A 24 hour NHS

There is a call by some for a 24 hour NHS.
Apparently you have a bigger chance of dying if you are ill at night or at a weekend. I am sure this has always been the case, but hard working doctors have to sleep sometime.
However, there is a confusion between emergency hospital care and routine stuff.
Emergency care has always been provided by the day team using an on-call rota system.
Unless you experience it, you cannot imagine the awfulness of working a long hard day, going to bed exhausted, only to be woken soon afterwards by the phone for an emergency.  Having to get up and deal with it, then, if you are lucky, getting back to bed for a minimal sleep, before getting up at the normal time for the next day's work.
Mothers of young babies have a similar experience, but do not have to snap their brains and bodies into action in a similar way. I know as I have experienced both.
Routine hospital work is a different thing.
Does it make sense for expensive scanners, operating theatres etc to be sitting idle at night and at weekends when there are such huge queues for their use?
Well - that is how accountants see it. But these expensive  facilities are only functional with the appropriate teams of expensive experts to run them. So - yes - the scanner could be used all night and weekend, but money would have to be found to employ a second team of staff to work at those times.
The operating theatre could be used 24/7, but a second team of staff would have to be employed to man it. There would also have to be additional pre-op, high dependency and post-op wards to put those patients into and additional staff employed to man those wards.
They would then have to factor in the reduced  life expectancy of scanning equipment and OR equipment, that was being used twice as much as before.
Additional path lab facilities would also have to be paid for.
Where would all these extra highly trained members of staff come from?
So - in a world where money was no object - it is a splendid idea, but otherwise - NO
I was in hospital about 5 years ago - for an operation. I noticed several empty wards and was told it was because of a lack of nursing staff. Since then - there has been a further reduction in nursing staff!

Would you pay your neighbours mortgage for them?

I have just read an excellent wee quote from an unknown source at the UK Treasury.
It is information to be published next month, about the situation re the pound, if Scotland becomes independent.
Alex Salmond initially was all for Scotland joining the Euro after independence - until the Euro went down the plug hole.
Then he said  - oh well, Scotland would just keep the pound then.
This report is going to let him know that, if Scotland wants to stay in the pound backed up by the Bank of England, then Scotland is going to have some pretty tough financial conditions put on it by what is left of the UK, which it may not like.
The source said
"As has been shown in Europe you can't have a formal currency union, without fiscal and political rules being applied
and he added
"You may be friends with your neighbour but you don't want to pay their mortgage if they get into trouble"
Too right
That is why independence is such a crazy idea. As one country, the separate parts  of the UK  - England Ireland Scotland and Wales, are all there to help each other out in a crisis, as happened when Scotland's two banks went bankrupt recently.
As an independent country Scotland could expect and would get - no favours.

La Gomera recovering well from fire

La Gomera had a terrible forest fire last year which took some time to get under control. There was a lot of damage. Large tracts of countryside where affected and some poor people lost their homes and all they had.
But
Nature is wonderful. Spring is springing in La Gomera and it is all growing back. The magical ancient forest in the island's centre, consist mainly of heather trees and laurel trees. In the areas that were affected, the burnt trees, that are all black and sad, are sprouting healthy new growth from their bases.
On the lower slopes, the palm trees with burnt trunks are quite unperturbed and are growing as normal.
The ground is covered in green lush growth with beautiful flowers everywhere.
We hesitated when booking our holiday, fearing that fire damage would spoil things. This certainly has not been the case in any way at all.
In the Scottish highlands where there are large areas covered in heather, land owners will sometimes organise fires in the autumn to burn away the old leggy heather. This results in much nicer young fresh heather when spring arrives. Admittedly the Scottish heather is a small knee-high plant compared to Gomera's heather which is a tree, but perhaps the principle will be the same. Perhaps good will come from something that at the time seemed such tragic desecration.

Above shows a burnt heather tree sprouting new growth at the base

Above here is burnt palm tree with healthy new green growth above

Above shows a felled pine tree with new growth from the remaining stump

Above shows burnt trees arranged to form a terrace. La Gomera's heather trees act as sponges and soak up condensation in the air. Without their ability to do this the island would dry up. The trees also prevent soil erosion. By placing the felled burnt trees in this way erosion will be prevented and rain water retained.

Above is the summit of Garajonay, the highest peak, where beautiful wild flowers now carpet the ground under the recovering burnt trees

Above shows the beautiful carpet of wild flowers covering the slopes beneath burnt pine forest.

La Gomera - Sea fishing

We went sea-fishing this morning in a smallish boat with a driver and 5 passengers. The sun was out , the sea was blue and off we went with high expectations of a huge tuna or two.
Sadly there were no tuna, so the size of rod was changed and to general excitement I caught a tiny red fish which promptly puffed out his cheeks at me and was I gather a puffer fish.
Our trusty captain then stopped the boat and served out pies filled with tuna!
 We then headed back, with the wonderful sight of the Canary Island's highest mountain, covered in snow, in the distance, hovering over the sea like an air born mirage.
 Our captain had for years been a sailor in the Olympic squad. I wonder what other athletes do after years of high pressure training?
For us ordinary mortals, it was a glorious way to spend a morning.

Walking stick use

I have always regarded a walking stick as a tool for the very elderly or for a particular sort of annoying walker.
 But - I am on a holiday with nice walks. Walks that are very up and then very down and not the usual perambulations that me and my pensioner knees are used to.
My knees don't much like up or down. When I was at school my knees took a similar dislike. I informed the authorities who had both legs encased in plaster for many months, thus destroying my chances of being captain of junior tennis and causing me to change course and start a life as an academic. I didn't resent the physical stuff that I missed out on, reckoning that life was long and it would all get done sometime later when the knees or whatever else were ok.
Now in that last section of life, I realise that sore knees or sore anything else, can no longer be reason to avoid doing  things, because the sore knees are not going to get better. The poor old body is wearing out and all the sore bits are just going to get sorer.
So
Someone this week suggested that for these steep walks, I try using a walking stick. Me use a stick! Oh dear, it is but one removed from a zimmer. But I decided to try. To my surprise, I am a complete convert. Wow - what a huge difference. It is like having a third leg. It improves balance and reduces pain.
I highly recommend one to all, but it must be a proper adjustable walking stick with a non slippy end and it must be used properly. Short to go up hill and long to go downhill.

Hair removal

I am on a glorious little holiday away from the Scottish grey skies and cold. Ah I am so lucky

 For months now every inch of me has been covered up in many thermal layers. We talk about days as 1,2,3 or 4 fleece days depending on how cold it is and I am talking about inside the house!
No-one but me knows what horrors exist underneath all the clothes.
Now large areas of me are to be exposed to sun and air and sea  - and the human eye.
This means hunting out the razor and attacking the elderly remnants of bodily hair still in existence. Most of my lustrous bodily hair seems to have migrated to my face, where it tries to mimick my husbands beard and moustache.
But I find the razor and in the shower, I set about denuding underarms and legs. This becomes an increasingly difficult job as you get older. Sore stiff joints make bending and twisting hard, and poor eyesight makes it impossible to see. With specs on there is just mist and with specs off there is just a blur. The end result is like something attacked by moths.
Pensioner legs are not pretty things with their swollen arthritic joints and puffy ankles' not to mention varicose veins.
Pensioner feet are even worse with hairs sprouting like a werewolf and nails that blunt the chiropodist's clippers. Feet are almost impossible to reach and cannot be seen. My spectacles for far sight can't focus on them and neither can my reading specs.
I have magnificentally got around the elderly dangly pubic hair problem by getting a swimsuit with a skirt - a swimming dress. This completely takes away any concerns about escaping hair and removes, the quite dreadful possibility, of a trip to a beautician for hair removal, from an area where, in my book, no beautician should ever be allowed.
Perhaps after a certain age the body is best not exposed?
However pensioners still get overheated if overdressed and still enjoy the feeling of sun and air on naked flesh.
More than younger people they need exposure to build up vitamin levels, depleted through months of lack of sun. The elderly have reduced ability to build up their vitamin d levels and need increased time in the sun with more surface area exposed

Changing communication methods

Communication methods are changing apparently and us oldies are becoming very different to the young
This is according to something I read (to which my children agree), the order of communication is now this in ascending order of intimacy -
Facebook
Email
Gmail
Text
Phone call
Talk in person

It was even said that there is a new etiquette -
To text before you phone, to make sure that it is OK to phone
The only people now who use land-lines, are the same people who still send Christmas cards, reply to invitations and write thank-you letters - that is us - the pensioners

q

How Easyjet manages to be cheap

I recently had to get a flight with Easyjet.
All went well until me and the last 20 passengers were told we could not board. Questioning the laddie standing between us and the door, we discovered that a member of the crew had not arrived yet.
Health and safety rules etc demanded that there be certain proportion of staff to passengers so we could not get on the plane.
We waited and we waited for what seemed like a very long time until this elusive crew member arrived.
The poor lass had not overslept but had been mis-scheduled by Easyjet to return to work before she had had the statutory number of hours off between flights.
This is why the flights are cheap.
But that is why we choose them

An NHS where no-one takes responsibilty

       Oh how horrifying and how frightening is The Francis Report into our poor old NHS.

       We old doctors have watched the decline over the years with a terrible feeling of hopelessness.

       My old cleaning lady told me once that her father was a scaffy. 

A scaffy is the old Scottish word for a street cleaner. Her father's job was to clean Ann Street - that was his street. Each scaffy had his own street and they all took immense proprietorial pride in their street, each one vying to be the best. 

       Today our city's streets are cleaned by some big company, employing people who give the impression of not giving a damn.

       I believe the same principle applies in hospitals.

       When I started my career as a doctor, I applied to work for a particular consultant. It was his decision whether to employ me or not. His team consisted of a houseman (me) and a registrar and himself. In this first job - surgery - there were 2 surgical teams, each having a huge old fashioned nightingale ward. 

        Like the scaffy, the patients in my ward where mine. It was my job to look after them. I lived in the hospital, but was allowed out every other night and every other weekend. When I was not there, the houseman from the other surgical team covered my patients. I did the same for her when she went out. So we both got to know each other’s patients. 

        The nurses on my ward were wonderful. If I remember right, there were 3 sisters and several staff nurses, who rotated every 8 hours. Again - that ward was their ward and they took a pride in it being to the highest standard possible.

        The ward also had its own cleaner who came in everyday and took a similar pride in her ward

The hospital had a matron who regularly inspected each ward.

       All this has been lost. Consultants are no longer allowed to choose who work for them. They do not have a particular ward and a team. Junior doctors now all follow a complicated training rotation, which moves them here there and everywhere, never being allowed to experience the responsibility of having their own patients  

       Their hours are now governed by the EU which protects them from the crippling regimes that we endured but does not allow enough hours to give proper cover or to learn enough to practice.

       Nurses also seem to be moved from ward to ward, so that no one sister, is on one ward, long enough to get a sense of responsibility for it. I do think that the biggest problem with nursing is under staffing. Most nurses want to do a good job but find it impossible because they are too busy. 

        Because nurses are now frequently going off sick, the NHS constantly has to employ agency nurse at vast expense. Agency nurses should be just stop gaps, for emergencies, but it seems that often there are more of them, than the regular nursing staff. With all the best will in the world an agency nurse will not be as appropriate. 

Everything everywhere is getting too big and too impersonal - is this globalisation?

I don't like it

Must not have Posh accent in Scottish politics

         Did anyone watch Question Time last night from Stirling? 

Brian Souter said something about

        "Us Scots not wanting to be pushed around by the posh boys down south"

It got me thinking -

         Class is becoming an increasingly big issue in the UK, especially in Scotland.

         It is now fairly well accepted, that to exist in politics, in Scotland you must not have a posh accent. In Scotland a posh accent means an English accent - a BBC accent (received English). In fact there are many areas of Scotland where someone with an English accent will be beaten up just for opening their mouth and talking.

        Posh people send their children to posh boarding schools where they lose their regional Scottish accent and learn to talk posh. Talking posh gains you access to Britain's posh club - the upper part of society. 

          It was a habit started after the Battle of Culloden when Prince Charlie and his Catholic Jacobites where defeated. The English saw that the best way to tame the Highland Chieftains, was to anglify them and they insisted that all the aristocracy attend posh English boarding schools and spent a few years at Court - doing the season. 

         In my childhood many posh Scots where in politics and everyone seemed quite happy with it. Then Margaret Thatcher and the poll tax happened and Scots changed. No longer where they going to be "pushed around by the posh boys down South - or up North".  

        Even Alistair Darling, as Scottish as anyone could be, is considered by many to be too anglified to run the Better Together campaign. 

       When the SNP where discussing their possible constitution, it was said that a person's class should be a factor in determining their suitability for a position of public responsibility!

       Why is this happening? 

Is it some sort of bloodless revolution - the Baveheart effect (from watching the film Braveheart)?

Is it anti-posh or anti-English? The Scots can’t tell the difference.

Is it happening elsewhere in the UK?

Is it being made worse by the present Labour party's policy of depicting Cameron, Osborne and Clegg as posh private school boys?

        Would Brian Souter have made that remark if Labour had still been in power in the UK parliament? Both Blair and Brown where Scottish, although Blair went to the posh school - Fettes - in Edinburgh and was thus - anglified.  

        Come to think about it, Brian Souter sent his son to the posh school - Dollar - so he wants his son to be part of the posh club. But I am sure he wouldn't want to be pushed around by him either

Television as a contraceptive

              Well - us doctors knew ages ago that male fertility was affected by wearing tight Y-fronts, as opposed to loose boxer shorts and assumed that it was an overheating problem.  We knew that too much time spent on a bicycle was not a good thing for the poor old testicles either.
                   But
A new vilain has entered the scene
              Television
A new report has found a direct relationship between declining male fertility and hours spent watching television.
              Men who watched more than than 20 hours of TV a week had sperm counts
44 % lower than those who watched fewer than 4 hours
(after adjusting for factors such as diet smoking and obesity).
             They found that sperm count fell steadily, as TV watching increased although the sperm shape and movement was not affected.
           They also found that men who did plenty of exercise had sperm counts 73% higher than those who did none.

Horrific criticism of Prof Beard

        I have just been reading some of the really horrible stuff written recently about Professor Mary Beard and her appearance. She is a woman who has made it to the top intellectually and has now moved to the media with her programs on archaeology- an amazing woman.
        OK - she has long grey hair - so what? She has always had long hair, why should she dye it and why should she change the style just because the colour has changed?
        Why is it that when you grow old as a woman, society expects you to start  doing different things with your appearance  Things you did not do when younger.
        Woman perhaps fall into 2 categories - those that do lots of make-up and have expensive hair and those that don't.The camp that do, feel it important to make the 'best of oneself' the camp that don't - don't really care and are basically happy with themselves as they are.
        Now - if you fall into the second group, as I do and Prof Mary Beard and many of the hippies of the 60's and 70's and also many intellectuals, then it is sort of considered OK while you are young,
 BUT
       Once the hair goes grey, then society has a problem with us. We are expected to begin to make ourselves look like societies idea of a respectable old person. This involves preferably dying ones hair.
If - shock horror- that is not done, then the offending grey hair must be either put up in a bun or else must be beautifully and regularly  groomed in an expensive hair do.
      We are also expected to smarten up our clothes. Nothing hippy, no grubby jeans and t-shirt and to be careful not to look like mutton dressed as lamb. We are expected to conform
      But - why should we. Is there the same expectation of men?    - No

Labour may have to split UK for SNP

Here's a thought
What if -
The SNP wins the referendum in 2014 and there is a Yes vote for Scottish Independence.
Then -
The SNP lose the vote in the Scottish General elections in 2016 and Labour gets in.
Under current proposals -
It will be up to the party in office to continue to arrange the division of the UK
and the Labour Party, like all other parties, does not want division!
It makes no sense.

No pensions with independence

eeeeeeek
       What is going to happen to my pension if Scotland becomes independent.
My pension comes from Newcastle -that is in England - which will be a foreign country.
       The extra-ordinary thing is, that this very scary issue, has been raised by non other than Jim Sillars, former MP of the Scottish Nationalist Party (SNP) and husband of Margo MacDonald, former SNP member of the Scottish parliament  and currently an independent member of the the Scottish parliament.
      Both of them are now of pensioner age and perhaps understand the fear.
      Jim Sillars is saying that he thinks the SNP are losing the place. They are failing to address problems such as,
What Scotland will do about Europe and the Euro
What Scotland will do about a currency and a central bank
What Scotland will do about defence
etc
etc
etc

Private schools keep the class divide

         Private schools are very much in the news, with lots of talk about the unfairness of people paying to get a better education for their children.
        I would like to call a spade a spade and say the thing that no-one else dares to say.
            "It is not about education - It is about class".
       Going to a private school in Britain, is the passport to being posh - it is the entry to the upper classes - and it always has been
       Parents who consider themselves posh and those who want to be posh know this. I have seen families who have been posh for generations (but who have fallen on hard times) go to the most extreme lengths to send their child to a posh school, if only for the last 2 years. When they were already getting a very good education where they where.
       Going to a private school will  (they hope) rid their child of a regional accent (Scottish if you are in Scotland) better than any elocution lessons and produce that longed for english yah accent which is a requirement of that class. They will also make friends with and marry similar people and become part of that great upper class countywide network.
        I went to a private convent boarding school. It was said quite openly and with admiration, that the nun who was headmistress ruled with the Bible in one hand and a copy of Who's Who in the other.
        Private schooling is the biggest factor behind Britain's class divide. Get rid of private schools and you would get rid of the class divide. If it were done in one go, over night, I think in a crazy way it would be a huge relief for many of the parents. Most of them can't really afford the fees, they are only doing it because every one else is.
        I worked as a school doctor in the private sector and it was quite clear to me that many children at private schools actually get a much worse deal than those in the state sector. In a private school any  child having any kind of problem is quietly required to go elsewhere. They don't want their league tables affected and they don't want to pay for any form of effective remedial  help.
       State schools cannot get rid of pupils and therefore a huge range of services are available for pupils experiencing difficulties. I fought very hard for my pupils to get those same services, arguing that they were paying the same taxes as anyone else, but with little effect.
       But what do you do if you live in the catchment area of a really bad state school? People that can, move to the catchment area of a good state school and there are many. The trouble is - that puts house prices up in that area and produces affluent ghettos, perhaps another form of class divide.
       This could be fixed by government insisting that all state schools reach the same high standard and certainly they are trying to do this in England.
       But - removing all private schools overnight could never happen - it is all pie in the sky.
       Because - suddenly the government would have to find funds to educate all those extra children  - which most conveniently it does not have to do at present, and there is not enough money in the kitty.

Berlusconi - Mad or Bad

          Berlusconi - Is he mad or bad?
He is now making out that Mussolini was a good guy. Excuse me, but good guys are not responsible for loss of freedom, torture, deaths, genocide etc.

          Putin - Is he mad or bad?
He is now making out that Stalin was a good guy, even revising the school curriculum to describe him as a "competent manager" whose actions where "entirely rational". He completely overlooks the purges, the gulags, the famines and all the millions of deaths he was responsible for.

          Do Berlusconi and Putin subconsciously admire and wish to be like these 2 horrific dictators of the past?
         Why would a man want to be like that unless he were either mad or bad?
         Could it be that they have such a huge conceit, that they truly believe, that only they can put right all the problems of their country. Done for the good of everyone in the country, they would argue, it gave them the right to take any action no matter how heinous. In their eyes everyone else is a fool, of no worth.
         Words like narcissistic and psychopath float around my mind.

Poor Hearing

         As a school doctor, one of the things I had to do regularly was check hearing. This is done with a gadget called an audiometer.
       I later trained in something fascinating called Sound Therapy. In this, one of the beliefs is that some people fail to hear certain frequencies properly and that this can lead to problems with spelling. Training that person to hear those frequencies better, can then help them to spell better.
        It all involves much use of the audiometer.When I retired,  it got put away.  Now it has come out again.
       Old age and deteriorating hearing go hand in hand. It is nice to be able to check my own hearing but depressing to see it getting a bit worse. I dread the day I will have to wear a hearing aid. Not because of it's appearance, I don't care a jot about that, it is being able to hear that matters
        At one point in my medical training, we were all made to wear hearing aids in each ear for a time, so that we could see what it was like. What I hadn't realised until then, was that the aid cuts out all normal hearing, because it completely blocks the ear canal. So all you hear is what is being transmitted by the aid. It sounds like a very bad old fashioned tinny radio - it doesn't sound real at all. It does not give you a good clear sound, you can't tune it as you would a radio and if you turn the volume up it just makes the unclear sound with all the interference - louder.
       However - the human brain is quite amazing - and I gather that after a month or two, it does adjust and it is - sort of OK. It is always advised that we don't leave getting hearing-aids until too late, because the older we get, the harder that adjustment is to make.
       Recent research has shown that geriatrics with poor hearing develop dementia faster that those without. This does not surprise me. Not to hear is a dreadful thing. The person is cut off from the world, with nothing to stimulate their brain - so of course the brain deteriorates.
        Hearing is such a precious thing. The young abuse it terribly by playing music too loud through headphones. Damage caused that way cannot be cured although work with stem cells is showing some promise.