They always like hiding out in international hotels. No-one dares send a rocket into one, lest some American businessman ends up as an unintended casualty. See also the Hamas leadership hiding out in Doha, until the Qataris cancelled their visas and told them to bugger off.
Do we know where they went? I presume Turkey as they have reportedly have billions of reality estate investments.
Reality estate investments? Are they Apprentice Trumpites?
No they actually own theirs, rather than just sticking their brand on them for a fee.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
I can't book someone who knows about hands, though, I have to talk to my GP first, who if he does know about hands it will be a surprise, he will then have to decide there is indeed a problem with my hand and I need to see someone who knows about hands. I wouldn't mind an 18 week wait if I could just more easily get into the system. I will try harder next week and see if any appointments are available to book online early in the morning. The problem with phoning at 8am or whenever the phone lines open is that that is exactly when I need to be on my way to work. Which is great if I have gone down with the lurgy and need to take time off, but not otherwise.
Yes, my GP has the same "must phone at 8am on the day, even if it's something that could easily wait a week". To be fair to them they have got the admin side of it down pretty well -- you sit in a phone queue, but not for long, you speak to the receptionist who triages you into nurse/on-site physio/GP, the GP calls back for a phone consultation within an hour or two. But as a system it definitely puts me off from attempting to engage with it -- it was months before I decided a dodgy shoulder really wasn't going away on its own and I really did need to go through the hassle of the 8am phone queue.
The 8 AM rush is a legacy of targetism from previous regimes.
It became a requirement to be able to offer appointments within 48 hours, and in a system lacking capacity the simplest way to do that was to cease advance booking of appointments.
Targets always distort delivery. Something that Starmer should pay attention to.
No online booking? My GP has offered it for years. Admittedly I'm in good health so don't see them too often but I have had a few non-urgent issues over the years and I can't remember when I last had to phone the surgery to make an appointment.
I think I would have to phone for an urgent appointment but with many of the routine bookings done online it must be much easier to get through than otherwise.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
I can just imagine myself weeping over the 300 pages of badly designed, indifferently documented, off-spec mix of JSON and SOAP calls they'd come up with.
Ha yes, and they’d hire a lead architect on £48k per year, because someone who uses his computer for email says that the role is grade 2B+ for which that’s the salary available.
Alternatively, hire half a dozen devs and half a dozen analysts, on £150k and £100k respectively, and see the first phase of the job up and running in about three months. As we saw during the pandemic.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
Good, get them all thinking well outside the box.
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
Good, get them all thinking well outside the box.
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
But what happens when an actual look at the patient is needed? Back to square 1.
And one very, very obvious issue. Legalities. Patient confidentiality; medical standards; licence to practice.
Edit: the insurance companies have to be kept happy, first of all (both for the patient and the medics).
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
I can just imagine myself weeping over the 300 pages of badly designed, indifferently documented, off-spec mix of JSON and SOAP calls they'd come up with.
Ha yes, and they’d hire a lead architect on £48k per year, because someone who uses his computer for email says that the role is grade 2B+ for which that’s the salary available.
Alternatively, hire half a dozen devs and half a dozen analysts, on £150k and £100k respectively, and see the first phase of the job up and running in about three months. As we saw during the pandemic.
SOAP calls? What’s with the mad futuristic shit?
I’m currently participating in rebuilding a bank with a team of 8.
I know it’s the Daily Mail but that’s unbelievably unfair framing in the headline.
She knocked over a box in which a loaded gun was stored; it went off and the bullet hit her father in the face.
It was a tragic accident that traumatised her. Fair play that it inspired her to get into medicine (she said it was because her father was bleeding out and she didn’t know how to help him)
It's also how Farage as next PM might happen. If there's a slow trickle of Tory defections while Reform stays fairly high in the polls, then that could start a feedback loop. Then those like Jenrick, who likely care far more about their careers than party, decide Reform is their best chance of preferment...
Reform with 5 MPs isn't going to see Farage as PM .. but if they went into the next election with fifty or more ?
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
Good, get them all thinking well outside the box.
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
What we need is more acceptance of remote appointments in general. See where we came in, with @JohnLilburne's dodgy thumb. I was a reluctant convert but now, with the toys Foxy made PBers buy at the start of the pandemic, I can report my pulse rate and blood pressure along with my symptoms, perhaps even a photo of some spots, which 90 per cent of the time is all the GP would measure before sending a prescription directly to the pharmacy or referring me to a consultant or for more tests.
Good riddance it seems to the evil Assad family, Syria finally freed from them.
The rebels are probably no better, but I'm a big believer in chaos and evolution being better than stagnation at getting something better eventually. Every time a dictator is toppled is a good thing, even if the replacement is (this time) no better because eventually it will be.
Syria was one link in what I've referred to as the Axis of Evil between Iran, Russia, Syria and Hezbollah. That Axis has taken a real hammering this year.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
Good, get them all thinking well outside the box.
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
But what happens when an actual look at the patient is needed? Back to square 1.
And one very, very obvious issue. Legalities. Patient confidentiality; medical standards; licence to practice.
What you’re doing is adding capacity, so freeing up the on-the-ground GPs for those who need to be seen in person. What currently happens is the GP sits in his usual office on Webex or Teams instead of speaking to the person in front of him, still taking up a time slot.
The NHS already sends people abroad for treatment, so the issues around security and privacy aren’t insurmountable with a bit of effort.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
Good, get them all thinking well outside the box.
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
What we need is more acceptance of remote appointments in general. See where we came in, with @JohnLilburne's dodgy thumb. I was a reluctant convert but now, with the toys Foxy made PBers buy at the start of the pandemic, I can report my pulse rate and blood pressure along with my symptoms, perhaps even a photo of some spots, which 90 per cent of the time is all the GP would measure before sending a prescription directly to the pharmacy or referring me to a consultant or for more tests.
Me too, and you can add the oxygen saturation of the blood to that in terms of Foxy-recommended toys.
I was pleasantly surprised at the time how cheap they were, those toys, compared to some of the boys' toys on PB.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
I agree with your first point, but disagree with your second. The NHS would probably get quoted £XX billion to set up a website and it would take about 10 years.
It's not a coincidence that some of the best systems for organising public services are private apps developed using public data. For example, my council stated it would be impossible or massively costly to provide a live data feed for one of their services - it took me an FOI request and two days of fiddling and I had a template ready for them.
I think there is huge potential for pro bono work like this. There must be thousands of tech-savvy people who, sick to death of working on boring stuff for a mega-corp, would get a real benefit from providing something to their local communities for free. We could have a new Honours system to reflect that work - Member/Knight of the Online Order or something.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
PBers were asking about the Crush Crime chappie the other day. Spectator TV has just published a 20 minute interview with him, and if anyone wants a job as proofreader, the Spectator is not hiring. The Spectator's Natasha Froze from the Spectator indeed!
‘Theft is essentially legal’: Lawrence Newport’s plan to crush crime | SpectatorTV
The Spectator's Natasha Froze from The Spectator sits down with Dr. Lawrence Newport, academic and founder of the new campaign Crush Crime. They discuss the alarming increase in crime rates across the UK over the past decade and explore the roots of the problem, including policing challenges, judicial inefficiencies, and societal factors. Dr. Newport shares his 8-point-plan for crushing crime, involving practical reforms, community involvement, and restoring public trust in the justice system. https://www.youtube.com/watch?v=_4EfwqQuN7I
Surprising, and a little frightening, that new homes and education are so low.
The neo-feudal gerontocracy is real. Looking at the age breakdowns, pensioners have very little interest in the economy and housing. I think that is the root political cause for why the economy is so lethargic. Time to link their pensions to real wages and levy council tax based on home values.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
Good, get them all thinking well outside the box.
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
But what happens when an actual look at the patient is needed? Back to square 1.
And one very, very obvious issue. Legalities. Patient confidentiality; medical standards; licence to practice.
What you’re doing is adding capacity, so freeing up the on-the-ground GPs for those who need to be seen in person. What currently happens is the GP sits in his usual office on Webex or Teams instead of speaking to the person in front of him, still taking up a time slot.
The NHS already sends people abroad for treatment, so the issues around security and privacy aren’t insurmountable with a bit of effort.
Mm, some good debating points, though given the known behaviour of foreign medical firms with NHS data I don't agree that the latter is realistic. Sending them abroad for treatment is pretty low in numbers by comparison and there is a strong reason to do so by definition.
Plus within the UK it only spreads the workload. If I lived in Doncaster I'd be a bit cheesed off at the idea that the local GPs had time to spare for worried patients in Surbiton. A quick riffle yields...
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Rachel Reeves has repeated the blunders of George Osborne's omnishambles budget but in an area where potential outcomes are literally and not just metaphorically fatal. Removing WFA is a neat bureaucratic fix that would appeal to Treasury apparatchiks but which is politically tin-eared, and especially while Reeves and other MPs have their own heating bills subsidised by the state.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
This might be true but it's too late this year. We're just over two weeks to Christmas and you can't just flick a switch and start the payments immediately. The government would lose any budgetary benefit it's got from scrapping WFA and keep all of the opprobrium it's got from doing it in the first place. They'd be much better to stick with it and see if the anger dies down and if not reintroduce it next year with some bromide about cost of living or gas prices.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
Good, get them all thinking well outside the box.
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
What we need is more acceptance of remote appointments in general. See where we came in, with @JohnLilburne's dodgy thumb. I was a reluctant convert but now, with the toys Foxy made PBers buy at the start of the pandemic, I can report my pulse rate and blood pressure along with my symptoms, perhaps even a photo of some spots, which 90 per cent of the time is all the GP would measure before sending a prescription directly to the pharmacy or referring me to a consultant or for more tests.
Me too, and you can add the oxygen saturation of the blood to that in terms of Foxy-recommended toys.
I was pleasantly surprised at the time how cheap they were, those toys, compared to some of the boys' toys on PB.
The new generation smart watches are going to be revolutionary for millions of people living with chronic conditions, in many cases replacing devices costing many times more because of certification requirements. Apple and Samsung have actually gone to the trouble of certification in many countries.
But yes, that there’s £2.99 pulse oxymeters, and £20 electronic blood pressure readers, can make remote diagnosis considerably more accurate and feasible for many. Some will stil want to see the doc in person, which is fine, but a remote consultant can be anywhere. Even if not outsourced abroad, you could have a retired GP living where he likes and working two hours a day three days a week. Every little helps.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
Good, get them all thinking well outside the box.
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
But what happens when an actual look at the patient is needed? Back to square 1.
And one very, very obvious issue. Legalities. Patient confidentiality; medical standards; licence to practice.
What you’re doing is adding capacity, so freeing up the on-the-ground GPs for those who need to be seen in person. What currently happens is the GP sits in his usual office on Webex or Teams instead of speaking to the person in front of him, still taking up a time slot.
The NHS already sends people abroad for treatment, so the issues around security and privacy aren’t insurmountable with a bit of effort.
Mm, some good debating points, though given the known behaviour of foreign medical firms with NHS data I don't agree that the latter is realistic. Sending them abroad for treatment is pretty low in numbers by comparison and there is a strong reason to do so by definition.
Plus within the UK it only spreads the workload. If I lived in Doncaster I'd be a bit cheesed off at the idea that the local GPs had time to spare for worried patients in Surbiton. A quick riffle yields...
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
I can't book someone who knows about hands, though, I have to talk to my GP first, who if he does know about hands it will be a surprise, he will then have to decide there is indeed a problem with my hand and I need to see someone who knows about hands. I wouldn't mind an 18 week wait if I could just more easily get into the system. I will try harder next week and see if any appointments are available to book online early in the morning. The problem with phoning at 8am or whenever the phone lines open is that that is exactly when I need to be on my way to work. Which is great if I have gone down with the lurgy and need to take time off, but not otherwise.
Yes, my GP has the same "must phone at 8am on the day, even if it's something that could easily wait a week". To be fair to them they have got the admin side of it down pretty well -- you sit in a phone queue, but not for long, you speak to the receptionist who triages you into nurse/on-site physio/GP, the GP calls back for a phone consultation within an hour or two. But as a system it definitely puts me off from attempting to engage with it -- it was months before I decided a dodgy shoulder really wasn't going away on its own and I really did need to go through the hassle of the 8am phone queue.
The 8 AM rush is a legacy of targetism from previous regimes.
It became a requirement to be able to offer appointments within 48 hours, and in a system lacking capacity the simplest way to do that was to cease advance booking of appointments.
Targets always distort delivery. Something that Starmer should pay attention to.
No online booking? My GP has offered it for years. Admittedly I'm in good health so don't see them too often but I have had a few non-urgent issues over the years and I can't remember when I last had to phone the surgery to make an appointment.
I think I would have to phone for an urgent appointment but with many of the routine bookings done online it must be much easier to get through than otherwise.
System is pathetic, some offer great service , online quick appointments etc whereas others are dire. It is a postcode lottery.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
Good, get them all thinking well outside the box.
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
What we need is more acceptance of remote appointments in general. See where we came in, with @JohnLilburne's dodgy thumb. I was a reluctant convert but now, with the toys Foxy made PBers buy at the start of the pandemic, I can report my pulse rate and blood pressure along with my symptoms, perhaps even a photo of some spots, which 90 per cent of the time is all the GP would measure before sending a prescription directly to the pharmacy or referring me to a consultant or for more tests.
Me too, and you can add the oxygen saturation of the blood to that in terms of Foxy-recommended toys.
I was pleasantly surprised at the time how cheap they were, those toys, compared to some of the boys' toys on PB.
The new generation smart watches are going to be revolutionary for millions of people living with chronic conditions, in many cases replacing devices costing many times more because of certification requirements. Apple and Samsung have actually gone to the trouble of certification in many countries.
But yes, that there’s £2.99 pulse oxymeters, and £20 electronic blood pressure readers, can make remote diagnosis considerably more accurate and feasible for many. Some will stil want to see the doc in person, which is fine, but a remote consultant can be anywhere. Even if not outsourced abroad, you could have a retired GP living where he likes and working two hours a day three days a week. Every little helps.
I seemed to remember these watches might have been mentioned once or twice on here....
The top target on the NHS - 92% of routine hospital treatments to be conducted within 18 weeks - is suspiciously precise, especially when compared with the other 5 targets. I wonder why
Britain is not so rich a country with so much surplus money that it can afford to bung normal pensioners extra cash for fuel on top of the state pension.
The NHS had a go at an all-singing, all-dancing system twenty years ago, and it crashed and burned. Sadly for me because just before I retired I was offered 6 months retirement 'work' in Bangalore making the system crash/helping to iron out the bugs. However, that was then and this is now. I have to say our GP's system is quite good, BUT, one has to ring at 8am to be sure of getting a face-to-face appointment that day. It has to be remembered that there are several sorts of patients. There are people, generally males under 50 and over 10 who have short-term transient needs, there are people who have regular but predictable needs and there are people like me who have fairly complex and irregular requirements. And that's just those with physical problems. Then there are those with mental or psychological or social problems and they are often very difficult to deal with.
They always like hiding out in international hotels. No-one dares send a rocket into one, lest some American businessman ends up as an unintended casualty. See also the Hamas leadership hiding out in Doha, until the Qataris cancelled their visas and told them to bugger off.
I was half expecting Rudy Giuliani to pop up in the back of the shot.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
I agree with your first point, but disagree with your second. The NHS would probably get quoted £XX billion to set up a website and it would take about 10 years.
It's not a coincidence that some of the best systems for organising public services are private apps developed using public data. For example, my council stated it would be impossible or massively costly to provide a live data feed for one of their services - it took me an FOI request and two days of fiddling and I had a template ready for them.
I think there is huge potential for pro bono work like this. There must be thousands of tech-savvy people who, sick to death of working on boring stuff for a mega-corp, would get a real benefit from providing something to their local communities for free. We could have a new Honours system to reflect that work - Member/Knight of the Online Order or something.
Time and again, if you create a portal to access the data, people will do all kinds of stuff with it.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
Good, get them all thinking well outside the box.
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
we have all had experience of overseas help desks, almost all are shit , either you cannot understand a word they say , they quickly run out of their tick sheets and you then get bounced about forever till the line unexplainably cuts off and you are back to square one and usually just give up.
Britain is not so rich a country with so much surplus money that it can afford to bung normal pensioners extra cash for fuel on top of the state pension.
The government need to win the argument on this.
Unfortunately Lab don't seem great at making the arguments let alone winning them.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
I agree with your first point, but disagree with your second. The NHS would probably get quoted £XX billion to set up a website and it would take about 10 years.
It's not a coincidence that some of the best systems for organising public services are private apps developed using public data. For example, my council stated it would be impossible or massively costly to provide a live data feed for one of their services - it took me an FOI request and two days of fiddling and I had a template ready for them.
I think there is huge potential for pro bono work like this. There must be thousands of tech-savvy people who, sick to death of working on boring stuff for a mega-corp, would get a real benefit from providing something to their local communities for free. We could have a new Honours system to reflect that work - Member/Knight of the Online Order or something.
To be fair, wasn't that the idea of NHS X, that they could actually get stuff done...but that rather shit the bed with the COVID tracker app after Hancock hired his mates.
The government apparently paid £17k for the website for the investment summit....because it had the ability to book break out sessions.....who is paying any real money for a temporary landing page these days and a few wordpress plugins.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Rachel Reeves has repeated the blunders of George Osborne's omnishambles budget but in an area where potential outcomes are literally and not just metaphorically fatal. Removing WFA is a neat bureaucratic fix that would appeal to Treasury apparatchiks but which is politically tin-eared, and especially while Reeves and other MPs have their own heating bills subsidised by the state.
Hard to imagine how low these curs can stoop. Rob poor pensioners yet claim huge amounts for their second homes. How do these hypocrites sleep at night.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
Good, get them all thinking well outside the box.
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
we have all had experience of overseas help desks, almost all are shit , either you cannot understand a word they say , they quickly run out of their tick sheets and you then get bounced about forever till the line unexplainably cuts off and you are back to square one and usually just give up.
We used 111 yesterday and the service was reasonably quick, efficient and comprehensible. The initial operator was polite and helpful and after going through his checklist said that we needed to have a check with a medic. 10 minutes later we were phoned by a polite and helpful lady who went through a more detailed checklist and asked one or two other questions based on the answers. Based on our experience we'd certainly use it again.It was better than the last time we used it, 10 or so years ago.
Britain is not so rich a country with so much surplus money that it can afford to bung normal pensioners extra cash for fuel on top of the state pension.
The government need to win the argument on this.
They have already lost it big time. Good idea but shit implementation. Will be a millstone round their neck for as long as it lasts. Especially as they trouser thousands to heat their second homes, how dumb can you be. PS: My wife and I just got £10 each in bank account for some bizarre reason , why they still paying that out.
The fast-track planning process would apply to housing proposals and associated infrastructure such as schools, if they had already been broadly agreed as part of local development plans where councils set out a strategy for land use in their areas.
If the proposals "comply" with these plans, the government has said, they could "bypass planning committees entirely to tackle chronic uncertainty, unacceptable delays and unnecessary waste of time and resources".
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Rachel Reeves has repeated the blunders of George Osborne's omnishambles budget but in an area where potential outcomes are literally and not just metaphorically fatal. Removing WFA is a neat bureaucratic fix that would appeal to Treasury apparatchiks but which is politically tin-eared, and especially while Reeves and other MPs have their own heating bills subsidised by the state.
Hard to imagine how low these curs can stoop. Rob poor pensioners yet claim huge amounts for their second homes. How do these hypocrites sleep at night.
Malc, neither you nor I NEED WFA. Nice to have, but that's it, but yes there are some who do need it. As I said yesterday the first step ought to have been taxing it.
Britain is not so rich a country with so much surplus money that it can afford to bung normal pensioners extra cash for fuel on top of the state pension.
The government need to win the argument on this.
Unfortunately Lab don't seem great at making the arguments let alone winning them.
I don't get why this is such a hard argument to make. There is no justification for people like my late parents getting another £200 they don't need.
In fact I think if anyone it is people on Child Benefit who ought to get the WFA, they are more likely to be struggling than pensioners who aren't on Pension Credit.
Britain is not so rich a country with so much surplus money that it can afford to bung normal pensioners extra cash for fuel on top of the state pension.
The government need to win the argument on this.
Unfortunately Lab don't seem great at making the arguments let alone winning them.
Yes £20B for that nutter Milliband to waste on carbon capture, really skint. £100M for a bat tunnel and on and on. Some people are really gullible.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Featherbedded spoilt people expecting others to give them money they haven't earned and don't need deserve zero sympathy. None whatsoever.
Pensioners are not the "most vulnerable" in society, that is pig ignorant. 75% own their own home without a mortgage and they aren't even the most vulnerable to the cold, that is infants under 1 year of age who are far more vulnerable than pensioners but have never had such entitlement.
Welfare should be a safety net for those who need it.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
I can't book someone who knows about hands, though, I have to talk to my GP first, who if he does know about hands it will be a surprise, he will then have to decide there is indeed a problem with my hand and I need to see someone who knows about hands. I wouldn't mind an 18 week wait if I could just more easily get into the system. I will try harder next week and see if any appointments are available to book online early in the morning. The problem with phoning at 8am or whenever the phone lines open is that that is exactly when I need to be on my way to work. Which is great if I have gone down with the lurgy and need to take time off, but not otherwise.
Yes, my GP has the same "must phone at 8am on the day, even if it's something that could easily wait a week". To be fair to them they have got the admin side of it down pretty well -- you sit in a phone queue, but not for long, you speak to the receptionist who triages you into nurse/on-site physio/GP, the GP calls back for a phone consultation within an hour or two. But as a system it definitely puts me off from attempting to engage with it -- it was months before I decided a dodgy shoulder really wasn't going away on its own and I really did need to go through the hassle of the 8am phone queue.
The 8 AM rush is a legacy of targetism from previous regimes.
It became a requirement to be able to offer appointments within 48 hours, and in a system lacking capacity the simplest way to do that was to cease advance booking of appointments.
Targets always distort delivery. Something that Starmer should pay attention to.
No online booking? My GP has offered it for years. Admittedly I'm in good health so don't see them too often but I have had a few non-urgent issues over the years and I can't remember when I last had to phone the surgery to make an appointment.
I think I would have to phone for an urgent appointment but with many of the routine bookings done online it must be much easier to get through than otherwise.
System is pathetic, some offer great service , online quick appointments etc whereas others are dire. It is a postcode lottery.
Exactly, there is no excuse for this, it's not like systems haven't existed for a long time. Something for Streeting to look at, it feels like an easy win to mandate it.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
I agree with your first point, but disagree with your second. The NHS would probably get quoted £XX billion to set up a website and it would take about 10 years.
It's not a coincidence that some of the best systems for organising public services are private apps developed using public data. For example, my council stated it would be impossible or massively costly to provide a live data feed for one of their services - it took me an FOI request and two days of fiddling and I had a template ready for them.
I think there is huge potential for pro bono work like this. There must be thousands of tech-savvy people who, sick to death of working on boring stuff for a mega-corp, would get a real benefit from providing something to their local communities for free. We could have a new Honours system to reflect that work - Member/Knight of the Online Order or something.
@Eabhal - Good point. Have you seen the Wait Less app? Only available for Urgent Treatment Centres and in the South East, but surely it would be easy to integrate a National version covering A&Es into the NHS app?
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
Good, get them all thinking well outside the box.
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
we have all had experience of overseas help desks, almost all are shit , either you cannot understand a word they say , they quickly run out of their tick sheets and you then get bounced about forever till the line unexplainably cuts off and you are back to square one and usually just give up.
We used 111 yesterday and the service was reasonably quick, efficient and comprehensible. The initial operator was polite and helpful and after going through his checklist said that we needed to have a check with a medic. 10 minutes later we were phoned by a polite and helpful lady who went through a more detailed checklist and asked one or two other questions based on the answers. Based on our experience we'd certainly use it again.It was better than the last time we used it, 10 or so years ago.
Have to say the one time I used it they were very good, the ambulance peopel who arrived were less enthusiastic in helping and had to be chivved into doing things and finally taking patient to hospital. If I had not argued with them it would have been totally different outcome.
Manchester United sporting director Dan Ashworth has left his role after just five months. The 53-year-old officially joined the club on 1 July after spending five months on gardening leave at Newcastle.
In the end, United paid £10m for Ashworth, who ended up on gardening leave for the same amount of time he was actually in post at United. In total, hiring Amorim and Ashworth and sacking Ten Hag have cost the club in excess of £30m.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
Common data interchange standards are good, although back-fitting them to equipment from ten or twenty years ago might be hard, and there is no money for comprehensive replacement. Your idea of fungible GP appointments ignores the registration and competition issues, and if it did work would soon be supplemented by wholly offshore remote consultations which would be controversial even if effective.
Good, get them all thinking well outside the box.
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
we have all had experience of overseas help desks, almost all are shit , either you cannot understand a word they say , they quickly run out of their tick sheets and you then get bounced about forever till the line unexplainably cuts off and you are back to square one and usually just give up.
We used 111 yesterday and the service was reasonably quick, efficient and comprehensible. The initial operator was polite and helpful and after going through his checklist said that we needed to have a check with a medic. 10 minutes later we were phoned by a polite and helpful lady who went through a more detailed checklist and asked one or two other questions based on the answers. Based on our experience we'd certainly use it again.It was better than the last time we used it, 10 or so years ago.
Have to say the one time I used it they were very good, the ambulance peopel who arrived were less enthusiastic in helping and had to be chivved into doing things and finally taking patient to hospital. If I had not argued with them it would have been totally different outcome.
Malky G ended up in an argument, never had that down on the bingo card.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Rachel Reeves has repeated the blunders of George Osborne's omnishambles budget but in an area where potential outcomes are literally and not just metaphorically fatal. Removing WFA is a neat bureaucratic fix that would appeal to Treasury apparatchiks but which is politically tin-eared, and especially while Reeves and other MPs have their own heating bills subsidised by the state.
Hard to imagine how low these curs can stoop. Rob poor pensioners yet claim huge amounts for their second homes. How do these hypocrites sleep at night.
Malc, neither you nor I NEED WFA. Nice to have, but that's it, but yes there are some who do need it. As I said yesterday the first step ought to have been taxing it.
Agree , the implementation was abysmal. There must have been some much better way for people to apply for it and be screened to see they really needed it. Just arbitrary cutting off as they did is just laziness as they looked for headlines to show how tough they were.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Featherbedded spoilt people expecting others to give them money they haven't earned and don't need deserve zero sympathy. None whatsoever.
Pensioners are not the "most vulnerable" in society, that is pig ignorant. 75% own their own home without a mortgage and they aren't even the most vulnerable to the cold, that is infants under 1 year of age who are far more vulnerable than pensioners but have never had such entitlement.
Welfare should be a safety net for those who need it.
Universal winter fuel allowance is not needed
Those most in need can apply for help.
All pensioners including higher rate tax payers have had a near 500 quid uplift due to triple lock
The fucking Daily Mail have attacked pensioners in need for 14 years... We all know the fucking ghouls are just waiting for a suitable death to exploit.
Stand firm Labour.
Remove universal wfa permanently, remove the triple lock and increase pension credit thresholds marginally if you need to.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Featherbedded spoilt people expecting others to give them money they haven't earned and don't need deserve zero sympathy. None whatsoever.
Pensioners are not the "most vulnerable" in society, that is pig ignorant. 75% own their own home without a mortgage and they aren't even the most vulnerable to the cold, that is infants under 1 year of age who are far more vulnerable than pensioners but have never had such entitlement.
Welfare should be a safety net for those who need it.
I just wonder if politically they can create up a way to target it at those that need it.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Featherbedded spoilt people expecting others to give them money they haven't earned and don't need deserve zero sympathy. None whatsoever.
Pensioners are not the "most vulnerable" in society, that is pig ignorant. 75% own their own home without a mortgage and they aren't even the most vulnerable to the cold, that is infants under 1 year of age who are far more vulnerable than pensioners but have never had such entitlement.
Welfare should be a safety net for those who need it.
I just wonder if politically they can create up a way to target it at those that need it.
Easy, taper it starting at £20k, base it on prior year income.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Featherbedded spoilt people expecting others to give them money they haven't earned and don't need deserve zero sympathy. None whatsoever.
Pensioners are not the "most vulnerable" in society, that is pig ignorant. 75% own their own home without a mortgage and they aren't even the most vulnerable to the cold, that is infants under 1 year of age who are far more vulnerable than pensioners but have never had such entitlement.
Welfare should be a safety net for those who need it.
You are not even at the level of a halfwit. Plenty of pensioners are poor you absolute unfeeling twat , an excuse for a human being.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Featherbedded spoilt people expecting others to give them money they haven't earned and don't need deserve zero sympathy. None whatsoever.
Pensioners are not the "most vulnerable" in society, that is pig ignorant. 75% own their own home without a mortgage and they aren't even the most vulnerable to the cold, that is infants under 1 year of age who are far more vulnerable than pensioners but have never had such entitlement.
Welfare should be a safety net for those who need it.
I just wonder if politically they can create up a way to target it at those that need it.
Easy, taper it starting at £20k, base it on prior year income.
Then I think that’s what they should do. I still think the principle was right.
The Russian withdrawal from Syria, makes the US withdrawal from Afghanistan look like it was well organised and brilliantly executed.
What a shame for Putin’s 21st Century Potemkin army.
I wouldn't celebrate too soon. Putin needs a win, fast, and the only place he can get it is Ukraine.
They are also struggling and a major Russian push could see a sudden collapse.
It would be a grim irony if the disaster Russia has suffered in the ME led to a mirror effect in Ukraine.
And an utter disaster if Syria falls to the jihadi rebels and Putin makes further incursions into Ukraine before Trump tries and imposes a peace deal
It's clear that in your mind, anyone who is not Christian is a Jihadi rebel...
Your takes on this situation have been truly awful.
The rebels are led by Al Qaeda linked militants and ISIS are beginning to make a resurgence too in parts of Syria as the rebels pushed against Assad's regime.
It is what Syria looks like this time next year or in 2030 that is significant, not some celebrations over statues falling this week
There are many rebel groups.
I'd say you're a fool, but you're now well into maliciousness.
Most with Al Qaeda or ISIS links, Syria may now become the biggest centre for jihadi terrorism in the world by far
HTS are the good bit of AQ apparently. They've got a HR Dept. and do a lot of work for charity.
The reason that Islamists have such popularity is because they do provide food, healthcare and education, while the Arab authoritarians simply embezzle and spend on secret police and prisons.
We really have got to the stage where our biggest dickheads are openly defending Islamists on here, dear God. 'Food, healthcare and education' - who would that education be for you moral vacuum - presumably not girls. I'd love you to move your family to the new Syria to enjoy all that 'food healthcare and education'. I'm sure you'd all have a super time.
The Turkish backed SNA is taking territory from the mostly Kurdish SDF. I'm not sure that the prospects for peace in Syria are that good. It looks like Turkey is going to have a go at crushing the Kurds in Syria.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Featherbedded spoilt people expecting others to give them money they haven't earned and don't need deserve zero sympathy. None whatsoever.
Pensioners are not the "most vulnerable" in society, that is pig ignorant. 75% own their own home without a mortgage and they aren't even the most vulnerable to the cold, that is infants under 1 year of age who are far more vulnerable than pensioners but have never had such entitlement.
Welfare should be a safety net for those who need it.
I'm talking about the politics of this, not the think tank view of it.
But anyway, they could design a system that took it away from those who dont really need it but Reeves didn't. She rushed into something in a bid, I can only presume, to look like the 'Iron Chancellor' she dreams of being.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Featherbedded spoilt people expecting others to give them money they haven't earned and don't need deserve zero sympathy. None whatsoever.
Pensioners are not the "most vulnerable" in society, that is pig ignorant. 75% own their own home without a mortgage and they aren't even the most vulnerable to the cold, that is infants under 1 year of age who are far more vulnerable than pensioners but have never had such entitlement.
Welfare should be a safety net for those who need it.
I'm talking about the politics of this, not the think tank view of it.
But anyway, they could design a system that took it away from those who dont really need it but Reeves didn't. She rushed into something in a bid, I can only presume, to look like the 'Iron Chancellor' she dreams of being.
I think the principle of the policy was right.
But the communication and implementation has been a disaster.
Manchester United sporting director Dan Ashworth has left his role after just five months. The 53-year-old officially joined the club on 1 July after spending five months on gardening leave at Newcastle.
In the end, United paid £10m for Ashworth, who ended up on gardening leave for the same amount of time he was actually in post at United. In total, hiring Amorim and Ashworth and sacking Ten Hag have cost the club in excess of £30m.
Britain is not so rich a country with so much surplus money that it can afford to bung normal pensioners extra cash for fuel on top of the state pension.
The government need to win the argument on this.
Unfortunately Lab don't seem great at making the arguments let alone winning them.
Yes £20B for that nutter Milliband to waste on carbon capture, really skint. £100M for a bat tunnel and on and on. Some people are really gullible.
£22 billion. And that is just for the first 2 transport & storage networks and 3 capture projects. We'll need tens of billions more for the next 2 clusters and more capture projects for the first 2.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Rachel Reeves has repeated the blunders of George Osborne's omnishambles budget but in an area where potential outcomes are literally and not just metaphorically fatal. Removing WFA is a neat bureaucratic fix that would appeal to Treasury apparatchiks but which is politically tin-eared, and especially while Reeves and other MPs have their own heating bills subsidised by the state.
Hard to imagine how low these curs can stoop. Rob poor pensioners yet claim huge amounts for their second homes. How do these hypocrites sleep at night.
Malc, neither you nor I NEED WFA. Nice to have, but that's it, but yes there are some who do need it. As I said yesterday the first step ought to have been taxing it.
Yep.
There were some ways of doing this that didn't end up with the high likely potential for the deaths from cold this winter being blamed squarely on Reeves.
Even Starmer has agreed now I gather from somewhere I read this week that it was a mistake. He needs to call her into his office.
"Labour seem to be saying that Angela [Rayner] knows best and local people can be ignored"
Shadow treasury minister Richard Fuller criticises the news that council planning committees will be bypassed as part of government house-building plans
The Turkish backed SNA is taking territory from the mostly Kurdish SDF. I'm not sure that the prospects for peace in Syria are that good. It looks like Turkey is going to have a go at crushing the Kurds in Syria.
So instead of four groups fighting we'll have three. Or is that five down to four?
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Rachel Reeves has repeated the blunders of George Osborne's omnishambles budget but in an area where potential outcomes are literally and not just metaphorically fatal. Removing WFA is a neat bureaucratic fix that would appeal to Treasury apparatchiks but which is politically tin-eared, and especially while Reeves and other MPs have their own heating bills subsidised by the state.
Hard to imagine how low these curs can stoop. Rob poor pensioners yet claim huge amounts for their second homes. How do these hypocrites sleep at night.
Malc, neither you nor I NEED WFA. Nice to have, but that's it, but yes there are some who do need it. As I said yesterday the first step ought to have been taxing it.
Yep.
There were some ways of doing this that didn't end up with the high likely potential for the deaths from cold this winter being blamed squarely on Reeves.
Even Starmer has agreed now I gather from somewhere I read this week that it was a mistake. He needs to call her into his office.
I think this is a political mistake rather than a policy one. I just think this policy is now untenable - but then where do they find the money?
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Featherbedded spoilt people expecting others to give them money they haven't earned and don't need deserve zero sympathy. None whatsoever.
Pensioners are not the "most vulnerable" in society, that is pig ignorant. 75% own their own home without a mortgage and they aren't even the most vulnerable to the cold, that is infants under 1 year of age who are far more vulnerable than pensioners but have never had such entitlement.
Welfare should be a safety net for those who need it.
You are not even at the level of a halfwit. Plenty of pensioners are poor you absolute unfeeling twat , an excuse for a human being.
Plenty of people of all ages are poor - why do only pensioners matter to you?
If poor people need welfare, then it should be targeted at those who need it, not those who don't.
And the most in need are poor babies, not pensioners. Contrary to received myths on here, pensioners have never been the most vulnerable to the cold.
As a recent-ish patient in several places, it seems to me that some management by walking around could harvest some low hanging fruit.
For instance, my test last week included:-
the appointment letter being delivered literally as I left for the appointment
a booklet badly put together
a booklet that referred to the wrong hospital
signposting that ended short of the destination
some guesswork as to the correct waiting area
confusing directions about gowns
So, investment needed in admin, rather than front line clinicians? 🤔
Or maybe as well as.
I have a slightly dodgy left thumb, it has been painful and "clicky" for a while. It needs looking at. Preferably on a Friday when I don't work. But I'm right handed so it's not my favourite digit, there's no rush.
I haven't worked out how to book an appointment yet. The surgery website tells me I can book on line but the NHS app consistently tells me there's nothing available. There is no point requesting a teleconsult as someone needs to look at it. In any case, last time I had one of those I missed it, because the doctor rang at a random time and I was unable to get to my phone in time. Neither do they ring twice. Presumably I could join a telephone queue early in the morning but it's not an emergency.
In contrast, Specsavers tell me it's time to have a new hearing test so I go online and book it at a time of my choosing, at the end of a working day so I only have to leave work a few minutes early. Yes it was a few weeks ahead, but again it's not urgent, convenience was more important.
So, yes, the admin certainly has to improve.
For such booking schemes to work there has to be capacity (and in your case capacity for someone who knows about hands, on a friday).
Specsavers makes more money if it creates fresh capacity, the NHS does not, it has a finite budget.
So the reduction in 18 week waits to what they were in 2010 is the base for what you need.
The difference between Specsavers and the NHS is Specsavers has meaningful competition. Specsavers have to be able to offer you a reasonably priced appointment at that's convenient, otherwise you'd just go to Vision Express et-all instead. And since Specsavers is owned by rational capitalisists trying to turn a profit through client bookings, it's heavily in their interests to make the customers experience attractive.
There is literally no "commercial" incentive to make the NHS patient experience attractive - if anything the reverse - less patients makes everything easier for everyone in the NHS.
The difficulty is that this is very easy to observe, but much harder to fix.
GPs are, at least on paper, in competition with each other, as are health trusts, so mindlessly invoking "the market" will not help, as we have seen from the 1980s onward. What Specsavers does have is scale and top-down direction, whereas fixing GP practices involves corralling thousands of independent GP practices.
For instance, if I go to my GP's website, I can see at least two ways to make online requests, Klinik and the NHS App, and, oh, Evergreen Life is a third, and, oh no, the E-consult link looks like a fourth but just gives a message that the practice does not offer it (so why provide the link?) and Klinik requests are only accepted in normal working hours. Basically, it is a complete bloody mess even though I am welcome to take my "business" to a different practice.
What Specsavers can do that Wes Streeting cannot is require that all practice web sites use software package X and absolutely no others, and the reason Streeting cannot do that is precisely because GP practices are in competition with each other.
What Streeting can do though, is mandate a particular data structure and framework that NHS-approved software has to follow, and design an API themselves.
Even better would be an NHS.gov website that interfaces with all the GP surgery software, and can highlight when and where GP appointments are available. Your local GP may be full up all week, but the one in the next town can do 14:30 tomorrow.
I agree with your first point, but disagree with your second. The NHS would probably get quoted £XX billion to set up a website and it would take about 10 years.
It's not a coincidence that some of the best systems for organising public services are private apps developed using public data. For example, my council stated it would be impossible or massively costly to provide a live data feed for one of their services - it took me an FOI request and two days of fiddling and I had a template ready for them.
I think there is huge potential for pro bono work like this. There must be thousands of tech-savvy people who, sick to death of working on boring stuff for a mega-corp, would get a real benefit from providing something to their local communities for free. We could have a new Honours system to reflect that work - Member/Knight of the Online Order or something.
Time and again, if you create a portal to access the data, people will do all kinds of stuff with it.
The COVID dashboard is a case in point
With the progress people like Vercel are making with tools like https://v0.dev/ - soon enough people will be able to just make the basic apps themselves. GitHub's new equivalent does much the same, but runs in a sandbox on your device - but you can share it with friends too. I can imagine a lot of little one-off apps being created for local whatsapp/FB groups at the drop of a hat.
"Labour seem to be saying that Angela [Rayner] knows best and local people can be ignored"
Shadow treasury minister Richard Fuller criticises the news that council planning committees will be bypassed as part of government house-building plans
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Rachel Reeves has repeated the blunders of George Osborne's omnishambles budget but in an area where potential outcomes are literally and not just metaphorically fatal. Removing WFA is a neat bureaucratic fix that would appeal to Treasury apparatchiks but which is politically tin-eared, and especially while Reeves and other MPs have their own heating bills subsidised by the state.
Hard to imagine how low these curs can stoop. Rob poor pensioners yet claim huge amounts for their second homes. How do these hypocrites sleep at night.
Malc, neither you nor I NEED WFA. Nice to have, but that's it, but yes there are some who do need it. As I said yesterday the first step ought to have been taxing it.
Yep.
There were some ways of doing this that didn't end up with the high likely potential for the deaths from cold this winter being blamed squarely on Reeves.
Even Starmer has agreed now I gather from somewhere I read this week that it was a mistake. He needs to call her into his office.
I think this is a political mistake rather than a policy one. I just think this policy is now untenable - but then where do they find the money?
The policy is very tenable. Its been done.
What's not tenable is u-turning now. A u-turn would both be too late for this winter so what's the point, and would show the government is a pushover that will u-turn to any selfish vested interests that raise a stink.
I can't believe Stokes declared when he was on 49 not out.
I can’t believe Rohit Sharma hasn’t resigned as India captain yet. He’s lost the last four tests he’s played - India winning the one where he was absent at a canter - and he can’t buy a run.
If he had Stokes’ selfless attitude he’d have retired when Bumrah led India to that win.
"Labour seem to be saying that Angela [Rayner] knows best and local people can be ignored"
Shadow treasury minister Richard Fuller criticises the news that council planning committees will be bypassed as part of government house-building plans
Yes, they should. Just look at any of the objections on the applications, these people are idiots.
It will encourage builders to follow the local plan - houses in areas inside the local plan - easy application, housing outside the local plan expect issues.
It will also encourage councils to keep their local plan up to date - as it makes things easier for them..
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Featherbedded spoilt people expecting others to give them money they haven't earned and don't need deserve zero sympathy. None whatsoever.
Pensioners are not the "most vulnerable" in society, that is pig ignorant. 75% own their own home without a mortgage and they aren't even the most vulnerable to the cold, that is infants under 1 year of age who are far more vulnerable than pensioners but have never had such entitlement.
Welfare should be a safety net for those who need it.
Universal winter fuel allowance is not needed
Those most in need can apply for help.
All pensioners including higher rate tax payers have had a near 500 quid uplift due to triple lock
The fucking Daily Mail have attacked pensioners in need for 14 years... We all know the fucking ghouls are just waiting for a suitable death to exploit.
Stand firm Labour.
Remove universal wfa permanently, remove the triple lock and increase pension credit thresholds marginally if you need to.
Nothing about ending higher rate tax relief on pension contributions? The perk enjoyed only by the well-off, including highly-paid columnists and pundits who call instead for measures that hit the poorer pensioner.
"Protecting wildlife shouldn't come at the expense of building more homes, Angela Rayner has said."
I have a message for Angela: Fuck off.
Frankly I think in this case she’s right I’m afraid. The current system is just completely unsustainable.
We are miles apart on this issue, I know.
Let's agree to disagree to avoid 50 fruitless posts where we fail to change each other's minds!
I’m happy to accept that my view of “just get rid of planning regulations” isn’t politically or systematically doable but I think it’s hard to claim that the current planning system works?
I know people think I am obsessed with phone masts but it’s an area I did work in for many years so I like to speak on things I know where possible. It’s utter lunacy that a company can find an existing structure, want to build on it and the locals say “no it looks horrible”, whilst sitting next to a pylon and then complaining their signal is rubbish!
This government does indeed have very poor comms but quietly, somewhere, they are making quite substantial changes it seems.
These planning reforms are a good start but let’s see the detail.
You halfwit , fine words butter no parsnips. They have done hee haw so far.
Why do you have to be so rude?
stop posting absolute bollox and I won't be, keep your fantasies till they become realities. Also if you think that is rude you need to get out more.
You don’t ever contribute anything useful. You just swear and shout at everyone.
I’ve been nothing but kind to you and you’ve never shown me any respect in return.
You’re clearly a very bitter, nasty person.
Please go away now.
Get a life , you obviously don't read my words of wisdom. I am not easily fooled by duplitious politician's and feel free to deride those who are. Given you do not own the site , I will ignore your pitiful request. Toughen up lightweight.
These planning reforms sound really encouraging, I’m sad the Tories are going to oppose them.
It feels like the Tories are falling into the trap of all oppositions and just opposing everything.
I’m very concerned about this as I worry about a Reform government.
I know we’ve discussed many times that the Tories aren’t looking to expand their coalition but they’re going down the path of making the mistakes Labour made before.
The Government should embrace the fact it has pissed off a self-centred vested interest group that primarily didn't vote for it anyway and do the right things that for too long haven't been done for the country.
Planning reform so that young people can own their own home, even if it affects the views or property prices of landlords.
End the triple lock and link pensioners salaries to working people's salaries so that we really are "all in it together".
Merge NI and Income Tax so everyone pays the same tax rate regardless of whether they're working or not.
Labour should grasp the nettle and govern for people who are working for a living like their name implies.
One local NIMBY arsehole turned up to the meeting with his own barrister, to try and stop a collective of local farmers from selling their own food in a small restaurant.
Britain is not so rich a country with so much surplus money that it can afford to bung normal pensioners extra cash for fuel on top of the state pension.
The government need to win the argument on this.
Unfortunately Lab don't seem great at making the arguments let alone winning them.
I don't get why this is such a hard argument to make. There is no justification for people like my late parents getting another £200 they don't need.
In fact I think if anyone it is people on Child Benefit who ought to get the WFA, they are more likely to be struggling than pensioners who aren't on Pension Credit.
Well, that's a reasonable argument, but one that Lab don't seem capable of articulating. All that sticks out is we need to balance the books, black hole etc, plus that blithering idiot Lucy Powell suggesting the UK would face a run on the pound and an economic crash if the WFP hadn't been slashed.
Attended a planning meeting on Tuesday. Leicestershire County Council wanted to reduce percentage of "affordable" homes on a site already agreed by the planning authority from 40% to 10% to make a 2,750 home site viable. [The development will actually never be viable IMHO]. When asked how if replace small affordable homes with 4 and 5 bedroom ones they can still fit 2,750 home on the land allocated, Council representative said "Oh,2,750 homes is a maximum".
Getting developers -in this case the County Council - to actually build anything is like pushing on string.
"Protecting wildlife shouldn't come at the expense of building more homes, Angela Rayner has said."
I have a message for Angela: Fuck off.
Frankly I think in this case she’s right I’m afraid. The current system is just completely unsustainable.
We are miles apart on this issue, I know.
Let's agree to disagree to avoid 50 fruitless posts where we fail to change each other's minds!
I’m happy to accept that my view of “just get rid of planning regulations” isn’t politically or systematically doable but I think it’s hard to claim that the current planning system works?
I know people think I am obsessed with phone masts but it’s an area I did work in for many years so I like to speak on things I know where possible. It’s utter lunacy that a company can find an existing structure, want to build on it and the locals say “no it looks horrible”, whilst sitting next to a pylon and then complaining their signal is rubbish!
Visual impact is a much lower concern for me than habitat loss or other negative impact on wildlife.
Plonking a mast on the roof of an office block isn't something that would get me manning the barricades.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Featherbedded spoilt people expecting others to give them money they haven't earned and don't need deserve zero sympathy. None whatsoever.
Pensioners are not the "most vulnerable" in society, that is pig ignorant. 75% own their own home without a mortgage and they aren't even the most vulnerable to the cold, that is infants under 1 year of age who are far more vulnerable than pensioners but have never had such entitlement.
Welfare should be a safety net for those who need it.
Universal winter fuel allowance is not needed
Those most in need can apply for help.
All pensioners including higher rate tax payers have had a near 500 quid uplift due to triple lock
The fucking Daily Mail have attacked pensioners in need for 14 years... We all know the fucking ghouls are just waiting for a suitable death to exploit.
Stand firm Labour.
Remove universal wfa permanently, remove the triple lock and increase pension credit thresholds marginally if you need to.
Nothing about ending higher rate tax relief on pension contributions? The perk enjoyed only by the well-off, including highly-paid columnists and pundits who call instead for measures that hit the poorer pensioner.
They end up paying tax on the pension contributions at a later date, so just deferred, hardly a perk given they will be paying shedloads as it is and when supporting themselves from said pension. Saving for a pension also means they are thinking , intelligent , caring people , unlikely to sponge off the state like many feckless do.
The Government should embrace the fact it has pissed off a self-centred vested interest group that primarily didn't vote for it anyway and do the right things that for too long haven't been done for the country.
Planning reform so that young people can own their own home, even if it affects the views or property prices of landlords.
End the triple lock and link pensioners salaries to working people's salaries so that we really are "all in it together".
Merge NI and Income Tax so everyone pays the same tax rate regardless of whether they're working or not.
Labour should grasp the nettle and govern for people who are working for a living like their name implies.
It seems to me that if they just accept they are already going to be unpopular then their limit on what they can do is essentially removed.
With this kind of majority, they really should be making generational change on the scale of Mrs Thatcher.
"Protecting wildlife shouldn't come at the expense of building more homes, Angela Rayner has said."
I have a message for Angela: Fuck off.
Frankly I think in this case she’s right I’m afraid. The current system is just completely unsustainable.
We are miles apart on this issue, I know.
Let's agree to disagree to avoid 50 fruitless posts where we fail to change each other's minds!
I’m happy to accept that my view of “just get rid of planning regulations” isn’t politically or systematically doable but I think it’s hard to claim that the current planning system works?
I know people think I am obsessed with phone masts but it’s an area I did work in for many years so I like to speak on things I know where possible. It’s utter lunacy that a company can find an existing structure, want to build on it and the locals say “no it looks horrible”, whilst sitting next to a pylon and then complaining their signal is rubbish!
Hence the need for planning permission when we have nutters like you who would have ugly masts all over so that you can dribble into a phone anywhere you want.
"Protecting wildlife shouldn't come at the expense of building more homes, Angela Rayner has said."
I have a message for Angela: Fuck off.
Frankly I think in this case she’s right I’m afraid. The current system is just completely unsustainable.
We are miles apart on this issue, I know.
Let's agree to disagree to avoid 50 fruitless posts where we fail to change each other's minds!
I’m happy to accept that my view of “just get rid of planning regulations” isn’t politically or systematically doable but I think it’s hard to claim that the current planning system works?
I know people think I am obsessed with phone masts but it’s an area I did work in for many years so I like to speak on things I know where possible. It’s utter lunacy that a company can find an existing structure, want to build on it and the locals say “no it looks horrible”, whilst sitting next to a pylon and then complaining their signal is rubbish!
Visual impact is a much lower concern for me than habitat loss or other negative impact on wildlife.
Plonking a mast on the roof of an office block isn't something that would get me manning the barricades.
And yet go and read some planning applications and the most common reason they are rejected is “visual intrusion”.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
Featherbedded spoilt people expecting others to give them money they haven't earned and don't need deserve zero sympathy. None whatsoever.
Pensioners are not the "most vulnerable" in society, that is pig ignorant. 75% own their own home without a mortgage and they aren't even the most vulnerable to the cold, that is infants under 1 year of age who are far more vulnerable than pensioners but have never had such entitlement.
Welfare should be a safety net for those who need it.
Universal winter fuel allowance is not needed
Those most in need can apply for help.
All pensioners including higher rate tax payers have had a near 500 quid uplift due to triple lock
The fucking Daily Mail have attacked pensioners in need for 14 years... We all know the fucking ghouls are just waiting for a suitable death to exploit.
Stand firm Labour.
Remove universal wfa permanently, remove the triple lock and increase pension credit thresholds marginally if you need to.
Nothing about ending higher rate tax relief on pension contributions? The perk enjoyed only by the well-off, including highly-paid columnists and pundits who call instead for measures that hit the poorer pensioner.
I'd certainly look to end that. "Hello, well off person, here's some extra help for you, is a cheque from HMRC ok?"
I was amazed when I benefited from it on setting up a SIPP. I thought there must be some mistake.
One local NIMBY arsehole turned up to the meeting with his own barrister, to try and stop a collective of local farmers from selling their own food in a small restaurant.
That particular barrister (ironically, given Clarkson’s views on it) is a noted scourge of HS2. This has included repeating false claims about the importance of certain local areas and landmarks in order to try and block it, e.g. the Roald Dahl wood that wasn’t. While that hasn’t worked, it has been a major factor in ballooning costs.
I haven’t checked whether he was one of the people behind the ‘bat tunnel’ but it seems eminently possible.
Comments
I think I would have to phone for an urgent appointment but with many of the routine bookings done online it must be much easier to get through than otherwise.
Alternatively, hire half a dozen devs and half a dozen analysts, on £150k and £100k respectively, and see the first phase of the job up and running in about three months. As we saw during the pandemic.
Just popped in and that is excellent news
Who cares if a remote appointment GP is based in Doncaster, Dubai, or Dehli?
And one very, very obvious issue. Legalities. Patient confidentiality; medical standards; licence to practice.
Edit: the insurance companies have to be kept happy, first of all (both for the patient and the medics).
I’m currently participating in rebuilding a bank with a team of 8.
If there's a slow trickle of Tory defections while Reform stays fairly high in the polls, then that could start a feedback loop. Then those like Jenrick, who likely care far more about their careers than party, decide Reform is their best chance of preferment...
Reform with 5 MPs isn't going to see Farage as PM .. but if they went into the next election with fifty or more ?
Good riddance it seems to the evil Assad family, Syria finally freed from them.
The rebels are probably no better, but I'm a big believer in chaos and evolution being better than stagnation at getting something better eventually. Every time a dictator is toppled is a good thing, even if the replacement is (this time) no better because eventually it will be.
Syria was one link in what I've referred to as the Axis of Evil between Iran, Russia, Syria and Hezbollah. That Axis has taken a real hammering this year.
The NHS already sends people abroad for treatment, so the issues around security and privacy aren’t insurmountable with a bit of effort.
I was pleasantly surprised at the time how cheap they were, those toys, compared to some of the boys' toys on PB.
It's not a coincidence that some of the best systems for organising public services are private apps developed using public data. For example, my council stated it would be impossible or massively costly to provide a live data feed for one of their services - it took me an FOI request and two days of fiddling and I had a template ready for them.
I think there is huge potential for pro bono work like this. There must be thousands of tech-savvy people who, sick to death of working on boring stuff for a mega-corp, would get a real benefit from providing something to their local communities for free. We could have a new Honours system to reflect that work - Member/Knight of the Online Order or something.
Either Reeves needs to back down/ameliorate or Starmer needs to sack her before she ends their 2028-29 chances with four years to go.
It's a bloody disaster as PBers like me said on the day it was announced.
" ‘It’s only a matter of time until we get some terrible case,’ a minister confided to me. ‘It happens every year, some tragedy where a pensioner dies alone. But this year it will be blamed on us – for winter fuel allowance cuts. And then we’re going to be in the midst of a full-blown crisis.’ "
"But they cannot align the relatively small saving with the potentially catastrophic political cost of being seen to target some of the most vulnerable in society in wintertime."
"I’ve spoken to Cabinet ministers, junior ministers, MPs, councillors, party officials, activists, trade union officials. I have yet to find a single person within Labour’s ranks who genuinely believes in the winter fuel benefit cut. Or thinks it is politically sustainable."
https://www.dailymail.co.uk/debate/article-14168519/DAN-HODGES-Pensioners-die-freezing-minister-confided-winter-fuel-axe-Labours-ranks-tell-fear-worse-come.html
‘Theft is essentially legal’: Lawrence Newport’s plan to crush crime | SpectatorTV
The Spectator's Natasha Froze from The Spectator sits down with Dr. Lawrence Newport, academic and founder of the new campaign Crush Crime. They discuss the alarming increase in crime rates across the UK over the past decade and explore the roots of the problem, including policing challenges, judicial inefficiencies, and societal factors. Dr. Newport shares his 8-point-plan for crushing crime, involving practical reforms, community involvement, and restoring public trust in the justice system.
https://www.youtube.com/watch?v=_4EfwqQuN7I
Plus within the UK it only spreads the workload. If I lived in Doncaster I'd be a bit cheesed off at the idea that the local GPs had time to spare for worried patients in Surbiton. A quick riffle yields...
https://www.doncasterfreepress.co.uk/health/average-south-yorkshire-gp-looking-after-hundreds-more-patients-as-doctor-workforce-shrinks-4507760
But yes, that there’s £2.99 pulse oxymeters, and £20 electronic blood pressure readers, can make remote diagnosis considerably more accurate and feasible for many. Some will stil want to see the doc in person, which is fine, but a remote consultant can be anywhere. Even if not outsourced abroad, you could have a retired GP living where he likes and working two hours a day three days a week. Every little helps.
If my practice is anything to go by, it is early retirement / 3 day weeks that is the issue, although they are utterly useless in other ways too.
I'm not sure what we can do about that. Pay more and a proportion will retire even earlier.
The government need to win the argument on this.
However, that was then and this is now.
I have to say our GP's system is quite good, BUT, one has to ring at 8am to be sure of getting a face-to-face appointment that day.
It has to be remembered that there are several sorts of patients. There are people, generally males under 50 and over 10 who have short-term transient needs, there are people who have regular but predictable needs and there are people like me who have fairly complex and irregular requirements. And that's just those with physical problems.
Then there are those with mental or psychological or social problems and they are often very difficult to deal with.
The COVID dashboard is a case in point
The government apparently paid £17k for the website for the investment summit....because it had the ability to book break out sessions.....who is paying any real money for a temporary landing page these days and a few wordpress plugins.
Based on our experience we'd certainly use it again.It was better than the last time we used it, 10 or so years ago.
This government does indeed have very poor comms but quietly, somewhere, they are making quite substantial changes it seems.
These planning reforms are a good start but let’s see the detail.
Especially as they trouser thousands to heat their second homes, how dumb can you be.
PS: My wife and I just got £10 each in bank account for some bizarre reason , why they still paying that out.
If the proposals "comply" with these plans, the government has said, they could "bypass planning committees entirely to tackle chronic uncertainty, unacceptable delays and unnecessary waste of time and resources".
https://www.bbc.co.uk/news/articles/c80vv9d4xzno
This seems like they’ve been reading my posts. I am Sir Horse Starmer.
In fact I think if anyone it is people on Child Benefit who ought to get the WFA, they are more likely to be struggling than pensioners who aren't on Pension Credit.
Featherbedded spoilt people expecting others to give them money they haven't earned and don't need deserve zero sympathy. None whatsoever.
Pensioners are not the "most vulnerable" in society, that is pig ignorant. 75% own their own home without a mortgage and they aren't even the most vulnerable to the cold, that is infants under 1 year of age who are far more vulnerable than pensioners but have never had such entitlement.
Welfare should be a safety net for those who need it.
In the end, United paid £10m for Ashworth, who ended up on gardening leave for the same amount of time he was actually in post at United. In total, hiring Amorim and Ashworth and sacking Ten Hag have cost the club in excess of £30m.
https://www.bbc.co.uk/sport/football/articles/c1elzp6xeq7o
Those most in need can apply for help.
All pensioners including higher rate tax payers have had a near 500 quid uplift due to triple lock
The fucking Daily Mail have attacked pensioners in need for 14 years... We all know the fucking ghouls are just waiting for a suitable death to exploit.
Stand firm Labour.
Remove universal wfa permanently, remove the triple lock and increase pension credit thresholds marginally if you need to.
I have a message for Angela: Fuck off.
But anyway, they could design a system that took it away from those who dont really need it but Reeves didn't. She rushed into something in a bid, I can only presume, to look like the 'Iron Chancellor' she dreams of being.
I’ve been nothing but kind to you and you’ve never shown me any respect in return.
You’re clearly a very bitter, nasty person.
Please go away now.
But the communication and implementation has been a disaster.
There were some ways of doing this that didn't end up with the high likely potential for the deaths from cold this winter being blamed squarely on Reeves.
Even Starmer has agreed now I gather from somewhere I read this week that it was a mistake. He needs to call her into his office.
Shadow treasury minister Richard Fuller criticises the news that council planning committees will be bypassed as part of government house-building plans
https://x.com/bbcpolitics/status/1865704994009206873
Yes, they should. Just look at any of the objections on the applications, these people are idiots.
Not really sure that's much of an improvement.
Let's agree to disagree to avoid 50 fruitless posts where we fail to change each other's minds!
If poor people need welfare, then it should be targeted at those who need it, not those who don't.
And the most in need are poor babies, not pensioners. Contrary to received myths on here, pensioners have never been the most vulnerable to the cold.
What's not tenable is u-turning now. A u-turn would both be too late for this winter so what's the point, and would show the government is a pushover that will u-turn to any selfish vested interests that raise a stink.
If he had Stokes’ selfless attitude he’d have retired when Bumrah led India to that win.
It will also encourage councils to keep their local plan up to date - as it makes things easier for them..
I know people think I am obsessed with phone masts but it’s an area I did work in for many years so I like to speak on things I know where possible. It’s utter lunacy that a company can find an existing structure, want to build on it and the locals say “no it looks horrible”, whilst sitting next to a pylon and then complaining their signal is rubbish!
But you aren’t vaguely impartial on this, as shown by your response to my example the other day.
Toughen up lightweight.
I know we’ve discussed many times that the Tories aren’t looking to expand their coalition but they’re going down the path of making the mistakes Labour made before.
Planning reform so that young people can own their own home, even if it affects the views or property prices of landlords.
End the triple lock and link pensioners salaries to working people's salaries so that we really are "all in it together".
Merge NI and Income Tax so everyone pays the same tax rate regardless of whether they're working or not.
Labour should grasp the nettle and govern for people who are working for a living like their name implies.
Ineos spent millions poaching Dan Ashworth from Newcastle United yet today he's leaving Man Utd by mutual consent..
https://www.youtube.com/watch?v=c9c1KF4Opy4
One local NIMBY arsehole turned up to the meeting with his own barrister, to try and stop a collective of local farmers from selling their own food in a small restaurant.
Getting developers -in this case the County Council - to actually build anything is like pushing on string.
Plonking a mast on the roof of an office block isn't something that would get me manning the barricades.
With this kind of majority, they really should be making generational change on the scale of Mrs Thatcher.
Masts don’t cause damage to wildlife.
I was amazed when I benefited from it on setting up a SIPP. I thought there must be some mistake.
I haven’t checked whether he was one of the people behind the ‘bat tunnel’ but it seems eminently possible.