Blogging Break

It is time for a blogging break, which allows more time to read other blogs, which I am enjoying.
Many thanks for the kind e mails and comments.

Cuddle Power

Today the BBC reported how Japanese women are buying the ultimate sleeping partner. As the picture illustrates it's a pillow with a 'built in comfort' to cuddle up to. It's shaped like a man's torso but is guaranteed not to snore or disturb them in the middle of the night.

Apparently, they have been selling in droves and Japanese women say they are good for well-being! For more information see here.

Can he Deliver?

So what omen does the new Secretary of State for Health bring with him? It seems ironic that the former postman takes over the helm of the health service exactly the same day as threatened postal strikes. However, putting that aside it’s a big chance for the health of our nation, if he can get it right.

There is no doubt the job is a great privilege and challenge. There will be much for him to learn and understand, but if he asked for three points on the first day of his new post, I would say:

First, 'put patients first'. It’s imperative for patients to be thought of in front of bureaucrats and quangocrats.
Second, the NHS should be there for patients and not be used as a political football.
Third, as there are calls for the NHS to be depoliticised; accountability should remain.

Although nobody will want to remember Patricia Hewitt, her legacy was of frequent political, ill-thought through legislation, whilst she refused to be accountable for her results. That must change.

Alan Johnson, my three words to you are ‘Patients, Patients, Patients.’

Good luck!

And Finally...

Patricia Hewitt has finally ceased to be Health Minister.

Cameron on the NHS

As we await the new leadership of the labour party, below is a clip from webcameron, explaining how the Department of Health will go public.

Working Women

Today Doctors.Net reported that according to a new study nearly two thirds of medical graduates are now women and most want flexible working arrangements. In fact 58% of doctors who graduated last year were women and a fifth of these expect to need part-time work during their careers. The study recruited some 435 graduates last year to take part in a ten year study of their career development and found that many were already showing signs of demoralisation.

These figures clearly show that work force planning will be necessary for the NHS. With current unemployment problems of the 'Modernising Medical Careers', it may be worth considering the impact of part time posts, perhaps there will need to be more doctors, not less.

Laurel and Hardy Politics

As the NHS awaits a new Prime Minister and the removal of Patricia Hewitt, hospitals have been left with yet 'another fine mess' to sort out. Nobody could have missed the Modernising Medical Careers debacle. It has been left to hospitals to save the day, as they scramble to fill medical jobs in time to ensure patient safety. This is no small under taking, as doctors have all been forced to change jobs on the same day (1st August) in a way which has never happened before... and will never happen again.

So, what does the future hold under new Gordon Brown leadership? There are mumblings that he will increase NHS spending. Hence, exactly the same idea he's had for the past ten years, which hardly inspires the feeling of a fresh start. Knowing the government's capacity for money to be wasted long before it reaches patients, leaves me with the concern that there will be more Laurel and Hardy NHS policies. There is no prize for guessing which one in the picture represents Brown.... but the person he 'points' to be new Secretary of State for Health will have a very important job on his/her hands.

What's in a Video Game?

Today a video game has been banned from British shops on the ground that it encourages extreme violence and "casual sadism". The video game is believed to have images of the toddler James Bulger, including the unforgetable CCTV image of him being abducted.

Violent acts are commonly believed to increase after exposure to watched or television violence. There may be a reduction in the emotional response to violence, as brains become ‘desensitised’ to viewing on-screen violence. This leaves a potential problem for both viewers and film-makers. Film-makers need to escalate behaviour in order to get the same level of emotional response, whilst the viewer develops desensitisation to viewed violence. A study in 1974 by Drabman and Thomas found that eight year olds were less likely to tell an adult about a fight in the playroom after viewing a violent programme than if they had not seen it. The ongoing debate about the relationship between media violence and aggression is far from resolved. In Britain the link between the two was last in the spotlight following the murder of two year old James Bulger by two teenage boys in 1993. At their trial, Mr Justice Moreland said “It is not for me to pass judgement on their upbringing, but I suspect that exposure to violent video films may, in part, be an explanation.” Let's hope we've learnt from history.

Cameron Keynote Speech

Today I was in Tooting listening to David Cameron give his keynote speech. He described how the re-building of the Conservative Party was well underway. David Cameron used the well-known house analogy, explaining how the centre ground had been prepared, foundations completed and it was now time for the exciting part - watching the house take form, laid brick by brick.

It was a great speech and addressed a wide range of topics with the central theme of social responsibility. It was good to hear a father of three (the day after father's day) talk about the family as the cornerstone of society, suggesting that "It is simply no use talking about opportunity for all unless we give every child in our country the secure start in life that comes from a stable, loving home.”

And it wasn’t just David Cameron who spoke today, there was Philippa Stroud explaining the background to the ‘social justice policy group’, Grant Schapps with his enthusiasm for local communities along with Francis Maude, Mark Clarke and Michael Gove. Overall, David Cameron's speech was a breath of fresh air for the political arena; it was clear he is not going to be building a paper house to be blown in any direction, but a brick house built for the future. The full pdf of his speech can be read here.

Father's Day

Six year old Connie singing on 'Britain's Got Talent' could not fail to bring a smile to the face and warmth to the heart, as she sang in the final and dedicated her song to her dad on father's day. Below is a clip of the six year old and her two supportive parents:

Who is the Better Spin Doctor - a Princess or a Prime Minister?

As Tony Blair’s long goodbye comes to an end, he offered a final damming report about twenty-four hour media coverage, claiming “the media is a feral beast, tearing people to pieces.” His parting shot asserted that the media make no distinction between fact, comment and news. Instead being more concerned with sensationalising stories and boosting their diminishing ratings.

Yet, it was Tony Blair who built his leadership upon the culture of spin that became the hallmark of New Labour. Even before he became leader in 1994, Tony Blair was courting the media stating, “it is better to ride the tiger’s back than to let it rip your throat out.”

It was under his watch that the ‘Labour media machine’ was well oiled, offered pre-emptive strikes, round the clock monitoring and ruthless spin doctoring. Journalists were handled with a combination of flattery and bullying, given stories if they played ball and frozen out if they did not. Perhaps in recent years the spin became bigger than the man himself, with the unforgettable collision between government and media, over the ‘two war dossiers’ and then the ‘Hutton inquiry’ into Dr Kelly’s death.

His departing speech sounded somewhat reminiscent of Earl Spencer's moving funeral address at Westminster Abbey about the media's 'sneering' reporting of Princess Diana. There is little doubt she would have agreed with the majority of her brothers’ remarks, particularly his line about her being 'the most hunted person of the modern age'. However, the Princess was far from being 'baffled' by the media. On the contrary, all the evidence suggests that she understood them only too well, and worked diligently to bring them 'on side’, as much the wooer as the wooed.

Following the canonization of her memory, it now seems shocking to recall the Princess as she really was. But while she was alive her skill and adeptness at manipulating the media was widely recognised, as was the fact that during the latter years of her 'loveless' marriage to Prince Charles the tabloids had been one of her greatest weapons. Who can forget the poignancy for instance, of that lone shot of her in front of the Taj Mahal and the endless comment it sparked about the Princess's isolation and her 'unrequited love'? She herself set up that famous photograph, and as one tabloid editor put it: 'She was a great politician, a great spin doctor.'

Who knows if Tony Blair will want his very own ‘Taj Mahal’ photo shoot as he leaves Downing Street. But for now, his answer to the media has been in true New Labour style, perhaps the only answer he knows, regulation. He suggested that all media mediums should come under the umbrella of a new ‘European regulatory body’, to be fully accountable to more than just viewing figures and reading ratings. Perhaps this is the most fitting end to his reign. He has ended, ten years on, the same way as he started, wanting and trying to control the headlines.

An interesting Tale

I was told an interesting tale today, which is as follows:

'A small Hungarian detachment was on military manoeuvres in the Alps. The lieutenant sent a reconnaissance unit out into the icy wilderness just as it began to snow. It snowed for two days and the unit did not return. The lieutenant feared that he had dispatched his people to their deaths, but the third day they returned. The lieutenant asked them how they had made their way back? Yes, they said, we considered ourselves lost and gave up, waiting for the end. Then one of us found a map in his pocket. That gave us hope, we pitched camp, waited for the storm to pass and then took our bearings, and here we are. The lieutenant looked at the map and found to his astonishment, that is was a map of the Pyrenees, not of the Alps at all.' (Albert Szent-Gyorgi)

So, if you're completely lost, any map is better than none at all. It can provide a reference point, a place to start from, the hope that things can change, all of which may become secondary once an activity gets underway.

The Gordon Brown Result

After many amusing comments it seems that out of the 5 types of men classified over the past few days, Gordon Brown has been selected to be most like 'The Man in Charge'. This means that on first impressions, he is admired as one can rely upon his help. However, things to watch out for would be:

He feels mistrustful towards people not under his control.

He may get be concerned if private e mails or conversations are held without his knowledge.

He may believe that without his help one cannot succeed in life.

He questions decisions made by others, and offers his own advice.

He gets annoyed if you don’t follow his advice.
He is proud of his own refusal to give in/ inflexibility.

The one thing which is certainly true about this selection is that he very much will be 'the man in charge' as he takes over as Prime Minister.

Could This be Gordon Brown (5)?

5) The Little Boy
First impressions: He is fun and exciting.
Warning signs: He is not emotionally mature, so he may find it difficult to handle commitment or responsibility.
He takes, whilst others give.
He invests little in personal relationships, he thinks they will run themselves without compromise.
He does not financially plan for the future or for ‘rainy days’ as believes others will be there to help him.
He passively gets by, and has a history of being taken care of by others.

So now the big vote, does Gordon Brown fit into any of these 5 stereotypes? Please comment on whether he is:
1) The Man in Charge
2) The Scriptwriter
3) The Man Without Fault
4) The Invisible Man

5) The Little Boy?

I eagerly await the poll result!

Could This be Gordon Brown (4)?

4) The Invisible Man
First impressions: A quiet shy man who is steady.
Warning signs: He is emotionally restricted and may trust hobbies more than people.
He goes to great lengths to avoid conflict or anger.
He may lack responsiveness and isn’t really “there”.
He rarely initiates or contributes and may suffer with low moods.

After a while, conversations don’t lead to anything new.

Could This be Gordon Brown (3)?

3) The Man Without Fault
First impressions: He feels his life is more valuable than anyone else’s
Warning signs: He is unable to self-reflect or take responsibility for his actions and/or feelings.
Relationships revolve around him.
He overvalues his own achievements and dismisses any negative impact that his behaviour may have on others.
He is prone to moralising.
If his feelings are hurt he will attack back with cruelty.
Concerns of others may be trivialised.

He always believes his own future is bright.

Could This be Gordon Brown (2)?

2) The Scriptwriter
First impressions: Opens his heart on the first meeting
Warning signs: Embraces the belief ‘I know you better than you know yourself’
He is convinced that others are never there for him in times of need.
He projects his ideas on to other people, who may the feel coerced into expressing feelings or thoughts which are not their own.

He believes he knows your true motivation

More to follow tomorrow.

What Kind of Man is Gordon Brown?

Whilst the United Kingdom await their new Prime Minister, many people are pondering about what type of man Gordon Brown is, and what makes him tick. With this in mind, over the next five days I’ll summarise the types of men psychotherapist Bethany Marshall has identified in her new self-help book entitled Deal Breakers. She believes that there are broadly five different types of men. By the end of the week people will be able to vote on whether Gordon Brown could fit any of these stereotypes.
Lets start today with:

1) The Man in Charge
First impressions: He is admired as one can rely upon his help
Warning signs: He feels mistrustful towards people not under his control.
He may get be concerned if private e mails or conversations are held without his knowledge.
He believes that without his help one cannot succeed in life.
He questions decisions made by others, and offers his own advice.
He gets annoyed if you don’t follow his advice.
One or both of his parents may have dominated him as a child.

He is proud of his own refusal to give in/ inflexibility.

Over the next few days the other choices will be:

2) The Scriptwriter

3) The Man Without Fault

4) The Invisible Man

5) The Little Boy

I shall await the readers verdict with interest!

The Ghost of Health

My blog post today is over at ‘The Ghost cabinet’, please do take a look.

So What Does Your Perfect Day Reveal?

'The perfect day exercise' (see yesterday's blog) is the ideal way of getting the conscious mind and unconscious mind to work together, often bringing your underlying unconscious motivation to the surface. It is what you would really like to do in life and what gives you real pleasure, not what society has enforced upon you. Perhaps contrary to evolutionary psychology, sex does not usually play a big role in the perfect day exercise, although if your ideal day involved waking up with James Bond or kissing Kylie Minogue, there’s no wrong day, and no two people’s perfect days will ever be the same. They are as unique as fingerprints.

Happiness will probably not be achieved by replication of this exact day, but it offers the opportunity to help consider a direction of travel, helping to align your conscious and unconscious motivations. In fact, it’s a bit like the so-called ‘Rorschah’ or ‘ink blot’ test, which asks you to make pictures out of ink blots, to see what the unconscious mind sees. The different images people see, come from everyone’s unique brain wiring, not the ink blot shapes themselves.

With the perfect day exercise it’s perhaps interesting to note that top achievers frequently do not have goal conflicts. For example, when Olympic gold medal winners are asked for their perfect day, it is often found that they will have dreamt about getting an Olympic gold on their perfect day. This shows the immense power and importance of the conscious and unconscious working in harmony. Most people find this exercise very helpful and I certainly hope you all enjoyed doing it.

Perfect Day

With morale within hospitals hitting rock bottom, and Patricia Hewitt remaining in post, all be it, for now.... I thought I'd write about the future and 'The Perfect Day Exercise' to lighten the tone.

Lou Reed (1972) wrote a song about his perfect day “Just a perfect day, Drink Sangria in the park, And then later when it gets dark we go home, Just a perfect day, Feed animals in the zoo, then later, a movie too, And then home”. If you don’t have a clear idea about your goals, then life can become a bit aimless. The ‘perfect day’ exercise asks you to consider what is your perfect day?

So, sit down and let your imaginative and creative juices overflow. In your perfect day you have a metaphorical blank cheque, so you could be anything and go anywhere in the entire world. The key is that it is your perfect day, nobody else’s and there are absolutely no wrong answers. Everyone will have a different perfect day, but you are not just thinking of a good day, but your perfect day, completely and utterly the best day ever. You should try and think about this day in as much detail as possible. The questions below may help you crystallise your perfect day:
What time would you get up in the morning?
Do you wake up alone?
What do you have for breakfast?
Would you have breakfast at Tiffany’s?
Where would you be?
What do you do after breakfast?
How long is breakfast for?

Then go through the day in as much detail as you possibly can. Some people may say that they are flying on Concord to pick up an award, others relaxing with their families whilst others might be catching their perfect wave. It is unique to you and can be as outrageous as you like. It is nobody else’s day. It’s important that before you read tomorrow's blog, you have a very detailed plan of your perfect day.

Flying Solo

The key players in the MMC debacle are falling like a house of cards. The resignation of James Johnson (BMA chairman) being the latest, and the call for Patricia Hewitt to resign has become even louder.

The result of the junior doctors v DoH Judicial Review is eagerly awaited, for justice and faith to be restored within the medical profession. Tonight, newsnight will debate 'morale in the NHS'. It has been reported that morale has never been lower amongst NHS staff, and for those working in the profession, that comes as no surprise. I have previously written an article about the medical professionals suffering from learned helplessness, because automony has been lost, and the professional voice silenced. For this to be reversed, the training of our doctors is key. After all, the government wouldn't enforce airline pilots to radically reduce flying hours before taking charge of solo flights; if they did, can you imagine the safety implications outcry? So, why has Patricia Hewitt been allowed to radically change doctor training without consultation?

Will the government listen?

As the Judicial Review continues in the High Court today regarding the enforced governmental changes to doctor training. A staggering 80% of consultants believe the implementation of the government's Modernising Medical Careers (MMC) programme should be delayed, according to findings published in the leading medical journal, The Lancet. Modernising Medical Careers (MMC) is the government’s new run-through training programme that aims to produce senior doctors in a streamlined manner. The programme has provoked major concerns over its potentially detrimental effects on both patient safety and medical training.

The Lancet's results were based on a survey of 3255 consultants and junior doctors on their attitudes to the proposed changes in medical training, due to be introduced in August this year. The results demonstrate clearly that doctors believe that MMC in its current form jeopardises patient safety, diminishes the quality and scope of training, and damages Britain's potential for innovative and life-saving research.

The government has failed to address adequately the genuine concerns raised by the medical profession. Solutions provided by the initial review body, promising a single interview for each applicant, were deemed unsatisfactory by 75% of those surveyed. Findings of the second review will not be available until September.

The Medical Training Application System (MTAS), the online job application system for doctors, has been deemed unsatisfactory for further use by Patricia Hewitt (15/05/07). Hiding behind the inevitable collapse of this failed system, only highlights the fact that the DoH continues to fail to address the complex issues that fuel the shambolic reforms. Doctors are not opposed to change but Modernising Medical Careers in its current form is ill thought out and fuelled with potential problems.

With less than 11 weeks to go until doctors’ current contracts end, there is palpable tension within the NHS. With thousands of interviews still pending, 85% of doctors surveyed are calling for consultants to withdraw from the interview process completely. Changes to medical training will affect up to 32,000 doctors, yet only 10% of these think it will result in improved training. “That a crisis in medical recruitment and education has occurred is beyond doubt”, said Dr Jane Graham, a junior doctor from Addenbrooke’s hospital. “As the 1st August fast approaches, the question remains, how many patients must be put at risk before the Government listens to the professions’ warnings?”

Can the government prevent the impending disaster? I hope so; the message is loud and clear.

Who Are You Gonna Call?... The Ghost Cabinet

One dark night, some leading anti-government bloggers decided that it would be a good idea to form a crack unit to provide firm government opposition. They decided to form a Ghost Cabinet. This team is to be organised like a Cabinet. The initial appointments are all popular bloggers with a strong interest or expertise in the given policy area. Freed from usual constraints such as collective responsibility or needing to win an election or grab a headline, these ghosts eschew normal political conventions by presenting ideas that will actually improve the country.

Each ghost vows to haunt the relevant government minister on a regular basis. Further, ghosts offer alternative policies in monthly "blue moon thinking" slots and may also host a guest ghosts. The 'Ghost of Health' has been so named in memory of all the initiatives that have failed to improve patient care. The blog is being launched tomorrow at http://ghostcabinet.blogspot.com/. Watch this space!

Patricia Hewitt Answers Questions on the Channel 4 News

This is a clip from the Channel 4 news yesterday, showing Patricia Hewitt in action:

MTAS is over

Today the MTAS system was finally laid to rest. However, it will not rest in peace. It will be remembered as the system that wasted £6.3 million of NHS money, leaked confidential and highly personal information across the internet and had a never-ending list of problems. Patricia Hewitt said live on channel 4 news tonight that “criminal offences may have been committed” following the MTAS computer access and has handed over material to the police. For more on this story read the report from Dr Crippen. I am sure the police will be grateful that the MTAS system has been laid to rest, following reports in the Times newspaper about doctors' information being misused to potentially breach hospital security.

Channel 4's Jon Snow stated that “it’s hard to overstate the gravity of this disaster” and suggested to Patricia Hewitt that she would “have to resign.” She said that she would “take complete responsibility” for the computer shambles but felt that she still had widespread support. She went onto try and explain MTAS, MMC and the interview process; but she left the logic out of the explanation. Even Jon Snow said “we’re all getting a little confused.”

Professor Humphrey Hodgson went onto point out that patient care is being affected by MMC with a lot of non-emergency work being cancelled to sort out the mess that MMC has created. His final polite words on Channel 4 were about the poll of over 3500 doctors, which had showed that confidence in Patricia Hewitt was “low”. MTAS may be the first to fall, but it will not be the last.

Breaking news

The well overdue news that the MTAS system has been scrapped is welcomed. For the BBC report read here. This is the first important step – but a lot still remains to be done.

Missing Madeleine McCann

One family, one little girl, one possible suspect - a man, wearing light trousers, a blue top, with a partly shaven head was spotted a few hours before Madeleine disappeared. The search must go on:

Patricia Hewitt in the Dock

In a statement released by Remedy UK, a group representing junior doctors, describe how next week is an "historic week" for the medical profession. After doctors have marched together en masse, debated, discussed and lobbied as one, the finale" is that "doctors from all over the land will unite to take the Department of Health and the Secretary of State for Health to Court." This will be the first big test for Gordon Brown, after his pledge the make the NHS central to his campaign. It will also show whether he is going to side with real doctors or be advised by spin doctors.

Remedy UK are standing up for "everyone who has felt that the unfairness and... has been the product of a downtrodden emasculated profession." So, don't miss the drama on Wednesday and Thursday in the High Courts of Justice on the Strand. The time has come to finally to draw a line in the sand that it is not acceptable to behave or treat people in this way. If Gordon Brown wants "to listen" as he so pledged in his leadership campaign, he should know where to start. His spin doctors may try and advise him that this group are not representative of the profession. However, real doctors have already done their research and published it. The leading medical journal, the Lancet, has published findings from a recent survey of 3255 consultants and junior doctors calling for a halt to proposed changes in medical training due to be introduced in August this year. A staggering 80% of those surveyed have "major concerns that MMC will have detrimental effects on both medical training and patient safety." The evidence whether academic, legal or professional is the same... listening will be the key.

It's the Final Countdown

As the news of the day has been the historic announcement that the legacy is over, I'll leave a picture to paint a thousand words:

Is it all Womens' Fault?

Famous astronomer Sir Patrick Moore who holds the Guinness Book of Records title for the longest-serving TV presenter, having appeared on his show about astronomy since 1957, has claimed that British TV standards are deteriorating because the BBC is "run by women". He has called for separate channels to cater for the needs of the different sexes. He went on "I would like to see two independent wavelengths - one controlled by women, and one for us, controlled by men." Claiming "The trouble is the BBC now is run by women and it shows soap operas, cooking, quizzes, kitchen-sink plays. You wouldn't have had that in the golden days."

I am not sure that you can blame women for his claim about 'banal' television; he could have claimed that the medical profession is suffering under the reign of female Patricia Hewitt - but I can assure him not all women would do such a thing!

The Medical Heroes Unite

An open letter has been sent to Consultants, on behalf of: Prof Morris Brown (Cambridge), Dr Mei Nortley (London), Dr Helen Wise (Wessex), Dr Sarah Spencer (Bridgend, Wales), Dr Chris Allen (Cambridge), Dr Gordon Caldwell (Worthing), and many other concerned consultant and junior doctor colleagues in the UK. Parts of it are reproduced here:

"Many of you find yourselves in the position, at once enviable and difficult, of having more say now over the fate of the Juniors than the DoH mandarins and quangos who have ridden roughshod over just process and individual rights. This opportunity arises because MTAS cannot proceed without the collaboration of Consultants in the round 1b interviews. Some of you will be well aware of the flaws and injustices of MTAS, and just need to know your views are shared by the majority of colleagues. We have conducted an online poll at http://www.cai.cam.ac.uk/people/mjb14/ which shows that 81% of 813 Consultants and 85% of 2422 Juniors want a Consultant boycott...

The week-long shut-down of the MTAS computer due to leaks of confidential information has added to both the agony of applicants awaiting news of interviews and to the incredulity that this untried system will deliver matching of applicants and posts – with sensitivity to the needs of partners and families – by 1 st August. Channel4 News has reported that "Hundreds of junior doctors in Scotland have had details of interviews lost in the latest IT chaos to hit the NHS". Their full report can be viewed at here.We believe that the spiralling debacle of MTAS and our poll results will embolden Consultants to follow those in Trusts and specialties who have already declared themselves against further participation in MTAS interviews. The sooner this happens, the sooner Deaneries can activate their contingency plans for a temporary solution, and a revised date for the August changeover can be set, thus preventing any further harm to our service to patients...

We believe the recent intransigence over revisions to MTAS make it essential to halt any MMC appointments before a thorough Review is complete. Otherwise we will be told it is too late or illegal to make major changes."

I would like to thank all those consultants taking an interest and leading the way in making medical history. Their actions are both appreciated and needed and I hope they are heeded.

We all know that Patricia Hewitt's days are numbered leaving someone to fill her shoes, all be it messy shoes. As everyone seems to be predicting who will take over from Patricia Hewitt, anyone interested in my bet - it would be Ed Balls!

Thought of the Week

As everyone has enjoyed the hottest April for 300 years, reader (Deborah King) wrote to me asking to blog a piece about the environment, and so thought of the week is - "We can all make a difference".

Sometimes the problem when considering the environment is that the issues are so big they can be perceived as overwhelming, and this can lead people to conclude that they are unable to have any effect. However, as Edmund Burke poignantly said, "No one could make a greater mistake than he who did nothing because he could do only a little." We can all make a difference not only through the effect of our own actions on the environment around us but also by the intangible effect of our own actions potentially inspiring others. Perhaps the best known example of whether humans can make a difference to the environment is the way the destruction of the ozone layer by CFCs was turned around in the 1980s and 1990s following the original discovery of the hole in the ozone layer by a British Antarctic expedition in the 1970s.

It can seem that we are constantly bombarded with ideas about how to help the environment and often it’s hard to boil them down into some simple practical steps. But here are a few suggestions which are commonly made:
1. Drive less and keep your tyres inflated for better fuel efficiency.
2. Re-cycle where you can.
3. Use less electricity by adjusting the thermostat, changing to energy-saving light bulbs and considering low-flow showerheads and washing clothes in warm as opposed to hot water.
4. Save electricity by turning off electrical devices such as your TV, DVD player, stereo and computer when you’re not using them.
5. Avoid products with a lot of packaging.
6. Consider moving to a green electricity provider such as one which uses wind power as opposed to fossil fuels in its processes.
7. Consider off-setting either some of all of your emissions through, for example, joining a scheme which plants trees in proportion to your carbon footprint.

Many Thanks to all who Voted.

I’d like to say many thanks to all the people who voted for me yesterday in the local election, with a resulting 8% swing to the Conservatives. My congratulations go to the winner (Lib Dem, Mike Pitt).
Today I’m taking a break, after a long night at the count, but Ellee Seymour’s blog is worth a special mention today as she tackles the question ‘are you a psychopath?’

Voting Day!

Today is local election day and I’m off to vote… but by clicking here you can see and hear who I voted for in the last general election... I should give a prize to the first person who spots me!

A New Medical Illness

An e mail was sent to me today, it made me smile, so I thought I'd share it with you:

"Medical Training Anxiety and Stress disorder (MTAS)

A new psychiatric disorder is sweeping across the nation at an alarming rate. Officials have not yet been able to control the epidemic of a new condition that has been named Medical Training Anxiety and Stress (MTAS) disorder. The disorder, which appears to be affecting primarily junior doctors, is characterised by a previously unseen cluster of symptoms including thought disorder, hallucinations, escalating paranoia and obsessive behaviours.

Epidemiology and Aetiology

It is estimated that there have been as many as 34,000 new cases of MTAS disorder since January 2007, though this may be grossly underestimated. The lifetime risk for developing the disorder is thought to be as high as 100% in the at-risk groups. MTAS disorder appears to affects junior doctors at any stage in their careers and the severity does not appear to be affected by gender, race or duration of medical working life.

Clinical features MTAS disorder is characterised by a number of psychological and physical symptoms. Remarkably this disorder seems to be characterised by one common delusion; those affected are convinced that they are in regular communication with government officials via Internet websites and that their lives and career aspirations are being monitored. Thought insertion is a common symptom. Individuals describe government dictation of life plans, most specifically career choices. Many also report thought withdrawal, describing that previous career aspirations have been removed from their heads. Thought broadcasting is another common theme. Many individuals report that their thoughts and work-related experiences have been documented and broadcast via the Internet. Those affected have developed obsessive behaviours, repeatedly describing difficult cases they have been involved in, when their patients have made them feel upset or angry. Other obsessive behaviours have been observed; those affected are rendered incapable of being in the vicinity of a computer without trying repeatedly to access government websites describing grandiose ideas that they may be called to attend interviews across the lengths and breadths of the country at a moments notice. Physical symptoms include disturbed sleep pattern, palpitations, tachycardia and those with severe obsessive behaviours have developed repetitive strain injury from overuse of computers.

Management

Early indications are that psychosocial therapies are ineffective in the management of MTAS disorder. Trials into medical therapies are continuing but so far anti-psychotic medications have done nothing to reduce paranoia, delusions or persecutions. The spectrum of symptoms is worsening despite frantic research and trials of therapy.

Prognosis

Though little known is known about MTAS Disorder it is thought to have a poor prognosis. The long-term effects are not known but there are indications of likely long-term psychological damage with significant destruction of morale, self-esteem and ambition. Experts have been called in but so far their efforts have been negligible. There are serious concerns regarding what is to become of the medical profession. The world will watch with scrutiny over the next few months as the disaster unfolds."

Are you Sure you want to Follow the Yellow Brick Road?

Patricia Hewitt told the House of Commons today that the security breaches in the doctor job application system, which leaked highly sensitive data such as sexual orientation and criminal records, were "utterly deplorable". Andrew Lansley said that the medical profession had lost confidence in her and junior doctors wanted her to resign. He continued "She is not going to go but the next prime minister ought to move her. I hope he does." For the BBC story read here.

Patricia Hewitt perhaps wants to be remembered as ‘the iron lady’, refusing to back down on the shambolic process of modernising medical careers. However, it may be more fitting to remember her as ‘the tin man’. Only a woman without a heart could continue with such a system that will endanger patients under her ‘modernising’ regime from 1st August. Tony Blair and Gordon Brown be warned - following that yellow brick road has no happy ending.

Why Lawyers?

Today the Times newspaper reported that lawyers are being encouraged to take 'time out' in The Priory, usually well known for their high profile clients. A book entitled 'Why Lawyers Should Surf' co-authored by myself and barrister Tim Kevan is a self-help book aimed especially at lawyers, after several studies have cited that lawyers suffer from an above average rate of low mood. An extract from the book is given below:

"In the early 1990s a John Hopkins University study compared the rates of depression among one hundred and four occupations and found that lawyers were nearly four times above the average rate of depression. This then begs the question ‘why do lawyers have such a high level of depression’? There are several hypotheses for this, well beyond the explanation that law is a stressful and busy job.

Professor Martin Seligman argues that the key thing about lawyers is that they tend to have pessimistic personality types. When lawyers are asked the famous question: ‘Is the cup half empty or half full?’ most respond by saying 'half empty'. This somewhat pessimistic response may be a distinguishing advantage within the legal profession, because viewing troubles as pervasive and continuing, is at the very heart of being a prudent lawyer. The inherent and honed ‘scepticism skills’, enable the lawyer to see every conceivable hiccup or catastrophe that might occur in legal transactions. Therefore, the ability to anticipate any pending or possible snare or disaster gives a positive legal outcome, as the lawyer can then help clients defend against potential negative eventualities. Hence, ‘pervasive pessimism’ and possibly ‘catastrophizing’ can be seen as a powerful legal tool, helping to anticipate disaster, and encouraging lawyers to think the worst before it has happened. However, on the flip side of the same coin, is that if you take that same pessimistic mindset home with you from the office, it may form part of the answer as to why lawyers are more likely to suffer with low moods.

Another hypothesis is that lawyers tend to express ‘high-dominance’ as a key feature of their personality; again something which aids successful legal careers. Key features of a ‘high-dominance’ personality include people who: interrupt others, talk longer, take charge of conversations, decide when to change topic, state strong preferences and opinions, have an unyielding manner and tend to enjoy giving instructions and advice. ‘High dominance’ personalities also tend to believe in statements, such as, ‘winning is more important than playing the game’. This may be an integral part of being a successful lawyer who never looses a battle, however, when this is mindset extended outside the workplace it fits less well with the challenges of daily life. When things have not gone the way high dominance personalities have planned, it can be a time when they struggle to manage or cope on a psychological level.

A further hypothesis is based on the accumulating psychological evidence that much work stress arises from interacting with people rather than things. In fact, ‘emotional labour’ is more mentally taxing than the old fashion labour jobs that were more physically taxing. It has been shown that the more your job requires you to fake emotions, the more emotionally detached you become from those around you. Hiding or faking emotions, can lead to ‘clinical burnout’. Since lawyers keep a professional detachment from their cases and cannot get too emotionally involved, this could potentially lead to the burnout state of mind. Burnout can result in symptoms of emotional exhaustion, fatigue, detached attitude towards others, low sense of effectiveness, helplessness and also low mood.

The risk of the inherent pessimism means that lawyers should be especially careful not to extend the negative mindset perspective into other areas of their lives. This book will hopefully assist the reader in finding perspective, so that even during the most difficult times in life a context can be found, which can also provide something to learn and grow from. As Shakespeare said, “There is nothing either good or bad, but thinking makes it so”.

The book can be pre-ordered on amazon here

Thought of the Week - Has This Also Happened in your Area?

This week the 'Dr Crippen diaries' questioned psychiatry health provision. This blog post is dedicated to looking back at some of the local provision of psychiatry services. Although, I am not aware of this local story ever breaking into the national papers; I suspect similar cuts to mental health provision are mirrored in other areas. For reasons that will be obvious from the text, I am not going to comment on these issues, but merely offer the links and some of the text, as reported in the local rag (Cambridge Evening News):

Only last week the latest report highlighted the scale of the mental health crisis in Cambridgeshire, “when the figures showed that the county's specialist trust has lost almost one in five dedicated hospital beds in just two years.” Local MP Andrew Lansley said: "These figures demonstrate in the clearest terms the pressure that we know mental health services in our NHS are under…While the number of people sectioned has hit its highest level in history, the NHS financial crisis is forcing the closure of mental health beds throughout the country.”

Looking at older reports, “Health Secretary Patricia Hewitt chose to back £3 million cuts” to the local mental health services, despite “a House of Commons debate… in an attempt to stop the cuts” and despite “hundreds of protesters” who “marched through Cambridge to oppose savage cuts to mental health and other NHS services.” Reports went onto say “Patricia Hewitt has ignored the opinions of every organisation concerned with the provision of health care by the City of Cambridge and South Cambridgeshire Primary Care Trusts” including the saddest fact of all, that “patients will be let down by savage reductions in mental health services.”

And let's not forget the report when MP David Howarth "launched a furious attack on mental health chiefs who have tried to "gag" staff." After a "letter" had "been sent to all employees of the Cambridgeshire and Peterborough Mental Health Partnership NHS Trust demanding that they do not contact the media.” This followed on from a letter signed by “27 consultant psychiatrists" who wrote "about the plans to strip £3 million from the local mental health budget”.

10 years on from "24 hours to save the NHS"

There is one very big anniversary coming up – this Monday is 10 years since Tony Blair said those unforgettable words “24 hours to save the NHS”. Never has there been a time when those words rang so true. The BBC cover the medical crisis here.

The story about changing medical careers has been a catalogue of errors, which is fast developing into an urgent patient safety issue. The BMA chairman James Johnson has written to Tony Blair warning doctors' anger will grow if the government does not address the problems with MTAS "with the level of urgency they deserve." As Andrew Lansley has said, Patricia Hewitt is in "denial", so it's down to Tony Blair to urgently answer the questions:

Are there doctors to staff the wards on the 1st August?

Which doctors will have a job and where?

Why are the next generation of consultants having an estimated two thirds of their training time cut?

How did the errors in the MTAS system occur?

How did personal details of applicants leak all over the internet?

Why has the government not listened?

And if he doesn't feel comfortable answering medical questions, there are plenty of legal questions to answer as well. His very own 24 hour clock is ticking.

And Finally...

Just when you thought it couldn’t get any worse… Channel 4 news reported that if you want the name, address, personal details, telephone number, race, religion, police records and even sexual orientation of any MMC doctor applicant... their details were all exposed via the on-line recruitment system. For the rest of the story read here.

Watching Patricia Move

In a brief review of some of the highlights from the Hansard Report:

Shadow Health Secretary Andrew Lansley started by stating his reasons for the debate "First, we want to secure some answers; secondly,... we want to make clear the necessary steps that the Government should accept to regain the confidence and support of the medical profession; and thirdly and not least, we want to demonstrate to the many junior doctors who have come to Westminster today to tell their Members of Parliament of their personal experiences, their disillusionment and, in many cases, their anger at what has happened to them…” He went on to quote from a junior doctor, who I know to be an excellent doctor, and described his experiences: “I have a first-class degree in medicine/neuroscience, medical degrees with distinction, two research doctorates . . . in behavioural neuroscience, nearly 30 scientific publications including text books and commercialized research software, research prizes, three years’ experience as a lecturer in neuroscience at the University of Cambridge, and two years’ experience as a medical SHO at teaching hospitals . . . whilst I was short-listed for an ST2 medical position I failed to be shortlisted for ST1 psychiatry, which requires no previous psychiatry experience." He continued with “The consultants at Addenbrookes in my constituency sent me the results of a consultant survey that they had recently undertaken, and three quarters of those consultants said that they would refuse to take part in further interviews. Ninety-seven per cent. of them wanted to see the previous system of appointments restored for this year. I do not necessarily agree with that. However, there is something that we can and must do between now and August. It is not good enough to wait for Sir John Tooke’s review in order to produce a report in September.”

Henry Bellingham MP highlighted that “doctors are worried that they will not receive sufficient training under MMC. For example, orthopaedic surgeons received 22,000 hours of training under the old system, but they will receive only 6,000 hours of training under MMC.” Norman Lamb MP poignantly stated “What will happen on 1 August?” and continued by calling modernising medical careers “a straitjacket.” He highlighted that warnings “went unheeded. The Royal College of Physicians warned but was ignored. The British Medical Association said that it tried to get the Government to listen, but it was ignored.”

Then it was over to Mrs Nadine Dorries MP to lighten the mood and recount the words of Dr. Sonia Heyer: “As a junior doctor who may be unemployed this summer as a result of the present recruitment fiasco, I was delighted to learn that we may be required to seek employment with voluntary services overseas. I would go, provided I could secure the company of the present Secretary of State for Health, in which case I would gladly accept a mapless mission to the Amazon jungle.”

Finally, perhaps it's also worth mentioning that watching from the gallery, Patricia Hewitt was observed to shuffle once in her seat, and it was to these words from Andrew Lansely "The review still has serious problems and it will be subject to legal challenge."

More from the Lobby

The below clip is a very short piece from the lobby today, with the junior doctors' RemedyUK representative. He explains how the government have changed training into a tick box exercise rather than being concerned about patient care:

The Lobby

Today was the mass medical lobby at Parliament. It started with a rally outside the House of Commons with cross party speakers (Conservative Andrew Lansley, Lib Dem Norman Lamb and Labour Ian Gibson), the RemedyUK organisers and hundreds of doctors from every grade.

After that it was time to lobby my local MP (David Howarth) along with Dr Rupert Beale and Dr Zoe Fritz. David Howarth MP, was very supportive of both junior doctors' concerns and the concerns regarding patient safety. In the short term, patient safety may be compromised when job changes come into effect on 1st August, and in the long term patient safety may be compromised if consultant doctors have not been given enough time to train within their chosen specialty (training time to become an orthopaedic consultant surgeon has been cut from 22,000 hours to a mere 6,000 under the propsed MMC).

Previously this blog has written about the thoughts from three eminent consultants, and today there was a debate in the House about these impending changes. Andrew Lansley suggested that Patricia Hewitt was in "denial" about the scale of the disaster created by MMC and her "chronic mismanagement". He went onto highlighted that she has scheduled the 'second MMC review' to report in September. However, as 1st August is the key date when doctors start new jobs, such a review date is too little, too late.

A Guest Blog - Dr Rupert Beale

The following post has been written by a medical Senior House Officer - he is a doctor twice over (qualified as a medical doctor and has a PhD). He is one of the doctors caught in the middle of the changes to medical careers. He is an experienced and excellent clinician, is married and has three (very lovely) children:

"Many thanks to Michelle for inviting me to contribute. I'm one of roughly 30,000 doctors caught up in the Modernising Medical Careers fiasco as I try to complete my training in general medicine. Tomorrow I am going to lobby my MP to do all he can to bring the government to account over this astoundingly incompetent implementation of a very bad idea. I suppose I am generally an optimist, but even someone fully dosed up on the strongest happy pills would struggle to think we are going to be able to entirely reverse the government's policy. Depressingly, we are looking for damage limitation in one form or another.

I'm not going to recite the litany of blunders and half-baked lunacy that has led to the sorry mess we find ourselves in now. What I'd like to do is highlight the various forces at work behind what is happening at the moment. Unless you are immersed in what has been going on, you may not even have heard of some of them. My main point here is that there are so many of them, each with an important role in this process and each claiming to represent some disenfranchised body such as patients, voters, junior doctors, the NHS, medical education, surgeons etc. Since there are so many of them, I propose a simple classification scheme:

Forces of Darkness:
The Department of Health Trying to control doctors to serve political ends
NHS Employers Trying to drive down the cost of doctors by manipulating supply and demand
Patricia Hewitt Trying to save her sorry political neck
MMC (Modernising Medical Careers) It has lost its head (twice). Like many other stupid things, this still runs around the farmyard
MTAS (Medical Transportation to Australia Service) computerised system for selecting doctors on the basis of their creative writing skills
PMETB (Postgraduate Medical Education and Training Board) set up to wrest control of medical training from the Royal Colleges.
Deaneries Cravenly implementing Hewitt's policy because of legal threats

Forces of Light:
RemedyUK Noble organisation, shoestring budget, run full time by junior docs. Oh, sorry – actually run by full time junior docs.
Prof Morris Brown et. al. Actually most of the consultants are against MMC, but until now very few of them have had the courage to say so. See blog post 'Medical Heroes'.

Farces:
BMA Hasn't even bothered to find out the views of its members, let alone actually do anything.
BMA JDC (Junior doctor's Committee) They have been in the review. Then out. Then in. Then used by Patricia Hewitt as evidence that junior doctors support the review findings. Muppets.
Royal Colleges Moribund organisations that will shortly go the way of the once powerful medieval guilds.

You will notice that the Forces of Light are outnumbered and out-gunned, but since it's St George's day and the situation in Scotland, Wales and Northern Ireland isn't as bad...
Cry God for Morris, England and Saint George!"

Doctors Mass Lobby the Government Tomorrow

Tomorrow will make history when thousands of doctors will lobby the Government about propsed plans to reform medical training that will put patient care at risk. Some Cambridge medics have sent me some of the points they will be raising with their MP tomorrow:

"Patient care is set to suffer under current proposed government changes to medical training. The controversial Modernising Medical Careers programme (MMC) is being implemented by the government on August 1st 2007, despite vehement opposition from the majority of doctors and the Royal Colleges. Patricia Hewitt has already “unreservedly apologised” for the shambolic national application scheme (MTAS), which has prompted two independent reviews. She has yet, however, to acknowledge the detrimental impact that the proposed major changes in training will have on patient care.

On Tuesday 24 April, doctors from all over the country will come together to exercise their right to lobby MPs in Parliament. The mass lobby, co-ordinated by Remedy UK (www.remedyuk.org, an independent representative group for medics), aims to raise awareness of the impact MMC will have on patient care. They argue that the changes proposed by MMC can not be allowed to go through if patient safety and the quality of medical training is to be maintained. An immediate, comprehensive and genuinely independent review of changes in training must be undertaken.

Current medical training consists of “preregistration years” followed by several years at Senior House Officer (SHO) level, during which doctors broaden their medical knowledge and take professional exams to become members of the appropriate Royal College. Once these century-old, internationally recognised and respected exams had been passed, doctors apply for Registrar posts in their chosen speciality and continue training for 5-7 years before being able to become consultants.

The reforms being implemented by the government do away with both SHO/Registrar training, and the collegiate exams and replace them with “run-though” training programmes of 4-5 years. This shortens the period of training, removes any flexibility from the system ( for example, the option to gain furrther training abroad, work in a related speciality, or indeed to take time out to have children), and requires doctors to choose a speciality early in their careers, before knowing what might best suit them. In addition, there are insufficient training posts for the number of doctors currently educated in this country.

Changes to training as a consequence of MMC, will result in a reduction in the length of training for doctors in many specialties – at the same time as the average working week is reducing from 56 to 48 hours, in line with the European Working Time Directive. Inevitably, this will result in doctors who do not have the necessary experience to provide safe practice. For example, it is thought that training time for surgeons to become consultants will be effectively be cut from 21,000 hours to just 6,000 hours.

The MMC programme’s requirement to select a specialty at a significantly earlier stage in a doctors’ career, does not equip a doctor with the skills necessary to identify and treat complications or patients with multiple medical problems. Due to the ageing population in Britain, patients with multiple coexisting illnesses are becoming increasingly common ,meaning a broader knowledge base is required, which seems contrary to MMC implementation.

“Modernising Medical Careers will result in poorly trained doctors working in specialities in which they have little interest,” said Dr Jane Graham, a Remedy UK spokesperson for SE England. An overwhelming majority of doctors believe that the new programme will be detrimental to patient care throughout all specialities of hospital medicine. At the national meeting of the Association of British Neurologists in Cambridge on 13 April, 350 physicians voted against the motion ‘MMC is good for patients, trainees and the Practice of Neurology’. Only 4 votes were passed in favour.

The most immediate victims of the government’s ill-thought through “reforms” are those Senior House Officers with with the most clinical experience and knowledge who are loosing out to more junior doctors to ensure that the governments proposed training reforms can be implemented. In a leaked memo on the impending employment crisis for junior doctors from Sian Thomas, director of the NHS Employers Organisation, it stated that of those 10,000 doctors unemployed from August, the Department of Health plans to prioritise finding posts for only the most junior and inexperienced doctors. Those more experienced doctors, who currently provide the back bone of NHS medical care, will effectively be removed from practising, thus putting patients at serious risk.

The health service is already being put under considerable strain as junior doctors currently have to travel to interviews around the country, leaving wards dangerously understaffed. No one can predict the scale of the disruption to service that will follow when the new scheme if introduced this August. The government propose to simultaneously uproot overnight 18,000 doctors, to start work in what for many will be a new hospital, with a new team, in a new speciality. Previously, the transition between junior doctors’ contracts have always been staggered to ensure continuity of patient care and patient safety.

The Royal Colleges have been in charge of medical training since the 16th century, but their grave concerns have been dismissed. There is growing alarm that the quality and level of patient care will suffer both in the short and long term because of the government-driven change. It is of the utmost importance that those in power listen to the concerns raised, and that the public is aware of the dangers, if these serious issues are not addressed immediately."

The Medical Heroes

Three eminent doctors speaking about the proposed changes to doctor training include:
Dr Chris Allen
Professor Morris Brown
And Dr David Clow. You may remember the now iconic video when Dr David Clow spoke during the London doctors' march back on the 17th March.

Here, Dr David Clow returns exclusively to 'The Psychiatrist Blog' to express his views about the changes to medical training:

"Good Things About Reforms
Before I make criticisms of the reforms of the recruitment and post-graduate training of doctors in the UK, let me state some beneficial reasons for reform:

The first is that the cost of job advertisements has spiralled over the years to fill all the posts that become vacant in an organisation the size of the NHS. So, in itself, the use of a workable computer application service for NHS jobs may seem to be a good idea to save costs that could better be used for patient care.

Second, the increased output from medical schools and junior posts has led to multiple applications. For example, I was getting over 200 CVs to short-list and out of those short-listed over 50% would not attend, as they already had a job, or had since been offered something they preferred and this process was a waste of time to all concerned. Furthermore, it led to the degree of rudeness from some trust personnel who on occasions did not even acknowledge those who had not been short-listed.

Why Modernising Medical Careers (MMC) is not the answer
However, despite the need for reform, MMC is fatally flawed because it is being run by self-appointed experts in ‘Medical Education’ and not Consultants at the coal face. The facile mistake is the idea that passing a competence test means that the doctor is competent. Competence tests only measure the ability to pass tests, and not clinical skills.

MMC needs to realise that our "trainees" spend three quarters of their time with no teaching, but are "covering patients” they do not know, because of the way we have chosen to implement the European Working Time directive. Staff are over-tired on their shift patterns that ignore circadian rhythms, and destroy any quality of life. No-one in manufacturing producing 24 hour programmes would use this system.

It’s also important to realise the need to teach ‘the knowledge of the science and art’ of medicine. It is doubtful that one can simply learn "communication skills" second hand. It is best done by learning from experience, teaching and practice in order to improve on your ability. This is the model that we should adopt; see one, do one and then teach one. MMC only looks at the first. MMC must include work and experience for our trainees who have the knowledge but not the experience of working, as they have never followed up their patients and cannot get through the work in the time constraints.

If I can explain from my own experience. As a student I won all the prizes for surgery and felt this should be my career, but when operating under Consultant assistance my manual dexterity was incompetent, and it was clear to me that my patients would be better choosing someone who could operate better. General Practice was attractive, but seeing 60 patients in a surgery and trying to welcome the 61st was impossible . As a middle grade working in paediatrics in a district hospital I found the best form of medicine for my skills and interest. The inflexibility of MMC in making career blind ends at the F2 stage has to change. How can doctors make sensible career choices when they have never worked in their chosen field and thus do not know what to choose?

To restore any faith in the MTAS a public announcement needs to be made that it has been scrapped. I take very seriously the complete disillusion of my fellow marchers at a system that ignores all their previous work, qualifications and experience for selecting a career.
The way of marking, has produced a lottery which only the defendants of the indefensible may argue is completely fair to all candidates.

The Chinese Communist Government allocated positions according to the candidates’ political reliability. Their performance, on such a random method of choosing, resulted in widespread starvation till the system was reformed to allow for choice and competence. If we continue to devalue doctors we risk getting the sort of Health Service, where no one really cares for the patient or their relatives.

This is something I care passionately about. I have devoted my life to the NHS. As I get older it is very likely I will also need to start using it and calling upon the help of these young doctors. Patricia Hewitt needs to change and to show that she really cares about the quality of the NHS by addressing the substance of the objections to the system she has introduced. "

Dr David Clow, Consultant Paediatrician, Greenwich

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:

Coming Up...

Tomorrow there should be a treat for 'The Psychiatrist Blog'... so watch this space for the Friday Coup.

Will the Commons Listen to the Lords?

A YouGov poll just published found that the public do not support proposed laws that would make it easier to detain and treat people with mental health problems against their wishes.

The poll, commissioned by the Royal College of Psychiatrists, showed that:

72% do not think that people with mental health problems should be forced to have ‘treatment’ from which they cannot benefit.
68% do not believe that hospitals should be used to detain people with mental health problems if they cannot benefit from treatment and have committed no crime.

These poll results have been released in advance of this week’s second reading of the Mental Health Bill in the House of Commons. The Government has indicated that it intends to force through amendments to the current Bill. The Royal College of Psychiatrists believes that this would bring far more people who cannot benefit from ‘treatment’ within the scope of mental health legislation and make it more likely people would be detained and treated inappropriately.
Professor Sheila Hollins, President of the Royal College of Psychiatrists said “The House of Lords has made some very sensible amendments to the Bill, which if retained would lead to fair and effective mental health legislation fit for the 21st Century. We call on the Government and all MPs not to overturn these amendments in The Commons.”

New Labour do Things in Pairs

If there was going to be an apology then why not make it two in one day?
New labour united the health and defence of the nation, in the form of a 'sorry'. The first, from Patricia Hewitt who said that "this has been a time of great distress for junior doctors and their families and I apologise unreservedly to them for the anxiety that has been caused." Understanding that she has caused a great deal of distress and anxiety, her plan: to establish "a second independent Review to consider these and other broader issues." It remains to be seen if 'committifying' this issue with yet another review will help; the answer called for by over 2,000 doctors is to stop the MMC process until it is fit for purpose.

The second sorry came from the Defence Secretary Des Browne who accepted responsibility, admitted to making a mistake and said sorry for the shambles of the cash-for-stories affair.

Perhaps a white flag will be the 10 year legacy.