Tuesday, February 23, 2021
Friday, December 25, 2020
Wednesday, November 25, 2020
Healthcare has corrupted its mission
Tuesday, August 25, 2020
The indictment of medicine
His story is an indictment of the state that clinical governance in medicine has created. As I said in my BMJ letter, the increasing regulation of doctors has created a climate of fear and a culture of defensive practice. Over-reaction in investigation reports may lead to naming, blaming and shaming for what is presumed to be incompetence, carelessness or recklessness. But reports are not immune from mistakes and do not always deserve the authority given to them. Clinical errors occur and actually do not always detract from safety (see previous post). Clinicians live with uncertainty and have to act in the real world.
Judgement about clinical behaviour needs to be fair and open. Even the legal system did not protect David Sellu, although it did eventually exonerate him on appeal. Medicine and surgery are in a precarious state when a decent and competent surgeon can wrongly be found guilty of manslaughter. Medicine needs to stop pretending that clinical practice is always objective and build on its professionalism and experience.
Thursday, August 06, 2020
Now again retired
Tuesday, May 12, 2020
Now only semi-retired
Monday, April 20, 2020
Tuesday, April 14, 2020
Sunday, April 12, 2020
Proximity in the time of coronavirus
Sunday, April 05, 2020
Thursday, April 02, 2020
Friday, March 27, 2020
Wednesday, March 25, 2020
Friday, March 20, 2020
British racism exposed by Windrush scandal
Thursday, March 19, 2020
Tuesday, February 11, 2020
Friday, January 17, 2020
Wednesday, November 27, 2019
Rethinking medicine
Sunday, September 08, 2019
Wednesday, July 31, 2019
Practising as a doctor
When I first became a doctor, revalidation was unnecessary. Qualification was enough to make me fit to practice (although of course fitness-to-practice proceedings could always be instigated against me - and have been (see previous post)). Following the Shipman inquiry, revalidation was eventually introduced, and I have had to undertake annual appraisals. Giving up my licence means I am no longer subject to revalidation as I am not practising as a doctor.
I guess I have always primarily been a clinician rather than an academic. It's taken me a while to give up this privilege but I'm now looking forward to my retirement (including from my Cambridge PhD (see previous post), currently in intermission).
Thursday, May 09, 2019
Friday, January 11, 2019
Sunday, September 16, 2018
Didn’t Lansley reforms put an end to naive political interference?
The essence of the problems is poor usability; taking too much time; interference with face-to-face patient contact; and degradation of clinical documentation.I’m not disputing the need to give an impetus to IT in the NHS, but this does need to be focused on improving clinician satisfaction rather than making work in the NHS more difficult. Otherwise we’re just going to go through another wasteful phase of computer consultants ripping off the NHS.
How will the film Cold War go down in Poland?
Monday, September 03, 2018
Nothing left in the tank
Monday, April 23, 2018
Monday, April 16, 2018
Monday, April 09, 2018
Medical disciplinary procedures need improving
Friday, April 06, 2018
Friday, March 30, 2018
Ian Kennedy's back
However, he seems to have now come back 'on song'. As reported in the BMJ, he is quoted as saying that the "role of criminal law and medical manslaughter in cases where doctors make mistakes must be rethought" (see news item). After all, David Sellu was jailed for gross negligence manslaughter and later had his conviction overturned (see another BMJ news item). This has relevance for the Hazida Bawa-Garba case (see timeline). It even has relevance for the Ian Paterson case which Kennedy himself reviewed (see yet another BMJ news item). Even the prosecutor at the trial admitted that Paterson's motives remained obscure (see BMJ news item). However unprofessional his conduct may have been he seems to have not been aware of it. Paterson maintained his innocence throughout the trial and sat with his eyes mostly closed, shaking his head throughout the statements (see another BMJ news item).
Maybe Kennedy is angling to do the report on this matter. He even did the MPs' expenses inquiry. I do wonder though whether he ought to hand over to someone else.
Saturday, March 24, 2018
Monday, January 22, 2018
Saturday, August 12, 2017
Medical staffing in the NHS
Actually the NHS has always been poor about providing written contracts. It maybe seemed to matter less in the past when there was a good personal relationship with someone in medical staffing. One had confidence at least that one would be paid correctly. Rotas were often worked out by the doctors themselves, which gave them flexibility.
This goodwill has gone in the era of acountable, so-called patient-centred care. It's reasonable for doctors to expect the NHS to be accountable in the same way as they are.
Sunday, July 30, 2017
The Laker Balcony has one of best views in world cricket and is so close to Pavilion balcony that it is almost extension of those facilities 30 Jul 2017, 19:56 |
I was there on Friday! 30 Jul 2017, 19:57 |
Wednesday, May 31, 2017
Tuesday, May 23, 2017
Academic critical psychiatry
Friday, January 20, 2017
The club of consultant psychiatrists
At that time, my contract was with Sheffield Health Authority, although I was working for the mental health service unit. This was before the days of NHS Trusts and Foundation Trusts. Consultant contracts were subsequently transferred to these provider organisations, even if, as I mentioned in my previous post, mine has been suspended twice. Health Authorities were also replaced by purchaser GP organisations, now called Clinical Commissioning Groups.