MTAS Scrapped - Congratulations To Those With Backbone

I've been following the MTAS debacle unfold since the early days. Just seen Patricia Hewitt interviewed on Channel Four news. She is responsible for this mess.

Not only has this episode led directly to incredible distress and discomfort to doctors and patients, but there have been many heroes and villains of the piece.

Well done Dr Crippen, Michelle Tempest, The Stirrer and David Cameron for holding the government to account. Who else deserves a mention?

NHS Rant

Dr Rant gathers the views of a team of doctors at his site. He and his team have prepared a manifesto-style post on what should be done with the NHS. As someone who is interested in how taxpayer's money is spent, I was particularly interested in the things that Dr Rant says the NHS should stop. I don't know whether the list is in any order, but it's worth reviewing.

-Patsy Hewitt
-Tony Blair
-Gordon Brown
-Andy Burnham
-Liam Bryne
-Lord Hunt
-Sir Liam Donaldson
-Spin doctors being preferred to medical doctors.
-Wasting money on PFI
-Wasting money on management consultants
-Wasting money on managers
-Wasting money on redisorganisations
-Wasting money on computer projects
-Wasting money on useless wheezes such as walk in centres, "">independent sector treatment centres
-Wasting money on stillborn administrative idiocies
such as practice based commissioning and payment by results (which are arcane concepts, even to their authors.)
-Wasting money on useless ideas such as “choice” and “choose and book”
-Wasting money on NHS direct
-Wasting money pandering to the “worried well” rather than those who are sick
-Wasting money on clinical governance
-Wasting money on arm’s length QUANGOS such as NICE and NPSA and the modernisation agency
-Wasting money on unused and unwanted “guidelines”
-Wasting money paying out negligence claims
-Wasting money and peoples’ lives in useless schemes such as MMC and MTAS
-Wasting money training midwives and physiotherapists for no jobs at the end of their courses
-Wasting money on non jobs such as “five a day eating co-ordinators”
-Wasting time on meetings that reduce hours to minutes, and their participants to tears.
-Listening to people who pretend to know something about healthcare but actually don't
-specifically Alan Maynard, Julian Le Grande, Paul Corrigan, Simon Stevens, Alan Milburn, Lord Warner, and the false expertise of spinmeister management consultants.
-Pretending that it can deliver all healthcare to all people
-Pretending that patients can have whatever they want
-Pretending that the NHS is in any way "patient centred" or "patient focused" (It isn’t, never will be, and never should be for reasons I’ll demonstrate in a future rant)
-Dealing with well people.

The rest of the post is also worth a read. When you look at the problems in the NHS/Rant's manifesto it's hard to know where to start.

Health Of The Nation

I've set up a health section in my links bar. A regular commenter here, Mens Sana is a consultant in the NHS. He/she has just started blogging and Mens Sana's commenting style translates to his or her blog we can expect posts that are honest, direct and opinionated. The first post is about doctor's pay - a nice starter for ten.

The wildly successful NHS blog doc - Dr Crippen does some great posts (I especially like his anecdotes) but is also performing a unique role in rounding up the best of the medical blogs.

I've recently become aware of Dr Grumble, another NHS doctor who is a favourite curmudgeon of mine. I particularly like the way that he campaigned strongly against MMC/MTAS and the rapier wit in a recent post about being right all along.

I hope that she won't be offended if I say that Dr Michelle Tempest is an old favourite of mine. In fact, I believe that more than one of her posts have affected me in a positive way. I'm sure I can't say that about many bloggers.

My knowledge of the health sector is fragmented. I'm trying to learn more about the NHS. Does anyone have any other suggested links?

Cameron On the NHS

I am drugged up on Benylin - it says on the pack "May cause drowsiness. Do not drive or operate machinery" - so I'm taking it that excessive blogging is also a bad idea. However, what I will say about the NHS is that the government has spent so much of our money and completely failed to deliver in every dimension.

Just Being In Hospital Is Far More Dangerous Than Driving

Deaths in NHS hospitals due to viruses contracted in those hospitals are at least as preventable as car deaths and are rising steeply as a cause of death. Based on the analysis below, just being in hospital is many times more dangerous than driving.

Preventable Deaths On The Road

A - Average UK car mileage (2005) 15,872km/annum
B - Vehicles On Uk Roads 25,000,000
C - Vehicle Kilometres Per Annum (A*B) 396,800,000,000km/annum
D - Road Fatalities (2005) 3,201
E - Vehicle Kilometres Per Fatality (C/D) 123,961,262km
F - Average speed on UK roads 50km/hour
G - Hours Driving Per Road Death (E/F) 2,479,225

Source for A. Source for D. B and F are ball park estimates.

Preventable Deaths In Hospital

A - Clostridium difficile on Death Certificates 3,807
B - MRSA On Death Certificate 2,080
C - Low Estimate Of Preventable Deaths In Hospital (A+B) 5,887
D - On NHS Wards (90% of C) 5,298
E - NHS Beds In Use (180,000 at 90% capacity) (2005) 162,000
F - Hours Spent In NHS Beds Per Annum (E*24*365) 1,419,120,000
G - Hours In Hospital Beds Per Death (F/D) 241,060

Source for A, B and D. Source for E.

Conclusion

At least 10 times as many preventable deaths are occurring in hospitals compared to the nation's roads. Resources should be reallocated with this in mind. For example, in 2006/07, Transport For London's budget for road safety is £42m, up from £18m in 2000. I don't believe this is an efficient allocation of public funds.

Hewitt Attacks Self

It's well documented that most of the extra NHS cash doesn't lead to an improved NHS. Wat Tyler has analysed the latest figures at the blog "Burning Our Money" and reveals that no less than 87% of the extra NHS cash is being spent on cost increases. This is what happens when you simply tip money into the top of an organisation. In part it explains why, after a Labour spending splurge (that's our money by the way), nurses are facing redundancy, graduate doctors can't find a job and 80 or so hospitals are closing.

A prime example of incompetent spending is GP contracts. These were introduced in 2004 and GP pay rose 30% (!) to an average of £106,000 in the first year of implementation. But, surely we're getting more in return say the optimists. A spokesman from a Health Watchdog reports that after the introduction of the new contracts GPs no longer do evenings, no night work, weekend work - this has all got to be paid for somewhere else. Magic.

Friends of mine who are experienced GPs live in a house that is worth half a million - I don't believe a mortgage was required. They're still working. Many others are enjoying their early retirement on the backs of their bonanzas.

In an admission of incompetence coupled with an extraordinary attack on the GPs themselves, Health Minister, Patricia Hewitt regrets the deal that the government struck. What a shower. Next she'll be taking part in demonstrations against herself a la Junior Health Minister Ivan Lewis.