Rather than trouble you with reams of pages on what is wrong with the new generation, I thought I would make it easy for you to get the bigger picture in under 5 minutes......
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Apparently the government has been successful in getting many food companies to colour code their products to indicate calorie density. Great News. Finally we will be able to overturn the massive tide of obesity that was looming on our gloomy beach. If you believed that, you are too gullible and shouldn't even be reading this without an adult being present.
Am I being told that the major reason why cigarette smoking has dramatically fallen is thanks to someone writing on cigarette packs that it is injurious to health? Or because ugly pictures of smoked lungs and broken hearts were put up on there? See recommendation above if you believe that and dial mummy now. Changing the carnal desires that drive high-calorie food-seeking behaviour through colours and letters is mere wishful thinking by the dreamers who desire an MBE for excellence in generating public health ideas. Nothing more. The public (read tax payer) who is sick and tired of seeing the person in front of them stacking up the shopping trolleys with adipotrophics (patented new word) lives in hope of regulation to sort out their fellow beings. Banning adverts of high energy food on television before 8.59 pm, preventing advertisement boards from being put up 299 feet from a school, rulings that no fast food joints should be erected within 299.9 feet from colleges, are all evidence of foolhardy recommendations that give the public false reassurances that "everything possible is being done" by the government. These kind of recommendations abound in the NHS as anyone familiar with the target culture is aware. But something has to be done, I hear you grimace in frustration at my negative optimism. Yes, just because something needs to be done does not mean something ridiculous has to be done asap. But apparently that is not a sensible argument, judging from the seeming conviction about the efficacy of current strategies. Since when has speed cameras slowed vehicles down? Never in the history of mankind has a speed camera been effective in slowing anyone down. It was the court summons that did the job. Get my drift? Enough said. Once up on a time there was a Jungle. In the jungle lived goats and monkeys and leopards. The goats looked after the elderly goats jungle wide. It was all free.
But soon it became difficult for goats to look after their older goats. So they thought they would teach the monkeys to look after the older goats. They sent the monkeys on "Goading the Goat" courses and such. Enlightened monkeys came back and looked after goats happily. Jungle was cool. Then the first goat safety incident happened. It was a famous goat who gave up his goat, I mean ghost. Monkeys were given new guidance on goat safety. Even a monkey could follow those protocols. They did. To the letter. Jungle was cool. But summer came. Apparently one monkey did not show enough compassion to an elderly, sorry, older, goat. Generic training was arranged for all monkeys on how to look compassionate. Most monkeys attended. Post course, Goats monitored monkeys. Scales of compassion were drawn up. The monkeys made faces. Compassionate faces. They screwed up their face this way, they screwed up their face that way. In short, they screwed it up. Jungle Times published cases of many goats still suffering apian abuse. League tables of compassion shocked the goat land. Frustrated at the end of the year Goats wrote to the Leopards, "This monkey business is not working. We need destructive reforms". The Leopards obliged. No monkey remained. Leopards offered to fill the void to provide goat care. Goats were jubilant. They bleated about new efficiencies. Some goats just said Bah! Leopards drew up jungle level agreement (JLA) with 40 pounds of milk per visit. Goats blogged about how timely LepCare would be. Advances in LepCare were tweeted and retweeted fiercely. But soon milk ran out. Goats suggested appraisal. Leopards planned on reprisal. Milk became blood. Goats gave in sheepishly. Leopards lived happily ever after. Credits (in order of appearance) Goat..played by Joe public Monkeys..portrayed by Junior doctors Leopards..given life to by "any private provider" Jungle times editor..Doc Foster Generic training for monkeys..provided on the NHS Ask me when the movies were greatest and I would say the 90s.
Ask me when the music was greatest and I would say the 80s. Ask me when people had a real good time and I would say the 70s. Ask me when medical students were educated properly and I would say till just before 2000 Call me old... and I will sue for discrimination. That should make you think twice before making accusations of me being outdated. I was tempted to do a survey on this, but like most other things in the NHS, you do surveys on things you already know the answer to. Then you get the wrong responses and you have to explain why the outcome did not match your hypothesis. I have been critically appraising too many journals me thinks. Ask any senior doctor and they will point out how educational standards have deteriorated and continue to deteriorate. Ask any junior and they can give you the reasons why the old method of education is outdated and not fit for purpose for the wider NHS. So, how do we reconcile the new and the old approaches and deliver the best education possible? (sorry, I know that sounded like a question from somebody in management). For me the question is akin to asking how can we as good people live in harmony with the terrorists? Sell our souls, betray our profession, accept lower standards, condone poor practice, tolerate mediocrity, temper aspirations, avoid passion; all scenarios fleet through my mind's eye. Instances of all these are now abundant in daily clinical life. So was it not the case before, I hear you asking. Maybe, but I doubt it was so rampant. But even if I were to be biased in that view, it is not the fact that it is present more frequently that bodes ill for the profession, but instead the inability to set it right in the bigger scheme of things. Inability to set it right? I could hear you do an incredulous sigh and show the proverbial eyebrow wiggle. I see that you dont understand what inability stops experienced clinicians from setting things right for upcoming generation of medical trainees. "Let me explain....". No, I wont try to explain because I could be here till I sustain an RSI of my wrist or the proverbial cattle come home. Instead I will merely state the obvious sign of the times. Responsibility without power for supervisors and Power without responsibility for trainees. If I have to elaborate further for you to understand what this means, it means you have never filled out the new generation CBD on the eportfolio, never had to supervise a trainee and sign him off anyway against your own better judgement, never stifled honest comments and instead clicked on "unable to comment radio button" so that it becomes someone else's problem, never felt that your trainees looked at you as if you were a dinosaur with ridiculous expectations of the medical profession, never had a trainee tell you that despite no doctors on the ward she had to go to the generic training day come what may, and it is even more likely that you never had a trainee tell you "why dont you feed that back to my educational supervisor since you are only my clinical supervisor".........Trainee 1 , Supervisor 0. p.s: By the way, 60s was also good. There was no intention to offend senior citizens, merely that I had no experience of it. Should the NHS be abolished?
This question is usually a conversation stopper...and an argument starter! I have seen people passionately arguing as to how the NHS is a beacon to the rest of the world, looking after its own people. In total contrast, these days you could reframe this question and easily get people to even agree with you to abolish the NHS. Should the NHS be privatised? I have read paragraphs and essays on this topic and come out with my own view, unchanged. Ultimately most of us are sold out on what we want because we have strong views on finances and ethics that are not easily swayed. Equally, hypothetical questions as these are generic questions that could be interpreted whichever way you want. What does privatisation mean? Virgin taking over NHS hospital with a clean reception area where the beautiful receptionists beckon you towards the MRI scanner to get scanned for a better life? Or is it that same old district hospital where you pay twenty pounds at the entrance to get treated for your urinary infection while waiting on the same old trolley? Or is it where you pay £40 to read the latest glossy "garden magazine" while waiting with an elite group of people dressed in suits with the air conditioner blowing a sweet wisp of scent and the DAB radio saying sweet nothings while you wait to have a tooth removed? Oh, Sorry, you are already doing it? Ok, So which one is it? Did you know that foundation trusts are already privatised organisations in a sense? the independent sector treatment centres? the NHS hospital at Hinchinbrooke? All of our GPs? I could rant more, but for the sake of this session, let me summarise my thoughts on how the voting is likely to go. So should the NHS be privatised? If you voted YES: I suspect you are 1. Young 2. Free of disease 3. Working and earning a reasonable salary 4. Working in the NHS 5. Not contributed to NHS pension for more than 2 years 6. Believe that private companies run everything more efficiently 7. Recognise that patient care will be costly, but will be more timely and effective If you Voted NO: I suspect you are: 1. Middle aged to Older 2. Have a chronic disease 3. Living in fear of an exotic illness that you cant fund hitting you any time around...now 4. Working in the NHS or likely never worked at all! 5. Contributed to NHS pension for more than 5 years 6. Paranoid about the intentions of private companies 7. Fear that patients will suffer more (than they currently do) post privatisation So the real outcome of any voting exercise will revolve around what YOU want out of the NHS rather than what the patients will get out of it. It is "all about me". So who are you really? NHS Mortality
I can see no better theme to start off with other than Mortality in the NHS, given the time and effort that this subject takes up at work and in the canteens UK wide. So here goes, my thoughts and feelings on the subject. Do contribute if you are sleepless and want to vent some steam........ I always get the feeling that the rapid gallop of the NHS under New Labour was transformed to a canter by two factors, the arrival of the coalition government and the publication of the mortality league table. The focus turned overnight, from excellence to survival for many trusts. Staff ran from steering committees to planning groups to mortality action teams. Action plans started coming out of everyone's ears. It was all about the process, planning, being seen as doing. Change, radical change. Everything had to change. New paradigms, innovative working, destructive reforms. Management speak. Management spoke. Peppered in the action teams were clinicians, tastemakers in an otherwise bland dish. Detached, disillusioned, disorientated, disabused, disenchanted, and disenfranchised. Mere zombies, attending meetings as if to merely answer the call of duty, if not that of nature! providing a quorate status to the proceedings and nothing more. A select few embraced the proceedings, clinical managers as they were called, wanting to contribute to the organisation's ethos to save lives, prevent death. Yes, prevent death. Death was unacceptable. Even more unacceptable if it was unexpected. Zero tolerance to death. Everyone had to live. Everyone had to leave hospital. No one was to die. Not on my watch, not on your watch, not that we are allowed to wear one anymore. Death was a serious untoward event. There had to be a root cause to every death. It was just a matter of finding it. It was just a matter of time. Time that everyone had, prior to getting involved with the mortality action group! (....to be continued) |
AuthorLuxy John Warning!May contain Nuts, Sarcasm and cynicism.
DisclaimerThe content of the blogs is not representative of my views about my local hospital or CCG, but instead is based on the generic issues in the wider NHS landscape.
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