Wednesday, June 13, 2007

Lazy, torturing, fucking scum

Our health care workers are—we are told (by darling Patsy, amongst others)—hard-working, sympathetic angels, doing their very best with awful pay and bad conditions. We are constantly assured that their hours are long and their rewards so very little and yet still they minister unto us, selfless saints in an uncaring world.

Why do I have such trouble believing this?

Oh, that'll be, first, because I've met and been treated by some of them and, second, because of stories like this. [Emphasis mine.]
Staff at one of London’s top teaching hospitals ignored a man’s pleas for help as his newborn baby died, an inquest was told yesterday.
...

Giving evidence at St Pancras Coroner’s Court, Mr Croft said that the couple were initially turned away from the hospital when they reported to have their baby induced. He said: “They said no beds were available. In fact we were taunted by some staff who said, ’There’s no room at the inn, you’ll have to go home’.”

The couple waited nearly eight hours the next day to see a doctor, before a midwife who induced the birth told Ms Paterson that she was a “silly girl” who was not really in pain.

Mr Croft said that a midwife had told them, “very firmly” that she would induce the birth herself, by applying the gel Prostin, which immediately left his wife in crippling pain. He said: “Heather’s arms and legs were convulsing because of the intense pain.

“Heather was becoming very distressed because of the pain and was literally screaming for someone to come and help her with pain relief or give her a Caesarean section.

“I asked several times if my wife could be seen by a doctor and we were refused. The midwife kept saying to her that her pain was not real. She said ‘no pain, no gain. This is what you have to go through, this is what it’s like’. . . . At some time she said to my wife, ‘You are a silly girl. You don’t deserve this baby. I’m going to take it off you’. Six hours later the baby was dead.”

Mr Croft said that two midwives, Ine Toby and Beverly Blankson, ignored the couple’s pleas for help. He was then told to monitor the baby’s heart-rate himself, and to trigger an alarm button if it fell below a certain level.

He said: “It did drop three times and I pressed the button each time. In the end I had to go out into the corridor to bring her back in to look at it. She kept telling us not to be so fussy.”

The couple did not see a doctor until shortly before the baby was finally born. Mr Croft said: “All of a sudden the room was filled with doctors attending to the baby and at 8.28am they asked for permission to stop. Our baby was dead.”

A postmortem examination, which Mr Croft said staff tried to “bully” him out of having, showed that the child died from asphyxia.

The inquest continues, apparently. Needless to say, if all of these allegations are shown to be true, then the staff who taunted these (brief) parents should be publically flogged and then sacked without references.

The two midwives should have all of their orifices filled with cockroaches and then they should be placed in the stocks for three days. If they survive that, then any accreditation that they have should be removed, they should be sacked without references and blacklisted by all hospitals or midwifery schemes. Then they should be put on trial for the murder of the baby and the unnecessary torture of a young woman. Their punishment should be made public every step of the way, so that these fucking public sector cunts learn what happens when you deliberately fuck about on the job.

If, at any stage, either of them starts whining about "the management" then they both get taken behind the bins and shot in the head.

For some rather more harsh analysis from a man who thinks that the whole midwifery profession is full of patronising, no-nothing, surly, unprofessional fuckwits (but is far too polite to say so in those terms) why not read this piece by Doctor Crippen?

145 comments:

JuliaM said...

"...A postmortem examination, which Mr Croft said staff tried to “bully” him out of having..."

All credit to him that they didn't succeed. I wonder how many times they have...?

the a&e charge nurse said...

Devil - congratulations, you have even managed to outdo the midwife loathing Dr Crippen by rubbishing an entire workforce based on the actions of two apparently incompetent individuals.

As you know NHS clinical staff include radiographers, O/T's, physio's, not to mention half a million nurses and 120,000 doctors.

Do you extend this principle to other groups ?
In which case I assume that after Abu Ghraib the British army can no longer be relied on to treat prisoners decently.

I will not labour the point by dwelling on teaching scandals, nor will I give a blow by blow account of cases involving legal maleasance - but any shortcomings by individuals in these disciplines presumably reflects badly on the rest of the profession and, who knows, perhaps even the entire geographical hemisphere ?

I wonder how many other commentators subscribe to the 'one shit, all shit' philosophy - I don't.

the a&e charge nurse said...

Incidentally, the torturing scum are delivering 25% more babies than can reasonably be expected if we accept the recommendations made by the Royal College of Midwives when it comes to safe midwife - mother/baby ratios.

The birth rate has increased by 12.5% since 2001 hitting a 26yr high of 635,679 births in 2006.
So todays 30,000 midwives [statistically] are delivering 33.7 babies each year rather than the safe upper limit of 27.5.

Lazy fuckers.

Shotgun said...

This is where I chuck something hard at the monitor...

How can some utter cunt and piece of scum shite, like Bliar and some other cunts here, say never mind and stop concentrating on the very few bad things...look at all the good being done.

These cunts should have their children forcibly removed from them and see how they like it.


I wonder how many other commentators subscribe to the 'one shit, all shit' philosophy - I don't.


That's because you are a callous cunt, who is complacent and is driving this culture of incompetence. One death is too many and these nurses should be jailed...then see how the fuckers perform next time. You sweep the death of a child and the protracted suffering of the parents under the carpet and expect everyone to feel shame for making an issue out of it? You utter cunt.

assegai mike said...

33.7 babies per year? I make that considerably less than one baby a week. Sounds pretty cushy to me. But no doubt I just don't understand what's involved.

Bertie Big Balls said...

In which case I assume that after Abu Ghraib the British army can no longer be relied on to treat prisoners decently.

Eh! I know the Iraq monomaniacs have always been keen to pin their obsession's tail on any passing donkey, but what the fuck?

Pete in Dunbar said...

"The birth rate has increased by 12.5% since 2001 hitting a 26yr high of 635,679 births in 2006.

So todays 30,000 midwives [statistically] are delivering 33.7 babies each year rather than the safe upper limit of 27.5."


No matter how I try, I can't make those figures add up. Even if it's really 20,000 midwives, it still doesn't work. If 30,000 is correct, the the number per midwife is 21.19, well within the "safe limit", or one delivery every twelve working days or so.

Chuck Unsworth said...

The a&e charge nurse: "The birth rate has increased by 12.5% since 2001 hitting a 26yr high of 635,679 births in 2006.
So todays 30,000 midwives [statistically] are delivering 33.7 babies each year rather than the safe upper limit of 27.5."

And that would make such treatment perfectly acceptable, eh?

Which 'hospital' do you 'work' in then Gauleiter?

I just want to ensure that I never get anywhere near it, even - or maybe particularly - if I'm a complete basket case.

Neal Asher said...

Which probably explains why some people end up screwed by getting the wrong dosage of drugs. What was that recent article about nurses' education? A whole day on the poverty during the Russian revolution and about two hours on how to set up a drip. I guess there's no time for mathematics either.

Vicola said...

To be honest, a lot of women my age are now terrified of having children thanks to the horror stories that are constantly coming out about either incompetent and callous bitches of midwives like the ones attending to poor Heather Croft or hospitals where the maternity ward is so grossly understaffed that one harrassed midwife is attempting to attend to 20 mothers-to-be and your child is likely to be delivered by the cleaner.

the a&e charge nurse said...

Shotgun - the death of a baby hitting the national headlines is unlikely to be swept under the carpet.

I have no way of knowing the full circumstances of this case, and neither do you.

Lets not forget the midwives are unable to give their account but the newspapers have no such constraints - I'm certain they would not do something so sordid as to manipulate a few gullible punters in order to increase sales.

A few years back a child died from meningitis after attending a neighbouring A&E department - the tabloids had field day, especially since the parents were particularly photogenic.
Needless to say the papers neglected to mention one or two minor details including the fact the child had actually been offered admission, but the parents declined [sadly].
Of course after the dust had settled none of the papers provided a more balanced and honest report - no, rather like ambulance chasing lawyers they were already in hot pursuit of another story to alarm their timerous readership.

You might prefer to think of me as a 'callous cunt' but experience has taught me to be rather more circumspect until the facts are known and that things are not always quite as simple as the Daily Mail would have you believe.

Bertie Big Balls said...

things are not always quite as simple as the Daily Mail would have you believe

Eh! I know the Daily Mail monomaniacs have always been keen to pin their obsession's tail on any passing donkey, but what the fuck? DK links to The Times!

Dr Ray said...

Actually the comparison with Abu Ghraib is quite appropriate.
If you give too much responsibility to a group of people with limited ability and an "attitude" and then fail to provide adequate supervision you get this sort of behavior. Normal people become savages with loyalties to their clan rather to the wider community. This syndrome must have a name but I don't know it. The nearest I can think of is "Lord of the Flies"
Unfortunately, midwifes are selected from the most dysfunctional groups in the NHS and, like Dr Crippen, I could not stand them as a medical student or hospital doctor. They start off as nurses but become midwives because they relish the power and autonomy this provides; all the ones I have met hate doctors, male or female, and a good number are childless lesbians who hate the idea of women having babies and subconsciously want them to suffer. In many hospitals they rule with absolute power. Consultant obstetricians or anaesthetists are only allowed to see patients at the midwifes invitation and this is usually when they have fucked things up to such a degree that they are well out of their depth.
OK, perhaps they are not all like this, but there are enough who are to set the tone of the whole profession and new midwives either conform to the rules of the clan or leave to do something else.
They have got away with this for so long because a)most births have a favourable outcome dispite the midwife, b) they are all female so any critisism is sexist, c) they are empowered nurses so any critisism from doctors is elitist, d) parents have other things to worry about (new baby/brain damaged baby/funeral) than complain about the midwife, e) the hospital (i.e. the taxpayer) picks up the tab (and responsibility) for anyone who sues and the midwife is never mentioned.

Chuck Unsworth said...

The a&e charge nurse:

"I have no way of knowing the full circumstances of this case, and neither do you."
OK so where do we go from here?

"Lets not forget the midwives are unable to give their account but the newspapers have no such constraints"
Why ever not? They (or their professional body) can take the matter through the courts, or they can offer a response interview - the same as everyone else. Suing newspapers can be quite lucrative - as long as you've got a decent case.

JonnyB said...

Hummmm. Not sure I agree with some of the extreme comments above. All I know is that after we made our official complaint about the treatment we got at the hands of midwives (and the midwife system), we basically got told to piss off by the hospital.

So that would be a 100% negative experience. Hopefully if and when we have another child we can drag it down to a more acceptable 50%.

Devil's Kitchen said...

A & E Charge Nurse -- ha! Good for you: I knew this one'd bring you out fighting! If you read my piece, there are quite a few qualifiers in there.

First, I have pointed out that the hearing is ongoing (as does the newspaper) and, second, I have proposed these punishments "if all of these allegations are shown to be true".

I don't write off an entire profession either: I'm sceptical about the ministering angels, yes, because it simply isn't true. Many nurses do do a very difficult job and keep a smile on their face and a spring in their step; most do not. But then I wouldn't necessarily expect them to.

What I do expect is that they do their job competently and I'm afraid that the rash of stories over the last few years alone -- not of single cases but endemic failure in nursing care throughout the country -- show that this is increasingly something that we cannot take for granted.

DK

woman on a raft said...

DK - the last time a subject like this was approached, it ended with you withdrawing material.

Obviously, your gaff, your rules, but you did express some exasperation that people were apparently criticizing certain medics.

Yet this is only one of a series of cases which are grinding slowly through courts and GMC, and have been for at least the last ten years.

The danger is that any one case may be seen as an isolated example of bad practice, not representative.

Actually, this happens every day, everywhere, and has been happening for some years now (1994 to my certain knowledge) but usually not to journalists as they tend to be slightly better at stopping the midwifery/nursing staff treating them like shit.

When patients have complained there have been repeated attempts (such as the Rose Addis affair in 2002 concerning elderly care) to discredit and intimidate them on a personal basis.

That trend continues in the BMJ, which regularly runs articles claiming that patients are persuing vexatious claims when people merely insist on a proper explanation of What Happened.

the a&e charge nurse said...

chuck unsworth - you raise some very important issues.

Midwives, as with all NHS clinical staff are forbidden from making public disclosures since they are bound by strict rules governing patient confidentiality.

At the very least a serious incident enquiry will be convened and any negligence or malpractice will be dealt with in the first instance under the Royal Free Trusts disciplinary procedures.
Further measures may be taken by the RCM.
The family can also take legal advice about bringing a prosecution through the courts.

One study suggested the number of doctors charged with manslaughter had increased significantly since the 90's
http://news.bbc.co.uk/1/hi/health/5033198.stm

I have no idea if the midwives were as vindictive as the Times suggest but my original point was the Devils post seemed more concerned with whipping up a generalised disgust toward NHS clinical staff rather than dealing with the specific issues.

Dr Ray - I find it impossible to reconcile your bizarre rant with the astute observations you normally offer on so many other health matters.
Some midewives are trained nurses, but not all, and the childless lesbian taunt is something I'd expect from the good Devil, not a distinguished senior radiologist - have you been spending too much on doctorsnet rather than reporting ?

Mr. Hughes said...

For once I find myself slightly in disagreement here. The particular incident you mention sounds absolutley horrendous, but as several have pointed out it is hardly fair to condemn an entire profession on this basis. Perhaps it depends rather a lot on one's own personal experience of the NHS? In my own case this has been pretty positive, on the whole. The last occasion I found myself in hospital (thankfully a rare experience for me, so far) I was dealt with reassuringly competently - although I admit there were moments when I felt a slight lack of compassion around, as at the time I genuinely thought I was in imminent danger of a painful and inexorable death. Funnily enough the ambulance staff seemed much more apparently concerned. But then the medical profession do have to deal with these sorts of situations all the time, and a certain hardening process must be inevitable. That should not of course interfere with their professionalism. Personally I am much more worried about absolutely basic problems like the steady increase of deadly infections in hospitals due to poor hygiene than the failings of specific individuals.

Mr. Hughes said...

P.S. The number of offences for which I find myself attracted to the idea of public floggings as a punishment grows longer on a daily basis - but erring midwifery is a new one for me! The insects idea is rather novel, though I can see some virtue in it.

the a&e charge nurse said...

Devil- I welcome your scepticism, or indeed anything else that keeps complacent staff on theirs - the NHS has over 1million employees so I daresay a percentage of them are crap, just as they are in any other sector of the workforce.

Perhaps because there are so many of us [Worlds 3rd largest employer and all that] it just SEEMS that things are worse than they actually are.

I know you are rather fond of the French system - so was I until the heatwave of 2003 which killed 15,000, or will you have the temerity to suggest that heatstroke and dehydration are not ameanable to medical treatment ?

Devil's Kitchen said...

Charge Nurse,

I have, as you know, worked as an Aux (albeit mostly in a private medical centre as opposed to an NHS hospital) so I have a certain sympathy for nurses. At the same time, and by the same token, I tend to be extremely hard on them when they fuck up.

It is the (alleged) attitude of the staff that particularly annoys the hell out of me in this piece.

The NHS is, as you point out, a huge organisation (which is why it doesn't work efficiently) and whilst there are going to be a percentage of good staff and bad staff, I suspect that many people are just going to work to earn a living.

Re: the French heatwave. An extraordinary system surely? Would the NHS have coped any better? Part of the problem, surely, was getting medical treatment to people, which was not helped by the fact that many of the deaths occurred in the (relatively) sparsely populated south (France has about the same population as Britain but is twice the geographical size, I believe).

Still, for all those who believe in severe global warming, perhaps we will have a chance to test this soon...

DK

Devil's Kitchen said...

P.S. An extraordinary system surely?

Sorry, I meant "situation", not "system".

DK

lost_nurse said...

(pops head round virtual hospital curtain, internet majors)

Afternoon, A+E C/N. Seems busy here - I wondered if you needed any help, but you seem to be doing just fine. Like you, I'm not sure that some [ghastly, if only alleged] comments can be used to condemn an entire profession. With apologies to Kipling, "it's nursey this, n' nursey that..."

Mr. Hughes,

"The last occasion I found myself in hospital I was dealt with reassuringly competently..."

Yes, god forbid that some people are actually doing their jobs properly.

(DK, with respect, I'd take your posts more seriously if you dropped the imaginery violence. I'm aware that this makes me deeply old-fashioned.)

the a&e charge nurse said...

Hi, lost_nurse - yes, the Devil and his acolytes have been banging the drum all morning - even the reliable Dr Ray seems to have taken leave of his senses [a temporary aberration I'm sure].

We've just reached a point comparing the French health system, which couldn't manage patients after a few sunny afternoons and the NHS which dealt effectively with 700 casualties after the 7/7 bombings - I know, I was there.

I'm just slightly suprised that some of the more rapid commentators have not called for the ducking stool given the accused are both midwives and female.

Dr Ray said...

A&E chargenurse said:Dr Ray - I find it impossible to reconcile your bizarre rant with the astute observations you normally offer on so many other health matters.
Some midewives are trained nurses, but not all, and the childless lesbian taunt is something I'd expect from the good Devil, not a distinguished senior radiologist - have you been spending too much on doctorsnet rather than reporting ?

My last contact with midwives was as a medical student and I have avoided anything to do with midwifery since then. This was the impression I got at the time but I admit it was some years ago and only on one unit. You mention Doctorsnet and I know there are many postings about midwives there which, shall we say, are not full of praise, so I am not the only doctor who has developed a dislike of the profession based on first hand experience

Rotty said...

"I wonder how many other commentators subscribe to the 'one shit, all shit' philosophy - I don't."

Not me. (But hold onto the 'shit' imagery, I'll be getting back to it in due courst.) See, I subscribe to the notion that NHS staff (on the whole, anyway) are decent enough people. You get up in the morning, scratch, cough, and think, 'Christ, but not another day listening to some silly bitch whining on about how much she'd like an epidural'. Okay. I get that. We all hate working. And we'd all rather get paid for doing next to nothing as opposed to being bollocked for not working hard enough.

This is the reason they invented the free market.

See, in a free market, you're perfectly entitled to offer a crap, superbug-invested service to your customers. And, likewise, said customers are perfectly entitled to tell you to go shove a dinner-fork up your arse and twist it around until it's not funny anymore. No harm, no foul. Deliver enough happy, healthy babies to happy, pain-free mums and you're rolling in money. Deliver enough dead babies and you're out of business.

Only, here's the thing: You're not working in a free-market, are you? You're working in a socialised system. And, guess what? It doesn't matter whether you follow-through with your 'fuck 'em' thoughts first thing on a rainy Monday morning or not -- Deliver a live baby or a dead one, and you guys still get paid. Do a Dr. Crippen and blog about NHS failures or do a Dr. Shipman and exploit them in order to go on a killing spree and ... You guys still get paid.

This is the reason the arguments in favour of socialism are about as convincing as Paris Hilton's recent discovery of Jesus.

Look at it this way: Socialism is like a huge, stinking pit filled with shit (see, I told you I'd get back to that). Everyone working in a socialised industry is dumped into that shit-pit (appropriately enough in this instance, the NHS). Now, some of the people swimming about in the cess-pool will be decent enough, some will be monsters. Most will be ordinary Joes and Janes who just couldn't care less so long as they get paid.

Whatever. They all wind up smelling the same, and, as for the rest of us, well, we none of us want to stand downwind of them. Deal with it.

lost_nurse said...

"Deliver a live baby or a dead one, and you guys still get paid."


Riiiight, because the profit motive always drives successful clinical outcomes in neonates, doesn't it? Must be why my dad became a Consultant Paediatrician, and not a plastic surgeon.

Go on then, rotty. Explain how the market works in emergency interventions and critical care.
And I want fine detail, esepcially about infrastructure and staffing. The kind of stuff I can pass on to amubulance control and PICU nurses. Y'know, in a freaking hurry.


A+E C/N - Ducking stools? Don't give 'em ideas (although, do you think Patsy floats?)

Roger Thornhill said...

It will come as no surprise that I agree with rotty in that a market is needed, badly.

Rotty said...

I'd be happy to ... But, first, let me put a torch to your strawman. See, I never suggested that 'the profit motive *always* drives successful clinical outcomes in neonates' -- What I suggested (spelling it out here) is that the profit motive acts as a useful insurance policy against gross and repeated incompetence, on the one hand, while rewarding professional excellence on the other. Sure, some babies are always going to die, but if you make a habit of standing around mocking the women who spend hours screaming as they attempt to birth them, well, then, what's the betting that a profit-driven industry will get shut of you pdq? *That's* the reason the shit-pit -- sorry, the NHS -- doesn't work. None of you have any incentive to do a good job.

"I want fine detail, esepcially about infrastructure and staffing. The kind of stuff I can pass on to amubulance control and PICU nurses. Y'know, in a freaking hurry."

*Sigh* I thought I just had explained this. Some people are saints. They fight, fight, fight, fight, fight to save their suffering fellow men no matter what the cost. Good for them! Whether they work socialised or free-market systems, these individuals will always do their Mother Teresa stuff. However. Most of us aren't saints. Most of us need a little 'push' in order to always do the right thing. The free-market, obligingly, gives us this push. The socialism system you worship doesn't.

Now, if you're really hot for refuting this argument, then, please, explain to me how delivering large numbers of dead babies would hurt you financially? In any way at all, I mean.

the a&e charge nurse said...

rotty, you may hate socialism but not as much as Blair & Co do - look at their disasterous obsession with unleashing 'market forces' in the NHS.

So we get dysfunctional PFIs which have virtually bankrupted local services in order to pay off huge loans [don't worry, only 30 more years to go].

And do you know about the cost of patientline or other private hospital based phone services - it would probably be cheaper to hire a Learjet and visit in person.

You mention superbug infested hospitals - but you fail to mention the downturn in hygiene standards after cleaning, catering and so on were 'outsourced' to private firms.

Of course ISTCs received preferential contracts while privately run GP OOH services has seen the sublime replaced with the ridiculous.

But don't worry unfettered private health care will soon swamp the UK health market - lets hope it is only half as successful as the arrangements for dentistry.
Remember photographs of huge queues vainly searching for the few remaining places on the last NHS dentists list.

ChrisC said...

"Crap" employees tend to be fired.

How many NHS employess were fired (not made redundant) but fired for cause over the past five years?

Devil's Kitchen said...

A&E Charge Nurse,

Ah, PFIs; has there ever been a stupider system invented? In theory, it's lovely but it doesn't work -- combining, as it does, the worst elements of both worlds: the private companies' desire to make profit and the inefficiencies of the public sector.

Crucially, what PFI removes is the ability for a private company to go bust and thus removes the incentive for the private company to run the hospitals either efficiently or decently: in fact, they have the same thing as public sector workers: it doesn't matter how shit the hospital is, the private company is always going to get paid.

So stupidly have the public sector negotiated the contracts that the rapacious private sector negotiators have walked all over them (a situation which Burning Our Money calls "the state as Simple Shopper").

I don't support PFI; I do support private hospitals and genuine competition between them.

Apart from anything else, given the capital costs required, I think that what we would begin to see is a greater quantity of smaller hospitals -- which will be easier to keep clean and can be more responsive to local needs -- rather than the enormous, difficult to run monoliths that we currently go for.

DK

Devil's Kitchen said...

But don't worry unfettered private health care will soon swamp the UK health market - lets hope it is only half as successful as the arrangements for dentistry.

Remember photographs of huge queues vainly searching for the few remaining places on the last NHS dentists list.


Yes, dentistry in this country is appalling but it is no more expensive than the US and we all know what the Americans think of British teeth, eh?

There is not the culture of insuring here: there should be. Ever heard of Denplan? It's insurance for teeth.

Why are dentists not doing NHS work anymore? Because they lose money by doing it. Thus, my dentist, for instance, charges his adult patients more because he loses money on the NHS work (children and students only) that he does.

So, in the really fair manner that socialists love, I get to subsidise other people's lifestyle choices, i.e. their bloody children.

DK

lost_nurse said...

Who said I worship socialism? (although - gasp - I do take a certain amount of civic pride in paying my taxes fo healthcare and a standing army).

I am first, and foremost, a pragmatic type. My view remains that the NHS (esp. as regards emergency and critical care) is not something to be pissed away lightly, leastways if Patsy would just stop screwing it around. It is absurd to suggest that [the majority] of staff who elect to do demanding (and poorly-paid) work do not have any "incentive to do a good job." You might well find - post privatisation - that goodwill and hard-won expertise do not come cheap.

If the *idea of the NHS offends you - fine. But don't pretend that this kind of political jousting has any bearing on why ITU nurses etc crack on with the task in hand. Just be thankful they do. Your question about delivering dead babies is simply bizarre. I don't usually deliver rug rats myself - but if you are suggesting that such gross negligence would go unnoticed and unpunished by my peers, you are way out of line.

Dr John Crippen said...

Hi guys

Gosh this is getting heated. Good robust defence from the ever temperate A & E Charge nurse.

But a factual inaccuracy. I do NOT loathe midwives. I do approach them with a degree of antipathy and I do so because of their MANNER rather than their competence.

I can cope with midwives who make mistakes. We all do that. What I hate and detest is anyone in medicine who patronises patients. And midwives, par excellence, patronise pregnant women.

Could you tell me why, for example, a 30 year old barrister who happens to be naked from the waist down loses the right to be routinely called Ms Smith, but instead is called Joan without permission by all the midwives?


If the tables were turned, and the barrister was defending the midwife in a negligence case, she would call the midwife Ms Jones. It would not occur to her to appropriate her first name.

Why is this? It is called courtesy . Professional courtesy in this case.

Many midwives do not understand such things and are both arrogant and patronising. Of course there are some lovely, kind, caring midwives. But they are let down irretrievably by the poisonously patronising ones.

The statement above about childless lesbians is of course outrageous...but it is as well that you cannot access doctors.net because there is lots of that around.

However, there are a lot of midwives who have not had children themselves. That does not help.


And tell me, A & E Charge nurse, what do you think of this spokesperson for the Independent Madwives:

Annie Francis, spokeswoman for the Independent Midwives’ Association said:

“Most clients understand you can’t insure against things going wrong during childbirth, only against negligence, and negligence is not really an issue for us”

++++++++++

"Negligence is not really an issue for us".

Breathtaking.

My interpretation is that this woman is an ignorant, arrogant fuckwit, and I would not let her deliver a pregnant rabbit.

What would your take on her be?



John

Devil's Kitchen said...

You might well find - post privatisation - that goodwill and hard-won expertise do not come cheap.

Why? We have, we are told, a glut of nurses who cannot find jobs; supply and demand would suggest that we could actually pay them rather less than we currently do.

The same applies to doctors. Apparently there are some 8,000 more doctors than training places, so we can obviously pay less for them...

DK

Devil's Kitchen said...

Good robust defence from the ever temperate A & E Charge nurse.

As a detractor, one of my most valuable commenters...

Just letting you know that your frequent contributions are always appreciated A&E, even if we disagree on almost everything...

DK

lost_nurse said...

DK, I'm talking about experienced staff nurses (the kind our under-strength HM Forces will give an £8000 golden hello). Nursing is now a global labour market, like anything else. There is a trade-off in harnessing that kind of goodwill and talent. As far as I'm concerned, the NHS has done pretty well on that front, until comparatively recently.

Devil's Kitchen said...

lost_nurse,

You are, of course, correct in that. Further, the ability of hospitals to set their own contracts outside of the national pay deal would mean that nurses in places such as London would get a decent salary.

A really good nurse is pretty indispensible but it's not the good ones we've been discussing here.

DK

Mark Wadsworth said...

My wife was in labour for 18 hours with her first child, by midnight the midwife was still insisting "Give it another half an hour".

A surgeon walked in and said "Look, the baby is suffering, would you like a Caesarian?"

Midwife contradicted.

I told the Mrs to have a Caesarian, so she did and it all turned out fine.

However, I do still worry about the obvious professional/ego clash between midwife and surgeon, to this day I haven't worked out whether it was professional pride ("I want to do it MY way") or genuine difference of opinion that made them give completely opposing recommendations, my poor Mrs was hardly in a state for great intellectual debate by this stage.

Rotty said...

Let's play the Blame Game.

A&E Charge Nurse blames: Blair & Co + bankrupted local services + patientline + private 'cleaning' firms + GP OOH services.

Lost Nurse (who, predictably, gets a cheap thrill out of receiving £2 from the public purse for every £1 he/she pays in) blames: Patsy.

Who do I blame? I'll let Dr. Crippin answer this one for me:

"What I hate and detest is anyone in medicine who patronises patients. And midwives, par excellence, patronise pregnant women."

*This* is what I mean when I say that socialised systems wind up producing the kind of people who smell less like roses than rose-manure -- Crippin is, after all, a well-meaning guy. And yet. He's sunk so deep into the socialist NHS that he really can't work-out that what we're talking about here is a young woman, screaming in agony and terror for the safety of her unborn child. What Dr. Crippin (NHS employee all-the-way) thinks we're talking about is the thought that said agonized and terrified mother- not-to-be might feel 'patronised'.

God damn, but the whole lot of you really do live in your own, precious little world, don't you?

lost_nurse said...

rotty, methinks you are not very familiar with Dr Crippen...

Rotty said...

Lost Nurse: Oh, but I *am* familiar with him. Like you, he spends most of his time looking for other people to blame for the NHS' failures. Unlike you, of course, Crippin doesn't have the usual lefty targets in his sights. Whatever. Your fellow NHS-drone Crippin *did* pick 'patronise' over 'screaming agony' -- Why not answer that point instead of trying to play the smartarse?

lost_nurse said...

"Why not answer that point instead of trying to play the smartarse?"

Familiar? Could have fooled me. Read some of Dr Crippen's comments on pain-control during childbirth (see NHS Blog Doc passim).

As for the rest... please free yourself from the delusion that NHS staff are the last great enemy in the Cold War that you are still fighting.

the a&e charge nurse said...

Thanks Dr Crippen - I'm sure you would agree that it is not only the midwives who might feel alienated from the pronouncements of their so called leaders, I have been following your dogged pursuit of the perpertrators of MTAS from day 1.

I do not know very much about Annie Francis but I do know the indies are being run out of town because nobody is willing to insure them - but clearly her comments are indefensible, and I'll bet she wishes she never made them.

I have three of my own, and yes, the midwives were incredibly bossy but even this was preferable to the sheer tedium of waiting for the cervix to fully dilate [sorry love].
The hospital births were all uneventful from a medical perspective [fortunately] and I cannot recall any particular tensions between either camp, maybe that's why I'm slightly suprised by the venomous undertone creeping into some of the comments.

rotty - I'm merely reporting objective facts about the disasterous consequences of profiteering in the NHS, or are you seriously suggesting that Bliar is a socialist.

Devil - we all enjoy the sheer force of your personality, not to mention the genuine pearls of wisdom that sometimes lurk behind the histrionic facade - I remain an avid fan.

woman on a raft said...

"I'm slightly suprised by the venomous undertone creeping into some of the comments."

Care to enlarge?

Rotty said...

*Sigh* I don't *care* what Crippin thinks about any, specific issue. The *point* is that, when push comes to shove, Crippin twitters strangely on about 'patronising' patients. So. Let's hear, again, from Heather Paterson's partner (yes, she had a name), she of the screaming agony and dead son (Riley -- He had one too):

"Heather’s arms and legs were convulsing because of the intense pain.
"Heather was becoming very distressed because of the pain and was literally screaming for someone to come and help her with pain relief or give her a Caesarean section.
"I asked several times if my wife could be seen by a doctor and we were refused. The midwife kept saying to her that her pain was not real. She said ‘no pain, no gain."

Now let's hear, again, Crippin's take on this issue:

"Could you tell me why, for example, a 30 year old barrister who happens to be naked from the waist down loses the right to be routinely called Ms Smith, but instead is called Joan without permission by all the midwives?
If the tables were turned, and the barrister was defending the midwife in a negligence case, she would call the midwife Ms Jones. It would not occur to her to appropriate her first name."

Well, then, to hell with the 30 hours of agony and grief for a dead son -- The *real* question is: Did the midwife refuse the sobbing, screaming mum- not-to-be treatment with the words 'Ms. Paterson' or (boo! hiss!) a patronising, derogatory, Crippin-irking 'Heather'?

And, since you raise the issue of the Cold War, what are your thoughts on the fate of Russian peasantry? Was it 'forced starvation'? Or 38th 'poor winter' in a row?

Dr Ray said...

Rotty- there is a belief amongst many economists that people are basically lazy and workshy and that they will only produce the goods if incentivized (or punished). This is the current economic thinking in many private companies and explains why, for example the CEOs of big companies and hedge fund managers need to be paid many £millions per year.
It doesn't really explain why people go into medicine or nursing-there are not many that do it for the money. Even more, it fails to explain why, say a soldier, will risk his life-soldiers are not on pay-per-kill or other incentives as far as I know. Same applies to voluntary work. I am not saying that the people who work in the NHS or a charity shop are not benefitting in some way but it is more complicated than the simple market forces you think will solve everything. One of the strengths of the NHS is that the people working in it have no financial incentive to act in one way or another-you see this as a weakness. When people phone me up asking for a total body private MRI scan, market economics would suggest I take the money and do the scan but my NHS background makes me explain to them why I think they could spend their money better elsewhere. How does this tie in with market forces improving standards and financial incentives?

Dr John Crippen said...

Hi Rotty

You said:

++++++++++++++

"What I hate and detest is anyone in medicine who patronises patients. And midwives, par excellence, patronise pregnant women."

*This* is what I mean when I say that socialised systems wind up producing the kind of people who smell less like roses than rose-manure -- Crippin is, after all, a well-meaning guy. And yet. He's sunk so deep into the socialist NHS that he really can't work-out that what we're talking about here is a young woman, screaming in agony and terror for the safety of her unborn child. What Dr. Crippin (NHS employee all-the-way) thinks we're talking about is the thought that said agonized and terrified mother- not-to-be might feel 'patronised'.

God damn, but the whole lot of you really do live in your own, precious little world, don't you?

+++++++++++++++

I don’t take back one word about hating people who patronise patients. And I don’t quite know what you mean by “sunk so deep into the socialist NHS…” – if you mean that I am committed to all UK citizens being able to access a reasonable standard of health care independent of status or income, then I plead guilty. If you mean that I support the New Labour Stalinist control freakery that has dominated the NHS for ten years, then you are way way out.

As to the case in hand; it sounds like there was gross incompetence by the midwives in question (if the facts are as presented). They should be struck off. Furthermore, I there is enough her for the civil court to pass the case to the crown prosecution service to consider a prosecution for manslaughter.

You have painted over my article with too broad a brush. I am not suggesting that the “manner” of the midwives was more important than the mother’s loss. What I was telling you, from many years experience, was that the patronising and arrogant way these midwives behaved (“no room at the inn”, refusing to call a doctor, telling the father he was making a fuss…. And so on) rings true.

The problem with these patronising, arrogant midwives is that they do not know there boundaries and they are too arrogant to call for help when it is needed. Had they not been so arrogant and patronising, they might have called for help early rather than telling the father he was “making a fuss”.

You say:

“God damn, but the whole lot of you really do live in your own, precious little world, don't you?”

What’s your point?



John

JuliaM said...

"How many NHS employess were fired (not made redundant) but fired for cause over the past five years?"

Probably the same as the number of social workers fired for cause....

"At the very least a serious incident enquiry will be convened and any negligence or malpractice will be dealt with in the first instance under the Royal Free Trusts disciplinary procedures.
Further measures may be taken by the RCM.
The family can also take legal advice about bringing a prosecution through the courts."


Yup, it looks like that is exactly what will have to happen:

http://news.independent.co.uk/health/article2651291.ece

"He said he learned of a case in 2001 at the Royal Free where a baby had died in similar circumstances and a full inquiry made recommendations."

Hmm, guess it is more than an isolated case then....

Devil's Kitchen said...

A&E Charge Nurse,

I'm merely reporting objective facts about the disasterous consequences of profiteering in the NHS, or are you seriously suggesting that Bliar is a socialist.

Blair is, I suspect, an idealogical vacuum. However, Brown is a socialist.

The problem with the NHS is not the profiteering per se: it is the profiteering with no element of risk to the private company. PFI was supposed to transfer risk to private companies; in practise, because the public sector are crap at negotiating, this did not happen.

Brown and Blair thought that they could get private money to expand the NHS, but at the same time they wanted to keep political control. Hence the absolute fucking disaster that has been PFI: as I said, all of the drawbacks and none of the benefits.

The other motive, of course, was that it keeps the PFI spending off the government's books, thus allowing Brown to claim his reputation for prudence. It's a scam; according to Burning Our Money, only about £24 billion of these new projects appear on the Treasury's accounts; actual spending is more like £90 billion.

(Incidentally, BOM estimates total government debt to be about £1,800 billion, or rather more than Britain's current annual GDP).

Brown and Blair were so ignorant and arrogant that they thought that they could, essentially, get private companies to do the work out of the kindness of their hearts.

But that is always the socialist way; my view -- and one shared by Adam Smith -- is that everyone is, mostly, self-interested: if you treat them as such (and treat companies, which are run by people after all) the same way, then you will not make these kind of colossal miscalculations.

Unfortunately, the socialist mindset usually does not see people that way; it at least pretends to assume that people will act in the best interests of others of only you give 'em a chance to.

We are now reaping the rewards of this naivety.

DK

Rotty said...

My point? That whether you punch to the left or to the right, none of you ever seem willing to even accept the possibility that the socialised system you're working for could be the reason why healthcare standards in Britain are falling faster than Mahmoud Abbas' popularity at a Hamas convention.

Why is this?

Well, I guess if (human nature -- and our capacity for self-delusion -- being what it is) *I* were raking in £100 grand a year, the thought of any nasty capitalists spilling gravy from my train would send a shiver down my spine too.

Welcome, folks, to Dr. Crippin's 'precious, little world':

"I am committed to all UK citizens being able to access a reasonable standard of health care independent of status or income"

And how's that commitment going?

Superbugs?

Women screaming in agony as they birth dying sons?

Pensioners left to die on trolleys?

£100 grand per year to prop up the system?

One of these is the odd one out. One of these doesn't belong.

"John"

I prefer your non-deplume. Considering who you work for, it's far more fitting.

lost_nurse said...

DK, valid points about NuLab arrogance - but don't forget that el Gordo took a Tory policy (PFI) and ran with it. It's not just political naivety and shite procurement (though both are clear enough) that's to blame. Much DoH policy has been of a serious revolving-door nature - i.e. the ridiculous (& utterly skewed)comparators that are used to justify PFI spending, ISTCs etc. The private sector are making a killing - in part because their interests are now so deeply entrenched within government.

We can argue about the merits (or otherwise) of a "free-market" in health (and I hold that no such market is EVER as fluid as people like to pretend) - but one thing's for sure: handing out public infrastructure like sweets to some of the current big players is doing nothing for patient care. Or the taxpayer.

Fidothedog said...

the a&e charge nurse, it would appear that you are the NHS version of councillor Terry Kelly.

lost_nurse said...

"the a&e charge nurse, it would appear that you are the NHS version of councillor Terry Kelly."

And it is more than apparent that you have no idea what you are talking about.

Rotty said...

Lost Nurse said: "rotty, methinks you are not very familiar with Dr Crippen..."

And THEN Lost Nurse said: "And it is more than apparent that you have no idea what you are talking about."

So look on the bright side, Fido, at least LN takes the trouble to paraphrase his/her insults. Clearly, we're dealing with a student nurse -- After a few years (and a few humungous pay-increases out of our pockets) he/she will be able to copy/paste insults as easily as he/she walks past dying pensioners begging for food on the way to a selfish face-stuffing at the hospital canteen.

lost_nurse said...

Give it a rest, rotty. You are obviously unaware of Dr Crippen's many postings on women suffering unneccessary pain during childbirth - somewhat contrary to your assertion that he is only bothered by midwives being "patronising." Hence my post.

Fido clearly has no idea about A+E C/N.

As for the rest of your ramblings... I'm not sure I can be bothered to reply.

the a&e charge nurse said...

rotty, our pensioner loving super-hero, seems to think that if he trots out enough insults, in the style of a frustrated Tommy Saxondale, someone might mistake his tedious cliches as a cogent argument.

May I respectfully suggest rotty that you either increase your dose of haloperidol or actually make a point - if Dr Crippen can't understand you then I doubt if anyone else can.

fidothedog - excellent contribution, keep up the exciting work.

Roger Thornhill said...

IIRC Dr C. has spoken favourably about "fundholding" - that scheme scrapped on DAY 1 with no thought by Mr Blair. A shameful act which makes me suspect he "owed" a Union or two.

Fundholding or something close (but not the AFAICT faux "choose and book" IT veneer) would be one of the steps to bringing efficiency and accountability to the system.

PFI is an abomination. In fact I am surprised the entire concept is even legal.

lost_nurse said...

He was right about my hospital canteen, though. It's pretty good. For a moment, I thought he might be the infamous HJ in disguise.

Shotgun said...

Shotgun - the death of a baby hitting the national headlines is unlikely to be swept under the carpet.

I have no way of knowing the full circumstances of this case, and neither do you.


Then you should keep your big fucking 'defending the indefensible' mouth shut then you callous cunt.

The problem with the NHS is that mistakes and incompetence is not punished fully or effectively, thereby tacitly making it acceptable, then cunts like you and Bliar come along and demand we concentrate on the good alone and stop harping on about the bad, making incompetence even more acceptable.

Charge the cunts with manslaughter and make an example, and next time a child might live as these fuckers think twice about the treatment they are paid to give.

Cunt.

Midwifemuse said...

D.K - 'Sticks and stones etc.', only that isn't really true because your words do 'hurt' me, particularly since they appeared to be such a abusive tirade against all midwives and I initially thought that you were talking about something you know about, but I don't believe that you do.
Anyway, all that aside, the case that started off this discussion. The evidence from the bereaved Father, that I am reading in the papers, tells a truly disgraceful story, and I am unsurprised at the general outcry, in fact I join in demanding that these midwives lose their registration. However, as previous commentators have pointed out, there are malpractitioners within all fields, so please do not cover us all with the same label.
With regard to the number of midwives per woman, this is not solely servicing women in labour. The figures represent the number of midwives, both within the hospital and the community, required to provide care to pregnant women from the time of booking, in early pregnancy, until discharge from midwifery care, generally between 10 - 28 days following the birth.

Shotgun said...

I'm just slightly suprised that some of the more rapid commentators have not called for the ducking stool given the accused are both midwives and female.

So how do we weed out the bad apples? To people like me it seems there is constant problems that are not addressed and are tossed off the cuff with comments like stop concentrating on the bad. I know of at least three cases, my own mother included, where NHS incompetence resulted in a death.

Was anything done? No fucking chance because the staff banded together and defended each other saying they might be next. The people responsible should have been immediately sacked, but until the NHS and medical unions take these problems seriously I will lump the whole profession together.

People are dying in the thousands because of filth, primarily from nurses, people are dying of malnutrition or undernourishment because nurses don't have the time to feed them, apparently, and people are dying through sheer incompetence...but everything is fine because we must concentrate on the good, and not just band everyone in together.

These are real fucking people with real fucking families, and cunts like you defending a system and organisation that defends a culture of incompetence and indifference that results in actual death are true cunts in the worst sense of the word.

You are quick to point out that in an organisation that employs a million people there are bound to be a few bad ones.. but this isn't a fucking call centre where you might get charged a few quid too much, or a supermarket where you might get short changed; people are fucking dying you callous cunt.

Rotty said...

Aww don't be like that, LN. Me and Fido are only kidding. I'm sure you're a cracking, good nurse (at least by NHS/shit-pit standards). Doubtless, all of those countless stories we keep hearing about NHS-neglect, from all over the country, wouldn't have happened on your watch. Damn, but if only there were more nurses like you around!

And, of course, if only there were more GPs like Crippin (junior). Here he is, explaining how *he* sorts out an elderly couple (she with dementia, he with a dicky heart):

"I speak to the nurse and the reception staff. The nurse is about to finish her session and volunteers to follow Elaine home."

So, sorry, again, LN. I didn't realise that you worked in the same (almost-mythicaly -saintly) practice as Crippin. How'd the old dear do? She get home alright? You know, with you driving behind her all the way to make sure she didn't have an accident.

Oh. Wait. What's that? You say you *don't* work for DC? Well, that's weird, isn't it? Because, if you're a living saint, and DC's nurse is a living saint, then how come the rest of poor shmucks wind up starving on trolleys and watching our wives screaming in agony as our sons die inside them? Hmm?

Maybe we're just really, really unlucky. We keep missing out on all the docs and nurses who actually do the jobs they're paid to do. Because, damnit, I've never even *heard* of a real-life nurse kindly shadowing a senile driver home while hubby heads off to hospital for a heartscan.

Most of us have, however, heard of this kind of thing:

"Some have a tray placed on the end of the bed, tantalising with hot food. It may be just an inch out of reach but it might as well be a mile. To a bed-ridden pensioner, it must seem like torture."

[Just do a search for 'pensioner starve hospital' -- Guess which caring, sharing, socialist healthcare system Google reaches for.]

---------------

"He was right about my hospital canteen, though. It's pretty good."

Starving pensioners. Ho-ho-ho. Your taxes at work, folks.

lost_nurse said...

"Starving pensioners. Ho-ho-ho. Your taxes at work, folks."

You can fuck right off, you pompous little jerk. The canteen remark was a joke, as anyone who tries to bolt cold scoff during a fifteen minute break on a twelve hour shift will understand. I've cleaned up more shit, cared for more dying pensioners, fed more malnourished patients and attended more cardiac arrests than you will ever see in your miserable little paranoid existence. Do you think I don't get angry at what goes on?

I can say - with certainty - that you would not last five minutes as a staff nurse. It would make you piss yourself with fear. Fuck you.

lost_nurse said...

"...making incompetence even more acceptable."

And Shotgun: I am sorry to hear about your mother, but concentrate your fire on the mendacious politicos. No medic or nurse here is defending "a culture of incompetence and indifference." Quite the opposite. Precisely because, as you say, healthcare is not like running call-centres and supermarkets.

Rotty said...

"You can fuck right off, you pompous little jerk."

Ohhh, talk dirty to me -- I love it. (Mainly because it means you've run out of your admittedly piss-poor counter-arguments and can only resort to abuse.)

"The canteen remark was a joke, as anyone who tries to bolt cold scoff during a fifteen minute break on a twelve hour shift will understand."

Awww. Poor you. Bolting 'cold scoff'. Still, unlike those starving pensioners, at least you *can* bolt down food. And, unlike those unmedicated mothers- not-to-be, at least you're not screaming in agony while you -- Do what? Stuff your selfish face in exactly the way I accused you of doing? Damn, but only a lefty could get as self-righteous as you're doing without having the wit to realise they were actually *conceding* the contended point. Twit.

"I've cleaned up more shit, cared for more dying pensioners, fed more malnourished patients and attended more cardiac arrests than you will ever see in your miserable little paranoid existence."

What's this? A human-suffering dick-measuring contest? Gosh, but this would be a more effective counter-argument if the rest of us hadn't *also* heard of all the pensioners you guys starve to death in order to 'bolt down' 'cold scoff' -- And what the hell *is* cold scoff anyway? Is the NHS feeding its drones platefuls of cold porridge? Or, more likely, are you talking about 'eating a cheese sandwich with no chance to sit around gossiping afterwards'? Danm, but it must be a bit of a bitch to have to walk back to the ward in order to watch those pensioners die of hunger while reaching for their food. Kind of like being forced to watch Babi's mother's deathscene over and over again. I mean, who needs that? Huh? (Well, the relatives of the newly-starved might want to see it postponed for the first time, but fuck them, eh? Why should something as insignificant as human agony come between you and a cheese sarni?)

"I can say - with certainty - that you would not last five minutes as a staff nurse. It would make you piss yourself with fear. Fuck you."

And coming from someone who pisses herself with fear at the thought of a horribly-truncated lucnchbreak, I suppose I should take note ...

... Though, fyi, that twelve-hour thing you were whining about. Most of us don't call that 'hardship', we call it 'working for a living'. Do try to learn about this kind of thing -- millions of us do it every day in order to bankroll you saintly NHS-types. In return, of course, we fully expect you to:

(a) Call us 'pompous little jerks' when we're healthy enough to fight back, and

(b) Starve us to death while you 'bolt' cheese sandwiches when we're too old and/or sick to oppose you anymore.

And, of course, if any of us have the audacity to bleed or shit, well, you'll complain about that too, won't you?

Dr Ray said...

As usual, intelligent comment has been replaced with name calling and insults.
Rotty-have you no idea what it means to work in a hospital? You seem to think that NHS staff should be like Mother Teresa and work a 12 hour shift without food or a chance of a bit of gossip. You seem to think that normal working people can do this day after day and that their performance will not suffer. You seem to resent that they are paid for going to work. What we should expect of NHS staff is that they do a professional job. We don't ask that nurses should go without food or not be paid. How would this help the patients?
Can you not see how moronic your comments are?

Shotgun said...

... Though, fyi, that twelve-hour thing you were whining about. Most of us don't call that 'hardship', we call it 'working for a living'. Do try to learn about this kind of thing -- millions of us do it every day in order to bankroll you saintly NHS-types.

I wasn't going to comment again, having said my piece, but this comment is right on the money.

Do we rush out to congratulate binmen when they do a the job they are paid to do, then shrug our shoulders when they leave rubbish all over the street repeatedly, all because they have done a good job in the past? Same for any other profession.

You seem to think that NHS staff should be like Mother Teresa and work a 12 hour shift without food or a chance of a bit of gossip.

I don't see that, and I don't think that. There is a world of difference between objecting to nursing staff killing patients, literally, and expecting them to be Mother Theresa and going without food, and you failing to even acknowledge that distinction shows you to be a cretin, and having made the point for us.

Lost Nurse...
And Shotgun: I am sorry to hear about your mother, but concentrate your fire on the mendacious politicos.

Our fire is nearly always pointed at politicos, but that does not excuse nursing staff, and politicos or their policies did not kill my mother, though it may have contributed.

the a&e charge nurse said...

Shotgun - unlike the semi-delirious rotty you actually raise some important issues.

Personally I could do without the the poor mans Derek & Clive routine, that type of material may sound hilarious in the hands of a comedy genius but coming from you it sounds as if the neural pathways to the frontal lobes have been severed[sorry, Dr Ray].

But I digress, in summary your allegations can be summarised as follows;
Complicity by NHS staff to pevert the course of justice after a serious incident.
Unwillingness of health professionals to self regulate cowboy operators.
A lack of appropriate remedies, or if you prefer punishment after harm has been proved [tricky given your first two propositions].
Unacceptably poor standards epistomised by filth, malnutrition, serial incompetence, and lack of staff time or compassion - although I'm rather suprised you would want any doctor, nurse, or indeed midwife within a mile of you, your family or presumably anyone else for that matter.

For the moment I will wait to see if any of the bloggers following this volatile thread concur with your controversial analysis [with the exception of rotty, obviously].

Personally, I would have no hesitation in shopping any doctor, nurse........ or midwife who was deliberately harming a patient, but as I mentioned earlier, allegations however serious, do not preclude the presumption of innocence until guilt is proven - even when distressing news items are published in the Murdoch press.

Rotty said...

"As usual, intelligent comment has been replaced with name calling and insults."

Sorry, dr ray. I humbly apologise for calling your fellow NHS Drone a 'pompous little jerk'. I also regret telling her to 'fuck right off'. I'll try to avoid 'name calling and insults' in future ... What can I say? When you're Jonesing for a cheese-sandwich, common-civility just flies out of the window! Oh. Wait.

"Rotty-have you no idea what it means to work in a hospital?"

Duhhh. Me sooo dumb. Me no unnerstann.

"You seem to think that NHS staff should be like Mother Teresa and work a 12 hour shift without food or a chance of a bit of gossip. You seem to think that normal working people can do this day after day and that their performance will not suffer. You seem to resent that they are paid for going to work. What we should expect of NHS staff is that they do a professional job. We don't ask that nurses should go without food or not be paid."

Well, no. Actually I couldn't care any more for what you NHS drones think/feel than I could care about what the girl on the checkout at Tescos thinks. When I pay for goods/services, I just expect to get what I paid for. Tescos (bless them) manage to feed me the food I pay them to feed me with -- So why can't you deliver me the healthcare I pay you for? Hmm? No shite about short lunchbreaks and how tired you are. I don't care. *I'm* tired, but I don't tell my customers to 'fuck off'. I just do the job I'm paid to do. Food. No food. Pay. No pay. Why should I care how crap your management is? *I* paid for the service you offered at *my* end, so WHY WON'T YOU DELIVER?

"Can you not see how moronic your comments are?"

... So I'm a moron for expecting to receive the very service I paid for? And I'm a moron for thinking , 'Hmm, maybe if I could get the Gordon-shaped gorilla off my back, I might be able to cut a better healthcare deal.'

Maybe that's an arrogant thought and maybe not. Whatever. At least, none of the people I'd try to cut it with would tell me to 'fuck off', call me a 'moron', or step over my nearly-starving body in order to gobble-up a cheese-bun.

Matt said...

rotty,

As you are so clearly critical of NHS staff, please tell us what job/profession you have so we can have a chance to denigrate you and your chosen field.

I do hope it's something in Law!

Rotty said...

It's worse than law (or better, depending on how much you either hate lawyers or want to mock me).

Whatever. I work in animal rescue. Right now, I'm fifteen-minutes away from bottle-feeding a litter of six orphaned kittens.

Prior to mixing up the Cimicat, however, I'm going to grab a cheese-and-pickle sandwich. (This is, btw, the free-market approach to animal-husbandry. After driving dozens of senile pensioners home, NL was good enough to impart the NHS approach:

Eat your sarny, Rotty Then eat another. Still hearing the hungry screams from those pensio -- uh. Sorry. From those kittens? Then eat a third, fourth, fith, sixth sandwich. The main thing (according to the NHS) is to not move from the cheese -bun-position until the screaming stops. (Apparently, this approach works well for kittens, pensioners and expectant-mums ...)

... Though, from what I hear, you have to be some kind of cheese-addicted sociopath to appreciate this advice.

JuliaM said...

"...even when distressing news items are published in the Murdoch press."

Hmm, seems to me that most national newspapers carried the horrific tale of the Crofts, even the 'Independent' & 'Guardian'. The basic fcts, as presented to the coroner, were reported in each.

So I can't see how you can claim that this is a scandal ginned up by newspapers whose political outlook is not shared by you.

"It's worse than law..."

OMG! It's not PR, is it...? ;)

Still, Rotty, if those kittens die, don't worry about proscution by the RSPCA.

It seems the thing to do is to consider all the kittens that haven't died....

Roger Thornhill said...

To me the biggest problem is that people do not have the basic freedom to NOT have to use one provider. This very issue is at the root of the NHS dysfunction and exponentially increases the anger when treatment is arrogant, dismissive or negligent.

It is in the interests of everyone that the NHS monolith is no more and we focus on providing a true NI with safety net.

the a&e charge nurse said...

Juliam - it is mandatory for hospitals to report any sudden or unexplained death to the coroner [i.e. any death occuring less than 24hrs after admission].

The coroner's job is to determine cause and may make recommendations for action to prevent recurrance.

The Guardian & others may have reported the story, but newspaper items, irrespective of their political bias, are no substitute for an independent enquiry - it's the only way that both sides of the story can properly be heard.

Some commentators have presupposed an assumption of guilt.
This group do not seem remotely interested in what the midwives might have to say, but then why bother with such tedious details when these women MUST be guilty - it's not a view I subscribe to, and fortunately neither does the legal system.
Paradoxically its one the libertarians seem to ?

Shotgun said...

Personally, I would have no hesitation in shopping any doctor, nurse........ or midwife who was deliberately harming a patient, but as I mentioned

I won't bother Googling or searching for cases, because we both know they exist, and exist in relatively large numbers.

Culpability and responsibility are collective and results in investigations with accompanying recommendations, but in individual cases nothing is done.

You know it and I know it.

lost_nurse said...

Rotty, you crossed the line some way back. You know nothing about my record at work, and have no grounds for alleging that I leave ulcerated pensioners short of food and care. If you make such comments, expect incoming. In fact, I'm tempted to come round and bill you personally for all the unpaid overtime I've done in the last nine years.

Besides, if you are indeed the rotty that DK links to, it's clear that you are an A-grade nutjob and military fantasist. What riles you more? Muslims? Or abortion clinics? Whatever - keep on fighting for the free world, if it keeps you off the streets.

We could sit around and discuss cases of negligence from every healthcare system under the sun - and it would do little to prove your binary (free-market vs. socialised) vision of the world. The serious points that shotgun makes (underneath all his swearing) underline the idiocy of politicos sticking their fingers into healthcare - witness Patsy's recent comments about "choice" in maternity services. He may care to register that the despised unions are fighting for better staffing ratios (perhaps *the key factor in poor clinical outcomes - i.e. not enough bloody nurses). Such things are clearly affordable - cheaper, even - compared with NuLab's vainglory schemes, NHS IT, PFI etc.

I have never done anything but relish the challenge of the job - contrary to the bleeding hearts accusations above. It just pisses me off when people talk shite about what they know not. I know for a fact that Shotgun is ex-army - I doubt he'd take too kindly to me accusing him of defending "a culture of incompetence and indifference" in HM Forces, though the parallels are there. And whilst he's at it, he might like to ask a QA where they get their critical care expertise from.

the a&e charge nurse said...

lost_nurse - have you noticed how some detractors feel it it is OK to dump indiscriminately on NHS staff, then complain bitterly when we are reluctant to suck it up ?

These crass manouvres are invariably rationalised with child-like references to a mysterious 'market'.
Presumably the same market occupied by HSBC, et al who, along with a few others are doing a tidy bit of business in Iraq these days.

Dr Ray is absolutely correct [see, I told you normal service would be resumed] this debate has been hi-jacked by the name callers [myself included].

It's clear where you stand on providing decent clinical standards, so it's a bit of shame that one or two of the commentators here don't seem to realise that you are actually one of the good guys.

lost_nurse said...

"Dr Ray is absolutely correct [see, I told you normal service would be resumed] this debate has been hi-jacked by the name callers [myself included]."


I fear that I am much more guilty of name-calling (and rising to the bait) than your good self. Must... practice... restraint.

Matt said...

the a&e Charge nurse says "Some commentators have presupposed an assumption of guilt.
This group do not seem remotely interested in what the midwives might have to say, but then why bother with such tedious details when these women MUST be guilty - it's not a view I subscribe to, and fortunately neither does the legal system.
Paradoxically its one the libertarians seem to?"

It has been my contention for a long time, and I have argued this on previous blogs about, for instance, whether the BNP should be given a platform, that so-called liberals are in fact fasciasts. They know better and their way is the only way. If you oppose them, you are rascist, chauvanist, or whatever is appropriate in the circumstances.

rotty, little furry animals! aaaaaah! So I suppose we could regard you as a Nurse or at least a Vetinary HCP. Welcome to the fold!

JuliaM said...

"The Guardian & others may have reported the story, but newspaper items, irrespective of their political bias.."

So, why the opprobrium thrown at the 'Murdoch press', as you put it? This nomenclature is rather telling...

"lost_nurse - have you noticed how some detractors feel it it is OK to dump indiscriminately on NHS staff.."

I don't see anyone doing this though. No-one has waded into the comments to abuse the author of the 'Random Acts of Reality' or 'Nee Naw' blogs, for instance.

Both are well-written & show the problems facing NHS front-line staff; I couldn't imagine either of them treating patients in the way the Crofts recounted to the coroners court. So spare us the red herring accusation of being 'NHS bashers'.

If Rotty thinks that 'Dr Crippen' sometimes shows himself to be arrogant in his blog, well, he isn't alone in that opinion...

"...HSBC, et al who, along with a few others are doing a tidy bit of business in Iraq these days."

Good grief! Do we need a corollary to Godwin's Law..?

Where the hell did you pull Iraq from, and how on earth is it relevant to a discussion of an incident of appalling service in the NHS.

lost_nurse said...

"Where the hell did you pull Iraq from..."

I think A+E C/N was making a generalised point about these kind of debates (i.e. people invoking/disputing "the market"). I dunno - maybe you could ask Paul Bremer? Given that his post-war strategy has been so marvellous (i.e. not - in case rotty is unable to detect irony).

Back on topic: nobody here is defending malpractice, anymore than Tom Reynolds would. Unfortunately, the discussion became sidetracked - as I am sure you can see. Something about sandwiches.

JuliaM said...

The discussion became sidetracked because of the people jumping on to argue:

a) Oh, but they are just bad apples, look at the good others do; or
b) You are just bashing the NHS; or
c) Let's not rush to judgement on these two, despite the coroner's judgement...

In other words, you & 'A&E' banded together to face off an attack on what you see as your profession.

What you seem to forget, however, is that we all use the NHS, we mostly don't have a choice (or in paying for it) - we've seen the good, and the bad. These days, it's rather more of the latter than the former.

"Ms Toby has since left the Royal Free Hospital but continues to work as a midwife, while the other midwife, Beverley Blankson, still works there."

Still works there. Let that sink in for a bit.

Yes, until the hearing, she is technically innocent. But is letting her practice a sensible decision? If an officer shoots someone in the line of duty, he/she is relieved of duty until it is determined if the actions were warranted. Why should the same not apply here?

It now emerges that the Royal Free had a similar case in 2001 and as usual, 'lessons were learned' and 'recommendations were made'. Sound familiar?

I think we can see where this is going...

lost_nurse said...

"In other words, you & 'A&E' banded together to face off an attack on what you see as your profession."

I'm not a midwife. You may have noticed one commenting earlier, thus:

"I am unsurprised at the general outcry, in fact I join in demanding that these midwives lose their registration. However, as previous commentators have pointed out, there are malpractitioners within all fields, so please do not cover us all with the same label."

For the record, and subject to the full facts being known, I second that comment.

___________________________

"Sound familiar?"

It does sound familiar. For example: "Lessons were learned and where appropriate systems were improved."

Spokesperson for the Portland hospital in 2002 following the [easily avoidable - but no post op checks were undertaken...] death of a mother post c/section.

Portland Hospital is a private hospital - and requires serious dosh. Yet they failed even the most basic duty of care. Do I condemn the entire private sector on the basis of a single case? I do not. Do I believe (as Rotty does) that maternity care - indeed, any potentially critical situation - is like buying a tin of beans at the supermarket? No, I don't.

That is why I tend to stick up for my profession. And, indeed, why I'd like to see more midwives (and nurses) on the job.

JuliaM said...

"I'm not a midwife. "

Didn't think you were - and the profession I was referring to was that of 'NHS worker'.

Yes, I did see that comment, good for him/her. If only more were willing, as Shotgun points out, to take action on poor service by colleagues rather than agreeing in condemnation after the fact.
"Portland Hospital is a private hospital..."

You seem to be forgetting something. If I go private, I can choose, on the basis of that report on the Portland, to go elsewhere. NHS 'customers' cannot...

Just for the record, do you think (no matter what the eventual medical care) that customers at the Portland are spoken to in the manner of the Crofts...?

lost_nurse said...

"Just for the record, do you think (no matter what the eventual medical care) that customers at the Portland are spoken to in the manner of the Crofts...?"

I'm not - for a moment - defending poor communication. But frankly, I'd be far more concerned at their ability to monitor my condition.

"You seem to be forgetting something."

With respect, so do you. What kind of process do you think produces good trauma surgeons, and the like? It ain't market forces. Whatever Rotty believes, there is no "supermarket customer" equivalent of polytrauma, or MIs, or triple-As. Even the NHS's most bitter detractors concede the difficulty in providing for such scenarios. Personally speaking, I'd rather have a tax-funded system that I knew would pick me up in emergencies, even if I had to queue on other occasions. As a patient, I don't much care for "choice" - it's a misnomer in healthcare, and is often just hollow political rhetoric, or sales-talk.

You'll have to excuse me, as I have to shape up and shift out for a night of fun on the wards. But maybe read some of the Dr Rant team's stuff (http://www.drrant.net/), as they put it much better than I.

Shotgun said...

Back on topic: nobody here is defending malpractice, anymore than Tom Reynolds would. Unfortunately, the discussion became sidetracked - as I am sure you can see. Something about sandwiches.

There is defending, and there is defending.

JuliaM said...

"..poor communication.."

Please:

"we were taunted by some staff who said, ’There’s no room at the inn, you’ll have to go home’.”

a midwife who induced the birth told Ms Paterson that she was a “silly girl” who was not really in pain

The midwife kept saying to her that her pain was not real. She said ‘no pain, no gain. This is what you have to go through, this is what it’s like’. . . . At some time she said to my wife, ‘You are a silly girl. You don’t deserve this baby. I’m going to take it off you’

In the end I had to go out into the corridor to bring her back in to look at it. She kept telling us not to be so fussy.”"


Poor communication...? Is that really how you describe the above?

For the benefit of any patients you may come into contact with on your shift tonight, the term for the above is not 'poor communication'.

The correct term is 'abuse'...

JuliaM said...

"What kind of process do you think produces good trauma surgeons, and the like? It ain't market forces.."

So, in countries where socialised medicine doesn't exist, there are no good trauma surgeons?

"Personally speaking, I'd rather have a tax-funded system that I knew would pick me up in emergencies..."

You forgot to add: "...and not treat me like shit, or an inconvenience, or talk down to me."

JuliaM said...

Oh, yeah, and not try to convince me not to complain when it all goes wrong:

"A postmortem examination, which Mr Croft said staff tried to “bully” him out of having, showed that the child died from asphyxia."

As I said at the start of this comment thread, they didn't succeed this time. Have they succeeded in the past..?

lost_nurse said...

Just quickly - come on, that's not how I'd describe it! Are you rotty in disguise? I meant communication in a general (i.e. "customer facing") sense. The above qualifies as abuse. No dispute there. It's unforgivable. Shameful.

I took your question as being about what you might term "sales-patter".

Other countries: co-payment and so on when they do it well. The kind of continental model that we should move towards, if anything. But it ain't ever a fluid market.

I really have to go...

JuliaM said...

"I took your question as being about what you might term "sales-patter"."

Then you made the wrong assumption. The above was what I was referring to.

Nice to see you can finally acknowledge it as unforgivable & shameful with no 'if they really said it as described' caveats.

And no, I'm not Rotty in disguise.

Matt said...

juliam,

I'm sorry to tell you that the vast majority of patients who use the NHS have a satisfactory experience and outcome. This doesn't match with the picture you are painting.

I'm sorry if this disappoints you.

And what is your saintly job/professon please tell?

Anonymous said...

"I'm sorry to tell you that the vast majority of patients who use the NHS have a satisfactory experience and outcome"

I'm thinking of my own experience, and that of some of my relatives, and work colleagues.

Not entirely negative, but the good staff stand out very much so because of the bad, indifferent or incompetent that seem to exist in greater numbers.

"And what is your saintly job/professon please tell?"

When my own job becomes germane to the comment I'm making, I'll mention it. Why are you so keen to know? Do you want to indulge in the

JuliaM said...

(as described by Rotty) 'human-suffering dick-measuring contest?'...?

Or do you just think that mere customers of NHS services lose the right to comment?

the a&e charge nurse said...

Juliam - sorry, I didn't realise that you and a fly on the wall documentary crew were actually in the hospital and had obtained a verbatim transcript, well done.

Presumably your reference to the midwives still working precludes the possibilty that there is much more to this tragedy than a few columns in a newspaper, or perhaps you're insinuating that the system is so corrupt nowadays it really doesn't matter what midwives do.

You're nearly correct when you say that we 'all' use the NHS, most do [including my family] but not all.
There is a burgeoning private sector for those that can pay, or who work for the right firm.

And you mention the Portland customers, yes, I'm sure the staff are very nice, providing you're the sort of 'customer' that can actually afford to cross the threshold in the first place.
But you can't 'choose' to go back if any emergency post-op complications arise, no, those nice people at the Portland will point you in the direction of the nearest NHS A&E department.
And guess what, if you become really sick while you're in a private hospital, those nice people will speedily send you on your way to the nearest......well, I'm sure you can figure out the rest.

Remember the private surgeon who treated Penny Campbell but couldn't be arsed seeing her when she became unwell after the operation - no, Penny Campbell was told very nicely to fuck off and see a NHS doctor - the surgeon had her weekend holiday to worry about, so not much choice there, either.

You may prefer to characterise paramedics as a different breed, but I'm sorry to tell you that you're wrong again.
Tom may be a top bloke but this service recruits exactly the same mix of dedicated and profesional workers, along with the odd smattering of wankers and incompetents.

[Sorry lost_nurse, I promised to be good but I just couldn't help it].

Fidothedog said...

Good in depth debate from lost_nurse

You can fuck right off, you pompous little jerk.

and of course

Fuck you.

My tax money well spent there. Nice to see the art of debate is not dead.

the a&e charge nurse said...

fido - another scintillating observation [yawn], thanks for keeping us informed about your tax contributions

May I suggest you obtain a quarterly breakdown from HMG detailing exactly how your dosh is spent - it would be fascinating to know more than the meagre snippet you have teased us with this evening.

Matt said...

juliam says "When my own job becomes germane to the comment I'm making, I'll mention it."

Let us decide if it is relevant.

"Or do you just think that mere customers of NHS services lose the right to comment?"

You are perfectly free to comment. The fact that you are talking through your arse is the problem.

"the good staff stand out very much so because of the bad, indifferent or incompetent that seem to exist in greater numbers."

Hearsay!

"I'm thinking of my own experience, and that of some of my relatives, and work colleagues."

How many people are involved here. It it a statistically significant sample?

"we've seen the good, and the bad. These days, it's rather more of the latter than the former."

Hearsay again!

All you are doing is trotting out the old boring cliches - yawn!

Nobody on this blog is defending bad practice or abuse. That doesn't mean however that we have to suffer your rantings in silence.

So go on, tell us what crap profession you belong to, or are you ashamed of it!

Rotty said...

LN said: "Rotty, you crossed the line some way back. You know nothing about my record at work, and have no grounds for alleging that I leave ulcerated pensioners short of food and care. If you make such comments, expect incoming. In fact, I'm tempted to come round and bill you personally for all the unpaid overtime I've done in the last nine years."

But you already *did* bill me, LN. I, and everyone else here who doesn't dip their fingers in the public purse have already paid and paid and paid for the 'service' you offer. So why am I 'crossing the line'? By pointing out it seems odd that, while *every* NHS drone we ever encounter claims they're secular saints, every NHS *service-user* claims you're a bunch of workshy parasites who leave pensioners starving to death on trollies? Either we're lying or some of you are. (Of course, maybe you, personally, are an absolute saint -- But, you know, it gets sooo tiresome hearing all of these protestations of competence coming from so useless an industry.)

"Besides, if you are indeed the rotty that DK links to, it's clear that you are an A-grade nutjob and military fantasist. What riles you more? Muslims? Or abortion clinics? Whatever - keep on fighting for the free world, if it keeps you off the streets."

'Military fantasist'? You mean I work on the Idema campaign? Trying to get justice for an illegally-imprisoned soldier? What part of that is fantasy? As for what riles me -- Try Muslim *terrorists* -- Last time I checked, most of the Northern Alliance guys I've spent the last two years fulsomely praising were Muslims.

"We could sit around and discuss cases of negligence from every healthcare system under the sun - and it would do little to prove your binary (free-market vs. socialised) vision of the world."

Are you really that dumb? Socialist systems have been tested to destruction over and over and over again -- They have *always* been found to be inferior.

"The serious points that shotgun makes (underneath all his swearing) underline the idiocy of politicos sticking their fingers into healthcare - witness Patsy's recent comments about "choice" in maternity services. He may care to register that the despised unions are fighting for better staffing ratios (perhaps *the key factor in poor clinical outcomes - i.e. not enough bloody nurses). Such things are clearly affordable - cheaper, even - compared with NuLab's vainglory schemes, NHS IT, PFI etc."

Blah, blah, blah. No one really cares about your unions, staffing levels, problems and so on -- We've paid for a service and we expect to receive it. Why can't you grasp that concept. Because, really, it isn't such a difficult one. We don't *care* what your problems (IT, PFI, need for longer lunch-breaks) are -- Can you fix them? If not, then we have every right to complain.

"I have never done anything but relish the challenge of the job - contrary to the bleeding hearts accusations above. It just pisses me off when people talk shite about what they know not."

I know whether I'm getting the service I paid for or not. And I'm not. End of story

GM Roper said...

The A&E charge nurse said: "I wonder how many other commentators subscribe to the 'one shit, all shit' philosophy - I don't."

Utter nonsense. If you have any prejudices at all, ANY then you do indeed have have a bona-fide subscription th the 'one shit, all shit' philosophy.

I work in the health care field in the USA, and also know of individual bumpkins and idiots. If there are enough of them, than they all get tarred with the brush of the incompetent.

In this country lawyers are generally held in contempt. Why is that? Congressmen are held in contempt. Why is that? Surgeons are held in contempt (until you need one of course). Why is that?

My late first wife was also a Nurse, she would bring home tales that would curl the hair of a bald man. Don't tell me that all nurses are crap, because I know better, but don't tell me either that a whole bunch of them aren't either, because having worked with nurses for 38 years and having been married to one for 27 years before she passed away, I know better.

As a mental health counselor, I know that many of my profession are crap, and I and others do what we can to weed them out, what we don't do is use the overworked, underpaid, disrespected bull crap that entirely too many do. If you are sick of hearing this, than do something to clean up the health care profession. Report abusers, refuse to work with incompetents, refer to someone else. It's easy, just do it.

kender said...

LN, (apologies to those in the world that have asked me to play nicely you are either somewhat off your rocker or blindly defending your profession.

Rotty is correct. The free market works much better for healthcare than government intervention. I am in the states, and when (by law mind you) I was forced to use government providers (just to clarify I am on dialysis and only doctors that accept medicare will deal with you unless you are filthy rich) and my level of care dropped.

Significantly. Where I once received great attention and quick and complete service I now have to call doctors repeatedly to get a simple script refill.

Before the docs knew I could find a more attentive doc, and treated me accordingly. Now they know I am stuck with them so why rush, what's the hurry? I am not going to up and switch doctors if they let me wallow in pain for another night.

You whining sounds like defense of the socialist system you have over there, (and one they want to put into play here in the states), and frankly I think that if you had to compete for your job with good service and a good attitude that you would probably be living under a bridge with a "will nurse for food" sign.

I am glad you will never be taking care of me.

Rotty said...

Kender: I think you're being far too kind to the socialist drones. They're not defending the system because they actually *believe* in it -- What the drones do is take a long, hard look at the way US docs and nurses wake up sweating over the thought they might get sued for malpractice (or be forced to put in a hard day's work in order to avoid that fate), and think, 'Isn't the NHS gravy-train just lovely? I get to *say* I care about people. And I get to walk past starving pensioners in pursuit of a long lunch. *And* I am almost guaranteed never to be successfully sued for malpractice/neglect. *AND* I get to suck on Big Government's teat for the whole of my working life. Wow. But defending this system doesn't have a downside.'

Only, it does. See, NHS drones, one day *you're* going to wind up on that trolley, drooling, senile and starving -- Do you really think the nurses of 2047 will pause on their way to the cheese-sandwich bar to stuff some food into your mouths? What goes around comes around ... Which is something I'd find quite delightful were it not for the fact that the system you're propping up will also be the one that finishes me off as well.

JuliaM said...

"I didn't realise that you ...were actually in the hospital and had obtained a verbatim transcript"

This is the statement given to the coroner's court - or do you prefer to believe that the complainant is just one of those lying bastard members of the publc instead? Plenty of people on DR Crippen's blog have pointed out how accurate this sounds, and recounted their own experiences - some of them are doctors.

"...your reference to the midwives still working precludes the possibilty that there is much more to this tragedy than a few columns in a newspaper.."

Err, no. It's more a case of what you go on to say! I'm pointing out that perhaps in these cases, the complaint & outcome are so serious, adopting the police procedure of immediate suspension & speedy hearing would be best.

I take it you don't agree?

"There is a burgeoning private sector for those that can pay, or who work for the right firm"

Private care really sticks in your craw, doesn't it? It seems to colour every discussion you get involved in.

Why shouldn't people who can, pay? They don't get their NI back, so are paying twice, so what's your problem?

JuliaM said...

"All you are doing is trotting out the old boring cliches - yawn!"

Ah, what an interlocuter you are, 'matt'.... ;)

"That doesn't mean however that we have to suffer your rantings in silence."

Careful, you sound like a midwife: uppity customers, what makes them think they get a voice, they'll do as they're told...

JuliaM said...

"Report abusers, refuse to work with incompetents, refer to someone else. It's easy, just do it."

Santy at last! Than you, 'gm roper', for that honest opinion. Let's hope you don't get ignored as another NHS basher or worse, because no one bothered to read your whole comment.

How about it, 'A&E' & 'Lost_nurse'..?

Or do you want to go on with the futility of pursuing the 'all nurses are angels' line in comment threads you feel are unfair to your profession, while a lot of service users at home compare it with our own experiences & wonder how long the NHS can ignore reality...?

the a&e charge nurse said...

Juliam - very long thread, I know but I'll restate my earlier comment, I would have no hesitation in shopping any nurse, doctor or midwife who I suspected was involved in abuse.

Your logic seems to be as follows,
Accept one side of the story [unless you are in possession of statements, or counter-claims made by the midwives].
Assume probability of guilt because a few febrile bloggers have painted a less than flattering picture of the midwifery profession.
Feel content that the media have provided a comprehensive and exhaustive account of all the circumstances surrounding these allegations.

Why don't we turn the tables - supposing YOU had been accused of an equally serious charge, lets say rape.
Would you be feeling quite so smug if;
The jury were only permitted to hear the victims account ?
It was OK for the jury to make assumptions about you simply on the basis of your profession [the one you are apparently afraid to disclose here].
And the entire process was played out in the newspapers rather than a court of law.

No, I thought not.

On the matter of private health, no, it's not non-NHS providers that stick in my craw, just ill informed comments about choice.
Unless you mean private hopsitals choose not to see you until you can afford it.
or choose not to follow up unexpected post-op complications [see death of Penny Campbell].
or choose to ship you out to the NHS when severe complications arise.

gm ropper - if you don't know why lawyers [particularly American lawyers] are held in contempt then it makes it very difficult to take anything else you say too seriously.

Anyway, I have not made any complaint, EVER, about being overworked, underpaid or disrespected.
I have already commented more than once about abuse.
If I have a problem with a colleague then I follow the hospitals procedures, in exactly the same that a consultant or senior manager would.

lost_nurse said...

"all nurses are angels"

Don't put words into my mouth, sunshine. I'd shop a crooked nurse faster than you can say "monolithic provision." I'd expect the same of all my colleagues.


"Nice to see you can finally acknowledge it as unforgivable & shameful with no 'if they really said it as described' caveats."


Right, and for the last time, let me lay it out nice and clear. As far as I'm concerned, this thread has two issues:

1. The appalling (as reported) actions of two individuals. Nobody here is either defending them, or closing ranks to protect them. Got that?

2. Whether the actions of said individuals can be used to condemn an entire profession, i.e. midwives (and by extension, the whole of the NHS). Something I contest. DK may have been careful to qualify his comments later on - but that's not obvious in either the tone or language of his original post. That's where I swung in, partly in response to the ramblings of rotty.

If I said: "Baha Mousa died in custody - ergo, no British unit is fit to guard prisoners. And all NCOs get away with it because they close ranks. ps. Overstretch is no excuse - British soldiers are lazy fucks" - shotgun would (rightfully) tear me off a strip. That, however, is the level of debate here. Am I expected to stand by and take it? Especially from internet punters who know absolute zero about me - and yet presume to judge my capability? My sister (a medic) recently returned from emergency aid work in maternity hospital in Zambia, where mums and babies often die for want of (inexpensive) treatment. She would have a thing or two to say about the healthcare that most british citizens are able to access. Actually, I'd combine any potential free-market in healthcare with a year's hard labour (for all) as an aux nurse (good on you, DK). A kind of national service to sieve out all the bullshit I hear.

As for commentating "pending full knowledge", this is a work environment inwhich a decimal point in the wrong place can kill. Simple as. If you are hard-wired into documenting everything properly, it makes you very wary of snap judgements - especially on the basis of msm reports. That is emphatically not the same as saying "shit happens - but look on the bright side." Think about the last time you administered a potentially lethal drug, oh all knowing juliam, and then get back to me.

It goes without saying that my heart goes out to Mr and Mrs Croft, in all their suffering. And on that note, goodbye (oh, and hello A+E C/N!).

Devil's Kitchen said...

Actually, I'd combine any potential free-market in healthcare with a year's hard labour (for all) as an aux nurse (good on you, DK).

I don't condone slavery to the state, but I get your point.

Nursing is a tricky and exhausting job; in my year there, of the four new Auxes we recruited, two went on their lunch breaks on their first day and never came back; one lasted one day and another lasted three days...

For those who are interested, here is the fullest and most personal account that I have written about my time as an Aux.

DK

lost_nurse said...

Thanks DK - I've said it before, but that is a deeply moving - and beautifully judged - post. You sure can write (y'know, when you're not swearing...). ;)

Devil's Kitchen said...

Thank you, lost_nurse; appreciated. That post was, as I said in the antescript, essentially a stream-of-consciousness: once I started, I couldn't stop.

Like everything else I write, it was still a first draft though...

DK

the a&e charge nurse said...

Devil - like many of your acolytes, it sounds like the patients enjoyed the sheer force of your marlboro & booze fuelled personality.

The market dealt you and them a shitty hand [and it probably will again when its your turn, SAH are not that uncommon], yet you still regard it as a panacea to most of lifes intractable problems, are you a masochist ?

Matt said...

My last post seems to have disappeared. I made it at around 8.30. Blogger accepted it and it appeared on the end of the list and then "Poof!" (no offence intended!)

The a&e charge nurse and
lost_nurse have stolen most of my thunder with their recent posts.

Juliam, Oh dear!

"Ah, what an interlocuter you are, 'matt'.... ;)"

in·ter·loc·u·tor
Pronunciation: "in-t&r-'lä-ky&-t&r
Function: noun
Etymology: Latin interloqui to speak between, issue an interlocutory decree, from inter- + loqui to speak
1 : one who takes part in dialogue or conversation
2 : a man in the middle of the line in a minstrel show who questions the end men and acts as leader

Thanks, and roses are red and violets are blue!

Why 'matt'? My name is Matthew, 2 t's.

You smear a whole organization with hearsay and insults and members of that organization defend it (though not blindly). When they defend it, you smear them.

I probably should ignore you, turn the other cheek and all that, but where's the fun.

You, rotty and now kender clearly have a Utopian vision of private health care.

"The free market works much better for healthcare than government intervention."

Anything would work better without intervention from our current Government - even the NHS!

Devil's Kitchen said...

Matt,

Just to clarify, I didn't delete your post: I never delete posts except in extremis, i.e. spam or if someone threatens to sue me*.

DK

*The only person who has done so is a doctor; so all doctors are arrogant bastards, obviously.

woman on a raft said...

verdict from the coroner's jury.

"A jury at St Pancras Coroner's Court found yesterday that he died from natural causes contributed to by neglect."

The verdict was given on 13 June, but the important point which was available prior to that was:

"The trust apologised "unreservedly" to Riley's parents. It said a board-level inquiry had been undertaken and the Local Supervising Authority in charge of London's midwives carried out a concurrent investigation."

(Both quotes are from the verdict report, but the admission of liability was known a the start of the proceedings.)
http://news.independent.co.uk/health/article2651291.ece

Based on the verdict, the parents are to launch a civil claim. It is up to the coroner now to decide whether, based on the verdict, the police should be instructed to carry out a criminal investigation and pass a file to the CPS.

....

"Why 'matt'? My name is Matthew, 2 t's."

'matt' is what it says at the top of your post in big black all lower-case letters.If you want to be called something else, you only have to say, but I don't think it is reasonable to expect people to be psychic in that regard.

A name is no big deal - or apparently it is, as Dr Crippen pointed out quite some time ago, and you presumably agree with him or else you wouldn't have got so annoyed over it.

JuliaM said...

"...the one you are apparently afraid to disclose here.."

Not at all. I said I would disclose it if it were germane to the comment thread. It isn't.

"Would you be feeling quite so smug if..."

I'm not sure 'smug' describes my feelings at all. And as for your 'example', it really doesn't hold water - it simply isn't comparable to this situation.

"My sister ... recently returned from emergency aid work in maternity hospital in Zambia, where mums and babies often die for want of (inexpensive) treatment. She would have a thing or two to say about the healthcare that most british citizens are able to access"

Because other countries have a poorer health system than ours, we should accept treatment like that of the Crofts & not complain..?

Hmm, I'm somewhat unconvinced by your 'argument' there.

"Why 'matt'? My name is Matthew, 2 t's."

I'd point out your error here, but 'woman on a raft' has already done so in my absence(cheers!).

It seems I misjudged you - I assumed you didn't read other peoples' comments properly. It seems you also don't read your own....

Still, you seem to be working the spell checker OK, I'd forgotten a misspelled word invalidated all comments made by the commenter. ;)

"You smear a whole organization with hearsay and insults..."

No, mostly with my own or relatives' experiences of such. Keep calling it 'hearsay', it won't miraculously change that into hearsay. Unless my relatives and colleagues are lying of course....

"Anything would work better without intervention from our current Government - even the NHS!"

Now you finally have said something I can agree with!

kender said...

Matt, I do not have a utopian vision of private healthcare. I KNOW that I received better healthcare when I was allowed to pay for it and choose my doctors. Now that I have been forced onto a government system my healthcare is lacking in service.

But iti snice to find people online that know what I am thinking and what I believe.

So tell me Matt, what am I thinking of making for dinner today?

lost_nurse said...

This thread is like reality TV. I try to avoid it but I can't help myself.

"Because other countries have a poorer health system than ours, we should accept treatment like that of the Crofts & not complain..?"

Don't be crass. My point was that the sooner we stop treating acute care like it's the perfume counter at Boots, the better. A major bleed out is not like your conventional shopping experience. We need a proper debate about funding and delivery - but a dose of realism would be nice.

To kender: I'm sorry about your situation. You will understand concern in the UK that we do not import US-style medico-legal paralysis. Or the kind of insurance-dominated treatment plans that leave can chronic sufferers in limbo. And, for sure, it ain't perfect here - but much that is good is being thrown away, in the guise of "reform." All the best, anyway.

Matt said...

DK,

I neither thought or implied that you deleted my post! I'm sure Blogger is to blame. Even you are getting touchy on this particular blog!

Woman on a raft and juliam,

We are getting a bit bogged down in semantics here. Juliam, in your post @ 05:36:00 on 15.05.2007 you put my name in italics. I was questioning the italics. Why did you put my name in italics? And I am not annoyed about it at all!

"It seems I misjudged you - I assumed you didn't read other peoples' comments properly. It seems you also don't read your own...."

Gratuitous remark?

"No, mostly with my own or relatives' experiences of such. Keep calling it 'hearsay', it won't miraculously change that into hearsay. Unless my relatives and colleagues are lying of course....

Hear·say (hîr'sā') n.

Unverified information heard or received from another; rumor.

Law. Evidence based on the reports of others rather than the personal knowledge of a witness and therefore generally not admissible as testimony.

As I said. hearsay.

Devil's Kitchen said...

"Even you are getting touchy on this particular blog!"

Ha ha! Not at all; I just wanted to assure everyone that I wasn't censoring anything.

DK

JuliaM said...

"My point was that the sooner we stop treating acute care like it's the perfume counter at Boots, the better. A major bleed out is not like your conventional shopping experience."

Oh, you brought up 'poor benighted natives in Africa struggling with crap healthcare while the UK public grumble about a few deaths' but I'm crass for pointing out this is not an excuse for having it (and putting up with it) here? Heh...

As for 'a conventional shopping experience at Boots', you can use this comparison the next time a shopper is abused and mocked by a girl on the perfume counter, directly leading to the death of a fellow shopper. Don't forget - I can always take my custom to Superdrug, should that happen ;)

"Juliam, in your post @ 05:36:00 on 15.05.2007 you put my name in italics."

Really...? Let's have a look:

"Ah, what an interlocuter you are, 'matt'.... ;)"

Please point out the italics, I can't seem to see them myself....

"..Unverified information heard or received from another; rumor."

Yes, but it isn't 'heard from another' is it..?

I was present WITH my relatives (and on the other end of the phone, when referring to a colleague's poor service with the NHS, she was driven to tears by the attitude of the staff and I had to help her), it's just that I wasn't the subject of their poor service, THEY were.

Therefore, not hearsay at all.

The comments by other doctors over on Dr Crippen's Blog probably count as hearsay. Bloody doctors, who do they think they are, compaining about crap service by...err...other NHS staff....

Matt said...

Juliam says " Please point out the italics, I can't seem to see them myself...."

Sorry I meant apostrophes. Why did you put my name in apostrophes? Anyway, it is not the correct use of apostrophes so you are not perfect just like we poor mortals who work in the NHS.

"If Rotty thinks that 'Dr Crippen' sometimes shows himself to be arrogant in his blog, well, he isn't alone in that opinion..."

Are you the pot or the kettle?


You really are a prickly shit aren't you! Do you treat everyone you deal with, with such distain?

None of the medical posters on this blog are defending the action of the Midwives involved in the Croft case if what was related in the Inquest is correct. The qualification (if) is correctly used here as they have not been found guilty of anything in a Court. You equate the use of qualification is this case as somehow a defence. It isn't. When this posting started, the Inquest was still ongoing. You are too perfect to see that aren't you?

The reporting of Inquests and Court cases by the media can be sensational and disgraceful. As was pointed out to you earlier, if you were the subject of court proceedings you might have a balanced view of this. Not that you would ever be the subject of court proceedings as you are perfect.

You ask how many NHS employees have been fired for cause in the past 5 years. The NHS is ultimately managed by non-clinical people and politicians. Why don't you aim your ire at them?

"do you want to go on with the futility of pursuing the 'all nurses are angels' line in comment threads you feel are unfair to your profession, while a lot of service users at home compare it with our own experiences & wonder how long the NHS can ignore reality...?"

This is a typical example of one of your comments - misquoteing other posters and using hearsay.

I'm sorry if your personal experiences of the NHS have not been good but that does not mean that I or other posters here will let you away with biased, uninformed and vindictive comments.

And with that, I'm off! I need to go to work and kill some people (after been rude to them first, of course!)

See you in Court!

Goodbye.

This is my last post on this particular blog so you can be as nasty about me as you want.

JuliaM said...

Hmmmm:

"Are you the pot or the kettle?

Followed by:

You really are a prickly shit aren't you!"

Can't help noticing the irony there... ;)

"The NHS is ultimately managed by non-clinical people and politicians. Why don't you aim your ire at them?"

Oh, but when it's warranted, I do as do so many others. But a hospital administrator didn't mock and abuse a woman struggling to birth her dying son, it was a pair of midwives.

The hospital administrator just tried to hush up the case, according to Mr Croft, no doubt so that they could continue to employ these harpies. And oh, look, they still do employ them! And you wonder why people are rightly furious..?

And by the way, 'Waaaah, the others are just as bad..' isn't much of a defence, or an excuse. Unless you are three years old.

"I'm sorry if your personal experiences of the NHS have not been good .... biased, uninformed and vindictive comments."

If my personal experiences haven't been good, then I'm hardly 'uninformed' am I..? Do you need a refresher definition of that word, as well as 'hearsay' (which I see you are still using)?

Gareth said...

I've come to this argument slightly late but as the recently ex-husband of a dentist and father of two with her, I feel vaguely qualified to comment!!

Our first child was born by emergency caesarian after nearly 24 hours of painful and, for both of us, deeply traumatic labour. He was fitted with a foetal heart monitor quite early in the piece and I was briefed by the rather unimpressive midwife to "keep an eye"! Janet was in significant pain. She had gas and air, she finally got an epidural from an anaesthsetist who seemed a little concerned but said nothing. I monitored Bens heart rate as ordered, it fluctuated wildly between 200 and fuck all. This was highly distressing but every time I got the midwife in she told me not to worry!!! With wife and child in increasing distress I got grumpy and insisted on others being involved. Eventually the senior midwife deigned to arrive and, spookily, only 5 minutes later the obs/gynea consultant was rushing in to our room and, in no time, was calling for an emergency caesarian. He performed it himself and did an outstanding job.

My son is now 13, an outstanding rugby player, top of his year in maths and science and a genuinely well balanced, intelligent, caring individual. Midwives nearly robbed me of that person and it still rankles.

My daughter's birth, in a different city, was a better but by no means edifying experience and the patronising got so extreme I actually shouted at the midwife to show a little more respect. My wife really enjoyed the manual recovery of placenta!

lost_nurse said...

"You can use this comparison the next time a shopper is abused and mocked by a girl on the perfume counter."

You missing my point by a country mile.

lost_nurse said...

you are missing my point, even.

JuliaM said...

"My son is now 13...Midwives nearly robbed me of that person and it still rankles."

Glad it turned out ok in the end for you, and very scary to think what might have happened if you had been a more compliant personality. Be prepared to have your direct experience rejected as 'hearsay' by some, however (mostly those that do not own a dictionary)...

""You can use this comparison the next time a shopper is abused and mocked by a girl on the perfume counter."

You missing my point by a country mile."


Really..? You don't like the comparison..? Well, let's make it more like the NHS:

You are compelled to pay part of your salary to Boots, even if you don't want any cosmetics that month...or at all!

In addition, if you prefer to shop at Superdrug, you must still pay part of your salary to Boots, and pay extra for your personal shopping choice.

Boots don't train staff in customer service beyond the basics, fending off all complaints with statistics and propaganda, because they have a captive market.

And if the girl on the counter screws up, the result is not an embarrassing episode where your lip gloss clashes with your foundation, but potential disfigurement or death.

And if that happens, Boots might hold a leisurely inquest if you shout loud enough, or go to the media, but meanwhile Felicity Fuckup is still free to serve at that counter until the inquest is concluded (I've asked the question twice, and neither you, 'matt' nor 'a&e' have answered: should the NHS adopt the police firearms unit's policy of immediate suspension?).

Getting closer to NHS-world now, am I....?

the A&E Charge Nurse said...

Juliam - you raise the issue of 'immediate suspension'
Do you mean in all ALL cases when an unexpected death occurs in hospital, including non-NHS providers ?

or just deaths involving midwives ?

or only when complaints arise ?

I cannot emphase enough that the avoidable death of either a mother or her baby [due to negligence] is just about the most shattering and serious accusation that can be made against clinical staff.

The fact that the two midwives were not immediately suspended raises the possibility that there is more to this dreadful story than we have been able to glean from the coroners report [which I have not seen in full] or press items.

the A&E Charge Nurse said...

By the way Juliam, slightly of topic I know but the Royal Free had the lowest national mortality rates for the second year running [a whopping 26% below the average].

Not bad for a hospital that I think I'm right in saying has just about the highest number of specialties [plastics, neurosurgery, liver transplant, HIV, etc, etc] in the region.

JuliaM said...

"Do you mean in all ALL cases when an unexpected death occurs in hospital, including non-NHS providers ?"

Yes. That's exactly what I mean. Even non-NHS providers.

"..the Royal Free had the lowest national mortality rates for the second year running.."

Your point...? Or are you falling back on the 'look at all the ones that don't die!' again? That's (pardon the pun) been done to death, don't you think..?

the A&E Charge Nurse said...

Nationally there are many sudden/unexpected deaths in hospital from PEs, to massive MIs and CVAs, etc, etc and that's before we get to patients who die in A&E from unkown causes.

Don't forget nearly 1/4 million people die in UK hospitals each year - who would actually be left to look after patients, if you introduce a policy of suspending everybody directly associated with these deaths, not to mention those indirectly involved but who hold vicarious responsibility [such as A&E charge nurses or consultants].

The mortality stats at the RFH suggest they must have a pretty robust system for critically ill and peri-arrest patients, and this is probably allied to a culture of decent standards of care.
But more importantly I suspect that senior clinicians and managers would be very unlikely to take unecessary risks with any cowboys that might damage this hard earned achievement/reputation.

You started this thread by implying that the midwives had a history of bullying, and later that they were both sadistic and dangerous - clearly nothing I can say, or anybody else for that matter, can disuade you from this position, even though none of us here are in full posession of the facts.

JuliaM said...

"You started this thread by implying that the midwives had a history of bullying, and later that they were both sadistic and dangerous.."

No, I don't belive I ever said they had a history of it (I wouldn't be surprised though....). Care to point out which comment you are interpreting as such?

As for being 'sadistic and dangerous', I think the coroner's verdict proves that one: "A jury at St Pancras Coroner's Court found yesterday that he died from natural causes contributed to by neglect."

lost_nurse said...

Juliam, maybe you could explain to this chap how mortality figures are just like lipstick prices:

"Back in the 1950s, kidney disease used to be a killer," Gawande says, "and there was a medical team in the US that was pioneering transplant surgery. Their first 30 patients died. Imagine that. You or I might have stopped at 10, thinking it just wasn't going to work. After 20 deaths, even members of the team began to wonder if they were murderers. But then they got it right, Joe Murray won a Nobel prize and we now have an everyday operation that has saved many thousands of lives."

Surgeon Atul Gawande.

JuliaM said...

Nice little anecdote. Does it have a bearing on this subject..?

Or did you just omit the part where the pioneering open heart surgeons mocked and abused their dying patients?

Also, were the first 30 guinea pigs for that surgery volunteers? Not something that could be said for NHS patients today (unless there's a trial on c. diff transmission vectors)!

lost_nurse said...

I have no idea if they were volunteers - although I suspect that they would have consented as such. I was just pointing out that the variables involved in analysing hospital mortality (as A+E C/N has already alluded to) can be somewhat more, uuhhh, complex than comparing the cost of foundation/the smile on the till girl/boy's face in Boots and Superdrug. Ask your "average" paediatric cardiac surgeon.


As for transmission vectors: Even if all UK healthcare was privatised overnight, I can guarantee that both MRSA and C.Diff would continue to be significant and growing problems. As will antibiotic resistance - and a whole bunch of other things that tabloids like to ignore (though fast-evolving pathogens rarely care about Daily Mail headlines). On account of which, nurses are screaming for better staffing, improved isolational capacity and an end to spurious targets (nothing like a game of musical beds to screw up infection control...and no, I am not excusing staff who do not wash their hands). Rotty probably interprets this as the whinging of the lazy.

Still, enough from me - you seem like a forward planning kinda gal, and as I'm sure you would agree, there's nothing better than a bit of market research. I would seriously advocate that you enrol as a health care assistant - or even better, as a volunteer in your local hospital. It will inform your choices better than these games of internet tennis. :)

JuliaM said...

"I would seriously advocate that you enrol as a health care assistant..."

Nah, it doesn't pay enough ;)

And I don't tolerate fools gladly, as you might have realised....

sloshed_nurse said...

("volunteer" as in making tea for patients, btw. Not for the sake of pioneering surgery - just realised how that might come across...)

lost_nurse said...

"And I don't tolerate fools gladly, as you might have realised...."

Well then - you're a born matron. After all, as someone said, it's not what we can't do that scares us, it's what we can do - and don't. And on that woolly note, au revoir!

Anonymous said...

"And I don't tolerate fools gladly, as you might have realised...."

How do you live with yourself then?

Ha Ha!

JuliaM said...

"How do you live with yourself then?

Ha Ha!"


Nelson Muntz, is that you...?

Or is 'matt' screwing up his comments entry again?

'matt' said...

Juliam says,

"Or is 'matt' screwing up his comments entry again?"

Not me Guv! Cracking comment though.

"Nelson Muntz, is that you...?"

Who's he? Your CPN?

JuliaM said...

""Nelson Muntz, is that you...?"

Who's he? Your CPN?"


No Google skillz 'matt'...?

Henry North London said...

Having been in the maternity suites of two hospitals as a medical student to get my five deliveries it seems that nothing has changed in the 13 years since I delivered the three boys and the two girls that I was reluctantly given to deliver by said madwives.

It is a shocking state of affairs these days and the plain fact of the matter is that more midwives are needed but the government is loath to employ more.

Its like the abandonment of the 10000 doctors this August the NHS simply cannot afford to employ them but managers are still needed to strike the slave drums at a higher pace for the ones that are left.

Gordon being Priminister well as I said on 18 doughty street this evening

Beware of the wolf in presbyterian sheepswool clothing.