Hope your recovery is coming all nicely, Mr. Smithson.
I wonder if this ties into migration. Whilst a stat I saw before the referendum indicated EU nationals had a percentage of NHS staff exactly corresponding to their proportion of the population (ie their presence makes effectively no difference to the NHS' effectiveness either way), many may feel that excessive migration is causing the burden on the NHS to increase too rapidly.
Not a view I'd take. A combination of not enough new staff being trained and, in particular, the demographic problem of the baby boomers getting old and sick seem likelier causes.
It'd be interesting to try and discover if sympathy for NHS staff has declined following their strikes of recent times.
Half of your total health spend happens in the last six months of your life.
Which (a) suggests that while migrants may cause problems such as increased time to see GPs, they aren't the biggest burden on it. And (b) indicates we can cut health spending on half and just all agree to live six months less.
I seem to recall seeing a statistic about working age use of the NHS that implied an absolutely massive gender imbalance as well.
FFS! Who uses aol? Lucky for Pence the GOP never focussed on the use of private emails. Oh.
Vice President Mike Pence used a private email account to discuss homeland security and other sensitive issues, it has been reported.
Emails released under a public records law show that while Mr Pence was the governor of Indiana he regularly used the AOL address to speak to advisers about state business, the Indianapolis Star reports.
FFS! Who uses aol? Lucky for Pence the GOP never focussed on the use of private emails. Oh.
Vice President Mike Pence used a private email account to discuss homeland security and other sensitive issues, it has been reported.
Emails released under a public records law show that while Mr Pence was the governor of Indiana he regularly used the AOL address to speak to advisers about state business, the Indianapolis Star reports.
FFS! Who uses aol? Lucky for Pence the GOP never focussed on the use of private emails. Oh.
Vice President Mike Pence used a private email account to discuss homeland security and other sensitive issues, it has been reported.
Emails released under a public records law show that while Mr Pence was the governor of Indiana he regularly used the AOL address to speak to advisers about state business, the Indianapolis Star reports.
Mr. Pulpstar, our debt interest payments exceed the funding gap mentioned below.
If the cash requirement for health care is growing faster than our economy, reality is going to bite sooner or later. Arithmetic will tell us we either need to increase our economic growth by 2% per year, every year, or the gap between what we spend, and what we can afford will open 2% per year every year, leading to either a slowly dying health service, or increasing cuts made in something else to cover it.
The chilling reality is that the Kings Fund think we will need to increase health spending by 35bn per year by 2020/21, just to stand still, and 43bn to spend the same as others appear to. The former figure is (in round terms) what we spend in total on Education, the second what we spend in total on Defense.
The gig economy is all very well if you are a web designer or copywriter but not so much if you are a delivery driver.
It's the new economy companies that come out with guff on flexibility and freedom to choose, but turns out it means poverty wages for their staff.
Many of these companies offer payment per job, with you often having to fund the cost of the vehicle yourself. Some people earn ok if the do a 60 hour week, but woe betide you use your flexibility for illness or holiday, you won't get given new jobs. You decline too many jobs and your metrics crash.
There are other even worse off having to work long hours still to make little money, with often effective rates of pay being less than £2 per hour.
Luckily the courts are catching on to these dodges, if you are effectively making people work a mandatory number of hours they're really full time employees not independent contractors.
They deserve the minimum wage and sick pay.
Besides it can't have escaped the governments notice the companies are not paying national insurance or company pensions.
Flexibility is fine as long as it benefits both parties, rather than a way to screw down wages and tax payments.
On topic: I think one needs to be a bit careful in interpreting this sort of data. To an extent public concern will reflect what is in the media, and the BBC has been running the most extraordinary 7-day-a-week NHS moan-a-thon for the last couple of months. The importance of a particular issue is also relative to other concerns; when unemployment is high, for example, the NHS or other issues are likely to be pushed down the scale, and vice versa. At the moment, people seem to be fairly unconcerned about the economy (wrongly, in my view, but that's by the by), so it would be natural for the NHS to become more prominent as a concern even if the underlying picture on health wasn't changing.
None of this is to say that the concern over the NHS is unimportant or unjustified; as others have pointed out, just keeping up with demand is a huge challenge, and as Mike's experience shows, this is of course a vital issue in people's lives.
On the politics, Labour's approach of continual doom-and-gloom combined with ludicrous attacks on the motives and integrity of Conservative politicians on health is unlikely to win them much support. They need to think about answers, not insults - no-one thinks this is an easy problem, voters are not so stupid.
Secondly, with regard to political resonance, it’s perhaps more informative to see how many people regard the NHS as the most important issue, as opposed to an important issue. It is just 18%.
Then look at who the 18% are. The Welsh (run by Labour), public sector workers and older folk seem to be the main people.
It also shouldn’t be assumed that mentioning the NHS equates to agreeing with Labourite descriptions of it’s problems nor their proposed solutions.
It seems to me that just as many people are likely to describe the issues with the NHS as over-bloated as underfunded, over-used as under resourced and over committed rather than not reaching far enough.
I’m firmly of the view that if someone started with a blank of sheet of paper, and a mindset to use the best of modern technology, data storage and telecommunications, combined with the most efficient business structures and economies of scale, they would not design the NHS in it’s present form.
They certainly wouldn't design the GP point of entry as it is and that has repercussions down/up the line.
Bit like London Underground! However, generally I agree. I would be hesitant about describing it as 'over-bloated’, if that means too many managers. There may be too much micro-management, and too many micro-managers, but this is the result of an over-reliance on targets.
FFS! Who uses aol? Lucky for Pence the GOP never focussed on the use of private emails. Oh.
Vice President Mike Pence used a private email account to discuss homeland security and other sensitive issues, it has been reported.
Emails released under a public records law show that while Mr Pence was the governor of Indiana he regularly used the AOL address to speak to advisers about state business, the Indianapolis Star reports.
Mr. Eagles/Mr. Chestnut, but the ball is in Fillon's court.
I could step in if Jennifer Morrison and Olivia Wilde wanted a third attendee at their jacuzzi, champagne and pillow fights party. But my invite appears to be lost in the post.
When I was concerned with these things the working, statistically based, hypothesis was that someone over 65 had 10 times the number of prescriptions as someone in their 40’s.
I don't know about over 65s but chatting to my local pharmacist he reckons between 50 and 60% of the population of Hurstpierpoint over the age of 55 are on regular medication. That seems an incredible proportion to me but I have to assume he knows his business. I think it raises two questions:
1. How much over prescribing is going on? Do people really need the medicines they take or is there an element of doctors giving patients a tablet to shut them up and make them go away? From the other side of the seven different medicines I am prescribed and take daily there are two which were prescribed years ago for conditions which I haven't had for years but which the GP says I should keep taking, just in case.
2. Payment. Until I was sixty I paid about £100 a year for a "season ticket" as my direct contribution to the cost of my medication. The moment I turned sixty I no longer had to pay anything even though my financial position remained exactly the same. That to me is crackers. Free prescriptions should be for those who cannot afford to pay not because one has reached some arbitrary age. If all the over sixties who can afford £100 per annum (i.e. most of us) were required to cough up there would be a lot more dosh sloshing around in the NHS drugs fund.
"If we were to close this gap solely by increasing NHS spending (and assuming that health spending in other UK countries was in line with the 2015 Spending Review plans for England), by 2020/21 it would take an increase of 30 per cent – £43 billion – in real terms to match the EU-15 weighted average spend in 2013, taking total NHS spending to £185 billion"
The public need to be given the facts on this. The gap is staggering. Are they willing to see that kind of level of tax increase to cover the additional £43billion? If not, then we need to rethink NHS funding in 21st century.
1% increase in NI raises about £5billion according to IFS.
Raising taxes by £43 bn, or cutting other spending by £43 bn would probably generate a lot of hostility.
"If we were to close this gap solely by increasing NHS spending (and assuming that health spending in other UK countries was in line with the 2015 Spending Review plans for England), by 2020/21 it would take an increase of 30 per cent – £43 billion – in real terms to match the EU-15 weighted average spend in 2013, taking total NHS spending to £185 billion"
The public need to be given the facts on this. The gap is staggering. Are they willing to see that kind of level of tax increase to cover the additional £43billion? If not, then we need to rethink NHS funding in 21st century.
1% increase in NI raises about £5billion according to IFS.
Raising taxes by £43 bn, or cutting other spending by £43 bn would probably generate a lot of hostility.
All parties are competing to avoid telling the public the truth, because the first one that does, will lost the next few elections.
I am doubtful even the current modest economic growth will continue for more than a few days, and that is nothing to do with BrExit, that is to do with a slowdown being due in the economic cycle, another dotcom crash is more than overdue when investors start to notice how ludicrously overvalued a lot of tech stocks are, and because there are enough bumps on the horizon that one of them is pretty much bound to happen (Trump crash, conflict with China in the South China Sea, renewed cold war with Russia, GrExit, ItExit, adiEU etc). Cuts are going to be needed anyway never mind scraping around behind the sofa for a few more quid for the NHS.
Mr. Pulpstar, our debt interest payments exceed the funding gap mentioned below.
If the cash requirement for health care is growing faster than our economy, reality is going to bite sooner or later. Arithmetic will tell us we either need to increase our economic growth by 2% per year, every year, or the gap between what we spend, and what we can afford will open 2% per year every year, leading to either a slowly dying health service, or increasing cuts made in something else to cover it.
The chilling reality is that the Kings Fund think we will need to increase health spending by 35bn per year by 2020/21, just to stand still, and 43bn to spend the same as others appear to. The former figure is (in round terms) what we spend in total on Education, the second what we spend in total on Defense.
The ratio between the number of working aged people and retired (and particularly really old) people is rising, and will continue to rise for the foreseeable future.
This means we're all going to be sending more of income to old people, and that means that even if productivity grows at 3% per year, our disposable income will grow less quickly.
Mr. Eagles/Mr. Chestnut, but the ball is in Fillon's court.
I could step in if Jennifer Morrison and Olivia Wilde wanted a third attendee at their jacuzzi, champagne and pillow fights party. But my invite appears to be lost in the post.
Such invitations tend not to come in the post. Whatsapp is a more usual medium for such communications.
Forgive my innocence, but what's wrong with AOL? Been on it since freeserve and it has been rock solid over the decades.
When AOL opened up its walled garden and lets its users onto the public internet it caused something of a shock in what had until then largely been the purview of academics and large corporates. All sorts of sensible and at least mid-brow discussion groups and fora suddenly got over-run by tens of thousands of bored American teenagers. A lot of (for example) IRC servers banned the whole aol.com domain because of the level of spam and abuse that suddenly occured. AOL because christened "A*sholes Online" in many quarters as a result.
When I was concerned with these things the working, statistically based, hypothesis was that someone over 65 had 10 times the number of prescriptions as someone in their 40’s.
I don't know about over 65s but chatting to my local pharmacist he reckons between 50 and 60% of the population of Hurstpierpoint over the age of 55 are on regular medication. That seems an incredible proportion to me but I have to assume he knows his business. I think it raises two questions:
1. How much over prescribing is going on? Do people really need the medicines they take or is there an element of doctors giving patients a tablet to shut them up and make them go away? From the other side of the seven different medicines I am prescribed and take daily there are two which were prescribed years ago for conditions which I haven't had for years but which the GP says I should keep taking, just in case.
2. Payment. Until I was sixty I paid about £100 a year for a "season ticket" as my direct contribution to the cost of my medication. The moment I turned sixty I no longer had to pay anything even though my financial position remained exactly the same. That to me is crackers. Free prescriptions should be for those who cannot afford to pay not because one has reached some arbitrary age. If all the over sixties who can afford £100 per annum (i.e. most of us) were required to cough up there would be a lot more dosh sloshing around in the NHS drugs fund.
I suspect your pharmacist is correct. Meds to combat high blood pressure and gastric reflux alone must take up half of that. Charging for missed GP appointments could be added to making wealthier over 60's pay.
"If we were to close this gap solely by increasing NHS spending (and assuming that health spending in other UK countries was in line with the 2015 Spending Review plans for England), by 2020/21 it would take an increase of 30 per cent – £43 billion – in real terms to match the EU-15 weighted average spend in 2013, taking total NHS spending to £185 billion"
The public need to be given the facts on this. The gap is staggering. Are they willing to see that kind of level of tax increase to cover the additional £43billion? If not, then we need to rethink NHS funding in 21st century.
1% increase in NI raises about £5billion according to IFS.
Raising taxes by £43 bn, or cutting other spending by £43 bn would probably generate a lot of hostility.
All parties are competing to avoid telling the public the truth, because the first one that does, will lost the next few elections.
I am doubtful even the current modest economic growth will continue for more than a few days, and that is nothing to do with BrExit, that is to do with a slowdown being due in the economic cycle, another dotcom crash is more than overdue when investors start to notice how ludicrously overvalued a lot of tech stocks are, and because there are enough bumps on the horizon that one of them is pretty much bound to happen (Trump crash, conflict with China in the South China Sea, renewed cold war with Russia, GrExit, ItExit, adiEU etc). Cuts are going to be needed anyway never mind scraping around behind the sofa for a few more quid for the NHS.
A few more days?
Now that is pessimistic. I'm a lot more confident than that.
Why would i) a cross-bench peer have any idea how many Tory MPs are likely to revolt ii) any Tory MP who has previously voted against unilateral guarantees for EU migrants switch their vote?
Sounds like Soubry is coming out with fantasy numbers to try to get enough backbenchers on her side.
"If we were to close this gap solely by increasing NHS spending (and assuming that health spending in other UK countries was in line with the 2015 Spending Review plans for England), by 2020/21 it would take an increase of 30 per cent – £43 billion – in real terms to match the EU-15 weighted average spend in 2013, taking total NHS spending to £185 billion"
The public need to be given the facts on this. The gap is staggering. Are they willing to see that kind of level of tax increase to cover the additional £43billion? If not, then we need to rethink NHS funding in 21st century.
1% increase in NI raises about £5billion according to IFS.
Raising taxes by £43 bn, or cutting other spending by £43 bn would probably generate a lot of hostility.
All parties are competing to avoid telling the public the truth, because the first one that does, will lost the next few elections.
I am doubtful even the current modest economic growth will continue for more than a few days, and that is nothing to do with BrExit, that is to do with a slowdown being due in the economic cycle, another dotcom crash is more than overdue when investors start to notice how ludicrously overvalued a lot of tech stocks are, and because there are enough bumps on the horizon that one of them is pretty much bound to happen (Trump crash, conflict with China in the South China Sea, renewed cold war with Russia, GrExit, ItExit, adiEU etc). Cuts are going to be needed anyway never mind scraping around behind the sofa for a few more quid for the NHS.
A few more days?
Now that is pessimistic. I'm a lot more confident than that.
Oops! Years ofc. Mind running ahead of the keyboard syndrome
Forgive my innocence, but what's wrong with AOL? Been on it since freeserve and it has been rock solid over the decades.
When AOL opened up its walled garden and lets its users onto the public internet it caused something of a shock in what had until then largely been the purview of academics and large corporates. All sorts of sensible and at least mid-brow discussion groups and fora suddenly got over-run by tens of thousands of bored American teenagers. A lot of (for example) IRC servers banned the whole aol.com domain because of the level of spam and abuse that suddenly occured. AOL because christened "A*sholes Online" in many quarters as a result.
Oh, thanks. That completely passed me by. Thank goodness the rest of the internet didn't follow suit.
Why would i) a cross-bench peer have any idea how many Tory MPs are likely to revolt ii) any Tory MP who has previously voted against unilateral guarantees for EU migrants switch their vote?
Sounds like Soubry is coming out with fantasy numbers to try to get enough backbenchers on her side.
The question is also who wants to be on Theresa's sh*t list, its not like she doesnt have form when people cross her
When I was concerned with these things the working, statistically based, hypothesis was that someone over 65 had 10 times the number of prescriptions as someone in their 40’s.
I don't know about over 65s but chatting to my local pharmacist he reckons between 50 and 60% of the population of Hurstpierpoint over the age of 55 are on regular medication. That seems an incredible proportion to me but I have to assume he knows his business. I think it raises two questions:
1. How much over prescribing is going on? Do people really need the medicines they take or is there an element of doctors giving patients a tablet to shut them up and make them go away? From the other side of the seven different medicines I am prescribed and take daily there are two which were prescribed years ago for conditions which I haven't had for years but which the GP says I should keep taking, just in case.
2. Payment. Until I was sixty I paid about £100 a year for a "season ticket" as my direct contribution to the cost of my medication. The moment I turned sixty I no longer had to pay anything even though my financial position remained exactly the same. That to me is crackers. Free prescriptions should be for those who cannot afford to pay not because one has reached some arbitrary age. If all the over sixties who can afford £100 per annum (i.e. most of us) were required to cough up there would be a lot more dosh sloshing around in the NHS drugs fund.
My other half is entitled to free prescriptions because, as part of the initial assessment made of him when he had his accident, they decided that he was diabetic. This seems ludicrous to me on two fronts:
1) we can afford to pay the prescription. 2) given everything else he's been through, diabetes is the least of his worries.
When I mentioned this incredulously in Northern Ireland, I was told that no one there pays for prescriptions.
"If we were to close this gap solely by increasing NHS spending (and assuming that health spending in other UK countries was in line with the 2015 Spending Review plans for England), by 2020/21 it would take an increase of 30 per cent – £43 billion – in real terms to match the EU-15 weighted average spend in 2013, taking total NHS spending to £185 billion"
The public need to be given the facts on this. The gap is staggering. Are they willing to see that kind of level of tax increase to cover the additional £43billion? If not, then we need to rethink NHS funding in 21st century.
1% increase in NI raises about £5billion according to IFS.
Raising taxes by £43 bn, or cutting other spending by £43 bn would probably generate a lot of hostility.
All parties are competing to avoid telling the public the truth, because the first one that does, will lost the next few elections.
I am doubtful even the current modest economic growth will continue for more than a few days, and that is nothing to do with BrExit, that is to do with a slowdown being due in the economic cycle, another dotcom crash is more than overdue when investors start to notice how ludicrously overvalued a lot of tech stocks are, and because there are enough bumps on the horizon that one of them is pretty much bound to happen (Trump crash, conflict with China in the South China Sea, renewed cold war with Russia, GrExit, ItExit, adiEU etc). Cuts are going to be needed anyway never mind scraping around behind the sofa for a few more quid for the NHS.
By running a deficit and increasing government debt we continue to steal from future generations.
When we built up debt in the second world war we were doing it for future generations as well as ourselves. Now we are just being selfish.
I have a son who is an experienced paramedic working in East London. He used to work as a full time employee of the NHS but has now chosen to work for them on a part time "bank contract" which still gives earns his pension entitlement for hours worked with the very important advantage that he is not obliged to work the hours and shifts the NHS was telling him to and he can plan and live his life in a much better way. He is now also partly employed by a private company as a trainer giving "first responder" training courses to NHS employees (including doctors and nurses working in hospitals) who need to renew and update their knowledge and skills. His pay from the private training company is considerably better than that provided within the NHS. I am very pleased for him but this does not appear to me to be good management by the NHS.
Paramedics in generally are underpaid (incredibly they are not designated by the Government as an Emergency Service), overworked and under great pressure at the moment as has been extensively reported in the media. Despite the NHS 111 telephone service my son tells me about 75% of the emergency call outs he makes turn out not to require trained paramedics and an emergency ambulance. The Government and the NHS really do need to find more effective ways of preventing unnecessary emergency call outs and thus reducing costs. Perhaps it is time to introduce a small fee for everyone that calls for an emergency ambulance and a system of fines for the cases where people are found to have irresponsibly abused this service?
Personally I also think a lot of money could be saved if the Fire Service and the Emergency Ambulance services were to be amalgamated similar to the French Model.
Why would i) a cross-bench peer have any idea how many Tory MPs are likely to revolt ii) any Tory MP who has previously voted against unilateral guarantees for EU migrants switch their vote?
Sounds like Soubry is coming out with fantasy numbers to try to get enough backbenchers on her side.
Soubry backs the government's position on EU citizens
Labour keep banging on about the NHS and keep losing elections, a glance at the front page of today's Mirror is an extension of the discussion on here yesterday. We can throw more money at it but it will never be enough, sooner or later the whole thing will need dismantling and rebuilding.
That's not to say people don't receive first class treatment and that the clinical staff aren't superb but the waste is obvious. The electorate understands that if Corbyn doesn't.
"Throwing money at something". Toryspeak for spending on something you disagree with.
"Spending" the universal Labour answer for anything no matter if they extra money actually improves anything
It's not called "spending", it's called "investment".
Every year or so my dentist does a general health check of all the medicines I'm taking. I start saying bendro...... and he and the nurse join in with a sing-song chant of the three or four blood pressure pills that local GPs are dishing out to everyone.
FFS! Who uses aol? Lucky for Pence the GOP never focussed on the use of private emails. Oh.
Vice President Mike Pence used a private email account to discuss homeland security and other sensitive issues, it has been reported.
Emails released under a public records law show that while Mr Pence was the governor of Indiana he regularly used the AOL address to speak to advisers about state business, the Indianapolis Star reports.
Why would i) a cross-bench peer have any idea how many Tory MPs are likely to revolt ii) any Tory MP who has previously voted against unilateral guarantees for EU migrants switch their vote?
Sounds like Soubry is coming out with fantasy numbers to try to get enough backbenchers on her side.
Soubry backs the government's position on EU citizens
Peter Hitchens and Nigel Farage disagree on this... I don't know what to think!
I don't know about over 65s but chatting to my local pharmacist he reckons between 50 and 60% of the population of Hurstpierpoint over the age of 55 are on regular medication. That seems an incredible proportion to me but I have to assume he knows his business. I think it raises two questions:
1. How much over prescribing is going on? Do people really need the medicines they take or is there an element of doctors giving patients a tablet to shut them up and make them go away? From the other side of the seven different medicines I am prescribed and take daily there are two which were prescribed years ago for conditions which I haven't had for years but which the GP says I should keep taking, just in case.
2. Payment. Until I was sixty I paid about £100 a year for a "season ticket" as my direct contribution to the cost of my medication. The moment I turned sixty I no longer had to pay anything even though my financial position remained exactly the same. That to me is crackers. Free prescriptions should be for those who cannot afford to pay not because one has reached some arbitrary age. If all the over sixties who can afford £100 per annum (i.e. most of us) were required to cough up there would be a lot more dosh sloshing around in the NHS drugs fund.
Morning Mr L. From memory ..... it’s from a while ago so may be better than recent, my thoughts on point 1 are as follows. A significant proportion of females 45 or so plus will be using some form of medication for the menopause. A significant proportion of both sexes, but most likely males will be on some form of preventative medication such as statins. Assuming that these reduce hospital admissions, then overall there’s probably a saving. Lowest price statin is 84p for a months supply. Some of both sexes will be diabetic. Home treatment for this, while more effective nowadays is becoming more expensive. Then there will be some patients with short term problems.
It’s always a good idea to review medication use, and increasingly often this is being done. A growing number of GP practices now have a pharmacist on site to do among other things that, and to handle requests for repeat medications. In my day there was unquestionably an amount of unnecessary repeat prescribing and I and colleagues spent quite an amount of time dealing with that.
As far as point 2 is concerned the whole business of ‘prescription charges' has got wildly out of control and the DoH, told by the Treasury that we can’t do what Scotland and Wales have done and abolish the charges, doesn’t seem to have a clue as to what it can do, so increases the charges to what is, compared with the actual cost of the drugs often an astronomical level and simultaneously increases the number of exemptions.
Why would i) a cross-bench peer have any idea how many Tory MPs are likely to revolt ii) any Tory MP who has previously voted against unilateral guarantees for EU migrants switch their vote?
Sounds like Soubry is coming out with fantasy numbers to try to get enough backbenchers on her side.
Soubry backs the government's position on EU citizens
Peter Hitchens and Nigel Farage disagree on this... I don't know what to think!
When I was concerned with these things the working, statistically based, hypothesis was that someone over 65 had 10 times the number of prescriptions as someone in their 40’s.
I don't know about over 65s but chatting to my local pharmacist he reckons between 50 and 60% of the population of Hurstpierpoint over the age of 55 are on regular medication. That seems an incredible proportion to me but I have to assume he knows his business. I think it raises two questions:
1. How much over prescribing is going on? Do people really need the medicines they take or is there an element of doctors giving patients a tablet to shut them up and make them go away? From the other side of the seven different medicines I am prescribed and take daily there are two which were prescribed years ago for conditions which I haven't had for years but which the GP says I should keep taking, just in case.
2. Payment. Until I was sixty I paid about £100 a year for a "season ticket" as my direct contribution to the cost of my medication. The moment I turned sixty I no longer had to pay anything even though my financial position remained exactly the same. That to me is crackers. Free prescriptions should be for those who cannot afford to pay not because one has reached some arbitrary age. If all the over sixties who can afford £100 per annum (i.e. most of us) were required to cough up there would be a lot more dosh sloshing around in the NHS drugs fund.
You get into a spiral of meds for the side effects and then for the side effects of the meds for the side effects. Hospital letters routinely tell you to bring with you all the meds you are on, in the original container, because people tend not to have a clue what they are on, and for what condition.
I now get the anti-depressants I have been on for 20 years, free because I have had cancer for 4. Suits me fine, but it seems unfair to make cancer a poster child disease as if other lethal diseases were less deadly or less unpleasant.
If it were up to me I would abolish prescription charges and start charging per GP appointment at the same rate as a prescription costs now. That would free the system up by reducing timewasters and no-shows.
Ages ago, I read about 70% of health spending was on women (may've been whilst I was at university). There are some obvious disparities that help explain some of this (pregnancy, for a start, and women live longer making them more prone to diseases that affect the elderly. Women are also likelier to have both depression and stress, the two most common psych issues).
However, there's also the 'sexiness' of some matters. Breast cancer gets lots of funding. Testicular/prostate cancer less so. Some gender neutral (as far as I know) cancers like bowel/pancreatic also get relatively low funding.
When there's uneven funding that's judged to help men more than women (cycling funding, with 2/3 of cyclists being men) the response is to try and shovel money into a female majority/only sport (netball's funding just got hiked). When the reverse is true (public money for refuges dedicated to victims of domestic violence) not a lot happens.
If there were 'fair' funding for conditions I think there'd still be a majority spent on women, just because of longevity/pregnancy. But the bizarre way that any disparity that favours men is seen as wicked, and any disparity that favours women is tolerated, suggests that there should perhaps be more funding for male and gender-neutral cancers, and that probably applies to other medical conditions too.
Edited extra bit: Mr. Z, hope it can be cured entirely.
Every year or so my dentist does a general health check of all the medicines I'm taking. I start saying bendro...... and he and the nurse join in with a sing-song chant of the three or four blood pressure pills that local GPs are dishing out to everyone.
Lower BP or a stroke? We checked at our local surgery recently and the number of no-shows was very low indeed.
I have a son who is an experienced paramedic working in East London. He used to work as a full time employee of the NHS but has now chosen to work for them on a part time "bank contract" which still gives earns his pension entitlement for hours worked with the very important advantage that he is not obliged to work the hours and shifts the NHS was telling him to and he can plan and live his life in a much better way. He is now also partly employed by a private company as a trainer giving "first responder" training courses to NHS employees (including doctors and nurses working in hospitals) who need to renew and update their knowledge and skills. His pay from the private training company is considerably better than that provided within the NHS. I am very pleased for him but this does not appear to me to be good management by the NHS.
Paramedics in generally are underpaid (incredibly they are not designated by the Government as an Emergency Service), overworked and under great pressure at the moment as has been extensively reported in the media. Despite the NHS 111 telephone service my son tells me about 75% of the emergency call outs he makes turn out not to require trained paramedics and an emergency ambulance. The Government and the NHS really do need to find more effective ways of preventing unnecessary emergency call outs and thus reducing costs. Perhaps it is time to introduce a small fee for everyone that calls for an emergency ambulance and a system of fines for the cases where people are found to have irresponsibly abused this service?
Personally I also think a lot of money could be saved if the Fire Service and the Emergency Ambulance services were to be amalgamated similar to the French Model.
There are tentative steps towards firefighters responding to medical emergencies. There is a reluctance to fund it and to provide adequate training, although we are all trained to FPOS standards, we don't get the experience to be properly competent at it. There is a suspicion that it is just a box ticking exercise for both the Fire Service and Ambulance Service. The local Fire Services get brownie points for taking on more work, and we help the Ambulance Service meet their attendance times. In reality, we'll end up holding hands and administering oxygen until a real paramedic shows up. There is real scope in this for a game changing partnership, but no one wants to pay for it, or lose their empire.
Mr Dancer, there’s also an element of results of research. Breast cancer is relatively easy to get good results with; pancreatic cancer, and indeed ovarian much less so. Although recently there appears to be some progress on pancreatic, and I’m personally glad to see, prostate cancer.
Sympathies for the alarming experience, Mike - the developments sound encouraging and I hope the treatment leads to swift, full recovery.
The NHS has always been very good at emergencies and really urgent cases, and I tihnk that's still largely true, though clearly there are lengthening waits at A&E across the country. Where there really does seem to be a serious and worsening problem is elective surrgery (e.g. hip replacement), as well as the bundle of issues relating to release to adequate care. Hospitals with increasing budgetary constraints rightly try to protect the urgent care at the expense of everything else, but there isn't any doubt that amber lights are flashing over most of the rest of the system.
The only way that I can foresee a government being able to introduce charges for GP appointments, penalties for unattended appointments, abolition of certain free prescription exemptions etc is if they have very specific support for the measures mentioned from the public after the public have been given a vote.
@mattholehouse: PM May denounces separatist factions in British politics who obsess over constitutional grievances instead of improving public services
@IanDunt: This is a great speech. If only she wasn't actively pursuing the exact opposite of everything she has proposed.
@IanDunt: I remember the good old days, when political speeches were just misleading rather than grand exercises in double-think
@DPJHodges: Slice it however you want. You can't simultaneously argue the UK can flourish outside of the EU, but Scotland can't flourish outside the UK.
Lucy Fisher Retweeted Neil Henderson Excl: Labour has lost nearly 26,000 members since last summer, according to leaked party data. Snr party figures say tide turning on Corbyn
Some senior party figures have never been very keen. What's mostly happening is that not all the new recruits are renewing (three quarters of the lapsees joined in the last two years), so there's an overall drop of 5%. I don't think this in isolation tells us very much (especially as the figure is not net - it doesn't allow for new joiners): anyone who has run any membership organisation will tell you that retention after the first year is a challenge, unless you can sign everyone up on Direct Debit.:I'll be surprised if the retention rate for new members after a full year exceeds 80%, and that's just on general principles, nothing to do with Labour.
Mr. Pulpstar, I missed (with tiny stakes) 101 on Juppe a few days ago by less than a minute. Got on at 51, though, and all green, so can't complain too much.
The OECD statistics database is a good place to look at comparative health spending across counties. The table goes from 2000 to 2015 so is up to date.
@DPJHodges: Slice it however you want. You can't simultaneously argue the UK can flourish outside of the EU, but Scotland can't flourish outside the UK.
It's far easier to achieve a painless divorce from someone who you have no children with whilst renting a flat after one year of marriage, than it is to divorce someone after thirty years who you have a family and property with.
The UK union is much more heavily embedded that the european one.
Mr Dancer, thank you. Clear scans for 3 years now, so if it weren't hubristic I would be toying with the "cured" word.
I hope it’s better for you Mr Z than it was for me. 5 years clear test results, discharged, then a different one appeared! Went to a talk on cancer from a researcher at our local Uni the other day and he remarked that 50% of us will get cancer of some sort. Somebody near me remarked that neither he nor his wife had, so I told him I must have his share!
@DPJHodges: Slice it however you want. You can't simultaneously argue the UK can flourish outside of the EU, but Scotland can't flourish outside the UK.
Except the majority of the UK trade is outside the EU, and the majority of Scotland trade is not outside the rUK.
Mr. Pulpstar, my Betfair account's anaemic, which limits my room to manoeuvre. I may give it an infusion from the winnings, though.
Mr. Chestnut, precisely. Leaving the EU is significant, but it's leaving a 40 year trade bloc and 20 year political bloc. The UK is 300 years old. Scotland would need to change its currency or be without a lender of last resort. Furthermore, the UK single market is worth four times more to Scotland than the EU single market. Arguing for leaving the latter because the effect of leaving the former is so terrible is akin to complaining at losing a finger and solving the problem by hacking the other four off.
Edited extra bit: Juppe now shorter than Le Pen. Drunken madness.
But if you backed Juppe two days ago at 101, you can now lay at about 4. C'est formidable!
Alain Juppé (last traded at 4.2) is now shorter than Marine Le Pen (last traded at 4.4) on Betfair. Not bad for someone who isn't even yet a candidate.
@IanDunt: This is a great speech. If only she wasn't actively pursuing the exact opposite of everything she has proposed.
@IanDunt: I remember the good old days, when political speeches were just misleading rather than grand exercises in double-think
@DPJHodges: Slice it however you want. You can't simultaneously argue the UK can flourish outside of the EU, but Scotland can't flourish outside the UK.
Sorry, but that last point is utter bollocks. Scotland going independent would be a far bigger upheaval than a be U.K. leaving for the EU.
When I was concerned with these things the working, statistically based, hypothesis was that someone over 65 had 10 times the number of prescriptions as someone in their 40’s.
I don't know about over 65s but chatting to my local pharmacist he reckons between 50 and 60% of the population of Hurstpierpoint over the age of 55 are on regular medication. That seems an incredible proportion to me but I have to assume he knows his business. I think it raises two questions:
1. How much over prescribing is going on? Do people really need the medicines they take or is there an element of doctors giving patients a tablet to shut them up and make them go away? From the other side of the seven different medicines I am prescribed and take daily there are two which were prescribed years ago for conditions which I haven't had for years but which the GP says I should keep taking, just in case.
2. Payment. Until I was sixty I paid about £100 a year for a "season ticket" as my direct contribution to the cost of my medication. The moment I turned sixty I no longer had to pay anything even though my financial position remained exactly the same. That to me is crackers. Free prescriptions should be for those who cannot afford to pay not because one has reached some arbitrary age. If all the over sixties who can afford £100 per annum (i.e. most of us) were required to cough up there would be a lot more dosh sloshing around in the NHS drugs fund.
You get into a spiral of meds for the side effects and then for the side effects of the meds for the side effects. Hospital letters routinely tell you to bring with you all the meds you are on, in the original container, because people tend not to have a clue what they are on, and for what condition.
I now get the anti-depressants I have been on for 20 years, free because I have had cancer for 4. Suits me fine, but it seems unfair to make cancer a poster child disease as if other lethal diseases were less deadly or less unpleasant.
If it were up to me I would abolish prescription charges and start charging per GP appointment at the same rate as a prescription costs now. That would free the system up by reducing timewasters and no-shows.
The 'no shows' at our surgery are primarily drug users or those with mental issues who have little control over their own actions.
The Scots will never have a better moment to go for independence than now, if that is what they want to do.
The shrill cries of Leavers who are determined to insist that their peculiar view of the appropriate governance arrangements for these islands is the only conceivable view convince only themselves.
@DPJHodges: Slice it however you want. You can't simultaneously argue the UK can flourish outside of the EU, but Scotland can't flourish outside the UK.
Except the majority of the UK trade is outside the EU, and the majority of Scotland trade is not outside the rUK.
And the UK is a net contributor to the EU and Scotland is a net recipient from the rUK.....
Comments
Vice President Mike Pence used a private email account to discuss homeland security and other sensitive issues, it has been reported.
Emails released under a public records law show that while Mr Pence was the governor of Indiana he regularly used the AOL address to speak to advisers about state business, the Indianapolis Star reports.
https://twitter.com/SkyNews/status/837594915118940160
https://twitter.com/joshspero/status/837573972870987776
Macron's odds have slightly lengthened, 1.9 to 2. Le Pen steady at 3.
If Fillon is going to go, surely it has to be soon, otherwise it's too damned late?
Fillon best not change his bloody mind now.
Traitors sneer....
If he withdraws now he might be able to run again. If he clings on and loses, surely that'd anger a lot of people who might've backed him?
The chilling reality is that the Kings Fund think we will need to increase health spending by 35bn per year by 2020/21, just to stand still, and 43bn to spend the same as others appear to. The former figure is (in round terms) what we spend in total on Education, the second what we spend in total on Defense.
http://www.catholicherald.co.uk/news/2017/03/03/catholic-mp-with-ashes-on-her-forehead-causes-stir-in-the-commons/
It's the new economy companies that come out with guff on flexibility and freedom to choose, but turns out it means poverty wages for their staff.
Many of these companies offer payment per job, with you often having to fund the cost of the vehicle yourself. Some people earn ok if the do a 60 hour week, but woe betide you use your flexibility for illness or holiday, you won't get given new jobs. You decline too many jobs and your metrics crash.
There are other even worse off having to work long hours still to make little money, with often effective rates of pay being less than £2 per hour.
Luckily the courts are catching on to these dodges, if you are effectively making people work a mandatory number of hours they're really full time employees not independent contractors.
They deserve the minimum wage and sick pay.
Besides it can't have escaped the governments notice the companies are not paying national insurance or company pensions.
Flexibility is fine as long as it benefits both parties, rather than a way to screw down wages and tax payments.
None of this is to say that the concern over the NHS is unimportant or unjustified; as others have pointed out, just keeping up with demand is a huge challenge, and as Mike's experience shows, this is of course a vital issue in people's lives.
On the politics, Labour's approach of continual doom-and-gloom combined with ludicrous attacks on the motives and integrity of Conservative politicians on health is unlikely to win them much support. They need to think about answers, not insults - no-one thinks this is an easy problem, voters are not so stupid.
#BREAKING -- Juppé could step in if Fillon abandons #présidentielle2017 race: Juppé camp /via @AFP #France
I could step in if Jennifer Morrison and Olivia Wilde wanted a third attendee at their jacuzzi, champagne and pillow fights party. But my invite appears to be lost in the post.
1. How much over prescribing is going on? Do people really need the medicines they take or is there an element of doctors giving patients a tablet to shut them up and make them go away? From the other side of the seven different medicines I am prescribed and take daily there are two which were prescribed years ago for conditions which I haven't had for years but which the GP says I should keep taking, just in case.
2. Payment. Until I was sixty I paid about £100 a year for a "season ticket" as my direct contribution to the cost of my medication. The moment I turned sixty I no longer had to pay anything even though my financial position remained exactly the same. That to me is crackers. Free prescriptions should be for those who cannot afford to pay not because one has reached some arbitrary age. If all the over sixties who can afford £100 per annum (i.e. most of us) were required to cough up there would be a lot more dosh sloshing around in the NHS drugs fund.
Don't answer all of them ...
I am doubtful even the current modest economic growth will continue for more than a few days, and that is nothing to do with BrExit, that is to do with a slowdown being due in the economic cycle, another dotcom crash is more than overdue when investors start to notice how ludicrously overvalued a lot of tech stocks are, and because there are enough bumps on the horizon that one of them is pretty much bound to happen (Trump crash, conflict with China in the South China Sea, renewed cold war with Russia, GrExit, ItExit, adiEU etc). Cuts are going to be needed anyway never mind scraping around behind the sofa for a few more quid for the NHS.
Waits for more stories on Juppe's little difficulties with corruption.
This means we're all going to be sending more of income to old people, and that means that even if productivity grows at 3% per year, our disposable income will grow less quickly.
I'm told.
Now that is pessimistic. I'm a lot more confident than that.
Why would
i) a cross-bench peer have any idea how many Tory MPs are likely to revolt
ii) any Tory MP who has previously voted against unilateral guarantees for EU migrants switch their vote?
Sounds like Soubry is coming out with fantasy numbers to try to get enough backbenchers on her side.
1) we can afford to pay the prescription.
2) given everything else he's been through, diabetes is the least of his worries.
When I mentioned this incredulously in Northern Ireland, I was told that no one there pays for prescriptions.
@JournoStephen: "The SNP have been allowed to get away with it for too long. Now Scots have a fighter in @RuthDavidsonMSP." -- Theresa May #SCC17
When we built up debt in the second world war we were doing it for future generations as well as ourselves. Now we are just being selfish.
Paramedics in generally are underpaid (incredibly they are not designated by the Government as an Emergency Service), overworked and under great pressure at the moment as has been extensively reported in the media. Despite the NHS 111 telephone service my son tells me about 75% of the emergency call outs he makes turn out not to require trained paramedics and an emergency ambulance. The Government and the NHS really do need to find more effective ways of preventing unnecessary emergency call outs and thus reducing costs. Perhaps it is time to introduce a small fee for everyone that calls for an emergency ambulance and a system of fines for the cases where people are found to have irresponsibly abused this service?
Personally I also think a lot of money could be saved if the Fire Service and the Emergency Ambulance services were to be amalgamated similar to the French Model.
A significant proportion of females 45 or so plus will be using some form of medication for the menopause.
A significant proportion of both sexes, but most likely males will be on some form of preventative medication such as statins. Assuming that these reduce hospital admissions, then overall there’s probably a saving. Lowest price statin is 84p for a months supply.
Some of both sexes will be diabetic. Home treatment for this, while more effective nowadays is becoming more expensive.
Then there will be some patients with short term problems.
It’s always a good idea to review medication use, and increasingly often this is being done. A growing number of GP practices now have a pharmacist on site to do among other things that, and to handle requests for repeat medications. In my day there was unquestionably an amount of unnecessary repeat prescribing and I and colleagues spent quite an amount of time dealing with that.
As far as point 2 is concerned the whole business of ‘prescription charges' has got wildly out of control and the DoH, told by the Treasury that we can’t do what Scotland and Wales have done and abolish the charges, doesn’t seem to have a clue as to what it can do, so increases the charges to what is, compared with the actual cost of the drugs often an astronomical level and simultaneously increases the number of exemptions.
(Edited for better English!)
I now get the anti-depressants I have been on for 20 years, free because I have had cancer for 4. Suits me fine, but it seems unfair to make cancer a poster child disease as if other lethal diseases were less deadly or less unpleasant.
If it were up to me I would abolish prescription charges and start charging per GP appointment at the same rate as a prescription costs now. That would free the system up by reducing timewasters and no-shows.
However, there's also the 'sexiness' of some matters. Breast cancer gets lots of funding. Testicular/prostate cancer less so. Some gender neutral (as far as I know) cancers like bowel/pancreatic also get relatively low funding.
When there's uneven funding that's judged to help men more than women (cycling funding, with 2/3 of cyclists being men) the response is to try and shovel money into a female majority/only sport (netball's funding just got hiked). When the reverse is true (public money for refuges dedicated to victims of domestic violence) not a lot happens.
If there were 'fair' funding for conditions I think there'd still be a majority spent on women, just because of longevity/pregnancy. But the bizarre way that any disparity that favours men is seen as wicked, and any disparity that favours women is tolerated, suggests that there should perhaps be more funding for male and gender-neutral cancers, and that probably applies to other medical conditions too.
Edited extra bit: Mr. Z, hope it can be cured entirely.
We checked at our local surgery recently and the number of no-shows was very low indeed.
Francois Fillon's presidential campaign unravels as key supporters desert him, including, this morning, his chief spokesman.
Edited extra bit: hedge now, or hedge later?
There is real scope in this for a game changing partnership, but no one wants to pay for it, or lose their empire.
Although recently there appears to be some progress on pancreatic, and I’m personally glad to see, prostate cancer.
The NHS has always been very good at emergencies and really urgent cases, and I tihnk that's still largely true, though clearly there are lengthening waits at A&E across the country. Where there really does seem to be a serious and worsening problem is elective surrgery (e.g. hip replacement), as well as the bundle of issues relating to release to adequate care. Hospitals with increasing budgetary constraints rightly try to protect the urgent care at the expense of everything else, but there isn't any doubt that amber lights are flashing over most of the rest of the system.
@IanDunt: I remember the good old days, when political speeches were just misleading rather than grand exercises in double-think
@DPJHodges: Slice it however you want. You can't simultaneously argue the UK can flourish outside of the EU, but Scotland can't flourish outside the UK.
Go on, Baroin. You know you want to.
Edited extra bit: Mr. Z, huzzah!
You should have a medicinal whisky, to fortify the immune system.
http://stats.oecd.org/index.aspx?DataSetCode=SHA
The UK union is much more heavily embedded that the european one.
Went to a talk on cancer from a researcher at our local Uni the other day and he remarked that 50% of us will get cancer of some sort. Somebody near me remarked that neither he nor his wife had, so I told him I must have his share!
Mr. Chestnut, precisely. Leaving the EU is significant, but it's leaving a 40 year trade bloc and 20 year political bloc. The UK is 300 years old. Scotland would need to change its currency or be without a lender of last resort. Furthermore, the UK single market is worth four times more to Scotland than the EU single market. Arguing for leaving the latter because the effect of leaving the former is so terrible is akin to complaining at losing a finger and solving the problem by hacking the other four off.
Edited extra bit: Juppe now shorter than Le Pen. Drunken madness.
But if you backed Juppe two days ago at 101, you can now lay at about 4. C'est formidable!
Remember the generic republican candidate polling vs Hillary.............
The shrill cries of Leavers who are determined to insist that their peculiar view of the appropriate governance arrangements for these islands is the only conceivable view convince only themselves.