How the world (UK Gov/NHS) now works – or doesn’t (spoiler alert – manipulating numbers)
Mon 10:14 am +01:00, 31 Oct 2022
[How fewer doctors means more doctors – it’s official]
By Dr. Malcolm Kendrick | October 30, 2022
This blog has nothing to do with heart disease, or vaccines, or anything directly about medical practice at all.
However, it does have a great deal to do with data manipulation, which is something very close to my heart. It also illustrates how a ‘fact’ can be anything but.
I am also hoping to help highlight an increasingly worrying trend that now scours the planet. Namely that we are living in a world distorted to fit whatever narrative those in power are trying to stuff down our throats. Although, I continue to marvel at how anyone can spout utter, utter, nonsense, and not simply curl-up and die of acute embarrassment.
Anyway, gentle reader, let me set the scene for your delectation.
In the UK, more specifically England, doctors and nurses have been leaving the profession in droves. In particular GPs. This has caused a degree of faux concern by politicians, who always wish to claim they are the great protectors of the NHS. The NHS is inevitably a big issue at every election.
Years ago, Jeremy Hunt, the then health secretary – and slippery eel made flesh – promised he would ensure there would be five thousand more GPs within about five years(ish). The actual number of years it was going to take kept moving around as the target receded into the distance. ‘Did I say three, I meant five… or was it ten.’
Commentary on this was not complementary:
“Delivering 5,000 extra GPs in five years, when training a GP takes 10 years, was a practical impossibility that was never going to be achieved,” said Dr Chaand Nagpaul, chair of the BMA’s GPs committee.
“It was a pledge that also ignored the fact that one third of GPs are planning to retire by 2020, and the current medical graduates do not want to join an overworked, underfunded service, with more than 400 GP trainee posts left unfilled last year.”
Andrew Gwynne, the shadow health minister, said Hunt was backtracking on the pledge, and that “the Tories’ election promises are unravelling one by one”.1
Seven years, or so, have now passed since Hunt’s promise, and the number of GPs has fallen. As predicted by anyone who knew why GPs were leaving. Basically, they were all burnt out, and pissed off, and nothing was being done to make their lives easier, especially, especially not by Jeremy Hunt – who did nothing but make the job considerably more difficult. I should know, I am one. Both burnt out, and pissed off, but clinging on – for increasingly unfathomable reasons. Money, mainly.
Now, however, the UK has a new Prime Minister, a new cabinet, a new health minister and a new Chancellor of the Exchequer (one Jeremy Hunt, no less). Lo and behold, we find that the number of doctors and nurses has actually, mysteriously, who’d have thunk it … increased. Even GP numbers have increased!
[*this is a new, new, health secretary. The previous new one, began this sorry saga]‘Latest data published by NHS Digital shows that, compared to August 2021, there are also over 3,700 more doctors and over 9,100 more nurses working in the NHS.
Secretary of State for Health and Social Care Steve Barclay* said:
More healthcare staff means better care for patients, which is why it’s fantastic to see a record number of over 1.2 million staff working hard in the NHS.
With over 3,700 more doctors and 9,100 more nurses, we are really putting patients first and NHS England is developing a long-term workforce plan so we can continue to recruit and retain more NHS staff.
Thanks to all our doctors, nurses and NHS healthcare staff who work tirelessly to look after us and our loved ones and continue to inspire future generations to join this rewarding career.
The government continues to deliver on its commitment to recruit 50,000 more nurses by 2024, with 29,000 more nurses since September 2019.’ 2
Phew, all is well. Sorted. What a remarkable thing. How has this been achieved … virtually overnight? Did they manage to compress the average training time for a fully qualified doctor from at least ten years to one month? Did they find a locked room full of 3,700 doctors and 9,100 nurses that no-one had noticed before? ‘You are now free to leave and start working. Go, go now, and tend to the sick.’
No, to understand where these figures come from, let us go back in time. Twenty-nine days from the date I wrote this blog – to be exact. We shall visit a website known as doctors.net. A place where doctors post about various things – but nothing critical of vaccines obviously. Here, twenty-nine days ago, we find this, possibly, strange post:
‘I’ve just had an email from the GMC saying the secretary of state has asked for my emergency registration to run until 2024. I doubt she had me in mind specifically. I wonder what has been foretold?’
And this one:
‘Oh. My wife tells me she has also been re-registered.’
And this one, amongst many others:
‘I’ve had the email too. They’ve also apparently restored emergency registration for the nurses, too; just after some of the ones I was working with at the vaccination centre paid to continue their registration. They are somewhat pissed off.’
What is this emergency registration of which they speak? Well, during the COVID19 panic, sorry pandemic, a number of doctors and nurses who had recently retired, (and who had handed back their registration) were unceremoniously dragged back onto the register. Thus, allowing them to keep on practicing medicine. Whether they wanted to or not … most didn’t.
These doctors and nurses didn’t need to do anything themselves, not even ask to be re-instated. It was just done. This policy was designed to help plug holes in staffing. It was known as emergency registration. As stated here, with regard to nurses:
‘The Coronavirus Act 2020 gives the Registrar a new emergency power to temporarily register a person or group of persons as registered nurses, midwives or nursing associates if the Secretary of State advises that an emergency has occurred, is occurring or is about to occur.’ 3
Then as the panic, sorry pandemic, fell away, emergency registrations began to be withdrawn.
‘Many temporary Coronavirus Act provisions remain in force. However, by default they will expire on 25 March 2022. The Government has said it will allow almost all these provisions to expire.
The following policy areas have temporary changes which are set to expire in England or (where relevant) on a UK-wide basis:
– temporary registration of health and social care professionals’ 4
Of course, getting rid of emergency registration would have the effect of (appearing to) sharply reduce the number of doctors and nurses. Even if the vast majority of those who had been plonked on the register never did an extra day’s work and remained happily retired. Yes, this was always a ‘pretend’ workforce. ‘Look at all these additional doctors and nurses we have created… who we haven’t spoken to, and we have no idea if they will ever work again …’
Anyway, the Government was dispensing with emergency registration. Then, out of the blue, it was back again. With retired doctors and nurses placed back on the ‘pretend’ doctors and nurse’s lists once more – until 2024. Which just happens to be the year of the next general election.
What is the explanation for this? Well, according to the General Medical Council in September 2022:
[The General Medical Council (GMC) controls medical registration].‘The UK government asked us to give temporary emergency registration to suitable people, as part of the response to the coronavirus (COVID-19) pandemic.’ 5
What…? We had a new COVID-19 pandemic last month? I thought it started in 2020. Did you know it was back with a vengeance? Did you? Did you hear anything about it? No, you didn’t, because it never happened. This statement is simply … not true. I would never dream of calling it a damned lie. Other’s may feel differently.
Anyway, let me take you through this from a slightly different angle.
The UK Government is desperately trying to claim they are doing everything they can to support the NHS, which is currently falling to bits, and will damage their prospects at the next election. One of the key things they wish to claim is that they are increasing the work force – especially doctors and nurses (not managers for some strange reason). However, …
‘More than 40,000 nurses have left the NHS in England in the past year, an analysis by the Nuffield Trust has revealed.
The analysis, conducted by the think tank for the BBC, said that this is the highest number and proportion of nurses leaving the NHS since trend data began.
It found that many of these nurses were often highly skilled and knowledgeable with many more years of work left.’ 6
In addition:
‘Over the last year, the NHS has lost 339 individual (headcount) GP partners and 305 salaried, locum and retainer GPs. This has created a net loss of 644 individual GPs since September 2021… There are now just 0.44 fully qualified GPs per 1,000 patients in England – down from 0.52 in 2015.’ 7
Yet, despite all these people heading for the exit, the Government now informs us that the workforce is not falling, it is going up, up, up, baby. I find this apparent conundrum to be spookily similar to my findings when studying research papers. How can various results be reconciled, when they seem directly contradictory? Heart attacks fell, but deaths from heart disease increased. In the same trial? Oh no, I must read the methodology section – usually impenetrable.
In the same way, we find the number of ‘registered’ doctors is going up, whilst the number of doctors is falling. This leaves us with two seemingly contradictory facts. Which of them is true? Or can they both be true?
In my simple little world, the true ‘fact’ is that the number of doctors is falling, rapidly. However, the Government have solved this issue by creating an equal and opposite fact. Which is that the number of doctors is going up.
They achieved this remarkable feat by bringing back the emergency re-registration of retired doctors, sharply increasing ‘pretend’ doctor’s numbers. In this weird, distorted, manipulated way we have another’ fact’ on our hands. Which is that there are more doctors on the register a.k.a. ‘more doctors.’
Which of these facts is true? Yes, in the hands of politicians, facts can become slippery little swine.
To quote John Martyn: ‘Half the lies I tell you are not true.’
In truth, once you cut through the utter steaming bullshit, I know, and you now know, what is going on – as did many doctors at the time. Here are a few more posts, from twenty-nine days ago, commenting on the re-introduction of emergency registration:
‘After a few hours to consider, I have now emailed the GMC to ask that my temporary registration be removed. FWIW (for what it is worth) I think it highly likely that this is an attempt by the government to inflate the apparent numbers of doctors available.’
Or this one:
‘It has been foretold that for purposes of political spin, they need to say that they have more doctors on the register.’
Another doctor was even more acute in their observation – twenty-nine days ago:
‘The weird thing about this is the clear and direct nature of cheating.
If – as is highly likely – this process relates to absolutely nothing at all apart from manipulating stats to misrepresent reality for political ambitions, then there would be people with job time allocated to it, meetings, emails, conclusions, notes, presentations etc.
“Are you going to the meeting about cheating the doctor numbers tomorrow?”
“Yes, I should make that meeting where we deliberately lie about how many doctors there are”
“Great, see you there. Hopefully we can cheat those figures really efficiently and get away on time!”
And lo, the game played out, exactly as predicted. One month ago, the Government very deliberately inflated figures on doctor’s numbers (and nurse’s numbers). Now they are crowing, in public, about this magnificent increase. ‘Look how brilliant we are. ‘
‘Crikey, how did you manage this totes amazeballs thing?’
‘Well, wouldn’t like to boast about it, really. Hard work, dedication … I would like to thank my team. Golly, is that the time, must dash.’
Do they think we are all completely stupid? Don’t answer that, they clearly do. Do they think no-one noticed? People were tweeting about it at the time:
‘Why has Secretary of State for Health and Social Care @theresecoffey asked the GMC @gmcuk to extend temporary registrations until 2024? Is this to prevent a sudden drop in the number of doctors on the register, causing embarrassing stats in the press?’ 8
Today, we are swimming in a sea of misinformation, and deliberately manipulated statistics. Yet, people seem to shrug their shoulders. ‘Don’t get worked up about it. Everyone is up to it, who cares. Same old, same old. The other lot are just as bad.’
It is time, I believe, for pitchforks and burning torches, and people taking to the streets in protest about the way that this world is going. So very badly wrong.
‘In a time of deceit telling the truth is a revolutionary act.’ George Orwell.
1: https://www.theguardian.com/society/2015/jun/24/doubt-lingers-over-jeremy-hunts-pledge-5000-new-gps
2: https://www.gov.uk/government/news/record-numbers-of-staff-working-in-the-nhs
4: https://commonslibrary.parliament.uk/expiry-of-the-coronavirus-acts-temporary-provisions/
5: https://www.gmc-uk.org/registration-and-licensing/guide-for-doctors-granted-temporary-registration
8: https://twitter.com/TheSmartGP/status/1575832771821727746
https://alethonews.com/2022/10/30/how-the-world-now-works-or-doesnt/
