There's Plod standing there allowing it to happen, why wasn't that deranged bitch arrested? Behaviour likely to cause a breach of the peace? Our Police are f*cking toothless (unless you throw an egg at Jezza)...
Best pension advice I could give is have it now while you can ... I have had two wipes out so I thought bollocks to that and brought abroad again I do t have rainy days to save for plus you get one over on all the parasites who claim to looking after your money ... they are not Live now
The Americans don't want to buy the NHS, they want their firms to be able to bid for NHS contracts – which EU firms can do already, because the EU ordered us to open up procurement is this right
please log in to view this image crimes so out of control in peterborough the police have even started putting ankle bracelets on the locals to help find them if they get stolen
But if you're Jewish tough sh*t. The previous Labour MP is a jailbird, these are examples of Jezza's 'nicer politics'...
I don’t think so. The NHS has contracted out a lot of its services since day one. This became more pronounced under Thatcher towards the end of her term, but especially Blair, and has continued since. EU procurement rules mean that bids and tenders have to be EU wide, but I don’t think they compel any services to be contracted out. US firms can already bid if they want, and some have. At least one, United Health, which is enormous, tried running small scale more than a decade ago and concluded there was no profit in it, and too much hassle. The vast majority of primary care services - GP and community pharmacy - the bits of health care we access most - have never been provided directly by the NHS. All of the supplies used by the NHS - medicines, disposables, equipment - have always come from the private sector. Do we want MRI machines installed and maintained by the organisations that designed and built them? Yes please. I’m never sure what this argument is really about. If services are accessible by all, paid for out of taxation and free at the point of care, and of high quality, what does it matter how they are provided or who provides them? My problem with contracting out is that you have to create a bureaucracy to manage the contracts, which is wasteful.
Trump has commented critically in the past about the fact that the NHS can buy US drugs much cheaper than Americans can. Isn't the concern that they would seek to dilute the NHS's buying power?
To be honest the NHS is a tiny part of the problem for US drug manufacturers, every single other country has much lower prices than the US, where a bunch of perverse incentives and middlemen keep the prices high. The US does, in effect, subsidise the rest of the world, and especially the socialised systems in Europe. They would be better off trying to get the prices in the States down to EU levels (and they vary country to country here, we share - until we leave - a common regulatory body which is now moving from London to Amsterdam, but this just gives permission to sell, price negotiations are on a country by country basis). Trump is pretending to do stuff about US prices, not to much effect so far. It is a very confusing scenario, the frankly incredible list prices of drugs are not a good guide to what patients actually pay. That depends on their insurance, co-pay levels, the rebates that middlemen and insurers negotiate and how much of those they pass on to patients etc. But if you don’t have decent insurance coverage, through employer, privately or through Obamacare (everyone in theory should be covered) or are taking a drug which isn’t covered, it’s brutal. I’m very glad I don’t have to negotiate this system. Of course this works two ways, British, European and Japanese companies benefit hugely from high US prices. GSK gets a cheque for a couple of billion dollars every quarter from its US affiliate. In my time in this industry the UK has gone from a top five market to something much lower in terms of attractiveness to launch new drugs early. This is because of the way NICE works. It’s a good, transparent process in most cases (very bad for oncology and other drugs for very seriously ill people, where the treatment can never be ‘cost effective’ even if it extends life and manages symptoms) until it gets to demanding discounts which are secret, but it’s a definite brake on innovation and means drugs which are available elsewhere aren’t here. If Trump wants to do something spectacularly popular he could demand tariffs on imported medicines (currently I think tariff free) or increase tax foreign companies on US sales and use the proceeds to subsidise US prices. Bit socialist for him though.
The non cost effective drugs are almost impossible to get here Pharmac nearly always insist on more trials no matter how many times other countries have already proved the drugs worth I hope I never get to the day that I have to rely on pharmacs charity
New Zealand is about the toughest place in the developed world. We closed our offices there a decade ago, you are now a tiny bit of Australia as far as we are concerned. No one is going to spend hundreds of millions of dollars to conduct a trial that NZ wants in order to get access to 8 patients.
Pharmac have a budget It's really pitiful by world standards But it's what we have Some really harrowing stories about people having to sell everything to stay alive for an extra 12 months I don't know what the answer is Funding everything would break the country As I said I hope I never get anything that's not funded The wife would probably send me back to the nhs
For me, a big problem with the NHS, is that it is such an easy political target that there can never be any reasoned debate, because it's so easy to say that the other side want to destroy it. This makes it so difficult to improve. I don't understand why if I stay in hospital (after an operation,etc), all my food is free. I would be paying for my food if I was at home. Also why are medicines free when you stay in hospital, but I have to pay for prescriptions once I return home. When my children were born, my wife's contractions started three days before the boys were born (premature twins so they tried to slow down the labour). I was in the hospital with her for three days waiting. Every time she got her free meal, I had to go out to get food. (I would have willingly paid for the hospital food and kept the money in the NHS. Nowadays, I notice that Costa have have a concession in the hospital! I do believe that the NHS, as great as it is, could be improved, but what politician would risk their future by suggesting improvements. There needs to be a thorough review of current practices, with politicians, NHS leaders and other users, to work out how best to go forward. Even if there was, I would envisage a politician walking out of the meetings and saying that couldn't stay and listen to the other side trying to sell the NHS off. Such is my regard of current politicians!!!!
The major challenge is workforce, there simply aren’t enough doctors, nurses and other clinicians to keep up with ever increasing demand, which makes the working environment even more stressful (as if healthcare wasn’t stressful enough) leading to people leaving the professions and early retirements, with not enough people in training to make up the shortfall. Hence the heavy reliance on foreign workers in the NHS. It’s needs a long term commitment to pay and conditions to change this, and it won’t be fixed anytime soon even with this. Then you have overall funding - the NHS is surprisingly efficient but we spend much less on healthcare than other developed countries and our outcomes are variable - and that fact that the public, just as much as politicians, fear change. Underfunding for social care means a lot of NHS resource goes on caring for people who don’t actually need medical care, especially in hospitals. Of course if people looked after themselves a bit better some of the pressure would be taken off. There was a programme on telly last night about diets, with a very overweight lady testing a slim fast diet or something. She was an insulin dependent type two diabetic (the programme falsely claimed that insulin is usually only for type one diabetics, which is bollocks. Type one diabetics just need insulin from the off because, for reasons other than lifestyle, their pancreas doesn’t work. Type twos have multiple options before they need insulin, but they will end up there if they don’t look after themselves). This lady was then shown putting three sugars in her tea and trying to stay off chocolate. She ‘lost’ 4lbs, which I reckon is within normal day to day variations in weight, especially for someone her size. I wonder if anyone has told her, especially when she was first diagnosed, that the course of this disease if uncontrolled leads to amputations, blindness, heart disease and stroke. And of course death. And type two can be controlled through diet and exercise if caught early enough, before the pancreas has given up. One thing this country has been very good at is public health, but investment in that is on the way down too, even though it is the most cost effective spending there is.
A big problem also (with what I do anyway) is ‘burnout’. Very difficult to do this job for 5 years plus when you are constantly stressed, adrenaline levels going up and down and always having to keep an eye on times dealing. I knew it would be stressful but to be honest, I didn’t realise how stressful. I can’t see myself doing this till I retire and always feel I’m just 1 bad job away from quitting. Hope to doing it a while yet though ‘cos it truly can be the best job in the world
Trump's Met Police motorcycle escort. Are they trying to say something? please log in to view this image
For those wondering where Diane Abbot is, she's been taking glider lessons in Connecticut please log in to view this image
