able to prescribe any medicine except DDAs. They will also be able to examine, treat and prescribe. This, coupled with the proliferation of Dentists claiming to be "Facial Aesthetic Medicine Specialists", plus the new "Assistant Medical Practitioners (Nurses)" puts all our futures in jeopardy. In fact one website of a member of this group advertises a Nurse as an "Aesthetic Medical Practitioner". I despair at the draconian regulation by the GMC and Healthcare Commission of our profession on the one hand, and the total lack of regulation of our Dental and Nursing colleagues on the other.Fascinatingly "Private Doctors" are regulated by the HCC. but not Private Dentists or Nurses. It is also interesting that Private Dentists who call themselves "Doctor" are totally exempt from HCC inspection. I believe that if they want the title, they have to put up with the regulation that comes with it. Power without responsibilty the ultimate patients nightmare. I am also afraid that the HCC is an organisation run by Nurses for Nurses and that any recommendations will be Pro-Nurse and anti-Doctor.<br /><br />What do you think?</div></div>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com1tag:blogger.com,1999:blog-35436118.post-5126664492498859612006-12-17T16:19:00.000+00:002008-11-13T16:48:33.866+00:00BAE Eurofighter<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiIwyjj-dsS5WnsOYnSvP6WD90qOlblobGzNq9-U3KSVX4K9Vp2hzOxV3sLuL3PcjS5j5kHeOx0cfAiOv2-AsTDWbs8v46tYQIxA1PVaoALaQ1hGVyK-1UqDxzHR2hPhBZkO5r8pA/s1600-h/bae"><img id="BLOGGER_PHOTO_ID_5009531942689049266" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiIwyjj-dsS5WnsOYnSvP6WD90qOlblobGzNq9-U3KSVX4K9Vp2hzOxV3sLuL3PcjS5j5kHeOx0cfAiOv2-AsTDWbs8v46tYQIxA1PVaoALaQ1hGVyK-1UqDxzHR2hPhBZkO5r8pA/s320/bae" border="0" /></a><br /><strong>For Once Blair is Right!</strong><br /><br /><br />Justifying the forced closure of the Serious Fraud Office’s inquiry into corruption in a Saudi arms deal to buy 72 Eurofighter jets from BAE Systems, Tony Blair spoke as an old-fashioned realist. Nations have interests; those strategic interests are paramount. [..] Pressing for political reform in Saudi Arabia is urgent. Mr Blair is not pursuing that course, but instead is acquiescing in corruption for reasons of state. It is an unprincipled decision, but worse, it is a stupid one. - Oliver Kamm in <a href="http://www.timesonline.co.uk/article/0,,6-2507368,00.html">The Times</a><br /><br />If you lived near any of the BAE sites you would realise the impact of losing this order. Who cares about some Arabs getting some freebies in the 1980s.It was a long time ago, it may not be right but it is pragmatic to let it go.Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-3941310091447191862006-12-16T21:14:00.000+00:002008-11-13T16:48:33.989+00:00Road Pricing<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXieu_amXVkV6B-nDar_2m69zJtnBN31UrjdZMfiufctGSJm-hYjghBtlliVZ-MKf73bdwu64DhzODfQvRmAwWIGFr1vbugTw1O0gtuHqCcM7gtuaeLoAPenoKSTIuS8kLOFMSlw/s1600-h/carvan2"><img id="BLOGGER_PHOTO_ID_5009529584752003746" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXieu_amXVkV6B-nDar_2m69zJtnBN31UrjdZMfiufctGSJm-hYjghBtlliVZ-MKf73bdwu64DhzODfQvRmAwWIGFr1vbugTw1O0gtuHqCcM7gtuaeLoAPenoKSTIuS8kLOFMSlw/s320/carvan2" border="0" /></a><br /><div>Have the "Get everybody off the roads" brigade gone mad?<br />Figures of £1.28 per mile have been suggested at rush hour on motorways. This is completely out of order and defies logic. People will still use their cars, the public transport system in this country will never be as good as it needs to be. The net result will be increasingly clogged A roads and empty motorways. More traffic jams and more CO2 emissions. There has to be a better way of tackling the problem.<br /><br />I suggest a levy of £2 a mile for caravans and people with cloth caps driving Metros -that should fix it.<br /><br /><br /><br /><div><br /><div align="center"><br /><strong>DURHAM TOLL ROAD HITS SMALL TRADERS</strong><br /><br />The first UK toll road in 100 years was introduced Durham on 1 October, 2002. Drivers are charged £2 to enter a small part of the city centre between 10am and 4pm, Monday to Saturday. The affected area runs from the entrance to the Market Place, up along the historic, narrow Saddler Street, to the Durham Cathedral peninsular. A ticket machine is linked to an automatic barrier in the carriageway, which lowers when drivers pay to leave the charging zone. The system is monitored by security cameras and drivers caught dodging the charge are liable for a fine of up to £30.<br />Traffic in the zone has fallen from 2,000 to 200 vehicles a day, much more than the 50% expected by planners, and there is a European feel to the old city area, with shoppers walking casually in the single-carriage roadway alongside the occasional vehicle.<br />According to the BBC the local council is pleased and claims that the environment has benefited, and that the roads were now safer.<br />"This is a model that can be used on a small scale for historic places such as Durham, or large scale for cities like London." said their spokesman.<br />Some small independent traders are less keen, and have complained at having to pay £2 every time they take a delivery to their shops during the charging hours. They also claim that, paradoxically, there are now less casual pedestrian visitors than when there were more cars in the zone.<br />Peter Jackson, chairman of the local chamber of trade, agrees that the schemes has cut down the vehicles, although he doubts the reduction is as great as the county council says. "The real problem for business is that if I want to unload from a van it costs me £2 a time. I have at least 500 deliveries a year, which means £1,000 in charges a year.<br />The council argues that traders are learning to alter their delivery hours and methods, and that people who live and work in the zone are also adjusting to the charges.<br />The City of Durham Civic Trust also supports the scheme. Its chairman Roger Cornwell said: "Pedestrians have been given a chance to reclaim the street. Having just one barrier may seem a rather low-tech solution, but it appears to be working. There is a reduction in the number of people who would drive in just to use a cash point, or to drop someone off and then come back five minutes later to pick them up."<br />And local resident Henry Martin Taylor said: "It is a definite improvement, with more pedestrians and less traffic. I am all for it." 21 Feb 2003</div></div></div>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-49175033327930831212006-12-16T21:05:00.000+00:002008-11-13T16:48:34.175+00:00UKIP home website<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUan5dZpTpJiLayvQ2zmVRYVBDGDR1izEMIod3b8GH2YubWvyKjH_a8JdGXizjqbUtUF5vMEIm86iIeVfYo1USwhXIpQrkv6g8jrlnDzqy5sIrGXQSIGO4lOZqjL1AR1gWphJ9WQ/s1600-h/vicky+pollard.jpg"><img id="BLOGGER_PHOTO_ID_5009235134679091842" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUan5dZpTpJiLayvQ2zmVRYVBDGDR1izEMIod3b8GH2YubWvyKjH_a8JdGXizjqbUtUF5vMEIm86iIeVfYo1USwhXIpQrkv6g8jrlnDzqy5sIrGXQSIGO4lOZqjL1AR1gWphJ9WQ/s320/vicky+pollard.jpg" border="0" /></a><br /><div><strong>Can anybody follow the logic of this post on the UKIP website</strong> <strong>?</strong></div><strong></strong><br /><strong>If i vote but yer but no but!</strong> <div><br /><br />TORY PPC SIGNS UP TO BETTEROFFOUTFrom BOO:"Gordon Henderson, the Conservative Party Prospective Parliamentary Candidate for Sittingbourne and Sheppey, has just become the first Conservative Party PPC to support the BETTER OFF OUT campaign (see his message below). This is very much to his credit, as we are unable to guarantee that UK Independence Party candidates will stand down against Conservative Party candidates at the next election - except in the case of those MPs who have signed up to BETTER OFF OUT.<br />Naturally, we will try to draw his position on British membership of the EU to the attention of the electorate in his constituency, so that voters may draw their own conclusions and vote accordingly.<br />It is apparent from <a href="http://www.sittingbournesheppeyconservatives.com/blog.php?sectionid=9">Gordon's blog</a> - that his support for freeing Britain from the EU runs deep, as he has written an excellent piece on there, "Time for a Referendum on Europe".Good on Gordon, but I do hope that Nigel is true to his word and that UKIP stands in this seat as Gordon is not a sitting MP, and with Labour holding a majority of <a href="http://news.bbc.co.uk/1/shared/vote2005/html/519.stm">just 79</a> and UKIP polling 926 votes last time, there is always a chance for people to abuse BOO for political opportunism.If you really want out of the EU, then you should be standing for a party that has that as a policy.And before Iain Dale starts ranting that UKIP are "helping Labour", "blocking someone who wants out of the EU" etc, remember that the Tory Party are not going to offer EU withdrawal or a referendum as part of their next manifesto and nothing is going to change that, not 10, not 20, not even 50 new anti-EU Tory MP's, so what is the point in voting for them if you passionately support EU withdrawal?If we followed Dale's logic then most Tory voters should switch to voting Labour as they offer much the same policy agenda and are clearly in the best position to deliver it.Tip: The UKIP leaflets for this seat (and others) should clearly highlight that Cameron has banned any MP who supports EU withdrawal from his front bench team, therefore showing that a vote for an EU withdrawal Tory is a wasted vote as they can never deliver their aim</div><br /><div></div><br /><div></div>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com7tag:blogger.com,1999:blog-35436118.post-22360384343238633902006-12-16T16:36:00.000+00:002006-12-16T17:40:29.007+00:00Giving GPs more powers? Pulse December 15thYour story “More power to GPs within PCTs” highlights the history of PECs to date<br /><br />I spent six years on a PEC. On reflection it was largely a waste of time and money – a view shared by several other GPs who were similarly involved.<br /><br />Our PEC became increasingly populated by PAMs (professions allied to medicine) , which in my view weakened it. The argument by the PCT management team being that dentists and optometrists etc were of equal importance and knowledge to GPs in managing local services. The final straw was when I sent around a spoof email suggesting clergymen be on the PEC and got two serious replies from GP colleagues.<br /><br />The reality is that GPs are responsible for spending nearly all the of the PCT budget(by referral and prescription) and are in a unique position to know what is needed locally. Whatever the merits of PAMs they do not know how General Practice works and what drives and motivates referrals and prescribing.<br /><br />Our PCT like many others has disengaged GPs.<br />Engaging them again is going to be a huge task. Most GPs are just not interested in what they view as a pointless charade.<br />There also needs to be a reality check over the payment for PCT workPaul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com2tag:blogger.com,1999:blog-35436118.post-1163874803979038072006-11-18T18:32:00.000+00:002006-11-18T18:38:44.360+00:00Try this airlineIts the best carrrier in the world<br /><a href="http://video.google.co.uk/videoplay?docid=-63711994125288566">http://video.google.co.uk/videoplay?docid=-63711994125288566</a>Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0tag:blogger.com,1999:blog-35436118.post-1163270172367233582006-11-11T18:35:00.000+00:002006-11-18T19:02:45.671+00:00Choose and book- letter to GP magDear Sir<br /><br />Paul Searle is quite right about Choose and Book (letter 27 october). Being a progressive practice we decided to use it. It has caused considerable problems. The system is slow, when it was demonstrated you could get straight through and the whole procedure of the actual booking was done fairly quickly. In vivo , you can sit there like a lemon with the patient waiting for the system to respond. My average booking time was in excess of five minutes. We tried all methods of getting round this including asking our staff to book the patients later and telephone them. This was wasting much time and causing great problems. The final straw was an elderly patient who attended outpatients with a C and B booking but was sent away because the referral letter could not be accessed from the hospital computer. For the time being our practice has decided to reduce our commitment to choose and book which effectively means junking it for the majority.<br /><br />Choose and Book is a not a bad idea but it appears that the IT system is not up to scratch. Personally I did not train as a GP to act as an appointments clerk and even an extra 2 minutes per referral is significant if you extrapolate it to all partners over a working week. Despite this some of my partners (once they have removed their anoraks) like to choose and book patients as they feel patients like it. Of course patients would like a free foot massage, coffee and flowers at the surgery but that does not mean it makes good financial sense.Paul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com3tag:blogger.com,1999:blog-35436118.post-1161897056501209182006-10-26T21:10:00.000+00:002006-11-18T19:29:06.549+00:00Deck Chairs on the Titanic?Will the re-organisation of PCTS make a difference?<br />Our old one was frequently inept and messed things up by amateur negotiation skills, inability to make decisions and poor record keeping.<br />The new one consists of the old one plus another even more debt ridden PCT.<br />The staff of the new one are virtually the same as the previous two organisations. It is difficult to see how things are going to get better (where have I heard that before?)<br />The newly appointed intrim PCT CEO executive said on the telephone to me that a particular consultant "was not one of those money grabbing doctors " she went on to say that she didnt like hostility or threats- I think she might be in the wrong jobPaul Charlsonhttp://www.blogger.com/profile/11048995958209856086noreply@blogger.com0