Just watched the Sky Newspaper Panel,and one of the resident reporters totally destroy Burnhams two page spread in the Miror about how the NHS will cease to exist if the Tories get back in..It took them about 20 seconds What a plonker that lad is
What would be an "unrecognisable" NHS would be one that fixed broke people, and did it with alacrity. If I am off work with an incapacity that needs an operation to fix it, I need said operation tomorrow, not in six months time when my employers have got fed up with my absence and lack of progress, and fired me. The NHS needs to understand that working age people need to be returned to the Labour market ASAP for their good and that of the country.
Largely that is what the New Labour changes in the NHS did. By introducing targets (currently 18 weeks for referral to treatment so your hypothetical worker would not be waiting 6 months btw) the priority was made first appointments and elective surgery, over the care of long term conditions and emergency work. Indeed as emergency work over the 2009 baseline is paid at only 30% of cost to the Acute Trust (the emergency rate marginal tariff) the NHS is incentivised for doing elective work and penalised for doing emergency work. This sort of central direction of funds is in part why the hospitals with the busiest emergency departments have the biggest debts.
Doc, I don't know whether you saw the article by Robert Colville in the Telegraph the other day, or if you did what you think of it. I found it the most informative and interesting piece I have read about the NHS in a very long time.
A very good article. We have much the same issues in Leicester with the busiest Emergency dept and the next nearest Hospital 30 miles away not easy to divert.
There is no simple solution, and to manage those emergencies the QE had to cancel elective surgery such as JohnL's knee replacement.
The problem is mostly one of lack of capacity and lack of trained staff.
On another point: We have sometimes employed locums whose English struggled with local dialect and accents. The alternative was employing no one and closing down services. No one is happy to do so, but what choice do we have. Undergraduate med school places are being cut next year, as are postgraduate training places. We train far too few nurses also. It is a failure of linked up government. Cut immigration by training Britons, simples!
I can't see anything wrong with "healthcare professionals" having to speak perfect English in England. Can you?
In Nige's fantasy land of soundbite politics there would be no problem.
Here in the Real World there are at least 2 practical issues
1. What is the definition of "perfect English" and how is it objectively measured?
2. Assuming not every current "healthcare professional" meets that standard, there would be an immediate staffing crisis.
Apart from that, it's surefire winner...
1.Fairly easy even for a numpty like you , people need to understand what they are saying in English and they need to be able to understand people speaking in English to them 2. Just proves the point , hoe the F*** do you get a job in healthcare if you cannot speak and understand people in their language.
Possible deflation and we could see printing money. Not sure the Germans are too fond of that idea.
The Germans only get 2 votes out of 22 on the council. A majority of members have already spoken in favour (14-15 IIRC).
In addition, a compromise has been agreed where The Bundesbank only buys German government debt, the Banque National French government debt, etc. In this way, Merkel can say "if the whole thing goes tits up, we won't be saddled with a bunch of Greek government debt".
Has that deal been done? It has certainly been floated but I have not read before that it has actually been agreed and I don't think Mr Draghi at the ECB is in favour of it (there are risks and it could dilute the QE effect).
Nothing is official, but I heard from a very senior member of the CDU that Mrs Merkel was comfortable with it. If it has official German backing, then I'd be very surprised if it didn't go through.
Possible deflation and we could see printing money. Not sure the Germans are too fond of that idea.
The classical definition of deflation is a contraction of money and credit that leads to falling prices. Eurozone broad money M3 and narrow money M1 are nowhere near contraction, growing by 2.5% and 6.2% respectively in the 12 months to October. A fall in oil prices merely leads to more money being spent on non energy goods and services, raising their prices, a zero sum effect.
QE is not needed and would be a disaster, hopefully the positive economic data arriving in the next few months will dissuade the ECB.
I can't see anything wrong with "healthcare professionals" having to speak perfect English in England. Can you?
In Nige's fantasy land of soundbite politics there would be no problem.
Here in the Real World there are at least 2 practical issues
1. What is the definition of "perfect English" and how is it objectively measured?
2. Assuming not every current "healthcare professional" meets that standard, there would be an immediate staffing crisis.
Apart from that, it's surefire winner...
Ummm. Out here in the world away from party political prejudice we note that the General Medical Council support the idea that doctors should not be allowed to practice in the UK unless they have a sufficiently good command of the English language. To suggest that nurses and other professionals making life or death decisions (e.g. dispensing drugs, running triage, listening to patients relating their symtoms etc.) should have the same command seems unexceptional to me.
How to objectively measure a persons grasp of a language is not actually difficult. Its done in every school and university in the land. It is called an examination.
I can't see anything wrong with "healthcare professionals" having to speak perfect English in England. Can you?
In Nige's fantasy land of soundbite politics there would be no problem.
Here in the Real World there are at least 2 practical issues
1. What is the definition of "perfect English" and how is it objectively measured?
2. Assuming not every current "healthcare professional" meets that standard, there would be an immediate staffing crisis.
Apart from that, it's surefire winner...
Where as in the Conservative fantasy land we can continue to sweep this sort of issue under the carpet, imply in passing is a bit uncouth to talk about it, and that 76% of the population that want immigration reduced will all come skipping over to vote for them. Or maybe they could do something about issues like this which is where the majority of voters who do not live in an ethnically diverse area come into contact with the issue and get a poor experience.
I'm a Tory, but I despair of the Tories at the moment, the campaign consists of equal parts of lying about things they can't do, lying about the things they can do, but dont want to do, and belittling the concerns of their natural supporters and then rubbishing them when they consider voting for another party which might be a bit eccentric, but sounds to a lot of voters like it is listening to them.
Possible deflation and we could see printing money. Not sure the Germans are too fond of that idea.
The Germans only get 2 votes out of 22 on the council. A majority of members have already spoken in favour (14-15 IIRC).
In addition, a compromise has been agreed where The Bundesbank only buys German government debt, the Banque National French government debt, etc. In this way, Merkel can say "if the whole thing goes tits up, we won't be saddled with a bunch of Greek government debt".
Has that deal been done? It has certainly been floated but I have not read before that it has actually been agreed and I don't think Mr Draghi at the ECB is in favour of it (there are risks and it could dilute the QE effect).
Nothing is official, but I heard from a very senior member of the CDU that Mrs Merkel was comfortable with it. If it has official German backing, then I'd be very surprised if it didn't go through.
I'd be surprised if it didn't too. However, that rather leaves your point that Germany only has two votes out of 22 high and dry.
I can't see anything wrong with "healthcare professionals" having to speak perfect English in England. Can you?
In Nige's fantasy land of soundbite politics there would be no problem.
Here in the Real World there are at least 2 practical issues
1. What is the definition of "perfect English" and how is it objectively measured?
2. Assuming not every current "healthcare professional" meets that standard, there would be an immediate staffing crisis.
Apart from that, it's surefire winner...
1. Something called an exam
2. You would need to put a training programme into place. It would be a bit stupid* to expect everyone to come up to scratch immediately you changed the rules, and you would probably have problems with employment law when you tried to fire them.
I can't see anything wrong with "healthcare professionals" having to speak perfect English in England. Can you?
In Nige's fantasy land of soundbite politics there would be no problem.
Here in the Real World there are at least 2 practical issues
1. What is the definition of "perfect English" and how is it objectively measured?
2. Assuming not every current "healthcare professional" meets that standard, there would be an immediate staffing crisis.
Apart from that, it's surefire winner...
As I said, I'm no fan of Farage or UKIP, just concerned that during a very distressing time, the "healthcare professionals" couldn't communicate what was going to happen to my relative, what they needed him to do, and, crucially, misinterpreted what a doctor had told them in front of my relative, which is when I had enough and had a word with the ward sister. Perfect English might be a stretch, I accept, and I don't have a clue how you measure it, but in all honesty, I wouldn't want the 2 nurses involved anywhere near me, or my loved ones, staffing crisis or not.
Just watched the Sky Newspaper Panel,and one of the resident reporters totally destroy Burnhams two page spread in the Miror about how the NHS will cease to exist if the Tories get back in..It took them about 20 seconds What a plonker that lad is
What would be an "unrecognisable" NHS would be one that fixed broke people, and did it with alacrity. If I am off work with an incapacity that needs an operation to fix it, I need said operation tomorrow, not in six months time when my employers have got fed up with my absence and lack of progress, and fired me. The NHS needs to understand that working age people need to be returned to the Labour market ASAP for their good and that of the the NHS is incentivised for doing elective work and penalised for doing emergency work. This sort of central direction of funds is in part why the hospitals with the busiest emergency departments have the biggest debts.
Well I'm not going to defend apparently stupid A&E funding methods. But what does "for referral to treatment" actually mean? Does it mean "from diagnosis to the procedure being carried out? I suspect not, and as 18 weeks is already 4 months I suspect that waiting 6-9 months for an operation is in fact common.
RTT times are from point of referral by the GP, or other referring professional.
Only applies to NHS England. I do not know the rules elsewhere.
Having waded through the jargon, I see the wording is actually "a new right for patients to start consultant-led non- emergency treatment within a maximum of 18 weeks of a GP referral". What does "start treatment" mean? Being cynical, I presume it means "the first appointment with your consultant".
And of course the presence of an 18 week target doesn't incentivise health services to treat people any quicker, or is there another target for this?
Seeing the Consultant does not constitute treatment, the surgery does (assuming that is the appropriate treatment). 18 weeks from referral to treatment means what it says. Our unit runs at 92% RTT. The other 8% are treated consecutively so generally not more than a week or two over.
We have a weekly planning meeting within our department where we look at all those more than 13 weeks into the pathway and allocate appropriate dates.
If your local hospital is gaming the system then report it to the CQC.
2. You would need to put a training programme into place. It would be a bit stupid* to expect everyone to come up to scratch immediately you changed the rules, and you would probably have problems with employment law when you tried to fire them.
Doc, I don't know whether you saw the article by Robert Colville in the Telegraph the other day, or if you did what you think of it. I found it the most informative and interesting piece I have read about the NHS in a very long time.
A very good article. We have much the same issues in Leicester with the busiest Emergency dept and the next nearest Hospital 30 miles away not easy to divert.
There is no simple solution, and to manage those emergencies the QE had to cancel elective surgery such as JohnL's knee replacement.
The problem is mostly one of lack of capacity and lack of trained staff.
On another point: We have sometimes employed locums whose English struggled with local dialect and accents. The alternative was employing no one and closing down services. No one is happy to do so, but what choice do we have. Undergraduate med school places are being cut next year, as are postgraduate training places. We train far too few nurses also. It is a failure of linked up government. Cut immigration by training Britons, simples!
Do enough people want to be nurses? Having moved to a University training model, you have to live on thin air for three years and have a loan to pay back. If you are going to do that, you might as well do something else (lets face it, nursing for some reason is a profession without high status in this country). Back in the day... when you wanted to be a student nurse you were effectively taken on as a nursing assistant and received a wage while you were trained. I can understand wanting to increase the academic status and intellectual rigour of nurse training, but I think they threw out the baby with the bathwater.
If that were the case wouldn't UKIP be proposing a zero immigration level, rather than a capped point system that is completely acceptable at a number of progressive western countries like Canada and Australia ?
No
If we are to believe Nige this morning, he is delighted with immigrants, as long as they don't work in the NHS...
Or on trains.
He approves of those who cook his breakfast, and iron his cords.
2. You would need to put a training programme into place. It would be a bit stupid* to expect everyone to come up to scratch immediately you changed the rules, and you would probably have problems with employment law when you tried to fire them.
And the party political axe grinding rumbles on... rather than say engaging with the issue, and the concern of the voters. Shouting at voters and telling them that they must believe you because you are right, works every time....
Seeing the Consultant does not constitute treatment, the surgery does (assuming that is the appropriate treatment). 18 weeks from referral to treatment means what it says. Our unit runs at 92% RTT. The other 8% are treated consecutively so generally not more than a week or two over.
We have a weekly planning meeting within our department where we look at all those more than 13 weeks into the pathway and allocate appropriate dates.
If your local hospital is gaming the system then report it to the CQC.
Thanks for the information, actually that's quite useful (and apologies if you think I was poking with a stick). If a patient doesn't get treated within 18 weeks, what should they do? CQC?
Doc, I don't know whether you saw the article by Robert Colville in the Telegraph the other day, or if you did what you think of it. I found it the most informative and interesting piece I have read about the NHS in a very long time.
A very good article. We have much the same issues in Leicester with the busiest Emergency dept and the next nearest Hospital 30 miles away not easy to divert.
There is no simple solution, and to manage those emergencies the QE had to cancel elective surgery such as JohnL's knee replacement.
The problem is mostly one of lack of capacity and lack of trained staff.
On another point: We have sometimes employed locums whose English struggled with local dialect and accents. The alternative was employing no one and closing down services. No one is happy to do so, but what choice do we have. Undergraduate med school places are being cut next year, as are postgraduate training places. We train far too few nurses also. It is a failure of linked up government. Cut immigration by training Britons, simples!
Do enough people want to be nurses? Having moved to a University training model, you have to live on thin air for three years and have a loan to pay back. If you are going to do that, you might as well do something else (lets face it, nursing for some reason is a profession without high status in this country). Back in the day... when you wanted to be a student nurse you were effectively taken on as a nursing assistant and received a wage while you were trained. I can understand wanting to increase the academic status and intellectual rigour of nurse training, but I think they threw out the baby with the bathwater.
Sounds right. Not to mention the almost-free accommodation in nurses' homes up until the mid-80s.
It seems to me that Labour being the largest party is increasingly nailed on with the risk of an Ed majority clearly increasing. I have been very interested in following Professor Fisher's model although largely because it has not worked. What it has shown was given the starting point nearly a year ago the Tories were on course for a comfortable majority. Labour had never got close to a large enough lead to win.
What we have seen since is a failure of the swingback model. The Tories have not made progress and the projection from each starting point is less favourable to them. So we have over the last year moved from a comfortable Tory majority to NOC to Labour as the largest party. In my opinion people like Audreyanne are whistling in the dark. With the starting point of today Labour wins. Only Scotland raises a serious question mark about that majority. But it is a brave man or woman who is now betting on anyone else being the largest party.
Doc, I don't know whether you saw the article by Robert Colville in the Telegraph the other day, or if you did what you think of it. I found it the most informative and interesting piece I have read about the NHS in a very long time.
A very good article. We have much the same issues in Leicester with the busiest Emergency dept and the next nearest Hospital 30 miles away not easy to divert.
There is no simple solution, and to manage those emergencies the QE had to cancel elective surgery such as JohnL's knee replacement.
The problem is mostly one of lack of capacity and lack of trained staff.
On another point: We have sometimes employed locums whose English struggled with local dialect and accents. The alternative was employing no one and closing down services. No one is happy to do so, but what choice do we have. Undergraduate med school places are being cut next year, as are postgraduate training places. We train far too few nurses also. It is a failure of linked up government. Cut immigration by training Britons, simples!
Do enough people want to be nurses? Having moved to a University training model, you have to live on thin air for three years and have a loan to pay back. If you are going to do that, you might as well do something else (lets face it, nursing for some reason is a profession without high status in this country). Back in the day... when you wanted to be a student nurse you were effectively taken on as a nursing assistant and received a wage while you were trained. I can understand wanting to increase the academic status and intellectual rigour of nurse training, but I think they threw out the baby with the bathwater.
There were 100 000 applicants for 20 000 Nursing places last year, so there are the numbers out there interested.
I would tie Nursing bursaries and Medical bursaries to NHS service, with student debts being wiped clean after 5 and ten years respectively, if I was directing policy in these areas.
2. You would need to put a training programme into place. It would be a bit stupid* to expect everyone to come up to scratch immediately you changed the rules, and you would probably have problems with employment law when you tried to fire them.
And the party political axe grinding rumbles on... rather than say engaging with the issue, and the concern of the voters. Shouting at voters and telling them that they must believe you because you are right, works every time....
Don't worry. Give him a few days and Farage will be saying it was all nonsense.
The country needs instant results. People need instant results - or they will lose their jobs and might end up on long term benefits. The business might not need the instant result, they can recruit someone else. The question remains: how do other jurisdictions manage it? Of course you can't ask that question as "not invented here" holds particularly strongly when it comes to the NHS. I am not sure that the NHS manages capacity very well, if I need said operation I am happy to go anywhere in the country to have it.
Nobody anywhere offers instant results for everyone; the question is how close we get, how much we're willing to pay for it collectively and how far we want to leave it to individuals and companies.
The NHS is pretty damn good at critical emergency treatment and always has been - managements rightly prioritise someone teeetering on the brink of death but savable over everything else. There's a current serious issue over slower ambulance response times, but otherwise I'm not worried about this.
The NHS will also offer a choice under the much-maligned Choose & Book system between convenience and speed. When I needed a quick check in 2009 for an alarming symptom (false alam, as it turned out), I looked up my local hospitals online and found that I could get checked almost immediately if I went to Derby, but it'd take a week if I waited for my then local hospital in Nottingham. I went to Derby like a shot; others might have chosen to wait for their familiar local place. This sort of thing is a good idea which tends to even out waiting times, and the reason it's perhaps not generally known is that most patients aren't that computer-friendly and some GPs don't like to bother to do the survey of local choices as they're supposed to (I think this is something the practice nurse should do).
Where I differ up to a point from Fox is in his opposition to capped waiting times, especially for A&E. I can see that from the professional viewpoint it forces suboptimal decisions - see the bloke with a broken toenail because he's been waiting 4 hours. But predictability is very important to many patients. I know someone with panic attacks who makes life-threatening decisions not to go to A&E when she has an asthma attack because she thinks that she may have to wait an UNKNOWN period in the generally stressed conditions of an A&E waiting room.
2. You would need to put a training programme into place. It would be a bit stupid* to expect everyone to come up to scratch immediately you changed the rules, and you would probably have problems with employment law when you tried to fire them.
The only direct quote is this: "If people don't speak English and they are dealing with English-speaking patients surely they shouldn't be employed in the first place." The headline "Nigel Farage has said UKIP would sack all foreign NHS workers who 'cannot speak English properly'" is a Sky paraphrase so I will take it with a pinch of salt. But it seems there is a possibility you are right ;-)
Giving people 6 months to come up to snuff would seem reasonable. My view is that if you wish to emigrate, you should learn your new country's language before going there.
2. You would need to put a training programme into place. It would be a bit stupid* to expect everyone to come up to scratch immediately you changed the rules, and you would probably have problems with employment law when you tried to fire them.
And the party political axe grinding rumbles on... rather than say engaging with the issue, and the concern of the voters. Shouting at voters and telling them that they must believe you because you are right, works every time....
Don't worry. Give him a few days and Farage will be saying it was all nonsense.
I'm not worried about Farage, I am not going to vote for him. I am worried about the Conservatives thinking that trying to rubbish Farage is a substitute for having a policy which meets the concerns of the electorate.
Doc, I don't know whether you saw the article by Robert Colville in the Telegraph the other day, or if you did what you think of it. I found it the most informative and interesting piece I have read about the NHS in a very long time.
A very good article. We have much the same issues in Leicester with the busiest Emergency dept and the next nearest Hospital 30 miles away not easy to divert.
There is no simple solution, and to manage those emergencies the QE had to cancel elective surgery such as JohnL's knee replacement.
The problem is mostly one of lack of capacity and lack of trained staff.
On another point: We have sometimes employed locums whose English struggled with local dialect and accents. The alternative was employing no one and closing down services. No one is happy to do so, but what choice do we have. Undergraduate med school places are being cut next year, as are postgraduate training places. We train far too few nurses also. It is a failure of linked up government. Cut immigration by training Britons, simples!
Do enough people want to be nurses? Having moved to a University training model, you have to live on thin air for three years and have a loan to pay back. If you are going to do that, you might as well do something else (lets face it, nursing for some reason is a profession without high status in this country). Back in the day... when you wanted to be a student nurse you were effectively taken on as a nursing assistant and received a wage while you were trained. I can understand wanting to increase the academic status and intellectual rigour of nurse training, but I think they threw out the baby with the bathwater.
There were 100 000 applicants for 20 000 Nursing places last year, so there are the numbers out there interested.
I would tie Nursing bursaries and Medical bursaries to NHS service, with student debts being wiped clean after 5 and ten years respectively, if I was directing policy in these areas.
You have mentioned that policy before and I am amazed that the major parties have not taken it up. It is a good and sensible policy in its own right but it also ticks so many boxes, not least the dependency on imported NHS staff.
Doc, I don't know whether you saw the article by Robert Colville in the Telegraph the other day, or if you did what you think of it. I found it the most informative and interesting piece I have read about the NHS in a very long time.
A very good article. We have much the same issues in Leicester with the busiest Emergency dept and the next nearest Hospital 30 miles away not easy to divert.
There is no simple solution, and to manage those emergencies the QE had to cancel elective surgery such as JohnL's knee replacement.
The problem is mostly one of lack of capacity and lack of trained staff.
On another point: We have sometimes employed locums whose English struggled with local dialect and accents. The alternative was employing no one and closing down services. No one is happy to do so, but what choice do we have. Undergraduate med school places are being cut next year, as are postgraduate training places. We train far too few nurses also. It is a failure of linked up government. Cut immigration by training Britons, simples!
Do enough people want to be nurses? Having moved to a University training model, you have to live on thin air for three years and have a loan to pay back. If you are going to do that, you might as well do something else (lets face it, nursing for some reason is a profession without high status in this country). Back in the day... when you wanted to be a student nurse you were effectively taken on as a nursing assistant and received a wage while you were trained. I can understand wanting to increase the academic status and intellectual rigour of nurse training, but I think they threw out the baby with the bathwater.
There were 100 000 applicants for 20 000 Nursing places last year, so there are the numbers out there interested.
I would tie Nursing bursaries and Medical bursaries to NHS service, with student debts being wiped clean after 5 and ten years respectively, if I was directing policy in these areas.
That seems reasonable. I have always thought that the Government should offer state scholarships or bursaries for students prepared to study in areas where there is a social need for the graduates and the "free market" of fee-paying courses doesn't provide it.
Seeing the Consultant does not constitute treatment, the surgery does (assuming that is the appropriate treatment). 18 weeks from referral to treatment means what it says. Our unit runs at 92% RTT. The other 8% are treated consecutively so generally not more than a week or two over.
We have a weekly planning meeting within our department where we look at all those more than 13 weeks into the pathway and allocate appropriate dates.
If your local hospital is gaming the system then report it to the CQC.
Thanks for the information, actually that's quite useful (and apologies if you think I was poking with a stick). If a patient doesn't get treated within 18 weeks, what should they do? CQC?
In the first place I would suggest contacting the Hospital PILS department (Patient Information and Liasion Service) who should get a reply from the departmental management.
The 18 week rule does throw up curiosities; we have a number of patients who winter in Spain or Gujerat, and have to be discharged and re-referred when they are back in Blighty. The rules do not allow me to set a date shortly after their return, unless it is within 18 weeks...
I can't see anything wrong with "healthcare professionals" having to speak perfect English in England. Can you?
In Nige's fantasy land of soundbite politics there would be no problem.
Here in the Real World there are at least 2 practical issues
1. What is the definition of "perfect English" and how is it objectively measured?
2. Assuming not every current "healthcare professional" meets that standard, there would be an immediate staffing crisis.
Apart from that, it's surefire winner...
1.Fairly easy even for a numpty like you , people need to understand what they are saying in English and they need to be able to understand people speaking in English to them 2. Just proves the point , hoe the F*** do you get a job in healthcare if you cannot speak and understand people in their language.
Does that mean those with a broad scots accent can't leave the homeland?:) ... if they want to work in healthcare.
Re - doctors speaking English. When I was a child I got referred to the family GP as the doctor who had done a check-up at my school had identified I had hearing problems. In reality I just couldn't understand his indian accent at all.
Haven't sporting either made a rick or were very cautious with their opening spread sizes?
If you look at the opening prices compared to now the Tories are up 5 and everyone else cancels each other out
The mid point is 633 allowing only 17 for NI, Plaid, green, respect and the speaker
So selling all if them at 623 is almost a bet.. Selling a combination of the big parties must be value
If you sell con lab and LD at 588 you are buying the others at 62
Assuming green respect and speaker as well as NI Parties and Plaid hold their seats, you'd be buying SNP and Ukip at 36 I think, which is better than current buy of (40?)
Lot of assumptions there though esp NI and Wales
That does seem to be a good bet - but it very much depends on whether you have a SPIN credit account.
2. You would need to put a training programme into place. It would be a bit stupid* to expect everyone to come up to scratch immediately you changed the rules, and you would probably have problems with employment law when you tried to fire them.
And the party political axe grinding rumbles on... rather than say engaging with the issue, and the concern of the voters. Shouting at voters and telling them that they must believe you because you are right, works every time....
Actually the problem with what Farage is saying is that in large parts of London, Newham & Tower Hamlets for instance, a big percentage the patients can barely speak English, and it would be better if the doctors spoke Bengali or Urdu
If you have a segregated and ghettoised city, the health professionals must reflect that... vibrant diversity
2. You would need to put a training programme into place. It would be a bit stupid* to expect everyone to come up to scratch immediately you changed the rules, and you would probably have problems with employment law when you tried to fire them.
And the party political axe grinding rumbles on... rather than say engaging with the issue, and the concern of the voters. Shouting at voters and telling them that they must believe you because you are right, works every time....
Don't worry. Give him a few days and Farage will be saying it was all nonsense.
I'm not worried about Farage, I am not going to vote for him. I am worried about the Conservatives thinking that trying to rubbish Farage is a substitute for having a policy which meets the concerns of the electorate.
Finally as a Christian, I think a lot of the 60s and subsequent reforms were a ghastly mistake or worse, particuarly easy divorce and abortion, and the current push to make women with under 5's work will cause catastrophic damage to society. I think its a typical example of middle class people forcing their aspirations onto the working class. Also, the idea of people identifying themselves and having privileges (including legal privileges) due to the minority they are in or identify with scandalises me. As a Catholic I am more than happy for a multi racial society but multiculturalism and its associated greviance mongering is the road to Srebrenica.
I think that the Conservatives will be shocked in May as to how many of their voters in recent years were not that enamored with tory party policy but voted for them due to the above paragraph and now will vote UKIP.
Yes, I'm tending that way currently for the reasons you say.
Nobody anywhere offers instant results for everyone; the question is how close we get, how much we're willing to pay for it collectively and how far we want to leave it to individuals and companies.
The NHS is pretty damn good at critical emergency treatment and always has been - managements rightly prioritise someone teeetering on the brink of death but savable over everything else. There's a current serious issue over slower ambulance response times, but otherwise I'm not worried about this.
The NHS will also offer a choice under the much-maligned Choose & Book system between convenience and speed. When I needed a quick check in 2009 for an alarming symptom (false alam, as it turned out), I looked up my local hospitals online and found that I could get checked almost immediately if I went to Derby, but it'd take a week if I waited for my then local hospital in Nottingham. I went to Derby like a shot; others might have chosen to wait for their familiar local place. This sort of thing is a good idea which tends to even out waiting times, and the reason it's perhaps not generally known is that most patients aren't that computer-friendly and some GPs don't like to bother to do the survey of local choices as they're supposed to (I think this is something the practice nurse should do).
Where I differ up to a point from Fox is in his opposition to capped waiting times, especially for A&E. I can see that from the professional viewpoint it forces suboptimal decisions - see the bloke with a broken toenail because he's been waiting 4 hours. But predictability is very important to many patients. I know someone with panic attacks who makes life-threatening decisions not to go to A&E when she has an asthma attack because she thinks that she may have to wait an UNKNOWN period in the generally stressed conditions of an A&E waiting room.
You still haven't answered the point about benchmarking procedures - such as my hypothetical knee op - and seeing how we compare with other jurisdictions. elsewhere. I suspect you know we wouldn't compare very well. Choose and Book seems a great idea, but your GP shouldn't be doing it - he's paid too much and should be treating patients. Ditto the practice nurse. I almost think patients should be referred to an administrative process to guide you through booking your hospital visit. And I don't see why "local" is necessary. I once had to wait several months for an MRI scan on a knee, I almost paid for it myself but as I seemed to be getting better very slowly I didn't bother in the end. In the end I had great treatment (it was a private facility contracted to the NHS and they obviously treated everyone the same) but I would have quite happily have travelled quite a distance to have it done, to speed it up.
The country needs instant results. People need instant results - or they will lose their jobs and might end up on long term benefits. The business might not need the instant result, they can recruit someone else. The question remains: how do other jurisdictions manage it? Of course you can't ask that question as "not invented here" holds particularly strongly when it comes to the NHS. I am not sure that the NHS manages capacity very well, if I need said operation I am happy to go anywhere in the country to have it.
Nobody anywhere offers instant results for everyone; the question is how close we get, how much we're willing to pay for it collectively and how far we want to leave it to individuals and companies.
The NHS is pretty damn good at critical emergency treatment and always has been - managements rightly prioritise someone teeetering on the brink of death but savable over everything else. There's a current serious issue over slower ambulance response times, but otherwise I'm not worried about this.
Where I differ up to a point from Fox is in his opposition to capped waiting times, especially for A&E. I can see that from the professional viewpoint it forces suboptimal decisions - see the bloke with a broken toenail because he's been waiting 4 hours. But predictability is very important to many patients. I know someone with panic attacks who makes life-threatening decisions not to go to A&E when she has an asthma attack because she thinks that she may have to wait an UNKNOWN period in the generally stressed conditions of an A&E waiting room.
I am not opposed to targets as such, but they do distort clinical priorities.
If you look at your local statistics you will see a sharp rise in admissions in patients about to breach the four hour rule. Some may have been waiting for a bed, but others will be admitted to prevent a breach.
The rule also tends to prevent the admitting team to focus on new arrivals rather than the patients that they admitted earlier in the day. Often admitted patients go a few hours before anything further is done, including discharge.
It seems to me that Labour being the largest party is increasingly nailed on with the risk of an Ed majority clearly increasing. I have been very interested in following Professor Fisher's model although largely because it has not worked. What it has shown was given the starting point nearly a year ago the Tories were on course for a comfortable majority. Labour had never got close to a large enough lead to win.
What we have seen since is a failure of the swingback model. The Tories have not made progress and the projection from each starting point is less favourable to them. So we have over the last year moved from a comfortable Tory majority to NOC to Labour as the largest party. In my opinion people like Audreyanne are whistling in the dark. With the starting point of today Labour wins. Only Scotland raises a serious question mark about that majority. But it is a brave man or woman who is now betting on anyone else being the largest party.
Probably worth adding the although RodCrosby isn't advocating for it much at the moment, using his _by-election_ swingback model in mid-term would have been a pretty good predictor of where the polls are pointing us now, with maybe a little bit more swingback yet to come.
Fisher's polling swingback thing was always a bit mad, because half the data he fed into the model came from before the pollsters made a bunch of changes to stop it swinging (then swinging back) as much, so the same tendency in old polls to overstate mid-term swing was getting corrected for twice.
Seeing the Consultant does not constitute treatment, the surgery does (assuming that is the appropriate treatment). 18 weeks from referral to treatment means what it says. Our unit runs at 92% RTT. The other 8% are treated consecutively so generally not more than a week or two over.
We have a weekly planning meeting within our department where we look at all those more than 13 weeks into the pathway and allocate appropriate dates.
If your local hospital is gaming the system then report it to the CQC.
Thanks for the information, actually that's quite useful (and apologies if you think I was poking with a stick). If a patient doesn't get treated within 18 weeks, what should they do? CQC?
In the first place I would suggest contacting the Hospital PILS department (Patient Information and Liasion Service) who should get a reply from the departmental management.
The 18 week rule does throw up curiosities; we have a number of patients who winter in Spain or Gujerat, and have to be discharged and re-referred when they are back in Blighty. The rules do not allow me to set a date shortly after their return, unless it is within 18 weeks...
I would have thought it would be cheaper to pay for them to have treatment in Gujarat!
For every party, and especially* for Labour, this election is all about the Tories. But once they've stopped the Tories, what then? The uncommitted centreground will see there's no alternative prospectus on offer, that it's all "sound and fury, signifying nothing".
Doc, I don't know whether you saw the article by Robert Colville in the Telegraph the other day, or if you did what you think of it. I found it the most informative and interesting piece I have read about the NHS in a very long time.
A very good article. We have much the same issues in Leicester with the busiest Emergency dept and the next nearest Hospital 30 miles away not easy to divert.
There is no simple solution, and to manage those emergencies the QE had to cancel elective surgery such as JohnL's knee replacement.
The problem is mostly one of lack of capacity and lack of trained staff.
On another point: We have sometimes employed locums whose English struggled with local dialect and accents. The alternative was employing no one and closing down services. No one is happy to do so, but what choice do we have. Undergraduate med school places are being cut next year, as are postgraduate training places. We train far too few nurses also. It is a failure of linked up government. Cut immigration by training Britons, simples!
Do enough people want to be nurses? Having moved to a University training model, you have to live on thin air for three years and have a loan to pay back. If you are going to do that, you might as well do something else (lets face it, nursing for some reason is a profession without high status in this country). Back in the day... when you wanted to be a student nurse you were effectively taken on as a nursing assistant and received a wage while you were trained. I can understand wanting to increase the academic status and intellectual rigour of nurse training, but I think they threw out the baby with the bathwater.
There were 100 000 applicants for 20 000 Nursing places last year, so there are the numbers out there interested.
I would tie Nursing bursaries and Medical bursaries to NHS service, with student debts being wiped clean after 5 and ten years respectively, if I was directing policy in these areas.
That seems reasonable. I have always thought that the Government should offer state scholarships or bursaries for students prepared to study in areas where there is a social need for the graduates and the "free market" of fee-paying courses doesn't provide it.
Re - doctors speaking English. When I was a child I got referred to the family GP as the doctor who had done a check-up at my school had identified I had hearing problems. In reality I just couldn't understand his indian accent at all.
I thought there was already a process for identifying applicants for NHS posts English skills? If I’m not much in error the GMC have a policy on the matter.
For every party, and especially* for Labour, this election is all about the Tories. But once they've stopped the Tories, what then? The uncommitted centreground will see there's no alternative prospectus on offer, that it's all "sound and fury, signifying nothing".
* But even more so the SNP!
For the Tories its seems to be all about UKIP, which is very odd since most of UKIP supports are left-leaners, and either ex-Labour, ex-NOTA or ex-DNV, and in any case they are going to get half a dozen seats.
This hatred is blinding them to the danger that Labour might take 50+ seats off them, complacency about Ed being crap (which he is, but many of the electorate may feel he is "not as crap as all that") is making them take their eye off the ball, and amuse themselves by rubbishing Farage, rather than coming up with policies that might appeal to the electorate, real policies, not gimmicks that collapse before the speaker has left the stage.
Doc, I don't know whether you saw the article by Robert Colville in the Telegraph the other day, or if you did what you think of it. I found it the most informative and interesting piece I have read about the NHS in a very long time.
A very good article. We have much the same issues in Leicester with the busiest Emergency dept and the next nearest Hospital 30 miles away not easy to divert.
There is no simple solution, and to manage those emergencies the QE had to cancel elective surgery such as JohnL's knee replacement.
The problem is mostly one of lack of capacity and lack of trained staff.
On another point: We have sometimes employed locums whose English struggled with local dialect and accents. The alternative was employing no one and closing down services. No one is happy to do so, but what choice do we have. Undergraduate med school places are being cut next year, as are postgraduate training places. We train far too few nurses also. It is a failure of linked up government. Cut immigration by training Britons, simples!
Do enough people want to be nurses? Having moved to a University training model, you have to live on thin air for three years and have a loan to pay back. If you are going to do that, you might as well do something else (lets face it, nursing for some reason is a profession without high status in this country). Back in the day... when you wanted to be a student nurse you were effectively taken on as a nursing assistant and received a wage while you were trained. I can understand wanting to increase the academic status and intellectual rigour of nurse training, but I think they threw out the baby with the bathwater.
There were 100 000 applicants for 20 000 Nursing places last year, so there are the numbers out there interested.
I would tie Nursing bursaries and Medical bursaries to NHS service, with student debts being wiped clean after 5 and ten years respectively, if I was directing policy in these areas.
That seems reasonable. I have always thought that the Government should offer state scholarships or bursaries for students prepared to study in areas where there is a social need for the graduates and the "free market" of fee-paying courses doesn't provide it.
O/T I watched.. The Theory of Everything ..last night .. brilliant
Yep.Eddie Redmayne is exceptional in a rather underwhelming awards season. He will get the BAFTA and at least a nomination for an Oscar.
Underwhelming apart from three acclaimed British biopics: TToE (Redmayne as Stephen Hawking); Mr Turner (Timothy Spall as JMWTurner); and The Imitation Game (Benedict Cumberbatch as Alan Turing).
They might split the vote and winning nothing, especially at the Oscars.
Of course the imitation game perpetuates the myth Turing killed himself, as invented by gay activist Andrew Hodges. Actually both his mother and Jack Copeland, who directs the Turing archive, think he accidentally poisoned himself whilst experimenting with gold electroplating.
There were 100 000 applicants for 20 000 Nursing places last year, so there are the numbers out there interested.
I would tie Nursing bursaries and Medical bursaries to NHS service, with student debts being wiped clean after 5 and ten years respectively, if I was directing policy in these areas.
That seems reasonable. I have always thought that the Government should offer state scholarships or bursaries for students prepared to study in areas where there is a social need for the graduates and the "free market" of fee-paying courses doesn't provide it.
Aren't UKIP proposing this?
Who knows?
– Subject to academic performance UKIP will remove tuition fees for students taking approved degrees in science, medicine, technology, engineering, maths on the condition that they live, work and pay tax in the UK for five years after the completion of their degrees.
O/T I watched.. The Theory of Everything ..last night .. brilliant
Yep.Eddie Redmayne is exceptional in a rather underwhelming awards season. He will get the BAFTA and at least a nomination for an Oscar.
Underwhelming apart from three acclaimed British biopics: TToE (Redmayne as Stephen Hawking); Mr Turner (Timothy Spall as JMWTurner); and The Imitation Game (Benedict Cumberbatch as Alan Turing).
They might split the vote and winning nothing, especially at the Oscars.
Of course the imitation game perpetuates the myth Turing killed himself, as invented by gay activist Andrew Hodges. Actually both his mother and Jack Copeland, who directs the Turing archive, think he accidentally poisoned himself whilst experimenting with gold electroplating.
Of course all three films sound incredibly dull and I shan't be seeing any.
None of them are in any way dull and all three performances deserve awards as far as I am concerned. But they do require a degree of intelligence and interest in intellectual matters from the audience. So you may well be wise to give them a miss.
You still haven't answered the point about benchmarking procedures - such as my hypothetical knee op - and seeing how we compare with other jurisdictions. elsewhere. I suspect you know we wouldn't compare very well. Choose and Book seems a great idea, but your GP shouldn't be doing it - he's paid too much and should be treating patients. Ditto the practice nurse. I almost think patients should be referred to an administrative process to guide you through booking your hospital visit. And I don't see why "local" is necessary. I once had to wait several months for an MRI scan on a knee, I almost paid for it myself but as I seemed to be getting better very slowly I didn't bother in the end. In the end I had great treatment (it was a private facility contracted to the NHS and they obviously treated everyone the same) but I would have quite happily have travelled quite a distance to have it done, to speed it up.
As I recall (may have changed, Fox will know), Choose and Book does have a telephone referral option through an administrative centre. The reason I think practice nurses should do it is that otherwise it puts the burden on the patient to sort it out. Some patients are proactive, fluent and on top of things. Some are not.
There isn't any need to be local - that was my point, and facilitating non-local choice was one of the things that the last government did well. If the only place you can get a good operation for your needs is John O'Groats, the NHS will offer you an operation there. However, the computer system is foicused on regions and finding out about operations further afield requires a manual search, e.g. by your local practice.
Benchmarks - I'm not in a position to offer an instant global survey of all international standards in every kind of health care! Perhaps others can help. My subjective impression from living in various countries is that most systems in the West offer a comparably prompt service for people with insurance in place (which outside the US is basically everyone). Other countries do pay more attention than we do to pleasantness of surroundings (I remember a Swiss holiday when I broke my arm - the hospital room was shared with three people, but nonetheless far nicer than my hotel, with a spectacular mountain view and tasty food), but I don't actually think that the health care is that different - certainly the outcomes in terms of life expectancy are remarkably similar.
O/T I watched.. The Theory of Everything ..last night .. brilliant
Yep.Eddie Redmayne is exceptional in a rather underwhelming awards season. He will get the BAFTA and at least a nomination for an Oscar.
Underwhelming apart from three acclaimed British biopics: TToE (Redmayne as Stephen Hawking); Mr Turner (Timothy Spall as JMWTurner); and The Imitation Game (Benedict Cumberbatch as Alan Turing).
They might split the vote and winning nothing, especially at the Oscars.
I would add another brilliant peformance by Ralph Fiennes in Grand Budapest Hotel. One of the best and driest comic turns I have seen in years. And the film is probably my highlight of the year as well against some pretty high competition.
Haven't sporting either made a rick or were very cautious with their opening spread sizes?
If you look at the opening prices compared to now the Tories are up 5 and everyone else cancels each other out
The mid point is 633 allowing only 17 for NI, Plaid, green, respect and the speaker
So selling all if them at 623 is almost a bet.. Selling a combination of the big parties must be value
If you sell con lab and LD at 588 you are buying the others at 62
Assuming green respect and speaker as well as NI Parties and Plaid hold their seats, you'd be buying SNP and Ukip at 36 I think, which is better than current buy of (40?)
Lot of assumptions there though esp NI and Wales
That does seem to be a good bet - but it very much depends on whether you have a SPIN credit account.
Good spot.
No account at all alas, but still like to work it out and see If there is any value!
O/T I watched.. The Theory of Everything ..last night .. brilliant
Yep.Eddie Redmayne is exceptional in a rather underwhelming awards season. He will get the BAFTA and at least a nomination for an Oscar.
Underwhelming apart from three acclaimed British biopics: TToE (Redmayne as Stephen Hawking); Mr Turner (Timothy Spall as JMWTurner); and The Imitation Game (Benedict Cumberbatch as Alan Turing).
They might split the vote and winning nothing, especially at the Oscars.
Of course the imitation game perpetuates the myth Turing killed himself, as invented by gay activist Andrew Hodges. Actually both his mother and Jack Copeland, who directs the Turing archive, think he accidentally poisoned himself whilst experimenting with gold electroplating.
Not quite, an inquest delivered a verdict of suicide so hardly "invented by gay activist Andrew Hodges". There is the alternative theory, that he conducted the experiment to provide plausible deniability. In any case, you don't have to be a "gay activist" to believe that he was treated shamefully (especially as lots of much more famous people got away with what was termed "indecency" at the time).
Charles Of course it is perfectly possible Paul could win Iowa, Christie New Hampshire and Cruz South Carolina rather throwing a spanner in any Jeb Bush, Huckabee plans if there are any
O/T I watched.. The Theory of Everything ..last night .. brilliant
Yep.Eddie Redmayne is exceptional in a rather underwhelming awards season. He will get the BAFTA and at least a nomination for an Oscar.
Underwhelming apart from three acclaimed British biopics: TToE (Redmayne as Stephen Hawking); Mr Turner (Timothy Spall as JMWTurner); and The Imitation Game (Benedict Cumberbatch as Alan Turing).
They might split the vote and winning nothing, especially at the Oscars.
Of course the imitation game perpetuates the myth Turing killed himself, as invented by gay activist Andrew Hodges. Actually both his mother and Jack Copeland, who directs the Turing archive, think he accidentally poisoned himself whilst experimenting with gold electroplating.
Of course all three films sound incredibly dull and I shan't be seeing any.
It is hard to see how suicide advances a gay agenda. If it was an accident, then it was a remarkable coincidence that Turing had previously spoken of committing suicide in just that manner. If it was suicide, then presumably Turing made it look like a plausible accident to shield his mother. However, since the police did not even test the apple for cyanide, we cannot be certain either way.
As I recall (may have changed, Fox will know), Choose and Book does have a telephone referral option through an administrative centre. The reason I think practice nurses should do it is that otherwise it puts the burden on the patient to sort it out. Some patients are proactive, fluent and on top of things. Some are not.
And that probably correlates with those who get good treatment by the NHS, and those who don't. Some people seem to need an advocate within the system. And if you are suffering from depression, for example, by definition you will not be "proactive, fluent and on top of things"
There isn't any need to be local - that was my point, and facilitating non-local choice was one of the things that the last government did well. If the only place you can get a good operation for your needs is John O'Groats, the NHS will offer you an operation there. However, the computer system is foicused on regions and finding out about operations further afield requires a manual search, e.g. by your local practice.
Surely it would be just as easy to make the computer system national?
Benchmarks - I'm not in a position to offer an instant global survey of all international standards in every kind of health care! Perhaps others can help. My subjective impression from living in various countries is that most systems in the West offer a comparably prompt service for people with insurance in place (which outside the US is basically everyone).
I am surprised. How do you manage a national health system if you cannot benchmark it against systems elsewhere? You have no idea how well you are doing. The study should be done and every politician should have it to hand
I don't actually think that the health care is that different - certainly the outcomes in terms of life expectancy are remarkably similar.
Life expectancy doesn't tell you everything, you would be unlikely to die of my hypothetical knee problem, for example.
Tom Newton Dunn (@tnewtondunn) 04/01/2015 09:49 Cameron insists on #Marr that his EU migrant benefits reforms will achieve an overall cap on arrivals. Total garbage and he knows it.
Presumably he can tell us what number that effective cap would be at?
Re - doctors speaking English. When I was a child I got referred to the family GP as the doctor who had done a check-up at my school had identified I had hearing problems. In reality I just couldn't understand his indian accent at all.
I thought there was already a process for identifying applicants for NHS posts English skills? If I’m not much in error the GMC have a policy on the matter.
The chap could speak English and I'm sure he had all the relevant qualifications. Just that a shy 7 year child who had never come across his accent before couldn't readily follow his instructions.
Re the two German votes on the ECB council. Jens Weidmann doesn't take his orders from Angel Merkel, the Bundesbank is fully independent.
However, I think there is a general view - even from the most QE sympathetic members of the council - that doing something that was outright opposed by both the Bundesbank and the Germany government would be A Bad Thing (TM). ECB council members (with the possible exception of Herr Doktor Weidmann) don't want to precipitate the breakup of the Euro, and therefore they wish to keep the German government on-side.
For that reason, I think it is unlikely that the ECB Council would propose any form of QE that it did not expect publicly approved by Germany.
Fun and games, if it transpires that immigrant workers written and spoken Englsh is better than that of the indigenous NHS staff.
As a Conservative thats fine with me, I want physicians that understand patients, incoherent white anglo saxon doctors are just as useless to me, although it seems unlikely they would have made if through a British medical school in that condition.
Fun and games, if it transpires that immigrant workers written and spoken Englsh is better than that of the indigenous NHS staff.
I have twice had cause to complain in the last 10 years about doctors I couldn't understand. One was a genuine case of a Polish doctor whose English was frankly (and surprisingly) atrocious. The other was an English doctor who mumbled so badly and so quietly that no one could understand what he was saying.
In both cases there had been numerous complaints against the doctors concerned. In the end all that matters is that the doctor can communicate clearly and effectively with the patient and understands in return what the patient is trying to say.
Fun and games, if it transpires that immigrant workers written and spoken Englsh is better than that of the indigenous NHS staff.
I have twice had cause to complain in the last 10 years about doctors I couldn't understand. One was a genuine case of a Polish doctor whose English was frankly (and surprisingly) atrocious. The other was an English doctor who mumbled so badly and so quietly that no one could understand what he was saying.
In both cases there had been numerous complaints against the doctors concerned. In the end all that matters is that the doctor can communicate clearly and effectively with the patient and understands in return what the patient is trying to say.
Since time immemorial hasn't doctors' handwriting been more of a worry?
Fun and games, if it transpires that immigrant workers written and spoken Englsh is better than that of the indigenous NHS staff.
I have twice had cause to complain in the last 10 years about doctors I couldn't understand. One was a genuine case of a Polish doctor whose English was frankly (and surprisingly) atrocious. The other was an English doctor who mumbled so badly and so quietly that no one could understand what he was saying.
In both cases there had been numerous complaints against the doctors concerned. In the end all that matters is that the doctor can communicate clearly and effectively with the patient and understands in return what the patient is trying to say.
Since time immemorial hasn't doctors' handwriting been more of a worry?
A lot of that is down to the abbreviations they use, which are aimed at the pharmacist and not you.
Tom Newton Dunn (@tnewtondunn) 04/01/2015 09:49 Cameron insists on #Marr that his EU migrant benefits reforms will achieve an overall cap on arrivals. Total garbage and he knows it.
Presumably he can tell us what number that effective cap would be at?
Re the two German votes on the ECB council. Jens Weidmann doesn't take his orders from Angel Merkel, the Bundesbank is fully independent.
However, I think there is a general view - even from the most QE sympathetic members of the council - that doing something that was outright opposed by both the Bundesbank and the Germany government would be A Bad Thing (TM). ECB council members (with the possible exception of Herr Doktor Weidmann) don't want to precipitate the breakup of the Euro, and therefore they wish to keep the German government on-side.
For that reason, I think it is unlikely that the ECB Council would propose any form of QE that it did not expect publicly approved by Germany.
I wouldn't argue with any of that. However, if no policy can be implemented that does not carry the seal of Germany's approval then the system is being run by Germany and the idea of votes on the council is a nonsense.
Re - doctors speaking English. When I was a child I got referred to the family GP as the doctor who had done a check-up at my school had identified I had hearing problems. In reality I just couldn't understand his indian accent at all.
I thought there was already a process for identifying applicants for NHS posts English skills? If I’m not much in error the GMC have a policy on the matter.
The chap could speak English and I'm sure he had all the relevant qualifications. Just that a shy 7 year child who had never come across his accent before couldn't readily follow his instructions.
In my very early pharmaceutical days I sometimes worked in Oldham. Could be difficult for someone with an Essex accent.
I can't see anything wrong with "healthcare professionals" having to speak perfect English in England. Can you?
In Nige's fantasy land of soundbite politics there would be no problem.
Here in the Real World there are at least 2 practical issues
1. What is the definition of "perfect English" and how is it objectively measured?
2. Assuming not every current "healthcare professional" meets that standard, there would be an immediate staffing crisis.
Apart from that, it's surefire winner...
1.Fairly easy even for a numpty like you , people need to understand what they are saying in English and they need to be able to understand people speaking in English to them 2. Just proves the point , hoe the F*** do you get a job in healthcare if you cannot speak and understand people in their language.
Does that mean those with a broad scots accent can't leave the homeland?:) ... if they want to work in healthcare.
Most people can be recognised and anyone trained as nurse/doctor would be 100% sure. A broad Scots accent is usually at least as easy to understand and often more easy than broad "English" accents. There are many "English" people supposedly speaking English whom I could not understand.
O/T I watched.. The Theory of Everything ..last night .. brilliant
Yep.Eddie Redmayne is exceptional in a rather underwhelming awards season. He will get the BAFTA and at least a nomination for an Oscar.
Underwhelming apart from three acclaimed British biopics: TToE (Redmayne as Stephen Hawking); Mr Turner (Timothy Spall as JMWTurner); and The Imitation Game (Benedict Cumberbatch as Alan Turing).
They might split the vote and winning nothing, especially at the Oscars.
I would add another brilliant peformance by Ralph Fiennes in Grand Budapest Hotel. One of the best and driest comic turns I have seen in years. And the film is probably my highlight of the year as well against some pretty high competition.
Grand Budapest might just be my favourite film of the 2010s so far, alongside 12 Years a Slave and The Lego Movie.
I'm going to see Birdman tomorrow,
Mentioned in Despatches: I watched Dawn of the Planet of the Apes last night, it is surprisingly good, if not a masterpiece. It is also, I realised (halfway through), a clever allegory of ISIS.
A menacing but dim species suddenly evolves and develops advanced intelligence. Their hostility/cleverness is spawned by "western" meddling. They progress by stealing "our" technology, learning how to use it, and turn it against us, with frightening speed.
The apes are ISIS.
ISIS don't have the assault rifles that never need reloading, though. That's got to be a bonus, when you're riding a horse at breakneck speed, whilst firing two machine guns on full automatic.
Fun and games, if it transpires that immigrant workers written and spoken Englsh is better than that of the indigenous NHS staff.
I have twice had cause to complain in the last 10 years about doctors I couldn't understand. One was a genuine case of a Polish doctor whose English was frankly (and surprisingly) atrocious. The other was an English doctor who mumbled so badly and so quietly that no one could understand what he was saying.
In both cases there had been numerous complaints against the doctors concerned. In the end all that matters is that the doctor can communicate clearly and effectively with the patient and understands in return what the patient is trying to say.
Since time immemorial hasn't doctors' handwriting been more of a worry?
A lot of that is down to the abbreviations they use, which are aimed at the pharmacist and not you.
It is a shame that OldKingCole is not around this morning to comment on that - he being a retired pharmacist. I seem to recall a few weeks ago he mentioned an exam he had to pass which was about correctly interpreting the doctors' instructions on prescription notes. The pass mark was 80%, which I found worryingly low.
Edit: speak of the Devil and he shall appear, the good Mr. Cole is with us.
O/T I watched.. The Theory of Everything ..last night .. brilliant
Yep.Eddie Redmayne is exceptional in a rather underwhelming awards season. He will get the BAFTA and at least a nomination for an Oscar.
Underwhelming apart from three acclaimed British biopics: TToE (Redmayne as Stephen Hawking); Mr Turner (Timothy Spall as JMWTurner); and The Imitation Game (Benedict Cumberbatch as Alan Turing).
They might split the vote and winning nothing, especially at the Oscars.
I would add another brilliant peformance by Ralph Fiennes in Grand Budapest Hotel. One of the best and driest comic turns I have seen in years. And the film is probably my highlight of the year as well against some pretty high competition.
Grand Budapest might just be my favourite film of the 2010s so far, alongside 12 Years a Slave and The Lego Movie.
I'm going to see Birdman tomorrow,
Mentioned in Despatches: I watched Dawn of the Planet of the Apes last night, it is surprisingly good, if not a masterpiece. It is also, I realised (halfway through), a clever allegory of ISIS.
A menacing but dim species suddenly evolves and develops advanced intelligence. Their hostility/cleverness is spawned by "western" meddling. They progress by stealing "our" technology, learning how to use it, and turn it against us, with frightening speed.
Doc, I don't know whether you saw the article by Robert Colville in the Telegraph the other day, or if you did what you think of it. I found it the most informative and interesting piece I have read about the NHS in a very long time.
A very good article. We have much the same issues in Leicester with the busiest Emergency dept and the next nearest Hospital 30 miles away not easy to divert.
There is no simple solution, and to manage those emergencies the QE had to cancel elective surgery such as JohnL's knee replacement.
The problem is mostly one of lack of capacity and lack of trained staff.
On another point: We have sometimes employed locums whose English struggled with local dialect and accents. The alternative was employing no one and closing down services. No one is happy to do so, but what choice do we have. Undergraduate med school places are being cut next year, as are postgraduate training places. We train far too few nurses also. It is a failure of linked up government. Cut immigration by training Britons, simples!
Do enough people want to be nurses? Having moved to a University training model, you have to live on thin air for three years and have a loan to pay back. If you are going to do that, you might as well do something else (lets face it, nursing for some reason is a profession without high status in this country). Back in the day... when you wanted to be a student nurse you were effectively taken on as a nursing assistant and received a wage while you were trained. I can understand wanting to increase the academic status and intellectual rigour of nurse training, but I think they threw out the baby with the bathwater.
Reminds me of the unnecessary distortions caused by pressures on young people to go to uni rather than take a quality apprenticeship (if they can find one).
The idea that there was no NHS in the 1930s, is a bit of a deception. Most parts of the UK had county run health services with much the same principals, the London County Council was the worlds largest health provider. Those who could afford to had to contribute (just like we still do with dentists and prescriptions) but no one was turned away because of lack of money.
Labour IMHO made a historic mistake by nationalising. The problem was that some counties were too small/unwilling to do it properly. They should have replaced the smaller counties with merged larger counties and left the "NHS" with them with minimum service levels imposed. Then health would have been in the hands of elected officials not regional health board quangos.
The other thing they did was quasi nationalise GPs which I also think was a mistake which leaves us in many ways with the worst of both worlds. This didn't happen with dentists and everyone (who is deemed to be able to afford to) happily pays £18 for a check up. But more importantly , I have a dentist, who always treats me and I can build a relationship with, which sadly is no longer the case with GPs. I would be happy to pay £20 a visit to a GP if it meant better service and being able to choose who my doctor is like I can with my dentist.
However the idea that before the NHS the UK was like the USA is now is a canard and one that the Tories would be well advised to put to rest if they ever want serious health reform
Doc, I don't know whether you saw the article by Robert Colville in the Telegraph the other day, or if you did what you think of it. I found it the most informative and interesting piece I have read about the NHS in a very long time.
A very good article. We have much the same issues in Leicester with the busiest Emergency dept and the next nearest Hospital 30 miles away not easy to divert.
There is no simple solution, and to manage those emergencies the QE had to cancel elective surgery such as JohnL's knee replacement.
The problem is mostly one of lack of capacity and lack of trained staff.
On another point: We have sometimes employed locums whose English struggled with local dialect and accents. The alternative was employing no one and closing down services. No one is happy to do so, but what choice do we have. Undergraduate med school places are being cut next year, as are postgraduate training places. We train far too few nurses also. It is a failure of linked up government. Cut immigration by training Britons, simples!
Do enough people want to be nurses? Having moved to a University training model, you have to live on thin air for three years and have a loan to pay back. If you are going to do that, you might as well do something else (lets face it, nursing for some reason is a profession without high status in this country). Back in the day... when you wanted to be a student nurse you were effectively taken on as a nursing assistant and received a wage while you were trained. I can understand wanting to increase the academic status and intellectual rigour of nurse training, but I think they threw out the baby with the bathwater.
Reminds me of the unnecessary distortions caused by pressures on young people to go to uni rather than take a quality apprenticeship (if they can find one).
There appears to be some issue with professional insurance that really screws up apprenticeships in practise. A friend of mine did all the NVQ plumbing courses, but was told he needed to serve an apprenticeship with a qualified plumber to complete his training. Asking around a number of well regarded local plumbers he was told that taking on an apprentice so increased their professional liability insurance that it made the whole exercise a financial nonsense to them.
I see Janet Daley is predicting a small Tory majority at the election. I'm guessing the Tories would probably need a 12% lead over Labour in England to make that happen. Variable swings could hep a little but it sounds optimistic to say the least. OGH is right. Betting on Tory seats is most sensible. Polls currently suggest around 250. If you expect governments to recover before the election, then maybe 270 is more realistic.
As a former nurse, and one who has worked in a A&E department during my training, and who also worked in a Respiratory Unit as a staff nurse for a time. I find it incredible that anyone who become distressed and then suffered an asthma attack would ever be left languishing in an A&E waiting room if they needed urgent medical attention. There is a hell of a lot that goes on out with the waiting area of an A&E department, and serious emergencies must always take precedence over more minor complaints. And capped waiting times should not ever take precedence over staff being given the appropriate time and care to treat each individual patient who comes in the door.
The country needs instant results. People need instant results - or they will lose their jobs and might end up on long term benefits. The business might not need the instant result, they can recruit someone else. The question remains: how do other jurisdictions manage it? Of course you can't ask that question as "not invented here" holds particularly strongly when it comes to the NHS. I am not sure that the NHS manages capacity very well, if I need said operation I am happy to go anywhere in the country to have it.
Where I differ up to a point from Fox is in his opposition to capped waiting times, especially for A&E. I can see that from the professional viewpoint it forces suboptimal decisions - see the bloke with a broken toenail because he's been waiting 4 hours. But predictability is very important to many patients. I know someone with panic attacks who makes life-threatening decisions not to go to A&E when she has an asthma attack because she thinks that she may have to wait an UNKNOWN period in the generally stressed conditions of an A&E waiting room.
O/T I watched.. The Theory of Everything ..last night .. brilliant
Yep.Eddie Redmayne is exceptional in a rather underwhelming awards season. He will get the BAFTA and at least a nomination for an Oscar.
Underwhelming apart from three acclaimed British biopics: TToE (Redmayne as Stephen Hawking); Mr Turner (Timothy Spall as JMWTurner); and The Imitation Game (Benedict Cumberbatch as Alan Turing).
They might split the vote and winning nothing, especially at the Oscars.
I would add another brilliant peformance by Ralph Fiennes in Grand Budapest Hotel. One of the best and driest comic turns I have seen in years. And the film is probably my highlight of the year as well against some pretty high competition.
Grand Budapest might just be my favourite film of the 2010s so far, alongside 12 Years a Slave and The Lego Movie.
I.
I agree about Grand Budapest Hotel, and likewise with Richard Tyndall on this: it's a brilliant performance from Ralph Fiennes. He has been in storming form lately. The performance as Voldemort in the final HP was breathtaking. He does a damned good cameo as Gareth Mallory in Skyfall. But it's wonderful to see him turning in such a genius comic performance in G.Budapest. Superb and huge fun.
I thought The Hobbit pt 3 (or is it 4?) was pretty rubbish to be honest, unless you like 2.5 hours of fighting with almost no plot.
Am going to have to watch Interstellar very soon as everyone I know who has seen it has been raving. Which is always a bad sign. Bound to be a let-down, but will drag myself along.
And that probably correlates with those who get good treatment by the NHS, and those who don't. Some people seem to need an advocate within the system. And if you are suffering from depression, for example, by definition you will not be "proactive, fluent and on top of things"
Yes, and that's a more general issue. I deliberately signed on at the Job Centre after losing my seat to see how the system worked. Up to a point it was OK, but only if you really understood the system and were comfortable with filling out complex forms. I'd think that many people on JSA don't easily meet both those conditions.
This is an area where it's genuinely true that senior politicians tend to be out of touch. Lots of things in Britain work perfectly well if you know the ropes - and I don't mean taking naughty short cuts or using influence, just carefully going through the required procedures. But there is very little proactive support for people who aren't on top of their game - suffering from depression, for instance, as you say - and what support there is you generally have to go and look for yourself, which by definition you're not very able to do.
That's why MPs' advice surgeries are filled with people asking for personal help. I was able to help a lot of people with entirely non-political stuff; they came to me because they'd heard that I was helpful and they didn't know who else to go to. CAB are supposed to fill the gap, and they do a good job as far as they can, but they are overloaded and short of firepower when what's needed is a sharp phone call demanding that X's problem is given proper attention.
Only a tw*t like you could take that from the story, did you even read it
Salmond was strutting around thinking he had won by 14pts - making plans for government - based on some Canadian outsiders who were monitoring tweets.., what a plonker.
Tom Newton Dunn (@tnewtondunn) 04/01/2015 09:49 Cameron insists on #Marr that his EU migrant benefits reforms will achieve an overall cap on arrivals. Total garbage and he knows it.
Presumably he can tell us what number that effective cap would be at?
Rafal Trzaskowski says discriminating on grounds of nationality is an 'absolute red line' and his country will block David Cameron's plans
So its not going to happen.
More stupid lies, he should have learned by now.
He never learns, that is the problem from cutting the deficit in half , reducing the debt, curbing immigration, no top down re - organisation of the NHS, no plans to raise VAT, large issues, to even ones where nobody gives one, like eating a pasty, or riding a horse and foxhunting, the man just keeps telling them.
I’m not sure how Lord Ashcroft is selecting his Scottish constituency seats but my seat, Stirling, which is a key 4 way marginal, would be worthwhile considering. If the SNP can take Stirling comfortably, that would put them into 40+ seats territory.
As a SNP ex-SLAB supporter here is my current perspective on the SNP surge and its likely impact in May 2015.
The majority of people joining the SNP are motivated, working, new to political activism, aged 25 to 55 and from a range of socio-economic backgrounds. Therefore, I think the media portrayal of the SNP surge as being driven by blind faith cyber-Nats and benefit junkies is way off the mark. Interestingly, the surge is being lead by women, who now make up 44% of the SNP membership, pre-surge it was 33%.
Turning to the May 2015 election in Stirling, currently Ladbrokes have Labour at 4/6, SNP at 11/10 and Tories at 50/1. In 2010 the result was Labour 42%, Tories 24%, SNP 17% and LibDem 15%. In the referendum, Stirling was 60% No and 40% Yes. I think the SNP will win Stirling with around 40% support. I do not anticipate any significant Unionist tactical voting.
In terms of the GE2015 ground campaign, the SNP now have over 1500 members in Stirling. Candidate selection is underway with 7 good candidates, 3 with political and 4 with ‘’normal’’ backgrounds. The sitting SLAB MP, Anne McGuire, is retiring and the leader of Stirling Council (Johanna Boyd) is standing. Interestingly, Johanna leads a SLAB/Tory coalition with SNP being the largest party, suffice to say SLAB and the Tories make uneasy bedfellows.
Looking at Scotland more broadly, I think the SNP membership surge is pretty much across the board, so to the extent that the GOTV effort makes a difference the SNP are in an extremely strong position on the ground. One of SLAB’s problems is that it has taken for granted it’s dominant position in Scotland, so it does not seem to have much of a grassroots effort to combat the SNP.
I’m not sure how Lord Ashcroft is selecting his Scottish constituency seats but my seat, Stirling, which is a key 4 way marginal, would be worthwhile considering. If the SNP can take Stirling comfortably, that would put them into 40+ seats territory.
As a SNP ex-SLAB supporter here is my current perspective on the SNP surge and its likely impact in May 2015.
The majority of people joining the SNP are motivated, working, new to political activism, aged 25 to 55 and from a range of socio-economic backgrounds. Therefore, I think the media portrayal of the SNP surge as being driven by blind faith cyber-Nats and benefit junkies is way off the mark. Interestingly, the surge is being lead by women, who now make up 44% of the SNP membership, pre-surge it was 33%.
Turning to the May 2015 election in Stirling, currently Ladbrokes have Labour at 4/6, SNP at 11/10 and Tories at 50/1. In 2010 the result was Labour 42%, Tories 24%, SNP 17% and LibDem 15%. In the referendum, Stirling was 60% No and 40% Yes. I think the SNP will win Stirling with around 40% support. I do not anticipate any significant Unionist tactical voting.
In terms of the GE2015 ground campaign, the SNP now have over 1500 members in Stirling. Candidate selection is underway with 7 good candidates, 3 with political and 4 with ‘’normal’’ backgrounds. The sitting SLAB MP, Anne McGuire, is retiring and the leader of Stirling Council (Johanna Boyd) is standing. Interestingly, Johanna leads a SLAB/Tory coalition with SNP being the largest party, suffice to say SLAB and the Tories make uneasy bedfellows.
Looking at Scotland more broadly, I think the SNP membership surge is pretty much across the board, so to the extent that the GOTV effort makes a difference the SNP are in an extremely strong position on the ground. One of SLAB’s problems is that it has taken for granted it’s dominant position in Scotland, so it does not seem to have much of a grassroots effort to combat the SNP.
Stirling would only need a 12.25% swing from SNP to Lab.If you believe the polls Stirling will be one of the easiest SNP gains,nailed on SNP, and if 12.25 was the swing on 7 May,LibDems who will only lose 4 and Labour,who will only lose 9,will be delighted.
I can't see anything wrong with "healthcare professionals" having to speak perfect English in England. Can you?
In Nige's fantasy land of soundbite politics there would be no problem.
Here in the Real World there are at least 2 practical issues
1. What is the definition of "perfect English" and how is it objectively measured?
2. Assuming not every current "healthcare professional" meets that standard, there would be an immediate staffing crisis.
Apart from that, it's surefire winner...
As I said, I'm no fan of Farage or UKIP, just concerned that during a very distressing time, the "healthcare professionals" couldn't communicate what was going to happen to my relative, what they needed him to do, and, crucially, misinterpreted what a doctor had told them in front of my relative, which is when I had enough and had a word with the ward sister. Perfect English might be a stretch, I accept, and I don't have a clue how you measure it, but in all honesty, I wouldn't want the 2 nurses involved anywhere near me, or my loved ones, staffing crisis or not.
If Farage said the Earth revolves around the Sun, the usual suspects would criticise him for it. Health workers being able to communicate with their patients is about as contentious as that.
I’m not sure how Lord Ashcroft is selecting his Scottish constituency seats but my seat, Stirling, which is a key 4 way marginal, would be worthwhile considering. If the SNP can take Stirling comfortably, that would put them into 40+ seats territory.
As a SNP ex-SLAB supporter here is my current perspective on the SNP surge and its likely impact in May 2015.
The majority of people joining the SNP are motivated, working, new to political activism, aged 25 to 55 and from a range of socio-economic backgrounds. Therefore, I think the media portrayal of the SNP surge as being driven by blind faith cyber-Nats and benefit junkies is way off the mark. Interestingly, the surge is being lead by women, who now make up 44% of the SNP membership, pre-surge it was 33%.
Turning to the May 2015 election in Stirling, currently Ladbrokes have Labour at 4/6, SNP at 11/10 and Tories at 50/1. In 2010 the result was Labour 42%, Tories 24%, SNP 17% and LibDem 15%. In the referendum, Stirling was 60% No and 40% Yes. I think the SNP will win Stirling with around 40% support. I do not anticipate any significant Unionist tactical voting.
In terms of the GE2015 ground campaign, the SNP now have over 1500 members in Stirling. Candidate selection is underway with 7 good candidates, 3 with political and 4 with ‘’normal’’ backgrounds. The sitting SLAB MP, Anne McGuire, is retiring and the leader of Stirling Council (Johanna Boyd) is standing. Interestingly, Johanna leads a SLAB/Tory coalition with SNP being the largest party, suffice to say SLAB and the Tories make uneasy bedfellows.
Looking at Scotland more broadly, I think the SNP membership surge is pretty much across the board, so to the extent that the GOTV effort makes a difference the SNP are in an extremely strong position on the ground. One of SLAB’s problems is that it has taken for granted it’s dominant position in Scotland, so it does not seem to have much of a grassroots effort to combat the SNP.
Stirling would only need a 12.25% swing from SNP to Lab.If you believe the polls Stirling will be one of the easiest SNP gains,nailed on SNP, and if 12.25 was the swing on 7 May,LibDems who will only lose 4 and Labour,who will only lose 9,will be delighted.
It is a while since I was last in Stirling, I had a good holiday there some years back. Does the constituency include much rural hinterland?
Hard to see why the substantial numbers of Stirling Tories would go to others, and as second placed in the seat 50/1 seems very long odds on the Tories taking it. In a SLAB/SNP competition there is room for a less left wing party.
I can't see anything wrong with "healthcare professionals" having to speak perfect English in England. Can you?
In Nige's fantasy land of soundbite politics there would be no problem.
Here in the Real World there are at least 2 practical issues
1. What is the definition of "perfect English" and how is it objectively measured?
2. Assuming not every current "healthcare professional" meets that standard, there would be an immediate staffing crisis.
Apart from that, it's surefire winner...
As I said, I'm no fan of Farage or UKIP, just concerned that during a very distressing time, the "healthcare professionals" couldn't communicate what was going to happen to my relative, what they needed him to do, and, crucially, misinterpreted what a doctor had told them in front of my relative, which is when I had enough and had a word with the ward sister. Perfect English might be a stretch, I accept, and I don't have a clue how you measure it, but in all honesty, I wouldn't want the 2 nurses involved anywhere near me, or my loved ones, staffing crisis or not.
If Farage said the Earth revolves around the Sun, the usual suspects would criticise him for it. Health workers being able to communicate with their patients is about as contentious as that.
I agree with Twisted on this one. Would we accept a nurse that couldn't bandage properly? Or did not know how to follow proper hygienic processes?
If they cannot communicate clearly enough in English to understand and be understood, then they have no place as a healthcare worker in this country.
I can't see anything wrong with "healthcare professionals" having to speak perfect English in England. Can you?
In Nige's fantasy land of soundbite politics there would be no problem.
Here in the Real World there are at least 2 practical issues
1. What is the definition of "perfect English" and how is it objectively measured?
2. Assuming not every current "healthcare professional" meets that standard, there would be an immediate staffing crisis.
Apart from that, it's surefire winner...
As I said, I'm no fan of Farage or UKIP, just concerned that during a very distressing time, the "healthcare professionals" couldn't communicate what was going to happen to my relative, what they needed him to do, and, crucially, misinterpreted what a doctor had told them in front of my relative, which is when I had enough and had a word with the ward sister. Perfect English might be a stretch, I accept, and I don't have a clue how you measure it, but in all honesty, I wouldn't want the 2 nurses involved anywhere near me, or my loved ones, staffing crisis or not.
If Farage said the Earth revolves around the Sun, the usual suspects would criticise him for it. Health workers being able to communicate with their patients is about as contentious as that.
Very true SeanF
It should be an uncontested requirement for Health workers in the British Isles.
Mr. G, this accent talk reminds me of when London clowns on the BBC claimed the 7/7 bombers (in their video speeches) had 'broad Yorkshire' accents. They didn't. Broad Yorkshire is bloody hard to understand and not the same thing as a Yorkshire accent, but being beyond the M25 appeared to also be beyond the knowledge of the BBC.
Mr. City, my first GP was bloody awful. As well as being grumpy as ****, his handwriting was incomprehensible and neither I nor my mother could make out what the hell he was saying. Fortunately, I was never seriously ill as a child.
Comments
There is no simple solution, and to manage those emergencies the QE had to cancel elective surgery such as JohnL's knee replacement.
The problem is mostly one of lack of capacity and lack of trained staff.
On another point: We have sometimes employed locums whose English struggled with local dialect and accents. The alternative was employing no one and closing down services. No one is happy to do so, but what choice do we have. Undergraduate med school places are being cut next year, as are postgraduate training places. We train far too few nurses also. It is a failure of linked up government. Cut immigration by training Britons, simples!
2. Just proves the point , hoe the F*** do you get a job in healthcare if you cannot speak and understand people in their language.
QE is not needed and would be a disaster, hopefully the positive economic data arriving in the next few months will dissuade the ECB.
How to objectively measure a persons grasp of a language is not actually difficult. Its done in every school and university in the land. It is called an examination.
I'm a Tory, but I despair of the Tories at the moment, the campaign consists of equal parts of lying about things they can't do, lying about the things they can do, but dont want to do, and belittling the concerns of their natural supporters and then rubbishing them when they consider voting for another party which might be a bit eccentric, but sounds to a lot of voters like it is listening to them.
2. You would need to put a training programme into place. It would be a bit stupid* to expect everyone to come up to scratch immediately you changed the rules, and you would probably have problems with employment law when you tried to fire them.
* which is obviously what you think Kippers are
Perfect English might be a stretch, I accept, and I don't have a clue how you measure it, but in all honesty, I wouldn't want the 2 nurses involved anywhere near me, or my loved ones, staffing crisis or not.
Not difficult.
@SkyNews: Farage: Sack NHS Staff Who Don't Speak English http://t.co/QcN7PwI9ng
What we have seen since is a failure of the swingback model. The Tories have not made progress and the projection from each starting point is less favourable to them. So we have over the last year moved from a comfortable Tory majority to NOC to Labour as the largest party. In my opinion people like Audreyanne are whistling in the dark. With the starting point of today Labour wins. Only Scotland raises a serious question mark about that majority. But it is a brave man or woman who is now betting on anyone else being the largest party.
I would tie Nursing bursaries and Medical bursaries to NHS service, with student debts being wiped clean after 5 and ten years respectively, if I was directing policy in these areas.
The NHS is pretty damn good at critical emergency treatment and always has been - managements rightly prioritise someone teeetering on the brink of death but savable over everything else. There's a current serious issue over slower ambulance response times, but otherwise I'm not worried about this.
The NHS will also offer a choice under the much-maligned Choose & Book system between convenience and speed. When I needed a quick check in 2009 for an alarming symptom (false alam, as it turned out), I looked up my local hospitals online and found that I could get checked almost immediately if I went to Derby, but it'd take a week if I waited for my then local hospital in Nottingham. I went to Derby like a shot; others might have chosen to wait for their familiar local place. This sort of thing is a good idea which tends to even out waiting times, and the reason it's perhaps not generally known is that most patients aren't that computer-friendly and some GPs don't like to bother to do the survey of local choices as they're supposed to (I think this is something the practice nurse should do).
Where I differ up to a point from Fox is in his opposition to capped waiting times, especially for A&E. I can see that from the professional viewpoint it forces suboptimal decisions - see the bloke with a broken toenail because he's been waiting 4 hours. But predictability is very important to many patients. I know someone with panic attacks who makes life-threatening decisions not to go to A&E when she has an asthma attack because she thinks that she may have to wait an UNKNOWN period in the generally stressed conditions of an A&E waiting room.
Giving people 6 months to come up to snuff would seem reasonable. My view is that if you wish to emigrate, you should learn your new country's language before going there.
The 18 week rule does throw up curiosities; we have a number of patients who winter in Spain or Gujerat, and have to be discharged and re-referred when they are back in Blighty. The rules do not allow me to set a date shortly after their return, unless it is within 18 weeks...
Good spot.
If you have a segregated and ghettoised city, the health professionals must reflect that... vibrant diversity
It's hard to have any clear communications on here today, its not the understanding that the problem, its the deafening sound of axes being ground.
If you look at your local statistics you will see a sharp rise in admissions in patients about to breach the four hour rule. Some may have been waiting for a bed, but others will be admitted to prevent a breach.
The rule also tends to prevent the admitting team to focus on new arrivals rather than the patients that they admitted earlier in the day. Often admitted patients go a few hours before anything further is done, including discharge.
Fisher's polling swingback thing was always a bit mad, because half the data he fed into the model came from before the pollsters made a bunch of changes to stop it swinging (then swinging back) as much, so the same tendency in old polls to overstate mid-term swing was getting corrected for twice.
But once they've stopped the Tories, what then? The uncommitted centreground will see there's no alternative prospectus on offer, that it's all "sound and fury, signifying nothing".
* But even more so the SNP!
This hatred is blinding them to the danger that Labour might take 50+ seats off them, complacency about Ed being crap (which he is, but many of the electorate may feel he is "not as crap as all that") is making them take their eye off the ball, and amuse themselves by rubbishing Farage, rather than coming up with policies that might appeal to the electorate, real policies, not gimmicks that collapse before the speaker has left the stage.
http://takimag.com/article/a_nerd_for_our_times_alan_turing_steve_sailer/page_2#axzz3NqnqzSaB
Of course all three films sound incredibly dull and I shan't be seeing any.
There isn't any need to be local - that was my point, and facilitating non-local choice was one of the things that the last government did well. If the only place you can get a good operation for your needs is John O'Groats, the NHS will offer you an operation there. However, the computer system is foicused on regions and finding out about operations further afield requires a manual search, e.g. by your local practice.
Benchmarks - I'm not in a position to offer an instant global survey of all international standards in every kind of health care! Perhaps others can help. My subjective impression from living in various countries is that most systems in the West offer a comparably prompt service for people with insurance in place (which outside the US is basically everyone). Other countries do pay more attention than we do to pleasantness of surroundings (I remember a Swiss holiday when I broke my arm - the hospital room was shared with three people, but nonetheless far nicer than my hotel, with a spectacular mountain view and tasty food), but I don't actually think that the health care is that different - certainly the outcomes in terms of life expectancy are remarkably similar.
Re the two German votes on the ECB council. Jens Weidmann doesn't take his orders from Angel Merkel, the Bundesbank is fully independent.
However, I think there is a general view - even from the most QE sympathetic members of the council - that doing something that was outright opposed by both the Bundesbank and the Germany government would be A Bad Thing (TM). ECB council members (with the possible exception of Herr Doktor Weidmann) don't want to precipitate the breakup of the Euro, and therefore they wish to keep the German government on-side.
For that reason, I think it is unlikely that the ECB Council would propose any form of QE that it did not expect publicly approved by Germany.
http://m.scotsman.com/news/euan-mccolm-twitter-classes-show-power-in-politics-1-3650261
In both cases there had been numerous complaints against the doctors concerned. In the end all that matters is that the doctor can communicate clearly and effectively with the patient and understands in return what the patient is trying to say.
http://www.theguardian.com/uk-news/2014/nov/28/david-cameron-immigration-eu-treaty-change http://www.telegraph.co.uk/news/uknews/immigration/11266917/Poland-will-block-bid-to-slash-EU-migrant-benefits-minister-warns.html So its not going to happen.
More stupid lies, he should have learned by now.
Maybe the late Nicholas Ridley had it right.
Edit: speak of the Devil and he shall appear, the good Mr. Cole is with us.
Labour IMHO made a historic mistake by nationalising. The problem was that some counties were too small/unwilling to do it properly. They should have replaced the smaller counties with merged larger counties and left the "NHS" with them with minimum service levels imposed. Then health would have been in the hands of elected officials not regional health board quangos.
The other thing they did was quasi nationalise GPs which I also think was a mistake which leaves us in many ways with the worst of both worlds. This didn't happen with dentists and everyone (who is deemed to be able to afford to) happily pays £18 for a check up. But more importantly , I have a dentist, who always treats me and I can build a relationship with, which sadly is no longer the case with GPs. I would be happy to pay £20 a visit to a GP if it meant better service and being able to choose who my doctor is like I can with my dentist.
However the idea that before the NHS the UK was like the USA is now is a canard and one that the Tories would be well advised to put to rest if they ever want serious health reform
I thought The Hobbit pt 3 (or is it 4?) was pretty rubbish to be honest, unless you like 2.5 hours of fighting with almost no plot.
Am going to have to watch Interstellar very soon as everyone I know who has seen it has been raving. Which is always a bad sign. Bound to be a let-down, but will drag myself along.
This is an area where it's genuinely true that senior politicians tend to be out of touch. Lots of things in Britain work perfectly well if you know the ropes - and I don't mean taking naughty short cuts or using influence, just carefully going through the required procedures. But there is very little proactive support for people who aren't on top of their game - suffering from depression, for instance, as you say - and what support there is you generally have to go and look for yourself, which by definition you're not very able to do.
That's why MPs' advice surgeries are filled with people asking for personal help. I was able to help a lot of people with entirely non-political stuff; they came to me because they'd heard that I was helpful and they didn't know who else to go to. CAB are supposed to fill the gap, and they do a good job as far as they can, but they are overloaded and short of firepower when what's needed is a sharp phone call demanding that X's problem is given proper attention.
"Only a true Catholic would be posting on a political forum rather than going to church on a Sunday morning."
You've obviously never heard of Saturday night mass. Don't worry, your ignorance on anything religious is fairly common mowadays.
More stupid lies, he should have learned by now.
He never learns, that is the problem from cutting the deficit in half , reducing the debt, curbing immigration, no top down re - organisation of the NHS, no plans to raise VAT, large issues, to even ones where nobody gives one, like eating a pasty, or riding a horse and foxhunting, the man just keeps telling them.
As a SNP ex-SLAB supporter here is my current perspective on the SNP surge and its likely impact in May 2015.
The majority of people joining the SNP are motivated, working, new to political activism, aged 25 to 55 and from a range of socio-economic backgrounds. Therefore, I think the media portrayal of the SNP surge as being driven by blind faith cyber-Nats and benefit junkies is way off the mark. Interestingly, the surge is being lead by women, who now make up 44% of the SNP membership, pre-surge it was 33%.
Turning to the May 2015 election in Stirling, currently Ladbrokes have Labour at 4/6, SNP at 11/10 and Tories at 50/1. In 2010 the result was Labour 42%, Tories 24%, SNP 17% and LibDem 15%. In the referendum, Stirling was 60% No and 40% Yes. I think the SNP will win Stirling with around 40% support. I do not anticipate any significant Unionist tactical voting.
In terms of the GE2015 ground campaign, the SNP now have over 1500 members in Stirling.
Candidate selection is underway with 7 good candidates, 3 with political and 4 with ‘’normal’’ backgrounds. The sitting SLAB MP, Anne McGuire, is retiring and the leader of Stirling Council (Johanna Boyd) is standing. Interestingly, Johanna leads a SLAB/Tory coalition with SNP being the largest party, suffice to say SLAB and the Tories make uneasy bedfellows.
Looking at Scotland more broadly, I think the SNP membership surge is pretty much across the board, so to the extent that the GOTV effort makes a difference the SNP are in an extremely strong position on the ground. One of SLAB’s problems is that it has taken for granted it’s dominant position in Scotland, so it does not seem to have much of a grassroots effort to combat the SNP.
Hard to see why the substantial numbers of Stirling Tories would go to others, and as second placed in the seat 50/1 seems very long odds on the Tories taking it. In a SLAB/SNP competition there is room for a less left wing party.
I agree with Twisted on this one. Would we accept a nurse that couldn't bandage properly? Or did not know how to follow proper hygienic processes?
If they cannot communicate clearly enough in English to understand and be understood, then they have no place as a healthcare worker in this country.
It should be an uncontested requirement for Health workers in the British Isles.
Mr. G, this accent talk reminds me of when London clowns on the BBC claimed the 7/7 bombers (in their video speeches) had 'broad Yorkshire' accents. They didn't. Broad Yorkshire is bloody hard to understand and not the same thing as a Yorkshire accent, but being beyond the M25 appeared to also be beyond the knowledge of the BBC.
And, speaking of Scottish things, I thought you might like this:
https://www.youtube.com/watch?v=0q5SSoho0cs