I once heard the PM described as “the man [sic] you hire to do the things that you don’t want to think about but know that they need to be done”. I’ve never been able to track it down again though!
In a perfect world we wouldn’t do deals with Saudi. But they are not an existential threat to us in the way that China could be. Sometimes your enemy’s enemy is your friend (in this case to counterpoint Iran) for geopolitical reasons. Regardless of how distasteful they may be.
And when they overstep even those weak limits - as with that guy in the Saudi embassy in Turkey - then they need to be slapped down
In that case I’m glad we can dispense with cant about ‘fundamental’ values.
Everyone - government, organisation and individual - talks about fundamental values (or just values). There's always a point where we waive them, but some do it sooner and more blatantly than others is all.
A genuine question here is whether we should be even-handed or try to set higher standards for ourselves. Within reason, I think we should, and, on the whole, we don't (in foreign policy).
King Cole, that's largely due to some stupid decisions on energy. Merkel throwing away nuclear in Germany because of what happened in Fukushima[sp] is a perfect example.
Dr. Foxy, New Zealand is isolated and has been far chummier with the Communists than they might wish to be.
As for Australia, the rising threat of China is something that must be accounted for. Sure, you can feed a crocodile, but appeasement does not work. Australia must be able to defend itself.
New Zealand is and has been a non-nuclear state for three decades - that's why ANZUS was suspended as NZ didn't want American nuclear submarines in its waters which is, I think, the main reason Auckland has been excluded from the AUKUS discussions.
NZ, like Australia, has significant trading links with China worth a lot to the NZ economy. Tourism from the mainland was growing strongly pre-pandemic as well.
In any case, are we seriously arguing China is a significant military threat to Australia and New Zealand? It may be more significant if, for instance, China did a deal with Fiji and established a military base at Suva or Nadi or some other island.
China shares a border with many other countries - Russia, India, Afghanistan and Vietnam to name but four. Are we offering them any kind of guarantee or support against Chinese military expansionism? I doubt it but again that's missing the point - China is achieving economically what the PLA couldn't do militarily. It effectively controls parts of Africa - Chinese funded infrastructure may be about getting access to resources but the local Governments aren't going to say no to improved road and rail links and the economic benefits they bring.
How has the West responded to China's economic imperialism (that's what it is)? Answer it hasn't. The thinking and the rhetoric remains trapped in the Cold War - a couple of nuclear submarines versus providing jobs and a better standard of living for thousands of impoverished people. I think we know what works.
What does "economic imperialism" even mean?
Have you been to Africa? - it means buying huge chunks of countries in deals with the people who run the country. The local people find huge areas are then barbwired off - they are often excluded from the vast facilities built were.
Of course, in what we would late mediaeval times Chinese ships reached what we now call Australia. However, AIUI, they reached the north west and saw little to encourage them to settle.
They don't appear to have reached Aotearoa/New Zealand.
Covid has shown up quite how sparse our weapons against disease are. The vaccines were later then we needed, even fat a brilliantly accelerated development. Therapeutic developments have been very disappointing.
I would like to see a Manhattan Project on therapeutics. The world needs to throw billions into development of drugs and strategies that will help keep people out of hospital from even 'normal' illnesses such as flu.
An issue is that vaccines have been seen to work and, in a couple of cases, vastly profitable. The sector will throw lots of money into vaccines. But vaccines are inevitable delayed; they need to be developed for each individual illness. Therapeutic drugs and techniques can help with many different illnesses that attack in similar ways.
I think you are wrong on the facts here. There was very good work done on therapeutics in the UK - I think it was called the REACT study - and among other improvements in care it lead to the use of Dexamethasone, which cut the fatality rate by one-third. You would expect that discovery would have save tens of thousands of lives during our Alpha wave.
There was also the improvements in supplying oxygen that came out of the ventilator challenge.
I can't find much to fault in the medical response. There is a question over whether challenge trials should be used to speed up the vaccine development process.
I'm not denying that there's been *some* progress in therapeutics - but also a lot of dead ends. However, we've got vaccines that are 80-90% effective against death. As far as I'm aware, the therapeutics we've developed during this crisis have been nowhere near as effective.
Edit: and I don't wish to cast shade on our medical response.
King Cole, that's largely due to some stupid decisions on energy. Merkel throwing away nuclear in Germany because of what happened in Fukushima[sp] is a perfect example.
Maybe, but what is, now, the alternative? Particularly in the short-term.
King Cole, that's largely due to some stupid decisions on energy. Merkel throwing away nuclear in Germany because of what happened in Fukushima[sp] is a perfect example.
She didn’t seem to appreciate at the time, that closing Germany’s nuclear power stations, for reasons that made no sense at the time, would lead to her being Putin’s (female canine) a few years later.
Another example of rhetoric missing reality. Much fanfare last week with the news London offices were apparently now full again with people returning to work at desks in vast numbers amidst signs London was back to normal and all this usual positive propaganda.
The truth, in terms of passenger transport numbers, is very different. On the tube, passenger numbers reached 54% of pre-Covid on Thursday 9th. The numbers travelling have been pretty static since mid-August. There's been no mass return at least on the Underground.
The numbers are improving at the weekend - up to 70% of pre-Covid numbers so obviously there are those who re getting out and about for leisure (presumably) and that's my anecdotal evidence as well. Yet there's been no attempt to re-balance the service by putting more trains on at the weekend and taking off some of the very quiet off-peak weekday services (I forgot, they can't, condition of the Government bailout etc).
Indeed, when a rail company like South-West Railways tries to argue reduced passenger numbers don't justify maintaining current levels of service, they get pilloried with local Conservative County Councillors and Liberal Democrat District Councillors all lining up to be the passengers' friend and champion:
The Treasury is driving this - as the Government looks to turn off the financial lifeline to train companies which led to empty trains running up and down the rails day after day, the train companies are trying to figure out what a 40% reduction in peak traffic means longer term for their operating model and viability. Inevitably, it means fewer trains across the network and some stations will see a reduced train service.
Yes. The "Covid is over, everyone back to work plebs" rhetoric sharply contrasts with the rapid work to reduce rail services long term into cities. On topic there won't be another lockdown even if the NHS does fall over this winter as many warn it may. Even if the government tried to impose one people would ignore it- unless there was a catastrophic new variant that rendered the vaccines useless.
What is very clear from usage patterns is that punters are much happier travelling for leisure than they are work. Indeed reductions in foreign holidays plus a change of working patterns seems to have turbocharged domestic leisure activities.
The DfT publish on a weekly basis estimates of the daily use of transport compared with pre covid times.
The latest numbers for the week commencing 6th September suggest that cars are approximately at 95% (but upto 110% over the weekend), but light and heavy goods vehicles are at 108%.
National Rail is only at 63%, whilst the Tube is at 53% and London Busses at 70%. Tubes are up to about 65% over the weekend, whilst rail declines to 58%.
From a personal perspective, I had a trip into London this week for the first time in around 18 months. A normal peak commuter train which would normally be crushed loaded pre covid had around 50% of seats empty. Ok this was Friday, but it indicates the scale of the problem for train companies and hence the Goverment as the DfT have full economic control.
This is where rhetoric will once again splat against the wall of reality. It is clear that work practices and thus travel patterns have changed. The status quo ante is gone. So the network needs to be geared more around leisure than commuting. The problem is that the DfT continue to micromanage to death the network and now have complete control.
Based on the idiocy of the government I won't be surprised to see them continue to order the network to allow for commuting that doesn't exist any more in an increasingly forlorn attempt to force companies and employees into office working so they can pay exorbitant ticket prices and buy twatty coffee from tax dodgers. We need a refocus away from mad intense commuter frequency and crap to no service outside that.
...and the Labour party will enthusiastically support the retention of a full commuting service because rail unions...
You may well be right. We strongly suspect that the contractual arrangements of the drivers have a lot to do with the collapse of the weekend service around here. The theory is as follows:
1. Staff rotas are strongly tilted towards servicing the now half-vanished weekday commuter market. The operators failed to employ enough drivers (so as to keep a lid on costs and maximise profits, of course,) preferring to rely on those wanting to earn overtime to keep weekend services running. 2. The first wave of plague almost completely wiped out rail travel. Reduced services for essential workers were run as a consequence. Overtime opportunities were cut back or removed. 3. Many drivers (who are, in any event, both well-paid and made to work some anti-social early morning and late night shifts as it is) re-evaluated their work-life balance, and concluded that they would rather work fewer hours and do without the overtime, thank you very much. 4. Drivers are now doing their minimum duties keeping the weekday services running and aren't interested in plugging the gaps at weekends anymore. Which suits them just fine.
It doesn't take much imagination to understand why it is that the train operators, especially now that they're effectively nationalised and being sustained by the public purse, don't want to change the timetables to favour the leisure traveller over the commuter. This doesn't suit the drivers, who will demand large pay increases to compensate for the inconvenience, go on strike, or both. So much easier not to rock the boat.
Dr. Foxy, New Zealand is isolated and has been far chummier with the Communists than they might wish to be.
As for Australia, the rising threat of China is something that must be accounted for. Sure, you can feed a crocodile, but appeasement does not work. Australia must be able to defend itself.
New Zealand is and has been a non-nuclear state for three decades - that's why ANZUS was suspended as NZ didn't want American nuclear submarines in its waters which is, I think, the main reason Auckland has been excluded from the AUKUS discussions.
NZ, like Australia, has significant trading links with China worth a lot to the NZ economy. Tourism from the mainland was growing strongly pre-pandemic as well.
In any case, are we seriously arguing China is a significant military threat to Australia and New Zealand? It may be more significant if, for instance, China did a deal with Fiji and established a military base at Suva or Nadi or some other island.
China shares a border with many other countries - Russia, India, Afghanistan and Vietnam to name but four. Are we offering them any kind of guarantee or support against Chinese military expansionism? I doubt it but again that's missing the point - China is achieving economically what the PLA couldn't do militarily. It effectively controls parts of Africa - Chinese funded infrastructure may be about getting access to resources but the local Governments aren't going to say no to improved road and rail links and the economic benefits they bring.
How has the West responded to China's economic imperialism (that's what it is)? Answer it hasn't. The thinking and the rhetoric remains trapped in the Cold War - a couple of nuclear submarines versus providing jobs and a better standard of living for thousands of impoverished people. I think we know what works.
What does "economic imperialism" even mean?
The flippant answer is it is when another country decides to take our rightful place as the chief exploiter of poorer countries.
Mr. Sandpit, it was a knee jerk emotional reaction that didn't have any real reason behind it. See also, the migrant crisis "Come to Germany".
King Cole, in the short term, the only thing to do is remember an obvious lesson that should not have been needed in the first place, and plan long term accordingly.
[The UK has also made such mistakes, our energy policy is scratchy at best and we were way too soft and naive with China under Cameron].
Dr. Foxy, New Zealand is isolated and has been far chummier with the Communists than they might wish to be.
As for Australia, the rising threat of China is something that must be accounted for. Sure, you can feed a crocodile, but appeasement does not work. Australia must be able to defend itself.
New Zealand is and has been a non-nuclear state for three decades - that's why ANZUS was suspended as NZ didn't want American nuclear submarines in its waters which is, I think, the main reason Auckland has been excluded from the AUKUS discussions.
NZ, like Australia, has significant trading links with China worth a lot to the NZ economy. Tourism from the mainland was growing strongly pre-pandemic as well.
In any case, are we seriously arguing China is a significant military threat to Australia and New Zealand? It may be more significant if, for instance, China did a deal with Fiji and established a military base at Suva or Nadi or some other island.
China shares a border with many other countries - Russia, India, Afghanistan and Vietnam to name but four. Are we offering them any kind of guarantee or support against Chinese military expansionism? I doubt it but again that's missing the point - China is achieving economically what the PLA couldn't do militarily. It effectively controls parts of Africa - Chinese funded infrastructure may be about getting access to resources but the local Governments aren't going to say no to improved road and rail links and the economic benefits they bring.
How has the West responded to China's economic imperialism (that's what it is)? Answer it hasn't. The thinking and the rhetoric remains trapped in the Cold War - a couple of nuclear submarines versus providing jobs and a better standard of living for thousands of impoverished people. I think we know what works.
Dr. Foxy, New Zealand is isolated and has been far chummier with the Communists than they might wish to be.
As for Australia, the rising threat of China is something that must be accounted for. Sure, you can feed a crocodile, but appeasement does not work. Australia must be able to defend itself.
New Zealand is and has been a non-nuclear state for three decades - that's why ANZUS was suspended as NZ didn't want American nuclear submarines in its waters which is, I think, the main reason Auckland has been excluded from the AUKUS discussions.
NZ, like Australia, has significant trading links with China worth a lot to the NZ economy. Tourism from the mainland was growing strongly pre-pandemic as well.
In any case, are we seriously arguing China is a significant military threat to Australia and New Zealand? It may be more significant if, for instance, China did a deal with Fiji and established a military base at Suva or Nadi or some other island.
China shares a border with many other countries - Russia, India, Afghanistan and Vietnam to name but four. Are we offering them any kind of guarantee or support against Chinese military expansionism? I doubt it but again that's missing the point - China is achieving economically what the PLA couldn't do militarily. It effectively controls parts of Africa - Chinese funded infrastructure may be about getting access to resources but the local Governments aren't going to say no to improved road and rail links and the economic benefits they bring.
How has the West responded to China's economic imperialism (that's what it is)? Answer it hasn't. The thinking and the rhetoric remains trapped in the Cold War - a couple of nuclear submarines versus providing jobs and a better standard of living for thousands of impoverished people. I think we know what works.
My understanding is that it doesn’t really provide jobs for the locals - they fly in Chinese workers who live in a separate compound and build. (Based on an article I read about Tuvalu).
The “gift” is also structured as a loan - it’s all about intergovernmental power and influence
Infrastructure development might have been a better use of foreign aid money which has just been cut, of course. Apparently hard-headed soft power is only effective when directed from Beijing.
Dr. Foxy, New Zealand is isolated and has been far chummier with the Communists than they might wish to be.
As for Australia, the rising threat of China is something that must be accounted for. Sure, you can feed a crocodile, but appeasement does not work. Australia must be able to defend itself.
New Zealand is and has been a non-nuclear state for three decades - that's why ANZUS was suspended as NZ didn't want American nuclear submarines in its waters which is, I think, the main reason Auckland has been excluded from the AUKUS discussions.
NZ, like Australia, has significant trading links with China worth a lot to the NZ economy. Tourism from the mainland was growing strongly pre-pandemic as well.
In any case, are we seriously arguing China is a significant military threat to Australia and New Zealand? It may be more significant if, for instance, China did a deal with Fiji and established a military base at Suva or Nadi or some other island.
China shares a border with many other countries - Russia, India, Afghanistan and Vietnam to name but four. Are we offering them any kind of guarantee or support against Chinese military expansionism? I doubt it but again that's missing the point - China is achieving economically what the PLA couldn't do militarily. It effectively controls parts of Africa - Chinese funded infrastructure may be about getting access to resources but the local Governments aren't going to say no to improved road and rail links and the economic benefits they bring.
How has the West responded to China's economic imperialism (that's what it is)? Answer it hasn't. The thinking and the rhetoric remains trapped in the Cold War - a couple of nuclear submarines versus providing jobs and a better standard of living for thousands of impoverished people. I think we know what works.
What does "economic imperialism" even mean?
Have you been to Africa? - it means buying huge chunks of countries in deals with the people who run the country. The local people find huge areas are then barbwired off - they are often excluded from the vast facilities built were.
In Covid, as in so many other areas, the government is not in control of events. The fire at the interconnector is the straw that will break the camel´s back. Utility prices are already 50% up, and already steel production is being cut, because electricity prices are too high for the steel plants to compete. Inflation is already over shooting, and utility costs, plus the "supply chain issues" will send inflation way above target, to the point that even the government´s poodle at the Bank of England will have to take action to avoid a Sterling crisis. There has not been a mortgage rate rise for 15 years, and yet almost no one has been prepaying.
We are on the eve of a major domestic economic crisis and Johnson is more interested in undermining efficiency and our global competativeness with nonsense like returning to gills and ounces while play stupid geopolitical games that tie us to the declining United States and antagonise our neighbours and the rising powers of Asia.
When inflation hits and the promised pay rises dont come for key workers then we will see serious industrial unrest added to the mix. It really is back to the seventies.
The utter incompetence, the stunning arrogance, the sheer bloody awfulness of this government will absolutely not be able to cope with "events, dear boy, events". So I think that there is a pretty good chance that they will not just be beaten in 2024, but flayed. Odds on sub 200 seats for the Tories then?
Dr. Foxy, New Zealand is isolated and has been far chummier with the Communists than they might wish to be.
As for Australia, the rising threat of China is something that must be accounted for. Sure, you can feed a crocodile, but appeasement does not work. Australia must be able to defend itself.
New Zealand is and has been a non-nuclear state for three decades - that's why ANZUS was suspended as NZ didn't want American nuclear submarines in its waters which is, I think, the main reason Auckland has been excluded from the AUKUS discussions.
NZ, like Australia, has significant trading links with China worth a lot to the NZ economy. Tourism from the mainland was growing strongly pre-pandemic as well.
In any case, are we seriously arguing China is a significant military threat to Australia and New Zealand? It may be more significant if, for instance, China did a deal with Fiji and established a military base at Suva or Nadi or some other island.
China shares a border with many other countries - Russia, India, Afghanistan and Vietnam to name but four. Are we offering them any kind of guarantee or support against Chinese military expansionism? I doubt it but again that's missing the point - China is achieving economically what the PLA couldn't do militarily. It effectively controls parts of Africa - Chinese funded infrastructure may be about getting access to resources but the local Governments aren't going to say no to improved road and rail links and the economic benefits they bring.
How has the West responded to China's economic imperialism (that's what it is)? Answer it hasn't. The thinking and the rhetoric remains trapped in the Cold War - a couple of nuclear submarines versus providing jobs and a better standard of living for thousands of impoverished people. I think we know what works.
What does "economic imperialism" even mean?
Have you been to Africa? - it means buying huge chunks of countries in deals with the people who run the country. The local people find huge areas are then barbwired off - they are often excluded from the vast facilities built were.
Oh, that. I can see why the West wants to put a stop to that sort of thing, yes. I wonder where China got the idea.
Indeed.
The world is supposed to be improving. Not going for Round II Of The Same Shit.
What a day to be going to France! It seems Johnson has chosen to alienate the EU and China and throw in his lot with a dysfunctional US and an insignificant Australia.
To describe him as the Frank Spencer of world politics flatters him
In Covid, as in so many other areas, the government is not in control of events. The fire at the interconnector is the straw that will break the camel´s back. Utility prices are already 50% up, and already steel production is being cut, because electricity prices are too high for the steel plants to compete. Inflation is already over shooting, and utility costs, plus the "supply chain issues" will send inflation way above target, to the point that even the government´s poodle at the Bank of England will have to take action to avoid a Sterling crisis. There has not been a mortgage rate rise for 15 years, and yet almost no one has been prepaying.
We are on the eve of a major domestic economic crisis and Johnson is more interested in undermining efficiency and our global competativeness with nonsense like returning to gills and ounces while play stupid geopolitical games that tie us to the declining United States and antagonise our neighbours and the rising powers of Asia.
When inflation hits and the promised pay rises dont come for key workers then we will see serious industrial unrest added to the mix. It really is back to the seventies.
The utter incompetence, the stunning arrogance, the sheer bloody awfulness of this government will absolutely not be able to cope with "events, dear boy, events". So I think that there is a pretty good chance that they will not just be beaten in 2024, but flayed. Odds on sub 200 seats for the Tories then?
In Covid, as in so many other areas, the government is not in control of events. The fire at the interconnector is the straw that will break the camel´s back. Utility prices are already 50% up, and already steel production is being cut, because electricity prices are too high for the steel plants to compete. Inflation is already over shooting, and utility costs, plus the "supply chain issues" will send inflation way above target, to the point that even the government´s poodle at the Bank of England will have to take action to avoid a Sterling crisis. There has not been a mortgage rate rise for 15 years, and yet almost no one has been prepaying.
We are on the eve of a major domestic economic crisis and Johnson is more interested in undermining efficiency and our global competativeness with nonsense like returning to gills and ounces while play stupid geopolitical games that tie us to the declining United States and antagonise our neighbours and the rising powers of Asia.
When inflation hits and the promised pay rises dont come for key workers then we will see serious industrial unrest added to the mix. It really is back to the seventies.
The utter incompetence, the stunning arrogance, the sheer bloody awfulness of this government will absolutely not be able to cope with "events, dear boy, events". So I think that there is a pretty good chance that they will not just be beaten in 2024, but flayed. Odds on sub 200 seats for the Tories then?
That's why Johnson will cut and run with an election in Spring 2023.
Entirely possible they reached Australia, but the medieval reference did make me wonder.
Didn't realise it had been discredited, but yes, as a memory. There have, apparently been some 17thC Chinese coins discovered, on nearby islands, IIRC, but, again IIRC, they are thought be the result of Indonesian fishermen venturing a bit further than usual. Bit like the West English and Breton fishermen getting glimpses of what we now know as N. America.
Dr. Foxy, New Zealand is isolated and has been far chummier with the Communists than they might wish to be.
As for Australia, the rising threat of China is something that must be accounted for. Sure, you can feed a crocodile, but appeasement does not work. Australia must be able to defend itself.
New Zealand is and has been a non-nuclear state for three decades - that's why ANZUS was suspended as NZ didn't want American nuclear submarines in its waters which is, I think, the main reason Auckland has been excluded from the AUKUS discussions.
NZ, like Australia, has significant trading links with China worth a lot to the NZ economy. Tourism from the mainland was growing strongly pre-pandemic as well.
In any case, are we seriously arguing China is a significant military threat to Australia and New Zealand? It may be more significant if, for instance, China did a deal with Fiji and established a military base at Suva or Nadi or some other island.
China shares a border with many other countries - Russia, India, Afghanistan and Vietnam to name but four. Are we offering them any kind of guarantee or support against Chinese military expansionism? I doubt it but again that's missing the point - China is achieving economically what the PLA couldn't do militarily. It effectively controls parts of Africa - Chinese funded infrastructure may be about getting access to resources but the local Governments aren't going to say no to improved road and rail links and the economic benefits they bring.
How has the West responded to China's economic imperialism (that's what it is)? Answer it hasn't. The thinking and the rhetoric remains trapped in the Cold War - a couple of nuclear submarines versus providing jobs and a better standard of living for thousands of impoverished people. I think we know what works.
My understanding is that it doesn’t really provide jobs for the locals - they fly in Chinese workers who live in a separate compound and build. (Based on an article I read about Tuvalu).
The “gift” is also structured as a loan - it’s all about intergovernmental power and influence
Sure. China learned a lot from the "unequal treaties" of the 19th century, foreign concessions and extraterritorality. They are holding the whip now.
What a day to be going to France! It seems Johnson has chosen to alienate the EU and China and throw in his lot with a dysfunctional US and an insignificant Australia.
To describe him as the Frank Spencer of world politics flatters him
Another example of rhetoric missing reality. Much fanfare last week with the news London offices were apparently now full again with people returning to work at desks in vast numbers amidst signs London was back to normal and all this usual positive propaganda.
The truth, in terms of passenger transport numbers, is very different. On the tube, passenger numbers reached 54% of pre-Covid on Thursday 9th. The numbers travelling have been pretty static since mid-August. There's been no mass return at least on the Underground.
The numbers are improving at the weekend - up to 70% of pre-Covid numbers so obviously there are those who re getting out and about for leisure (presumably) and that's my anecdotal evidence as well. Yet there's been no attempt to re-balance the service by putting more trains on at the weekend and taking off some of the very quiet off-peak weekday services (I forgot, they can't, condition of the Government bailout etc).
Indeed, when a rail company like South-West Railways tries to argue reduced passenger numbers don't justify maintaining current levels of service, they get pilloried with local Conservative County Councillors and Liberal Democrat District Councillors all lining up to be the passengers' friend and champion:
The Treasury is driving this - as the Government looks to turn off the financial lifeline to train companies which led to empty trains running up and down the rails day after day, the train companies are trying to figure out what a 40% reduction in peak traffic means longer term for their operating model and viability. Inevitably, it means fewer trains across the network and some stations will see a reduced train service.
Yes. The "Covid is over, everyone back to work plebs" rhetoric sharply contrasts with the rapid work to reduce rail services long term into cities. On topic there won't be another lockdown even if the NHS does fall over this winter as many warn it may. Even if the government tried to impose one people would ignore it- unless there was a catastrophic new variant that rendered the vaccines useless.
What is very clear from usage patterns is that punters are much happier travelling for leisure than they are work. Indeed reductions in foreign holidays plus a change of working patterns seems to have turbocharged domestic leisure activities.
The DfT publish on a weekly basis estimates of the daily use of transport compared with pre covid times.
The latest numbers for the week commencing 6th September suggest that cars are approximately at 95% (but upto 110% over the weekend), but light and heavy goods vehicles are at 108%.
National Rail is only at 63%, whilst the Tube is at 53% and London Busses at 70%. Tubes are up to about 65% over the weekend, whilst rail declines to 58%.
From a personal perspective, I had a trip into London this week for the first time in around 18 months. A normal peak commuter train which would normally be crushed loaded pre covid had around 50% of seats empty. Ok this was Friday, but it indicates the scale of the problem for train companies and hence the Goverment as the DfT have full economic control.
This is where rhetoric will once again splat against the wall of reality. It is clear that work practices and thus travel patterns have changed. The status quo ante is gone. So the network needs to be geared more around leisure than commuting. The problem is that the DfT continue to micromanage to death the network and now have complete control.
Based on the idiocy of the government I won't be surprised to see them continue to order the network to allow for commuting that doesn't exist any more in an increasingly forlorn attempt to force companies and employees into office working so they can pay exorbitant ticket prices and buy twatty coffee from tax dodgers. We need a refocus away from mad intense commuter frequency and crap to no service outside that.
...and the Labour party will enthusiastically support the retention of a full commuting service because rail unions...
You may well be right. We strongly suspect that the contractual arrangements of the drivers have a lot to do with the collapse of the weekend service around here. The theory is as follows:
1. Staff rotas are strongly tilted towards servicing the now half-vanished weekday commuter market. The operators failed to employ enough drivers (so as to keep a lid on costs and maximise profits, of course,) preferring to rely on those wanting to earn overtime to keep weekend services running. 2. The first wave of plague almost completely wiped out rail travel. Reduced services for essential workers were run as a consequence. Overtime opportunities were cut back or removed. 3. Many drivers (who are, in any event, both well-paid and made to work some anti-social early morning and late night shifts as it is) re-evaluated their work-life balance, and concluded that they would rather work fewer hours and do without the overtime, thank you very much. 4. Drivers are now doing their minimum duties keeping the weekday services running and aren't interested in plugging the gaps at weekends anymore. Which suits them just fine.
It doesn't take much imagination to understand why it is that the train operators, especially now that they're effectively nationalised and being sustained by the public purse, don't want to change the timetables to favour the leisure traveller over the commuter. This doesn't suit the drivers, who will demand large pay increases to compensate for the inconvenience, go on strike, or both. So much easier not to rock the boat.
Now that it’s been demonstrated, that there can be minimal economic damage caused by most people working from home temporarily, is it now not time to shake a big stick at the rail unions, and drag them into the 21st century?
King Cole, that's largely due to some stupid decisions on energy. Merkel throwing away nuclear in Germany because of what happened in Fukushima[sp] is a perfect example.
She didn’t seem to appreciate at the time, that closing Germany’s nuclear power stations, for reasons that made no sense at the time, would lead to her being Putin’s (female canine) a few years later.
Lots of people/organisations predicted precisely that at the time, including the Economist IIRC.
Another example of rhetoric missing reality. Much fanfare last week with the news London offices were apparently now full again with people returning to work at desks in vast numbers amidst signs London was back to normal and all this usual positive propaganda.
The truth, in terms of passenger transport numbers, is very different. On the tube, passenger numbers reached 54% of pre-Covid on Thursday 9th. The numbers travelling have been pretty static since mid-August. There's been no mass return at least on the Underground.
The numbers are improving at the weekend - up to 70% of pre-Covid numbers so obviously there are those who re getting out and about for leisure (presumably) and that's my anecdotal evidence as well. Yet there's been no attempt to re-balance the service by putting more trains on at the weekend and taking off some of the very quiet off-peak weekday services (I forgot, they can't, condition of the Government bailout etc).
Indeed, when a rail company like South-West Railways tries to argue reduced passenger numbers don't justify maintaining current levels of service, they get pilloried with local Conservative County Councillors and Liberal Democrat District Councillors all lining up to be the passengers' friend and champion:
The Treasury is driving this - as the Government looks to turn off the financial lifeline to train companies which led to empty trains running up and down the rails day after day, the train companies are trying to figure out what a 40% reduction in peak traffic means longer term for their operating model and viability. Inevitably, it means fewer trains across the network and some stations will see a reduced train service.
Yes. The "Covid is over, everyone back to work plebs" rhetoric sharply contrasts with the rapid work to reduce rail services long term into cities. On topic there won't be another lockdown even if the NHS does fall over this winter as many warn it may. Even if the government tried to impose one people would ignore it- unless there was a catastrophic new variant that rendered the vaccines useless.
What is very clear from usage patterns is that punters are much happier travelling for leisure than they are work. Indeed reductions in foreign holidays plus a change of working patterns seems to have turbocharged domestic leisure activities.
The DfT publish on a weekly basis estimates of the daily use of transport compared with pre covid times.
The latest numbers for the week commencing 6th September suggest that cars are approximately at 95% (but upto 110% over the weekend), but light and heavy goods vehicles are at 108%.
National Rail is only at 63%, whilst the Tube is at 53% and London Busses at 70%. Tubes are up to about 65% over the weekend, whilst rail declines to 58%.
From a personal perspective, I had a trip into London this week for the first time in around 18 months. A normal peak commuter train which would normally be crushed loaded pre covid had around 50% of seats empty. Ok this was Friday, but it indicates the scale of the problem for train companies and hence the Goverment as the DfT have full economic control.
This is where rhetoric will once again splat against the wall of reality. It is clear that work practices and thus travel patterns have changed. The status quo ante is gone. So the network needs to be geared more around leisure than commuting. The problem is that the DfT continue to micromanage to death the network and now have complete control.
Based on the idiocy of the government I won't be surprised to see them continue to order the network to allow for commuting that doesn't exist any more in an increasingly forlorn attempt to force companies and employees into office working so they can pay exorbitant ticket prices and buy twatty coffee from tax dodgers. We need a refocus away from mad intense commuter frequency and crap to no service outside that.
...and the Labour party will enthusiastically support the retention of a full commuting service because rail unions...
You may well be right. We strongly suspect that the contractual arrangements of the drivers have a lot to do with the collapse of the weekend service around here. The theory is as follows:
1. Staff rotas are strongly tilted towards servicing the now half-vanished weekday commuter market. The operators failed to employ enough drivers (so as to keep a lid on costs and maximise profits, of course,) preferring to rely on those wanting to earn overtime to keep weekend services running. 2. The first wave of plague almost completely wiped out rail travel. Reduced services for essential workers were run as a consequence. Overtime opportunities were cut back or removed. 3. Many drivers (who are, in any event, both well-paid and made to work some anti-social early morning and late night shifts as it is) re-evaluated their work-life balance, and concluded that they would rather work fewer hours and do without the overtime, thank you very much. 4. Drivers are now doing their minimum duties keeping the weekday services running and aren't interested in plugging the gaps at weekends anymore. Which suits them just fine.
It doesn't take much imagination to understand why it is that the train operators, especially now that they're effectively nationalised and being sustained by the public purse, don't want to change the timetables to favour the leisure traveller over the commuter. This doesn't suit the drivers, who will demand large pay increases to compensate for the inconvenience, go on strike, or both. So much easier not to rock the boat.
I think that changing working practices is a part of this. Yes.
But the wider problem is institutional inertia. Once a thing become "Policy" it has the force of dogma. Rational opposition to it is nearly futile.
Some years ago, when I was living out in the sticks, a chap came up with a proposal to offer a replacement for a bus service. Instead of horrendous diesel buses coming by once every 2 hours, with one passenger on board, he proposed a more frequent service using Priuses. This worked for him, because it would effectively subsidise a cab company. His proposal pointed out that the CO2 emission reduction was massive. And would increase the number of passenger places. And because of the increased frequency might well increase ridership through increased use.
The proposal was hammered by the local greeny types - Buses Are Good, Cars Are Bad.
It’s ironic and tragic that in a move designed to counter growing Chinese power we have divided the democracies on the security council and thereby weakened us relative to the Chinese.
It’s a shame that they didn’t find a route in the Pacific that kept us united. Why couldn’t the Aussies have both types of submarines?
Well, the Attack class order was for 12 submarines. Australia are having enough trouble keeping their existing six Collins-class subs crewed. Reducing the Attack-class order would have had hefty penalties. Then you have the problem of maintaining two very different types of sub, with very different kit and equipment.
Also, NG and France's behaviour throughout this has not been that good IMO. It's not all Australia's fault.
Then you finally get the issue that the Attack-class didn't really meet their needs in the first place.
It’s harmful bullshit if that’s what you mean by “useful”.
Western democracies have fundamental values - freedom of speech, of assembly, of religion - that our forefathers fought and bled to secure. We must stick up for those values and not kowtow to an authoritarian dictatorship for a couple of brass farthings
There is a whole squadron of RAF aircraft that have the Qatari flag on them in pursuit of brass riyals.
Soon to be joined by a second squadron. Imagine how dickhurt you'd be if that were an EU flag.
Something astonishing has just arrived in the post this morning. Amongst the bumpf is a junk mail flyer from McCarthy Stone, looking to tempt local olds to buy or rent one or two bedroom flats in one of their retirement complexes, located in the next town a few miles down the main road.
Prices start (i.e. this must be the cost of the cheapest available one bedroom apartment) at £329,000 to buy or £1,840 pcm to rent - and the photos indicate that, whilst these places aren't nasty little shoeboxes, they're hardly palatial either.
Now, I know that these development have a few bells and whistles attached to them, notably a live-in warden to phone the ambulance when the old ducks fall over, and then wait with them for the requisite number of hours until it shows up - but, all the same, this is double or more what you'd expect to pay for a flat on the general market in this area, and stands comparison with prices in some parts of inner London.
If anyone tries to convince you that a very large fraction of the pensioner population isn't absolutely minted, then don't listen.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
The trick is sweating the physical assets. Most suites are not used by the NHS at weekends so you can create additional capacity.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
One hopes this surgical training will be better organised than the impression given on some of the fly-on-the-wall series – that junior hospital doctors' first priority is the wards, but when they find some quiet time, and an operation is about to start, they can ask the surgeon if it is OK for them to stand around holding swabs.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
The trick is sweating the physical assets. Most suites are not used by the NHS at weekends so you can create additional capacity.
You skill need surgeons to be able to sweat the assets and those surgeons don't exist in the numbers you seem to think they do
I once heard the PM described as “the man [sic] you hire to do the things that you don’t want to think about but know that they need to be done”. I’ve never been able to track it down again though!
In a perfect world we wouldn’t do deals with Saudi. But they are not an existential threat to us in the way that China could be. Sometimes your enemy’s enemy is your friend (in this case to counterpoint Iran) for geopolitical reasons. Regardless of how distasteful they may be.
And when they overstep even those weak limits - as with that guy in the Saudi embassy in Turkey - then they need to be slapped down
In that case I’m glad we can dispense with cant about ‘fundamental’ values.
It’s not cant.
There is a powerful authoritarian dictatorship that threatens our way of life and that of our friends. I’m glad we are standing up for freedom and democracy
Another example of rhetoric missing reality. Much fanfare last week with the news London offices were apparently now full again with people returning to work at desks in vast numbers amidst signs London was back to normal and all this usual positive propaganda.
The truth, in terms of passenger transport numbers, is very different. On the tube, passenger numbers reached 54% of pre-Covid on Thursday 9th. The numbers travelling have been pretty static since mid-August. There's been no mass return at least on the Underground.
The numbers are improving at the weekend - up to 70% of pre-Covid numbers so obviously there are those who re getting out and about for leisure (presumably) and that's my anecdotal evidence as well. Yet there's been no attempt to re-balance the service by putting more trains on at the weekend and taking off some of the very quiet off-peak weekday services (I forgot, they can't, condition of the Government bailout etc).
Indeed, when a rail company like South-West Railways tries to argue reduced passenger numbers don't justify maintaining current levels of service, they get pilloried with local Conservative County Councillors and Liberal Democrat District Councillors all lining up to be the passengers' friend and champion:
The Treasury is driving this - as the Government looks to turn off the financial lifeline to train companies which led to empty trains running up and down the rails day after day, the train companies are trying to figure out what a 40% reduction in peak traffic means longer term for their operating model and viability. Inevitably, it means fewer trains across the network and some stations will see a reduced train service.
Yes. The "Covid is over, everyone back to work plebs" rhetoric sharply contrasts with the rapid work to reduce rail services long term into cities. On topic there won't be another lockdown even if the NHS does fall over this winter as many warn it may. Even if the government tried to impose one people would ignore it- unless there was a catastrophic new variant that rendered the vaccines useless.
What is very clear from usage patterns is that punters are much happier travelling for leisure than they are work. Indeed reductions in foreign holidays plus a change of working patterns seems to have turbocharged domestic leisure activities.
The DfT publish on a weekly basis estimates of the daily use of transport compared with pre covid times.
The latest numbers for the week commencing 6th September suggest that cars are approximately at 95% (but upto 110% over the weekend), but light and heavy goods vehicles are at 108%.
National Rail is only at 63%, whilst the Tube is at 53% and London Busses at 70%. Tubes are up to about 65% over the weekend, whilst rail declines to 58%.
From a personal perspective, I had a trip into London this week for the first time in around 18 months. A normal peak commuter train which would normally be crushed loaded pre covid had around 50% of seats empty. Ok this was Friday, but it indicates the scale of the problem for train companies and hence the Goverment as the DfT have full economic control.
An interesting list, thanks.
I would be interested to know if anyone’s burrowed into the data. That 63%, for example - how much of the lost third is commuter travel? Does it affect longer distance services? What about freight loads?
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
In Covid, as in so many other areas, the government is not in control of events. The fire at the interconnector is the straw that will break the camel´s back. Utility prices are already 50% up, and already steel production is being cut, because electricity prices are too high for the steel plants to compete. Inflation is already over shooting, and utility costs, plus the "supply chain issues" will send inflation way above target, to the point that even the government´s poodle at the Bank of England will have to take action to avoid a Sterling crisis. There has not been a mortgage rate rise for 15 years, and yet almost no one has been prepaying.
We are on the eve of a major domestic economic crisis and Johnson is more interested in undermining efficiency and our global competativeness with nonsense like returning to gills and ounces while play stupid geopolitical games that tie us to the declining United States and antagonise our neighbours and the rising powers of Asia.
When inflation hits and the promised pay rises dont come for key workers then we will see serious industrial unrest added to the mix. It really is back to the seventies.
The utter incompetence, the stunning arrogance, the sheer bloody awfulness of this government will absolutely not be able to cope with "events, dear boy, events". So I think that there is a pretty good chance that they will not just be beaten in 2024, but flayed. Odds on sub 200 seats for the Tories then?
The Tories lost workers even in 2019, it was only their landslide win with pensioners which gave them their big majority.
So as long as pensioners stick with the party by the big margins they are doing there is no way the Tories will go under 200 seats even if they lost, remember Blair actually won pensioners and over 65s in the 1997 Labour landslide.
Anyway inflation is still far below the levels it was in the 1970s and much of the 1980s
Something astonishing has just arrived in the post this morning. Amongst the bumpf is a junk mail flyer from McCarthy Stone, looking to tempt local olds to buy or rent one or two bedroom flats in one of their retirement complexes, located in the next town a few miles down the main road.
Prices start (i.e. this must be the cost of the cheapest available one bedroom apartment) at £329,000 to buy or £1,840 pcm to rent - and the photos indicate that, whilst these places aren't nasty little shoeboxes, they're hardly palatial either.
Now, I know that these development have a few bells and whistles attached to them, notably a live-in warden to phone the ambulance when the old ducks fall over, and then wait with them for the requisite number of hours until it shows up - but, all the same, this is double or more what you'd expect to pay for a flat on the general market in this area, and stands comparison with prices in some parts of inner London.
If anyone tries to convince you that a very large fraction of the pensioner population isn't absolutely minted, then don't listen.
It's a few years ago now admittedly, but when Bro-in-law tried to sell his aunts M&S flat for what M&S said it was worth he had no takers. Had to cut the price quite a lot. In a pleasant NW seaside location.
What a day to be going to France! It seems Johnson has chosen to alienate the EU and China and throw in his lot with a dysfunctional US and an insignificant Australia.
To describe him as the Frank Spencer of world politics flatters him
You're still really butthurt aren't you?
The EU without the UK is starting to look ever more like that French-German vanity project.
Something astonishing has just arrived in the post this morning. Amongst the bumpf is a junk mail flyer from McCarthy Stone, looking to tempt local olds to buy or rent one or two bedroom flats in one of their retirement complexes, located in the next town a few miles down the main road.
Prices start (i.e. this must be the cost of the cheapest available one bedroom apartment) at £329,000 to buy or £1,840 pcm to rent - and the photos indicate that, whilst these places aren't nasty little shoeboxes, they're hardly palatial either.
Now, I know that these development have a few bells and whistles attached to them, notably a live-in warden to phone the ambulance when the old ducks fall over, and then wait with them for the requisite number of hours until it shows up - but, all the same, this is double or more what you'd expect to pay for a flat on the general market in this area, and stands comparison with prices in some parts of inner London.
If anyone tries to convince you that a very large fraction of the pensioner population isn't absolutely minted, then don't listen.
Their business is about swapping the pensioners house for one of the their flats. So rather than all the faff of selling your house, you give it to the nice people from McCarthy Stone and get a shiny new flat plus a pile of cash. Or, in a number of cases the house + cash = McCarthy Stone flat.
The valuation you get for the house from McCarthy Stone.... Combine that with the interesting prices for their flats, and you can see where the scam is....
There won't be another full lockdown unless hospitalisations as well as cases rise significantly and the vaccinations are still keeping hospitalisations down even if cases rise
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
The trick is sweating the physical assets. Most suites are not used by the NHS at weekends so you can create additional capacity.
You skill need surgeons to be able to sweat the assets and those surgeons don't exist in the numbers you seem to think they do
Not just surgeons. Currently my Trust has a rolling programme of theatre shutdowns so the theatre and recovery staff can keep ICU going. Surgeons are generally keen to operate, and restricted by inadequate support staff.
Theatres are expensive, but the expense is really in the software, not the hardware.
Something astonishing has just arrived in the post this morning. Amongst the bumpf is a junk mail flyer from McCarthy Stone, looking to tempt local olds to buy or rent one or two bedroom flats in one of their retirement complexes, located in the next town a few miles down the main road.
Prices start (i.e. this must be the cost of the cheapest available one bedroom apartment) at £329,000 to buy or £1,840 pcm to rent - and the photos indicate that, whilst these places aren't nasty little shoeboxes, they're hardly palatial either.
Now, I know that these development have a few bells and whistles attached to them, notably a live-in warden to phone the ambulance when the old ducks fall over, and then wait with them for the requisite number of hours until it shows up - but, all the same, this is double or more what you'd expect to pay for a flat on the general market in this area, and stands comparison with prices in some parts of inner London.
If anyone tries to convince you that a very large fraction of the pensioner population isn't absolutely minted, then don't listen.
You really don’t want to buy one of those! It’s probably worth £200k tops if you want to sell it, and more like £150k if you don’t have six months to sell it.
Something astonishing has just arrived in the post this morning. Amongst the bumpf is a junk mail flyer from McCarthy Stone, looking to tempt local olds to buy or rent one or two bedroom flats in one of their retirement complexes, located in the next town a few miles down the main road.
Prices start (i.e. this must be the cost of the cheapest available one bedroom apartment) at £329,000 to buy or £1,840 pcm to rent - and the photos indicate that, whilst these places aren't nasty little shoeboxes, they're hardly palatial either.
Now, I know that these development have a few bells and whistles attached to them, notably a live-in warden to phone the ambulance when the old ducks fall over, and then wait with them for the requisite number of hours until it shows up - but, all the same, this is double or more what you'd expect to pay for a flat on the general market in this area, and stands comparison with prices in some parts of inner London.
If anyone tries to convince you that a very large fraction of the pensioner population isn't absolutely minted, then don't listen.
You really don’t want to buy one of those! It’s probably worth £200k tops if you want to sell it, and more like £150k if you don’t have six months to sell it.
And yet there are clearly plenty of ducks who are prepared to buy them, or they wouldn't be able to advertise those extraordinary prices. It leads inevitably towards the conclusion that these people have money to burn.
I think there is genuine worry by those who support the EU just how much this is going to damage not only France's reputation but the wider implications for the EU itself on security and defence
I have not heard a response to the crisis from any EU member, but if the EU was under threat it would be the US they would turn to, not their own non existent defence force
This is the biggest crisis the EU has faced and trying to blame AUKUS will not cut it
That's just nonsense. Conflating the EU and NATO is a cheap jibe which doesn't cut it any more.
Those members of the EU not in NATO (Ireland) and those members of NATO not in the EU (Iceland, Turkey) might see it differently.
I assume nothing about AUKUS changes the US commitment to the defence of western Europe from any aggression in the name of collective defence and security. Washington is still prepared to go to war to defend Riga, Vilnius and even Paris and to call this "the biggest crisis the EU has faced" is absurd hyperbole.
Certainly, compared with the Eurozone crisis of 2008-10, AUKUS is insignificant.
In defence terms it is and is anyone confident that NATO is relevant
The EU is not a military body and never has been. The embryonic WEU and the Franco-German corps were attempts to try to make a pan-European defence force but NATO is and has been a hugely successful alliance.
Is it "relevant"? The Conservatives, the Daily Mail and others keep banging on about the "threat" from Putin, Someone on here yesterday claimed the Russian Army was ready to sweep across Europe and could conquer the whole European landmass up to and including the Channel.
Not convinced and a couple of aircraft flying over the North Sea and a rusty old battleship sailing up the Channel don't exactly give me sleepless nights.
In any case, Putin isn't stupid enough to risk armageddon by trying to annex Estonia so for now NATO remains the primary guarantor of British defence. What AUKUS has done, arguably, is to raise tensions and create a new front line in the Pacific. Is an attempted Chinese invasion of Taiwan analogous to a Russian push into Estonia - it would seem so?
It's not even a solid policy of containment - it's a half-guarantee to a couple of places but, as I argued earlier, if you are serious about containing China (which we aren't), what about guarantees to India, Russia, Vietnam and Afghanistan (all of whom border China as does North Korea of course)?
It's analogous to the Ukraine - we aren't going to rush to Kiev's defence if Putin decides to move in. They aren't in NATO so we're not obliged.
I agree that Putin is not a threat nor do I think is China at present
However, it is clear Australia and the Trans-Pacific do see it as such and AUKUS is the nucleus of a wider cooperation agreement between all those countries in the area to deter China from any consideration of military involvement
Furthermore, there is a trade element in this as CPTPP expands to include the UK and the US, who are reopening talks cancelled by Trump, creating a consumer competitor for Chinese goods
I think it was @Foxy who said we should reduce our purchase of Chinese goods and he is correct on that
I would say that the reason that Putin is not a threat to the Baltic states and Eastern Europe (minus Ukraine) is that he is convinced that the Americans (and others) via NATO would fight.
This is another emerging split - the er... Russia Accommodating types in the EU are upset that the Americans are involved and see the whole thing as a problem between Russia and states that don't accept the reality of the situation.
Russia and China are both threats, and it is futile to say Taiwan or Baltic states are safe when Hong Kong or Crimea say otherwise, and when cyberwarfare is supplemented by the occasional murder by Russian tourists. Of course, we do not expect to see Russian tanks sweeping across Belgium any time soon.
ETA Russia is also accused of hiking gas prices to undermine European economic recovery (or just to make more money).
Mr Putin's problem is that Russia is very, very, very big. So big that assets at one end of the country cannot be easily and quickly moved to counter a threat at the other end. With a perceived threat from NATO, and a resurgent China threatening Siberia and looking to sail its navy up the Russian coast as global warming clears the ice, that's a real concern.
Capitalists have let Chinese influence spread faster than COVID through pure greed.
Now some are trying to ramp up Cold War ii
Pathetic
You mean people like your chum Boris?
As I recall, Team Blair used every legal trick to arrest peaceful protestors about Tibet, when the Chinese President visited. Apparently a few signs saving "Hands off Tibet" would cause offence....
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
It takes 6-12 months for a foreign doctor to get over the hurdles for registration. That however (with very few exceptions) doesn't get them accredited as a Specialist for independent practice, which generally takes 5 or more years of supervised experience.
It would be better all round to train our own, who are currently not getting that supervision.
King Cole, that's largely due to some stupid decisions on energy. Merkel throwing away nuclear in Germany because of what happened in Fukushima[sp] is a perfect example.
She didn’t seem to appreciate at the time, that closing Germany’s nuclear power stations, for reasons that made no sense at the time, would lead to her being Putin’s (female canine) a few years later.
Lots of people/organisations predicted precisely that at the time, including the Economist IIRC.
Including more than a few of us on here!
Germany’s reactors were of a much more modern and safer design than those at Fukushima, many of them had decades of life left in them - oh, and Germany was rather unlikely to get hit by a tsunami.
Now they are watching CO2 emissions from electricity generaton rising, and are utterly dependent on a tyrant not turning off the gas taps.
Government talks. It will be beer and sandwiches at Number 10 soon.
That URL is slightly misleading in that the issue is that carbon dioxide (and ammonia) supplies come from fertiliser plants which have been shut down, in turn in response to soaring gas prices.
I think there is genuine worry by those who support the EU just how much this is going to damage not only France's reputation but the wider implications for the EU itself on security and defence
I have not heard a response to the crisis from any EU member, but if the EU was under threat it would be the US they would turn to, not their own non existent defence force
This is the biggest crisis the EU has faced and trying to blame AUKUS will not cut it
That's just nonsense. Conflating the EU and NATO is a cheap jibe which doesn't cut it any more.
Those members of the EU not in NATO (Ireland) and those members of NATO not in the EU (Iceland, Turkey) might see it differently.
I assume nothing about AUKUS changes the US commitment to the defence of western Europe from any aggression in the name of collective defence and security. Washington is still prepared to go to war to defend Riga, Vilnius and even Paris and to call this "the biggest crisis the EU has faced" is absurd hyperbole.
Certainly, compared with the Eurozone crisis of 2008-10, AUKUS is insignificant.
In defence terms it is and is anyone confident that NATO is relevant
The EU is not a military body and never has been. The embryonic WEU and the Franco-German corps were attempts to try to make a pan-European defence force but NATO is and has been a hugely successful alliance.
Is it "relevant"? The Conservatives, the Daily Mail and others keep banging on about the "threat" from Putin, Someone on here yesterday claimed the Russian Army was ready to sweep across Europe and could conquer the whole European landmass up to and including the Channel.
Not convinced and a couple of aircraft flying over the North Sea and a rusty old battleship sailing up the Channel don't exactly give me sleepless nights.
In any case, Putin isn't stupid enough to risk armageddon by trying to annex Estonia so for now NATO remains the primary guarantor of British defence. What AUKUS has done, arguably, is to raise tensions and create a new front line in the Pacific. Is an attempted Chinese invasion of Taiwan analogous to a Russian push into Estonia - it would seem so?
It's not even a solid policy of containment - it's a half-guarantee to a couple of places but, as I argued earlier, if you are serious about containing China (which we aren't), what about guarantees to India, Russia, Vietnam and Afghanistan (all of whom border China as does North Korea of course)?
It's analogous to the Ukraine - we aren't going to rush to Kiev's defence if Putin decides to move in. They aren't in NATO so we're not obliged.
I agree that Putin is not a threat nor do I think is China at present
However, it is clear Australia and the Trans-Pacific do see it as such and AUKUS is the nucleus of a wider cooperation agreement between all those countries in the area to deter China from any consideration of military involvement
Furthermore, there is a trade element in this as CPTPP expands to include the UK and the US, who are reopening talks cancelled by Trump, creating a consumer competitor for Chinese goods
I think it was @Foxy who said we should reduce our purchase of Chinese goods and he is correct on that
I would say that the reason that Putin is not a threat to the Baltic states and Eastern Europe (minus Ukraine) is that he is convinced that the Americans (and others) via NATO would fight.
This is another emerging split - the er... Russia Accommodating types in the EU are upset that the Americans are involved and see the whole thing as a problem between Russia and states that don't accept the reality of the situation.
Russia and China are both threats, and it is futile to say Taiwan or Baltic states are safe when Hong Kong or Crimea say otherwise, and when cyberwarfare is supplemented by the occasional murder by Russian tourists. Of course, we do not expect to see Russian tanks sweeping across Belgium any time soon.
ETA Russia is also accused of hiking gas prices to undermine European economic recovery (or just to make more money).
Mr Putin's problem is that Russia is very, very, very big. So big that assets at one end of the country cannot be easily and quickly moved to counter a threat at the other end. With a perceived threat from NATO, and a resurgent China threatening Siberia and looking to sail its navy up the Russian coast as global warming clears the ice, that's a real concern.
More likely that Russia finds China a congenial business partner for the Belt and Road Initiative. After all, there is nothing that the Russian Kleptocracy likes more than a pay off.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
It takes 6-12 months for a foreign doctor to get over the hurdles for registration. That however (with very few exceptions) doesn't get them accredited as a Specialist for independent practice, which generally takes 5 or more years of supervised experience.
It would be better all round to train our own, who are currently not getting that supervision.
It has always struck me as completely insane, that we deliberately train less staff than then NHS requires. The NHS plans ahead for a few years - the numbers are pretty much known. But the number of places at University and in further training are lower. And not by a small margin, either.
"Baby boomers shrug off pandemic, but still think young people are selfish A new study has found that the post-war generation are twice as likely as younger people to say the pandemic did not harm them" (£)
It has buttons that allow you to filter out the whites or the men.
They also point out that the 4 ministers removed/demoted were the lowest polling on the Conhome survey. I wonder where they could have got an idea like that?
King Cole, that's largely due to some stupid decisions on energy. Merkel throwing away nuclear in Germany because of what happened in Fukushima[sp] is a perfect example.
She didn’t seem to appreciate at the time, that closing Germany’s nuclear power stations, for reasons that made no sense at the time, would lead to her being Putin’s (female canine) a few years later.
Lots of people/organisations predicted precisely that at the time, including the Economist IIRC.
Including more than a few of us on here!
Germany’s reactors were of a much more modern and safer design than those at Fukushima, many of them had decades of life left in them - oh, and Germany was rather unlikely to get hit by a tsunami.
Now they are watching CO2 emissions from electricity generaton rising, and are utterly dependent on a tyrant not turning off the gas taps.
The fun bit is the apologists for this policy. They turn up on Reddit/Facebook/etc and use Special Logic to prove that burning brown coal is better for the environment.
Indeed, most young people quite reasonably won't understand imperial measurements.
Yes we can happily drink beer in pints, or drive in miles, but those are integer unit. No conversions necessary. There's no need to think about how many fluid ounces or gallons or firkins or whatever are related to pints.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Yes, though in the long term, one hopes we can train more British doctors. Separately, there also seems to be a problem with working hours (possibly not helped by Jeremy Hunt's victory over junior hospital doctors) in that many doctors seem to be taking gap years or working less than full-time.
ETA a short-term kludge of the pension rules might help retention at the top end.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
It takes 6-12 months for a foreign doctor to get over the hurdles for registration. That however (with very few exceptions) doesn't get them accredited as a Specialist for independent practice, which generally takes 5 or more years of supervised experience.
It would be better all round to train our own, who are currently not getting that supervision.
It has always struck me as completely insane, that we deliberately train less staff than then NHS requires. The NHS plans ahead for a few years - the numbers are pretty much known. But the number of places at University and in further training are lower. And not by a small margin, either.
More important than rookie graduates, we need investment in postgraduate training. The numbers of surgical training places have not changed in 15 years. Too expensive though it seems. It is not just haulage companies that have come to rely on imported EU workers.
Indeed, most young people quite reasonably won't understand imperial measurements.
Yes we can happily drink beer in pints, or drive in miles, but those are integer unit. No conversions necessary. There's no need to think about how many fluid ounces or gallons or firkins or whatever are related to pints.
I'm only happy driving in miles because I know they're exactly eighty cricket wickets
I think there is genuine worry by those who support the EU just how much this is going to damage not only France's reputation but the wider implications for the EU itself on security and defence
I have not heard a response to the crisis from any EU member, but if the EU was under threat it would be the US they would turn to, not their own non existent defence force
This is the biggest crisis the EU has faced and trying to blame AUKUS will not cut it
That's just nonsense. Conflating the EU and NATO is a cheap jibe which doesn't cut it any more.
Those members of the EU not in NATO (Ireland) and those members of NATO not in the EU (Iceland, Turkey) might see it differently.
I assume nothing about AUKUS changes the US commitment to the defence of western Europe from any aggression in the name of collective defence and security. Washington is still prepared to go to war to defend Riga, Vilnius and even Paris and to call this "the biggest crisis the EU has faced" is absurd hyperbole.
Certainly, compared with the Eurozone crisis of 2008-10, AUKUS is insignificant.
In defence terms it is and is anyone confident that NATO is relevant
The EU is not a military body and never has been. The embryonic WEU and the Franco-German corps were attempts to try to make a pan-European defence force but NATO is and has been a hugely successful alliance.
Is it "relevant"? The Conservatives, the Daily Mail and others keep banging on about the "threat" from Putin, Someone on here yesterday claimed the Russian Army was ready to sweep across Europe and could conquer the whole European landmass up to and including the Channel.
Not convinced and a couple of aircraft flying over the North Sea and a rusty old battleship sailing up the Channel don't exactly give me sleepless nights.
In any case, Putin isn't stupid enough to risk armageddon by trying to annex Estonia so for now NATO remains the primary guarantor of British defence. What AUKUS has done, arguably, is to raise tensions and create a new front line in the Pacific. Is an attempted Chinese invasion of Taiwan analogous to a Russian push into Estonia - it would seem so?
It's not even a solid policy of containment - it's a half-guarantee to a couple of places but, as I argued earlier, if you are serious about containing China (which we aren't), what about guarantees to India, Russia, Vietnam and Afghanistan (all of whom border China as does North Korea of course)?
It's analogous to the Ukraine - we aren't going to rush to Kiev's defence if Putin decides to move in. They aren't in NATO so we're not obliged.
I agree that Putin is not a threat nor do I think is China at present
However, it is clear Australia and the Trans-Pacific do see it as such and AUKUS is the nucleus of a wider cooperation agreement between all those countries in the area to deter China from any consideration of military involvement
Furthermore, there is a trade element in this as CPTPP expands to include the UK and the US, who are reopening talks cancelled by Trump, creating a consumer competitor for Chinese goods
I think it was @Foxy who said we should reduce our purchase of Chinese goods and he is correct on that
I would say that the reason that Putin is not a threat to the Baltic states and Eastern Europe (minus Ukraine) is that he is convinced that the Americans (and others) via NATO would fight.
This is another emerging split - the er... Russia Accommodating types in the EU are upset that the Americans are involved and see the whole thing as a problem between Russia and states that don't accept the reality of the situation.
Russia and China are both threats, and it is futile to say Taiwan or Baltic states are safe when Hong Kong or Crimea say otherwise, and when cyberwarfare is supplemented by the occasional murder by Russian tourists. Of course, we do not expect to see Russian tanks sweeping across Belgium any time soon.
ETA Russia is also accused of hiking gas prices to undermine European economic recovery (or just to make more money).
Mr Putin's problem is that Russia is very, very, very big. So big that assets at one end of the country cannot be easily and quickly moved to counter a threat at the other end. With a perceived threat from NATO, and a resurgent China threatening Siberia and looking to sail its navy up the Russian coast as global warming clears the ice, that's a real concern.
The difference for the Baltics (say) is the presence of American and other NATO troops. This means that any overt moves by Russia would quickly end up with a US vs Russia situation.
In power politics, a few troops on the ground = we will escalate this, if your touch this place.
Note that the US hasn't gone as far as having US troops in Taiwan. But they do in South Korea, Japan etc.
Covid has shown up quite how sparse our weapons against disease are. The vaccines were later then we needed, even fat a brilliantly accelerated development. Therapeutic developments have been very disappointing.
I would like to see a Manhattan Project on therapeutics. The world needs to throw billions into development of drugs and strategies that will help keep people out of hospital from even 'normal' illnesses such as flu.
An issue is that vaccines have been seen to work and, in a couple of cases, vastly profitable. The sector will throw lots of money into vaccines. But vaccines are inevitable delayed; they need to be developed for each individual illness. Therapeutic drugs and techniques can help with many different illnesses that attack in similar ways.
The Manhattan Project is a really bad analogy. Apart from the huge sums spent on research every year in any event, the problem is not a singular one amenable to a brute force approach like that. While it's true that some agents will prove useful in multiple diseases, defining what those might be and why is still as much as hoc as it is systemic.
Fundamentally we just need a lot more knowledge - a project which industry, government and academia are already spending hundreds of billions on.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
It takes 6-12 months for a foreign doctor to get over the hurdles for registration. That however (with very few exceptions) doesn't get them accredited as a Specialist for independent practice, which generally takes 5 or more years of supervised experience.
It would be better all round to train our own, who are currently not getting that supervision.
It has always struck me as completely insane, that we deliberately train less staff than then NHS requires. The NHS plans ahead for a few years - the numbers are pretty much known. But the number of places at University and in further training are lower. And not by a small margin, either.
Choke the supply, keep the wages high. In pharmacy we’ve seen the opposite. Train too many, wages, especially locum rates, crash.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
It takes 6-12 months for a foreign doctor to get over the hurdles for registration. That however (with very few exceptions) doesn't get them accredited as a Specialist for independent practice, which generally takes 5 or more years of supervised experience.
It would be better all round to train our own, who are currently not getting that supervision.
It has always struck me as completely insane, that we deliberately train less staff than then NHS requires. The NHS plans ahead for a few years - the numbers are pretty much known. But the number of places at University and in further training are lower. And not by a small margin, either.
More important than rookie graduates, we need investment in postgraduate training. The numbers of surgical training places have not changed in 15 years. Too expensive though it seems. It is not just haulage companies that have come to rely on imported EU workers.
Yes - the whole process needs expanding. What will happen to the extra graduates in a couple of years time? Since the A-Level/COVID debacle increased the size of many University classes by 20%, there are going to be a lot of extra medical graduates looking for jobs/training, surely?
This is really really bad news. Evergrande have fingers is all sorts of pies, not just real estate, they have 200k direct employees, 3.8 million indirectly. Also, China's largest high yield dollar bond issuer.
Add in the likes of the US going nuts with the money printing / borrowing. It could be 2008 all over again.
I’ve been slowly selling off equities for months. Thank goodness.
You will have cost yourself money then unless it was all mining stock as apart from them most stocks are well above where they were June
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
It takes 6-12 months for a foreign doctor to get over the hurdles for registration. That however (with very few exceptions) doesn't get them accredited as a Specialist for independent practice, which generally takes 5 or more years of supervised experience.
It would be better all round to train our own, who are currently not getting that supervision.
It has always struck me as completely insane, that we deliberately train less staff than then NHS requires. The NHS plans ahead for a few years - the numbers are pretty much known. But the number of places at University and in further training are lower. And not by a small margin, either.
Choke the supply, keep the wages high. In pharmacy we’ve seen the opposite. Train too many, wages, especially locus rates, crash.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
It takes 6-12 months for a foreign doctor to get over the hurdles for registration. That however (with very few exceptions) doesn't get them accredited as a Specialist for independent practice, which generally takes 5 or more years of supervised experience.
It would be better all round to train our own, who are currently not getting that supervision.
It has always struck me as completely insane, that we deliberately train less staff than then NHS requires. The NHS plans ahead for a few years - the numbers are pretty much known. But the number of places at University and in further training are lower. And not by a small margin, either.
Choke the supply, keep the wages high. In pharmacy we’ve seen the opposite. Train too many, wages, especially locus rates, crash.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
It takes 6-12 months for a foreign doctor to get over the hurdles for registration. That however (with very few exceptions) doesn't get them accredited as a Specialist for independent practice, which generally takes 5 or more years of supervised experience.
It would be better all round to train our own, who are currently not getting that supervision.
It has always struck me as completely insane, that we deliberately train less staff than then NHS requires. The NHS plans ahead for a few years - the numbers are pretty much known. But the number of places at University and in further training are lower. And not by a small margin, either.
Say it really quietly, but another issue is that too many doctors are leaving the profession. Many, for example, decide to take a decade off in their thirties, as life becomes more important than work to them.
I do not expect a further lockdown unless the virus escapes the vaccines
Life seems to be back to near normal and of course the booster jabs are on their way
On the French strop has any EU country come out in support of them
I have heard it said that in any security crisis the US would be their first call for help
It is unfortunate that France has fallen out with AUKUS but ultimately this is not about France or Europe, but the defence of the Trans Pacific and just as EU countries would if under threat, Australia has turned to the US
The submarines are some decade or two off service. The more immediate effect is more US forces based in Australia. This is quite an interesting piece from Australia on what it all means:
"Hugh White : what SM has done this week. He has tied Australia to a deal that undermines our sovereign capabilities,overspends on hardware we can barely be confident of operating,& drags us closer to front line of a war we may have no interest in fighting."
I did wonder if the US or even the UK may allocate a nuclear sub to Australia to smooth the process of integration
It's not like borrowing a Ford Focus to nip to Aldi. Insurmountable (for the US) security concerns aside; how would they command, crew and maintain it?
If they want boats before 2035 the only option is to buy the two Astutes under construction at Barrow. The tories, who never saw a defence cut they didn't like, would love this but it might not be politically sustainable in Australia - I don't know.
I had wondered about Barrow and it does seem a possibility, but as you say it is not like borrowing a Ford focus to nip to Aldi
It did make me smile
I’d be amazed if @Dura_Ace would ever borrow anything so staid as a Ford Focus 🙂
I once drove a borrowed Mk.1 Focus from Minsk to Moscow in December. It cost me more in bribes to various cops than the car was worth.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
It takes 6-12 months for a foreign doctor to get over the hurdles for registration. That however (with very few exceptions) doesn't get them accredited as a Specialist for independent practice, which generally takes 5 or more years of supervised experience.
It would be better all round to train our own, who are currently not getting that supervision.
It has always struck me as completely insane, that we deliberately train less staff than then NHS requires. The NHS plans ahead for a few years - the numbers are pretty much known. But the number of places at University and in further training are lower. And not by a small margin, either.
Choke the supply, keep the wages high. In pharmacy we’ve seen the opposite. Train too many, wages, especially locus rates, crash.
The dissonance among our 'remainer' friends on here and elsewhere this morning is a sight to behold. Turns out being at the back of the queue gives you the last laugh as well. Next the demonisation of Biden begins.
Something astonishing has just arrived in the post this morning. Amongst the bumpf is a junk mail flyer from McCarthy Stone, looking to tempt local olds to buy or rent one or two bedroom flats in one of their retirement complexes, located in the next town a few miles down the main road. Prices start (i.e. this must be the cost of the cheapest available one bedroom apartment) at £329,000 to buy or £1,840 pcm to rent - and the photos indicate that, whilst these places aren't nasty little shoeboxes, they're hardly palatial either. Now, I know that these development have a few bells and whistles attached to them, notably a live-in warden to phone the ambulance when the old ducks fall over, and then wait with them for the requisite number of hours until it shows up - but, all the same, this is double or more what you'd expect to pay for a flat on the general market in this area, and stands comparison with prices in some parts of inner London. If anyone tries to convince you that a very large fraction of the pensioner population isn't absolutely minted, then don't listen.
You really don’t want to buy one of those! It’s probably worth £200k tops if you want to sell it, and more like £150k if you don’t have six months to sell it.
And yet there are clearly plenty of ducks who are prepared to buy them, or they wouldn't be able to advertise those extraordinary prices. It leads inevitably towards the conclusion that these people have money to burn.
A good friend of mine who lives in the same complex as myself has just sold his flat to move into an Audley Village retirement home nearby. (Age early 60s and fit). He is absolutely thrilled to do so because of what he sees to be luxury. He is paying £265k for a ground floor flat and £800 a month in service charges (four times what he pays here), whilst selling his current flat of a similar size for 235k (£15k less than market value so it would sell in a week). What he gets is a fully equipped on site gym and swimming pool (which the public pay £90 to access and he will use daily), a very good onsite restaurant and bar (again open to the public which he gets £60 a month in 'free' meal vouchers), shared residents lounge, onsite Doctor, great gardens, all repairs maintenance, organised games evenings and travel to nearby shops, etc.. He said to me that he deserves this in his retirement having scraped and saved throughout his life. An ex-primary school teacher, his Father died before he was a teenager and his Mother raised him having very little income. (He recalls them regularly eating sugar sandwiches as that was all they could afford). When his retirement appartment is subsequently sold Audley will keep 1% of the sale price for every year he has lived there up to a maximum of 15%. He says that is to cover deferred management charges and he doesn't care as he has no children to leave money to.
Covid has shown up quite how sparse our weapons against disease are. The vaccines were later then we needed, even fat a brilliantly accelerated development. Therapeutic developments have been very disappointing.
I would like to see a Manhattan Project on therapeutics. The world needs to throw billions into development of drugs and strategies that will help keep people out of hospital from even 'normal' illnesses such as flu.
An issue is that vaccines have been seen to work and, in a couple of cases, vastly profitable. The sector will throw lots of money into vaccines. But vaccines are inevitable delayed; they need to be developed for each individual illness. Therapeutic drugs and techniques can help with many different illnesses that attack in similar ways.
The Manhattan Project is a really bad analogy. Apart from the huge sums spent on research every year in any event, the problem is not a singular one amenable to a brute force approach like that. While it's true that some agents will prove useful in multiple diseases, defining what those might be and why is still as much as hoc as it is systemic.
Fundamentally we just need a lot more knowledge - a project which industry, government and academia are already spending hundreds of billions on.
The Manhattan project is frequently used as shorthand for a "Crash Program to do X"
The interesting bit about the Manhattan project was that the basic answers - "We need need kilos of U235 and Pu239" - were already known. As were the list of possible ways to get there. There was surprisingly little abstract science innovation in the project. It was an engineering competition to see which methods worked the best, by trying them all in competition with each other.
The COVID treatment issue equivalent would be if we had micro grams of various treatments that probably work in the labs, but need tons. And don't have the methods to make tons.
We don't have that. What we need (and is happening) is alot of primary science to find the treatment methods and ideas. Once we have the treatments, the pharma industry will give us the tons in fairly short order.
I once heard the PM described as “the man [sic] you hire to do the things that you don’t want to think about but know that they need to be done”. I’ve never been able to track it down again though!
In a perfect world we wouldn’t do deals with Saudi. But they are not an existential threat to us in the way that China could be. Sometimes your enemy’s enemy is your friend (in this case to counterpoint Iran) for geopolitical reasons. Regardless of how distasteful they may be.
And when they overstep even those weak limits - as with that guy in the Saudi embassy in Turkey - then they need to be slapped down
In that case I’m glad we can dispense with cant about ‘fundamental’ values.
It’s not cant.
There is a powerful authoritarian dictatorship that threatens our way of life and that of our friends. I’m glad we are standing up for freedom and democracy
It also enables our way of life. It makes what we consume and lends us the money to buy it. China, QE, debt, low interest rates, these are key ingredients of the potion we use to stave off a painful readjustment.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
It takes 6-12 months for a foreign doctor to get over the hurdles for registration. That however (with very few exceptions) doesn't get them accredited as a Specialist for independent practice, which generally takes 5 or more years of supervised experience.
It would be better all round to train our own, who are currently not getting that supervision.
It has always struck me as completely insane, that we deliberately train less staff than then NHS requires. The NHS plans ahead for a few years - the numbers are pretty much known. But the number of places at University and in further training are lower. And not by a small margin, either.
Say it really quietly, but another issue is that too many doctors are leaving the profession. Many, for example, decide to take a decade off in their thirties, as life becomes more important than work to them.
Doctors are paid well, and I imagine are generally not the sort of people who are in it for the money. If I was a GP I would certainly be thinking about working part time or retiring early.
The dissonance among our 'remainer' friends on here and elsewhere this morning is a sight to behold. Turns out being at the back of the queue gives you the last laugh as well. Next the demonisation of Biden begins.
Erm, isn't it mainly the Brexiteers telling us for months that Biden is gaga?
Of course the government doesn't want a lockdown. But equally obviously, that could make it more - not less - likely that other mandatory restrictions will be brought in. To avoid a full lockdown. This time they have been explicit enough about keeping their options open on lesser restrictions. It's only a full lockdown that would be viewed as an undeniable political failure.
At the moment the signs seem positive, with the rate of positive tests (I wish they would stop calling it "cases", which is just plain wrong) falling, contrary to most expectations, for the second time in a couple of months.
Deaths as a proportion of positive tests have been rising, but that is probably manageable so long as infections don't start rising rapidly again. As always, "cases" are the key, regardless of moderate fluctuations in the death rate and hospitalisation rate per "case".
But the situation in Scotland at the moment should be a caution against thinking there's nothing to worry about any more.
What situation in Scotland are you talking about then, do you know something us residents up here don't know about?
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
It takes 6-12 months for a foreign doctor to get over the hurdles for registration. That however (with very few exceptions) doesn't get them accredited as a Specialist for independent practice, which generally takes 5 or more years of supervised experience.
It would be better all round to train our own, who are currently not getting that supervision.
It has always struck me as completely insane, that we deliberately train less staff than then NHS requires. The NHS plans ahead for a few years - the numbers are pretty much known. But the number of places at University and in further training are lower. And not by a small margin, either.
Choke the supply, keep the wages high. In pharmacy we’ve seen the opposite. Train too many, wages, especially locus rates, crash.
Of course the government doesn't want a lockdown. But equally obviously, that could make it more - not less - likely that other mandatory restrictions will be brought in. To avoid a full lockdown. This time they have been explicit enough about keeping their options open on lesser restrictions. It's only a full lockdown that would be viewed as an undeniable political failure.
At the moment the signs seem positive, with the rate of positive tests (I wish they would stop calling it "cases", which is just plain wrong) falling, contrary to most expectations, for the second time in a couple of months.
Deaths as a proportion of positive tests have been rising, but that is probably manageable so long as infections don't start rising rapidly again. As always, "cases" are the key, regardless of moderate fluctuations in the death rate and hospitalisation rate per "case".
But the situation in Scotland at the moment should be a caution against thinking there's nothing to worry about any more.
What situation in Scotland are you talking about then, do you know something us residents up here don't know about?
John Swinney still in charge of education should be situation enough to worry anybody.
It has buttons that allow you to filter out the whites or the men.
Very progressive.
and totally unsurprising. I am suprised you cant search for gay, lesbian transgender, non binary or any other non norm grouping tgat may crop up over time.
It will enable the BBC to claim that there is discrimination even when there isnt.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
It takes 6-12 months for a foreign doctor to get over the hurdles for registration. That however (with very few exceptions) doesn't get them accredited as a Specialist for independent practice, which generally takes 5 or more years of supervised experience.
It would be better all round to train our own, who are currently not getting that supervision.
It has always struck me as completely insane, that we deliberately train less staff than then NHS requires. The NHS plans ahead for a few years - the numbers are pretty much known. But the number of places at University and in further training are lower. And not by a small margin, either.
Choke the supply, keep the wages high. In pharmacy we’ve seen the opposite. Train too many, wages, especially locus rates, crash.
It’s like being hit by a swarm of locus…
You are saying that pay declines?
No, that would be a swarm of locosts.
It's a two stage process, sadly. The first drop in income is manageable; what kills them is the second declension...
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
Which is why postgraduate surgical training needs to be the core of any NHS recovery plan*. Many surgical trainees have hardly operated in the last 18 months due to staff redeployment.
*it won't be...
Do surgeons, as happens with airline pilots, need to do minimum numbers of operations over time, to remain ‘current’ and work unsupervised?
A lot of airlines are struggling now, as they try and bring more planes back into service, that the pilots they furloughed need to have their licences re-validated.
Yes it is a part of annual appraisal, or the ARCP process in respect of Trainees. Many are currently failing on the numbers needed to get Specialist Registration.
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
Thanks for that, I had assumed there was probably some formal process in place.
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
It takes 6-12 months for a foreign doctor to get over the hurdles for registration. That however (with very few exceptions) doesn't get them accredited as a Specialist for independent practice, which generally takes 5 or more years of supervised experience.
It would be better all round to train our own, who are currently not getting that supervision.
It has always struck me as completely insane, that we deliberately train less staff than then NHS requires. The NHS plans ahead for a few years - the numbers are pretty much known. But the number of places at University and in further training are lower. And not by a small margin, either.
Outsourcing training costs to poorer countries = economic imperialism. Send in the nuclear subs to stop this!
There is an almost comical irony in that for years lefties have promoted immigration of foreign quacks, ignoring that it depletes poorer countries' healthcare systems, while those on the right deplore immigration but revel in money saved.
It has buttons that allow you to filter out the whites or the men.
Very progressive.
and totally unsurprising. I am suprised you cant search for gay, lesbian transgender, non binary or any other non norm grouping tgat may crop up over time.
It will enable the BBC to claim that there is discrimination even when there isnt.
More interesting is lower down – that Boris's Cabinet is 2/3 privately-educated, up from 1/3 Theresa May's. And historically, even Boris is quite low.
It’s ironic and tragic that in a move designed to counter growing Chinese power we have divided the democracies on the security council and thereby weakened us relative to the Chinese.
It’s a shame that they didn’t find a route in the Pacific that kept us united. Why couldn’t the Aussies have both types of submarines?
Well, the Attack class order was for 12 submarines. Australia are having enough trouble keeping their existing six Collins-class subs crewed. Reducing the Attack-class order would have had hefty penalties. Then you have the problem of maintaining two very different types of sub, with very different kit and equipment.
Also, NG and France's behaviour throughout this has not been that good IMO. It's not all Australia's fault.
Then you finally get the issue that the Attack-class didn't really meet their needs in the first place.
It’s harmful bullshit if that’s what you mean by “useful”.
Western democracies have fundamental values - freedom of speech, of assembly, of religion - that our forefathers fought and bled to secure. We must stick up for those values and not kowtow to an authoritarian dictatorship for a couple of brass farthings
What happens to those values of freedom of speech, of assembly and of religion when the representatives of our country get on the blower to Riyadh?
Binned pretty quickly when it suits , like faces they have one for every occasion , if it wasn't so tragic it would be funny. Rich thick Hoorays like Charles pontificating about values , pass the sick bucket.
Indeed, most young people quite reasonably won't understand imperial measurements.
Yes we can happily drink beer in pints, or drive in miles, but those are integer unit. No conversions necessary. There's no need to think about how many fluid ounces or gallons or firkins or whatever are related to pints.
You need to know how many pints are in a firkin if you are serving beer! (72, but 65 is a better estimate of saleable pints).
I tend to switch between metric and imperial, and if I had kids they would have learned about imperial as I use them. And the fact that a pound contains 16 ounces is a feature, not a bug. Customary measures are quite useful for everyday transactions, cooking, weighing and measuring people and familiar objects, etc. If I need precision or I'm doing any sort of tricky calculation I naturally use metric. The two systems can happily co-exist.
The dissonance among our 'remainer' friends on here and elsewhere this morning is a sight to behold. Turns out being at the back of the queue gives you the last laugh as well. Next the demonisation of Biden begins.
Erm, isn't it mainly the Brexiteers telling us for months that Biden is gaga?
Dunno - I'm not a Brexiteer - however, it looks now like they have allies.
Gérard Araud seems to think France should pull out of NATO.
The new reality of the world rivalry of great and middle powers should lead France to a 2.0 Gaullist stance. Allied but not aligned. Some confrontations are not ours.
The dissonance among our 'remainer' friends on here and elsewhere this morning is a sight to behold. Turns out being at the back of the queue gives you the last laugh as well. Next the demonisation of Biden begins.
Erm, isn't it mainly the Brexiteers telling us for months that Biden is gaga?
Dunno - I'm not a Brexiteer - however, it looks now like they have allies.
Right.
So what are you, out of idle curiosity? It's disconcerting when you have classified a post as tediously partisan, to be told that it doesn't even clear that low bar.
More anecdata concerning the disintegration of the NHS:
People with cancer forced to go private
In January this year, Steve Deeman in Nottinghamshire was looking at an eight-week delay to have the lesion on his forehead diagnosed. “It was suspicious looking and grew quite rapidly over the next few weeks,” said the 69-year-old retired teacher.
He was referred to a local hospital dermatology department in early March and was given a consultation appointment for May. “I decided I couldn’t wait that long and sought private medical care a few days later,” he said.
Deeman saw a specialist dermatologist who diagnosed the lesion as cancerous and it was removed the next day. His treatment so far has cost about £1,500 but further follow-ups have been recommended which could bring the total to £2,000. “I was fortunate in that I was able to afford treatment but there are a lot of people who wouldn’t be able to.”
When Fabien needed to have a decayed tooth removed in May, his dentist told him that he would have to wait up to three years to have it done on the NHS. In disbelief, the 27-year-old from Edinburgh rang 50 dental practices but without any luck. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £600 from his family.
If you've the means and knowhow to trade in shares then private healthcare groups are probably a good bet. As the latter piece goes on to say, quoting the director of a health think tank,
“There is a big risk that unless government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine middle-class support for a tax-funded NHS.
“It’s not likely that we will end up with a US-style insurance system. But a two-tier system, where the NHS is a residual service for those without the means to pay is a possibility – ultimately these are political choices.”
Certainly there is likely to be a boom in the sector, both from the self pay private market and in terms of outsourcing of NHS work, which is a major source of income to private hospitals. That said the performance of Spire shares hasn't been great recently.
It is curious although the Spire price has been more influenced by take over speculation than anything else. What I find strange is that the private medical sector is not absolutely booming with significant new capital being raised and deployed. It is going to take a decade for the NHS to recover from the backlog now in place and many, many more are going to go private. If you are in pain from a hip or knee and being told to wait 2 or more years for a replacement it is an absolute no brainer if you can afford it. If you are working it even makes economic sense.
The free at the point of delivery service in the NHS has always kept this sector quite small in this country but it just seems inevitable that there is going to be a large expansion. I would expect some of the American players to invest.
The NHS has, of course, been an established fact of life for such a very long time that it simply doesn't occur to a lot of people who might benefit from going private to do so. Private hospitals are either not thought of at all, or bring to mind images of cosmetic vanity procedures and/or being something very exclusive for royalty and rich celebrities.
It takes time for such a mindset to change, but if comfortably off middle-aged and retired folk with reasonably deep pockets find themselves having to wait years for necessary surgery, then change it surely will.
There will be a lot more companies looking at private insurance for staff too, if we see waiting lists for routine treatment keeping people off work for weeks.
Problem is everybody fishing in the same pool of surgeons. Shorter waits for paying punters means even longer waits for Our Beloved NHS.
The trick is sweating the physical assets. Most suites are not used by the NHS at weekends so you can create additional capacity.
They are not used because the surgeons are playing golf. See the problem?
I once heard the PM described as “the man [sic] you hire to do the things that you don’t want to think about but know that they need to be done”. I’ve never been able to track it down again though!
In a perfect world we wouldn’t do deals with Saudi. But they are not an existential threat to us in the way that China could be. Sometimes your enemy’s enemy is your friend (in this case to counterpoint Iran) for geopolitical reasons. Regardless of how distasteful they may be.
And when they overstep even those weak limits - as with that guy in the Saudi embassy in Turkey - then they need to be slapped down
In that case I’m glad we can dispense with cant about ‘fundamental’ values.
It’s not cant.
There is a powerful authoritarian dictatorship that threatens our way of life and that of our friends. I’m glad we are standing up for freedom and democracy
What a laugh, UK murdering women and children in Yemen is standing up for freedom and democracy, what a pile of horse manure.
Comments
They don't appear to have reached Aotearoa/New Zealand.
Edit: and I don't wish to cast shade on our medical response.
https://www.amazon.co.uk/1421-Year-China-Discovered-World/dp/0553815229
Entirely possible they reached Australia, but the medieval reference did make me wonder.
1. Staff rotas are strongly tilted towards servicing the now half-vanished weekday commuter market. The operators failed to employ enough drivers (so as to keep a lid on costs and maximise profits, of course,) preferring to rely on those wanting to earn overtime to keep weekend services running.
2. The first wave of plague almost completely wiped out rail travel. Reduced services for essential workers were run as a consequence. Overtime opportunities were cut back or removed.
3. Many drivers (who are, in any event, both well-paid and made to work some anti-social early morning and late night shifts as it is) re-evaluated their work-life balance, and concluded that they would rather work fewer hours and do without the overtime, thank you very much.
4. Drivers are now doing their minimum duties keeping the weekday services running and aren't interested in plugging the gaps at weekends anymore. Which suits them just fine.
It doesn't take much imagination to understand why it is that the train operators, especially now that they're effectively nationalised and being sustained by the public purse, don't want to change the timetables to favour the leisure traveller over the commuter. This doesn't suit the drivers, who will demand large pay increases to compensate for the inconvenience, go on strike, or both. So much easier not to rock the boat.
King Cole, in the short term, the only thing to do is remember an obvious lesson that should not have been needed in the first place, and plan long term accordingly.
[The UK has also made such mistakes, our energy policy is scratchy at best and we were way too soft and naive with China under Cameron].
We are on the eve of a major domestic economic crisis and Johnson is more interested in undermining efficiency and our global competativeness with nonsense like returning to gills and ounces while play stupid geopolitical games that tie us to the declining United States and antagonise our neighbours and the rising powers of Asia.
When inflation hits and the promised pay rises dont come for key workers then we will see serious industrial unrest added to the mix. It really is back to the seventies.
The utter incompetence, the stunning arrogance, the sheer bloody awfulness of this government will absolutely not be able to cope with "events, dear boy, events". So I think that there is a pretty good chance that they will not just be beaten in 2024, but flayed. Odds on sub 200 seats for the Tories then?
The world is supposed to be improving. Not going for Round II Of The Same Shit.
To describe him as the Frank Spencer of world politics flatters him
Bit like the West English and Breton fishermen getting glimpses of what we now know as N. America.
Now some are trying to ramp up Cold War ii
Pathetic
But the wider problem is institutional inertia. Once a thing become "Policy" it has the force of dogma. Rational opposition to it is nearly futile.
Some years ago, when I was living out in the sticks, a chap came up with a proposal to offer a replacement for a bus service. Instead of horrendous diesel buses coming by once every 2 hours, with one passenger on board, he proposed a more frequent service using Priuses. This worked for him, because it would effectively subsidise a cab company. His proposal pointed out that the CO2 emission reduction was massive. And would increase the number of passenger places. And because of the increased frequency might well increase ridership through increased use.
The proposal was hammered by the local greeny types - Buses Are Good, Cars Are Bad.
Prices start (i.e. this must be the cost of the cheapest available one bedroom apartment) at £329,000 to buy or £1,840 pcm to rent - and the photos indicate that, whilst these places aren't nasty little shoeboxes, they're hardly palatial either.
Now, I know that these development have a few bells and whistles attached to them, notably a live-in warden to phone the ambulance when the old ducks fall over, and then wait with them for the requisite number of hours until it shows up - but, all the same, this is double or more what you'd expect to pay for a flat on the general market in this area, and stands comparison with prices in some parts of inner London.
If anyone tries to convince you that a very large fraction of the pensioner population isn't absolutely minted, then don't listen.
However, there is some truth in that. The naivety, complacency, and lack of foresight has been alarming.
Ramping up Cold War 2 may be more down to China seizing half a sea and the territories of other nations and starting to rattle its sabre Taiwan's way.
Edited extra bit: Communist*, even
There is a powerful authoritarian dictatorship that threatens our way of life and that of our friends. I’m glad we are standing up for freedom and democracy
In response to importing surgeons, that option has been closed off by Brexit. With a few exceptions (Australasia being one) it takes years for a foreign surgeon to be accredited as Specialist, even if competent ones are available. But wasn't the point of Brexit to stop foreign workers undermining sturdy British Yeoman's pay bargaining position?
So as long as pensioners stick with the party by the big margins they are doing there is no way the Tories will go under 200 seats even if they lost, remember Blair actually won pensioners and over 65s in the 1997 Labour landslide.
Anyway inflation is still far below the levels it was in the 1970s and much of the 1980s
The valuation you get for the house from McCarthy Stone.... Combine that with the interesting prices for their flats, and you can see where the scam is....
Also a good point on validation of qualification for foreign-trained doctors. That process needs to be made much simpler if the hiring targets are to be met.
Theatres are expensive, but the expense is really in the software, not the hardware.
Industry leaders warned companies' stocks of carbon dioxide could run out in less than 14 days
https://www.telegraph.co.uk/business/2021/09/17/food-supplies-risk-gas-prices-soar/
ETA Russia is also accused of hiking gas prices to undermine European economic recovery (or just to make more money).
Mr Putin's problem is that Russia is very, very, very big. So big that assets at one end of the country cannot be easily and quickly moved to counter a threat at the other end. With a perceived threat from NATO, and a resurgent China threatening Siberia and looking to sail its navy up the Russian coast as global warming clears the ice, that's a real concern.
"Matt Goodwin
@GoodwinMJ
Support for imperial measures
Leavers 64%
Remainers 28%"
https://twitter.com/GoodwinMJ/status/1438897012271951873
It would be better all round to train our own, who are currently not getting that supervision.
Germany’s reactors were of a much more modern and safer design than those at Fukushima, many of them had decades of life left in them - oh, and Germany was rather unlikely to get hit by a tsunami.
Now they are watching CO2 emissions from electricity generaton rising, and are utterly dependent on a tyrant not turning off the gas taps.
That URL is slightly misleading in that the issue is that carbon dioxide (and ammonia) supplies come from fertiliser plants which have been shut down, in turn in response to soaring gas prices.
"Baby boomers shrug off pandemic, but still think young people are selfish
A new study has found that the post-war generation are twice as likely as younger people to say the pandemic did not harm them" (£)
https://www.telegraph.co.uk/news/2021/09/18/baby-boomers-shrug-pandemic-still-think-young-people-selfish/
Yes we can happily drink beer in pints, or drive in miles, but those are integer unit. No conversions necessary. There's no need to think about how many fluid ounces or gallons or firkins or whatever are related to pints.
ETA a short-term kludge of the pension rules might help retention at the top end.
In power politics, a few troops on the ground = we will escalate this, if your touch this place.
Note that the US hasn't gone as far as having US troops in Taiwan. But they do in South Korea, Japan etc.
Apart from the huge sums spent on research every year in any event, the problem is not a singular one amenable to a brute force approach like that.
While it's true that some agents will prove useful in multiple diseases, defining what those might be and why is still as much as hoc as it is systemic.
Fundamentally we just need a lot more knowledge - a project which industry, government and academia are already spending hundreds of billions on.
What he gets is a fully equipped on site gym and swimming pool (which the public pay £90 to access and he will use daily), a very good onsite restaurant and bar (again open to the public which he gets £60 a month in 'free' meal vouchers), shared residents lounge, onsite Doctor, great gardens, all repairs maintenance, organised games evenings and travel to nearby shops, etc..
He said to me that he deserves this in his retirement having scraped and saved throughout his life. An ex-primary school teacher, his Father died before he was a teenager and his Mother raised him having very little income. (He recalls them regularly eating sugar sandwiches as that was all they could afford).
When his retirement appartment is subsequently sold Audley will keep 1% of the sale price for every year he has lived there up to a maximum of 15%. He says that is to cover deferred management charges and he doesn't care as he has no children to leave money to.
The interesting bit about the Manhattan project was that the basic answers - "We need need kilos of U235 and Pu239" - were already known. As were the list of possible ways to get there. There was surprisingly little abstract science innovation in the project. It was an engineering competition to see which methods worked the best, by trying them all in competition with each other.
The COVID treatment issue equivalent would be if we had micro grams of various treatments that probably work in the labs, but need tons. And don't have the methods to make tons.
We don't have that. What we need (and is happening) is alot of primary science to find the treatment methods and ideas. Once we have the treatments, the pharma industry will give us the tons in fairly short order.
It will enable the BBC to claim that there is discrimination even when there isnt.
I tend to switch between metric and imperial, and if I had kids they would have learned about imperial as I use them. And the fact that a pound contains 16 ounces is a feature, not a bug. Customary measures are quite useful for everyday transactions, cooking, weighing and measuring people and familiar objects, etc. If I need precision or I'm doing any sort of tricky calculation I naturally use metric. The two systems can happily co-exist.
https://twitter.com/Keir_Starmer/status/1439116600934871044?s=20
The new reality of the world rivalry of great and middle powers should lead France to a 2.0 Gaullist stance. Allied but not aligned. Some confrontations are not ours.
https://twitter.com/gerardaraud/status/1439163329952591872
So what are you, out of idle curiosity? It's disconcerting when you have classified a post as tediously partisan, to be told that it doesn't even clear that low bar.