Why is hospital food so damned awful?

Apologies for the lack of blogging, I've been a bit pre-occupied when my next child made an unexpected appearance early when my wife's waters broke at 36 weeks. I won't bore you with all the details but thankfully baby Toby was born on the 29th May at 1030 weighing 5lb8oz. Mum and baby are doing well.

Anyway there were numerous things that caused problems, not least there being no beds on labour ward- a recurrent problem. You'd think with a Labour government in power they'd at least get that sorted ;)

I don't know if you've ever been to Leeds General Infirmary but its main car park is a bloody nightmare. It is, without any doubt, the worst designed car park in the UK. The angles on the approach to the ramp to go up each floor that you have to swing out wide to get around them. Newcomers to the car park regularly get it wrong and have to do a sort of 3-point turn to get up each level. The worst thing though, is the 1foot thick concrete miniwalls up each ramp. It seems they have designed these to jut out and rip up your wheel arch as you try and navigate the turn.

I've caught my car on it and so has my wife. In fact if you look at each ramp wall you can see a multi-coloured smear of car paint that is a testament to the number of cars that have had their wheel arches ruined on those damned stupid wall ramps. If you, like I did, wander about and look at the rear driver side wheel arch of most of the staff cars in the car park I would estimate approx 25-30% have been torn up by that stupid-ass designed car park. Let that be a warning to you if you ever park at the main car park in the LGI. Drive a small car.

Ok the other thing that I really don't understand is why is hospital food so bloody shit? I've been to multiple hospitals in the past and I have yet to go in one where the food they serve the patients is nutritious, edible and tasty. An adult male requires 2500 calories per day, 2000 for a female. This is higher if you are ill, recovering from surgery or breast feeding. Quite how you are meant meet these requirements on hospital food alone I do not know.

I remember doing my medicine for the elderly job and regularly we'd prescribe fortsips (calorie and protein dense milkshakes) to compensate for the utterly shit food that was served to patients. Honestly if you served this food to prisoners there would be riots. But as its a bunch of old crumblies who can't complain who gives a shit right?

Its no better on the adult wards for medicine and surgery. The portion sizes are pathetic, any salad consists of limp lettuce and a slice of anaemic tomato. Bread is hard, white and cardboard like. Butter is frozen solid. Everything is reheated and alarmingly whatever the ingredients it contains it all seems to taste and smell the same once it comes out of the reheater. Its a fact that the LGI cannot cook any fresh food on the premises for patients.

Get this, it is prepared in Wales and the transported via lorry to the hospital where it is reheated and then served. God alone knows why this is. Carbon footprint be damned I guess. If the swine flu pandemic kicks off and lorry drivers go off sick then I've no idea how they'll get the food to the LGI. I very much doubt relatives will bring it into a hospital full of swine flu patients.

One of the starters on the menu they gave to my wife was Orange Juice. Since when has a drink been a starter?! Oh yes, I remember now, when I did Home Economics when I was 13!! WTF? It that wasn't bad enough one of the main courses was Gravy. Thats right. Gravy. It can't possibly be a bowel of gravy could it? We weren't brave (or foolish?) enough to order it to find out. Needless to say my wife had all sorts of nice food bought in by me to supplement/replace the bloody awful shite the LGI had the audacity to serve to their patients.

So, if ever you have to go to the LGI for to visit a patient then make sure you come in a small car ( or park elsewhere) and for God's sake bring them some decent food (not grapes!).

MPs are greedy cheating bastards. Who is not surprised?

Well well well! What a week! MPs expenses have been exposed by the Telegraph (after all the hard work was done by this person).

Its hard to know where to start! The government has been undertaking a smear campaign against GPs for the past 2-3 years. Finally we get our own back! I would say 98% of what was written about fatcat GPs was complete bullshit. They picked out a few high earning GPs and claimed we were all the same.

Now in parallel we have a variety of MPs who have been 'creative' with their expenses. Of course not all MPs have been misbehaving but they have been tarred with the same brush - much like we have eh?

What really grinds my gears is the complete lack of guilt the MPs have been showing. Ok, so the expenses system may have had very weak rules that could be bent so you could claim for all sorts of uncessary shit. You still have a moral obligation to do the right thing, to act 'honarably'. Just because you can claim for frivolous things that doesn't mean you should. Giving back the money just won't cut it. And as for the Speaker? He is responsible for overseeing all claims, if all these dodgy claims happened under his watch then he must take responsibilty for this. After all, if his expenses committee had done their job properly then none of these claims would have been approved.

My big worry is that this puts people off voting. If we don't vote then how can we change anything? If we don't vote your saying we don't care who gets in. If we don't vote then that mad racist homophobe down the road will and he'll vote in some equally racist homophobe.

Anyway, enough politics. Work has been ok this week. More partners working so thats helped. Practice manager wants me to help do the Pandemic flu planning and looking at workload issues. Should be interesting, said I'd only do it if he gives me some time off clinical sessions. I foresee we will be arguing about workload problems. Must make sure I read the BMA salaried contract and make sure we stick to that.

Just finished series 1 of The Wire. How cool is that series? Got series 2 and will start watching it with the wife when we get some time.

Anyone see the end of Heroes series 3 on TV the other night? What a heap of shit that series is turning into. Not sure I can be bothered to watch the next series.

Enough inane ramblings. Catch you later!

Tax is taxing thank you very much Adam Hart-Davies

After all my ranting last week I was taken off RAC (Rapid Access Clinic) at the last moment. Phew. Doing it on monday though. Bollox. Honestly the rota at work is so borked its unbelievable. Its my understanding that a session of work for a salaried GP is taken to be 4hrs 10mins according to the BMA. That includes paperwork, visits etc... Well we seem to have so many urgent extras that our morning clinic now finishes at 12-1230. That leaves 10-20mins to do visits (normally 2-3 @ 20mins each at least) + any paperwork (referrals, form filling, letter reading, checking results etc).

I honestly have no idea how we are meant to do all this. Its not only me whos getting backed up on the paperwork front. Its fine for the partners to pop in on their day off or stay late and catch up as thats whats being a partner is about - hence the fat paycheck they reward themselves. I know some of the salarieds stay late to catch up and they are slowly (or not so slowly) heading towards burnout. Its really fucked up. I'm glad I am leaving in December to go to Liverpool (part of wife's PICU training). If i wan't I think I'd leave where I am working anyway. I could rant about work all day but frankly I guess its boring to read. Still it helps me get things of my chest I suppose.

When I went into General Practice there was a shortfall in the number of Drs going into GP-land. So for a double edged promotion of sorts the government offered a golden hello (£6000 I think) + GP contracts were renegioated . Funding for GP's was altered and linked to Quality Outcomes Framework (essentially points for reaching certain clinical and managerial targets), in addition GPs no longer had to do Out-of-hours (OOH) cover (for a £6000 pay cut).

So when I went in things were looking rosey. I got a golden hello, no OOH cover and pay for GPs was going up. An unforseen (perhaps) consequence of the new funding arrangement was that it was financially better for a GP partner to hire a salaried GP rather than take on another partner in the business. For example - new partner = £120k reduction in profits, salaried GP = £70k reduction in profits, remaining profit to be split between existing partners.

In addition the government did a spectacular U-turn on the OOH cover, demanding that GPs cover from 8-8pm (even though there was v.little demand from the public for this), for no extra funding.

So now I find myself stuck in a target driven GP-land with fatcat GP partners making the salaried GPs do the donkey work and potentially having to do OOH again. Brilliant. Not only this but the government seriously fucked up hospital Dr training (MTAS) with the result that hospital Drs have had their careers ruined as well.

Labour have majorly fucked up the NHS in a HUGE way. I know of no doctor anywhere who will be voting Labour in the next election.

Well thats all the ranting out of the way. Whats that got to do with the title? Absolutely nothing. Whats happened is that I have been on basic tax rate for my GP specialist work meaning I owe the tax man over £3000. Quite how this has happened I do not know as I spoke to him in Jan after getting a massive tax bill then too and he didn't spot anything. Doing Tax returns, even online is tedious and painful, especially when you get stung for a huge tax bill.

My first entry

Woohoo. So here it is, my blog. To be honest I'll be amazed if anyone reads this. I think the main reason why I am writing this is so I can offload about how shitty work is and how GPs (especially salaried ones are getting crapped on). I might do a bit on Swine Flu as well as it seems to be the topic of the moment. This is all new to me, I guess I should post links to various bits and bobs but frankly I can't be arsed and everyone knows how to use google nowadays anyway.

I've taken a peek at various other blogs - my 2 favourites are Dr Rant and NHS Blog Doctor . Hey fancy that, I've made a couple of links. Anyway, I doubt this blog will be anywhere near as good as them as I have a sneaky suspicion that work has blocked access to blogs - the bastards. Thankfully I still have access to Twitter.

Ok, lets take a peek at BBC News health section and see whats going on there...

Hmm, mild swine flu? Its quite amusing that people seem to be miffed that its not fatal like avian flu has been or like SARS. Give it time. Influenza viruses mutate at a fair rate. Who knows, come winter it might be a bad-ass and people will be dropping like flies (or should that be pigs?). Frankly I'm glad its mild (so far), people at my practice tend to turn up literally hours after a sniffle or cough starts so even if its mild the increase workload will be a real pain in the ass.

This is rather worrying . Its hard enough to get anyone to do Child Protection. Its terrible that the GP involved who referred the child twice to A+E with suspected Non-accidental injuries has been suspended by the GMC. Not sure I understand why - does anyone? Politics I guess. Lets see, Prof Southall got suspended by the GMC and then reinstated for false accusations re child abuse. This other GP gets suspended for correct accusations re child abuse. Damned if you do, damned if you don't.

Doing Rapid Access Clinic tomorrow. Brain-child of one of the partners. Originally conceived as a rapid, simple, drop-in clinic for things like coughs, sore throat, ear ache etc. The idea was that these problems only take 2-3 mins to sort out and so don't need a 10min appointment. Trouble is is that people are coming in with stuff that really doesn't need to a GP - like waking up that morning with a sore throat. As a result the clinic is full (30+) of minor crap that could be self treated or waiting for it to settle. The clinic should really be done by a nurse with appropriate training. Complete waste of bloody time but alas, as a simple salaried GP I am unable to sway the partners. I can't even get them to change the name of the clinic - its no longer rapid access (drop-in) its now pre booked appointment slots. Completely fucking stupid.

When I get a moment I'll go through whats wrong with the practice where I am working. Mainly so I have a note of what not to do if I ever become a partner (GP partner jobs are rare as rocking-horse shit). Will save that for another day.