Friday, May 30, 2008

Gordon Brown: Time for Palliative Care

A necrosing, fungating, pungent mass may be excised by a surgeon’s knife, using a wide margin excision. The histological report and analogy with Crewe and Nantwich could return terminal for Gordon Brown; as the Labour stronghold was voted out in favour of the 165th target Tory seat. A wide margin of resection, by any measure.

So, does that signify the end for Gordon Brown, or will more surgical misery ensue? Surgeon Lord Darzi, has suggested that traditional GP surgeries could soon be replaced by new ‘polyclinics’, which house GPs alongside other health professionals, all under the same roof. If a trial of these new centres in London is successful they could be enforced across the country. However, if they take after Gordon Brown any honeymoon period they enjoy will have no happy ending.

The Blair days of “24 hours to save the NHS” have long since departed, and the time has come to stop squandering billions of taxpayer pounds on NHS white elephants, such as electronic records that still don’t work. Despite Labour’s abysmal mismanagement of the NHS, they are pushing full steam ahead with the polyclinic idea. Yet, for many patients, losing their GP is not as easy as it sounds. Rapport and trust between doctor and client is built gradually and develops over time. It’s not always possible to pick up the nuisances of an illness in a ten minute consultation, especially if the service user is unknown to the GP and suffers with multiple chronic illnesses.

As Eamonn Butler suggests in ‘The Best Book on the Market’, if we trust the market, then polyclinics would not have to be enforced, but would naturally develop in areas where the local community wanted them. Although nobody expects markets to be perfect; it’s often their imbalances and imperfections that make them work. If information is the grit in the market oyster then GPs may be the black pearl. GPs already have access to the local information and health needs, so why not trust the professionals to be entrepreneurs? Trust them to lead and respond to changes within their community. Free them from bureaucracy, red tape and the centrally-dictated targets.

Rather than the institutionalised ‘learned helplessness’ of the NHS professionals, free them to build their GP practice like a business. Allow market forces to naturally develop according to need. For example, let services and client’s needs develop symbiotically; where the client dictates the opening hours and the surguries perhaps charge patients who do not attend and waste precious appointment slots.

In conclusion, I believe the NHS needs to encourage innovation, open the market and end central control from a dictatorial Prime Minister. Until that day, Gordon Brown is offering as much depth to the NHS debate as a flat screen television. He’s doing nothing more than imposing regulation like a sledgehammer that misses the nut.

Thursday, May 22, 2008

Crewe and Nantwich

A necrosing, fungating, pungent mass may well be excised by a surgeon’s knife using a wide margin excision. The histological analogy with Crewe and Nantwich seems unmistakable. If Gordon Brown's party are excised in the Labour stronghold, in favour of the 165th target Tory seat, the voters would have excised him with a wide margin resection, by any measure.

Tuesday, May 13, 2008

Are you affected by the ‘Affluenza Virus?’

According to Oliver James in his book 'Affluenza', the Affluenza Virus increases your susceptibility to the commonest emotional distresses: depression, anxiety, substance abuse and personality disorder (like the me, me, me narcissism, febrile moods or confused identity).

He asks –Have you contacted the affluenza virus? Answer ‘yes’ or ‘no’ to the following statements.

I would like to be a wealthy person.
I would like my name known by many people
I would like to successfully hide the signs of ageing
I would like to be admired by many people
I would like to have people comment often about how attractive I look
I like to keep up with fashions in hair and clothing
I would like to have my name appear frequently in the media
I often compare what I own with what others own
Possessions can be just as important as people
Shopping or thinking about what to buy greatly preoccupies me
If a friend can’t help me get ahead in life, I usually end the friendship
I’m less concerned with what work I do than with what I get for it
I admire people who own expensive homes, cars and clothes
My life would be better if I owned certain things I don’t have now
The things I will own will say a lot about how well I’ve done in life
I want a lot of luxury in life.

If you answered ‘yes’ to any of the questions, then it’s said you have the virus. The more ‘yes’ answered, the higher the viral load.

Saturday, May 03, 2008

A Vascular Surgeon to the Rescue

Today several newspapers reported how a retired teacher severed an artery after falling off her bike, and impaling herself on the handlebars. She was luckily saved by vascular surgeon, John Thompson, who just happened to be passing by. He not only treated her at the scene but then followed the ambulance to hospital and operated on her leg himself.

In a short time she had lost a quarter of the blood in her body, and unless he had been there to administer the acute care, she would have died in minutes. Mr Thompson, described his being there as, “an amazing stroke of luck.”

The political anology seems unmistakable. NuLabour have reinvented the NHS wheel so many times, they’ve fallen off and impaled themselves, wasting money on computer systems, red tape and quangocrats. However, for them, I doubt there’ll be a passing vascular surgeon to save the day. They’ve reduced training posts and medical training so radically, that their haemorrhage of support is critical.