The BMA are Blackleg scum

What do you call it, when a failing union disrupts the work of a new organisation which successfully represents the membership that’s being stitched up and ignored? My social history isn’t really up to the mark here. How about:

The BMA are Blackleg scum

Yep. I think that sums it up nicely.

The BMA (British Medical Association) have prevented the BMJ (British Medical Journal) Careers Supplement from running an ad for Remedy UK. You may think this doesn’t matter to you, but it does.

Remedy UK is an organisation which was formed by and for Junior Doctors when the BMA stood by and watched them being sacrificed on the alter of government doctrine. In the last 12 months, Remedy has gone from strength to strength, and thousands of doctors have cancelled their memberships of the BMA in outrage and disgust.

Let me now quote from the Remedy website:

As part of a membership drive, the RemedyUK committee decided to place a paid-for loose insert in the Christmas issue of BMJ Careers. The BMJ asked to see the copy before agreeing. They had no concerns about the insert or its content.

We were then told, late last week, that as the BMJ is a wholly owned subsidiary of the BMA, their approval would also be needed. The BMA have banned the insert from appearing. …

It is hard to see how the BMJ’s editorial independence cannot now be open to question. And it is difficult not to draw the conclusion that the BMA’s refusal to allow the insert is an attempt to prevent Remedy from spreading its message more widely.

This matters because – to quote the leaflet concerned:

There are currently 70% more medical students than there were five years ago, but only a minimal increase in training places.

Junior doctors, already traumatised by MMC/MTAS 2007, face a recruitment round in less than two months in which competition ratios will be worse than this year, with some small specialties in some regions likely to be offering no ST3 posts at all. The process for selecting people into run-through for subspecialty training is in disarray. And 14,000 juniors face career termination. (My italics).

If you are a patient it matters to you. No one should have to work under the sort of strain described below, and you and your relatives should be treated by people working under this sort of strain:

One particular junior doctor was seen crying quietly in a corner on Monday, coming to terms with having no interviews and perhaps no career. She was in clinic at the time and had taken 5 minutes to check out her future on the MTAS website, 5 minutes after learning her fate she was back seeing patients, doing what she wants to do, what she deserves to do, what she is needed for but what the system might stop her doing come August. – I’m a Medical Student – Get me Out of Here

As patients we deserve the best doctors the NHS can train and recruit. This is not how to find them:

We were on the wards today when the SHO opened her mail to discover that interview for her specialty were scheduled for the same day in the Yorkshire and West of Scotland areas. Its not a large specialty (Rheumatology) so this seems a little weird.

Neither is allowed to change it’s dates due to a protocol … So the chances of a morning interview in Leeds, a 200 mile drive and an afternoon interview in Glasgow seem remote. She said she was not the only SHO in this situation.

Interview dates were published after the SHO’s had ranked their choices, thus they did not know which interview dates would conflict.

It’s crazy… Comment by dyb on Dr Crippen’s blog

We had astonishingly good doctors in the UK: the Department of Health has spent the last year throwing them away:

Unsurprisingly, like many of my colleagues I was not shortlisted for a single interview in this first round of job applications. In fact, of the seven junior trainees in my department, only one of us has been shortlisted for any jobs. Yet our unit is one of the leading tertiary referral centres in the UK. Paul Malone in a letter to the Times (My italics).

Remedy UK fights, among other things, to make sure that medical selection in the UK is fair, transparent and effective at choosing the very best. It is hard to see how this form of interview can do that:

The second station [at my interview] involved ‘Communication Skills’. It was awful. First, I had to fold a piece of paper according to verbal instructions. It did not make a crane – perhaps I did it wrong? Then I was given a random series of shapes on a piece of paper and had to describe them to another Consultant for her to draw them. Hmmph. Goodness only knows how I did on this station. I felt stupid and I know that I didn’t show how well I can actually communicate about real things. What I don’t understand is how this is supposed to supply them with reasonable doctors. If I did it all wrong, am I a bad Doctor? If I did it right, should you fast track me to a Consultant’s post?

Bloody weird. – Junior Docspot – Origami Anyone?

What Remedy UK is doing matters to all of us. The British Medical Association stood to one side and let the Department of Health inflict Modernising Medical Careers and MTAS on the medical workforce, and thus on us all.

The independent report by Sir John Tooke is damning, saying explicitly “the medical profession’s effective involvement in training policy making has been weak”. Well that is down to the BMA. And also saying “… from this experience must come a re-commitment to optimal standards of postgraduate medical education and training. This can only happen if a new partnership is struck between the profession and the Department of Health … each constituency has been found wanting so far.”

Yeah. BMA. Blackleg scum. Sums it up, really.

NaBloPoMo – Two to Go

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Andy and the Masons

A building I go to regularly has set after set of photos of the local great and good of the 1940s, 50s, 60s and 70s hung on its walls in room after room. They are oddly disturbing photographs. I am sure that individually they were perfectly normal men for their times, but collectively they look decidedly creepy, as if every member of the Manhattan Project had been photographed all at once. It may be all those tie pins and brylcreme. I’m not sure.

I’ve wanted to Warhol them ever since I first saw them. I finally got a photograph with little enough reflection in it to have a go, though it’s intriguing how persistent the reflections on the left are. I’m not entirely happy with this for lots of reasons, not least because its harder than it looks to balance bright splashes of colour in a space. He knew a thing or two, did Andy Warhol.

Anyway, here they are.

Insert Name Here

Oh, I’ve been tagged for a meme by Charlotte:

List one fact, word or tidbit that is somehow relevant to your life for each letter of your first or middle name. You can theme it to your blog or make it general. Then tag one person for each letter of your name.

A – Anger – the blog has been a good place to vent mainly political rage.

P – Patricia Hewitt – ironic to use a verbal medium to write about a woman who leaves me speechless.

H – Humour – when not Hyperventilating, I do have a sense of humour and have expressed it here, though it is a tag I keep forgetting to use

R – Reading – I ought to read other peoples’ blogs more than I do, but there’s a selection of those I read regularly, with the links to the ones I still miss left in for old time’s sake

A – Analysis – Q: What do mathematicians do when they are constipated? A: Sit down and work it out with a pencil. Well, I sit down and work it out with a blog.

And on that disgusting note, I’ll knock on your door telling you to use this meme if you want to, and run away into the blogosphere laughing.

Fantasy CEO – The Last Round Up

The final Fantasy CEO scores are published, and congratulations are due to Jeremy Fraser and commiserations to those who were slugging it out on the first page.

There were some high ranking folks who were missing in the last round or two, which probably helped the rest of us slither up the rankings. I’m curious about where the drop-outs were positioned in the league table at the time that they dropped out, but simply cannot bring myself to cut and paste the data from 70-odd web pages into Excel.

I’m better with numbers when they are presented visually, so forgive me the indulgence of the charts.

As you can see, my place in the ranks bounced up and down in the first few weeks but it improved gently through the second half of the game. However I can’t help wondering how much that is because others dropped out. Since I set out to learn stuff, the real question is whether or not I got better at playing the game, and my balanced scorecard results suggest that eventually I did. A bit. Maybe.

But what went wrong for me in Week 3? At first sight I thought that maybe other people got better at the game in Week 3, and I got worse. Looking at my Annual Report, Round 3 was the first round I played to the scorecard, so it’s ironic that my scorecard results were worse in Round 3. That was when I decided that I had to undo some of the decisions of previous rounds, though, which might explain it. Mistakes whiplash through the subsequent rounds and I suspect you cannot afford to make any mistakes at all if you are going to do well in a league-based game like this.  That said, even the winner got a visit from Big Al.

I would like to play the game next year, if they run it, and if I have the time. I’d like to see if I have actually learned owt.

Feeling the strain

A blogger who blogged on the net
Said “I always forget
That NaBloPoMo’s a bind
I really do find
It’s a tedious 30-way bet”

Now you CD it, now you don’t

It is good to see that Paul Gray resigned from his position as chairman of Revenue and Customs. (It was even better to see Alistair Darling squirm, but that was a more vindictive delight). I’m wary of gratuitous scape-goating with this business of the CDs that have gone missing containing the details of 25m people and 13m bank accounts. However, whatever way I look at it I come back to the thought that there are two ways to secure data, and both start right to the top.

The first way to secure data is physical: you make it physically impossible for your staff to export data. You install PCs without CD drives and disable the CD drives on the PCs which have them. While you are at it you disable the USB ports and impose limits on sending emails with attachments. You place limits on the changes that most people can make to their PCs, and provide them with a help desk and an audited order process to use when they want to do something outwith their permissions. None of this is hard and none of it is particularly expensive, though all of it makes things inconvenient for your staff. Not as inconvenient as having to clear up the mess when the details of 13,000,000 bank accounts get into the wrong hands, of course, particularly when the banks turn sulky and say “we’ve done nothing wrong and we aren’t paying for your mistake Mr Darling”. The banks have every right to be irritated since they do make sure that it is very hard for any member of their staff to steal data. This approach does require that those at the top take security seriously and ensure that adequate security policies are written and that the technology is configured to support those policies. Not rocket science, more a question of those at the top prioritising security, employing competent staff and saying “Make it so”.

The second way to secure data is through cultural norms. You make it impossible for someone to think it’s ok to copy personal data on to CDs and bung them in the post. Likewise you make it impossible for someone to think it’s ok to use real data as test data for new systems, or to dispose of confidential waste other than by shredding it, or to walk away from their desk without activating a password controlled screensaver, or to write passwords on post-it notes, or to look up someone’s personal data without a valid reason, or to leave a laptop in a car or an unlocked cupboard. You make it socially acceptable for someone to say “no, I’m sorry, I’m not swiping you in to the building with my card” or “no, you can’t use my account if you’ve forgotten your password”. This sort of security-focused culture is hard to create where it does not exist already, but it is relatively easy to maintain. The code-breaking at Bletchley Park remained a secret until the 1970s despite the fact that over 10,000 people worked there. A culture of treating data security responsibly is, without a shadow of doubt, down to the leaders to create, take seriously, pay for and maintain.

Slackness about data appears to be endemic at HMRC, which is the point that I am making. According to the Guardian “The chancellor explained that in September the records of 15,000 Standard Life customers had been lost in transit from HMRC offices in Newcastle; in the same month a laptop and other materials were also lost.” The article also mentions 41 missing laptops.

So no matter how I slice and dice this one, I cannot let Gordie off the hook. HMRC was his bailiwick before it was Darling’s. This is the government who’s attitude to security was sufficiently cavalier for the personal details including names, addresses, religious beliefs and sexual orientation of tens of thousand of doctors to be posted unsecured on the internet. This is the government who wants to put you full medical history on the NHS spine. This is the government who want to impose ID cards on us all.

Data is incredibly powerful when it gets into the wrong hands.

The problem is, it’s already in the wrong hands.

In the Pardoner’s footprints

Work has just arranged for us employees to offset our carbon footprints by making a donation to an eco-charity through our pay. So that’s ok then.

There’s a pause while Aphra whomps up the central heating, opens all the windows, turns on all the lights and drives into town to book an entirely gratuitous holiday abroad.

I have, of course, bought my freedom from green-guilt. When the crops fail and the seas boil and we all die nasty, violent, hungry deaths fighting over the last lollo rosso in Sainsburys, it won’t be MY fault, ok? Think I’m exaggerating? The picture on the right shows people queueing outside Asda in Tewkesbury for their six allocated bottles of water in Gloucestershire this summer.

Amartya Sen postulated that there has never been a famine in a democracy. The benefit of democracy is not about choosing which bunch of power-crazed loons will ruin our lives and the planet next, it’s about holding the bastards accountable. That’s the reason it’s important to vote. It’s cheap of me to compare the 2007 floods in the UK with Katrina, and cynical of me to suggest that if terrorists had bombed the levees then the good ole southern boys of the Bush government would have done something about New Orleans, but no matter how generous I try to be, I cannot help thinking that the US Government simply didn’t care because the people were black and few of them were voters. This is all at something of tangent to what I am saying here, but Katrina in one way and the 2007 UK floods in another are still rich with examples of the double-think involved in climate-change denial.

And here’s a third. The democrats are guilty too. It’s estimated that the carbon footprint for Live8 was 31,500 tonnes, with Madonna’s annual carbon footprint estimated at 1017 tonnes. But of course, it wasn’t about the fame and the exposure, it was about saving the planet, right?

One of the drivers for protestantism was Luther’s disgust with the way that the Catholic Church sold “indulgences” and “pardons” for cash, making no attempt to actually change people’s behaviour. Even in those days virtue was unprofitable but guilt was gilt. But of course, only virtue is virtue, and we are kidding ourselves if we think that off-sets and rock concerts will save the planet.

And so, even though it makes me feel dirty, even though it feels like blood money, even though the double-think hurts my brain, I’ve duly calculated my carbon footprint, worked out the monthly sum, and signed the standing order that means that none of it’s my fault, ok.

(For what it’s worth, my direct footprint is somewhere between 6 and 8 tonnes depending on which calculator I use, though there’s a secondary footprint for the goods I buy and the services I use which I haven’t even tried to work out).

In which Aphra posts by the skin of her teeth

Aphra rushes in and posts a one-liner for Thursday with 26 minutes to spare.

Soft is hard

One of the things that annoys me about the industry I work in is how much it undervalues what it persists in calling “soft” skills. Tech skills are the hard skills which command respect. Don’t get me wrong. I love geeks, in fact I find geekiness really sexy. I like it when a guy’s skillset is really hard. But before we tumble too far down the road of pornuendo, I want to wave a flag for soft skills.

(Incidentally, it’s not just my industry: surgeons are godlike if they do good scalpel but their bedside manner is considered irrelevant because you can’t quantify it, despite the rather obvious thought that the placebo effect is a neat way to improve a post-op complication rate and that there is a direct relationship between faith in the practitioner and the power of the placebo).

Now I have pretty good soft skills. Give me a bunch of folks and half a day and I can get just about any form of coherent analysis out of them you’d care to mention – be that a plan, a process, a set of requirements, a list of deliverables, a taxonomy. You name it, all we need are post-it notes, marker pens and caffeine and carbs, and we’ll end the day tired, happy and in agreement. I’m not bad at training sessions, though it’s not really my thang. I can plan a series of activities to take a group of people through the acceptance cycle when we are imposing change on them. I know a reasonable amount about NLP and how to use it appropriately in business situations. I spent more of my life than I care to remember selling, which is the ultimate test of soft-skills in action.

The problem is that soft skills are hard. They are hard for a lot of reasons. They are hard partly because soft processes are only logical in hindsight. You can look back at a soft process – the process used to manage a series of changes to the way that people work, for example – and think it was all pretty obvious. But try to design it… ah that’s another thing.

There are very few “how-to” guides to soft skills. I think I’ve found two on requirements analysis in all of the IT bookshops I have ever been to. There’s a lot of literature about training skills and some about introducing change to people, but a lot of it is either off-puttingly pretentious (“Soft Systems Methodology” – I mean, wtf?) nauseatingly cute (“The one-minute cheese-monger”) or theoretical but not practical (“The Tipping Point”).

The other challenge is that soft skills are implicit skills; they are hidden, obscure, almost invisible. This doesn’t make them easy but it does mean they are undervalued. The people with the best soft skills don’t make it look easy. Oh no. When you are with people with really good soft skills, you don’t notice that anything is happening at all. On the other hand when change is introduced badly, it is obvious for all to see. The best and most recent example I can think of from this blog is the MTAS debacle where change was imposed on the victims with no attempt to get them to actually want the change. MTAS could have been a success; the system it replaced was broke enough to be worth fixing. MTAS needed better technical implementation for sure, but those affected could have been brought at least to a state of neutral acceptance of the concepts behind it, and maybe even trust and support, if had been handled right.

Soft skills are subjective skills, when using soft skills you need be aware of context and to exercise judgement. You need imagination. You have to be willing to walk in someone else’s shoes. They involve taking risks and making yourself vulnerable. When you are exercising soft skills, you have to be willing not to know. This subjectivity makes them difficult to turn into a system or a methodology.

With soft skills there’s no right or wrong answer, there is better and worse, more useful and less useful, but no right and wrong.

That’s not easy.

In fact, it’s hard.