What you MUST remember here is that this is one of the three most glittering prizes in world politics. Power is the reason that politicians draw breath. Trump might appear like a shoo-in right now but when the pincer movement by other candidates begins they will really start laying into him. They have a huge amount of ammo with which to do so. Their aim will be simple: defenestrate Trump and then its an open dog-fight amongst themselves.
I don't see how you can do that against a candidate with at least 40% (at an absolute minimum) under the primary rules. If you've got a bunch of guys all attacking one guy who's on 40%, the guy on 40% doesn't get defenestrated, he wins. This is exactly what happened last time.
For someone to beat Trump they need to do it the normal way: Get a strong vote in the early primaries and hoover up you *own* lane, then you might have a chance in a head-to-head.
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
To play devil's advocate, because we are entering the period where declining immunity in the vaxxed adult population might start to really whack the numbers up, with the booster programme seemingly being quite slow to get going.
Whether this impacts hospitalisations materially is anyone's guess.
It isn't purely good news either. We're back to there being an inelastic labour pool. At least in the short term we are going to see shortages because there simply aren't enough people to fill vacancies.
Oh indeed. It’s just all rather amusing to see pretty much the whole centre-left lining up in opposition to a sharp reduction in inequality.
Speaking as a member of the centre-left, I'm all in favour of a sharp reduction in inequality, and am delighted that so many members of the centre-right are as well, in these strange times.
However, I'm less in favour of global domination by Amazon. I know I'm swimming against the tide, but there's little doubt that the growth of Amazon (and a few others) has a negative impact on small retailers, and on our high streets. We may live to regret the demise of town centre shops, and the concomitant impact on communities, in the future.
As a centre-righty, I've always been in favour of a reduction in inequality in principle. However, there have been nuances to this: A reduction in inequality is really a secondary aim to making poorer people richer. A reduction in inequality which is achieved simply by making rich people poorer helps no-one. We also don't really help simply by taking money from rich people and giving it to poor people. It's at best a temporary fix. To make poor people richer we need to give them the tools to be so - the jobs, the skills, the opportunities, etc. And also find ways to value some poorly paid jobs better. To some extent, this comes back to the 'head, hand, heart' issue which was discussed last year - for 20-odd years, we have valued those who make their living by their heads far higher than those who make their living by hand or heart. I think all agreed that this was a problem, but there was little in the way of a robust consensus for a solution. But there does seem now to be something of a rebalancing going on.
On Amazon, I fully agree with you. 20-odd years ago, the big corporate bogeyman was Microsoft, whose market dominance was, I think, finally addressed with anti-trust/monopoly legislation in America. The Americans have normally been pretty good at taking on monopolies - I wonder if the day will come when they do the same with Amazon, Twitter et al.?
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
Waning immunity in the double vaccinated will take over from kids being the main source of cases and keep those cases rising or at similar levels heading into the winter months. Particularly in the UK where a great deal of the population had Astrazeneca which wanes quicker compared to Pfizer against Delta. It's one of the reasons why Europe isn't experiencing the level of cases and deaths that we are.
It's imperative that the booster programme needs ramping up.
Anecdotally in my office of 4, 2 are off with Covid at the moment both double AZ; myself and another colleague are Pfizer.
I have experienced the same at work and at home. Just recently my sister has just gone back to work after being off with Covid, she had two AZ and thankfully the vaccine clearly had an impact in terms of her recovering and severity of symptoms. All these vaccines are amazing and how they reduce severity of this disease.
Both myself and my sister who live in the same house had two Pfizer and somehow managed to dodge it. As far as we are aware neither of us have had Covid before.
Can't wait until I get my Pfizer booster on Wednesday.
What you MUST remember here is that this is one of the three most glittering prizes in world politics. Power is the reason that politicians draw breath. Trump might appear like a shoo-in right now but when the pincer movement by other candidates begins they will really start laying into him. They have a huge amount of ammo with which to do so. Their aim will be simple: defenestrate Trump and then its an open dog-fight amongst themselves.
No opposition has ever coasted a candidate, especially one who lost last time (whatever he thinks). Only an incumbent President gets the right to coast a nomination.
Trump defeated every other Republican candidate in 2016 with some ease despite many objective weaknesses in his character and record.
Potential Republican rivals had the opportunity to definitively put him out of the running for 2024 by convicting him in the Senate - and they flunked it, because they were intimidated by Trump's support among the Republican base.
If Trump wants the nomination he gets the nomination, and I don't see his ego allowing him to walk away.
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
Waning immunity in the double vaccinated will take over from kids being the main source of cases and keep those cases rising or at similar levels heading into the winter months. Particularly in the UK where a great deal of the population had Astrazeneca which wanes quicker compared to Pfizer against Delta. It's one of the reasons why Europe isn't experiencing the level of cases and deaths that we are.
It's imperative that the booster programme needs ramping up.
Goodness knows where we are with the boosters. No data on the daily dashboard. How many are getting one on a typical day?
What a bizarrely worded good news story. "Electric Power Units" - the motor? The inverter? Love it when hacks haven't a clue what they are writing.
The power train for a electric car is a bit more elaborate than just a battery and a motor.
I would suspect that "Electric Power Units" are the company terminology for motor, a fixed ratio gear box and a controller, which on a number of designs is single unit that bolts to the rest of the car. It might, as you suggest also include conversion of AC to DC....
Hang on! I thought higher pay was a failsafe solution to shortage of labour? Some seem to be implying that we can't see a GP cos their pay means they don't want to do a full week. If so, when does crossover happen? Should we increase pay at the bottom and reduce it at the top? Sounds like Communism.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
They did in 1958. This BBC documentary on the tenth anniversary of the NHS features interviews with lots of doctors, and it is interesting and mildly amusing to hear the three branches (consultants, GPs, public health) taking potshots at each other. https://www.bbc.co.uk/iplayer/episode/p013ylyp/on-call-to-a-nation
A question for PB experts on booster jabs (I've got mine tomorrow). Assuming the initial two doses have waned, should one expect the booster to take 2-3 weeks to take effect, as was advised with the first two vaccines?
Hang on! I thought higher pay was a failsafe solution to shortage of labour? Some seem to be implying that we can't see a GP cos their pay means they don't want to do a full week. If so, when does crossover happen? Should we increase pay at the bottom and reduce it at the top? Sounds like Communism.
Like many effects, there is a curve. When you have more money than you actually want to spend, substituting leisure for work is a rational choice. And previous seen in various jobs.
I transferred my GP registration to the online Babylon GP at hand service a couple of years ago. It's NHS, free etc but all online. The couple of times I needed an appointment I got one within 15 minutes of requesting, and in both cases got a referral straight away.
Not sure how scalable it is, and I think there is some controversy surrounding the service, but it worked for me.
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
Waning immunity in the double vaccinated will take over from kids being the main source of cases and keep those cases rising or at similar levels heading into the winter months. Particularly in the UK where a great deal of the population had Astrazeneca which wanes quicker compared to Pfizer against Delta. It's one of the reasons why Europe isn't experiencing the level of cases and deaths that we are.
It's imperative that the booster programme needs ramping up.
Goodness knows where we are with the boosters. No data on the daily dashboard. How many are getting one on a typical day?
It isn't purely good news either. We're back to there being an inelastic labour pool. At least in the short term we are going to see shortages because there simply aren't enough people to fill vacancies.
Oh indeed. It’s just all rather amusing to see pretty much the whole centre-left lining up in opposition to a sharp reduction in inequality.
Speaking as a member of the centre-left, I'm all in favour of a sharp reduction in inequality, and am delighted that so many members of the centre-right are as well, in these strange times.
However, I'm less in favour of global domination by Amazon. I know I'm swimming against the tide, but there's little doubt that the growth of Amazon (and a few others) has a negative impact on small retailers, and on our high streets. We may live to regret the demise of town centre shops, and the concomitant impact on communities, in the future.
As a centre-righty, I've always been in favour of a reduction in inequality in principle. However, there have been nuances to this: A reduction in inequality is really a secondary aim to making poorer people richer. A reduction in inequality which is achieved simply by making rich people poorer helps no-one. We also don't really help simply by taking money from rich people and giving it to poor people. It's at best a temporary fix. To make poor people richer we need to give them the tools to be so - the jobs, the skills, the opportunities, etc. And also find ways to value some poorly paid jobs better. To some extent, this comes back to the 'head, hand, heart' issue which was discussed last year - for 20-odd years, we have valued those who make their living by their heads far higher than those who make their living by hand or heart. I think all agreed that this was a problem, but there was little in the way of a robust consensus for a solution. But there does seem now to be something of a rebalancing going on.
On Amazon, I fully agree with you. 20-odd years ago, the big corporate bogeyman was Microsoft, whose market dominance was, I think, finally addressed with anti-trust/monopoly legislation in America. The Americans have normally been pretty good at taking on monopolies - I wonder if the day will come when they do the same with Amazon, Twitter et al.?
Nothing much was done about Microsoft - by the time it got to the political level, Apple and Linux were challenging them enough that they managed to evade the calls for break up.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years. Be understanding to the ones we have, and are working under pressure or it will be a negative feedback look getting worse and worse.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
O'Dowd is giving the Netherlands a chance, the rest of the team not so much.
Dont follow cricket much but in an Ireland v Netherlands match I wouldn't have had an O'Dowd down as a Netherlands player.
Players with such names tend to have Dutch mothers (or half-Dutch) a British Isles originating father, and be born in S. Africa (commonly) or Australia.
Rather sorry to see what happened to former Essex player, Ryan ten Doeschate. Import from S.Africa, courtesy of Graham Gooch. Maybe his bowling and fielding will redeem him.
Anyone seen anything about the Chinese hypersonic missile?
Apart from what's online? No.
Aren't we lucky Boris has signed us up for war with China in order to sell billions of dollars' worth of American submarines to Australia? Our cut being schadenfreude at annoying the French but no actual cash in return for facing this exciting new threat. And we thought it was only Russian hypersonic missiles we needed to worry about.
Typical extremist failing to realise the purpose of a solid defence program is to prevent war in the first place. Not to need to fight it.
Si vis pacem, para bellum.
You sould like the appeasers of the mid 30s.. peace our time and all that. Eventually you have to stand up to bullying even if its only in the fi form of woke.
What are you talking about? I have no idea why you'd jump from China to woke, but I was the one calling for standing up to [Chinese] bullying.
I think you need to brush up on your Latin if you think what you wrote was criticism of what I was writing.
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
Waning immunity in the double vaccinated will take over from kids being the main source of cases and keep those cases rising or at similar levels heading into the winter months. Particularly in the UK where a great deal of the population had Astrazeneca which wanes quicker compared to Pfizer against Delta. It's one of the reasons why Europe isn't experiencing the level of cases and deaths that we are.
It's imperative that the booster programme needs ramping up.
Goodness knows where we are with the boosters. No data on the daily dashboard. How many are getting one on a typical day?
Mum just got a text from the NHS (not the GP surgery as with the previous doses) saying she's eligible for the booster. She had her second dose mid-April.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years. Be understanding to the ones we have, and are working under pressure or it will be a negative feedback look getting worse and worse.
Fixing the pensions taper would be an easy start on the retention problem and would probably buy us a few extra years of work from many doctors approaching retirement.
What I can't understand is why we have a shortage of doctors AND it's really, really difficult to get into medical school, particularly as a postgraduate. I'm not saying it should be easy to get in... but when you hear about 30+ applications per place... feels like we are obviously not training enough doctors!
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years. Be understanding to the ones we have, and are working under pressure or it will be a negative feedback look getting worse and worse.
Fixing the pensions taper would be an easy start on the retention problem and would probably buy us a few extra years of work from many doctors approaching retirement.
What I can't understand is why we have a shortage of doctors AND it's really, really difficult to get into medical school, particularly as a postgraduate. I'm not saying it should be easy to get in... but when you hear about 30+ applications per place... feels like we are obviously not training enough doctors!
Yep but it costs serious money and won't solve the problems for 10 or so years (initial degree and training before specialisation) so we aren't increasing university places.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years. Be understanding to the ones we have, and are working under pressure or it will be a negative feedback look getting worse and worse.
Fixing the pensions taper would be an easy start on the retention problem and would probably buy us a few extra years of work from many doctors approaching retirement.
What I can't understand is why we have a shortage of doctors AND it's really, really difficult to get into medical school, particularly as a postgraduate. I'm not saying it should be easy to get in... but when you hear about 30+ applications per place... feels like we are obviously not training enough doctors!
Official policy has been to train less medical staff than the projected numbers required for the NHS, for decades.
The shortage is made up by immigration.
The reactions when you suggest training 90% of the projected requirement are interesting......
O'Dowd is giving the Netherlands a chance, the rest of the team not so much.
Dont follow cricket much but in an Ireland v Netherlands match I wouldn't have had an O'Dowd down as a Netherlands player.
LOL I did a double-take on that too.
I do follow cricket but to be perfectly frank neither Ireland nor the Netherlands are proper cricketing nations whose players would be well known.
Ireland have Test status. Tend to play 50 over and t20 games though. Players are full-time.
They do but they're not very good at it. There's a reason along with Afghanistan and Zimbabwe they don't take part in the ICC Test Championship. Those three nations are really a second tier of test playing nations - whether Afghanistan will continue to be one I don't know?
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years. Be understanding to the ones we have, and are working under pressure or it will be a negative feedback look getting worse and worse.
Fixing the pensions taper would be an easy start on the retention problem and would probably buy us a few extra years of work from many doctors approaching retirement.
What I can't understand is why we have a shortage of doctors AND it's really, really difficult to get into medical school, particularly as a postgraduate. I'm not saying it should be easy to get in... but when you hear about 30+ applications per place... feels like we are obviously not training enough doctors!
Much of the problem is the lag time. To become a GP takes, IIRC 6 or so years, plus application time so todays 'new' GP's made the decision to 'do' medicine in 2013 or 14.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years. Be understanding to the ones we have, and are working under pressure or it will be a negative feedback look getting worse and worse.
Fixing the pensions taper would be an easy start on the retention problem and would probably buy us a few extra years of work from many doctors approaching retirement.
What I can't understand is why we have a shortage of doctors AND it's really, really difficult to get into medical school, particularly as a postgraduate. I'm not saying it should be easy to get in... but when you hear about 30+ applications per place... feels like we are obviously not training enough doctors!
Official policy has been to train less medical staff than the projected numbers required for the NHS, for decades.
The shortage is made up by immigration.
The reactions when you suggest training 90% of the projected requirement are interesting......
We should be training ~120% of the projected requirement.
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
Waning immunity in the double vaccinated will take over from kids being the main source of cases and keep those cases rising or at similar levels heading into the winter months. Particularly in the UK where a great deal of the population had Astrazeneca which wanes quicker compared to Pfizer against Delta. It's one of the reasons why Europe isn't experiencing the level of cases and deaths that we are.
It's imperative that the booster programme needs ramping up.
Goodness knows where we are with the boosters. No data on the daily dashboard. How many are getting one on a typical day?
Mum just got a text from the NHS (not the GP surgery as with the previous doses) saying she's eligible for the booster. She had her second dose mid-April.
All my medically vulnerable relatives have had their boosters. And the old ones as well.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years. Be understanding to the ones we have, and are working under pressure or it will be a negative feedback look getting worse and worse.
Fixing the pensions taper would be an easy start on the retention problem and would probably buy us a few extra years of work from many doctors approaching retirement.
What I can't understand is why we have a shortage of doctors AND it's really, really difficult to get into medical school, particularly as a postgraduate. I'm not saying it should be easy to get in... but when you hear about 30+ applications per place... feels like we are obviously not training enough doctors!
Of course we are not training enough. In 2015 the govt promised 5000 more GPs over 5 years. They delivered 290 less, so made another promise to deliver 6000 more which we wont hit either.
Whilst the public allow our politicians to use silly slogans they have no intention of making work instead of proper investment we get what we deserve.
What a bizarrely worded good news story. "Electric Power Units" - the motor? The inverter? Love it when hacks haven't a clue what they are writing.
EPU is Ford's nomenclature for motor, traction inverter and HV/LV harnesses. They're probably just repeating the press release...
If its all of the above getting manufactured in Merseyside then that does indeed seem like a good news story.
The individual bits are bolted together at Haleswood but FMC don’t actually 'manufacture' the components. The electric motors are made by Borg Warner in the USA.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
One of the least quoted drivers of this - and yet another example of how Blair’s actions have had negative long-term consequences - was the move by New Labour to allow female GPs far greater flexibility to work part-time and not do the usual GP commitments. Becoming a GP therefore became a lot more attractive to women who wanted to maintain earnings power while having a job that gave them maximum flexibility around raising a family. As a result, 54pc of GPs were women in 2017 vs 42pc in 2007.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
O'Dowd is giving the Netherlands a chance, the rest of the team not so much.
Dont follow cricket much but in an Ireland v Netherlands match I wouldn't have had an O'Dowd down as a Netherlands player.
LOL I did a double-take on that too.
I do follow cricket but to be perfectly frank neither Ireland nor the Netherlands are proper cricketing nations whose players would be well known.
Ireland have Test status. Tend to play 50 over and t20 games though. Players are full-time.
They do but they're not very good at it. There's a reason along with Afghanistan and Zimbabwe they don't take part in the ICC Test Championship. Those three nations are really a second tier of test playing nations - whether Afghanistan will continue to be one I don't know?
Yes; question over Afghanistan because the 'current Government' won't countenance a women's team and the ICC say there must be. The mens side is certainly good enough though.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years. Be understanding to the ones we have, and are working under pressure or it will be a negative feedback look getting worse and worse.
Fixing the pensions taper would be an easy start on the retention problem and would probably buy us a few extra years of work from many doctors approaching retirement.
What I can't understand is why we have a shortage of doctors AND it's really, really difficult to get into medical school, particularly as a postgraduate. I'm not saying it should be easy to get in... but when you hear about 30+ applications per place... feels like we are obviously not training enough doctors!
Yep but it costs serious money and won't solve the problems for 10 or so years (initial degree and training before specialisation) so we aren't increasing university places.
Some university courses expanded by 25% last year.
One wonders what will happen to the medical lot - there won't be places in the NHS for them to continue training as doctors and nurses unless something is changed.....
What a bizarrely worded good news story. "Electric Power Units" - the motor? The inverter? Love it when hacks haven't a clue what they are writing.
The power train for a electric car is a bit more elaborate than just a battery and a motor.
I would suspect that "Electric Power Units" are the company terminology for motor, a fixed ratio gear box and a controller, which on a number of designs is single unit that bolts to the rest of the car. It might, as you suggest also include conversion of AC to DC....
Yes, and there is a divide of opinion about how to manufacture and package the various components. Legacy manufacturers wanting to build EVs alongside fossil cars package all of this as a stack to go in the engine bay - my Nissan Leaf was like this.
Others understand there is no need for such things and distribute accordingly. I hope that Ford are planning a transition to dedicated EV platforms and production, otherwise they are at risk of being left as a marginal player.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
One of the least quoted drivers of this - and yet another example of how Blair’s actions have had negative long-term consequences - was the move by New Labour to allow female GPs far greater flexibility to work part-time and not do the usual GP commitments. Becoming a GP therefore became a lot more attractive to women who wanted to maintain earnings power while having a job that gave them maximum flexibility around raising a family. As a result, 54pc of GPs were women in 2017 vs 42pc in 2007.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
The result of a public-sector monopoly in the profession, and government policy over decades that have positively encouraged part-time working and early retirement of expensively-trained human resources.
There needs to be both a large overseas recruitment drive, and a step-up in medical school places being made available. If you want to kill two birds with one stone, set up an NHS teaching hospital in Mumbai or Manila, run by retired British doctors and with permanent visas on offer to graduates.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years. Be understanding to the ones we have, and are working under pressure or it will be a negative feedback look getting worse and worse.
Fixing the pensions taper would be an easy start on the retention problem and would probably buy us a few extra years of work from many doctors approaching retirement.
What I can't understand is why we have a shortage of doctors AND it's really, really difficult to get into medical school, particularly as a postgraduate. I'm not saying it should be easy to get in... but when you hear about 30+ applications per place... feels like we are obviously not training enough doctors!
Much of the problem is the lag time. To become a GP takes, IIRC 6 or so years, plus application time so todays 'new' GP's made the decision to 'do' medicine in 2013 or 14.
Right, but we've had the Tories in power for 11 years and counting. So they've had at least 5 years to do something that would be taking effect now.
What a bizarrely worded good news story. "Electric Power Units" - the motor? The inverter? Love it when hacks haven't a clue what they are writing.
EPU is Ford's nomenclature for motor, traction inverter and HV/LV harnesses. They're probably just repeating the press release...
If its all of the above getting manufactured in Merseyside then that does indeed seem like a good news story.
The individual bits are bolted together at Haleswood but FMC don’t actually 'manufacture' the components. The electric motors are made by Borg Warner in the USA.
That’s the business model for most automotive OEMs. Screwdriver facilities Subbing out manufacture to large tier 1s even to the degree of leasing those Tier 1s floorspace in their factories.
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
Good old Andrew.
Constantly predicting "it will get better in a bit" is a great strategy because eventually you will be right. Just relies on people memory holing all your previous pronouncements.
Brother-in-law's mother-in-law (in her 80s) tested positive. Relatively mild symptoms and improving. Thanks to the vaccine.
Meanwhile relatives in Canada are still sanitising their groceries.
I've been sanitising our groceries since March last year!
You must have missed the update re fomites vs aerosol transmission...
Which update??
(I also missed the bit where Mum accuses me of being excessively paranoid )
Science around covid has overwhelmingly moved to the main risk being aerosol transmission, not contact with infected surfaces. There is no need to wash groceries. By all means wash your hands frequently - that's just good hygiene...
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
Waning immunity in the double vaccinated will take over from kids being the main source of cases and keep those cases rising or at similar levels heading into the winter months. Particularly in the UK where a great deal of the population had Astrazeneca which wanes quicker compared to Pfizer against Delta. It's one of the reasons why Europe isn't experiencing the level of cases and deaths that we are.
It's imperative that the booster programme needs ramping up.
Goodness knows where we are with the boosters. No data on the daily dashboard. How many are getting one on a typical day?
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
Good old Andrew.
Constantly predicting "it will get better in a bit" is a great strategy because eventually you will be right. Just relies on people memory holing all your previous pronouncements.
Good old Alistair.
It has been better. Since about March.
Its the constant predictions of "it will get worse" that need memory holing now.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
One of the least quoted drivers of this - and yet another example of how Blair’s actions have had negative long-term consequences - was the move by New Labour to allow female GPs far greater flexibility to work part-time and not do the usual GP commitments. Becoming a GP therefore became a lot more attractive to women who wanted to maintain earnings power while having a job that gave them maximum flexibility around raising a family. As a result, 54pc of GPs were women in 2017 vs 42pc in 2007.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
Women in healthcare has always been a thorny issue. Its a challenge for pharmacy too - our intake is massively skewed to women and there is no doubt that many of them will want to drop full time work when the kids start coming. I make on judgement on that. But if you are planning your labour market you need to be aware of it.
Brother-in-law's mother-in-law (in her 80s) tested positive. Relatively mild symptoms and improving. Thanks to the vaccine.
Meanwhile relatives in Canada are still sanitising their groceries.
I've been sanitising our groceries since March last year!
You must have missed the update re fomites vs aerosol transmission...
Which update??
(I also missed the bit where Mum accuses me of being excessively paranoid )
Science around covid has overwhelmingly moved to the main risk being aerosol transmission, not contact with infected surfaces. There is no need to wash groceries. By all means wash your hands frequently - that's just good hygiene...
Thanks for that, won't need so much disinfectant solution
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
Waning immunity in the double vaccinated will take over from kids being the main source of cases and keep those cases rising or at similar levels heading into the winter months. Particularly in the UK where a great deal of the population had Astrazeneca which wanes quicker compared to Pfizer against Delta. It's one of the reasons why Europe isn't experiencing the level of cases and deaths that we are.
It's imperative that the booster programme needs ramping up.
Goodness knows where we are with the boosters. No data on the daily dashboard. How many are getting one on a typical day?
Mum just got a text from the NHS (not the GP surgery as with the previous doses) saying she's eligible for the booster. She had her second dose mid-April.
That's good to hear. My wife had her second jab in late April, so hopefully she'll get the text message soon.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years. Be understanding to the ones we have, and are working under pressure or it will be a negative feedback look getting worse and worse.
Fixing the pensions taper would be an easy start on the retention problem and would probably buy us a few extra years of work from many doctors approaching retirement.
What I can't understand is why we have a shortage of doctors AND it's really, really difficult to get into medical school, particularly as a postgraduate. I'm not saying it should be easy to get in... but when you hear about 30+ applications per place... feels like we are obviously not training enough doctors!
Much of the problem is the lag time. To become a GP takes, IIRC 6 or so years, plus application time so todays 'new' GP's made the decision to 'do' medicine in 2013 or 14.
Or in some cases, told to do medicine by their parents in 2013/14.
What you MUST remember here is that this is one of the three most glittering prizes in world politics. Power is the reason that politicians draw breath. Trump might appear like a shoo-in right now but when the pincer movement by other candidates begins they will really start laying into him. They have a huge amount of ammo with which to do so. Their aim will be simple: defenestrate Trump and then its an open dog-fight amongst themselves.
No opposition has ever coasted a candidate, especially one who lost last time (whatever he thinks). Only an incumbent President gets the right to coast a nomination.
If Trump wants the nomination he gets the nomination, and I don't see his ego allowing him to walk away.
This is nonsense.
Written in a polite way not as an Ad hominem.
Happy to disagree on this subject with those of you on here who, I suspect, don't fully grasp the complexities of the US nomination process.
My PG has a ringback system. You make the appointment through the online system, then wait for a call back. If you miss the call, even by a second there is absolutely no way to get in contact with the doctor who just called you unless they decide to call you back. It's infuriating when you miss the call.
I once had a referral from my GP to a podiatrist and he made it generic so I could pick the consultant I wanted (I had private insurance). The podiatrist's office said I needed a named doctor. So I call up my GPS office and ask if the doctor can amend it. They said no, I would need to speak to the doctor himself, as they couldn't pass on the message for just making the slight change to the referral I already had.
I said fine, can the doctor call me back when he next made outgoing calls. They said no, I had to call back at 8-9am on Wednesdays or Fridays to be added to the call back list. This was a pain for me as I commuted during this time, but I arranged to go into work late and stayed on the phone both times but couldn't get through and the voice message box was full.
I called them back at a non-busy time and they advised for me to come in person as they prioritized in person ahead of people on the phone. So I had to cancel client meetings and take a morning off work to go in person during work hours to get a call back from the doctor to change a prescription he had already agreed to.
Strangely I am not sympathetic to GPS complaining they are assessed on access. It needs to go further to stop them manipulating statistics to look like demand is lower than it is.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
One of the least quoted drivers of this - and yet another example of how Blair’s actions have had negative long-term consequences - was the move by New Labour to allow female GPs far greater flexibility to work part-time and not do the usual GP commitments. Becoming a GP therefore became a lot more attractive to women who wanted to maintain earnings power while having a job that gave them maximum flexibility around raising a family. As a result, 54pc of GPs were women in 2017 vs 42pc in 2007.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
The result of a public-sector monopoly in the profession, and government policy over decades that have positively encouraged part-time working and early retirement of expensively-trained human resources.
There needs to be both a large overseas recruitment drive, and a step-up in medical school places being made available. If you want to kill two birds with one stone, set up an NHS teaching hospital in Mumbai or Manila, run by retired British doctors and with permanent visas on offer to graduates.
The generous pensions for doctors are definitely part of the problem. The average retirement age is 58 and they are retiring on average of around £50k pa, some retiring on over £100k pa. Think on that. A retired person retiring on almost twice what the average person earns, and all at the taxpayers expense!
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
One of the least quoted drivers of this - and yet another example of how Blair’s actions have had negative long-term consequences - was the move by New Labour to allow female GPs far greater flexibility to work part-time and not do the usual GP commitments. Becoming a GP therefore became a lot more attractive to women who wanted to maintain earnings power while having a job that gave them maximum flexibility around raising a family. As a result, 54pc of GPs were women in 2017 vs 42pc in 2007.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
The result of a public-sector monopoly in the profession, and government policy over decades that have positively encouraged part-time working and early retirement of expensively-trained human resources.
There needs to be both a large overseas recruitment drive, and a step-up in medical school places being made available. If you want to kill two birds with one stone, set up an NHS teaching hospital in Mumbai or Manila, run by retired British doctors and with permanent visas on offer to graduates.
My wife's cousin's son (yep, got that right!) is a doctor, and has recently come to the UK from India - currently waiting for the accreditation to be fully sorted before he can start work.
As an aside, he did his medical degree in Ukraine. (Getting a place in India is also a PITA.) The teaching was in Russian, so the first thing he had to do was learn the language.
Anybody know about diesel particulate filters? Apparently I have an option of buying a new one or somehow fiddling with the car's computer and making the warning lights go away. Neither option cheap so I suspect the answer is I'm just screwed.
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
Waning immunity in the double vaccinated will take over from kids being the main source of cases and keep those cases rising or at similar levels heading into the winter months. Particularly in the UK where a great deal of the population had Astrazeneca which wanes quicker compared to Pfizer against Delta. It's one of the reasons why Europe isn't experiencing the level of cases and deaths that we are.
It's imperative that the booster programme needs ramping up.
Goodness knows where we are with the boosters. No data on the daily dashboard. How many are getting one on a typical day?
3.6m boosters given in England, about 200k per day rate something like that.
Thanks. Numbers looking fairly decent, but a loooong way to go.
The booster programme ought to closely follow the trend of the initial roll-out if people are called up six months after their second dose. So a slow start is to be expected, but we ought to see it go up quite soon.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
One of the least quoted drivers of this - and yet another example of how Blair’s actions have had negative long-term consequences - was the move by New Labour to allow female GPs far greater flexibility to work part-time and not do the usual GP commitments. Becoming a GP therefore became a lot more attractive to women who wanted to maintain earnings power while having a job that gave them maximum flexibility around raising a family. As a result, 54pc of GPs were women in 2017 vs 42pc in 2007.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
The result of a public-sector monopoly in the profession, and government policy over decades that have positively encouraged part-time working and early retirement of expensively-trained human resources.
There needs to be both a large overseas recruitment drive, and a step-up in medical school places being made available. If you want to kill two birds with one stone, set up an NHS teaching hospital in Mumbai or Manila, run by retired British doctors and with permanent visas on offer to graduates.
My wife's cousin's son (yep, got that right!) is a doctor, and has recently come to the UK from India - currently waiting for the accreditation to be fully sorted before he can start work.
As an aside, he did his medical degree in Ukraine. (Getting a place in India is also a PITA.) The teaching was in Russian, so the first thing he had to do was learn the language.
Interesting story. A Russian friend of my wife is married to an Indian doctor. They met while he was at med school in Moscow (also learning the lingo) and they now live in the UAE.
Doctors are very highly internationally mobile, which of course gives issues with retention and workload for a state-run service like the NHS.
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
Waning immunity in the double vaccinated will take over from kids being the main source of cases and keep those cases rising or at similar levels heading into the winter months. Particularly in the UK where a great deal of the population had Astrazeneca which wanes quicker compared to Pfizer against Delta. It's one of the reasons why Europe isn't experiencing the level of cases and deaths that we are.
It's imperative that the booster programme needs ramping up.
Goodness knows where we are with the boosters. No data on the daily dashboard. How many are getting one on a typical day?
3.6m boosters given in England, about 200k per day rate something like that.
Thanks. Numbers looking fairly decent, but a loooong way to go.
The booster programme ought to closely follow the trend of the initial roll-out if people are called up six months after their second dose. So a slow start is to be expected, but we ought to see it go up quite soon.
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
Waning immunity in the double vaccinated will take over from kids being the main source of cases and keep those cases rising or at similar levels heading into the winter months. Particularly in the UK where a great deal of the population had Astrazeneca which wanes quicker compared to Pfizer against Delta. It's one of the reasons why Europe isn't experiencing the level of cases and deaths that we are.
It's imperative that the booster programme needs ramping up.
Goodness knows where we are with the boosters. No data on the daily dashboard. How many are getting one on a typical day?
Mum just got a text from the NHS (not the GP surgery as with the previous doses) saying she's eligible for the booster. She had her second dose mid-April.
I had a letter this morning from the NHS reminding me to get a booster, where the appointment had been set up with my GP a fortnight ago for early November.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
One of the least quoted drivers of this - and yet another example of how Blair’s actions have had negative long-term consequences - was the move by New Labour to allow female GPs far greater flexibility to work part-time and not do the usual GP commitments. Becoming a GP therefore became a lot more attractive to women who wanted to maintain earnings power while having a job that gave them maximum flexibility around raising a family. As a result, 54pc of GPs were women in 2017 vs 42pc in 2007.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
The result of a public-sector monopoly in the profession, and government policy over decades that have positively encouraged part-time working and early retirement of expensively-trained human resources.
There needs to be both a large overseas recruitment drive, and a step-up in medical school places being made available. If you want to kill two birds with one stone, set up an NHS teaching hospital in Mumbai or Manila, run by retired British doctors and with permanent visas on offer to graduates.
When I was in London it usually meant I had to wait 2-3 weeks for an appointment and that was if I just took the next slot regardless of inconvenience. Here in the US, I can usually book a slot at a time that works for me within two days.
I also have multiple urgent care facilities (a midpoint between A&E and a GP) within 20 minutes drive of my home. I can arrange online to come in, they give me a time within the next 2 hours, and then I turn up and am immediately seen.
But my favourite thing is prescriptions. If I get one from any doctor, I name my pharmacy and they put it into the electronic system in 2 minutes. I then drive home and pick it up at the drive through pharmacy on the way. Usually it is a five minute wait, though sometimes 10-15 minutes because I got there too quick.
What a bizarrely worded good news story. "Electric Power Units" - the motor? The inverter? Love it when hacks haven't a clue what they are writing.
EPU is Ford's nomenclature for motor, traction inverter and HV/LV harnesses. They're probably just repeating the press release...
If its all of the above getting manufactured in Merseyside then that does indeed seem like a good news story.
The individual bits are bolted together at Haleswood but FMC don’t actually 'manufacture' the components. The electric motors are made by Borg Warner in the USA.
My PG has a ringback system. You make the appointment through the online system, then wait for a call back. If you miss the call, even by a second there is absolutely no way to get in contact with the doctor who just called you unless they decide to call you back. It's infuriating when you miss the call.
I once had a referral from my GP to a podiatrist and he made it generic so I could pick the consultant I wanted (I had private insurance). The podiatrist's office said I needed a named doctor. So I call up my GPS office and ask if the doctor can amend it. They said no, I would need to speak to the doctor himself, as they couldn't pass on the message for just making the slight change to the referral I already had.
I said fine, can the doctor call me back when he next made outgoing calls. They said no, I had to call back at 8-9am on Wednesdays or Fridays to be added to the call back list. This was a pain for me as I commuted during this time, but I arranged to go into work late and stayed on the phone both times but couldn't get through and the voice message box was full.
I called them back at a non-busy time and they advised for me to come in person as they prioritized in person ahead of people on the phone. So I had to cancel client meetings and take a morning off work to go in person during work hours to get a call back from the doctor to change a prescription he had already agreed to.
Strangely I am not sympathetic to GPS complaining they are assessed on access. It needs to go further to stop them manipulating statistics to look like demand is lower than it is.
The medical profession continues to hide behind a deified image that enables them to treat their customers with contempt (they call us patients because they demand we are such). The general public need to wake up and start to realise that they are not gods, they are human, and as such there are good ones and bad ones. The media could start by not giving them such a free rein to moan and complain without coming up with concrete answers that don't just involve filling their already overfilled wallets with more cash (they call it resources).
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
One of the least quoted drivers of this - and yet another example of how Blair’s actions have had negative long-term consequences - was the move by New Labour to allow female GPs far greater flexibility to work part-time and not do the usual GP commitments. Becoming a GP therefore became a lot more attractive to women who wanted to maintain earnings power while having a job that gave them maximum flexibility around raising a family. As a result, 54pc of GPs were women in 2017 vs 42pc in 2007.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
The result of a public-sector monopoly in the profession, and government policy over decades that have positively encouraged part-time working and early retirement of expensively-trained human resources.
There needs to be both a large overseas recruitment drive, and a step-up in medical school places being made available. If you want to kill two birds with one stone, set up an NHS teaching hospital in Mumbai or Manila, run by retired British doctors and with permanent visas on offer to graduates.
When I was in London it usually meant I had to wait 2-3 weeks for an appointment and that was if I just took the next slot regardless of inconvenience. Here in the US, I can usually book a slot at a time that works for me within two days.
I also have multiple urgent care facilities (a midpoint between A&E and a GP) within 20 minutes drive of my home. I can arrange online to come in, they give me a time within the next 2 hours, and then I turn up and am immediately seen.
But my favourite thing is prescriptions. If I get one from any doctor, I name my pharmacy and they put it into the electronic system in 2 minutes. I then drive home and pick it up at the drive through pharmacy on the way. Usually it is a five minute wait, though sometimes 10-15 minutes because I got there too quick.
In London we can book a GP slot same day if we are willing to go private and it will be much cheaper than the US.
Excellent General. Seriously ordinary Secretary of State. His evidence that Hussein had weapons of mass destruction at the UN was totally embarrassing. I started off wanting to believe it and ended up nothing short of incredulous.
Edit, on reflection that could have been better phrased but the evidence Iraq had weapons of mass destruction at the UN was on a par with that they had such weapons in Iraq itself.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
One of the least quoted drivers of this - and yet another example of how Blair’s actions have had negative long-term consequences - was the move by New Labour to allow female GPs far greater flexibility to work part-time and not do the usual GP commitments. Becoming a GP therefore became a lot more attractive to women who wanted to maintain earnings power while having a job that gave them maximum flexibility around raising a family. As a result, 54pc of GPs were women in 2017 vs 42pc in 2007.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
The result of a public-sector monopoly in the profession, and government policy over decades that have positively encouraged part-time working and early retirement of expensively-trained human resources.
There needs to be both a large overseas recruitment drive, and a step-up in medical school places being made available. If you want to kill two birds with one stone, set up an NHS teaching hospital in Mumbai or Manila, run by retired British doctors and with permanent visas on offer to graduates.
When I was in London it usually meant I had to wait 2-3 weeks for an appointment and that was if I just took the next slot regardless of inconvenience. Here in the US, I can usually book a slot at a time that works for me within two days.
I also have multiple urgent care facilities (a midpoint between A&E and a GP) within 20 minutes drive of my home. I can arrange online to come in, they give me a time within the next 2 hours, and then I turn up and am immediately seen.
But my favourite thing is prescriptions. If I get one from any doctor, I name my pharmacy and they put it into the electronic system in 2 minutes. I then drive home and pick it up at the drive through pharmacy on the way. Usually it is a five minute wait, though sometimes 10-15 minutes because I got there too quick.
In London we can book a GP slot same day if we are willing to go private and it will be much cheaper than the US.
Prescriptions are usually now electronic in the UK.
My PG has a ringback system. You make the appointment through the online system, then wait for a call back. If you miss the call, even by a second there is absolutely no way to get in contact with the doctor who just called you unless they decide to call you back. It's infuriating when you miss the call.
I once had a referral from my GP to a podiatrist and he made it generic so I could pick the consultant I wanted (I had private insurance). The podiatrist's office said I needed a named doctor. So I call up my GPS office and ask if the doctor can amend it. They said no, I would need to speak to the doctor himself, as they couldn't pass on the message for just making the slight change to the referral I already had.
I said fine, can the doctor call me back when he next made outgoing calls. They said no, I had to call back at 8-9am on Wednesdays or Fridays to be added to the call back list. This was a pain for me as I commuted during this time, but I arranged to go into work late and stayed on the phone both times but couldn't get through and the voice message box was full.
I called them back at a non-busy time and they advised for me to come in person as they prioritized in person ahead of people on the phone. So I had to cancel client meetings and take a morning off work to go in person during work hours to get a call back from the doctor to change a prescription he had already agreed to.
Strangely I am not sympathetic to GPS complaining they are assessed on access. It needs to go further to stop them manipulating statistics to look like demand is lower than it is.
The medical profession continues to hide behind a deified image that enables them to treat their customers with contempt (they call us patients because they demand we are such). The general public need to wake up and start to realise that they are not gods, they are human, and as such there are good ones and bad ones. The media could start by not giving them such a free rein to moan and complain without coming up with concrete answers that don't just involve filling their already overfilled wallets with more cash (they call it resources).
It's more about the "service industry" model that the NHS is using, is from the 1950s.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
One of the least quoted drivers of this - and yet another example of how Blair’s actions have had negative long-term consequences - was the move by New Labour to allow female GPs far greater flexibility to work part-time and not do the usual GP commitments. Becoming a GP therefore became a lot more attractive to women who wanted to maintain earnings power while having a job that gave them maximum flexibility around raising a family. As a result, 54pc of GPs were women in 2017 vs 42pc in 2007.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
The result of a public-sector monopoly in the profession, and government policy over decades that have positively encouraged part-time working and early retirement of expensively-trained human resources.
There needs to be both a large overseas recruitment drive, and a step-up in medical school places being made available. If you want to kill two birds with one stone, set up an NHS teaching hospital in Mumbai or Manila, run by retired British doctors and with permanent visas on offer to graduates.
When I was in London it usually meant I had to wait 2-3 weeks for an appointment and that was if I just took the next slot regardless of inconvenience. Here in the US, I can usually book a slot at a time that works for me within two days.
I also have multiple urgent care facilities (a midpoint between A&E and a GP) within 20 minutes drive of my home. I can arrange online to come in, they give me a time within the next 2 hours, and then I turn up and am immediately seen.
But my favourite thing is prescriptions. If I get one from any doctor, I name my pharmacy and they put it into the electronic system in 2 minutes. I then drive home and pick it up at the drive through pharmacy on the way. Usually it is a five minute wait, though sometimes 10-15 minutes because I got there too quick.
In London we can book a GP slot same day if we are willing to go private and it will be much cheaper than the US.
As long as I always stay in network (and that has never been an inconvenience) my employer covers all my healthcare costs, with the exception of a $200 yearly deductible.
Anybody know about diesel particulate filters? Apparently I have an option of buying a new one or somehow fiddling with the car's computer and making the warning lights go away. Neither option cheap so I suspect the answer is I'm just screwed.
It depends on the manufacturer and how difficult it is to remap the ECU via ODB2 to suppress the DPF codes. I use a combination of Toad Pro and Viezu. The latter is particularly good on BMWs. I've used to change the boost maps of BMW hire cars before I get them out of the car park.
Just suppressing the warning when the DPF is clogged is not a good idea. If you are going full planet killer you're better off just deleting it along with the EGR and the crankcase breather recirc.
Andrew Lilico @andrew_lilico · 1h One way to think about this. Cases in non-kids are currently ~1/2 their level in July & have hardly changed since. Cases in kids are about to crash. So for total cases to rise, cases in non-kids wld need to nearly double, despite having bn stable up to now. Why wld they do that?
Good old Andrew.
Constantly predicting "it will get better in a bit" is a great strategy because eventually you will be right. Just relies on people memory holing all your previous pronouncements.
Good old Alistair.
It has been better. Since about March.
Its the constant predictions of "it will get worse" that need memory holing now.
Ah yes, my "I think saying we've got herd immunity in early June and that Delta is just a blip is premature and cases will probably rise over the coming months with an attendant rise in hospitalisations and deaths" was really blown out of the water by events wasn't it.
I'm sure that's directly equivalent to "There's no second wave in Autumn 2020" for levels of inaccuracy.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
One of the least quoted drivers of this - and yet another example of how Blair’s actions have had negative long-term consequences - was the move by New Labour to allow female GPs far greater flexibility to work part-time and not do the usual GP commitments. Becoming a GP therefore became a lot more attractive to women who wanted to maintain earnings power while having a job that gave them maximum flexibility around raising a family. As a result, 54pc of GPs were women in 2017 vs 42pc in 2007.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
The result of a public-sector monopoly in the profession, and government policy over decades that have positively encouraged part-time working and early retirement of expensively-trained human resources.
There needs to be both a large overseas recruitment drive, and a step-up in medical school places being made available. If you want to kill two birds with one stone, set up an NHS teaching hospital in Mumbai or Manila, run by retired British doctors and with permanent visas on offer to graduates.
When I was in London it usually meant I had to wait 2-3 weeks for an appointment and that was if I just took the next slot regardless of inconvenience. Here in the US, I can usually book a slot at a time that works for me within two days.
I also have multiple urgent care facilities (a midpoint between A&E and a GP) within 20 minutes drive of my home. I can arrange online to come in, they give me a time within the next 2 hours, and then I turn up and am immediately seen.
But my favourite thing is prescriptions. If I get one from any doctor, I name my pharmacy and they put it into the electronic system in 2 minutes. I then drive home and pick it up at the drive through pharmacy on the way. Usually it is a five minute wait, though sometimes 10-15 minutes because I got there too quick.
In London we can book a GP slot same day if we are willing to go private and it will be much cheaper than the US.
Prescriptions are usually now electronic in the UK.
Pharmacists finally got fed up with trying to read doctors’ handwriting?
Excellent General. Seriously ordinary Secretary of State. His evidence that Hussein had weapons of mass destruction at the UN was totally embarrassing. I started off wanting to believe it and ended up nothing short of incredulous.
Edit, on reflection that could have been better phrased but the evidence Iraq had weapons of mass destruction at the UN was on a par with that they had such weapons in Iraq itself.
Nonetheless he played a pivotal role in liberating Kuwait and also getting rid of Saddam so Iraq is now a free and democratic state, certainly compared to most of the Middle East.
At one point he was a contender for the GOP nomination in 1996 but declined and Bob Dole got the nomination instead.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
One of the least quoted drivers of this - and yet another example of how Blair’s actions have had negative long-term consequences - was the move by New Labour to allow female GPs far greater flexibility to work part-time and not do the usual GP commitments. Becoming a GP therefore became a lot more attractive to women who wanted to maintain earnings power while having a job that gave them maximum flexibility around raising a family. As a result, 54pc of GPs were women in 2017 vs 42pc in 2007.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
The result of a public-sector monopoly in the profession, and government policy over decades that have positively encouraged part-time working and early retirement of expensively-trained human resources.
There needs to be both a large overseas recruitment drive, and a step-up in medical school places being made available. If you want to kill two birds with one stone, set up an NHS teaching hospital in Mumbai or Manila, run by retired British doctors and with permanent visas on offer to graduates.
When I was in London it usually meant I had to wait 2-3 weeks for an appointment and that was if I just took the next slot regardless of inconvenience. Here in the US, I can usually book a slot at a time that works for me within two days.
I also have multiple urgent care facilities (a midpoint between A&E and a GP) within 20 minutes drive of my home. I can arrange online to come in, they give me a time within the next 2 hours, and then I turn up and am immediately seen.
But my favourite thing is prescriptions. If I get one from any doctor, I name my pharmacy and they put it into the electronic system in 2 minutes. I then drive home and pick it up at the drive through pharmacy on the way. Usually it is a five minute wait, though sometimes 10-15 minutes because I got there too quick.
In London we can book a GP slot same day if we are willing to go private and it will be much cheaper than the US.
As long as I always stay in network (and that has never been an inconvenience) my employer covers all my healthcare costs, with the exception of a $200 yearly deductible.
I have been fortunate but not sure I have ever needed as much as $200 of GP services in a year. Generally about 1 visit every 5 years, which if I chose to go private to skip the queue would cost £50-80. I would far rather our system than the US one.
a) Put in a full working week*, rather than so many being part timers b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Sure, if you can convince GPs who have decided to go part time, retire or leave the profession to go full time you have more GP hours available.......this is all obvious, but in reality we are more likely to go the other way with further GPs leaving and reducing hours.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
Quite a few GPs in West London have gone this trajectory -
1) Worked like hell for 10-15 years. 2) Married another GP. 3) Paid off the family house. 4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
But so what? Are we going to conscript them back into work? Pay them ££££££££ to get them back and tax ourselves the same amount?
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years.
Well, we need to start with what is happening.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
One of the least quoted drivers of this - and yet another example of how Blair’s actions have had negative long-term consequences - was the move by New Labour to allow female GPs far greater flexibility to work part-time and not do the usual GP commitments. Becoming a GP therefore became a lot more attractive to women who wanted to maintain earnings power while having a job that gave them maximum flexibility around raising a family. As a result, 54pc of GPs were women in 2017 vs 42pc in 2007.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
The result of a public-sector monopoly in the profession, and government policy over decades that have positively encouraged part-time working and early retirement of expensively-trained human resources.
There needs to be both a large overseas recruitment drive, and a step-up in medical school places being made available. If you want to kill two birds with one stone, set up an NHS teaching hospital in Mumbai or Manila, run by retired British doctors and with permanent visas on offer to graduates.
My wife's cousin's son (yep, got that right!) is a doctor, and has recently come to the UK from India - currently waiting for the accreditation to be fully sorted before he can start work.
As an aside, he did his medical degree in Ukraine. (Getting a place in India is also a PITA.) The teaching was in Russian, so the first thing he had to do was learn the language.
Interesting story. A Russian friend of my wife is married to an Indian doctor. They met while he was at med school in Moscow (also learning the lingo) and they now live in the UAE.
Doctors are very highly internationally mobile, which of course gives issues with retention and workload for a state-run service like the NHS.
Mrs DA qualified as a dentist in Saint Petersburg despite being from Mumbai as her parents couldn't afford to send her to university in a country with competent dentists. She spent the first year of her course doing nothing but learning Russian.
I think there is John LeCarre novel where they identify a body as Russian by the state of the dental work. "No German dentist did this, it looks more like the work of a bricklayer." or some similar pithy observation.
Comments
For someone to beat Trump they need to do it the normal way: Get a strong vote in the early primaries and hoover up you *own* lane, then you might have a chance in a head-to-head.
Whether this impacts hospitalisations materially is anyone's guess.
A reduction in inequality is really a secondary aim to making poorer people richer. A reduction in inequality which is achieved simply by making rich people poorer helps no-one.
We also don't really help simply by taking money from rich people and giving it to poor people. It's at best a temporary fix. To make poor people richer we need to give them the tools to be so - the jobs, the skills, the opportunities, etc. And also find ways to value some poorly paid jobs better.
To some extent, this comes back to the 'head, hand, heart' issue which was discussed last year - for 20-odd years, we have valued those who make their living by their heads far higher than those who make their living by hand or heart. I think all agreed that this was a problem, but there was little in the way of a robust consensus for a solution. But there does seem now to be something of a rebalancing going on.
On Amazon, I fully agree with you. 20-odd years ago, the big corporate bogeyman was Microsoft, whose market dominance was, I think, finally addressed with anti-trust/monopoly legislation in America. The Americans have normally been pretty good at taking on monopolies - I wonder if the day will come when they do the same with Amazon, Twitter et al.?
a) Put in a full working week*, rather than so many being part timers
b) Kept working until the state retirement age
I suspect that the shortage of GPs would be sorted. Not a shortage of bodies, a shortage of working hours.
*A full working week for GPs being 4 days. Yep. Even when they are full timers, they are part timers.
A question for those in the profession: Do hospital medics view GPs as "not proper doctors" or in any way inferior in the role they perform?
Many are not as perfect as you are !!!
Both myself and my sister who live in the same house had two Pfizer and somehow managed to dodge it. As far as we are aware neither of us have had Covid before.
Can't wait until I get my Pfizer booster on Wednesday.
O'Dowd is giving the Netherlands a chance, the rest of the team not so much.
Potential Republican rivals had the opportunity to definitively put him out of the running for 2024 by convicting him in the Senate - and they flunked it, because they were intimidated by Trump's support among the Republican base.
If Trump wants the nomination he gets the nomination, and I don't see his ego allowing him to walk away.
I would suspect that "Electric Power Units" are the company terminology for motor, a fixed ratio gear box and a controller, which on a number of designs is single unit that bolts to the rest of the car. It might, as you suggest also include conversion of AC to DC....
Brother-in-law's mother-in-law (in her 80s) tested positive. Relatively mild symptoms and improving. Thanks to the vaccine.
Meanwhile relatives in Canada are still sanitising their groceries.
Some seem to be implying that we can't see a GP cos their pay means they don't want to do a full week.
If so, when does crossover happen? Should we increase pay at the bottom and reduce it at the top? Sounds like Communism.
Giving them grief when its a simple case of demand far exceeds supply is not helpful.
The retailers getting monstered in the comments under the Mail article though.
1) Worked like hell for 10-15 years.
2) Married another GP.
3) Paid off the family house.
4) Both gone part time.
When you have zero housing costs, London is really not especially expensive....
https://www.bbc.co.uk/iplayer/episode/p013ylyp/on-call-to-a-nation
Britain is now facing a pie crisis amid 'perfect storm' of foil tins running low due to rising global aluminium prices, labour shortages and inflation
https://www.dailymail.co.uk/news/article-10101163/Britain-facing-pie-crisis-amid-perfect-storm-foil-tins-running-low.html
Not sure how scalable it is, and I think there is some controversy surrounding the service, but it worked for me.
I do follow cricket but to be perfectly frank neither Ireland nor the Netherlands are proper cricketing nations whose players would be well known.
3.6m boosters given in England, about 200k per day rate something like that.
We have fewer GPs available and training new ones will take years (and there is not much evidence of funding suggesting we will be miles better off in 10 years time anyway). There is a surge in demand post pandemic.
We will have to live with a shortage of GPs for the next few years. Be understanding to the ones we have, and are working under pressure or it will be a negative feedback look getting worse and worse.
Except e-readers us e-ink, and the blue light referred to tablets. Which are capable of reading e-books (as are phones) but are not e-readers.
Which is that evening and weekend GP appointments have largely disappeared. And many GPs are part time.
Rather sorry to see what happened to former Essex player, Ryan ten Doeschate. Import from S.Africa, courtesy of Graham Gooch.
Maybe his bowling and fielding will redeem him.
I think you need to brush up on your Latin if you think what you wrote was criticism of what I was writing.
What I can't understand is why we have a shortage of doctors AND it's really, really difficult to get into medical school, particularly as a postgraduate. I'm not saying it should be easy to get in... but when you hear about 30+ applications per place... feels like we are obviously not training enough doctors!
The shortage is made up by immigration.
The reactions when you suggest training 90% of the projected requirement are interesting......
(I also missed the bit where Mum accuses me of being excessively paranoid
Whilst the public allow our politicians to use silly slogans they have no intention of making work instead of proper investment we get what we deserve.
Hats off to the GPs but it has means that the capacity of GPs - particularly for weekend / evening calls - has been declining for years and that the “customer” now faces a severe restraint when it comes to the supply of GPs to see them.
The mens side is certainly good enough though.
One wonders what will happen to the medical lot - there won't be places in the NHS for them to continue training as doctors and nurses unless something is changed.....
Others understand there is no need for such things and distribute accordingly. I hope that Ford are planning a transition to dedicated EV platforms and production, otherwise they are at risk of being left as a marginal player.
There needs to be both a large overseas recruitment drive, and a step-up in medical school places being made available. If you want to kill two birds with one stone, set up an NHS teaching hospital in Mumbai or Manila, run by retired British doctors and with permanent visas on offer to graduates.
So they've had at least 5 years to do something that would be taking effect now.
It’s still a good news story.
Constantly predicting "it will get better in a bit" is a great strategy because eventually you will be right. Just relies on people memory holing all your previous pronouncements.
It has been better. Since about March.
Its the constant predictions of "it will get worse" that need memory holing now.
Written in a polite way not as an Ad hominem.
Happy to disagree on this subject with those of you on here who, I suspect, don't fully grasp the complexities of the US nomination process.
I said fine, can the doctor call me back when he next made outgoing calls. They said no, I had to call back at 8-9am on Wednesdays or Fridays to be added to the call back list. This was a pain for me as I commuted during this time, but I arranged to go into work late and stayed on the phone both times but couldn't get through and the voice message box was full.
I called them back at a non-busy time and they advised for me to come in person as they prioritized in person ahead of people on the phone. So I had to cancel client meetings and take a morning off work to go in person during work hours to get a call back from the doctor to change a prescription he had already agreed to.
Strangely I am not sympathetic to GPS complaining they are assessed on access. It needs to go further to stop them manipulating statistics to look like demand is lower than it is.
As an aside, he did his medical degree in Ukraine. (Getting a place in India is also a PITA.) The teaching was in Russian, so the first thing he had to do was learn the language.
https://edition.cnn.com/2021/10/18/politics/colin-powell-dies/index.html
Doctors are very highly internationally mobile, which of course gives issues with retention and workload for a state-run service like the NHS.
https://twitter.com/PaulMainwood/status/1448986113662726147?s=20
I don't think it's clear why there's such a big gap between numbers eligible and numbers of boosters delivered, but it's a problem.
https://twitter.com/lewis_goodall/status/1450072236208033792?s=20
So databases not entirely joined up.
I also have multiple urgent care facilities (a midpoint between A&E and a GP) within 20 minutes drive of my home. I can arrange online to come in, they give me a time within the next 2 hours, and then I turn up and am immediately seen.
But my favourite thing is prescriptions. If I get one from any doctor, I name my pharmacy and they put it into the electronic system in 2 minutes. I then drive home and pick it up at the drive through pharmacy on the way. Usually it is a five minute wait, though sometimes 10-15 minutes because I got there too quick.
Edit, on reflection that could have been better phrased but the evidence Iraq had weapons of mass destruction at the UN was on a par with that they had such weapons in Iraq itself.
Just suppressing the warning when the DPF is clogged is not a good idea. If you are going full planet killer you're better off just deleting it along with the EGR and the crankcase breather recirc.
I'm sure that's directly equivalent to "There's no second wave in Autumn 2020" for levels of inaccuracy.
At one point he was a contender for the GOP nomination in 1996 but declined and Bob Dole got the nomination instead.
Had Powell got it he might have beaten Clinton, Powell defeated Clinton 50–38 in a hypothetical match-up proposed to voters in the exit polls conducted on Election Day.
https://www.nytimes.com/2007/02/07/opinion/07plissner.html
Good.
Daft buggers round here forever setting them off.
I think there is John LeCarre novel where they identify a body as Russian by the state of the dental work. "No German dentist did this, it looks more like the work of a bricklayer." or some similar pithy observation.