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.
Yes it was absolutely well and truly blown out of water. We removed all our restrictions months ago without any meaningful rise in deaths etc since then.
The virus was over as something to be hysterical about back in June. Well it was over months before then actually.
How is predicting a new wave that doesn't happen any better than being sceptical about a new wave that does happen?
The Philippine military was trying a half arsed coup against democracy. The Philippine government requested that the American airforce based in the Philippines, should shoot down some Philippine airforce jets that were about to take off.
Colin Powell realised that if that was done, the coup supporters would play the "American Colonialists" line and maybe get more support.
So he ordered that the American fighter jets should make low passes overt the airfield in question.
The rebels pilots refused to take off, and the coup collapsed. The rebel pilots were lambasted as cowards - by their own side.....
One interesting difference between the USA and the EU is that despite America actually being a single country there doesn't seem to be the same inclination to stop States from competing against each other.
Texas is quite happy to go out of its way to attract investment away from California.
Whenever a company like Tesla or Amazon are looking to build a new base of operations then cities and states basically whore themselves in an auction to see who can be most attractive for it.
The USA views competition as a healthy thing, the EU does not. That is why the USA is and the EU is not successful.
If post-Brexit the EU start to view themselves in competition with the UK [as they did in the vaccines debacle] then that might make life better for both Europeans and Brits in the end.
Competition makes us become the best versions of ourselves.
It's argued that H. sapiens ability to work together in reasonably large groups was a significant part of the reason for it's success vis-a-vis the Neanderthals, Denisovians etc.
Absolutely and 67 million people is a reasonably large group to be working with. Its possibly too large still.
Is 1450 million people in China too large for them?
Yes.
There's a reason China lacks democracy and there's a reason that the average salary in Taiwan is considerably better than the average in China.
Is 333 million people in the US too large for them?
Diversity, not size, is America's problem. Identity politics is a zero sum game. That's why it's close to being ungovernable.
(Of course diversity is also a huge strength, as a quick glance at any list of Silicon Valley CEO names will show).
I like Morgan Freeman's suggestion that we stop talking about it.
If we didn't endlessly talk about what race, sex, sexuality and gender everyone was - categorising and judging them accordingly - we might find out we had rather a lot in common.
Judging people by their race is racism. It should never be acceptable.
If racism exists it should be called out and opposed, so gestures like kneeling against intolerance are a good thing.
But to be racist yourself in reply is a very bad thing. You don't fix racism, by being racist yourself.
It's an interesting debate. Positive discrimination, for example, might have the ability to kickstart a process which otherwise would take a far longer time to address.
Not enough black people in the workforce or as CEOs? Then positive discrimination would redress that balance at the expense of, what? "The best candidate for the job"? Perhaps. But as with, ahem, Brexit, a transition period would mean that there are costs which are justified for the longer term overall benefit.
And I of course put "best candidate for the job" in quotation marks because it is far from clear that the best candidate for the job wouldn't be picked.
The problem arises from best candidate for the job quite often does not equal best person to do the job.
Yes I appreciate that. But they might also be. And for the longer term we would have a rebasing of the (whatever) sector.
I think I was agreeing with you, but posting whilst doing several other things. Right now we have a situation where "best candidate for the job" usually equals "person most similar to the person or people doing the appointing." Whether conscious or not. Race is only one factor amongst many, but a significant one.
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.
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.
*Sudden mild panic that I should be booking a booster* - checks website - no, it's only down to the over 50s yet.
But the crucial sentence is this: "You'll only be able to book an appointment for a booster dose if it's been at least 6 months (182 days) since your 2nd dose of the vaccine." - which means only those who had had their second jabs before 18th April can have them. Which is not that many people, surely?
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
Yes, his general ship in the first Gulf war was simply outstanding. He had overwhelming force of course but he used it to great effect to achieve total victory with the absolute minimum of casualties. I have always thought that there was an indirect causal connection between the complete massacre of Soviet era equipment in that war and the collapse of the Soviet Union. It laid bare the idea that the Russians were even close to matching NATO's power was a complete joke. It became obvious that the 1st Armoured division's firepower was such that it could have marched on Moscow. But it was deployed to great effect.
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.
So databases not entirely joined up.
They're not at all joined up.
To be honest, I've been astonished how well this has all worked given the state of NHS data systems.
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.
Yes it was absolutely well and truly blown out of water. We removed all our restrictions months ago without any meaningful rise in deaths etc since then.
The virus was over as something to be hysterical about back in June. Well it was over months before then actually.
Covid deaths 1st of June: 4 Covid Deaths 1st of October: 123
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.
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.
*Sudden mild panic that I should be booking a booster* - checks website - no, it's only down to the over 50s yet.
But the crucial sentence is this: "You'll only be able to book an appointment for a booster dose if it's been at least 6 months (182 days) since your 2nd dose of the vaccine." - which means only those who had had their second jabs before 18th April can have them. Which is not that many people, surely?
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.
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.
*Sudden mild panic that I should be booking a booster* - checks website - no, it's only down to the over 50s yet.
But the crucial sentence is this: "You'll only be able to book an appointment for a booster dose if it's been at least 6 months (182 days) since your 2nd dose of the vaccine." - which means only those who had had their second jabs before 18th April can have them. Which is not that many people, surely?
About 7 million, by the look of it, of whom about 3 million have been done.
As with the teenager jabs (Schoolchildinromford has got a date now, but at the end of November), it all seems remarkably casual. A bit of mild panic would be helpful.
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.
Yes it was absolutely well and truly blown out of water. We removed all our restrictions months ago without any meaningful rise in deaths etc since then.
The virus was over as something to be hysterical about back in June. Well it was over months before then actually.
Covid deaths 1st of June: 4 Covid Deaths 1st of October: 123
No meaningful rise etc.
Yes none. That's not meaningful it is background noise as people who are bound to die, die, or antivaxxers get their wishes fulfilled.
If there were meaningful exponential growth we'd be talking thousands etc. Instead its just background noise that we may have to live with forever. Time to stop counting or testing beyond any other virus or disease.
I made the error of looking at BBC News. So there is now a panic about online harms and politicians safety in light of the Amess murder. Not Islamic fundamentalism, of course.
In a democracy, the disconnect between what people are told by the media and politicians, and what people actually know to be true, must eventually find a political expression. Trump and Brexit are not going to be aberrations, I think there is going to be much darker stuff around the corner.
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.
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.
*Sudden mild panic that I should be booking a booster* - checks website - no, it's only down to the over 50s yet.
But the crucial sentence is this: "You'll only be able to book an appointment for a booster dose if it's been at least 6 months (182 days) since your 2nd dose of the vaccine." - which means only those who had had their second jabs before 18th April can have them. Which is not that many people, surely?
About 7 million, by the look of it, of whom about 3 million have been done.
As with the teenager jabs (Schoolchildinromford has got a date now, but at the end of November), it all seems remarkably casual. A bit of mild panic would be helpful.
Hm, well, I had assumed that we were still on people in their 70s. Whereas last time around I was watching like a hawk as it ticked down the ages. Which perhaps illustrates the point. But I don't think anything less is being done to publicise/encourage. I think we are generally less interested. I was pleased to get the vaccination as a protection against dying, but more pleased because as we progressed down the ages we were rapidly bringing forward the day when all this would be over. Now all this IS over, the level of attention given to how the process progresses is just much less. It's not the number one thing on people's minds any more. Will I get a booster? Yes, of course. But I'm not chomping at the bit to get it in the way that I was last time around. My antibodies may be fading, but they're not nonexistent like they were last time. Plus, I've had covid now, which itself acts as something of a booster.
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
Yes, his general ship in the first Gulf war was simply outstanding. He had overwhelming force of course but he used it to great effect to achieve total victory with the absolute minimum of casualties. I have always thought that there was an indirect causal connection between the complete massacre of Soviet era equipment in that war and the collapse of the Soviet Union. It laid bare the idea that the Russians were even close to matching NATO's power was a complete joke. It became obvious that the 1st Armoured division's firepower was such that it could have marched on Moscow. But it was deployed to great effect.
The Soviets knew the game was up when it came to contesting US military technology way before that. They sent Marshal Kutakhov to Syria after the Beqaa Valley Turkey Shoot in 1982 and his findings indicated an unbridgeable gap.
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.
I gave my reasons, based on my reading of key political events.
You are airily appealing to complexities without giving any reason, with a dose of insult thrown in.
There will be no extra time to stop climate change. Team (Flag of European Union) is delivering with #EUGreenDeal But to meet our goals & save our planet we need the whole Earth globe europe-africa to deliver at #COP26. We are all in the first team. We can all make a difference. #EveryTrickCounts @EU_Commission @UEFA
I made the error of looking at BBC News. So there is now a panic about online harms and politicians safety in light of the Amess murder. Not Islamic fundamentalism, of course.
In a democracy, the disconnect between what people are told by the media and politicians, and what people actually know to be true, must eventually find a political expression. Trump and Brexit are not going to be aberrations, I think there is going to be much darker stuff around the corner.
Same was true on pb this morning.
ETA though I'm not keen on the term Islamic Fundamentalism and prefer to talk of Islamist terrorism. The F-word can be misleading in this context.
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.
Yes it was absolutely well and truly blown out of water. We removed all our restrictions months ago without any meaningful rise in deaths etc since then.
The virus was over as something to be hysterical about back in June. Well it was over months before then actually.
Covid deaths 1st of June: 4 Covid Deaths 1st of October: 123
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
Given the huge pressures on the NHS, surely it makes sense to try to tackle behaviour which adds, unnecessarily, to that pressure. Namely:
a) people visiting their GPs when it really isn't necessary. b) people attending A&E when it really isn't necessary.
These are both very difficult to solve, without risking turning people away when they actually do need to be seen. But if phone consultations with GPs can reduce some of the pressure on a), that's all to the good. Similarly on b), more efficient ways of rapidly diagnosing whether a visit to A&E justifies joining the queue would be useful. The problem is, of course, that as soon as somebody is mistakenly turned away, the press would have a field day.
One problem is that of long-term-treatable conditions.
More and more conditions can be treated. The patient takes x pills a week. They can then live their life without much apparent difficulty (in many cases).
A couple of relatives have such conditions. Their health requires monitoring because of the powerful medications. So, every couple of months, they get blood tests etc. Then go to the GP, who smiles, and says that this iso put of her knowledge and sends them on to their usual consultant.
The appointment with the GP adds nothing.
What they really need is a permanent booking in the diary of the consultant in question, once every x months.
EDIT: A&E is often used as a substitute for seeing a GP, since GPs don't generally work weekends, or out of working hours. In experiments where they triaged the A&E queues to see (in effect) GPs in the hospital, much of the A&E queue moved that way.
A friend who is a GP said that there was a system during the pandemic (doctors correct/enlighten me) whereby if someone registered online they could see a GP at 24-hrs notice. This was playing havoc with their weekends as people would do it throughout. They then turned this facility off at the weekends and, as many peoples' symptoms had disappeared by Monday, they saw a vastly reduced number of applications vs previously.
A lot of those people will be back to going to A&E...
We have made use of drop in GP clinics in recent times. These are a good alternative, to be available alongside the normal GP's.
I think one of the issues we have at the moment is the perception that GP's are hard to see, or get to. Many surgeries that wont be an issue. My parents surgery, based in a village, is easy to get same day appointments. My surgery, a medium sized town, getting a physical GP appointment has been hard for many years, with typical offerings of 5 weeks in the future. However they have worked hard on other provision, and the e-consult has worked really well for us. People don't really like change, and I don't think GP surgeries have always explained things to their patients that well. As an example I was contact by text in mid August to arrange my flu jab. I was on holiday and missed the allocated 7 days. I assumed I would ne contacted again. Up to last week, nothing, so I rang the surgery, only for the receptionist to be faintly rude, and say there is no news as they have no flu vaccine. Why not put that on the web-page then? Patients also do not like receptionists conducting triage for patients. I think at least a nurse would be better than a nosy. middle-aged gossip who you might bump into in Waitrose. (Last bit was a JOKE, but only just...)
A lot of GPs make appointments very hard to get. 5 weeks in the future is ridiculous. Expecting people to repeat speed dial at exactly 8am to get one of 2 appointments reserved to be open that day.....
No wonder people just go to A&E....
It is interesting that the experiences of people around the country are so different. I know of one case in Grantham last year where a stomach cancer patient who had been in remission and started to get symptoms again could not get an appointment with the GP and by the time things were so bad they went to A&E it was too late and they died. Another of my closest friend who became seriously ill after an infection in his leg and was unable to get an appointment so ended up in hospital where they thankfully managed to save his leg. And yet at the same time the country surgeries which are using the Ask My GP app are doing so in such a way that if need be you can get an appointment within a couple of hours. They have assigned a doctor to do online triage but with the expectation of offering face to face visits if either the Doctor or the patient request it and it is meaning they can effectively deal with a much higher workload and those who do need to be seen get a much quicker response.
The problem to me seems to be with those GPs who, for whatever reason, simply don't want to do face to face at all anymore. If that is their attitude then they should find another job.
Say farewell to GPs then.
The reality is we don't have enough GPs and those that are qualified to do it don't need the money anymore.,
Not sure that would be a bad thing. Looking at other countries they don't have the gatekeeper function that GPs enact in the NHS. At least no where near to the same extent. In Poland for example you book directly with a specialist in the area you have an issue. If they think there is another issue they will refer you on.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
Given the huge pressures on the NHS, surely it makes sense to try to tackle behaviour which adds, unnecessarily, to that pressure. Namely:
a) people visiting their GPs when it really isn't necessary. b) people attending A&E when it really isn't necessary.
These are both very difficult to solve, without risking turning people away when they actually do need to be seen. But if phone consultations with GPs can reduce some of the pressure on a), that's all to the good. Similarly on b), more efficient ways of rapidly diagnosing whether a visit to A&E justifies joining the queue would be useful. The problem is, of course, that as soon as somebody is mistakenly turned away, the press would have a field day.
One problem is that of long-term-treatable conditions.
More and more conditions can be treated. The patient takes x pills a week. They can then live their life without much apparent difficulty (in many cases).
A couple of relatives have such conditions. Their health requires monitoring because of the powerful medications. So, every couple of months, they get blood tests etc. Then go to the GP, who smiles, and says that this iso put of her knowledge and sends them on to their usual consultant.
The appointment with the GP adds nothing.
What they really need is a permanent booking in the diary of the consultant in question, once every x months.
EDIT: A&E is often used as a substitute for seeing a GP, since GPs don't generally work weekends, or out of working hours. In experiments where they triaged the A&E queues to see (in effect) GPs in the hospital, much of the A&E queue moved that way.
A friend who is a GP said that there was a system during the pandemic (doctors correct/enlighten me) whereby if someone registered online they could see a GP at 24-hrs notice. This was playing havoc with their weekends as people would do it throughout. They then turned this facility off at the weekends and, as many peoples' symptoms had disappeared by Monday, they saw a vastly reduced number of applications vs previously.
A lot of those people will be back to going to A&E...
We have made use of drop in GP clinics in recent times. These are a good alternative, to be available alongside the normal GP's.
I think one of the issues we have at the moment is the perception that GP's are hard to see, or get to. Many surgeries that wont be an issue. My parents surgery, based in a village, is easy to get same day appointments. My surgery, a medium sized town, getting a physical GP appointment has been hard for many years, with typical offerings of 5 weeks in the future. However they have worked hard on other provision, and the e-consult has worked really well for us. People don't really like change, and I don't think GP surgeries have always explained things to their patients that well. As an example I was contact by text in mid August to arrange my flu jab. I was on holiday and missed the allocated 7 days. I assumed I would ne contacted again. Up to last week, nothing, so I rang the surgery, only for the receptionist to be faintly rude, and say there is no news as they have no flu vaccine. Why not put that on the web-page then? Patients also do not like receptionists conducting triage for patients. I think at least a nurse would be better than a nosy. middle-aged gossip who you might bump into in Waitrose. (Last bit was a JOKE, but only just...)
A lot of GPs make appointments very hard to get. 5 weeks in the future is ridiculous. Expecting people to repeat speed dial at exactly 8am to get one of 2 appointments reserved to be open that day.....
No wonder people just go to A&E....
It is interesting that the experiences of people around the country are so different. I know of one case in Grantham last year where a stomach cancer patient who had been in remission and started to get symptoms again could not get an appointment with the GP and by the time things were so bad they went to A&E it was too late and they died. Another of my closest friend who became seriously ill after an infection in his leg and was unable to get an appointment so ended up in hospital where they thankfully managed to save his leg. And yet at the same time the country surgeries which are using the Ask My GP app are doing so in such a way that if need be you can get an appointment within a couple of hours. They have assigned a doctor to do online triage but with the expectation of offering face to face visits if either the Doctor or the patient request it and it is meaning they can effectively deal with a much higher workload and those who do need to be seen get a much quicker response.
The problem to me seems to be with those GPs who, for whatever reason, simply don't want to do face to face at all anymore. If that is their attitude then they should find another job.
Say farewell to GPs then.
The reality is we don't have enough GPs and those that are qualified to do it don't need the money anymore.,
Not sure that would be a bad thing. Looking at other countries they don't have the gatekeeper function that GPs enact in the NHS. At least no where near to the same extent. In Poland for example you book directly with a specialist in the area you have an issue. If they think there is another issue they will refer you on.
Eliminate GPs and have triage in hospitals seems a better solution for a lot of people.
That people need a GP referral for chronic conditions especially is utterly absurd. It is pure makework.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
Many people suggested, at the time, that Tesla selecting Germany was an... interesting idea, since the German car companies are seen as part of the state.
Allowing Tesla into the German industrial scene would be directly against their interests and those of their political backers.
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
Yes, his general ship in the first Gulf war was simply outstanding. He had overwhelming force of course but he used it to great effect to achieve total victory with the absolute minimum of casualties. I have always thought that there was an indirect causal connection between the complete massacre of Soviet era equipment in that war and the collapse of the Soviet Union. It laid bare the idea that the Russians were even close to matching NATO's power was a complete joke. It became obvious that the 1st Armoured division's firepower was such that it could have marched on Moscow. But it was deployed to great effect.
The Soviets knew the game was up when it came to contesting US military technology way before that. They sent Marshal Kutakhov to Syria after the Beqaa Valley Turkey Shoot in 1982 and his findings indicated an unbridgeable gap.
Sure, but the Republican Guard being wiped out with several hundred tanks and armoured vehicles destroyed when the 1st Armoured had 4 casualties in the war (blue on blue IIRC) showed this was not just a gap but a chasm.
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.
Yes it is a model that used to be followed by other nationalised industries: the staff of the service provider are more important than the service user.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
Many people suggested, at the time, that Tesla selecting Germany was an... interesting idea, since the German car companies are seen as part of the state.
Allowing Tesla into the German industrial scene would be directly against their interests and those of their political backers.
Berlin was selected partially because it makes it easy for Tesla to poach talent from Porsche and BMW at Leipzig.
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
Yes, his general ship in the first Gulf war was simply outstanding. He had overwhelming force of course but he used it to great effect to achieve total victory with the absolute minimum of casualties. I have always thought that there was an indirect causal connection between the complete massacre of Soviet era equipment in that war and the collapse of the Soviet Union. It laid bare the idea that the Russians were even close to matching NATO's power was a complete joke. It became obvious that the 1st Armoured division's firepower was such that it could have marched on Moscow. But it was deployed to great effect.
One of the US military's greatest strengths has always been in logistics. Which is one of the reasons China is likely to be a far more formidable adversary than ever was the USSR.
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
This is just a lie. Iraq is not currently a free democratic state. It is an unfree autocracy.
Given the huge pressures on the NHS, surely it makes sense to try to tackle behaviour which adds, unnecessarily, to that pressure. Namely:
a) people visiting their GPs when it really isn't necessary. b) people attending A&E when it really isn't necessary.
These are both very difficult to solve, without risking turning people away when they actually do need to be seen. But if phone consultations with GPs can reduce some of the pressure on a), that's all to the good. Similarly on b), more efficient ways of rapidly diagnosing whether a visit to A&E justifies joining the queue would be useful. The problem is, of course, that as soon as somebody is mistakenly turned away, the press would have a field day.
One problem is that of long-term-treatable conditions.
More and more conditions can be treated. The patient takes x pills a week. They can then live their life without much apparent difficulty (in many cases).
A couple of relatives have such conditions. Their health requires monitoring because of the powerful medications. So, every couple of months, they get blood tests etc. Then go to the GP, who smiles, and says that this iso put of her knowledge and sends them on to their usual consultant.
The appointment with the GP adds nothing.
What they really need is a permanent booking in the diary of the consultant in question, once every x months.
EDIT: A&E is often used as a substitute for seeing a GP, since GPs don't generally work weekends, or out of working hours. In experiments where they triaged the A&E queues to see (in effect) GPs in the hospital, much of the A&E queue moved that way.
A friend who is a GP said that there was a system during the pandemic (doctors correct/enlighten me) whereby if someone registered online they could see a GP at 24-hrs notice. This was playing havoc with their weekends as people would do it throughout. They then turned this facility off at the weekends and, as many peoples' symptoms had disappeared by Monday, they saw a vastly reduced number of applications vs previously.
A lot of those people will be back to going to A&E...
We have made use of drop in GP clinics in recent times. These are a good alternative, to be available alongside the normal GP's.
I think one of the issues we have at the moment is the perception that GP's are hard to see, or get to. Many surgeries that wont be an issue. My parents surgery, based in a village, is easy to get same day appointments. My surgery, a medium sized town, getting a physical GP appointment has been hard for many years, with typical offerings of 5 weeks in the future. However they have worked hard on other provision, and the e-consult has worked really well for us. People don't really like change, and I don't think GP surgeries have always explained things to their patients that well. As an example I was contact by text in mid August to arrange my flu jab. I was on holiday and missed the allocated 7 days. I assumed I would ne contacted again. Up to last week, nothing, so I rang the surgery, only for the receptionist to be faintly rude, and say there is no news as they have no flu vaccine. Why not put that on the web-page then? Patients also do not like receptionists conducting triage for patients. I think at least a nurse would be better than a nosy. middle-aged gossip who you might bump into in Waitrose. (Last bit was a JOKE, but only just...)
A lot of GPs make appointments very hard to get. 5 weeks in the future is ridiculous. Expecting people to repeat speed dial at exactly 8am to get one of 2 appointments reserved to be open that day.....
No wonder people just go to A&E....
It is interesting that the experiences of people around the country are so different. I know of one case in Grantham last year where a stomach cancer patient who had been in remission and started to get symptoms again could not get an appointment with the GP and by the time things were so bad they went to A&E it was too late and they died. Another of my closest friend who became seriously ill after an infection in his leg and was unable to get an appointment so ended up in hospital where they thankfully managed to save his leg. And yet at the same time the country surgeries which are using the Ask My GP app are doing so in such a way that if need be you can get an appointment within a couple of hours. They have assigned a doctor to do online triage but with the expectation of offering face to face visits if either the Doctor or the patient request it and it is meaning they can effectively deal with a much higher workload and those who do need to be seen get a much quicker response.
The problem to me seems to be with those GPs who, for whatever reason, simply don't want to do face to face at all anymore. If that is their attitude then they should find another job.
Say farewell to GPs then.
The reality is we don't have enough GPs and those that are qualified to do it don't need the money anymore.,
Not sure that would be a bad thing. Looking at other countries they don't have the gatekeeper function that GPs enact in the NHS. At least no where near to the same extent. In Poland for example you book directly with a specialist in the area you have an issue. If they think there is another issue they will refer you on.
Completely agree. The GP system is just a wasteful money pit. It isn't going to change though, because deference to the medical profession and "our" NHS is the only area where real unquestioning deference still exists right across UK society. The BMA knows this all too well, and exploits it to the maximum degree.
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
This is just a lie. Iraq is not currently a free democratic state. It is an unfree autocracy.
You were obviously in such a lather about this that you were unable to read his last eight words.
There will be no extra time to stop climate change. Team (Flag of European Union) is delivering with #EUGreenDeal But to meet our goals & save our planet we need the whole Earth globe europe-africa to deliver at #COP26. We are all in the first team. We can all make a difference. #EveryTrickCounts @EU_Commission @UEFA
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
Many people suggested, at the time, that Tesla selecting Germany was an... interesting idea, since the German car companies are seen as part of the state.
Allowing Tesla into the German industrial scene would be directly against their interests and those of their political backers.
Not convinced that will go anywhere. Tesla need only point to the scads of money going to subsidise rival battery factories, I think.
On topic surely he only fails to file such a Statement if he's dead?
Even if he's not going to run, a Statement would allow him to fundraise and milk his followers for every penny he can get off them.
His supporters would expect him to file even if he was dead. No joke, they would. US politics is developing a black magic feel to it. Like, is the Republican Party really going to choose this guy again? And if they do are the American people really going to put him back in the White House? I cling to sanity and say No and No. Or rather No and N/A. Logic says Yes and Maybe but a deeper intuition tells me that America, having stepped back from the edge of the abyss less than a year ago, will not change its mind and decide to jump this time. I can't sit here and tell you exactly what or who is going to prevent it. All I know is something will.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
Many people suggested, at the time, that Tesla selecting Germany was an... interesting idea, since the German car companies are seen as part of the state.
Allowing Tesla into the German industrial scene would be directly against their interests and those of their political backers.
Berlin was selected partially because it makes it easy for Tesla to poach talent from Porsche and BMW at Leipzig.
I know a surefire way to get the booster programme really firing on all cylinders. Get Emmanuel Macron to make a passing comment about Les Anglais falling badly behind and you can be sure ministers will be on it virtually forcing everyone through the doors of mass vaxx centres within minutes. While he's at it if he could make some sarcastic reference to our sluggishness in jabbing schoolchildren that would be much appreciated.
Given the huge pressures on the NHS, surely it makes sense to try to tackle behaviour which adds, unnecessarily, to that pressure. Namely:
a) people visiting their GPs when it really isn't necessary. b) people attending A&E when it really isn't necessary.
These are both very difficult to solve, without risking turning people away when they actually do need to be seen. But if phone consultations with GPs can reduce some of the pressure on a), that's all to the good. Similarly on b), more efficient ways of rapidly diagnosing whether a visit to A&E justifies joining the queue would be useful. The problem is, of course, that as soon as somebody is mistakenly turned away, the press would have a field day.
One problem is that of long-term-treatable conditions.
More and more conditions can be treated. The patient takes x pills a week. They can then live their life without much apparent difficulty (in many cases).
A couple of relatives have such conditions. Their health requires monitoring because of the powerful medications. So, every couple of months, they get blood tests etc. Then go to the GP, who smiles, and says that this iso put of her knowledge and sends them on to their usual consultant.
The appointment with the GP adds nothing.
What they really need is a permanent booking in the diary of the consultant in question, once every x months.
EDIT: A&E is often used as a substitute for seeing a GP, since GPs don't generally work weekends, or out of working hours. In experiments where they triaged the A&E queues to see (in effect) GPs in the hospital, much of the A&E queue moved that way.
A friend who is a GP said that there was a system during the pandemic (doctors correct/enlighten me) whereby if someone registered online they could see a GP at 24-hrs notice. This was playing havoc with their weekends as people would do it throughout. They then turned this facility off at the weekends and, as many peoples' symptoms had disappeared by Monday, they saw a vastly reduced number of applications vs previously.
A lot of those people will be back to going to A&E...
We have made use of drop in GP clinics in recent times. These are a good alternative, to be available alongside the normal GP's.
I think one of the issues we have at the moment is the perception that GP's are hard to see, or get to. Many surgeries that wont be an issue. My parents surgery, based in a village, is easy to get same day appointments. My surgery, a medium sized town, getting a physical GP appointment has been hard for many years, with typical offerings of 5 weeks in the future. However they have worked hard on other provision, and the e-consult has worked really well for us. People don't really like change, and I don't think GP surgeries have always explained things to their patients that well. As an example I was contact by text in mid August to arrange my flu jab. I was on holiday and missed the allocated 7 days. I assumed I would ne contacted again. Up to last week, nothing, so I rang the surgery, only for the receptionist to be faintly rude, and say there is no news as they have no flu vaccine. Why not put that on the web-page then? Patients also do not like receptionists conducting triage for patients. I think at least a nurse would be better than a nosy. middle-aged gossip who you might bump into in Waitrose. (Last bit was a JOKE, but only just...)
A lot of GPs make appointments very hard to get. 5 weeks in the future is ridiculous. Expecting people to repeat speed dial at exactly 8am to get one of 2 appointments reserved to be open that day.....
No wonder people just go to A&E....
It is interesting that the experiences of people around the country are so different. I know of one case in Grantham last year where a stomach cancer patient who had been in remission and started to get symptoms again could not get an appointment with the GP and by the time things were so bad they went to A&E it was too late and they died. Another of my closest friend who became seriously ill after an infection in his leg and was unable to get an appointment so ended up in hospital where they thankfully managed to save his leg. And yet at the same time the country surgeries which are using the Ask My GP app are doing so in such a way that if need be you can get an appointment within a couple of hours. They have assigned a doctor to do online triage but with the expectation of offering face to face visits if either the Doctor or the patient request it and it is meaning they can effectively deal with a much higher workload and those who do need to be seen get a much quicker response.
The problem to me seems to be with those GPs who, for whatever reason, simply don't want to do face to face at all anymore. If that is their attitude then they should find another job.
Say farewell to GPs then.
The reality is we don't have enough GPs and those that are qualified to do it don't need the money anymore.,
Not sure that would be a bad thing. Looking at other countries they don't have the gatekeeper function that GPs enact in the NHS. At least no where near to the same extent. In Poland for example you book directly with a specialist in the area you have an issue. If they think there is another issue they will refer you on.
Eliminate GPs and have triage in hospitals seems a better solution for a lot of people.
That people need a GP referral for chronic conditions especially is utterly absurd. It is pure makework.
Given the huge pressures on the NHS, surely it makes sense to try to tackle behaviour which adds, unnecessarily, to that pressure. Namely:
a) people visiting their GPs when it really isn't necessary. b) people attending A&E when it really isn't necessary.
These are both very difficult to solve, without risking turning people away when they actually do need to be seen. But if phone consultations with GPs can reduce some of the pressure on a), that's all to the good. Similarly on b), more efficient ways of rapidly diagnosing whether a visit to A&E justifies joining the queue would be useful. The problem is, of course, that as soon as somebody is mistakenly turned away, the press would have a field day.
One problem is that of long-term-treatable conditions.
More and more conditions can be treated. The patient takes x pills a week. They can then live their life without much apparent difficulty (in many cases).
A couple of relatives have such conditions. Their health requires monitoring because of the powerful medications. So, every couple of months, they get blood tests etc. Then go to the GP, who smiles, and says that this iso put of her knowledge and sends them on to their usual consultant.
The appointment with the GP adds nothing.
What they really need is a permanent booking in the diary of the consultant in question, once every x months.
EDIT: A&E is often used as a substitute for seeing a GP, since GPs don't generally work weekends, or out of working hours. In experiments where they triaged the A&E queues to see (in effect) GPs in the hospital, much of the A&E queue moved that way.
A friend who is a GP said that there was a system during the pandemic (doctors correct/enlighten me) whereby if someone registered online they could see a GP at 24-hrs notice. This was playing havoc with their weekends as people would do it throughout. They then turned this facility off at the weekends and, as many peoples' symptoms had disappeared by Monday, they saw a vastly reduced number of applications vs previously.
A lot of those people will be back to going to A&E...
We have made use of drop in GP clinics in recent times. These are a good alternative, to be available alongside the normal GP's.
I think one of the issues we have at the moment is the perception that GP's are hard to see, or get to. Many surgeries that wont be an issue. My parents surgery, based in a village, is easy to get same day appointments. My surgery, a medium sized town, getting a physical GP appointment has been hard for many years, with typical offerings of 5 weeks in the future. However they have worked hard on other provision, and the e-consult has worked really well for us. People don't really like change, and I don't think GP surgeries have always explained things to their patients that well. As an example I was contact by text in mid August to arrange my flu jab. I was on holiday and missed the allocated 7 days. I assumed I would ne contacted again. Up to last week, nothing, so I rang the surgery, only for the receptionist to be faintly rude, and say there is no news as they have no flu vaccine. Why not put that on the web-page then? Patients also do not like receptionists conducting triage for patients. I think at least a nurse would be better than a nosy. middle-aged gossip who you might bump into in Waitrose. (Last bit was a JOKE, but only just...)
A lot of GPs make appointments very hard to get. 5 weeks in the future is ridiculous. Expecting people to repeat speed dial at exactly 8am to get one of 2 appointments reserved to be open that day.....
No wonder people just go to A&E....
It is interesting that the experiences of people around the country are so different. I know of one case in Grantham last year where a stomach cancer patient who had been in remission and started to get symptoms again could not get an appointment with the GP and by the time things were so bad they went to A&E it was too late and they died. Another of my closest friend who became seriously ill after an infection in his leg and was unable to get an appointment so ended up in hospital where they thankfully managed to save his leg. And yet at the same time the country surgeries which are using the Ask My GP app are doing so in such a way that if need be you can get an appointment within a couple of hours. They have assigned a doctor to do online triage but with the expectation of offering face to face visits if either the Doctor or the patient request it and it is meaning they can effectively deal with a much higher workload and those who do need to be seen get a much quicker response.
The problem to me seems to be with those GPs who, for whatever reason, simply don't want to do face to face at all anymore. If that is their attitude then they should find another job.
Say farewell to GPs then.
The reality is we don't have enough GPs and those that are qualified to do it don't need the money anymore.,
Not sure that would be a bad thing. Looking at other countries they don't have the gatekeeper function that GPs enact in the NHS. At least no where near to the same extent. In Poland for example you book directly with a specialist in the area you have an issue. If they think there is another issue they will refer you on.
Completely agree. The GP system is just a wasteful money pit. It isn't going to change though, because deference to the medical profession and "our" NHS is the only area where real unquestioning deference still exists right across UK society. The BMA knows this all too well, and exploits it to the maximum degree.
GPs or family doctors existed long before the NHS.
Given the huge pressures on the NHS, surely it makes sense to try to tackle behaviour which adds, unnecessarily, to that pressure. Namely:
a) people visiting their GPs when it really isn't necessary. b) people attending A&E when it really isn't necessary.
These are both very difficult to solve, without risking turning people away when they actually do need to be seen. But if phone consultations with GPs can reduce some of the pressure on a), that's all to the good. Similarly on b), more efficient ways of rapidly diagnosing whether a visit to A&E justifies joining the queue would be useful. The problem is, of course, that as soon as somebody is mistakenly turned away, the press would have a field day.
One problem is that of long-term-treatable conditions.
More and more conditions can be treated. The patient takes x pills a week. They can then live their life without much apparent difficulty (in many cases).
A couple of relatives have such conditions. Their health requires monitoring because of the powerful medications. So, every couple of months, they get blood tests etc. Then go to the GP, who smiles, and says that this iso put of her knowledge and sends them on to their usual consultant.
The appointment with the GP adds nothing.
What they really need is a permanent booking in the diary of the consultant in question, once every x months.
EDIT: A&E is often used as a substitute for seeing a GP, since GPs don't generally work weekends, or out of working hours. In experiments where they triaged the A&E queues to see (in effect) GPs in the hospital, much of the A&E queue moved that way.
A friend who is a GP said that there was a system during the pandemic (doctors correct/enlighten me) whereby if someone registered online they could see a GP at 24-hrs notice. This was playing havoc with their weekends as people would do it throughout. They then turned this facility off at the weekends and, as many peoples' symptoms had disappeared by Monday, they saw a vastly reduced number of applications vs previously.
A lot of those people will be back to going to A&E...
We have made use of drop in GP clinics in recent times. These are a good alternative, to be available alongside the normal GP's.
I think one of the issues we have at the moment is the perception that GP's are hard to see, or get to. Many surgeries that wont be an issue. My parents surgery, based in a village, is easy to get same day appointments. My surgery, a medium sized town, getting a physical GP appointment has been hard for many years, with typical offerings of 5 weeks in the future. However they have worked hard on other provision, and the e-consult has worked really well for us. People don't really like change, and I don't think GP surgeries have always explained things to their patients that well. As an example I was contact by text in mid August to arrange my flu jab. I was on holiday and missed the allocated 7 days. I assumed I would ne contacted again. Up to last week, nothing, so I rang the surgery, only for the receptionist to be faintly rude, and say there is no news as they have no flu vaccine. Why not put that on the web-page then? Patients also do not like receptionists conducting triage for patients. I think at least a nurse would be better than a nosy. middle-aged gossip who you might bump into in Waitrose. (Last bit was a JOKE, but only just...)
A lot of GPs make appointments very hard to get. 5 weeks in the future is ridiculous. Expecting people to repeat speed dial at exactly 8am to get one of 2 appointments reserved to be open that day.....
No wonder people just go to A&E....
It is interesting that the experiences of people around the country are so different. I know of one case in Grantham last year where a stomach cancer patient who had been in remission and started to get symptoms again could not get an appointment with the GP and by the time things were so bad they went to A&E it was too late and they died. Another of my closest friend who became seriously ill after an infection in his leg and was unable to get an appointment so ended up in hospital where they thankfully managed to save his leg. And yet at the same time the country surgeries which are using the Ask My GP app are doing so in such a way that if need be you can get an appointment within a couple of hours. They have assigned a doctor to do online triage but with the expectation of offering face to face visits if either the Doctor or the patient request it and it is meaning they can effectively deal with a much higher workload and those who do need to be seen get a much quicker response.
The problem to me seems to be with those GPs who, for whatever reason, simply don't want to do face to face at all anymore. If that is their attitude then they should find another job.
Say farewell to GPs then.
The reality is we don't have enough GPs and those that are qualified to do it don't need the money anymore.,
Not sure that would be a bad thing. Looking at other countries they don't have the gatekeeper function that GPs enact in the NHS. At least no where near to the same extent. In Poland for example you book directly with a specialist in the area you have an issue. If they think there is another issue they will refer you on.
Completely agree. The GP system is just a wasteful money pit. It isn't going to change though, because deference to the medical profession and "our" NHS is the only area where real unquestioning deference still exists right across UK society. The BMA knows this all too well, and exploits it to the maximum degree.
GPs or family doctors existed long before the NHS.
So did local markets and local butchers and local bookstores etc instead of supermarkets and Amazon.
Given the huge pressures on the NHS, surely it makes sense to try to tackle behaviour which adds, unnecessarily, to that pressure. Namely:
a) people visiting their GPs when it really isn't necessary. b) people attending A&E when it really isn't necessary.
These are both very difficult to solve, without risking turning people away when they actually do need to be seen. But if phone consultations with GPs can reduce some of the pressure on a), that's all to the good. Similarly on b), more efficient ways of rapidly diagnosing whether a visit to A&E justifies joining the queue would be useful. The problem is, of course, that as soon as somebody is mistakenly turned away, the press would have a field day.
One problem is that of long-term-treatable conditions.
More and more conditions can be treated. The patient takes x pills a week. They can then live their life without much apparent difficulty (in many cases).
A couple of relatives have such conditions. Their health requires monitoring because of the powerful medications. So, every couple of months, they get blood tests etc. Then go to the GP, who smiles, and says that this iso put of her knowledge and sends them on to their usual consultant.
The appointment with the GP adds nothing.
What they really need is a permanent booking in the diary of the consultant in question, once every x months.
EDIT: A&E is often used as a substitute for seeing a GP, since GPs don't generally work weekends, or out of working hours. In experiments where they triaged the A&E queues to see (in effect) GPs in the hospital, much of the A&E queue moved that way.
A friend who is a GP said that there was a system during the pandemic (doctors correct/enlighten me) whereby if someone registered online they could see a GP at 24-hrs notice. This was playing havoc with their weekends as people would do it throughout. They then turned this facility off at the weekends and, as many peoples' symptoms had disappeared by Monday, they saw a vastly reduced number of applications vs previously.
A lot of those people will be back to going to A&E...
We have made use of drop in GP clinics in recent times. These are a good alternative, to be available alongside the normal GP's.
I think one of the issues we have at the moment is the perception that GP's are hard to see, or get to. Many surgeries that wont be an issue. My parents surgery, based in a village, is easy to get same day appointments. My surgery, a medium sized town, getting a physical GP appointment has been hard for many years, with typical offerings of 5 weeks in the future. However they have worked hard on other provision, and the e-consult has worked really well for us. People don't really like change, and I don't think GP surgeries have always explained things to their patients that well. As an example I was contact by text in mid August to arrange my flu jab. I was on holiday and missed the allocated 7 days. I assumed I would ne contacted again. Up to last week, nothing, so I rang the surgery, only for the receptionist to be faintly rude, and say there is no news as they have no flu vaccine. Why not put that on the web-page then? Patients also do not like receptionists conducting triage for patients. I think at least a nurse would be better than a nosy. middle-aged gossip who you might bump into in Waitrose. (Last bit was a JOKE, but only just...)
A lot of GPs make appointments very hard to get. 5 weeks in the future is ridiculous. Expecting people to repeat speed dial at exactly 8am to get one of 2 appointments reserved to be open that day.....
No wonder people just go to A&E....
It is interesting that the experiences of people around the country are so different. I know of one case in Grantham last year where a stomach cancer patient who had been in remission and started to get symptoms again could not get an appointment with the GP and by the time things were so bad they went to A&E it was too late and they died. Another of my closest friend who became seriously ill after an infection in his leg and was unable to get an appointment so ended up in hospital where they thankfully managed to save his leg. And yet at the same time the country surgeries which are using the Ask My GP app are doing so in such a way that if need be you can get an appointment within a couple of hours. They have assigned a doctor to do online triage but with the expectation of offering face to face visits if either the Doctor or the patient request it and it is meaning they can effectively deal with a much higher workload and those who do need to be seen get a much quicker response.
The problem to me seems to be with those GPs who, for whatever reason, simply don't want to do face to face at all anymore. If that is their attitude then they should find another job.
Say farewell to GPs then.
The reality is we don't have enough GPs and those that are qualified to do it don't need the money anymore.,
Not sure that would be a bad thing. Looking at other countries they don't have the gatekeeper function that GPs enact in the NHS. At least no where near to the same extent. In Poland for example you book directly with a specialist in the area you have an issue. If they think there is another issue they will refer you on.
Completely agree. The GP system is just a wasteful money pit. It isn't going to change though, because deference to the medical profession and "our" NHS is the only area where real unquestioning deference still exists right across UK society. The BMA knows this all too well, and exploits it to the maximum degree.
GPs or family doctors existed long before the NHS.
So did local markets and local butchers and local bookstores etc instead of supermarkets and Amazon.
That is true. Whether it is relevant is another question. But it is ironic that the part of the NHS where there is a consumer market, ie general practice, is where there are most complaints. It may be that, as suggested before, what politicians think is important differs from what most patients see.
Given the huge pressures on the NHS, surely it makes sense to try to tackle behaviour which adds, unnecessarily, to that pressure. Namely:
a) people visiting their GPs when it really isn't necessary. b) people attending A&E when it really isn't necessary.
These are both very difficult to solve, without risking turning people away when they actually do need to be seen. But if phone consultations with GPs can reduce some of the pressure on a), that's all to the good. Similarly on b), more efficient ways of rapidly diagnosing whether a visit to A&E justifies joining the queue would be useful. The problem is, of course, that as soon as somebody is mistakenly turned away, the press would have a field day.
One problem is that of long-term-treatable conditions.
More and more conditions can be treated. The patient takes x pills a week. They can then live their life without much apparent difficulty (in many cases).
A couple of relatives have such conditions. Their health requires monitoring because of the powerful medications. So, every couple of months, they get blood tests etc. Then go to the GP, who smiles, and says that this iso put of her knowledge and sends them on to their usual consultant.
The appointment with the GP adds nothing.
What they really need is a permanent booking in the diary of the consultant in question, once every x months.
EDIT: A&E is often used as a substitute for seeing a GP, since GPs don't generally work weekends, or out of working hours. In experiments where they triaged the A&E queues to see (in effect) GPs in the hospital, much of the A&E queue moved that way.
A friend who is a GP said that there was a system during the pandemic (doctors correct/enlighten me) whereby if someone registered online they could see a GP at 24-hrs notice. This was playing havoc with their weekends as people would do it throughout. They then turned this facility off at the weekends and, as many peoples' symptoms had disappeared by Monday, they saw a vastly reduced number of applications vs previously.
A lot of those people will be back to going to A&E...
We have made use of drop in GP clinics in recent times. These are a good alternative, to be available alongside the normal GP's.
I think one of the issues we have at the moment is the perception that GP's are hard to see, or get to. Many surgeries that wont be an issue. My parents surgery, based in a village, is easy to get same day appointments. My surgery, a medium sized town, getting a physical GP appointment has been hard for many years, with typical offerings of 5 weeks in the future. However they have worked hard on other provision, and the e-consult has worked really well for us. People don't really like change, and I don't think GP surgeries have always explained things to their patients that well. As an example I was contact by text in mid August to arrange my flu jab. I was on holiday and missed the allocated 7 days. I assumed I would ne contacted again. Up to last week, nothing, so I rang the surgery, only for the receptionist to be faintly rude, and say there is no news as they have no flu vaccine. Why not put that on the web-page then? Patients also do not like receptionists conducting triage for patients. I think at least a nurse would be better than a nosy. middle-aged gossip who you might bump into in Waitrose. (Last bit was a JOKE, but only just...)
A lot of GPs make appointments very hard to get. 5 weeks in the future is ridiculous. Expecting people to repeat speed dial at exactly 8am to get one of 2 appointments reserved to be open that day.....
No wonder people just go to A&E....
It is interesting that the experiences of people around the country are so different. I know of one case in Grantham last year where a stomach cancer patient who had been in remission and started to get symptoms again could not get an appointment with the GP and by the time things were so bad they went to A&E it was too late and they died. Another of my closest friend who became seriously ill after an infection in his leg and was unable to get an appointment so ended up in hospital where they thankfully managed to save his leg. And yet at the same time the country surgeries which are using the Ask My GP app are doing so in such a way that if need be you can get an appointment within a couple of hours. They have assigned a doctor to do online triage but with the expectation of offering face to face visits if either the Doctor or the patient request it and it is meaning they can effectively deal with a much higher workload and those who do need to be seen get a much quicker response.
The problem to me seems to be with those GPs who, for whatever reason, simply don't want to do face to face at all anymore. If that is their attitude then they should find another job.
Say farewell to GPs then.
The reality is we don't have enough GPs and those that are qualified to do it don't need the money anymore.,
Not sure that would be a bad thing. Looking at other countries they don't have the gatekeeper function that GPs enact in the NHS. At least no where near to the same extent. In Poland for example you book directly with a specialist in the area you have an issue. If they think there is another issue they will refer you on.
Completely agree. The GP system is just a wasteful money pit. It isn't going to change though, because deference to the medical profession and "our" NHS is the only area where real unquestioning deference still exists right across UK society. The BMA knows this all too well, and exploits it to the maximum degree.
GPs or family doctors existed long before the NHS.
So did local markets and local butchers and local bookstores etc instead of supermarkets and Amazon.
That is true. Whether it is relevant is another question. But it is ironic that the part of the NHS where there is a consumer market, ie general practice, is where there are most complaints. It may be that, as suggested before, what politicians think is important differs from what most patients see.
Except it's not a consumer market. What market there is exists between the CCGs and healthcare providers (and has to some extent been bypassed by Covid emergency measures. The actual consumer brings only per capita funding.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
Many people suggested, at the time, that Tesla selecting Germany was an... interesting idea, since the German car companies are seen as part of the state.
Allowing Tesla into the German industrial scene would be directly against their interests and those of their political backers.
Berlin was selected partially because it makes it easy for Tesla to poach talent from Porsche and BMW at Leipzig.
A very sensible strategy
Which relies on the German federal and state government being fine with market share being potentially taken from the existing German companies.
Or they could put a few sharp stones in Elon's shoes.
Anecdotally I know of several people who have recently graduated from proper universities with proper degrees, now training as Amazon drivers.
Can’t say I’ve been following the UK graduate job market this year. Do we have a lower than usual number of vacancies because of pandemic/WFH effects, and/or a higher than usual number of graduates/firsts awarded?
It appears there’s lots of opportunities for the enterprising young to earn some serious cash this winter, with pretty much unlimited hours available to people willing to work. I recall once putting in the December timesheet with more than 300 hours on it, in a hospitality job. Hourly paid, of course. That covered a lot of beer the costs of living for the next semester.
I would not be surprised that, how low pay can be for "credentialed jobs", that such substituting can occur.
As a result of the degrees-for-all approach, there are alot of people looking a a career in some seriously low end "white collar" jobs.
According to an Australian friend, once inside Amazon, there are (at least in some parts of the world) considerable opportunities to get up the rungs.
The CEO of Dechra Pharmaceuticals started out working on the “shop” floor in one of their warehouses
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.
Indeed. I took a look at the England Ages data. It's the drop in the ages 20-40 that drives Lilco's stat. Which has been profound.
But cases in every single age group over 40 are at the July peak level and on a constantly upwards trajectory. And these age groups account for nearly 80% of the hospitalisations recently.
Given the huge pressures on the NHS, surely it makes sense to try to tackle behaviour which adds, unnecessarily, to that pressure. Namely:
a) people visiting their GPs when it really isn't necessary. b) people attending A&E when it really isn't necessary.
These are both very difficult to solve, without risking turning people away when they actually do need to be seen. But if phone consultations with GPs can reduce some of the pressure on a), that's all to the good. Similarly on b), more efficient ways of rapidly diagnosing whether a visit to A&E justifies joining the queue would be useful. The problem is, of course, that as soon as somebody is mistakenly turned away, the press would have a field day.
One problem is that of long-term-treatable conditions.
More and more conditions can be treated. The patient takes x pills a week. They can then live their life without much apparent difficulty (in many cases).
A couple of relatives have such conditions. Their health requires monitoring because of the powerful medications. So, every couple of months, they get blood tests etc. Then go to the GP, who smiles, and says that this iso put of her knowledge and sends them on to their usual consultant.
The appointment with the GP adds nothing.
What they really need is a permanent booking in the diary of the consultant in question, once every x months.
EDIT: A&E is often used as a substitute for seeing a GP, since GPs don't generally work weekends, or out of working hours. In experiments where they triaged the A&E queues to see (in effect) GPs in the hospital, much of the A&E queue moved that way.
A friend who is a GP said that there was a system during the pandemic (doctors correct/enlighten me) whereby if someone registered online they could see a GP at 24-hrs notice. This was playing havoc with their weekends as people would do it throughout. They then turned this facility off at the weekends and, as many peoples' symptoms had disappeared by Monday, they saw a vastly reduced number of applications vs previously.
A lot of those people will be back to going to A&E...
We have made use of drop in GP clinics in recent times. These are a good alternative, to be available alongside the normal GP's.
I think one of the issues we have at the moment is the perception that GP's are hard to see, or get to. Many surgeries that wont be an issue. My parents surgery, based in a village, is easy to get same day appointments. My surgery, a medium sized town, getting a physical GP appointment has been hard for many years, with typical offerings of 5 weeks in the future. However they have worked hard on other provision, and the e-consult has worked really well for us. People don't really like change, and I don't think GP surgeries have always explained things to their patients that well. As an example I was contact by text in mid August to arrange my flu jab. I was on holiday and missed the allocated 7 days. I assumed I would ne contacted again. Up to last week, nothing, so I rang the surgery, only for the receptionist to be faintly rude, and say there is no news as they have no flu vaccine. Why not put that on the web-page then? Patients also do not like receptionists conducting triage for patients. I think at least a nurse would be better than a nosy. middle-aged gossip who you might bump into in Waitrose. (Last bit was a JOKE, but only just...)
A lot of GPs make appointments very hard to get. 5 weeks in the future is ridiculous. Expecting people to repeat speed dial at exactly 8am to get one of 2 appointments reserved to be open that day.....
No wonder people just go to A&E....
It is interesting that the experiences of people around the country are so different. I know of one case in Grantham last year where a stomach cancer patient who had been in remission and started to get symptoms again could not get an appointment with the GP and by the time things were so bad they went to A&E it was too late and they died. Another of my closest friend who became seriously ill after an infection in his leg and was unable to get an appointment so ended up in hospital where they thankfully managed to save his leg. And yet at the same time the country surgeries which are using the Ask My GP app are doing so in such a way that if need be you can get an appointment within a couple of hours. They have assigned a doctor to do online triage but with the expectation of offering face to face visits if either the Doctor or the patient request it and it is meaning they can effectively deal with a much higher workload and those who do need to be seen get a much quicker response.
The problem to me seems to be with those GPs who, for whatever reason, simply don't want to do face to face at all anymore. If that is their attitude then they should find another job.
Say farewell to GPs then.
The reality is we don't have enough GPs and those that are qualified to do it don't need the money anymore.,
Not sure that would be a bad thing. Looking at other countries they don't have the gatekeeper function that GPs enact in the NHS. At least no where near to the same extent. In Poland for example you book directly with a specialist in the area you have an issue. If they think there is another issue they will refer you on.
Completely agree. The GP system is just a wasteful money pit. It isn't going to change though, because deference to the medical profession and "our" NHS is the only area where real unquestioning deference still exists right across UK society. The BMA knows this all too well, and exploits it to the maximum degree.
GPs or family doctors existed long before the NHS.
So did local markets and local butchers and local bookstores etc instead of supermarkets and Amazon.
That is true. Whether it is relevant is another question. But it is ironic that the part of the NHS where there is a consumer market, ie general practice, is where there are most complaints. It may be that, as suggested before, what politicians think is important differs from what most patients see.
Except it's not a consumer market. What market there is exists between the CCGs and healthcare providers (and has to some extent been bypassed by Covid emergency measures. The actual consumer brings only per capita funding.
And many people have zero choice of GP, unless they pay to go private.
Given the huge pressures on the NHS, surely it makes sense to try to tackle behaviour which adds, unnecessarily, to that pressure. Namely:
a) people visiting their GPs when it really isn't necessary. b) people attending A&E when it really isn't necessary.
These are both very difficult to solve, without risking turning people away when they actually do need to be seen. But if phone consultations with GPs can reduce some of the pressure on a), that's all to the good. Similarly on b), more efficient ways of rapidly diagnosing whether a visit to A&E justifies joining the queue would be useful. The problem is, of course, that as soon as somebody is mistakenly turned away, the press would have a field day.
One problem is that of long-term-treatable conditions.
More and more conditions can be treated. The patient takes x pills a week. They can then live their life without much apparent difficulty (in many cases).
A couple of relatives have such conditions. Their health requires monitoring because of the powerful medications. So, every couple of months, they get blood tests etc. Then go to the GP, who smiles, and says that this iso put of her knowledge and sends them on to their usual consultant.
The appointment with the GP adds nothing.
What they really need is a permanent booking in the diary of the consultant in question, once every x months.
EDIT: A&E is often used as a substitute for seeing a GP, since GPs don't generally work weekends, or out of working hours. In experiments where they triaged the A&E queues to see (in effect) GPs in the hospital, much of the A&E queue moved that way.
A friend who is a GP said that there was a system during the pandemic (doctors correct/enlighten me) whereby if someone registered online they could see a GP at 24-hrs notice. This was playing havoc with their weekends as people would do it throughout. They then turned this facility off at the weekends and, as many peoples' symptoms had disappeared by Monday, they saw a vastly reduced number of applications vs previously.
A lot of those people will be back to going to A&E...
We have made use of drop in GP clinics in recent times. These are a good alternative, to be available alongside the normal GP's.
I think one of the issues we have at the moment is the perception that GP's are hard to see, or get to. Many surgeries that wont be an issue. My parents surgery, based in a village, is easy to get same day appointments. My surgery, a medium sized town, getting a physical GP appointment has been hard for many years, with typical offerings of 5 weeks in the future. However they have worked hard on other provision, and the e-consult has worked really well for us. People don't really like change, and I don't think GP surgeries have always explained things to their patients that well. As an example I was contact by text in mid August to arrange my flu jab. I was on holiday and missed the allocated 7 days. I assumed I would ne contacted again. Up to last week, nothing, so I rang the surgery, only for the receptionist to be faintly rude, and say there is no news as they have no flu vaccine. Why not put that on the web-page then? Patients also do not like receptionists conducting triage for patients. I think at least a nurse would be better than a nosy. middle-aged gossip who you might bump into in Waitrose. (Last bit was a JOKE, but only just...)
A lot of GPs make appointments very hard to get. 5 weeks in the future is ridiculous. Expecting people to repeat speed dial at exactly 8am to get one of 2 appointments reserved to be open that day.....
No wonder people just go to A&E....
It is interesting that the experiences of people around the country are so different. I know of one case in Grantham last year where a stomach cancer patient who had been in remission and started to get symptoms again could not get an appointment with the GP and by the time things were so bad they went to A&E it was too late and they died. Another of my closest friend who became seriously ill after an infection in his leg and was unable to get an appointment so ended up in hospital where they thankfully managed to save his leg. And yet at the same time the country surgeries which are using the Ask My GP app are doing so in such a way that if need be you can get an appointment within a couple of hours. They have assigned a doctor to do online triage but with the expectation of offering face to face visits if either the Doctor or the patient request it and it is meaning they can effectively deal with a much higher workload and those who do need to be seen get a much quicker response.
The problem to me seems to be with those GPs who, for whatever reason, simply don't want to do face to face at all anymore. If that is their attitude then they should find another job.
Say farewell to GPs then.
The reality is we don't have enough GPs and those that are qualified to do it don't need the money anymore.,
Not sure that would be a bad thing. Looking at other countries they don't have the gatekeeper function that GPs enact in the NHS. At least no where near to the same extent. In Poland for example you book directly with a specialist in the area you have an issue. If they think there is another issue they will refer you on.
Completely agree. The GP system is just a wasteful money pit. It isn't going to change though, because deference to the medical profession and "our" NHS is the only area where real unquestioning deference still exists right across UK society. The BMA knows this all too well, and exploits it to the maximum degree.
GPs or family doctors existed long before the NHS.
So did local markets and local butchers and local bookstores etc instead of supermarkets and Amazon.
That is true. Whether it is relevant is another question. But it is ironic that the part of the NHS where there is a consumer market, ie general practice, is where there are most complaints. It may be that, as suggested before, what politicians think is important differs from what most patients see.
Except it's not a consumer market. What market there is exists between the CCGs and healthcare providers (and has to some extent been bypassed by Covid emergency measures. The actual consumer brings only per capita funding.
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.
Indeed. I took a look at the England Ages data. It's the drop in the ages 20-40 that drives Lilco's stat. Which has been profound.
But cases in every single age group over 40 are at the July peak level and on a constantly upwards trajectory. And these age groups account for nearly 80% of the hospitalisations recently.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
And? It isn't news that large parts of Germany don't like the Tesla Gigafactory.
I think the view of the German government is that they don't want competition for their car companies... but if they are going to have competition, better that it is competition from someone with a factory *in* Germany.
Given the huge pressures on the NHS, surely it makes sense to try to tackle behaviour which adds, unnecessarily, to that pressure. Namely:
a) people visiting their GPs when it really isn't necessary. b) people attending A&E when it really isn't necessary.
These are both very difficult to solve, without risking turning people away when they actually do need to be seen. But if phone consultations with GPs can reduce some of the pressure on a), that's all to the good. Similarly on b), more efficient ways of rapidly diagnosing whether a visit to A&E justifies joining the queue would be useful. The problem is, of course, that as soon as somebody is mistakenly turned away, the press would have a field day.
One problem is that of long-term-treatable conditions.
More and more conditions can be treated. The patient takes x pills a week. They can then live their life without much apparent difficulty (in many cases).
A couple of relatives have such conditions. Their health requires monitoring because of the powerful medications. So, every couple of months, they get blood tests etc. Then go to the GP, who smiles, and says that this iso put of her knowledge and sends them on to their usual consultant.
The appointment with the GP adds nothing.
What they really need is a permanent booking in the diary of the consultant in question, once every x months.
EDIT: A&E is often used as a substitute for seeing a GP, since GPs don't generally work weekends, or out of working hours. In experiments where they triaged the A&E queues to see (in effect) GPs in the hospital, much of the A&E queue moved that way.
A friend who is a GP said that there was a system during the pandemic (doctors correct/enlighten me) whereby if someone registered online they could see a GP at 24-hrs notice. This was playing havoc with their weekends as people would do it throughout. They then turned this facility off at the weekends and, as many peoples' symptoms had disappeared by Monday, they saw a vastly reduced number of applications vs previously.
A lot of those people will be back to going to A&E...
We have made use of drop in GP clinics in recent times. These are a good alternative, to be available alongside the normal GP's.
I think one of the issues we have at the moment is the perception that GP's are hard to see, or get to. Many surgeries that wont be an issue. My parents surgery, based in a village, is easy to get same day appointments. My surgery, a medium sized town, getting a physical GP appointment has been hard for many years, with typical offerings of 5 weeks in the future. However they have worked hard on other provision, and the e-consult has worked really well for us. People don't really like change, and I don't think GP surgeries have always explained things to their patients that well. As an example I was contact by text in mid August to arrange my flu jab. I was on holiday and missed the allocated 7 days. I assumed I would ne contacted again. Up to last week, nothing, so I rang the surgery, only for the receptionist to be faintly rude, and say there is no news as they have no flu vaccine. Why not put that on the web-page then? Patients also do not like receptionists conducting triage for patients. I think at least a nurse would be better than a nosy. middle-aged gossip who you might bump into in Waitrose. (Last bit was a JOKE, but only just...)
A lot of GPs make appointments very hard to get. 5 weeks in the future is ridiculous. Expecting people to repeat speed dial at exactly 8am to get one of 2 appointments reserved to be open that day.....
No wonder people just go to A&E....
It is interesting that the experiences of people around the country are so different. I know of one case in Grantham last year where a stomach cancer patient who had been in remission and started to get symptoms again could not get an appointment with the GP and by the time things were so bad they went to A&E it was too late and they died. Another of my closest friend who became seriously ill after an infection in his leg and was unable to get an appointment so ended up in hospital where they thankfully managed to save his leg. And yet at the same time the country surgeries which are using the Ask My GP app are doing so in such a way that if need be you can get an appointment within a couple of hours. They have assigned a doctor to do online triage but with the expectation of offering face to face visits if either the Doctor or the patient request it and it is meaning they can effectively deal with a much higher workload and those who do need to be seen get a much quicker response.
The problem to me seems to be with those GPs who, for whatever reason, simply don't want to do face to face at all anymore. If that is their attitude then they should find another job.
Say farewell to GPs then.
The reality is we don't have enough GPs and those that are qualified to do it don't need the money anymore.,
Not sure that would be a bad thing. Looking at other countries they don't have the gatekeeper function that GPs enact in the NHS. At least no where near to the same extent. In Poland for example you book directly with a specialist in the area you have an issue. If they think there is another issue they will refer you on.
Completely agree. The GP system is just a wasteful money pit. It isn't going to change though, because deference to the medical profession and "our" NHS is the only area where real unquestioning deference still exists right across UK society. The BMA knows this all too well, and exploits it to the maximum degree.
GPs or family doctors existed long before the NHS.
So did local markets and local butchers and local bookstores etc instead of supermarkets and Amazon.
That is true. Whether it is relevant is another question. But it is ironic that the part of the NHS where there is a consumer market, ie general practice, is where there are most complaints. It may be that, as suggested before, what politicians think is important differs from what most patients see.
Except it's not a consumer market. What market there is exists between the CCGs and healthcare providers (and has to some extent been bypassed by Covid emergency measures. The actual consumer brings only per capita funding.
Patients are free to change GP if they wish.
In many places there is no choice. Unless you move house.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
Many people suggested, at the time, that Tesla selecting Germany was an... interesting idea, since the German car companies are seen as part of the state.
Allowing Tesla into the German industrial scene would be directly against their interests and those of their political backers.
Berlin was selected partially because it makes it easy for Tesla to poach talent from Porsche and BMW at Leipzig.
Also, because there are still massive subsidies for opening up businesses in East Germany.
Given the huge pressures on the NHS, surely it makes sense to try to tackle behaviour which adds, unnecessarily, to that pressure. Namely:
a) people visiting their GPs when it really isn't necessary. b) people attending A&E when it really isn't necessary.
These are both very difficult to solve, without risking turning people away when they actually do need to be seen. But if phone consultations with GPs can reduce some of the pressure on a), that's all to the good. Similarly on b), more efficient ways of rapidly diagnosing whether a visit to A&E justifies joining the queue would be useful. The problem is, of course, that as soon as somebody is mistakenly turned away, the press would have a field day.
One problem is that of long-term-treatable conditions.
More and more conditions can be treated. The patient takes x pills a week. They can then live their life without much apparent difficulty (in many cases).
A couple of relatives have such conditions. Their health requires monitoring because of the powerful medications. So, every couple of months, they get blood tests etc. Then go to the GP, who smiles, and says that this iso put of her knowledge and sends them on to their usual consultant.
The appointment with the GP adds nothing.
What they really need is a permanent booking in the diary of the consultant in question, once every x months.
EDIT: A&E is often used as a substitute for seeing a GP, since GPs don't generally work weekends, or out of working hours. In experiments where they triaged the A&E queues to see (in effect) GPs in the hospital, much of the A&E queue moved that way.
A friend who is a GP said that there was a system during the pandemic (doctors correct/enlighten me) whereby if someone registered online they could see a GP at 24-hrs notice. This was playing havoc with their weekends as people would do it throughout. They then turned this facility off at the weekends and, as many peoples' symptoms had disappeared by Monday, they saw a vastly reduced number of applications vs previously.
A lot of those people will be back to going to A&E...
We have made use of drop in GP clinics in recent times. These are a good alternative, to be available alongside the normal GP's.
I think one of the issues we have at the moment is the perception that GP's are hard to see, or get to. Many surgeries that wont be an issue. My parents surgery, based in a village, is easy to get same day appointments. My surgery, a medium sized town, getting a physical GP appointment has been hard for many years, with typical offerings of 5 weeks in the future. However they have worked hard on other provision, and the e-consult has worked really well for us. People don't really like change, and I don't think GP surgeries have always explained things to their patients that well. As an example I was contact by text in mid August to arrange my flu jab. I was on holiday and missed the allocated 7 days. I assumed I would ne contacted again. Up to last week, nothing, so I rang the surgery, only for the receptionist to be faintly rude, and say there is no news as they have no flu vaccine. Why not put that on the web-page then? Patients also do not like receptionists conducting triage for patients. I think at least a nurse would be better than a nosy. middle-aged gossip who you might bump into in Waitrose. (Last bit was a JOKE, but only just...)
A lot of GPs make appointments very hard to get. 5 weeks in the future is ridiculous. Expecting people to repeat speed dial at exactly 8am to get one of 2 appointments reserved to be open that day.....
No wonder people just go to A&E....
It is interesting that the experiences of people around the country are so different. I know of one case in Grantham last year where a stomach cancer patient who had been in remission and started to get symptoms again could not get an appointment with the GP and by the time things were so bad they went to A&E it was too late and they died. Another of my closest friend who became seriously ill after an infection in his leg and was unable to get an appointment so ended up in hospital where they thankfully managed to save his leg. And yet at the same time the country surgeries which are using the Ask My GP app are doing so in such a way that if need be you can get an appointment within a couple of hours. They have assigned a doctor to do online triage but with the expectation of offering face to face visits if either the Doctor or the patient request it and it is meaning they can effectively deal with a much higher workload and those who do need to be seen get a much quicker response.
The problem to me seems to be with those GPs who, for whatever reason, simply don't want to do face to face at all anymore. If that is their attitude then they should find another job.
Say farewell to GPs then.
The reality is we don't have enough GPs and those that are qualified to do it don't need the money anymore.,
Not sure that would be a bad thing. Looking at other countries they don't have the gatekeeper function that GPs enact in the NHS. At least no where near to the same extent. In Poland for example you book directly with a specialist in the area you have an issue. If they think there is another issue they will refer you on.
Completely agree. The GP system is just a wasteful money pit. It isn't going to change though, because deference to the medical profession and "our" NHS is the only area where real unquestioning deference still exists right across UK society. The BMA knows this all too well, and exploits it to the maximum degree.
GPs or family doctors existed long before the NHS.
So did local markets and local butchers and local bookstores etc instead of supermarkets and Amazon.
That is true. Whether it is relevant is another question. But it is ironic that the part of the NHS where there is a consumer market, ie general practice, is where there are most complaints. It may be that, as suggested before, what politicians think is important differs from what most patients see.
Except it's not a consumer market. What market there is exists between the CCGs and healthcare providers (and has to some extent been bypassed by Covid emergency measures. The actual consumer brings only per capita funding.
Patients are free to change GP if they wish.
In many places there is no choice. Unless you move house.
I'm not sure what the geographic reach of GP-at-hand is, but as I mentioned down-thread I switched to their all online service a couple of years ago.
EDIT: just checked and the online service is nationwide (possibly also while you're overseas if you have an NHS number) but the face to face clinics for follow up are only in London and Birmingham.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
And? It isn't news that large parts of Germany don't like the Tesla Gigafactory.
I think the view of the German government is that they don't want competition for their car companies... but if they are going to have competition, better that it is competition from someone with a factory *in* Germany.
Not an unreasonable view, if you ask me.
Part of the German government wanted the Tesla factory to give a kick to the rest of the German car industry.
Now that's been done, slow rolling the permits for the factory is in the interest of all the other car makers and their political allies. Which is a lot of power, in Germany.
There will be no extra time to stop climate change. Team (Flag of European Union) is delivering with #EUGreenDeal But to meet our goals & save our planet we need the whole Earth globe europe-africa to deliver at #COP26. We are all in the first team. We can all make a difference. #EveryTrickCounts @EU_Commission @UEFA
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
And? It isn't news that large parts of Germany don't like the Tesla Gigafactory.
I think the view of the German government is that they don't want competition for their car companies... but if they are going to have competition, better that it is competition from someone with a factory *in* Germany.
Not an unreasonable view, if you ask me.
Part of the German government wanted the Tesla factory to give a kick to the rest of the German car industry.
Now that's been done, slow rolling the permits for the factory is in the interest of all the other car makers and their political allies. Which is a lot of power, in Germany.
So that's what those German car manufacturers David Davis kept telling us about were up to all this time.
Given that the evidence is growing that mixing-and-matching vaccines produces better immune response than being homogeneous, is HMG being more... flexible... with their booster shot guidance?
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
And? It isn't news that large parts of Germany don't like the Tesla Gigafactory.
I think the view of the German government is that they don't want competition for their car companies... but if they are going to have competition, better that it is competition from someone with a factory *in* Germany.
Not an unreasonable view, if you ask me.
Part of the German government wanted the Tesla factory to give a kick to the rest of the German car industry.
Now that's been done, slow rolling the permits for the factory is in the interest of all the other car makers and their political allies. Which is a lot of power, in Germany.
So that's what those German car manufacturers David Davis kept telling us about were up to all this time.
LOL
In some ways it is an ideal situation for them. Tesla have made their investment and can't produce cars.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
Many people suggested, at the time, that Tesla selecting Germany was an... interesting idea, since the German car companies are seen as part of the state.
Allowing Tesla into the German industrial scene would be directly against their interests and those of their political backers.
Berlin was selected partially because it makes it easy for Tesla to poach talent from Porsche and BMW at Leipzig.
A very sensible strategy
Which relies on the German federal and state government being fine with market share being potentially taken from the existing German companies.
Or they could put a few sharp stones in Elon's shoes.
Given that the evidence is growing that mixing-and-matching vaccines produces better immune response than being homogeneous, is HMG being more... flexible... with their booster shot guidance?
Not exactly. Pretty much all the boosters will be mRNA, even if the first two doses were.
"Most people will be offered a booster dose of the Pfizer/BioNTech vaccine or Moderna vaccine.
This means your booster dose may be different from the vaccines you had for your 1st and 2nd doses.
Some people may be offered a booster dose of the Oxford/AstraZeneca vaccine if they cannot have the Pfizer/BioNTech or Moderna vaccine."
The more the global vaccine rollout unfolds the more I realise how lucky we were to have had 2 early breakthroughs by Pfizer-Biontech and Oxford-AZ. Several other big players were unsuccessful e.g. GSK/Sanofi, CSL, and others quickly got to good trial results but have really struggled to scale up (NovaVax, Moderna to some extent). Had one or both of the big 2 stumbled then the situation would a whole lot worse than it is. You could probably add Sinovac to that list as despite lower efficacy it did at least scale up production very rapidly.
Now we are so used to vaccines we tend to forget what an amazing and by no means inevitable achievement it was for the industry to manage what it did in such a short space of time.
Things seem to be slowing down a bit now though, don't they? Where is the updated plug-and-play mRNA or vector vaccine for the Delta variant, or even for the old Beta one? I thought Moderna in particularly would be straight out of the blocks with a Delta-beating jab. Where are the nasal sprays which AZ were trialling, which were hoped to be more effective than injections? Perhaps these are all still in the pipeline, but - aside from the Valneva news this morning - it's all been rather quiet recently.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
Many people suggested, at the time, that Tesla selecting Germany was an... interesting idea, since the German car companies are seen as part of the state.
Allowing Tesla into the German industrial scene would be directly against their interests and those of their political backers.
Berlin was selected partially because it makes it easy for Tesla to poach talent from Porsche and BMW at Leipzig.
A very sensible strategy
Which relies on the German federal and state government being fine with market share being potentially taken from the existing German companies.
Or they could put a few sharp stones in Elon's shoes.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
And? It isn't news that large parts of Germany don't like the Tesla Gigafactory.
I think the view of the German government is that they don't want competition for their car companies... but if they are going to have competition, better that it is competition from someone with a factory *in* Germany.
Not an unreasonable view, if you ask me.
Part of the German government wanted the Tesla factory to give a kick to the rest of the German car industry.
Now that's been done, slow rolling the permits for the factory is in the interest of all the other car makers and their political allies. Which is a lot of power, in Germany.
Aren't permit at the behest of the state government? And there's no love for Bavaria in Saxony or in Berlin.
Given that the evidence is growing that mixing-and-matching vaccines produces better immune response than being homogeneous, is HMG being more... flexible... with their booster shot guidance?
Well as far as I'm aware it's either Pfizer or Moderna for boosters. I have a number of relatives who had AZ and are now having a Pfizer Booster. I will be getting a third Pfizer as that's what my Trust is offering.
I guess not using AZ will mean that there could be supply and demand issues when it comes to securing supply of the other vaccines. The data from PHE suggests Pfizer and Moderna are better against Delta.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
And? It isn't news that large parts of Germany don't like the Tesla Gigafactory.
I think the view of the German government is that they don't want competition for their car companies... but if they are going to have competition, better that it is competition from someone with a factory *in* Germany.
Not an unreasonable view, if you ask me.
Part of the German government wanted the Tesla factory to give a kick to the rest of the German car industry.
Now that's been done, slow rolling the permits for the factory is in the interest of all the other car makers and their political allies. Which is a lot of power, in Germany.
Aren't permit at the behest of the state government? And there's no love for Bavaria in Saxony or in Berlin.
Well, they might not talk to each other - or they might swap favours. Which is exactly what the States do, in the US....
The more the global vaccine rollout unfolds the more I realise how lucky we were to have had 2 early breakthroughs by Pfizer-Biontech and Oxford-AZ. Several other big players were unsuccessful e.g. GSK/Sanofi, CSL, and others quickly got to good trial results but have really struggled to scale up (NovaVax, Moderna to some extent). Had one or both of the big 2 stumbled then the situation would a whole lot worse than it is. You could probably add Sinovac to that list as despite lower efficacy it did at least scale up production very rapidly.
Now we are so used to vaccines we tend to forget what an amazing and by no means inevitable achievement it was for the industry to manage what it did in such a short space of time.
Things seem to be slowing down a bit now though, don't they? Where is the updated plug-and-play mRNA or vector vaccine for the Delta variant, or even for the old Beta one? I thought Moderna in particularly would be straight out of the blocks with a Delta-beating jab. Where are the nasal sprays which AZ were trialling, which were hoped to be more effective than injections? Perhaps these are all still in the pipeline, but - aside from the Valneva news this morning - it's all been rather quiet recently.
The issue with Delta is not that it is radically different, it's simply that because those infected spread viral matter at up 1,000x the levels of previous variants, then people receive much larger doses of it.
That's what is causing breakthrough infections - not your immune system not recognising the variant.
The extent to which your immune system is primed therefore becomes the key determinant of whether there is a breakthrough infection. And the best priming appears to be either:
- Moderna (where the doses of vaccine were more than twice Pfizer's) - mix and match (particularly AZ followed by an mRNA vaccine) - infection plus a vaccine - booster shots
We might also get to add nasally administered vaccines in the fullness of time.
Or is this driven by what happened to them in Scotland?
No, they are pro the Union.
Once Scotland leave and Ireland is reunited the independence train in Wales will start rolling, and Labour here too, will be left at the station.
I guess there's an important difference between Labour and Lafur? Drakeford seems pleasantly rational on the issue which may be the product of Plaid not being much of a threat at the moment? Though SLab were pretty anti SNP even before they were reduced to third party status (they're off the SNPbad scale now).
FPT
All 3 of Rhodri Morgan, Carwyn Jones & Mark Drakeford were/are fluent Welsh speakers.
I think Drakeford said he considered joining Plaid Cymru as a young man, before settling on Llafur. So, Drakeford is popular with many Plaid Cymru voters.
I suspect Drakeford prefers Wales to be in the UK -- but not in a UK run by Johnson or with endless Tory Govts in Westminster.
Drakeford has surprised me (and others) on the upside. He looks like a bumbling, incompetent academic, but he has a set of skills and attributes that has proved electorally successful in Wales.
In fact, I prefer Drakeford to any of his likely successors -- he is standing down as leader of Llafur before the next Senedd elections.
Be interesting to see what happens next to Llafur. Incompetent, half-assed leadership is certainly one of the things that killed SLAB, and that Llafur have so far avoided.
Wales also voted for Brexit, just like England and its 2 main parties are Labour and the Conservatives, just like England.
Nationalism in Wales is just confined to mainly a few Welsh speaking areas on the West coast and in the NorthWest and Anglesey and parts of the Rhondda.
Hence Labour can easily ignore Plaid
Off topic
Things change HY.
I am a staunch supporter of the Union of England, Wales and Scotland. Less so NI. However, if Scotland leave, then what's the point of the "Union" of England and Wales?
Wales are completely ill-equipped for independence, and it is as yet not a popular option, but if Scotland jump ship, so what? I'd give it a whirl. I also think should independence occur the political dynamics of Wales will change. I suspect the Conservatives will hold on as the main opposition group, who will occasionally take power in a rainbow coalition when the left are unpopular, but I am not sure about the centre-left parties including Labour, they might be all subsumed into some centrist porridge that will need to do deals with the Greens and the SWP from time to time.
Meanwhile in England you have Sine Die Boris Johnson Governments. What is there for you not to like?
Given that the evidence is growing that mixing-and-matching vaccines produces better immune response than being homogeneous, is HMG being more... flexible... with their booster shot guidance?
Well as far as I'm aware it's either Pfizer or Moderna for boosters. I have a number of relatives who had AZ and are now having a Pfizer Booster. I will be getting a third Pfizer as that's what my Trust is offering.
I guess not using AZ will mean that there could be supply and demand issues when it comes to securing supply of the other vaccines. The data from PHE suggests Pfizer and Moderna are better against Delta.
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
This is just a lie. Iraq is not currently a free democratic state. It is an unfree autocracy.
Wrong. Apart from Jordan and Israel, Iraq is now the most democratic and free nation in the Middle East with an elected President and elected Parliament
Under Saddam it was led by the most brutal dictator in the Middle East.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
Many people suggested, at the time, that Tesla selecting Germany was an... interesting idea, since the German car companies are seen as part of the state.
Allowing Tesla into the German industrial scene would be directly against their interests and those of their political backers.
Berlin was selected partially because it makes it easy for Tesla to poach talent from Porsche and BMW at Leipzig.
A very sensible strategy
Which relies on the German federal and state government being fine with market share being potentially taken from the existing German companies.
Or they could put a few sharp stones in Elon's shoes.
... and Tory Bruno invites Elon for factory tours at ULA.
Doesn't mean that ULA isn't spending a lot of money in Washington to slow SpaceX down....
Well ULA is sure as hell spending a lot of money. Not quite sure what they’re hoping to achieve with it, but they definitely know how to make bank at the end of the month.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
Many people suggested, at the time, that Tesla selecting Germany was an... interesting idea, since the German car companies are seen as part of the state.
Allowing Tesla into the German industrial scene would be directly against their interests and those of their political backers.
Berlin was selected partially because it makes it easy for Tesla to poach talent from Porsche and BMW at Leipzig.
A very sensible strategy
Which relies on the German federal and state government being fine with market share being potentially taken from the existing German companies.
Or they could put a few sharp stones in Elon's shoes.
... and Tory Bruno invites Elon for factory tours at ULA.
Doesn't mean that ULA isn't spending a lot of money in Washington to slow SpaceX down....
Well ULA is sure as hell spending a lot of money. Not quite sure what they’re hoping to achieve with it, but they definitely know how to make bank at the end of the month.
Cost plus contracts on the basis of "spend all the money you need to, to achieve 100% reliability" is a good business model. If you can find a customer for that....
So, the final approval process for Tesla's Berlin gigafactory takes three weeks. I'd be prepared to bet that at the end of the process, it is approved, and that production begins there this year.
Edit to add: the remaining permit is from the Brandenburg Ministry of the Environment, and they've been pretty forthright in their support for the project so far. It's also worth remembering that the last serious legal challenge against the project was rejected about six weeks ago.
The more the global vaccine rollout unfolds the more I realise how lucky we were to have had 2 early breakthroughs by Pfizer-Biontech and Oxford-AZ. Several other big players were unsuccessful e.g. GSK/Sanofi, CSL, and others quickly got to good trial results but have really struggled to scale up (NovaVax, Moderna to some extent). Had one or both of the big 2 stumbled then the situation would a whole lot worse than it is. You could probably add Sinovac to that list as despite lower efficacy it did at least scale up production very rapidly.
Now we are so used to vaccines we tend to forget what an amazing and by no means inevitable achievement it was for the industry to manage what it did in such a short space of time.
Things seem to be slowing down a bit now though, don't they? Where is the updated plug-and-play mRNA or vector vaccine for the Delta variant, or even for the old Beta one? I thought Moderna in particularly would be straight out of the blocks with a Delta-beating jab. Where are the nasal sprays which AZ were trialling, which were hoped to be more effective than injections? Perhaps these are all still in the pipeline, but - aside from the Valneva news this morning - it's all been rather quiet recently.
I think they are still in development and these Gen 2 vaccines will be out next year. The mRNA vaccines are still doing a fantastic job overall against at Delta.
From reading some recent articles it seems like these companies and their research teams are thinking bigger picture stuff at the moment, so whilst I have no doubt development is ongoing for even better vaccines against Covid, it's not their sole focus.
They are talking about vaccines and in particular mRNA vaccines for example against AIDS and Cancers. Oxford/Astrazeneca is also focusing on vaccines for Nipah and Mers (both bat borne viruses that have made the leap to humans and make Covid look tame).
The lasting legacy of Covid might be huge strides in other scientific and medical advancements in protecting and treating against other diseases.
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.
Indeed. I took a look at the England Ages data. It's the drop in the ages 20-40 that drives Lilco's stat. Which has been profound.
But cases in every single age group over 40 are at the July peak level and on a constantly upwards trajectory. And these age groups account for nearly 80% of the hospitalisations recently.
We would he miss out those important facts?
Indeed
And in case people get a bit confused by the separate age ranges, here's it simplified to "Under 20", "20-39", "40+"
The red line is the one we must be most worried about in terms of hospitalisations and especially deaths. 80% of hospitalisations come from that line.
The green line is indeed the one fuelling most of the cases and gives only a small contribution to hospitalisations. And it's true that if you add and correctly weight the blue and red lines together, they'll be pretty level overall, which was Lilco's factoid, but it's disingenuous to then claim "hey, what are you worrying about?"
What we're worrying about is the red line climbing rapidly and above the highest point it's been since January.
Banging my head against a brick wall with bet365's customer service team. Trying to establish the settlement rules for Top Male and Top Female for Strictly. First reply was rubbish.
"This market is for the win only meaning that who you pick, either a male participant or a female participant would have to come first in order for the bet to win. This would mean that reaching the final wouldn't class the bet as a win or a loss at this stage. bets will settle on the overall winner of the competition".
Second reply, from a different agent, is clearer but still rubbish.
"If a male participant goes on to win Strictly Come Dancing, then there would be no Top Woman and bets on this market would be settled as a loss".
Think there could be some value around but just want confirmation on rules but these guys are clueless. If the bets settle on the overall winner there is no need for top male or top female markets with much shorter prices than the outright FFS.
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.
Thanks, it's a Toyota. I asked about whether we are just suppressing the warning and got an unconfident no. Apparently they are cleaning the DPF somehow, but resetting the software and deleting the data is essential to avoid this happening repeatedly.
I know **** all about cars, but this explanation seems implausible, and therefore is perhaps true. Essentially with this garage (indeed with every garage) it feels like they are just making it up as I go along.
tips on what to look out for when I test-drive whatever the hell they've done tomorrow?
The more the global vaccine rollout unfolds the more I realise how lucky we were to have had 2 early breakthroughs by Pfizer-Biontech and Oxford-AZ. Several other big players were unsuccessful e.g. GSK/Sanofi, CSL, and others quickly got to good trial results but have really struggled to scale up (NovaVax, Moderna to some extent). Had one or both of the big 2 stumbled then the situation would a whole lot worse than it is. You could probably add Sinovac to that list as despite lower efficacy it did at least scale up production very rapidly.
Now we are so used to vaccines we tend to forget what an amazing and by no means inevitable achievement it was for the industry to manage what it did in such a short space of time.
Things seem to be slowing down a bit now though, don't they? Where is the updated plug-and-play mRNA or vector vaccine for the Delta variant, or even for the old Beta one? I thought Moderna in particularly would be straight out of the blocks with a Delta-beating jab. Where are the nasal sprays which AZ were trialling, which were hoped to be more effective than injections? Perhaps these are all still in the pipeline, but - aside from the Valneva news this morning - it's all been rather quiet recently.
The issue with Delta is not that it is radically different, it's simply that because those infected spread viral matter at up 1,000x the levels of previous variants, then people receive much larger doses of it.
That's what is causing breakthrough infections - not your immune system not recognising the variant.
The extent to which your immune system is primed therefore becomes the key determinant of whether there is a breakthrough infection. And the best priming appears to be either:
- Moderna (where the doses of vaccine were more than twice Pfizer's) - mix and match (particularly AZ followed by an mRNA vaccine) - infection plus a vaccine - booster shots
We might also get to add nasally administered vaccines in the fullness of time.
I have a strong suspicion that if we can get vaccines to nasally administered or, even better, pill form, antivaxxing would drop considerably.
I've got a hypothesis that when you tie in the natural "ow, I don't like needles; I'm inclined to find any way to rationalise not getting jabbed" with the "injecting something by a needle is a very intrusive way of administering anything; must be really significant and potentially dangerous" mindsets, you're primed for finding a significant number of people getting hesitant.
People will take a pill very casually, drink a fluid slightly less casually, take a nasal spray a bit less casually, and accept an injection far far less casually than any of these. Even though pills can very easily be the most dangerous route for any of this.
But we all can get pills for this, that, or the other really easily at home, whilst injecting something is to do with hospitals and doctors and surgeries and... you get the drift.
And I really wouldn't overlook the entire dislike of getting jabbed by a needle element. It sounds childish, but everyone's got a childish part of their brain. And will rationalise away anything they don't like.
Or is this driven by what happened to them in Scotland?
No, they are pro the Union.
Once Scotland leave and Ireland is reunited the independence train in Wales will start rolling, and Labour here too, will be left at the station.
I guess there's an important difference between Labour and Lafur? Drakeford seems pleasantly rational on the issue which may be the product of Plaid not being much of a threat at the moment? Though SLab were pretty anti SNP even before they were reduced to third party status (they're off the SNPbad scale now).
FPT
All 3 of Rhodri Morgan, Carwyn Jones & Mark Drakeford were/are fluent Welsh speakers.
I think Drakeford said he considered joining Plaid Cymru as a young man, before settling on Llafur. So, Drakeford is popular with many Plaid Cymru voters.
I suspect Drakeford prefers Wales to be in the UK -- but not in a UK run by Johnson or with endless Tory Govts in Westminster.
Drakeford has surprised me (and others) on the upside. He looks like a bumbling, incompetent academic, but he has a set of skills and attributes that has proved electorally successful in Wales.
In fact, I prefer Drakeford to any of his likely successors -- he is standing down as leader of Llafur before the next Senedd elections.
Be interesting to see what happens next to Llafur. Incompetent, half-assed leadership is certainly one of the things that killed SLAB, and that Llafur have so far avoided.
Wales also voted for Brexit, just like England and its 2 main parties are Labour and the Conservatives, just like England.
Nationalism in Wales is just confined to mainly a few Welsh speaking areas on the West coast and in the NorthWest and Anglesey and parts of the Rhondda.
Hence Labour can easily ignore Plaid
Off topic
Things change HY.
I am a staunch supporter of the Union of England, Wales and Scotland. Less so NI. However, if Scotland leave, then what's the point of the "Union" of England and Wales?
Wales are completely ill-equipped for independence, and it is as yet not a popular option, but if Scotland jump ship, so what? I'd give it a whirl. I also think should independence occur the political dynamics of Wales will change. I suspect the Conservatives will hold on as the main opposition group, who will occasionally take power in a rainbow coalition when the left are unpopular, but I am not sure about the centre-left parties including Labour, they might be all subsumed into some centrist porridge that will need to do deals with the Greens and the SWP from time to time.
Meanwhile in England you have Sine Die Boris Johnson Governments. What is there for you not to like?
Scotland won't be leaving anytime soon, No still leads most polls and this government will continue to refuse indyref2 anyway.
However if there was an indyref2 granted under say a Labour minority government in the next 10 years and Scotland voted Yes then obviously in the short term Labour would try and keep Wales otherwise it would be completely screwed in England alone under anything other than a Blairite leader yes.
However in the longer term as I said as young Welsh continue to move to English cities and Tory voting English retirees continue to move to Wales then the already Brexit voting Wales will become indistinguishable from England in its political culture
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
This is just a lie. Iraq is not currently a free democratic state. It is an unfree autocracy.
Wrong. Apart from Jordan and Israel, Iraq is now the most democratic and free nation in the Middle East with an elected President and elected Parliament
Under Saddam it was led by the most brutal dictator in the Middle East.
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
This is just a lie. Iraq is not currently a free democratic state. It is an unfree autocracy.
Apart from Jordan and Israel Iraq is now the most democratic and free nation in the Middle East.
Under Saddam it was led by the most brutal dictator in the Middle East.
So my comment stands absolutely
Iraq is now a free and democratic state {factcheck: The Economist's Democracy Index classes it as "Authoritarian"} certainly compared to most of the Middle East {factcheck: true}
Your comment was both false and true.
Nope my comment was both valid and completely true.
Iraq's President and Parliament are elected in democratic elections with multiple party candidates and it is far more free than under Saddam. Name me one other Middle Eastern country other than Israel and Jordan now more free and democratic than Iraq is now?
Given the huge pressures on the NHS, surely it makes sense to try to tackle behaviour which adds, unnecessarily, to that pressure. Namely:
a) people visiting their GPs when it really isn't necessary. b) people attending A&E when it really isn't necessary.
These are both very difficult to solve, without risking turning people away when they actually do need to be seen. But if phone consultations with GPs can reduce some of the pressure on a), that's all to the good. Similarly on b), more efficient ways of rapidly diagnosing whether a visit to A&E justifies joining the queue would be useful. The problem is, of course, that as soon as somebody is mistakenly turned away, the press would have a field day.
One problem is that of long-term-treatable conditions.
More and more conditions can be treated. The patient takes x pills a week. They can then live their life without much apparent difficulty (in many cases).
A couple of relatives have such conditions. Their health requires monitoring because of the powerful medications. So, every couple of months, they get blood tests etc. Then go to the GP, who smiles, and says that this iso put of her knowledge and sends them on to their usual consultant.
The appointment with the GP adds nothing.
What they really need is a permanent booking in the diary of the consultant in question, once every x months.
EDIT: A&E is often used as a substitute for seeing a GP, since GPs don't generally work weekends, or out of working hours. In experiments where they triaged the A&E queues to see (in effect) GPs in the hospital, much of the A&E queue moved that way.
A friend who is a GP said that there was a system during the pandemic (doctors correct/enlighten me) whereby if someone registered online they could see a GP at 24-hrs notice. This was playing havoc with their weekends as people would do it throughout. They then turned this facility off at the weekends and, as many peoples' symptoms had disappeared by Monday, they saw a vastly reduced number of applications vs previously.
A lot of those people will be back to going to A&E...
We have made use of drop in GP clinics in recent times. These are a good alternative, to be available alongside the normal GP's.
I think one of the issues we have at the moment is the perception that GP's are hard to see, or get to. Many surgeries that wont be an issue. My parents surgery, based in a village, is easy to get same day appointments. My surgery, a medium sized town, getting a physical GP appointment has been hard for many years, with typical offerings of 5 weeks in the future. However they have worked hard on other provision, and the e-consult has worked really well for us. People don't really like change, and I don't think GP surgeries have always explained things to their patients that well. As an example I was contact by text in mid August to arrange my flu jab. I was on holiday and missed the allocated 7 days. I assumed I would ne contacted again. Up to last week, nothing, so I rang the surgery, only for the receptionist to be faintly rude, and say there is no news as they have no flu vaccine. Why not put that on the web-page then? Patients also do not like receptionists conducting triage for patients. I think at least a nurse would be better than a nosy. middle-aged gossip who you might bump into in Waitrose. (Last bit was a JOKE, but only just...)
A lot of GPs make appointments very hard to get. 5 weeks in the future is ridiculous. Expecting people to repeat speed dial at exactly 8am to get one of 2 appointments reserved to be open that day.....
No wonder people just go to A&E....
It is interesting that the experiences of people around the country are so different. I know of one case in Grantham last year where a stomach cancer patient who had been in remission and started to get symptoms again could not get an appointment with the GP and by the time things were so bad they went to A&E it was too late and they died. Another of my closest friend who became seriously ill after an infection in his leg and was unable to get an appointment so ended up in hospital where they thankfully managed to save his leg. And yet at the same time the country surgeries which are using the Ask My GP app are doing so in such a way that if need be you can get an appointment within a couple of hours. They have assigned a doctor to do online triage but with the expectation of offering face to face visits if either the Doctor or the patient request it and it is meaning they can effectively deal with a much higher workload and those who do need to be seen get a much quicker response.
The problem to me seems to be with those GPs who, for whatever reason, simply don't want to do face to face at all anymore. If that is their attitude then they should find another job.
Say farewell to GPs then.
The reality is we don't have enough GPs and those that are qualified to do it don't need the money anymore.,
Not sure that would be a bad thing. Looking at other countries they don't have the gatekeeper function that GPs enact in the NHS. At least no where near to the same extent. In Poland for example you book directly with a specialist in the area you have an issue. If they think there is another issue they will refer you on.
Eliminate GPs and have triage in hospitals seems a better solution for a lot of people.
That people need a GP referral for chronic conditions especially is utterly absurd. It is pure makework.
How much of this is the Lansley legacy ?
If that's not rhetorical, 'quite a bit', I think. May have been standard procedure before, but the Lansley reforms really set in stone the GP as the gatekeeper.
Our daughter has some long term medication (not a severe condition - facial haemangioma). We're lucky that, being paediatrics, we do have some direct access to the paediatric consultant. But the prescription, although originating in secondary care, is managed in primary care. So when the set of repeat prescriptions comes to an end, we have to make a phone appointment with the GP, which is basically along the lines of: GP: Did the consultant say to continue? Us: Yes GP: Same dose? Us: Yes GP: Ok, I'll put that through then Complete waste of time, ours and the GP's
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
This is just a lie. Iraq is not currently a free democratic state. It is an unfree autocracy.
Wrong. Apart from Jordan and Israel, Iraq is now the most democratic and free nation in the Middle East with an elected President and elected Parliament
Under Saddam it was led by the most brutal dictator in the Middle East.
Banging my head against a brick wall with bet365's customer service team. Trying to establish the settlement rules for Top Male and Top Female for Strictly. First reply was rubbish.
"This market is for the win only meaning that who you pick, either a male participant or a female participant would have to come first in order for the bet to win. This would mean that reaching the final wouldn't class the bet as a win or a loss at this stage. bets will settle on the overall winner of the competition".
Second reply, from a different agent, is clearer but still rubbish.
"If a male participant goes on to win Strictly Come Dancing, then there would be no Top Woman and bets on this market would be settled as a loss".
Think there could be some value around but just want confirmation on rules but these guys are clueless. If the bets settle on the overall winner there is no need for top male or top female markets with much shorter prices than the outright FFS.
That bet is completely useless as I cannot remember any time when the order of the finalists who didn't win have been announced even after the show.
At best you would get a winner in a single market prior to the final as all other males / female are knocked out and if the actually winner is a person of the opposite sex than both markets would be settled but otherwise not a chance.
Given that the evidence is growing that mixing-and-matching vaccines produces better immune response than being homogeneous, is HMG being more... flexible... with their booster shot guidance?
It's all Pfizer I thought, despite the rhetoric Az is basically persona non gratia in developed countries now
And I really wouldn't overlook the entire dislike of getting jabbed by a needle element. It sounds childish, but everyone's got a childish part of their brain. And will rationalise away anything they don't like.
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
This is just a lie. Iraq is not currently a free democratic state. It is an unfree autocracy.
Apart from Jordan and Israel Iraq is now the most democratic and free nation in the Middle East.
Under Saddam it was led by the most brutal dictator in the Middle East.
So my comment stands absolutely
Iraq is now a free and democratic state {factcheck: The Economist's Democracy Index classes it as "Authoritarian"} certainly compared to most of the Middle East {factcheck: true}
Your comment was both false and true.
Nope my comment was both valid and completely true.
Iraq's President and Parliament are elected in democratic elections with multiple party candidates and it is far more free than under Saddam. Name me one other Middle Eastern country other than Israel and Jordan now more free and democratic than Iraq is now?
Banging my head against a brick wall with bet365's customer service team. Trying to establish the settlement rules for Top Male and Top Female for Strictly. First reply was rubbish.
"This market is for the win only meaning that who you pick, either a male participant or a female participant would have to come first in order for the bet to win. This would mean that reaching the final wouldn't class the bet as a win or a loss at this stage. bets will settle on the overall winner of the competition".
Second reply, from a different agent, is clearer but still rubbish.
"If a male participant goes on to win Strictly Come Dancing, then there would be no Top Woman and bets on this market would be settled as a loss".
Think there could be some value around but just want confirmation on rules but these guys are clueless. If the bets settle on the overall winner there is no need for top male or top female markets with much shorter prices than the outright FFS.
Thanks. You just reminded me I had a few quid on Strictly a while back and then forgot about it. I rarely bother watching. Just did a partial cash out so I am all green.
There's a German documentary going to air tonight that criticises the Tesla project in Brandenburg for its environmental impact and alleges that the subsidies are against EU rules.
Many people suggested, at the time, that Tesla selecting Germany was an... interesting idea, since the German car companies are seen as part of the state.
Allowing Tesla into the German industrial scene would be directly against their interests and those of their political backers.
Berlin was selected partially because it makes it easy for Tesla to poach talent from Porsche and BMW at Leipzig.
A very sensible strategy
Which relies on the German federal and state government being fine with market share being potentially taken from the existing German companies.
Or they could put a few sharp stones in Elon's shoes.
... and Tory Bruno invites Elon for factory tours at ULA.
Doesn't mean that ULA isn't spending a lot of money in Washington to slow SpaceX down....
I think the VW/Tesla relationship is quite warm. "A recent report from Business Insider Germany asserts that former BMW exec, and current Volkswagen Group boss Herbert Diess was offered the Tesla CEO position in 2015. The offer was reportedly extended by none other than the Tesla CEO himself, Elon Musk."
Or is this driven by what happened to them in Scotland?
No, they are pro the Union.
Once Scotland leave and Ireland is reunited the independence train in Wales will start rolling, and Labour here too, will be left at the station.
I guess there's an important difference between Labour and Lafur? Drakeford seems pleasantly rational on the issue which may be the product of Plaid not being much of a threat at the moment? Though SLab were pretty anti SNP even before they were reduced to third party status (they're off the SNPbad scale now).
FPT
All 3 of Rhodri Morgan, Carwyn Jones & Mark Drakeford were/are fluent Welsh speakers.
I think Drakeford said he considered joining Plaid Cymru as a young man, before settling on Llafur. So, Drakeford is popular with many Plaid Cymru voters.
I suspect Drakeford prefers Wales to be in the UK -- but not in a UK run by Johnson or with endless Tory Govts in Westminster.
Drakeford has surprised me (and others) on the upside. He looks like a bumbling, incompetent academic, but he has a set of skills and attributes that has proved electorally successful in Wales.
In fact, I prefer Drakeford to any of his likely successors -- he is standing down as leader of Llafur before the next Senedd elections.
Be interesting to see what happens next to Llafur. Incompetent, half-assed leadership is certainly one of the things that killed SLAB, and that Llafur have so far avoided.
Wales also voted for Brexit, just like England and its 2 main parties are Labour and the Conservatives, just like England.
Nationalism in Wales is just confined to mainly a few Welsh speaking areas on the West coast and in the NorthWest and Anglesey and parts of the Rhondda.
Hence Labour can easily ignore Plaid
Off topic
Things change HY.
I am a staunch supporter of the Union of England, Wales and Scotland. Less so NI. However, if Scotland leave, then what's the point of the "Union" of England and Wales?
Wales are completely ill-equipped for independence, and it is as yet not a popular option, but if Scotland jump ship, so what? I'd give it a whirl. I also think should independence occur the political dynamics of Wales will change. I suspect the Conservatives will hold on as the main opposition group, who will occasionally take power in a rainbow coalition when the left are unpopular, but I am not sure about the centre-left parties including Labour, they might be all subsumed into some centrist porridge that will need to do deals with the Greens and the SWP from time to time.
Meanwhile in England you have Sine Die Boris Johnson Governments. What is there for you not to like?
Scotland won't be leaving anytime soon, No still leads most polls and this government will continue to refuse indyref2 anyway.
However if there was an indyref2 granted under say a Labour minority government in the next 10 years and Scotland voted Yes then obviously in the short term Labour would try and keep Wales otherwise it would be completely screwed in England alone under anything other than a Blairite leader yes.
However in the longer term as I said as young Welsh continue to move to English cities and Tory voting English retirees continue to move to Wales then the already Brexit voting Wales will become indistinguishable from England in its political culture
That's not going to happen.
Johnson has captured the zeitgeist. Not my zeitgeist, but seemingly everyone elses!
Johnson is very English- centric, this is grating in Scotland as we speak and it will become so in Wales. Johnson will eventually have to capitulate to a second IndyRef, and the longer that goes on, the more chance he has of losing Scotland.
Johnson's populism does play well in aspirational working class Wales as it does in the Midlands and Northern England, but I feel, and I maybe wrong, that is tempered by a distrust of English toffs. As we speak Johnson is a working class hero in Wales, but at some point he may become characterised as an English absentee landlord.
Lol at the SNP Types 100pc masked up in the House of Commons. You'd have thought that they'd be able to know their location by some sort of smart phone app.
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
This is just a lie. Iraq is not currently a free democratic state. It is an unfree autocracy.
Wrong. Apart from Jordan and Israel, Iraq is now the most democratic and free nation in the Middle East with an elected President and elected Parliament
Under Saddam it was led by the most brutal dictator in the Middle East.
Comments
The virus was over as something to be hysterical about back in June. Well it was over months before then actually.
How is predicting a new wave that doesn't happen any better than being sceptical about a new wave that does happen?
The Philippine military was trying a half arsed coup against democracy. The Philippine government requested that the American airforce based in the Philippines, should shoot down some Philippine airforce jets that were about to take off.
Colin Powell realised that if that was done, the coup supporters would play the "American Colonialists" line and maybe get more support.
So he ordered that the American fighter jets should make low passes overt the airfield in question.
The rebels pilots refused to take off, and the coup collapsed. The rebel pilots were lambasted as cowards - by their own side.....
https://www.youtube.com/watch?v=wBKuDAcONDQ
Shadsy aka Matthew Shaddick is the former Ladbrokes and now Smarkets political betting big cheese.
But the crucial sentence is this:
"You'll only be able to book an appointment for a booster dose if it's been at least 6 months (182 days) since your 2nd dose of the vaccine."
- which means only those who had had their second jabs before 18th April can have them. Which is not that many people, surely?
To be honest, I've been astonished how well this has all worked given the state of NHS data systems.
Covid Deaths 1st of October: 123
No meaningful rise etc.
As with the teenager jabs (Schoolchildinromford has got a date now, but at the end of November), it all seems remarkably casual. A bit of mild panic would be helpful.
If there were meaningful exponential growth we'd be talking thousands etc. Instead its just background noise that we may have to live with forever. Time to stop counting or testing beyond any other virus or disease.
In a democracy, the disconnect between what people are told by the media and politicians, and what people actually know to be true, must eventually find a political expression. Trump and Brexit are not going to be aberrations, I think there is going to be much darker stuff around the corner.
But I don't think anything less is being done to publicise/encourage. I think we are generally less interested. I was pleased to get the vaccination as a protection against dying, but more pleased because as we progressed down the ages we were rapidly bringing forward the day when all this would be over. Now all this IS over, the level of attention given to how the process progresses is just much less. It's not the number one thing on people's minds any more.
Will I get a booster? Yes, of course. But I'm not chomping at the bit to get it in the way that I was last time around. My antibodies may be fading, but they're not nonexistent like they were last time. Plus, I've had covid now, which itself acts as something of a booster.
You are airily appealing to complexities without giving any reason, with a dose of insult thrown in.
Give your reasons or say nothing.
@vonderleyen
Team (Flag of European Union) is delivering with #EUGreenDeal
But to meet our goals & save our planet we need the whole Earth globe europe-africa to deliver at #COP26.
We are all in the first team. We can all make a difference.
#EveryTrickCounts
@EU_Commission
@UEFA
Mega Green UEFA, sponsored by Gazprom 2012-2024
https://www.uefa.com/insideuefa/news/0269-124ffe0cee51-2308c1da4764-1000--gazprom-partners-with-uefa-national-team-football-and-renews-ue/
ETA though I'm not keen on the term Islamic Fundamentalism and prefer to talk of Islamist terrorism. The F-word can be misleading in this context.
https://twitter.com/DasErste/status/1450074616022683655
That people need a GP referral for chronic conditions especially is utterly absurd. It is pure makework.
Speaking of which….. laters 🍻
Allowing Tesla into the German industrial scene would be directly against their interests and those of their political backers.
Which is one of the reasons China is likely to be a far more formidable adversary than ever was the USSR.
Should Europe say to Gazprom we don’t want to buy from them anymore ?
Tesla need only point to the scads of money going to subsidise rival battery factories, I think.
What market there is exists between the CCGs and healthcare providers (and has to some extent been bypassed by Covid emergency measures.
The actual consumer brings only per capita funding.
Or they could put a few sharp stones in Elon's shoes.
It's the drop in the ages 20-40 that drives Lilco's stat. Which has been profound.
But cases in every single age group over 40 are at the July peak level and on a constantly upwards trajectory. And these age groups account for nearly 80% of the hospitalisations recently.
We would he miss out those important facts?
Not an unreasonable view, if you ask me.
EDIT: just checked and the online service is nationwide (possibly also while you're overseas if you have an NHS number) but the face to face clinics for follow up are only in London and Birmingham.
Now that's been done, slow rolling the permits for the factory is in the interest of all the other car makers and their political allies. Which is a lot of power, in Germany.
Bloomberg UK
@BloombergUK
·
3m
EXCLUSIVE: U.K. Prime Minister Boris Johnson talks to
@BloombergTV
.
Watch tonight, from 11 p.m. London time: https://trib.al/KHizVaM
https://twitter.com/BloombergUK/status/1450093618342076430?s=20
Laura Kuenssberg
@bbclaurak
·
2m
Commons was absolutely packed for the moment's silence - full tributes to Sir David will start at 3.30
In some ways it is an ideal situation for them. Tesla have made their investment and can't produce cars.
"Most people will be offered a booster dose of the Pfizer/BioNTech vaccine or Moderna vaccine.
This means your booster dose may be different from the vaccines you had for your 1st and 2nd doses.
Some people may be offered a booster dose of the Oxford/AstraZeneca vaccine if they cannot have the Pfizer/BioNTech or Moderna vaccine."
From: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-booster-vaccine/
Now we are so used to vaccines we tend to forget what an amazing and by no means inevitable achievement it was for the industry to manage what it did in such a short space of time.
Things seem to be slowing down a bit now though, don't they? Where is the updated plug-and-play mRNA or vector vaccine for the Delta variant, or even for the old Beta one? I thought Moderna in particularly would be straight out of the blocks with a Delta-beating jab. Where are the nasal sprays which AZ were trialling, which were hoped to be more effective than injections? Perhaps these are all still in the pipeline, but - aside from the Valneva news this morning - it's all been rather quiet recently.
Doesn't mean that ULA isn't spending a lot of money in Washington to slow SpaceX down....
I guess not using AZ will mean that there could be supply and demand issues when it comes to securing supply of the other vaccines. The data from PHE suggests Pfizer and Moderna are better against Delta.
That's what is causing breakthrough infections - not your immune system not recognising the variant.
The extent to which your immune system is primed therefore becomes the key determinant of whether there is a breakthrough infection. And the best priming appears to be either:
- Moderna (where the doses of vaccine were more than twice Pfizer's)
- mix and match (particularly AZ followed by an mRNA vaccine)
- infection plus a vaccine
- booster shots
We might also get to add nasally administered vaccines in the fullness of time.
Things change HY.
I am a staunch supporter of the Union of England, Wales and Scotland. Less so NI. However, if Scotland leave, then what's the point of the "Union" of England and Wales?
Wales are completely ill-equipped for independence, and it is as yet not a popular option, but if Scotland jump ship, so what? I'd give it a whirl. I also think should independence occur the political dynamics of Wales will change. I suspect the Conservatives will hold on as the main opposition group, who will occasionally take power in a rainbow coalition when the left are unpopular, but I am not sure about the centre-left parties including Labour, they might be all subsumed into some centrist porridge that will need to do deals with the Greens and the SWP from time to time.
Meanwhile in England you have Sine Die Boris Johnson Governments. What is there for you not to like?
Under Saddam it was led by the most brutal dictator in the Middle East.
So my comment stands absolutely
Edit to add: the remaining permit is from the Brandenburg Ministry of the Environment, and they've been pretty forthright in their support for the project so far. It's also worth remembering that the last serious legal challenge against the project was rejected about six weeks ago.
From reading some recent articles it seems like these companies and their research teams are thinking bigger picture stuff at the moment, so whilst I have no doubt development is ongoing for even better vaccines against Covid, it's not their sole focus.
They are talking about vaccines and in particular mRNA vaccines for example against AIDS and Cancers. Oxford/Astrazeneca is also focusing on vaccines for Nipah and Mers (both bat borne viruses that have made the leap to humans and make Covid look tame).
The lasting legacy of Covid might be huge strides in other scientific and medical advancements in protecting and treating against other diseases.
The red line is the one we must be most worried about in terms of hospitalisations and especially deaths. 80% of hospitalisations come from that line.
The green line is indeed the one fuelling most of the cases and gives only a small contribution to hospitalisations. And it's true that if you add and correctly weight the blue and red lines together, they'll be pretty level overall, which was Lilco's factoid, but it's disingenuous to then claim "hey, what are you worrying about?"
What we're worrying about is the red line climbing rapidly and above the highest point it's been since January.
"This market is for the win only meaning that who you pick, either a male participant or a female participant would have to come first in order for the bet to win. This would mean that reaching the final wouldn't class the bet as a win or a loss at this stage. bets will settle on the overall winner of the competition".
Second reply, from a different agent, is clearer but still rubbish.
"If a male participant goes on to win Strictly Come Dancing, then there would be no Top Woman and bets on this market would be settled as a loss".
Think there could be some value around but just want confirmation on rules but these guys are clueless. If the bets settle on the overall winner there is no need for top male or top female markets with much shorter prices than the outright FFS.
I know **** all about cars, but this explanation seems implausible, and therefore is perhaps true. Essentially with this garage (indeed with every garage) it feels like they are just making it up as I go along.
tips on what to look out for when I test-drive whatever the hell they've done tomorrow?
I've got a hypothesis that when you tie in the natural "ow, I don't like needles; I'm inclined to find any way to rationalise not getting jabbed" with the "injecting something by a needle is a very intrusive way of administering anything; must be really significant and potentially dangerous" mindsets, you're primed for finding a significant number of people getting hesitant.
People will take a pill very casually, drink a fluid slightly less casually, take a nasal spray a bit less casually, and accept an injection far far less casually than any of these. Even though pills can very easily be the most dangerous route for any of this.
But we all can get pills for this, that, or the other really easily at home, whilst injecting something is to do with hospitals and doctors and surgeries and... you get the drift.
And I really wouldn't overlook the entire dislike of getting jabbed by a needle element. It sounds childish, but everyone's got a childish part of their brain. And will rationalise away anything they don't like.
However if there was an indyref2 granted under say a Labour minority government in the next 10 years and Scotland voted Yes then obviously in the short term Labour would try and keep Wales otherwise it would be completely screwed in England alone under anything other than a Blairite leader yes.
However in the longer term as I said as young Welsh continue to move to English cities and Tory voting English retirees continue to move to Wales then the already Brexit voting Wales will become indistinguishable from England in its political culture
https://freedomhouse.org/countries/freedom-world/scores
https://freedomhouse.org/country/iraq/freedom-world/2021
https://freedomhouse.org/explore-the-map?type=fiw&year=2021
Iraq's President and Parliament are elected in democratic elections with multiple party candidates and it is far more free than under Saddam. Name me one other Middle Eastern country other than Israel and Jordan now more free and democratic than Iraq is now?
Our daughter has some long term medication (not a severe condition - facial haemangioma). We're lucky that, being paediatrics, we do have some direct access to the paediatric consultant. But the prescription, although originating in secondary care, is managed in primary care. So when the set of repeat prescriptions comes to an end, we have to make a phone appointment with the GP, which is basically along the lines of:
GP: Did the consultant say to continue?
Us: Yes
GP: Same dose?
Us: Yes
GP: Ok, I'll put that through then
Complete waste of time, ours and the GP's
At best you would get a winner in a single market prior to the final as all other males / female are knocked out and if the actually winner is a person of the opposite sex than both markets would be settled but otherwise not a chance.
Go Rose though.
"A recent report from Business Insider Germany asserts that former BMW exec, and current Volkswagen Group boss Herbert Diess was offered the Tesla CEO position in 2015. The offer was reportedly extended by none other than the Tesla CEO himself, Elon Musk."
Johnson has captured the zeitgeist. Not my zeitgeist, but seemingly everyone elses!
Johnson is very English- centric, this is grating in Scotland as we speak and it will become so in Wales. Johnson will eventually have to capitulate to a second IndyRef, and the longer that goes on, the more chance he has of losing Scotland.
Johnson's populism does play well in aspirational working class Wales as it does in the Midlands and Northern England, but I feel, and I maybe wrong, that is tempered by a distrust of English toffs. As we speak Johnson is a working class hero in Wales, but at some point he may become characterised as an English absentee landlord.
Lol at the SNP Types 100pc masked up in the House of Commons. You'd have thought that they'd be able to know their location by some sort of smart phone app.
Globally, Freedom House say:
"2020 was the 15th consecutive year of decline in global freedom."