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[05omegav6]

2. My wife has recently been - reluctantly - prescribed tabs, that my GP tells me cost £198 per month for 28 tablets, I can buy 150 of the same tablets from Greece for 40 Euros! Go figure. I have written to my MP with these figures and await her reply with interest.

Why the NHS isn't exercising its' considerable buying power and instead chooses to be shafted I'll never know. Need to get  someone with some nouse running it, IMHO.

Probably because they are forced to buy absolutely everything via NHS Supply Chain, which itself is about as efficient as British Rail...

[Nick W]

2. My wife has recently been - reluctantly - prescribed tabs, that my GP tells me cost £198 per month for 28 tablets, I can buy 150 of the same tablets from Greece for 40 Euros! Go figure. I have written to my MP with these figures and await her reply with interest.

Why the NHS isn't exercising its' considerable buying power and instead chooses to be shafted I'll never know. Need to get  someone with some nouse running it, IMHO.

Probably because they are forced to buy absolutely everything via NHS Supply Chain, which itself is about as efficient as British Rail...

If they're an essential part of the NHS then all the employees should be doing the same 24hour 7 days a week that the medical staff are expected to. That would soon sort out what is, and isn't necessary/efficient.

[biggriffin]

2. My wife has recently been - reluctantly - prescribed tabs, that my GP tells me cost £198 per month for 28 tablets, I can buy 150 of the same tablets from Greece for 40 Euros! Go figure. I have written to my MP with these figures and await her reply with interest.

Why the NHS isn't exercising its' considerable buying power and instead chooses to be shafted I'll never know. Need to get  someone with some nouse running it, IMHO.

Probably because they are forced to buy absolutely everything via NHS Supply Chain, which itself is about as efficient as British Rail...

If they're an essential part of the NHS then all the employees should be doing the same 24hour 7 days a week that the medical staff are expected to. That would soon sort out what is, and isn't necessary/efficient.

NHS supply chain is run by DHL.
Think your referring to procurement. That's government supply contracts, a den of back handers and fiddling, by minsters, and civil servents who are "entertained" by large corporations.

[Varche]

Www.huntjeremy.co.uk

[jimbo125]

I work for the NHS and find that the rules are all made by 8 - 5 office workers who do not work nights, weekends, bank holidays or any other antisocial hours but deem themselves experts on those that do and have never done the job they impose changes on. I am not an accountant and would not tell an accountant how to do his/her job but plenty of these oppsers tell me how to do mine

[Terbs]

I work for the NHS and find that the rules are all made by 8 - 5 office workers who do not work nights, weekends, bank holidays or any other antisocial hours but deem themselves experts on those that do and have never done the job they impose changes on. I am not an accountant and would not tell an accountant how to do his/her job but plenty of these oppsers tell me how to do mine

Well said, that man. And that applies to many especially government !!!!!!!!!!!!

[biggriffin]

I work for the NHS and find that the rules are all made by 8 - 5 office workers who do not work nights, weekends, bank holidays or any other antisocial hours but deem themselves experts on those that do and have never done the job they impose changes on. I am not an accountant and would not tell an accountant how to do his/her job but plenty of these oppsers tell me how to do mine

Aggred. The busiest time around here on the roads is when the hospital starts work 07.45 and finishes 16.45. That goes for the police hq which is on the same site.

[D]

There's a table here to show things as simply as possible

We will fight contract imposition, says BMA
http://www.bbc.co.uk/news/uk-england-35548091

I was looking at that table earlier and found it misleading,  the synic in me thinks there may be a small amount of deliberate obfuscation of the truth in it.

table on the left presents % as a whole, the other 2 represent amount + x%.  eg 120% of basic vs basic + 30%, the second one is actually higher but looks smaller.  At least subconsciously anyhow.

This strike is about nothing but money, ok there is a little bit of politics here (oooo look at the nasty tories killing the NHS) but 95% about the money.  At every turn the BMA will make you think it is about patient safety but those arguments are simply BS and the arguements don't stand up to scruteny. 

BMA: "These plans will affect patient safety"
Interviewer: "Can you explain how? "
BMA: "No, but trust me, I'm a doctor"
 

We were working long hours in Afghan at the hospital, minimum 8 but upto 14 hours a day 7 days a week.  People were working long shifts and dealing with some pretty horrific and busy work patterns, without a pay rise.  They looked at patient outcomes and Bastion Role 3 hospital was rated the best in the world for trauma.  Why?  Because the specialists and the management (leadership) weren't afraid to make some pretty ballsy decisions and changes to the fundemental doctrine we had not changed in decades.  Changes such as taking the front door of A&E to the scene of the incident, including damage control surgery in the back of a chinook (which when I saw it in action just blew me away)

If something didn't work we changed it.

Nobody cried.  Some still sadly died.

We learned, we adapted and we worked hard.  The men and women I had the honour of working alongside did some amazing things and saved many lives.

I think it is sad that what is mostly just a financial isue is being hidden by this "Patient Safety" arguement.  It has already been proven that if you have a stroke at the weekend you are more likely to die than if you have one during the week.  Where is the patient safety arguement here?  Why is nobody on the front line or the BMA suggesting or making fundemental changes to how they work in order to change that?

That is a completely wrong, biased and moronic appraisal of a very complicated and important issue. I will say no more because you cannot have a discussion with someone as mis-informed as you who likes to make blanket statements about someone/something else without understanding anything about it. Of course when it comes to something like cycling, you will spend hours spouting crap and writing up proposals to protect your backside. When it comes to your job or your health; again you spend time bleating about it and making it sound like it is the most important thing in the world. However when it comes to the issue of doctors, you always seem to have some sort of hidden agenda of making it look like they are always wrong.

I will leave you with this question. Show me one study that actually shows increased stroke mortality on a weekend is related to the care (or more specifically to the number of doctors) they receive on a weekend rather than other factors including nurses/physio/OT/speech and language therapists/imagers/interventionalists/drug availability/patient transport etc:

https://fullfact.org/health/ask-full-fact-stroke-patients-and-weekend-deaths/

Additionally in response to patient outcomes from Bastion Role 3; there was and still is a lack of information of physiological severity scoring of patients treated and admitted to the unit. And how does comparing outcomes from such a unit apply to a normal NHS hospital. Chinooks which are fully adapted vs tiny air ambulances in the NHS? Level 3 care vs smaller hospitals in the UK, some of whom do not even have level 3 beds? 34% of patients were transferred out to other units. Imagine that in the NHS. 18% were evacuated by a critical care aeromedical evacuation team. None of this happens in the NHS. Why? Because of the level of investment in the above hospital vs what a normal NHS hospital receives.

The average ITU stay in Camp Bastion was 2.5 days. Completely incomparable to a normal NHS hospital ITU stay.

So Jeremy Hunt's explanation of thinning out an already stretched workforce even thinner does not work. What you need is more doctors/nurses/HCA/physios/OT/SALT/images/porters/ phlebotomists to bolster the weekends. Not stretch the workforce and in the process make the weekday less safe.

I am not a junior doctor, but I see the degree of altruism in my junior doctors. Most, if not all of them give up their free time for the patients that they really care about. And you cheapen and insult that dedication by calling it "about the money". Shame on you!

[STEMO]

Steady on, D. You'll have a coronary and end up in hospital. You don't wanna do that on a weekend. 

[Gaffers]

Steady on, D. You'll have a coronary and end up in hospital. You don't wanna do that on a weekend. 

I know, but I think he has to get off the fence and come out with what he really thinks about me

[Gaffers]

That is a completely wrong, biased and moronic appraisal of a very complicated and important issue. I will say no more because you cannot have a discussion with someone as mis-informed as you

I like that statement when it precedes War and Peace

I know I am a moron, but there is no need to get personal about it.  Look, you seem to think I dont like doctors.  You are obviously one and I admire your passion.  I even looked at going to medical school during my military career but when I got my diagnosis  I knew that would be a bad move so I decided to develop my IT skillset instead.

Oh, but that's not me bleating about being ill.  Jeez, I am not the first on here to talk about their ailments. Chill dude.

Nor am I on some crusade to "protect my backside" on cycling.  Rather than go loggerheads with motorists on the subject (erm, I'm one of them too) I am instead trying to bring around a change in the fundementals of road infrastructure design processes while also trying to bridge a gap between understanding from those who ride a bike and those that dont.  I am the first to acknowledge there are bad eggs on both sides of that debate.  Again, chill dude.

Right, back on to the subject.  I have avoided responding this weekend because Iwas busy and had better things to do such as dragging Al out of his bed.  He took his frustration of lack of sleep out on my boot lid by hammering it like a man possessed and now it works again.  Yippie!  (p.s. Al, funds inbound this evening for the bumper )

The feeling I got from your response made it quite clear you dont like me, not that I care a toss.  But you did make some rather sweeping accusations about me and other subjects that I would have to put straight.  Firstly, I have the utmost admiration for the medical profession.  Doctors nurses HCAs all, well nearly all, do an amazing job and we as a nation are blessed to have such a health system.  Ok, occasionally it fails such as when my dad's cancer diagnosis was missed for over a year by which stage he was stage 4 and weeks away from death.  Because we dont look part-indian in our family his doctor didn't check the lower oesophagus for squamus cell (dad's grandma was from Gujerat)  In the end it was a liver specialist who made the corect diagnosis and it was Professor Hawkins at Christies that took a radical and uncoventional approach to his treatent and amazingly put it in to remission.  8 years on and he is still 100% clear.  Amazing.  I was misdiagnosed for 4 years and unless I had practically forced the locum GP to refer me to a specialist I may have waited much longer to be properly diagnosed.  I learnt later by doing an SAR on my medical notes that the GP actually wrote "I am only referring him to you because he insists, I do not feel anything substantial is wrong but up to you if you wish to see him".  However, I would not be alive it weren't for a certain Col Young who had cool fluids ready on a day that fell ill to heatstroke and a rectal temp of 41.9C.  The doctors at Frimley A&E that continued the good work that Col Young started also were a mix of civilian and military and some have since become some good friends.

Yet my view on doctors is completely unaffected.  I have had the honour of working alongside and supporting them in some pretty inhospitable areas on the globe.  Seeing firsthand the amazing work they do was humbling.  This is why I have no problem with all health professionals being paid more, including junior doctors.  However what I do object to is false pretences.  Every single point on patient safety brought up by the BMA, including new rules to reduce the maximum overtime a junior dr can work and increasing fines for trusts that break them, on the new contract were addressed.  The final point of contention was the weekend working and the rates and hours for basic vs overtime, and it was this which sent the junior doctors on strike.  Every single post on FB from my doctor friends has been about pay, and how little they earn compared to, say, an Aldi shelf stacker.  Not one comment or explaination of the connection between the changes to working hours and patient safety despite me asking several of them.

So please.  Educate me.

[Gaffers]

In return I will pre-emptively pass on a few buggets of my own:

- The study on Bastion R3 was not simply looking at the hospital but the entire medical chain from point of wounding through to rehabilitation.  I fully accept what you say about 2.5 days, but I am pretty sure that this statistic refers to UK personnel av ITU occupation rates.  I nkow for a fact that there were many Afghan army/police/locals who stayed there much longer, often weeks or more than a month, I know because we had to try and get other facilities to transfer them too, once they were well enough.  I got to know a couple of them and even had to source spirits in an emergency once as we had run out of the drugs used to treat methanol poisoning.  Getting gin and vodka from Kabul in the space of 3 hours on a Sunday morning when almost everyone is still in bed (except the medical staff of course ) was tough.  Getting the Brigadier to argue with a US general about letting the booze go through his airport was even harder . I grew a bit of a reputation in HQ after that one I can tell you

- Weekend mortality rate.  There are as many studies supporting the claims as there are disproving them, so Iguess the jury is out.  The research by the R4 programme 'More or Less' was pretty good and (for once on the BBC) pretty impartial - http://www.bbc.co.uk/programmes/p03flxkc   I will also say that if the mix of patients differs at weekends, as suggested in the programme, then obviously people subconsciously or consciously know, or certainly feel, that the level of care at the weekend is not on par with that during the week.  The study mentioned in the programme did state that 5 out of 6 weekend stroke patients did not get a brain scan soon enough, which as I am sure you know is pretty crucial for patient outcomes when it comes to strokes.  However, that study was done 5 years ago and inroads have been made since.  That said, it would be interesting to repeat the study to see what has changed 

[STEMO]

You forgot to put kisses at the end. 

[Gaffers]

You forgot to put kisses at the end. 

I always get carried away with too much tongue 

[Kevin Wood]

I'm still troubled by the mental image of Telemacher hammering at your rear end.