Oct 20, 2020 -- 10:56AM, Foinavon wrote:
Hell's bells, I find myself agreeing with Andy Burnham.
So do I. I'm surprised as well but I think he talks more sense than anyone in the government does.
Oct 20, 2020 -- 12:24PM, nineteen points wrote:
cider maybe the taxpayer will get screwed even more to pay for this sh1testorm? you obviously dont give a jot about all the folk who will lose their jobs ,businesses and maybe even a family member because of this tyranical behaviour.i would guess you are in the comfortable im alright jack bracket.you wont be affected so why should you care about others eh?
It's all propaganda 19. There's no additional pressure on the NHS currently. No excess deaths currently. No businesses should be forced to shut. If they feel they have to do it then obviously local is much better than national.
Oct 20, 2020 -- 12:33PM, 1st time poster wrote:
manchester should plug gap with money set aside for road cleaners ,bins etc and when bins not getting emptied hit the tv screens,good for tory levelling up, at least for non tory,s anyway
Sounds like a typical socialist experience.
Oct 20, 2020 -- 1:32PM, 1st time poster wrote:
yep you spent 7 months telling us,now for once in those 7 months prey tell us
Oct 20, 2020 -- 2:17PM, Cider wrote:
Are you claiming that nightingales are there just to look at? there must be contingencies in place, retired medics, army medics, private health staff, agency etc.
You could staff them if you shut down other services but not with trained intensive care experts or nurses. They never really used the London one, mostly for those reasons and the planning went backwards and forwards but the best solutions they came up with, I think, were either a very primitive ITU that wouldn’t have coped with more complex patients and / or a palliative unit for those likely to die. For reasons I won’t go into, unless anyone is interested, neither of those would have been very helpful, or fair to those patients. Better option than nothing in absolute desperation, really.
What you could do, more effectively to handle major local outbreaks, is borrow staff from other regions that are less affected but that’s difficult to do and obviously denudes those areas. It also wouldn’t necessarily need the Nightingales. At present I don’t think there’s a large risk of exceeding surge capacity. There’s obviously a much higher risk of damaging the ability to run other services, especially routine surgery.
Oct 20, 2020 -- 3:03PM, Foinavon wrote:
If you close down businesses you have to give adequate support to the lowest paid, it's basic humanity.In itself, closing down is a huge mistake. If we've learnt one thing since March, this isn't another Black Death, it's nothing like and the measures are totally disproportionate. It's not the government's job to keep everyone 100% safe, it's their job to balance all the factors and that includes keeping the economy going and not turning the NHS into the National COVID service.People are suffering and people are dying because of the draconian measures taken and it's wrong.
I agree with a lot of this but aren’t you simultaneously contending that the government should be more relaxed about increased cases and that the NHS should expend less resource on dealing with what you’d be happy to be more demand for care for Covid?
Oct 20, 2020 -- 2:40PM, nineteen points wrote:
cider i am sorry but you have lost all credibility as a poster but more importantly as a human being.£8.20 is the max,£6.45 is the min.if you think another human being can live on 2/3 of that,bring food into the house,pay a mortgage,electric,cloth kids etc then i pity you.you are a sad person and frankly a heartless man. and i am loath to use the word man
No need for the grandstanding. You're not Burnhamall!
40 hours minimum wage take home week £307
40 hours minimum wage take home week @8% £260
40 hours minimum wage take home week @67% £227
So the new rate in the pay packet is £33 less per week than the furlough rate. Not ideal of course, but only £80 less than full pay, with no expenses like travel and lunch. Plus, my understanding is UI brings it up to at least 80%.
Oct 20, 2020 -- 3:24PM, nineteen points wrote:
mr slogger,would it be impertinent of me to suggest staff could of been trained to do these tasks in the quiet summer period when they themselves admitted they were very quiet.or would that have hindered the production of tiktok videos?
It’s a fair question, although don’t overplay the TicTok angle. I was thinking earlier today about how HMG should have encouraged a massive recruitment to PHE in April and May to set up test and trace, rather than their subcontract a private firm or two with no real expertise at immense cost approach. They should probably have also used the military for logistics. They’re good at that stuff. Can’t say I have loads of detail of what they did consider and their options appraisals though.
As far as the NHS goes, it’s complicated. In the early pandemic a lot of people did a certain amount of retraining but the people you have in a hospital with the skills to work in intensive care at a high level are either theatre staff and anaesthetist, who mostly just shuffled straight across to helping in expanded units or were working in other specialities that bore the brunt of Covid work, particularly respiratory and acute medicine. By the summer, which was certainly quieter than usual in June and July, people were putting a lot of work into restarting their own services and I guess hoping that we wouldn’t see the same pressures again. One consequence of resource depletion is a focus on the immediate horizon.
Oct 20, 2020 -- 3:22PM, 1st time poster wrote:
hospitals still one of biggest covid spreaders,and you think transferring nhs staff back and forth from different hospitals in different area,s is a good idea
Not really advocating it but if you took staff from say the South West, they wouldn’t be bringing Covid with them and you could do some testing and bubbling to reduce the risk further. How many volunteers you’d get is a different question.
Oct 20, 2020 -- 3:16PM, Fatslogger wrote:
Oct 20, 2020 -- 8:17PM, Cider wrote:Are you claiming that nightingales are there just to look at? there must be contingencies in place, retired medics, army medics, private health staff, agency etc.You could staff them if you shut down other services but not with trained intensive care experts or nurses. They never really used the London one, mostly for those reasons and the planning went backwards and forwards but the best solutions they came up with, I think, were either a very primitive ITU that wouldn’t have coped with more complex patients and / or a palliative unit for those likely to die. For reasons I won’t go into, unless anyone is interested, neither of those would have been very helpful, or fair to those patients. Better option than nothing in absolute desperation, really. What you could do, more effectively to handle major local outbreaks, is borrow staff from other regions that are less affected but that’s difficult to do and obviously denudes those areas. It also wouldn’t necessarily need the Nightingales. At present I don’t think there’s a large risk of exceeding surge capacity. There’s obviously a much higher risk of damaging the ability to run other services, especially routine surgery.
Pretty much the only time we saw Simon Stevens since March was doing a presser from the excel nightingale taking credit after the army had built it. Presumably he has a strategy for staffing them.
It's moot in any case because there's no sign yet that we're close to needing to make use of the facilities.
Oct 20, 2020 -- 3:54PM, peckerdunne wrote:
Cider, fighting the causes of the lower paid as a leader of what? pls
People leader, that's as much as I'm prepared to divulge.
Oct 20, 2020 -- 3:57PM, Foinavon wrote:
The NHS has been given more resources, Fatslogger. I'm contending that they should not be prioritising covid sufferers over those with cancer or organ failure, especially in paediatrics.GP services have been difficult to come by and I'm not sure proper diagnosis can always be made over the telephone or the internet. Misdiagnosis and lack of follow-up can lead to tragic consequences. There is a balance to be achieved.
You haven’t really resolved your own paradox with this reply. Are you saying Covid patients should be left in the corridor so we can do more cancer work? Once someone lands in a hospital with Covid, looking after them is likely to be resource intensive. There’s no real way round that other than reducing the number of people getting it.
There’s basically no Covid problem in paeds anyway, so that’s a red herring.
I actually agree about phone and virtual working. It’s fine for some things, not great for others. That’s why we do some stuff face to face, some by phone, internet platforms or virtually. I suspected GPs probably could have done more face to face a couple of months ago but I don’t think that right now.
Oct 20, 2020 -- 5:49PM, shiny new shoes please wrote:
Hope ya don't have cancer fatts
Are you okay?
Oct 20, 2020 -- 5:59PM, Foinavon wrote:
They used to leave people in corridors during winter flu epidemics, I've seen it for myself. They didn't shut down everything else and they didn't have the Nightingales as overspill.I know specialised staff can become overstretched but that's happened before.
Yes but that’s both obviously a terrible thing in itself and utterly bonkers for a highly infectious disease.
Oct 21, 2020 -- 5:59AM, Foinavon wrote:
It's not ideal, fatslogger, nor is letting people die of other things. The Nightingales were constructed to cope with overspill, perhaps it would be better to use them as isolation units for all COVID cases. If we crash the economy we won't be able to afford the health service we have let alone a gold-plated one which everyone, including me, would in an ideal world like to see.
There is obviously a balance to be struck here. I would probably strike it in a different place to you (but perhaps not that different - I’m pretty much the only person to have put a number on acceptable deaths in Charlie’s thread). Anyway, that’s fine but I won’t be having the narrative that the NHS not treating other things is a problem because we’re not blasé enough about Covid, when the risk is almost all in the other direction. At a low to moderate level Covid can be handled fine, although it is a pain and we are seeing quite large numbers of deaths again. If capacity gets pushed beyond a certain point, this will impact on other services. The Covid precautions in health care right now are not preventing activity, although there have been some accommodations that have changed how things are delivered. In many cases this is actually an improvement for patients. The NHS had been painfully slow to update clinic working to reflect the use of that ultra modern technology, the mobile phone.
Oct 21, 2020 -- 10:05AM, Pleasegivemeanailedontip wrote:
I thought it was a fairly fundemental principle in the health sector that a life prolonged is a bonus, rather than a right, but it seems not.We seem to have moved through people caring for the unwell against all odds in horrific circumstances without judgement, through a GP a few years ago telling me not to come back until i have changed my lifestyle, into an era of medical staff crying on twitter videos because there are too many ill peopleIm not completely unsympathetic to them and im all for some pragmatism but the medical profession above any other needs to maintain a thick skin
What was wrong with your lifestyle? I have tremendous difficulty with mine.
I agree with much of this. Not everyone will survive an acute illness and life has a 100% mortality in the end. There is a question of what a country wants from health care staff. I think advocation on behalf of often vulnerable people who died in large numbers, mostly separated from their families, is a fair thing to have provided.
Oct 21, 2020 -- 12:04PM, Foinavon wrote:
Thanks for the clarifications, Fatslogger, appreciate it.
No worries. Nature of forums is a bit adversarial (with the exception of you and edy, obvs). I actually suspect I have quite a lot of common ground with many of the people I argue with. For example, I thought GPs should have been doing more face to face work a couple of months ago and that they’d got too entrenched in remote services when some things are much better face to face. I feel that less strongly now when there is much higher Covid risk.
Oct 21, 2020 -- 5:27PM, Pleasegivemeanailedontip wrote:
Well a reduced number of v sick people is better for all of the people who would otherwise have been v sick; for the staff who would have been looking after them and for the other patients who will get more time and resource dedicated to them.Maybe true but there seems to be a reason that patients are given the choice to refuse treatment that overlaps with this. Not the same thing but coming from the same fundamental place that it isnt for the medical profession to force treatment on people, even if it is more effecient.The meds dont have to make this choice though, seems to me a line of ‘heres some things you can do to help yourselves, hers some things the government should seriously consider, but bottom line; we are here to help as many people as we can whatever the crisis’ is both professional and compassionate.Thanks for the liver advice
I get the point. Like I said, I don’t approve of preachy and generally don’t think it works well but a calm explanation of risks is fair enough. I don’t think that’s the same as not imposing treatment on people, as good, evidenced based advice is essential for people to make an informed view of whether or not to have treatment, stop drinking, wear a mask, whatever. Public health advice is difficult though, because things are complicated and it’s very tough to cut through with nuanced messages. Simple is easier but less honest.
No worries about the advice. It wasn’t very specific!