Friday, April 20, 2007

The One to Watch

Consultant Neurologist Dr Chris Allen speaks exclusively about the reforms to junior doctor training. Dr Allen has been the Dean of Cambridge University medical school, authored books and has published widely, including the Lancet and British Medical Journal. He is a member of the Association of British Neurologists and a Fellow of the Royal College of Physicians. I thank him kindly for his time today to give this interview; it makes compelling viewing:

24 comments:

Anonymous said...

What a guy... what a hero... someone that talks sense!

Anonymous said...

I remember him from med school.Wonderful video.He made some very good points.

Dr

Peter Smallbone said...

Wow. Strong stuff.

Anonymous said...

This is a call to arms for every man woman and child in the country... or if we want to remain proud of our country!!!!

Anonymous said...

Patients need to know that this system it is not good news for them...

QUASAR9 said...

Not sure I understood his point.

Doctors know best?
Doctors know what patients need?

Or doctors should be allowed to decide what patients need, or what they are willing to provide patients - and choose where they want to work?

We want more doctors, and we want the government or NHS to provide junior doctors with jobs for life.

But it is doctors want to privatise the nhs, and introduce charges. Private dental surgeries have not improved dentistry or reduced the costs to the nhs, they've just left thirty per cent of the population with inadequate dentistry - from dentists unwilling or unable to offer a better service to those who cannot pay - and increasing the fees they charge those who need dentistry and can pay.

This is the way health care is going - I challenge anyone to claim it is better in any way.

Suppose tomorrow you lose your job, or there is a disaster and you lose your home, and you are left without a penny in the bank

and to top it all you have an illness or disease or malady - or are in pain - and the doctor tells you if you cannot pay I'll have to turn you away
Because this IS The Only Way!
we can provide better services or treatment for those who can pay!

David Anthony said...

You've obviously got some high ranking contacts. Interesting to hear his thoughts on the matter, does anyone at all in the NHS, at any level, think that the MMC programme is a good thing?

I see today that a leaked document shows the government are drawing up a 'rescue plan'. Even they can't believe that it has been a good idea now.

Have you considered creating a 'citizen journalist' piece for 18DS about this?

Dr. Deb said...

Don't know him....gonna google then come back for the show.

Man in a shed said...

It seems there has been some interesting gamesmanship going on. As the best doctors have kicked up a fuss over the appointment system - which appeared to operate in an almost random manner, but knowing that many thousands of doctors could never get a training post.

So the initial protests missed the real target, but served the interests of the better and stronger doctors.

Am I right in thinking this is a temporary blip caused by changes in the training process ? What will happen next year ?

If there are too many Doctors will the salary offered to them drop ? Surely Doctors should offer a pay cut as a temporary measure to allow for more Doctors to be trained, or employers should be given the freedom to drop salaries to reflect the supply situation. Its what happens to your patients in their everyday lives.

I don't mean to be unsympathetic - but you must share the same reality that the rest of the UK lives in.

The underlying cause is no doubt government miscalculation on training. Its unfair - but as medics you'll know that life is often like that.

James Matthews said...

Quasar9. I read this blog quite a lot and you are very often ranting in an incredibly negative way. Why not try and say something constructive just for once. It's all very well sitting outside the system demanding that it be perfect. But it would be more helpful to come up with the odd suggestion whilst you're at it rather than merely sniping from the sidelines. The articulate nature of your comments suggests that you are not as small-minded as the content might suggest. Go on. Give it a go! You might even find it makes you less angry.

QUASAR9 said...

Man in A Shed said:
"Surely Doctors should offer a pay cut as a temporary measure to allow for more Doctors to be trained, or employers should be given the freedom to drop salaries to reflect the supply situation. Its what happens to your patients in their everyday lives."

Not a pay cut (hard to swallow)
but a pay freeze for five or ten years - and instead of cost increases because of pay rises
Use the said cost increases to pay for more doctors - oh and doctors on the front line looking after patients - not hiding in labs playing with guinea pigs ...

Is it any wonder they then view nhs patients (humans) as little more than guinea pigs to be processed at their convenience and for the doctors benefit (profit).

More doctors doing more of the real time consuming care work that is then left in the hands of unpaid volunteers and relatives.

Surgery or drug prescription is only a very small part of treating any sympton, illness or disease.
Of course, it is the most 'public' visible and costly part.

Have a hip replacement, and you'll be right as rain - you'll be leaping like a lamb in no time.
In your dreams!

Here, take this prescription three times a day, it will regenarate your bone, regeneraste your neural cells, and your teeth or amputated breast or limb will grow again -
In Your Dreams!

Dr Michelle Tempest said...

Thanks to the anonymous writers.
Peter - indeed it's a big issue and it needs sorting out fast...otherwise patients will suffer come August.
Quasar9 - this interview is with an eminent doctor, who has been involved in training 1000's of young doctors. The Government are forcing through changes to doctor traning, and the general public have the right to hear views from professionals who have been training doctors for many years... UK medical training currently has global respect. If the Government was forcing through changes to the way your profession was trained, I would want to hear your views, from the coal face.
Plus, to answer your other question, many many doctors choose to work in the NHS and for the NHS not private healthcare. This is not to say that the NHS could not improve; wasting £20 billion on a failed NHS computer system.
David - as always many thanks for your comments. In a straw poll of doctors in my hospital yesterday 96% thought the MMC process will be bad for patient care - so were not in favour.
Man in the shed - thanks for the comments. I'm not going to discuss doctor wages here, I have little interest in wages... The value of public service providers are a topic in themselves.
As for MMC - it is not a one off "blip" - it is an entire restructure of the way UK doctors are trained. The changes are under review (for a second time), and there are problems at every level, from short term, intermediate term and long term. I do agree with you that life can be and often is unfair, but it would be wrong for this country to be led to believe that all healthcare professionals are happy with the enforced changes and the way it has been implemented.
Quasar9 - I know the TV and newspapers have been full of news about guinea pigs and trials of treatment... does it ever make you wonder why this story has surfaced as a headline now? I remember the story from my own childhood... a long time ago! There is more than one type of doctor, spin, academic, medical etc. I am sure all are busy with their own jobs at the moment.
Thanks to all of you for your comments.
Michelle

mens sana said...

In the end it all comes down to the government believing (probably at least partly rightly) that the royal colleges were controlling doctors' training with doctor' interests at heart rather than the benefit of the health service as a whole.

So they decided to break the power of the Royal Colleges and take over the system. This might have been a good thing if they had taken the trouble to find out how the system worked in the first place.

Unfortunately it has been an unmitigated disaster and I couldn't argue with a single word Chris Allen says

Good post Michelle-worth waiting for

QUASAR9 said...

Hi Michelle,
I appreciate you allowing my comments to get thru unedited. (I'm sure you are aware that underneath it all I agree with anything that is good, and most things you say). Some less savvy young woman would have probably been extremely irritated and 'barred' me by now.

But that is the whole point.
I have no doubts on the eminence of the Dean of Medical School in Cambridge (past or present).

I also have no doubt that he mumbled something coherent about how to train doctors and offering junior doctors places.

But I repeat:
We need More doctors doing more of the real time consuming care work that is then left in the hands of unpaid volunteers and relatives.

Surgery or drug prescription is only a very small part of treating any sympton, illness or disease.
Of course, it is the most 'public' visible and costly part.

And drug research is often wholly detached from the 'human' element.
Clinical Trials can be use to prove just about whatever I choose.

QUASAR9 said...

Until I hear the medical profession talk about patient needs (regardless of costs)
I'll remain sceptical about doctors, medical training and research.

Someone involved in research should not be concerned about costs - but finding whatever solution.
Someone involved in medical should not be concerned about medical costs - but patient needs
Someone involved in surgery should not be concerned about cocts or profit - but saving teeth, saving sight, saving whatever part of the patient (as well as saving life).

Give me a team dedicated to the above - and I'll start showing you miracles in medicine.
Change the attitude of the healers and I'll show you improvements in medical care - costs, incomes, salary and 'profits' should be secondary in the medical profession, vocation or career.

We often expect more commitment and dedication from nurses, carers, volunteers (and charity) than we expect from those at the top on higher paid jobs.

Now I'm sure you are a kind hearted soul, but you are increasingly in a minority trying to speak for an increasingly cold hearted (and calculating) majority.

David Anthony said...

quasar9 said...
Someone involved in research should not be concerned about costs - but finding whatever solution.
Someone involved in medical should not be concerned about medical costs - but patient needs
Someone involved in surgery should not be concerned about cocts or profit - but saving teeth, saving sight, saving whatever part of the patient (as well as saving life).


Someone like that should live in a fantasy world where money grows on trees and disease and hardship do not exist.

Politics is the art of the possible and so is healthcare. Sure, we'd all like to have no waiting lists and instant availablity to all of the latest new drugs ... but life doesn't work like that.

To suggest that healthworkers should not worry about being able to pay their bills and morgages come August is just ridiculous. I'm sure if you were told that your income and career prospects would be ended in a few months through no choice of your own you'd have something to say about it.

Dr Michelle Tempest said...

Quasar9 - I agree that patient care comes first to the medical professional, and agree with you :
"More doctors doing more of the real time consuming care work" and that "drug prescription is only a very small part of treating any sympton, illness or disease."
Mens Sana - thanks for the comment and I'm delighted that you like the great clip.
David - thanks for the comment, and I aso agree that politics is an art - right now they need to get back to the drawing board for MMC.
Thanks to you all and please do encourage everyone you know to watch this clip.
Thanks
Michelle

Anonymous said...

Best comments I've heard about it so far... that clip should be on newsnight.

Sarah said...

This is on the BritMed Awards - very well deserved by both you and Dr Chris Allen. WELL DONE INDEED, GREAT REPORTING.
Sarah

QUASAR9 said...

David Anthony,
a long time ago, I learnt people can misunderstand or deliberately misinterpret what is being said.

No one is talking about - what healthworkers choose to spend their time off or income on.

I am saying if a patient needs an x-ray he needs an x-ray
he does not need someone to budget or price how much an x-ray costs.

If a patient needs a drug, he does not need someone to set a purely artificial and wholly subjective price on what the drug costs.

And if a patient needs a surgery or treatment we have 'developed' he does not need someone to make false excuses about why he cannot have it.

Nowdays we offer hip replacement to just about anyone who needs it and I dare say to some who don't.

Not that long ago someone like you would have probably made some perverse argument why a patient could not have hip replacement.

The reason we don't give decent dentistry to nhs patients, is not because we don't have dentists, nor because dentists are rushed off their feet - but because dentists cannot be bothered doing nhs work - but they still want 2000 patients registered on their books to get £100,000 from the nhs for their 'private practice'

That is why we have people with poor dentistry and bad teeth in Cambridge and the uk.
One third of the population have been consistently and repeatedly been denied the treatment that has been paid for year on year, for ten twenty thirty forty years or more.

QUASAR9 said...

The only reason we do not have an ideal world - is because people like you dismiss ideal worlds ass unrealistic or unachievable.

What is the point of spending £hundreds of millions and moving Papworth to Addenbrookes with the promise of wonderful cardio-thoraxic surgery available to all.

When what we really mean is for All those patients around the world willing to pay for surgery in Cambridge - and if we have time we'll treat a few local patients, crumbs from the table.

Is that your ideal world, or is that the ideal world for some making the real world for other far from the ideal.

How about spending £hundreds of millions from the NHS and MRC to discover miracle cancer cures.

But of course in your ideal world it will only be available to those who can pay or have employers BUPA scheme or other private health insurance - and to those in the real world on lower income, with no employee health insurance and no private health insurance, or in long term unemployment - no can do.

Be careful the 'real' world don't come and bite you in the behind. Imagine if people who cannot get jobs, Yes that's right it may shock you to hear that not all unemployed are happy to be unemployed, but may have historically been prejudiced against for religious or political beliefs - or simply prejudiced against for lack of qualifications or abilities or skills - all of a sudden decide, well if I can't work and get health insurance, there is still one sure way to get money to pay, or to remove those on any queues or waiting lists who think they are before me, or more deserving than I.

We are all striving for an ideal world, except some ignorant people still think you can have an ideal world - which 'excludes' others from enjoying the same benefits.

David Anthony said...

quasar9, may I suggest someone prescribe you a sedative...

QUASAR9 said...

david anthony you are free to suggest whatever you choose, and
whoever 'prescribes' is free to prescribe whatever he/she chooses

I can equally suggest someone prescribe a chemical to alter your mental picture or 'state of mind'

Maybe you should try it!

Dr Michelle Tempest said...

Lets keep the debate constructive guys. Doctors need decent training to care for patients. I thank you for your interest and I hope you will take an interest in the doctors lobby organised for 24th April Tuesday.
Thanks,
Michelle