That line of attack won't work, as it did for Gordon Brown, because there was never any serious intention of holding one then in the first place.
SKS will still try though. So will you.
What was the line Cameron used? Something like, "Brown is the only man scared to call an election that he thinks he will win."
No-one is going to think that Sunak is hiding from an election he might win. Everyone understands that he'll wait to pretty much the last moment because he's facing defeat.
Hmm. I'm not sure "Sunak is clinging on until the bitter end because he is scared of what the electorate will do to him" is a much better look TBH.
It's not great, but no-one is going to seriously believe that Sunak had decided to call an election in May and then bottled it - but people do believe that Brown had decided to call an election in autumn 2007 and then bottled it.
His noncommittal comments today will simply fuel speculation that it is a realistic option, and give SKS an easy "bottle-job" line if indeed Sunak does bottle it.
Not sure if it has been posted, but this week’s episode of the Skewer has a mash up of George Galloway singing Shania Twain’s that don’t impress me much: https://www.bbc.co.uk/sounds/play/m001wxzm
It also has a rather poignant working of the latest atrocity / regular war stuff (delete as appropriate) in Gaza and fantastic Mr Fox and the Cranberries’ Zombie.
Interesting article Wes Streeting might take a look at. Any comments, @Foxy ?
What the NHS can and cannot learn from the Singaporean health care system https://www.smf.co.uk/publications/nhs-lessons-from-singapore/ There is no simple reason why Singapore spends less than other developed countries on healthcare: Singaporean public hospitals do not deliver markedly lower unit costs than peer countries. Singapore charges patients to access healthcare services, and while this moderates demand, it cannot fully explain Singapore’s low hospital utilisation. Low demand is largely determined by population health and culture, which are difficult to emulate. Hong Kong and Taiwan spend more than Singapore on healthcare, but much less than Western countries. All three East Asian states have very low levels of obesity, high life expectancy, and low health inequality. Health experts should not uncritically cite parts of Singapore’s system to justify their favoured programme of reform. Instead, they should provide evidence that a specific part of Singapore’s healthcare system works better than the NHS. This paper applies this method to primary care.
RECOMMENDATIONS
The NHS should grant prescribing rights to Singaporean doctors, building on an existing EU Directive. Demand for private GP appointments is growing as patients struggle to access timely care. An appointment on a Singaporean telemedicine app costs half as much as private UK providers, and British patients are already using this service. The government should formalise this process, and make it accessible to more people. NHS England should trial Singaporean-style polyclinics in areas of England with too few GPs. Singaporean polyclinics deliver lower unit costs, and pay their doctors more than NHS GP practices...
Polyclinics were introduced by the last Labour government following the Darzi report but did not really take off. I've had a few tests over the last year or so at our local-ish one.
As for outsourcing video consultations to foreign doctors, well, you could but liability and confidentiality issues might be tricky.
Go right back to the foundations of the NHS with its three branches, and the public health division did have clinics for babies, teeth, feet and so on.
That line of attack won't work, as it did for Gordon Brown, because there was never any serious intention of holding one then in the first place.
SKS will still try though. So will you.
What was the line Cameron used? Something like, "Brown is the only man scared to call an election that he thinks he will win."
No-one is going to think that Sunak is hiding from an election he might win. Everyone understands that he'll wait to pretty much the last moment because he's facing defeat.
Hmm. I'm not sure "Sunak is clinging on until the bitter end because he is scared of what the electorate will do to him" is a much better look TBH.
It's not great, but no-one is going to seriously believe that Sunak had decided to call an election in May and then bottled it - but people do believe that Brown had decided to call an election in autumn 2007 and then bottled it.
Not least because he had.
All his outriders were quite open that "shortly there'll be an election..."
Same hasn't happened this year by anyone other than those talking their book.
The second point is quite a lot more complicated, but I was struck by this: ..Unit costs in Singaporean polyclinics are lower than English GP practices. National Healthcare Singapore Polyclinics kindly provided me with financial data for the 2018- 19 UK financial year. The University of Kent produces comparable unit cost estimates for the NHS. Singaporean polyclinic doctors earn slightly more than the average English GP. But cost per appointment is lower in Singapore than in England. National Healthcare Singaporean Polyclinics classify patients by the number of chronic health conditions. The cost of a "Moderate Chronic Health Patient" (2-3 conditions) is 40% less than the cost of a English GP appointment. The cost of an acute visit with no chronic conditions is less than half the English average.41 The Singaporean Ministry of Health recognises the efficiency of the polyclinic model and is rapidly increasing the number of polyclinics. There are currently 23 polyclinics in Singapore; by 2030 there will be 32.
The NHS is already moving in this direction. In her 2021 NHS England stocktake report, Dr Claire Fuller recommends a new pathway to improve access to same-day urgent care treatment centres in the community.43 She argues this would free up resources to enable greater continuity of care for patients who need it most, those with chronic health conditions. There is evidence from the United States that greater intensity of primary care for chronic patients reduces secondary health care utilisation, resulting in lower total health care spending.44 The advantage of the polyclinic model – collocating urgent and chronic care – is that patients who present through the urgent care route with a chronic health condition can be signed up for a “teamlet.” Currently, patients who present at urgent treatment centres with problems related to a chronic health condition are turned away, and told to book an appointment with their GP practice..
At least one country has no problem with building new houses.
Sheep as a lamb is probably the thinking.
Stealing someone's back yard certainly solves the NIMBY thing.
It's not stealing, it was owned by Jordan and Jordan relinquished it.
Arafat had an opportunity to create a Palestinian state in that land but rejected it. He chose instead to keep the border issue undecided in favour of future negotiations.
C'est la vie.
Israel can and absolutely should do whatever suits their own interests and strengthens their hand in future negotiations. Pandering has failed.
Nonsense. Israel has no more right to annex (and ethnically cleanse) the West Bank than Russia does to annex Crimea. Israel, like all countries, should obey international law.
Replace "Israel" in your last paragraph with "Russia" and read it back. Would you agree with that? Why does Israel get to act differently?
Replace "Israel" in your last paragraph with "England", "the West Bank" with "The United States of America" or "Australia" or "Ireland" or indeed countless other examples of land acquisition through conquest and war, and you will begin to understand how the world actually works.
Shouldn't the Palestinians be Realistic about confronting a nuclear power that has an ideological belief that it should have their land? Give up and move somewhere else? Rather than fighting other peoples proxy wars to the last Palestinian?
I can't speak for the Palestinians but throughout history lands have been acquired and reaquired. I'm betting that some have done so since the formation of UNWRA which institutionalised the "refugee" status. And look at the IRA. They haven't given up and moved somewhere else.
The problem is that AFAIA Israel has existed for quite some time and hence there are competing claims. Israel agreed to the UN 1947 partition plan but the Arabs didn't. More fool them because they lost the subsequent war and some lands with it. As I said how wars work. And they have been losing wars, and land, since.
Ah. There are "competing claims". So Israel has the right to do what it like.
Well, you know, wars are pretty awful and usually stem from "competing claims". So Israel has the right to do what it believes it should do in a war.
Other than that I'm not sure what you are trying to get at which is unusual for you because you are so clever.
Is it a war ? Given that Israel completely controls the borders, and almost all of the territory of Gaza, it now has the status of an occupation. Which brings with it legal responsibilities towards the population of the occupied territory.
As our Foreign Secretary pointed out yesterday.
Israel thinks it's war.
It actually being war wouldn't excuse what is happening let alone just thinking it is.
I know. War is shit. But luckily we can rely on you to let us know what should be happening. Perhaps yet another letter calls to Bibi. Just set out your thinking clearly and I'm sure it will have an effect.
Yes yes yes. But what is your point? I mean, I get that you have a visceral aversion to people expressing criticism of what Israel is doing in Gaza. But other than that?
I don't have a visceral dislike of them criticising Israel's actions. I just point out the illogicalities and inconsistencies and wishful thinking in their arguments.
Oh but you do. Any criticism of Israel and you're all over it like some rapid rebuttal unit.
As for what you point out, it seems to boil down to "this is war" and all is therefore fair. Rather a conversation stopper.
And inconsistency? Well what about other wars? Do you apply the same mantra across the board? That it's wrong to criticise the excesses?
Surely you don't. So why such latitude towards Israel?
It is war. And as far as they are concerned an existential one. People have forgotten what that means. We are used to isolated actions where sure there are casualties but you go home afterwards.
Israel believes it is fighting for its life. Same question for you. Had the IDF been on holiday on October 7th when would Hamas have stopped.
And as for the origins that is also straightforward. Israel was created via UN declaration, has tried to make peace since that time, and its neighbours at one time or another have wanted to destroy it. Some still do.
They don't think Israel should exist.
Can Israel do wrong? Of course. But this will be worked out when the fighting has stopped because it's in the middle of an existential war. And the war could stop tomorrow if Hamas wanted it to.
Interesting article Wes Streeting might take a look at. Any comments, @Foxy ?
What the NHS can and cannot learn from the Singaporean health care system https://www.smf.co.uk/publications/nhs-lessons-from-singapore/ There is no simple reason why Singapore spends less than other developed countries on healthcare: Singaporean public hospitals do not deliver markedly lower unit costs than peer countries. Singapore charges patients to access healthcare services, and while this moderates demand, it cannot fully explain Singapore’s low hospital utilisation. Low demand is largely determined by population health and culture, which are difficult to emulate. Hong Kong and Taiwan spend more than Singapore on healthcare, but much less than Western countries. All three East Asian states have very low levels of obesity, high life expectancy, and low health inequality. Health experts should not uncritically cite parts of Singapore’s system to justify their favoured programme of reform. Instead, they should provide evidence that a specific part of Singapore’s healthcare system works better than the NHS. This paper applies this method to primary care.
RECOMMENDATIONS
The NHS should grant prescribing rights to Singaporean doctors, building on an existing EU Directive. Demand for private GP appointments is growing as patients struggle to access timely care. An appointment on a Singaporean telemedicine app costs half as much as private UK providers, and British patients are already using this service. The government should formalise this process, and make it accessible to more people. NHS England should trial Singaporean-style polyclinics in areas of England with too few GPs. Singaporean polyclinics deliver lower unit costs, and pay their doctors more than NHS GP practices...
Polyclinics were introduced by the last Labour government following the Darzi report but did not really take off. I've had a few tests over the last year or so at our local-ish one...
The report talks about that. It seems that there's been little analysis of why - the report commissioned into them hasn't been published.
The account of how Singapore runs them is interesting.
Interesting article Wes Streeting might take a look at. Any comments, @Foxy ?
What the NHS can and cannot learn from the Singaporean health care system https://www.smf.co.uk/publications/nhs-lessons-from-singapore/ There is no simple reason why Singapore spends less than other developed countries on healthcare: Singaporean public hospitals do not deliver markedly lower unit costs than peer countries. Singapore charges patients to access healthcare services, and while this moderates demand, it cannot fully explain Singapore’s low hospital utilisation. Low demand is largely determined by population health and culture, which are difficult to emulate. Hong Kong and Taiwan spend more than Singapore on healthcare, but much less than Western countries. All three East Asian states have very low levels of obesity, high life expectancy, and low health inequality. Health experts should not uncritically cite parts of Singapore’s system to justify their favoured programme of reform. Instead, they should provide evidence that a specific part of Singapore’s healthcare system works better than the NHS. This paper applies this method to primary care.
RECOMMENDATIONS
The NHS should grant prescribing rights to Singaporean doctors, building on an existing EU Directive. Demand for private GP appointments is growing as patients struggle to access timely care. An appointment on a Singaporean telemedicine app costs half as much as private UK providers, and British patients are already using this service. The government should formalise this process, and make it accessible to more people. NHS England should trial Singaporean-style polyclinics in areas of England with too few GPs. Singaporean polyclinics deliver lower unit costs, and pay their doctors more than NHS GP practices...
Polyclinics, using exactly that term, were implemented by Blair and co in around iirc 2005. l
The second point is quite a lot more complicated, but I was struck by this: ..Unit costs in Singaporean polyclinics are lower than English GP practices. National Healthcare Singapore Polyclinics kindly provided me with financial data for the 2018- 19 UK financial year. The University of Kent produces comparable unit cost estimates for the NHS. Singaporean polyclinic doctors earn slightly more than the average English GP. But cost per appointment is lower in Singapore than in England. National Healthcare Singaporean Polyclinics classify patients by the number of chronic health conditions. The cost of a "Moderate Chronic Health Patient" (2-3 conditions) is 40% less than the cost of a English GP appointment. The cost of an acute visit with no chronic conditions is less than half the English average.41 The Singaporean Ministry of Health recognises the efficiency of the polyclinic model and is rapidly increasing the number of polyclinics. There are currently 23 polyclinics in Singapore; by 2030 there will be 32.
The NHS is already moving in this direction. In her 2021 NHS England stocktake report, Dr Claire Fuller recommends a new pathway to improve access to same-day urgent care treatment centres in the community.43 She argues this would free up resources to enable greater continuity of care for patients who need it most, those with chronic health conditions. There is evidence from the United States that greater intensity of primary care for chronic patients reduces secondary health care utilisation, resulting in lower total health care spending.44 The advantage of the polyclinic model – collocating urgent and chronic care – is that patients who present through the urgent care route with a chronic health condition can be signed up for a “teamlet.” Currently, patients who present at urgent treatment centres with problems related to a chronic health condition are turned away, and told to book an appointment with their GP practice..
Looks to me as though patients lifestyle has ‘something’ to do with it. Including, perchance, a society where elderly relatives are supported in ‘children’s’ homes.
Interesting article Wes Streeting might take a look at. Any comments, @Foxy ?
What the NHS can and cannot learn from the Singaporean health care system https://www.smf.co.uk/publications/nhs-lessons-from-singapore/ There is no simple reason why Singapore spends less than other developed countries on healthcare: Singaporean public hospitals do not deliver markedly lower unit costs than peer countries. Singapore charges patients to access healthcare services, and while this moderates demand, it cannot fully explain Singapore’s low hospital utilisation. Low demand is largely determined by population health and culture, which are difficult to emulate. Hong Kong and Taiwan spend more than Singapore on healthcare, but much less than Western countries. All three East Asian states have very low levels of obesity, high life expectancy, and low health inequality. Health experts should not uncritically cite parts of Singapore’s system to justify their favoured programme of reform. Instead, they should provide evidence that a specific part of Singapore’s healthcare system works better than the NHS. This paper applies this method to primary care.
RECOMMENDATIONS
The NHS should grant prescribing rights to Singaporean doctors, building on an existing EU Directive. Demand for private GP appointments is growing as patients struggle to access timely care. An appointment on a Singaporean telemedicine app costs half as much as private UK providers, and British patients are already using this service. The government should formalise this process, and make it accessible to more people. NHS England should trial Singaporean-style polyclinics in areas of England with too few GPs. Singaporean polyclinics deliver lower unit costs, and pay their doctors more than NHS GP practices...
Polyclinics, using exactly that term, were implemented by Blair and co in around iirc 2005. l
Up to a point. See discussion upthread - and read the report.
Can Israel do wrong? Of course. But this will be worked out when the fighting has stopped because it's in the middle of an existential war. And the war could stop tomorrow if Hamas wanted it to.
You couldn't be making it clearer that you are seeing everything exclusively through Israel's eyes.
Because whether Israel is doing wrong is - blindingly self evidently - not up to Israel alone. And right now the rest of the world has ample evidence to draw conclusions from.
Do you think you would be qualified in saying anything worth listening to about Russia's war against Ukraine, if you were looking at things exclusively from Putin's standpoint?
Is there a reason now why people need to see a GP attached to a particular centre/practice? For registration purposes, maybe. But otherwise?
I was not a huge fan of online consultations being introduced, but now that reality is here why not open this up to a patient seeing any GP online as the first port of call. If the GP or patient feels an in-person investigation is required following on from that, then they can make a referral to a local health centre. But otherwise let local surgeries deal with those patients that do not have the online technology, and treatment of chronic conditions that require repeat GP visits.
Interesting article Wes Streeting might take a look at. Any comments, @Foxy ?
What the NHS can and cannot learn from the Singaporean health care system https://www.smf.co.uk/publications/nhs-lessons-from-singapore/ There is no simple reason why Singapore spends less than other developed countries on healthcare: Singaporean public hospitals do not deliver markedly lower unit costs than peer countries. Singapore charges patients to access healthcare services, and while this moderates demand, it cannot fully explain Singapore’s low hospital utilisation. Low demand is largely determined by population health and culture, which are difficult to emulate. Hong Kong and Taiwan spend more than Singapore on healthcare, but much less than Western countries. All three East Asian states have very low levels of obesity, high life expectancy, and low health inequality. Health experts should not uncritically cite parts of Singapore’s system to justify their favoured programme of reform. Instead, they should provide evidence that a specific part of Singapore’s healthcare system works better than the NHS. This paper applies this method to primary care.
RECOMMENDATIONS
The NHS should grant prescribing rights to Singaporean doctors, building on an existing EU Directive. Demand for private GP appointments is growing as patients struggle to access timely care. An appointment on a Singaporean telemedicine app costs half as much as private UK providers, and British patients are already using this service. The government should formalise this process, and make it accessible to more people. NHS England should trial Singaporean-style polyclinics in areas of England with too few GPs. Singaporean polyclinics deliver lower unit costs, and pay their doctors more than NHS GP practices...
Polyclinics, using exactly that term, were implemented by Blair and co in around iirc 2005. l
Checking .. 2007-2010 then canned by Cameron etc.
A legacy is perhaps the far wider range of services offered by GPs.
Since 2010 the UK has had the weakest GDP per capita, the lowest wage growth, and among the highest unemployment rates of any period of government since WWII. Striking chart from the @resfoundation this morning 👇
UK unemployment rate is 3.8%
The UK has not had the highest unemployment rates of any period since WWII.
Anyone claiming that is playing silly buggers with the statistics.
You missed the word "among". More English comprehension training required.
It is Labour's job to make people think that Sunak has bottled out of calling a May election, irrespective of whether he does or not.
Yes. Surprising that he did not repeat the "working assumption is the Autumn" line today - that will only encourage Labour to push the "frit" message harder.
Too late now, but Sunak should have called the election for Maundy Thursday.
Then we wouldn't have had to worry about having to go to work after staying up for the results, and would be able to go on a 4-day bender to celebrate kicking the Tories out of office.
2nd May. And he should call it now to give the Tories the longest possible campaign period - who knows, they might close the gap.
Interesting article Wes Streeting might take a look at. Any comments, @Foxy ?
What the NHS can and cannot learn from the Singaporean health care system https://www.smf.co.uk/publications/nhs-lessons-from-singapore/ There is no simple reason why Singapore spends less than other developed countries on healthcare: Singaporean public hospitals do not deliver markedly lower unit costs than peer countries. Singapore charges patients to access healthcare services, and while this moderates demand, it cannot fully explain Singapore’s low hospital utilisation. Low demand is largely determined by population health and culture, which are difficult to emulate. Hong Kong and Taiwan spend more than Singapore on healthcare, but much less than Western countries. All three East Asian states have very low levels of obesity, high life expectancy, and low health inequality. Health experts should not uncritically cite parts of Singapore’s system to justify their favoured programme of reform. Instead, they should provide evidence that a specific part of Singapore’s healthcare system works better than the NHS. This paper applies this method to primary care.
RECOMMENDATIONS
The NHS should grant prescribing rights to Singaporean doctors, building on an existing EU Directive. Demand for private GP appointments is growing as patients struggle to access timely care. An appointment on a Singaporean telemedicine app costs half as much as private UK providers, and British patients are already using this service. The government should formalise this process, and make it accessible to more people. NHS England should trial Singaporean-style polyclinics in areas of England with too few GPs. Singaporean polyclinics deliver lower unit costs, and pay their doctors more than NHS GP practices...
Polyclinics, using exactly that term, were implemented by Blair and co in around iirc 2005. l
Checking .. 2007-2010 then canned by Cameron etc.
A legacy is perhaps the far wider range of services offered by GPs.
Is there a reason now why people need to see a GP attached to a particular centre/practice? For registration purposes, maybe. But otherwise?
I was not a huge fan of online consultations being introduced, but now that reality is here why not open this up to a patient seeing any GP online as the first port of call. If the GP or patient feels an in-person investigation is required following on from that, then they can make a referral to a local health centre. But otherwise let local surgeries deal with those patients that do not have the online technology, and treatment of chronic conditions that require repeat GP visits.
We could. Along those same lines, patients are already advised to call 111 first or consult their pharmacist.
Delays around tests could be reduced as more test providers can place results online for GP access, and even as more of us, since the pandemic, have basic gadgets at home. I can take my own pulse and measure my blood pressure at home using similar instruments to my doctor, and phone them in without needing to travel to the surgery.
ETA what you suggest might run into a cost problem when the minister decides this means medical records must be centralised so any GP can access them, and before long you've got another failed NHS IT project costing billions, just to catch a few edge cases.
Can Israel do wrong? Of course. But this will be worked out when the fighting has stopped because it's in the middle of an existential war. And the war could stop tomorrow if Hamas wanted it to.
You couldn't be making it clearer that you are seeing everything exclusively through Israel's eyes.
Because whether Israel is doing wrong is - blindingly self evidently - not up to Israel alone. And right now the rest of the world has ample evidence to draw conclusions from.
Do you think you would be qualified in saying anything worth listening to about Russia's war against Ukraine, if you were looking at things exclusively from Putin's standpoint?
By all means make your own mind up about the worth of my posts. Assign them zero value go for it.
Which bit of what I wrote do you dispute. The rest of the world will of course make its assessment and good luck to them.
Talking about the rest of the world and Russia, bear in mind the view of the Global South. Be careful what you wish for with the rest of the world. Do you mean "us" when you use that term.
@alexwickham When you’re worried Labour are going to accuse you of bottling a May election, certainly an interesting tactic to then not deny a May election
Quite agree. The only answer to that question is surely to repeat your “working assumption” that it will be in the second half of 2024? Even if you *are* planning to call an election in a recession when you’re 20 points behind
Is there a reason now why people need to see a GP attached to a particular centre/practice? For registration purposes, maybe. But otherwise?
I was not a huge fan of online consultations being introduced, but now that reality is here why not open this up to a patient seeing any GP online as the first port of call. If the GP or patient feels an in-person investigation is required following on from that, then they can make a referral to a local health centre. But otherwise let local surgeries deal with those patients that do not have the online technology, and treatment of chronic conditions that require repeat GP visits.
There used to be a walk-in GP clinic at Euston Station. Just rock up, pay £50 and get seen straight away. A bargain for anyone who earned more than £50 a day.
Is there a reason now why people need to see a GP attached to a particular centre/practice? For registration purposes, maybe. But otherwise?
I was not a huge fan of online consultations being introduced, but now that reality is here why not open this up to a patient seeing any GP online as the first port of call. If the GP or patient feels an in-person investigation is required following on from that, then they can make a referral to a local health centre. But otherwise let local surgeries deal with those patients that do not have the online technology, and treatment of chronic conditions that require repeat GP visits.
I believe that there is quite a lot of evidence that it is beneficial for patients to have a continuing relationship with an individual GP who can (in theory) get to know them and their health more thoroughly than a random locum who has skimmed through the file two minutes before an online consultation. I recently had some outpatient treatment which required follow-up visits - at each visit I saw a different doctor, most of whom were obviously unfamiliar with my case. This did not inspire much confidence that any problems would have been picked up. I guess continuity of care is an an unaffordable luxury in present circumstances but it should remain as aspiration for the NHS.
Too late now, but Sunak should have called the election for Maundy Thursday.
Then we wouldn't have had to worry about having to go to work after staying up for the results, and would be able to go on a 4-day bender to celebrate kicking the Tories out of office.
Two reasons why not. 1. He’s teetotal. 2. He’s Hindu
@alexwickham When you’re worried Labour are going to accuse you of bottling a May election, certainly an interesting tactic to then not deny a May election
Sunak clearly wants the option of a May election on the table. That's why so many journalists, politicians and commentators (including on here) are so feverishly excited about the prospect. There's been plenty of preparation to be in place for that option.
But it all falls into insignificance when you're 20 points behind in the polls. You simply don't call an election you'd be smashed in.
And much of the election gimmickery works at least as well for the autumn (when the Tories can say 'delivered' rather than just 'legislated for'), as for May.
Is there a reason now why people need to see a GP attached to a particular centre/practice? For registration purposes, maybe. But otherwise?
I was not a huge fan of online consultations being introduced, but now that reality is here why not open this up to a patient seeing any GP online as the first port of call. If the GP or patient feels an in-person investigation is required following on from that, then they can make a referral to a local health centre. But otherwise let local surgeries deal with those patients that do not have the online technology, and treatment of chronic conditions that require repeat GP visits.
For most people, quick online consultations with a doctor would be great.
But, for a lot of people who are elderly, disabled, or have a complex medical history, they really need to see *their* doctor.
It should, however, be really easy to set up a virtual doctor service with doctors overseas, with suitable vetting and qualifications checks in place. Start with places like Singapore and UAE where there is excess private medical capacity (but not USA where the incentives for doctors are totally messed up).
@alexwickham When you’re worried Labour are going to accuse you of bottling a May election, certainly an interesting tactic to then not deny a May election
Sunak clearly wants the option of a May election on the table. That's why so many journalists, politicians and commentators (including on here) are so feverishly excited about the prospect. There's been plenty of preparation to be in place for that option.
But it all falls into insignificance when you're 20 points behind in the polls. You simply don't call an election you'd be smashed in.
And much of the election gimmickery works at least as well for the autumn (when the Tories can say 'delivered' rather than just 'legislated for'), as for May.
Good morning from Wembley. I note the Trump thread and nod that the budget was such a non-event that it has no political implications the morning after.
So, stick or twist. Is the "actually you're still paying the most amount of tax ever" budget enough to make Sunak sprint for May? Or do they need another autumn statement and thus slide towards ELE?
The big story from yesterday is Hunt's journey on equalising IT and NI which is something labour should be in favour off not objecting strenuously to it this morning
Nothing sides more with workers than this policy and I expect it to be in the conservative manifesto
As you know I'm not voting Labour...
The simple truth is that almost none of these budget measures will be enacted, by any party. The country is broken and something more substantial will be needed after the election, whenever it is.
The NI and child benefit changes together with 8.5% pension increases will be in April's pay packets
Both of which reduce the size of the tax increase. Like reducing inflation, its still an increase...
Show your working.
For a median earner on PAYE it's a tax cut.
For someone like Malc who thinks he shouldn't pay the same rates as those on PAYE it's a tax rise.
Listen you lying little snake. I pay all the same taxes as everyone else and I bet multiple times the money you are paying as a thick low income sponger. I pay more than twice your minimum income so that you can get loads of freebies for you and your brood.
National Insurance is a tax you nincompoop.
HMRC says its a tax under international law and treaties.
Do you pay that? Or did you not understand that?
Are you lying, or ignorant?
You are a thick brainless absolute moronic cretin. I pay all the taxes the government levies, what part of that does your empty head not register. GFY it is like talking to a brick.
Is there a reason now why people need to see a GP attached to a particular centre/practice? For registration purposes, maybe. But otherwise?
I was not a huge fan of online consultations being introduced, but now that reality is here why not open this up to a patient seeing any GP online as the first port of call. If the GP or patient feels an in-person investigation is required following on from that, then they can make a referral to a local health centre. But otherwise let local surgeries deal with those patients that do not have the online technology, and treatment of chronic conditions that require repeat GP visits.
For most people, quick online consultations with a doctor would be great.
But, for a lot of people who are elderly, disabled, or have a complex medical history, they really need to see *their* doctor.
It should, however, be really easy to set up a virtual doctor service with doctors overseas, with suitable vetting and qualifications checks in place. Start with places like Singapore and UAE where there is excess private medical capacity (but not USA where the incentives for doctors are totally messed up).
I feel, rightly or wrongly, that I need to see the same GP nowadays , even though I’m fully aware that the three GP practice where I’m registered has a good reputation for its record keeping. Once upon a time I wouldn’t have been bothered.
Good morning from Wembley. I note the Trump thread and nod that the budget was such a non-event that it has no political implications the morning after.
So, stick or twist. Is the "actually you're still paying the most amount of tax ever" budget enough to make Sunak sprint for May? Or do they need another autumn statement and thus slide towards ELE?
The big story from yesterday is Hunt's journey on equalising IT and NI which is something labour should be in favour off not objecting strenuously to it this morning
Nothing sides more with workers than this policy and I expect it to be in the conservative manifesto
As you know I'm not voting Labour...
The simple truth is that almost none of these budget measures will be enacted, by any party. The country is broken and something more substantial will be needed after the election, whenever it is.
The NI and child benefit changes together with 8.5% pension increases will be in April's pay packets
Both of which reduce the size of the tax increase. Like reducing inflation, its still an increase...
Show your working.
For a median earner on PAYE it's a tax cut.
For someone like Malc who thinks he shouldn't pay the same rates as those on PAYE it's a tax rise.
Listen you lying little snake. I pay all the same taxes as everyone else and I bet multiple times the money you are paying as a thick low income sponger. I pay more than twice your minimum income so that you can get loads of freebies for you and your brood.
National Insurance is a tax you nincompoop.
HMRC says its a tax under international law and treaties.
Do you pay that? Or did you not understand that?
Are you lying, or ignorant?
You are a thick brainless absolute moronic cretin. I pay all the taxes the government levies, what part of that does your empty head not register. GFY it is like talking to a brick.
Employee NI is only applied to people below the pension age, once you qualify for the state pension you stop paying it.
Now you could instantly remove employee NI by adding 0.66% income tax for every penny reduction in Employee NI but then pensions would be paying more in tax - which given they are the only people voting for the Tory party is an insane thing for the Tory party to do
Is there a reason now why people need to see a GP attached to a particular centre/practice? For registration purposes, maybe. But otherwise?
I was not a huge fan of online consultations being introduced, but now that reality is here why not open this up to a patient seeing any GP online as the first port of call. If the GP or patient feels an in-person investigation is required following on from that, then they can make a referral to a local health centre. But otherwise let local surgeries deal with those patients that do not have the online technology, and treatment of chronic conditions that require repeat GP visits.
I believe that there is quite a lot of evidence that it is beneficial for patients to have a continuing relationship with an individual GP who can (in theory) get to know them and their health more thoroughly than a random locum who has skimmed through the file two minutes before an online consultation. I recently had some outpatient treatment which required follow-up visits - at each visit I saw a different doctor, most of whom were obviously unfamiliar with my case. This did not inspire much confidence that any problems would have been picked up. I guess continuity of care is an an unaffordable luxury in present circumstances but it should remain as aspiration for the NHS.
Yes. In fact I wrote a paper linking greater continuity in GP care to fewer A&E visits and emergency admissions.
However, that was in a group with chronic conditions. For those making occasional appointments for different issues, it's probably not very important. If those making occasional appointments (disproportionately younger/of working age?) could be shuffled off to more efficient options, it might increase the chances of those with ongoing GP needs being able to get appointments with the same person.
(It would be necessary to check the ratio of single visit versus series of visits type of contacts before having an idea whether this would really help in practice)
Good morning from Wembley. I note the Trump thread and nod that the budget was such a non-event that it has no political implications the morning after.
So, stick or twist. Is the "actually you're still paying the most amount of tax ever" budget enough to make Sunak sprint for May? Or do they need another autumn statement and thus slide towards ELE?
The big story from yesterday is Hunt's journey on equalising IT and NI which is something labour should be in favour off not objecting strenuously to it this morning
Nothing sides more with workers than this policy and I expect it to be in the conservative manifesto
As you know I'm not voting Labour...
The simple truth is that almost none of these budget measures will be enacted, by any party. The country is broken and something more substantial will be needed after the election, whenever it is.
The NI and child benefit changes together with 8.5% pension increases will be in April's pay packets
Both of which reduce the size of the tax increase. Like reducing inflation, its still an increase...
Show your working.
For a median earner on PAYE it's a tax cut.
For someone like Malc who thinks he shouldn't pay the same rates as those on PAYE it's a tax rise.
Listen you lying little snake. I pay all the same taxes as everyone else and I bet multiple times the money you are paying as a thick low income sponger. I pay more than twice your minimum income so that you can get loads of freebies for you and your brood.
National Insurance is a tax you nincompoop.
HMRC says its a tax under international law and treaties.
Do you pay that? Or did you not understand that?
Are you lying, or ignorant?
You are a thick brainless absolute moronic cretin. I pay all the taxes the government levies, what part of that does your empty head not register. GFY it is like talking to a brick.
That's a 5/10
The fury is excellent, but where's the poetry in the insults? The flow? The magic?
London nightlife under Khan, and the imams and nimbies of gloom
“In Hackney, all new venues must close by 11PM Mon-Fri and 12PM at the weekend. No new venues can operate later than this.
Over time the existing venues will need new licenses and therefore the venues that are open after 11/12 will slowly erode until there is literally none left.”
Is there a reason now why people need to see a GP attached to a particular centre/practice? For registration purposes, maybe. But otherwise?
I was not a huge fan of online consultations being introduced, but now that reality is here why not open this up to a patient seeing any GP online as the first port of call. If the GP or patient feels an in-person investigation is required following on from that, then they can make a referral to a local health centre. But otherwise let local surgeries deal with those patients that do not have the online technology, and treatment of chronic conditions that require repeat GP visits.
I believe that there is quite a lot of evidence that it is beneficial for patients to have a continuing relationship with an individual GP who can (in theory) get to know them and their health more thoroughly than a random locum who has skimmed through the file two minutes before an online consultation. I recently had some outpatient treatment which required follow-up visits - at each visit I saw a different doctor, most of whom were obviously unfamiliar with my case. This did not inspire much confidence that any problems would have been picked up. I guess continuity of care is an an unaffordable luxury in present circumstances but it should remain as aspiration for the NHS.
Yes. In fact I wrote a paper linking greater continuity in GP care to fewer A&E visits and emergency admissions.
However, that was in a group with chronic conditions. For those making occasional appointments for different issues, it's probably not very important. If those making occasional appointments (disproportionately younger/of working age?) could be shuffled off to more efficient options, it might increase the chances of those with ongoing GP needs being able to get appointments with the same person.
(It would be necessary to check the ratio of single visit versus series of visits type of contacts before having an idea whether this would really help in practice)
I agree with this. If someone is used to seeing the same doctor to discuss ongoing treatment/symptoms I can see the merit in that. Hence why I posited in my earlier post that for those with chronic conditions having regular appointments with the same doctor/at the surgery would be the appropriate course.
There have to be a good chunk of the population though for whom this doesn’t matter and the critical issue is simply being seen. They don’t need to be blocking up in person appointments at specified surgeries. It feels to me we create an artificial bottleneck at the GP stage. Back in the day when everyone could be guaranteed a relatively quick appointment with a family doctor, there was no issue. But those days are gone, and it’s time the system adapted rather than pretend it can still cope.
Good morning from Wembley. I note the Trump thread and nod that the budget was such a non-event that it has no political implications the morning after.
So, stick or twist. Is the "actually you're still paying the most amount of tax ever" budget enough to make Sunak sprint for May? Or do they need another autumn statement and thus slide towards ELE?
The big story from yesterday is Hunt's journey on equalising IT and NI which is something labour should be in favour off not objecting strenuously to it this morning
Nothing sides more with workers than this policy and I expect it to be in the conservative manifesto
As you know I'm not voting Labour...
The simple truth is that almost none of these budget measures will be enacted, by any party. The country is broken and something more substantial will be needed after the election, whenever it is.
The NI and child benefit changes together with 8.5% pension increases will be in April's pay packets
Both of which reduce the size of the tax increase. Like reducing inflation, its still an increase...
Show your working.
For a median earner on PAYE it's a tax cut.
For someone like Malc who thinks he shouldn't pay the same rates as those on PAYE it's a tax rise.
Listen you lying little snake. I pay all the same taxes as everyone else and I bet multiple times the money you are paying as a thick low income sponger. I pay more than twice your minimum income so that you can get loads of freebies for you and your brood.
National Insurance is a tax you nincompoop.
HMRC says its a tax under international law and treaties.
Do you pay that? Or did you not understand that?
Are you lying, or ignorant?
You are a thick brainless absolute moronic cretin. I pay all the taxes the government levies, what part of that does your empty head not register. GFY it is like talking to a brick.
Employee NI is only applied to people below the pension age, once you qualify for the state pension you stop paying it.
Now you could instantly remove employee NI by adding 0.66% income tax for every penny reduction in Employee NI but then pensions would be paying more in tax - which given they are the only people voting for the Tory party is an insane thing for the Tory party to do
Bart Simpson fails to grasp that fact and counts pensioners tax dodgers as they don't pay a tax they are not entitled to pay. He is the dullest tool in the box for sure.
Boris Johnson would hang it out until Christmas. He'd roll the dice, hope that something would magically appear to save him, and cling on. Deus ex machina, old boy.
Rishi Sunak is not a gambler. He's looking at the next 6 mo with no guarantee it'll improve. Rwanda flights get Royal Assent March 20, and if he can get a plane in the air he'll call a general on March 26, which will hit the May 2 local elections.
If he doesn't, he will lose almost every Tory councillor in the country. And if he goes to the polls in October, there'll be no-one prepared to put a poster up or bang on a door for him. It's May 2 or bust.
The header is a good analysis, to which I would add this point: In recent weeks there have been a number of incidents suggesting that the Loser may be sliding into dementia.
(If his close supporters see those problems, they might react by talking about Biden's problems. Which are also real, but not nearly as severe.
As we all know, in politics, accusations are often also confessions.)
Good morning from Wembley. I note the Trump thread and nod that the budget was such a non-event that it has no political implications the morning after.
So, stick or twist. Is the "actually you're still paying the most amount of tax ever" budget enough to make Sunak sprint for May? Or do they need another autumn statement and thus slide towards ELE?
The big story from yesterday is Hunt's journey on equalising IT and NI which is something labour should be in favour off not objecting strenuously to it this morning
Nothing sides more with workers than this policy and I expect it to be in the conservative manifesto
As you know I'm not voting Labour...
The simple truth is that almost none of these budget measures will be enacted, by any party. The country is broken and something more substantial will be needed after the election, whenever it is.
The NI and child benefit changes together with 8.5% pension increases will be in April's pay packets
Both of which reduce the size of the tax increase. Like reducing inflation, its still an increase...
Show your working.
For a median earner on PAYE it's a tax cut.
For someone like Malc who thinks he shouldn't pay the same rates as those on PAYE it's a tax rise.
Listen you lying little snake. I pay all the same taxes as everyone else and I bet multiple times the money you are paying as a thick low income sponger. I pay more than twice your minimum income so that you can get loads of freebies for you and your brood.
National Insurance is a tax you nincompoop.
HMRC says its a tax under international law and treaties.
Do you pay that? Or did you not understand that?
Are you lying, or ignorant?
You are a thick brainless absolute moronic cretin. I pay all the taxes the government levies, what part of that does your empty head not register. GFY it is like talking to a brick.
That's a 5/10
The fury is excellent, but where's the poetry in the insults? The flow? The magic?
You can do better.
Malmesbury, too busy working to pay my tax bills to think of poetry
The header is a good analysis, to which I would add this point: In recent weeks there have been a number of incidents suggesting that the Loser may be sliding into dementia.
(If his close supporters see those problems, they might react by talking about Biden's problems. Which are also real, but not nearly as severe.
As we all know, in politics, accusations are often also confessions.)
That last point is so true: whenever Trump accuses someone of something, it is almost always because that is how behaves.
That said, can you imagine a "debate" between Biden and Trump when they're both so clearly in mental decline?
Good morning from Wembley. I note the Trump thread and nod that the budget was such a non-event that it has no political implications the morning after.
So, stick or twist. Is the "actually you're still paying the most amount of tax ever" budget enough to make Sunak sprint for May? Or do they need another autumn statement and thus slide towards ELE?
The big story from yesterday is Hunt's journey on equalising IT and NI which is something labour should be in favour off not objecting strenuously to it this morning
Nothing sides more with workers than this policy and I expect it to be in the conservative manifesto
As you know I'm not voting Labour...
The simple truth is that almost none of these budget measures will be enacted, by any party. The country is broken and something more substantial will be needed after the election, whenever it is.
The NI and child benefit changes together with 8.5% pension increases will be in April's pay packets
Which for those paid at the end of the month will come after their postal votes do, if the election's 2 May. Even for those voting in person, most people won't notice the difference as payslips are generally a thing of the past (never mind pay packets themselves), and you don't notice pay rises until you start having spare money (or more spare money) left over at the end of the month.
Is there a reason now why people need to see a GP attached to a particular centre/practice? For registration purposes, maybe. But otherwise?
I was not a huge fan of online consultations being introduced, but now that reality is here why not open this up to a patient seeing any GP online as the first port of call. If the GP or patient feels an in-person investigation is required following on from that, then they can make a referral to a local health centre. But otherwise let local surgeries deal with those patients that do not have the online technology, and treatment of chronic conditions that require repeat GP visits.
I believe that there is quite a lot of evidence that it is beneficial for patients to have a continuing relationship with an individual GP who can (in theory) get to know them and their health more thoroughly than a random locum who has skimmed through the file two minutes before an online consultation. I recently had some outpatient treatment which required follow-up visits - at each visit I saw a different doctor, most of whom were obviously unfamiliar with my case. This did not inspire much confidence that any problems would have been picked up. I guess continuity of care is an an unaffordable luxury in present circumstances but it should remain as aspiration for the NHS.
Yes. In fact I wrote a paper linking greater continuity in GP care to fewer A&E visits and emergency admissions.
However, that was in a group with chronic conditions. For those making occasional appointments for different issues, it's probably not very important. If those making occasional appointments (disproportionately younger/of working age?) could be shuffled off to more efficient options, it might increase the chances of those with ongoing GP needs being able to get appointments with the same person.
(It would be necessary to check the ratio of single visit versus series of visits type of contacts before having an idea whether this would really help in practice)
I'm 65 now, fortunately not had much need to contact my GP in the past, but even though I have no immediate problems it would be helpful to have a relationship with someone with whom I could have a general discussion about my health on, say, an annual basis. At the moment all I get is occasional requests to go for a routine blood test - these seems to come at random (two within three months last year) and result in no follow-up unless one of the readings is outside the normal parameters. If this happens I get a call or text which effectively tells me the NHS treatment protocol for that result - there is no contextual discussion or consideration of the result (eg I once got a high blood sugar reading which led to me being advised I was at risk of diabetes, even though previous and subsequent tests were normal). It's all very impersonal and formulaic; however the GPs at my surgery seem to change so often that the chances of seeing the same onw twice are slim.
Good morning from Wembley. I note the Trump thread and nod that the budget was such a non-event that it has no political implications the morning after.
So, stick or twist. Is the "actually you're still paying the most amount of tax ever" budget enough to make Sunak sprint for May? Or do they need another autumn statement and thus slide towards ELE?
The big story from yesterday is Hunt's journey on equalising IT and NI which is something labour should be in favour off not objecting strenuously to it this morning
Nothing sides more with workers than this policy and I expect it to be in the conservative manifesto
As you know I'm not voting Labour...
The simple truth is that almost none of these budget measures will be enacted, by any party. The country is broken and something more substantial will be needed after the election, whenever it is.
The NI and child benefit changes together with 8.5% pension increases will be in April's pay packets
Both of which reduce the size of the tax increase. Like reducing inflation, its still an increase...
Show your working.
For a median earner on PAYE it's a tax cut.
For someone like Malc who thinks he shouldn't pay the same rates as those on PAYE it's a tax rise.
Listen you lying little snake. I pay all the same taxes as everyone else and I bet multiple times the money you are paying as a thick low income sponger. I pay more than twice your minimum income so that you can get loads of freebies for you and your brood.
National Insurance is a tax you nincompoop.
HMRC says its a tax under international law and treaties.
Do you pay that? Or did you not understand that?
Are you lying, or ignorant?
You are a thick brainless absolute moronic cretin. I pay all the taxes the government levies, what part of that does your empty head not register. GFY it is like talking to a brick.
That's a 5/10
The fury is excellent, but where's the poetry in the insults? The flow? The magic?
You can do better.
Malmesbury, too busy working to pay my tax bills to think of poetry
Always make time for poetry. Remember, one night John Wilkes was drunk and angry. Immortality awaited...
Earl of Sandwich - "Sir, I do not know whether you will die on the gallows or of the pox." Wilkes - "That depends, my lord, on whether I embrace your lordship's principles or your mistress."
Sad that the UK's Premier political event, the Lewisham mayoral byelection, is not being covered.
If only PB.com had a man on the spot to do the honours...
Well, I channeled Leon and got an AI bot to do it:
Today, residents of Lewisham eagerly head to the polls to cast their votes in the highly anticipated Mayoral by-election. This election comes as a crucial moment for this vibrant London borough, as residents seek to elect a new leader who will guide them through the upcoming challenges and opportunities.
The candidates vying for the position bring diverse backgrounds and experiences to the table, promising a dynamic race filled with debates on key issues such as housing affordability, community safety, and environmental sustainability. Each candidate has outlined their vision for Lewisham's future, offering residents a choice between different approaches and priorities.
As voters queue up at polling stations across the borough, there is a palpable sense of civic engagement and excitement in the air. The outcome of this election will not only determine the next Mayor of Lewisham but also set the course for the borough's development and progress in the years to come.
Regardless of the result, today's by-election serves as a testament to the strength of democracy and the power of community participation. Lewisham residents are exercising their democratic right to choose their representatives, shaping the future of their borough through their votes.
Bit light on candidate details, but I think it captures the palpable excitement of the event
ETA: I asked for an added bit on the candidates standing: Among the candidates is John Smith, a long-serving community activist known for his grassroots work on housing and youth empowerment. Sarah Thompson, a former city council member, has emphasized her track record in promoting environmental initiatives and social inclusion. Additionally, David Patel, a local business leader, has placed a strong emphasis on economic development and job creation in his campaign. (None of these are actual candidates according to Wikipedia or the BBC)
@alexwickham When you’re worried Labour are going to accuse you of bottling a May election, certainly an interesting tactic to then not deny a May election
I think he's trying to shit up Tory MPs who may be considering getting rid of him. "Try it and I'll do the electoral equivalent of a suicide bomb and take us all out"
Is there a reason now why people need to see a GP attached to a particular centre/practice? For registration purposes, maybe. But otherwise?
I was not a huge fan of online consultations being introduced, but now that reality is here why not open this up to a patient seeing any GP online as the first port of call. If the GP or patient feels an in-person investigation is required following on from that, then they can make a referral to a local health centre. But otherwise let local surgeries deal with those patients that do not have the online technology, and treatment of chronic conditions that require repeat GP visits.
I believe that there is quite a lot of evidence that it is beneficial for patients to have a continuing relationship with an individual GP who can (in theory) get to know them and their health more thoroughly than a random locum who has skimmed through the file two minutes before an online consultation. I recently had some outpatient treatment which required follow-up visits - at each visit I saw a different doctor, most of whom were obviously unfamiliar with my case. This did not inspire much confidence that any problems would have been picked up. I guess continuity of care is an an unaffordable luxury in present circumstances but it should remain as aspiration for the NHS.
Yes. In fact I wrote a paper linking greater continuity in GP care to fewer A&E visits and emergency admissions.
However, that was in a group with chronic conditions. For those making occasional appointments for different issues, it's probably not very important. If those making occasional appointments (disproportionately younger/of working age?) could be shuffled off to more efficient options, it might increase the chances of those with ongoing GP needs being able to get appointments with the same person.
(It would be necessary to check the ratio of single visit versus series of visits type of contacts before having an idea whether this would really help in practice)
I'm 65 now, fortunately not had much need to contact my GP in the past, but even though I have no immediate problems it would be helpful to have a relationship with someone with whom I could have a general discussion about my health on, say, an annual basis. At the moment all I get is occasional requests to go for a routine blood test - these seems to come at random (two within three months last year) and result in no follow-up unless one of the readings is outside the normal parameters. If this happens I get a call or text which effectively tells me the NHS treatment protocol for that result - there is no contextual discussion or consideration of the result (eg I once got a high blood sugar reading which led to me being advised I was at risk of diabetes, even though previous and subsequent tests were normal). It's all very impersonal and formulaic; however the GPs at my surgery seem to change so often that the chances of seeing the same onw twice are slim.
I’ve always been mildly irritated that blood tests in GP land tend to be specific purposes. Thus a few weeks ago I had one as a follow-up for prostate cancer (all well, thanks for asking). However when I asked the receptionist at the surgery whether everything else was OK …. blood sugars, anything else …… I was told that, no, they’d only reported on the PSA levels. They’ve got the blood sample, why ask me to come back for cholesterol etc?
London nightlife under Khan, and the imams and nimbies of gloom
“In Hackney, all new venues must close by 11PM Mon-Fri and 12PM at the weekend. No new venues can operate later than this.
Over time the existing venues will need new licenses and therefore the venues that are open after 11/12 will slowly erode until there is literally none left.”
A recent consultation found that 75% of Hackney residents said they were opposed to the council’s plans for a clamp down on the borough’s night time economy. This included 77% against doubling the size of the Shoreditch ‘Special Policy Area’ and 84% against making new bars close at 11pm on weekdays and midnight at weekends anywhere in the borough.
The residents are against it. Are other boroughs likely to follow suit (Thinking particularly Islington and Camden...) ? I'd have thought it's one of the big plus points for somewhere like London and surely a big attractor for young people ?!?
The councils are all over the place - Westminster have long been the toughest, but Hackney, Camden, and Southwark aren't far behind. Tower Hamlets and Lambeth are traditionally the most liberal, but the latter has all but stopped issuing new licences in the past few years.
It's a mess, and is something that really needs to be passed to the Mayor and/or GLA.
Comments
It also has a rather poignant working of the latest atrocity / regular war stuff (delete as appropriate) in Gaza and fantastic Mr Fox and the Cranberries’ Zombie.
As for outsourcing video consultations to foreign doctors, well, you could but liability and confidentiality issues might be tricky.
Go right back to the foundations of the NHS with its three branches, and the public health division did have clinics for babies, teeth, feet and so on.
All his outriders were quite open that "shortly there'll be an election..."
Same hasn't happened this year by anyone other than those talking their book.
..Unit costs in Singaporean polyclinics are lower than English GP practices. National Healthcare Singapore Polyclinics kindly provided me with financial data for the 2018- 19 UK financial year. The University of Kent produces comparable unit cost estimates for the NHS. Singaporean polyclinic doctors earn slightly more than the average English GP. But cost per appointment is lower in Singapore than in England. National Healthcare Singaporean Polyclinics classify patients by the number of chronic health conditions. The cost of a "Moderate Chronic Health Patient" (2-3 conditions) is 40% less than the cost of a English GP appointment. The cost of an acute visit with no chronic conditions is less than half the English average.41 The Singaporean Ministry of Health recognises the efficiency of the polyclinic model and is rapidly increasing the number of polyclinics. There are currently 23 polyclinics in Singapore; by 2030 there will be 32.
The NHS is already moving in this direction. In her 2021 NHS England stocktake report, Dr Claire Fuller recommends a new pathway to improve access to same-day urgent care treatment centres in the community.43 She argues this would free up resources to enable greater continuity of care for patients who need it most, those with chronic health conditions. There is evidence from the United States that greater intensity of primary care for chronic patients reduces secondary health care utilisation, resulting in lower total health care spending.44 The advantage of the polyclinic model – collocating urgent and chronic care – is that patients who present through the urgent care route with a chronic health condition can be signed up for a “teamlet.” Currently, patients who present at urgent treatment centres with problems related to a chronic health condition are turned away, and told to book an appointment with their GP practice..
https://youtu.be/sbRXurWHmIA?si=ccr3k3zDVNyvOxcl
Israel believes it is fighting for its life. Same question for you. Had the IDF been on holiday on October 7th when would Hamas have stopped.
And as for the origins that is also straightforward. Israel was created via UN declaration, has tried to make peace since that time, and its neighbours at one time or another have wanted to destroy it. Some still do.
They don't think Israel should exist.
Can Israel do wrong? Of course. But this will be worked out when the fighting has stopped because it's in the middle of an existential war. And the war could stop tomorrow if Hamas wanted it to.
I don't get your confusion.
It seems that there's been little analysis of why - the report commissioned into them hasn't been published.
The account of how Singapore runs them is interesting.
l
https://twitter.com/sc_cath/status/1763803767558774843
See discussion upthread - and read the report.
Because whether Israel is doing wrong is - blindingly self evidently - not up to Israel alone. And right now the rest of the world has ample evidence to draw conclusions from.
Do you think you would be qualified in saying anything worth listening to about Russia's war against Ukraine, if you were looking at things exclusively from Putin's standpoint?
I was not a huge fan of online consultations being introduced, but now that reality is here why not open this up to a patient seeing any GP online as the first port of call. If the GP or patient feels an in-person investigation is required following on from that, then they can make a referral to a local health centre. But otherwise let local surgeries deal with those patients that do not have the online technology, and treatment of chronic conditions that require repeat GP visits.
A legacy is perhaps the far wider range of services offered by GPs.
Delays around tests could be reduced as more test providers can place results online for GP access, and even as more of us, since the pandemic, have basic gadgets at home. I can take my own pulse and measure my blood pressure at home using similar instruments to my doctor, and phone them in without needing to travel to the surgery.
ETA what you suggest might run into a cost problem when the minister decides this means medical records must be centralised so any GP can access them, and before long you've got another failed NHS IT project costing billions, just to catch a few edge cases.
Which bit of what I wrote do you dispute. The rest of the world will of course make its assessment and good luck to them.
Talking about the rest of the world and Russia, bear in mind the view of the Global South. Be careful what you wish for with the rest of the world. Do you mean "us" when you use that term.
When you’re worried Labour are going to accuse you of bottling a May election, certainly an interesting tactic to then not deny a May election
Quite agree. The only answer to that question is surely to repeat your “working assumption” that it will be in the second half of 2024? Even if you *are* planning to call an election in a recession when you’re 20 points behind
1. He’s teetotal.
2. He’s Hindu
But it all falls into insignificance when you're 20 points behind in the polls. You simply don't call an election you'd be smashed in.
And much of the election gimmickery works at least as well for the autumn (when the Tories can say 'delivered' rather than just 'legislated for'), as for May.
But, for a lot of people who are elderly, disabled, or have a complex medical history, they really need to see *their* doctor.
It should, however, be really easy to set up a virtual doctor service with doctors overseas, with suitable vetting and qualifications checks in place. Start with places like Singapore and UAE where there is excess private medical capacity (but not USA where the incentives for doctors are totally messed up).
Now you could instantly remove employee NI by adding 0.66% income tax for every penny reduction in Employee NI but then pensions would be paying more in tax - which given they are the only people voting for the Tory party is an insane thing for the Tory party to do
However, that was in a group with chronic conditions. For those making occasional appointments for different issues, it's probably not very important. If those making occasional appointments (disproportionately younger/of working age?) could be shuffled off to more efficient options, it might increase the chances of those with ongoing GP needs being able to get appointments with the same person.
(It would be necessary to check the ratio of single visit versus series of visits type of contacts before having an idea whether this would really help in practice)
The fury is excellent, but where's the poetry in the insults? The flow? The magic?
You can do better.
There have to be a good chunk of the population though for whom this doesn’t matter and the critical issue is simply being seen. They don’t need to be blocking up in person appointments at specified surgeries. It feels to me we create an artificial bottleneck at the GP stage. Back in the day when everyone could be guaranteed a relatively quick appointment with a family doctor, there was no issue. But those days are gone, and it’s time the system adapted rather than pretend it can still cope.
Look.
Boris Johnson would hang it out until Christmas. He'd roll the dice, hope that something would magically appear to save him, and cling on. Deus ex machina, old boy.
Rishi Sunak is not a gambler. He's looking at the next 6 mo with no guarantee it'll improve. Rwanda flights get Royal Assent March 20, and if he can get a plane in the air he'll call a general on March 26, which will hit the May 2 local elections.
If he doesn't, he will lose almost every Tory councillor in the country. And if he goes to the polls in October, there'll be no-one prepared to put a poster up or bang on a door for him. It's May 2 or bust.
(If his close supporters see those problems, they might react by talking about Biden's problems. Which are also real, but not nearly as severe.
As we all know, in politics, accusations are often also confessions.)
https://www.youtube.com/watch?v=C35Zhdk2V4U
That said, can you imagine a "debate" between Biden and Trump when they're both so clearly in mental decline?
Earl of Sandwich - "Sir, I do not know whether you will die on the gallows or of the pox."
Wilkes - "That depends, my lord, on whether I embrace your lordship's principles or your mistress."
Today, residents of Lewisham eagerly head to the polls to cast their votes in the highly anticipated Mayoral by-election. This election comes as a crucial moment for this vibrant London borough, as residents seek to elect a new leader who will guide them through the upcoming challenges and opportunities.
The candidates vying for the position bring diverse backgrounds and experiences to the table, promising a dynamic race filled with debates on key issues such as housing affordability, community safety, and environmental sustainability. Each candidate has outlined their vision for Lewisham's future, offering residents a choice between different approaches and priorities.
As voters queue up at polling stations across the borough, there is a palpable sense of civic engagement and excitement in the air. The outcome of this election will not only determine the next Mayor of Lewisham but also set the course for the borough's development and progress in the years to come.
Regardless of the result, today's by-election serves as a testament to the strength of democracy and the power of community participation. Lewisham residents are exercising their democratic right to choose their representatives, shaping the future of their borough through their votes.
Bit light on candidate details, but I think it captures the palpable excitement of the event
ETA: I asked for an added bit on the candidates standing:
Among the candidates is John Smith, a long-serving community activist known for his grassroots work on housing and youth empowerment. Sarah Thompson, a former city council member, has emphasized her track record in promoting environmental initiatives and social inclusion. Additionally, David Patel, a local business leader, has placed a strong emphasis on economic development and job creation in his campaign.
(None of these are actual candidates according to Wikipedia or the BBC)
NEW THREAD
https://www.researchgate.net/figure/Clouds-in-the-subtropical-LES-domain-at-different-CO2-levels-Stratocumulus-decks-prevail_fig2_331337101
An unremarked potential benefit of global warming tbh.
Also, we must be back in the EU by then. Look at the traffic.
Oh
They’ve got the blood sample, why ask me to come back for cholesterol etc?
It's a mess, and is something that really needs to be passed to the Mayor and/or GLA.
Listen to Rogan talking about how MT trained for his last exhibition fight, the guy is an animal.
https://youtube.com/watch?v=bpgJJtbQLhU