Archive for the ‘Politics’ Category

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Has Murdoch Ditched Gordon?

April 27, 2008

I have been struck over the last week or two by the number of headlines in the Sun and the Times carrying pro-Tory messages.  In particular, the Murdoch press has come out strongly in favour of Boris for the Mayoral race.  More than all the disasters for Labour over the last 6 months, I think this may be a real turning point.  There are two explanations:

1) The News International press tries to reflect the feeling of the country as a whole to attract a larger readership

or

2) The Dirty Digger thinks that Gordon is a Loser and is not going to back him.

Murdoch has acute political judgment.  Neither explanation bodes well for Gordon Brown

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Dogma dogma

May 16, 2007

Grammar schools are an odd thing to get hung up on.

What we should be getting hung up on is these three facts

1) There is less social mobility in this country now than there was 50 years ago, and less in Britain than in almost every developed nation It has even got worse (amazingly) despite 10 years of a Labour government

2) 50% of children leave primary school unable to perform at a basic level in reading, writing and arithmetic.. This may not be surprising as many primary school teachers are now unable to pass basic literacy and numeracy tests

3) Our universities are unable to differentiate between the bright and the average student when selecting because of the ridiculous number of people achieving straight ‘A’ grades

My position is very clear, Academic selection and streaming are essential if we are to allow the brightest children in our schools to flourish. They are the future leaders of our country, our innovators, our scientists, our financiers, our doctors, our business champions, our civil servants. We NEED them to achieve their potential if we are to do so as a country. I do not think selective entry to school is necessary if schools have sufficient numbers of pupils and resources to provide a truly intellectually stimulating environment for the brightest children. If we are unable to provide that environment then we need selective schools.

The corollary to that is that most of our children are not the brightest, and they need to be given the opportunity to thrive as well. This is where the Grammar school system let us down, or rather the secondary moderns did. Secondary schools should all be able to educate children to a university standard (whatever that is these days). If there is a selective school in the area then it needs to work in partnership with the local non-selected school to identify late developers and include them.

I do not believe that binary selection at 11 is an appropriate way to sift our children, and late developers have to be given the same educational opportunities as precocious children (see above).

But my major problem with education in this country is that too many state schools are simply too unambitious for their children. No matter how well they are educated, they are not given the ambition to succeed, the belief that they can be captains of industry or prime minister. The best they can hope for is to be a ‘B’-list celebrity. That is what is missing. That is what I hope City Technology Colleges and other secondary schools in the future will provide. But we have to prioritise the brightest children

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Tangled Webs

May 5, 2007

If you think this is just political, stick with it till the end, you may be surprised.

Reading THIS in the Daily Mirror:

DAVID Cameron tried to put a brave face on Tory election results yesterday as his hopes of a landslide failed to materialise.

and THIS in the Soaraway Sun:

DAVID Cameron turned the map blue last night as he showed the Tories are finally back in business. The Conservative leader was celebrating after winning a whopping 875 council seats in the town hall elections.

did make me wonder if the political journalists had been reporting on the same election, though I think the map below probably tells the story (look away if blue isn’t your favourite colour)

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And initially I got quite cross, railing internally and occasionally vocally at the Mirror, Guardian, BBC etc.

But consider the following statements:

“I’m afraid you have lung cancer. The prognosis is very bad-most people will live less than a year. The best treaments we have is chemotherapy but that will only add about 8 weeks to your survival time on average (the chemo is a 12 week course) and there is a significant risk of side effects”,

and

“I’m afraid you have lung cancer. Although some people have bad outcomes, many people now live for 2-3 years after the diagnosis. I would suggest you have some drug treatment (chemotherapy). We know that the majority of people will see improvements in their quality of life and symptoms, and a significant minority (probably 30%) will also get a major response to chemotherapy and will live longer as a result”

I use both these sentences (or at least some variation on them-I probably wouldn’t use the first one as it stands) quite often. I use the first when my assessment is that a given patient is not likely to benefit from treatment-for example if they have other major illesses which increase the risk of side effects from treatment. I use the second when I think that people are likely to benefit. Both are true. Both rely on the same data, but it will not surprise you to hear that recipients of statement 1 rarely ask for chemotherapy whereas recipients of statement 2 rarely decline treatment

So now who’s the spin doctor?

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What makes a good day?

May 4, 2007

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Well, waking up to THIS, for a start.

Even the rather bizarre BBC reporting doesn’t seem to affect the general aura of well-being. Does make you wonder what would be classified as a good result in BBC-land though!

I suspect even Patricia Hewitt’s parliamentary researcher hates her after Patsy promised to answer any emails with queries or concerns about the health service on Question Time last night. I bet they are having rather a busy day

But I did wonder if she had a hand in introducing the new electoral system in Scotland, after I heard the man from the electoral commission on the Today programme explaining how they had expressly told the government that they should not hold the parliamentary and council elections on the same day as it would inevitably lead to confusion and problems with the new voting system. What did the government do-you guessed it. Result? 100,000 disenfranchised Scots. Are you sure you weren’t involved, Patricia

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Stop Press: Mental health services improving

April 30, 2007

Well, delusion has once again got the better of the Prime Minister as he claims that the NHS is on the right track and that cardiac care, cancer care and mental health services have improved over the last 10 years. Now credit where credit is due, I believe that there have been improvements in cardiac and cancer care, though whether they are in proportion to the money spent is another question-don’t forget this graph from the ONS showing that productivity in the NHS has fallen by 4%, with output increasing by 28%, while costs have increased by nearly 300%: Is this value for money?

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But Mental Health? I hope Michelle Tempest has been listening to the PM as I expect she will be able to give a more informed view, but my perspective is that we are seeing terrible problems with mental health at the moment as budgets are cut to feed more glamorous specialties: see HERE, HERE, HERE, HERE, HERE and HERE for a few examples chosen at random from the plethora of stories available. Last year a report by the Sainsbury Centre for Mental Health found that:

“More than half of England’s mental health trusts have seen money diverted away from them to pay for deficits in other local health services.”

So, Tony, in your self delusional world, please tell me how exactly you think mental health services have been improved? No, let me guess, Patsy “The NHS has had it’s best year ever” Halfwitt told you didn’t she?

And just to remind ourselves exactly what Labour has achieved in the NHS in 10 years lets look at this cartoon, originally I think from the Daily Telegraph, now reissued by Dr Rant:

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Tony also had this to say:

“I’ve been through this so many times, I just think its really tough while it’s happening. What we’ve just got to do in a sense is hold our nerve,”

Well do it this time Tony: Resign and take Patricia with you!

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If you’ve got IT, you’ve really got IT

April 25, 2007

Anyone who was in any doubt about the wisdom of letting this government introduce ID cards should read THIS post from Dr Crippen. As those of you who take any medical interest will know the government has recently introduced a computer application system for job applications for junior doctors: MTAS. This has been controversial enough, and the implementation could perhaps most kindly be described as a complete unmitigated disaster. Now we learn that someone in the DoH forgot to password protect the applications. So all the information in them (Address, phone no, sexuality, criminal record etc) was available for anyone to read on the web. Channel 4 have more details . This is what will happen if the ID cards bill goes through. Don’t let them do it

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But I want to pay…

April 23, 2007

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I would recommend reading THIS short document from Doctors for Reform illustrating a number of ways in which top-up payments are being introduced by stealth into the NHS system, also commented on by the good Dr Crippen. I have experienced several of these in cancer treatment, most notably in relation to the funding of three new drugs, bevacizumab (Avastin), Cetuximab (erbitux) and erlotinib (Tarceva). All are expensive. All are effective in a proportion of patients. None of them are cures. Exhaustive cost-benefit analysis has been applied to each treatment by the National Institute for Health and Clinical Excellence (not-so-NICE), and they have all been found to cost more than the notional threshold of willingness to pay (Currently approximately £30,000 per quality adjusted life year gained (QALY). Their efficacy is not in dispute.

So what are we to do? Here in the real world these treatments, despite being standard practice in Europe and the USA, are not economically affordable by the NHS, though they are all funded by ‘proper’ insurance companies. But why shouldn’t people be allowed to pay for them? At the moment in our region we have received advice from the Department of Health that patients may not pay for top-up care. If they wish to go private, all of their care must be given privately, which means they have to pay consultants’ fees and a 100% markup charged by private pharmacies for dispensing the drugs. Interestingly this opinion is disputed in the Doctors for Reform paper.

And should we tell our NHS patients about these treatments or not (assuming they don’t ask)? I have previously always found it rather difficult to say ‘here is the best treatment, but we’re going to give you the 2nd best’, but now I wonder: shouldn’t everyone know what their options are? probably they should, and I am much more open in my approach to this issue, though I generally try to discourage people from taking the private route unless they have insurance. Unsurprisingly, the Primary Care Trust do not want us to advertise these treatments to patients, but they have recently produced a standard letter explaining the above. But before we get to the stage that we can have a sensible discussion in the clinic, people have to accept the principle that the highest standard of care is not necessarily a right. I don’t think we have reached that point.