Friday, 28 September 2007

Hospital Scandal: "MP did not consent to digital insertion"

Nulabour MP, James Purnell, has accused Tameside General Hospital of subjecting him to a digital insertion without his consent.
The NHS Trust has admitted that a digital insertion took place but claims that Mr Purnell asked for it. Mr Purnell, 37, is Gordon Brown's new Secretary of State for Culture, Media and Sport, a post previously held by Chris Smith, the first openly gay MP.
The alleged incident took place on the new hospital building site after Mr Purnell arrived late for a photoshot and found himself alone. His parliamentary colleagues had already been photographed and left but Mr Purnell agreed to the one-on-one session with the Trust's photographer. He has subsequently claimed that he did not, however, consent to the digital insertion and the Trust has been forced to issue an apology.
Opposition supporters have greeted the story with unrestrained glee. "Here is cast-iron proof that Labour ministers are quite happy to 'fake it' if they think they can get away with it," said Mr Hunt (shadow culture minister).
For the full story go to the BBC website.

Thursday, 27 September 2007

Cyberwarfare: The Clash of the Computer Nerds

Dr Ray at Work

A lot of fun to be had on the net today if you are that way inclined.
It started with the much anticipated Webchat by His Eminence the Lord Darzi of Park Royal.
I had been posting questions for a couple of days and encouraging others to do the same. I had a vague hope that if all the lurkers on DoctorsNet.UK all posted questions it would overwhelm the Downing Street website and crash it but, either not enough doctors did or no taxpayers expense was spared to protect the site from a denial of service cyberattack. A more tangible aim was to create a record of questions which could be disclosed under a FOI request should he choose to ignore the real issues.
As it happened he did address the issues to a degree. Jill Robson asked why he was interfering with General Practice when the Government's own surveys showed widespread satisfaction with the service. Catherine Heaton asked why payments were made to participants in the Citizens Juries (revealed on this blog last week) in return for their opinion. His Mostness had no answer for this and simply said that the idea that participants could be influenced by being offered money was absurd. I personally can't see what is absurd in this. If it wasn't true why are drug companies not allowed to offer doctors money?
There were a few less critical questions but none obviously planted to make him look good. At the end he gave a couple of links including to a Mum's website where the consultation would continue.
I had a look at the site and it seemed kosher with no obvious link to Nulabour so I registered and added my comments. I noticed that Garth of the Ferret Fancier Blog had done the same and later at least one other doctor. The comments on the site were already not that complimentary of NuLabour or Lord Haw-Haw of Harlesden but, after a few well aimed observations from the doctors, I think NuLabour must have regretted allowing free comment on this forum. I don't know if they expected a smooth ride from the grateful mums to whom they had offered 120 quids worth of vegetables but they didn't get it.
A mistake from His Darziship I think.

If you want to give your opinion of the NHS you could do worse than visit or www.nhsreview.

Tuesday, 25 September 2007

The "Brown" Economy

Tarmac your drive guv?

For a Party which gave the Inland Revenue unprecedented powers to forcibly enter homes and businesses without a warrant, force banks to divulge information on their customers' accounts and even to empty a customer's bank account without even having to inform the owner, it is odd that it has chosen to pay lay participants in the Citizens Juries in cash. The payments (which were only offered to the "public" after NHS staff were asked to leave) were described in my earlier blog and caused a bit of excitement and frank disbelief but have now been admitted and documented in this article in the GP magazine "Pulse".

The reasons given for handing out tax payers money in this way are quite frankly an insult to our intelligence. The money is claimed to be for "expenses". This may seem reasonable at first sight, but if this was the case why were "expenses" not offered to everyone who attended. My colleague had a 100 mile round trip to attend the meeting while supposed to be on leave. Then there is the irony. Blood donors in the UK receive no payment. They are expected to give blood as a public service. In fact, the argument is made that offering money would attract the wrong type of person whose blood might be tainted and impure. So, a pint of blood is worth less if it is paid for but an opinion on the future of the NHS is worth £75.

Why was the money handed out at the end of the meeting if it was "for expenses"? A cynic might suggest that the payment of expenses was contingent on a "satisfactory" outcome.

The Department of Health spokesperson said the money had to be paid in cash because not everyone would have a bank account. It was, in fact, this government which stopped pension and benefit payments in cash. This lead to the closure of thousands of Post Offices. This was done to reduce fraud. We can all work out for ourselves why payment was made in cash. The recipients will be untraceable if someone should question who they were and how they were selected. It won't be detectable if the same people turn up at every meeting. Conveniently the money will also be untaxable

There was an explanation for the sealed envelope too. The spokesman said it would have been difficult to handle the loose £50 and £20 notes. That is true enough but why were the NHS staff asked to leave before they were handed out? Did someone have something to hide?

The rules under which doctors deal with drug companies strictly control inducements and gratuities. If a drug company offered doctors £75 in an envelope at the end of a sponsored meeting it would find itself in breach of the Pharmaceutical Industries Code of Practice and the doctor may well have to face a GMC investigation. It is not unreasonable to expect the same standard of behavior from the politicians who write the rules.

Don't forget. Prof., Sir, Lord, Your Worship, Dr., Mr., His Majesty Ara Darzi is doing a webchat on Thursday. Go onto the Downing St website and ask him if he is happy with medical staff representation at the Citizens Juries bearing in mind that they were given as little as 24 hours notice to attend. They are taking questions now. Make them realize we do not believe this is "consultation".

Monday, 24 September 2007

Dr Ray's 15 minutes of fame

Andy Warhol's portrait of Dr Ray

My description of the Citizen's Jury in Birmingham on the 18th (see previous blog) caused quite a stir and propelled the normally quiet and reclusive Dr Ray into the limelight of publicity.

Events unfolded with amazing speed after the Dr Rant team picked up the story. Within 24 hours all the major medical blogs had reproduced or linked to the story and even the political bloggers and the blogging MP Iain Dale gave it extensive coverage. Three separate threads started on and by Monday one of the threads had reached the top quality postings and the person who started the thread reached the weeks top author. By Monday afternoon, Hospital Doctor had picked it up and included it as top medical blog for the day.

Journalists and politicians were emailed and the word went out to uncover Dr Ray.

Initially almost all comments were supportive. The only exception was one anonymous on Iain Dale blog who complained that Dr Ray misused an apostrophe. Then one or two people pointed out that there was no supporting evidence for the statements in the blog and the early stirrings of the rebuttal unit could be heard. Hints of legal action for defamation of Prof Darzi appeared on even though my only mention of him was to say that he was there. My work colleague answered enquiries from journalists and posted replies on on my behalf asking for some other doctors who attended the meeting to confirm or deny that the blog was truthful but by this evening only two people had come forward to confirm that the notice period was as short as 24 hours and no one who attended the Birmingham meeting had appeared. Is it possible that my colleague was the only independent doctor at the whole Birmingham rally? It was, after all, fortuitous that she was free to attend because she was already on leave.

I think the whole episode is going to be forgotten in a few days. The opportunity to embarrass Gordo at the NuLabour Love-in will pass and the next we shall hear is that "following extensive in-depth consultation with the medical profession and stakeholders we have reached a consensus that the DGH model of care must be modernised to meet the needs of the 21st century" (i.e. closed down and replaced with privately run , profit motivated clinics owned by shysters, spivs and barrow-boys and staffed by Eastern Europeans).

Ara Darzi is doing a Downing Street webchat on Thursday and they are taking questions now. Obviously they will filter out any that might cause embarrassment or need a truthful answer but if several hundred doctors all ask him about his confidence in the consultation process it will presumably be on record somewhere and might come back to haunt them whether they choose to ignore the questions or answer them untruthfully.

Here's a funny thing. The consultant who attended the meeting and started the whole thing is on holiday and not a fan of blogs or the internet so is probably unaware of all the excitement.

Friday, 21 September 2007

Nulabour's hospital closure consultation

Gordon Brown.....Alan Johnson.....Ara Darzi

Yesterday evening I had an insight into the workings of Nulabours "consultation" process on the planned closure of NHS District General Hospitals and replacement with dumbed down polyclinics.

A few weeks ago invitations to attend a public consultation were sent to consultants at our Trust. We were only given one day to reply for the meeting in the near future even though we have to give 6 weeks notice of leave because of "choose and book".

Obviously this meant that most of us could not attend but one consultant did take up the invitation.

The location of the meeting was kept secret until three days before the event and when this consultant was eventually told the location and turned up in Birmingham for the "Citizens Jury" it turned out that medical staff were outnumbered 2:1 by laypeople specifically chosen by an agency to attend the event. The media were present and had obviously been invited to publicise the event.

The delegates were split up into groups and each allocated an electronic voting device. A "minder" was allocated to each group.

Then the stars of the show arrived: Gordon Brown, Alan Johnson and Ara Darzi.

There followed a rapid succession of questions from the podium on which the delegates were asked to vote. The minder was available to suggest the best answer if there was any doubt.

Strangely, almost all the votes were 2:1 in favour of Nulabour's policy. Even the question: "Would you prefer gynaecological surgery to be carried out in your GP practice even if it meant the closure of your DGH facility?" was answered with 2:1 in favour.

Following the "consultation" the medical delegates were told to leave but the other 2/3 of the audience were kept back and each given an envelope. My colleague was intrigued by this and managed to catch one of the "chosen ones" and ask about the contents. Each envelope contained £75 in cash!

So now the consultation is over and the results indicate there is overwhelming public and doctor support for closing down the DGHs. I can only say that the way the voting was done makes the "Blue Peter" voting fraud seem like, well, "Blue Peter".

According to the Downing Street website there are nine more of these "consultations" due around the county. Thats an awful lot of people to bribe with taxpayers money, but once they're done the business of closing the DGHs can start in earnest.

Wednesday, 5 September 2007

3000 year wait for CT scan

Egyptian CT scanner.

Quite a lot happening on the UK-radiology front which is one of the reasons I have not been blogging recently.

I set up a new website called It's nothing special - just a single page that directs visitors to the main website and I wouldn't have bothered had not a mysterious shyster been buying up all the specialty names in almost every town in the UK. So now they own aberdeencardiology, aberdeenradiology etc. Hundreds of sites, but I managed to buy ours before them. Presumably they will be approaching each group and offering the domain name for sale or threaten to sell it to their competitors. Anyway, I put it to good use and used the website and search engine optimisation to get visitors from the Birmingham and West Midlands and this has now started to work with first page google ranking already.

One of the Birmingham visitors today was the Museum and Art Gallery. They wanted us to scan their Egyptian Mummies. I would have loved to do this. It would have been really fascinating and would have given us national publicity, but, thanks to being ripped off by Toshiba when they sold us the scanner, our image processing software isn't up to the job of producing those 3D reconstructions of the whole skeleton. Also I was wary of the press. You can't really predict what sort of spin they would choose to put on it. It could be something corney but harmless like "Birmingham Mummy waits 3000 years for a scan" or maybe more damaging like "NHS scanner used on 3000 year old corpse but cancer patients denied scans" Anyway, with great sadness I had to direct them elsewhere. Just wait till I buy my own scanner!

The other landmark recently was our first international referral. I was contacted from Thailand by someone who found me on the internet and I carried out a scan when they visited the UK, faxing the report back to a consultant in Thailand.

The income from our venture has been put to good use. The collapse of Atos Origin as a 2nd wave diagnostics provider not only cheered me up a great deal but provided us with an MRI radiographer looking for work. We have been able to employ him to extend the working day for our NHS patients and we now run 8 to 6.30 weekdays and alternate Saturday mornings whereas previously we only ran 9 to 5 weekdays. Oddly, the success of our low cost private service and increased NHS provision has not reduced our private referrals to the local Nuffield Hospital who pay the full rate. What seems to be happening is that, as we become better known as serious players, we are attracting insured private patients on the basis of reputation and quality rather than just price.

So far it really does seem like a virtuous circle.