The Psychiatrist Blog

Fundraising for the North West Durham campaign

2009-12-04T13:11:00.000-08:00

As readers here know I am currently standing as the Conservative candidate for the beautiful constituency of North West Durham. I do this completely voluntarily. If you want to join me in trying to make a difference, please feel free to donate direct to my campaign on line. Thank you.

North West Durham

2009-04-21T08:17:00.000-07:00

Many thanks to all the people who have kindly followed this blog over the years. Until further notice this blog has been moved to here.

Global Warming and Science

2009-02-20T08:00:00.000-08:00

I was sent this today and thought I'd share it here:

Would You Trust Labour with our Labour Wards?

2009-02-16T09:06:00.000-08:00

For those of you who requested a copy of the maternity care discussion written by myself and Dr Mark Slack, Lead Consultant in Urogynaecology at Addenbrookes Hospital, I've reproduced it here:

The birth of any baby is so precious, that obstetric care must be paramount in any political climate and during any recession. Has birth become more or less risky under Labour? And has Health Secretary and ex-postman Alan Johnson delivered?

Perhaps surprisingly for a government that prides itself on an ever increasing mountain of health and safety regulations, results in the delivery suite show a concerning trend. Between 2005 and 2007 patient safety adverse incidents showed a staggering 260% increase. Medico-legal claims from alleged negligent care during labour now dwarf all other medical claims. Of claims brought for brain damage, most were caused because babies were not delivered at the appropriate time, resulting in babies suffering oxygen deprivation.

Britain is almost unique in having the majority of normal births being conducted by midwives. Midwives are popular with parents and can provide one-to-one care during labour, although this remains difficult to achieve due to staff shortages. A recent poll by the Royal College of Midwives found 91% of midwives believe care has suffered as a result of rising birth rates. An extra 40,000 more babies were born in 2006 than the Department of Health officials expected. The overall birth rate is now at its highest for 26 years and some reports say that maternity wards are being forced to turn away expectant mothers. Last year’s announcement of £330 million to increase midwife numbers over the next three years was welcome, but is it too little too late? Midwives are excellent for uncomplicated deliveries, however, consultant obstetricians are vital if complications arise.

In Europe, it would almost be inconceivable for a consultant not to be present on a labour ward, and beyond belief for the consultant not to be leading a complicated delivery. Yet, over the last ten years NHS consultant obstetric workforce has not been a priority. The National Caesarean audit found that at potentially complicated caesareans, the recorded consultant presence was merely 21%. According to the Royal College of Obstetrics and Gynaecology, 80 out of 207 maternity units in England and Wales could claim to have the minimum recommended 40 hours per week of consultant obstetric presence.

As a consequence, most of the complicated deliveries are supervised and carried out by doctors in training. But do new parents want to be subjected to a constant and repeated cycle of learning? Ideally, most care should be delivered by consultants on a 24 hour basis. Following the ‘Short report’ a few maternity units were set up as a consultant delivered service. Hinchingbrooke Hospital in Huntingdon continued to work with this pattern between 1983 and 2000. During this time it had the lowest litigation rate in the country.

To apply George Osborne’s analogy, the Government failed to fix the roof while the sun was shining. It seems for maternity units, the roof hasn’t even been completed. Instead, this Government continues to develop a service only fit for sunshine; when the rain comes and complications arise, shelter is lacking. Although the cost of increasing obstetric consultants may sound expensive, it pales into insignificance in contrast to the cost of long term care for brain damaged babies. Scope, the charity that works for cerebral palsy sufferers, estimates that up to 13,000 people, or 10% of Britons affected by this form of brain damage, suffered avoidable birth trauma.

In conclusion, despite their name, the Labour government has failed to deliver care on the labour wards. The Conservatives need to hold them to account over the health needs of babies and parents.

Beautiful Britain

2009-02-04T14:46:00.000-08:00

After a hectic day, this clip of Tunstall Reservoir, County Durham, made me smile:

Saying Goodbye to the Snow

2009-02-03T11:15:00.000-08:00

Inside The House of Commons

2009-01-23T12:23:00.000-08:00

Debate in the House of Commons at the moment is electric, with sparks flying over the state on the economy. I thought I'd highlight an excellent speech delivered on the 21st January by Conservative MP Mr Brooks Newmark (Braintree), not least because I was very honoured to get a mention!

"Under the Government’s current economic policy, prudence seems to go unrewarded. Regrettably, the Government have still not reacted to the devastating consequences that interest rate cuts have brought to a generation of savers. The Government may be offering bail-out after bail-out to over-leveraged banks. However, they are failing to help, if not reward, those in our society who have put aside money in the form of savings, especially the more vulnerable in our society, such as pensioners, who are now seeing their standard of living drop daily.
We need a savings culture at the heart of our economy if it is to grow out of this recession. Thrift and prudence will ensure confidence and the ability to invest in the future. However, recent economic policy has only consolidated a longer-term trend that has emerged under this Government. That trend, which was exemplified by the Prime Minister when he was Chancellor, is towards a Government built on a mountain of debt and indulging in their own spending binge. Encouraged by the Government’s poor household financial management, ordinary individuals have gone on a borrowing and spending binge too. The result is that in 2007 the household savings ratio fell to less than one third of what it was in 1997.
Cutting interest rates was indeed the right thing to do to deal with the current crisis. However, hanging savers out to dry in the process is completely unacceptable. We have now seen seven consecutive interest rate cuts—that is seven consecutive hits on savers and seven opportunities lost by the Government to give help to those who need it. Instead of looking after savers, the Government have written a blank cheque for the banks—many of them the very institutions that helped to create the economic mess. With taxpayers’ money keeping them afloat, those same banks continue to slash interest rates on savings accounts, which have reached as low as 0.1 per cent. for some instant access accounts.
Savers and borrowers are confused about how to play the game of interest rate roulette. With low returns on savings, high borrowing costs and interest rate cuts not being passed on to borrowers, people simply do not know what to do. With poor savings rates on offer and a drop in confidence in the banks, it is projected that 45 per cent. of people are less likely to save in the next three months. What is it that people save for? They save to put a deposit on a house, help provide care for themselves in old age or send their children to university. Without savings, none of that can happen, which will have grave consequences for our economic recovery.
The Government may claim that their economic policies are offering real help to the people who need it most, but unfortunately those polices have failed to help the most vulnerable in our society—the poor and the elderly. With interest rates not expected to rise again in the near future, the Government must urgently create incentives to save again. Even bank bosses agree that we need tax incentives for our savers.
I thus ask the Minister at least to reflect on the proposals of my right hon. Friend the Member for Witney (Mr. Cameron) and the shadow Chancellor my hon. Friend the Member for Tatton (Mr. Osborne), as outlined in this debate by my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond): to reduce to zero the 10p starting rate and the 20p basic rate of tax on savings, so that basic rate taxpayers pay no tax at all on their income from savings, thus helping them by up to £7,200 a year; and, secondly, to increase age-related personal allowances by £2,000 for those aged 65 and over, benefiting them by up to £400 a year.
To conclude, this debt-addicted Government are doing nothing for those who have been more prudent than themselves. To borrow more money to get the country out of its problems, according to Dr. Tempest, is a bit like telling a heroin addict that he needs more heroin in order to recover. This country does not want a legacy of debt; it needs a culture of saving and a Government who are willing to take urgent action to make it happen."

Gordon Brown - Double or Quits?

2009-01-21T15:41:00.000-08:00

Whilst watching ‘The City Uncovered with Evan Davis: Tricks with Risk’ I was struck by the words of Nick Leeson; the man who broke Barings bank. He said “I tried big bets using futures and options…I believed that one day I would be able to resolve the situation and move on from it. There’s a degree of stubbornness and compulsion…it’s the human element, more often than not, needs to be controlled.” His story ended when Barings bank thought he had lost over £2 million of their money, but this later ballooned to a figure of £208 million.

Nick Leeson is right that the economy and psychology are linked. So if Gordon Brown also has a tendency for stubbornness and compulsion, then maybe we should be very afraid. His first £37 billion bail out has been quickly followed by a second bigger bail out. Yet, all of this money has been spent, without knowing the depth of toxic debts on the balance books. It seems betting on futures and options is a risky business – but I don’t want Gordon Brown betting my options, or my children's future away.

What is Happening on our Labour wards?

2009-01-21T07:00:00.000-08:00

Today the Centre for Policy Studies hosts a blog, written by myself and Dr Mark Slack. See here. It questions the legacy the Labour government shall leave their NHS namesake, the labour wards.

Patrick McGoohan

2009-01-14T10:27:00.000-08:00

This blog is in rememberance of Patrick McGoohan who sadly passed away today at the age of 80 years. He was best known for starring in cult 1960s TV show The Prisoner. The actor, who was born in New York, was raised in England and Ireland. It is often forgotten that he was also a writer and wrote some of the episodes of The Prisoner himself, under a different name. In The Prisoner his character spent the entire time attempting to escape from The Village and finding out the identity of his captor, the elusive Number One.
He repeatedly declared: "I am not a number - I am a free man!"

Ecstasy - the UK's third most widely used illegal drug

2009-01-13T10:03:00.000-08:00

Neil McKeganey, a professor of drug misuse research at the University of Glasgow wrote the following in The Guardian today:

For Simon Jenkins, the debate around the possible reclassification of ecstasy has only two sides (Who will cure ministers of illiberal headline addiction?, 7 January). On the one side there is the rational weighing of evidence that would recommend the reclassification of ecstasy from class A to class B under the Misuse of Drugs Act; and on the other there is a prime minister and a home secretary living in mortal fear of a mauling from the tabloid press were they to accept the advice of their expert committee.
The home secretary, Jenkins claims, "may be putty in the hands of her advisers on curbing civil liberty but sternly resists all the blandishments of reason in the matter of narcotics". What would it take for the home secretary to accept those blandishments? According to Jenkins it would be to accept the advice of her experts and reclassify ecstasy to class B.
"The justification for regulating drugs," he writes, "can only be the harm their use imposes on individuals and the community." A Lancet study cited by Jenkins "classified 20 mind-altering substances by personal and social harm" and "put ecstasy at the bottom, well below alcohol and nicotine". The research on which that list was based, though, was not about assessing the scientific-evidenced harm of different drugs but on a poll of addiction specialists. This was scientific opinion rather than scientific fact, and only 37% of those asked to provide their assessment chose to do so.
There is, though, a wealth of research evidence from both Britain and the US on the harms of ecstasy use that shows the adverse impact of this drug on the heart, on mood, on brain activity and on sleep pattern. It has been shown that individuals will often combine the use of ecstasy with the use of other illegal drugs. While there is some dispute as to the number of deaths directly associated with ecstasy, it is clear that use of this drug is associated with an elevated risk of death.
We should also be concerned at the speed with which ecstasy has become the UK's third most widely used illegal drug. Research has shown that those who consume the drug are often not even aware of the chemical constituents of the pills they are taking. Ecstasy may in this sense be playing a major role in normalising drug use, and may therefore be having a much more harmful impact.
Jenkins makes the point that if the home secretary does reject the advice from the Advisory Council on the Misuse of Drugs, this "would render the committee largely pointless". Surely those receiving the advice should retain the right to make up their mind as to whether or not to accept it. A second rejection of the ACMD's advice may not make the committee pointless, but it may lead to a different question: why is the ACMD preoccupying itself with the matter of where drugs are placed when there are surely many more urgent questions on how we tackle our developing drug problem?

The North/South Divide - Does it exist?

2009-01-08T05:18:00.000-08:00

Today The Guardian reported on ‘how northern children top the happiness league’. An Ofsted report found that teenagers in the north of England are emotionally more secure and have more than one best friend by the age of 15. The survey ratings were less good news for leafy Richmond, London. Where children reported the lowest levels of emotional well-being.

So, perhaps during this current recession we should all learn something from the community spirit that remains alive and well in the north of England. In the last ten years Gordon Brown has tested to destruction his theory that money can buy happiness – it can’t. As psychologist Winnicott famously stated, life is about interactions between people. But then when Gordon Brown has Peter Mandelson as his best friend, I can not imagine a happy outcome for him.

A Book Review for the New Year

2008-12-26T07:41:00.000-08:00

In 2009 a fellow psychiatrist's book will be on the shelves - ‘The Meaning of Madness’ by Dr Neel Burton. This book aims to explore what mental disorders can teach us about human nature and the human condition. For example, what is schizophrenia? Why is it so common? Why does it affect human beings and not animals? What might this tell us about mind and body, language and creativity, music and religion? What are the boundaries between mental disorder and ‘normality’? Is there a relationship between mental disorder and genius?

The book looks behind the usual categories to ask: why does this mental disorder exist and what adaptive or evolutionary advantage, if any, could it have? It’s an interesting way of looking at things, and one that puts a much needed positive spin on illnesses which are usually portrayed as being nothing but negative.

According to Professor Bill Fulford of Oxford University, ‘The Meaning of Madness’ contrasts from other books on mental disorder in that it neither polemical nor over-technical. Instead, it provides a highly readable and at the same time authoritative account that, by combining literary, philosophical, and scientific sources, shows the deep connections between ‘madness’ and some of most important attributes as human beings. The book’s central message that mental disorders are an expression of our deepest human nature is both important and timely, and one that can make a real difference to the perception, experience, and outcome of mental disorder.

Well done to Dr Neel Burton, it certainly makes an interesting read. Hot of the press it can be pre-ordered here.

A Bipolar Economy?

2008-10-07T13:46:00.000-07:00

During the present glum destructive nature of the economy, histrionic panic should be avoided. It’s similar to treating an economy with bipolar disorder. Suffering a crash after a prolonged ‘high’ or manic episode. Going from euphoria to despair. During the years of boom and mania, there was inflated opinion, increased self-esteem, carefree joviality, boorish behaviour, over-optimistic ideas and reckless acts without thinking of the consequences. Now we stare in the face of depression. The market suffers the bipolar opposite feelings of recession. Suffering with guilt, lack of self-esteem, feelings of worthlessness and a bleak and pessimistic view about the future.

Politicians need to communicate and co-ordinate. Any psychiatrist will tell you, inconsistency and uncertainty are to be avoided. Casino party capitalism has no chips left to place on the table. Initial stabilisation must occur, and confidence in the Treasury is now paramount. I hope they prescribe the correct treatment at the right dose!

Conservative Health Debate

2008-09-26T08:49:00.000-07:00

Last night I was kindly hosted by Beaconsfield Conservatives and spoke with Dominic Grieve MP (Shadow Home Secretary). Many thanks to all the people who came along to join in the health debate.

Doctors Car Stolen

2008-08-14T09:26:00.000-07:00

News from Greater Manchester Police is that a doctor left the car running whilst she did the decent thing and rushed over to help a man in his 70's suffering a serious head injury. Being a good samaritan she pulled up in her red Renault Clio leaving the keys in the ignition.

Unfortunately, a thief jumped in her car and drove off! The incident happened at 4.50pm on Wednesday, on Eccles New Road, near Hope Hospital in Salford, Greater Manchester. The car's registration is NY05 RZN and police would like to hear from anybody who has seen it.

Book Review

2008-08-13T07:58:00.000-07:00

‘Why Lawyers Should Surf’ has been reviewed by:
Times online and Swordplay.

The Future?

2008-07-26T08:18:00.000-07:00

Barack Obama and David Cameron share political dreams with confidence and the audacity of hope. Perhaps the next time they meet, both will be elected leaders.

A Brief History of Childhood Behaviour

2008-07-18T07:23:00.000-07:00

As childhood knife crime is dominating the headlines, perhaps it's worthwhile remembering the words of Jean-Jacques Rousseau. He believed infants were born infinitely malleable with the potential for moral goodness that experience of life corrupted. "Everything is good" he wrote in 1762 "that leaves the Creator's hands: everything degenerates in the hands of man."

Since the end of the eighteenth century, the concept of childhood as a time of extreme impressionability, and of crucial significance for personality development, has been a powerful force politically and socially. Descriptions by Charles Dickens of the terrible living conditions of the poor were meant to move politicians, and they did. It was known then that only social reform and active measures could solve the problem.

Knife Crime in A&E

2008-07-15T05:59:00.001-07:00

This picture was taken during the 'doctors march', March 2007. It illustrated how the then health secretary Patricia Hewitt treated junior doctors over Modernising Medical Careers (MMC).

In 20o8 may I remind the Home Secretary Jacqui Smith that A&E is for an accident and/or an emergency. It is not, and never will be, part of the criminal justice system.

The Quango Theme

2008-07-01T05:10:00.000-07:00

Today Kathy Gyngell discusses quangos, see here.

Quangos Cost More Than Our Armed Forces.

2008-06-30T04:53:00.000-07:00

Alan Duncan today announced that Regional Development Agencies (RDAs), are evolving into an executive arm of government instead of being “a business-led force for good”. He fears RDAs have become “increasingly politicised” and that the government’s plans to give them strategic planning powers is “a huge mistake...ingraining a tier of regional government with no mandate, no legitimacy and no accountability”.

To me RDAs sound like yet another unaccountable, unelected, undemogratic quango. Perhaps it's worth remembering that the Labour government spend more on quangos, than on our own armed forces.

Gordon Brown's NHS

2008-06-29T10:10:00.000-07:00

Gordon Brown celebrates 60 years of the NHS.
Check out this clip - a must see episode of Yes Minister with a hospital full of administration but no patients. Is this an example of life imitating art?

Why Lawyers Should Surf

2008-06-26T13:14:00.000-07:00

The book 'Why Laywers Should Surf' was reviewed this week in surfing magazine Drift.

NHS - Happy 60th

2008-06-25T11:35:00.000-07:00

Yesterday I was at Guy's hospital, celebrating 60 years of the NHS. David Cameron spoke about how the Conservatives were going to reduce targets and focus on outcomes. He also gave a personal account of how his son Ivan has frequently used the NHS and how grateful he was to the hard working health professionals.