So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It’s not really about limit8ng demand, it’s sorting the 1% that needs further attention from the 99% which can be handled in primary care. It doesn’t always get it right, but it mostly works (or did, we are having a lot of issues now as we don’t have enough GPs, partly as so many have reduced their hours.) There is a lot that can be done, pharmacists can do more to manage simple infections and asthma medication for instance. I need to order inhalers via a phone system - might be easier if I could just pop into the pharmacy.
I know they have changed the laws of football in some very peculiar ways, as shown by United’s first goal yesterday, but are Arsenal really allowed to win the league again? I thought that had been stopped.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
Any health System has to prioritise. Under SKS unskilled patients will take charge.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
It might have been a silly example but equally internal bleeding it likely to be an emergency so people will "self-refer" themselves to A&E, so perhaps he wasn't so wrong.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It's more about efficient allocation of resources. I have paid the Nuffield for psychiatry and for new hips, and in both cases they quite rightly won't initially talk to me, even at £250 an hour, without a GP referral.
One area that is ridiculous is people with diagnosed, long term, treatable illnesses.
A number of these are like this
1) incurable 2) treatment, which means you can live a normal life, consists of taking some pills/injections for the rest of your life 3) on a regular basis, you need to have tests and an appointment with a specialist consultant - both for dosage levels of the medicine and to check whether the medicine is causing problems, such as liver damage.
The NHS includes the step, after you have a blood test, you must see your GP. Who solemnly says they aren’t qualified to read the results and refers you to the specialist….
The government is finally set to announce a new law banning so-called conversion therapy.
ITV News understands that the ban - due to be announced this week - will outlaw attempts to change a person’s sexuality and also attempts to change someone’s gender identity.
The government had previously said that trans conversion therapy would be excluded from a ban.
It’s understood that Downing Street has been surprised by the level of cross-party support - including from within the Conservative Party - for a total ban.
I truly don't see how this works, but I expect the reality to be:
G/B of any age says I think I am really a B/G: Yes of course you are, hurrah! = good, Are you quite sure about this, and sure you'll be sure in say 3 months time = criminal offence. Great.
And you expect this reality based on what, exactly?
Instructions from the Kremlin.
Also, a knowledge that this sort of thing is the orthodoxy
“This study provides further credence to guidance that practitioners and other professionals should affirm—rather than question—a child’s assertion of their gender, particularly for those who more strongly identify with their gender,” says Russell Toomey from the University of Arizona, who studies LGBTQ youth and is himself transgender."
It is essential that these children and young people can access the same level of psychological and social support as any other child or young person in distress, from their first encounter with the NHS and at every level within the service.
Re Sweden, after my recent deep dive on Europe and migration, I am now convinced a significant western European country will elect a hard/far right government in the next 5-10 years. And i don’t mean “in coalition” I mean: they will be handed the government, in toto. And they will enact some eye watering polices
My guess is that the first will either be Sweden or France
You could argue Italy has done it already with Meloni, but their system is so fucked and fractious nothing ever happens whoever is elected
The far right parties in both countries seem stuck on around 20%:
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It's more about efficient allocation of resources. I have paid the Nuffield for psychiatry and for new hips, and in both cases they quite rightly won't initially talk to me, even at £250 an hour, without a GP referral.
Having a direct relationship with dentists or physiotherapists seems to work ok. Does anyone think it would be a good idea to improve resource management by requiring referrals for dental treatment?
I don't dismiss the role of GPs, but it's not crazy to think that patients are sometimes better off being in control.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It’s not really about limit8ng demand, it’s sorting the 1% that needs further attention from the 99% which can be handled in primary care. It doesn’t always get it right, but it mostly works (or did, we are having a lot of issues now as we don’t have enough GPs, partly as so many have reduced their hours.) There is a lot that can be done, pharmacists can do more to manage simple infections and asthma medication for instance. I need to order inhalers via a phone system - might be easier if I could just pop into the pharmacy.
It has been seen, in a number of experiments that when you triage people in the A&E queues to see a GP like doctor in the hospital that this works very well.
Quite a few people going to A&E do so because of lack of GP access.
Which suggests to me that we should go with the flow. Have a bunch of GPs in the hospitals, and a 24 hour pharmacy. I will bet that if people know there is a GP they can go a see, they will go there.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
Any health System has to prioritise. Under SKS unskilled patients will take charge.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
I can't even see what stick he has got the wrong end of. Typical internet blurb about IB:
"How is internal bleeding diagnosed?
Diagnosis of internal bleeding begins with a thorough medical history. This is followed by a physical examination, concentrating on the area of the body where the internal bleeding may have occurred. For example, if there is concern about bleeding in the brain, the physical examination will focus on the neurologic system, or if it is intra-abdominal bleeding, the exam will be directed toward the abdomen.
Blood tests may be performed to check for a low red blood cell count, or anemia. However, if the bleeding occurs rapidly, the initial hemoglobin reading or red blood cell count may be normal.
Suspicion of internal bleeding will often require an imaging test to look for the bleeding source."
etc etc. Which bit of that does he think can be bypassed by some sort of home covid type test?
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
To a degree, yes indeed. We have a system that is free at the point of use. Demand isn't unlimited, but clearly exceeds capacity, hence we wait. We wait on the phone to make an appointment, we wait for appointments, we wait for investigations, we wait for surgery, we wait for ambulances and we wait in A and E.
The gatekeeper function is there at both GP and at A and E to filter out the stuff that can be dealt with in Primary care. If we want a system where competition drives better customer service then that only works where capacity exceeds demand, and the NHS has never been funded to that level.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It’s not really about limit8ng demand, it’s sorting the 1% that needs further attention from the 99% which can be handled in primary care. It doesn’t always get it right, but it mostly works (or did, we are having a lot of issues now as we don’t have enough GPs, partly as so many have reduced their hours.) There is a lot that can be done, pharmacists can do more to manage simple infections and asthma medication for instance. I need to order inhalers via a phone system - might be easier if I could just pop into the pharmacy.
It has been seen, in a number of experiments that when you triage people in the A&E queues to see a GP like doctor in the hospital that this works very well.
Quite a few people going to A&E do so because of lack of GP access.
Which suggests to me that we should go with the flow. Have a bunch of GPs in the hospitals, and a 24 hour pharmacy. I will bet that if people know there is a GP they can go a see, they will go there.
Yes. I’d also have walk in GPs attached to hospital (not A&E) where you can take a number and wait, like the good old days.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
Any health System has to prioritise. Under SKS unskilled patients will take charge.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
I can't even see what stick he has got the wrong end of. Typical internet blurb about IB:
"How is internal bleeding diagnosed?
Diagnosis of internal bleeding begins with a thorough medical history. This is followed by a physical examination, concentrating on the area of the body where the internal bleeding may have occurred. For example, if there is concern about bleeding in the brain, the physical examination will focus on the neurologic system, or if it is intra-abdominal bleeding, the exam will be directed toward the abdomen.
Blood tests may be performed to check for a low red blood cell count, or anemia. However, if the bleeding occurs rapidly, the initial hemoglobin reading or red blood cell count may be normal.
Suspicion of internal bleeding will often require an imaging test to look for the bleeding source."
etc etc. Which bit of that does he think can be bypassed by some sort of home covid type test?
Home test kit in SKS land mate
Comes with a link "how to carry out your own endoscopy" and a portable CT/MRI scanner through your letterbox
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
Any health System has to prioritise. Under SKS unskilled patients will take charge.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
It might have been a silly example but equally internal bleeding it likely to be an emergency so people will "self-refer" themselves to A&E, so perhaps he wasn't so wrong.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
Any health System has to prioritise. Under SKS unskilled patients will take charge.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
I can't even see what stick he has got the wrong end of. Typical internet blurb about IB:
"How is internal bleeding diagnosed?
Diagnosis of internal bleeding begins with a thorough medical history. This is followed by a physical examination, concentrating on the area of the body where the internal bleeding may have occurred. For example, if there is concern about bleeding in the brain, the physical examination will focus on the neurologic system, or if it is intra-abdominal bleeding, the exam will be directed toward the abdomen.
Blood tests may be performed to check for a low red blood cell count, or anemia. However, if the bleeding occurs rapidly, the initial hemoglobin reading or red blood cell count may be normal.
Suspicion of internal bleeding will often require an imaging test to look for the bleeding source."
etc etc. Which bit of that does he think can be bypassed by some sort of home covid type test?
Home test kit in SKS land mate
Comes with a link "how to carry out your own endoscopy" and a portable CT/MRI scanner through your letterbox
Could work, actually. Set your mobile to screencast to the 75" amoled, video ON, cram it where the sun disnae shine...
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
Any health System has to prioritise. Under SKS unskilled patients will take charge.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
It might have been a silly example but equally internal bleeding it likely to be an emergency so people will "self-refer" themselves to A&E, so perhaps he wasn't so wrong.
Re Sweden, after my recent deep dive on Europe and migration, I am now convinced a significant western European country will elect a hard/far right government in the next 5-10 years. And i don’t mean “in coalition” I mean: they will be handed the government, in toto. And they will enact some eye watering polices
My guess is that the first will either be Sweden or France
You could argue Italy has done it already with Meloni, but their system is so fucked and fractious nothing ever happens whoever is elected
The far right parties in both countries seem stuck on around 20%:
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It's more about efficient allocation of resources. I have paid the Nuffield for psychiatry and for new hips, and in both cases they quite rightly won't initially talk to me, even at £250 an hour, without a GP referral.
Somewhere else might have talked to you, possibly. Some private places will see you without what in many cases is the pure formality and resource-waste of a GP referral, although in my experience this is if you are self-paying and I think if you are claiming off insurance the insurer often does want a GP referral.
If you can find a specialist willing to chat honestly, they will heartily agree that GPs tend not to like ill people.
Think of the demand for a GP referral as similar to a bank's demand that its own surveyor comes to inspect a house before the bank signs off on a loan to the purchaser. "Surveyor" is not a protected term, and often the surveyor is a young boy who probably doesn't know a joist from a damp proof course, but the bank insists he comes anyway. Why? The purchaser may well already have sent a proper surveyor, and perhaps the bank is only lending half the value of the house anyway. But the bank's surveyor will still come and wiggle his ruler about. What has happened is that a wave of "We've got a shmuck here with his pockets open - dip in, everyone!" has rippled through the ranks of the professionals.
It's like that when somebody's ill - not so much when they are self-paying privately (when often you can walk out of the door and go somewhere else), but certainly the NHS is full of needless meetings etc., and years of c*ck-and-bullsh*t waiting and monitoring, and any time an insurer is involved you can also expect a degree of pickpocketing all justified with serious faces.
Given what the system actually is, often just slipping some money to a private GP for a referral is the sensible choice. If you're lucky, there will be one in the same building as the specialist you want to see. Sadly if you try to save every penny, you won't get decent specialist healthcare in this country.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It’s not really about limit8ng demand, it’s sorting the 1% that needs further attention from the 99% which can be handled in primary care. It doesn’t always get it right, but it mostly works (or did, we are having a lot of issues now as we don’t have enough GPs, partly as so many have reduced their hours.) There is a lot that can be done, pharmacists can do more to manage simple infections and asthma medication for instance. I need to order inhalers via a phone system - might be easier if I could just pop into the pharmacy.
It has been seen, in a number of experiments that when you triage people in the A&E queues to see a GP like doctor in the hospital that this works very well.
Quite a few people going to A&E do so because of lack of GP access.
Which suggests to me that we should go with the flow. Have a bunch of GPs in the hospitals, and a 24 hour pharmacy. I will bet that if people know there is a GP they can go a see, they will go there.
Yes. I’d also have walk in GPs attached to hospital (not A&E) where you can take a number and wait, like the good old days.
It’s my understanding that at the hospitals that have tried this, all the people in A&E who really wanted a GP are really happy to get.. a GP appointment.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
Any health System has to prioritise. Under SKS unskilled patients will take charge.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
I can't even see what stick he has got the wrong end of. Typical internet blurb about IB:
"How is internal bleeding diagnosed?
Diagnosis of internal bleeding begins with a thorough medical history. This is followed by a physical examination, concentrating on the area of the body where the internal bleeding may have occurred. For example, if there is concern about bleeding in the brain, the physical examination will focus on the neurologic system, or if it is intra-abdominal bleeding, the exam will be directed toward the abdomen.
Blood tests may be performed to check for a low red blood cell count, or anemia. However, if the bleeding occurs rapidly, the initial hemoglobin reading or red blood cell count may be normal.
Suspicion of internal bleeding will often require an imaging test to look for the bleeding source."
etc etc. Which bit of that does he think can be bypassed by some sort of home covid type test?
I think he means things like Faecal Occult Blood testing, for suspected bowel cancer.
This is currently done by the national bowel Cancer screening programme, who sent me a pack the other day. I have to sample a bit of pooh and send it back to them to check for blood. This is screening, so initiated without symptoms. Not much point if there is known to be blood, as that requires further investigation. People can buy FOB testing kits from Amazon for a few quid BTW.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It's more about efficient allocation of resources. I have paid the Nuffield for psychiatry and for new hips, and in both cases they quite rightly won't initially talk to me, even at £250 an hour, without a GP referral.
patients are sometimes better off being in control.
Not if they think they can ask for a home test kit to resolve their internal bleeding though eh
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
Any health System has to prioritise. Under SKS unskilled patients will take charge.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
I can't even see what stick he has got the wrong end of. Typical internet blurb about IB:
"How is internal bleeding diagnosed?
Diagnosis of internal bleeding begins with a thorough medical history. This is followed by a physical examination, concentrating on the area of the body where the internal bleeding may have occurred. For example, if there is concern about bleeding in the brain, the physical examination will focus on the neurologic system, or if it is intra-abdominal bleeding, the exam will be directed toward the abdomen.
Blood tests may be performed to check for a low red blood cell count, or anemia. However, if the bleeding occurs rapidly, the initial hemoglobin reading or red blood cell count may be normal.
Suspicion of internal bleeding will often require an imaging test to look for the bleeding source."
etc etc. Which bit of that does he think can be bypassed by some sort of home covid type test?
Home test kit in SKS land mate
Comes with a link "how to carry out your own endoscopy" and a portable CT/MRI scanner through your letterbox
Could work, actually. Set your mobile to screencast to the 75" amoled, video ON, cram it where the sun disnae shine...
A camera in the shape of German WWI ordinance might be popular….
She has been quite open about having a boob job done privately for cosmetic purposes, as post maternity her breasts became rather droopy.
I don't think anyone expects that sort of surgery to be done on the NHS, except where medically indicated such as breast reconstruction after cancer treatment.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
Any health System has to prioritise. Under SKS unskilled patients will take charge.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
I can't even see what stick he has got the wrong end of. Typical internet blurb about IB:
"How is internal bleeding diagnosed?
Diagnosis of internal bleeding begins with a thorough medical history. This is followed by a physical examination, concentrating on the area of the body where the internal bleeding may have occurred. For example, if there is concern about bleeding in the brain, the physical examination will focus on the neurologic system, or if it is intra-abdominal bleeding, the exam will be directed toward the abdomen.
Blood tests may be performed to check for a low red blood cell count, or anemia. However, if the bleeding occurs rapidly, the initial hemoglobin reading or red blood cell count may be normal.
Suspicion of internal bleeding will often require an imaging test to look for the bleeding source."
etc etc. Which bit of that does he think can be bypassed by some sort of home covid type test?
I think he means things like Faecal Occult Blood testing, for suspected bowel cancer.
This is currently done by the national bowel Cancer screening programme, who sent me a pack the other day. I have to sample a bit of pooh and send it back to them to check for blood. This is screening, so initiated without symptoms. Not much point if there is known to be blood, as that requires further investigation. People can buy FOB testing kits from Amazon for a few quid BTW.
Probably right about his thought process, but the Occult bit by definition means you don't know you are internally bleeding.
At my son's state school they've had to cut science lessons because they can't recruit and retain science teachers at current rates of pay, reflecting the government underfunding state schools. A whole load of science teachers just decamped from the school to nearby private schools, who have more money. So don't tell me that these schools aren't harming the state sector and the life chances of our kids, damn right they are. There's 31 kids in my son's class. He says it's a good class and the kids don't mess about, but the teachers simply don't have time for individual tuition when the class is so large. The problem isn't the unions, or kids not wanting to learn, I can tell you that as a parent. The problem is simple - the schools need more money so they can retain teachers, hire more and recuce class sizes to more manageable levels. If state schools got as much money as their private counterparts and weren't succeeding, then sure look for other causes. But don't tell me that funding isn't the main issue because as a parent I can tell you it absolutely 100% is.
Well for the left it always is more money, we know that
13 years of Tory penny pinching and a glance at the state of the country means more and more are thinking they may have a point.
UK PISA ranking rose from 25th in reading in 2009 for example to 14th in 2018
At my son's state school they've had to cut science lessons because they can't recruit and retain science teachers at current rates of pay, reflecting the government underfunding state schools. A whole load of science teachers just decamped from the school to nearby private schools, who have more money. So don't tell me that these schools aren't harming the state sector and the life chances of our kids, damn right they are. There's 31 kids in my son's class. He says it's a good class and the kids don't mess about, but the teachers simply don't have time for individual tuition when the class is so large. The problem isn't the unions, or kids not wanting to learn, I can tell you that as a parent. The problem is simple - the schools need more money so they can retain teachers, hire more and recuce class sizes to more manageable levels. If state schools got as much money as their private counterparts and weren't succeeding, then sure look for other causes. But don't tell me that funding isn't the main issue because as a parent I can tell you it absolutely 100% is.
Well for the left it always is more money, we know that
13 years of Tory penny pinching and a glance at the state of the country means more and more are thinking they may have a point.
UK PISA ranking rose from 25th in reading in 2009 for example to 14th in 2018
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It's more about efficient allocation of resources. I have paid the Nuffield for psychiatry and for new hips, and in both cases they quite rightly won't initially talk to me, even at £250 an hour, without a GP referral.
Somewhere else might have talked to you, possibly. Some private places will see you without what in many cases is the pure formality and resource-waste of a GP referral, although in my experience this is if you are self-paying and I think if you are claiming off insurance the insurer often does want a GP referral.
If you can find a specialist willing to chat honestly, they will heartily agree that GPs tend not to like ill people.
Think of the demand for a GP referral as similar to a bank's demand that its own surveyor comes to inspect a house before the bank signs off on a loan to the purchaser. "Surveyor" is not a protected term, and often the surveyor is a young boy who probably doesn't know a joist from a damp proof course, but the bank insists he comes anyway. Why? The purchaser may well already have sent a proper surveyor, and perhaps the bank is only lending half the value of the house anyway. But the bank's surveyor will still come and wiggle his ruler about. What has happened is that a wave of "We've got a shmuck here with his pockets open - dip in, everyone!" has rippled through the ranks of the professionals.
It's like that when somebody's ill - not so much when they are self-paying privately (when often you can walk out of the door and go somewhere else), but certainly the NHS is full of needless meetings etc., and years of c*ck-and-bullsh*t waiting and monitoring, and any time an insurer is involved you can also expect a degree of pickpocketing all justified with serious faces.
Given what the system actually is, often just slipping some money to a private GP for a referral is the sensible choice. If you're lucky, there will be one in the same building as the specialist you want to see. Sadly if you try to save every penny, you won't get decent specialist healthcare in this country.
I was going to say something about filtering out the nutters, but for psychiatric referrals that seems not to apply.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
Any health System has to prioritise. Under SKS unskilled patients will take charge.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
It might have been a silly example but equally internal bleeding it likely to be an emergency so people will "self-refer" themselves to A&E, so perhaps he wasn't so wrong.
He said order a home test though
SKS, please exsanguinate.
Well aye surely timing is important
Dear SKS
Should we do our own home endoscopy before or after we slip into shock, organ failure or coma?
She has been quite open about having a boob job done privately for cosmetic purposes, as post maternity her breasts became rather droopy.
I don't think anyone expects that sort of surgery to be done on the NHS, except where medically indicated such as breast reconstruction after cancer treatment.
Wait until someone finds out about private medical coverage for the Senior Management Team across government - national, regional, local. Including the NHS.
London to host major international meeting on war crimes Justice ministers from around the world will convene in London in March to support the International Criminal Court (ICC) investigating alleged war crimes in Ukraine.
Malmesbury asked: "Was this one posted?" (Picture of a woman in a destroyed Ukrainian apartment) Not that I saw, but, being 8 hours behind most of you, I don't always read the all the comments.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
Any health System has to prioritise. Under SKS unskilled patients will take charge.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
I can't even see what stick he has got the wrong end of. Typical internet blurb about IB:
"How is internal bleeding diagnosed?
Diagnosis of internal bleeding begins with a thorough medical history. This is followed by a physical examination, concentrating on the area of the body where the internal bleeding may have occurred. For example, if there is concern about bleeding in the brain, the physical examination will focus on the neurologic system, or if it is intra-abdominal bleeding, the exam will be directed toward the abdomen.
Blood tests may be performed to check for a low red blood cell count, or anemia. However, if the bleeding occurs rapidly, the initial hemoglobin reading or red blood cell count may be normal.
Suspicion of internal bleeding will often require an imaging test to look for the bleeding source."
etc etc. Which bit of that does he think can be bypassed by some sort of home covid type test?
I think he means things like Faecal Occult Blood testing, for suspected bowel cancer.
This is currently done by the national bowel Cancer screening programme, who sent me a pack the other day. I have to sample a bit of pooh and send it back to them to check for blood. This is screening, so initiated without symptoms. Not much point if there is known to be blood, as that requires further investigation. People can buy FOB testing kits from Amazon for a few quid BTW.
Probably right about his thought process, but the Occult bit by definition means you don't know you are internally bleeding.
Yes, but it could be done for example for abdominal pain etc. I cannot see there being vast demand though. The screening programme tests every 2 years and gets 56% participation.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
Any health System has to prioritise. Under SKS unskilled patients will take charge.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
I can't even see what stick he has got the wrong end of. Typical internet blurb about IB:
"How is internal bleeding diagnosed?
Diagnosis of internal bleeding begins with a thorough medical history. This is followed by a physical examination, concentrating on the area of the body where the internal bleeding may have occurred. For example, if there is concern about bleeding in the brain, the physical examination will focus on the neurologic system, or if it is intra-abdominal bleeding, the exam will be directed toward the abdomen.
Blood tests may be performed to check for a low red blood cell count, or anemia. However, if the bleeding occurs rapidly, the initial hemoglobin reading or red blood cell count may be normal.
Suspicion of internal bleeding will often require an imaging test to look for the bleeding source."
etc etc. Which bit of that does he think can be bypassed by some sort of home covid type test?
Home test kit in SKS land mate
Comes with a link "how to carry out your own endoscopy" and a portable CT/MRI scanner through your letterbox
Could work, actually. Set your mobile to screencast to the 75" amoled, video ON, cram it where the sun disnae shine...
I think he is getting cram it where the sun disnae shine
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It's more about efficient allocation of resources. I have paid the Nuffield for psychiatry and for new hips, and in both cases they quite rightly won't initially talk to me, even at £250 an hour, without a GP referral.
Somewhere else might have talked to you, possibly. Some private places will see you without what in many cases is the pure formality and resource-waste of a GP referral, although in my experience this is if you are self-paying and I think if you are claiming off insurance the insurer often does want a GP referral.
If you can find a specialist willing to chat honestly, they will heartily agree that GPs tend not to like ill people.
Think of the demand for a GP referral as similar to a bank's demand that its own surveyor comes to inspect a house before the bank signs off on a loan to the purchaser. "Surveyor" is not a protected term, and often the surveyor is a young boy who probably doesn't know a joist from a damp proof course, but the bank insists he comes anyway. Why? The purchaser may well already have sent a proper surveyor, and perhaps the bank is only lending half the value of the house anyway. But the bank's surveyor will still come and wiggle his ruler about. What has happened is that a wave of "We've got a shmuck here with his pockets open - dip in, everyone!" has rippled through the ranks of the professionals.
It's like that when somebody's ill - not so much when they are self-paying privately (when often you can walk out of the door and go somewhere else), but certainly the NHS is full of needless meetings etc., and years of c*ck-and-bullsh*t waiting and monitoring, and any time an insurer is involved you can also expect a degree of pickpocketing all justified with serious faces.
Given what the system actually is, often just slipping some money to a private GP for a referral is the sensible choice. If you're lucky, there will be one in the same building as the specialist you want to see. Sadly if you try to save every penny, you won't get decent specialist healthcare in this country.
I was going to say something about filtering out the nutters, but for psychiatric referrals that seems not to apply.
It's not just about filtering out, the GP referral is there to provide essential information on past medical history, medication prescribed previously, results of previous tests etc.
She has been quite open about having a boob job done privately for cosmetic purposes, as post maternity her breasts became rather droopy.
I don't think anyone expects that sort of surgery to be done on the NHS, except where medically indicated such as breast reconstruction after cancer treatment.
Yeah but under SKSs crackpot scheme expect a lot more saggy boobs self referals
Just what the Dr didnt order for our struggling NHS services
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
Any health System has to prioritise. Under SKS unskilled patients will take charge.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
I can't even see what stick he has got the wrong end of. Typical internet blurb about IB:
"How is internal bleeding diagnosed?
Diagnosis of internal bleeding begins with a thorough medical history. This is followed by a physical examination, concentrating on the area of the body where the internal bleeding may have occurred. For example, if there is concern about bleeding in the brain, the physical examination will focus on the neurologic system, or if it is intra-abdominal bleeding, the exam will be directed toward the abdomen.
Blood tests may be performed to check for a low red blood cell count, or anemia. However, if the bleeding occurs rapidly, the initial hemoglobin reading or red blood cell count may be normal.
Suspicion of internal bleeding will often require an imaging test to look for the bleeding source."
etc etc. Which bit of that does he think can be bypassed by some sort of home covid type test?
I think he means things like Faecal Occult Blood testing, for suspected bowel cancer.
This is currently done by the national bowel Cancer screening programme, who sent me a pack the other day. I have to sample a bit of pooh and send it back to them to check for blood. This is screening, so initiated without symptoms. Not much point if there is known to be blood, as that requires further investigation. People can buy FOB testing kits from Amazon for a few quid BTW.
It's also possible to get blood tests done for all sorts of things using a home-extracted sample sent off for analysis and without the company sending any info to your NHS GP (if you've got one) or even asking for their name. I mean legitimate places, not scammers. Tests include for thyroid, anaemia, cardiovascular risk, etc. Easy enough also to book an appointment for a nurse to extract the blood sample if that is what you prefer.
Well of course Rayner has, she has had a boob job she paid for. This isn't new!
She has absolutely got to become Labour leader before the next election. Let Andrew Neil start asking her about her tits and that poll lead might become a reality.
She has been quite open about having a boob job done privately for cosmetic purposes, as post maternity her breasts became rather droopy.
I don't think anyone expects that sort of surgery to be done on the NHS, except where medically indicated such as breast reconstruction after cancer treatment.
Yeah but under SKSs crackpot scheme expect a lot more saggy boobs self referals
Just what the Dr didnt order for our struggling NHS services
For sure.
It really shows a nihilism about fixing primary care, to simply bypass it.
Indeed, one of the major gripes I have heard from GPs is about "referral centres" set up by CCGs to direct referrals for hip pain etc, who bounce many back or refer everyone to physio, even when they have been seen by physio already in practice. There were brought in by this Conservative government.
The advocates of grammar schools rarely explain why 75% of pupils should, as a matter of policy, receive an inferior education.
If what you claim is true then advocates of abolishing Grammar schools should explain why 100% of pupils should, as a matter of policy, receive an inferior education.
So the government has given permission to offer an improved deal to the rail unions. But has no talks scheduled with nurses. Something isn't right at all.
Education is a good thing and people should be encouraged to spend money on it. Money spent on private schools means savings for local authorities. The most extreme I know is Edinburgh where nearly 1/3rd of secondary pupils go to private schools. If several of those schools close I am not sure that the local authority could cope.
But this is all about the politics of envy. And there is never a rational answer to that.
I think there are two canards here, which seem impervious to reason:
(1) Private schools are "subsided" by the State - this is nonsense and the truth is actually the opposite: every parent choosing to sending their child to private school still pays the tax for their state school place, which goes towards funding other state school children rather than theirs - this tax gain effect equates to 20-50% of the purchased place depending on how high the school fees are. It's why HMT hasn't touched it for decades, because they know making it VAT deductible (along with all other charitable educational activities) saves the taxpayer money overall.
(2) Compelling all "sharp-elbowed" and "loud mouth" private school parents to go to their local state school will lead to table-thumping demands to improve standards, which will magically lift all boats. There is precisely zero evidence for this, either in the UK or overseas, and it seems to be built on wishful thinking and popular myths of the sort of people that send their children to private schools, how they operate and weird beliefs of how they think the strings of Britain operate behind the scenes. What will happen is that it will drive up house prices in the vicinity of the best state schools and lead to a boon in private tutoring, and after-school clubs. Where it has no other outlet the balance of that displaced money will instead go into property and consumption, not education; it won't benefit a single average/poor pupil.
The net effect of this will be to increase the burden on the taxpayer, reduce diversity and employment in the education sector, and damage British education overall.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It's more about efficient allocation of resources. I have paid the Nuffield for psychiatry and for new hips, and in both cases they quite rightly won't initially talk to me, even at £250 an hour, without a GP referral.
Somewhere else might have talked to you, possibly. Some private places will see you without what in many cases is the pure formality and resource-waste of a GP referral, although in my experience this is if you are self-paying and I think if you are claiming off insurance the insurer often does want a GP referral.
If you can find a specialist willing to chat honestly, they will heartily agree that GPs tend not to like ill people.
Think of the demand for a GP referral as similar to a bank's demand that its own surveyor comes to inspect a house before the bank signs off on a loan to the purchaser. "Surveyor" is not a protected term, and often the surveyor is a young boy who probably doesn't know a joist from a damp proof course, but the bank insists he comes anyway. Why? The purchaser may well already have sent a proper surveyor, and perhaps the bank is only lending half the value of the house anyway. But the bank's surveyor will still come and wiggle his ruler about. What has happened is that a wave of "We've got a shmuck here with his pockets open - dip in, everyone!" has rippled through the ranks of the professionals.
It's like that when somebody's ill - not so much when they are self-paying privately (when often you can walk out of the door and go somewhere else), but certainly the NHS is full of needless meetings etc., and years of c*ck-and-bullsh*t waiting and monitoring, and any time an insurer is involved you can also expect a degree of pickpocketing all justified with serious faces.
Given what the system actually is, often just slipping some money to a private GP for a referral is the sensible choice. If you're lucky, there will be one in the same building as the specialist you want to see. Sadly if you try to save every penny, you won't get decent specialist healthcare in this country.
I was going to say something about filtering out the nutters, but for psychiatric referrals that seems not to apply.
It's not just about filtering out, the GP referral is there to provide essential information on past medical history, medication prescribed previously, results of previous tests etc.
Isn't it strange how so much of the rest of Europe (the ones with better health outcomes than the UK) seem to manage without the GP gatekeepers.
This is the problem. People like you oppose sensible reforms that will improve health outcomes even when they, quite rightly, will make no difference to free at the point of use.
It is a little frustrating that every time we discuss education on here it becomes about grammar schools and private schools. Grammars aren't coming back. And the vast majority can't afford private. So how will we improve the education of 80%?
What makes you think Labour's actually interested in that?
She has been quite open about having a boob job done privately for cosmetic purposes, as post maternity her breasts became rather droopy.
I don't think anyone expects that sort of surgery to be done on the NHS, except where medically indicated such as breast reconstruction after cancer treatment.
Yeah but under SKSs crackpot scheme expect a lot more saggy boobs self referals
Just what the Dr didnt order for our struggling NHS services
Your solution was to tax everyone into a lower material quality of life. People, erm, didn't go along with it, to say the least.
I went to a local grammar school which featured in Jackson and Marsden's Education and the Working Class. It looked at how working class boys (and girls) navigated high quality education which usually lead on to university. This included modified speech and changing attitudes to social and cultural values. Their general conclusion was that these cases were often left rootless - neither working class nor middle class. But I bucked the trend and moved effortlessly on to university and academia.
The modern equivalents would include using the right (latest) right-on words and echoing the key tenets of Wokery.
Those are the keys to access elite jobs today to distinguish you from the great unwashed, not accent.
It is a little frustrating that every time we discuss education on here it becomes about grammar schools and private schools. Grammars aren't coming back. And the vast majority can't afford private. So how will we improve the education of 80%?
What makes you think Labour's actually interested in that?
Well. If the Tories are, they are certainly not very good at it.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It's more about efficient allocation of resources. I have paid the Nuffield for psychiatry and for new hips, and in both cases they quite rightly won't initially talk to me, even at £250 an hour, without a GP referral.
Somewhere else might have talked to you, possibly. Some private places will see you without what in many cases is the pure formality and resource-waste of a GP referral, although in my experience this is if you are self-paying and I think if you are claiming off insurance the insurer often does want a GP referral.
If you can find a specialist willing to chat honestly, they will heartily agree that GPs tend not to like ill people.
Think of the demand for a GP referral as similar to a bank's demand that its own surveyor comes to inspect a house before the bank signs off on a loan to the purchaser. "Surveyor" is not a protected term, and often the surveyor is a young boy who probably doesn't know a joist from a damp proof course, but the bank insists he comes anyway. Why? The purchaser may well already have sent a proper surveyor, and perhaps the bank is only lending half the value of the house anyway. But the bank's surveyor will still come and wiggle his ruler about. What has happened is that a wave of "We've got a shmuck here with his pockets open - dip in, everyone!" has rippled through the ranks of the professionals.
It's like that when somebody's ill - not so much when they are self-paying privately (when often you can walk out of the door and go somewhere else), but certainly the NHS is full of needless meetings etc., and years of c*ck-and-bullsh*t waiting and monitoring, and any time an insurer is involved you can also expect a degree of pickpocketing all justified with serious faces.
Given what the system actually is, often just slipping some money to a private GP for a referral is the sensible choice. If you're lucky, there will be one in the same building as the specialist you want to see. Sadly if you try to save every penny, you won't get decent specialist healthcare in this country.
I was going to say something about filtering out the nutters, but for psychiatric referrals that seems not to apply.
It's not just about filtering out, the GP referral is there to provide essential information on past medical history, medication prescribed previously, results of previous tests etc.
Isn't it strange how so much of the rest of Europe (the ones with better health outcomes than the UK) seem to manage without the GP gatekeepers.
This is the problem. People like you oppose sensible reforms that will improve health outcomes even when they, quite rightly, will make no difference to free at the point of use.
Other systems do things differently. I recall a research seminar contesting the U.K. approach with somewhere on the continent (cannot recall where). Over there, if you needed tests, a lot would be done at the GP centre (obviously not all, but things such as bloods, which get sent off in the U.K., possibly ultrasound etc). It’s a different approach, but it would be a big shift to apply it here.
She has been quite open about having a boob job done privately for cosmetic purposes, as post maternity her breasts became rather droopy.
I don't think anyone expects that sort of surgery to be done on the NHS, except where medically indicated such as breast reconstruction after cancer treatment.
Yeah but under SKSs crackpot scheme expect a lot more saggy boobs self referals
Just what the Dr didnt order for our struggling NHS services
Your solution was to tax everyone into a lower material quality of life. People, erm, didn't go along with it, to say the least.
On private healthcare, why don't the (especially Labour) politicians admit that the reason they've used private healthcare is because the NHS is shit? Anyone would if they could afford it.
Re Sweden, after my recent deep dive on Europe and migration, I am now convinced a significant western European country will elect a hard/far right government in the next 5-10 years. And i don’t mean “in coalition” I mean: they will be handed the government, in toto. And they will enact some eye watering polices
My guess is that the first will either be Sweden or France
You could argue Italy has done it already with Meloni, but their system is so fucked and fractious nothing ever happens whoever is elected
The far right parties in both countries seem stuck on around 20%:
In France 20% can win you next to nothing, or a shedload of seats.
The big shift with past elections is the willingness of right wing, and even some left wing voters, to support RN in the second round.
And, it gets to the point where mainstream parties are forced to engage with the policy propositions rather than pretending the problem doesn't exist and that the voters are wrong.
The advocates of grammar schools rarely explain why 75% of pupils should, as a matter of policy, receive an inferior education.
In deprived areas like poor seaside towns or ex industrial towns and cities in the North, the Midlands and Wales often 100% of pupils now receive an inferior education in the comprehensives there. Whereas before even areas like Grimsby, Barnsley or Rotherham, West Bromwich and Hastings had a grammar school pre 1965
As I said, advocates on grammar schools rarely explain why, as a matter of policy, 75% of pupils in a given local authority should be provided with an inferior education.
There is another poster on PB, forget the name, who makes a case that the weakest pupils should receive extraordinary provision in specialised settings - now that could make a profound difference.
As I said advocates of comprehensives rarely explain why in poor and deprived areas 100% of pupils should be provided with an inferior education.
(Plus in some selective areas like Trafford and Bucks the high schools too get perfectly good results)
But it doesn't HAVE to be inferior. That's the whole point.
Comprehensives in Stoke or Barnsley will always be inferior to comprehensives in Surrey, that is just reality.
When the former had grammars however they had a state school that could compete with state schools in Surrey
Do you think kids from Stoke or Barnsley are intrinsically less capable? Or teachers less dedicated and talented? Or parents less committed and supportive?
It is not reality - it’s a depressing a defeatist attitude on your part
I thought this was a long established trend (although not to the degree mentioned) and had been laid at the door of massive increases in oestrogen in the environment.
Is that mainstream thinking or a fringe conspiracy theory?
It is a little frustrating that every time we discuss education on here it becomes about grammar schools and private schools. Grammars aren't coming back. And the vast majority can't afford private. So how will we improve the education of 80%?
What makes you think Labour's actually interested in that?
Seriously, what makes you think they are not? Do you think there is some secret cynical plan to keep education down?
I am sure they really are interested in improving education for the 80%, as to be fair, are the Tories. The issue is that neither have much idea how to effect the improvement.
The advocates of grammar schools rarely explain why 75% of pupils should, as a matter of policy, receive an inferior education.
If what you claim is true then advocates of abolishing Grammar schools should explain why 100% of pupils should, as a matter of policy, receive an inferior education.
One argument that used to be made is that the abolition of grammar schools would improve comprehensive schools because all the ambitious and assertive parents would then be forced to advocate within them to lift standards.
It's been several decades since their abolition (in the main) so we now have a good evidence base to draw upon.
Education is a good thing and people should be encouraged to spend money on it. Money spent on private schools means savings for local authorities. The most extreme I know is Edinburgh where nearly 1/3rd of secondary pupils go to private schools. If several of those schools close I am not sure that the local authority could cope.
But this is all about the politics of envy. And there is never a rational answer to that.
I can't speak for the rest of the left wing wokerati but my motivation is not the politics of envy. I could afford to pay for private education for my children but I chose not to on a point of principle. I believe selective education either by money or by 11 plus exam deprives the majority of resource, either by money shovelled into Grammar Schools to the detriment of the rest, or by an exemption on VAT. I don't want my taxes to benefit a grammar school elite at the expense of everyone else, and while I don't want to deprive you of the liberty to spend your money on a private education for your children, pay the VAT on it.
Make universal education fantastic for all, and measure it on added value, not just on GCSE A* passes.
Not sure where grammar schools come into this. They are state run and, like all state schools, therefore VAT exempt.
Private schools do not cost the state money, they save it.
Between £5k and £7k per pupil. This is significantly more than the waived VAT would be, roughly twice as much. Labour claiming that this policy will produce more money for state schools shows a basic innumeracy.
I accept that there are social costs in that we end up with a relatively small and privileged elite who get a proper education in circumstances conducive to learning which gives them an unfair advantage in life. I agree that the ideal would be that state schools were so good than no one was willing to pay . But they aren't and there is absolutely no focus on making them so. To do that you would need to take on the teachers unions and no one is brave enough to do that.
Two responses to that post:
1. Labour claiming that this policy will produce more money for state schools does not show 'a basic innumeracy'... unless, and this is important, you assume that more than 30% of private pupils will no longer attend private school but will switch to state schools. Now you may think that's the case, Labour clearly don't (nor do I). But in any event there is no innumeracy on Labour's part.
2. I'm interested in your view that it is the teachers unions, not average spend per pupil (£6.5k state, £15k private), that prevents state schools being as good as private ones. Do you have any evidence for that?
When comparing the spend per pupil, it is worth remembering that in the purely academic spend, the difference is a lot lower.
Fair enough but just to be clear, what do you consider as non-academic* spend?
(*That'll be non-academic spend currently benefiting from the education VAT exemption presumably.)
An issue in the West is delaying even trying. Women, as you often note, are at their peak in their early twenties, and are there most fertile then. If you choose to prioritise career over reproduction then there can be consequences.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
Good evening
He also wants to use the private sector to reduce waiting lists which is common sense
It’s not really common sense
The businesses operate by using staff employed by the NHS (outside their trust to avoid conflicts) and utilising NHS facilities that are left empty at weekends
The common sense thing to do would be to move the NHS to a well run 7 day operation in order to maximise capacity utilisation.
But if the NHS management is unwilling or unable to do that, then paying a premium to someone else to do it is the second choice
There seems to be a reasonable amount of evidence for this fertility shift, worldwide. Even without biological triggers world population should start shrinking by mid century. The metaverse and wider virtualisation of human relations may accelerate that timescale.
Catastrophists tend to assume the human race will disappear in a huge nuclear fireball, or a runaway climate change furnace, antibiotic-resistant superbug or Terminator-2 style robot Armageddon, but what if the empire of the humans goes the way of the Holy Roman Empire or indeed the British Empire, not with a bang but a whimper?
The two prime candidates for this demise are fertility and a slow replacement of human genetic replication by digital memetic replication.
She has been quite open about having a boob job done privately for cosmetic purposes, as post maternity her breasts became rather droopy.
I don't think anyone expects that sort of surgery to be done on the NHS, except where medically indicated such as breast reconstruction after cancer treatment.
Yeah but under SKSs crackpot scheme expect a lot more saggy boobs self referals
Just what the Dr didnt order for our struggling NHS services
Your solution was to tax everyone into a lower material quality of life. People, erm, didn't go along with it, to say the least.
"Your idea was to tax everyone" blah blah blah.
No mate not the many just the few
Where do you draw the line between the many and the few (aka “us” and “them”)? That’s the tricky bit.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It's more about efficient allocation of resources. I have paid the Nuffield for psychiatry and for new hips, and in both cases they quite rightly won't initially talk to me, even at £250 an hour, without a GP referral.
Somewhere else might have talked to you, possibly. Some private places will see you without what in many cases is the pure formality and resource-waste of a GP referral, although in my experience this is if you are self-paying and I think if you are claiming off insurance the insurer often does want a GP referral.
If you can find a specialist willing to chat honestly, they will heartily agree that GPs tend not to like ill people.
Think of the demand for a GP referral as similar to a bank's demand that its own surveyor comes to inspect a house before the bank signs off on a loan to the purchaser. "Surveyor" is not a protected term, and often the surveyor is a young boy who probably doesn't know a joist from a damp proof course, but the bank insists he comes anyway. Why? The purchaser may well already have sent a proper surveyor, and perhaps the bank is only lending half the value of the house anyway. But the bank's surveyor will still come and wiggle his ruler about. What has happened is that a wave of "We've got a shmuck here with his pockets open - dip in, everyone!" has rippled through the ranks of the professionals.
It's like that when somebody's ill - not so much when they are self-paying privately (when often you can walk out of the door and go somewhere else), but certainly the NHS is full of needless meetings etc., and years of c*ck-and-bullsh*t waiting and monitoring, and any time an insurer is involved you can also expect a degree of pickpocketing all justified with serious faces.
Given what the system actually is, often just slipping some money to a private GP for a referral is the sensible choice. If you're lucky, there will be one in the same building as the specialist you want to see. Sadly if you try to save every penny, you won't get decent specialist healthcare in this country.
I was going to say something about filtering out the nutters, but for psychiatric referrals that seems not to apply.
It's not just about filtering out, the GP referral is there to provide essential information on past medical history, medication prescribed previously, results of previous tests etc.
Isn't it strange how so much of the rest of Europe (the ones with better health outcomes than the UK) seem to manage without the GP gatekeepers.
This is the problem. People like you oppose sensible reforms that will improve health outcomes even when they, quite rightly, will make no difference to free at the point of use.
Other systems do things differently. I recall a research seminar contesting the U.K. approach with somewhere on the continent (cannot recall where). Over there, if you needed tests, a lot would be done at the GP centre (obviously not all, but things such as bloods, which get sent off in the U.K., possibly ultrasound etc). It’s a different approach, but it would be a big shift to apply it here.
But surely these big shifts are exactly what we need. The current system is, by all accounts, no longer fit for purpose so we need to make fundamental changes. We need to learn from other health systems and pick the best of their practices and ideas. Saying it would take a big shift seems to imply (and forgive me if this is not what you are saying) that it is not possible nor something we should attempt.
The important point for me is that the fundamental idea of the Health Service being free at the point of use is maintained. (Though I would suggest the French system of a payment for doctors appointments which is refunded if you attend). Everything else should be up for review so we can learn from best practice elsewhere, including internally within our own system.
Re Sweden, after my recent deep dive on Europe and migration, I am now convinced a significant western European country will elect a hard/far right government in the next 5-10 years. And i don’t mean “in coalition” I mean: they will be handed the government, in toto. And they will enact some eye watering polices
My guess is that the first will either be Sweden or France
You could argue Italy has done it already with Meloni, but their system is so fucked and fractious nothing ever happens whoever is elected
The far right parties in both countries seem stuck on around 20%:
She has been quite open about having a boob job done privately for cosmetic purposes, as post maternity her breasts became rather droopy.
I don't think anyone expects that sort of surgery to be done on the NHS, except where medically indicated such as breast reconstruction after cancer treatment.
Yeah but under SKSs crackpot scheme expect a lot more saggy boobs self referals
Just what the Dr didnt order for our struggling NHS services
Your solution was to tax everyone into a lower material quality of life. People, erm, didn't go along with it, to say the least.
"Your idea was to tax everyone" blah blah blah.
No mate not the many just the few
Of course. But few people won't pay for NHS for 60 million people.
She has been quite open about having a boob job done privately for cosmetic purposes, as post maternity her breasts became rather droopy.
I don't think anyone expects that sort of surgery to be done on the NHS, except where medically indicated such as breast reconstruction after cancer treatment.
Yeah but under SKSs crackpot scheme expect a lot more saggy boobs self referals
Just what the Dr didnt order for our struggling NHS services
Your solution was to tax everyone into a lower material quality of life. People, erm, didn't go along with it, to say the least.
"Your idea was to tax everyone" blah blah blah.
No mate not the many just the few
Where do you draw the line between the many and the few (aka “us” and “them”)? That’s the tricky bit.
In every other European society the answer is that everyone hand over more money in tax than Brits, including the average- and low-paid workers who end up living in little flats forever.
Uniquely the Corbyn cult worked out how to get squillions from absolutely nobody in particular, not just once but sustainably every year.
Allegedly the Germans are saying they cannot renovate / refit stored Leopard 2 tanks for Ukraine in under a year.
A few thoughts: 1) This is bullshit. 2) The war started a year ago. 3) Give them some of the Bundeswehr's current tanks.
Excuses, excuses...
This is an interesting thread on how widespread certain erroneous beliefs are in Germany. Just a couple of days ago, the main news channel claimed that the Fukushima accident killed 18,500 people, apparently attributing the death toll from the tsunami to the nuclear accident.
It is a little frustrating that every time we discuss education on here it becomes about grammar schools and private schools. Grammars aren't coming back. And the vast majority can't afford private. So how will we improve the education of 80%?
What makes you think Labour's actually interested in that?
Seriously, what makes you think they are not? Do you think there is some secret cynical plan to keep education down?
I am sure they really are interested in improving education for the 80%, as to be fair, are the Tories. The issue is that neither have much idea how to effect the improvement.
A truly progressive (and, by progressive, I mean the UK making progress as a country overall; nothing more) education policy would involve extending the school day so it covered 8am-6pm each day. This would allow:
(1) One or both parents to work full-time, raising their family income & mildly boosting the economy overall (2) Improve gender equality, as at the moment it's largely women who are forced to take part-time work to pick up their kids at 3pm, thus lowering their salaries and creating the perception of a structural gender gap (3) Allow breakfast, lunch and (afternoon/ high) tea to be provided to all children (4) Allow structured non-academic education activity to take place as part of the core curriculum, including design & technology, outdoor pursuits, arts, music, debating, and drama.
However, to do this would probably involve increasing the state education budget by c.30% and taking on the teaching unions (as @DavidL says) to adjust working patterns to shift.
I have regularly advocated for less spending on pensions and the NHS and more investment in education instead.
This is where I would spend it, and I'd introduce vouchers on top - so ordinary parents could exercise choice.
I'm 31 next month and surprisingly few of my friends and acquaintances have children. I think the main reasons are cost of living and moving away from "home" and thus losing the option of grandparental childcare (related to cost of living point).
@rcs1000 brings it up a lot, but I really think the French option of gifting your personal allowance to your partner would really help.
On private healthcare, why don't the (especially Labour) politicians admit that the reason they've used private healthcare is because the NHS is shit? Anyone would if they could afford it.
Because criticising the NHS in that way is extremely risky. It would be liable to be treated by a large segment of the population as a religious heresy, and would be presented by Labour's political opponents as a direct personal attack on hard working nurses, etc, etc.
Starmer is already taking a considerable risk with his "reform or die" rhetoric as it is. Certainly any measure which threatens the authority of GPs, let alone deciding further down the line to do away with the practice system entirely and impose NHS contracts on them, is liable to result in a lot of screaming. One can imagine the level of outrage and the volume of tears that would ensue were members of the Shadow Cabinet to come straight out with it and say that they ran off to the Spire because they thought the NHS useless.
Re Sweden, after my recent deep dive on Europe and migration, I am now convinced a significant western European country will elect a hard/far right government in the next 5-10 years. And i don’t mean “in coalition” I mean: they will be handed the government, in toto. And they will enact some eye watering polices
My guess is that the first will either be Sweden or France
You could argue Italy has done it already with Meloni, but their system is so fucked and fractious nothing ever happens whoever is elected
The far right parties in both countries seem stuck on around 20%:
In 2010 the Sweden Democrats crossed the 5% threshold. For the first time
Saying they are “stuck” on 20% is a bit like saying to the Wright Brothers ‘guys, you seem to be stuck in the air’
I think stuck is about right. 30-35% seems to be the ceiling of proper alt- or far-right belief including proper racism and sexual conservatism.
FPTP in the US and the runoff process in France and Brazil meant the support for a far right candidate could get above that ceiling but listen to the testimony of the floating voters in all those elections and above a certain threshold it’s all “Hilary’s just as bad”, “Lula is a crooked communist” and “Macron sold out the workers” rather than real far right opinion.
The Nazis only ever managed mid 30s in the mid 30s. The secret for Fascists is not to get a majority but a plurality, and then turn the screw through canny coalition making and more nefarious means.
The advocates of grammar schools rarely explain why 75% of pupils should, as a matter of policy, receive an inferior education.
In deprived areas like poor seaside towns or ex industrial towns and cities in the North, the Midlands and Wales often 100% of pupils now receive an inferior education in the comprehensives there. Whereas before even areas like Grimsby, Barnsley or Rotherham, West Bromwich and Hastings had a grammar school pre 1965
As I said, advocates on grammar schools rarely explain why, as a matter of policy, 75% of pupils in a given local authority should be provided with an inferior education.
There is another poster on PB, forget the name, who makes a case that the weakest pupils should receive extraordinary provision in specialised settings - now that could make a profound difference.
As I said advocates of comprehensives rarely explain why in poor and deprived areas 100% of pupils should be provided with an inferior education.
(Plus in some selective areas like Trafford and Bucks the high schools too get perfectly good results)
Whichever way you call it, when there is a Grammar School in the area everyone else has a second rate education. Why should two taxpayers paying identical tax in Stratford upon Avon get two different qualities of school/ education for their children on the basis of a two hour exam at aged 11.
On the inequity of the 11 plus alone the Conservatives should be banished from Government forever.
It is a little frustrating that every time we discuss education on here it becomes about grammar schools and private schools. Grammars aren't coming back. And the vast majority can't afford private. So how will we improve the education of 80%?
What makes you think Labour's actually interested in that?
Seriously, what makes you think they are not? Do you think there is some secret cynical plan to keep education down?
I am sure they really are interested in improving education for the 80%, as to be fair, are the Tories. The issue is that neither have much idea how to effect the improvement.
Sadly, debating education on here is almost as pointless as debating Brexit.
I posted a summary of the entirely reasonable and interesting TEC report on education here the other week (one endorsed by several previous PMs, lauded by both parties, and cheered by all previous education secretaries).
I got a lot of ranting and ad-hominem for my trouble.
I think education pushes some visceral class buttons for the British, and makes them hysterical.
It’s all down to the increasing availability of porn. In the good old days every chap had a weeks worth of sperm sitting in them waiting to go in their Saturday night special. Unfortunately now every chap is going crazy over Stepmoms eight times a day on their phone in the work loos.
Stepmoms’ gain is societies loss. Down with this sort of thing.
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It's more about efficient allocation of resources. I have paid the Nuffield for psychiatry and for new hips, and in both cases they quite rightly won't initially talk to me, even at £250 an hour, without a GP referral.
Somewhere else might have talked to you, possibly. Some private places will see you without what in many cases is the pure formality and resource-waste of a GP referral, although in my experience this is if you are self-paying and I think if you are claiming off insurance the insurer often does want a GP referral.
If you can find a specialist willing to chat honestly, they will heartily agree that GPs tend not to like ill people.
Think of the demand for a GP referral as similar to a bank's demand that its own surveyor comes to inspect a house before the bank signs off on a loan to the purchaser. "Surveyor" is not a protected term, and often the surveyor is a young boy who probably doesn't know a joist from a damp proof course, but the bank insists he comes anyway. Why? The purchaser may well already have sent a proper surveyor, and perhaps the bank is only lending half the value of the house anyway. But the bank's surveyor will still come and wiggle his ruler about. What has happened is that a wave of "We've got a shmuck here with his pockets open - dip in, everyone!" has rippled through the ranks of the professionals.
It's like that when somebody's ill - not so much when they are self-paying privately (when often you can walk out of the door and go somewhere else), but certainly the NHS is full of needless meetings etc., and years of c*ck-and-bullsh*t waiting and monitoring, and any time an insurer is involved you can also expect a degree of pickpocketing all justified with serious faces.
Given what the system actually is, often just slipping some money to a private GP for a referral is the sensible choice. If you're lucky, there will be one in the same building as the specialist you want to see. Sadly if you try to save every penny, you won't get decent specialist healthcare in this country.
I was going to say something about filtering out the nutters, but for psychiatric referrals that seems not to apply.
It's not just about filtering out, the GP referral is there to provide essential information on past medical history, medication prescribed previously, results of previous tests etc.
Isn't it strange how so much of the rest of Europe (the ones with better health outcomes than the UK) seem to manage without the GP gatekeepers.
This is the problem. People like you oppose sensible reforms that will improve health outcomes even when they, quite rightly, will make no difference to free at the point of use.
Other systems do things differently. I recall a research seminar contesting the U.K. approach with somewhere on the continent (cannot recall where). Over there, if you needed tests, a lot would be done at the GP centre (obviously not all, but things such as bloods, which get sent off in the U.K., possibly ultrasound etc). It’s a different approach, but it would be a big shift to apply it here.
But surely these big shifts are exactly what we need. The current system is, by all accounts, no longer fit for purpose so we need to make fundamental changes. We need to learn from other health systems and pick the best of their practices and ideas. Saying it would take a big shift seems to imply (and forgive me if this is not what you are saying) that it is not possible nor something we should attempt.
The important point for me is that the fundamental idea of the Health Service being free at the point of use is maintained. (Though I would suggest the French system of a payment for doctors appointments which is refunded if you attend). Everything else should be up for review so we can learn from best practice elsewhere, including internally within our own system.
I think my preference is to use the easier access parts of primary care better. Pharmacists are ideal for a lot of conditions, and new graduates from 2025 will all be able to prescribe drugs. Nurses in GPs surgery do a lot of monitoring of chronic conditions.
Yes, it would be good to change how a patient gets tests, certainly things like blood tests. My leukaemia required blood, collected on a Monday to be sent to the hospital. I was called to come to A&E 48 hours later, at a time when I was in far more danger than I realised. Blood testing on site may have had me at the hospital 48 hours earlier. In the event it didn’t matter, but it could.
And maybe now is the time to try to change, but it feels challenging because despite an increase on NHS funding, in real terms, and in respect of demand, there is a huge problem. More money is the sole answer, but it is surely part of it.
The advocates of grammar schools rarely explain why 75% of pupils should, as a matter of policy, receive an inferior education.
In deprived areas like poor seaside towns or ex industrial towns and cities in the North, the Midlands and Wales often 100% of pupils now receive an inferior education in the comprehensives there. Whereas before even areas like Grimsby, Barnsley or Rotherham, West Bromwich and Hastings had a grammar school pre 1965
As I said, advocates on grammar schools rarely explain why, as a matter of policy, 75% of pupils in a given local authority should be provided with an inferior education.
There is another poster on PB, forget the name, who makes a case that the weakest pupils should receive extraordinary provision in specialised settings - now that could make a profound difference.
As I said advocates of comprehensives rarely explain why in poor and deprived areas 100% of pupils should be provided with an inferior education.
(Plus in some selective areas like Trafford and Bucks the high schools too get perfectly good results)
Whichever way you call it, when there is a Grammar School in the area everyone else has a second rate education. Why should two taxpayers paying identical tax in Stratford upon Avon get two different qualities of school/ education for their children on the basis of a two hour exam at aged 11.
On the inequity of the 11 plus alone the Conservatives should be banished from Government forever.
Actually the Sutton Report into Grammar schools nailed that myth. It showed there was no reduction in results for Comprehensive schools in Grammar school areas compered to those without Grammars.
So yours is absolutely just the politics of envy and the lowest common denominator. Your policy is, in effect, if you can't have everyone getting a better education then no one should get one.
Education is a good thing and people should be encouraged to spend money on it. Money spent on private schools means savings for local authorities. The most extreme I know is Edinburgh where nearly 1/3rd of secondary pupils go to private schools. If several of those schools close I am not sure that the local authority could cope.
But this is all about the politics of envy. And there is never a rational answer to that.
I can't speak for the rest of the left wing wokerati but my motivation is not the politics of envy. I could afford to pay for private education for my children but I chose not to on a point of principle. I believe selective education either by money or by 11 plus exam deprives the majority of resource, either by money shovelled into Grammar Schools to the detriment of the rest, or by an exemption on VAT. I don't want my taxes to benefit a grammar school elite at the expense of everyone else, and while I don't want to deprive you of the liberty to spend your money on a private education for your children, pay the VAT on it.
Make universal education fantastic for all, and measure it on added value, not just on GCSE A* passes.
Not sure where grammar schools come into this. They are state run and, like all state schools, therefore VAT exempt.
Private schools do not cost the state money, they save it.
Between £5k and £7k per pupil. This is significantly more than the waived VAT would be, roughly twice as much. Labour claiming that this policy will produce more money for state schools shows a basic innumeracy.
I accept that there are social costs in that we end up with a relatively small and privileged elite who get a proper education in circumstances conducive to learning which gives them an unfair advantage in life. I agree that the ideal would be that state schools were so good than no one was willing to pay . But they aren't and there is absolutely no focus on making them so. To do that you would need to take on the teachers unions and no one is brave enough to do that.
Two responses to that post:
1. Labour claiming that this policy will produce more money for state schools does not show 'a basic innumeracy'... unless, and this is important, you assume that more than 30% of private pupils will no longer attend private school but will switch to state schools. Now you may think that's the case, Labour clearly don't (nor do I). But in any event there is no innumeracy on Labour's part.
2. I'm interested in your view that it is the teachers unions, not average spend per pupil (£6.5k state, £15k private), that prevents state schools being as good as private ones. Do you have any evidence for that?
When comparing the spend per pupil, it is worth remembering that in the purely academic spend, the difference is a lot lower.
Fair enough but just to be clear, what do you consider as non-academic* spend?
(*That'll be non-academic spend currently benefiting from the education VAT exemption presumably.)
Boarding costs, better sports facilities, extra curricula activities etc
So we have record waiting numbers for NHS appointments and SKS thinks its a good idea to allow people who feel a bit ill to self refer.
How can policies like this even make it past first base FFS.
Laughing stock
So the only way a nationalised system can function is with gatekeepers to limit demand?
It's more about efficient allocation of resources. I have paid the Nuffield for psychiatry and for new hips, and in both cases they quite rightly won't initially talk to me, even at £250 an hour, without a GP referral.
Somewhere else might have talked to you, possibly. Some private places will see you without what in many cases is the pure formality and resource-waste of a GP referral, although in my experience this is if you are self-paying and I think if you are claiming off insurance the insurer often does want a GP referral.
If you can find a specialist willing to chat honestly, they will heartily agree that GPs tend not to like ill people.
Think of the demand for a GP referral as similar to a bank's demand that its own surveyor comes to inspect a house before the bank signs off on a loan to the purchaser. "Surveyor" is not a protected term, and often the surveyor is a young boy who probably doesn't know a joist from a damp proof course, but the bank insists he comes anyway. Why? The purchaser may well already have sent a proper surveyor, and perhaps the bank is only lending half the value of the house anyway. But the bank's surveyor will still come and wiggle his ruler about. What has happened is that a wave of "We've got a shmuck here with his pockets open - dip in, everyone!" has rippled through the ranks of the professionals.
It's like that when somebody's ill - not so much when they are self-paying privately (when often you can walk out of the door and go somewhere else), but certainly the NHS is full of needless meetings etc., and years of c*ck-and-bullsh*t waiting and monitoring, and any time an insurer is involved you can also expect a degree of pickpocketing all justified with serious faces.
Given what the system actually is, often just slipping some money to a private GP for a referral is the sensible choice. If you're lucky, there will be one in the same building as the specialist you want to see. Sadly if you try to save every penny, you won't get decent specialist healthcare in this country.
I was going to say something about filtering out the nutters, but for psychiatric referrals that seems not to apply.
It's not just about filtering out, the GP referral is there to provide essential information on past medical history, medication prescribed previously, results of previous tests etc.
Isn't it strange how so much of the rest of Europe (the ones with better health outcomes than the UK) seem to manage without the GP gatekeepers.
This is the problem. People like you oppose sensible reforms that will improve health outcomes even when they, quite rightly, will make no difference to free at the point of use.
Other systems do things differently. I recall a research seminar contesting the U.K. approach with somewhere on the continent (cannot recall where). Over there, if you needed tests, a lot would be done at the GP centre (obviously not all, but things such as bloods, which get sent off in the U.K., possibly ultrasound etc). It’s a different approach, but it would be a big shift to apply it here.
But surely these big shifts are exactly what we need. The current system is, by all accounts, no longer fit for purpose so we need to make fundamental changes. We need to learn from other health systems and pick the best of their practices and ideas. Saying it would take a big shift seems to imply (and forgive me if this is not what you are saying) that it is not possible nor something we should attempt.
The important point for me is that the fundamental idea of the Health Service being free at the point of use is maintained. (Though I would suggest the French system of a payment for doctors appointments which is refunded if you attend). Everything else should be up for review so we can learn from best practice elsewhere, including internally within our own system.
I think my preference is to use the easier access parts of primary care better. Pharmacists are ideal for a lot of conditions, and new graduates from 2025 will all be able to prescribe drugs. Nurses in GPs surgery do a lot of monitoring of chronic conditions.
Yes, it would be good to change how a patient gets tests, certainly things like blood tests. My leukaemia required blood, collected on a Monday to be sent to the hospital. I was called to come to A&E 48 hours later, at a time when I was in far more danger than I realised. Blood testing on site may have had me at the hospital 48 hours earlier. In the event it didn’t matter, but it could.
And maybe now is the time to try to change, but it feels challenging because despite an increase on NHS funding, in real terms, and in respect of demand, there is a huge problem. More money is [not] the sole answer, but it is surely part of it.
I don't disagree - although I think you missed out a [not] in your last sentence and I have added it in as that makes more sense in terms of what you are, I think, trying to say.
The trouble is that most people - and certainly most politicians - seem to think that throwing more money at it IS the only answer and that there is no need to do anything else. It is not helped by people like Foxy on the inside whose knee jerk reaction seems to be to oppose anything that might hint that the NHS in its current form is not the best in the world.
Comments
There is a lot that can be done, pharmacists can do more to manage simple infections and asthma medication for instance. I need to order inhalers via a phone system - might be easier if I could just pop into the pharmacy.
You cannot seriously think his idea of booking a home test for internal bleeding is a good idea
I volunteer to take out SKS's spleen!
A number of these are like this
1) incurable
2) treatment, which means you can live a normal life, consists of taking some pills/injections for the rest of your life
3) on a regular basis, you need to have tests and an appointment with a specialist consultant - both for dosage levels of the medicine and to check whether the medicine is causing problems, such as liver damage.
The NHS includes the step, after you have a blood test, you must see your GP. Who solemnly says they aren’t qualified to read the results and refers you to the specialist….
It is essential that these children and young people can access the same level of psychological and social support as any other child or young person in distress, from their first encounter with the NHS and at every level within the service.
https://cass.independent-review.uk/publications/interim-report/
https://en.wikipedia.org/wiki/Opinion_polling_for_the_2026_Swedish_general_election
https://en.wikipedia.org/wiki/Next_French_legislative_election
I don't dismiss the role of GPs, but it's not crazy to think that patients are sometimes better off being in control.
Quite a few people going to A&E do so because of lack of GP access.
Which suggests to me that we should go with the flow. Have a bunch of GPs in the hospitals, and a 24 hour pharmacy. I will bet that if people know there is a GP they can go a see, they will go there.
"How is internal bleeding diagnosed?
Diagnosis of internal bleeding begins with a thorough medical history. This is followed by a physical examination, concentrating on the area of the body where the internal bleeding may have occurred. For example, if there is concern about bleeding in the brain, the physical examination will focus on the neurologic system, or if it is intra-abdominal bleeding, the exam will be directed toward the abdomen.
Blood tests may be performed to check for a low red blood cell count, or anemia. However, if the bleeding occurs rapidly, the initial hemoglobin reading or red blood cell count may be normal.
Suspicion of internal bleeding will often require an imaging test to look for the bleeding source."
etc etc. Which bit of that does he think can be bypassed by some sort of home covid type test?
Well he is funded by Donors with huge investments in the Private Health Sector as is Streeting, so of course he will propose that.
You do realize NHS staff will be the ones used in the private sector dont you?
They will be paid a premium of course out of NHS monies meaning even less for core service but money in the Banks of Starmers Donors.
We have been there before.
We had £1m top sliced from our budget at my hospital last time and for the work carried out the Trust would have only been paid half that
The gatekeeper function is there at both GP and at A and E to filter out the stuff that can be dealt with in Primary care. If we want a system where competition drives better customer service then that only works where capacity exceeds demand, and the NHS has never been funded to that level.
The 4 key figures are:
Angela Rayner
Wes Streeting
Lisa Nandy
Yvette Cooper
https://twitter.com/POLITlCSUK/status/1614690505300008967
Comes with a link "how to carry out your own endoscopy" and a portable CT/MRI scanner through your letterbox
Angela Rayner, woman of the people too !
https://pbs.twimg.com/media/FmeLQFyXoAEBO-3?format=jpg&name=large
Blokes a dangerous crackpot
https://twitter.com/dougboneparth/status/1614638630869377024?s=61&t=UQlSh0yHfQwaN4HrPVJXwA
The big shift with past elections is the willingness of right wing, and even some left wing voters, to support RN in the second round.
If you can find a specialist willing to chat honestly, they will heartily agree that GPs tend not to like ill people.
Think of the demand for a GP referral as similar to a bank's demand that its own surveyor comes to inspect a house before the bank signs off on a loan to the purchaser. "Surveyor" is not a protected term, and often the surveyor is a young boy who probably doesn't know a joist from a damp proof course, but the bank insists he comes anyway. Why? The purchaser may well already have sent a proper surveyor, and perhaps the bank is only lending half the value of the house anyway. But the bank's surveyor will still come and wiggle his ruler about. What has happened is that a wave of "We've got a shmuck here with his pockets open - dip in, everyone!" has rippled through the ranks of the professionals.
It's like that when somebody's ill - not so much when they are self-paying privately (when often you can walk out of the door and go somewhere else), but certainly the NHS is full of needless meetings etc., and years of c*ck-and-bullsh*t waiting and monitoring, and any time an insurer is involved you can also expect a degree of pickpocketing all justified with serious faces.
Given what the system actually is, often just slipping some money to a private GP for a referral is the sensible choice. If you're lucky, there will be one in the same building as the specialist you want to see. Sadly if you try to save every penny, you won't get decent specialist healthcare in this country.
Do you support it?
This is currently done by the national bowel Cancer screening programme, who sent me a pack the other day. I have to sample a bit of pooh and send it back to them to check for blood. This is screening, so initiated without symptoms. Not much point if there is known to be blood, as that requires further investigation. People can buy FOB testing kits from Amazon for a few quid BTW.
I don't think anyone expects that sort of surgery to be done on the NHS, except where medically indicated such as breast reconstruction after cancer treatment.
So they'll have learnt to read under a Labour government's Primary education policies.
Dear SKS
Should we do our own home endoscopy before or after we slip into shock, organ failure or coma?
Regards
BJO
Justice ministers from around the world will convene in London in March to support the International Criminal Court (ICC) investigating alleged war crimes in Ukraine.
https://www.gov.uk/government/news/london-to-host-major-international-meeting-on-war-crimes
Thanks for pointing that rescue photo out, too.
With a subscription to the disnae channel
Just what the Dr didnt order for our struggling NHS services
"My view on British politics, for what it’s worth is:
- The Tories have presided over mass avoidable death, collapsing living standards and imploding public services
- The Labour leadership are a bunch of unpleasant liars who are devoid of principle or vision
So that sucks!"
The difference being OJ will be asking people to vote LAB at the next GE me I would rather cut off my own penis
Oh hang on SKS might be proposing self penis removal at home by then as a policy idea in the next of his bat shit policies series!!
11-13 best price.
Who'd have thought that before the season?
It really shows a nihilism about fixing primary care, to simply bypass it.
Indeed, one of the major gripes I have heard from GPs is about "referral centres" set up by CCGs to direct referrals for hip pain etc, who bounce many back or refer everyone to physio, even when they have been seen by physio already in practice. There were brought in by this Conservative government.
But has no talks scheduled with nurses.
Something isn't right at all.
(1) Private schools are "subsided" by the State - this is nonsense and the truth is actually the opposite: every parent choosing to sending their child to private school still pays the tax for their state school place, which goes towards funding other state school children rather than theirs - this tax gain effect equates to 20-50% of the purchased place depending on how high the school fees are. It's why HMT hasn't touched it for decades, because they know making it VAT deductible (along with all other charitable educational activities) saves the taxpayer money overall.
(2) Compelling all "sharp-elbowed" and "loud mouth" private school parents to go to their local state school will lead to table-thumping demands to improve standards, which will magically lift all boats. There is precisely zero evidence for this, either in the UK or overseas, and it seems to be built on wishful thinking and popular myths of the sort of people that send their children to private schools, how they operate and weird beliefs of how they think the strings of Britain operate behind the scenes. What will happen is that it will drive up house prices in the vicinity of the best state schools and lead to a boon in private tutoring, and after-school clubs. Where it has no other outlet the balance of that displaced money will instead go into property and consumption, not education; it won't benefit a single average/poor pupil.
The net effect of this will be to increase the burden on the taxpayer, reduce diversity and employment in the education sector, and damage British education overall.
But, that's what the politics of envy looks like.
This is the problem. People like you oppose sensible reforms that will improve health outcomes even when they, quite rightly, will make no difference to free at the point of use.
“Fertility is disappearing
According to Dr. Shanna Swan, humans now meet the criteria for an endangered species.
1 in 4 couples cannot conceive naturally and that number is skyrocketing. Sperm counts are down 60%
Here's what is happening:”
https://twitter.com/alpacaaurelius/status/1614253561583484928?s=61&t=maCAvRbX3dFfFWnry2KG2g
Those are the keys to access elite jobs today to distinguish you from the great unwashed, not accent.
No mate not the many just the few
It is not reality - it’s a depressing a defeatist attitude on your part
Is that mainstream thinking or a fringe conspiracy theory?
I am sure they really are interested in improving education for the 80%, as to be fair, are the Tories. The issue is that neither have much idea how to effect the improvement.
It's been several decades since their abolition (in the main) so we now have a good evidence base to draw upon.
Did that happen?
(*That'll be non-academic spend currently benefiting from the education VAT exemption presumably.)
A few thoughts:
1) This is bullshit.
2) The war started a year ago.
3) Give them some of the Bundeswehr's current tanks.
Excuses, excuses...
The businesses operate by using staff employed by the NHS (outside their trust to avoid conflicts) and utilising NHS facilities that are left empty at weekends
The common sense thing to do would be to move the NHS to a well run 7 day operation in order to maximise capacity utilisation.
But if the NHS management is unwilling or unable to do that, then paying a premium to someone else to do it is the second choice
Catastrophists tend to assume the human race will disappear in a huge nuclear fireball, or a runaway climate change furnace, antibiotic-resistant superbug or Terminator-2 style robot Armageddon, but what if the empire of the humans goes the way of the Holy Roman Empire or indeed the British Empire, not with a bang but a whimper?
The two prime candidates for this demise are fertility and a slow replacement of human genetic replication by digital memetic replication.
Thing is nobody will mind because it won’t hurt.
The important point for me is that the fundamental idea of the Health Service being free at the point of use is maintained. (Though I would suggest the French system of a payment for doctors appointments which is refunded if you attend). Everything else should be up for review so we can learn from best practice elsewhere, including internally within our own system.
Saying they are “stuck” on 20% is a bit like saying to the Wright Brothers ‘guys, you seem to be stuck in the air’
Uniquely the Corbyn cult worked out how to get squillions from absolutely nobody in particular, not just once but sustainably every year.
https://twitter.com/AndrewHammel1/status/1614257748509614082
(1) One or both parents to work full-time, raising their family income & mildly boosting the economy overall
(2) Improve gender equality, as at the moment it's largely women who are forced to take part-time work to pick up their kids at 3pm, thus lowering their salaries and creating the perception of a structural gender gap
(3) Allow breakfast, lunch and (afternoon/ high) tea to be provided to all children
(4) Allow structured non-academic education activity to take place as part of the core curriculum, including design & technology, outdoor pursuits, arts, music, debating, and drama.
However, to do this would probably involve increasing the state education budget by c.30% and taking on the teaching unions (as @DavidL says) to adjust working patterns to shift.
I have regularly advocated for less spending on pensions and the NHS and more investment in education instead.
This is where I would spend it, and I'd introduce vouchers on top - so ordinary parents could exercise choice.
@rcs1000 brings it up a lot, but I really think the French option of gifting your personal allowance to your partner would really help.
Starmer is already taking a considerable risk with his "reform or die" rhetoric as it is. Certainly any measure which threatens the authority of GPs, let alone deciding further down the line to do away with the practice system entirely and impose NHS contracts on them, is liable to result in a lot of screaming. One can imagine the level of outrage and the volume of tears that would ensue were members of the Shadow Cabinet to come straight out with it and say that they ran off to the Spire because they thought the NHS useless.
FPTP in the US and the runoff process in France and Brazil meant the support for a far right candidate could get above that ceiling but listen to the testimony of the floating voters in all those elections and above a certain threshold it’s all “Hilary’s just as bad”, “Lula is a crooked communist” and “Macron sold out the workers” rather than real far right opinion.
The Nazis only ever managed mid 30s in the mid 30s. The secret for Fascists is not to get a majority but a plurality, and then turn the screw through canny coalition making and more nefarious means.
On the inequity of the 11 plus alone the Conservatives should be banished from Government forever.
I posted a summary of the entirely reasonable and interesting TEC report on education here the other week (one endorsed by several previous PMs, lauded by both parties, and cheered by all previous education secretaries).
I got a lot of ranting and ad-hominem for my trouble.
I think education pushes some visceral class buttons for the British, and makes them hysterical.
Stepmoms’ gain is societies loss. Down with this sort of thing.
Yes, it would be good to change how a patient gets tests, certainly things like blood tests. My leukaemia required blood, collected on a Monday to be sent to the hospital. I was called to come to A&E 48 hours later, at a time when I was in far more danger than I realised. Blood testing on site may have had me at the hospital 48 hours earlier. In the event it didn’t matter, but it could.
And maybe now is the time to try to change, but it feels challenging because despite an increase on NHS funding, in real terms, and in respect of demand, there is a huge problem. More money is the sole answer, but it is surely part of it.
SKS can't.
So yours is absolutely just the politics of envy and the lowest common denominator. Your policy is, in effect, if you can't have everyone getting a better education then no one should get one.
The trouble is that most people - and certainly most politicians - seem to think that throwing more money at it IS the only answer and that there is no need to do anything else. It is not helped by people like Foxy on the inside whose knee jerk reaction seems to be to oppose anything that might hint that the NHS in its current form is not the best in the world.