The Night Mail

[AndyID]

4 hours ago, iL Dottore said:

People have NO idea what the various procedures cost the NHS - which is a big part of the problem.

 

 

I think that has become the biggest part of the problem. The UK mindset is that healthcare is somehow "free" because the real costs are largely invisible. Even though I'm now on Medicare (plus some supplementary insurance) I am still fully aware of the actual cost of the treatment.

 

BTW, treating the US as one unit might be slightly misleading. I have been fortunate to have received excellent care in the US, including a potentially terminal condition. The states are all a bit different and some are definitely much better than others.

[New Haven Neil]

11 minutes ago, pH said:

The factor we used was 107% of a person’s basic rate i.e. we doubled the rate. Personnel costs quickly added up.

 

In my NHS HR days, we used 114%......#thinks#.....oh!

[AndyID]

12 minutes ago, SM42 said:

 

The usual way is to pump water uphill, but creating hydrogen sounds a good alternative. 

 

That's definitely a good, and efficient, means to store excess energy but that energy is not exactly portable. Hydrogen is, and despite all the silliness created by the Hindenburg, hydrogen is probably our planet's only viable long-term solution. Believe it or not the energy stored in liquid hydrogen is much, much safer than the energy stored in lithium batteries.

[Northmoor]

Should I be superstitious and point out that when England play their first match in the European (Football) Championships on Sunday, TNM might still be on page 1966?

[iL Dottore]

1 hour ago, jamie92208 said:

Knew that Dr's are often heavy drinkers but why should they be chargeable when they are Drunk and Incapale

 

Jamie

1 alcoholic  

/ˌælkəˈhɑːlɪk/

adjective

Someone's who drinks more than his GP

[AndyID]

10 minutes ago, iL Dottore said:

1 alcoholic  

/ˌælkəˈhɑːlɪk/

adjective

Someone's who drinks more than his GP

 

Let us not forget that alcoholic drinks like beer and wine were originally health drinks (with benefits).

[SM42]

2 minutes ago, AndyID said:

 

Let us not forget that alcoholic drinks like beer and wine were originally health drinks (with benefits).

 

Beer is not alcohol 

 

Not in the Motherland at least. 

 

I always thought beer ( ale) was drunk as it was less likely to kill you than water 

 

Andy

[AndyID]

1 minute ago, SM42 said:

 

Beer is not alcohol 

 

Not in the Motherland at least.

 

I guess they got the general idea 😀

[Hroth]

4 minutes ago, SM42 said:

 

Beer is not alcohol 

 

Not in the Motherland at least. 

 

I always thought beer ( ale) was drunk as it was less likely to kill you than water 

 

Andy

 

Yep  - You boil the water to make beer. Kills all the nasties jiggling about in the water..

 

[Tony_S]

 

We are in Dorset.

Not too bad a journey. Satnav traffic advice was to use the A3 not the M3.  That was ok. Various minor hold ups after Southampton. We stopped at Kingston Lacey National Trust for a cup of tea. As we approached the tea rooms Aditi fell over and landed on her face scraping her lips. Later we found she had hit her nose too and her knees were sore.  First aiders were summoned and once the surprise of hitting the ground hard passed she was fine. We did get the cup of tea, courtesy of the NT staff who were very kind. When we got here I unloaded the car and did dinner. That is a bit of an exaggeration I microwaved  the chilli and rice Aditi had prepared and frozen last week. 
The cottage is very comfortable. 
Tony

Edited June 14 by Tony_S

[AndyID]

3 minutes ago, Tony_S said:

 

We are in Dorset.

Not too bad a journey. Satnav traffic advice was to use the A3 not the M3.  That was ok. Various minor hold ups after Southampton. We stopped at Kingston Lacey National Trust for a cup of tea. As we approached the tea rooms Aditi fell over and landed on a face scraping her lips. Later we found she had hit her nose too and her knees were sore.  First aiders were summoned and once the surprise of hitting the ground hard passed she was fine. We did get the cup of tea, courtesy of the NT staff who were very kind. When we got here I unloaded the car and did dinner. That is a bit of an exaggeration I microwaved  the chilli and rice Aditi had prepared and frozen last week. 
The cottage is very comfortable. 
Tony

 

I'm sure we all hope Aditi is recovering well.

 

This "getting old sh*t" does tend to be a bit of bummer, although I really have no reason to complain.

[Tony_S]

19 minutes ago, AndyID said:

I'm sure we all hope Aditi is recovering well.

She is fine but a bit sore. She is pleased she didn't break her teeth or nose. She has a swollen lip and a scabby philtrum which she thinks looks awful but doesn’t really. The shower here is an over bath type so she hopes she will be able to get in. I said there is a hose outside for washing dogs so not a problem. When I fell and injured my left leg last year in France, I got in the bath and at first couldn’t get out. Aditi thought she was going to have to ask reception to help but I eventually managed.  
Tony

[zarniwhoop]

1 hour ago, New Haven Neil said:

 

In my NHS HR days, we used 114%......#thinks#.....oh!

In my electricity board days (before privatisation) we called it "oncost". Not everything was oncosted, but most things were. I think that for non-industrial staff (clerical, admin, engineers, managers) the rates were in the 20% range. For industrial staff (porters, drivers, linesmen, people digging up the road) I think the rates were in the upper 40% range. All for the books to come out even at the end of the day, and to charge third-parties appropriately for loss of service they had caused, or for work on new items such as new transmission lines (LV for the electricity board, CEGB did the HV) and new substations.

 

Fortunately, I've mostly forgotten about that. Rates changed frequently, e.g. for expected pay rises (in those days everyone, even managers, were subject to negotiated national agreements), changes for actual pay rises where the estimate differed, and other reasons I forget. And maintaining the programs which calculated the oncost (one of my responsibilities) and the nights fixing them when they broke was a pain in the proverbial. 

[AndyID]

1 hour ago, AndyID said:

That's definitely a good, and efficient, means to store excess energy but that energy is not exactly portable. Hydrogen is, and despite all the silliness created by the Hindenburg, hydrogen is probably our planet's only viable long-term solution. Believe it or not the energy stored in liquid hydrogen is much, much safer than the energy stored in lithium batteries.

 

Cripes! I just had an AndyID thought. Entirely half-baked I must admit 🤣

 

Has there been a study to compare the real cost of lithium energy storage versus liquefied hydrogen storage? One is chemical and the other is physical. 

[PhilJ W]

1 hour ago, Hroth said:

 

Yep  - You boil the water to make beer. Kills all the nasties jiggling about in the water..

 

And the fermentation finishes off the job.

[monkeysarefun]

13 hours ago, polybear said:

  They run a private system for better/quicker treatment for those that can afford it

 

 

Thats kind of the Australian system -   its a Public/Private hybrid  system working in conjunction with each other.

 

We have Federal Government funded  Medicare which provides free healthcare (but not dental)  to every Australian citizen. It is also available to  visitors from countries that Australia has a reciprocal arrangement with. The UK for instance -we get free healthcare if we visit over there, so therefore UK visitors receive it here if they require it.

 

Everyone from the drug-damaged homeless  to the PM are covered by Medicare at no cost to them. It does have NHS style downsides though, waiting lists for non-urgent cases would be the main one.  Also if we have a procedure done privately  we will be up for  the cost, however Medicare has a list of scheduled costs  for what it thinks  we should pay, so if we were charged more for it, Medicare will refund us the difference (called "the gap").

 

If  we want to minimise the rest of the cost, we also have a private healthcare layer though. This is a monthly payment to any of several healthcare insurance companies of our choice.  We are under no obligation to be in one, however once we earn over a certain income we have to pay an extra tax component if we aren't  (which is usually slightly more than paying for private health cover) so most people over the threshhold age and income are in a fund. The cost is variable and depends on factors like age plus the level of cover we choose, as well as what we want covered. 

 

The healthcare fund can cover  dental and optical as well, so  we can get a free pair of glasses or two a year and so on. Others have gimmicky things like free running shoes and subsidised gym membership , intended  to  encourage a less sedentary lifestyle.

 

If  we do have a procedure and choose to do it under our private cover  - the advantage being no waiting time and we can choose the doctor/surgeon - then it acts in conjunction with Medicare. We will still get the Gap payment from Medicare if the procedure was over the scheduled fee, plus we will get a payment from our healthcare company to cover  the rest of the cost. It will invariably not be the full amount however, usually about 30 to 50%.

 

SO basically, no one HAS   to have  private health cover. If we keel over in the street and have no private cover we will get the same treatment in the emergency room as the person with the best health cover,  for no cost.  The advantage of being in a health fund will come into play if any subsequent non-urgent follow-up treatment is required. If we have no private health care we will go onto a waiting list, if we have cover we will go into the private system for immediate treatment. 

 

If we are on a public waiting list for non-emergency surgery (called "elective" surgery), the surgeon will place us in one of three tiers depending on the seriousness of our  case, either a 30 day waiting list for the most critical, 90 days  for lesser and 12 months for the least serious. The health system must endeavour to have our surgery organised  within these time frames, even if it means using an alternative  hospital or surgeon.  

 

The one thing to be aware of though is that ambulance trips are not free if we don't have ambulance cover, either via a health fund or as a specific policy, so we  could be up for a few hundred there.

 

If we we need it in an emergency in  the outback in a place out of range of the state run air ambulance services, then  the Royal Flying Doctor Service is called. Their service is completely free  (to Aus citizens at least..)  no matter how far  from civilisation we  are or how  difficult it is to get to us..

 

 

 

 

Edited June 15 by monkeysarefun

[monkeysarefun]

 .

 

One other Flying Doctor service that should get more coverage is its Memory Lane trips - again free of charge:

 

"For people with a terminal illness or in palliative care, a simple chance to reconnect with their lives in their final days/weeks can mean the world. Flying Doctor Memory Lane is a free service that allows  people to visit a place of personal significance; to admire their own garden, to feel the breeze of the seaside, or to be surrounded  once more by loved ones, friends  and pets in a place they loved.

 

The custom-built Memory Lane vehicles enable people in end-of-life care to overcome access barriers, making it possible for them to visit  a place that holds meaning safely and comfortably. Their expertise in transporting people to health and wellbeing services means they are well-place to deliver on their commitment.

 

Memory Lane is a no-cost service and is entirely donor-funded and staffed by medically trained health care professionals who volunteer their time."

 

Coupled with the Voluntary assisted dying laws we have, that could make someone's last day a peaceful experience at a place they loved, rather than weeks or months later in agony or a drugged out haze in a hospital ward, surrounded by strangers and machines that go ping.

 

 

Edited June 15 by monkeysarefun

[J. S. Bach]

Night Owl from the Piedmont.

[AndyID]

50 years on.

 

https://getpocket.com/explore/item/the-last-glimpses-of-california-s-vanishing-hippie-utopias?utm_source=pocket-newtab-en-us

[TheQ]

I know when I worked for GEC Marconi the MOD were being charged for the my labour in excess of 10X my pay. They were also being charged for someone up to 4 grades higher than Marconi were claiming to me what my grade was.

 

 

[AndyID]

5 hours ago, monkeysarefun said:

 .

 

One other Flying Doctor service that should get more coverage is its Memory Lane trips - again free of charge:

 

"For people with a terminal illness or in palliative care, a simple chance to reconnect with their lives in their final days/weeks can mean the world. Flying Doctor Memory Lane is a free service that allows  people to visit a place of personal significance; to admire their own garden, to feel the breeze of the seaside, or to be surrounded  once more by loved ones, friends  and pets in a place they loved.

 

The custom-built Memory Lane vehicles enable people in end-of-life care to overcome access barriers, making it possible for them to visit  a place that holds meaning safely and comfortably. Their expertise in transporting people to health and wellbeing services means they are well-place to deliver on their commitment.

 

Memory Lane is a no-cost service and is entirely donor-funded and staffed by medically trained health care professionals who volunteer their time."

 

Coupled with the Voluntary assisted dying laws we have, that could make someone's last day a peaceful experience at a place they loved, rather than weeks or months later in agony or a drugged out haze in a hospital ward, surrounded by strangers and machines that go ping.

 

 

 

Lorna was a nurse in the UK and the US. She was a domiciliary midwife (and Health Visitor) in Scotland and when she retired from nursing she was  a hospice nurse in Idaho. I think her services here were funded by the state.

 

She had to cover quite a large area and she helped people end their days in their homes with their loved ones. Unlike me she has the ability to handle birth and death as quite normal processes.

[polybear]

6 hours ago, monkeysarefun said:

 .

 

One other Flying Doctor service that should get more coverage is its Memory Lane trips - again free of charge:

 

"For people with a terminal illness or in palliative care, a simple chance to reconnect with their lives in their final days/weeks can mean the world. Flying Doctor Memory Lane is a free service that allows  people to visit a place of personal significance; to admire their own garden, to feel the breeze of the seaside, or to be surrounded  once more by loved ones, friends  and pets in a place they loved.

 

The custom-built Memory Lane vehicles enable people in end-of-life care to overcome access barriers, making it possible for them to visit  a place that holds meaning safely and comfortably. Their expertise in transporting people to health and wellbeing services means they are well-place to deliver on their commitment.

 

Memory Lane is a no-cost service and is entirely donor-funded and staffed by medically trained health care professionals who volunteer their time."

 

Coupled with the Voluntary assisted dying laws we have, that could make someone's last day a peaceful experience at a place they loved, rather than weeks or months later in agony or a drugged out haze in a hospital ward, surrounded by strangers and machines that go ping.

 

 

 

First Class.

Hold your heads in shame, British Government

 

2 hours ago, TheQ said:

I know when I worked for GEC Marconi the MOD were being charged for the my labour in excess of 10X my pay. They were also being charged for someone up to 4 grades higher than Marconi were claiming to me what my grade was.

 

 

 

Fraud.

 

 

[iL Dottore]

9 hours ago, AndyID said:

 

Let us not forget that alcoholic drinks like beer and wine were originally health drinks (with benefits).

 

9 hours ago, SM42 said:

 

Beer is not alcohol 

 

Not in the Motherland at least. 

 

I always thought beer ( ale) was drunk as it was less likely to kill you than water 

 

Andy

 

9 hours ago, Hroth said:

 

Yep  - You boil the water to make beer. Kills all the nasties jiggling about in the water..

 

It wasn’t that long ago that the water available for people to drink, even in cities like London, was so contaminated as to make Britain’s rivers today look like pristine, pure, Alpine streams. Back then, E Coli* was the least of your problems, waterborne - and lethal - diseases like cholera regularly turned up.

 

As @Hroth mentioned, the process of making beer killed off any nasties -  the boiling of the water and the creation of alcohol by the fermenting yeast both playing a role.

 

Given the dubious potability of water, most who could brewed their own low alcohol beer which was drunk by everyone from toddlers to the elderly. In England this low alcohol beer was known as (no, not supermarket own brand lager, boy) Small Beer

* E Coli, or to formally introduce him, Escherichia coli, is a bacteria that all mammals have in their gut (fecal matter contains dead bacteria and intestinal cells, plus indigestible materials like cellulose). It’s mostly harmless and may play a role in the immune system and we definitely have a mutualistic relationship with this bacterium. Problem is when E coli ends up where it shouldn’t (like in the prostate) or it turns out to be a pathogenic variant like Enterotoxigenic E. coli (ETEC).

[iL Dottore]

I’m glad to hear that Aditi had no severe consequences of her fall. @Tony_S must be relieved.

 

This post got me thinking about a recent medical journal article I read about fitness in the elderly. Now, I refuse to be “old”, but I am sane enough to recognise that I can’t stop the inexorable ravages of time; however, I can manage them. Which brings me back to the article.

 

Falls in the elderly can have deadly consequences: not immediately from the fall, but from the aftermath. A person has a fall, suffers an intertrochanteric or subtrochanteric fracture (which many health services, including some NHS trusts, will not repair in elderly patients) leaving the person bed bound with resulting physical and mental deterioration and an earlier death than would have been the case. This is now a major problem, affecting women more than men (due to post menopausal osteoporosis. A good review is here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610445/#:~:text=Hip fractures can be classified,as intertrochanteric and subtrochanteric fractures.)

 

However, regular weight training helps as by building, or maintaining, muscle mass, when you fall you tend to bounce rather than break (a good lay article here: https://www.washingtonpost.com/wellness/2023/02/20/aging-weight-training-health/)

 

I go regularly to the fitness centre (2x week), each time doing two circuits of mixed weight training and intense cardiovascular exercise and I’m now starting to feel the benefit (it does take a while). It’s definitely worth my while.

[Happy Hippo]

23 minutes ago, iL Dottore said:

I go regularly to the fitness centre (2x week), each time doing two circuits of mixed weight training and intense cardiovascular exercise and I’m now starting to feel the benefit (it does take a while). It’s definitely worth my while.

Sit ups every day of the week!