Thursday, July 23, 2009

Aphorisms IX - Who watches the Watchmen?

As I haven't changed my heading aphorism in a long time and in the light of recent revelations ...

- Member of Parliament expenses

- the National Health Service IT programme to keep all our healthcare records in one massive database

- government plans to introduce a national ID database

- various losses of confidential data on computers, USB sticks and even paper, both civil and military

- Joao de Menezes murder by the UK police

etc etc

it is time to change my head aphorism to ...

Quis custodiet ipsos custodes.

" Who watches the Watchmen?"

from Juvenal's Satires, VI, 347 - epigraph to the 1987 US Tower Commission Report into the Iran-Contra affair.

Monday, July 20, 2009

A Lover's Sonnet

What'll I do when you
are far away
and I am blue
What'll I do?

What'll I do when I
am wondering who
is kissing you
What'll I do?

What'll I do with just a photograph
to tell my troubles to?

When I'm alone with
only dreams of you
that won't come true
What'll I do?

© 1997 H. Stephenson

Friday, July 17, 2009

A Tale of Three Doctors, a Nurse Practitioner and a Pissing Contest

Obviously, the family has lost any natural resistance to malaria over the last three years and there are two malaria prophylaxis drugs recommended for children of Kezia's age travelling to countries with malaria:

Malarone with side-effects: neutropenia, pancytopenia.

Mefloquine with side-effects: principally psychological (bad dreams etc, nothing haematological)

Kezia's consultant wrote to our GP practice in the UK requesting they prescibe Kezia with Mefloquine. Our family doctor here recommends that Kezia takes Mefloquine.

Jaime and Kezia have been taking various vaccines over the last couple of weeks. And the "Nurse Specialist in paediatric and adult vaccinations" insists that Kezia takes Malarone, that she hasn't prescribed Mefloquine in ten years, and won't, that she has much experience in malaria prophylaxis.

Has she experience in paedeatric oncology/haematology? Has she experience in paedeatric oncology/haematology in malarial zones?

My brother Pete is going to try and get through to the Doctor rather than the "Nurse Specialist" tomorrow and sort this out. Thanks bruv.

Afrox - you have a long way to go.

And Drs Crippen and Rant you will hear more from me on "Nurse Specialists".

Wednesday, July 15, 2009

OGC Gateway Reviews - FOIA Response

Response from the Office of Government of Commerce regarding my FOIA request regarding North West and West Midlands SHA Gateway Reviews into IT. (Open in new tab to enlarge).

It seems the OGC's review of 2006 never took place!

Here we Go - Oh! Barfing all over the Ward!

Hello everyone, plus even more new people! Are you absolutely barking? Do you know what you've let yourselves in for? Indeed you do. And you're in good company.

Well, that was an ‘interesting’ week, in the sense of the Chinese curse ‘may you live in interesting times’…

Last Wednesday I went for my first dose of radiotherapy, (I have 30 doses to look forward to) which involved being stapled to a piece of steel for 25 minutes inside the mask I have had made up for me. To say it fits my face & throat like a glove is a bizarre exaggeration. It’s so tight that I can’t even open my EYES when I’ve got it on. Now THAT’S sensory deprivation for you. In fact, to riff off my Ripley / Alien theme, it really isn’t much different to having a face-hugger adhere to my face (thankfully without tube down throat planting alien seed in my stomach…)

Luckily, I’m not claustrophobic, and I can just about relax & persuade myself that it’s a bizarre, beepy, if oddly futuristic sci-fi spa treatment. Yes, I do have a lively imagination. Good thing too!

Anyhow, got that out of the way, and because it was Week One, I had to have one quick dose of chemo.

Quick? Well, that was the plan.

However, I had the worst reaction to any of my treatment so far.

When the Doctor asked me how I was, my answer was to throw up all over myself (how lovely – all my previous tossing-of-cookies has managed to hit a receptacle of some kind), have a massive collapse in the middle of Outpatients involving stretchers, ECG machines, nurses running around with heart monitors & twittering how I had a systolic blood pressure of 27 (impossible apparently) and a haemoglobin count of 7 (ditto).

Clearly, once again I just WASN’T GETTING ENOUGH ATTENTION and had to throw a big drama queen special. Sheesh.

So, I was hauled onto a Ward, and given my very first blood transfusion ever!

Three Bags Full, and all.

I am finally a true vampire living off the blood of others! How apt.

I’m only Type O Neg however, nothing exotic.

I was finally released on Friday night – or rather, I kind of discharged myself. I was fed up of not being able to stop vomiting. I just couldn’t eat the hospital food, and knew I was getting under-nourished, and would just get ‘iller’ if I stayed in. So, I am home and feeling better now that I can eat stuff I can actually (and indeed, literally) stomach.

So, it’s Monday, I have a wonderful friend taking me into radiotherapy, and here we go all over again!

29 doses to go. And counting, believe me.

Big love to all of you gorgeous gorgeous friends!!

Rosie xxxx

‘Some people are like Slinkies, really useless, but make me happy when pushed
down the stairs...’

Thursday, July 2, 2009

Payment by Result

I'm slowly clearing up the dining table, covered in shit (sorry, papers) in anticipation of the family's arrival on 31 July.

As I clear up all these papers, more accumulate. On top of the latest pile is the British Society of Haematology/Royal College of Pathologists' January 2008 report Haematology Consultation Workforcr: The Next 10 Years. Table 1 is entitled Initiatives since the previous workforce document (2001) and is divided into "Rgulatory Initiatives" and "Influential Initiatives".

One of the latter is "Payment by Results". How the hell are they going to evaluate and pay Kezia's consultant on whether she survives leukaemia when he is following an approved protocol for the treatment of T-cell ALL?

Is the doctor reponsible for me drinking like a chimney and smoking like a fish?

Wednesday, July 1, 2009

The National Programme for IT - "Gateway Reviews"

... otherwise known as "Connecting for Health" is the UK government's to produce one huge database of its citizens' healthcare ranging from booking an appointment with your family doctor to prescribing medication to keeping your medical records to ...

It has been widely critisised - by NHS staff, by the wider IT community, by politicians etc etc. Data security, contracting issues, technology, deadlines, training, consultation ... the list goes on.

The state treasury's Office of Government Commerce (OGC) has undertaken reviews of the project's status since its inception in 2002. These reports, known as Gateway Reviews have remained confidential, out of the public and media's eyes.

The magazine Computer Weekly submitted a Freedom of Information Act (FOIA) for these reviews to be published in public. Thirty one reports were published last week. Computer Weekly has a summary.

In 2005 responsibility for the project was passed from the Department of Health to five mega-conglomerates of regional Strategic Health Authorities (SHAs) The North West and West Midlands Cluster (NWWM) consists of six SHAs.

The Gateway Reviews highlight outstanding issues as with traffic lights - red, amber, green. In the NWWM Cluster of nine recommendations, one is green, five are amber and three are red.

The review was made in 2005.

The original project was budgeted at ₤5 billion - it is now ₤12 billion.

The head of IT at the Department of Health has stated that if no radical progress is made by November 2009, a radical "shake-up" will be necessary.

The NWWM Gateway Review of 2005 expected a further review for early 2006 - it was not published (or not done?). I have submitted a FOIA request to the OGC about this.

My previous FOIA request regarding how much Microsoft was earning from this project was rejected.