Surgery - What will the NHS do? - What happens if you have to pay privately?

Private NHS surgery is a whole subculture of the NHS that patients aren't aware of until they are in a situation which means they have to pay for treatment. I don't read the Mirror, but this is a link to a relevant article.
https://www.mirror.co.uk/news/uk-news/nhs-hospital-demands-18k-hip-16544619

Oxford University Hospitals have a website for the private work they undertake. I imagine that most NHS Commissioning areas do too.
https://www.ouh.nhs.uk/privatehealthcare/services/default.aspx

The reason I'm interested is because I had something on my face which could have been a Squamous cell Carcinoma, although neither my GP or I really thought it was. I was referred to a consultant at the Churchill hospital who confirmed that it was a cyst. That meant I had to pay for it to be removed. I was very concious of it & it had got quite a bit bigger, so I went ahead.

Whilst I was disappointed that I had to pay I understood the reason for it - It's cosmetic. However, possibly naively, I did expect that as a private patient certain things would or would not happen. I don't have medical insurance so I was not familiar with private consultations, except once at the Spire Dunedin in Reading to see a rheumatologist because I was in so much pain.

• I thought I would get written confirmation & instructions for the appointment I made over the phone - I actually had to phone & check the day before.
• I imagined that there would be private facilities - waiting area, coffee / tea / water etc - It was the same waiting room 2 I had been in as a NHS patient initiallly. It was very crowded.
• I really thought that a 3pm appointment meant a 3pm appointment - After waiting for an hour I asked a passing member of staff how long the delay would be. Although I saw the consultant fairly soon after that, I didn't go down for surgery until about 5pm.
• I would have expected to be informed, as a matter of courtesy, whether I was a NHS or Private patient, that there was a delay, how long that delay would be & when I could expect surgery to take place. Patients do get anxious about surgical procedures & they do have lives & commitments outside the NHS. Family / friends may also be involved in a patients appointment.
• I expected the consultant to know why I was there & have my notes from the initial consultation with his junior. He asked me why I was there.
• No one had checked to see if I was on blood thinners until I was actually in the operating room. I am on Rivaroxaban, but fortunately wasn't due to take it until 6pm, or I would have had to go home.
• I would have expected the procedure to be gone through so that I knew exactly what to expect, for example the anesthesia procedure - In fact I am not at all nervous. I have had quite a lot of interventions from the NHS over the years & have worked as a lay NHS volunteer in several capacities. But I am not typical.

I know there had been a problem with a patient earlier in the day which led to the backlog, because I did eventually ask. Was the clinic also overbooked? All the more reason to keep everyone informed.

The procedure went well. I have no complaints whatsoever about the consultant or my Nurse. They were both excellent & I actually enjoyed meeting them both & found them very professional. I realise that they were very busy.

This is a complaint about the admin, the logistics & the customer sevice. That is what the NHS, private or not, doesn't seem to grasp. We, the patients, are paying, directly or indirectly, for a service. I do think, that if you are paying privately on top of what you pay in taxes, you should be able to expect something a bit better.

I find myself in a difficult situation. If I was paying for any other service I would be expecting a significant discount. To have to pay almost £600, (I'm not even sure if there is VAT on top of that), for what happened to me goes completely against the grain. I don't actually agree with Private medical work anyway. Patients should not be able to have medical treatment simply because they can afford it.

I don't like to complain. I hope that lessons can be learnt from my experience. The best evaluation of the NHS is the patients experience of it. Mine left quite a bit to be desired.

  

The Lehman Trilogy

Utterly brilliant! A tour de force by three wonderful British actors. Three & a half hours of exquisite timing & characterisation. I don't think I have seen many productions of this calibre ever. It is gripping, funny & tragic.

The piano music is a clever thread running through, at times subtle & at times dominating, but always necessary. The whole conception of this poetic epic is wonderfully conceived & directed by Sam Mendes.

Hugely entertaining.

But, at it's heart, this is the story of 3 men, Henry, Rimpar & Emanuel & the dynasty they founded. They were Jewish emigrees from Bavaria to America & they started from a small dry goods store in Alabama & built an empire spanning the world.

The last Lehman, Bobbie, died in 1969 & Pete Peterson was brought in to save the firm. A series of CEO's followed culminating in the collapse of the company in 2008 because of their involvement in US sub-prime mortgage asset management. The world wide recession followed, which it is arguable we have still not fully recovered from. It was the largest failure of an investment bank. Thousands of people were adversely affected. It seems surprising that apparently the US weren't confident that they could prove that Lehman Brothers violated US laws in its accounting practices.

The ability to turn this story of 150 years of Western Capitalism into a hugely gripping theatrical production as innovative & unique as this just has to be admired. It is a credit to UK support of the Arts that the play "was developed over three years without the constraint of a schedule, or even a destination — I (Mendes) was allowed time to find its form, and to build a wonderful team with which to make it".

Unbelievable! So many lessons, on so many levels.

Terrorists & Foreign Policy.

I'm reading a book. I'm always reading a book, but this one is shaping up to be one of my all time most influential books. Noam Chomsky - "Who Rules the World?"  I can't put it down. All of my preconceptions about the foreign policy actions of the USA & the UK are being shattered.

The book is logical & evidenced based as you would expect from a man who is Emeritus Professor at MIT. His fields are Linguistics, Analytic Philosophy, History & Cognitive Science. He is very readable.

The first chapter looks at the responsibility of intellectuals. There are two types, conformist who support official policy & value oriented who are often dissident. You can probably guess which Chomsky values.

The second chapter asks who are the Terrorists? Well, all I can say is that I am shocked. The actions of successive American presidents, backed up by the UK make one ask "Who are the criminals? - Who are the terrorists?

The world we are living in now has been deliberately created by successive governments & politicians for years. The people with power have used it indiscriminately, pursuing policies, often illegal & self serving, which have caused great harm to people & whole countries. Thousands of innocent people have died as a direct result.

What really matters is not talk of freedom & human rights, it is actions that count & actions which show the real truth. Our politicians actions show that their political talk is at complete odds with their actions.

The thing is - we have allowed them to do this. For years. We need to become more questioning & more pro-active in researching & reading to find out the truth. The information is easily available in books & on the internet.

Brexit is a microcosm of this. We, the electorate allowed all of this to happen.

The Clothes on my Back

According to FashionUnited UK the fashion industry is worth 66 billion pounds & 555,000 people are employed in the fashion industry in the UK.
https://fashionunited.uk/uk-fashion-industry-statistics/

 

Another website shows how fashion fuels the UK economy.

https://www.thecreativeindustries.co.uk/industries/fashion/fashion-facts-and-figures/how-fashion-fuels-the-uk-economy

I could go on, but that isn't my point. You can look up the stats for yourselves.

When I was a child money was scarce. I had very few clothes & my growing out of them was a worry for my parents. Shoes in particular were expensive. Shops were not filled with ultra cheap fashion manufactured in countries like the Far East where labour is cheap. So clothes had to last as long as possible. My mother always encouraged me to go for quality not quantity.

That said a lot of my clothes were made by her. She had an old treadle Singer sewing machine followed by an electric one. There were plenty of haberdashery shops selling fabric & notions. She could also crochet & knit. I didn't mind home made clothes, she was quite good at it. I'm now sad that I didn't appreciate her effort more. I just took it for granted.

An added bonus was that she taught me valuable dressmaking skills. So as a teenager I took over making my own clothes. It was fortunate because I ended up doing textiles at college & making my daughters clothes when I had no spare cash when I was first married.

I'm now getting to the point. 

Today's fast fashion industry is toxic in ways we never dreamed of. Frequent new collections in the shops copy the catwalk immediately. The result is water pollution, the use of toxic chemicals & increasing levels of textile waste. 

Many vibrant colours for example are produced with toxic chemicals which pollute rivers in countries who don't have the resources to clean them up. These chemicals disrupt hormones & can be carcinogenic.

Polyester, an unpleasant but cheap fabric, sheds micro fibres which add to levels of plastic in oceans, which do not degrade. Fleece does the same thing in industrial quantities every time it's washed. These are harmful to aquatic life & we also end up eating them with goodness knows what long term consequences.

Watch "The True Cost" - https://truecostmovie.com/ Growing cotton is definitely not harm free.

There are now, literally, mountains of textile waste because of our obsession with "Fast Fashion". We demand constant newness regardless of the consequences.

Please read the "Independent" article:- 

https://www.independent.co.uk/life-style/fashion/environment-costs-fast-fashion-pollution-waste-sustainability-a8139386.html

Also watch the Stacey Dooley documentary "Fashion's Dirty Secrets". I was shocked.

I do understand that people today are more time-poor than in previous generations. Also that there has been a  loss of sewing and mending skills over time. But this is doing incalculable harm. This is really dangerous. This is threatening out environment directly. 

We simply can't go on like this. We have got to change. We know what harm we are doing now. Clothes are functional. The sooner we stop thinking about them in terms of fashion the better.

Environmental Criminals

If we are in a Climate Emergency then I feel we should be tackling
Environmental Criminals with the full force of the law. What is the point of law if it isn't enforced? What is the point if the sactions are not sufficient to really deter the criminals?

Environmental crime is an illegal act which directly harms the environment. Criminal exploitation of the world’s natural resources affects our everyday lives, from the food we eat to the air we breathe. Environmental criminals pose a grave threat to our everyday lives, our planet and to future generations.
https://www.interpol.int/en/Crimes/Environmental-crime

The top 5 environmental crimes are:-

• Wild animal traffic
• Indiscriminate logging
• Electronic waste mismanagement
• Finning - up to 70 million sharks a year are captured only to have their fins cut off alive on the ship & then are thrown back into the sea for a slow & painful death.
• Dumping in rivers & aquifers by companies, factories & public administrations.

https://www.activesustainability.com/environment/crimes-against-the-environment/

In the USA EPA referrals for criminal prosecutions for environmental crimes are at a 30-year low.

 

The United Nations report "The Rise of Environmental Crime" recommends:-

 1 - Reduce threats to security and peace:  Strengthen the information collection, analysis and sharing,across sectors, in peacekeeping missions, Sanctions Commit-tees and across the UN as a whole on the role of natural resource exploitation in conflicts and security in order to inform holistic responses towards securing peace, secu-rity and sustainable development.

This includes integrating INTERPOL liaison officers in peacekeeping missions.  

2 - Rule of law: The international community must recog-nize and address environmental crimes as a serious threat to peace and sustainable development and strengthen the environmental rule of law at all levels to prevent safe havens including disrupting overseas tax havens, improve legislation at international and national levels, implement dissuasive penalties, substantial sanctions and punishments, capacity building and technological support, in order to enhance the enforcement and adjudication capacities in the area of environmental crime. 

3 - Leadership: Governments should establish central coor-dination and national cross-sectoral plans, with unity ofcommand and unity of efforts, in coordination with the relevant UN entities, INTERPOL, and other relevant international treaty bodies and institutions, as appropriate, to combat the involve-ment of criminal organized groups in environmental crimes.

4 - Financial support: Call upon the international devel-opment community to recognize and address environ-mental crime as a serious threat to sustainable development and strengthen the share of ODA to governance and judicial sector reform including to combating and preventing envi-ronmental crime. This should be targeted to capacity building and technological support to relevant agencies, national, regional and global law enforcement efforts against environ-mental crimes, such as information and analysis, inter-agency collaboration, enforcement, prosecution and the judiciary, especially in developing countries and fragile states.

5 - Economic incentives and consumer awareness:Strengthen economic incentives, relevant institutionsand awareness. This requires that plans for alternative liveli-hoods, economic incentives and consumer awareness also in importing countries are fully integrated and coordinated with enforcement efforts. Identifying best practices in behavioural change should be undertaken to reduce demand, including through a Communications Summit to address all points of this trade

https://wedocs.unep.org/bitstream/handle/20.500.11822/7662/-The_rise_of_environmental_crime_A_growing_threat_to_natural_resources_peace%2C_development_and_security-2016environmental_crimes.pdf.pdf?sequence=3&isAllowed=y 

Every living thing on the planet depends on being able to live in harmony with the environment. We are the ones who disturb that balance. We are the ones who rape & destroy our own world. 

We are knowingly pissing on our own home. Ultimately we are also the ones who will pay the price for our actions & non actions. 

 

• by companies, factories and Public Administrations.
  
  https://www.activesustainability.com/environment/crimes-against-the-environment/
  up to 70 million of them are captured to only have their fins cut off alive on the ship and then be thrown back into the sea.
  
  https://www.activesustainability.com/environment/crimes-against-the-environment/Up to 70 million shaks are
  up to 70 million of them are captured to only have their fins cut off alive on the ship and then be thrown back into the sea.
  
  https://www.activesustainability.com/environment/crimes-against-the-environment/
  up to 70 million of them are captured to only have their fins cut off alive on the ship and then be thrown back into the sea.
  
  https://www.activesustainability.com/environment/crimes-against-the-environment

Speech, Belief, Actions & Practice

It isn't necessarily what we say that is important. It is what we do. I can say literally anything. I don't have to believe or mean what I'm saying. "Words are cheap". Actions do "speak louder than words".

If I am to be believed, my actions have to show that I mean what I say. I have to "practice what I preach".

Most of us are capable of dissembling, to put it kindly. Or even lying. Most of us understand that we can't always tell the complete "unvarnished truth". If we do we can hurt others or do enormous damage to relationships.

I imagine most of us have been put in a situation where we have been asked to keep a secret. Breaking our word becomes a moral issue. In what circumstances should we do it? Or should we keep a promise come what may?

So, if we wish to be believed & respected as truthful, how do we tread the thin line between absolute truth & white lies to protect others? It's a question of good judgement. What is the other person capable of hearing & understanding?

If I were always completely honest & said exactly what I thought, in all circumstances, I probably wouldn't have any relationships left! If we were to "tell it as it is" all the time we wouldn't have many friends left to tell anything to. We all have to learn to edit our thoughts & speech.

My way of doing things isn't yours. My way isn't necessarily right. (Neither is yours). Actions are always questionable. The way I see the world isn't the same way you do. We as human beings, are constantly judging people, situations & actions.

So all we can do it try to act with wisdom & a highly developed moral compass. We need to care what impact what we say & do has on others. We definitely need to "think before we speak, (or act)". Because once out, the words cannot be retracted. The actions cannot be undone. They are always there between us.

That is the code by which I have learned to live. But there is a new "post truth" world, when the most powerful world leaders routinely lie & dissemble. I don't feel I can trust or believe many of them.

Where do we go from this new reality where nothing can be relied on? What is the point of having a vote when there is no one in power who can be believed?

 

Boris - Elected "Just Like That"

I can't help feeling that we now have Tommy Cooper as our Prime Minister. He was elected by 0.2% of the population. The Conservative party has just 180,000 members, whose average age is 72. Presumably not all of them voted. 141 of MP's are Conservative out of 314 - Not even half. It makes "The Will of the People" look ridiculous - UK democracy seems to be well & truly dead!

Boris's political record has been an almost total fairy story. He certainly has difficulty with truth & accuracy - Possibly learnt from Trump's success with virtual reality.
https://www.bbc.co.uk/news/uk-politics-48663963
Interestingly that fact sems to be completely ignored by those who voted for him.

His personal life shows him to be unable to maintain a relationship with one woman
https://www.express.co.uk/news/politics/1139287/Boris-Johnson-wife-married-women-Allegra-Mostyn-Owen-Marina-Wheeler-Carrie-Symonds
He must have something, because all of the women seem to be quite influential in their own right. Of course they are also the ones we know about - It does seem to be a pattern of behaviour, which is relevant, in my opinion, to whether I trust him.

He is taking the job of Prime minister seriously though I'm glad to say. He's had a haircut. So my concerns are completely groundless!