New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
The NHS has (partially) digitised a lot of areas. The problem is incompatible systems and mix of digital with paper.
Most GPs are digitised, IIRC
The sane approach is a gradual building of bridges between systems, rolling updates heading towards a new (and as you say) decentralised system.
I would say that you could get a fairly integrated system in about 20 years.
Yep. Both at Bart’s and my GPs, test results are all quickly uploaded online, and you can inspect your own medical records with a couple of clicks from the email notifying me of an update to my records. It’s actually quite impressive. And the NHs login gets me into both.
If there’s a flaw, it’s that I don’t think the systems are linked, so Barts can’t see my GP test results and vice versa.
Similarly, I had an eye screening test yesterday at 10am. Despite being told that I'd get the results within a couple of weeks, a letter detailing the results was uploaded by 1pm. Impressive.
The bond markets may have saved her. Quite incredible times.
But what does she do now? After the retreats on WFP and benefits cuts how does she meet her self imposed targets in her forthcoming budget? The only way I can see that are more tax increases, probably at least £20bn worth. Its going to be very difficult to do that given her previous promises and assurances.
Keir and Rachel
There's no way out, they've painted themselves into a corner and she will resign before long.
I once had a student summer job, where one of the bright students was given the task of painting a floor with a bitumen-type stuff. He literally painted himself into a corner.
Everyone in the plant dropped round - for hours - to see if it had dried yet.
The next day they sent him to the stores, for a long weight... He was there hours.
On patient records, NHS England decided not to digitise all its records for the obvious reason they didn't need to.
The truth is most people never visit a GP or have any contact with the NHS. What happens is a patient's records are digitised and made available when required. I was told by the person who led the digitisation project about 10% of those registered with a GP have their records uploaded - they would be those with chronic or ongoing conditions and the hypochondriacs. Another 10% would come in on an emergency basis once in a blue moon and their records would alo be uploaded but everyone else - no, it wasn't the time, effort or money to digitise the records and the storage of the old paper records was cheaper and easier than digitisation and disposal.
Normally, if you make an appointment and your records aren't on the system, they get uploaded and that can be done in an emergency within an hour if need be. That's the arrangement NHS England has with the off-site storage company who have to retrieve the paper file (the old Lloyd George envelope) and scan it in as part of their contract.
The bond markets may have saved her. Quite incredible times.
But what does she do now? After the retreats on WFP and benefits cuts how does she meet her self imposed targets in her forthcoming budget? The only way I can see that are more tax increases, probably at least £20bn worth. Its going to be very difficult to do that given her previous promises and assurances.
Keir and Rachel
There's no way out, they've painted themselves into a corner and she will resign before long.
I once had a student summer job, where one of the bright students was given the task of painting a floor with a bitumen-type stuff. He literally painted himself into a corner.
Everyone in the plant dropped round - for hours - to see if it had dried yet.
The next day they sent him to the stores, for a long weight... He was there hours.
admit it, it was you wasn't it.
Not guilty this time.
And neither did I fall for going to the stores for a tin of tartan paint...
But you did ask the chemist for the elbow grease for your fellow workers ...
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
I have quite enjoyed looking at old quotes by Starmer over the last few days. His overblown self-regard is very clear and quite amusing in the light of the hash he has made of being PM.
On the rare occasion the quotes don’t start with “when I was DPP*…” he’s trying to sneer at his opponents and makes himself a massive hostage to fortune:
“Every time there's been the threat of a rebellion he's backed down. The one thing you get if you win the leadership of your party is the right to say 'I've won the leadership and I'm going to do this, and we're going to do it and this is what I'm saying we're going to do with the party, and we're going to do it’. He doesn't have the ability to do that because he hasn't got a mandate.”
Speaking on the Political Party podcast with Matt Forde, as cited in "Sir Keir Starmer: I loathed unprincipled, lying Boris Johnson" The Times (21 February 2023)
* his being DPP is often held up as an example of his ability - out of interest what is the competition like for that role? Is he up against thousands of potential rivals, hundreds, tens? Is it a bit of a niche role that frankly, most of the top lawyers don’t really want so not a real reflection of him being the best of the best?
Its a role of some considerable distinction amongst lawyers. Without researching it I would expect most incumbents end up in a fairly senior judicial role having done their public service (since for most top silks it will result in a significant drop in income).
Hmm.... the evidence is a bit more mixed.
1. Sir Thomas Hetherington: appointed in 1977. During his time there was the Confait case - a serious miscarriage of justice which eventually led to the Police and Criminal Evidence Act 1984 and the creation of the CPS. The IICSA child abuse inquiry heard evidence that he lied to newspapers about his office not receiving reports about abuse allegations against Cyril Smith. Wrote a report which led to the War Crimes Act. 2. Allan Green: resigned after kerb-crawling in Kings X. Went back to the Bar. 3. Barbara Mills: lots of criticism of her for her failures to prosecute corrupt policemen in the West Midlands Serious Crime squad (implicated in the Irish miscarriages of justice) and in the Met (the Countryman investigations) and over deaths in police custody. Had a lot of the usual public sector roles after she resigned. 4. David Calvert-Smith: the CPS was described as "institutionally racist" by him and in a couple of reports. However he did make CPS lawyers rather than the police the final arbiters on whether prosecutions could be brought. Was made a judge. 5. Ken MacDonald: one of the more successful DPPs. Now a peer and a deputy High Court judge. 6. Starmer 7. Alison Saunders: quite a lot of controversies during her time in office over how sexual assault claims should be prosecuted. Not reappointed. Now a Linklaters partner. 8. Max Hill 9. Stephen Parkinson - the current DPP.
So only one judge among the lot of them, 2 if you include McDonald.
How much distinction each of these lawyers had is a matter of opinion.
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
Yes. iirc museums some time ago agreed a standard schema for data interchange.
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Although one might surmise that after serving as Chief Secretary to the Treasury under Brown the fact shes been put pretty much everywhere - Shadiw Foreign, Home, DWP etc etc except back in the Treasury it suggests she didnt set the world alight with her economics
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
From what I have read so far on the proposed change it seems to make sense. The big change feels like the switch from marketised competitive medicine to community medicine. If its in your community then there isn't the need for the vast cost and complexity of what we have now.
I'm only sat on the outside I know, but I look at the structure of the English NHS and think we can remove so much cost by getting rid of competitive internal structures. My old community had a health centre with two GP practices inside it competing for patients. Each then has separate connections with and contracts for care when its patients need referring or transferring. Each had its own management systems and structures and staff. In a new community based structure why would you need the cost and complexity of that?
There has to be some consumer choice for GPs though because if they are shit (and remember they are often private organisations) then what can a resident do? Move house?
Most practices have more than 1 GP. If you live in a big urban area then perhaps you can go to a different practice - not an option for many.
We're NHS Scotland not England so it's a completely different organisation. Our GP surgery is in a practice which has surgeries in multiple villages. They will often give you an appointment with a random GP in a different village. Which only works if you have a car as there is no public transport between the villages.
My problem with the false choice narrative is that many of the choices are crap, and most people want local services.
I don't understand the fascination with local services, surely specialist treatment should be managed nationally. I would quite happily go somewhere else for specialist assessment and treatment eg a national MRI scanning centre in Birmingham.
I once thought I would need knee surgery. (I didn't, it just seems that it took a lot longer to heal than the "up to six months" my GP warned about, plus some gym work to develop my muscles)
After surgery I would be somewhat incapacitated. I lived on my own in SW London and didn't really know anyone locally. It would have been much better for me to have the surgery near friends or family so I could stay with them after the surgery, rather than my "local" hospital in Kingston, but it seems the NHS couldn't do that.
Why not manage services nationally for the young and relatively fit who can travel, and keep local services for the elderly and infirm?
Because mostly people cannot travel. Suppose you'd been gored by marauding sheep now that MattW has had all the cattle grids removed. Kingston hospital A&E needs to scan you onsite – they can hardly send you on a 3-hour ride to a national MRI centre in the Midlands and then to Cornwall for blood tests.
Similarly much of the pressure for digitised GP records came from Members of Parliament whose care might be shared between their home GP and one in London. Most people do not have weekly commutes, and especially not most ill people.
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
Yes. iirc museums some time ago agreed a standard schema for data interchange.
There is a data exchange format for medical stuff called HL7 but frankly its a mess
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Has Cooper ever shown any inclination of wanting to be Chancellor? It’s a role that tends to be reserved for those who have particular designs on it. Hunt was perhaps an exception as being essentially a senior figure parachuted in to help stabilise things, but otherwise most appointees have all been people heavily trailed as wanting the job in advance.
She has for some time been rather immersed in the Home Affairs brief and I’ve always felt that was where her interests lay.
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Although one might surmise that after serving as Chief Secretary to the Treasury under Brown the fact shes been put pretty much everywhere - Shadiw Foreign, Home, DWP etc etc except back in the Treasury it suggests she didnt set the world alight with her economics
Our whole system is based on ministers not being specialists. Mrs Thatcher was not actually driving the tank in that famous picture. Chancellors do not need to have more than the most basic grasp of economics. They do need to have a policy.
The bond markets may have saved her. Quite incredible times.
But what does she do now? After the retreats on WFP and benefits cuts how does she meet her self imposed targets in her forthcoming budget? The only way I can see that are more tax increases, probably at least £20bn worth. Its going to be very difficult to do that given her previous promises and assurances.
Keir and Rachel
There's no way out, they've painted themselves into a corner and she will resign before long.
That's the funniest thing I've seen for ages. Love the ducks.
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
From what I have read so far on the proposed change it seems to make sense. The big change feels like the switch from marketised competitive medicine to community medicine. If its in your community then there isn't the need for the vast cost and complexity of what we have now.
I'm only sat on the outside I know, but I look at the structure of the English NHS and think we can remove so much cost by getting rid of competitive internal structures. My old community had a health centre with two GP practices inside it competing for patients. Each then has separate connections with and contracts for care when its patients need referring or transferring. Each had its own management systems and structures and staff. In a new community based structure why would you need the cost and complexity of that?
There has to be some consumer choice for GPs though because if they are shit (and remember they are often private organisations) then what can a resident do? Move house?
Most practices have more than 1 GP. If you live in a big urban area then perhaps you can go to a different practice - not an option for many.
We're NHS Scotland not England so it's a completely different organisation. Our GP surgery is in a practice which has surgeries in multiple villages. They will often give you an appointment with a random GP in a different village. Which only works if you have a car as there is no public transport between the villages.
My problem with the false choice narrative is that many of the choices are crap, and most people want local services.
For competition to work for consumer choice there needs to be surplus capacity. In a state of shortage of capacity and excess demand then people have to take what they can get. It's the same for health as housing or schools.
Excess capacity is too often seen as waste rather than the lubrication needed for smooth working. We need capacity for peak demand, not average or trough demand.
Over a hundred years ago, OR professionals noted that organisations run at 99% of capacity had
- poor productivity - poor worker retention - poor quality - workers start “soldiering” - just doing the minimum to keep their job without regard for actual outputs. - high probability of accidents - high probability of organisational collapse
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Although one might surmise that after serving as Chief Secretary to the Treasury under Brown the fact shes been put pretty much everywhere - Shadiw Foreign, Home, DWP etc etc except back in the Treasury it suggests she didnt set the world alight with her economics
Our whole system is based on ministers not being specialists. Mrs Thatcher was not actually driving the tank in that famous picture. Chancellors do not need to have more than the most basic grasp of economics. They do need to have a policy.
Yes, and her being kept away from the Treasury/shadow Treasury for 16 years and never talking about the economy says she doesn't have a policy. She's very unlikely ro get the gig imo
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Has Cooper ever shown any inclination of wanting to be Chancellor? It’s a role that tends to be reserved for those who have particular designs on it. Hunt was perhaps an exception as being essentially a senior figure parachuted in to help stabilise things, but otherwise most appointees have all been people heavily trailed as wanting the job in advance.
She has for some time been rather immersed in the Home Affairs brief and I’ve always felt that was where her interests lay.
Cooper went in that direction because her husband is Ed Balls and she was sensible enough not to be on competition with her husband for the exact same job
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
Yes. iirc museums some time ago agreed a standard schema for data interchange.
There is a data exchange format for medical stuff called HL7 but frankly its a mess
Recent strange text message from my GP surgery:
Dear [76 year old male] Please be advised that with immediate effect, we're no longer accepting Urine Samples over the Reception desk from Women between the ages of 16 - 64 with suspected UTI. You will need to ring the surgery to be referred to Pharmacy First if appropriate. Please do not attend the pharmacy with a urine sample, as they cannot accept these. You will be assessed based on your symptoms. Thanks, The XXXXX. Medical Practice
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
On patient records, NHS England decided not to digitise all its records for the obvious reason they didn't need to.
The truth is most people never visit a GP or have any contact with the NHS. What happens is a patient's records are digitised and made available when required. I was told by the person who led the digitisation project about 10% of those registered with a GP have their records uploaded - they would be those with chronic or ongoing conditions and the hypochondriacs. Another 10% would come in on an emergency basis once in a blue moon and their records would alo be uploaded but everyone else - no, it wasn't the time, effort or money to digitise the records and the storage of the old paper records was cheaper and easier than digitisation and disposal.
Normally, if you make an appointment and your records aren't on the system, they get uploaded and that can be done in an emergency within an hour if need be. That's the arrangement NHS England has with the off-site storage company who have to retrieve the paper file (the old Lloyd George envelope) and scan it in as part of their contract.
"The truth is most people never visit a GP or have any contact with the NHS" until they get to about 60 would be more accurate.
The difference between the average number of prescriptions for someone in middle age and that for older people is, IIRC a factor of 10.
The bond markets may have saved her. Quite incredible times.
But what does she do now? After the retreats on WFP and benefits cuts how does she meet her self imposed targets in her forthcoming budget? The only way I can see that are more tax increases, probably at least £20bn worth. Its going to be very difficult to do that given her previous promises and assurances.
Keir and Rachel
There's no way out, they've painted themselves into a corner and she will resign before long.
I once had a student summer job, where one of the bright students was given the task of painting a floor with a bitumen-type stuff. He literally painted himself into a corner.
Everyone in the plant dropped round - for hours - to see if it had dried yet.
The next day they sent him to the stores, for a long weight... He was there hours.
admit it, it was you wasn't it.
My first job was as a runner on the LIFFE market and I was sent out one day by one of the brokers to buy the porno mags ‘Fat & Forty’ and ‘Asian Babes’… it only occurred to me about 20 years later that it might have been a wind up, I did it without feeling embarrassed at all, despite not being someone who’d buy that sort of thing for myself
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
By schema I just mean defining
These are the tables that will exist These are the columns each table will have along with datatypes and foreign keys
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
The NHS has (partially) digitised a lot of areas. The problem is incompatible systems and mix of digital with paper.
Most GPs are digitised, IIRC
The sane approach is a gradual building of bridges between systems, rolling updates heading towards a new (and as you say) decentralised system.
I would say that you could get a fairly integrated system in about 20 years.
Yep. Both at Bart’s and my GPs, test results are all quickly uploaded online, and you can inspect your own medical records with a couple of clicks from the email notifying me of an update to my records. It’s actually quite impressive. And the NHs login gets me into both.
If there’s a flaw, it’s that I don’t think the systems are linked, so Barts can’t see my GP test results and vice versa.
Similarly, I had an eye screening test yesterday at 10am. Despite being told that I'd get the results within a couple of weeks, a letter detailing the results was uploaded by 1pm. Impressive.
A big issue is joining stuff up.
My Aunt just got out of hospital. Needs lots of care and follow up. I get various people calling me (down on the paperwork as a contact) to ask if I know what everyone else is doing.
Imagine an app. Shows the discharge plan. Shows the required visits, by various outfits. Shows the required equipment. Medications etc etc. shows status of all of the above. Who visited, when, status, notes, actions….
Full of links to all the different parties involved - messaging in the app?
Make it available to the patient as well. So they can see.
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Has Cooper ever shown any inclination of wanting to be Chancellor? It’s a role that tends to be reserved for those who have particular designs on it. Hunt was perhaps an exception as being essentially a senior figure parachuted in to help stabilise things, but otherwise most appointees have all been people heavily trailed as wanting the job in advance.
She has for some time been rather immersed in the Home Affairs brief and I’ve always felt that was where her interests lay.
Cooper went in that direction because her husband is Ed Balls and she was sensible enough not to be on competition with her husband for the exact same job
She'd had a more senior role to him in the Treasury before he became Shadow CoE (hed been ecomonic secretary she was later chief secretary).she moved to Shadow home the same day Miliband made Balls Shadow CoE and then went onto chair the Home Affairs committee after the 2015 election
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Although one might surmise that after serving as Chief Secretary to the Treasury under Brown the fact shes been put pretty much everywhere - Shadiw Foreign, Home, DWP etc etc except back in the Treasury it suggests she didnt set the world alight with her economics
Our whole system is based on ministers not being specialists. Mrs Thatcher was not actually driving the tank in that famous picture. Chancellors do not need to have more than the most basic grasp of economics. They do need to have a policy.
Yes, and her being kept away from the Treasury/shadow Treasury for 16 years and never talking about the economy says she doesn't have a policy. She's very unlikely ro get the gig imo
Re Thatcher and tank. Like all VIPs, she was sitting in the commanders seat, while the actual driver drove a pre-arranged course.
To actually fight the tank, you’d need a trained, experienced commander in her place.
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Although one might surmise that after serving as Chief Secretary to the Treasury under Brown the fact shes been put pretty much everywhere - Shadiw Foreign, Home, DWP etc etc except back in the Treasury it suggests she didnt set the world alight with her economics
Our whole system is based on ministers not being specialists. Mrs Thatcher was not actually driving the tank in that famous picture. Chancellors do not need to have more than the most basic grasp of economics. They do need to have a policy.
Yes, and her being kept away from the Treasury/shadow Treasury for 16 years and never talking about the economy says she doesn't have a policy. She's very unlikely ro get the gig imo
It might - but there are other equally possible reasons.
I have quite enjoyed looking at old quotes by Starmer over the last few days. His overblown self-regard is very clear and quite amusing in the light of the hash he has made of being PM.
On the rare occasion the quotes don’t start with “when I was DPP*…” he’s trying to sneer at his opponents and makes himself a massive hostage to fortune:
“Every time there's been the threat of a rebellion he's backed down. The one thing you get if you win the leadership of your party is the right to say 'I've won the leadership and I'm going to do this, and we're going to do it and this is what I'm saying we're going to do with the party, and we're going to do it’. He doesn't have the ability to do that because he hasn't got a mandate.”
Speaking on the Political Party podcast with Matt Forde, as cited in "Sir Keir Starmer: I loathed unprincipled, lying Boris Johnson" The Times (21 February 2023)
* his being DPP is often held up as an example of his ability - out of interest what is the competition like for that role? Is he up against thousands of potential rivals, hundreds, tens? Is it a bit of a niche role that frankly, most of the top lawyers don’t really want so not a real reflection of him being the best of the best?
Its a role of some considerable distinction amongst lawyers. Without researching it I would expect most incumbents end up in a fairly senior judicial role having done their public service (since for most top silks it will result in a significant drop in income).
Hmm.... the evidence is a bit more mixed.
1. Sir Thomas Hetherington: appointed in 1977. During his time there was the Confait case - a serious miscarriage of justice which eventually led to the Police and Criminal Evidence Act 1984 and the creation of the CPS. The IICSA child abuse inquiry heard evidence that he lied to newspapers about his office not receiving reports about abuse allegations against Cyril Smith. Wrote a report which led to the War Crimes Act. 2. Allan Green: resigned after kerb-crawling in Kings X. Went back to the Bar. 3. Barbara Mills: lots of criticism of her for her failures to prosecute corrupt policemen in the West Midlands Serious Crime squad (implicated in the Irish miscarriages of justice) and in the Met (the Countryman investigations) and over deaths in police custody. Had a lot of the usual public sector roles after she resigned. 4. David Calvert-Smith: the CPS was described as "institutionally racist" by him and in a couple of reports. However he did make CPS lawyers rather than the police the final arbiters on whether prosecutions could be brought. Was made a judge. 5. Ken MacDonald: one of the more successful DPPs. Now a peer and a deputy High Court judge. 6. Starmer 7. Alison Saunders: quite a lot of controversies during her time in office over how sexual assault claims should be prosecuted. Not reappointed. Now a Linklaters partner. 8. Max Hill 9. Stephen Parkinson - the current DPP.
So only one judge among the lot of them, 2 if you include McDonald.
How much distinction each of these lawyers had is a matter of opinion.
Only Cyclefree has the capacity to play DPP Top Trumps.
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
By schema I just mean defining
These are the tables that will exist These are the columns each table will have along with datatypes and foreign keys
I am not talking about sql in the least
NoSQL DB might be better…
In any event, trying to hard specify the data structure for the whole NHS gets you back to Mega Projects. Which always fail. And often die from requirements growing like KPMG bills.
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Although one might surmise that after serving as Chief Secretary to the Treasury under Brown the fact shes been put pretty much everywhere - Shadiw Foreign, Home, DWP etc etc except back in the Treasury it suggests she didnt set the world alight with her economics
Our whole system is based on ministers not being specialists. Mrs Thatcher was not actually driving the tank in that famous picture. Chancellors do not need to have more than the most basic grasp of economics. They do need to have a policy.
Yes, and her being kept away from the Treasury/shadow Treasury for 16 years and never talking about the economy says she doesn't have a policy. She's very unlikely ro get the gig imo
It might - but there are other equally possible reasons.
Of course. There are always lots of possibles. I happen to think this one is quite likely.
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Although one might surmise that after serving as Chief Secretary to the Treasury under Brown the fact shes been put pretty much everywhere - Shadiw Foreign, Home, DWP etc etc except back in the Treasury it suggests she didnt set the world alight with her economics
Our whole system is based on ministers not being specialists. Mrs Thatcher was not actually driving the tank in that famous picture. Chancellors do not need to have more than the most basic grasp of economics. They do need to have a policy.
But they do need to be able to count. There is little evidence Reeves can count. There is absolute evidence that Keir Starmer is functionally disnumerate and I wouldn't be surprised is Reeves is much the same.
Starmer’s immediate problem, which I do not see how he can solve, is how to stop gilts going further through the floor when his chancellor inevitably resigns.
I should add that I necessarily don’t think he will fire her but that she’ll go. There’s a political law of the jungle. Once you’ve passed a certain level of public humiliation and credibility collapse, the ability to do the job evaporates
Labour seem to be close to losing their minds as the Tories did whilst governing.
Farage will be PM if they oust Starmer so soon after he won a mandate imho.
If he resigns six months/year before next GE saying time for a younger candidate then that's different.
The party don't appear to like him. He was a practical choice when they were trying to flee Corbynism but there is no sense hes great pals with many in the party, hes an outsider who came in for career purposes, he's anything but the 'moral crusade' and he isnt providing success like Blair so there is simply no attachment to him. If the PLP had a proper 'process' a la 1922 it would already be underway i think
Labour seem to be close to losing their minds as the Tories did whilst governing.
Farage will be PM if they oust Starmer so soon after he won a mandate imho.
If he resigns six months/year before next GE saying time for a younger candidate then that's different.
The party don't appear to like him. He was a practical choice when they were trying to flee Corbynism but there is no sense hes great pals with many in the party, hes an outsider who came in for career purposes, he's anything but the 'moral crusade' and he isnt providing success like Blair so there is simply no attachment to him. If the PLP had a proper 'process' a la 1922 it would already be underway i think
Edit - and yep, ousting = PM spiv
I don’t think he entered politics to become PM more Attorney General - and then Corbyn appeared and a lot of the other options disappeared
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
By schema I just mean defining
These are the tables that will exist These are the columns each table will have along with datatypes and foreign keys
I am not talking about sql in the least
NoSQL DB might be better…
In any event, trying to hard specify the data structure for the whole NHS gets you back to Mega Projects. Which always fail. And often die from requirements growing like KPMG bills.
The trick is not to try and do it all at once however, start with the basics release that spec then iterate bit by bit. The problem currently is a hospital is using app A with its own db structure, App B comes out and is much better but they can't switch easily because the two apps use different structures to store the data so you either have to create a migration script which is horribly error prone or stick with the worse app. I really don't think its as big a job as you suggest either. The app I worked on that was used in hospitals had about 20 odd tables and handled pretty much most stuff the hospitals wanted
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Although one might surmise that after serving as Chief Secretary to the Treasury under Brown the fact shes been put pretty much everywhere - Shadiw Foreign, Home, DWP etc etc except back in the Treasury it suggests she didnt set the world alight with her economics
Our whole system is based on ministers not being specialists. Mrs Thatcher was not actually driving the tank in that famous picture. Chancellors do not need to have more than the most basic grasp of economics. They do need to have a policy.
But they do need to be able to count. There is little evidence Reeves can count. There is absolute evidence that Keir Starmer is functionally disnumerate and I wouldn't be surprised is Reeves is much the same.
SKS has an A in maths at A-level, and Reeves has an A in both maths and further maths, so it is absurd to claim that they are unable to count or "disnumerate" (a word which you appear to have invented; I assume you mean innumerate). They may not be the world's greatest economists, but they are certainly not stupid or innumerate.
Kemi Badenoch is refusing to sack her party's leader in London despite her backing a far-right group calling for the mass deportation of millions of people living legally in the UK.
A Conservative spokesman described the group as "non partisan" and said party members were free to join it
Labour seem to be close to losing their minds as the Tories did whilst governing.
Farage will be PM if they oust Starmer so soon after he won a mandate imho.
If he resigns six months/year before next GE saying time for a younger candidate then that's different.
It's ridiculous to assert Farage would become Prime Minister if Starmer left No.10. There won't be an election however much Reform puff and pant about it.
Your other point is more valid but if things are looking better by late 2027/early 2028, why would Starmer step down? I suspect he could promote from within the younger ranks of the Parliamentary Party and a successor might be lurking somewhere in that group but, unless private polling shows Starmer is far more disliked than Labour, he'll lead the party into the next election and stand down in 2030 or 2031 - he'll have done a decade in the second most difficult job in UK politics - the most difficult job is leading the Conservative Party.
With his 26 year old brother in the car in the early hours of the morning:
Liverpool star Diogo Jota has died at the age of 28 after his Lamborghini careered off a road in northern Spain - just two weeks after he married his childhood sweetheart.
The Portuguese forward was travelling in the supercar with his fellow footballer brother Andre, 26, who also died in the crash.
The Lamborghini's tyre is believed to have blown out while overtaking on the A-52 at Cernadilla near Zamora in northwestern Spain, close to the border with Portugal.
The supercar came off the road, rolled and then burst into flames in the early hours of this morning. The emergency services were called but the brothers could not be saved.
Has anyone driven the A-52 at Cernadilla. What is it like? AFAICS it is dual carriageway for a number of miles in both directions, but what are Spanish dual carriageways in that area like wrt maintenance etc?
I can't honestly see a reason for a Lambo tyre to explode, unless poorly maintained or caused by eg road debris.
Labour seem to be close to losing their minds as the Tories did whilst governing.
Farage will be PM if they oust Starmer so soon after he won a mandate imho.
If he resigns six months/year before next GE saying time for a younger candidate then that's different.
There is no mechanism to oust Starmer but for several months, I have said he will want to retire early. Ironically, the effect of ousting talk might be to make him hang on longer.
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Has Cooper ever shown any inclination of wanting to be Chancellor? It’s a role that tends to be reserved for those who have particular designs on it. Hunt was perhaps an exception as being essentially a senior figure parachuted in to help stabilise things, but otherwise most appointees have all been people heavily trailed as wanting the job in advance.
She has for some time been rather immersed in the Home Affairs brief and I’ve always felt that was where her interests lay.
Cooper went in that direction because her husband is Ed Balls and she was sensible enough not to be on competition with her husband for the exact same job
She'd had a more senior role to him in the Treasury before he became Shadow CoE (hed been ecomonic secretary she was later chief secretary).she moved to Shadow home the same day Miliband made Balls Shadow CoE and then went onto chair the Home Affairs committee after the 2015 election
Ed however was economic advisor to Gordon from 97-99
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Although one might surmise that after serving as Chief Secretary to the Treasury under Brown the fact shes been put pretty much everywhere - Shadiw Foreign, Home, DWP etc etc except back in the Treasury it suggests she didnt set the world alight with her economics
Our whole system is based on ministers not being specialists. Mrs Thatcher was not actually driving the tank in that famous picture. Chancellors do not need to have more than the most basic grasp of economics. They do need to have a policy.
But they do need to be able to count. There is little evidence Reeves can count. There is absolute evidence that Keir Starmer is functionally disnumerate and I wouldn't be surprised is Reeves is much the same.
SKS has an A in maths at A-level, and Reeves has an A in both maths and further maths, so it is absurd to claim that they are unable to count or "disnumerate" (a word which you appear to have invented; I assume you mean innumerate). They may not be the world's greatest economists, but they are certainly not stupid or innumerate.
The weirdest thing about the attacks on Reeves (and Starmer) is about their academic qualifications. In any other role they become irrelevant after about 5 years, and they are better qualified than some of our most effective politicians.
It's sufficient to opine that they are just rubbish at politics. In fact, the lesson might be that Labour need more Spad-type politicians to manage the party and work out the messaging.
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
By schema I just mean defining
These are the tables that will exist These are the columns each table will have along with datatypes and foreign keys
I am not talking about sql in the least
NoSQL DB might be better…
In any event, trying to hard specify the data structure for the whole NHS gets you back to Mega Projects. Which always fail. And often die from requirements growing like KPMG bills.
The trick is not to try and do it all at once however, start with the basics release that spec then iterate bit by bit. The problem currently is a hospital is using app A with its own db structure, App B comes out and is much better but they can't switch easily because the two apps use different structures to store the data so you either have to create a migration script which is horribly error prone or stick with the worse app. I really don't think its as big a job as you suggest either. The app I worked on that was used in hospitals had about 20 odd tables and handled pretty much most stuff the hospitals wanted
Yup, careful teration is the way to do it.
My other half is a clinical scientist with the NHS. They were having capacity and other issues with the venerable and much-patched software they use for processing clinical data, so they asked IT to improve it. In their wisdom, the IT department decided that a complete rewrite was the best course of action in order to "future-proof" the software, so off they went. This week, the new system went live, and all hell has broken loose. While the system does now (finally!) meet the formal specifications, it fails to do cover all the edge cases and unusual circumstances that the old software used to deal with, and which nobody thought to put in the specification. By the time the new software has been patched with all the bug fixes needed to make it usable, it'll probably be as big a mess as the original software.
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Has Cooper ever shown any inclination of wanting to be Chancellor? It’s a role that tends to be reserved for those who have particular designs on it. Hunt was perhaps an exception as being essentially a senior figure parachuted in to help stabilise things, but otherwise most appointees have all been people heavily trailed as wanting the job in advance.
She has for some time been rather immersed in the Home Affairs brief and I’ve always felt that was where her interests lay.
Cooper went in that direction because her husband is Ed Balls and she was sensible enough not to be on competition with her husband for the exact same job
She'd had a more senior role to him in the Treasury before he became Shadow CoE (hed been ecomonic secretary she was later chief secretary).she moved to Shadow home the same day Miliband made Balls Shadow CoE and then went onto chair the Home Affairs committee after the 2015 election
Ed however was economic advisor to Gordon from 97-99
Id forgotten that. Bit like Cameron being Lamonts bag boy
Kemi Badenoch is refusing to sack her party's leader in London despite her backing a far-right group calling for the mass deportation of millions of people living legally in the UK.
A Conservative spokesman described the group as "non partisan" and said party members were free to join it
I'm trying to figure out where Restore Britain stands on mass deportations, a move which Farage himself has described as impossible or impractical.
It seems to kick out 400,000 illegal immigrants (perhaps a third of the total, who knows?), we need a sevenfold increase in detention centre capacity (where? who pays for that?) and an unspecified increase in the number of Border Patrol staff (who? who pays for them? from where are they recruited? Oh, I know, we could offer a job with Border Patrol to the illegals who could then be paid to deport other illegals - seriously?).
It turns out three quarters of migrants come from countries with whom we have no Returns Agreemenr so somebody is going to have to go to these countries and get an agreement (nice little sweetener perhaps?).
The plan is so full of inconsistencies and holes it could be called a new Swiss Cheese.
BRITAIN will be “fat free” within a decade, paving the way for tax cuts worth billions of pounds, Wes Streeting declared yesterday.
People will be fat free or dead if the jabs have some inherent vice only revealed by Streetings mass beta test.
People have got overweight and under-fit by eating crap between meals - that only builds appetite not stops it - and zero exercise. And there’s some simple cheat that makes them fit and well?
Nope. God has told us over and over there are no simple “cheats” to wellness and resilience - if you want happiness it must be earned.
Living in LA, almost everyone is on ozempic. And one of the things I've noticed is that people taking it often cut their drinking back massively, and start exercising. When you are already overweight, exercise is tough and uncomfortable. Once you've lost a few kilograms (thanks to the magic of semiglutide), exercise becomes that much easier.
Starmer’s immediate problem, which I do not see how he can solve, is how to stop gilts going further through the floor when his chancellor inevitably resigns.
I should add that I necessarily don’t think he will fire her but that she’ll go. There’s a political law of the jungle. Once you’ve passed a certain level of public humiliation and credibility collapse, the ability to do the job evaporates
He surely can’t fire her at least before the budget. The optics of kicking her while she’s down would be far too grave, even for someone as ruthless as Starmer.
I do think it’s possible she leaves of her own volition, for the reasons I mentioned this morning.
With his 26 year old brother in the car in the early hours of the morning:
Liverpool star Diogo Jota has died at the age of 28 after his Lamborghini careered off a road in northern Spain - just two weeks after he married his childhood sweetheart.
The Portuguese forward was travelling in the supercar with his fellow footballer brother Andre, 26, who also died in the crash.
The Lamborghini's tyre is believed to have blown out while overtaking on the A-52 at Cernadilla near Zamora in northwestern Spain, close to the border with Portugal.
The supercar came off the road, rolled and then burst into flames in the early hours of this morning. The emergency services were called but the brothers could not be saved.
Has anyone driven the A-52 at Cernadilla. What is it like? AFAICS it is dual carriageway for a number of miles in both directions, but what are Spanish dual carriageways in that area like wrt maintenance etc?
I can't honestly see a reason for a Lambo tyre to explode, unless poorly maintained or caused by eg road debris.
Kemi Badenoch is refusing to sack her party's leader in London despite her backing a far-right group calling for the mass deportation of millions of people living legally in the UK.
A Conservative spokesman described the group as "non partisan" and said party members were free to join it
With his 26 year old brother in the car in the early hours of the morning:
Liverpool star Diogo Jota has died at the age of 28 after his Lamborghini careered off a road in northern Spain - just two weeks after he married his childhood sweetheart.
The Portuguese forward was travelling in the supercar with his fellow footballer brother Andre, 26, who also died in the crash.
The Lamborghini's tyre is believed to have blown out while overtaking on the A-52 at Cernadilla near Zamora in northwestern Spain, close to the border with Portugal.
The supercar came off the road, rolled and then burst into flames in the early hours of this morning. The emergency services were called but the brothers could not be saved.
Has anyone driven the A-52 at Cernadilla. What is it like? AFAICS it is dual carriageway for a number of miles in both directions, but what are Spanish dual carriageways in that area like wrt maintenance etc?
I can't honestly see a reason for a Lambo tyre to explode, unless poorly maintained or caused by eg road debris.
The tires need frequent replacement.
Magnesium wheels?
That description is almost word for word how Jose Antonio Reyes's death was reported at the time (think it might have been contested).
Starmer’s immediate problem, which I do not see how he can solve, is how to stop gilts going further through the floor when his chancellor inevitably resigns.
I should add that I necessarily don’t think he will fire her but that she’ll go. There’s a political law of the jungle. Once you’ve passed a certain level of public humiliation and credibility collapse, the ability to do the job evaporates
He surely can’t fire her at least before the budget. The optics of kicking her while she’s down would be far too grave, even for someone as ruthless as Starmer.
I do think it’s possible she leaves of her own volition, for the reasons I mentioned this morning.
If she is quitting it will be imminent using 'personal reasons' as the catslyst to avoid spooking the horses
One of my fave betting drills - because it so often pays - is to lay into irrational exuberance; eg where a perception something is about to happen takes off to a level which comfortably exceeds the actual probability of it happening. A recent example was Kemi Badenoch at 2.7 (!) to exit in 2025 in the aftermath of the May local election results. Crazy. But thank you. Are we seeing something similar with the notion that Rachel Reeves is toast as Chancellor? I think we are. Whilst I agree with TSE that Coop is appealing at 16/1 if RR does go, the market I'd really like to see is RR exit date. C'mon betfair.
Kemi Badenoch is refusing to sack her party's leader in London despite her backing a far-right group calling for the mass deportation of millions of people living legally in the UK.
A Conservative spokesman described the group as "non partisan" and said party members were free to join it
I'm trying to figure out where Restore Britain stands on mass deportations, a move which Farage himself has described as impossible or impractical.
It seems to kick out 400,000 illegal immigrants (perhaps a third of the total, who knows?), we need a sevenfold increase in detention centre capacity (where? who pays for that?) and an unspecified increase in the number of Border Patrol staff (who? who pays for them? from where are they recruited? Oh, I know, we could offer a job with Border Patrol to the illegals who could then be paid to deport other illegals - seriously?).
It turns out three quarters of migrants come from countries with whom we have no Returns Agreemenr so somebody is going to have to go to these countries and get an agreement (nice little sweetener perhaps?).
The plan is so full of inconsistencies and holes it could be called a new Swiss Cheese.
The only rational reason for having a policy of mass deportation is as a pretext for constructing the apparatus for a police state. Irrational reasons are also quite likely.
One of my fave betting drills - because it so often pays - is to lay into irrational exuberance; eg where a perception something is about to happen takes off to a level which comfortably exceeds the actual probability of it happening. A recent example was Kemi Badenoch at 2.7 (!) to exit in 2025 in the aftermath of the May local election results. Crazy. But thank you. Are we seeing something similar with the notion that Rachel Reeves is toast as Chancellor? I think we are. Whilst I agree with TSE that Coop is appealing at 16/1 if RR does go, the market I'd really like to see is RR exit date.
The fundamentals probably still point to her clinging on, but I don’t think it’s an insignificant chance, particularly given the briefing and reporting.
Firstly, it does appear she has been very bruised by the events of the last week.
Secondly, and I am not going to speculate, but we do not know what is going on in her personal life and what sort of impact that is having on her, beyond of course the scenes in the Commons yesterday.
Thirdly there are hints that all is not well in the relationship between No10 and No11.
Fourthly Starmer is not known to be particularly loyal.
Fifthly is the “blood in the water” effect that once a politician becomes the story and is seen to be bruised, it becomes much harder for them to stay afloat.
Now balanced against this is a) the political capital Starmer will certainly not want to spend being seen to push her at this stage and b) the wobbly markets which will give her a personal mission to want to stay on. I do think it’s more likely than not that she gets to the budget and to 2026, but I wouldn’t say it’s inconceivable she goes in the next week, say.
Kemi Badenoch is refusing to sack her party's leader in London despite her backing a far-right group calling for the mass deportation of millions of people living legally in the UK.
A Conservative spokesman described the group as "non partisan" and said party members were free to join it
Starmer’s immediate problem, which I do not see how he can solve, is how to stop gilts going further through the floor when his chancellor inevitably resigns.
I should add that I necessarily don’t think he will fire her but that she’ll go. There’s a political law of the jungle. Once you’ve passed a certain level of public humiliation and credibility collapse, the ability to do the job evaporates
He surely can’t fire her at least before the budget. The optics of kicking her while she’s down would be far too grave, even for someone as ruthless as Starmer.
I do think it’s possible she leaves of her own volition, for the reasons I mentioned this morning.
Resign/sack/stay (this year) are all possible so we have to do numbers. Here's mine:
Kemi Badenoch is refusing to sack her party's leader in London despite her backing a far-right group calling for the mass deportation of millions of people living legally in the UK.
A Conservative spokesman described the group as "non partisan" and said party members were free to join it
Kemi Badenoch is refusing to sack her party's leader in London despite her backing a far-right group calling for the mass deportation of millions of people living legally in the UK.
A Conservative spokesman described the group as "non partisan" and said party members were free to join it
With his 26 year old brother in the car in the early hours of the morning:
Liverpool star Diogo Jota has died at the age of 28 after his Lamborghini careered off a road in northern Spain - just two weeks after he married his childhood sweetheart.
The Portuguese forward was travelling in the supercar with his fellow footballer brother Andre, 26, who also died in the crash.
The Lamborghini's tyre is believed to have blown out while overtaking on the A-52 at Cernadilla near Zamora in northwestern Spain, close to the border with Portugal.
The supercar came off the road, rolled and then burst into flames in the early hours of this morning. The emergency services were called but the brothers could not be saved.
Has anyone driven the A-52 at Cernadilla. What is it like? AFAICS it is dual carriageway for a number of miles in both directions, but what are Spanish dual carriageways in that area like wrt maintenance etc?
I can't honestly see a reason for a Lambo tyre to explode, unless poorly maintained or caused by eg road debris.
Tyres are more likely to explode at high speeds as a supercar can regularly reach unfortunately
Starmer’s immediate problem, which I do not see how he can solve, is how to stop gilts going further through the floor when his chancellor inevitably resigns.
I should add that I necessarily don’t think he will fire her but that she’ll go. There’s a political law of the jungle. Once you’ve passed a certain level of public humiliation and credibility collapse, the ability to do the job evaporates
He surely can’t fire her at least before the budget. The optics of kicking her while she’s down would be far too grave, even for someone as ruthless as Starmer.
I do think it’s possible she leaves of her own volition, for the reasons I mentioned this morning.
Resign/sack/stay (this year) are all possible so we have to do numbers. Here's mine:
Resign 20% Sack 5% Stay 75%
Broadly where I am I think. Maybe 30/5/65 from me.
Yes Cooper is probably the most heavyweight frontbencher if Reeves goes. May mean Ed Balls is backseat driving on economic policy if she becomes Chancellor though
Has Cooper ever shown any inclination of wanting to be Chancellor? It’s a role that tends to be reserved for those who have particular designs on it. Hunt was perhaps an exception as being essentially a senior figure parachuted in to help stabilise things, but otherwise most appointees have all been people heavily trailed as wanting the job in advance.
She has for some time been rather immersed in the Home Affairs brief and I’ve always felt that was where her interests lay.
She is more heavyweight than McFadden who is also tipped for the post
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
By schema I just mean defining
These are the tables that will exist These are the columns each table will have along with datatypes and foreign keys
I am not talking about sql in the least
NoSQL DB might be better…
In any event, trying to hard specify the data structure for the whole NHS gets you back to Mega Projects. Which always fail. And often die from requirements growing like KPMG bills.
Yes: one with surely be much better off defining a few simple standards: this is the JSON for a patient, a prescription, etc.
Table (relational) databases existed because computing power was expensive, and this was by far the most efficient way of storing data. These days, those constraints do not exist.
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
The NHS has (partially) digitised a lot of areas. The problem is incompatible systems and mix of digital with paper.
Most GPs are digitised, IIRC
The sane approach is a gradual building of bridges between systems, rolling updates heading towards a new (and as you say) decentralised system.
I would say that you could get a fairly integrated system in about 20 years.
Yep. Both at Bart’s and my GPs, test results are all quickly uploaded online, and you can inspect your own medical records with a couple of clicks from the email notifying me of an update to my records. It’s actually quite impressive. And the NHs login gets me into both.
If there’s a flaw, it’s that I don’t think the systems are linked, so Barts can’t see my GP test results and vice versa.
Similarly, I had an eye screening test yesterday at 10am. Despite being told that I'd get the results within a couple of weeks, a letter detailing the results was uploaded by 1pm. Impressive.
A big issue is joining stuff up.
My Aunt just got out of hospital. Needs lots of care and follow up. I get various people calling me (down on the paperwork as a contact) to ask if I know what everyone else is doing.
Imagine an app. Shows the discharge plan. Shows the required visits, by various outfits. Shows the required equipment. Medications etc etc. shows status of all of the above. Who visited, when, status, notes, actions….
Full of links to all the different parties involved - messaging in the app?
Make it available to the patient as well. So they can see.
I'm not sure if you are being serious, but the NHS app does a lot of that already, and includes a facility to manage health services for others.
I can see my health records through it, though I have not set up the service, and I don't really know the app in detail yet.
I'm not sure on things like discharge plans and messaging with all parties, but is a discharge plan in the health record?
@DPJHodges I’m sorry, but yesterday we were told the Chancellor was facing such serious personal issues she was in tears in the House of Commons chamber, causing market chaos. Now this morning she’s being sent out to launch the Government’s NHS plan. And we’re all supposed to act as if nothing’s happened.
Starmer’s immediate problem, which I do not see how he can solve, is how to stop gilts going further through the floor when his chancellor inevitably resigns.
I should add that I necessarily don’t think he will fire her but that she’ll go. There’s a political law of the jungle. Once you’ve passed a certain level of public humiliation and credibility collapse, the ability to do the job evaporates
One of my fave betting drills - because it so often pays - is to lay into irrational exuberance; eg where a perception something is about to happen takes off to a level which comfortably exceeds the actual probability of it happening. A recent example was Kemi Badenoch at 2.7 (!) to exit in 2025 in the aftermath of the May local election results. Crazy. But thank you. Are we seeing something similar with the notion that Rachel Reeves is toast as Chancellor? I think we are. Whilst I agree with TSE that Coop is appealing at 16/1 if RR does go, the market I'd really like to see is RR exit date.
The fundamentals probably still point to her clinging on, but I don’t think it’s an insignificant chance, particularly given the briefing and reporting.
Firstly, it does appear she has been very bruised by the events of the last week.
Secondly, and I am not going to speculate, but we do not know what is going on in her personal life and what sort of impact that is having on her, beyond of course the scenes in the Commons yesterday.
Thirdly there are hints that all is not well in the relationship between No10 and No11.
Fourthly Starmer is not known to be particularly loyal.
Fifthly is the “blood in the water” effect that once a politician becomes the story and is seen to be bruised, it becomes much harder for them to stay afloat.
Now balanced against this is a) the political capital Starmer will certainly not want to spend being seen to push her at this stage and b) the wobbly markets which will give her a personal mission to want to stay on. I do think it’s more likely than not that she gets to the budget and to 2026, but I wouldn’t say it’s inconceivable she goes in the next week, say.
Yes it's about the relative chances of all that. I rate the 'stay' forces a bit stronger than you do. She was a very particular pick by SKS. No strong political identity of her own. First woman CoE. Market friendly. Sees CoE as the ultimate, no leadership ambitions, loyal, no threat to SKS. It'd take a much bigger crisis than this one to make him ditch her imo. Of course there's the personal aspect, her tears etc, the stress, will she just decide she's had enough, that's impossible to assess from outside her head, but my sense is too much is being read into her looking upset in the HoC yesterday. Could have been anything.
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
By schema I just mean defining
These are the tables that will exist These are the columns each table will have along with datatypes and foreign keys
I am not talking about sql in the least
NoSQL DB might be better…
In any event, trying to hard specify the data structure for the whole NHS gets you back to Mega Projects. Which always fail. And often die from requirements growing like KPMG bills.
Yes: one with surely be much better off defining a few simple standards: this is the JSON for a patient, a prescription, etc.
Table (relational) databases existed because computing power was expensive, and this was by far the most efficient way of storing data. These days, those constraints do not exist.
There are other differences between relational and document dbs that merely computer power, you pick the right tool for the right job and I believe for nhs data the choice is relational all the way
Most of the data for a start is highly strutured and ACID is definitely a benefit for nhs applications
With his 26 year old brother in the car in the early hours of the morning:
Liverpool star Diogo Jota has died at the age of 28 after his Lamborghini careered off a road in northern Spain - just two weeks after he married his childhood sweetheart.
The Portuguese forward was travelling in the supercar with his fellow footballer brother Andre, 26, who also died in the crash.
The Lamborghini's tyre is believed to have blown out while overtaking on the A-52 at Cernadilla near Zamora in northwestern Spain, close to the border with Portugal.
The supercar came off the road, rolled and then burst into flames in the early hours of this morning. The emergency services were called but the brothers could not be saved.
Has anyone driven the A-52 at Cernadilla. What is it like? AFAICS it is dual carriageway for a number of miles in both directions, but what are Spanish dual carriageways in that area like wrt maintenance etc?
I can't honestly see a reason for a Lambo tyre to explode, unless poorly maintained or caused by eg road debris.
Tyres are more likely to explode at high speeds as a supercar can regularly reach unfortunately
Yes, but why would anyone be driving at high speed *for a Lambo* on a public road, even if doing a penis size demonstration in the early hours?
I can see 110 or 130mph for a young footballer showing off to his brother, but the tyres are specified for the car maximums not the public road limitations - which would be more like 180-190mph.
Even my huge pedestrian 150hp diesel estate tops out at a ludicrous ~135mph.
And I don't see a Liverpool footballer needing to skimp on maintenance.
We need to know the cause of the tyre blowout, which was then the cause of the crash.
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
By schema I just mean defining
These are the tables that will exist These are the columns each table will have along with datatypes and foreign keys
I am not talking about sql in the least
NoSQL DB might be better…
In any event, trying to hard specify the data structure for the whole NHS gets you back to Mega Projects. Which always fail. And often die from requirements growing like KPMG bills.
Yes: one with surely be much better off defining a few simple standards: this is the JSON for a patient, a prescription, etc.
Table (relational) databases existed because computing power was expensive, and this was by far the most efficient way of storing data. These days, those constraints do not exist.
Um, I'm easily ten years out of date for Big Data stuff, but back in the day you'd use a "schema-last" approach. You upload all of it into a data lake as is and impose the schema at the time of the query. That way you can cope with a vlarge number of records with a vlarge combination of structures. Given the magnitude of the problem that's probably the only way you can do it.
I assume there's somebody on PB who is laughing at my retroness, but is there another way of doing it given that the amount of data can be measured in the shit-tonnes?
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
By schema I just mean defining
These are the tables that will exist These are the columns each table will have along with datatypes and foreign keys
I am not talking about sql in the least
NoSQL DB might be better…
In any event, trying to hard specify the data structure for the whole NHS gets you back to Mega Projects. Which always fail. And often die from requirements growing like KPMG bills.
The trick is not to try and do it all at once however, start with the basics release that spec then iterate bit by bit. The problem currently is a hospital is using app A with its own db structure, App B comes out and is much better but they can't switch easily because the two apps use different structures to store the data so you either have to create a migration script which is horribly error prone or stick with the worse app. I really don't think its as big a job as you suggest either. The app I worked on that was used in hospitals had about 20 odd tables and handled pretty much most stuff the hospitals wanted
Yup, careful teration is the way to do it.
My other half is a clinical scientist with the NHS. They were having capacity and other issues with the venerable and much-patched software they use for processing clinical data, so they asked IT to improve it. In their wisdom, the IT department decided that a complete rewrite was the best course of action in order to "future-proof" the software, so off they went. This week, the new system went live, and all hell has broken loose. While the system does now (finally!) meet the formal specifications, it fails to do cover all the edge cases and unusual circumstances that the old software used to deal with, and which nobody thought to put in the specification. By the time the new software has been patched with all the bug fixes needed to make it usable, it'll probably be as big a mess as the original software.
@DPJHodges I’m sorry, but yesterday we were told the Chancellor was facing such serious personal issues she was in tears in the House of Commons chamber, causing market chaos. Now this morning she’s being sent out to launch the Government’s NHS plan. And we’re all supposed to act as if nothing’s happened.
No, Dan, you're not supposed to do anything but what you do ... which is write this sort of thing.
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
By schema I just mean defining
These are the tables that will exist These are the columns each table will have along with datatypes and foreign keys
I am not talking about sql in the least
NoSQL DB might be better…
In any event, trying to hard specify the data structure for the whole NHS gets you back to Mega Projects. Which always fail. And often die from requirements growing like KPMG bills.
Yes: one with surely be much better off defining a few simple standards: this is the JSON for a patient, a prescription, etc.
Table (relational) databases existed because computing power was expensive, and this was by far the most efficient way of storing data. These days, those constraints do not exist.
There are other differences between relational and document dbs that merely computer power, you pick the right tool for the right job and I believe for nhs data the choice is relational all the way
Most of the data for a start is highly strutured and ACID is definitely a benefit for nhs applications
You may think it is - I suspect that’s because you’ve never looked at how crowbarred that data is.
I think you’ve picked the wrong side of the battle if you are talking about relational databases
@DPJHodges I’m sorry, but yesterday we were told the Chancellor was facing such serious personal issues she was in tears in the House of Commons chamber, causing market chaos. Now this morning she’s being sent out to launch the Government’s NHS plan. And we’re all supposed to act as if nothing’s happened.
Quite. Obviously everything is normal, totally normal and the personal issues have gone away. And if you question any of that, you're a monster, a total monster
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
By schema I just mean defining
These are the tables that will exist These are the columns each table will have along with datatypes and foreign keys
I am not talking about sql in the least
NoSQL DB might be better…
In any event, trying to hard specify the data structure for the whole NHS gets you back to Mega Projects. Which always fail. And often die from requirements growing like KPMG bills.
Yes: one with surely be much better off defining a few simple standards: this is the JSON for a patient, a prescription, etc.
Table (relational) databases existed because computing power was expensive, and this was by far the most efficient way of storing data. These days, those constraints do not exist.
Um, I'm easily ten years out of date for Big Data stuff, but back in the day you'd use a "schema-last" approach. You upload all of it into a data lake as is and impose the schema at the time of the query. That way you can cope with a vlarge number of records with a vlarge combination of structures. Given the magnitude of the problem that's probably the only way you can do it.
I assume there's somebody on PB who is laughing at my retroness, but is there another way of doing it given that the amount of data can be measured in the shit-tonnes?
Nope beyond the fact that you probably want to preprocess the data so that it’s indexed for popular queries that would be the current modern approach
I recently got stopped & ticketed by the City of London Police for, & I kid you not, “cycling no handed”. Even though it’s clearly not an offence, the officer said they were ticketing me under the Human Rights Act as I was infringing other people’s Article 2 ‘Right to Life’, in case I fell off & injured them: utterly bonkers stuff.
One of my fave betting drills - because it so often pays - is to lay into irrational exuberance; eg where a perception something is about to happen takes off to a level which comfortably exceeds the actual probability of it happening. A recent example was Kemi Badenoch at 2.7 (!) to exit in 2025 in the aftermath of the May local election results. Crazy. But thank you. Are we seeing something similar with the notion that Rachel Reeves is toast as Chancellor? I think we are. Whilst I agree with TSE that Coop is appealing at 16/1 if RR does go, the market I'd really like to see is RR exit date.
The fundamentals probably still point to her clinging on, but I don’t think it’s an insignificant chance, particularly given the briefing and reporting.
Firstly, it does appear she has been very bruised by the events of the last week.
Secondly, and I am not going to speculate, but we do not know what is going on in her personal life and what sort of impact that is having on her, beyond of course the scenes in the Commons yesterday.
Thirdly there are hints that all is not well in the relationship between No10 and No11.
Fourthly Starmer is not known to be particularly loyal.
Fifthly is the “blood in the water” effect that once a politician becomes the story and is seen to be bruised, it becomes much harder for them to stay afloat.
Now balanced against this is a) the political capital Starmer will certainly not want to spend being seen to push her at this stage and b) the wobbly markets which will give her a personal mission to want to stay on. I do think it’s more likely than not that she gets to the budget and to 2026, but I wouldn’t say it’s inconceivable she goes in the next week, say.
You forgot the sixth fact, which is that she us blatantly and totally out of her depth as Chancellor and has no convincing ideas at all to end the chronic economic stagnation we face.
And maybe a seventh, which is that her future is tied to a PM who is widely and increasingly loathed and despised across his party and the country.
Why has some bellend reporter just asked Starmer about Jota? I’m a Liverpool fan and it’s tragic news but the PM is there to be grilled with a finite time and number of questions about political issues and someone asks about this.
With his 26 year old brother in the car in the early hours of the morning:
Liverpool star Diogo Jota has died at the age of 28 after his Lamborghini careered off a road in northern Spain - just two weeks after he married his childhood sweetheart.
The Portuguese forward was travelling in the supercar with his fellow footballer brother Andre, 26, who also died in the crash.
The Lamborghini's tyre is believed to have blown out while overtaking on the A-52 at Cernadilla near Zamora in northwestern Spain, close to the border with Portugal.
The supercar came off the road, rolled and then burst into flames in the early hours of this morning. The emergency services were called but the brothers could not be saved.
Has anyone driven the A-52 at Cernadilla. What is it like? AFAICS it is dual carriageway for a number of miles in both directions, but what are Spanish dual carriageways in that area like wrt maintenance etc?
I can't honestly see a reason for a Lambo tyre to explode, unless poorly maintained or caused by eg road debris.
Tyres are more likely to explode at high speeds as a supercar can regularly reach unfortunately
Yes, but why would anyone be driving at high speed *for a Lambo* on a public road, even if doing a penis size demonstration in the early hours?
I can see 110 or 130mph for a young footballer showing off to his brother, but the tyres are specified for the car maximums not the public road limitations - which would be more like 180-190mph.
Even my huge pedestrian 150hp diesel estate tops out at a ludicrous ~135mph.
And I don't see a Liverpool footballer needing to skimp on maintenance.
We need to know the cause of the tyre blowout, which was then the cause of the crash.
I'd keep an open mind about any of the reports. Look at the wiki entry for Reyes:
With his 26 year old brother in the car in the early hours of the morning:
Liverpool star Diogo Jota has died at the age of 28 after his Lamborghini careered off a road in northern Spain - just two weeks after he married his childhood sweetheart.
The Portuguese forward was travelling in the supercar with his fellow footballer brother Andre, 26, who also died in the crash.
The Lamborghini's tyre is believed to have blown out while overtaking on the A-52 at Cernadilla near Zamora in northwestern Spain, close to the border with Portugal.
The supercar came off the road, rolled and then burst into flames in the early hours of this morning. The emergency services were called but the brothers could not be saved.
Has anyone driven the A-52 at Cernadilla. What is it like? AFAICS it is dual carriageway for a number of miles in both directions, but what are Spanish dual carriageways in that area like wrt maintenance etc?
I can't honestly see a reason for a Lambo tyre to explode, unless poorly maintained or caused by eg road debris.
Tyres are more likely to explode at high speeds as a supercar can regularly reach unfortunately
Yes, but why would anyone be driving at high speed *for a Lambo* on a public road, even if doing a penis size demonstration in the early hours?
I can see 110 or 130mph for a young footballer showing off to his brother, but the tyres are specified for the car maximums not the public road limitations - which would be more like 180-190mph.
Even my huge pedestrian 150hp diesel estate tops out at a ludicrous ~135mph.
And I don't see a Liverpool footballer needing to skimp on maintenance.
We need to know the cause of the tyre blowout, which was then the cause of the crash.
I wonder if it was kept for holidays at home, and not used terribly frequently.
Tyre pressures would be the first guess but you'd have thought a car like that would have warnings, so it could just have been a random item on the road.
Tragic. A horrible reminder that car accidents are the leading cause of death worldwide for older children and adults under 30.
With his 26 year old brother in the car in the early hours of the morning:
Liverpool star Diogo Jota has died at the age of 28 after his Lamborghini careered off a road in northern Spain - just two weeks after he married his childhood sweetheart.
The Portuguese forward was travelling in the supercar with his fellow footballer brother Andre, 26, who also died in the crash.
The Lamborghini's tyre is believed to have blown out while overtaking on the A-52 at Cernadilla near Zamora in northwestern Spain, close to the border with Portugal.
The supercar came off the road, rolled and then burst into flames in the early hours of this morning. The emergency services were called but the brothers could not be saved.
Has anyone driven the A-52 at Cernadilla. What is it like? AFAICS it is dual carriageway for a number of miles in both directions, but what are Spanish dual carriageways in that area like wrt maintenance etc?
I can't honestly see a reason for a Lambo tyre to explode, unless poorly maintained or caused by eg road debris.
Tyres are more likely to explode at high speeds as a supercar can regularly reach unfortunately
Yes, but why would anyone be driving at high speed *for a Lambo* on a public road, even if doing a penis size demonstration in the early hours?
I can see 110 or 130mph for a young footballer showing off to his brother, but the tyres are specified for the car maximums not the public road limitations - which would be more like 180-190mph.
Even my huge pedestrian 150hp diesel estate tops out at a ludicrous ~135mph.
And I don't see a Liverpool footballer needing to skimp on maintenance.
We need to know the cause of the tyre blowout, which was then the cause of the crash.
I wonder if it was kept for holidays at home, and not used terribly frequently.
Tyre pressures would be the first guess but you'd have thought a car like that would have warnings, so it could just have been a random item on the road.
Tragic. A horrible reminder that car accidents are the leading cause of death worldwide for older children and adults under 30.
Worldwide, but not in the UK IIRC. We have exceptionally safe roads in this country.
Not much better what is the leading cause in the UK - suicide.
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
By schema I just mean defining
These are the tables that will exist These are the columns each table will have along with datatypes and foreign keys
I am not talking about sql in the least
NoSQL DB might be better…
In any event, trying to hard specify the data structure for the whole NHS gets you back to Mega Projects. Which always fail. And often die from requirements growing like KPMG bills.
Yes: one with surely be much better off defining a few simple standards: this is the JSON for a patient, a prescription, etc.
Table (relational) databases existed because computing power was expensive, and this was by far the most efficient way of storing data. These days, those constraints do not exist.
Um, I'm easily ten years out of date for Big Data stuff, but back in the day you'd use a "schema-last" approach. You upload all of it into a data lake as is and impose the schema at the time of the query. That way you can cope with a vlarge number of records with a vlarge combination of structures. Given the magnitude of the problem that's probably the only way you can do it.
I assume there's somebody on PB who is laughing at my retroness, but is there another way of doing it given that the amount of data can be measured in the shit-tonnes?
Yup. Which tends to go with a NoSql approach. Some funky tools out there to generate schemas from data. Fit to ever higher percentages, offer the exceptions up for review, rinse/repeat…
I recently got stopped & ticketed by the City of London Police for, & I kid you not, “cycling no handed”. Even though it’s clearly not an offence, the officer said they were ticketing me under the Human Rights Act as I was infringing other people’s Article 2 ‘Right to Life’, in case I fell off & injured them: utterly bonkers stuff.
I think FDR summed this up in his "Five freedoms speech": Freedom of speech, freedom of worship, freedom from want, freedom from fear, freedom from no-handed cyclists. Hence the latter's inclusion now in most definitions of "Human Rights".
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
By schema I just mean defining
These are the tables that will exist These are the columns each table will have along with datatypes and foreign keys
I am not talking about sql in the least
NoSQL DB might be better…
In any event, trying to hard specify the data structure for the whole NHS gets you back to Mega Projects. Which always fail. And often die from requirements growing like KPMG bills.
Yes: one with surely be much better off defining a few simple standards: this is the JSON for a patient, a prescription, etc.
Table (relational) databases existed because computing power was expensive, and this was by far the most efficient way of storing data. These days, those constraints do not exist.
Um, I'm easily ten years out of date for Big Data stuff, but back in the day you'd use a "schema-last" approach. You upload all of it into a data lake as is and impose the schema at the time of the query. That way you can cope with a vlarge number of records with a vlarge combination of structures. Given the magnitude of the problem that's probably the only way you can do it.
I assume there's somebody on PB who is laughing at my retroness, but is there another way of doing it given that the amount of data can be measured in the shit-tonnes?
Yup. Which tends to go with a NoSql approach. Some funky tools out there to generate schemas from data. Fit to ever higher percentages, offer the exceptions up for review, rinse/repeat…
With his 26 year old brother in the car in the early hours of the morning:
Liverpool star Diogo Jota has died at the age of 28 after his Lamborghini careered off a road in northern Spain - just two weeks after he married his childhood sweetheart.
The Portuguese forward was travelling in the supercar with his fellow footballer brother Andre, 26, who also died in the crash.
The Lamborghini's tyre is believed to have blown out while overtaking on the A-52 at Cernadilla near Zamora in northwestern Spain, close to the border with Portugal.
The supercar came off the road, rolled and then burst into flames in the early hours of this morning. The emergency services were called but the brothers could not be saved.
Has anyone driven the A-52 at Cernadilla. What is it like? AFAICS it is dual carriageway for a number of miles in both directions, but what are Spanish dual carriageways in that area like wrt maintenance etc?
I can't honestly see a reason for a Lambo tyre to explode, unless poorly maintained or caused by eg road debris.
Tyres are more likely to explode at high speeds as a supercar can regularly reach unfortunately
Yes, but why would anyone be driving at high speed *for a Lambo* on a public road, even if doing a penis size demonstration in the early hours?
I can see 110 or 130mph for a young footballer showing off to his brother, but the tyres are specified for the car maximums not the public road limitations - which would be more like 180-190mph.
Even my huge pedestrian 150hp diesel estate tops out at a ludicrous ~135mph.
And I don't see a Liverpool footballer needing to skimp on maintenance.
We need to know the cause of the tyre blowout, which was then the cause of the crash.
This tyre story is arse. I'm sure the tyre did blow out but after it was cartwheeling through the scenery at 200km/h+ with the rest of the wreckage.
He might have been something in Naval Infantry, but the Chief of the Main Staff (ie Deputy CinC) of the Russian Navy is an Admiral not a Major General.
New neighbourhood health services, open 12 hours a day, six day days a week, will be launched across the country offering tests, post-operation care, nursing and mental health treatment
To "bring back the family doctor" system, thousands more GPs will be trained
There will also be a push for GPs to lean on artificial intelligence to take notes while other technology will be used to speed up answering calls to surgeries
Newly qualified dentists will need to practise in the NHS for a minimum period - the government has indicated they intend this to be three years
Lord Darzi proposed this 20 years ago. I can't remember, why didn't it happen?
Or indeed when May promised it in 2019. It's a good plan that is very difficult to implement.
I suppose we will see the detail later today, but all those new neighbourhood health centres and staff are going to need funding, and it's not obvious where either that capital or revenue are coming from. Or the trained staff for that matter. The NHS workforce plan seems to have all gone quiet since it's announcement.
I am not convinced by AI either. It confabulates too much to be reliable for medical notes.
The NHS has failed to digitize its records, despite huge sums being thrown at the project. Just possibly the solution may lie in digitization of records at a surgery level, rather than at a national level- start with GPs and primary care and then take it to regional hospital and clinical level. With the right security, it could deliver the kind of cost savings/efficiency gains that it would pay for itself quite quickly. Giving primary healthcare trusts the ability to do this could allow this new policy enough power to deliver. As the internet is not a single massive database, the idea that the NHS should have such an approach has been a huge mistake. This is a policy that has several merits, and I have not been saying that very often over the past year.
This being an area I have worked in. One of the issues with the nhs is a lack of standards. Ideally what should be possible is that you can use applications from different firms depending on your needs which can all work with the existing data, meaning that if someone produces a better app for your needs its just slot it in and no need to migrate all your data it just works with it without issue.
The NHS should certainly layout a DB schema for patient data and auditing access etc and make that schema publiclly available. They could even potentially make a little money by running a certification program so for a fee a company can have their software certified as NHS ready
The last thing they should do is define a DB schema as schemas tend to app architecture specific. If they're going to define anything it's a standardised remote interface reusing as much traditional stable technology as possible.
While that would be preferable certainly I lack faith in public sector software development to deliver it, whereas laying out a db schema I am more confident they would possibly be able to deliver
It'll either be shared through an abstracting api (the common interface) or you'll be sharing, what, raw sql?
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
By schema I just mean defining
These are the tables that will exist These are the columns each table will have along with datatypes and foreign keys
I am not talking about sql in the least
NoSQL DB might be better…
In any event, trying to hard specify the data structure for the whole NHS gets you back to Mega Projects. Which always fail. And often die from requirements growing like KPMG bills.
Yes: one with surely be much better off defining a few simple standards: this is the JSON for a patient, a prescription, etc.
Table (relational) databases existed because computing power was expensive, and this was by far the most efficient way of storing data. These days, those constraints do not exist.
There are other differences between relational and document dbs that merely computer power, you pick the right tool for the right job and I believe for nhs data the choice is relational all the way
Most of the data for a start is highly strutured and ACID is definitely a benefit for nhs applications
Why not use webservice APIs to access data between systems, which will almost certainly have different methods for storing even the simplest of data (e.g. addresses). This would be stage 1 and systems could be moved in a controlled way to a common data structure. The data should be cleansed as part of that process. This is a genuine question as I'm sure others will have more experience in this field than I do.
Comments
The truth is most people never visit a GP or have any contact with the NHS. What happens is a patient's records are digitised and made available when required. I was told by the person who led the digitisation project about 10% of those registered with a GP have their records uploaded - they would be those with chronic or ongoing conditions and the hypochondriacs. Another 10% would come in on an emergency basis once in a blue moon and their records would alo be uploaded but everyone else - no, it wasn't the time, effort or money to digitise the records and the storage of the old paper records was cheaper and easier than digitisation and disposal.
Normally, if you make an appointment and your records aren't on the system, they get uploaded and that can be done in an emergency within an hour if need be. That's the arrangement NHS England has with the off-site storage company who have to retrieve the paper file (the old Lloyd George envelope) and scan it in as part of their contract.
1. Sir Thomas Hetherington: appointed in 1977. During his time there was the Confait case - a serious miscarriage of justice which eventually led to the Police and Criminal Evidence Act 1984 and the creation of the CPS. The IICSA child abuse inquiry heard evidence that he lied to newspapers about his office not receiving reports about abuse allegations against Cyril Smith. Wrote a report which led to the War Crimes Act.
2. Allan Green: resigned after kerb-crawling in Kings X. Went back to the Bar.
3. Barbara Mills: lots of criticism of her for her failures to prosecute corrupt policemen in the West Midlands Serious Crime squad (implicated in the Irish miscarriages of justice) and in the Met (the Countryman investigations) and over deaths in police custody. Had a lot of the usual public sector roles after she resigned.
4. David Calvert-Smith: the CPS was described as "institutionally racist" by him and in a couple of reports. However he did make CPS lawyers rather than the police the final arbiters on whether prosecutions could be brought. Was made a judge.
5. Ken MacDonald: one of the more successful DPPs. Now a peer and a deputy High Court judge.
6. Starmer
7. Alison Saunders: quite a lot of controversies during her time in office over how sexual assault claims should be prosecuted. Not reappointed. Now a Linklaters partner.
8. Max Hill
9. Stephen Parkinson - the current DPP.
So only one judge among the lot of them, 2 if you include McDonald.
How much distinction each of these lawyers had is a matter of opinion.
Similarly much of the pressure for digitised GP records came from Members of Parliament whose care might be shared between their home GP and one in London. Most people do not have weekly commutes, and especially not most ill people.
She has for some time been rather immersed in the Home Affairs brief and I’ve always felt that was where her interests lay.
- poor productivity
- poor worker retention
- poor quality - workers start “soldiering” - just doing the minimum to keep their job without regard for actual outputs.
- high probability of accidents
- high probability of organisational collapse
Anyone recognise anything?
Dear [76 year old male]
Please be advised that with immediate effect, we're no longer accepting Urine Samples over the Reception desk from Women between the ages of 16 - 64 with suspected UTI. You will need to ring the surgery to be referred to Pharmacy First if appropriate. Please do not attend the pharmacy with a urine sample, as they cannot accept these. You will be assessed based on your symptoms.
Thanks,
The XXXXX. Medical Practice
Given that sql is more a suggestion - rather than a fully formal spec - that'd tie you to specific DB implementations owned by specific orgs over generational timespans.
The difference between the average number of prescriptions for someone in middle age and that for older people is, IIRC a factor of 10.
These are the tables that will exist
These are the columns each table will have along with datatypes and foreign keys
I am not talking about sql in the least
My Aunt just got out of hospital. Needs lots of care and follow up. I get various people calling me (down on the paperwork as a contact) to ask if I know what everyone else is doing.
Imagine an app. Shows the discharge plan. Shows the required visits, by various outfits. Shows the required equipment. Medications etc etc. shows status of all of the above. Who visited, when, status, notes, actions….
Full of links to all the different parties involved - messaging in the app?
Make it available to the patient as well. So they can see.
To actually fight the tank, you’d need a trained, experienced commander in her place.
In any event, trying to hard specify the data structure for the whole NHS gets you back to Mega Projects. Which always fail. And often die from requirements growing like KPMG bills.
Farage will be PM if they oust Starmer so soon after he won a mandate imho.
If he resigns six months/year before next GE saying time for a younger candidate then that's different.
Starmer’s immediate problem, which I do not see how he can solve, is how to stop gilts going further through the floor when his chancellor inevitably resigns.
I should add that I necessarily don’t think he will fire her but that she’ll go. There’s a political law of the jungle. Once you’ve passed a certain level of public humiliation and credibility collapse, the ability to do the job evaporates
https://x.com/CitySamuel/status/1940515794645127618
If the PLP had a proper 'process' a la 1922 it would already be underway i think
Edit - and yep, ousting = PM spiv
DEPUTY COMMANDER OF RUSSIAN NAVY KILLED IN RUSSIA'S KURSK REGION, GOVERNOR SAYS
Kemi Badenoch is refusing to sack her party's leader in London despite her backing a far-right group calling for the mass deportation of millions of people living legally in the UK.
A Conservative spokesman described the group as "non partisan" and said party members were free to join it
https://bsky.app/profile/adambienkov.bsky.social/post/3lt2fp7uen22h
Your other point is more valid but if things are looking better by late 2027/early 2028, why would Starmer step down? I suspect he could promote from within the younger ranks of the Parliamentary Party and a successor might be lurking somewhere in that group but, unless private polling shows Starmer is far more disliked than Labour, he'll lead the party into the next election and stand down in 2030 or 2031 - he'll have done a decade in the second most difficult job in UK politics - the most difficult job is leading the Conservative Party.
Liverpool star Diogo Jota has died at the age of 28 after his Lamborghini careered off a road in northern Spain - just two weeks after he married his childhood sweetheart.
The Portuguese forward was travelling in the supercar with his fellow footballer brother Andre, 26, who also died in the crash.
The Lamborghini's tyre is believed to have blown out while overtaking on the A-52 at Cernadilla near Zamora in northwestern Spain, close to the border with Portugal.
The supercar came off the road, rolled and then burst into flames in the early hours of this morning. The emergency services were called but the brothers could not be saved.
Has anyone driven the A-52 at Cernadilla. What is it like? AFAICS it is dual carriageway for a number of miles in both directions, but what are Spanish dual carriageways in that area like wrt maintenance etc?
I can't honestly see a reason for a Lambo tyre to explode, unless poorly maintained or caused by eg road debris.
It's sufficient to opine that they are just rubbish at politics. In fact, the lesson might be that Labour need more Spad-type politicians to manage the party and work out the messaging.
My other half is a clinical scientist with the NHS. They were having capacity and other issues with the venerable and much-patched software they use for processing clinical data, so they asked IT to improve it. In their wisdom, the IT department decided that a complete rewrite was the best course of action in order to "future-proof" the software, so off they went. This week, the new system went live, and all hell has broken loose. While the system does now (finally!) meet the formal specifications, it fails to do cover all the edge cases and unusual circumstances that the old software used to deal with, and which nobody thought to put in the specification. By the time the new software has been patched with all the bug fixes needed to make it usable, it'll probably be as big a mess as the original software.
It seems to kick out 400,000 illegal immigrants (perhaps a third of the total, who knows?), we need a sevenfold increase in detention centre capacity (where? who pays for that?) and an unspecified increase in the number of Border Patrol staff (who? who pays for them? from where are they recruited? Oh, I know, we could offer a job with Border Patrol to the illegals who could then be paid to deport other illegals - seriously?).
It turns out three quarters of migrants come from countries with whom we have no Returns Agreemenr so somebody is going to have to go to these countries and get an agreement (nice little sweetener perhaps?).
The plan is so full of inconsistencies and holes it could be called a new Swiss Cheese.
I do think it’s possible she leaves of her own volition, for the reasons I mentioned this morning.
Magnesium wheels?
India 2.4
England 2.76
Draw 4.7
https://www.betfair.com/exchange/plus/en/cricket/test-matches/england-v-india-betting-34452308
You feel England would only need a couple of wickets this morning to be favourites.
Does that relate to the black hole the Treasury says it has discovered ?
Irrational reasons are also quite likely.
Firstly, it does appear she has been very bruised by the events of the last week.
Secondly, and I am not going to speculate, but we do not know what is going on in her personal life and what sort of impact that is having on her, beyond of course the scenes in the Commons yesterday.
Thirdly there are hints that all is not well in the relationship between No10 and No11.
Fourthly Starmer is not known to be particularly loyal.
Fifthly is the “blood in the water” effect that once a politician becomes the story and is seen to be bruised, it becomes much harder for them to stay afloat.
Now balanced against this is a) the political capital Starmer will certainly not want to spend being seen to push her at this stage and b) the wobbly markets which will give her a personal mission to want to stay on. I do think it’s more likely than not that she gets to the budget and to 2026, but I wouldn’t say it’s inconceivable she goes in the next week, say.
Resign 20%
Sack 5%
Stay 75%
https://bylinetimes.com/2025/07/03/kemi-badenoch-refuses-to-sack-london-conservative-leader-backing-far-right-group-demanding-mass-deportations/
Table (relational) databases existed because computing power was expensive, and this was by far the most efficient way of storing data. These days, those constraints do not exist.
https://x.com/igorsushko/status/1940673354865967113
I can see my health records through it, though I have not set up the service, and I don't really know the app in detail yet.
I'm not sure on things like discharge plans and messaging with all parties, but is a discharge plan in the health record?
RIP.
@DPJHodges
I’m sorry, but yesterday we were told the Chancellor was facing such serious personal issues she was in tears in the House of Commons chamber, causing market chaos. Now this morning she’s being sent out to launch the Government’s NHS plan. And we’re all supposed to act as if nothing’s happened.
Most of the data for a start is highly strutured and ACID is definitely a benefit for nhs applications
I can see 110 or 130mph for a young footballer showing off to his brother, but the tyres are specified for the car maximums not the public road limitations - which would be more like 180-190mph.
Even my huge pedestrian 150hp diesel estate tops out at a ludicrous ~135mph.
And I don't see a Liverpool footballer needing to skimp on maintenance.
We need to know the cause of the tyre blowout, which was then the cause of the crash.
I assume there's somebody on PB who is laughing at my retroness, but is there another way of doing it given that the amount of data can be measured in the shit-tonnes?
https://www.joelonsoftware.com/2000/04/06/things-you-should-never-do-part-i/
RIP Rotary Club 1967-2025 I guess.
https://www.bbc.co.uk/news/articles/c5ygg6ypp18o
You may think it is - I suspect that’s because you’ve never looked at how crowbarred that data is.
I think you’ve picked the wrong side of the battle if you are talking about relational databases
Obviously everything is normal, totally normal and the personal issues have gone away. And if you question any of that, you're a monster, a total monster
I recently got stopped & ticketed by the City of London Police for, & I kid you not, “cycling no handed”. Even though it’s clearly not an offence, the officer said they were ticketing me under the Human Rights Act as I was infringing other people’s Article 2 ‘Right to Life’, in case I fell off & injured them: utterly bonkers stuff.
And maybe a seventh, which is that her future is tied to a PM who is widely and increasingly loathed and despised across his party and the country.
https://en.wikipedia.org/wiki/José_Antonio_Reyes#Personal_life_and_death
Tyre pressures would be the first guess but you'd have thought a car like that would have warnings, so it could just have been a random item on the road.
Tragic. A horrible reminder that car accidents are the leading cause of death worldwide for older children and adults under 30.
Not much better what is the leading cause in the UK - suicide.
I'm sure it's an honest mistake.
🟦 Reform UK: 30% (-)
🔴 Labour: 22% (-)
🔵 Conservatives: 16% (-2)
🟠 Lib Dems: 15% (+2)
🟢 Greens: 11% (-)
Changes from 25th June
[Find Out Now, 2nd July, N=2,604]
This is a genuine question as I'm sure others will have more experience in this field than I do.