This is the fourth chapter of a novel that will be published in serial form in the Daily Sceptic. It’s a dystopian satire about the emergence of a social credit system in the U.K. in the near future. Read chapter one here, two here and three here.
Afternoon. A break from work, jogging.
The morning’s drizzle having given way to a full blown fog, Ella could just make out the shape of the path ahead, carving its narrow course through the fields as it followed the bend of the river. It was her usual running loop, and, however much the landscape had been transformed over the years, still, just about, enough of a space to think and just ‘be’.
Her mind drifted. You had to hand it to them, the way they’d masterminded it had been sublime.
Originally marketed as a purely voluntary scheme, the Health Efficiency Programme (as it had originally been named) had at first dangled common sense, appealing rewards and prizes–- free trainers, subsidised gym memberships, contributions towards e-bikes and the like. “Well, we need to get people exercising somehow,” she had said to her mother-in-law one weekend as they were pacing across some muddy field.
“A state which dwarfs its men, in order that they may be more docile instruments in its hands even for beneficial purposes, will find that with small men no great thing can really be accomplished,” her mother-in-law might have replied, but did not, instead nodding enthusiastically: “Yes I think so. They have to get everyone fit again somehow, don’t they?”
Reaching a fork in the path, Ella very deliberately took the low road.
That one clung to the river, and the route, though longer and much muddier, lent at least another few minutes of undisturbed nature to her run. The path higher up led out into what a few years back had been open farmland but whose last verdured remnants were now eclipsed by The Complex. Every time she ran this way, without fail she took the river route; along this path it was still just about possible to pretend she was still in countryside, at least if one blocked out the roar of the motorway to the left and the sight of the distant solar farms glinting on the horizon.
It hadn’t been long until rewards and freebies had became more overt nudges. Even then, though, the scheme had still largely been welcomed. “I like to see it as a promise, not a threat,” the ‘Right Honourable’ Minister for Opportunities, a weaselly little woman called Mrs Surrey, had soothed, her smirk barely perceptible, doing the media show-rounds.
To the extent that awkward-squad enclaves of freethinking dissidents urged caution – what if the scheme was extended to areas beyond ‘simply’ health, what if it became mandatory, what if nudges turned to sanctions and penalties – they were no match for the rest of those all-trusting know-it-alls. In a world where most had had blissfully little reason not to trust the Government’s word, that word prevailed.
“I can confirm that there are absolutely no plans to extend the Government’s ‘Good Health Rewards Scheme,” Mr. Wahazi, the Health Minister, had declared in Parliament around the same time, ostensibly putting the matter to rest, most people simply too busy with the treadmill of their lives to think too hard, or indeed at all, about the philosophical questions of Mill versus Rousseau and whether in this ditty little scorecard there might not lie the gateway to a fascist hell.
Jogging the last few paces of the field, she turned the corner.
From here, the dark, monstrous mass of The Complex could be made out, the towering, clinical symmetry of the Zeeta building and the huge oval structure of Demerna’s headquarters, its sharp, jagged edges and haloed centrepiece of spiked towers piercing the fog. However many times she ran this route her revulsion never diminished on sighting the colossal form springing up from the fringes of what had, only a few years before, been an expanse of countryside so peaceful and undisturbed that the first time she’d accidentally stumbled over it after moving up from London and realised it was only a stone’s throw from the house, she’d wept: actually wept, with the joy of understanding that there was a space so green and vast and sacred so close to where they lived.
A shuddering sneer. Like finding half a caterpillar on your dinner plate, or standing in dog poo, it was a reflexive reaction of which she was barely conscious and unable to control.
Shirles, to be fair, got it from the very first moment.
In Ella’s kitchen the day it was announced, Shirles had been listening to the lunchtime show on ADFREE News.
“Earlier today, Government announced its plans for the ‘Be Healthy’ voucher scheme. We want to hear your reaction,” the presenter was saying, as ever her straight talking Geordie accent sparking up their kitchen. “Do you think this is a good thing? Do you have concerns? Will you use it? Tweet us your thoughts.”
There was a bitter poignancy in thinking back to the days of phone-ins and free opinions and social media and presenters who were allowed to say what they thought and come to think of it entire TV channels broadcasting anything other than The Efficiency Agenda.
“I’m really not sure about this,” said Shirles, half watching, half chopping potatoes and shaking her head in a way that certainly had nothing to do with the potatoes. “There’s no such thing as a free lunch.”
“Hmm, I dunno,” Ella had replied, launching into a moralising lecture about how there was a serious obesity crisis in this country and too many people who wouldn’t take responsibility for their own health and how at some point people who couldn’t make good decisions surely needed to be coaxed and if they couldn’t be coaxed then surely a little push was okay.
Listening indulgently, Shirles had eventually chimed back,
“Yes, but they make it bloody impossible for us, don’t they? All those e-numbers and crap in the food. Everything in the shops is packed with rubbish. Most people don’t have time to do anything about it. Why don’t they start by fixing the food? Then people could chose for themselves.”
Before Ella had had a chance to interject, Shirles was off again.
“Watch my words, it’ll not be weeks before they start demanding something in return. I wouldn’t trust them as far as I could spit them,” she added, a final shake of her head sealing the matter.
Shirles, of course, was right.
A few short years later and benevolent aunt had morphed to oppressive patriarch, all the while slowly stewing us all in a soup of our own naïve, blind consent.
Now up against the boundary of The Complex, Ella could see clearly now the endless state and industry buildings in their awful grim glory — achromatic turrets of science labs, an array of concrete blocks the size of football pitches each competing to be uglier, more brutal, less welcoming than its neighbour, incinerators with furnaces 50 foot high; the whole thing slowly metastasising, a cancer devouring the countryside.
Shivering at her dreadful naïvety she checked the time. 2:45pm. The light was starting to go. If she got back now she just might be able to squeeze another hour of work in before she had to collect the kids. Turning on her heels, she jogged back the way she’d come.
A couple of hundred metres or so along, she glanced back over her shoulder. A tractor ploughed the last remaining field. Set against the metallic monstrosity behind, it looked tiny and forlorn, an insignificant anachronism in a world moved on.
Look out for chapter five next week.
M. Zermansky is a pseudonym.
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Should sharply reduce iatrogenic deaths.
That might be true if the entire upshot of the vaccine programme were not…iatrogenic deaths.
Absolutely true!
First principle of medical intervention – do no harm . Whatever happened to that?
( No money in it!)
My GP practice had a fairly good online booking system until 2020. It has now changed and all that’s on there are links to private services for physiotherapy, counciling etc. Etc. Oh and as of writing there is 1 phone appointment. For 28th June at 07:15. Of the 6 practices they have taken in approx £1.5 million in Covid jabby fees. So they don’t really need to do that old fashioned Doctoring any more.
I’m exactly the same, I’d like to earn more but there’s literally no point being stuck at a desk all day when half your effort goes to the state.
If they really did want to increase output, they’d get rid of the tax burden stopping us doing it
just half?
Income tax
+ Employer NI
+ Employee NI
+ Corp Tax
+ VAT
The Tax burden on the middle class worker is, in total at, or around 50% as far as I can gather.
When I began work in 1976 I paid around 30% of my wages to central government for everything.
My parents paid rates on our home, but that was about it. My grandparents could live reasonably well on their state pension whilst living in their council houses.
Now, I don’t expect us to go back in time. We were not contributing enough to avoid the demographic time bomb we are now living through however, our governments of the time knew it was approaching, and did nothing.
Where then is the accountability for their neglect?
Not one has ever been sanctioned in any way for it, instead, they are lavishly awarded titles and invited into highly paid jobs in the private sector with gold plated public sector pensions awaiting their retirement.
My continuing beef is that there is no accountability for failure.
And what real, national successes can we really point to since the second world war?
You think WW2 was a success?
Exactly how were the British people better off in 46 than they had been in 38?
I didn’t say WW2 was a success. I said since WW2.
Wot?
You mean the Laffer curve is in action again?
Nothing like using state grants to advertise private services. In most countries that would be called what it is. Ditto with “I can get you an earlier appointment if I refer you privately.”
Probably best you don’t ever make a grammatical error a spelling mistake or a typo in future. People might be inclined to berate you with CAPITAL LETTERS.
In Wembley it took me over 2 weeks before I could speak to a doctor on the phone & then a further two weeks to see her, miracle of miracles, face to face. The first time I’ve seen a doctor in over three years. When seeing her she noted they had requested an x-ray & asked if I’d received an appointment which I hadn’t. It’s now about 3 months & I still haven’t received an appointment date. But when you read there is a waiting list of 6.5 million people many with life threatening ailments you end up just shrugging your shoulders & thinking, “I’m 80 so what will come first my appointment or the Grim Reaper”
That 3 day week is largely a consequence of them being overpaid – working less reduces their tax bill and still gives them a confortable income. I’m self employed and I manage my own work to reduce my tax liabilities, no surprise to me that doctors do the same.
It’s 80% of GPs who work part time now – and up to 95% of trainees who say they will work part time.
They are struggling with workloads don’t you know. Weirdly A&E departments get filled with people with worsening illnesses – maybe a parliamentary inquiry could be set up to take a few years to discover if these two things are related
Havin a laff intcha…….
https://www.thetimes.co.uk/article/longest-waits-at-aande-since-2004-show-nhs-faces-severe-strain-j37zhcsc6zd
A&E went under the hammer when Gordon “I’m a ****ing idiot” Brown doubled doctors’ salaries and told them they didn’t have to work weekends.
What else was going to happen? And now, the only way to guarantee seeing a medic is to go to A&E. Again – what the **** else did they expect would happen?
Also, a high number of GPs are women, who work part time so that they can look after children. My own GP is one such; she only works a maximum of 2.5 days a week, most of that now being by telephone. In the practice as a whole, there is 1 male GP. There may be a lot of GPs named as working there, but as the majority only do part time hours, in reality there’s not that many. Even so, they shove as much as they can of the face to face work onto nurses.
Nice “short time” work if you can get it !
Yes, quite.The practice I’m registered with has loads listed, but all appear to be part time and I don’t think I’ve ever seen (or more often spoken to) the same one more than once. There’s no continuity at all.
Had to recently request a report for work on a long-standing issue. Never sought any assistance for it since I’ve been with that practice (I learnt years ago that the NHS has no help to offer) and never discussed it with them. I assumed that when work put in the request one of the GPs would at least call me to discuss it – but no. One of them (who I have never met or even spoken to) wrote a brief and useless report largely from old medical records of years ago (some of which were wrong – which I wouldn’t have known otherwise). Utterly useless.
I thought about changing to another practice, but there are only two in the town, and the one I’m with seems to be regarded as by far the best of the two!
I was a cop in the 70’s/80’s and we had an Indian doctor on call specifically to take blood from suspected drunk drivers.
He worked as a GP but was on call and would frequently attend 3 or 4 stations in the division every night he was working, which seemed to me every night in life.
No doubt he was well paid for his attendance but the guy worked his bollox off. I have no idea when he slept as he was frequently in the station until 5 or 6 in the morning.
He also happened to be a totally brilliant bloke. He recognised me in a motorway service station somewhere between England and Scotland several years after I last saw him, and greeted me like a long lost relative.
I remember Ted Heath putting the country on a 3 day week to save energy owing to industrial action by coal miners and railway workers in 1973. They found out later it had little or no effect on industrial output which showed how inefficient industry was in the 70s.
Isn’t the Master Plan to do away with General Practice altogether as a method of diagnosing and responding to patient need? Do they not fancifully imagine that they can Digitalise the whole system into a Virtual Appointment culture where algorithms diagnose, prescribe and distribute drugs for ‘patients’ from a Central Hub?
Patients traditionally kept in Hospitals will stay at home placed in Virtual Wards and ‘checked ‘ by text message. The “chipped” patients will have their bodily rhythms recorded and sent digitally for assessment and action.
In other words, they have a Great Reset, digital nerd led dystopian nightmare planned for us, where in the majority of cases, no human contact is involved.
How the are going to “manage” the anticipated explosion of illness and serious medical conditions as the direct result of the massive immune system damage (VAIDS) being caused by the mass vaccination programme is anybody’s guess.
I suppose encouraging people to “die quietly at home, after a short illness’ has some of it covered
They have that gizmo in Star Trek.
And Monty Python, The Machine That Goes PING
It would have some of it covered, but then there’s the disposal of the dead bodies. Two years ago ambulance teams were made to spend a lot of time polishing and re-polishing stuff and they were banned from attending “care homes” for reported respiratory problems. But boy were they allowed to attend to cart away a corpse after a person died.
(Sections covering the disposal of corpses were included in the Coronavirus Act 2020. Next time it’s not going to be pretty. Which isn’t to say it was pretty last time for those who choked to death in “care homes” because they were denied help.)
In my neck of the woods it will take my mum 57 weeks on the waiting list before she can have her cataracts removed. The other two local hospitals are not even performing cataract operations.
The NHS and the public medical system in this country is an utter disgrace and should be ripped down and started again. People first, not pharmaceutical profit and the inhumane digital dystopia.
It is currently being collapsed before our eyes!
The NHS inexorable collapse is like the fall of the soviet union, inevitable failure but takes longer than you think.
Another similarity is that it is an experiment in socialism. And as you rightly point out, it is doomed to suffer the same fate. I hope it takes the government and opposition with it when it falls, as it must.
Very few sovietologists before 1989 were predicting the short-term or even medium-term collapse of the USSR. Some were, but they weren’t many at all. Of course once the events of late 1989 had begun, the large majority didn’t like to draw attention to the fact that they had completely missed what was about to happen, in their own specialist field. (“The herd mind – what’s that?”)
I did notice the appalling failure of the west’s intelligence agencies in predicting well ANYTHING accurately.
JUST who were they spying on with all those 10s of billions of currency? I guess it was us !
They wanted my 85 year old mother mother to wait for 3 years for an appointment with an ENT specialist. That was 4 years ago. Luckily (I suppose) she was one of that generation who had suffered (genuine) austerity and had saved all her life, so she was able to pay to go privately.
At age 68, I’d better book my cataract operations a year before I anticipate getting any cataracts. My parents both had them at about age 75.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168597/
Maybe time to consider Keto?
Great foresight.
If she speaks to an optician, they may be able to direct her to a private provider who does nhs work. My Mum did this instead of going through her gp and got it done in weeks.
The other relevant issue is that sometimes one can see the same practitioner on the private side, rather than being on the waiting list in a nearby NHS place. This happened to me years ago, when I was working for a firm that had private cover for it’s staff. Like many places, the private place was literally round the corner from an NHS hospital. Certain specialists are allowed to work for both, with their time split between them.
“The NHS and the public medical system in this country is an utter disgrace“.
Agreed totally.
But Boris Johnson says clap to say “thank you”. It’s rather like saying “Thank you, Sir” when you’ve received six of the best.
Healthcare is generally very patchy across the country. I live in the West Midlands; earlier this year, within a month of my eye test I received an appointment, and within six weeks had my cataract surgery. Other medical procedures have also been dealt with relatively quickly. Seeing a GP is as difficult as everywhere else, with the same problem of part-time doctors, reception harridans, telephone appointments etc., but I cannot fault the speed with which tests and other procedures have been done.
Last August my own GP said to me “don’t bother with the NHS, how are you fixed financially”. Because he knew that I would have to wait too long for an appointment and then treatment at my nearest regional hospital. And he was right, they wanted me to wait 16 weeks for an initial appointment. That same hospital has a large sign up outside the main vehicle entrance which says that you have to phone ahead if you need to use the accident and emergency department. That’s right, in the new normal we now need to plan our accidents and emergencies. I imagine it’s all part of the new world order built back better to take us to net zero.
The 16 weeks is an inbuilt delay – nothing to do with availability. It’s either that or 13 weeks, a quarter of the year. The NHS has been doing this for ages. I’d urge anyone to keep onto the appointments system until you get the desired result. Write letters, make phone calls, they will give up eventually and find there is an earlier appointment.
imagine a business TRYING to delay paying customers, they’d wouldn’t stay open long would they?
Recently my daughter had meningitis.The ambulance arrived and rushed her off to the nearest hospital, where they said they couldn’t take her as they were full. So they then rushed her another 20 miles to the next hospital, where they refused to take her because they had not been informed. My daughter, lying in the ambulance, heard the paramedics arguing furiously with whoever was refusing entry, and eventually they let her in. By this time the strange meningitis ‘rash’ was joining up all over her body and her condition was very serious.
Within 30 minutes of admission my daughter was with consultants and on an IV drip. It’s thanks to the persistence of those paramedics that she is alive today. The whole experience was appalling and I still can’t get over how something like this could happen in a first world country.
Maybe we’re not as first world as we used to be. When they promised us healthcare free at the point if delivery from cradle to grave in exchange for higher levels of taxation. It seems that all that is left of that promise is the taxation bit.
https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us
“A long time ago in a galaxy far, far away….”
…. the vexxines made it to number one.
Primum non nocere (The Nutella Jar is Empty – or something like that)
Switch them to a per visit per patient fee. Introduce £10 fee for patients per visit handed over to the GP… GP gets balance from NHS once he has recorded patient visit.
This will cut out a lot of time wasters, and mean GPs will have to do their job if they want to be paid.
It is not administratively difficult.
There was a survey a few years back suggesting that a significant majority of GPs wanted a charge to be introduced.
That’s because GPs don’t like ill people, particularly ill people who are poor; because GPs are lazy; and because they like the idea of being slipped banknotes.
That’s roughly like the German system works. Health insurance is mandatory and there’s a default insurer who’s required to accept everyone. But doctor’s practices are private enterprises and compete for patients in order to get paid (at least in theory). Doctors who want to partake in this must not spend all their time on appointments but must have a so-called Sprechstunden (consultation times) during which everybody can just walk in and people get served one after another (again, at least in theory).
Sounds better (in theory).
Give all appointments immediately the need is identified – the same as happens in most of the rest of the economy (including car tyre changes and most dentistry). Fine the head of the health board and any medic who is involved 10% of their annual salary for every patient who is kept waiting more than 15 minutes for an appointment to be made. If it happens again, fine them 20%. Three strikes and it’s the sack, public exposure, and a lifetime ban on working in the health sector.
They wouldn’t like it up ’em.
Your suggestion would hardly change the behaviour of GPs at all, other than that they’d put in for more money to administer the money that would now be coming in from two sources.
The only way to improve services is through competition. Although the hysterical left hate the idea, the profit motive is what drives efficiency and improves quality and availability. Also, free at the point of access means the NHS will always have to resort to rationing to prevent demand from spiralling away towards infinity.
Mind you, as long the NHS is essentially a leftie pressure group, staffed by people who think of themselves as angelic heroes, and who detest the idea that everything comes at a price and resources are finite, it’ll remain the World Health Service and continue to drive immigration and freeloading.
Specsavers replaced NHS specs.
Just think if a similar de-extortion of funding could happen in GPs competing for patients!
Specsavers is an absolute horror to deal with if you’re above a certain age (seems to be around 45) because they have no real specialists there who are trying to solve customer problems, just more-or-less covert salespeople who are supposed to talk or trick people into buying stuff they neither want nor need.
[In my case, that would be reading glasses. It doesn’t matter how often I tell these people that I do not need glasses for reading, they simply ignore that and keep claiming that I certaintly must need them using loads of medically sounding technobabble]
Unfortunately competition requires excess capacity – unless you want price gouging and cartel behaviour.
We don’t have excess capacity.
When there is a supply side shortage you have to go the other way – prevent the private sector poaching doctors to serve only rich people.
Extortion funding requires insufficient capacity.
i.e. nagging is the currency to get treatment. for those who will not nag, bargain, nepotise or bribe they find themselves permanently at the end of a queue getting longer until eventually they may receive a meagre ration of treatment enough to shut them up and rejoin the queue.
We don’t have excess capacity when the services are free. At other price points, supply and demand would balance.
exactly, with it being “free” (well extortion funded to subsidise poor health choices) the demand is artificially excessive, not the supply.
Which is just about serving rich people.
Yes all that extortion subsidises the establishment very nicely.
That’s just one of the reasons it’s way past time to bin the dismal NHS
And replace it with what? The NHS suffers from the same entropy any large operation suffers from, and needs breaking up to force systemic renewal.
However there is no private mechanism that will deliver what the NHS delivers – because there isn’t the spare physical capacity to provide the excess supply required to make competition work.
All you end up with is the bureaucracy moving to the insurance companies – as we see in the USA.
The cost is then borne by poorer people.
The principle of free at the point of delivery based upon need not ability to pay stands and should be maintained. Unless you are into exterminating people.
You mean fining productive people to subsidise poor lifestyles?
Because that’s the main thing the NHS achieves.
The fee for NHS should be linked to the risk of needing services.
May as well privatise it in that case, and go for proper medical insurance, based on risk.
How do you know there isn’t excess capacity? If it’s being run as a workers commune where no one is motivated (by market forces for example) to do things better, faster, cheaper, then yes, all work expands to fill the available capacity. That could be improved very quickly by some focus on profit centres and cost centres. I read headlines recently where NHS managers were bleating about the financial cost of missed patient appointments. And yet the same NHS refuses to charge non payers (ie immigrants/healthcare tourists) for treatment, because ‘racism/white supremacy/diversity/equity/illegal immigrants welcome. The NHS is an experiment in socialism which has failed, and if it isn’t stopped it will eventually consume the entire National tax revenue for redistribution to the members of those workers communes I mentioned.
The lack of excess capacity allegation is disproven by the 60+% of GPs working part time stated above.
So that one’s going down in flames.
Curious how many Wah!NHS devotees want to continue with a system that reserves 1st world healthcare for the uber-rich.
our MMT nutter knows nothing about economics.
Go on then explain how staff in short supply and which you are fighting over are going to work 60 hour weeks for nothing.
Not going to happen is it.
“The lack of excess capacity allegation is disproven by the 60+% of GPs working part time stated above.
So that one’s going down in flames.”
How is it disproven. How are you going to get them to work more, when they can just go ‘no’ and go somewhere else?
Medical staff are in short supply, so you do what they want, not the other way around. That’s how market competition works.
Wow, the hard of thinking chap is half way there.
Incentives matter, medical staff are not in short supply, with 60% of them content to work part time with a luxurious middle class lifestyle funded by the taxpayer, there is a entiful supply.
Its just that as with most public sector workers, they are very reluctant to work hard or put in a full working week.
“How do you know there isn’t excess capacity? ”
It couldn’t be improved at all without trimming back the demand, or increasing the supply of doctors.
You can’t use profit and cost centres when you don’t have a surplus of staff. They will simply go somewhere else where they don’t do that and you will go bust.
Missed patient appointments are an issue, and that ought to be dealt with by eliminating appointments for GPs and running them instead like the A&E. You turn up, put your name in the queue, and you wait.
At the moment the GPs spend most of the morning checking and signing repeat prescriptions and most of the afternoon checking and signing sick notes. Appointments are fit around that.
There is an intense bureaucracy in the NHS, and too much paper shuffling that can be eliminated. They never walk back silly restrictions – like the masks we still see everywhere. A lot of that needs to go, but it is quite a challenge given the type of people in the NHS.
The NHS is paid for by time, not money. You queue and you wait. That’s how rich people pay more than poor people.
Some GPs overbook, i.e. like airlines used to do … maybe airlines still do.
The airlines have been doing that this week.
Far better just to get people to sit and wait. If you have to turn up before you get your name on a list, then you have invested some cost to access the service. Making it easy on an app with no come back doesn’t work when the supply is limited.
They overbook to cover their arses for no shows
Have you noticed what’s happened to the British railway system since privatisation?
It wasn’t really privatised (apart from freight).
The network was sold to Railtrack who were so bad that it had to be re-nationalised as Network Rail a few years later. Freight was privatised (and that seems to work). Passenger operations were split into a number of time-limited franchises (with government backing – if they went bust the government would step in). It didn’t work at all well and led to a load of fragmentation and duplication of management. Recently the government has taken back more control and the operators are on management contracts with little control but nothing seems to be improving.
I really don’t know what the answer is – the franchises didn’t work, and there were fewer and fewer companies interested in bidding (several of the big bus companies, who ran a lot of the franchises, don’t want to know now). But equally the government and their minions already appear to be making a mess of it, with service cuts right at the time when passenger numbers are increasing again.
It got a bit better than when the government ran it! I remember the slam door trains.
they were on the way out anyway under British Rail. If it got marginally better (it’s questionable) that’s probably because BR was starved of funds for its latter years.
Oh come on. Slam door trains were the most disgustingly grotty places to occupy the world has ever known.
Not that there was anything wrong with them other than they couldn’t hold as many people (crammed cheek to jowl) as modern trains, but they were just ill maintained and filthy.
In my opinion, used quite maliciously to shepherd in privatisation by misery. Nor do I object to privatisation, but had the unions any sense they would have made damn sure those old carriages sparkled every single time they hit a station.
The very few good ones I ever encountered were delightful to spend a journey in. Harry Potterish; genuinely comfortable for everyone and a moment out your life to enjoy being chauffeured to your destination.
Now we have utilitarianism, and we are expected to accept this as an alternative to driving in a comfortable car to work.
And whilst I hate the country clinging to Victorian/Edwardian/Tudor legacies (architecture is my pet hate) the country has lost a sense of it’s unique style and appeal by conforming, slavishly, to the clarion of modernity and minimalism.
We are one of the wealthiest countries in the world, why the hell should we endure IKEA type, cheapskate minimalism?
I’m curious to know whether these highly paid people have ever been able to cure anything (and that’s not sarcasm, for a change)
From the web:
‘Prof Thomas is a Professor of Surgical Oncology at the Royal Marsden Hospital, London and a Consultant Surgeon at the Lister Hospital, Chelsea where he is available for private patients.
Prof Thomas has a particular clinical interest in the treatment of soft tissue sarcoma, melanoma and parotid tumours’
But no mention in the article of merit awards and private practice amongst surgeons, eh JMT?
If anyone is interested, read this to understand how the changes in OOH care came about, and why it was necessary.
https://abetternhs.net/2013/05/10/true-history/
GPs gave up a monopoly in exchange for allowing private players into the NHS, which was what Bliar and Simon Stevens wanted all along. And a wad of cash of course, which was clawed back and more over the next decade.
Howzabout the squillions p****d away on the NPFIT? The NHS has become a Management Consultants wet dream.
’GPs work is far less complicated’ Here we see the traditional Specialist view of General Practice and GPs that hasn’t changed in my lifetime. However I also spent 30yrs as a doctor, and treated any number of specialists from the DGH’s in my orbit with stress and burnout, so frankly, bollocks to your personal opinion. With love, of course.
Acronyms? Not all of us have medical backgrounds.
BTL comments in the Speccie are similar to those here.
I left this country in 1996 and returned in 2012.. In the early nineties the NHS wasn’t too bad at all in my recollection but after returning here I noticed a marked deterioration, compared with both the NHS as it was and with GP consultations abroad. The events of the last couple of years catalysed the entropy. Even before that time general practice was coming to be seen as less attractive than it once was. What are you, a customer service agent for drug companies who does his best to avoid referrals to more costly and less profitable interventions.
Doctors are overrated.
Many African countries, following on from China, have found that resources are often better invested in paramedics with 6 months training. who actually visit sick people and have learned how the treat the ailments which make up the vast majority of cases.
You do need some doctors – but far fewer.
https://www.unicef.org/esa/stories/eritrea-revitalizes-barefoot-doctor-programme
Something like this could easily be implemented in western countries.
We already have this in the English urgent care centre system, or certainly in and around Leicester, Leicestershire and Rutland.
Both advanced paramedic and advanced nurse practitioners are able to prescribe. Also there are home visiting services where a paramedic, nurse practitioner or GP will visit a person at home if they’re unable to get to a UCC.
Theres no equivalent in either Wales or Scotland.
Thanks – didn’t know that.
It’s pretty uniformly dismal though…
That’s not fair.
I spent months being cared for at home by our ‘Hospital at Home’ team following an infected replacement hip, and they were fantastic. The concept is that they are based at the hospital you were treated at so you are not discharged. They have a direct line to your consultant so he/she knows what’s going on.
One visit to my GP some years ago was with a paramedic. He was very good, without the breadth of knowledge of a doctor, but only a call away from one.
We really must move on from demanding highly qualified doctors, being paid mega bucks per hour, for an ingrown toenail. It’s utterly ludicrous.
I have had far too many occasions when I have required the intervention of a medical professional. With a couple of notable exceptions I can truthfully state that diagnosis and treatment provided by a decent nurse is always way better than that of a doctor.
On behalf of my former nursing colleagues Thank you
My wife has trained you guys for the last 30 + years and insists there is nothing like a good GP. And a good GP relies on an inquiring patient.
Sadly, GP’s are now required to diagnose and treat by tick box. Patients accept it, invariably without question.
Our health is our responsibility. GP’s are a means to an end.
Malcolm Kendrick illustrates this regularly.
My understanding is that GP practices are private businesses contracted to the NHS.
But unlike other private businesses they hold a monopoly over a certain geographical area so they have no competition.
When I recently moved 5 miles to another village I was forced to change from a practice I had used for 30 years to a another practice. Why?
No GPs have out of hours so it makes no difference to them. Most appointments are online/telephone. Which works well for me 9 times out of 10. I am self-employed and don’t lose half a day’s work travelling and sitting for an hour for an always late appointment in an overcrowded waiting room.
In distance I am only 1/2 mile furher from the practice which is still nearer than the one I have had to change to.
My previous practice was rated good, the new one requires improvement.
So why do they have geographical monopoly.
Why can’t we choose? This would mean better practices would be rewarded and could grow and poor one’s would have to up their game or fail or be taken over.
Like any private company.
It is another example of health care looking after itself so the dross can keep going.
In the current scenario why as a GP would you go above and beyond?
It’s extortion funded, so it’s run for the convenience of staff not benefit to patient.
There are private GPs in the more populous areas, particularly London, and they are not particularly expensive. I haven’t used the NHS for a very long time. There are also a number of online GP services now, not so good if only because they can’t run tests, but pretty cheap.
With the internet, there are lots of experts available if all you want is to stay healthy, mostly doctors and biochemists. Two examples of very many I’ve found useful are Dr. David Grimes (UK) and Dr Robb Wolf (USA).
One can search online for others’ opinions of them. In the current climate, comments such as ‘too close to known vaccine shills’ can be helpful in knowing who to trust.
As there are around here. But that was not the point I was trying to make.
You can register with any GP, as long as you sign away your rights to home visits.
Apparently this is not a universal rule in England as I asked and was told no.
I can’t see the point of having a UK GP any longer, we’d get a better service if it were all done via the telephone from India … and it would cost a fraction of what they charge.
Yes and the language issue would be exactly the same!
But, but if the Wah!NHS got 100% of GDP until the heat death of the universe is should be able to cope.
It’s like running through brick walls in some places trying to see a GP – except for when they have some Big Pharma product to push in which case they can’t see you fast enough
The GP’s were told don’t come to work we will still pay you
Try getting them off their backsides now
I spoke with my uncled who is in his seventies and the things he told me about about getting old were very depressing. He said that when you’re young people will pay for your company but when you’re old you will have to pay someone to endure you. And the sense that you have to visit your doctor every month. We have made a very cold world for the elderly that are still alive and redemption should start with reversing this trend. It is the very opposite of the great reset agenda.
The complete failure of the General Practice system in this country is another crime against humanity (us) that can be laid fairly and squarely at Bozo’s door.
He’s building one hell of a charge sheet.
GP is a non-job, and typically British. It’s similar to how the legal system is divided here. “Members of the public” aren’t considered worthy enough to be able to approach barristers themselves – they have to go through a “solicitor”. Similarly if you’ve got a pain in your foot and you approach a foot specialist (on the NHS anyway), his receptionist will tell you (as if you’re an ignorant cretin) not to waste the great man’s time, and to go to “your doctor”, meaning “your” GP.
Imagine if changing car tyres was organised like that. “You can’t come here without a referral. Go to your local car boy. He’ll tell you whether you need your tyre changed. Perhaps you only need a new wing mirror.”
Even the word “doctor” when applied to people who happen to be medics who have never been anywhere near making three-year long contributions to knowledge in an academic environment (or five-minute contributions for that matter) tells you a lot about Britain. They all keep straight faces too, as they allow people to believe that they’re real doctors. If they could get away with it, they’d probably have patients referring to them as “Sirs”, e.g. “Go to your Sir”. The term “general practitioner” conveys additional ridiculousness. What’s the problem with calling themselves local area medics, or non-specialist medics, or prescribing nurses, or referrers? Are they ashamed of the job they actually do?
GPs are a bunch of lying, pennypinching expense claimers who think they’re highly educated and their “patients” (who in the NHS aren’t even their clients!) are mostly filth. (They are rather similar to many solicitors in that regard.) On this very website we had a medic who took pleasure in boasting of how he told his proletarian patients to make sure to close their toilet lids before they flushed toilets, so as to prevent “faecal matter” from flying all about the house. He seemed to assume that he wipes his bum cleaner than a manual worker wipes hers. Why on earth would somebody assume that? Because they’re a petty bourgeois (or possibly bourgeois) snob, that’s why. Because that’s how their parents brought them up, to think the “general public” are filthy b*stards who don’t have the intelligence or culture to deal with their own waste properly. What proportion of the population don’t close toilet lids before they flush away their poo? It’s probably about one person in 20 or 50.
If GPs get abolished, good riddance. And why have they been paid large sums for two years to do hardly any work? Sounds like a right cushy number. That must be why they whinge all the time.
People talk about self-sufficiency but this is difficult in healthcare. You need a skilled surgeon and a clean room at least. I would avoid ideas of trying to develop rudimentary medicine from scratch. There is an episode of The Twilight Zone called ‘Time Enough At Last’. A frustrated bank clerk with literary aspirations suddenly finds that he has all the time in the world. And then his specactles break. There is no self-serving way out of this situation.
Don’t be so pessimistic! There is much that we can do for ourselves by making ourselves healthier & more resistant to disease. Excellent resources can be found at the World Council for Health & The People’s Health Alliance – For The People, by The People (the-pha.org) where there is also at a list of practitioners.
Community solutions is what is required.
How can an organisation with 1.7million staff disappear off the map?
They refuse point blank to pick up the phone or treat anyone
Look at the people who live next door to you and decide which one you would go to in an emergency. Hopefully you will have a healer amongst you. If you don’t then it’s just waiting for the miracle to come. I hope that you have been building up strong networks of resilience in you area because you will need to do so.
An alternative healthcare system is being built in the UK. They are currently fundraising so that an emergency response can be provided outside the NHS – West Midlands Ambulance service has stated that they will stop taking 999 calls from August.
– The People’s Health Alliance (the-pha.org)
You know when a business has become too big and too bloated to operate efficiently, when it can afford to pay for the likes of external PR consultants, woke springs to mind but I’m sure there are many other examples. Put aside the word reset and replace with restructure, start with fattest, most bloated and most useless public businesses first.
Or diversity managers.
Indeed. Big business seems to be ‘bureaucracy central’. If you read the 2018 book ‘Bullshit Jobs’ by David Graeber, as he sets out, the rise in red tape has often been greater in the private sector than in the public sector. Counterintuitive, I know. He quotes figures from US state and private universities and elsewhere.
Yes, quite – the whole ‘diversity’ industry has balooned in the past decade, and on fairly high salaries too.
A few months ago I looked at the job adverts on the website of a small (less than 50 staff) wildlife charity. They were only advertising two, both part time but the full-time salaries were shown along with the pro-rata.
One job was leading a species conservation project – clearly required someone with strong knowledge and a fair few years of specialist experience.
The other was for an ‘Equality, Diversity and Inclusion Officer’.
Guess which one was on two grand more than the other…
Big business rivals the public sector in its waste and inefficiency. Same problem, better PR.
taxing on “profits” rather than charging for Patent and copyright protection leads to rent-seeking and the same problems as the current excess of government.
Have you had your jabs? No? Then get them. Your illness, whatever it is, won’t go away until you do. I will get you booked in.
You have had your jabs? Then your illness must be long Covid. Nothing to do with the jabs, which have saved you from getting it worse.
You see, I know how to play this game. So can I be a GP now please?
Giving legal protection to the term “doctor”, so that only people who hold doctoral degrees from recognised institutions are allowed to call themselves “doctor”, would help improve the general culture in the country where health services are concerned. At the moment, anyone is allowed to call themselves a “doctor”, which is why medics don’t get whacked for doing it.
I used to accommodate foreign students in my home. I would not do it now, because when they need medical care there is no longer a local doctor for them to see. Telephone appointments have a three week wait. No face to face appointments.
These young foreign women cannot understand why there is no immediate access to medical care in this country for things like normal sickness or headaches, things no-one in Britain would dream of being able to see a doctor for any more.
God knows what I would do if there were a true emergency, and I would be held responsible (at least morally) to their parents if something went wrong.
This has really brought home to me the parlous state of medical care in the UK.
I had to go to A&E after an accident 3 weeks ago. It was packed at 1 pm and had to wait over 3 hrs to be seen for a nasty but not life-threatening injury. The 3 people booking in in front of me should not have been there, each having some excuse for not seeing a GP, their obvious first port of call. The same was true of the 2 people either side of me when I sat down. There were frequent PA requests for people to go if their complaint was not serious but I only saw people leave on discharge.
A neighbour called an ambulance as she couldn’t get a GP appointment and thought by being trucked into A&E she’d get faster treatment.
if my experience is in any way representative then the system is broken. I can only see it getting worse.
FWIW once I was seen the NHS gave me excellent service, getting me patched up then operated on within 2 days.
The practices seem absolutely petrified of humans. Triage/telephone is as far as I have gotten – and these were frustrating/disappointing experiences.
The Practice has recorded messages stating that it is imperative that you must not visit the surgery if you think you may have any covid symptoms. Another message begs the caller not to proceed with an actual triage call unless the need is urgent; you are then steered towards 111. The Practice message also whines about being short-staffed, and under great pressure. Well, I can’t feel sympathetic as a lot of the problems/issues are of their own making I think.
A couple of days ago, I did call 111. Their recorded message included a statement emphasising that, for the vast majority of people, covid is very mild and usually you will get better in a few days; that you can also get over-the-counter relief as per cold/flu, so no need to worry about it at all – unless you are very poorly.
111 says not to flap about covid: it’s a mere trifle for most. Why then, if you turn up at A&E, you are met with ‘MUST wear a mask’ signs everywhere?
Blair started all this. Just turn up on Monday, 13th June at 1pm on Castle Hill, Windsor to express your anger at him receiving his knighthood on that day. If I were the Queen I’d miss with the sword.
Do an Anne Boleyn on him!
… they haven’t had any contractual responsibility for out-of-hours care since 2004.
Toni Bloody Blair: worst ever PM. Even Boris is less bad.
This is the result of successive governments providing perverse incentives. If only we could have a government which f***s off and leaves us alone. I can’t see that happening any time soon.
Many of the type of people who become politicians are those who like to interfere in everybody’s lives – either just because they are busibodies, or because it’s in the financial interests of themselves or their mates.
Exactly so.
The curtain twitchers of the nation.
We’re living the era of managed decline, Agenda 21-30.
Besides their efforts to depopulate the planet, they’re so obviously beginning to restrict our means of travel.
Today another cruise ship has crashed (the longest in the world, no less). Cruise ships and cargo ships seem to be crashing all the time now. P&O Ferries, the biggest operator effectively killed itself.
Separately today, I overheard on the radio a report about the chaos of trying to book a driving test. Apparently the system is in meltdown.
Rail/tube strikes. Roadworks inexplicably scheduled at the busiest time of year, preventing people from getting to the station on time for their train.
Airliners inexplicably cancelling hundreds of flights at the busiest time of the year. Queuing system at airports causing enormous waiting times. Passport service in absolute disarray.
Petrol and diesel pricing inexplicably exploding. Road maintenance (everywhere that isnt outside an airport or trainstation) has completely stopped, with pot holes wrecking cars.
Surely – SURELY – people can see what is happening. Surely they’ve seen Pfeffel attending Cock26 in Glasgow, lecturing the world that we must change our way of life and stop travelling?
This is a managed decline.
It would seem that way, and whilst I can’t entirely disagree with you, if it is the case then someone is making a smash and grab at ‘environmental’ globalised governance over a very short period of time, unreasonably so.
Which means someone is in a hellfire hurry to get it done. And the concept of revolution rather than evolution comes from which political side? The left of course.
And which leftist global leader has a right wing opponent snapping at his heels? Joe Biden of course.
And the way things are going, Trump is a shoo in for a 2024 re-election, and he’s going to go after every single one of the ‘deep state’ from the day he’s elected, and they all know it.
Biden has two and a half years to pull off his plan to globalise the world, there’s only one problem. Vladimir Putin.
The ‘Mad Vlad’ has thrown a spanner in the works and is exposing the environmental underpinnings of globalisation for precisely what it is, a massive scam.
Putin is a big country, small nation guy, with an approval rating of 83% at home. When was the last time, if ever, a western leader had an approval rating that high?
Yea, yea, I know. He’s a despot who beats his people into complying and his propaganda has them voting for him but, Russia has been, to date, an open country with people free to come and go as they please. They also happen to know what oppression looks like first hand, whilst the west hasn’t a clue.
I understand Putin has created a genuine nation state, with a clear delineation between the state and corporate interests, the state being dominant. By some accounts, he’s quite happy watching Oligarchs being sanctioned and having assts frozen by the west because they are criminal pest’s in Russia.
The dominance of the state might seem sinister, but without it there is no democracy. On the other hand, western states are infested with corporate interests, pulling the strings of government officials.
Fascism by any other name.
Biden, and the corporate organisation behind the the deep state (which is independent of Biden and any other POTUS) are being exposed by the very means by which they have seized control of the west; energy.
The industrial/military/pharma/enviro complex went too far, too fast, and Putin called their bluff over a tin pot, corrupt little country no one cared about unless they had money to launder.
He’s now holding the world to ransom over environmentalism and the climate change cabal who are using energy, or the lack of it from renewable energy, to break the back of Build Back Better/NetZero/Brave New World, whatever the current buzzword is for fleecing Taxpayers for global dictatorship.
Nor do I imagine Putin is working on behalf of the global community, or that he’s an altruist; no, he’s only interested in the independence of his own country and maintaining the values of an emerging democracy, which is far from perfect, but one which had a clean sheet of paper to start from.
By the looks of it, the biggest fear of western politicians is, that an unacceptable degree of Russian political simplicity may infect the west, and that would be bad for the entrenched industrial/military/pharma/enviro complex.
NHS have just released their new logo….
There are too many female doctors who are more likely to work part time: a long term problem that has been denied and certainly not addressed. Our old friend common sense tells us that this must be a contributory factor.
Gobsmacked! Phoned our Practice first thing this morning to try and request a triage call with a doctor. Recorded message: Practice is closed on Thursday 2nd and Friday 3rd for the Jubilee. We will reopen on Monday 6th. If your situation is urgent, call 999. If your condition is non life-threatening, call 111. Ta ta.
Wtf?!?
Well, if GPs can afford to work only three days in five, maybe we are paying them too much?
General practice is certainly in a mess (I’m a retired GP and pretty horrified) but I’m not sure that a retired surgeon with a chip on his shoulder is the best qualified person to diagnose the problems and propose solutions, his experience being based on a very restricted hospital based focus.
I can see lots of reasons for the problems we have, but no simple solutions
Just look at the take up on this petition. And it runs out on 22 June.
If any proof were needed that GP is broken, then it’s the need for the wording in a petition like this.
https://petition.parliament.uk/petitions/603305