‘Richard Branson’s company becomes one of the first of many vultures to start picking over the rich, tender flesh of the NHS now that it has been splayed open by the (Health) Bill.’ So wrote pseudonymous Telegraph doctor Max Pemberton on the news that Virgin Care has won a £500?million contract to provide community services across Surrey and began running these services, as well as the county’s prison healthcare, on April 1.

When Telegraph columnists slate private healthcare provision, the government knows it has a problem but the groundwork for all this was done by Labour. In January 2009, it published Transforming community services: enabling new patterns of provision. ‘This guidance is intended to help PCT providers of community services to move their relationship with their commissioners to a purely contractual one and consider what type(s) of organisations would best meet the future needs of patients and local communities.’

The Health Bill cements and accelerates Labour’s vision of a competitive market for healthcare but may come a cropper if the public aren’t sufficiently involved in the decision making. Section 242 of the NHS Act 2006 makes clear that formal consultation is required in ‘instances in which the manner in which services are delivered, or the range of the services, will change.’ So the game is now on to hand services to the private sector while claiming they won’t change in order to avoid formal consultation with angry protestors who vehemently disagree with the giving large sums of public money and power to private companies and their share holders.

In September 2011, patient Michael Lloyd, 75, challenged the transfer of community services from NHS Gloucestershire Primary Care Trust to a private community interest company. His argument was that the PCT did not consult adequately on the proposals or give proper consideration to alternatives that would have seen the services remain within the NHS. The challenge went all the way to judicial review, with the PCT caving in on day 2 and agreeing to advertise for ‘expressions of interest for the provision of local services’ which may keep the service within the NHS. Or it may not.

Alas the judge did not clarify how EU procurement law will affect these NHS ‘outsourcing decisions’, but companies based in the EU and eyeing up the NHS market may have a legal right to be included in the tendering process, which would make it even harder, expensive and legally tortuous for the NHS to cling onto the provision of NHS services. As David Lock QC wrote in the Health Service Journal: ‘The duties of transparency, equal treatment and non-discrimination imposed by the EU treaty and the Public Contracts Regulations 2006 mean that all contracts placed with a body outside an NHS trust should be subject to a “degree of advertising” to allow healthcare providers located in another EU country the chance to bid for the contract.’

Despite this, a private hospital in Kent is already claiming it will offer the NHS and private patients ‘the only cardiothoracic and neurosurgery tertiary care beds in the county.’ The Clydesdale Bank last week agreed a £34m loan deal to help build and run the Kent Institute of Medicine and Surgery, which is due to open in the second quarter of 2014. Another £80 million will be provided by corporate and private investors, including around 100 clinicians.

Private provision in healthcare thrives when the NHS gives up trying (e.g. long term care of the elderly, psychiatry) and with so many hospitals and PCTs in huge debt, and the Department of Health facing a ‘significant’ accounts auditing problem, the choice for many NHS community and hospital services may soon be between private provision or nothing. And Labour started it all.

‘Once in a lifetime’ reform of the NHS is nothing new. Tony Blair, Lord Darzi and David Cameron have all promised it in the last 12 years. Either we’re being lied to, or life expectancy will soon plummet to four years. But the biggest failing of the Health and Social Care Bill is that it’s unreadable. At 353 pages it’s bigger than the Bill that founded the NHS. By page 19, I’d given up the will to live. It’s an impossibly complex mix of regulations, substitutions and amendments. No GP can possibly digest them, and for us to take control of rationing the NHS is a huge leap of faith. It’s like being handed the steering wheel of a runaway coach as it plummets over the cliff. Oh, and here’s the instruction manual. In German.

The phrase ‘any willing provider’ suggests doctors in supermarkets, with loyalty cards for liposuction, two diagnoses for the price of one and a checkout for six symptoms or less. Price completion works when you’re buying things – curtains, soap, Cornflakes – but not when you’re buying complex treatments for patients with several diseases. The NHS improved under Labour, but not as much as it should have done. Lansley’s idea of staff and patients designing services and deciding how the money is spent is spot on, but we need time to sit down and share ideas and experiences. It’s pointless ‘giving patients a voice’ if they don’t know how to be heard. GP Consortia have ridiculously confusing names like Bexley Clinical Cabinet and Cumbria Senate, and patients aren’t guaranteed a seat on the board.

Health reform, like healthcare, relies on trust. Who should we trust to make the best use of NHS resources? Lansley believes that ‘GPs know what patients want’, but some doctors are very bad at listening to patients and a medical degree is no substitute for clairvoyance. What the NHS needs more than anything is to rediscover its humanity. Staff and patients need time together, and services need to collaborate rather than compete in difficult times, without the insecurity of rapid change. Political dogma dictates that if you don’t blow the NHS out of the water in the first year of office, you won’t be able to touch it at all. But the Tories have now realised they need to slow down, if only to placate the Liberal Democrats. Even better, they can blame their more cautious partners when the NHS hits the buffers next year.

Thanks to all who came to the benefit gig for for Patients First, to help and support NHS and Social Care Whistleblowers. It was a sell out.  Two other benefits coming up. May 20th at Bath Komedia to stop the uneeded asbestos landfill in the Chew Valley.

May 31st at Clapham Grand (with Arthur Smith and Harry Hill) in aid of the Klevis Kola Foundation,  started by medical students at St George’s Hospital, supporting refugee and asylum-seeking children and families in South London

PLEASE SUPPORT AND SPREAD THE WORD

Gigs soon in Southampton, Tewkesbury and Frome – see Tour Dates tab

ANDREW LANSLEY WILL ONLY LET YOU SEE A SUMMARY, BUT THE HEALTH AND SOCIAL CARE BILL RISK REGISTER (EARLY VERSION) IS AVAILABLE TO DOWNLOAD HERE Health Bill Transition Risk Register – NC 15 Oct 10 (Dept Bd Version) v1.1

HEALTH AND SOCIAL CARE BILL BUSINESS CASE OCTOBER 2011 DRAFT – A bit more meat than the Risk Register but still decidely flimsy. Either they’re very boring fakes (unlikely) or there isn’t a very good buisiness case for the Health Bill and it’s far too risky. You decide.

Transition business case

‘SHOOT THE MESSENGER’ – PRIVATE EYE SPECIAL INVESTIGATION INTO WHISTLEBLOWING IN THE NHS AVAILABLE TO DOWNLOAD HERE  Shoot_the_Mesenger_FINAL

Read them all and you’ll spot that one of the biggest risks of the Health and Social Care Bill is that, now David Cameron has staked his reputation on it, whistleblowers will be brutally suppressed as they were when Tony Blair and Gordon Brown pulled the same trick. NHS reform is invariably reduced to saving the reputation of the Prime Minister rather than improving the service. There is no room for honest, open debate in such a politicised system.

Latest Private Eye Column:

Unhappy Anniversary

It’s now twenty years since the Eye broke the story of the Bristol heart scandal (Eye May 8, 1992). It took seven years to get a public inquiry which, in 2001, declared that 30-35 more children under one year died from open heart surgery in Bristol between 1984 and 1995 than at other comparable units. A similar number were left severely brain damaged. The overriding conclusion was that to make the service safe, complex child heart surgery has to be concentrated into fewer, larger units with the appropriate staffing, expertise, resources, audit and training – and the crucial ability to expand. Twenty years later, we’re still waiting.

We have, however, had a further scandal in a small unit (Oxford), an estimation of another 78 ‘excess deaths’ spread over four units in eight years, two expert reviews calling for a reduction in the number of centres and the clinical director of the NHS – Sir Bruce Keogh (himself a cardiac surgeon) –declaring that ‘failure to reconfigure child heart surgery will be a stain on the soul of the specialty and will compromise the treatment of the most vulnerable members of the next generation.’ (Eye 20.1.10)

So why the delay? Politicians rarely show strategic leadership in the NHS, particularly when it necessitates the closure or down-grading of a specialist unit in their constituency. There are currently around 30 consultant heart surgeons who operate on children spread across 11 surgical centres in England. The latest review, Safe and Sustainable, is overseen by a Department of Health-mandated organisation called the Joint Committee of Primary Care Trusts (JCPCT). It managed to get all 11 centres to sign up to a process that was highly likely to recommend a reduction in the number of centres. After the most exhaustive and transparent consultation in NHS history, options were proposed for future centres which the Royal Brompton and Harefield trust didn’t like. Last year, it derailed the review by getting the process of choosing centres quashed, with the judge ruling the assessment had not taken proper account of the London hospital’s research strengths.

For good measure, the Brompton also threw in allegations of bias and impropriety against specialist advisers to the JCPCT who are connected with Great Ormond Street Hospital, the Evelina Children’s Hospital and Southampton General Hospital. The JCPCT appealed against the judicial review finding, and on April 19^th three Court of Appeal judges ruled that the Safe and Sustainable process for the public consultation was fair, lawful and proper, and dismissed as unfounded all of the allegations raised by the Royal Brompton Hospital. In the meantime, the Brompton has blown at least £1.5 million on legal fees that should have gone on patient care, and the process of making child heart surgery safe has been delayed for another year.

Stephen Bolsin, the cardiac anaesthetist who sacrificed his NHS career by blowing the whistle in Bristol, would doubtless be horrified that the culture of infighting, commercial interest and misguided institutional loyalty that blighted Bristol twenty years ago is still prevalent in the NHS now, and that babies undergoing complex heart surgery are still suffering ad a result. Professor Bolsin is flying in from Australia speak to the Patient Safety Congress on May 29^th in Birmingham. As Professor Bolsin puts it: ‘Improved ethical behaviour in health and social care is mandated by professional and managerial failings such as Bristol, Mid Staffs, North Staffs and ‘Baby P’. The benefit is a significant quantifiable cost saving amounting to billions of pounds each year.’ As the Royal Brompton has proved, litigation is a very expensive and harmful substitute for proper consultation.

MD

Medicine Balls, Private Eye, Issue 1312

Labour Pains

‘Richard Branson’s company becomes one of the first of many vultures to start picking over the rich, tender flesh of the NHS now that it has been splayed open by the (Health) Bill.’ So wrote pseudonymous Telegraph doctor Max Pemberton on the news that Virgin Care has won a £500 million contract to provide community services across Surrey and began running these services, as well as the county’s prison healthcare, on April 1.

When Telegraph columnists slate private healthcare provision, the government knows it has a problem but the groundwork for all this was done by Labour. In January 2009, it published Transforming community services: enabling new patterns of provision. ‘This guidance is intended to help PCT providers of community services to move their relationship with their commissioners to a purely contractual one and consider what type(s) of organisations would best meet the future needs of patients and local communities.’

The Health Bill cements and accelerates Labour’s vision of a competitive market for healthcare but may come a cropper if the public aren’t sufficiently involved in the decision making. Section 242 of the NHS Act 2006 makes clear that formal consultation is required in ‘instances in which the manner in which services are delivered, or the range of the services, will change.’ So the game is now on to hand services to the private sector while claiming they won’t change in order to avoid formal consultation with angry protestors who vehemently disagree with the giving large sums of public money and power to private companies and their share holders.

In September 2011, patient Michael Lloyd, 75, challenged the transfer of community services from NHS Gloucestershire Primary Care Trust to a private community interest company. His argument was that the PCT did not consult adequately on the proposals or give proper consideration to alternatives that would have seen the services remain within the NHS. The challenge went all the way to judicial review, with the PCT caving in on day 2 and agreeing to advertise for ‘expressions of interest for the provision of local services’ which may keep the service within the NHS. Or it may not.

Alas the judge did not clarify how EU procurement law will affect these NHS ‘outsourcing decisions’, but companies based in the EU and eyeing up the NHS market may have a legal right to be included in the tendering process, which would make it even harder, expensive and legally tortuous for the NHS to cling onto the provision of NHS services. As David Lock QC wrote in the Health Service Journal: ‘The duties of transparency, equal treatment and non-discrimination imposed by the EU treaty and the Public Contracts Regulations 2006 mean that all contracts placed with a body outside an NHS trust should be subject to a “degree of advertising” to allow healthcare providers located in another EU country the chance to bid for the contract.’

Despite this, a private hospital in Kent is already claiming it will offer the NHS and private patients ‘the only cardiothoracic and neurosurgery tertiary care beds in the county.’ The Clydesdale Bank last week agreed a £34m loan deal to help build and run the Kent Institute of Medicine and Surgery, which is due to open in the second quarter of 2014. Another £80 million will be provided by corporate and private investors, including around 100 clinicians.

Private provision in healthcare thrives when the NHS gives up trying (e.g. long term care of the elderly, psychiatry) and with so many hospitals and PCTs in huge debt, and the Department of Health facing a ‘significant’ accounts auditing problem, the choice for many NHS community and hospital services may soon be between private provision or nothing. And Labour started it all.

Reasons why we must stop the Chew Valley Asbestos Landfill.

The application is to deposit 645,000 tonnes of asbestos and other hazardous waste in Stowey quarry over 10 years. That’s 64,500 tonnes a year, of which 32,500 tonnes a year would be asbestos

1.      It is simply not needed. Local waste should be disposed of locally. In 2010, only 6,600 tonnes of asbestos waste was generated by the councils of BANES, Bristol, North Somerset and South Gloucestershire combined – and asbestos waste production is declining. To fill Stowey Quarry, asbestos would have to be transported to the Chew Valley from all over the UK, in direct contradiction to the policy of local disposal of waste.

2.     The application is for 100 lorry journeys a day, six days a week for 10 years. That’s 312,000 lorry journeys across the UK and through the Chew Valley. The noise and air pollution would be huge, the country roads converging on the Chew Valley from all directions are in parts narrow, difficult to pass and hazardous in icy weather. All parishes of the chew valley could be affected

3.     The site itself is completely unsuitable. Stowey quarry is a shallow pit on top of a windy escarpment. Independent surveys have found evidence of land instability and highlighted the risk of contamination of underlying springs and streams that feed into Chew Valley reservoir. Bristol Water has strongly opposed the application. The site has no mains water supply and yet all lorries must be effectively jet-washed to remove asbestos dust. 60,000 litres of contaminated wash off water would be generated each month, on top of a hill sloping down to the reservoir and its tributaries.

4.     The economic impact would be considerable. The area is one of outstanding natural beauty. The view from the quarry rivals the Italian lakes. There are five footpaths around the quarry, a nature reserve and Folly Farm, both two sites of special scientific interest. The impact on wildlife, tourist trade and property prices would be considerable. Families are unlikely to move to the vicinity of such a large asbestos landfill, and may well move away.

5.     The long term health risks of asbestos fibres dispersing from such a windy site, and hazardous waste eventually leaching through the lining and entering the water supply are significant. The World Health Organization says there is ‘no safe level’ of Chrysolite asbestos, which is the form most likely to be deposited. Mesothelioma – the incurable lung cancer caused by asbestos fibre inhalation –takes up to 40 years to develop.

6.     The track record of the applicant gives grave cause for concern.  He has not complied with previous planning permissions, nor made any attempt to meet and consult with residents. He has several failed directorships behind him and no evident experience in the complex field of asbestos disposal

7.      The track record of the Environment Agency in monitoring nearby breaches of asbestos disposal after planning permission and a permit have been granted also gives grave cause for concern.  The operator of a landfill site at Southwood near Evercreech deliberately smashed up and crushed waste asbestos despite being warned by the Environment Agency of the a ‘significant potential for pollution of the environment and harm to human health.’ The Stowey application involves far greater volumes of asbestos than at Evercreech.

http://www.thisissomerset.co.uk/Southwood-boss-fined-dumping-asbestos/story-12340969-detail/story.html

WHAT YOU CAN DO

Please visit the website, print off and sign letters of objection and sign the e petition.

www.stopstoweyquarry.co.uk

Please also object directly on the BANES website

http://idox.bathnes.gov.uk/WAM/showCaseFile.do?appNumber=10/05199/EFUL

Please come to the benefit gig on May 20^th. Dr Phil Hammond is performing his critically acclaimed Rude Health Show in Bath at the Komedia, and all the proceeds go to the campain fighting fund. We are likely to amass £10,000 in costs, mainly legal. If you can’t come to the show, you can donate whatever you can on the www.stopstoweyquarry.co.uk site

Dr Phil’s Rude Health Show tickets can be purchased at:

http://komediabath.ticketsolve.com/shows/126524867/events     

A final decision is currently dues at a public meeting on June 6th.  Details will be posted on the website.

Finally, please circulate to everyone you think might be willing to protest, wherever they live.

  **** Review in The Times, January 24, 2012

‘If Hammond were a medicine, he would be worth swigging by the litre.’

Dr Phil’s Rude Health Show at South Hill Park, Bracknell

Clive Davis

January 24 2012 12:01AM

Hammond’s roles as a GP and medical campaigner help him to juggle life-and-death issues with naughty but nice A&E tales

A comic who has a hinterland? A stand-up who doesn’t build his material around the soaps he has been watching in his hotel room? Phil Hammond’s twin roles as a GP and a medical campaigner add weight to a performance that juggles life-and-death issues with the kind of naughty but nice A&E anecdotes that have kept many an over-worked junior doctor sane down the years.

This brisk and breezy show gives him the opportunity to explain how he acquired his outsider status. Initially raised in Australia, he spent the remainder of his youth in the West Country, ditching his newly acquired Wurzle accent when his stepfather, an unassuming builder, paid for him to attend the sixth form at Marlborough College. Rubbing shoulders with the elite brought an injection of self-confidence but, deep down, Hammond was perhaps too much of an Aussie to be bought off.

It is hard not to warm to his unpretentious, self-mocking bedside manner. Having worked his passage through the NHS — he seems to have been the most cack-handed physician ever let loose in a labour ward — he has acquired a brutally unsentimental view of its inner workings. The system creaks, doctors muddle along and paperwork takes priority over patients. (Having had plenty of exposure to the system myself recently, I find myself envying the TLC my cat receives from her vet.) But will the looming programme of reforms make things any better? Hammond suspects not.

It is a pity that he doesn’t spend more time on this rather than the tales of his fellow humans’ never-ending ability to find unsuitable objects to insert in the wrong orifices. And his account of his experiences as a columnist in Private Eye is dispatched very quickly too. But these are quibbles. If Hammond were a medicine, he would be worth swigging by the litre.

Clive Davis

POLYOAKS HAS BEEN RECOMMISSIONED BY RADIO 4 – A NEW 6 PART SERIES FOR AUTUMN 2012

IT’S A  MEDICAL COMEDY WRITTEN BY PHIL HAMMOND AND DAVID SPICER ABOUT  STAFF IN A DEEPLY DYSFUNCTIONAL GENERAL PRACTICE STRUGGLING  TO COMBINE THE DAY JOB WITH THE NHS REFORMS.  SERIES ONE WAS BROADCAST AND REPEATED IN 2011, STARRING NIGEL PLANER, TONY GARDNER, CELIA IMRIE, DAVID WESTHEAD, CARLA MENDONSA, DAVID HOLT, PHIL CORNWELL and KATE O’SULLIVAN.

EDINBURGH FRINGE 2011 REVIEWS

VERONICA LEE – SUNDAY TELEGRAPH

DR PHIL’S RUDE HEALTH SHOW *****

Dr Phil Hammond, from Radio 4 and Private Eye, offers a consistently funny show that mixes wry political analysis of the NHS with saucy stuff ‘between the femurs and the coccyx’. His stageside manner is thoughtful and witty, but a quiet exterior barely masks his deep anger about how a revered national institution has been reduced to targets and profits rather than decent patient care. He has anecdotes aplenty from his doctoring, and also some from his Australian relatives, who sound a blast. His Auntie Queenie’s best sex advice was ‘Keep it in your trousers.’

Dr Phil’s Rude Health Show

PRIVATE EYE NHS WHISTLEBLOWING SPECIAL

On July 5 2011 Private Eye published a special investigation by Phil Hammond and Andrew Bousfield into the NHS, entitled “SHOOT THE MESSENGER – How NHS Whistleblowers Are Silenced and Sacked“It appeared in Issue 1292, on sale until July 22. Back orders are available by calling Private Eye Subs on 01795 414870.  A campaigning website for a safer, more transparent NHS featuring whistleblowers and patients stories is at www.medicalharm.org

Erectile dysfunction quote of the day (a patient): ‘I’m still keen but it’s like playing snooker with a piece of rope..’

Sex addiction quote of the day (Radio 5): ‘Just like any other addiction, it’s all about filling a hole.’

STIs on the increase (again). Time to invent a condom you can put on first time, the right way around, with less than five hands.

Monday 30 May 2011

Daily Telegraph

Standing up for rude health

Dr Phil Hammond tells Jasmine Malone about his new comedy show and why he loves being a GP.

By Jasmine Malone 7:00AM BST 30 May 2011

When I arrive at the Royal Society of Medicine to interview Dr Phil Hammond, he tells me he hopes that I am not disappointed – that I hadn’t expected Dr Phil of Oprah fame. “He is much more famous than me,” he says, “but on the plus side, I have much more hair.”

Hammond is also far more entertaining than Oprah’s Dr Phil. Coffee orders taken, he tells me that he is the patron of the Herpes Virus Association – and not the Patron Saint of Herpes, as he was recently described. But he admits that sexual health is an area of medicine severely in need of a comic injection.

Hammond believes we shouldn’t talk about sexually transmitted infections, but ones that are sexually shared. “If we share pleasure, we also share bugs. So it’s only fair that we share treatment.”

His stand-up show, which is back on tour next month, is called Dr Phil’s Rude Health Show. However, he is keen to share the more risqué title he plans to use when he appears at the Edinburgh Fringe Festival this summer: “’How to pleasure yourself in a safe and sustainable way,’” he says with a grin.

Beyond the joke, Hammond insists there is a serious message. With up to 70 per cent of illnesses burdening the NHS categorised as self-induced, he believes we must moderate our pleasures, meaning less smoking, alcohol, overeating and unsafe sex. “No system can cope with a tsunami of chronic disease,” he says.

But he is also quick to criticise the widespread changes to the NHS being considered by this Government. “That’ll be the third ‘once in a lifetime change’ we’ve had in the past 12 years,” he says. “What the NHS needs is stability and wise, non-bullying leaders, as well as a sense of collaboration among staff and patients, to work out how to improve the service when money is tight.”

The Coalition’s NHS reforms are the subject of Hammond’s latest BBC Radio 4 project, a timely medical satire called Polyoaks. The sitcom follows the lives of three GPs who run a traditional practice that faces becoming a super-surgery, or polyclinic. “Anyone who wants to know what’s really happening to the NHS but can’t wade through the 367-page Health and Social Care Bill should listen,” says Hammond.

Nigel Planer plays Dr Roy Thornton, a fusty, cardigan-wearing traditionalist who is loath to change any aspect of his family practice. His younger brother, Dr Hugh Thornton, is played by Tony Garder, Hammond’s former stand-up partner in the Radio 4 comedy about medical matters, Struck Off and Die. Dr Hugh hates being a GP and is very much looking forward to becoming a modern polyclinic commissioner.

The third character, Dr Jeremy, played by David Westhall, is obsessed with sexual health, very popular with patients, much to the chagrin of his colleagues, and based loosely on Hammond himself. “He’s the lazy celebrity TV doctor, who only works at the surgery to give himself a veneer of credibility. He nearly got struck off and makes all his diagnoses on Google.”

As well as being a health commentator, author and comedian, Hammond is a practising GP. The balancing act involved is evident when I call him to follow up on our interview. He found time to speak in between seeing patients at his surgery in Keynsham , near Bristol, on what has been a hectic Monday morning: “They must have all had a crazy weekend.”

Hammond says he loves being a doctor because he gets material to be a comedian, and loves being a comedian because it makes him a better doctor. Beyond writing about health-care issues and penning medical satires, touring the comedy circuit is a particular pleasure because it gives him a connection with the public.

Over the years, Hammond has noticed a shift in his material, from defending doctors to protecting patients. One of his first television ventures, Trust Me, I’m a Doctor, which was broadcast on BBC Two in 1997, was an attempt to encourage patients to question their doctors’ decisions, a feat Hammond knows isn’t easy. “When you’re sick, you’re frightened, and it’s not easy to ask a surgeon what his or her success rate is.”

As is evident with Polyoaks, policy affecting patient care is now the subject close to his heart. “What we want is health reforms that focus first and foremost on patient safety, not on cutting costs,” he says.

Hammond made his name writing about the health service for Private Eye. One of his first stories, into the deaths of children undergoing heart surgery at Bristol Royal Infirmary, appeared in 1992, nine years before an official public inquiry concluded that between 30 and 35 babies and young children had died as a result of substandard care.

He is currently working on a special edition of Private Eye about the NHS. “When you put cutting costs first, inevitably patient welfare is compromised, leading to scandal,” he says. “The NHS needs to rediscover its humanity, and the best measure of that is not just how we treat the most vulnerable patients, but how we respond to those who raise concerns about the safety of the service. At present, far too many whistle-blowers are being silenced with gagging clauses and pay-offs with public money. If we don’t start listening to carers, patients and staff who speak up, we’ll end up with a WikiLeaks for the NHS and all hell will break loose. In fact, I think I might start one.”

These action shots were taken in 1988, by photographer Homer Sykes, when glasses were riduclously big and babies were ridiculously slippery. If you think you might be one of them, please let me know.  You may be entitled to compensation.

My toughest case: Baby Phil

 Early in my medical career, in-between stitching my glove onto the top of a man’s head and watching my spectacles fall into an open wound, I realised a career in surgery probably wasn’t for me. So I joined a GP training scheme and prepared for a life of therapeutic gossip and viral probability. But to get there, I still had to do two years of hospital jobs, starting with the most inappropriate one imaginable; 6 months on a special care baby unit.

It was the toughest time of my life, trying to put drips, drains, tubes and catheters in the tiniest of babies. Luckily, the nurses saw me coming and when it was quiet, we’d swap roles. They’d do all the high-tech fiddly stuff and I’d fetch the coffee and Hobnobs. But when it was busy, I’d be called into action. In 1988, the training mantra was ‘see one, do one, teach one’. As one consultant advised: ‘If you’re not sure what you’re doing, put on  a mask of relaxed brilliance.’ But no mask can calm the panic of a premature birth and dash to special care.

The baby was 32 weeks and not breathing. I looked around for sister. Sister was busy with another baby. I’d done six successful intubations (passing a tube into the trachea to allow ventilation) but never on my own. I chose a tube, I picked up the laryngoscope and prayed my glasses would stay on my sweaty nose long enough to get a good view of the vocal cords. I eased the tube in and fate directed it to the correct hole. As the tiny lungs inflated, Mum placed a lump of amethyst next to her baby ‘for the healing energy.’ An unlikely juxtaposition, even for the West Country.

Some babies get rapidly better, others rapidly worse, but this baby remained in limbo for weeks, unable to come off the ventilator but hanging in there. I’d take blood and fiddle with the ventilator, willing him to thrive with science, while Mum brought in a succession of totems. Healing beads, horse’s hair, homeopathic creams. Nothing either of us did seemed to work. Then one morning, she stuck a picture of the Pope on the incubator and went for a coffee.

Sleep deprivation does odd things to the mind, and for some reason I decided to fashion the Pope a Jimmy Saville wig out of a yellow X-ray form. Sister spotted it, just as Mum returned, whipped it off and turned it upside down. “What’s that?” asks Mum. “It’s Dr Phil’s lucky horseshoe. He made it especially.” From that miraculous moment, her baby picks up.  Within a week, he’s off the ventilator. Mum’s overwhelmed, Dad wants to name the baby after me and I’m presented me with an enormous box of chocolates.  I give them to sister, obviously. Baby Phil may have escaped special care, but I’ve still got 5 months to survive.

Total Politics Q&A December 2010

If I Were Prime Minister…

What campaign stunt would you pull in a general election and why?

I’d offer babies MMR jabs while I kissed them, and their parents contraception. If we want to save the NHS and the planet, we need to focus on prevention.

Would you take part in a TV debate with leaders of other parties?

Only if bullying was outlawed. Picking on the one with poor social skills who can’t tell a joke is just cruel. Other than that, no notes, no podium, no rules. And I’d hold it in the Ring o’ Bells at Hinton Blewett, so I could have a couple of pints and walk home.

What would your winning political slogan be and why?

I’d rotate slogans. ‘Dogs not Drugs.’ ‘Bring Back Stairs.’ ‘Foreplay, foreplay, foreplay.’ Dogs and exercise are wonder drugs, especially together, and intimacy before taking the plunge is sadly neglected.

What would you travel around the country in and why?

I’d go round in the Popemobile, with the Pope driving. It’s the least he can do after we bank-rolled his visit. And what better way to hand out Dr Phil’s Easy-On Condoms (motto: ‘they roll both ways’)?

Who would be your Alastair Campbell and why?

Nate Borofsky from the band Girlyman. I don’t want to be surrounded by anger, aggression, blame and repressed homosexuality. Their music is full of liberation and joy, and lifts my mood better than any drug. I once advised Nick Clegg to get some Girlyman in his life and look where he is now.

Who would be your George Osborne and why?

Any one of my patients who somehow manages to live on £30 a week. We’re all in this together, ha, ha, ha.

Who would be in your cabinet and why?

I’d pick Shirley Williams and then let her pick the next person, and so on and so on until we had a love train.

What would you legalise and why?

I’d ensure breast feeding filled all those public spaces smoking has vacated. If more mums were able to do it for six months, it would have a profound effect on childhood health and obesity. But six months is a long time and you need to get out of the house. Currently, the public sign for breast feeding is a bottle. We couldn’t be more repressed. And I’d legalise sex work. We all need a minimum wage, the right to say no and a safe place to pleasure each other.

What would you ban and why?

Very bad food. No health service can cope with obesity. The trans-fatty gristle burger should be a class A drug. A Victoria sponge would be class C (you’re allowed a small slice yourself but you mustn’t push it onto other people). The punishment would be to work in a tall building with no lifts, but beautiful, clean, inspiring staircases.

How would you respond to being booed in public?

I’d savour it. Booing politicians is a fine example of safe and sustainable pleasure. For the recipient, it’s much better than indifference (but the dry cleaning bill is higher).

How would you deal with a sex scandal in the cabinet?

We need to grow up about sex. It’s only a scandal if it isn’t consensual. But I’d check they all know how to put a condom on properly. Harder than it looks, especially with fading eyesight.

What would you have as a new national anthem and why?

Love Train by the O Jays. If people all over the world joined hands and start a love train, it would solve most of our problems (although they might need help to put a condom on. I once met a sex worker who can do it with no hands, but most of us need at least three)

What would keep you awake at night and why?

Being reported to the General Medical Council by William Hague’s Press Secretary (it’s happened before, it could happen again. See Sex, Sleep or Scrabble? P 223)

Which pet would you get for No 10 and why?

Two Labradors. They give you unconditional love, keep you active, reduce your blood pressure and even lower your cholesterol (by eating your food). And if you’re too depressed to put your pants on in the morning, they lick your testicles. You don’t get that with Prozac. Or marriage. I’ve already got a golden on and a black one I could bring (that’s Labradors, not testicles)

How would you see off a younger, better looking political rival?

With one of Dr Phil’s Go Quickly Pills.

How would you increase participation in politics?

Explain what politics means. A hundred people, a hundred answers. To me, the central ethical dilemma in life/ sex/ politics/ religion/ healthcare is the responsible use of power. Only by connecting with people can you avoid abusing them. Failing that, I’d make a pledge before the election that affected them profoundly, then break it afterwards just to make them very angry and ‘engaged’.

Who would succeed you as PM?

Nate from Girlyman

What would your commemorative statue look like and be made of and why?

A pair of polished ginger balls, made out of cornelian, to remind us of the Cornelian dilemma at the heart of politics (being obliged to choose between two courses of action either of which will have a detrimental effect on yourself or on someone near to you).

What would you call your memoirs of being PM and why?

‘First do no harm, now give some pleasure.’ We’re all African apes on the briefest of joy rides, but to enjoy life we need to slow down and connect. The secret of pleasure is to pleasure others.

What legacy would you like to leave and why?

I’d only work 48 hours a week as PM. Workaholism is the hidden addiction in politics and the NHS. I’d donate the proceeds of Dr Phil’s Easy-On Condoms to the Herpes Viruses Association (of which I am patron). And I’d give people choice in dying. My wife Jo is also a GP and we have a pact: First one to put CDs in the toaster gets one of Dr Phil’s Go Quickly Pills. You get one free with my DVDs

WORLD EXCLUSIVE

David Milliband quits to spend time with secret ginger love child

Dr Tony's Braineater, Berkley Brasserie Bristol 1990

The Rivals

‘Hello I’m Dr Phil’ ‘And I’m Dr Tony’ ‘We’re Struck Off and Die’

So started my first foray into the Edinburgh Fringe twenty years ago. My comedy partner, Tony Gardner, had been before as a student and knew how to survive in a sweltering Masonic lodge at midnight. I took a little longer to acclimatise but by the end of the run, we’d had rave reviews in the national press, been recorded by Radio 4 and were destined to be the next big thing in comedy.

That was the theory. Alas, when the Radio 4 show went out (rather unwisely after the Archers) it got a record number of complaints to the Broadcasting Standards Council, upheld as ‘inappropriate material for a comedy show.’ Radio 4 stuck with us, and we recorded three series of Struck Off and Die, winning a Writers’ Guild and Silver Sony Awards. But we couldn’t get into television. As one producer put it: ‘On the eve of your hip replacement, you don’t want to hear stories of knackered junior doctors cocking up, burning the notes, burying the X-rays and laughing it off in the mess.’

After five seasons at the Fringe, and three hearings at the BSC, we realised Radio 4 was as far as we were going. The reviews were still good, if a little divisive. ‘What makes this show rise above the rest is the genuine comic talent of Tony Gardner.’ I particularly enjoyed that one. Tony often made me corpse on stage and when the show went well, people would cry with laughter (at least I hope that’s what they were doing). But he needed to break out of the straightjacket of the medical revue. So he gave up the day job to try to make it as a professional actor.

Going from the most secure job in the world to the least never appealed to me, so I stuck with my GP training and continued in the comfort zone of medical humour. Tony got work in Armstrong and Miller, Lead Balloon and The Thick Of It, and landed the lead role in My Parents Are Aliens, while I looked at verrucas by day and peddled medical humour in chilly provincial theatres and corporate conferences at night. Having been very close, we drifted apart – partly because we now inhabited different worlds but also because comedy is very competitive, none more so than in a divorced double-act. You pretend to wish your ex-partner well but you secretly want him so struggle without you.

Since our last Struck Off and Die gig, a hospital party in a seedy Croydon hotel in 2001, Tony and I have barely spoken, which is ridiculous considering we were each other’s best men and Tony is Godfather to Will. As my wife Jo cheerfully put it: ‘If you die, shall I even tell him?’ So when my tour took me to Tony’s home city of Colchester in July, I suggested we go for a drink. I didn’t want him to be in the audience – that would really have thrown me – but in any case he was in London, rehearsing for Sheridan’s The Rivals. Ten years after Struck Off and Die, Tony would be touring with Sir Peter Hall and sharing the stage with Penelope Keith and Peter Bowles. They were reopening the refurbished Bath Theatre Royal. And I was telling knob gags in Colchester.

Tony didn’t suggest that I come, but I wanted to, and I wanted Will to meet him. Alas, by the time we booked, the only two tickets were A1 and A2. Any closer and we’d have been on stage with him. I told him we’d be there but not that my Belisha beacon hair would be in his line of sight for two hours. He clocked us but didn’t appear fazed and delivered a faultless performance as Faukland, both funny and touching. The rave reviews have all singled him out, but none of them spotted that his funniest mannerisms and movements were vintage Struck Off and Die.

We had a drink after and carefully slotted back in to friendship. Soul mates are rare and it’s lazy, selfish and foolish to let them go. Oddly, I wasn’t overly jealous of his success. It’s been a struggle to get castings when you have no classical training but Sir Peter Hall clearly knows talent when he sees it. I wonder if he’s got a small part for the ginger one?

The Rivals is now on national tour. Dr Phil’s Rude Health Show is at the Redgrave Theatre, Bristol on October 31. FFI The Comedy Box 0117 902 0344

Cover Blurb

Phil Hammond is a comedian trapped in a doctor’s body. He is Private Eye’s medical correspondent and possibly the only comic to have performed at a Public Inquiry. Dr Phil has done plenty of  Have I Got News for You, The News Quiz, The Now Show, The One Show and Countdown but still finds time to see patients (Mondays only).  In his live show, he is disarmingly rude about politicians, doctors, death, drugs, sex and especially himself, and encourages people to pleasure themselves in a safe and sustainable way. He has yet to be struck off, but he has been reported to the General Medical Council by William Hague’s Press Secretary. Dr Phil has a wife, two kids, two dogs, two cats, two ponies (retired), a penis enlarger (retired), three excellent books and companion DVD, all of which can be purchased at www.drphilhammond.com  Free swabs and sick notes with orders over £10

 ‘Thought provoking, scalpel- sharp stand up.’ The Independent

‘A tremendous show. Sceptical, irreverent and very funny.’ Time Out

‘Great to have a pint with, but you wouldn’t want him as your doctor.’  The Times

Amazon review

I’ve been a fan of Dr Phil since I saw him at Edinburgh in the junior doctor double-act Struck Off and Die in 1990. He’s matured a bit since then – his humour is less aggressive and his hair is less ginger, but his delivery is effortless and the range of material he covers (from pubic to public inquiries) is impressively broad. Like his books, Dr Phil’s live show is `comedy with a message’ which may irritate those who like their comics just to be funny. But Dr Phil is never preachy – he just believes that the NHS is dangerous (`£110 billion a year and it’s still no safer than bungee jumping’) and we (patients) need to stand up for ourselves if we don’t want to end up `snoring in the mortuary.’

Much of the material is taken from his current tour but there’s an utterly shameless and fearless description his brush with the clap that was new to me. The mock consultation extras are also a treat. This is light-years from a medical student review, possibly because Dr Phil is light-years from being a medical student. The material is dark and dangerous at times, but there’s a philosophical edge and poignancy that suggests it is possible to survive medical training with your empathy intact. But only if you have a sense of humour. Dr Phil apparently still works as a GP (`because I need the material’) and writes for Private Eye but has somehow only had one brush with the GMC (thanks to William Hague’s Press Secretary). Highly recommended for doctors, patients and anyone considering becoming either.

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Dr Phil’s fllow up DVD, Confessions of a Doctor, is out in Autumn 2010

Cover Blurb

Following the extraordinary success of his debut DVD, Dr Phil is back with an on-stage confession of all those personal and professional cock-ups that have made him a GP, and thankfully not a heart surgeon. Farting in theatre, falling asleep with a penis enlarger on, making a Jimmy Saville wig for the Pope and the asymmetrical lady-part repair….. By way of balance, he’s included other people’s disasters too…. the turnip birth, the Shrove Tuesday severance, the bedside flambé and the breaking in through the pantry window and slipping onto the ketchup bottle incident. Effortlessly suave and deliciously vulgar in equal measure, this is an ideal gift for doctors and anyone foolish enough to use them.

Note: Not suitable for anyone on the Fitness to Practice Committee of the General Medical Council

Dr Phil (MA (Cantab) MB BChir MRCGP DGM) is a GP, journalist, broadcaster and possibly the only comic to have appeared at a Public Inquiry.

Also by Dr Phil:

Dr Phil’s Rude Health Show (a companion DVD)

Sex, Sleep or Scrabble? (a saucy pleasure manual)

Trust Me, I’m (Still) a Doctor (a Private Eye whistle-blower’s diary)

Medicine Balls (a comic prescription to save the NHS)