Kimbers – there’s a pretty good explanation for the CRUK trend above which is that there has been a very substantial increase in the number of patients being referred for diagnosis in Secondary Care.

This “front loading” and long lead time in increasing diagnostic capacity (Machines and skilled people to use them) leads to the %age of patients starting treatment going down i.e. more patients diagnosed but same number of staff available for helping patients to commence treatment.

Between 2010 and 2014 the number of patients referred for an urgent cancer diagnosis increased by 53% to 1.5m. The significant increase in the number of urgent referrals also has the effect of leading to small delays in first treatments for patients who have smaller / less aggressive cancers where the risk factors of starting treatment later are lower.

I’d be interested to know what those other criteria might be because it seems a bit odd that a private firm could make better diagnosises, using the same scanner and most likely the same NHS staff or at least staff with the same NHS training.

The contract didn’t go to a “private firm”. It’s a consortium comprising the The Christie NHS Foundation Trust – which is well known for it’s world class cancer diagnosis / treatments, as well as other local NHS Trusts, charitable providers and academic institutions.

Alliance Medical seem to be bringing new technology and expertise of driving process efficiency to the party – which has the potential to reduce wait times and increase early detection. Both of which can lead to improvements in cancer outcomes. The UK continues to have amongst the worst cancer survival rates in Europe so maintaining the current status quo clearly hasn’t worked.

I see for example that a private firm Alliance Medical (whose board includes Malcolm Rifkind MP) have just been awarded an £80 million contract for cancer screening, despite an NHS consortium putting in a bid that was £7 million cheaper.

The contract award was more than a year ago and Malcolm Rifkind is quite rightly no longer an MP. It’s quite likely the procurement took into account a range of factors in the award criteria – cost is thankfully almost never the sole criteria.

In 1946 the BMA mounted a highly personalised attack on the then Secretary of State for Health Aneurin Bevan.

In exactly the same way they’ve acted with every single health secretary since the BMA basically bullied a government minister and mounted a sustained personalised attack to stop him establishing the NHS. At the time Bevan described the BMA as follows:

“a small body of politically poisoned people” who had decided “to fight the Health Act itself and to stir up as much emotion as they can in the profession.” (source – wikipedia).

It’a a matter of record that at least 2 of the BMA’s current lead negotiators stated their intent 18 months ago to use the renegotiations as a proxy for a left wing attack on the government -Yannis Gourtsoyannis went as far as to say ” a victory for the junior doctors would signify the first real crack in the entire edifice of austerity in the UK”.

The reason the negotiations have taken 4 years is very little to do with the current Secretary of State – he has personally had very little to do with the negotiations as those have been handled by NHS Employers, comprising NHS Chief Execs and clinicians amongst others.

The real reason there’s no agreement and why the BMA has effectively run a massive bullying campaign on social media is that it never intended to compromise on anything. The principles underpinning the changes to the contract they say can’t work are already the basis of contracts worked by hundreds of thousands of nurses, paramedics and AHPs. Doctors have been systematically misled by their union – which has gone as far as using made up numbers in a calculator as the basis for the 40% pay cut claim. You can’t blame the doctors but I think if they had first hand experience of the brazen dishonesty within the senior ranks of the BMA they may reach a different conclusion as to why the negotiations ultimately failed.

just say the old name and new name together and over time stop using the old one. That’s how one police force re-trained Alsations they bought from Germany to recognise their new “english” names.

They have already started on the nurses – bursaries going means less applicant’s, whose going want take on uni debt to end with nurse salaries?

Nurses already earn more than the median average wage – which of course covers many other graduates working in other professions, so simply puts them on a par with everyone else when it comes to how the training is paid for.

The Royal College of Nurses made a sustained push for nursing to become a degree level qualification. Arguably this at the root cause of so many people dropping out of nursing training (because it’s now very removed from patients for the early years) and the experience/ complaints from patients which is many newly qualified “degree level” Nurses are much less inclined to do hands on care than their non-degree qualified peers of 20 or 30 years ago.

so basically it’s got less gears, is more expensive and much heavier than a double chainset alternative at the same price point…?

EE are doing 50% off their 25Gb Sim only plans at the moment – so you could get two of those to get 50Gb a month for £30 which would probably still be cheaper and faster than a landline and “adsl” internet.

EE UK Offers 25GB Half Price 4G Mobile Broadband Data SIM

You can write fraudulent prescriptions and still be a doctor?

The most recent estimate of fraud in the NHS – estimated by the most recent head of NHS Counter Fraud) is £5Bn a year, of which £1.5Bn was attributable to NHS Doctors and Dentists. To put that into perspective, the amount defrauded by NHS Doctors and Dentists would pay for an extra 75,000 nurses a year.

On top of the £5Bn fraud estimate, there’s £2Bn / year lost to financial errors, and a compensation bill that is heading for £2Bn / year paying out for mistakes that are in many cases avoidable. There’s also the small matter of close to 6,000+ patients a year who die due to errors in care – and that figure is massively understated due to poor reporting and a culture in some trusts of clinicians not speaking up when their colleagues are clearly not fit to practice.

http://www.bbc.co.uk/news/health-26654001

benpinnick – contactless doesn’t seem to have been working for a while on quite a few of the machines. When trying to pay for parking by contactless you press the button to add hours, then press the green button to confirm. The machine display then says “press green button for contactless” but when you press it, the display then says “transaction cancelled”.

This was the same on all the machines I tried – and other people trying to use them for contactless were having the same problem…

dunno …but Bracknell Council seem to do a pretty good job of demonstrating why local authorities shouldn’t run things like the Swinley Cafe.

It was “closed” weeks before the signs said it would be and even when it’s open the offering is pretty poor.

None of the machines in the car park work for contactless card payments even though they are supposed to. And despite the considerable revenue generated from parking their doesn’t seem to be any noticeable investment in CCTV despite pretty regular thefts of bikes and car break ins.

I’ll vote for “out”.

Europe is in the midst of the worst crisis for 70 years and its leaders have clearly still not recognised the need for change.

Having to rely on leaders of countries that are smaller than the population of London for permission to effectively manage migration to our own country is ridiculous, as is the failure of policy makers in Europe to deal decisively with the economic malaise that many countries still find themselves in.

Switzerland has more reciprocal free trade agreements than the EU, and a majority of Britain’s trade is outside the EU now. Europe must reform and reform quickly but sees no need to. It’s better to be on the outside and focus on maintain trading than inside a movement which is clearly focussed on increasing fiscal, monetary and political union as a goal in its own right.

Two issues are overhyped:

1. Britons still have to show passports when travelling to Europe – “free movement” is not there for us anyway.

2. The german and french economies will still need to sell cars etc. to us. It’s as much in their interests for trade to be maintained as it is for ours – and countries already outside the EU have little difficulty trading with it.

Nottingham Police have form on this – they failed to detect the driver of a fatal hit and run 2 years ago for similar reasons.

there was an offer on Virgin in MoneySavingExpert’s email last week – Phone line + 50mb broadband for £22.99 a month all in on a 12 month contract.

Not sure you’ll get much cheaper than that even on the likes of TalkTalk.

http://www.uswitch.com/broadband/splash/16328?_cid=118165166

A lot of western Governments have also used “austerity” as an excuse to cut and cripple tax authorities. So even when the rules exist, Peter taxman sitting in a lonely office buried under a pile of paper has no **** chance to enforce them.

Not quite the case with HMRC:

– their conviction rate is up 58% year on year with £26B more tax collected overall
– the ringfenced budget for complex tax avoidance detection has been increased by £60m
– the revenue from investigations into self-assessment returns will hit close to £1B – it has risen five fold from the £200m collected under Labour in 2007/08 prior to the the economy tanking.

And in related news:

http://www.theguardian.com/business/2015/nov/26/kpmg-partners-arrested-hmrc-tax-evasion-inquiry

Graham S – the allowances are detailed in the document on the link you provided – see page 14 onwards.

How many employees outside of the NHS would get an additional £60 for delivering a lecture to colleagues in work time that’s already paid for. Or a premium for each customer they see at home in working time they are already paid for?

That’s typical of the ridiculous nature of the current contract.

perhaps if they keep striking you will finally develop empathy rather than just use this sort of argument when it suits your agenda?

Which is pretty much the level of “debate” that can be expected on this.

Graham S – you can add another 40-60% on top of those base salaries to reflect:

– antisocial hours payments
– the value of the defined benefit pension
– bonuses clinical merit awards
– ad-hoc payments for signing death certificates etc.

And then you’d need to put a value on the following to make a fair comparison with other jobs / employers:

– 35-40 days annual leave
– guaranteed job for life
– the ability to run a job on the side during working hours and using your employer’s resources at no / discounted cost

The BMA is very happy to have a discussion about “pay” as it suits them rather well by obfuscating the objective discussion of total incomes and terms and conditions relative to other jobs.

The biggest resource the NHS has got is its staff. “Using them as efficiently as possible” generally means doing more work for the same pay in my experience.

Using NHS staff efficiently also means a whole bunch of other things as well:

– Using experience correctly. There’s still plenty of day to day work that can be done to the same standard by less expensive resources thus releasing the more experienced / expensive staff to focus on more complex treatment and getting it right first time. A good example of this in Primary care is the use of prescribing Pharmacists and Nurses to relieve workload from GPs – in many cases prescribing nurses make better decisions with Patients who are living with a long term condition.

Getting the diagnosis and care right first time, not the second or third time. This avoids unnecessary use of expensive diagnostics or having to treat the patient several times before the condition is properly managed. This typically reduces emergency admissions and associated in patient admissions.

Smoothing the flow – so instead of the peaks and troughs that occur for scheduled care, diagnostics suites, wards etc. making more continuous use of resources and thus avoiding the need for bank staff etc. This is well established on the continent but something UK Doctors say can’t be done her because it’s not possible.

Tackling the waste of resources caused by the separation of care / social care – this generally results in a “we’re not responsible” attitude on both sides, a massive waste of resources and the patient invariably stuck in the middle.

Breaking antiquated and inefficient working practices by using Technology to streamline and automate. Anyone who’s been on the receiving end of numerous letters all from the same hospital and same day confirming diagniostics all on different days will probably get this. The NHS hasn’t even tried to make it’s processes patient friendly and the result of this is missed appointments, endless telephone calls and for some patients – getting sick and requiring an otherwise avoidable emergency admission.

And insists that the BMA calculations are wrong, hardly anyone will get a paycut, despite plenty of worked examples to the contrary.

When Hunt said that the BMA’s calculations were wrong he was completely correct.

The calculator on the website that many JDs were using to calculate their “loss” wasn’t underpinned by the data from the actual discussions or offer, just the BMA’s original guesstimate of what would be offered and the rule tables hadn’t been checked properly with the result it overestimated the losses and underestimated the increase in basic pay and didn’t take into account the increase in pensionable pay on overall remuneration.

When this was pointed out the calculations were very discretely removed in the third week of October and replaced 2 weeks later with one that produced very different (higher) pay forecasts which is precisely why quite a few medics have gone from being adamant they would lose out to now saying the calculator tells them their income won’t change.

With this level of opacity and when some of the BMA’s negotiators have compared the Secretary of State to Nazis and also said they are intent on using the disagreement to fight a proxy dispute with the government about its Austerity agenda it’s not difficult to see why the discussions so far have been less than constructive.

Both sides need their heads banging together but any negotiation in which one side compares a pay dispute to actions in the Holocaust is completely unacceptable – particularly when this is done in the name of professional that commands almost universal public respect.

there’s a real chance that the slump in oil price and commodities will cause deflation – so I’d not be betting on a rate rise anytime soon. The BoE has been “floating” the prospect of rate rises since late 2013 and 3 years later there’s still no sign of one anytime soon.

the remote control plus from Maplin work well and cost about £20. If you want to control a plug from outside the house have a look at the Belkin WeMo plugs – they can be turned on/off from a smartphone or set to follow programmable rules e.g. turn on / off at sunrise.

one of my German colleagues was telling me today that this has been going on for a while albeit not on the same scale before as New Year’s eve in which the men were calling women “Bitches” and “Wh*res” as well as attacking them.

In the the interests of balance a similar mindset is pretty prevalent in London – I had the “pleasure” of an Uber cab 2 months ago in which the driver was very happy to tell the wife and her colleague that it would be their fault if men attacked them because they were wearing skirts, and that the one out of his 7 sisters who chose not to “cover” herself would only have herself to blame if she got raped because men can’t be expected to control their urges – presumably the same applies to the many thousands of children raped by grooming gangs.

These “values” are clearly not acceptable with european values, culture or ways of living but the navel gazing and deafening silence from many politicians on these issues is just allowing the behaviours to spread unchallenged.

That looks perfect for flying into the engines of a real plane that’s taking off / landing…

Which judging by the number of recent near misses reported at Heathrow seems likely to result in an accident sooner rather than later and very soon if ISIL type nutjobs decide to give it a go.

At which point all drones will hopefully be banned – based on recent experience of chavs people repeatedly flying drones at low height around neighbours houses and gardens at night using remote viewing software so they could fly them without requiring line of sight.

Edit – not saying all people that fly drones are Chavs, just the ones that we’ve had problems with!

I live on my own in a 1 bed flat, I think some of your bills are very light
Last month my bills were:
gas £60
electricity £40
water £18
Sky £63
Broadband £47

Wow. 😯

By contrast our bills for a joint household whole living in a poorly insulated Victorian house are:

gas: £50 (averaged over the whole year)
electricity: £29
water: £9
Sky: n/a
Broadband: £35 (including line rental and unlimited fibre)

There’s good money to be saved for anyone interested –

– put your gas on low heat all the time so the flat doesn’t get cold enough for moisture to condense i.e. avoids the flat feeling cold for long periods after the heating is switched on as all the moisture condenses on the walls etc
– put some timer clocks on as many electrical items as possible
– reduce the flow of cold water to taps
– reduce the flow of hot water to taps and shower heads (which saves on heating hot water as well)
– switch broadband to something more cost effective

Halal preparation of meat doesn’t cause additional suffering, if it did it would probably be illegal in the UK

Sorry but this is just plain wrong. The British Veterinary Assoc. could not have been clearer in their last observational study of slaughterhouses – slaughter without stunning causes significant avoidable suffering particularly to larger animals.

I forget the exact figure but I think it was around 1/5 of cows were not rendered immediately unconscious by having their throats slit – many continued to remain conscious for up to 3 minutes and a good number of these ultimately choked to death on their own blood.

There’s no two ways about it – the laws that were put in place to ensure humane slaughter have now been circumvented on an industrial scale to the point where around I live there are now very few places that don’t serve Halal.

If you choose to eat Halal you should do so knowing that there’s a 1/10 chance that the animal suffered terribly in its final few minutes of life – all so that the requirements of a book of stories can be observed.

http://www.theguardian.com/world/2014/mar/06/reform-of-kosher-and-halal-slaughter-practices

I’ve put a fair amount of distance between myself and former “best mates” in recent years.

I noticed quite early on when friends started having families that there are two groups:

1. Friends who still try and arrange to meet up and if you ask them if they are free will take responsibility for making an arrangement.

or

2. Friends who say that I should check with their husband / wife to see if they are free and take no responsibility for making an arrangement.

After some reflection I came to the conclusion that trying to maintain an active friendship with the latter group was actually quite depressing – I landed up feeling like my friendship wasn’t valued even after a lot of time / effort / gifts etc. when their kids were in the early years.

With 2 of my oldest friends I’d land up having to go to theirs pretty much every time we met up because they wouldn’t make the effort to come and see me. Despite a few years of quite significant troubles on a number of fronts they just didn’t really seem to care enough about anyone apart from their immediate family to bother asking “so how are you… really?“. For me that’s a red line in a friendship (it works both ways too).

Yes, that will be why France & Germany have a long-hours culture, poor pensions, low benefits, low taxation and privatised state infrastructure.

Oh.

Erm – 30% of employees in East Germany were earning less than the minimum wage in 2014. 36% of all germans working in hospitality earned less than the minimum wage, and 44% pf germans working in Agriculture. The minimum wage there is €8.50 an hour.

I guess these people will marvel at the utopia in which they apparently live.

Oh.

Hmmm, looks like he was doing a bit of middle lane hogging in the first bit of the video – Dashcam man’s hazards seem to be reflected in the front of the lorry even though there’s room for the car driver to pull over and there’s no visible hazard / reason for having them on from the view in the forward facing camera. The lorry may be speed limited hence the difficulty in overtaking and the lorry driver was obviously doing the right thing by not under taking.

In the second part of the video Mr dashcam has obviously overtaken the lorry again so all in all it seems a bit odd.

I was going to write that the difference between the whale and the chicken is that the chicken gets stunned before suffering an otherwise painful death, but the latest trends suggest that hundreds of millions of animals are now being slaughtered in Britain without being stunned first in the interests of accommodating barbaric religious practices.

Having read the British Vets last report it staggers me that we are allowing around 25% of large animals that are slaughtered to effectively die by choking to death on their own blood for up to 3 minutes ( whilst in many cases standing up and concious of this) when 30 years ago this was simply not allowed.

Sorry what? Pretty much the entire “medical establishment” has supported the decision. A few of the royal colleges have made ambiguous politically correct statements not criticising either side, but that’s been as far “against” any of the establishments have come out with.

The royal colleges etc, have supported the campaign by the JDs but not their decision to strike. It is possible to support the aim without supporting the method and the nuance is in what’s not said rather than what is said. If you read what the MRCs have published they support individual Doctor’s right to industrial action but do not seem to have given blanket support to the plan for a national strike.

What the MRCs have said is as follows:
“The academy is urging both sides in the current dispute around junior doctors’ contracts to step back from the brink and re-enter negotiations in good faith so that an agreement can be reached. Failure to do so will have an adverse impact on the NHS and current and future patients.”

They don’t seem to have said – “a national strike is a jolly good idea” or “we fully support it”.

ecampbell – are you just reading into it what you want to read into it though?

You seem very certain that he has a secret agenda to privatise everything so don’t you think that the Tories would be cracking on with that now unencumbered by a coalition with the Lib Dems if that’s what they really intended.

Despite what the rabid left would have us believe – and they’ve been telling us for close to 40 years that the Tories want to dismantle the NHS the facts of the matter are that every Tory government has left office with NHS spending higher than when the started. It’s also a fact that every Health minister (Labour and Conservative) has been subject to highly personalised attacks by the BMA.

And what say you to the inconvenient facts that private sector provision rose faster under the last Labour government than any government before or since?

Private sector activity has barely changed in the 6 years since Labour left office although it is fair to say that NHS trusts are still saddled with £80B of PFI loans and close to £2Bn of interest payments from when “anti privatisation” Andy Burnham was in charge.

As for the above tweet – most observers are saying today that the suspension of strike action is common sense – even if it will come too late for the many patients due to have elective surgery, many of whom will now have to spend weeks in pain due to their operations being rescheduled.

Apart from the BMA, very few members of the medical establishment backed strike action or the BMA’s refusal to even meet with the DH Employers team since June this year.

I suppose the £300K cost of the missiles needs to be balanced alongside the potential costs of achieving the same result through ground based forces.

As well as the direct cost, the avoided cost of injured servicemen and associated compensation and rehabilitation probably make air strikes quite cheap in comparison.

The £190K is likely to be total income – based on where they work my reckoning is that their salaries are probably around the £150K mark combined with the rest being bonuses that may or may not happen.

Looking at the size of their combined mortgages the couple are massively over leveraged so it’s not surprising they are panicking – their options are:

– drop their private school aspirations
– downsize
– train the kids to be stars on x-factor and then retire early
– sell the children to a dubious Fagin like character and live the good life.
– take out life insurance and both do a Lord Lucan so that the kids can go to boarding school until they are 18
– move the family home to the midlands and both spend 4 hours a day on a train scuttling to and from London
– buy and read a copy of “personal finance” for dummies and make some common sense decisions that most people irrespective of income can take i.e. reduce regular outgoings to no more than 90% of net income.

I suppose there’s also the security angle – when our PM is using scheduled flights the whole of twitter will know that he’s boarded and where’s he’s going within seconds of him taking his seat. In these days of nutjobs having rocket launchers amongst other things not advertising his movements in advance seems fairly sensible.

Using a refurbished plane seems to make sense on cost grounds but potentially also increases the PM’s security and that of the 200 or so people who would be otherwise sharing a plane with him – you can’t fit anti-rocket devices to all of BA’s planes.

The article doesn’t say they spend £5K a year on holidays – it’s one of the “experts” saying that.

The couple still need their heads knocking together though – they should move to one of the many parts of London that have great primary and secondary schools, free up the education costs and either work less and spend more time with the kids or take up simple cheap hobbies like mountain biking.

I have a rabid and most likely entirely irrational hatred for slippers of all types.

takes some balls to go into a confined space knowing that kind of weaponry is likely to be pointed at you.

Obviously the US and UK’s post 9/11 actions have gotten us to where we are today.

Where we are today is that there’s still infighting between Shia and Sunni muslims. It’s been going on for more than 1,400 years so far – it just has better weaponry now and most of the justifications are just designed to obfuscate this.

Jim Jam – I’m not so sure. Going by that wikipedia link in the decade preceding 9/11 you had one bomb attack in London, one in NY and one in Paris. In the decade preceding that, one in the UK, none in the U.S.

I don’t think I was wrong.

But you’ve missed the other attacks on european and american citizens . Does it really matter where the attacks were – the only constant is that citizens of countries in the west are seen as fair targets irrespective of where they are.

1993 – Attack on CIA in the USA
1993 – bomb at world trade centre in USA
1994 – bombing of an embassy in London
1994 – attack on air france flight
1995 – two bombings in France
1995 – bombing of US Air Force personnel
1996 – murder of 15 Greek tourists
1997 – murder of c50 european tourists at Luxor
1998 – bombing of US Embassy
2000 – attack on USA Warship

etc etc.