There's a dickens quote: “Annual income twenty pounds, annual expenditure nineteen nineteen and six , result happiness. Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery”
This logic applies to queues. If you can process 200 people/hour and you get 195, great, if you get 205, then each hour 5 are added to the queue. if you have even slightly less resources than necessary to keep ahead of incoming requests, as a long run average, then how bad it can get (how long the waiting time) is unbounded. This is particularly noticeable in computing, because computers don't change their behavior unless told to, even if everything is going to shit.
The NHS doesn't quite match this theory, because in the theoretical model nothing leaves the queue until it's served, whereas people in the A&E queue can die. But yes, it can and will get worse than this. You can save some people from the wait by triaging harder, but that means the severity level at which people are not treated urgently is increased. It sounds like it's already much higher than anyone would wish - especially as the waiting time for non-urgent care is also upwards of 6 months and increasing in many cases.
We need to boost social care to get people out of hospitals into a cheaper and more appropriate setting. We need to use the resources released in hospital to get people out of A&E much more quickly. We need to ensure that highly trained paramedics do not spend half their shift, or more, sitting in a hospital carpark waiting to offload a patient whilst people who need their care die whilst waiting. We need to focus on early detection for better and cheaper outcomes. We need to emphasise that people can affect their own health by losing weight, drinking less, exercising more, etc and that they cannot expect the NHS to pick up the consequences of the failure to do this.
Others, such as the sums wasted on administration and internal cost allocation, are much more difficult but they are burning resource that we need and that is not acceptable.
On the first bolded point, this has been obvious for so long you have to wonder why we aren't seeing progress on it. What going wrong here? Is it simple want of money in the right budget? Some organisational failure? Cost of housing making it hard to increase supply of nursing house spaces?
On the second bolded point, there is an interesting article by PB's bete noire Devi Sridar in the Grauniad yesterday on at least half that point. It includes this simple, and perhaps obvious sentence: "If you add physical activity to a balanced diet, sleep and friends, that is a recipe for good physical and mental health."
If you were to put that sentence at the centre of government policy I wonder what changed priorities it might imply? What might government be able to do that doesn't cost £bns, but that would make it easier for people to live their lives in such a way?
One of the manifestations of the Housing Theory of Everything.
We don't build family-sized homes within towns and cities unless the Prince of Wales is involved. So people have to drive to work, so you need to reserve lots of space for cars. So people end up driving everywhere; partly because they have two cars already but also because local facilities are spread out by the need for car space. So they end up poorer, fatter and sadder.
We need to boost social care to get people out of hospitals into a cheaper and more appropriate setting. We need to use the resources released in hospital to get people out of A&E much more quickly. We need to ensure that highly trained paramedics do not spend half their shift, or more, sitting in a hospital carpark waiting to offload a patient whilst people who need their care die whilst waiting. We need to focus on early detection for better and cheaper outcomes. We need to emphasise that people can affect their own health by losing weight, drinking less, exercising more, etc and that they cannot expect the NHS to pick up the consequences of the failure to do this.
Others, such as the sums wasted on administration and internal cost allocation, are much more difficult but they are burning resource that we need and that is not acceptable.
Agree with most of these, although healthcare is undermanaged in the UK, not overmanaged.
Also: Healthcare is underfunded by about 20% compared with comparator European countries and this does show up in health outcomes. I don't think it's a case of increasing spending by 20% across the board and it will be fine. There are certain areas that are woefully underfunded, particularly capital expenditure on equipment, automated testing and so on.
Nurses' salaries need looking at. If we are to take a genuine market approach on this, they would be getting a lot more. Their jobs have changed in the last few decades and taking a lot more responsibility for clinical management but their career structure hasn't updated to reflect this.
Also need more focus on primary care. Every expert has been banging on about this years. As part of that prioritisation we probably need to close a few hospitals - difficult conversation with the public on this that politicians have no intention of having.
But what should they get. The average package for a nurse outside of London is £50k although they only get paid £35K.
Not an expert, but understand nurses' salaries are not bad at graduation, but there is little career progression. Hence low retention rates. Also there's a tight somewhat international market for nurses. You are not going get many if you consistently underpay.
Firstly: why these numbers? Who settled on these suspiciously round numbers as the right level for a target? Are these numbers based on clinical need or cost? What treatment fields are the priority? Are there enough positions in training facilities and universities to train this number? If not, how do you propose to address this?
How much is the non-dom tax leak? What are the sources for this number? What is the NAO and HMRC view? What are the tax losses for scrapping the non-dom status for overseas citizens? Is there even a net gain to the exchequer from doing this?
Glib slogans backed by thin cheer pieces from a biased media is the kind of garbage that got us into the Tory mess.
Why would it be different from Labour?
Our problems are not just with the particular party of government, bad, thought the current bunch truly, truly are, we have a problem with our whole system.
The last Labour government did, of course, deliver a tangible improvement in NHS services. In stark contrast to the current mob.
The inference you are drawing there, however, is that it will only take a change in administration and that happy state will subsequently be restored.
I think even you'd concede that's not true. The massive increase in funding for public services, and maintenance of Thatcher-era low taxes, was funded from 1997 through to 2007 in very benign economic conditions, and off the back of an asset boom.
We are now not in that world so, say, if Labour does want to increase spending on the NHS by, say, £30-£40bn a year in real-terms to make a material difference, how will it pay for it in stagnant economic conditions? And in a world where we also need to up defence spending, invest more in education, science and industry, and maintain the welfare safety net?
To govern is to choose.
We are well past the point where restricting NHS pay is saving us money, it is costing us money.
Big increases in agency pay, which will get exponentially worse as more leave and morale drops amongst the permanents - this is a vicious circle that needs to be avoided. Loss of experienced staff creates inefficiencies that require more staff to do the same work Increase in training costs to replace those leaving Millions off sick unable to work and pay tax instead receiving welfare whilst waiting years for operations - such a long gap will see a proportion of those needlessly economically inactive ongoing Crumbling UK infrastructure in health, travel and education will see investment across our economy well below where it could have been
This is not being done to save money, but out of ideological belief that public sector pay needs to be tightly restrained. Which to be fair, it normally does, but now is absolutely the wrong time to be doing it.
Again, I ask the question: how will you pay for it?
I'm not sure you're arguing it's self-funding I strongly disagree - most users of the NHS are the old and chronically unwell; it's about as self-funding as Liz Truss's tax cuts.
Again, I ask the question: how will you pay for the cost of not paying for it?
The cost of waiting lists is a workforce where millions are long term sick, or suffering chronic pain. Low productivity is a big problem with a big cost. Then we have the economic cost of people working full time and having not enough money to pay their bills never mind consume. That costs jobs, which cuts consumption which costs more jobs.
You cannot rationally say "how will you pay for it" - not paying for it also has a cost.
The truth is, as the population ages, we are all going to be a lot poorer.
Two main options as far as I see:
1) Use the resource in the housing stock to fund the investment required in social care. Clearly the Conservative Party does not want to upset the voting bloc who owns it. Therefore Labour must.
2) Place more emphasis on the traditional safety net undertaken primarily by the wider family unit. Unfortunately we have an incredibly atomised society = not possible. Therefore the social safety net for us all is, compared to say Japan, considerably more expensive.
I think your second point is hugely important. One of the great failings of our post war society mostly unrelated to politics or any particular ideology has been the growth in the practice of shoving the care of ones parents and grandparents off onto someone else - whether it is the state or private providers. Or indeed of just leaving them to fend for themselves unaided.
Clearly there is a growing number for whom family help is not practical because of conditions such as dementia or because the children are no longer around themselves or never existed and in those cases I fully understand and support the use of the state or private provision to look after them. But as a society we seem to have accepted that it is now okay to simply cast ones elderly relatives adrift or get others - primarily the state - to look after them so we can get on with our own lives and not suffer the inconvenience of having them around. It is not something that I can find it in my heart to agree with all the more so when those younger generations then complain about the costs involved.
To butcher the old advert, parents are for life, not just for Christmas presents.
This is something that is really cutting through to people. A major topic of conversation at local U3A meetings, book groups, coffee mornings etc. is how it is nearly impossible to get through to local surgeries. If by some fluke you do, you'll be lucky to get a phone consultation with a nurse. Forget seeing a doctor. A couple of months ago a friend's 80 year old ex-husband fell and hit his head. He phoned 999. When the ambulance arrived 13 hours later, he was dead These are not scare stories. People are worried it could be them or a loved one next.
GPs are often migrating to eConsult forms. We have used this and it has worked well for us, with good access to doctors when needed. It's not always obvious the best way to get help, but the model of ringing the surgery seems broken everywhere .
Just before Christmas you couldn't even get through to our local surgery on e-consult. Even early in the morning it said no appointments available.
This is something that could be solved tomorrow by an early application of AI
The machines are getting REALLY good at diagnosis. In some ways they are already better than human doctors
“Algorithm That Detects Sepsis Cut Deaths by Nearly 20 Percent
Over two years, a machine-learning program warned thousands of health care providers about patients at high risk of sepsis, allowing them to begin treatments nearly two hours sooner”
“doctors 🩺+ AI🤖 = 🤯
NEW state of the art AI scores 67% (up from 50%) and surely will improve to head to 90%+ in relevant + accurate answers for medical diagnosis + recommendations.
Full paper: (via DeepMind + Google Research teams) arxiv.org/pdf/2212.13138…”
An AI GP will be available 24/7; it could see 4m patients every 9 minutes. This technology is available NOW and will only get better
Of course there will be many cases requiring physical inspection, they can be handed on to human docs but anyone requiring an e-consult could be sorted right now. Why aren’t we doing it?
Lethargy, inertia and incompetence.
Yes, and @LostPassword posted a similar interesting message up thread about this too.
I refuse to be pessimistic about this - far too much of that above.
We need to invest in growing the pie and the technologies of the future.
This is something that is really cutting through to people. A major topic of conversation at local U3A meetings, book groups, coffee mornings etc. is how it is nearly impossible to get through to local surgeries. If by some fluke you do, you'll be lucky to get a phone consultation with a nurse. Forget seeing a doctor. A couple of months ago a friend's 80 year old ex-husband fell and hit his head. He phoned 999. When the ambulance arrived 13 hours later, he was dead These are not scare stories. People are worried it could be them or a loved one next.
My brother-in-law collapsed before Xmas - he was in hospital within 30 minutes, and kept in for OBS until the next day. Currently undergoing monitoring for a possible heart condition. This in Sunderland. Anecdotes tell many stories .
So what? Every case should be like that. What weight does a single one which is, carry?
“ EXC: Rishi Sunak has shelved plans for a ‘big bang’ overhaul of the childcare system drafted by Liz Truss
Truss was looking at an extra 20hrs of free childcare + scrapping staff-child ratios. Due to be revealed pre Xmas
But reforms delayed + scaled back”
I genuinely don’t see why the conservatives are bothering being in power any longer. Would have been one of those sensible policies for parents locked out of work via childcare costs. A mystery why people aren’t having children..
Sunak comes across as a caretaker PM. Truly terrified of taking any sort of bold action on anything
Sunak is the Invisible Man.
Overall we are seeing what happens when for a year we have chaotic, incompetent government obsessed by court politics and infighting. There is no overall strategy of government, just unstable lurches from one direction to another.
The government had taken its eye off the ball on health, with no plan for the current situation, ignored the energy price crisis until it got whacked in the face by it in October, and even now has no thought on the problems in education, criminal justice, Social Care, Northern Ireland etc etc
It is a Zombie government stumbling through a minefield.
Ministers could have had their eye on the ball in all those departments. They could have been doing an impeccable job for all we know. None of them was allowed to do it because they've been moved, repeatedly, for purely internal Party reasons. That is a major part of why we are here. And that is unforgivable Tory self-indulgence. Regardless of any other contributory factors at play.
Nick Gibb's been in post for most of the last twelve years and his eye's not so much been off the ball as examining an entire different game.
We need to boost social care to get people out of hospitals into a cheaper and more appropriate setting. We need to use the resources released in hospital to get people out of A&E much more quickly. We need to ensure that highly trained paramedics do not spend half their shift, or more, sitting in a hospital carpark waiting to offload a patient whilst people who need their care die whilst waiting. We need to focus on early detection for better and cheaper outcomes. We need to emphasise that people can affect their own health by losing weight, drinking less, exercising more, etc and that they cannot expect the NHS to pick up the consequences of the failure to do this.
Others, such as the sums wasted on administration and internal cost allocation, are much more difficult but they are burning resource that we need and that is not acceptable.
Agree with most of these, although healthcare is undermanaged in the UK, not overmanaged.
Also: Healthcare is underfunded by about 20% compared with comparator European countries and this does show up in health outcomes. I don't think it's a case of increasing spending by 20% across the board and it will be fine. There are certain areas that are woefully underfunded, particularly capital expenditure on equipment, automated testing and so on.
Nurses' salaries need looking at. If we are to take a genuine market approach on this, they would be getting a lot more. Their jobs have changed in the last few decades and taking a lot more responsibility for clinical management but their career structure hasn't updated to reflect this.
Also need more focus on primary care. Every expert has been banging on about this years. As part of that prioritisation we probably need to close a few hospitals - difficult conversation with the public on this that politicians have no intention of having.
The charts I have seen of late suggest that we are now moving up to the EU average on health care. I don't think that your 20% is correct. Otherwise I agree.
It depends on how you measure it, % of GDP, PPP, actual money spent, whether you include out of pocket expenses and so on. These figures are from 2018; another calculation in the same report reduces the gap to about 15%. As I say I don't think the UK systems are underfunded across the board. They are very underfunded in certain critical areas.
Per capita spending on healthcare almost has to be lower in the UK than in many other European countries, because our per capita GDP is also lower. You can't spend what you don't earn.
Up to a point, yes.
One root cause of the NHS woes was Osborne's austerity policy - a policy choice other countries didn't make - which directly led to a worse healthcare system and indirectly to a relatively poorer country with less money to spend. Also whether you spend more money on healthcare and less on other things is neutral to your GDP.
Finally if you spend more money on your healthcare in general you should get better outcomes. France and Germany may be richer than the UK due to Conservative government economic and Brexit policies, it wouldn't change the facts of their healthcare services being better in that case.
The NHS was the one government department explicitly protected from austerity; it's just that wasn't enough.
It needs large increases each and every year to run to stand still.
In the end we will need far fewer doctors. Machines will do it all - and do it better
This NHS crisis is yet another debate which is happening in a vacuum. As if AI isn’t around the corner. But it is
“#PLOSDigitalHealth: Predicting dementia from spontaneous speech using ChatGPT”
“AI technology triples stroke recovery”
“The world's first #AI cancer diagnosis robot, developed by an #OVC company, will provide free cervical cancer screening for 10,000 women in Pakistan.🔬🤖
The robot has performed detection for over 10 million women in China and #BRI countries, and has saved 60,000+ lives.💪”
“Testing out @OpenAI to see how #ChatGPT handles writing up dictated GP consults. Only a matter of time before we have strong AI assisting us in practice. Could also ask it questions about differential diagnosis, treatment and safety netting - try it!”
Prediction algorithms will help with certain diagnoses long-term but unlikely to reduce the number of doctors, certainly not nurses or carers.
How will the AI wipe your bottom or change your sheets?
Delusional. Of course they will replace doctors. AI will revolutionise health care; from robot surgeons to ChatGPs (see what I did there). Anyone with a brainstem can see this is inevitable. I am mystified by those that are apparently incapable of this foresight
Ironically (and this is true across many professions) they will come for the more educated specialist roles FIRST (against expectations). The lower end physical tasks - the bottom wipers - will be the hardest to automate. Perhaps impossible
Imagine your children wiping bottoms forever. That is the future for us all
I have expertise in this field. I'm telling you it will aid with certain things but with many other things it won't.
It's not going to do much to help people falling over and ending up in hospital, people who can't breathe very well as they have Covid or flu or people who are too demented to wipe their own bottoms.
Things in general are not as uniformly amazing or disastrous as you tend to point out. There are bits in between. I understand that's hard to grasp for someone with such a manic personality.
I just put your reply into ChatGP and it says you are idiot
“Artificial intelligence revolutionising NHS stroke care Use of cutting-edge AI technology is associated with a tripling of the number of patients recovering and able to perform daily activities from 16% to 48%.”
“A diagnostic AI that knows when to step in - @MIT_CSAIL's system can look at chest X-rays to diagnose pneumonia, and also knows when to defer to a radiologist.”
This is actually fantastic news. And cause for much needed optimism. So many of our worst and apparently intractable human problems are about to be solved
This is something that is really cutting through to people. A major topic of conversation at local U3A meetings, book groups, coffee mornings etc. is how it is nearly impossible to get through to local surgeries. If by some fluke you do, you'll be lucky to get a phone consultation with a nurse. Forget seeing a doctor. A couple of months ago a friend's 80 year old ex-husband fell and hit his head. He phoned 999. When the ambulance arrived 13 hours later, he was dead These are not scare stories. People are worried it could be them or a loved one next.
GPs are often migrating to eConsult forms. We have used this and it has worked well for us, with good access to doctors when needed. It's not always obvious the best way to get help, but the model of ringing the surgery seems broken everywhere .
Just before Christmas you couldn't even get through to our local surgery on e-consult. Even early in the morning it said no appointments available.
This is something that could be solved tomorrow by an early application of AI
The machines are getting REALLY good at diagnosis. In some ways they are already better than human doctors
“Algorithm That Detects Sepsis Cut Deaths by Nearly 20 Percent
Over two years, a machine-learning program warned thousands of health care providers about patients at high risk of sepsis, allowing them to begin treatments nearly two hours sooner”
“doctors 🩺+ AI🤖 = 🤯
NEW state of the art AI scores 67% (up from 50%) and surely will improve to head to 90%+ in relevant + accurate answers for medical diagnosis + recommendations.
Full paper: (via DeepMind + Google Research teams) arxiv.org/pdf/2212.13138…”
An AI GP will be available 24/7; it could see 4m patients every 9 minutes. This technology is available NOW and will only get better
Of course there will be many cases requiring physical inspection, they can be handed on to human docs but anyone requiring an e-consult could be sorted right now. Why aren’t we doing it?
Lethargy, inertia and incompetence.
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
In the end we will need far fewer doctors. Machines will do it all - and do it better
This NHS crisis is yet another debate which is happening in a vacuum. As if AI isn’t around the corner. But it is
“#PLOSDigitalHealth: Predicting dementia from spontaneous speech using ChatGPT”
“AI technology triples stroke recovery”
“The world's first #AI cancer diagnosis robot, developed by an #OVC company, will provide free cervical cancer screening for 10,000 women in Pakistan.🔬🤖
The robot has performed detection for over 10 million women in China and #BRI countries, and has saved 60,000+ lives.💪”
“Testing out @OpenAI to see how #ChatGPT handles writing up dictated GP consults. Only a matter of time before we have strong AI assisting us in practice. Could also ask it questions about differential diagnosis, treatment and safety netting - try it!”
Prediction algorithms will help with certain diagnoses long-term but unlikely to reduce the number of doctors, certainly not nurses or carers.
How will the AI wipe your bottom or change your sheets?
Delusional. Of course they will replace doctors. AI will revolutionise health care; from robot surgeons to ChatGPs (see what I did there). Anyone with a brainstem can see this is inevitable. I am mystified by those that are apparently incapable of this foresight
Ironically (and this is true across many professions) they will come for the more educated specialist roles FIRST (against expectations). The lower end physical tasks - the bottom wipers - will be the hardest to automate. Perhaps impossible
Imagine your children wiping bottoms forever. That is the future for us all
I have expertise in this field. I'm telling you it will aid with certain things but with many other things it won't.
It's not going to do much to help people falling over and ending up in hospital, people who can't breathe very well as they have Covid or flu or people who are too demented to wipe their own bottoms.
Things in general are not as uniformly amazing or disastrous as you tend to point out. There are bits in between. I understand that's hard to grasp for someone with such a manic personality.
I just put your reply into ChatGP and it says you are idiot
“Artificial intelligence revolutionising NHS stroke care Use of cutting-edge AI technology is associated with a tripling of the number of patients recovering and able to perform daily activities from 16% to 48%.”
“A diagnostic AI that knows when to step in - @MIT_CSAIL's system can look at chest X-rays to diagnose pneumonia, and also knows when to defer to a radiologist.”
This is actually fantastic news. And cause for much needed optimism. So many of our worst and apparently intractable human problems are about to be solved
To me, this graph suggests growing polarisation by age and Brexit partisanship over the issue of "Stay out" vs "Rejoin". Potentially a source of growing political pressures and frictions over time https://twitter.com/UKandEU/status/1609859259822481411
Interesting to see that 20% of Leave voters think we should Rejoin.
Firstly: why these numbers? Who settled on these suspiciously round numbers as the right level for a target? Are these numbers based on clinical need or cost? What treatment fields are the priority? Are there enough positions in training facilities and universities to train this number? If not, how do you propose to address this?
How much is the non-dom tax leak? What are the sources for this number? What is the NAO and HMRC view? What are the tax losses for scrapping the non-dom status for overseas citizens? Is there even a net gain to the exchequer from doing this?
Glib slogans backed by thin cheer pieces from a biased media is the kind of garbage that got us into the Tory mess.
Why would it be different from Labour?
Our problems are not just with the particular party of government, bad, thought the current bunch truly, truly are, we have a problem with our whole system.
The last Labour government did, of course, deliver a tangible improvement in NHS services. In stark contrast to the current mob.
The inference you are drawing there, however, is that it will only take a change in administration and that happy state will subsequently be restored.
I think even you'd concede that's not true. The massive increase in funding for public services, and maintenance of Thatcher-era low taxes, was funded from 1997 through to 2007 in very benign economic conditions, and off the back of an asset boom.
We are now not in that world so, say, if Labour does want to increase spending on the NHS by, say, £30-£40bn a year in real-terms to make a material difference, how will it pay for it in stagnant economic conditions? And in a world where we also need to up defence spending, invest more in education, science and industry, and maintain the welfare safety net?
To govern is to choose.
We are well past the point where restricting NHS pay is saving us money, it is costing us money.
Big increases in agency pay, which will get exponentially worse as more leave and morale drops amongst the permanents - this is a vicious circle that needs to be avoided. Loss of experienced staff creates inefficiencies that require more staff to do the same work Increase in training costs to replace those leaving Millions off sick unable to work and pay tax instead receiving welfare whilst waiting years for operations - such a long gap will see a proportion of those needlessly economically inactive ongoing Crumbling UK infrastructure in health, travel and education will see investment across our economy well below where it could have been
This is not being done to save money, but out of ideological belief that public sector pay needs to be tightly restrained. Which to be fair, it normally does, but now is absolutely the wrong time to be doing it.
Again, I ask the question: how will you pay for it?
I'm not sure you're arguing it's self-funding I strongly disagree - most users of the NHS are the old and chronically unwell; it's about as self-funding as Liz Truss's tax cuts.
Again, I ask the question: how will you pay for the cost of not paying for it?
The cost of waiting lists is a workforce where millions are long term sick, or suffering chronic pain. Low productivity is a big problem with a big cost. Then we have the economic cost of people working full time and having not enough money to pay their bills never mind consume. That costs jobs, which cuts consumption which costs more jobs.
You cannot rationally say "how will you pay for it" - not paying for it also has a cost.
We need to boost social care to get people out of hospitals into a cheaper and more appropriate setting. We need to use the resources released in hospital to get people out of A&E much more quickly. We need to ensure that highly trained paramedics do not spend half their shift, or more, sitting in a hospital carpark waiting to offload a patient whilst people who need their care die whilst waiting. We need to focus on early detection for better and cheaper outcomes. We need to emphasise that people can affect their own health by losing weight, drinking less, exercising more, etc and that they cannot expect the NHS to pick up the consequences of the failure to do this.
Others, such as the sums wasted on administration and internal cost allocation, are much more difficult but they are burning resource that we need and that is not acceptable.
On the first bolded point, this has been obvious for so long you have to wonder why we aren't seeing progress on it. What going wrong here? Is it simple want of money in the right budget? Some organisational failure? Cost of housing making it hard to increase supply of nursing house spaces?
On the second bolded point, there is an interesting article by PB's bete noire Devi Sridar in the Grauniad yesterday on at least half that point. It includes this simple, and perhaps obvious sentence: "If you add physical activity to a balanced diet, sleep and friends, that is a recipe for good physical and mental health."
If you were to put that sentence at the centre of government policy I wonder what changed priorities it might imply? What might government be able to do that doesn't cost £bns, but that would make it easier for people to live their lives in such a way?
One of the manifestations of the Housing Theory of Everything.
We don't build family-sized homes within towns and cities unless the Prince of Wales is involved. So people have to drive to work, so you need to reserve lots of space for cars. So people end up driving everywhere; partly because they have two cars already but also because local facilities are spread out by the need for car space. So they end up poorer, fatter and sadder.
It's patchy as well. One poster in Sutton Coldfield can't cycle to Tamworth (unless tired of life) because of the dangerous roads and lack of cycleways. Yet here - just fifteen miles away - I could cycle to Walsall* or Wolverhampton without going on a road at all.
*Yes, I know there is no good reason to cycle to Walsall. I was bored and thought I would explore where this lovely ex-railway now a cycle track went.
This is something that is really cutting through to people. A major topic of conversation at local U3A meetings, book groups, coffee mornings etc. is how it is nearly impossible to get through to local surgeries. If by some fluke you do, you'll be lucky to get a phone consultation with a nurse. Forget seeing a doctor. A couple of months ago a friend's 80 year old ex-husband fell and hit his head. He phoned 999. When the ambulance arrived 13 hours later, he was dead These are not scare stories. People are worried it could be them or a loved one next.
GPs are often migrating to eConsult forms. We have used this and it has worked well for us, with good access to doctors when needed. It's not always obvious the best way to get help, but the model of ringing the surgery seems broken everywhere .
Just before Christmas you couldn't even get through to our local surgery on e-consult. Even early in the morning it said no appointments available.
This is something that could be solved tomorrow by an early application of AI
The machines are getting REALLY good at diagnosis. In some ways they are already better than human doctors
“Algorithm That Detects Sepsis Cut Deaths by Nearly 20 Percent
Over two years, a machine-learning program warned thousands of health care providers about patients at high risk of sepsis, allowing them to begin treatments nearly two hours sooner”
“doctors 🩺+ AI🤖 = 🤯
NEW state of the art AI scores 67% (up from 50%) and surely will improve to head to 90%+ in relevant + accurate answers for medical diagnosis + recommendations.
Full paper: (via DeepMind + Google Research teams) arxiv.org/pdf/2212.13138…”
An AI GP will be available 24/7; it could see 4m patients every 9 minutes. This technology is available NOW and will only get better
Of course there will be many cases requiring physical inspection, they can be handed on to human docs but anyone requiring an e-consult could be sorted right now. Why aren’t we doing it?
Lethargy, inertia and incompetence.
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
But this is all before ChatGPT and, soon, GPT4. They are revolutionary. The Revolution is here
Firstly: why these numbers? Who settled on these suspiciously round numbers as the right level for a target? Are these numbers based on clinical need or cost? What treatment fields are the priority? Are there enough positions in training facilities and universities to train this number? If not, how do you propose to address this?
How much is the non-dom tax leak? What are the sources for this number? What is the NAO and HMRC view? What are the tax losses for scrapping the non-dom status for overseas citizens? Is there even a net gain to the exchequer from doing this?
Glib slogans backed by thin cheer pieces from a biased media is the kind of garbage that got us into the Tory mess.
Why would it be different from Labour?
Our problems are not just with the particular party of government, bad, thought the current bunch truly, truly are, we have a problem with our whole system.
The last Labour government did, of course, deliver a tangible improvement in NHS services. In stark contrast to the current mob.
The inference you are drawing there, however, is that it will only take a change in administration and that happy state will subsequently be restored.
I think even you'd concede that's not true. The massive increase in funding for public services, and maintenance of Thatcher-era low taxes, was funded from 1997 through to 2007 in very benign economic conditions, and off the back of an asset boom.
We are now not in that world so, say, if Labour does want to increase spending on the NHS by, say, £30-£40bn a year in real-terms to make a material difference, how will it pay for it in stagnant economic conditions? And in a world where we also need to up defence spending, invest more in education, science and industry, and maintain the welfare safety net?
To govern is to choose.
We are well past the point where restricting NHS pay is saving us money, it is costing us money.
Big increases in agency pay, which will get exponentially worse as more leave and morale drops amongst the permanents - this is a vicious circle that needs to be avoided. Loss of experienced staff creates inefficiencies that require more staff to do the same work Increase in training costs to replace those leaving Millions off sick unable to work and pay tax instead receiving welfare whilst waiting years for operations - such a long gap will see a proportion of those needlessly economically inactive ongoing Crumbling UK infrastructure in health, travel and education will see investment across our economy well below where it could have been
This is not being done to save money, but out of ideological belief that public sector pay needs to be tightly restrained. Which to be fair, it normally does, but now is absolutely the wrong time to be doing it.
Again, I ask the question: how will you pay for it?
I'm not sure you're arguing it's self-funding I strongly disagree - most users of the NHS are the old and chronically unwell; it's about as self-funding as Liz Truss's tax cuts.
I think the cost of not doing it is significantly greater than the cost of doing it, yes.
And anyway we will end up paying something closer to 8-10% anyway as the govt wont survive otherwise, so the options are:
Have three to six months of strikes through the winter, losing more staff to low morale and strikes and then pay the increases anyway
Pay them now and have (slightly) better healthcare through the rest of the winter but more importantly improve morale and retention.
The idea we can convince NHS workers to stay in their jobs and recruit 100k+ extra of them whilst reducing their real pay by 15% or so over 2 years, having them work through the collapse of the service, and see ex colleagues rake it in on bloated agency pay is simply for the birds.
I see a lot of arguments on here as to why funding should be increased, but I see far fewer as to where the money is going to come from.
I can only surmise that people simply haven't a scoobies so try and skirt the issue by indulging in wishful thinking instead.
This is something that is really cutting through to people. A major topic of conversation at local U3A meetings, book groups, coffee mornings etc. is how it is nearly impossible to get through to local surgeries. If by some fluke you do, you'll be lucky to get a phone consultation with a nurse. Forget seeing a doctor. A couple of months ago a friend's 80 year old ex-husband fell and hit his head. He phoned 999. When the ambulance arrived 13 hours later, he was dead These are not scare stories. People are worried it could be them or a loved one next.
My brother-in-law collapsed before Xmas - he was in hospital within 30 minutes, and kept in for OBS until the next day. Currently undergoing monitoring for a possible heart condition. This in Sunderland. Anecdotes tell many stories .
So what? Every case should be like that. What weight does a single one which is, carry?
Lol. Try reading and thinking.
Beyond me, so you will have to spell it out. Explain to me like I was 5, the implications of your anecdote.
To me, this graph suggests growing polarisation by age and Brexit partisanship over the issue of "Stay out" vs "Rejoin". Potentially a source of growing political pressures and frictions over time https://twitter.com/UKandEU/status/1609859259822481411
Interesting to see that 20% of Leave voters think we should Rejoin.
The question will mostly or at least significantly be answered as a proxy for should we have left in the first place rather than rejoin.
I would probably answer rejoin to the polling question but don't think we should go through the process of another divisive referendum, or taking another major decision without agreeing with the EU exactly what rejoin would look like ahead of such referendum.
For it to be worth rejoining I think you need about 65% in favour for a sustained period (5 years or so) and the EU to be open to making it work. The very earliest that might happen would be early to mid 2030s if ever. Far more likely that we can get to some less damaging hybrid level in the late 2020s.
Can't see why it's Sunak's fault. Excess deaths are probably indirectly caused by Covid 19 and the lockdown.
The NHS was never locked down. The deterioration in performance preceeded Covid, though was accelerated by it, as was the staffing crisis.
We are seeing what happens when services lack capacity. It doesn't matter if you have BUPA cover or not when you have a heart attack as private hospitals do not have emergency departments.
It's like teaching. Most of the issues were due to our appalling school building stock, which is either antiquated or so badly designed as to be worse than useless, and to our overstuffed classrooms.
Apart from assessments, which were largely due to the shockingly inept and rushed reform carried out by Spielman, Cummings, Gibb and Gove.
Not sure how you work that one out. They seem to be able to teach and learn adequately in Africa with mud floors and tin rooves.
You are Peter Hain and I claim my £5.
(And you're wrong. They really can't learn adequately under those conditions. Or have you never wondered why so few poorer Africans become leading politicians, scientists etc?)
Having actually visited such schools, they generally manage to teach reading, writing and a certain amount of maths and a bit of chemistry/biology.
That they do this is remarkable.
That they teach approximately what similar resourced schools taught, in the U.K., before the Victorians dumped a fuckton of money into education, isn’t. At least to me.
I would probably answer rejoin to the polling question but don't think we should go through the process of another divisive referendum, or taking another major decision without agreeing with the EU exactly what rejoin would look like ahead of such referendum.
There's a dickens quote: “Annual income twenty pounds, annual expenditure nineteen nineteen and six , result happiness. Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery”
This logic applies to queues. If you can process 200 people/hour and you get 195, great, if you get 205, then each hour 5 are added to the queue. if you have even slightly less resources than necessary to keep ahead of incoming requests, as a long run average, then how bad it can get (how long the waiting time) is unbounded. This is particularly noticeable in computing, because computers don't change their behavior unless told to, even if everything is going to shit.
The NHS doesn't quite match this theory, because in the theoretical model nothing leaves the queue until it's served, whereas people in the A&E queue can die. But yes, it can and will get worse than this. You can save some people from the wait by triaging harder, but that means the severity level at which people are not treated urgently is increased. It sounds like it's already much higher than anyone would wish - especially as the waiting time for non-urgent care is also upwards of 6 months and increasing in many cases.
In OR, we have special technical terminology for running system at capacity when it can have variable (emergency) demand.
Firstly: why these numbers? Who settled on these suspiciously round numbers as the right level for a target? Are these numbers based on clinical need or cost? What treatment fields are the priority? Are there enough positions in training facilities and universities to train this number? If not, how do you propose to address this?
How much is the non-dom tax leak? What are the sources for this number? What is the NAO and HMRC view? What are the tax losses for scrapping the non-dom status for overseas citizens? Is there even a net gain to the exchequer from doing this?
Glib slogans backed by thin cheer pieces from a biased media is the kind of garbage that got us into the Tory mess.
Why would it be different from Labour?
Our problems are not just with the particular party of government, bad, thought the current bunch truly, truly are, we have a problem with our whole system.
The last Labour government did, of course, deliver a tangible improvement in NHS services. In stark contrast to the current mob.
The inference you are drawing there, however, is that it will only take a change in administration and that happy state will subsequently be restored.
I think even you'd concede that's not true. The massive increase in funding for public services, and maintenance of Thatcher-era low taxes, was funded from 1997 through to 2007 in very benign economic conditions, and off the back of an asset boom.
We are now not in that world so, say, if Labour does want to increase spending on the NHS by, say, £30-£40bn a year in real-terms to make a material difference, how will it pay for it in stagnant economic conditions? And in a world where we also need to up defence spending, invest more in education, science and industry, and maintain the welfare safety net?
To govern is to choose.
We are well past the point where restricting NHS pay is saving us money, it is costing us money.
Big increases in agency pay, which will get exponentially worse as more leave and morale drops amongst the permanents - this is a vicious circle that needs to be avoided. Loss of experienced staff creates inefficiencies that require more staff to do the same work Increase in training costs to replace those leaving Millions off sick unable to work and pay tax instead receiving welfare whilst waiting years for operations - such a long gap will see a proportion of those needlessly economically inactive ongoing Crumbling UK infrastructure in health, travel and education will see investment across our economy well below where it could have been
This is not being done to save money, but out of ideological belief that public sector pay needs to be tightly restrained. Which to be fair, it normally does, but now is absolutely the wrong time to be doing it.
Again, I ask the question: how will you pay for it?
I'm not sure you're arguing it's self-funding I strongly disagree - most users of the NHS are the old and chronically unwell; it's about as self-funding as Liz Truss's tax cuts.
I think the cost of not doing it is significantly greater than the cost of doing it, yes.
And anyway we will end up paying something closer to 8-10% anyway as the govt wont survive otherwise, so the options are:
Have three to six months of strikes through the winter, losing more staff to low morale and strikes and then pay the increases anyway
Pay them now and have (slightly) better healthcare through the rest of the winter but more importantly improve morale and retention.
The idea we can convince NHS workers to stay in their jobs and recruit 100k+ extra of them whilst reducing their real pay by 15% or so over 2 years, having them work through the collapse of the service, and see ex colleagues rake it in on bloated agency pay is simply for the birds.
I see a lot of arguments on here as to why funding should be increased, but I see far fewer as to where the money is going to come from.
I can only surmise that people simply haven't a scoobies so try and skirt the issue by indulging in wishful thinking instead.
There are cost savings and increased tax receipts in the list above. It may cost more in year 1 or 2 but will be cheaper over the long run to move away from agency staff, retain experienced staff for longer and have more people fit and able to work and contribute in the wider economy which in turn attracts and generates investment.
In the short term there is not a fixed pot of money that the govt can spend.
When the govt u-turn, probably not far away now, and end up paying 8-10% increases that are needed the same people saying we can't afford it now will be championing the govt and Brexit for boosting pay for workers.
To me, this graph suggests growing polarisation by age and Brexit partisanship over the issue of "Stay out" vs "Rejoin". Potentially a source of growing political pressures and frictions over time https://twitter.com/UKandEU/status/1609859259822481411
Interesting to see that 20% of Leave voters think we should Rejoin.
When last polled by YouGov in February 2020, support for joining the euro in the UK was 11% with 18% unsure and 64% opposed - those are huge numbers.
It very much depends what sort of Rejoin is offered, and I expect it to be standard terms.
If the EU moved in a direction of "tiered" membership with differing levels of integration, in the years to come, then I think it would be possibly very different.
Firstly: why these numbers? Who settled on these suspiciously round numbers as the right level for a target? Are these numbers based on clinical need or cost? What treatment fields are the priority? Are there enough positions in training facilities and universities to train this number? If not, how do you propose to address this?
How much is the non-dom tax leak? What are the sources for this number? What is the NAO and HMRC view? What are the tax losses for scrapping the non-dom status for overseas citizens? Is there even a net gain to the exchequer from doing this?
Glib slogans backed by thin cheer pieces from a biased media is the kind of garbage that got us into the Tory mess.
Why would it be different from Labour?
Our problems are not just with the particular party of government, bad, thought the current bunch truly, truly are, we have a problem with our whole system.
The last Labour government did, of course, deliver a tangible improvement in NHS services. In stark contrast to the current mob.
The inference you are drawing there, however, is that it will only take a change in administration and that happy state will subsequently be restored.
I think even you'd concede that's not true. The massive increase in funding for public services, and maintenance of Thatcher-era low taxes, was funded from 1997 through to 2007 in very benign economic conditions, and off the back of an asset boom.
We are now not in that world so, say, if Labour does want to increase spending on the NHS by, say, £30-£40bn a year in real-terms to make a material difference, how will it pay for it in stagnant economic conditions? And in a world where we also need to up defence spending, invest more in education, science and industry, and maintain the welfare safety net?
To govern is to choose.
We are well past the point where restricting NHS pay is saving us money, it is costing us money.
Big increases in agency pay, which will get exponentially worse as more leave and morale drops amongst the permanents - this is a vicious circle that needs to be avoided. Loss of experienced staff creates inefficiencies that require more staff to do the same work Increase in training costs to replace those leaving Millions off sick unable to work and pay tax instead receiving welfare whilst waiting years for operations - such a long gap will see a proportion of those needlessly economically inactive ongoing Crumbling UK infrastructure in health, travel and education will see investment across our economy well below where it could have been
This is not being done to save money, but out of ideological belief that public sector pay needs to be tightly restrained. Which to be fair, it normally does, but now is absolutely the wrong time to be doing it.
Again, I ask the question: how will you pay for it?
I'm not sure you're arguing it's self-funding I strongly disagree - most users of the NHS are the old and chronically unwell; it's about as self-funding as Liz Truss's tax cuts.
I think the cost of not doing it is significantly greater than the cost of doing it, yes.
And anyway we will end up paying something closer to 8-10% anyway as the govt wont survive otherwise, so the options are:
Have three to six months of strikes through the winter, losing more staff to low morale and strikes and then pay the increases anyway
Pay them now and have (slightly) better healthcare through the rest of the winter but more importantly improve morale and retention.
The idea we can convince NHS workers to stay in their jobs and recruit 100k+ extra of them whilst reducing their real pay by 15% or so over 2 years, having them work through the collapse of the service, and see ex colleagues rake it in on bloated agency pay is simply for the birds.
I see a lot of arguments on here as to why funding should be increased, but I see far fewer as to where the money is going to come from.
I can only surmise that people simply haven't a scoobies so try and skirt the issue by indulging in wishful thinking instead.
There are cost savings and increased tax receipts in the list above. It may cost more in year 1 or 2 but will be cheaper over the long run to move away from agency staff, retain experienced staff for longer and have more people fit and able to work and contribute in the wider economy which in turn attracts and generates investment.
In the short term there is not a fixed pot of money that the govt can spend.
When the govt u-turn, probably not far away now, and end up paying 8-10% increases that are needed the same people saying we can't afford it now will be championing the govt and Brexit for boosting pay for workers.
I think we might be taking at cross purposes.
There's the settlement on pay for this year - where I agree HMG needs to up its offer- and there's the ongoing funding solution for the NHS that raises its performance to acceptable levels, which I think is far more difficult.
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
But this is all before ChatGPT and, soon, GPT4. They are revolutionary. The Revolution is here
Maybe tomorrow, but not today. I've looked at what ChatGPT produces in an area where I can check what it says, and it says both wrong things and right things in the same super-confident way. I wouldn't want it to be my GP any time soon (though an AI that suggested "hey, what about X?" and "ask patient about Y" as an assist to a human GP might be helpful).
To me, this graph suggests growing polarisation by age and Brexit partisanship over the issue of "Stay out" vs "Rejoin". Potentially a source of growing political pressures and frictions over time https://twitter.com/UKandEU/status/1609859259822481411
Interesting to see that 20% of Leave voters think we should Rejoin.
The question will mostly or at least significantly be answered as a proxy for should we have left in the first place rather than rejoin.
I would probably answer rejoin to the polling question but don't think we should go through the process of another divisive referendum, or taking another major decision without agreeing with the EU exactly what rejoin would look like ahead of such referendum.
For it to be worth rejoining I think you need about 65% in favour for a sustained period (5 years or so) and the EU to be open to making it work. The very earliest that might happen would be early to mid 2030s if ever. Far more likely that we can get to some less damaging hybrid level in the late 2020s.
Yes, I think that's probably the political trajectory we are currently on.
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
But this is all before ChatGPT and, soon, GPT4. They are revolutionary. The Revolution is here
Maybe tomorrow, but not today. I've looked at what ChatGPT produces in an area where I can check what it says, and it says both wrong things and right things in the same super-confident way. I wouldn't want it to be my GP any time soon (though an AI that suggested "hey, what about X?" and "ask patient about Y" as an assist to a human GP might be helpful).
Yup.
People have been working on automating diagnosis for decades. Seems simple - hell, they have diagnosis tree on medical text books. A question for each branch. You could code that on a ZX81.
Yet the reality is that, like self driving, still not happening.
And the bottleneck in healthcare isn’t diagnosis. It’s everything else….
To me, this graph suggests growing polarisation by age and Brexit partisanship over the issue of "Stay out" vs "Rejoin". Potentially a source of growing political pressures and frictions over time https://twitter.com/UKandEU/status/1609859259822481411
Interesting to see that 20% of Leave voters think we should Rejoin.
The question will mostly or at least significantly be answered as a proxy for should we have left in the first place rather than rejoin.
I would probably answer rejoin to the polling question but don't think we should go through the process of another divisive referendum, or taking another major decision without agreeing with the EU exactly what rejoin would look like ahead of such referendum.
For it to be worth rejoining I think you need about 65% in favour for a sustained period (5 years or so) and the EU to be open to making it work. The very earliest that might happen would be early to mid 2030s if ever. Far more likely that we can get to some less damaging hybrid level in the late 2020s.
I doubt if rejoin is an option. The root difficulty needs to be addressed. Probably most people who thought much about it would prefer not to be in the political/fiscal structures of the EU, not least because it is obvious, since the introduction of the Euro and the ECB, where this is heading, but most people would prefer, despite the limitations, to be in the free trading area.
Which means that the best available option (far from perfect, but we now know that isn't available) is EEA/EFTA. This outcome is also realistic given the 52/48 split in 2016.
This is something that is really cutting through to people. A major topic of conversation at local U3A meetings, book groups, coffee mornings etc. is how it is nearly impossible to get through to local surgeries. If by some fluke you do, you'll be lucky to get a phone consultation with a nurse. Forget seeing a doctor. A couple of months ago a friend's 80 year old ex-husband fell and hit his head. He phoned 999. When the ambulance arrived 13 hours later, he was dead These are not scare stories. People are worried it could be them or a loved one next.
My brother-in-law collapsed before Xmas - he was in hospital within 30 minutes, and kept in for OBS until the next day. Currently undergoing monitoring for a possible heart condition. This in Sunderland. Anecdotes tell many stories .
So what? Every case should be like that. What weight does a single one which is, carry?
Lol. Try reading and thinking.
Beyond me, so you will have to spell it out. Explain to me like I was 5, the implications of your anecdote.
Some backstory. 20 years ago I went to my doctors with a weird list of symptoms. They were completely mystified and spent weeks trying to work out what was wrong. Eventually I googled my symptoms myself, discovered that I probably had hypothyroidism. I went back to the docs and told them this and they were loftily skeptical. Too young too male etc. I had ti shout and scream to get a blood test
Eventually they agreed and a week later they sheepishly admitted. Yes, hypothyroid
I just tapped those symptoms into ChatGPT. This is literally its first reply. In 2 seconds
Some of the mental gymnastics by Leavers to explain away the NHS issues as nothing to do with Brexit is embarrassing.
It’s pretty obvious to most people that if you tell EU nationals they’re not welcome that they won’t be coming in their droves to have to jump through a load of hoops to get a job in the UK .
The Leave cult will desperately try and cling to the Brexit delusion and stick the whole problem onto covid .
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
But this is all before ChatGPT and, soon, GPT4. They are revolutionary. The Revolution is here
Maybe tomorrow, but not today. I've looked at what ChatGPT produces in an area where I can check what it says, and it says both wrong things and right things in the same super-confident way. I wouldn't want it to be my GP any time soon (though an AI that suggested "hey, what about X?" and "ask patient about Y" as an assist to a human GP might be helpful).
Being a little harsh, ChatGPT's skill - the one everyone is focusing on - is in bullshitting. Assemble a minimum of facts and create a plausible narrative around them. Bullshitting is a somewhat useful skill however. It's what I do on here all the time ....
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
But this is all before ChatGPT and, soon, GPT4. They are revolutionary. The Revolution is here
Maybe tomorrow, but not today. I've looked at what ChatGPT produces in an area where I can check what it says, and it says both wrong things and right things in the same super-confident way. I wouldn't want it to be my GP any time soon (though an AI that suggested "hey, what about X?" and "ask patient about Y" as an assist to a human GP might be helpful).
Yup.
People have been working on automating diagnosis for decades. Seems simple - hell, they have diagnosis tree on medical text books. A question for each branch. You could code that on a ZX81.
Yet the reality is that, like self driving, still not happening.
And the bottleneck in healthcare isn’t diagnosis. It’s everything else….
Except that self driving is happening
“I still can’t believe San Francisco has real driverless cars”
Some backstory. 20 years ago I went to my doctors with a weird list of symptoms. They were completely mystified and spent weeks trying to work out what was wrong. Eventually I googled my symptoms myself, discovered that I probably had hypothyroidism. I went back to the docs and told them this and they were loftily skeptical. Too young too male etc. I had ti shout and scream to get a blood test
Eventually they agreed and a week later they sheepishly admitted. Yes, hypothyroid
I just tapped those symptoms into ChatGPT. This is literally its first reply. In 2 seconds
A simpler, more reliable way of creating the same outcome is making broad spectrum testing cheaper and easier.
The technology on this is rolling forward at a tremendous pace and doesn’t require special breakthroughs.
One possible future is automated testing at your pharmacy…. Results available not in weeks, but in seconds
Firstly: why these numbers? Who settled on these suspiciously round numbers as the right level for a target? Are these numbers based on clinical need or cost? What treatment fields are the priority? Are there enough positions in training facilities and universities to train this number? If not, how do you propose to address this?
How much is the non-dom tax leak? What are the sources for this number? What is the NAO and HMRC view? What are the tax losses for scrapping the non-dom status for overseas citizens? Is there even a net gain to the exchequer from doing this?
Glib slogans backed by thin cheer pieces from a biased media is the kind of garbage that got us into the Tory mess.
Why would it be different from Labour?
Our problems are not just with the particular party of government, bad, thought the current bunch truly, truly are, we have a problem with our whole system.
The last Labour government did, of course, deliver a tangible improvement in NHS services. In stark contrast to the current mob.
The inference you are drawing there, however, is that it will only take a change in administration and that happy state will subsequently be restored.
I think even you'd concede that's not true. The massive increase in funding for public services, and maintenance of Thatcher-era low taxes, was funded from 1997 through to 2007 in very benign economic conditions, and off the back of an asset boom.
We are now not in that world so, say, if Labour does want to increase spending on the NHS by, say, £30-£40bn a year in real-terms to make a material difference, how will it pay for it in stagnant economic conditions? And in a world where we also need to up defence spending, invest more in education, science and industry, and maintain the welfare safety net?
To govern is to choose.
We are well past the point where restricting NHS pay is saving us money, it is costing us money.
Big increases in agency pay, which will get exponentially worse as more leave and morale drops amongst the permanents - this is a vicious circle that needs to be avoided. Loss of experienced staff creates inefficiencies that require more staff to do the same work Increase in training costs to replace those leaving Millions off sick unable to work and pay tax instead receiving welfare whilst waiting years for operations - such a long gap will see a proportion of those needlessly economically inactive ongoing Crumbling UK infrastructure in health, travel and education will see investment across our economy well below where it could have been
This is not being done to save money, but out of ideological belief that public sector pay needs to be tightly restrained. Which to be fair, it normally does, but now is absolutely the wrong time to be doing it.
Again, I ask the question: how will you pay for it?
I'm not sure you're arguing it's self-funding I strongly disagree - most users of the NHS are the old and chronically unwell; it's about as self-funding as Liz Truss's tax cuts.
Again, I ask the question: how will you pay for the cost of not paying for it?
The cost of waiting lists is a workforce where millions are long term sick, or suffering chronic pain. Low productivity is a big problem with a big cost. Then we have the economic cost of people working full time and having not enough money to pay their bills never mind consume. That costs jobs, which cuts consumption which costs more jobs.
You cannot rationally say "how will you pay for it" - not paying for it also has a cost.
So you have no answers as to how to pay for it.
Noted.
How are you paying for the consequences of this health crisis? Truss sunk her entire career trying to attack the low productivity of British workers. Big drivers of those are poor pay and conditions and poor health. So you have no answers either. But apparently prefer to continue to let people suffer and the economy slide because allowing capitalism to work is too expensive.
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
But this is all before ChatGPT and, soon, GPT4. They are revolutionary. The Revolution is here
Maybe tomorrow, but not today. I've looked at what ChatGPT produces in an area where I can check what it says, and it says both wrong things and right things in the same super-confident way. I wouldn't want it to be my GP any time soon (though an AI that suggested "hey, what about X?" and "ask patient about Y" as an assist to a human GP might be helpful).
Yup.
People have been working on automating diagnosis for decades. Seems simple - hell, they have diagnosis tree on medical text books. A question for each branch. You could code that on a ZX81.
Yet the reality is that, like self driving, still not happening.
And the bottleneck in healthcare isn’t diagnosis. It’s everything else….
Diagnosis is simple. Advice to "on no account consult Dr Google" is increasingly silly because if you have a degree level - in any subject - ability to assess the quality of sources and to understand the summary of a technical-but-not-very paper, google is and has been for at least 10 years as good as a GP at it. And the reason it's not so good at the next stage is nothing to do with algorithms, it's x rays and endoscopes and such which neither GPs nor AIs can do yet.
This is something that is really cutting through to people. A major topic of conversation at local U3A meetings, book groups, coffee mornings etc. is how it is nearly impossible to get through to local surgeries. If by some fluke you do, you'll be lucky to get a phone consultation with a nurse. Forget seeing a doctor. A couple of months ago a friend's 80 year old ex-husband fell and hit his head. He phoned 999. When the ambulance arrived 13 hours later, he was dead These are not scare stories. People are worried it could be them or a loved one next.
GPs are often migrating to eConsult forms. We have used this and it has worked well for us, with good access to doctors when needed. It's not always obvious the best way to get help, but the model of ringing the surgery seems broken everywhere .
Just before Christmas you couldn't even get through to our local surgery on e-consult. Even early in the morning it said no appointments available.
This is something that could be solved tomorrow by an early application of AI
The machines are getting REALLY good at diagnosis. In some ways they are already better than human doctors
“Algorithm That Detects Sepsis Cut Deaths by Nearly 20 Percent
Over two years, a machine-learning program warned thousands of health care providers about patients at high risk of sepsis, allowing them to begin treatments nearly two hours sooner”
“doctors 🩺+ AI🤖 = 🤯
NEW state of the art AI scores 67% (up from 50%) and surely will improve to head to 90%+ in relevant + accurate answers for medical diagnosis + recommendations.
Full paper: (via DeepMind + Google Research teams) arxiv.org/pdf/2212.13138…”
An AI GP will be available 24/7; it could see 4m patients every 9 minutes. This technology is available NOW and will only get better
Of course there will be many cases requiring physical inspection, they can be handed on to human docs but anyone requiring an e-consult could be sorted right now. Why aren’t we doing it?
Lethargy, inertia and incompetence.
Yes, and @LostPassword posted a similar interesting message up thread about this too.
I refuse to be pessimistic about this - far too much of that above.
We need to invest in growing the pie and the technologies of the future.
Agreed, yet Treasury orthodoxy will trample over any kind of investment and foreign investors/states will buy up UK companies doing those technologies of the future for pennies and our innovations will benefit everyone except us.
Our economic model is fundamentally broken and it has been for 30 or so years.
Unfortunate for Sunak but there are a lot of opportunities for the opposition with this problem. Perhaps 'Brexit isn't working'.
Whatever Sunak is (ie the size of an Amiibo) he isn't so stupid so he must know what's up. That time he had to go on TV and say, "I believe in Brexit" he looked like he was on the verge of starting to cry.
Struggling to see how nurses going on strike for an above inflation payrise inmediately screams 'Brexit' to you folks, but I suppose all is possible in terminal stage remoanerism.
Brexit has impacted on staffing vacancies, not only by FoM but also by losing recognition of qualifications. A Greek Doctor or Portuguese Nurse can no longer start next week, but rather takes 6 months to get their qualifications recognised. They now go to Germany or France instead.
After all, a large part of the purpose of Brexit was to force payrises for working Britons by reducing foreign competition. It is a feature not a bug of Brexit.
In short the conversation goes like this:
Brexiteer: "We have to ban foreign workers so we can take care of our own."
Our own: "I need a pay rise in order to pay my bills."
Brexiteer: "F*** Off!"
Either a Greek or Portuguese qualification needs 6 months of poring over, in which case it was bad and dangerous that this didn't happen before Brexit, or, more likely, they don't, which makes it solely a British NHS issue that it's taking 6 months. Perhaps you should consider apportioning some blame your desk jockey colleagues, who make up over half the NHS workforce, and whose whole job is meant to be sorting this stuff out.
Part of FoM was mutual recognition of qualifications, and that has now ended. Nearly all foreign graduates now have to apply for recognition of their qualifications the same way, whether Nigerian or Portuguese, and that is both expensive and time consuming.
I agree that it is unnessecary red tape, but that is Brexit and exiting the Single Market for you.
Incidentally the NHS doesn't have the power to recognise qualifications, that is a statutory responsibility of the GMC. Neither does the NHS issue work visas, as that is a statutory role of the Home Office.
No, it isn't Brexit or leaving the single market for you - Brexit provides us (and the EU) with a choice as to whether to continue to recognise these qualifications automatically or not. It is the EU's choice whether to recognise UK medical qualifications, and ours whether to recognise theirs. We choose whether to introduce red tape, or not to. If it has been introduced with grim enthusiasm, maybe we should consider whether those introducing it have an ideological axe to grind.
We chose to introduce the red tape by voting to leave the EU. This is not a surprise. Or do you propose we let anyone with a piece of paper that says 'nurse' enter the country?
Unfortunate for Sunak but there are a lot of opportunities for the opposition with this problem. Perhaps 'Brexit isn't working'.
Whatever Sunak is (ie the size of an Amiibo) he isn't so stupid so he must know what's up. That time he had to go on TV and say, "I believe in Brexit" he looked like he was on the verge of starting to cry.
Struggling to see how nurses going on strike for an above inflation payrise inmediately screams 'Brexit' to you folks, but I suppose all is possible in terminal stage remoanerism.
Brexit has impacted on staffing vacancies, not only by FoM but also by losing recognition of qualifications. A Greek Doctor or Portuguese Nurse can no longer start next week, but rather takes 6 months to get their qualifications recognised. They now go to Germany or France instead.
After all, a large part of the purpose of Brexit was to force payrises for working Britons by reducing foreign competition. It is a feature not a bug of Brexit.
In short the conversation goes like this:
Brexiteer: "We have to ban foreign workers so we can take care of our own."
Our own: "I need a pay rise in order to pay my bills."
Brexiteer: "F*** Off!"
Either a Greek or Portuguese qualification needs 6 months of poring over, in which case it was bad and dangerous that this didn't happen before Brexit, or, more likely, they don't, which makes it solely a British NHS issue that it's taking 6 months. Perhaps you should consider apportioning some blame your desk jockey colleagues, who make up over half the NHS workforce, and whose whole job is meant to be sorting this stuff out.
Part of FoM was mutual recognition of qualifications, and that has now ended. Nearly all foreign graduates now have to apply for recognition of their qualifications the same way, whether Nigerian or Portuguese, and that is both expensive and time consuming.
I agree that it is unnessecary red tape, but that is Brexit and exiting the Single Market for you.
Incidentally the NHS doesn't have the power to recognise qualifications, that is a statutory responsibility of the GMC. Neither does the NHS issue work visas, as that is a statutory role of the Home Office.
No, it isn't Brexit or leaving the single market for you - Brexit provides us (and the EU) with a choice as to whether to continue to recognise these qualifications automatically or not. It is the EU's choice whether to recognise UK medical qualifications, and ours whether to recognise theirs. We choose whether to introduce red tape, or not to. If it has been introduced with grim enthusiasm, maybe we should consider whether those introducing it have an ideological axe to grind.
We chose to introduce the red tape by voting to leave the EU. This is not a surprise. Or do you propose we let anyone with a piece of paper that says 'nurse' enter the country?
That's exactly what we appear to have done when we were in the EU, so why not?
Some of the mental gymnastics by Leavers to explain away the NHS issues as nothing to do with Brexit is embarrassing.
It’s pretty obvious to most people that if you tell EU nationals they’re not welcome that they won’t be coming in their droves to have to jump through a load of hoops to get a job in the UK .
The Leave cult will desperately try and cling to the Brexit delusion and stick the whole problem onto covid .
Except the facts don't match your biased view.
"In June 2016 there were 58,702 NHS staff with a recorded EU nationality, and in June 2022 there were 70,735 – an apparent rise. But to present this as the full story would be misleading, because there are over 57,000 more staff for whom nationality is known now than in 2016. It is very likely that there has been an overall increase in the number of NHS staff with EU nationality since 2016, but we can’t be sure about the scale of the change, and it would be misleading to calculate an increase based solely on the two numbers above."
Taking their warning at face value, any claims about rises and falls in EU nationals in the NHS are to be greeted with caution and your claims certainly don't match either the perceived or the raw numbers.
Some of the mental gymnastics by Leavers to explain away the NHS issues as nothing to do with Brexit is embarrassing.
It’s pretty obvious to most people that if you tell EU nationals they’re not welcome that they won’t be coming in their droves to have to jump through a load of hoops to get a job in the UK .
The Leave cult will desperately try and cling to the Brexit delusion and stick the whole problem onto covid .
Except the facts don't match your biased view.
"In June 2016 there were 58,702 NHS staff with a recorded EU nationality, and in June 2022 there were 70,735 – an apparent rise. But to present this as the full story would be misleading, because there are over 57,000 more staff for whom nationality is known now than in 2016. It is very likely that there has been an overall increase in the number of NHS staff with EU nationality since 2016, but we can’t be sure about the scale of the change, and it would be misleading to calculate an increase based solely on the two numbers above."
Taking their warning at face value, any claims about rises and falls in EU nationals in the NHS are to be greeted with caution and your claims certainly don't match either the perceived or the raw numbers.
On top of that migration to the UK is at record levels — despite Brexit — with about 460,000 people arriving in the year to September. In know it's a Remainer trope that everybody is fleeing the UK but it simply isn't true. A drop in EU immigration has been more than offset by the other 95% of the World.
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
But this is all before ChatGPT and, soon, GPT4. They are revolutionary. The Revolution is here
Maybe tomorrow, but not today. I've looked at what ChatGPT produces in an area where I can check what it says, and it says both wrong things and right things in the same super-confident way. I wouldn't want it to be my GP any time soon (though an AI that suggested "hey, what about X?" and "ask patient about Y" as an assist to a human GP might be helpful).
Yup.
People have been working on automating diagnosis for decades. Seems simple - hell, they have diagnosis tree on medical text books. A question for each branch. You could code that on a ZX81.
Yet the reality is that, like self driving, still not happening.
And the bottleneck in healthcare isn’t diagnosis. It’s everything else….
Diagnosis is simple. Advice to "on no account consult Dr Google" is increasingly silly because if you have a degree level - in any subject - ability to assess the quality of sources and to understand the summary of a technical-but-not-very paper, google is and has been for at least 10 years as good as a GP at it. And the reason it's not so good at the next stage is nothing to do with algorithms, it's x rays and endoscopes and such which neither GPs nor AIs can do yet.
I wouldn’t say diagnosis is simple. I have a skin complaint (seborrhoeic dermatitis / basically a natural fungi we all have really on our skin particularly likes mine and over reacts) - that took 5 GP appointments to identify and was only fixed without a hospital appointment because the hospital specialist visits our GP surgery once a week.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
It's not due to Nurses and other staff being on strike of course. Perish the thought..its not due to the lunacy of Brown agreeing g GPS didnt have to work nights and weekends causing a logjam in A and E that has never been solved. Pah...
Some of the mental gymnastics by Leavers to explain away the NHS issues as nothing to do with Brexit is embarrassing.
It’s pretty obvious to most people that if you tell EU nationals they’re not welcome that they won’t be coming in their droves to have to jump through a load of hoops to get a job in the UK .
The Leave cult will desperately try and cling to the Brexit delusion and stick the whole problem onto covid .
Except the facts don't match your biased view.
"In June 2016 there were 58,702 NHS staff with a recorded EU nationality, and in June 2022 there were 70,735 – an apparent rise. But to present this as the full story would be misleading, because there are over 57,000 more staff for whom nationality is known now than in 2016. It is very likely that there has been an overall increase in the number of NHS staff with EU nationality since 2016, but we can’t be sure about the scale of the change, and it would be misleading to calculate an increase based solely on the two numbers above."
Taking their warning at face value, any claims about rises and falls in EU nationals in the NHS are to be greeted with caution and your claims certainly don't match either the perceived or the raw numbers.
On top of that migration to the UK is at record levels — despite Brexit — with about 460,000 people arriving in the year to September. In know it's a Remainer trope that everybody is fleeing the UK but it simply isn't true. A drop in EU immigration has been more than offset by the other 95% of the World.
Worldwide population has increased by a billion in the last 12 years. Brexit was at the midpoint of that period.
Firstly: why these numbers? Who settled on these suspiciously round numbers as the right level for a target? Are these numbers based on clinical need or cost? What treatment fields are the priority? Are there enough positions in training facilities and universities to train this number? If not, how do you propose to address this?
How much is the non-dom tax leak? What are the sources for this number? What is the NAO and HMRC view? What are the tax losses for scrapping the non-dom status for overseas citizens? Is there even a net gain to the exchequer from doing this?
Glib slogans backed by thin cheer pieces from a biased media is the kind of garbage that got us into the Tory mess.
Why would it be different from Labour?
Our problems are not just with the particular party of government, bad, thought the current bunch truly, truly are, we have a problem with our whole system.
The last Labour government did, of course, deliver a tangible improvement in NHS services. In stark contrast to the current mob.
The inference you are drawing there, however, is that it will only take a change in administration and that happy state will subsequently be restored.
I think even you'd concede that's not true. The massive increase in funding for public services, and maintenance of Thatcher-era low taxes, was funded from 1997 through to 2007 in very benign economic conditions, and off the back of an asset boom.
We are now not in that world so, say, if Labour does want to increase spending on the NHS by, say, £30-£40bn a year in real-terms to make a material difference, how will it pay for it in stagnant economic conditions? And in a world where we also need to up defence spending, invest more in education, science and industry, and maintain the welfare safety net?
To govern is to choose.
We are well past the point where restricting NHS pay is saving us money, it is costing us money.
Big increases in agency pay, which will get exponentially worse as more leave and morale drops amongst the permanents - this is a vicious circle that needs to be avoided. Loss of experienced staff creates inefficiencies that require more staff to do the same work Increase in training costs to replace those leaving Millions off sick unable to work and pay tax instead receiving welfare whilst waiting years for operations - such a long gap will see a proportion of those needlessly economically inactive ongoing Crumbling UK infrastructure in health, travel and education will see investment across our economy well below where it could have been
This is not being done to save money, but out of ideological belief that public sector pay needs to be tightly restrained. Which to be fair, it normally does, but now is absolutely the wrong time to be doing it.
Again, I ask the question: how will you pay for it?
I'm not sure you're arguing it's self-funding I strongly disagree - most users of the NHS are the old and chronically unwell; it's about as self-funding as Liz Truss's tax cuts.
I think the cost of not doing it is significantly greater than the cost of doing it, yes.
And anyway we will end up paying something closer to 8-10% anyway as the govt wont survive otherwise, so the options are:
Have three to six months of strikes through the winter, losing more staff to low morale and strikes and then pay the increases anyway
Pay them now and have (slightly) better healthcare through the rest of the winter but more importantly improve morale and retention.
The idea we can convince NHS workers to stay in their jobs and recruit 100k+ extra of them whilst reducing their real pay by 15% or so over 2 years, having them work through the collapse of the service, and see ex colleagues rake it in on bloated agency pay is simply for the birds.
I see a lot of arguments on here as to why funding should be increased, but I see far fewer as to where the money is going to come from.
I can only surmise that people simply haven't a scoobies so try and skirt the issue by indulging in wishful thinking instead.
Any measures to deal with the crisis have to be short term. My suggestions:
Salary increases for nurses and paramedics meet inflation for this year and next. This is as much to remove an issue that is getting in the way of dealing with the healthcare crisis, as it is to deal with a labour supply issue. It isn't inflationary; it just takes away those groups from a wheeze by the government to get itself out of the fiscal hole it has put the country in, by reducing the real wages of public servants.
Remove the requirement for work permits for any EU citizen involved in clinical or direct social care for the next five years - reinstating the situation prior to 2020.
A programme to tackle bed blocking by creating social care alternatives for those going out of hospital. This will cost new money.
There's a lot of medium and long term actions than need to happen as well. They should start now.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
The self-image (no stranger to affectionate attention) receives yet another clean and polish.
Firstly: why these numbers? Who settled on these suspiciously round numbers as the right level for a target? Are these numbers based on clinical need or cost? What treatment fields are the priority? Are there enough positions in training facilities and universities to train this number? If not, how do you propose to address this?
How much is the non-dom tax leak? What are the sources for this number? What is the NAO and HMRC view? What are the tax losses for scrapping the non-dom status for overseas citizens? Is there even a net gain to the exchequer from doing this?
Glib slogans backed by thin cheer pieces from a biased media is the kind of garbage that got us into the Tory mess.
Why would it be different from Labour?
Our problems are not just with the particular party of government, bad, thought the current bunch truly, truly are, we have a problem with our whole system.
The last Labour government did, of course, deliver a tangible improvement in NHS services. In stark contrast to the current mob.
The inference you are drawing there, however, is that it will only take a change in administration and that happy state will subsequently be restored.
I think even you'd concede that's not true. The massive increase in funding for public services, and maintenance of Thatcher-era low taxes, was funded from 1997 through to 2007 in very benign economic conditions, and off the back of an asset boom.
We are now not in that world so, say, if Labour does want to increase spending on the NHS by, say, £30-£40bn a year in real-terms to make a material difference, how will it pay for it in stagnant economic conditions? And in a world where we also need to up defence spending, invest more in education, science and industry, and maintain the welfare safety net?
To govern is to choose.
We are well past the point where restricting NHS pay is saving us money, it is costing us money.
Big increases in agency pay, which will get exponentially worse as more leave and morale drops amongst the permanents - this is a vicious circle that needs to be avoided. Loss of experienced staff creates inefficiencies that require more staff to do the same work Increase in training costs to replace those leaving Millions off sick unable to work and pay tax instead receiving welfare whilst waiting years for operations - such a long gap will see a proportion of those needlessly economically inactive ongoing Crumbling UK infrastructure in health, travel and education will see investment across our economy well below where it could have been
This is not being done to save money, but out of ideological belief that public sector pay needs to be tightly restrained. Which to be fair, it normally does, but now is absolutely the wrong time to be doing it.
Again, I ask the question: how will you pay for it?
I'm not sure you're arguing it's self-funding I strongly disagree - most users of the NHS are the old and chronically unwell; it's about as self-funding as Liz Truss's tax cuts.
Again, I ask the question: how will you pay for the cost of not paying for it?
The cost of waiting lists is a workforce where millions are long term sick, or suffering chronic pain. Low productivity is a big problem with a big cost. Then we have the economic cost of people working full time and having not enough money to pay their bills never mind consume. That costs jobs, which cuts consumption which costs more jobs.
You cannot rationally say "how will you pay for it" - not paying for it also has a cost.
So you have no answers as to how to pay for it.
Noted.
How are you paying for the consequences of this health crisis? Truss sunk her entire career trying to attack the low productivity of British workers. Big drivers of those are poor pay and conditions and poor health. So you have no answers either. But apparently prefer to continue to let people suffer and the economy slide because allowing capitalism to work is too expensive.
Noted.
The UK has a problem with productivity when it comes to the stats because, for years, it was very easy for employers just to use cheap EU labour rather than spend on capital investment. Agriculture was a classic example of this.
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
But this is all before ChatGPT and, soon, GPT4. They are revolutionary. The Revolution is here
Maybe tomorrow, but not today. I've looked at what ChatGPT produces in an area where I can check what it says, and it says both wrong things and right things in the same super-confident way. I wouldn't want it to be my GP any time soon (though an AI that suggested "hey, what about X?" and "ask patient about Y" as an assist to a human GP might be helpful).
Yup.
People have been working on automating diagnosis for decades. Seems simple - hell, they have diagnosis tree on medical text books. A question for each branch. You could code that on a ZX81.
Yet the reality is that, like self driving, still not happening.
And the bottleneck in healthcare isn’t diagnosis. It’s everything else….
Diagnosis is simple. Advice to "on no account consult Dr Google" is increasingly silly because if you have a degree level - in any subject - ability to assess the quality of sources and to understand the summary of a technical-but-not-very paper, google is and has been for at least 10 years as good as a GP at it. And the reason it's not so good at the next stage is nothing to do with algorithms, it's x rays and endoscopes and such which neither GPs nor AIs can do yet.
I wouldn’t say diagnosis is simple. I have a skin complaint (seborrhoeic dermatitis / basically a natural fungi we all have really on our skin particularly likes mine and over reacts) - that took 5 GP appointments to identify and was only fixed without a hospital appointment because the hospital specialist visits our GP surgery once a week.
Yet ChatGPT has just done what 6 surgery visits and 4 doctors were unable to do. Diagnose my hypothyroidism. In 2 seconds
Of course they won’t replace GPs all at once. At first the machines will be assistants and collaborators
But eventually we will accept that they are better at this than humans. Tireless, inexpensive, near flawless, unemotional. Available online and in person 24/7/365
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Sounds like an AI. Have you and these AI computers ever been seen in the same room...?
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
The self-image (no stranger to affectionate attention) receives yet another clean and polish.
QED. You’re an accountant. You cannot begin to imagine what it is like to have an imagination
I can’t imagine what it is like NOT to have one. They can be a curse. Monsters come in the night
To me, this graph suggests growing polarisation by age and Brexit partisanship over the issue of "Stay out" vs "Rejoin". Potentially a source of growing political pressures and frictions over time https://twitter.com/UKandEU/status/1609859259822481411
Interesting to see that 20% of Leave voters think we should Rejoin.
The question will mostly or at least significantly be answered as a proxy for should we have left in the first place rather than rejoin.
I would probably answer rejoin to the polling question but don't think we should go through the process of another divisive referendum, or taking another major decision without agreeing with the EU exactly what rejoin would look like ahead of such referendum.
For it to be worth rejoining I think you need about 65% in favour for a sustained period (5 years or so) and the EU to be open to making it work. The very earliest that might happen would be early to mid 2030s if ever. Far more likely that we can get to some less damaging hybrid level in the late 2020s.
Yes, I think that's probably the political trajectory we are currently on.
Listen you surrender monkeys, we voted to Leave ( well I didn't). Leavers drowning in their buyers remorse tears doesn't wash. Make it work Brexiteers. You told me it would be fantastic and I'm taking your word for it.
It's not due to Nurses and other staff being on strike of course. Perish the thought..its not due to the lunacy of Brown agreeing g GPS didnt have to work nights and weekends causing a logjam in A and E that has never been solved. Pah...
Given that theses increases in deaths apparently predate the strikes I think we can be on pretty firm ground if we say that, no, the strikes are not the cause of these increases.
Brown's GP reforms were utter bollocks I agree. But again these were more than a decade ago so I find it hard to believe they are responsible in any major way for the problems now being experienced on the front line. At worst they are a small part contributing to a worsening situation.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Sounds like an AI. Have you and these AI computers ever been seen in the same room...?
Christ, an AI with an ego like Leon's alongside his insecurities, would finally convince me that the futures shown in Terminator and The Matrix were truly possible.
It's not due to Nurses and other staff being on strike of course. Perish the thought..its not due to the lunacy of Brown agreeing g GPS didnt have to work nights and weekends causing a logjam in A and E that has never been solved. Pah...
I see the rabid PB Tories have come out fighting today. NHS crisis, what crisis? Not our problem squire, we are just in government. It was the nurses, Aneurin Bevan and the last Labour Government wot dun it.
Firstly: why these numbers? Who settled on these suspiciously round numbers as the right level for a target? Are these numbers based on clinical need or cost? What treatment fields are the priority? Are there enough positions in training facilities and universities to train this number? If not, how do you propose to address this?
How much is the non-dom tax leak? What are the sources for this number? What is the NAO and HMRC view? What are the tax losses for scrapping the non-dom status for overseas citizens? Is there even a net gain to the exchequer from doing this?
Glib slogans backed by thin cheer pieces from a biased media is the kind of garbage that got us into the Tory mess.
Why would it be different from Labour?
Our problems are not just with the particular party of government, bad, thought the current bunch truly, truly are, we have a problem with our whole system.
The last Labour government did, of course, deliver a tangible improvement in NHS services. In stark contrast to the current mob.
The inference you are drawing there, however, is that it will only take a change in administration and that happy state will subsequently be restored.
I think even you'd concede that's not true. The massive increase in funding for public services, and maintenance of Thatcher-era low taxes, was funded from 1997 through to 2007 in very benign economic conditions, and off the back of an asset boom.
We are now not in that world so, say, if Labour does want to increase spending on the NHS by, say, £30-£40bn a year in real-terms to make a material difference, how will it pay for it in stagnant economic conditions? And in a world where we also need to up defence spending, invest more in education, science and industry, and maintain the welfare safety net?
To govern is to choose.
We are well past the point where restricting NHS pay is saving us money, it is costing us money.
Big increases in agency pay, which will get exponentially worse as more leave and morale drops amongst the permanents - this is a vicious circle that needs to be avoided. Loss of experienced staff creates inefficiencies that require more staff to do the same work Increase in training costs to replace those leaving Millions off sick unable to work and pay tax instead receiving welfare whilst waiting years for operations - such a long gap will see a proportion of those needlessly economically inactive ongoing Crumbling UK infrastructure in health, travel and education will see investment across our economy well below where it could have been
This is not being done to save money, but out of ideological belief that public sector pay needs to be tightly restrained. Which to be fair, it normally does, but now is absolutely the wrong time to be doing it.
Again, I ask the question: how will you pay for it?
I'm not sure you're arguing it's self-funding I strongly disagree - most users of the NHS are the old and chronically unwell; it's about as self-funding as Liz Truss's tax cuts.
Again, I ask the question: how will you pay for the cost of not paying for it?
The cost of waiting lists is a workforce where millions are long term sick, or suffering chronic pain. Low productivity is a big problem with a big cost. Then we have the economic cost of people working full time and having not enough money to pay their bills never mind consume. That costs jobs, which cuts consumption which costs more jobs.
You cannot rationally say "how will you pay for it" - not paying for it also has a cost.
So you have no answers as to how to pay for it.
Noted.
How are you paying for the consequences of this health crisis? Truss sunk her entire career trying to attack the low productivity of British workers. Big drivers of those are poor pay and conditions and poor health. So you have no answers either. But apparently prefer to continue to let people suffer and the economy slide because allowing capitalism to work is too expensive.
Noted.
The UK has a problem with productivity when it comes to the stats because, for years, it was very easy for employers just to use cheap EU labour rather than spend on capital investment. Agriculture was a classic example of this.
So the solution is Brexit, which is having a serious negative effect on productivity that wasn't great to begin with?
To me, this graph suggests growing polarisation by age and Brexit partisanship over the issue of "Stay out" vs "Rejoin". Potentially a source of growing political pressures and frictions over time https://twitter.com/UKandEU/status/1609859259822481411
Interesting to see that 20% of Leave voters think we should Rejoin.
When last polled by YouGov in February 2020, support for joining the euro in the UK was 11% with 18% unsure and 64% opposed - those are huge numbers.
It very much depends what sort of Rejoin is offered, and I expect it to be standard terms.
If the EU moved in a direction of "tiered" membership with differing levels of integration, in the years to come, then I think it would be possibly very different.
I don't think we should join the euro (in the foreseeable future, it's not a theological issue for me), but I do think we should rejoin the EU on the standard terms. Why? Because there is no mechanism to make a country join the euro and there is a very simple mechanism a country can adopt to put off euro membership indefinitely - failing to join the ERM. This is how Sweden has never joined the euro and never will until it decides it wants to. Of course, these are fairly sophisticated arguments and I would expect most people's ignorance on these questions will be effectively exploited by those opposed to us rejoining. Nevertheless, I would hope that on a sophisticated forum such as this the true nature of the issue should be well understood.
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
But this is all before ChatGPT and, soon, GPT4. They are revolutionary. The Revolution is here
Maybe tomorrow, but not today. I've looked at what ChatGPT produces in an area where I can check what it says, and it says both wrong things and right things in the same super-confident way. I wouldn't want it to be my GP any time soon (though an AI that suggested "hey, what about X?" and "ask patient about Y" as an assist to a human GP might be helpful).
Yup.
People have been working on automating diagnosis for decades. Seems simple - hell, they have diagnosis tree on medical text books. A question for each branch. You could code that on a ZX81.
Yet the reality is that, like self driving, still not happening.
And the bottleneck in healthcare isn’t diagnosis. It’s everything else….
Diagnosis is simple. Advice to "on no account consult Dr Google" is increasingly silly because if you have a degree level - in any subject - ability to assess the quality of sources and to understand the summary of a technical-but-not-very paper, google is and has been for at least 10 years as good as a GP at it. And the reason it's not so good at the next stage is nothing to do with algorithms, it's x rays and endoscopes and such which neither GPs nor AIs can do yet.
I wouldn’t say diagnosis is simple. I have a skin complaint (seborrhoeic dermatitis / basically a natural fungi we all have really on our skin particularly likes mine and over reacts) - that took 5 GP appointments to identify and was only fixed without a hospital appointment because the hospital specialist visits our GP surgery once a week.
Yet ChatGPT has just done what 6 surgery visits and 4 doctors were unable to do. Diagnose my hypothyroidism. In 2 seconds
Of course they won’t replace GPs all at once. At first the machines will be assistants and collaborators
But eventually we will accept that they are better at this than humans. Tireless, inexpensive, near flawless, unemotional. Available online and in person 24/7/365
Then they will replace the doctors
ChatGPT did not diagnose your hypothyroidism. It merely listed that as one of four possibilities (and hinted there were others). Your wider point that machines will get better in future is nothing new.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Firstly you did not make a ludicrous mistake. You said 'might' and she might have. Myself and Big G I think both said the same. I thought there was a 90% chance she was probably going to be very boring and a 10% chance she was going to be a breath of fresh air. I didn't anticipate the car crash.
Re the imagination stuff I think that is nonsense. Engineers and Scientists generally have a lot of imagination. Now I note you said 'creative imagination' If by that you mean the ridiculous then yes you are right. They don't imagine stuff that they have no knowledge about creating, but they do imagine stuff that they can't do, but hope they or others can in the future or they come up with a unique off the wall idea they then try and implement.
It is the difference between a Computer Scientist making a breakthrough in AI because he used his imagination and you using your creative imagination to foresee time travel. I think that makes his/her imagination more useful and more credible. Creative imagination is just fiction that may or may not come true.
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
But this is all before ChatGPT and, soon, GPT4. They are revolutionary. The Revolution is here
Maybe tomorrow, but not today. I've looked at what ChatGPT produces in an area where I can check what it says, and it says both wrong things and right things in the same super-confident way. I wouldn't want it to be my GP any time soon (though an AI that suggested "hey, what about X?" and "ask patient about Y" as an assist to a human GP might be helpful).
The last sentence is a really easy win, to my eyes. Make an appointment (no, don't laugh) and fill in a basic web-form with a description of your symptoms. That's fed through ChatGPT and your GP can have a quick look just before your appointment. They might entirely dismiss the suggestions, but it might also show up something they wouldn't have thought of in the limited time they have to think about it.
Not a massive revolution, but really, really easy to do and quite cost-effective.
To me, this graph suggests growing polarisation by age and Brexit partisanship over the issue of "Stay out" vs "Rejoin". Potentially a source of growing political pressures and frictions over time https://twitter.com/UKandEU/status/1609859259822481411
Interesting to see that 20% of Leave voters think we should Rejoin.
When last polled by YouGov in February 2020, support for joining the euro in the UK was 11% with 18% unsure and 64% opposed - those are huge numbers.
It very much depends what sort of Rejoin is offered, and I expect it to be standard terms.
If the EU moved in a direction of "tiered" membership with differing levels of integration, in the years to come, then I think it would be possibly very different.
I don't think we should join the euro (in the foreseeable future, it's not a theological issue for me), but I do think we should rejoin the EU on the standard terms. Why? Because there is no mechanism to make a country join the euro and there is a very simple mechanism a country can adopt to put off euro membership indefinitely - failing to join the ERM. This is how Sweden has never joined the euro and never will until it decides it wants to. Of course, these are fairly sophisticated arguments and I would expect most people's ignorance on these questions will be effectively exploited by those opposed to us rejoining. Nevertheless, I would hope that on a sophisticated forum such as this the true nature of the issue should be well understood.
If they wanted to insist on it they could make it a condition of membership. No Euro, no membership. Don't forget that Sweden was already a member when the Euro was introduced.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
The self-image (no stranger to affectionate attention) receives yet another clean and polish.
QED. You’re an accountant. You cannot begin to imagine what it is like to have an imagination
I can’t imagine what it is like NOT to have one. They can be a curse. Monsters come in the night
You can't imagine what it's like to not have an imagination? Maybe you ain't as imaginative as you think.
It's not due to Nurses and other staff being on strike of course. Perish the thought..its not due to the lunacy of Brown agreeing g GPS didnt have to work nights and weekends causing a logjam in A and E that has never been solved. Pah...
Given that theses increases in deaths apparently predate the strikes I think we can be on pretty firm ground if we say that, no, the strikes are not the cause of these increases.
Brown's GP reforms were utter bollocks I agree. But again these were more than a decade ago so I find it hard to believe they are responsible in any major way for the problems now being experienced on the front line. At worst they are a small part contributing to a worsening situation.
Swiss cheese theory of system failures. When all the holes line up.
Most systems have redundancy and margin built in. So 20 things are needed for failure say. 10 go wrong…. We motor on. 18 are failed… the system rumbles… we motor on. 20 fail….
The GP issue is that they are used as gate keepers for the entire NHS.
My wife has a long term, treatable issue. Like so many of these, every so often she needs to see a specialist to review the dosages, check for problems etc. So she goes to the GP. Who solemnly books a blood test. The blood is drawn by the nurse and sent off. The GP schedules an appointment where she solemnly acknowledges that she isn’t qualified to say much about the results. And refers to the usual consultant.
Not sure why they can’t put a decade of every six months in the nurses calendar to do the test, followed by an equal number of appointments to see the consultant…
This is something that is really cutting through to people. A major topic of conversation at local U3A meetings, book groups, coffee mornings etc. is how it is nearly impossible to get through to local surgeries. If by some fluke you do, you'll be lucky to get a phone consultation with a nurse. Forget seeing a doctor. A couple of months ago a friend's 80 year old ex-husband fell and hit his head. He phoned 999. When the ambulance arrived 13 hours later, he was dead These are not scare stories. People are worried it could be them or a loved one next.
GPs are often migrating to eConsult forms. We have used this and it has worked well for us, with good access to doctors when needed. It's not always obvious the best way to get help, but the model of ringing the surgery seems broken everywhere .
Just before Christmas you couldn't even get through to our local surgery on e-consult. Even early in the morning it said no appointments available.
This is something that could be solved tomorrow by an early application of AI
The machines are getting REALLY good at diagnosis. In some ways they are already better than human doctors
“Algorithm That Detects Sepsis Cut Deaths by Nearly 20 Percent
Over two years, a machine-learning program warned thousands of health care providers about patients at high risk of sepsis, allowing them to begin treatments nearly two hours sooner”
“doctors 🩺+ AI🤖 = 🤯
NEW state of the art AI scores 67% (up from 50%) and surely will improve to head to 90%+ in relevant + accurate answers for medical diagnosis + recommendations.
Full paper: (via DeepMind + Google Research teams) arxiv.org/pdf/2212.13138…”
An AI GP will be available 24/7; it could see 4m patients every 9 minutes. This technology is available NOW and will only get better
Of course there will be many cases requiring physical inspection, they can be handed on to human docs but anyone requiring an e-consult could be sorted right now. Why aren’t we doing it?
Lethargy, inertia and incompetence.
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
As far as I remember from talking to people at the time - IBM's Watson was a load of PR to generate consulting revenue for IBM. They didn't really have the tech to remotely back up their claims. The stuff coming out of openai and the like is a very big step forward.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Sounds like an AI. Have you and these AI computers ever been seen in the same room...?
Christ, an AI with an ego like Leon's alongside his insecurities, would finally convince me that the futures shown in Terminator and The Matrix were truly possible.
On the plus side having a terminator that panics so often might make them easier to defeat.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Whether you're right or wrong, it's a bold statement to say that a bunch of boffins/engineers/scientists/statisticians can't understand the impact and implications of stuff like AI. I'd hazard those groups are the groups most likely to understand the impacts and implications, not the least likely.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
The self-image (no stranger to affectionate attention) receives yet another clean and polish.
QED. You’re an accountant. You cannot begin to imagine what it is like to have an imagination
I can’t imagine what it is like NOT to have one. They can be a curse. Monsters come in the night
You can't imagine what it's like to not have an imagination? Maybe you ain't as imaginative as you think.
My wife has a long term, treatable issue. Like so many of these, every so often she needs to see a specialist to review the dosages, check for problems etc. So she goes to the GP. Who solemnly books a blood test. The blood is drawn by the nurse and sent off. The GP schedules an appointment where she solemnly acknowledges that she isn’t qualified to say much about the results. And refers to the usual consultant.
Not sure why they can’t put a decade of every six months in the nurses calendar to do the test, followed by an equal number of appointments to see the consultant…
Basically the UK decided on one model of universal healthcare 70 years ago and has stuck with it since, learning very little from other countries along the way. But anyone who proposes real change will be accused of "privatising the NHS" and so we are stuck with a system that does not work very well.
On top of that most of what people argue about are the numbers of beds, nurses, doctors and so on, not what actually matters which is how healthy the nation is. We are obssessed with measuring the wrong things.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
"engineers are not known for their creative imagination"
So how come we've invented, designed, manufactured, fixed and made reliable just about every man-made object on the entire planet, and increasingly beyond it?
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Whether you're right or wrong, it's a bold statement to say that a bunch of boffins/engineers/scientists/statisticians can't understand the impact and implications of stuff like AI. I'd hazard those groups are the groups most likely to understand the impacts and implications, not the least likely.
Also more likely to spot the bullshit.
There was a reason that Theranos avoided real Biotech Venture Capital and targeted amateur investors.
1 \ BREAKING: New Israeli foreign minister Eli Cohen signaled a policy shift on Ukraine in his 1st speech hinting the new government will take a more pro-Russian line. He said he will speak on Tuesday with Russian FM Lavrov – 1st such call since the Russian invasion of Ukraine
2 \ In his speech Cohen hinted that unlike his predecessor Yair Lapid he will not condemn Russia publicly. “On the issue of Russia and Ukraine we will do on thing for sure – speak less in public”
3 \ The new Israeli FM said he is going to draft a “responsible” new policy on the war in Ukraine and stressed the foreign ministry “will prepare a detailed presentation to the security cabinet on this issue”. He also said the Israeli humanitarian aid to Ukraine will continue
4 \ Why it matters: Cohen’s predecessor Yair Lapid led a tough line Russia, condemned it publicly & even said the Russian military committed war crimes. Since the invasion Lapid didn’t speak to Lavrov & after he assumed office as caretaker prime minister he didn’t speak to Putin
My wife has a long term, treatable issue. Like so many of these, every so often she needs to see a specialist to review the dosages, check for problems etc. So she goes to the GP. Who solemnly books a blood test. The blood is drawn by the nurse and sent off. The GP schedules an appointment where she solemnly acknowledges that she isn’t qualified to say much about the results. And refers to the usual consultant.
Not sure why they can’t put a decade of every six months in the nurses calendar to do the test, followed by an equal number of appointments to see the consultant…
Basically the UK decided on one model of universal healthcare 70 years ago and has stuck with it since, learning very little from other countries along the way. But anyone who proposes real change will be accused of "privatising the NHS" and so we are stuck with a system that does not work very well.
On top of that most of what people argue about are the numbers of beds, nurses, doctors and so on, not what actually matters which is how healthy the nation is. We are obssessed with measuring the wrong things.
That's what happens when you turn it into a religion, any talk of change is sacrosanct.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Firstly you did not make a ludicrous mistake. You said 'might' and she might have. Myself and Big G I think both said the same. I thought there was a 90% chance she was probably going to be very boring and a 10% chance she was going to be a breath of fresh air. I didn't anticipate the car crash.
Re the imagination stuff I think that is nonsense. Engineers and Scientists generally have a lot of imagination. Now I note you said 'creative imagination' If by that you mean the ridiculous then yes you are right. They don't imagine stuff that they have no knowledge about creating, but they do imagine stuff that they can't do, but hope they or others can in the future or they come up with a unique off the wall idea they then try and implement.
It is the difference between a Computer Scientist making a breakthrough in AI because he used his imagination and you using your creative imagination to foresee time travel. I think that makes his/her imagination more useful and more credible. Creative imagination is just fiction that may or may not come true.
But it is literally my job to imagine things. The mad things I have imagined have bought me a nice flat in london and earned the taxman a large chunk of money
Is that true of anyone else on PB? Perhaps it is (this is a sincere question; I do not know)
I believe I have identified the source of PB’s occasional inability to look ahead
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
But this is all before ChatGPT and, soon, GPT4. They are revolutionary. The Revolution is here
Maybe tomorrow, but not today. I've looked at what ChatGPT produces in an area where I can check what it says, and it says both wrong things and right things in the same super-confident way. I wouldn't want it to be my GP any time soon (though an AI that suggested "hey, what about X?" and "ask patient about Y" as an assist to a human GP might be helpful).
Yup.
People have been working on automating diagnosis for decades. Seems simple - hell, they have diagnosis tree on medical text books. A question for each branch. You could code that on a ZX81.
Yet the reality is that, like self driving, still not happening.
And the bottleneck in healthcare isn’t diagnosis. It’s everything else….
Diagnosis is simple. Advice to "on no account consult Dr Google" is increasingly silly because if you have a degree level - in any subject - ability to assess the quality of sources and to understand the summary of a technical-but-not-very paper, google is and has been for at least 10 years as good as a GP at it. And the reason it's not so good at the next stage is nothing to do with algorithms, it's x rays and endoscopes and such which neither GPs nor AIs can do yet.
I wouldn’t say diagnosis is simple. I have a skin complaint (seborrhoeic dermatitis / basically a natural fungi we all have really on our skin particularly likes mine and over reacts) - that took 5 GP appointments to identify and was only fixed without a hospital appointment because the hospital specialist visits our GP surgery once a week.
Yet ChatGPT has just done what 6 surgery visits and 4 doctors were unable to do. Diagnose my hypothyroidism. In 2 seconds
Of course they won’t replace GPs all at once. At first the machines will be assistants and collaborators
But eventually we will accept that they are better at this than humans. Tireless, inexpensive, near flawless, unemotional. Available online and in person 24/7/365
Then they will replace the doctors
ChatGPT did not diagnose your hypothyroidism. It merely listed that as one of four possibilities (and hinted there were others). Your wider point that machines will get better in future is nothing new.
We were writing toy versions of medical diagnosis “expert systems” at university in the 90s.
It’s not a problem like image recognition/modification - increased numbers of “neurones” or whatever don’t seem to really improve the results. Which is why the IBM efforts stalled.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
"engineers are not known for their creative imagination"
So how come we've invented, designed, manufactured, fixed and made reliable just about every man-made object on the entire planet, and increasingly beyond it?
As I raised in my earlier post novelists and journalists can imagine all sorts of stuff that will never happen. That is easy. I'm sitting here at the moment doing just that. It takes a scientist/engineer to imagine stuff and then creating it.
You'd think, and probably it will happen one day, but in the last few years AI-assisted doctoring using IBM's Watson has been trialled in America with initially promising but ultimately disappointing results. Is 67 per cent good? Are human doctors wrong a third of the time?
But this is all before ChatGPT and, soon, GPT4. They are revolutionary. The Revolution is here
Maybe tomorrow, but not today. I've looked at what ChatGPT produces in an area where I can check what it says, and it says both wrong things and right things in the same super-confident way. I wouldn't want it to be my GP any time soon (though an AI that suggested "hey, what about X?" and "ask patient about Y" as an assist to a human GP might be helpful).
The last sentence is a really easy win, to my eyes. Make an appointment (no, don't laugh) and fill in a basic web-form with a description of your symptoms. That's fed through ChatGPT and your GP can have a quick look just before your appointment. They might entirely dismiss the suggestions, but it might also show up something they wouldn't have thought of in the limited time they have to think about it.
Not a massive revolution, but really, really easy to do and quite cost-effective.
I also think with all but the most regular ailments, GPs take a quick gander at Doctors 'Google' anyway. I certainly hope so; I wouldn't want a Doctor diagnosing me based solely on their ability to recall a lecture at medical college in 1988.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Firstly you did not make a ludicrous mistake. You said 'might' and she might have. Myself and Big G I think both said the same. I thought there was a 90% chance she was probably going to be very boring and a 10% chance she was going to be a breath of fresh air. I didn't anticipate the car crash.
Re the imagination stuff I think that is nonsense. Engineers and Scientists generally have a lot of imagination. Now I note you said 'creative imagination' If by that you mean the ridiculous then yes you are right. They don't imagine stuff that they have no knowledge about creating, but they do imagine stuff that they can't do, but hope they or others can in the future or they come up with a unique off the wall idea they then try and implement.
It is the difference between a Computer Scientist making a breakthrough in AI because he used his imagination and you using your creative imagination to foresee time travel. I think that makes his/her imagination more useful and more credible. Creative imagination is just fiction that may or may not come true.
But it is literally my job to imagine things. The mad things I have imagined have bought me a nice flat in london and earned the taxman a large chunk of money
Is that true of anyone else on PB? Perhaps it is (this is a sincere question; I do not know)
I believe I have identified the source of PB’s occasional inability to look ahead
My job is pretty much looking ahead (at what is likely to happen and where things could go wrong.)
Some posters on here have emphasised the need to take responsiblity for your health and exercise more. Where I live on the South Coast, the biggest topic after the shit state of the NHS is shit - at least the sewage being discharged into the local harbours. Keen wild swimmers are becoming reluctant to venture into the sea and even some local kayakers and dinghy sailors are wary of going out in case they capsize and swallow a mouthful. Not being able to go sailing might sound like a 1st world problem but if these activities are your main interest then it affects your mental and physical well being.
The whole sewage discharge fiasco just seem like a metaphor for this government.
Interesting debate here on the NHS today. But no-one has mentioned the demand side. We have become an overweight, lazy nation. Anyway, I have my walking boots on - going to take advantage of a nice sunny crisp (-2 degrees) day and go for a walk - see you in a bit.
By same token the NHS don't do much prevention, you would think a 15 minute annual check by a nurse at surgery and a few home truths etc might help. They don't even do that nowadays. My wife phoned about getting pneumonia jag only to be told she was not old enough even though she was , when she finally persuaded them to check they said they would put her on a list but as she insisted the nurse checked her records came back and said it was incredible given her recent problems that she had not had a nurse appointment in 3 years and they gave her hte jag that day. You normally get fobbed off either by the receptionist at the front or the nurse if you are lucky, a marathon to actually get to a GP nowadays.
I've been quite bemused by my interactions with my GP surgery. I went to see them after suffering really badly with stress & anxiety - at which point they realised I had high blood pressure (no surprise). So, onto meds for blood pressure. The stress/anxiety parts were 'treated' by printing out an A4 sheet with URLs to 'mindfulness' websites and that was it - never mentioned again.
When I was being given the blood pressure meds I'd ask questions like 'should I take them in the morning or evening?' - no answer. 'If I think I've forgotten to take them, should I risk taking too much or skip it for a day?' - no answer. They diligently record my weight, but never remark on it. Never 'take some excersise fatty' or 'you could lose a few pounds mate'.
They did a heart scan just to check (which is another matter - 'Your appointment at the fancy clinic is on the Xth of June' - no address, so I had to dig around google maps trying to find the place). I phoned them up about a month later to ask if they had the results. Nurse said 'hrm - yes. I think you should get a letter from the specialists soon.' About a month later I went in for my checkup and mentioned I hadn't had a letter. The nurse scrolled through my records and just said 'Hrm. Yeah. Guess they decided not to get you in. I suppose....'.
Last time I was in the nurse asked 'Do you want to go onto Medicine-X?' and I said '... I don't know? Do I need to go onto Medicine-X? I'd rather not take more meds if I don't need to?'. And got a smile and 'Ok then.' and that was the last it was mentioned.
This is something that is really cutting through to people. A major topic of conversation at local U3A meetings, book groups, coffee mornings etc. is how it is nearly impossible to get through to local surgeries. If by some fluke you do, you'll be lucky to get a phone consultation with a nurse. Forget seeing a doctor. A couple of months ago a friend's 80 year old ex-husband fell and hit his head. He phoned 999. When the ambulance arrived 13 hours later, he was dead These are not scare stories. People are worried it could be them or a loved one next.
GPs are often migrating to eConsult forms. We have used this and it has worked well for us, with good access to doctors when needed. It's not always obvious the best way to get help, but the model of ringing the surgery seems broken everywhere .
Just before Christmas you couldn't even get through to our local surgery on e-consult. Even early in the morning it said no appointments available.
This is something that could be solved tomorrow by an early application of AI
The machines are getting REALLY good at diagnosis. In some ways they are already better than human doctors
“Algorithm That Detects Sepsis Cut Deaths by Nearly 20 Percent
Over two years, a machine-learning program warned thousands of health care providers about patients at high risk of sepsis, allowing them to begin treatments nearly two hours sooner”
“doctors 🩺+ AI🤖 = 🤯
NEW state of the art AI scores 67% (up from 50%) and surely will improve to head to 90%+ in relevant + accurate answers for medical diagnosis + recommendations.
Full paper: (via DeepMind + Google Research teams) arxiv.org/pdf/2212.13138…”
An AI GP will be available 24/7; it could see 4m patients every 9 minutes. This technology is available NOW and will only get better
Of course there will be many cases requiring physical inspection, they can be handed on to human docs but anyone requiring an e-consult could be sorted right now. Why aren’t we doing it?
Lethargy, inertia and incompetence.
Yes, and @LostPassword posted a similar interesting message up thread about this too.
I refuse to be pessimistic about this - far too much of that above.
We need to invest in growing the pie and the technologies of the future.
Agreed, yet Treasury orthodoxy will trample over any kind of investment and foreign investors/states will buy up UK companies doing those technologies of the future for pennies and our innovations will benefit everyone except us.
Our economic model is fundamentally broken and it has been for 30 or so years.
Sounds like a football team that does a good job developing talent and then sells them on to the big boys.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Firstly you did not make a ludicrous mistake. You said 'might' and she might have. Myself and Big G I think both said the same. I thought there was a 90% chance she was probably going to be very boring and a 10% chance she was going to be a breath of fresh air. I didn't anticipate the car crash.
Re the imagination stuff I think that is nonsense. Engineers and Scientists generally have a lot of imagination. Now I note you said 'creative imagination' If by that you mean the ridiculous then yes you are right. They don't imagine stuff that they have no knowledge about creating, but they do imagine stuff that they can't do, but hope they or others can in the future or they come up with a unique off the wall idea they then try and implement.
It is the difference between a Computer Scientist making a breakthrough in AI because he used his imagination and you using your creative imagination to foresee time travel. I think that makes his/her imagination more useful and more credible. Creative imagination is just fiction that may or may not come true.
But it is literally my job to imagine things. The mad things I have imagined have bought me a nice flat in london and earned the taxman a large chunk of money
Is that true of anyone else on PB? Perhaps it is (this is a sincere question; I do not know)
I believe I have identified the source of PB’s occasional inability to look ahead
My job is pretty much looking ahead (at what is likely to happen and where things could go wrong.)
Interesting debate here on the NHS today. But no-one has mentioned the demand side. We have become an overweight, lazy nation. Anyway, I have my walking boots on - going to take advantage of a nice sunny crisp (-2 degrees) day and go for a walk - see you in a bit.
By same token the NHS don't do much prevention, you would think a 15 minute annual check by a nurse at surgery and a few home truths etc might help. They don't even do that nowadays. My wife phoned about getting pneumonia jag only to be told she was not old enough even though she was , when she finally persuaded them to check they said they would put her on a list but as she insisted the nurse checked her records came back and said it was incredible given her recent problems that she had not had a nurse appointment in 3 years and they gave her hte jag that day. You normally get fobbed off either by the receptionist at the front or the nurse if you are lucky, a marathon to actually get to a GP nowadays.
I've been quite bemused by my interactions with my GP surgery. I went to see them after suffering really badly with stress & anxiety - at which point they realised I had high blood pressure (no surprise). So, onto meds for blood pressure. The stress/anxiety parts were 'treated' by printing out an A4 sheet with URLs to 'mindfulness' websites and that was it - never mentioned again.
When I was being given the blood pressure meds I'd ask questions like 'should I take them in the morning or evening?' - no answer. 'If I think I've forgotten to take them, should I risk taking too much or skip it for a day?' - no answer. They diligently record my weight, but never remark on it. Never 'take some excersise fatty' or 'you could lose a few pounds mate'.
They did a heart scan just to check (which is another matter - 'Your appointment at the fancy clinic is on the Xth of June' - no address, so I had to dig around google maps trying to find the place). I phoned them up about a month later to ask if they had the results. Nurse said 'hrm - yes. I think you should get a letter from the specialists soon.' About a month later I went in for my checkup and mentioned I hadn't had a letter. The nurse scrolled through my records and just said 'Hrm. Yeah. Guess they decided not to get you in. I suppose....'.
Last time I was in the nurse asked 'Do you want to go onto Medicine-X?' and I said '... I don't know? Do I need to go onto Medicine-X? I'd rather not take more meds if I don't need to?'. And got a smile and 'Ok then.' and that was the last it was mentioned.
It really baffles me.
That’s pretty dreadful. And, again, it is hard to believe a computer would not do virtually all of this better
My wife has a long term, treatable issue. Like so many of these, every so often she needs to see a specialist to review the dosages, check for problems etc. So she goes to the GP. Who solemnly books a blood test. The blood is drawn by the nurse and sent off. The GP schedules an appointment where she solemnly acknowledges that she isn’t qualified to say much about the results. And refers to the usual consultant.
Not sure why they can’t put a decade of every six months in the nurses calendar to do the test, followed by an equal number of appointments to see the consultant…
Basically the UK decided on one model of universal healthcare 70 years ago and has stuck with it since, learning very little from other countries along the way. But anyone who proposes real change will be accused of "privatising the NHS" and so we are stuck with a system that does not work very well.
On top of that most of what people argue about are the numbers of beds, nurses, doctors and so on, not what actually matters which is how healthy the nation is. We are obssessed with measuring the wrong things.
That's what happens when you turn it into a religion, any talk of change is sacrosanct.
Except that is bollocks, both the religion bit and any talk of change.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Sounds like an AI. Have you and these AI computers ever been seen in the same room...?
Christ, an AI with an ego like Leon's alongside his insecurities, would finally convince me that the futures shown in Terminator and The Matrix were truly possible.
Though an interesting twist when Leon is unable to stop himself taking the blue AND red pills, and lots of them.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Firstly you did not make a ludicrous mistake. You said 'might' and she might have. Myself and Big G I think both said the same. I thought there was a 90% chance she was probably going to be very boring and a 10% chance she was going to be a breath of fresh air. I didn't anticipate the car crash.
Re the imagination stuff I think that is nonsense. Engineers and Scientists generally have a lot of imagination. Now I note you said 'creative imagination' If by that you mean the ridiculous then yes you are right. They don't imagine stuff that they have no knowledge about creating, but they do imagine stuff that they can't do, but hope they or others can in the future or they come up with a unique off the wall idea they then try and implement.
It is the difference between a Computer Scientist making a breakthrough in AI because he used his imagination and you using your creative imagination to foresee time travel. I think that makes his/her imagination more useful and more credible. Creative imagination is just fiction that may or may not come true.
But it is literally my job to imagine things. The mad things I have imagined have bought me a nice flat in london and earned the taxman a large chunk of money
Is that true of anyone else on PB? Perhaps it is (this is a sincere question; I do not know)
I believe I have identified the source of PB’s occasional inability to look ahead
My job is pretty much looking ahead (at what is likely to happen and where things could go wrong.)
I too also pay a hefty amount to the taxman.
So this is another thing you are wrong about.
But you don’t “imagine” for a job?
JOKE REDACTED
I do imagine.
I imagine where traders, clients, and other external parties might try and bugger up the system/act illegally/unethically. I have to imagine where our systems could be weak and how they could be exploited.
I also have so much fun imagining stuff when thing X is lawful in one country an unlawful in another country.
Don't even get me started on the near six year project I worked on prepping the UK for Brexit.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
"engineers are not known for their creative imagination"
So how come we've invented, designed, manufactured, fixed and made reliable just about every man-made object on the entire planet, and increasingly beyond it?
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Firstly you did not make a ludicrous mistake. You said 'might' and she might have. Myself and Big G I think both said the same. I thought there was a 90% chance she was probably going to be very boring and a 10% chance she was going to be a breath of fresh air. I didn't anticipate the car crash.
Re the imagination stuff I think that is nonsense. Engineers and Scientists generally have a lot of imagination. Now I note you said 'creative imagination' If by that you mean the ridiculous then yes you are right. They don't imagine stuff that they have no knowledge about creating, but they do imagine stuff that they can't do, but hope they or others can in the future or they come up with a unique off the wall idea they then try and implement.
It is the difference between a Computer Scientist making a breakthrough in AI because he used his imagination and you using your creative imagination to foresee time travel. I think that makes his/her imagination more useful and more credible. Creative imagination is just fiction that may or may not come true.
But it is literally my job to imagine things. The mad things I have imagined have bought me a nice flat in london and earned the taxman a large chunk of money
Is that true of anyone else on PB? Perhaps it is (this is a sincere question; I do not know)
I believe I have identified the source of PB’s occasional inability to look ahead
My job is pretty much looking ahead (at what is likely to happen and where things could go wrong.)
I too also pay a hefty amount to the taxman.
So this is another thing you are wrong about.
But you don’t “imagine” for a job?
JOKE REDACTED
Due to having fessed up to suffering from excessive boredom during Lockdown, PB's resident flint-knapper @Leon was commissioned by CCHQ to knap the perfect sculpture of Boris Johnson! Finally able to take a break from knapping strangely shaped sex-toys, he accepted the work in a heartbeat, and got to sculpting the same day. Arduous work, but he felt that, over the course of several weeks of almost continuous knapping, that he got it almost completely spot on with just a little bit more required.
However, @Leon had found that he had knapped so meticulously that his hands were thoroughly knackered and sore. He wondered about taking some time off in order to finish off his masterpiece at a later date. Boris's office phoned him back reasonably promptly, but to @Leon's horror, he was told in no uncertain terms that he would lose his fee if he stopped work!
My wife has a long term, treatable issue. Like so many of these, every so often she needs to see a specialist to review the dosages, check for problems etc. So she goes to the GP. Who solemnly books a blood test. The blood is drawn by the nurse and sent off. The GP schedules an appointment where she solemnly acknowledges that she isn’t qualified to say much about the results. And refers to the usual consultant.
Not sure why they can’t put a decade of every six months in the nurses calendar to do the test, followed by an equal number of appointments to see the consultant…
Basically the UK decided on one model of universal healthcare 70 years ago and has stuck with it since, learning very little from other countries along the way. But anyone who proposes real change will be accused of "privatising the NHS" and so we are stuck with a system that does not work very well.
On top of that most of what people argue about are the numbers of beds, nurses, doctors and so on, not what actually matters which is how healthy the nation is. We are obssessed with measuring the wrong things.
That's what happens when you turn it into a religion, any talk of change is sacrosanct.
Except that is bollocks, both the religion bit and any talk of change.
Still, lazy clichés are comforting aren't they?
I'd like to see evidence of a Tory proposal to change something in the NHS that wasn't greeted with such claims. What is needed with this (and many other things) is a grown-up discussion. But everything is just reduced to soundbites.
To me, this graph suggests growing polarisation by age and Brexit partisanship over the issue of "Stay out" vs "Rejoin". Potentially a source of growing political pressures and frictions over time https://twitter.com/UKandEU/status/1609859259822481411
Interesting to see that 20% of Leave voters think we should Rejoin.
When last polled by YouGov in February 2020, support for joining the euro in the UK was 11% with 18% unsure and 64% opposed - those are huge numbers.
It very much depends what sort of Rejoin is offered, and I expect it to be standard terms.
If the EU moved in a direction of "tiered" membership with differing levels of integration, in the years to come, then I think it would be possibly very different.
I don't think we should join the euro (in the foreseeable future, it's not a theological issue for me), but I do think we should rejoin the EU on the standard terms. Why? Because there is no mechanism to make a country join the euro and there is a very simple mechanism a country can adopt to put off euro membership indefinitely - failing to join the ERM. This is how Sweden has never joined the euro and never will until it decides it wants to. Of course, these are fairly sophisticated arguments and I would expect most people's ignorance on these questions will be effectively exploited by those opposed to us rejoining. Nevertheless, I would hope that on a sophisticated forum such as this the true nature of the issue should be well understood.
If they wanted to insist on it they could make it a condition of membership. No Euro, no membership. Don't forget that Sweden was already a member when the Euro was introduced.
I think it depends on how much the EU want us back. If we asked right now the Euro would be a condition... if we ask a decade down the line and the EU are sure that we won't change our mind about being in it yet again it might well be a different story. Rejoiners need to play a long game, and probably need the next Labour government to win three terms. I could something like this happening... 1st term - 2025, TCA renegotiated and we end up with something akin to May's deal 2nd term - 2029, we apply to join the EEA via EFTA following a commitment in the Labour manifesto 3rd term - 2034, we apply to join the EU and become a candidate country. Eventually, once terms are agreed following negotiations, we have a rejoin referendum.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Firstly you did not make a ludicrous mistake. You said 'might' and she might have. Myself and Big G I think both said the same. I thought there was a 90% chance she was probably going to be very boring and a 10% chance she was going to be a breath of fresh air. I didn't anticipate the car crash.
Re the imagination stuff I think that is nonsense. Engineers and Scientists generally have a lot of imagination. Now I note you said 'creative imagination' If by that you mean the ridiculous then yes you are right. They don't imagine stuff that they have no knowledge about creating, but they do imagine stuff that they can't do, but hope they or others can in the future or they come up with a unique off the wall idea they then try and implement.
It is the difference between a Computer Scientist making a breakthrough in AI because he used his imagination and you using your creative imagination to foresee time travel. I think that makes his/her imagination more useful and more credible. Creative imagination is just fiction that may or may not come true.
But it is literally my job to imagine things. The mad things I have imagined have bought me a nice flat in london and earned the taxman a large chunk of money
Is that true of anyone else on PB? Perhaps it is (this is a sincere question; I do not know)
I believe I have identified the source of PB’s occasional inability to look ahead
Well of course it is. No criticism of that. You provide a useful service in informing people about travel and entertaining them with your books and articles.
Because most of us live in the real world it is hard for us to compete on the imagination front because the stuff we do has to work. We just can't make it up, so our imagination has to be more imaginative because the end has to be achievable. Also I believe we do have other authors here (Morris dancer?) so there are others in your field and there are plenty of people who work in the theoretical arena (my son is one)
I also don't think you want to get into the field of whose got the nicest or most expensive pad or the biggest income from their endeavours and imagination. PB is not a cross section of society as you have identified yourself, so I would judge there are quite a few here that are pretty loaded by most peoples standards because of their achievements and of course money is not the only measure of success.
Here’s a concrete example of how AI could be used now to replace GPs
I have a recurring condition of otitis externa - swimmers ear. Not pleasant but easily fixed with antibiotic drops
Every so often I have to ask the GP to prescribe the medication. You can’t buy it OTC
This happened before Xmas. I had to call the surgery. They arranged a phone consultation a week later. The doctor rang me, listened to my symptoms, and said Yes: that’s the same condition. I’ll prescribe the drops. She also said “anything else?” - I said no
That was it. In total. Yet I had to go through that faff and a highly paid doctor had to carve out time in her day. ChatGP could have done exactly the same immediately, in 3 secs, for free
To me, this graph suggests growing polarisation by age and Brexit partisanship over the issue of "Stay out" vs "Rejoin". Potentially a source of growing political pressures and frictions over time https://twitter.com/UKandEU/status/1609859259822481411
Interesting to see that 20% of Leave voters think we should Rejoin.
When last polled by YouGov in February 2020, support for joining the euro in the UK was 11% with 18% unsure and 64% opposed - those are huge numbers.
It very much depends what sort of Rejoin is offered, and I expect it to be standard terms.
If the EU moved in a direction of "tiered" membership with differing levels of integration, in the years to come, then I think it would be possibly very different.
I don't think we should join the euro (in the foreseeable future, it's not a theological issue for me), but I do think we should rejoin the EU on the standard terms. Why? Because there is no mechanism to make a country join the euro and there is a very simple mechanism a country can adopt to put off euro membership indefinitely - failing to join the ERM. This is how Sweden has never joined the euro and never will until it decides it wants to. Of course, these are fairly sophisticated arguments and I would expect most people's ignorance on these questions will be effectively exploited by those opposed to us rejoining. Nevertheless, I would hope that on a sophisticated forum such as this the true nature of the issue should be well understood.
If they wanted to insist on it they could make it a condition of membership. No Euro, no membership. Don't forget that Sweden was already a member when the Euro was introduced.
I think it depends on how much the EU want us back. If we asked right now the Euro would be a condition... if we ask a decade down the line and the EU are sure that we won't change our mind about being in it yet again it might well be a different story. Rejoiners need to play a long game, and probably need the next Labour government to win three terms. I could something like this happening... 1st term - 2025, TCA renegotiated and we end up with something akin to May's deal 2nd term - 2029, we apply to join the EEA via EFTA following a commitment in the Labour manifesto 3rd term - 2034, we apply to join the EU and become a candidate country. Eventually, once terms are agreed following negotiations, we have a rejoin referendum.
Though if Labour got the UK to Step 2, I could imagine a Conservative party denuded of the 2026 gang, desparate for power and chafing at being outside the room doing the third.
How's that for imagination?
(God knows what Leon's blethering about. Physics is imagination - imaging that particles we can't see behave like things we can. Or imagining what distant world's are like. Engineers imagine things and make them to solve problems
The difference is that physical science imagination has to join up with reality. Or it's just Making Stuff Up.
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Firstly you did not make a ludicrous mistake. You said 'might' and she might have. Myself and Big G I think both said the same. I thought there was a 90% chance she was probably going to be very boring and a 10% chance she was going to be a breath of fresh air. I didn't anticipate the car crash.
Re the imagination stuff I think that is nonsense. Engineers and Scientists generally have a lot of imagination. Now I note you said 'creative imagination' If by that you mean the ridiculous then yes you are right. They don't imagine stuff that they have no knowledge about creating, but they do imagine stuff that they can't do, but hope they or others can in the future or they come up with a unique off the wall idea they then try and implement.
It is the difference between a Computer Scientist making a breakthrough in AI because he used his imagination and you using your creative imagination to foresee time travel. I think that makes his/her imagination more useful and more credible. Creative imagination is just fiction that may or may not come true.
But it is literally my job to imagine things. The mad things I have imagined have bought me a nice flat in london and earned the taxman a large chunk of money
Is that true of anyone else on PB? Perhaps it is (this is a sincere question; I do not know)
I believe I have identified the source of PB’s occasional inability to look ahead
Well of course it is. No criticism of that. You provide a useful service in informing people about travel and entertaining them with your books and articles.
Because most of us live in the real world it is hard for us to compete on the imagination front because the stuff we do has to work. We just can't make it up, so our imagination has to be more imaginative because the end has to be achievable. Also I believe we do have other authors here (Morris dancer?) so there are others in your field and there are plenty of people who work in the theoretical arena (my son is one)
I also don't think you want to get into the field of whose got the nicest or most expensive pad or the biggest income from their endeavours and imagination. PB is not a cross section of society as you have identified yourself, so I would judge there are quite a few here that are pretty loaded by most peoples standards because of their achievements and of course money is not the only measure of success.
You’re all a bunch of dull-witted geeks and nerds. Let’s face it
Whereas I am an IMAGINEER
And now I must imagine myself getting off PB, and walking the Heath with my daughter
I have just used my human brain to diagnose PB’s ailment. It is a lack of imagination
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
Firstly you did not make a ludicrous mistake. You said 'might' and she might have. Myself and Big G I think both said the same. I thought there was a 90% chance she was probably going to be very boring and a 10% chance she was going to be a breath of fresh air. I didn't anticipate the car crash.
Re the imagination stuff I think that is nonsense. Engineers and Scientists generally have a lot of imagination. Now I note you said 'creative imagination' If by that you mean the ridiculous then yes you are right. They don't imagine stuff that they have no knowledge about creating, but they do imagine stuff that they can't do, but hope they or others can in the future or they come up with a unique off the wall idea they then try and implement.
It is the difference between a Computer Scientist making a breakthrough in AI because he used his imagination and you using your creative imagination to foresee time travel. I think that makes his/her imagination more useful and more credible. Creative imagination is just fiction that may or may not come true.
But it is literally my job to imagine things. The mad things I have imagined have bought me a nice flat in london and earned the taxman a large chunk of money
Is that true of anyone else on PB? Perhaps it is (this is a sincere question; I do not know)
I believe I have identified the source of PB’s occasional inability to look ahead
Well of course it is. No criticism of that. You provide a useful service in informing people about travel and entertaining them with your books and articles.
Because most of us live in the real world it is hard for us to compete on the imagination front because the stuff we do has to work. We just can't make it up, so our imagination has to be more imaginative because the end has to be achievable. Also I believe we do have other authors here (Morris dancer?) so there are others in your field and there are plenty of people who work in the theoretical arena (my son is one)
I also don't think you want to get into the field of whose got the nicest or most expensive pad or the biggest income from their endeavours and imagination. PB is not a cross section of society as you have identified yourself, so I would judge there are quite a few here that are pretty loaded by most peoples standards because of their achievements and of course money is not the only measure of success.
You’re all a bunch of dull-witted geeks and nerds. Let’s face it
Whereas I am an IMAGINEER
And now I must imagine myself getting off PB, and walking the Heath with my daughter
Happy almost-new year
Yes, who can forget you imagining Liz Truss would turn out to be an awesome Prime Minister.
To me, this graph suggests growing polarisation by age and Brexit partisanship over the issue of "Stay out" vs "Rejoin". Potentially a source of growing political pressures and frictions over time https://twitter.com/UKandEU/status/1609859259822481411
Interesting to see that 20% of Leave voters think we should Rejoin.
When last polled by YouGov in February 2020, support for joining the euro in the UK was 11% with 18% unsure and 64% opposed - those are huge numbers.
It very much depends what sort of Rejoin is offered, and I expect it to be standard terms.
If the EU moved in a direction of "tiered" membership with differing levels of integration, in the years to come, then I think it would be possibly very different.
I don't think we should join the euro (in the foreseeable future, it's not a theological issue for me), but I do think we should rejoin the EU on the standard terms. Why? Because there is no mechanism to make a country join the euro and there is a very simple mechanism a country can adopt to put off euro membership indefinitely - failing to join the ERM. This is how Sweden has never joined the euro and never will until it decides it wants to. Of course, these are fairly sophisticated arguments and I would expect most people's ignorance on these questions will be effectively exploited by those opposed to us rejoining. Nevertheless, I would hope that on a sophisticated forum such as this the true nature of the issue should be well understood.
If they wanted to insist on it they could make it a condition of membership. No Euro, no membership. Don't forget that Sweden was already a member when the Euro was introduced.
I think it depends on how much the EU want us back. If we asked right now the Euro would be a condition... if we ask a decade down the line and the EU are sure that we won't change our mind about being in it yet again it might well be a different story. Rejoiners need to play a long game, and probably need the next Labour government to win three terms. I could something like this happening... 1st term - 2025, TCA renegotiated and we end up with something akin to May's deal 2nd term - 2029, we apply to join the EEA via EFTA following a commitment in the Labour manifesto 3rd term - 2034, we apply to join the EU and become a candidate country. Eventually, once terms are agreed following negotiations, we have a rejoin referendum.
Though if Labour got the UK to Step 2, I could imagine a Conservative party denuded of the 2026 gang, desparate for power and chafing at being outside the room doing the third.
How's that for imagination?
(God knows what Leon's blethering about. Physics is imagination - imaging that particles we can't see behave like things we can. Or imagining what distant world's are like. Engineers imagine things and make them to solve problems
The difference is that physical science imagination has to join up with reality. Or it's just Making Stuff Up.
The vast majority of Leavers now vote Conservative. It would take a decade or 2 for the Tories to even accept EFTA and EEA membership if Labour returned the UK to that in government let alone EU membership. If they did of course most of their voters would defect to Farage, certainly over 50 and they are the vast majority of Conservative voters now
Comments
This logic applies to queues. If you can process 200 people/hour and you get 195, great, if you get 205, then each hour 5 are added to the queue. if you have even slightly less resources than necessary to keep ahead of incoming requests, as a long run average, then how bad it can get (how long the waiting time) is unbounded. This is particularly noticeable in computing, because computers don't change their behavior unless told to, even if everything is going to shit.
The NHS doesn't quite match this theory, because in the theoretical model nothing leaves the queue until it's served, whereas people in the A&E queue can die.
But yes, it can and will get worse than this. You can save some people from the wait by triaging harder, but that means the severity level at which people are not treated urgently is increased. It sounds like it's already much higher than anyone would wish - especially as the waiting time for non-urgent care is also upwards of 6 months and increasing in many cases.
We don't build family-sized homes within towns and cities unless the Prince of Wales is involved. So people have to drive to work, so you need to reserve lots of space for cars. So people end up driving everywhere; partly because they have two cars already but also because local facilities are spread out by the need for car space. So they end up poorer, fatter and sadder.
Clearly there is a growing number for whom family help is not practical because of conditions such as dementia or because the children are no longer around themselves or never existed and in those cases I fully understand and support the use of the state or private provision to look after them. But as a society we seem to have accepted that it is now okay to simply cast ones elderly relatives adrift or get others - primarily the state - to look after them so we can get on with our own lives and not suffer the inconvenience of having them around. It is not something that I can find it in my heart to agree with all the more so when those younger generations then complain about the costs involved.
To butcher the old advert, parents are for life, not just for Christmas presents.
I refuse to be pessimistic about this - far too much of that above.
We need to invest in growing the pie and the technologies of the future.
It needs large increases each and every year to run to stand still.
See my post upthread.
“Artificial intelligence revolutionising NHS stroke care
Use of cutting-edge AI technology is associated with a tripling of the number of patients recovering and able to perform daily activities from 16% to 48%.”
https://www.gov.uk/government/news/artificial-intelligence-revolutionising-nhs-stroke-care
“A diagnostic AI that knows when to step in - @MIT_CSAIL's system can look at chest X-rays to diagnose pneumonia, and also knows when to defer to a radiologist.”
“Google Introduces ChatGPT-like ChatBot for Healthcare,
analyticsindiamag.com/google-introdu… #AI #DataScience #ArtificialIntelligence #bigdata”
This is actually fantastic news. And cause for much needed optimism. So many of our worst and apparently intractable human problems are about to be solved
Or at least, blow its own trumpet...
Noted.
*Yes, I know there is no good reason to cycle to Walsall. I was bored and thought I would explore where this lovely ex-railway now a cycle track went.
I can only surmise that people simply haven't a scoobies so try and skirt the issue by indulging in wishful thinking instead.
I would probably answer rejoin to the polling question but don't think we should go through the process of another divisive referendum, or taking another major decision without agreeing with the EU exactly what rejoin would look like ahead of such referendum.
For it to be worth rejoining I think you need about 65% in favour for a sustained period (5 years or so) and the EU to be open to making it work. The very earliest that might happen would be early to mid 2030s if ever. Far more likely that we can get to some less damaging hybrid level in the late 2020s.
That they do this is remarkable.
That they teach approximately what similar resourced schools taught, in the U.K., before the Victorians dumped a fuckton of money into education, isn’t. At least to me.
This is known as “Fucking Stupid”.
In the short term there is not a fixed pot of money that the govt can spend.
When the govt u-turn, probably not far away now, and end up paying 8-10% increases that are needed the same people saying we can't afford it now will be championing the govt and Brexit for boosting pay for workers.
It very much depends what sort of Rejoin is offered, and I expect it to be standard terms.
If the EU moved in a direction of "tiered" membership with differing levels of integration, in the years to come, then I think it would be possibly very different.
There's the settlement on pay for this year - where I agree HMG needs to up its offer- and there's the ongoing funding solution for the NHS that raises its performance to acceptable levels, which I think is far more difficult.
People have been working on automating diagnosis for decades. Seems simple - hell, they have diagnosis tree on medical text books. A question for each branch. You could code that on a ZX81.
Yet the reality is that, like self driving, still not happening.
And the bottleneck in healthcare isn’t diagnosis. It’s everything else….
Which means that the best available option (far from perfect, but we now know that isn't available) is EEA/EFTA. This outcome is also realistic given the 52/48 split in 2016.
Some backstory. 20 years ago I went to my doctors with a weird list of symptoms. They were completely mystified and spent weeks trying to work out what was wrong. Eventually I googled my symptoms myself, discovered that I probably had hypothyroidism. I went back to the docs and told them this and they were loftily skeptical. Too young too male etc. I had ti shout and scream to get a blood test
Eventually they agreed and a week later they
sheepishly admitted. Yes, hypothyroid
I just tapped those symptoms into ChatGPT. This is literally its first reply. In 2 seconds
It’s pretty obvious to most people that if you tell EU nationals they’re not welcome that they won’t be coming in their droves to have to jump through a load of hoops to get a job in the UK .
The Leave cult will desperately try and cling to the Brexit delusion and stick the whole problem onto covid .
“I still can’t believe San Francisco has real driverless cars”
https://twitter.com/starbuxman/status/1606517634509725697?s=46&t=LEjJ69hWgF6PXYT4PeRRmw
The technology on this is rolling forward at a tremendous pace and doesn’t require special breakthroughs.
One possible future is automated testing at your pharmacy…. Results available not in weeks, but in seconds
Noted.
Our economic model is fundamentally broken and it has been for 30 or so years.
"In June 2016 there were 58,702 NHS staff with a recorded EU nationality, and in June 2022 there were 70,735 – an apparent rise. But to present this as the full story would be misleading, because there are over 57,000 more staff for whom nationality is known now than in 2016. It is very likely that there has been an overall increase in the number of NHS staff with EU nationality since 2016, but we can’t be sure about the scale of the change, and it would be misleading to calculate an increase based solely on the two numbers above."
Taking their warning at face value, any claims about rises and falls in EU nationals in the NHS are to be greeted with caution and your claims certainly don't match either the perceived or the raw numbers.
https://commonslibrary.parliament.uk/research-briefings/cbp-7783/
Most of you are Boffins. Engineers. Scientists. Statisticians. It’s the kind of site that attracts people like this. No bad thing. But engineers are not known for their creative imagination
For that you need an artist. A flint knapper. I have an imagination - it’s my job to imagine things. It pays pretty well
Because I rely on my imagination I am liable to make ludicrous mistakes - “Liz truss might surprise on the upside”. But it also means I can imagine the future, perhaps, a little better than others
- Salary increases for nurses and paramedics meet inflation for this year and next. This is as much to remove an issue that is getting in the way of dealing with the healthcare crisis, as it is to deal with a labour supply issue. It isn't inflationary; it just takes away those groups from a wheeze by the government to get itself out of the fiscal hole it has put the country in, by reducing the real wages of public servants.
- Remove the requirement for work permits for any EU citizen involved in clinical or direct social care for the next five years - reinstating the situation prior to 2020.
- A programme to tackle bed blocking by creating social care alternatives for those going out of hospital. This will cost new money.
There's a lot of medium and long term actions than need to happen as well. They should start now.Of course they won’t replace GPs all at once. At first the machines will be assistants and collaborators
But eventually we will accept that they are better at this than humans. Tireless, inexpensive, near flawless, unemotional. Available online and in person 24/7/365
Then they will replace the doctors
I can’t imagine what it is like NOT to have one. They can be a curse. Monsters come in the night
Brown's GP reforms were utter bollocks I agree. But again these were more than a decade ago so I find it hard to believe they are responsible in any major way for the problems now being experienced on the front line. At worst they are a small part contributing to a worsening situation.
Go get 'em boys!
Of course, these are fairly sophisticated arguments and I would expect most people's ignorance on these questions will be effectively exploited by those opposed to us rejoining. Nevertheless, I would hope that on a sophisticated forum such as this the true nature of the issue should be well understood.
Re the imagination stuff I think that is nonsense. Engineers and Scientists generally have a lot of imagination. Now I note you said 'creative imagination' If by that you mean the ridiculous then yes you are right. They don't imagine stuff that they have no knowledge about creating, but they do imagine stuff that they can't do, but hope they or others can in the future or they come up with a unique off the wall idea they then try and implement.
It is the difference between a Computer Scientist making a breakthrough in AI because he used his imagination and you using your creative imagination to foresee time travel. I think that makes his/her imagination more useful and more credible. Creative imagination is just fiction that may or may not come true.
Not a massive revolution, but really, really easy to do and quite cost-effective.
Most systems have redundancy and margin built in. So 20 things are needed for failure say. 10 go wrong…. We motor on. 18 are failed… the system rumbles… we motor on. 20 fail….
The GP issue is that they are used as gate keepers for the entire NHS.
My wife has a long term, treatable issue. Like so many of these, every so often she needs to see a specialist to review the dosages, check for problems etc. So she goes to the GP. Who solemnly books a blood test. The blood is drawn by the nurse and sent off. The GP schedules an appointment where she solemnly acknowledges that she isn’t qualified to say much about the results. And refers to the usual consultant.
Not sure why they can’t put a decade of every six months in the nurses calendar to do the test, followed by an equal number of appointments to see the consultant…
On top of that most of what people argue about are the numbers of beds, nurses, doctors and so on, not what actually matters which is how healthy the nation is. We are obssessed with measuring the wrong things.
So how come we've invented, designed, manufactured, fixed and made reliable just about every man-made object on the entire planet, and increasingly beyond it?
There was a reason that Theranos avoided real Biotech Venture Capital and targeted amateur investors.
1 \ BREAKING: New Israeli foreign minister Eli Cohen signaled a policy shift on Ukraine in his 1st speech hinting the new government will take a more pro-Russian line. He said he will speak on Tuesday with Russian FM Lavrov – 1st such call since the Russian invasion of Ukraine
2 \ In his speech Cohen hinted that unlike his predecessor Yair Lapid he will not condemn Russia publicly. “On the issue of Russia and Ukraine we will do on thing for sure – speak less in public”
3 \ The new Israeli FM said he is going to draft a “responsible” new policy on the war in Ukraine and stressed the foreign ministry “will prepare a detailed presentation to the security cabinet on this issue”. He also said the Israeli humanitarian aid to Ukraine will continue
4 \ Why it matters: Cohen’s predecessor Yair Lapid led a tough line Russia, condemned it publicly & even said the Russian military committed war crimes. Since the invasion Lapid didn’t speak to Lavrov & after he assumed office as caretaker prime minister he didn’t speak to Putin
https://twitter.com/BarakRavid/status/1609888102906056705
I can only hope Iran also taking a pro Russia line might end up shaming the Bibi but I have my doubts.
Is that true of anyone else on PB? Perhaps it is (this is a sincere question; I do not know)
I believe I have identified the source of PB’s occasional inability to look ahead
It’s not a problem like image recognition/modification - increased numbers of “neurones” or whatever don’t seem to really improve the results. Which is why the IBM efforts stalled.
I too also pay a hefty amount to the taxman.
So this is another thing you are wrong about.
The whole sewage discharge fiasco just seem like a metaphor for this government.
When I was being given the blood pressure meds I'd ask questions like 'should I take them in the morning or evening?' - no answer. 'If I think I've forgotten to take them, should I risk taking too much or skip it for a day?' - no answer. They diligently record my weight, but never remark on it. Never 'take some excersise fatty' or 'you could lose a few pounds mate'.
They did a heart scan just to check (which is another matter - 'Your appointment at the fancy clinic is on the Xth of June' - no address, so I had to dig around google maps trying to find the place). I phoned them up about a month later to ask if they had the results. Nurse said 'hrm - yes. I think you should get a letter from the specialists soon.' About a month later I went in for my checkup and mentioned I hadn't had a letter. The nurse scrolled through my records and just said 'Hrm. Yeah. Guess they decided not to get you in. I suppose....'.
Last time I was in the nurse asked 'Do you want to go onto Medicine-X?' and I said '... I don't know? Do I need to go onto Medicine-X? I'd rather not take more meds if I don't need to?'. And got a smile and 'Ok then.' and that was the last it was mentioned.
It really baffles me.
JOKE REDACTED
Still, lazy clichés are comforting aren't they?
I imagine where traders, clients, and other external parties might try and bugger up the system/act illegally/unethically. I have to imagine where our systems could be weak and how they could be exploited.
I also have so much fun imagining stuff when thing X is lawful in one country an unlawful in another country.
Don't even get me started on the near six year project I worked on prepping the UK for Brexit.
However, @Leon had found that he had knapped so meticulously that his hands were thoroughly knackered and sore. He wondered about taking some time off in order to finish off his masterpiece at a later date. Boris's office phoned him back reasonably promptly, but to @Leon's horror, he was told in no uncertain terms that he would lose his fee if he stopped work!
"Why?" asked @Leon on the phone incredulously.
"Simple!" Boris's underling replied. "You're not entitled to any..." He paused for effect. "...Statue-Tory Sick Pay!"
I thank you!
Rejoiners need to play a long game, and probably need the next Labour government to win three terms. I could something like this happening...
1st term - 2025, TCA renegotiated and we end up with something akin to May's deal
2nd term - 2029, we apply to join the EEA via EFTA following a commitment in the Labour manifesto
3rd term - 2034, we apply to join the EU and become a candidate country. Eventually, once terms are agreed following negotiations, we have a rejoin referendum.
Because most of us live in the real world it is hard for us to compete on the imagination front because the stuff we do has to work. We just can't make it up, so our imagination has to be more imaginative because the end has to be achievable. Also I believe we do have other authors here (Morris dancer?) so there are others in your field and there are plenty of people who work in the theoretical arena (my son is one)
I also don't think you want to get into the field of whose got the nicest or most expensive pad or the biggest income from their endeavours and imagination. PB is not a cross section of society as you have identified yourself, so I would judge there are quite a few here that are pretty loaded by most peoples standards because of their achievements and of course money is not the only measure of success.
I have a recurring condition of otitis externa - swimmers ear. Not pleasant but easily fixed with antibiotic drops
Every so often I have to ask the GP to prescribe the medication. You can’t buy it OTC
This happened before Xmas. I had to call the surgery. They arranged a phone consultation a week later. The doctor rang me, listened to my symptoms, and said Yes: that’s the same condition. I’ll prescribe the drops. She also said “anything else?” - I said no
That was it. In total. Yet I had to go through that faff and a highly paid doctor had to carve out time in her day. ChatGP could have done exactly the same immediately, in 3 secs, for free
How's that for imagination?
(God knows what Leon's blethering about. Physics is imagination - imaging that particles we can't see behave like things we can. Or imagining what distant world's are like. Engineers imagine things and make them to solve problems
The difference is that physical science imagination has to join up with reality. Or it's just Making Stuff Up.
https://www.bbc.co.uk/news/world-europe-64144309
Whereas I am an IMAGINEER
And now I must imagine myself getting off PB, and walking the Heath with my daughter
Happy almost-new year
Labour returned the UK to that in government let alone EU membership. If they did of course most of their voters would defect to Farage, certainly over 50 and they are the vast majority of Conservative voters now