IntenseDebate - iannesbitt

3 years ago @ http://www.conservativ... - Kristian Niemietz: Wha... · 0 replies · +1 points

A simplistic article, peddling a narrow view, as with many such CH articles.

NZ- few points of entry (really easy to lockdown comparatively), small, more rural population, less ethically diverse, more inspiring and trusted leadership with clear policies- just a few reasons beyond the public/private point being made.

S Korea/Taiwan- SARS made a much bigger impact on long term planning for them than in W Europe: their action threshold was far lower than ours.

UK- densely populated, elderly co-morbid multi-ethic population with chronically under resourced healthcare (esp EPRR/Public health), thousands of points of entry, difficult to effectively lockdown and control, impossible to track & trace (and isolate) from the start etc etc.

I could go through other examples, but my point is that it's a very simplistic approach to link mortality with size of the public/private sector

3 years ago @ http://www.conservativ... - WATCH: WHO won't rule ... · 2 replies · +1 points

I think the message to take there is that lab escapes & accidents happen, and that once unleased can be unpredictable, not that we're throwing stones in glass houses.

It's not only sensible, but essential to investigate this properly. It's also highly unlikely the Chinese govt will cooperate properly.

3 years ago @ http://www.conservativ... - Sam Thurgood: The NHS ... · 0 replies · +1 points

One key difference between German/Swiss etc healthcare and the NHS is the amount of money they spend on it.
https://www.ons.gov.uk/peoplepopulationandcommuni...
(...UK spent £2,989 per person on healthcare, ....of the G7 group of large, developed economies, UK healthcare spending per person was the second-lowest, with the highest spenders being France (£3,737), Germany (£4,432) and the United States (£7,736).) So, you need to come up with a plan to squeeze another £1500 pp pa from the Great British Public if you want a German style system....

You can do as much structural reform as you want, but it won't help as much as properly funding healthcare.

Much of healthcare is reliant on people doing things, not machines, so you basically have to employ enough staff to do the work, and pay them enough, and treat them well enough, to make them want to stay.

The NHS isn't particularly good at that. Hence an overstretched system running at high capacity, with minimla flexibility to adapt to new challenges like covid (or even keep up with the slower changes in demography).

And (FWIW), there are lots of wasteful elements in German/French etc healthcare systems, so in terms of value for money, I don't think they are necessarily as good as their admirers suggest

3 years ago @ http://www.conservativ... - Sam Thurgood: The NHS ... · 0 replies · +1 points

The sector with least oversight is Private healthcare.

GPs & Trusts often complain about overly intrusive, frequently unhelpful, sometimes near incompetent investigations/regulatory bodies constantly pulling up the flowers to check the roots.

Look at the number of scandals involving organisations that had recently passed inspection with flying colours - evidence of the lack of fitness of the inspectors involved...

3 years ago @ http://www.conservativ... - Sam Thurgood: The NHS ... · 0 replies · +1 points

Competition isn't easy when the system lacks the redundant capacity to allow choice.

For much of healthcare in the UK, there isn't real choice (most private providers only do the easy stuff and nothing that won't turn a profit).

The longstanding elephant in the room is the lack of people willing to work for the NHS.
We're getting towards 100,000 staff short of what is required (other nations have similar looming staff shortages as demographics change), so the ability of the NHS to:

1. Catch up with the backlog of a year or more of covid cancellations
2. Keep working ever harder to keep up with ever increasing demand
3. Plan for the future properly, develop resilience rather than the brittleness we've seen in the covid pandemic

is extremely limited.

Many are suspicious that the ICS model is leading towards the US styled HMO system, whereby care is rationed, and dictated by insurers. You end up paying more and getting less for your cash.

Linking Health & Social Care is joining together two very expensive systems, so I'd be surprised if coverage doesn't become more limited, either by insurance (Continental model) or waiting times (old fashioned NHS model)

3 years ago @ http://www.conservativ... - Shifting health policy... · 1 reply · +1 points

the private sector was used, a bit, but given it partly relies on NHS staff to run it (in their spare time), and those staff were busy, it's hardly surprising that the private sector has had a limited effect on the pandemic

3 years ago @ http://www.conservativ... - WATCH: PMQs - "I and t... · 1 reply · +1 points

My original reply was deleted, and maybe this thread is already past it's best (morphing from the government management of covid to pet subject petulance from disappointingly ill informed posters like NorthernTory, although that's par for the course here tbh).

Anyway: please define "properly and fully locking down all the vulnerable but leaving the economy to carry on"
The modeling would suggest it isn't by any means as simple or effective as you might think or hope for, particulrly back in Spring when test/track/isolate capacity was tiny.

"...you can glibly dismiss the destruction of an economy when the cash is still rolling in for you."
Neither I, nor any of my colleagues glibly dismiss this. We all recognise we're fortunate to be paid 100% for working (maybe better than getting 80% salary for not working), and we avoid many of the frustrations of lockdown (it's hard to work in ICU from home...).
To insinuate that we're rubbing our hands with glee at this situation is just a nasty expression of your ingrained dislike for the NHS. As I've pointed out frequently here though, if/when you get an insurance model of healthcare, you'll probably have an anttack of nostalgia in your wallet when you next turn up to your GP or specialist.

3 years ago @ http://www.conservativ... - WATCH: PMQs - "I and t... · 0 replies · +1 points

Found it- it came from this thread (which for some reason only shows 48 of 93 comments, but it was c200 weeks ago) http://www.conservativehome.com/platform/2017/03/...

HEFCE has been disbanded since I posted that- perhaps it's successor organisation has greater BMA representation on it, but I'd still say that the contention that BMA and protectionist attitudes amongst doctors are the main (or a major) driver in determining medical school numbers is wrong

".........Q3: The Department of Health (DH) and the Higher Education Funding Council for England (HEFCE) share responsibility for determining the medical and dental school undergraduate intakes in England. (The strict constitutional position is that DH is responsible for determining overall numbers, and HEFCE has responsibility for the individual distribution to medical and dental schools).
The BMA and mainstream medics have little/no representation (the working party feeding information to HEFCE has several medical politicians on board, and some academics, but no wider representation, and they also acknowledge that CFWFI on which they base their decisions is fairly ropey)."

This link is slightly more recent, and demonstrates that Royal Colleges are asking for more doctors to be trained. http://allcatsrgrey.org.uk/wp/download/education/...

3 years ago @ http://www.conservativ... - WATCH: PMQs - "I and t... · 2 replies · +1 points

Yes, the BMA vote on lots of stuff they can't control or even influence, and many others they really should keep out of if they want to behave as a trade union.

Many working doctors regard the medical politicians of the BMA with a certain amount of contempt when they try to agitate beyond their supposed role as a trade union.

I guess you keep a 12 year old irrelevant vote that had no effect as ammunition to wheel out at times like this. I'll see if I can dig out the post I made here ages ago about the actual processes involved in determining med school numbers. You could look yourself of course....

3 years ago @ http://www.conservativ... - WATCH: PMQs - "I and t... · 1 reply · +1 points

Wm: I suggest you read this paper: Assessing the age specifcity of infection fatality rates for COVID‑19: systematic review, meta‑analysis, and public policy implications.
(GIYF)

After that, come back and see if you feel the same.

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