Smile of the decade blog

The NHS Plan promised an extra 7,500 consultants and 2,500 more GPs by 2004. The BMA believes even more doctors are needed and that more needs to be done to attract people into medicine.

The BMA idea probably involves paying doctors more money...and they are wrong, so much of the time this Doctors trade union is all wrong.

The NHS may indeed need more money spent on patient care efficiency - but one thing that it has, but doesn't need, is money as the motivation to get doctors to do their already very well paid jobs...

Recently I heard of a GP who had demanded a sizeable fee from a teacher who had asked for a medical report on a child at the school in order to enable them to get extra support for that child - this would typically involve copying the already written diagnosis, adding a few lines and getting the secretary to send the letter off.

This GP is one of those average ones you have read about, you know - the ones who already get paid more than the Prime Minister but don't have to do evenings or weekends.

He and his 7 partners already earn more than half the entire budget for this state school...but he wants more money to do this work. The teacher objected - in words that I would have been proud of.
The doctor still wants some money...

I have a friend who is a GP - a once radical hippie GP, he now appears decidedly old fashioned. Sure he quite likes having more money than he used to get, but he has always said he believes in the NHS - free at the point of delivery, and he has told me about many of the little cash scams that have slowly become norms in the field...

You may not have heard of "Ash Cash" but your doctor definitely has. This is the fee of over £70 that a doctor gets for signing off a dead body as OK to cremate - effectively countersigning the signature of the original certifying doctor.

This ash cash was claimed rather frequently by the practice nearest to a certain Dr Harold Shipman - no checks were taken as 240 odd people died in suspicious circumstances but any clues were missed (£70 is £70- might as well get some spending money for that fourth Caribbean holiday of the year).

It was the undertakers who blew the whistle on Shipman. They saw that too many people were being found dead sitting comfortably in their chair at home - that just doesn't happen naturally, they correctly noticed - and did something about it - not for money - because they were just being professional.

Ash Cash is only one small aspect of the bonus culture as it has slipped into common usage within the NHS system...hitting targets is another cause for a cash flow party. My GP mate caught himself one day, trying to make sure that a severely handicapped girl had a smear test, "caught himself" because he suddenly realised that he was pushing for something totally unnecessary for this girls health. Cervical smears are pointless on a virgin, but it would have helped him hit a target at which point he would have got significant extra money.

He stopped himself because he remembered his rationale for providing care - the GP trying to charge £100 for a report to a school, didn't and persisted in asking "Where's my extra money?". They may say there could be an avalanche of people demanding these free extra services - there wouldn't be, and you could limit them in many other ways - money does not create better doctoring, that's proven.

Cuba exports doctors to developing countries in Latin America and Africa - they have the most basic wage rates for doctors but the highest proportion of doctors per head of population of any country in the world.
MY GOD! cry the western doctors - what on earth could be motivating these idiot doctors?

The blood service in America used to be voluntary, like our own. They turned it into a financially driven "paid per unit" model in order to try and increase the quantity of blood supplies for transfusions. The result:
blood supply levels fell and quality issues became a nightmare.

People in Britain donate blood out of a genuine feeling of community, it is a gift, they feel proud of doing it. Once you make it a sale/purchase it becomes a different thing altogether, those who were proud to donate walk away leaving those who are desperate for cash to take their place.

The summary is:
It is madness to try and motivate people with cash.
So why have we screwed our NHS?,
which successfully recruited thousands of young general practitioners in the 1960s who would visit your home and do what they felt was right because...
they were your family doctor - and proud of it.

Now there are very few of these doctors left - nearly all are corrupted, inevitably, by the cash bonus culture that has also screwed banking. Cuba holds the model of how it might have been - how it could be, if we lived in a non capitalist, or at least a less brutally selfish capitalist, country. The next government, and the three after that, are going to have a hard job of turning this juggernaut around.

because Britain just lost one of its last living stereotypes, but one who successfully put his money where his very loud mouth was...
Omituaries has updated.

(title linked) - in which case we will be set with this transparently useless Old Etonian leader after the next general election:

I had to turn off Radio 4 this morning as MR Education Balls talked on and on, repeating and interrupting the questioner, about how different his party's promises on education spending were to those of the Tories...
and I just quietly wept for politics.

If this man represents the best chance for following up the Brown disaster with someone who can talk properly and not hide, chewing his fingernails, when a totally radical approach is required to 21st Century politics then labour is sunk - and despite my best socialist loyalties I would have to say "Good".

I was temporarily taken in by Blair's abilities and the progress on the Irish problem, enough to vote for him once more - except he then bought into the Bush oil wars and lying about his intelligence - since then it has been nearly all downhill - and just looking at Tony now it is impossible not to feel betrayed by the Labour party who allowed him to get away with it for so long...

I thought Brown just might, just might...
start to redistribute wealth - you know - the fundamentals of labour party principle? - whereby those earning more than the five hundred poorest families in Britain put together are made to give up a decent proportion in order to stop those, and other families from becoming desperate criminals.

it seems that all the current batch of labour politicians are not only on the side of the rich - they are widely partaking of the criminal acts to make themselves as rich as these rich folks...

Today we also hear Paddy Pantsdown suggesting that we might have to scale down our nuclear ambitions in light of the "new" world of politics, the end of the cold war...
Wow - has he just discovered that we went past 1990?

The stark staring fact was that our "independent nuclear deterrent" was only ever an expensive bit of haute couture for to sit looking important at the top table of greedy violent generals that run the western world. Norway feels no need for a nuclear deterrent
- are they at risk from terrorist attack? - no, we are!

So please can anyone with a brain and a way of altering government policy do whatever they can to prevent either of these nuclear addicted, money grabbing, poor despising, educationally challenged members of the two top parties from
a) renewing our nuclear version of the emperor's very expensive new clothes and
b) from getting back into power in this country.

I shall be voting Green - they have some genuine socialist policies and seem to have grasped the idea that the well played out notion of the planet as a rich man's play thing, has got to go pdq.

The radio 4 announcer put it more starkly than this BBC writer,(title linked): "The public have lost faith in the Metropolitan Police following the G20 and other protests" - the reaction from the police was fiercely in denial, saying that the "kettling" and other aspects of the policing were "a great success in very difficult circumstances".
...still not seen the missing element?

I have a problem here. We should all have a problem here. We all saw the videos shot on mobile phones, we all heard them being caught out blatantly lying to cover up the police induced death of bystander, Mr Ian Tomlinson, we all saw the subsequent videos of other officers slapping or beating static and passive protesters...

There is room for some wriggling from the police and this committee on why officers may have over-reacted in the circumstances, not much, just a little. There is apparently some debate between the parliamentary committee and the police as to whether there were sufficient numbers of police and whether these police were trained to the necessary levels...?
point avoidance here is beginning to puzzle everyone surely?

these are "your pictures of the G20 protest" as now put out by the BBC.
How edifying that they have managed to edit out all the nasties!
- and ONE key aspect...
where I have the biggest problem and so should we all.

?????????????????????????????????????????????????????????????
Where is the mentioning/photographs of the large number of police officers who covered or removed their badges before joining the throng?

?????????????????????????????????????????????????????????????

and, where is there reference to the planned "surprise" from the evening SPG aggression as announced to the protesters by the afternoon shift as they departed from successful and peaceful policing of the crowd?

I have read that there was to be an internal inquiry into the removal of badge numbers since this is clearly a preparation for illegal activity by these officers. That is bad enough, but the reports of the time made it quite clear, this was no last minute removal by a few rogue officers, it was planned, with the full knowledge of the immediate superiors to these officers.

So the report should be investigating the conspiracy to commit acts of violence by the police...conspiracy to commit violence by the police collectively.
That is some weighty accusation - but one with evidence that is undeniably captured on videos and stills - none of which appear on BBC websites any more...

The abject politicians make their pathetic suggestion that all we need is better training and more police officers...how servile can you get? Politicians will never dare confront the behaviour of the police, they fear the reprisal!
- we are so much nearer to the blatant corruption, that spokespeople here publicly scorn, in so many other countries than anyone in a position of power has the guts to suggest.
Surely we will carry on with this aspect buried just below the surface but the Thatcher legalised free movement prevention and picket bashing was the first real giveaway. Back then, the BBC edited its news coverage of Orgreave into a pro-police pro-Thatcher lie, so if you are hoping for an objective media to help tackle this issue, think again, we can never expect them to challenge the masters of the police force.

Tony Blair was Maggie's proudest achievement.
- her shame, his shame, the shame of them all, is our country's democracy-sabotaging approach to managing the police force.

The cliche used to be that Soccer was a gentleman's game played by thugs whereas with Rugby it was visa versa. This was an arrant piece of class snobbery by those who saw Rugby as the sport played in a gentlemanly manner by the upper classes at public schools such as Eton, Harrow and...err, Rugby, whereas those lower class oiks played football and fouled each other hopelessly.

Having spent most of my adult life in Wales this cliche was very much not the case in the far more egalitarian hillsides of the Welsh Valleys. The few snobby boys who got sent off to public school did their chances of playing for Pontypool and Wales no good at all.

There was always a pride in being tough... playing the game in a hard, physically challenging way but not arguing with the referee, that was the rule. And so was shaking hands with your opponents in a manner that was often lacking at the highest levels of the, internationally more popular, but ignored in South Wales, sport of soccer.

The Springboks are just now celebrating beating the British Lions with the last kick of the game in the second test, and thus winning the series, in their home country. But they won it playing like animals, and they are not the only such malevolent participants in this modern game, full of gouging, kicking, throat tackling, punching, stamping and other forms of cheating, it is the rule not the exception at club and international levels.

It needs to change or die...
There is no point in waiting and hoping for the crowds to boycott this abomination of the old sport, the "professionalism" that is now central to the game is probably encouraged by the crowds whose blood lust is as likely to keep them coming to watch as flowing passing manoeuvres.

I gave up Rugby at school level because I was fed up with the growing permitted and dangerous violence. I also remember "the lads" ribbing of me and Jim Fletcher on our deciding at 6th form level to take the option of ballroom dancing instead, loudly calling us poofs, (Gay, to you young people). We pointed out the irony of such a shout from a group of men going off to clutch each others scrotums and thrust their heads between each others buttocks, covered in mud... whilst we danced chest to breast with 22 women (best move I ever made) but machismo and stupidity went hand in glove then as it still does now.

38 years later, I just wish all aspiring thugby players had to opt out of NHS treatment and pay for their own private sector injury treatment costs. The insurance might be prohibitive. After all, these are effectively self-inflicted injuries with each player only having the feeblest defence of being mentally unstable in making the decision to play this barbaric semi-sport and the current estimated NHS bill of £14 MILLION A YEAR is money we could do with in a more deserving part of our society.

It is a shame because at its JPR to Shane Williams style best the game can be a joy to watch, but the South African celebrations are of a cheated win, in a cheating game, played by cheating thugs.

After the recent MP expenses scandal there has been a kind of settling back - the "better" MPs have been talking about how the majority are motivated by the desire to serve the public - I have my doubts.

Let us start by asking if Banking executives are motivated by a desire to serve the public?
- clearly not, seeing as we need to pay them more than their entire family needs to live comfortably for 400 years just to attract them to the job in this country - heaven knows if we only paid them £1 million a year they might choose to be an Afghan warlord instead...

Lawyers?
not sure about the morals of lawyers - above or below those of politicians? - but then so many of the buggers are both, some still earning from both professions too...

and incidentally - with this new found demand that all public sector workers earnings and expenses be transparent, why stop at the public sector? what does PLC stand for if not Public? - as in all the salaries and expenses of these firms' executives and managers should be in the public accounts... available online.

Some people have no similar embarrassment about their levels of pay.

Charity workers... ahhh now here you may just see that people are clearly motivated by the desire to serve - just check out the (title-linked) pay scales for the management jobs available in the charity sector...

surely these are the pay scales that MPs salaries should be "benchmarked" against? - clearly those managers in the third sector are somehow managing to live on their pay of £25 - £35 thousand a year. The motivation of service must be attractive enough to make this feel worthwhile...

so come on MPs, stop trying to "benchmark" your pay against the rates paid to assholes in the private sector and start comparing yourselves to those who genuinely do wish to serve - if you cannot stand the halving of your wages that this represents I am sure some altruistic types can be found who will accept them - maybe they will come from the charity sector?

I shall be laughing at the big lunch on July 19th
- and encouraging a whole load of other people to laugh,
at the big lunch.

Not laughing at the concept of course... promoting laughter there, on Minchinhampton Common, as a therapeutic aid to living a happy life. In our local community there is still some sort of sense of this "together - in gift" meaning of community that has largely gone to pieces since Maggie Thatcher's generation of "me and my money is the only reality", came along and built the sad celebrity world ethic we see so much today.

On July 19th, another in the new sustainable world supporting initiatives, prompted by Tom Smits and others at the Eden Project, gives us all an opportunity to rediscover the soul of our community and the common sense of working together, (to maximise resilience in the face of the inexorably failing capitalist consumerism...) oooh, bit political I know...

What's that you say?
You love your SUV/4x4, fame hunting, drugs and retiring to your moated castle?
- fine -
but please don't breed, the species needs people who want it to thrive collectively, not drop dead trying to be individually famous...
like Michael Jackson.

I have been incapacitated with the flu for a week and now everyone keeps asking "Is it the Swine flu?"
...to the point where I am tempted to say "Yes, I went to Mexico while you weren't looking and now I'm going to sneeze on you..."
the fact that, of those who have so far contracted this "new" flu strain, some tiny number have died has made it is imprint on everyone's brain that this H1N1 is the flu that matters.
The fact that 15,000 people in the Americas alone have died of ordinary influenza in the same period is completely lost on the public - and NO I haven't been to the doctor, and NO I will not be the new voice of movie trailers,
even though my impression of him is now wonderfully authentic...

"After a time in the lost world, John McClane is back... and he wants revenge..." you know the clichéd gravelly voice over....