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Jun 15, 2017 12:05:08 GMT
Post by Deleted on Jun 15, 2017 12:05:08 GMT
So, not fit for a purpose that needs to be redefined, then? All I mean is that my first and second-hand experience is that it seems largely fit for the purpose that most would consider its primary role, namely 'I'm ill, do what you can to make me better'.
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Jun 15, 2017 12:21:11 GMT
Post by michael on Jun 15, 2017 12:21:11 GMT
Unfortunately that's a bit like saying your car is fit for purpose because it can get you to the shops even though it does 1 mpg, handles like a paving slap and damages everything it passes with NOx fumes. It might make the ill you better but it increasingly can't meet the demand of everyone else.
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Jun 15, 2017 12:26:01 GMT
Post by Big Blue on Jun 15, 2017 12:26:01 GMT
This is the main issue I have with the NHS: it seems that getting ill people better gets more headline praise than getting people not to be (as) ill in the first place. Mainly down to reporting etc. but I have an annual check up because I ask for one, not because I'm told to have one. This year I had a blood test in about April; I could have galloping blood-rot or bits of my spleen floating about in my blood stream for all I know: the results are clearly on some secret list held in Millbank by the security services because they never made it to me. I agree, when I've been smashed up; when my kids are ill; when my father died the NHS did what I expected them to do but when I have routine tests that should tell me to carry on eating deep fried Mars Bars as they aren't affecting my health or whether I can only eat iceberg lettuce for the next year or I'll die they don't.
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Jun 15, 2017 12:35:45 GMT
Post by ChrisM on Jun 15, 2017 12:35:45 GMT
I always love it when people mention deep fried Mars bars.....
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Jun 15, 2017 12:57:24 GMT
Post by Tim on Jun 15, 2017 12:57:24 GMT
Eh? In my experience when you get tests they give you a result and some advice.
My Mum was in hospital last week with a suspected heart attack and the care couldn't've been better even considering she was taken in late on Saturday evening, normally a busy time.
My Dad has had exemplary care over the last 2 or 3 years, with low blood pressure, a very slow heart rate and various ongoing checkups, all despite him suffering from dementia and a clear candidate for being left to nature, as it were. 18 months ago I even had one of those 'you'd better get down here fairly quickly' calls from Mrs Tim when she had taken a day off to go and visit him and he was in a really bad way, yet they did everything they could do restore him to decent health and he's still with us.
Incidentally, all the political parties have been calling it "Our NHS", not just the 'lefties'
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Jun 15, 2017 13:30:36 GMT
Post by Deleted on Jun 15, 2017 13:30:36 GMT
Unfortunately that's a bit like saying your car is fit for purpose because it can get you to the shops even though it does 1 mpg, handles like a paving slap and damages everything it passes with NOx fumes. It might make the ill you better but it increasingly can't meet the demand of everyone else. I think that's more than a little hyperbolic, personally. I know it's far from perfect, but the fudging together of long term care and health is not the NHS's fault - it's a political fudge, and one without an answer within acceptable budgets, I fear.
Re BB - it would be a great idea if the NHS were preventative rather than just reactive*. But I doubt that those of us who care about such a notion would be prepared to pay for it for everyone else (who largely seem not to) when there's a Hell of a lot you can do just by trying to live sensibly. I know Jackie Stewart has a massively thorough medical examination each year - doubt that's within my budget, though!
* Our GP has only just started asking whether patients smoke, and it takes a pretty extreme BMI before the issue of weight gets discussed. Not how it should be but in an era of five-minute, single-subject consultations, I guess it's what you have to expect. I think the GP end of the NHS is rather more obviously flawed, here at least.
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Jun 20, 2017 9:10:31 GMT
Post by Deleted on Jun 20, 2017 9:10:31 GMT
Ageing population is main issue we face as a society. However....all governments are to blame as this situations been patently clear for the last 4 decades. Add in a bit of medical advancement too and it's a major problem.
What can you do?
Well we'll all have to pay more tax, that's for sure. How that is actually implemented we'll see who's in power.
For me then I'm sorting out my finances to shield me as much as possible from inflation and economic risk.
And much as I'm happy to pay a bit more tax, those who think they can tax the rich infinitum are deluding themselves as I'll just reduce my income until it blows over. I'm happy to work long hours but not for someone else's sake.
The irony is that with free Uni education and likely economic effects of a labour government I'd have been a major winner, but I voted for what I felt best for the country long term, not for my own circumstances.
(and like 12th I'm a lot more of a pragmastist than my younger self)
EDIT - as an aside our experience with the NHS has been excellent (arguably too good considering it's funding issues)
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Jun 20, 2017 16:12:24 GMT
Post by PG on Jun 20, 2017 16:12:24 GMT
Governments probably did see this coming, but they are key exponents of the mantra "why do today what you can panic about tomorrow". Fixing tomorrow's problems today only loses you votes if money is involved.
I can see that the NHS (and social care) needs more money, but unless some changes are made as well, it will just be more money into the same bottomless pit. It's like the worries about coal production in the the late 19th century and early 20th century. In 1900, 1,100,000 coal miners were employed in the UK and it was feared that there would be required a continually growing number of men to go down the mines to product enough coal to allow economic growth the continue - and this was unsustainable . Oil saved us from that fear.
I feel the NHS is the same - we need the health and social care equivalent of oil to save us from what is otherwise going to become an unsustainable cost - in terms of money and people required. The Lid Dems 1p on tax policy or Labour's tax the rich are just posturing and political role playing.
An ageing population, never ending health demands and demands caused by our lifestyles will all overwhelm whatever we try and do.
So some provocative things are going to have to be discussed - so maybe time for a Royal Commission and any party saying this stuff will never get elected: We've got to be prepared to talk about death. The concept of a good life and a good death has been lost. We now have the "keep me alive whatever" approach. Medical science may be able to give life (and will continually get better at that), but it cannot give "a life" and I don't see that improving. All long life seems to give most people is more time at the end to be sick and miserable. Yes, there are exceptions and I'm not advocating killing people off. What I'm saying is that treatment of people beyond a certain point is almost counter productive. I watched my mother just fade away for two years. She was on about 20 pills a day, 3 social care visits a day, she could not get out of bed, she had to be fed. I was more upset by that than her actually dying. Death almost seemed a relief at the end. I have a work colleague whose 85 year old mother has just had a serious stroke. She was resuscitated and is now in a nursing home. She cannot do anything for herself unaided. The lady in the next room to her is the same post stroke and has been there over 2 years. What quality of life is that? We've got to be prepared to say unpopular and difficult things about lifestyles and life choices. When I was a kid, nearly everybody smoked. To be anti-smoking was laughed at. Now look where we are - reduced smoking levels, no smoking in so many places. We have to do the same with obesity and diet, plus lack of physical exercise. Imagine if the 10% of the NHS budget that is spent treating type 2 diabetes was available for other things? I wonder if Dianne Abbott sees the irony of banging on about the underfunded NHS, when she as an overweight Type 2 diabetes sufferer is part of the issue (if she has a different medical condition then I apologise to her....but weight is a key factor in type 2 diabetes onset). Should we support (and even make tax deductible) top up insurance - as opposed to the all or nothing private v public system we currently have? Robotics / automated care / technology must be encouraged and funded.
I am sure there are many other areas that are difficult and nee discussion.
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Jun 20, 2017 16:28:45 GMT
Post by michael on Jun 20, 2017 16:28:45 GMT
I agree with much of what you're saying, PG. The problem with any sort of reform or modernisation is it's attacked as a cut to 'our NHS'. The NHS is not fit for purpose as it is simply not fit itself. With trusts up and down the country running deficits the system is ready to crash. From the user perspective the failing system is largely hidden, occasional waits being the most visible issue but there will come a point where a trust will collapse. In terms of things to do then personal responsibility is a big part of it but won't deliver results for years. I work in that field myself and a lot is being done but that is ultimately lambasted as the nanny state - sugar tax for example. Right now people need to accept that not every town needs a hospital when a local centre/clinic would be far more efficient. I can't imagine this ever happening as they see it as their right to have a hospital on their door step and somebody else should be paying for it. It's a ridiculous state of affairs.
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Jun 21, 2017 9:27:55 GMT
Post by Deleted on Jun 21, 2017 9:27:55 GMT
I don't see any difference between taxing sugar and taxing fags, in crude terms. Use it to encourage behaviours, and to steer the makers of such things - they'll find methods of making products healthier only when given financial incentive. The 'energy' content (and doesn't that word have positive connotations, whereas we all know calories are 'bad'?) of some things I see are just startling. There's a Lucozade drink that my youngest used to have that contained a third of an adult's recommended daily calorie intake in a 1L bottle. Such things should be legislated or taxed out of existence - they won't be missed.
I have heard calls for tax relief on things like gym membership, but I suspect all that might happen there is a benefit be given to those who are already exercising rather than encouraging those who are not.
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Jun 21, 2017 10:01:35 GMT
Post by johnc on Jun 21, 2017 10:01:35 GMT
We were in a coffee shop at the weekend and I was contemplating something "bad" like a piece of cake or a muffin etc. My wife did a quick online review of the coffee shop's products and the cake I wanted had almost the whole daily allowance of sugar for an adult male (39g I think). The muffin wasn't far behind and in relative terms, the pain au chocolat was positively healthy.
I didn't have anything but from the figures shown it is basically not possible to have any treat and remain within the daily allowance! That of course assumes that the recommended daily allowance is in any way scientifically proven and isn't just someone's idea of a reasonable amount.
Don't think I can live the rest of my life without a bit of cake now and then though.
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Jun 21, 2017 10:01:55 GMT
Post by michael on Jun 21, 2017 10:01:55 GMT
The key difference between taxing food and taxing cigarettes is you need to eat but you don't need to smoke. The sugar levy for soft drinks has seen manufacturers rush to reformulate drinks but there is more to be done. Energy drinks are a public health target as they're linked to a number of deaths in young people and the potential longer term health implications are a concern. My own view is that flavoured energy drinks should be banned.
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Jun 21, 2017 10:09:15 GMT
Post by Tim on Jun 21, 2017 10:09:15 GMT
I didn't have anything but from the figures shown it is basically not possible to have any treat and remain within the daily allowance! That of course assumes that the recommended daily allowance is in any way scientifically proven and isn't just someone's idea of a reasonable amount.
I think you're wrong. I recently got a meal deal from Tesco and the crisps, coke and whatever sandwich it was all complemented each other so that I ended up with a balanced meal
Some of the microwave meals (for an example) are shocking though with up to 80% of your allowance of some categories!
Also I've noticed that Birds Eye are sneaky, they have the traffic light symbols in shades of grey rather than colour. (I don't want to give the impression that I only eat rubbish!)
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Jun 21, 2017 10:35:22 GMT
Post by Big Blue on Jun 21, 2017 10:35:22 GMT
We've got to be prepared to talk about death. The concept of a good life and a good death has been lost. We now have the "keep me alive whatever" approach. Medical science may be able to give life (and will continually get better at that), but it cannot give "a life" and I don't see that improving. All long life seems to give most people is more time at the end to be sick and miserable. Yes, there are exceptions and I'm not advocating killing people off. What I'm saying is that treatment of people beyond a certain point is almost counter productive. I watched my mother just fade away for two years. She was on about 20 pills a day, 3 social care visits a day, she could not get out of bed, she had to be fed. I was more upset by that than her actually dying. Death almost seemed a relief at the end. I have a work colleague whose 85 year old mother has just had a serious stroke. She was resuscitated and is now in a nursing home. She cannot do anything for herself unaided. The lady in the next room to her is the same post stroke and has been there over 2 years. What quality of life is that? Plus 1Million When my father died after a two week stay in hospital I was relieved. During that period he had his guts ripped out and was given a colostomy bag. Those of you that remember he said I was to go and buy him a bottle of scotch and 200 Paracetamol if he ever made it home and (for once) he wasn't larking about. I was reminded of the good fortune of him passing away after a short period of incapacitation when I saw a woman about my age in the local pub helping her dad, who didn't look all that well / happy / compos mentis out of the pub and into the car. The only time I saw my dad not able to stand to attention was that last two weeks and a period of about a day after his heart by-pass in the '90s - so far all his passing away too early for my liking (75, so not too bad based on the year he was born) he didn't have much of a poor life-experience due to illness. It's this aspect of medical care and life expectation that we need to assess vs the hippocratic oath. Midwives used to smother deformed babies and declare still birth, so I understand. Brutal, horrible to imagine but ultimately a hard-nosed kindness in an era when society wasn't made for coping with the disabled.
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Jun 21, 2017 10:53:51 GMT
Post by michael on Jun 21, 2017 10:53:51 GMT
Also I've noticed that Birds Eye are sneaky, they have the traffic light symbols in shades of grey rather than colour.
There isn't an industry standard that has to be applied for a particular traffic light system so the whole thing is open to abuse. One of the large pizza chains was advertising their product as meeting daily nutritional guidelines but what they didn't make clear was this being based on a portion of one slice of pizza rather than the whole thing they sell you as a meal.
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Jun 21, 2017 11:21:25 GMT
Post by Deleted on Jun 21, 2017 11:21:25 GMT
A very contentious subject, life length over life quality. When my maternal grandfather became ill in november of 58, he was taken in to hospital and opened up. The cancer had spread so far they closed him up and sent him to a ward with some nice meds so he passed away peacefully. They did nothing heroic. Not many moons ago while I was working in nhs operating theatres, an older woman was brought in from a nursing home. She had contractures on all limbs and was basically emaciated. She had been 'dropped' from her bed by a single nurses aid who was was washing her which snapped her neck of femur like a dry twig. Her daughter refused to sign a consent form for a dhs (Dynamic Hip Screw) procedure so the doctors went through every relative they could until they found a grand daughter who signed the form. Three days later in lots of pain she died. The excuse for performing the procedure was "To improve her quality of life. How? Unable to move any of her limbs fixing the hip would never have improved things for her. She was compus mentis and was begging them NOT to do it.
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Jun 21, 2017 12:59:23 GMT
Post by Big Blue on Jun 21, 2017 12:59:23 GMT
Her daughter refused to sign a consent form for a dhs (Dynamic Hip Screw) procedure so the doctors went through every relative they could until they found a grand daughter who signed the form. She was compus mentis and was begging them NOT to do it. The first issue doesn't sit well with the second in the light of FB's comment. Was she forced to have an operation, or had she assigned her medical rights? I was asked by my dad's surgeon if it was OK to not continue treatment and I cleared it with my dad; if he'd have said "yes keep me alive at all costs, I know the next three sets of lottery numbers" I may have insisted they continue.
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Jun 21, 2017 13:51:47 GMT
Post by Deleted on Jun 21, 2017 13:51:47 GMT
Don't think I can live the rest of my life without a bit of cake now and then though. Me neither - like Chris says, you have good days and bad days, and I'm more concerned with overall calorific content in any given day.
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Jun 22, 2017 8:39:16 GMT
Post by Deleted on Jun 22, 2017 8:39:16 GMT
The woman in my post above would not sign a consent form, she wanted to be allowed to die with dignity, just given a suitable pain medication level and be as close to pain free as possible. Not a lot to ask. My problem with the team involved was that they went to such lengths to bypass the patient and her right to self determination. AQ case with a different outcome was a case where a patient was scheduled for an emergency op and cancelled five or six times in the one day. We never did the procedure as she was pronounced in the operating theatre. I asked if she be left on the ventilator so her husband could say good bye to a warm, apparently live wife. Odd thing is that despite being brain dead, when we removed her from the ventilator she started breathing, despite not having anyone in upstairs. A real dilemna.
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Jun 22, 2017 9:20:09 GMT
Post by scouse on Jun 22, 2017 9:20:09 GMT
treat
an event or item that is out of the ordinary and gives great pleasure.
Why I don't give a flying fuck about calories or sugar, or fat content in things like cakes or fast food. We eat balanced meals all week long, with 'treat' meals on a friday night and the occasional coffee & cake of a weekend.
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Jun 22, 2017 15:34:46 GMT
Post by Deleted on Jun 22, 2017 15:34:46 GMT
I agree with every word. I am sure that within my lifetime euthanasia will be legal. I've got POA for both my parents should it be needed and both (healthy mid to late 70's) have made it crystal clear they do not want keeping alive. The hope for the NHS and the Care Sector is the use of technology (just like Coal Mining), I've got a few projects working on this as the wins are quite massive, both financially and more importantly to free staff up for the more positive sides of the job.
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Jun 23, 2017 9:25:52 GMT
Post by Deleted on Jun 23, 2017 9:25:52 GMT
A treat meal fits fine with the "A little of what you fancy does you good". An eminently sensible choice imho. Is life worth living if all we eat is, in essence, cardboard? Looking forward to getting an oven/convention microwave and a hob so I can have a treat of steak and baked potato and sour cream with chives.
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Jun 23, 2017 12:31:36 GMT
Post by PG on Jun 23, 2017 12:31:36 GMT
.. "A little of what you fancy does you good". .. I also like the phrase "moderation in all things, including moderation itself sometimes".
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Jun 26, 2017 9:12:38 GMT
Post by johnc on Jun 26, 2017 9:12:38 GMT
We have a difficult Monday. One of our ladies is a seriously good baker and every now and then brings in a kings feast on a Monday if she's had a heavy baking weekend. Today we have caramel shortcake, mars bars cake, tablet and one of her signature marzipan cakes which is truly unbelievable!
2 extra games of golf this week will be needed to keep the calorie consumption under control!
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Jun 26, 2017 9:37:26 GMT
Post by Deleted on Jun 26, 2017 9:37:26 GMT
Sara introduce a method to control extra calorific activities and called it "Cake Friday". No extra calorific activities apart from that day. It seemed to do the trick bu apart from that she was on a more or less continual diet.
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