Could Cameron be right ...

... when he described "the bubble [politics] in Cardiff as being completely obsessed with assembly powers but voters had other priorities such as the recovery of the economy and the health service".

Well Carwyn and chums are going to prove Cameron wrong, in the Assembly today ...

the Active Travel Bill will proceed to the next stage.

... at a price of £12 million, is it what we have asked for, is it good value ?

Information: 

This year the Aneurin Bevan Health Board has a drug budget shortfall of £10 million, and there are another 6 health boards in Wales, our politicians prioritise cycle track maps over medicines.

But its democracy, we did vote for maps over medicines didn't we ......... with devolution !

.

Language dilemma for ...

... Meri Huws the Welsh Language Commissioner.

Westminster has decreed that EU doctors coming to work in the UK from April will have their language and communication skills tested by nominated senior doctors.

In Wales we have the Office of Language Commissioner who may do anything she (currently female) considers appropriate to:

• Promote the use of Welsh
• Facilitate the use of Welsh
• Work towards ensuring that the Welsh language will be treated as equally as English.

This includes promoting opportunities to use Welsh and encourage best practice in the use of Welsh by people dealing with other persons, or providing services to other persons; a recent Investigation report published into the implementation of Betsi Cadwaladr University Local Health Board’s Welsh Language Scheme (NHS in Wales).

The difficulty I envisage is satisfying the commissioner and the public in need of the NHS in Wales, as all our doctors are registered with The General Medical Council (charity registered in England
GMC0002 and Wales (1089278) and Scotland (SC037750)) and as there is no requirement for language skills other than English ...

... what is the point of our Welsh Language Commissioner.

Our NHS in Wales ...

... is like looking through a distorted mirror, take obesity ...

... to qualify for Metabolic and Obesity Surgery in England the criteria is :

... people must have a Body Mass Index (BMI) of 35 with related health problems, such as diabetes or sleep apnoea, or 40 without.

In Wales to qualify for the same procedures the criteria is :

... people must have a Body Mass Index (BMI) of 50 with related health problems. This means patients can only be operated on once they are in poor health

... yet the peoples of Wales pay the same taxes as their cousins to the east of Offa's Dyke.


It would be best if the British taxpayers were treated equally .......... on both sides of the dyke !


I digress ...



... something amiss !

... the stakeholder eisteddfod,

... in stakeholder Wales, in a stakeholder world.

It doesn't really matter how small the taxpayer contribution is, but for every penny of contribution (for every cent of contribution) we become stakeholders, and as stakeholders everyone should be included.

It's a simple formula, as a taxpayer (and that is everyone) we should expect an equal return on our investment, so the National Eisteddfod if it is to receive any funding from government must become inclusive, and to this end it should be subsumed by a new "Wales Eisteddfod" where the cultures of all the peoples are celebrated, where every stakeholder is able to share their particular cultural niche with everyone.  And Carwyn Jones our First Minister is well placed to lay the foundations for a celebration of everything that is Wales.

.................................

I digress ...

In the USA Apple have been awarded an enormous sum as damages from Samsung, but will the little people receive a stakeholder percentage through taxation, or will the damages be absorbed by Apple's offshore tax avoidance vehicles.  Just thinking ..............

.................................

Returning to Wales ...

If Carwyn Jones created a new eisteddfod he would become the first to create a cultural celebration for all ... the first to recognise the stakeholder citizen.

DNR, do not resuscitate ….

... written on the patient notes, the patient could be our beloved NHS, or might it be Wales Education, do you get my drift, those elements of government that do not work as intended.

Could it be time to cut off the life blood to failure and let others provide alternatives.  Our Labour led government have demonstrated they the ability to discard failed (embarrassing) organisations, funding to the All Wales Ethnic Minority Association (Awema) was cut off with alacrity just a few weeks ago; can we look forward to those who failed to heed warnings, and gave such poor oversight, falling on their sword, somehow I doubt it.

Those working at the sharp end of the NHS in Wales are echoing the words of David Cameron when he describes our health service as failing.  Those hard working nurses who deliver care are worried for their futures, and should we be surprised, how many times have they been reorganised since devolution, how many directives requiring a diversion of energy and effort have been imposed upon them, how much money was delivered by Westminster yet not delivered by WAG, it's about half a £billion this year alone.

When Carwyn Jones, and other left leaning politicians, turn their back on the very experience that generates the wealth used to fund the public services, I wonder whether the DNR label might not better be attached to the Assembly and all those that sail in this very sorry excuse for governance.

Carwyn could do better setting aside ...

... the baggage of "only public service allowed", it just doesn't fit with life in the 21^st century, a life that should be a reflection of the following letter in today's Times :

Sir, As head of radiology at a Glasgow teaching hospital for 23 years, I was very much in the front line of financial problems. Of course the NHS has been a success, much loved by the British public. But it is a huge monster devouring every penny it gets. The service could be fitter and slimmer.

On retirement, when working in Sydney, I was most impressed with the emphasis on service. All staff realised that they were in competition with other groups; the practice income and their pay depended on the quality of their service. Patients were examined that day or the next and left with a typed report — no delays for CT scans. Indeed, seeing the need for a scanner this group arranged its own funding; no need for endless time-consuming committees and layers of bureaucracy.

Patients were covered mainly by State insurance, some privately. If the practice did well, the income increased and staff were better paid. No obscure “Clinical Excellence” Awards there. Not only that, the practice handled a workload similar to that of UK hospitals but with fewer staff and a better service.

We must get away from political dogma — enterprise, ability and good service at all grades must be rewarded. Whatever else, the founding principles of the NHS must be preserved, free healthcare for all based on clinical need. Dr J.K.Davidson Glasgow Sir, Ian Rogers (letter, Feb 14) suggests that Clinical Excellence Awards for senior doctors should be scrapped because “hospital doctors undertaking the same responsibilities and workload should receive the same payment”. ............ letter in full £

Dr Andrew Bamji, Rye, E Sussex 

How might the experiences of Dr Bamji be applied to the NHS in Wales ?

Over the last 6 months or more I have had a very personal and direct association with our NHS doctors surgery (practice) and our local Health Board (Aneurin Bevan), what have I learned ?

The story...

Initially the practice diagnosed a probable meniscus tear to the left knee although I was told it could be arthritic, I had an x-ray within two weeks, followed by an MRI scan two weeks later, and an appointment with the consultant surgeon two weeks following.

At the appointment with the surgeon he was surprised that both x-ray and MRI scan results were in his hands, he explained that it was usual for the diagnostics to be requested by him, our practice had cut 6 to 8 weeks from the period of diagnosis.

Things got a little complicated, after a week off work the company I work for convinced me to return to work (light duties), this was probably a mistake, the pain at times when I was in the warehouse was pretty bad, some of the staff can be a problem which puts me on my feet and walking.  I was losing condition, muscle, I put it down to the knee pain.  During a visit to family during October, my sister in law commented that I "looked frail", not an expression I had heard before, it played on my mind.  Worried I visited the practice, not many questions asked, none to do with the knee, answers "Yes" to each question, the doctor smiled at me and said "join the club, its a royal club, you have diabetes".  There followed a week of tests and the first diagnosis that I had Type II diabetes.  During the following month medication and diet was modified until it seemed my Blood Glucose had stabilised.

The diagnosis was important to me, but unknowingly it would set back treatment for the knee.  Mid November a letter arrived to attend a Pre-Admission Clinic for knee surgery, happy days, not so happy, the newly diagnosed diabetes would put back surgery until such time that both my diabetic medication and Blood Glucose had stabilised.

During November and December we worked on the diet so as not to need further modifications to the medication, by early January I felt everything was looking good, so booked an appointment to see the diabetic nurse who arranged for a series of tests to confirm my feelings, I was right but it was better than my feelings, cholesterol both good and bad had dropped to normal readings, my 3 month average Blood Glucose was better than my readings (better test).  An angel, she was straight on the phone and followed everything up to the surgeons team by letter, a week later a letter of appointment arrived for 26^th Jan, it was just a test for nasties the surgical team preferred not to come into their theatres.  A couple of days later a letter for surgery 3^rd February.

How does my little tale help Carwyn, well, it could be any business dealing with departments, but it is also a description of a business dealing with another business['s], in my case 3 [4 including post operative therapy] enterprises...

• General Practice
• Diagnostic services
• Surgery
• Therapeutic services ()

 At present the departments are evaluated through politically set targets, what do politicians or their familiars know of the realities of medical process.

Dr Bamji might offer Carwyn the benefits of his experiences in Australia as it might be applied to Wales, Carwyn might also consider the need to devolve tax raising powers for health to give greater control, he might convince the voters to contribute more, Carwyn might consider the need to devolve wages to NHS businesses, not to cut salaries, but to enable salaries to rise in the wake of greater customer satisfaction, and a by-product of that satisfaction, greater productivity.

Just thoughts ........

NHS will pay for ...

... implant removal, but not an appointment by a diabetic to gain much needed advice from a dietician.

And the reason given, budgetary constraints, not a word of a lie !

And the single most important life skill for a diabetic .................... diet.

A Wales NHS decision, thanks Carwyn and chums ............

I feel a little like the man who went to market ............

.......... he took a cow to return home with a chicken.

The word Carwyn Jones is cheated, but you have your priorities !

Perhaps, ...

Professor Sir Mansel Aylward said on today's BBC Wales Politics Show ...

"We're not going to get many more chances - in the past we had plenty of money and perhaps we spent it wrongly,"

If the NHS in Wales were a work of art, aesthetics might conclude it not worthy to be viewed in the worlds top galleries, The Louvre would say 'non' and The Deutsche Guggenheim might cry "nien";  whilst in Wales the public it should be serving is reticent in its public condemnation, and our political representatives are lounging at the Cardiff Bay club for useless rhetoric, oblivious to the reality of the situation.

Might we apply a criteria to politics as we do with a painting, could we call for quality ............

... and the loony left of Wales say the NHS is best left as a public ...

... service, apparently businesses are incapable of providing a good enough service !

When I read the tired words of a sterile apology ...

Stephen Graves, chief executive of West Suffolk hospital, said: "We have passed on our sincere apologies for any anxiety or distress which Mrs Dixey experienced in our care and assured Mrs Jacques that lessons have been learnt as a result of her complaint. We are committed to ensuring that all of our patients are treated with dignity."

... I know the lessons and commitments are essentially nationalised industry bullshit.

The story from today's Sunday Times, written by Sarah-Kate Templeton the Health Editor, is horrific to those who might become elderly patients of the future, and that's everyone ...

On her visits to her mother during treatment at the West Suffolk hospital in Bury St Edmunds, Jacques would take notes of what she found. On one occasion her mother had become dehydrated and fluid charts showed she had had nothing to drink between 12pm and 7pm.  ........... Call bells were not answered, staff did not introduce themselves to patients or explain what they were about to do. Patients were also addressed in the most impertinent manner by young staff. She was addressed as a child. "Please is a word" [a nurse said to her].

Jacques mother, who was recuperating from a broken leg on a rehabilitation ward, died in April, just weeks after she had been discharged.


If the markets were in operation, if there was choice, if there were competition, would this particular parody of a caring organisation be open for business ?  I doubt it, it seems that to have the words "NHS Hospital" and "nursing" in the same sentence is oxymoron.


I am waiting for a knee operation, I think I might be safer paying for the operation, not for the surgeon, but the post op nursing ....................

What is the point of meaningless ...

... questions, dreamed up by BBC staff searching for bad news ?


... to wit ...

FREEDOM OF INFORMATION REQUEST. THE TOTAL NUMBER OF HOURS LOST DUE TO HOSPITAL TURNAROUNDS ABOVE 20 MINUTES. TURNAROUND BEING WHEN A&E NOTIFIED BY AMBULANCE CREW THAT PATIENT HAS ARRIVED TO PATIENT BEING HANDED OVER.

... and the bad news ...


BBC Wales health correspondent Arwyn Jones concludes that because there has been a notional rise in the time it takes ambulance staff to hand over patients to hospital staff there is a burdensome cost to the NHS in Wales, his research is published here, check the table, the average handover time from ambulance is ....


.... less than 20 minutes, I believe there should be an applause at this point for the ambulance service staff, but not from the buffoons at BBC Wales, the reporter has written ...

... the total number of hours lost in Wales due to hospital turnarounds above 20 minutes has increased from 37,712 hours in 2008-2009, to 54,476 hours in 2010-2011.

What is he implying, a level of incompetence possibly, or are the staff on a go-slow, it's a bullshit story from a bullshit organisation, the NHS in Wales hasn't an additional cost of  £10 million, what it has in reality is ...


... additional effort by the ambulance and A&E hospital staff to meet the demands of the public, and I say this with a certain confidence, because everyone gets treatment.


Maybe the reporters at BBC Wales should get out more, sit alongside people who actually work for a living rather than looking for a story where a story doesn't exist, paid for by the very same people they look to criticise.


They might also consider reading Robert Pirsig's MOQ, and pass it around the political reporters, they are in dire need ...

John Lewis NHS for England, in Wales we have ...

... the tired statism that excludes good ideas for the sake of political dogma.

Advocates of the John Lewis mutual model will send the syndicalist Plaid Cymru membership into raptures, the Labour Party membership in Cardiff Bay and the valleys will seem to enter a "seventh heaven", but I would be surprised if the rank and file of both political parties understand how the John Lewis Partnership actually works.

To quote the partnership ...

When our founder, John Spedan Lewis, set up the Partnership, he was careful to create a governance system, set out in our Constitution, that would be both commercial allowing us to move quickly to stay ahead in a competitive industry, and democratic giving every Partner a voice in the business they co-own. His combination of commercial acumen and corporate conscience, so ahead of its time, is what makes us what we are today.

Mutual is probably a misrepresentation of the John Lewis Partnership, in reality it is a business like any other business that is ruthless in its management style, yet manages to portray a paternalist image to the unwary; although it would be true to say that whilst you work for the company the benefits are a welcome addition to the daily toil.

To sum up, the John Lewis Partnership is a business that is ruthless in its business methods, it will buy and sell, hire and fire and most importantly take decisions that ensure its continuity, in essence it will make a profit; during the last financial year ...

... the John Lewis Partnership reported :

•  Gross sales up £784.8m, 10.6%, to £8.21bn
•  Group operating profit up £41.3m, 10.6%, to £431.0m
•  Profit before Partnership bonus and tax up £61.3m, 20.0%, to £367.9m
•  Partnership bonus of £194.5m; 18% of salary

For those syndicalist and socialists, it is essential to temper the euphoria as the operative word amongst the figures is "profit", without "profit" there is nothing to share.

Going back to the NHS, David Cameron will tomorrow offer "choice and control" to English communities, he will throw open every part of the public sector to the "best possible provider", and the example of this best possible provider he will give the public is the John Lewis Partnership, the best possible business model that will drag the health service into the 21st century whilst placating the public animosity to private health providers.

The model being offered is strong management unhindered by both politics and trade unionism, where success will be measured by the profitability of the "National Health Enterprises".

Whilst in the green valleys of home, the public in Wales will be restricted to the statist model so loved by the politicians of Wales, the doctrine that gives a centralised government control over economic planning and policy, a policy that rides roughshod over good business practice.

Is Carwyn Jones and his left leaning Minister for Health and Social Services,  Lesley Griffiths AM (Unison, theFabian Society and the BevanFoundation), likely to look at the Cameron model for the supply of public services, I doubt it, it requires qualities absent in our Welsh Assembly Government, an open mind and courage.

No rush he said, ....

... Carwyn Jones that is, it's just a shame he didn't tell his cabinet.  Or more to the point, Rural Affairs Minister Elin Jones and Health Minister Edwina Hart, both pieces of legislation contraversial, both pieces of legislation questionable.  Jones wants to slaughter badgers even though the reason for such action is rapidly reducing and Hart wants your body organs to become WAG property even though compulsion has been demonstrated in Spain as being ineffectual.

So how do the political representatives in opposition resist unneeded and unnecessary legislation in a unicameral legislative body where a single group holds a very dominant position, seemingly in perpetuity, the Welsh Assembly Government is in effect a dictatorship that cannot be effectively opposed except at the four yearly elections.

If a politician were able to challenge the government of the day, with a large enough body of Assembly Members, 20% for example, to put the question to the electorate in a referendum might be a good first step,something similar to Denmark where ...

Where a Bill has been passed by the Folketing (Welsh Assembly), one-third of the members of the Folketing (Welsh Assembly) may, within three weekdays from the final passing of the Bill, request of the President that the Bill be submitted to a referendum. Such request shall be made in writing and signed by the members making the request.

Just as with the Danish model, it shouldn't be designed to hamstring the day to day running of government, therefore certain administrative areas such as budget might be excluded, for example in Denmark its constitution continues ...

Finance Bills, Supplementary Appropriation Bills, Provisional Appropriation Bills, Government Loan Bills, Civil Servants (Amendment) Bills, Salaries and Pensions Bills, Naturalization Bills, Expropriation Bills, Taxation (Direct and Indirect) Bills, as well as Bills introduced for the purpose of discharging existing treaty obligations shall not be submitted to decision by referendum.

With a population of five and a half million, Denmark is not so dissimilar to Wales, though its Parliament consists of 175 members, one member to 30,000 people, the combination of MP's and AM's is a very close match.

Would sufficient people support a petition to the Assembly to create such a tool for our elected members to hold the Welsh Assembly Government to account, or is such a concept alien to Welsh democracy, accountabil;ity to to whole electorate, not just to its particular agenda.

Don't take my word for it, listen to what Ed ...

... Bridges has to say (Public Affairs Manager with the WRVS in Wales).

... he writes "the Welsh Government’s latest policy on social services is dealing with the symptoms rather than providing a long term answer for our problems".

Yet another example of shallow thinking, poor judgement, but don't take my word for it, read it all here.

... and remember Ed's words ...

The trick which the Welsh Government missed in the White Paper – alongside a conspicuous lack of funding to back up its ambitions – is how social services users with the most intensive needs can be helped through early, low-level interventions. To have done so would have produced a more radical agenda as well as being more cost-efficient and harnessing the power of partner organisations that can help deliver those services effectively.

The problem for the Welsh Assembly Government it is Ed's ideas are a little too close to the "Big Society" of David Cameron. ........ poor electorate, poor Wales !

... mustn't forget, the Welsh Assembly Government wants you to give them more powers .... when they can't get the important things right, the ideas that is .....

There is no one more reformed than ...

... an ex-smoker, so when I read the BBC headlines Welsh Assembly Government's 'smoke-free society' aim, I was intrigued .... it sounded good.

I wanted to read more, find out what their plans were, could I help in any way ?

The link from the BBC to the plan was the first step, it's only 47 pages try it for yourself, so I downloaded the document and 2 hours later after reading over lunch, a long lunch, I felt both optimistic and a cheated.

Optimism came at page 11, it had a vision, 3 parts, each part I could sign up to and then some ....

... after the vision came the platitudes of the political stocking filler, do you remember the chocolate Santa, brightly covered with red and silver paper with that smooth chocolate loved by children, but one bite and a hollow centre, "continue to support" "action plans" "ensure ... embedded ... planning", when it got to "WAG will work with ..." came the realisation the document was a "fart" from politicians and their staff with a lot of time on their hands, but with so little vision as to be handicapped, ........ poor electorate, poor Wales !

... memories of the stocking filler ...


There is a positive in the document, it invites views and comments by 18 May 2011, have I got something to say that might help the vision .......

Lies, damned lies and the IWA ....

... don't take pinocchios' word for it, read it for yourself, and then email the shyster directly and tell him the NHS in Wales is devolved, its troubles belong to the Welsh Assembly Government alone, voting No just puts the brakes on the out of control Cardiff coalition.