Monday, April 28, 2008

Backing Boris for Mayor

When Boris was asked "What single achievement are you most proud of in your life?" he replied, "It is yet to come. I will be immensely proud to serve Londoners if I become Mayor." With an 11 point lead, his dreams may well come true.

A Novel Psychiatrist

Tony Blair's former spin doctor Alastair Campbell is to publish his first novel. 'All in the Mind' is described as "the compelling story of a psychiatrist, his patients and family, and the pressures they bring to bear upon each other".
Campbell, who has previously spoken about his struggles with depression, said that although he has himself required psychiatric treatment "this is a book by me, not about me". I look forward to reading it with interest.

Wednesday, April 23, 2008

Who Cares for the Caring Profession?

With thanks to Dr Crippen and Newsnight for highlighting these grave statistics. Next month Newsnight are showing a documentary, "Struggling in Silence". They explore the dark side of the profession, about the little-known and rarely discussed problem of depression and suicide among physicians. The unsettling truth is that doctors have the highest rate of suicide of any profession. They report:

“Every year, between 300 and 400 physicians take their own lives—roughly one a day.”
That shocking statistic speaks for itself.

Tuesday, April 22, 2008

Gordon Brown - Robin Hood in Reverse?

Has Gordon Brown become Robin Hood in reverse? With the 10p tax, he's taking from the poor to give to the rich.

Monday, April 21, 2008

NHS - Number 1 Battle Ground in the Next General election

As I wrote before, to Gordon Brown the NHS is 'Not His Specialty'. Hence, the NHS, is likely to be the number one battle ground in the next election. Today, David Cameron offered much needed direction to a health organisation that spends around two billion pounds per week! He has said:
"In a nutshell, GPs should control the budgets that NHS patients are entitled to. There is a good economic rationale for this. Budget-holding is a natural guarantee of efficiency, ensuring that money follows the patient and it is spent on frontline care rather than on bureaucracy. GPs - rather than remote managers - should be responsible for reconciling the available resources with clinical priorities and patient choice. And there is a good health rationale for GP budget-holding too: what's called the continuity of care. The family doctor service is the way to ensure that - even though the patients may see many specialists - there is always one doctor in charge: the doctor closest to the patient. This is especially important when it comes to preventative action or the management of chronic conditions, which require significant patient involvement.Five years ago Gordon Brown said that "in healthcare the consumer is not sovereign" - meaning that patients should not be trusted or expected to manage their own care. Well I disagree. Because I believe in general practice. With the GP to advise the patient and to commission care on their behalf from a variety of providers, then in healthcare the consumer can be sovereign."
I totally agree that GPs are paramount to patient care. As a psychiatrist, I daily rely on GPs knowing their patients. They provide vital information about both long term health and subtle changes in patient presentation. I'd like to thank all the GPs I've trusted to manage my patients after hospital discharge. If I trust them with life and death, I would certainly trust GPs to spent money wisely.
I believe GPs, like hospital doctors, want the funds to follow the patient. The time has come to stop following the dictum of management consultants or government quangocrats. The political tide must turn. The patient must be the put at the heart of the NHS.

Sunday, April 20, 2008

Bulimia at the House of Commons

Well done to John Prescott for highlighting the plight of bulimia. In the words of Consultant psychiatrist Dr Ty Glover, an eating disorders specialist at Cheadle Royal Hospital in Cheshire, said: "It's hard enough for a young girl to confess to, but for a high-profile male politician approaching 70, it's especially impressive. It's believed that one in ten bulimia sufferers are men but I have never in all my years as a consultant specialising in eating disorders come across a man this old suffering from bulimia. It seriously makes me think that maybe we're completely missing a whole audience of middle-aged men who are too scared to admit they have a problem."

Friday, April 18, 2008

To Gordon Brown the NHS, is 'Not His Specialty'.

Gordon Brown seems to have had little grasp of the health brief either as Prime Minister or as Chancellor. He may have spend the money, but it's been shamefully squandered, and has not reached patient care. Money has been spent on useless projects, evidence that the NHS really is Not His Specialty. I've just found Sir Gerry Robinson trying to give Gordon advice on the NHS via YouTube. I have written about Sir Gerry before:
Here and here.

Backing Boris for Mayor

Thursday, April 17, 2008

The dangers of unlocking Alistair Darling from your unconscious

It is believed that dreaming about a politician, denotes 'displeasing companionships, and incidences where you will loose time and means'. So in our current economic climate, be warned, don't dream about Alistair Darling! We can't afford him to loose even more of our hard earned tax!

Tuesday, April 15, 2008

I’m Just No Jack in the Box

Sometimes the feeling of suffocation comes over me when I consider how imposed central government NHS services do not allow clinicians to breathe. Let's consider Jack, a young man who was admitted to hospital in delirium tremens (colloquially, the DTs). He admitted to drinking one and a half bottles of vodka per day and was also a heroin (opiate) addict. In the immediate short term, he could be detoxed on a medical ward. However, next came the problem.

He wanted to stop his addiction cycle. The medical profession also wanted to help him achieve this. However, the alcohol rehabilitation service is only contracted to treat alcohol addicts, not opiate addicts. And the opiate rehabilitation service is only contracted to treat opiate addicts, not alcohol addicts. The government has set up services within rigid boxes. But, just as Jack personifies, patients will never fit your boxes Mr Brown!

Saturday, April 12, 2008

Guest Blog - Dr Eamonn Butler

Today I'm delighted to have a star guest blogger, Dr Eamonn Butler, director of the Adam Smith Institute. He explains a mixture of economics and healthcare:

The political enthusiasts of state-funded (and worse, state-run) healthcare make me sick. I'm sick of being told that "We don't want the free-market American healthcare system here. It leaves millions of uninsured people to die on the street."

But that's a caricature of America. The American healthcare system is deeply flawed, that's for sure. I wouldn't want to reproduce it here. But it spends more on state-funded healthcare for elderly and poorer people than we do, and (thanks to a helpful tax system), its medical and healthcare charities are larger and stronger too. American's simply aren't doomed to die in the gutter because they can't afford doctors' bills.

And it's hardly a free market. In fact, it's the most regulated system in the world. When – to show how pro-consumer they are – some state governments insist that insurers should cover absolutely everything, is it any wonder that insurance becomes unaffordable? You might want a Fiat policy, but you don't get the option: only Rolls-Royce versions are on offer.

Worse, the whole system is in thrall to the doctors. The mediaeval guilds built themselves cosy monopolies by getting legislators to outlaw their competition under the guise of 'maintaining standards'. And as I say in my new book on markets (modestly entitled The Best Book on the Market):

What’s remarkable is that exactly the same still happens today. The medical profession is the most powerful mediaeval-style guild in America. To practise, you need a licence from the state, and to be a graduate of an approved medical school. But it’s the profession itself that approves the schools and decides how many people will be admitted. So the number of potential competitors is limited, and fees soar. The cutlers and hatters of Elizabethan England would have been proud of them.

I fear that many people who deny the role of markets in solving our deepest problems – like the provision of mental health and other public services – don't actually understand how markets work and how to make use of them. I hope my book might enlighten them. And I've written it in a light, accessible, Freakonomics style that, with luck, even politicians should be able to understand!

To buy ‘The Best Book on the Market’ click here.

Thursday, April 10, 2008

Book Review

The Independent reviewed ‘Why Lawyers Should Surf’, by myself and Tim Kevan. To read the review click here.

Wednesday, April 09, 2008

New Book!

I highly recommend a new book by Eamonn Butler, called ‘The Best Book on the Market’. A synopsis is here and it can be bought from amazon here. The book explains how and why, all markets need to consider human psychology. In the business of minds myself, I concur that nothing is more important than the human brain in decision making.

Monday, April 07, 2008

Clinton and Obama - take note of Shirley Chisholm.

In an address to congress on 21st May 1969, Shirley Chisholm, the first black Congresswomen (Democrat), said:

"I have been far oftener discriminated against because I am women than because I am black."