I don't get the media obsession with Pete Doherty and Amy Winehouse. It's like they are surprised that young rock stars take drugs and go out on the lash. Then, ooooh, how outrageous, some actually become drug addicts and their lives spiral out of control. Well shock horror, let's now have a pull out special on the faith of the Pope and the defeacation habits of bears.

Even worse are those magazines that go into loads of sordid detail - but only because of their genuine concern. Oh please.

At least Amy isn't criticised for her lack of musical talent. You wonder if these journos have ever heard a Libertines or Babyshambles song. How can someone listen to 'Can't Stand Me Now' and then say that Pete is talentless? It's worth the money just for one line:

Poor little boy kicked out at the world
The world kicked back a lot fucking harder

How very prescient. It's like they're all jealous that he had the gall to go out with Kate Moss. Pete Doherty may well rip off Byron in lifestyle as well as lyrically, but that doesn't make him talentless. Which they'll probably suddenly realise after his death, in a Princess Diana-type turnaround.

I've seen Babyshambles twice: once at Manchester Apollo in February when Pete was totally on form and they were comparable to The Jam at their very best. Then again at V in Stafford, when Pete was obviously out of it, and despite what the die-hard fans would have you believe, the show was dire. Didn't even get a write up in the NME, presumably because if they can't say anything nice about Pete they won't say anything at all.

Albion
by Babyshambles
Down in Albion
They're black and blue
But we don't talk about that
Are you from 'round here?
How do you do?
I'd like to talk about that

More gin in teacups
And leaves on the lawn
Violence in dole queues
And the pale thin girl
Behind the checkout

If you're looking for a cheap sort
Set in false anticipation
I'll be waiting in the photo booth
At the underground station

So come away, won't you come away
We could go to
Deptford, Catford, Watford, Digbeth, Mansfield
Ohh anywhere in Albion

Anywhere in Albion
Anywhere in Albion

Yellowing classics
And canons at dawn
Coffee wallahs and pith helmets
And an English song

Reebok classics
And canons at dawn
Terrible warlords, good Warlords
And an English song

Oh if you're looking for a cheap sort
All glint with perspiration
There's a four-mile queue
Outside the disused power station

Now come away, oh say you'll come away
We'll go to
Chatsworth, Telford, Yeovil, New-cast-le

If you are looking for a cheap tart
Don't glint with perspiration
There's a five-mile queue
Outside the disused power station
Now come away, won't you come away

We'll go to
Bolton, Oldham, Scunthorpe, Bristol
Anywhere in Albion

Anywhere in Albion
Anywhere in Albion
Anywhere in Albion
Anywhere in Albion...

[Some of the towns probably aren't right]

From BBC News

NHS 'must engage patients more'

The NHS must do more to put patients at the heart of the health service in England, experts say.

Oh no, not more experts....

Research by the Picker Institute and Health Foundation think-tanks said patients felt they were not consulted over decisions about their care.

But the two reports acknowledged they were satisfied with their care - and it had improved in recent years.

Patients' groups agreed the public were sidelined, but the government said it took patients' views very seriously.

Creating a patient-led NHS has been one of the key mantras of the government.

Even this week it was launching a public consultation as part of a review of NHS care being led by Sir Ara Darzi, a minister and practising surgeon.

The Picker Institute report, which looked at patient surveys done between 2002 and 2007 involving 1.4m patients, and the Health Foundation study, which analysed 40 pieces of evidence, praised cuts in waiting lists and improvements in the quality of care.

But they found problems over how the NHS engaged with patients.

The Picker Institute pointed out that in every national poll they looked at, between a third and a half of patients said they were not involved in decisions about their care and treatment as much as they would like.

Now this is fair enough if people actually have some knowledge of their own health, and some opinion on what they want. What I suspect though is that people had an option to say this in a questionairre, and so they did, unthinkingly.

I've been a physio since 1986. At each consultation I explain what I think is wrong, what I plan to do, what the effects and side-effects of the treatment can be, and then ask the patient if that is ok with them (this is 'informed consent'). In all that time I only remember one patient saying they didn't wish to proceed as I'd suggested (a man who refused ultrasound). Otherwise, 'whatever you think best' is the most frequent reply.

The studies said patients were particularly keen to have more choice of medication, the hospitals they were treated in and the doctors they were seen by.

They could perhaps try asking. Most doctors will change medications if asked, although they may be reluctant to do so. How a patient can choose a good hospital from a bad one I don't know: I couldn't do it, and I worked in the NHS for 15 years. Ditto doctors. Most will choose the one they 'like': yet the doctor who finally diagnosed my weird gland thing was a curmudgeonly git that I thought hadn't been listening to me at all during my less-than-five-minutes consultation. Clinically he was spot-on though.

Picker Institute chief executive Angela Coulter said: "The rhetoric of patient-centeredness has a hollow core."

This is such pants. Patients are our raison d'etre. And the NHS sure as hell isn't employee-centred.

She said evidence showed fully engaged patients had higher satisfaction rates and better health outcomes.

She also said they tended to be better at following their treatment programmes and attending screening, moves which would make the NHS more efficient.

As a physio student I did some research into this, which found that patients who were better educated about their condition felt less pain and had better outcomes. If this is what she means by engaged then fair enough. To be fair, the two are related, because unless you have knowledge, you can't make informed choices. But just asking patients what they want isn't enough.

And Stephen Thornton, of the Health Foundation, added: "It is now time for the government to make good on its commitments to increase patient engagement."

Roger Goss, of Patient Concern, said: "The NHS is organised for the benefit of providers... whether it is opening times or placing patients in mixed-sex wards.

"Meanwhile, consultations are mostly a mere ritual with patients having little power over services."

But a spokesman for the Department of Health said: "We take the views of patients extremely seriously, and have put their needs at the centre of our health service reform."

And on the public consultation launched this week, he added: "By discussing these issues honestly and directly we can deliver the most effective treatment and services to everyone."

The NHS is actually organised to be as cheap as possible so that it can pay upper management extortionate wages. It has also moved way beyond its original remit, and is now at breaking point, partly because governments keep on wanting to give patients everything they want, whilst demanding nothing in return by way of taxes.

Patients can make really useful suggestions, and most Trusts have procedures in place to take these suggestions into account. But I don't consider myself qualified to make suggestions about the Police force, because I know mothing about how policing works, even though I have used those services and found them seriously lacking. So why should patients be in charge of the NHS? It's as ludicrous as putting inmates in charge of prison policy.

If anything, the pendulum has swung too far away from staff (I mean on-the-ground staff, not managers). It comes to something when the easiest way for staff to get change is for them to get a patient group on side to raise the relevent issues.

From The Times:

Superbug fears kill off doctors' white coats
by Sadie Gray

Long-sleeved white coats worn by doctors will be banished from hospital wards because ministers believe that they contribute to the spread of superbugs.

Under a new dress code to be announced today by Alan Johnson, the Health Secretary, the arms of medics must be bare below the elbow whenever they are in contact with patients.

The Government believes that MRSA is spread from patient to patient on the cuffs of doctors’ coats. The guidelines are intended to make it easier for them to wash their hands between cases. The bare-arms rule is one of a number of measures to be unveiled by Mr Johnson to cut hospital-acquired infections such as MRSA and Clostridium difficile.

a)Why do ministers believe this? What is the evidence this is a major source of infection? Could not alien infiltration of water jugs be just as likely to cause C diff?

b) When do doctors ever touch patients? That would be in clinics, when most of them take off their coats and roll up their sleeves anyway. On the wards many like to wander around in short sleeved theatre blues, unless they are on ward rounds, when no-one ever pays any attention to the patient at all.

c) How does having short sleeves make doctors more likely to wash their hands?

He will say that the fear of catching a hospital superbug has overtaken waiting times as the public’s greatest concern over the NHS. The initiative comes as a public consultation begins on ways to improve the health service.

Bet they won't ask me. Good thing too, I hate it when my suggestions are utterly ignored.

Some hospital trusts have already banned white coats, and all are expected to do so by January. Doctors, nurses and other staff will also be ordered not to wear watches or jewellery, and advised against wearing ties while engaged in clinical activity.

Watches and jewellery????!!!!!! Since when have hospital staff (apart from doctors, who never touch patients etc etc) been allowed to wear watches and jewellery? How very slack and unprofessional (and I was the most rebellious physio student in my year).

A spokesman for the Department of Health said: “The traditional doctor’s coat will not be allowed. Where staff have direct patient contact, then suitable protection, for example plastic aprons, should be worn.”

Presumably the spokesman then went on to describe how to suck eggs to his grandma.

Matrons and nurses will have a chance to give hospital boards direct accounts of their efforts against superbugs to ensure that their recommendations are not overlooked by managers.

Mr Johnson said: “The problem we have identified is many matrons and nurses tell us they are the experts on how to resolve this problem on their wards, but their voice is not heard clearly enough.” [snip]

This is because their voices make suggestions that would cost money and would de-privatise aspects of the NHS.

MRSA has only become a problem outside of specific high-risk areas (burns units for example) since the late 80s/early 90s. It is unlikely to be coincidence that this is when the Tories brought in privatised hospital cleaning services. The NHS cleaning departments could bid for continuing their services, but none of them won their contracts: they were too expensive, because they based their bids on what was necessary for germ-killing cleanliness: a cleaner for each ward (under the supervision of the ward sisters), toilets and showers etc cleaned multiple times a day as necessary, weekly 'behind the beds' cleaning and so on. Private firms based their bids on what they could get away with. No 'behind the beds' cleaning. No particular staff for each ward. Daily toilet/shower cleaning (if the patients are lucky).

Go to a hospital and run your fingers along the top of the curtain rails. Then go and wash them thoroughly, because chances are you'll be horrified at what you find.

Another area where 'savings' have been made is in uniform laundry. When I began as a physio, staff uniforms were labelled with your name and department, and you'd send them to the hospital laundry for cleaning. You didn't wear them home or on the bus or to Tesco. You didn't wash them at 40 degrees and hope for the best. That's all changed now, again thanks to Thatcher. Now it's up to staff to wash their kit as and when they want. Some of the bachelors especially don't always wear their uniforms once only.

Then there's the hand washing. Some staff believe their status alone is antibacterial enough (that would be the doctors). Some think handwashing is a sign they're not busy enough (that would be the nurses). Some understand the real importance of handwashing and would chop their hands off sooner than not wash between patients at least once, because they understand that it is protecting them as much as their patients. THAT is what needs work: moving people into the last category.

Same with universal precautions. You can bet that the staff shouting loudest about wanting to know the HIV/Hep B/MRSA status of patients will be the ones who don't use universal precautions (where you treat everyone as potentially infected and take precautions such as gloves, aprons etc as necessary). Otherwise, why would they need to know?

People are selfish and healthcare staff are no different. So let's scare them into cleanliness!

The Executioner's Song by Norman Mailer
This book also took up part of April, believe it or not. It took me AGES to read, not because it was boring, but because it is huge and full of small writing (nice excuse, huh?).

It's fascinating, the complete story, everything you could ever have wanted to know about Gary Gilmore, his life, his crimes and his death. What remains a mystery is why he killed.

There's no attempt to make you sympathise with him, although to a certain extent you do. He's even overshadowed at times by his girlfriend Nicole, who is so understandable with her screwed up life and her co-dependent love.

In the end, that lack of sympathy is the great strength of the book, because you come away feeling that if anyone deserved the death penalty, then Gary Gilmore did. But he didn't.

I was anti-death penalty anyway, before reading the book. I'd be interested to see how someone pro-capital punishment would respond to it, because here is a man who mindlessly and pointlessly killed two complete strangers. Yet here he is presented as he is: a man. A person, a human being, just like you and me, except he killed. By the time of his execution, you have been 'with' him for so long it feels like they are executing someone you know. Despite all you know about him, or maybe because of it, it feels wrong.
(75/100)

Whilst watching TV this morning, I was frankly amazed at the gall of the likes of Dermot Murnaghan and Fiona Phillips criticising the 'vast' wages GPs receive.

Let's leave aside any arguing with the myth of the GPs 'six-figure income' (the average GP salary is around £70,000)and assume that every GP gets at least £100,000 a year. Let's imagine that Dermot and Fiona earn that too (I somehow doubt that's true).

GPs work on average 55 hours a week. They train for ten years. The perks of the job are few to non-existant. The strain on their own family life is great, especially if they happen to be female. There is a nationwide shortage of GPs.

Breakfast TV presenters sit on a sofa and read an autocue, in some cases only a couple of times a week. They occasionally have to interview people on subjects they plainly know nothing about. They get invited to all sorts of events and have ample opportunities for freebies and outside-hours jobs to boost their income. If one should choose to leave, there'd be a queue of wannabes lining up to take on the job.

Who is more deserving of a six-figure salary?