All I would say is all sectors are trying to protect themselves and cover their backsides while we have a government lack of vision and leadership, dogged up u-turns .
PS salute to Rashford 👍👍(despite me being due hard LFC fan😎 )
....which we are yet to fully understand......
(1) Interestingly , the issue has turned out to be a matter of vocabulary: ‘They must.....’ against ‘ They should’ as far as a public heath crisis is concerned.
（2） I can live with the logical argument of ‘ one size cannot fit all ‘ . But one would argue what is the evidence to support secondary care is a ‘Must’ and primary care is a ‘should’ ?The only condition here for debating is ‘when social distancing is not possible’ . Hence , have we already arrived at the conclusion that social distancing ( and vigilant cleansing , I would insist ) is NOT possible in hospitals but possible in general practice? Of course , that also justifies less PPE ‘can’ be provided to primary care centrally ??
(3)Then it is how this government has been ‘processing’ science to make judgements so far in this crisis , i.e. the track record for credibility. I would not blame the scientists as they are always carrying the baggage of living in the summit of an ivory tower . It is always about the leadership of a country to bridge the gap between complex knowledge( and layman public awareness . Yes , some kind of ‘gambling’ might be necessary but at a historic point like this , we need audacious and visionary leaders , not firefighting and pen-pushing technocrats( with only blind boldness to defend own reputation ) .
And I would stick to my argument that being pedantic is quintessentially part of the defence against an unprecedented enemy which we still yet to fully understand.
Speechless and hopeless 🤦🏻♂️
As I always said , incompetence is worse than malevolence.
The next BMA survey needs to include questions on fitness for purpose for both NHSE and PHE , full stop .
For those who completed the survey, I would say one question missing was ‘ would you agree to the statement ‘NHS England is not fit for purpose, given the circumstances‘ ？ ( call me a fire starter if you want）
NHSE and the government must be realistic rather than overpromising something impossible to deliver from Utopia .
Simply , you cannot get blood out of a stone .
(1)First of all , Jamie , it is important to be introspective and consciously ,sincerely examine our ‘mistakes’ every day . That is in line with honesty and humility to ourselves. What was considered absolutely ‘right’ in the past under the ‘right’ circumstances can become ‘absolutely wrong under today’s circumstances and virtues (2)Surely , identity politics has earned a lot more limelight in the last 5-10 years . The internet and social media , being a double-edged sword , have played a large part. We need to understand why our world has become so polarised right now ? And there is only one answer : we are human beings with our well known flaws ( e.g. seven sins if you go with religious faith). I suppose the more power one has in our societies , the more meaningful these flaws are .
(3) We have created this intersubjective reality ( as defined by Yuval Harari in his book , Sapiens (2011), highly recommended) with phenomena such as countries, borders, religion, money and companies, institutions etc ,all created to enable large-scale, flexible cooperation between different individual human beings. Problem is we, human , also attach our emotions strongly to these phenomena and complicate with a subjective reality . One line I always remember from Yoda in Star Wars is ‘Fear leads to anger , anger leads to hate , hate leads to suffering’
(4) I might be one of those who like to quote ‘famous’ people’s saying but I am also conscious the importance of falsifiability advocated by Karl Popper in philosophy of science .
But I would stick to my self-created motto( at least now) :
We let our disputes and differences ferment into division and confrontation . With the spice of arrogance and bigotry , we impose actions and inactions against each other .....
Thank you for writing this up in an article. What you described is the apparent phenomenon we are all conscious of everyday . Fundamentally, they represent , as I labelled in my previous comments, the deep-rooted structural imbalances and contradictions between us and government(s) .
Bottom line is like the name of Billy Joel’s famous song ,’ We didn’t start the fire’ .
PCN is an ideology moving towards funding only through big and bigger institutions instead of individual practices traditionally. The autonomy and individuality is ,of course, being crowded out by ‘one size fits all’ which incidentally, is what this government has been believing throughout. One can argue that this is the model which has failed miserably throughout the Covid 19 especially with lack of knowledge and loss of touch about the frontline situations .
My advice to you , young Padawan , is politics is never going to stop interfering your life as a GP( I would argue same for any other system in the world , just the difference in intensity). Only fight for what you believe , otherwise go back to the basics of what are the things most important to your life on drawing board ?
Life is only a journey , not a destination and life is short ......
Sorry , had said too much here really .....
I think the fact Pulse was considered and invited to ask him questions , means you guys have done well to raise the profile, Jaimie .
The reality is you more or less know the answers before asking the questions and there is no follow-up as expected . I foresee a very difficult September leading to Christmas for GPs . Winter is coming .....
.....1000 yuan per month ....,.
As I said from the beginning, Covid 19 somehow has an ‘ability’ to hit hard on those longstanding , bureaucratic ,intransigence/bigotry stricken behemouth-institutions with traditional power ( as defined by Bernard Russel in his 1938 book , Power: a new social analysis) ,we are now already witnessing some of the ramifications and consequences. The social norms and social contracts long laid down by various political , economic and social systems are up for a ‘Judgement Day ‘ . The common theme here is :any deep/rooted structural imbalance and contradiction in any system is brought right up to the surface vividly .
One can argue that the current protests sparked off by George Floyd’s death is not entirely associated with Covid 19 but ironically , we have a situation here in UK , at least , BAME population suffer far more from Covid 19 . Of course , our scientific cerebral cortex has concluded that the virus is not discriminatory . Still , the message of ‘something must be changed ‘ is reverberating .
In the Far East , President’s Xi’s humongous ‘Chinese Dream’ with the current declaration of a well-off middle class China , was seriously challenged by the official statement from his close comrade , Mr Li Keqiang( the Chinese Premier) in the 2 hour long press conference after the latest National People Conference(NPC). Mr Ki stated that about 600 million people( out of 1.4 billion total population)are currently earning 1000 yuan ( Chinese dollar: equivalent to about 0.1 pound ) . Covid 19 has certainly played a part as a trigger factor on their story .
For us (GPs) , we all know well what are the deep-rooted structural imbalances and contraindications in our system .Call me ‘naive’ , somehow , I have a ‘funny’ feeling about this post Covid 19 swathe of landscape .........
You all know my stance about face masks from Day one 😎
I bet the prime minister is praying right now that Mr Sharma does not test positive for Covid 19
Never dream for a single moment that I would get anything back from this government for the money I spent on PPE for my staff(I know , I know :some said that was the responsibility of the employer by default and stop moaning )
The truth is no expectation, no disappointment.
Good arguments are there .
All I would say is ‘old habit hard to rid’ in NHSE-CCG-STP
The old model of one size fits all again .
And this model had evidently been shown not effective throughout this crisis.
Salaried , registrars and retainers had increased in numbers. Partners and locums are diminishing.
And the total of FTE went done .
Well , the arithmetic is telling and the government should logically know where the focus of attention lies.
Guess not , GMS partnership is just too crap to be attractive.
NHS England's Dr Kanani said: 'We are not aware of this but are trying to find out more.'
Well , at least you were honest , in contrast to the so called ‘government spokesmen’ ( don’t even know whether that is a human being or simply a robotic recording ).
Otherwise , this is reminiscent of the sensitivity, awareness , in touch of the real world and of course , competence of this government through last 2 months .
How the history will judge , I leave that to your own device , Nickki...........
My only interest in this fiasco is on the political meaning to the system the government is supposed to serve .
If this country was China , Russia , Syria , Turkey , Brazil etc , Cummingsgate was an non-issue and we should not even talk about that .
Question in reality to the prime minister is , is it worth to pay so high political price in face of the check-and-balance (presumably a virtue we can still believe) ? The media , as part of the C&B will not cease throwing Molotov’s cocktails towards Boris and his cabinet . And he also knows that the Tory backbenchers , in majority, despise this quasi-Rasputin character . The fact that even European Research Group(ERG) led by our ‘favourite’ Red Skull is an enemy , simply means that date of Cummings’ political career is numbered .
I wouldn’t care less , otherwise .........
（1）What is interesting here is how the philosophy of the hitherto world of science conducting itself.l:
The article stated clearly in the Discussion section :
‘’The use of hydroxychloroquine or chloroquine in COVID-19 is based on widespread publicity of small, uncontrolled studies, which suggested that the combination of hydroxychloroquine with the macrolide azithromycin was successful in clearing viral replication.’’
（2）While these two groups of drug are well known for their benefits and side effects , especially the latter with QT prolongation common to both chloroquine/hydroxychloroquine and marcolides , the initial acceptance and insouciance of using these drugs so early in the pandemic crisis was phenomenal.
On the contrary , the controversy of whether face masks should be worn more liberally continues up to now . Masks are certainly not the whole answer but at the same time ,relatively and potentially much less harmful especially if social distancing deems practically impossible in circumstances .
（3）We are now in a phase of the pandemic when the social and economic outcomes are taking the main focus of attention instead . It is difficult to imagine taking a drug (if ever proven ‘effective’) can take the priority over a simple change in our daily social habit .