Cheers Mike – good point about Utah – had forgotten that. Lived there for three months years ago – fond memories of the biking!

Bont – biggest toe box of pretty much any shoes on the market as forefoot design is very different shape.

They are also fully mouldable multiple times and crazy stiff (yet feel like wearing slippers). Have the road shoes and they are fantastic – if a little ugly!

There was an excellent presentation at one of the national conferences a while ago – healthcare is becoming unaffordable for the population of the world – not just the NHS.

More funding is needed but so is better efficiency and useful data on cost effectiveness and outcomes of treatments. There are lots of treatments done with not as much regard for effectiveness or cost as there should be…

Omar mail not come through? Cheers. jet.

Hi mate could be interested. Mail is in profile or use jamestoml at Gmail dot com

I would say it but I don’t think NHS consultant pay is unfair. I spent 15 years working 50-60 hours a week to become one and still work 45 hrs/wk and a 7 day week 1 week in 7.

We are well paid but we work hard both to get there and for the money when we do get there.

I think for some staff groups more pay would help but the problem is actually far more than pay – there are far more things that negatively impact morale than just pay in the NHS at the moment.

There does also need to be a sensible discussion about what to fund and not fund as everything isn’t affordable…..

Always love it when people belt it between average cameras then slow down as they get to them.

#fail

Also got a buzzrunner. Driven to Alps, Pyrenees, and multiple UK trips 200 miles plus each way with no probs.

Roofbox also carry spares – you can buy pretty much any but of the rack as a spare if needed.

Can’t fault mine. Hasn’t been treated gently either!

@mudmonster – assuming you mean leg nerve type pain by ‘sciatica’ most common cause is disc or spine wear and tear compressing one of nerve roots. In 90% ish of people it is a self limiting condition that settles with pain relief and symptomatic management within three months.

Initiative treatment is painkillers and stay as mobile as you can. Physio osteopath etc – can help.

If not settling by 6-8 weeks worth getting referred. MRI scan before that adds very little – treatment would still be see if it settles. (MRI is really a test for assessing role for surgery or other intervention such as injection).

Hope that helps. jet.

A google of ‘lumbar radiculopathy’ will get you lots more info

Spinal surgeon, NHS. Awesome job, mostly. There are some tragic things you just can’t make much better, but there are many more where you can hugely improve quality of life and take away pain. I am very aware that is a great privilege!!

May be wrong but there seems to be lots of chatter in the press about diesel restrictions in cities and significant rises in charges for having them – can’t imagine that will happen quickly but how long you planning on keeping the car?

Biggest win with NHS would be make it managed by cross party committee, not by government alone. Would reduce it being used as a vote winner with initiatives driven by headlines not by good care.

The foreign patient thing – it’s about 0.5% of total NHS spend – it could be better but there are much bigger opportunities for improvement – just they don’t suit the daily mail headlines!

There is a philosophical debate to be had about what the NHS should and shouldn’t fund but it probably rates second to tax rises on the political suicide top ten!

Would second Obergurgl – quiet resort, never queued for a lift all week and lots of blue runs and some easy reds.

Solden down the valley has lovely blues on the glacier too which are v high up and thus good snow.

(Solden got some good blacks too if you want to sneak off!)

From Sheffield you could go rivelin valley, out to ladybower, bamford, Edale, mam nick, down winnats to Castleton, hathersage, grindleford, up froggatt, drop back towards hathersage, up to burbage, along ringinglow road back to Sheffield.

Scenic hilly loop and not too busy all things considered (ride lot of it regularly)

Smokey Jo definitely worth a day down there. Bus is free and 20 mins with lift pass.

Much bigger area at solden and some cracking runs high up on glacier. Very different feel to Obergurgl. Good day out.

Just had a week in Obergurgl. Amazing weather and pistes in fantastic condition considering not snowed for over a week now. Had a day at Solden which was excellent but some of runs there in a bit of a state – especially low down.

Large parts of current problem related to social care which is nothing to do with NHS budget.

Going forward health prevention also an issue – also nothing to do with NHS budget.

NHS efficiency could be greater in parts, some parts are ok.

But isolating it from public health and social care is madness. As is the so called competition and internal market

As per above – issue is social care. Patients can wait 21 days plus once medically fit (i.e. don’t need a hospital bed) for social care.

Social care = council budget, hospital bed = NHS budget. Need to combine them – then there is a major incentive to get the person to the right and most cost effective place.

Sounds harsh to talk about the cost – but ultimately there is one and it all comes out of one UK plc pot – so has to be spent as cost efficiently as possible while delivering best possible care.

With reference to the spmd graph – 45% of all spend on US healthcare goes on administration of billing, terrible system.

Th simple answer to what to fund is data is needed on quality outcomes versus cost of treatment. That data exists in a reliable format for very little – that should be the goal as allows genuine treat,ent comparisons.

Separation of public health from NHS has not helped – health prevention is now driven by councils not NHS – cheaper to prevent many problems than treat.

Separation of health and social care budgets not bright – incentive to keep elderly in hospital to save budget but at a far greater cost to UK plc.

Lack of joined up working doesn’t help – competition and the internal market has not helped in many ways as that market has to be administered.

Ultimately though, the issue isn’t just an NHS one – healthcare for the whole of planet earth is predicted to become unaffordable if current trends continue – arguing over which country then becomes irrelevant.

Veritas (great George St by hospital) has lots of decent ales o, as does Victoria hotel.

Not a pub as such but north bar good – beers from all over the world, bottled and draught. Worth a trip

Hydros are fantastic – can single finger brake even in pouring rain.

I wouldn’t use anything but if I was going disc.

(have the 105s – they work fantastically and predictably)

Wow. Considering many buyers man not be so inquisitive that is a stitch up and a half

@flanagaj – Could be any number of things. The bike may also just exacerabate a problem rather than be the problem.

A trip to your GP and a proper assessment would be a good option – if it bothers you enough to do so.

Hated the flare drops on my arkose. Much prefer normal compact deda drop bars. Didn’t find flares better in any way.

Maybe I missed something!

David

Live in Penistone and have lived in surrounding villages too for most of last 8 years.

Lots of good riding on doorstep, decent pubs around for both food and drink, although ‘nightlife’ bit restricted! Decent Indian eat in/out and Italian in Penistone and Tesco ok for food etc.

Penistone school also has gym and sportshall and outdoor pitches which accessible to public. Easy access to Wharncliffe and Langsett via Transpennine Trail.

Drop me a mail if you want any more info – jamestoml at gmail dot com

Somewhat ironic that a white, corporate, multi billionaire that steamrollers everything in his path is seen as the man of the people.

Or is it just me?

Heard an interesting talk the other day – all about police and guns. Even trained police (in US) often get shot as may not read signals fast enough that someone about to draw and shoot. If police get it wrong what are chances of guy in street saving themselves?!

Belgian blue just came out this week I think for Christmas.

Transpennine over dunford bridge direction then over to Langsett and cut gate is a good ride.

Lots of MTB and road biking too – do you ride both or just MTB?

jet

Done the short course on a cross bike with 35c tyres before and still felt a little under biked in parts – bit rocky in places amd also some high speed off road descents if you let them

Heckler maybe look at Portland design works full metal fender – very nice looking and designed for non guard mouny frame – mount via qrs.

@duane Wait for scan in most NHS units is few weeks maximum.

MRI should ideally be requested to answer a specific question. Depending on what the question is may affect how scan is done and what images are taken. It is thus sometimes more useful for surgeon to request scan – if they feel it is indicated.

Not always the case though.

Cambridge well worth a trip – lots of stuff to see around the colleges etc and a nice place. Punting along the river can be nice even in October if you get a warm day (big if!).

Some nice places to eat too for all budgets. Dojo (noodle bar) is worth a visit – not flash but great food.

@kirky the planet x is a great bike for a price point but it isnt the best frame to say the least. When I changed to a decent carbon frame and decent rim brakes the difference was night and day.

That said I also have a disc brake road bike for commuting and winter that said – in the wet and grime and in traffic it is worth having. If for dry stuff not in town just needs a decent stiff frame and good rim brakes.

Breck Farm near Holt very good. Good facilities too.

Dragon – lots of juniors are going to NZ and Oz already, not sure numbers have gone up YET though.

Private wise – most consultants work 40-44 hours for NHS and do private work in addition to this by choosing to work in their free time. This doesn’t seem unreasonable and a lot of work done in private hospitals is NHS work sent elsewhere as demand overwhelms the system.

The NHS is not perfect but the alternatives aren’t perfect – 44% of all money spent on healthcare in the US goes on billing and billing admin – i.e. is not spent on treating the punters – that is not a great system…

(I accept the NHS needs continuing adaption and change. Jury out on juniors pay – is it interesting that I got paid more in 2002 as a junior doc than they do now – the cost of living is a whole lot more in 2016 than in 2002)

Cheers guys – have pinged you both a mail. James

Jamba – this year for the first time ever there were places for medicine through clearing – applications are falling – admittedly slowly.

Working more nights and weekends – not that simple – most rotas now rely on locums to provide current levels of staff as not enough doctors. More weekend work would simply mean less doctors Monday to Friday and/or more locums as staffing levels are already stretched in many places.

The contract dispute has unfortunately come at a time when morale has been falling for many years, and it is no doubt in part the handling of the whole thing and not just the contract itself that is the issue.

Jamba- Cheers for the heads up.

The XC ride sounds ok depending on how rapid it is. I have been riding for years but am definitely more of a uppy downy XC rides type than some kind of freeride god!

3-4 hour ride be ideal or thereabouts as will ride with the Mrs in the afternoon which will be steadier.