And where is Sarah Wollaston these days?
Remember this news about the suicidal girl who could not be admitted because authorities could not find a bed. What did the judge say ?
Sir James said: "I feel shame and embarrassment; shame, as a human being, as a citizen and as an agent of the State, embarrassment as President of the Family Division, and, as such, Head of Family Justice, that I can do no more for X".
This is not sensationalism.
Where is the responsibility of this JAM(just about managing)government led by the JAM prime minister?
Another good teaching material is about the Labour MP
wrote her comments in a right wing 'popular' media and ended up resigning her position in the shadow cabinet.
Furthermore , the relationship between the media and the government should be about 'checks and balances' , not
propagating its political agendas.
Those who studied journalism and took that as a career should know about this code and conduct very well .
(1) I can accept the politically correct statement that everybody from these different angles should be responsible.
(2) Then who and what are actually reporting the ,at least , near to the truth and based on these objective 'facts' , making the subjective opinions?
(3) The remarks made by those with most political and media power are the most influential as far as the public is concerned.Hence , these people have more social responsibilities and should be careful in giving the opinions . Donald Trump is a very good educational material to demonstrate this argument. Daily Mail and its collaterals are supposed to be one of those 'most popular' media .
Like I said always
Resources mean money , manpower, expertise and time simultaneously, one for all , all for one .
Now , we have evidence what poor resources can do to patients.
Without investment of new resources, STPs are dangerous.
It is not a matter of giving NHSE credit because the word is always responsibility. After all , it is a subordinate body of DoH and government. Why are we in this mess now? What is the source?
Ice deep frozen down to three feet is not due to one day cold.
Have you not noticed CCGs have lately become 'common enemy' in the limelight and ironically, NHSE , in the eyes of some of us , actually derserved some credits as they did recognise the existence of our crisis?
Of course , the incompetence( malevolence, otherwise) could have originated from a CCG board but where is the source of the evil , otherwise.......? (Jon Snow said his father , Ned Stark, taught his children,' everything before the word BUT is horsesh*t)
And Jamie Lannister's father taught his children,' the lion doesn't concern himself with the opinions of the sheep.'
I suppose my idea of all CCG commissioners to walk out as a protest to the government, is always imbecile.......
(1)'To help the weak and aid the needy' . I am not the most religious person but I think that is one of teachings of Jesus Christ , isn't it , Helen?
(2) 'Too expensive ' to have video recordings and two examiners . Seriously, money is really the most important argument here?
(3) Then a good breakdown of how the money ,acquired from examination fees and continuing membership , was spent should be published. Transparency, please .
Yes , you can call me a anti-establishment demagogue,(can't be more worse than Trump anyway).......
No disrespect to Bob.
More a eighthies' fan.
UB40 fans .
Less original, their cover songs of others:
Red red wine
Can't help falling in love with you(still remember watching Sharon Stone's crappy Sliver!)
I got you babe
There is a Chinese saying,'' the luckiest doctor is the one always greeted by his parents towards the end of their illnesses.''
Yes, vote of no confidence is a good 'nuclear' weapon but it must be 'meaningful' depending on the circumstances.
In fact , liberty had often taken eqiality for granted .
There are multiple interesting issues here:
(1) Students from affluent families are more likely to enter medical school.
(2) These medical students from more advantaged backgrounds are less likely to become GPs.
(3)Private schools are doing better than independent schools as far as medical school entrances are concerned.
(4)There are relatively less representation of ethnic minorities in medical schools and hence , medical professions.
I am not attempting to find the explanations for these 'phenomena'. All I would say ,instead ,is the degree of extremity in each phenomenon reflects the kind of society we live in and the type of governing hierarchy.
The conflicts involving social classes , ethnic origins and religious beliefs have never stopped in human history. The notions of 'some types are better than the others' and 'we want to stick with the same type' continue to haunt our consciousness deep down . It is perhaps a naturally occurring temptation to use these arguments, if they apply, whenever there are disputes and differences in our societies: rich against poor(e.g.capitalism Vs socialism), racial conflicts(e.g. whites against blacks) and religious tribalism (e.g. Christianity Vs Islam) . The list can go on with further breakdown in term of differential polarisations. Even George Orwell was suspected for his intentions when he wrote the prose 'Antisemitism in Britain in 1945 .( read it for your own judgement).
We let the disputes and differences ferment into divisions and prejudices . With the catalysts of arrogance and bigotry, we took adversarial actions against each other .
May be , we have more liberties in 21st century with the advent of IT technology and globalisation but inequality is never a question being answered properly.In fact , liberty had often taken inequality for granted .
It is saddening yesterday to see a quick revision of the American Civil War when white nationalists confronted viciously with counter-protesters as the statute of one Confederate general was to be removed in Virginia.This took place in the country with largest world economy led by a president who only favours Twitter as the mean to convey his arrogant and belligerent comments to his people . Locked and loaded , he is now 'ready'(at least , verbally) for a war against another Mad King in North Korea
Mencius said ,''those malevolent with no virtues occupying high positions in a hierarchy spread the evil through the most.''
Evil Mao also once said , ''there is no love coming from no reason and there is no hatred coming from no origin.''
What could be done better ? We still turned to our political leaders . In fact , we elected them to represent and 'educate' us so as to find the way forward . In critical times in history, we need leaders with visions to create a relatively harmonious environment. The task of preventing extreme ideologies to creep into the mainstream is paramount.
Yes , it is easy said than done when you have a ,what appears to be, 'dire' reality. But in times, our expectation (in my opinion) could have been met by some humility and honesty from these elites we had chosen. Unfortunately, the old mistake of succumbing to self and partisan interest overruled the quest of social justice . It was a rarity to see a US veteran Republican senator to vote for his principles but against majority of his party in a repeal healthcare bill(though contentious in nature) established by the previous president of the opposition party, shortly recovering from his major operation to remove a nasty brain tumour.
Before he became prime minister in 1940 , Winston Churchill was alone with very little support from Tory party led by his predecessor for his stance against appeasement policy on Hitler. His principles triumphed eventually but was not with sacrifices.
Despite how much we complained of the adversities we are experiencing in our medical profession(s) , our young generations continue to show great passion and enthusiasm for medical school training. Most of my daughter's classmates want to do medicine as long as their grades will allow(she made up her mind to do environmental science long before). Why?
Doctors are the most trusted by public . This has become a common knowledge, poll after poll; study after study. If one fails to recognise the humility and honesty from our politicians, doctors can be the sanctuary to provide the trust he or she is yearning. Generically, we have halo on top of our heads. The mission of 'saving lives' is supported by medical science but we all know it is always about treating the whole person. Medicine is an art , not a science. The popular culture might have a parochial view that specialist doctors like cardiac and neurosurgeons matter a lot more . To some extent , it is an appeal to our youngster from elite families . No disrespect, the truth is family doctors are treating patients with multiple characters from different backgrounds everyday in the frontline.General practice is even more artistic as we look after collectively the physical, mental and social well beings of these patients and their families we know well .Something people tend to forget so easily . A consultant colleague told me a few years ago ,'' I cannot do your job , it is so hard to do your job well these days.''
Frankly ,the way general practitioners being treated by this government is disrespectful. But that just demonstrates one of its failures to address the best interests of people in the country, especially those just about managing (JAMs) famously highlighted by our JAM prime minister .
If the arguments mentioned in this article are correct , the government should be targeting at more non-affluent students(less likely to enter medical school) as they are more likely to become GPs . It has an ambition of 5000 more GPs by 2020 to fulfil. What you educate and train today are the ones who will potentially maintain the pillars in 20 years time. Rendering them debt stricken on leaving 5 years medical school is certainly counterproductive and nonsensical.
As I said many times , we did not start this war in the beginning but it is now prudent for those key opinion leaders (KOLs) representing us to fight at all corners against this government to secure better terms and conditions for this profession and its forthcoming generations .
There were certainly other better times to be a GP.
But at no other time in history,choosing to become GP is more admirable and respectable..........
A few points to consider and I could be wrong:
(1) One million dollar question about the UK economy is : will interest rate rise in the next 12 months ? Inflation rate has recently climbed down from 2.9% to 2.6% but is still higher the rise in wages. Spending power remains weaker and hence rise in GDP blunted in latest quarter . Biggest problem is the steriling which can easily depreciate further any time as a result of uncertainties associated with Brexit. Inflation can reach 3% or beyond? Many are now speculating a rise of interest rate to 0.5 and then 0.75% by next summer . This is a short term situation.
(2) In time like this , investors would be hesitant but if their investments are guaranteed return of revenues like primary care premises mentioned in this article. This is an opportunity when interest rate is low . As far as The City(London exchange market) is concerned , the long term prospect (25 years) received the blesssing of Mark Carney recently , provided this country could survive Brexit.
(3) Stevens is rushing STPs through , Naylor Reoprt/Review (read it if you don't know what it is)will be enforced on one hand and these primary care premises will be built . The former pressurised acute trusts to find 'surplus' land and buildings to sell to private devolopers and the latter will provide massive premises only for mega/super GP practices, MCPs or PACS. Overall , NHS Property Services will want to diminish the size of the estates it currently holds. Devil is always in small details.
(4) We are where we are , I can understand some will say to keep an open mind. But it is about terms and conditions as well as checks and balances . One can easily imagine which direction the rent will go , once the cycle of inflation , hence , interest rate rise begins .
This is on recent BMJ:
WHO downgrades oseltamivir on drugs list after reviewing evidence
BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2841 (Published 12 June 2017)
Cite this as: BMJ 2017;357:j2841
Evidence of the Minimal Benefit of Oseltamivir (Tamiflu) is Now 18 Years Old
And if you have the patience , read my long comment titled 'To Madam , with Love'.
I wonder what Helen would say after reading this list??
I would add:
S**t happens everyday but the new world can still be brave
And read PULSE?
Declare of interest : I am not an employee of PULSE , what so ever .....
Of course, young lady, five stars
Thank you for an inspiring article.
I guess all developed countries are confronting the same problem of capacity to cope with needs from ageing population as well as rising cost of medical care ,
It is not surprising why Trump walked into brick wall trying to repeal Obamacare . Thanks to the likes of John McCain's honourable vote immediately after his glioblastoma surgery .
It is always an argument whether people should see specialists directly without involving the middle man , hence , the gatekeeper. From your article , it appears reality has reinforced the role of general practitioners instead.