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Tuesday, 26 April 2016

Doctors Strike - Standing on the Brink?

My working life was as a Primary teacher & headteacher, so I know what it's like to work in one of the "caring" professions. I understand the issues around unreasonable expectations & goodwill. I experienced the erosion of my personal life & the constant pressure. If teachers strike, & they did during Mrs Thatchers premiership, that lost education cannot be recouped. But no one dies. 

Primum non nocere is a Latin phrase that means "first, do no harm". Non-maleficence, which is derived from the maxim, is one of the principal precepts of Bioethics. So I find it extremely difficult to support the Doctors strike. How can the junior doctors possibly say that effective cover can ensure that no one will suffer or, worse still, die, as a result of their strike action? If such cover can be arranged it means that the NHS is massively overstaffed, & we all know that is not true, or service provision is seriously curtailed.

There is a real risk of the loss of respect from the public, as happened with teachers. It took years to turn that around. Workers are not all the same. Some have the onus of expectation of professional behaviour & they know that when the take up the vocation. In losing respect the doctors lose the fight.

Conversely, I think the Conservative government, yet again, has handled this very badly.

A contract is a voluntary arrangement between two or more parties that is enforceable at law as a binding legal agreement. Something freely entered into by both parties. The key words here are "voluntary" & "freely". By definition a contract cannot be imposed. By threatening to impose this contract using "bully boy" tactics the government themselves have lost respect & lost the fight.

There are no winners here. All parties are tainted by the same brush. Possibly irreperable harm is done to both sides. But the real harm is to patients. Thousands have already suffered. The possibility of deaths is very real. Where does each side go from here? What is the next step? 

If a so-called civilised democracy cannot solve this problem by negotiation what hope is there for the world at large? Society is complex. We already have terrorism & wars on several fronts because men cannot agree through discussion & consensus. 

A strike, by anyone, shows that there are serious problems between employer & employee. When systems rely on goodwill to keep operating, (excuse the pun), employees are working unreasonable hours or in unreasonable conditions & moral is low people do things they would normally not consider.

I think we are standing on the brink. Everyone needs to step back. Now. Lets also stop using the misnomer "junior" doctors. These are highly qualified , dedicated, people who do a difficult job in trying conditions. A little respect would not go amiss.

Thursday, 21 April 2016

A Sick Society?

At this moment the daughters of two of my good friends have got Anorexia & another has got CFS / Fibromyalgia.

A male friend has had a stroke & another has been diagnosed with cancer. One male friend is in remission. Another has Alzheimers. A relatively young male family member has high blood pressure.

Three of my women friends are in remission after breast cancer - one also has repeated melanomas. A close woman friend has an eye problem, another has multiple chronic conditions.

That's just the circle of my close friends, which isn't huge. It doesn't count the friends & family who have already died, both young & old.

One common thread is the concern that something fundamental is wrong with our 21st century lifestyle & environment in the developed world. If my experience is representative the stats seem high to me.

The other common thread is the difficulty of getting a diagnosis and appropriate treatment. There seems to be a lack of willingness to refer patients in a timely way to consultants.

Regarding the first thread the pressures on mind & body today can be almost intolerable. We all lead such busy lives. There seems to be no time to just "be". Sadly I think this is impacting on children & young people too. We ignore the mind body link at our peril. Human beings are complex interlinked systems.

The link between health & nutrition simply cannot be ignored. The prevalence of  "processed" food as opposed to freshly cooked ingredients seems blindingly obviously detremental to me. It also seems obvious that the statistics for the incidence of diseases like obesity & diabetes have risen exponentially.

The second thread is about the lack of enough medics & funding for the NHS. The current situation is not sustainable. We need to have an informed discussion, as a society, about what out NHS can & should do & how we are going to pay for it. It seem to me that things have deteriorated since the role of PCT's was devolved to surgeries. I expect my medics to be good practitioners & if they don't know I expect them to refer me to someone who does. I don't expect them to be administrators & financial managers. Their skills lie elsewhere & they shouldn't have time for that. Their priority should be the welfare of the patient.

I can't help thinking about the many countries I have travelled to where people are far less wealthy & certainly have less of everything, but do seem far happier. Their lives are certainly not easy, but they have a sense of balance & belonging to a community which we have lost.

Health and happiness are treasures beyond compare, we are lost if we ignore that.

Sunday, 17 April 2016

Living on the Edge - Chaos Theory

I've just got back from a 3 night mini break in Berlin with my daughter. Everything went quite smoothly until the bus journey back to Tegel airport - although the very efficient, but complicated, integrated transport system did take some getting used to.

We checked out of the hotel, got the S Bahn (metro) to the TXL airport bus stop on the outskirts & just missed a bus. Couldn't get across the road! Within minutes the traffic on the road got very congested. We were the first people in the queue for the bus but as time went on people poured out of the metro station continuously & blocked the entrance & the pavement. It was pouring with rain & very cold. No buses came, but more & more taxis, full of people, passed by. Normally the TXL buses come very regularly. After about half an hour it became obvious that there was something very wrong. We assumed a traffic accident. Police cars somehow screamed their way through the traffic.

We tried flagging down taxis, but all were full. Eventually one stopped, but it had been ordered by a young man. He very kindly offered to share with us & a young woman. About this time we learnt that there was a bomb scare at Tegel & all roads in had been closed. The backed up traffic wasn't moving. The taxi driver had tried to take a fare to Tegel but had to turn round & come back. It was obvious we would just sit in the taxi at a standstill so we got out at an Aldi a little way along the road.

By this time the enormity of our predicament was obvious. We were soaking wet & shivering with cold. Neither of us could find out anything on our phones. BA & the airport phones were jammed. The young man & woman were hugely helpful. I dread to think what we would have done had we not met them. My German is OK, but I don't have the vocabulary for a situation like that.

We decided that all we could do was to walk back to the metro station & go back to the hotel & hope that we could get a room & some help sorting out what to do. By this time we were very worried indeed. I think it was a combination of factors. We had no control of the situation. We couldn't communicate or get enough information. We didn't have a base & were in a strange country. We felt very isolated. The knock on effect of not getting home would require a lot of sorting out.

As we got back to the station we saw that there were several TXL buses arriving. So we changed our plan & got on one, hoping. The traffic was very busy, but it was moving. The airport had re-opened. The bomb scare was apparently a bag of rubbish. We arrived & we caught our flight which was delayed by an hour.

The thing is that we were so completely unprepared for the situation. It all happened very quickly & could so easily have been dire. Actually we were extremely lucky in many ways, not least of which that it wasn't actually a bomb or terrorist attack.

In future I will have emergency phone numbers for the carrier, the airport & the hotel in my phone. I will also have websites where possible. I will duplicate all information in a notebook. Information & communication is key, but is one of the first things to be inaccessible. Ditto transportation. Goodness knows what people did before mobile phones, but there are so many the phone is actually useless in a foreign country where you don't have any contacts. Chaos is literally just round the corner.

It makes you seriously consider whether any non essential travel is actually a good idea nowadays. The world is so interconnected. An incident, real or not, can happen anywhere & at any time. When you are involved it shows you just how vulnerable you are & how little control you actually have.

We were very pleased & very lucky to get back to the UK in one piece.




Saturday, 2 April 2016

Gremlins & the Perversity of Life


I'm really p..... off. I can cope with one thing going wrong, but when you have a succession of problems to solve in a week or so it just gets very time consuming & frustrating.

  • The installer of my new ensuite managed to fit the "self closing" WC seat wrongly! I've been waiting for him to come & rectify it. He's been paid & swore he would come a week ago, but I've got to chase him. No surprise there. Done - waited 11 working days. Then he told me that there wasn't anything wrong. I've looked at every loo seat since the ensuite was finished & all of them fit the WC basin flush all round the edge. Mine was set back couple of cm at the front tapering to less round the sides. The manufacturers photos showed it as I expected. Is it a man thing? Don't they like admitting they have made a mistake? Or do they think that clients are stupid?

  • I discovered that the plumber who installed my new boiler hadn't given me a vital completion certificate. Texted to ask for it - No response. Re-sent the text - he said he would look in his records. Still haven't had it, so I've got to chase him too. Still haven't got it.
  • Then I got a streaming, sneezing cold. I'd forgotten how miserable that can make you feel. Gone.
  • My hearing aid and my watch both stopped working. The first involved a visit to the JR hospital & waiting for ages for someone to replace the plastic earpiece which took seconds to do. The second involved returning it to the online company I bought it from just 10 months ago. Response from the Watch Co. Apparently it was the battery, which should last longer than that. It seems that "new" watches have the battery fitted, so if a watch is on the shelf a while the battery life can be quite reduced. Why don't they put a battery in when it sells?
  • My GP surgery have had a problem with nurses so I couldn't get my regular INR / Warfarin blood test for 3 weeks.That meant going to the JR hospital for it, because I have to have the test on a certain date. Still very booked up, but they managed to squeeze me in for the next one.
  • I ordered a case of wine from M&S which was supposed to be delivered on Wednesday by 7pm. I stayed in all day. It didn't arrive till the next day. Fortunately I was in. Surprisingly no response to email sent to M&S.
  • To cap it all my computer browser has gone haywire. My computer man came to install a new router on Tuesday which took him hours over 2 days! When he had gone I had all sorts of problems with Firefox. Still not sorted, despite the help of my previous computer guru who really does know his stuff. Computers can & do eat up the hours of your life when they are working. When they aren't it's much worse & you lose the will to live. Finally sorted remotely by my ex neighbour & computer guru Steve on Monday night. Now I need to find a local computer man who is similarly competent - it's not going to be easy. Apparently there are no qualifications these people have to have. Anyone can set up as a computer "expert"! Where is the consumer protection in that?
All in all I'm pretty fed up. I know, I know - none of this is major. I also know that sooner or later all of it will probably get sorted. It is just the perversity of life. But it's my life & there isn't enough of it left for me to want to waste it on this sort of stuff.