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Gold, incentives and meh

Richard Rawlins

  • Could knowing the price of NHS treatments help patients grasp their true value?

    Richard Rawlins's comment 20 Oct 2018 6:11pm

    Not to tell the patient this is the case is surely treating them without having fully informed consent.

    And that is unethical.

    It would then be up to patients to make such representations as they may.

    It is not for doctors to deny them such information.
    For who would we be covering up?

  • Could knowing the price of NHS treatments help patients grasp their true value?

    Richard Rawlins's comment 20 Oct 2018 10:13am

    I did this for an article in the Middlesex Hospital Journal in 1967!
    Simply giving staff an indication of what everything cost. It did realign thinking, and might have reduced waste if the idea had been taken up.

    Patients might be concerned to know 'what it costs', yet we tell taxpayers what aircraft carriers cost, and we constantly tell them how much more the NHS could do with.

    'Indicative costings' could be used, not the cost of every item or transaction (which would cost a fortune to administer).

    So: "Please be advised that a standard course of this class of antibiotic costs the NHS around £xxx."; "A joint replacement such as has been recommended for you costs the NHS around £zzz."

  • BMA permitted to advise court in Bawa-Garba appeal

    Richard Rawlins's comment 11 May 2018 6:50pm

    The GMC (Terence Stephenson)maintain they appealed the determination of its own Tribunal Service in order "to maintain public confidence in the profession".
    What is the evidence that is the case? Where are the Lickert analyses of pubic opinion?
    Or did the GMC simply act on Stephenson's whim?

    The High Court had to side with the GMC once it appealed - that's the due process of the law.
    But a jury's decision as to the guilt of a doctor charged with a criminal offence, and the MPTS's view of the doctor's fitness to practice after suspension and remediation are two different issues - they should not be conflated.
    Dr Stephenson allegedly acted contrary to medical ethics in respect of bullying this doctor and is in denial. The Lancet has called for his resignation.

  • GP leaders instruct GPs to stop written reflections in light of Bawa-Garba case

    Richard Rawlins's comment 12 Mar 2018 8:58am

    The jury decided that Dr Bawa-Garba was guilty as charged, after being told of the challenges she faced. So be it.

    There is the issue as to why Mr Massey decided (or if not him, who was it?)that the GMC needed to go to the High Court and have its own MPTS determination overturned.
    Any suggestion that in some way this was necessary 'for the protection of the public' is spurious'. So what was the GMC's motive?

    Once the High Court had been approached, it had to support the due legal process. But that legal process was in the hands of a jury - albeit they were not Dr Bawa-Garba's peers, and could have had little real insight into the problems she faced, and just who was responsible for her being in such a situation.(A question they were not specifically asked to consider).

    Those who challenge this whole process will have to seek a clearer definition of how a doctor's peers are identified (or any professional person's). This has been a problem since the concept of 'trial by peers' was devised after Magna Carta - so a lot to take on. Good luck.

  • RCGP to discuss 'feasibility' of reflections in light of Dr Bawa-Garba case

    Richard Rawlins's comment 14 Feb 2018 12:00pm

    What are 'significant patient safety concerns'?

    To me, as a patient, ANY concern about safety (including stafing, facilities, bed availability etc)are significant.

    Significance is in the eye of the beholder.

    All patients should be told about ANY concerns, and the fact they have been told should be included on the consent form for treatment.
    They (we) cannot give informed consent otherwise.
    If some are put off having treatment - so be it.
    That is the standard of the GMC's own making.

    Richard Rawlins