In the longer term GP services as we know them will also be discarded. They are too expensive as a gateway into the Health Service and create massive inefficiencies, duplication and costs. In time will be seen as a quaint slice of history that worked in the 1950s to 1900s and then became one of the problems holding healthcare back. It will take a few years, but it will come.
While on the NHS, radio 5 had a snippet interviewing expats in Spain about the EU referendum (where Embassy is trying to enroll more voters). They were saying how the Spanish Health care is 'Second to None' I have no idea what model they use in Spain.
The Chinese have a more or less non-GP system - nearly everyone goes to the hospital if they feel ill. Problem is that you have to drive further to get there, see a random different doctor each time and tie up specialists dealing with trivia. They are keen to move to a GP system and I've given lots of seminars on the issue to visiting delegations, but they run into a wall of public scepticism - "if he was any good he'd be in the hospital, why is he living in my village?"
It's the sort of issue where being a dictatorship doesn't really help - hard to force people into a change of attitude. I told them that we insist that only A&E patients can go to a hospital directly and everyone else is required to go through a GP. Some of them looked shocked and said that seems very authoritarian...
While I'd say that's bulls**t. We suggest that only A&E patients can go to a hospital directly, but we don't insist upon it. Anyone with a trivial non-urgent case that rocks up at A&E is still seen rather than being sent away and told to call their GP.
Two years ago when my wife was very pregnant she fell outside and didn't feel the baby kick afterwards. We called her midwife who said to go urgently to A&E, we did and were made to wait for nearly four hours. During that four hour window we saw one genuine emergency arrive (someone arrived with a severed thumb) who was waived straight through to be seen immediately. Almost everyone else had trivial stuff like "I stubbed my toe last week and it still hurts" which I'd think should be seen by a GP. Didn't see anyone get triaged and told "this isn't appropriate for A&E call your GP".
EDIT: By the way I think ours should have been considered more urgent. When we were finally (just shy of four hours) seen by the doctor she said "You've felt the baby kick since haven't you" to which my wife said "no" and the doctor looked horrified. The nurse had entered the wrong information upon our entry. Thankfully everything was OK in the end.
However Corbyn did better with non-members and would almost certainly have lost if the vote was restricted to members who were already members before Ed resigned.
No - polls showed that Corbyn had a large lead in this group too, though not the 80% that he did with new members. Going further back, polls of pre-2010 members still showed him ahead but by less.
A contrast with the US is that people consume politics more through social media, short TV spots with paid ads and minor local outlets than in Britain, where it's still basically the BBC or print media for most people. That gives American anti-establishment types easier access to the public with simple messages. Party selections are an exception because party members are atypical and will read manifestos, seek out debates, etc.
Mr. G, Cameron wants Obama to bleat about the perils of the UK leaving the EU. That'll dictate his (non-)response.
Hmmm
Young Cameron is fast becoming the whipping boy of the G7
First he has to suck up to Angela, then he Kowtows to Li, Francois threatens to duff him up if he gets the wrong answer and now Obama says he's a useless pillock.
Lucky the Mexicans arent in it or he'd be used as a pinata.
I thought being an 'Aid Superpower' was meant to lead to influence and power around the world.
Cameron's really tested to destruction the theory that fawning towards others and handing out money to every country he visits wins friends and influence.
It doesn't.
It makes you look weak and leads to you being despised.
I thought Aid was meant to lead to stability and development in parts of the world that needed it, not influence and power.
Blair already tested to destruction the idea that fawning and handing out money wins friends and influence in Europe, handing over a large part of our rebate for some nebulous promise of CAP reform that never arrived.
Arrogant Andrew Mitchell boasted about the UK being an aid super-power and that aid to India would help us sell Typhoons. A few weeks later India bought French.
In the longer term GP services as we know them will also be discarded. They are too expensive as a gateway into the Health Service and create massive inefficiencies, duplication and costs. In time will be seen as a quaint slice of history that worked in the 1950s to 1900s and then became one of the problems holding healthcare back. It will take a few years, but it will come.
While on the NHS, radio 5 had a snippet interviewing expats in Spain about the EU referendum (where Embassy is trying to enroll more voters). They were saying how the Spanish Health care is 'Second to None' I have no idea what model they use in Spain.
The Chinese have a more or less non-GP system - nearly everyone goes to the hospital if they feel ill. Problem is that you have to drive further to get there, see a random different doctor each time and tie up specialists dealing with trivia. They are keen to move to a GP system and I've given lots of seminars on the issue to visiting delegations, but they run into a wall of public scepticism - "if he was any good he'd be in the hospital, why is he living in my village?"
It's the sort of issue where being a dictatorship doesn't really help - hard to force people into a change of attitude. I told them that we insist that only A&E patients can go to a hospital directly and everyone else is required to go through a GP. Some of them looked shocked and said that seems very authoritarian...
I wouldn't advocate a hospital only based system either.
As I am no expert my views can be discarded, however the current system is dire. There are far too many visits to A&E that don't need to be in a Hospital.
In a small to medium Town - say 35000 to 50000 population having between 4 and 8 Drs surgeries is mindless stupidity. Ultimately the link between me and MY GP is unsustainable. I want access 24 / 7, which an individual is hard pushed to provide. I don't want to see my Dr and be told to go somewhere else at another time for a blood test.
Local Health Centres could provide all the GP services, some A&E services minor day surgery, lots of preventative work, 24 / 7 service and much much more far more efficiently than the current system. GPs in the current format are a road block to a better service.
Your last paragraph rather sums up one of the problems of the NHS, it is stuck in a straight jacket that reveres its founding fathers and systems in a monolithic and dictatorial way. It is hideously resistant to change. The model that it runs on is outdated and needs to reflect the changes in society if it is to have a successful future, not to provide the needs of a society that was current 50 years ago.
I don't watch QT but my Twitter timeline has certainly been perturbed by it. Especially as not one but two failed Labour GE candidates were ordinary members of the public asking questions.
Blimmin' heck - even David Coburn thought the audience was unrepresentative - I may have to catch up on iPlayer for this one.
Looks like Trump will be the only one to meet the eight-state requirement. He has seven now to Cruz's four.
The GOP really will self-destruct if they change the rules purely to deny the sole and obvious winner his prize. Besides, Trump will very likely win an overall majority of delegates in addition to the eight state majorities.
It's over, barring some improbable results next Tuesday, or a Black Swan taking Trump out...
I agree that they can't afford to be seen to cheat Trump of the selection (just as the PLP can't afford to challenge Corbyn and then deny him a place on the ballot - that really would turn members into reselection mode). But surely they can't say oops, we only seem to have one qualified candidate, oh well. It'd make an anti-climactic election and even Trump would see drawbacks in that. I'd have thought that they'd at least get Cruz in, maybe by persuading the "uncommitted" delegates (Puerto Rico, PA?) to give him a nomination?
Wow, 2 consistent polls. It must be easier to get the right sample in a closed primary. 28% of the voters in the Dem Michigan primary were Independents and Sanders had a lead of 43% with them. Clinton won the registered democrat vote - though not by anything like the margin in the polls. Best explanation I've seen so far for the poll failure there.
I'll will pay more attention to the type of primary in future - Trump and Sanders both seem to benefit substantially when non-party registered voters can enter their primaries.
The question is does the entry of non-party voters provide good or bad news for November?
The general theory is that non-party voters better represent independent or swing minded voters who will help decide in November.
However Corbyn did better with non-members and would almost certainly have lost if the vote was restricted to members who were already members before Ed resigned.
The nature of who the non-party voters are is of crucial importance for November. Corbyn's entryists were not the kind needed to win a General Election - are Trumps?
It's odd this year as a lot of Independents are going for the insurgent candidates (Sanders and Trump). I think that these candidate have energised a different strand of Independent voter to those middle of the road Independents who usually come in to bolster the less extreme candidates at this stage of the primary cycle.
I think we are seeing a lot more disaffected Independent voters (non-voters) than moderate swing voting Independents. Very difficult to know what to will mean in November - they may simply go back to sitting it out if their candidate isn't on the ticket. For many I suspect it will come down to how much they dislike the other guy than than how much they love their own guy. In a Clinton v Trump race I would expect the Independents to break against Trump.
For myself I have no problem with the idea of a seven day NHS. I just don’t see how, without a significant increase in costs, it can be operated.
Interesting thought about GP’s. In fact they are much “older” than suggested and arise from a couple of, perhaps quintessentially, British compromises, In the rest of Europe the traditional apothecary morphed into todays’ pharmacist and physicians diagnosed and prescribed. In Britain, or more specifically England and Wales it was decided in 1703 (the Rose case) that apothecaries could diagnose, so long as they only charged for the medicine, supplied and physicians dispense so long as they didn’t charge for the medicine. All went OK for about a century until in the early 19th Century the physicians made a take over and, under the terms of the Apothecaries Act, requited a training similar to that of physicians for apothecaries, who consequently evolved into today’s GPs. British pharmacists evolved from a merger of the residium of the apothecaries and “chemists and druggists”, who only sold medicines and gave no advice.
That's interesting. How do surgeons fit into that? They have a history of their own, I believe.
@hugorifkind: Iain Duncan Smith has been a front bench politician for 19 years. He led the Conservative Party. I wonder who he thinks "the elites" are?
Mr. Alistair, it's nothing new. A few years ago (early Coalition, during the tuition fees issue) the audience was crammed with teachers and lecturers (impressively, Sadiq Khan still managed to lose the audience).
More recently (reportedly, didn't watch myself) Dimbleby asked if anyone in the audience wasn't a junior doctor.
Mr. G, Cameron wants Obama to bleat about the perils of the UK leaving the EU. That'll dictate his (non-)response.
Hmmm
Young Cameron is fast becoming the whipping boy of the G7
First he has to suck up to Angela, then he Kowtows to Li, Francois threatens to duff him up if he gets the wrong answer and now Obama says he's a useless pillock.
Lucky the Mexicans arent in it or he'd be used as a pinata.
They've all noticed that he talks tough, but walks like a wimp.
Everyone time he grovels to someone, he looks weaker and weaker, and the other leaders can see it too.
He's doing a fantastic job of diminishing the UK's standing in the world, with the whole 'too weedy to stand alone' routine. Silly man.
I don't watch QT but my Twitter timeline has certainly been perturbed by it. Especially as not one but two failed Labour GE candidates were ordinary members of the public asking questions.
Blimmin' heck - even David Coburn thought the audience was unrepresentative - I may have to catch up on iPlayer for this one.
I suspect Coburn thinks that's down to a lack of commentary on toaster-related EUSSR oppression rather than an excess of SNPbadderites..
The Chinese have a more or less non-GP system - nearly everyone goes to the hospital if they feel ill. Problem is that you have to drive further to get there, see a random different doctor each time and tie up specialists dealing with trivia. They are keen to move to a GP system and I've given lots of seminars on the issue to visiting delegations, but they run into a wall of public scepticism - "if he was any good he'd be in the hospital, why is he living in my village?"
It's the sort of issue where being a dictatorship doesn't really help - hard to force people into a change of attitude. I told them that we insist that only A&E patients can go to a hospital directly and everyone else is required to go through a GP. Some of them looked shocked and said that seems very authoritarian...
While I'd say that's bulls**t. We suggest that only A&E patients can go to a hospital directly, but we don't insist upon it. Anyone with a trivial non-urgent case that rocks up at A&E is still seen rather than being sent away and told to call their GP.
Two years ago when my wife was very pregnant she fell outside and didn't feel the baby kick afterwards. We called her midwife who said to go urgently to A&E, we did and were made to wait for nearly four hours. During that four hour window we saw one genuine emergency arrive (someone arrived with a severed thumb) who was waived straight through to be seen immediately. Almost everyone else had trivial stuff like "I stubbed my toe last week and it still hurts" which I'd think should be seen by a GP. Didn't see anyone get triaged and told "this isn't appropriate for A&E call your GP".
EDIT: By the way I think ours should have been considered more urgent. When we were finally (just shy of four hours) seen by the doctor she said "You've felt the baby kick since haven't you" to which my wife said "no" and the doctor looked horrified. The nurse had entered the wrong information upon our entry. Thankfully everything was OK in the end.
Well, it's entirely possible not to be registered with a GP (looks disapprovingly at younger self).
@hugorifkind: Iain Duncan Smith has been a front bench politician for 19 years. He led the Conservative Party. I wonder who he thinks "the elites" are?
People who are less shit at leading the Conservative Party than him?
For myself I have no problem with the idea of a seven day NHS. I just don’t see how, without a significant increase in costs, it can be operated.
Interesting thought about GP’s. In fact they are much “older” than suggested and arise from a couple of, perhaps quintessentially, British compromises, In the rest of Europe the traditional apothecary morphed into todays’ pharmacist and physicians diagnosed and prescribed. In Britain, or more specifically England and Wales it was decided in 1703 (the Rose case) that apothecaries could diagnose, so long as they only charged for the medicine, supplied and physicians dispense so long as they didn’t charge for the medicine. All went OK for about a century until in the early 19th Century the physicians made a take over and, under the terms of the Apothecaries Act, requited a training similar to that of physicians for apothecaries, who consequently evolved into today’s GPs. British pharmacists evolved from a merger of the residium of the apothecaries and “chemists and druggists”, who only sold medicines and gave no advice.
That's interesting. How do surgeons fit into that? They have a history of their own, I believe.
Evolved from the barbers or barber-surgeons, around the mid 16th C.. Again the physicians put pressure on them and the Royal College, with comparable education to physicians,was founded about 1800.
Again Remainers banging on about the Empire. It really does exercise them to a bizarre extent. No doubt a psychiatrist could elucidate further.
The UKIP paper Life After The EU had a whole chapter on re-establishing the Commonwealth as a trading block, seemingly unaware that it's two most populous members are nuclear armed enemies.
Rather thin on why the Commonwealth would want that too!
I wouldn't advocate a hospital only based system either.
As I am no expert my views can be discarded, however the current system is dire. There are far too many visits to A&E that don't need to be in a Hospital.
In a small to medium Town - say 35000 to 50000 population having between 4 and 8 Drs surgeries is mindless stupidity. Ultimately the link between me and MY GP is unsustainable. I want access 24 / 7, which an individual is hard pushed to provide. I don't want to see my Dr and be told to go somewhere else at another time for a blood test.
Local Health Centres could provide all the GP services, some A&E services minor day surgery, lots of preventative work, 24 / 7 service and much much more far more efficiently than the current system. GPs in the current format are a road block to a better service.
Your last paragraph rather sums up one of the problems of the NHS, it is stuck in a straight jacket that reveres its founding fathers and systems in a monolithic and dictatorial way. It is hideously resistant to change. The model that it runs on is outdated and needs to reflect the changes in society if it is to have a successful future, not to provide the needs of a society that was current 50 years ago.
What about the patients who do not want access 24x7 and do want to see "their" doctor? An awful lot of primary care medicine is the management of chronic conditions, and much of the rest is dealing with pre-school children. GPs are the closest thing we have to a competitive market for patients, and surgeries do differ in the range of services they provide -- some being close to cottage hospitals. Yet most patients do not shop around, so perhaps are broadly happy with the way things are.
However Corbyn did better with non-members and would almost certainly have lost if the vote was restricted to members who were already members before Ed resigned.
No - polls showed that Corbyn had a large lead in this group too, though not the 80% that he did with new members. Going further back, polls of pre-2010 members still showed him ahead but by less.
A contrast with the US is that people consume politics more through social media, short TV spots with paid ads and minor local outlets than in Britain, where it's still basically the BBC or print media for most people. That gives American anti-establishment types easier access to the public with simple messages. Party selections are an exception because party members are atypical and will read manifestos, seek out debates, etc.
Polls were not exactly reliable in 2015.
We do have some facts though from Labour directly. Corbyn got just less than half the vote of members, so would have won on the second round rather than the first round had the party been of members alone. However the membership was open to entryists until 12 August (and even had the deadline extended due to such a high number of sign ups).
For myself I have no problem with the idea of a seven day NHS. I just don’t see how, without a significant increase in costs, it can be operated.
Interesting thought about GP’s. In fact they are much “older” than suggested and arise from a couple of, perhaps quintessentially, British compromises, In the rest of Europe the traditional apothecary morphed into todays’ pharmacist and physicians diagnosed and prescribed. In Britain, or more specifically England and Wales it was decided in 1703 (the Rose case) that apothecaries could diagnose, so long as they only charged for the medicine, supplied and physicians dispense so long as they didn’t charge for the medicine. All went OK for about a century until in the early 19th Century the physicians made a take over and, under the terms of the Apothecaries Act, requited a training similar to that of physicians for apothecaries, who consequently evolved into today’s GPs. British pharmacists evolved from a merger of the residium of the apothecaries and “chemists and druggists”, who only sold medicines and gave no advice.
That's interesting. How do surgeons fit into that? They have a history of their own, I believe.
Evolved from the barbers or barber-surgeons, around the mid 16th C.. Again the physicians put pressure on them and the Royal College, with comparable edication to physicians,was founded about 1800.
Presumably the surgeons' "Mr", which is now part of their mystique, was originally disparaging.
For myself I have no problem with the idea of a seven day NHS. I just don’t see how, without a significant increase in costs, it can be operated.
Interesting thought about GP’s. In fact they are much “older” than suggested and arise from a couple of, perhaps quintessentially, British compromises, In the rest of Europe the traditional apothecary morphed into todays’ pharmacist and physicians diagnosed and prescribed. In Britain, or more specifically England and Wales it was decided in 1703 (the Rose case) that apothecaries could diagnose, so long as they only charged for the medicine, supplied and physicians dispense so long as they didn’t charge for the medicine. All went OK for about a century until in the early 19th Century the physicians made a take over and, under the terms of the Apothecaries Act, requited a training similar to that of physicians for apothecaries, who consequently evolved into today’s GPs. British pharmacists evolved from a merger of the residium of the apothecaries and “chemists and druggists”, who only sold medicines and gave no advice.
That's interesting. How do surgeons fit into that? They have a history of their own, I believe.
Evolved from the barbers or barber-surgeons, around the mid 16th C.. Again the physicians put pressure on them and the Royal College, with comparable edication to physicians,was founded about 1800.
Presumably the surgeons' "Mr", which is now part of their mystique, was originally disparaging.
Yes. It’s also odd that someone with a PhD, who, perfectly properly uses the title Doctor in normal life is often assumed to be a medical practitioner. So much so in fact, that a pharmacist with a PhD who decides to open their own pharmacy is precluded, by the profession, from putting Dr (eg Cole) on their shopfront. (No, I haven’t got a PhD!)
Must really hurt coming from a president that's been in power for 8 years and achieved zilch.
It's a classic gaffe in that the speaker almost certainly didn't intend the words to have the impact that they have had and they are entirely true. Britain and France made the same mistake that the USA made in Iraq. If anything, they failed harder and with the added criticism that they had the recent experience of the USA in Iraq to learn from.
I wouldn't advocate a hospital only based system either.
As I am no expert my views can be discarded, however the current system is dire. There are far too many visits to A&E that don't need to be in a Hospital.
In a small to medium Town - say 35000 to 50000 population having between 4 and 8 Drs surgeries is mindless stupidity. Ultimately the link between me and MY GP is unsustainable. I want access 24 / 7, which an individual is hard pushed to provide. I don't want to see my Dr and be told to go somewhere else at another time for a blood test.
Local Health Centres could provide all the GP services, some A&E services minor day surgery, lots of preventative work, 24 / 7 service and much much more far more efficiently than the current system. GPs in the current format are a road block to a better service.
Your last paragraph rather sums up one of the problems of the NHS, it is stuck in a straight jacket that reveres its founding fathers and systems in a monolithic and dictatorial way. It is hideously resistant to change. The model that it runs on is outdated and needs to reflect the changes in society if it is to have a successful future, not to provide the needs of a society that was current 50 years ago.
What about the patients who do not want access 24x7 and do want to see "their" doctor? An awful lot of primary care medicine is the management of chronic conditions, and much of the rest is dealing with pre-school children. GPs are the closest thing we have to a competitive market for patients, and surgeries do differ in the range of services they provide -- some being close to cottage hospitals. Yet most patients do not shop around, so perhaps are broadly happy with the way things are.
They make an appointment with 'their' Dr at a Health Centre at an appropriate time.
Edit: There are times when a second opinion is valuable, news eyes see different things.
And how do they know they don't want access to a local quality 24 / 7 service? Illness isn't done to a booking schedule.
Excellent article Alastaire. I think you have got the the Remain tactics absolutely right and that's what I'd expect to see. I was speaking to an advertising friend the other day and he thought the campaign would be full of high tech ads showing EU projects with the UK at the vanguard. I'd previously thought something more negative like what would happen if we weren't in the EU
Mr. G, Cameron wants Obama to bleat about the perils of the UK leaving the EU. That'll dictate his (non-)response.
Hmmm
Young Cameron is fast becoming the whipping boy of the G7
First he has to suck up to Angela, then he Kowtows to Li, Francois threatens to duff him up if he gets the wrong answer and now Obama says he's a useless pillock.
Lucky the Mexicans arent in it or he'd be used as a pinata.
I thought being an 'Aid Superpower' was meant to lead to influence and power around the world.
Cameron's really tested to destruction the theory that fawning towards others and handing out money to every country he visits wins friends and influence.
It doesn't.
It makes you look weak and leads to you being despised.
Apparently Obama prefers the hard blow them to bits influence to the soft cuddly stuff.
And yes internationally preople respect strength and despise weakness.
Just been listening to Blair on the way in to work telling us all how important Europe is and that we really out to appreciate our politicians so much more.
Did he say Europe? I Agree! Did he say "The EU"? Like H**l!
King Cole, the advance, and decline, of medicine over history isn't an especial area of interest for me, but it is noteworthy that (as in other fields) progress didn't just continually occur.
Indeed, consider the current situation. Many people have access to clean water, healthy food, and are managing to inflict chronic conditions on themselves by lack of exercise.
Just on surgeons: the Romans had special tongs for the removal of bullets (from slings). Bit sad that surgery could be relatively advanced then, only for it to crumble and be replaced by part-timers a thousand years later. Galen first noticed the head was the repository of the mind when he worked on gladiators suffering head injuries.
However Corbyn did better with non-members and would almost certainly have lost if the vote was restricted to members who were already members before Ed resigned.
No - polls showed that Corbyn had a large lead in this group too, though not the 80% that he did with new members. Going further back, polls of pre-2010 members still showed him ahead but by less.
A contrast with the US is that people consume politics more through social media, short TV spots with paid ads and minor local outlets than in Britain, where it's still basically the BBC or print media for most people. That gives American anti-establishment types easier access to the public with simple messages. Party selections are an exception because party members are atypical and will read manifestos, seek out debates, etc.
And that is why Labour lost the last election. The Conservatives did move on to social media, especially Facebook, Youtube and good old-fashioned email, where the old rules against attack ads don't apply and where content can be crafted for and targeted to different groups of voters. Forget Crosby, it was Messina what won it. Even where Labour got it right they got it wrong by concentrating on Twitter, home of the already engaged and obsessed, whereas most of the population is on Facebook.
Mr. G, Cameron wants Obama to bleat about the perils of the UK leaving the EU. That'll dictate his (non-)response.
Hmmm
Young Cameron is fast becoming the whipping boy of the G7
First he has to suck up to Angela, then he Kowtows to Li, Francois threatens to duff him up if he gets the wrong answer and now Obama says he's a useless pillock.
Lucky the Mexicans arent in it or he'd be used as a pinata.
I thought being an 'Aid Superpower' was meant to lead to influence and power around the world.
Cameron's really tested to destruction the theory that fawning towards others and handing out money to every country he visits wins friends and influence.
It doesn't.
It makes you look weak and leads to you being despised.
Apparently Obama prefers the hard blow them to bits influence to the soft cuddly stuff.
And yes internationally preople respect strength and despise weakness.
It's cockfighting and the biggest cocks win.
Trump is a shoe-in then!
I haven;t worked out if Donald and Vlad will be daggers drawn or really hit it off.
Must really hurt coming from a president that's been in power for 8 years and achieved zilch.
If you ignore the biggest trade pact ever, the biggest climate agreement ever, the Iran nuclear deal, bringing troops home from Iraq and Afghanistan, two supreme court justices and providing healthcare to 20m impoverished people.
The Chinese have a more or less non-GP system - nearly everyone goes to the hospital if they feel ill. Problem is that you have to drive further to get there, see a random different doctor each time and tie up specialists dealing with trivia. They are keen to move to a GP system and I've given lots of seminars on the issue to visiting delegations, but they run into a wall of public scepticism - "if he was any good he'd be in the hospital, why is he living in my village?"
It's the sort of issue where being a dictatorship doesn't really help - hard to force people into a change of attitude. I told them that we insist that only A&E patients can go to a hospital directly and everyone else is required to go through a GP. Some of them looked shocked and said that seems very authoritarian...
While I'd say that's bulls**t. We suggest that only A&E patients can go to a hospital directly, but we don't insist upon it. Anyone with a trivial non-urgent case that rocks up at A&E is still seen rather than being sent away and told to call their GP.
Two years ago when my wife was very pregnant she fell outside and didn't feel the baby kick afterwards. We called her midwife who said to go urgently to A&E, we did and were made to wait for nearly four hours. During that four hour window we saw one genuine emergency arrive (someone arrived with a severed thumb) who was waived straight through to be seen immediately. Almost everyone else had trivial stuff like "I stubbed my toe last week and it still hurts" which I'd think should be seen by a GP. Didn't see anyone get triaged and told "this isn't appropriate for A&E call your GP".
EDIT: By the way I think ours should have been considered more urgent. When we were finally (just shy of four hours) seen by the doctor she said "You've felt the baby kick since haven't you" to which my wife said "no" and the doctor looked horrified. The nurse had entered the wrong information upon our entry. Thankfully everything was OK in the end.
Well, it's entirely possible not to be registered with a GP (looks disapprovingly at younger self).
And a lot of people go to A&E because underinvestment in NHS has meant it can take weeks to see GP.
The Chinese have a more or less non-GP system - nearly everyone goes to the hospital if they feel ill. Problem is that you have to drive further to get there, see a random different doctor each time and tie up specialists dealing with trivia. They are keen to move to a GP system and I've given lots of seminars on the issue to visiting delegations, but they run into a wall of public scepticism - "if he was any good he'd be in the hospital, why is he living in my village?"
It's the sort of issue where being a dictatorship doesn't really help - hard to force people into a change of attitude. I told them that we insist that only A&E patients can go to a hospital directly and everyone else is required to go through a GP. Some of them looked shocked and said that seems very authoritarian...
While I'd say that's bulls**t. We suggest that only A&E patients can go to a hospital directly, but we don't insist upon it. Anyone with a trivial non-urgent case that rocks up at A&E is still seen rather than being sent away and told to call their GP.
Two years ago when my wife was very pregnant she fell outside and didn't feel the baby kick afterwards. We called her midwife who said to go urgently to A&E, we did and were made to wait for nearly four hours. During that four hour window we saw one genuine emergency arrive (someone arrived with a severed thumb) who was waived straight through to be seen immediately. Almost everyone else had trivial stuff like "I stubbed my toe last week and it still hurts" which I'd think should be seen by a GP. Didn't see anyone get triaged and told "this isn't appropriate for A&E call your GP".
EDIT: By the way I think ours should have been considered more urgent. When we were finally (just shy of four hours) seen by the doctor she said "You've felt the baby kick since haven't you" to which my wife said "no" and the doctor looked horrified. The nurse had entered the wrong information upon our entry. Thankfully everything was OK in the end.
Well, it's entirely possible not to be registered with a GP (looks disapprovingly at younger self).
And a lot of people go to A&E because underinvestment in NHS has meant it can take weeks to see GP.
Or the surgery is closed and they want treatment now.
Excellent article Alastaire. I think you have got the the Remain tactics absolutely right and that's what I'd expect to see. I was speaking to an advertising friend the other day and he thought the campaign would be full of high tech ads showing EU projects with the UK at the vanguard... snip ...
Great idea. Remind us where the EU gets the cash for these projects.
Oh yes, we pay it to them. And they skim it, and give some back.
Leave can always counter with publicity for the European funded motorways to nowhere, and abandoned ghost airports. Not to mention the large scale frauds. Billions of wasted Euro.
King Cole, the advance, and decline, of medicine over history isn't an especial area of interest for me, but it is noteworthy that (as in other fields) progress didn't just continually occur.
Indeed, consider the current situation. Many people have access to clean water, healthy food, and are managing to inflict chronic conditions on themselves by lack of exercise.
Just on surgeons: the Romans had special tongs for the removal of bullets (from slings). Bit sad that surgery could be relatively advanced then, only for it to crumble and be replaced by part-timers a thousand years later. Galen first noticed the head was the repository of the mind when he worked on gladiators suffering head injuries.
Mr D it’s probable that civil engineers, and particular ones involved with sanitary ones like Bazalgutee saved more British lives than all British “doctors” have ever done.
There’s some suggestion,too, that saving lives that would otherwise have been cut short by disease has contributed to the rise of dieases which commonly arise in later life. Another factor to be considered is is the disproportionate loss of life in two world wars, in Europe especially,of the brightest and best. The Lothian Birth Cohort research (http://www.lothianbirthcohort.ed.ac.uk) shows this clearly in respect of WWII.
Depending on the outcome I foresee (a bunch of?) cartoons depicting Britannia looking shocked/goosed/no-longer-"alone"/serious. But could Matt stoop to that? I think not: he seems to focus on ordinary folk.
Or the surgery is closed and they want treatment now.
Or the GP's surgery's "customer service" is poor. If I call my GP in the afternoon to schedule an appointment I get told they can't give any appointments now and to call back "tomorrow at 9am". Try calling at 9am and the line is engaged. Unsurprisingly.
It should be possible to make an appointment anytime and get the next available appointment and wait. Instead to massage their statistics when they've filled all appointments they simply stop taking them.
No private company would ever do anything similar, turn a customer away and tell you to call tomorrow instead.
As for the suggestion by someone below that people rarely change GP's which implies people are happy with the service - changing energy suppliers etc is also rarely done.
The Chinese have a more or less non-GP system - nearly everyone goes to the hospital if they feel ill. Problem is that you have to drive further to get there, see a random different doctor each time and tie up specialists dealing with trivia. They are keen to move to a GP system and I've given lots of seminars on the issue to visiting delegations, but they run into a wall of public scepticism - "if he was any good he'd be in the hospital, why is he living in my village?"
It's the sort of issue where being a dictatorship doesn't really help - hard to force people into a change of attitude. I told them that we insist that only A&E patients can go to a hospital directly and everyone else is required to go through a GP. Some of them looked shocked and said that seems very authoritarian...
While I'd say that's bulls**t. We suggest that only A&E patients can go to a hospital directly, but we don't insist upon it. Anyone with a trivial non-urgent case that rocks up at A&E is still seen rather than being sent away and told to call their GP.
Two years ago when my wife was very pregnant she fell outside and didn't feel the baby kick afterwards. We called her midwife who said to go urgently to A&E, we did and were made to wait for nearly four hours. During that four hour window we saw one genuine emergency arrive (someone arrived with a severed thumb) who was waived straight through to be seen immediately. Almost everyone else had trivial stuff like "I stubbed my toe last week and it still hurts" which I'd think should be seen by a GP. Didn't see anyone get triaged and told "this isn't appropriate for A&E call your GP".
EDIT: By the way I think ours should have been considered more urgent. When we were finally (just shy of four hours) seen by the doctor she said "You've felt the baby kick since haven't you" to which my wife said "no" and the doctor looked horrified. The nurse had entered the wrong information upon our entry. Thankfully everything was OK in the end.
Well, it's entirely possible not to be registered with a GP (looks disapprovingly at younger self).
And a lot of people go to A&E because underinvestment in NHS has meant it can take weeks to see GP.
Or the surgery is closed and they want treatment now.
The surgery will be closed more often as the crisis in recruitment and retention worsens:
King Cole, quite. One of the (many) reasons for Byzantium's downfall was that the population was continually eroded by bouts of plague.
One of the reasons by which NW European cities survived, allegedly anyway, was because they normally drank weakly alcoholic “small beer” rather than water. Less likely to carry infection.
Must really hurt coming from a president that's been in power for 8 years and achieved zilch.
If you ignore the biggest trade pact ever, the biggest climate agreement ever, the Iran nuclear deal, bringing troops home from Iraq and Afghanistan, two supreme court justices and providing healthcare to 20m impoverished people.
Well, it's an attempt to be positive at least! It demonstrates very little confidence in the strengths and capabilities of the UK - we need to be in Europe because we are plagued with self-doubt, we are not at peace with ourselves and we are an economic basket-case. Hmmh, positive, you say?
The economic situation has changed dramatically since the 1970s though - arguably driven by our own reforms rather than Europe, and partly due to the growth in the financial services industry worldwide which we were well placed to capitalise on
As for "being a peace with ourselves", I don't know how old you are Alastair. I'm 40 and, from my perspective - and from the perspective of virtual everyone else in my generation - the Empire is a part of our history. It's interesting that we did it, it's nice to know the details but it has absolutely zero impact on day to day life or my philosophy of what it means to be British. That wasn't the case in the 70s and 80s (when our politicians had been growing up during the 50s and 60s) but today it's utterly irrelevant
Mr. G, Cameron wants Obama to bleat about the perils of the UK leaving the EU. That'll dictate his (non-)response.
Hmmm
Young Cameron is fast becoming the whipping boy of the G7
First he has to suck up to Angela, then he Kowtows to Li, Francois threatens to duff him up if he gets the wrong answer and now Obama says he's a useless pillock.
Lucky the Mexicans arent in it or he'd be used as a pinata.
I thought being an 'Aid Superpower' was meant to lead to influence and power around the world.
Cameron's really tested to destruction the theory that fawning towards others and handing out money to every country he visits wins friends and influence.
It doesn't.
It makes you look weak and leads to you being despised.
Apparently Obama prefers the hard blow them to bits influence to the soft cuddly stuff.
And yes internationally preople respect strength and despise weakness.
It's cockfighting and the biggest cocks win.
Trump is a shoe-in then!
I haven;t worked out if Donald and Vlad will be daggers drawn or really hit it off.
The latter is likely to be considerably richer than Trump, but they're businessmen who understand and value money, and how to get a lot of it.
Well, it's an attempt to be positive at least! It demonstrates very little confidence in the strengths and capabilities of the UK - we need to be in Europe because we are plagued with self-doubt, we are not at peace with ourselves and we are an economic basket-case. Hmmh, positive, you say?
The economic situation has changed dramatically since the 1970s though - arguably driven by our own reforms rather than Europe, and partly due to the growth in the financial services industry worldwide which we were well placed to capitalise on
As for "being a peace with ourselves", I don't know how old you are Alastair. I'm 40 and, from my perspective - and from the perspective of virtual everyone else in my generation - the Empire is a part of our history. It's interesting that we did it, it's nice to know the details but it has absolutely zero impact on day to day life or my philosophy of what it means to be British. That wasn't the case in the 70s and 80s (when our politicians had been growing up during the 50s and 60s) but today it's utterly irrelevant
Or the surgery is closed and they want treatment now.
Or the GP's surgery's "customer service" is poor. If I call my GP in the afternoon to schedule an appointment I get told they can't give any appointments now and to call back "tomorrow at 9am". Try calling at 9am and the line is engaged. Unsurprisingly.
It should be possible to make an appointment anytime and get the next available appointment and wait. Instead to massage their statistics when they've filled all appointments they simply stop taking them.
No private company would ever do anything similar, turn a company away and tell you to call tomorrow instead.
GP surgeries are private companies, more or less, and patients are free to move from one to another. I'd agree there is a lot of suckage but for believers in markets, the evidence is most patients are satisfied.
As Foxinsox reminds us, there is a recruitment and retention crisis looming and perhaps that, together with increased demand as the population increases, is making it more difficult to get an appointment.
Looks like Trump will be the only one to meet the eight-state requirement. He has seven now to Cruz's four.
The GOP really will self-destruct if they change the rules purely to deny the sole and obvious winner his prize. Besides, Trump will very likely win an overall majority of delegates in addition to the eight state majorities.
It's over, barring some improbable results next Tuesday, or a Black Swan taking Trump out...
I agree that they can't afford to be seen to cheat Trump of the selection (just as the PLP can't afford to challenge Corbyn and then deny him a place on the ballot - that really would turn members into reselection mode). But surely they can't say oops, we only seem to have one qualified candidate, oh well. It'd make an anti-climactic election and even Trump would see drawbacks in that. I'd have thought that they'd at least get Cruz in, maybe by persuading the "uncommitted" delegates (Puerto Rico, PA?) to give him a nomination?
As far as I can see:-
a) the GOP could change the rule, as the first item of Convention business. But the optics would be terrible, if Trump is the only one to pass the current rule, as seems likely.
b) Delegates are bound to their candidates on the first vote proper. It seems farcical that they could defect purely to permit the nomination of a candidate they are unable to vote for. Puerto Rico delegates are bound to Rubio. PA might be theoretically possible. That's one state which might have the required leverage. So someone needs to win seven others to make PA relevant. The only someone that could possibly be seems to be Cruz, if he wins another three delegate majorities. Why would the GOP stitch it for Cruz?
c) The rule says eight "states", which implies the territories such as Virgin Islands don't count for nomination purposes. Again, it would seem ludicrous that microscopic places outside the US - who can't vote in the general election - could have such an impact on the process.
d) Trump looks likely to win an overall majority of delegates, in addition to at least eight state majorities. So a), b) and c) become moot...
While I'd say that's bulls**t. We suggest that only A&E patients can go to a hospital directly, but we don't insist upon it. Anyone with a trivial non-urgent case that rocks up at A&E is still seen rather than being sent away and told to call their GP.
Two years ago when my wife was very pregnant she fell outside and didn't feel the baby kick afterwards. We called her midwife who said to go urgently to A&E, we did and were made to wait for nearly four hours. During that four hour window we saw one genuine emergency arrive (someone arrived with a severed thumb) who was waived straight through to be seen immediately. Almost everyone else had trivial stuff like "I stubbed my toe last week and it still hurts" which I'd think should be seen by a GP. Didn't see anyone get triaged and told "this isn't appropriate for A&E call your GP".
EDIT: By the way I think ours should have been considered more urgent. When we were finally (just shy of four hours) seen by the doctor she said "You've felt the baby kick since haven't you" to which my wife said "no" and the doctor looked horrified. The nurse had entered the wrong information upon our entry. Thankfully everything was OK in the end.
Well, it's entirely possible not to be registered with a GP (looks disapprovingly at younger self).
And a lot of people go to A&E because underinvestment in NHS has meant it can take weeks to see GP.
Or the surgery is closed and they want treatment now.
The surgery will be closed more often as the crisis in recruitment and retention worsens:
Mr Hunt's solution: antagonise all the remaining doctors and worsen their conditions. Genius!
Whiny doctors pining for the glory days when Labour succeeded in giving them more, for doing less. Increased pay, but allowed GPs to opt out of providing out-of-hours care. This is where todays problems stem from.
All thanks to Alan Johnson, the Health Minister who manages to make Cameron look like the World Champion at contract negotiation.
Well, it's an attempt to be positive at least! It demonstrates very little confidence in the strengths and capabilities of the UK - we need to be in Europe because we are plagued with self-doubt, we are not at peace with ourselves and we are an economic basket-case. Hmmh, positive, you say?
The economic situation has changed dramatically since the 1970s though - arguably driven by our own reforms rather than Europe, and partly due to the growth in the financial services industry worldwide which we were well placed to capitalise on
As for "being a peace with ourselves", I don't know how old you are Alastair. I'm 40 and, from my perspective - and from the perspective of virtual everyone else in my generation - the Empire is a part of our history. It's interesting that we did it, it's nice to know the details but it has absolutely zero impact on day to day life or my philosophy of what it means to be British. That wasn't the case in the 70s and 80s (when our politicians had been growing up during the 50s and 60s) but today it's utterly irrelevant
Perhaps a better place to look might be maths, science, art, philosophy, engineering, medicine, etc, etc? Somehow such considerations make me think that we are part of Europe.
King Cole, in the 14th century it was a wifely duty to provide a certain quantity of ale for her man (and herself, presumably). And yes, small beer was safer than water.
Or the surgery is closed and they want treatment now.
Or the GP's surgery's "customer service" is poor. If I call my GP in the afternoon to schedule an appointment I get told they can't give any appointments now and to call back "tomorrow at 9am". Try calling at 9am and the line is engaged. Unsurprisingly.
It should be possible to make an appointment anytime and get the next available appointment and wait. Instead to massage their statistics when they've filled all appointments they simply stop taking them.
No private company would ever do anything similar, turn a company away and tell you to call tomorrow instead.
GP surgeries are private companies, more or less, and patients are free to move from one to another. I'd agree there is a lot of suckage but for believers in markets, the evidence is most patients are satisfied.
As Foxinsox reminds us, there is a recruitment and retention crisis looming and perhaps that, together with increased demand as the population increases, is making it more difficult to get an appointment.
There are quite a few places where, while it is theoretically possible to change surgeries, either lists are closed or “the practice doesn’t covedr your area". In urban areas practice areas can be quite small.
Underlines why leaving the EU isn't going to be as dire as some on the remain side would like us to think.
Does that take into account of the Rotterdam effect?
No. The trade with the Netherlands is not broken down.
So our trade deficit with the EU might not be so bad and our trade deficit with the rest of the world since famously a lot of imports to the EU are processed in Rotterdam and then counted by the UK as EU imports (despite nothing other than relocation from there).
Given the most likely result is a Remain win by an even narrower margin than indyref it will have failed to win the vote convincingly let alone the argument
King Cole, in the 14th century it was a wifely duty to provide a certain quantity of ale for her man (and herself, presumably). And yes, small beer was safer than water.
And indeed for her children, once they were no longer at the breast. I’m not sure, and would be interested to know, when the practice of giving cows milk to young children became widespread. What was the “household drink” in Byzantium? Watered wine?
Well, it's an attempt to be positive at least! It demonstrates very little confidence in the strengths and capabilities of the UK - we need to be in Europe because we are plagued with self-doubt, we are not at peace with ourselves and we are an economic basket-case. Hmmh, positive, you say?
The economic situation has changed dramatically since the 1970s though - arguably driven by our own reforms rather than Europe, and partly due to the growth in the financial services industry worldwide which we were well placed to capitalise on
As for "being a peace with ourselves", I don't know how old you are Alastair. I'm 40 and, from my perspective - and from the perspective of virtual everyone else in my generation - the Empire is a part of our history. It's interesting that we did it, it's nice to know the details but it has absolutely zero impact on day to day life or my philosophy of what it means to be British. That wasn't the case in the 70s and 80s (when our politicians had been growing up during the 50s and 60s) but today it's utterly irrelevant
Perhaps a better place to look might be maths, science, art, philosophy, engineering, medicine, etc, etc? Somehow such considerations make me think that we are part of Europe.
We are part of Europe, and always will be (unless @MorrisDancer and the octo-lemurs tow us offshore). But our philosophical tradition - Locke, Burke, Adams, Hume - is very different from the thinking of Descartes or Kant. Just because we have geographically co-located it doesn't mean that we should have the same governance structure
Given the most likely result is a Remain win by an even narrower margin than indyref it will have failed to win the vote convincingly let alone the argument
Underlines why leaving the EU isn't going to be as dire as some on the remain side would like us to think.
Does that take into account of the Rotterdam effect?
No. The trade with the Netherlands is not broken down.
So our trade deficit with the EU might not be so bad and our trade deficit with the rest of the world since famously a lot of imports to the EU are processed in Rotterdam and then counted by the UK as EU imports (despite nothing other than relocation from there).
The trade numbers are notoriously hard to correctly break down. Rotterdam is one example of why that is the base, but it is not the only one.
Take natural gas. We import natural gas from Norway (non-EU import), and then re-export it it to Ireland (EU export). Of course, as the Irish company has directly contracted with Statoil for the supply of gas, all we see is a 'toll' for its passage through pipes in the UK. Nevertheless, from an economic statistics point of view, it gets added to both exports and imports.
King Cole, I am afraid my knowledge of Eastern Roman drinking habits is severely lacking. I would guess they had a sound aqueduct system (early on, at least) but wine would've been a large part of their beverage habits.
Wine drinking may well have declined after the Ottomans conquered it. Not sure how strict they were about such things.
Well, it's an attempt to be positive at least! It demonstrates very little confidence in the strengths and capabilities of the UK - we need to be in Europe because we are plagued with self-doubt, we are not at peace with ourselves and we are an economic basket-case. Hmmh, positive, you say?
The economic situation has changed dramatically since the 1970s though - arguably driven by our own reforms rather than Europe, and partly due to the growth in the financial services industry worldwide which we were well placed to capitalise on
As for "being a peace with ourselves", I don't know how old you are Alastair. I'm 40 and, from my perspective - and from the perspective of virtual everyone else in my generation - the Empire is a part of our history. It's interesting that we did it, it's nice to know the details but it has absolutely zero impact on day to day life or my philosophy of what it means to be British. That wasn't the case in the 70s and 80s (when our politicians had been growing up during the 50s and 60s) but today it's utterly irrelevant
Leave demonstrably is not at peace with itself. It has no coherent vision for the future, just a raving dislike of the present. A decision to vote for Leave will be a decision to leave present moorings and drift on the currents. Those currents look pretty choppy and the Leave ship is rudderless and the crew is arguing among itself.
I'm puzzled by the continued collapse in the UKIP vote and its relationship to the EUREF polls. Is the phenomenon completely unrelated or does it suggest a problem for Leave? Or is it simply the Farage factor being taken over by the Boris factor. I genuinely am puzzled.
UKIP are a sideshow now that the Tory BOOers dominate the media. Interesting to see how well the LDs are doing again.
They seem to have got some, maybe most, of the "none of the above" vote back that they lost to UKIP last May. At least in council by elections.
It may also be that UKIP are undistinguished at best in Local Govt, while LDs are rather good at pavement politics. I suspect that LDs are also picking up votes from those repelled by Corbynmania.
It will be a long road back though.
Lib Dems have usually outperformed their poll ratings in local elections. Even in the last Parliament, that was true.
The LDs have lost councillors in net terms every year for the past 7. At some point they will have reached bottom. Is that now, maybe? But if they do lose more councillors then their much trumpeted "fightback" can be declared dead. After all they have only declined 2/3 in councillor numbers from their peak in 1996. A mere flesh wound.
There are quite a few places where, while it is theoretically possible to change surgeries, either lists are closed or “the practice doesn’t covedr your area". In urban areas practice areas can be quite small.
Yes, previous discussions here have shown that practice varies widely. Both my current and my previous GP allow online booking of appointments, eliminating the "Call at 830" crap which shocked Blair 15 years ago but still persists in some practices. Every practice I've had in Broxtowe and London has basically had the policy that you can book well ahead and either get a random GP in 2-3 days or your favourite in a week or so, which has always seemed to me a reasonable deal.
The semi-requirement that you are in the catchment area is no longer always followed - I stuck to my old Westminster GP for 10 years till she retired (a wonderful Norwegian - used to spend a month every year volunteering her services in Haiti) and the surgery merely said well, it means you won't get house calls if you're on the other side of London. I think it's time to get rid of it officially and allow people to choose any GP, with the house call aspect (rare now anyway) as one consideration to weigh up.
Underlines why leaving the EU isn't going to be as dire as some on the remain side would like us to think.
Does that take into account of the Rotterdam effect?
No. The trade with the Netherlands is not broken down.
So our trade deficit with the EU might not be so bad and our trade deficit with the rest of the world since famously a lot of imports to the EU are processed in Rotterdam and then counted by the UK as EU imports (despite nothing other than relocation from there).
The "Rotterdam effect" overstates our EU exports more than it overstates our EU imports. It actually makes the picture look slightly better than it is. I think it is something to do with the shipping route, a lot of container ships stop off in Southampton unload Asian cargo for UK/Ire and pick up UK/Ire cargo and then moves onto Rotterdam as the next stop which registers as non-EU imports and EU exports to the ONS and other trade bodies. A lot of our West Asian imports and EU imports from the southern nations come via Rotterdam too.
King Cole, I am afraid my knowledge of Eastern Roman drinking habits is severely lacking. I would guess they had a sound aqueduct system (early on, at least) but wine would've been a large part of their beverage habits.
Wine drinking may well have declined after the Ottomans conquered it. Not sure how strict they were about such things.
Does not Omar Khayyam talk about a jug of wine? I appreciaste he was pre-Ottoman.
Well, it's an attempt to be positive at least! It demonstrates very little confidence in the strengths and capabilities of the UK - we need to be in Europe because we are plagued with self-doubt, we are not at peace with ourselves and we are an economic basket-case. Hmmh, positive, you say?
The economic situation has changed dramatically since the 1970s though - arguably driven by our own reforms rather than Europe, and partly due to the growth in the financial services industry worldwide which we were well placed to capitalise on
As for "being a peace with ourselves", I don't know how old you are Alastair. I'm 40 and, from my perspective - and from the perspective of virtual everyone else in my generation - the Empire is a part of our history. It's interesting that we did it, it's nice to know the details but it has absolutely zero impact on day to day life or my philosophy of what it means to be British. That wasn't the case in the 70s and 80s (when our politicians had been growing up during the 50s and 60s) but today it's utterly irrelevant
Leave demonstrably is not at peace with itself. It has no coherent vision for the future, just a raving dislike of the present. A decision to vote for Leave will be a decision to leave present moorings and drift on the currents. Those currents look pretty choppy and the Leave ship is rudderless and the crew is arguing among itself.
Leave is not one monolithic organisation - there are different people with different reasons for not wanting to be part of the EU.
The likes of @DavidL, @Casino_Royale, @rcs1000 are all at peace with themselves. The likes of Tony Blair may be at peace with themselves - but they probably shouldn't be.
While I'd say that's bulls**t. We suggest that only A&E patients can go to a hospital directly, but we don't insist upon it. Anyone with a trivial non-urgent case that rocks up at A&E is still seen rather than being sent away and told to call their GP.
Two ye
Well, it's entirely possible not to be registered with a GP (looks disapprovingly at younger self).
And a lot of people go to A&E because underinvestment in NHS has meant it can take weeks to see GP.
Or the surgery is closed and they want treatment now.
The surgery will be closed more often as the crisis in recruitment and retention worsens:
Mr Hunt's solution: antagonise all the remaining doctors and worsen their conditions. Genius!
Whiny doctors pining for the glory days when Labour succeeded in giving them more, for doing less. Increased pay, but allowed GPs to opt out of providing out-of-hours care. This is where todays problems stem from.
All thanks to Alan Johnson, the Health Minister who manages to make Cameron look like the World Champion at contract negotiation.
John Reid was the minister at the time.
The BMA GP negotiators told the DoH that Out of Hours care could not be done at the price that the DoH wanted, so the DoH insisted that it would do OOH care. The BMA were right on the costs and difficulties, the DOH wrong. It frequently happens.
I qualified in the late eighties and my medical school year group on Facebook is a pretty demoralised bunch. The only happy ones seem to be those in Australia.
Looks like Trump will be the only one to meet the eight-state requirement. He has seven now to Cruz's four.
The GOP really will self-destruct if they change the rules purely to deny the sole and obvious winner his prize. Besides, Trump will very likely win an overall majority of delegates in addition to the eight state majorities.
It's over, barring some improbable results next Tuesday, or a Black Swan taking Trump out...
I agree that they can't afford to be seen to cheat Trump of the selection (just as the PLP can't afford to challenge Corbyn and then deny him a place on the ballot - that really would turn members into reselection mode). But surely they can't say oops, we only seem to have one qualified candidate, oh well. It'd make an anti-climactic election and even Trump would see drawbacks in that. I'd have thought that they'd at least get Cruz in, maybe by persuading the "uncommitted" delegates (Puerto Rico, PA?) to give him a nomination?
It seems to me that a situation where only one candidate is eligible but even he doesn't have a majority is nt sustainable.
Well, it's an attempt to be positive at least! It demonstrates very little confidence in the strengths and capabilities of the UK - we need to be in Europe because we are plagued with self-doubt, we are not at peace with ourselves and we are an economic basket-case. Hmmh, positive, you say?
The economic situation has changed dramatically since the 1970s though - arguably driven by our own reforms rather than Europe, and partly due to the growth in the financial services industry worldwide which we were well placed to capitalise on
As for "being a peace with ourselves", I don't know how old you are Alastair. I'm 40 and, from my perspective - and from the perspective of virtual everyone else in my generation - the Empire is a part of our history. It's interesting that we did it, it's nice to know the details but it has absolutely zero impact on day to day life or my philosophy of what it means to be British. That wasn't the case in the 70s and 80s (when our politicians had been growing up during the 50s and 60s) but today it's utterly irrelevant
Leave demonstrably is not at peace with itself. It has no coherent vision for the future, just a raving dislike of the present. A decision to vote for Leave will be a decision to leave present moorings and drift on the currents. Those currents look pretty choppy and the Leave ship is rudderless and the crew is arguing among itself.
Canvassing in south London last night - Labour ward - Remain and Sadiq well ahead. Labour voters more than 75% Remain.
Looks like Trump will be the only one to meet the eight-state requirement. He has seven now to Cruz's four.
The GOP really will self-destruct if they change the rules purely to deny the sole and obvious winner his prize. Besides, Trump will very likely win an overall majority of delegates in addition to the eight state majorities.
It's over, barring some improbable results next Tuesday, or a Black Swan taking Trump out...
I agree that they can't afford to be seen to cheat Trump of the selection (just as the PLP can't afford to challenge Corbyn and then deny him a place on the ballot - that really would turn members into reselection mode). But surely they can't say oops, we only seem to have one qualified candidate, oh well. It'd make an anti-climactic election and even Trump would see drawbacks in that. I'd have thought that they'd at least get Cruz in, maybe by persuading the "uncommitted" delegates (Puerto Rico, PA?) to give him a nomination?
It seems to me that a situation where only one candidate is eligible but even he doesn't have a majority is nt sustainable.
Who makes the rules? Are they Party rules or are they laid down elsewhere?
While I'd say that's bulls**t. We suggest that only A&E patients can go to a hospital directly, but we don't insist upon it. Anyone with a trivial non-urgent case that rocks up at A&E is still seen rather than being sent away and told to call their GP.
Two ye
Well, it's entirely possible not to be registered with a GP (looks disapprovingly at younger self).
And a lot of people go to A&E because underinvestment in NHS has meant it can take weeks to see GP.
Or the surgery is closed and they want treatment now.
The surgery will be closed more often as the crisis in recruitment and retention worsens:
Mr Hunt's solution: antagonise all the remaining doctors and worsen their conditions. Genius!
Whiny doctors pining for the glory days when Labour succeeded in giving them more, for doing less. Increased pay, but allowed GPs to opt out of providing out-of-hours care. This is where todays problems stem from.
All thanks to Alan Johnson, the Health Minister who manages to make Cameron look like the World Champion at contract negotiation.
John Reid was the minister at the time.
The BMA GP negotiators told the DoH that Out of Hours care could not be done at the price that the DoH wanted, so the DoH insisted that it would do OOH care. The BMA were right on the costs and difficulties, the DOH wrong. It frequently happens.
I qualified in the late eighties and my medical school year group on Facebook is a pretty demoralised bunch. The only happy ones seem to be those in Australia.
Australia, where everyone is encouraged to have medical insurance.
Funny how so many ex-pat NHS zealots abandon principle, and embrace private healthcare when it's warm and sunny outside.
Well, it's an attempt to be positive at least! It demonstrates very little confidence in the strengths and capabilities of the UK - we need to be in Europe because we are plagued with self-doubt, we are not at peace with ourselves and we are an economic basket-case. Hmmh, positive, you say?
The economic situation has changed dramatically since the 1970s though - arguably driven by our own reforms rather than Europe, and partly due to the growth in the financial services industry worldwide which we were well placed to capitalise on
As for "being a peace with ourselves", I don't know how old you are Alastair. I'm 40 and, from my perspective - and from the perspective of virtual everyone else in my generation - the Empire is a part of our history. It's interesting that we did it, it's nice to know the details but it has absolutely zero impact on day to day life or my philosophy of what it means to be British. That wasn't the case in the 70s and 80s (when our politicians had been growing up during the 50s and 60s) but today it's utterly irrelevant
Leave demonstrably is not at peace with itself. It has no coherent vision for the future, just a raving dislike of the present. A decision to vote for Leave will be a decision to leave present moorings and drift on the currents. Those currents look pretty choppy and the Leave ship is rudderless and the crew is arguing among itself.
Leave is not one monolithic organisation - there are different people with different reasons for not wanting to be part of the EU.
The likes of @DavidL, @Casino_Royale, @rcs1000 are all at peace with themselves. The likes of Tony Blair may be at peace with themselves - but they probably shouldn't be.
Lots of different reasons for not wanting to be part of the EU, lots of them mutually contradictory.
This is not about individual happiness - if so, I suggest ardent Leavers take up watercolour painting, origami or rock climbing rather than tinkering with Britain's place in the world. It is about setting a direction for the nation as a whole: collective happiness if you like. There is nothing on the Leave side that gives me any hope that a decision to Leave would increase the collective happiness of the nation. The very opposite.
Excellent article Alastaire. I think you have got the the Remain tactics absolutely right and that's what I'd expect to see. I was speaking to an advertising friend the other day and he thought the campaign would be full of high tech ads showing EU projects with the UK at the vanguard... snip ...
Great idea. Remind us where the EU gets the cash for these projects.
Oh yes, we pay it to them. And they skim it, and give some back.
Leave can always counter with publicity for the European funded motorways to nowhere, and abandoned ghost airports. Not to mention the large scale frauds. Billions of wasted Euro.
Of course there are ways to counter it but the point is this; There's no sensible way of selling REMAINING without selling the EU itself. At the moment one of the reasons LEAVE has as much traction as it does is because the EU looks broken. It's the first job of the REMAINERS to show that it isn't .
There are quite a few places where, while it is theoretically possible to change surgeries, either lists are closed or “the practice doesn’t covedr your area". In urban areas practice areas can be quite small.
Yes, previous discussions here have shown that practice varies widely. Both my current and my previous GP allow online booking of appointments, eliminating the "Call at 830" crap which shocked Blair 15 years ago but still persists in some practices. Every practice I've had in Broxtowe and London has basically had the policy that you can book well ahead and either get a random GP in 2-3 days or your favourite in a week or so, which has always seemed to me a reasonable deal.
The semi-requirement that you are in the catchment area is no longer always followed - I stuck to my old Westminster GP for 10 years till she retired (a wonderful Norwegian - used to spend a month every year volunteering her services in Haiti) and the surgery merely said well, it means you won't get house calls if you're on the other side of London. I think it's time to get rid of it officially and allow people to choose any GP, with the house call aspect (rare now anyway) as one consideration to weigh up.
The "call at 0830 crap" was a direct result of Labour policy. Tony insisted that appointments had to be avaliable at a days notice, with financial penalties for not doing so. GPs therefore would only open some slots on the day.
There is no financial cost to the patient for healthcare, so access is rationed by other means. I don't think this is nessecarily fairer.
Excellent article Alastaire. I think you have got the the Remain tactics absolutely right and that's what I'd expect to see. I was speaking to an advertising friend the other day and he thought the campaign would be full of high tech ads showing EU projects with the UK at the vanguard... snip ...
Great idea. Remind us where the EU gets the cash for these projects.
Oh yes, we pay it to them. And they skim it, and give some back.
Leave can always counter with publicity for the European funded motorways to nowhere, and abandoned ghost airports. Not to mention the large scale frauds. Billions of wasted Euro.
Of course there are ways to counter it but the point is this; There's no sensible way of selling REMAINING without selling the EU itself. At the moment one of the reasons LEAVE has as much traction as it does is because the EU looks broken. It's the first job of the REMAINERS to show that it isn't .
Well funnelling our own money back to us via a corrupt scheme of grants is not the selling point you think it is Roger. If the UK was a net beneficiary of the EU budget then it might be, but we aren't. The government pays in £18-19bn per year and the EU gives out grants and payments worth around £7-8bn per year to projects and farmers. £11bn per year is literally pissed away supporting the Brussels bureaucracy, EU farmers and corruption in southern Europe.
Or the surgery is closed and they want treatment now.
Or the GP's surgery's "customer service" is poor. If I call my GP in the afternoon to schedule an appointment I get told they can't give any appointments now and to call back "tomorrow at 9am". Try calling at 9am and the line is engaged. Unsurprisingly.
It should be possible to make an appointment anytime and get the next available appointment and wait. Instead to massage their statistics when they've filled all appointments they simply stop taking them.
No private company would ever do anything similar, turn a company away and tell you to call tomorrow instead.
GP surgeries are private companies, more or less, and patients are free to move from one to another. I'd agree there is a lot of suckage but for believers in markets, the evidence is most patients are satisfied.
Or they expect everyone else to be just as bad. Having been registered at several surgeries over the last 10 years, I certainly do.
Excellent article Alastaire. I think you have got the the Remain tactics absolutely right and that's what I'd expect to see. I was speaking to an advertising friend the other day and he thought the campaign would be full of high tech ads showing EU projects with the UK at the vanguard... snip ...
Great idea. Remind us where the EU gets the cash for these projects.
Oh yes, we pay it to them. And they skim it, and give some back.
Leave can always counter with publicity for the European funded motorways to nowhere, and abandoned ghost airports. Not to mention the large scale frauds. Billions of wasted Euro.
Of course there are ways to counter it but the point is this; There's no sensible way of selling REMAINING without selling the EU itself. At the moment one of the reasons LEAVE has as much traction as it does is because the EU looks broken. It's the first job of the REMAINERS to show that it isn't .
Hard to do if it is broken though.
Other than giving us a small fraction of out own money back, not a very valid argument, what does the EU do now that isn't broken?
Well, it's an attempt to be positive at least! It demonstrates very little confidence in the strengths and capabilities of the UK - we need to be in Europe because we are plagued with self-doubt, we are not at peace with ourselves and we are an economic basket-case. Hmmh, positive, you say?
The economic situation has changed dramatically since the 1970s though - arguably driven by our own reforms rather than Europe, and partly due to the growth in the financial services industry worldwide which we were well placed to capitalise on
As for "being a peace with ourselves", I don't know how old you are Alastair. I'm 40 and, from my perspective - and from the perspective of virtual everyone else in my generation - the Empire is a part of our history. It's interesting that we did it, it's nice to know the details but it has absolutely zero impact on day to day life or my philosophy of what it means to be British. That wasn't the case in the 70s and 80s (when our politicians had been growing up during the 50s and 60s) but today it's utterly irrelevant
Leave demonstrably is not at peace with itself. It has no coherent vision for the future, just a raving dislike of the present. A decision to vote for Leave will be a decision to leave present moorings and drift on the currents. Those currents look pretty choppy and the Leave ship is rudderless and the crew is arguing among itself.
Leave is not one monolithic organisation - there are different people with different reasons for not wanting to be part of the EU.
The likes of @DavidL, @Casino_Royale, @rcs1000 are all at peace with themselves. The likes of Tony Blair may be at peace with themselves - but they probably shouldn't be.
Lots of different reasons for not wanting to be part of the EU, lots of them mutually contradictory.
This is not about individual happiness - if so, I suggest ardent Leavers take up watercolour painting, origami or rock climbing rather than tinkering with Britain's place in the world. It is about setting a direction for the nation as a whole: collective happiness if you like. There is nothing on the Leave side that gives me any hope that a decision to Leave would increase the collective happiness of the nation. The very opposite.
If all us lefties dropped dead then the happiness of the nation would increase because the Tories and Kippers would have no living opponents.
Excellent article Alastaire. I think you have got the the Remain tactics absolutely right and that's what I'd expect to see. I was speaking to an advertising friend the other day and he thought the campaign would be full of high tech ads showing EU projects with the UK at the vanguard... snip ...
Great idea. Remind us where the EU gets the cash for these projects.
Oh yes, we pay it to them. And they skim it, and give some back.
Leave can always counter with publicity for the European funded motorways to nowhere, and abandoned ghost airports. Not to mention the large scale frauds. Billions of wasted Euro.
Of course there are ways to counter it but the point is this; There's no sensible way of selling REMAINING without selling the EU itself. At the moment one of the reasons LEAVE has as much traction as it does is because the EU looks broken. It's the first job of the REMAINERS to show that it isn't .
One of REMAINS problems is that there has been a consistent stream of negativity from certain parts of the media about straight bananas and the like.
Well, it's an attempt to be positive at least! It demonstrates very little confidence in the strengths and capabilities of the UK - we need to be in Europe because we are plagued with self-doubt, we are not at peace with ourselves and we are an economic basket-case. Hmmh, positive, you say?
The economic situation has changed dramatically since the 1970s though - arguably driven by our own reforms rather than Europe, and partly due to the growth in the financial services industry worldwide which we were well placed to capitalise on
As for "being a peace with ourselves", I don't know how old you are Alastair. I'm 40 and, from my perspective - and from the perspective of virtual everyone else in my generation - the Empire is a part of our history. It's interesting that we did it, it's nice to know the details but it has absolutely zero impact on day to day life or my philosophy of what it means to be British. That wasn't the case in the 70s and 80s (when our politicians had been growing up during the 50s and 60s) but today it's utterly irrelevant
Leave demonstrably is not at peace with itself. It has no coherent vision for the future, just a raving dislike of the present. A decision to vote for Leave will be a decision to leave present moorings and drift on the currents. Those currents look pretty choppy and the Leave ship is rudderless and the crew is arguing among itself.
Leave is not one monolithic organisation - there are different people with different reasons for not wanting to be part of the EU.
The likes of @DavidL, @Casino_Royale, @rcs1000 are all at peace with themselves. The likes of Tony Blair may be at peace with themselves - but they probably shouldn't be.
The problem then becomes the Brexit negotiation. If it does not deliver the benefits that you and others claim it will - and all you have is hope here - then a lot of people who voted Leave, as well as everyone who voted Remain, are going to be incredibly disappointed, perhaps even angry. And if it does deliver what you say it will, then those who are voting Leave to substantially reduce immigration are going to be furious.
There are quite a few places where, while it is theoretically possible to change surgeries, either lists are closed or “the practice doesn’t covedr your area". In urban areas practice areas can be quite small.
Yes, previous discussions here have shown that practice varies widely. Both my current and my previous GP allow online booking of appointments, eliminating the "Call at 830" crap which shocked Blair 15 years ago but still persists in some practices. Every practice I've had in Broxtowe and London has basically had the policy that you can book well ahead and either get a random GP in 2-3 days or your favourite in a week or so, which has always seemed to me a reasonable deal.
The semi-requirement that you are in the catchment area is no longer always followed - I stuck to my old Westminster GP for 10 years till she retired (a wonderful Norwegian - used to spend a month every year volunteering her services in Haiti) and the surgery merely said well, it means you won't get house calls if you're on the other side of London. I think it's time to get rid of it officially and allow people to choose any GP, with the house call aspect (rare now anyway) as one consideration to weigh up.
The "call at 0830 crap" was a direct result of Labour policy. Tony insisted that appointments had to be avaliable at a days notice, with financial penalties for not doing so. GPs therefore would only open some slots on the day.
There is no financial cost to the patient for healthcare, so access is rationed by other means. I don't think this is nessecarily fairer.
I must have a GP with a superior service, as they operate a "call at 8:00 crap" feature :-)
Excellent article Alastaire. I think you have got the the Remain tactics absolutely right and that's what I'd expect to see. I was speaking to an advertising friend the other day and he thought the campaign would be full of high tech ads showing EU projects with the UK at the vanguard... snip ...
Great idea. Remind us where the EU gets the cash for these projects.
Oh yes, we pay it to them. And they skim it, and give some back.
Leave can always counter with publicity for the European funded motorways to nowhere, and abandoned ghost airports. Not to mention the large scale frauds. Billions of wasted Euro.
Of course there are ways to counter it but the point is this; There's no sensible way of selling REMAINING without selling the EU itself. At the moment one of the reasons LEAVE has as much traction as it does is because the EU looks broken. It's the first job of the REMAINERS to show that it isn't .
One of REMAINS problems is that there has been a consistent stream of negativity from certain parts of the media about straight bananas and the like.
Remains biggest problem is that the people who are leading the campaign have spent years telling us how awful the EU is.
Well, it's an attempt to be positive at least! It demonstrates very little confidence in the strengths and capabilities of the UK - we need to be in Europe because we are plagued with self-doubt, we are not at peace with ourselves and we are an economic basket-case. Hmmh, positive, you say?
The economic situation has changed dramatically since the 1970s though - arguably driven by our own reforms rather than Europe, and partly due to the growth in the financial services industry worldwide which we were well placed to capitalise on
As for "being a peace with ourselves", I don't know how old you are Alastair. I'm 40 and, from my perspective - and from the perspective of virtual everyone else in my generation - the Empire is a part of our history. It's interesting that we did it, it's nice to know the details but it has absolutely zero impact on day to day life or my philosophy of what it means to be British. That wasn't the case in the 70s and 80s (when our politicians had been growing up during the 50s and 60s) but today it's utterly irrelevant
Leave demonstrably is not at peace with itself. It has no coherent vision for the future, just a raving dislike of the present. A decision to vote for Leave will be a decision to leave present moorings and drift on the currents. Those currents look pretty choppy and the Leave ship is rudderless and the crew is arguing among itself.
Canvassing in south London last night - Labour ward - Remain and Sadiq well ahead. Labour voters more than 75% Remain.
Will they turn out thought (for EU I mean). Shame for Remain that not on same day.
Comments
Two years ago when my wife was very pregnant she fell outside and didn't feel the baby kick afterwards. We called her midwife who said to go urgently to A&E, we did and were made to wait for nearly four hours. During that four hour window we saw one genuine emergency arrive (someone arrived with a severed thumb) who was waived straight through to be seen immediately. Almost everyone else had trivial stuff like "I stubbed my toe last week and it still hurts" which I'd think should be seen by a GP. Didn't see anyone get triaged and told "this isn't appropriate for A&E call your GP".
EDIT: By the way I think ours should have been considered more urgent. When we were finally (just shy of four hours) seen by the doctor she said "You've felt the baby kick since haven't you" to which my wife said "no" and the doctor looked horrified. The nurse had entered the wrong information upon our entry. Thankfully everything was OK in the end.
£10.3bn deficit in goods #trade in Jan 2016, down from £10.5bn in Dec 2015 https://t.co/BoxHMSdxhf
A contrast with the US is that people consume politics more through social media, short TV spots with paid ads and minor local outlets than in Britain, where it's still basically the BBC or print media for most people. That gives American anti-establishment types easier access to the public with simple messages. Party selections are an exception because party members are atypical and will read manifestos, seek out debates, etc.
As I am no expert my views can be discarded, however the current system is dire. There are far too many visits to A&E that don't need to be in a Hospital.
In a small to medium Town - say 35000 to 50000 population having between 4 and 8 Drs surgeries is mindless stupidity. Ultimately the link between me and MY GP is unsustainable. I want access 24 / 7, which an individual is hard pushed to provide. I don't want to see my Dr and be told to go somewhere else at another time for a blood test.
Local Health Centres could provide all the GP services, some A&E services minor day surgery, lots of preventative work, 24 / 7 service and much much more far more efficiently than the current system. GPs in the current format are a road block to a better service.
Your last paragraph rather sums up one of the problems of the NHS, it is stuck in a straight jacket that reveres its founding fathers and systems in a monolithic and dictatorial way. It is hideously resistant to change. The model that it runs on is outdated and needs to reflect the changes in society if it is to have a successful future, not to provide the needs of a society that was current 50 years ago.
I think we are seeing a lot more disaffected Independent voters (non-voters) than moderate swing voting Independents. Very difficult to know what to will mean in November - they may simply go back to sitting it out if their candidate isn't on the ticket. For many I suspect it will come down to how much they dislike the other guy than than how much they love their own guy. In a Clinton v Trump race I would expect the Independents to break against Trump.
More recently (reportedly, didn't watch myself) Dimbleby asked if anyone in the audience wasn't a junior doctor.
Everyone time he grovels to someone, he looks weaker and weaker, and the other leaders can see it too.
He's doing a fantastic job of diminishing the UK's standing in the world, with the whole 'too weedy to stand alone' routine. Silly man.
My first Brexit referendum forecast with @alanjrenwick : Remain 58% vote 87% chance of winning. Based on x-nat historic and current uk polls
These are the regions where people are most in debt https://t.co/xPtBTtIKNy https://t.co/QONZix1UeF
That ship sailed several decades ago.
'Obama criticising Cameron over Libya...'
Must really hurt coming from a president that's been in power for 8 years and achieved zilch.
We do have some facts though from Labour directly. Corbyn got just less than half the vote of members, so would have won on the second round rather than the first round had the party been of members alone. However the membership was open to entryists until 12 August (and even had the deadline extended due to such a high number of sign ups).
(No, I haven’t got a PhD!)
Edit: There are times when a second opinion is valuable, news eyes see different things.
And how do they know they don't want access to a local quality 24 / 7 service? Illness isn't done to a booking schedule.
Indeed, consider the current situation. Many people have access to clean water, healthy food, and are managing to inflict chronic conditions on themselves by lack of exercise.
Just on surgeons: the Romans had special tongs for the removal of bullets (from slings). Bit sad that surgery could be relatively advanced then, only for it to crumble and be replaced by part-timers a thousand years later. Galen first noticed the head was the repository of the mind when he worked on gladiators suffering head injuries.
http://us2.campaign-archive1.com/?u=4761a1f83089fd89eba4fef19&id=bb64a61c2d&e=[UNIQID]#mctoc7
Short and sour for the Lib Dems, and essential reading for anyone interested in that subject.
Oh yes, we pay it to them. And they skim it, and give some back.
Leave can always counter with publicity for the European funded motorways to nowhere, and abandoned ghost airports. Not to mention the large scale frauds. Billions of wasted Euro.
There’s some suggestion,too, that saving lives that would otherwise have been cut short by disease has contributed to the rise of dieases which commonly arise in later life. Another factor to be considered is is the disproportionate loss of life in two world wars, in Europe especially,of the brightest and best.
The Lothian Birth Cohort research (http://www.lothianbirthcohort.ed.ac.uk) shows this clearly in respect of WWII.
It should be possible to make an appointment anytime and get the next available appointment and wait. Instead to massage their statistics when they've filled all appointments they simply stop taking them.
No private company would ever do anything similar, turn a customer away and tell you to call tomorrow instead.
As for the suggestion by someone below that people rarely change GP's which implies people are happy with the service - changing energy suppliers etc is also rarely done.
http://www.bbc.co.uk/news/uk-england-35200033
Mr Hunt's solution: antagonise all the remaining doctors and worsen their conditions. Genius!
The economic situation has changed dramatically since the 1970s though - arguably driven by our own reforms rather than Europe, and partly due to the growth in the financial services industry worldwide which we were well placed to capitalise on
As for "being a peace with ourselves", I don't know how old you are Alastair. I'm 40 and, from my perspective - and from the perspective of virtual everyone else in my generation - the Empire is a part of our history. It's interesting that we did it, it's nice to know the details but it has absolutely zero impact on day to day life or my philosophy of what it means to be British. That wasn't the case in the 70s and 80s (when our politicians had been growing up during the 50s and 60s) but today it's utterly irrelevant
EU trade deficit - £8.1bn
http://www.ons.gov.uk/economy/nationalaccounts/balanceofpayments/bulletins/uktrade/january2016#main-figures-for-january-2016
Underlines why leaving the EU isn't going to be as dire as some on the remain side would like us to think.
I would add that our history and our Empire did show what we can achieve - the defeatist wet attitude of many today makes me roll my eyes.
As Foxinsox reminds us, there is a recruitment and retention crisis looming and perhaps that, together with increased demand as the population increases, is making it more difficult to get an appointment.
a) the GOP could change the rule, as the first item of Convention business. But the optics would be terrible, if Trump is the only one to pass the current rule, as seems likely.
b) Delegates are bound to their candidates on the first vote proper. It seems farcical that they could defect purely to permit the nomination of a candidate they are unable to vote for. Puerto Rico delegates are bound to Rubio. PA might be theoretically possible. That's one state which might have the required leverage. So someone needs to win seven others to make PA relevant. The only someone that could possibly be seems to be Cruz, if he wins another three delegate majorities. Why would the GOP stitch it for Cruz?
c) The rule says eight "states", which implies the territories such as Virgin Islands don't count for nomination purposes. Again, it would seem ludicrous that microscopic places outside the US - who can't vote in the general election - could have such an impact on the process.
d) Trump looks likely to win an overall majority of delegates, in addition to at least eight state majorities. So a), b) and c) become moot...
All thanks to Alan Johnson, the Health Minister who manages to make Cameron look like the World Champion at contract negotiation.
What was the “household drink” in Byzantium? Watered wine?
Let's hope so...
Take natural gas. We import natural gas from Norway (non-EU import), and then re-export it it to Ireland (EU export). Of course, as the Irish company has directly contracted with Statoil for the supply of gas, all we see is a 'toll' for its passage through pipes in the UK. Nevertheless, from an economic statistics point of view, it gets added to both exports and imports.
Wine drinking may well have declined after the Ottomans conquered it. Not sure how strict they were about such things.
These are just warm-up holidays for MPs' lengthy summer recess.... https://t.co/TP6h01OD0V
@rosschawkins: McDonnell: we are the party of the wealth creators
The semi-requirement that you are in the catchment area is no longer always followed - I stuck to my old Westminster GP for 10 years till she retired (a wonderful Norwegian - used to spend a month every year volunteering her services in Haiti) and the surgery merely said well, it means you won't get house calls if you're on the other side of London. I think it's time to get rid of it officially and allow people to choose any GP, with the house call aspect (rare now anyway) as one consideration to weigh up.
McDonnell: we are the party of the wealth creators
Bwahaha
http://www.sportstradingnetwork.com/article/what-election-bettors-can-learn-from-pro-sports-modellers/
The likes of @DavidL, @Casino_Royale, @rcs1000 are all at peace with themselves. The likes of Tony Blair may be at peace with themselves - but they probably shouldn't be.
The BMA GP negotiators told the DoH that Out of Hours care could not be done at the price that the DoH wanted, so the DoH insisted that it would do OOH care. The BMA were right on the costs and difficulties, the DOH wrong. It frequently happens.
I qualified in the late eighties and my medical school year group on Facebook is a pretty demoralised bunch. The only happy ones seem to be those in Australia.
He played his cards very well last night.
Funny how so many ex-pat NHS zealots abandon principle, and embrace private healthcare when it's warm and sunny outside.
This is not about individual happiness - if so, I suggest ardent Leavers take up watercolour painting, origami or rock climbing rather than tinkering with Britain's place in the world. It is about setting a direction for the nation as a whole: collective happiness if you like. There is nothing on the Leave side that gives me any hope that a decision to Leave would increase the collective happiness of the nation. The very opposite.
There is no financial cost to the patient for healthcare, so access is rationed by other means. I don't think this is nessecarily fairer.
Other than giving us a small fraction of out own money back, not a very valid argument, what does the EU do now that isn't broken?