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Saturday, 19 March 2011

The de-skilling of GPs

Yesterday's post was a little rushed, and I didn't have the time to mention the de-skilling of GPs. In my youth, GPs were capable of dealing with nearly all of the medical problems of their practice themselves; most patients will have routine and minor medical issues, and the number that used to require referral to hospital or to a consultant was, from memory, low. The stethoscope and the sphygmomanometer were the tools of choice, and clues in the patient's eyes, tongue, fingernails, skin, demeanour and so on aided diagnosis. White flecks on the nails? Vitamin C deficiency. A little yellow ring around the cornea? A smoker. Blue nail-beds? A pulmonary disorder. If confirmation was needed, the GP would take a blood, sputum, urine or stool sample and send if off.  

Now of course a GP won't even bother to look at your hands or eyes, let alone ask to take a peek at your tongue. Unless you've brought one of the half-dozen common and minor complaints he or she feels capable of dealing with without further investigation, these days it's a battery of blood tests to start with. Everything from Cholesterol to Zinc. Then they use a little book like a primer, with easy to follow flow charts, to tell them what the numbers mean. Half of these flow charts end up with the instruction 'Refer to Consultant'. 

Again, when I was younger, consultants were men (and yes almost always men) at the peak of their profession; members of the Royal Colleges in expensive suits and with a Bentley in the hospital car park. They were not to be bothered with trifles. Now, they're as ubiquitous as ward-cleaners, younger, and a lot less well qualified. In short, in the same way that 'A' levels have regressed to the level of the old 'O' levels, a first degree to the level of 'A' levels and a Master's to the level of the old Bachelor degree, so newly qualified GPs have regressed to the skills level of a nurse, and consultants to the skill level of the sort of GP that one found in my youth. To be frank, unless you've got a British-qualified GP over 50 you're probably better off using Wikipedia.  

Friday, 18 March 2011

The problem with the NHS?

The following graph, from Market Oracle, hardly needs a comment. Labour's damage to our economy is deep seated and will cause much pain to untangle.

Thursday, 17 March 2011

Forget 'liberty' think advantage

Heffer's piece in the Telegraph today makes a plea for us not to allow our hearts to rule our heads over Libya or anywhere else. Maintaining national competitive advantage is going to be critical over the next few years, and foreign policy decisions must be made on the basis of outcomes that enhance ours. Thus from Libya what we want from the ruling regime is simple;

1. Free access to oil on open markets with contracts honoured
2. A dam of the African drift North into Europe
3. No haven for Jihadists

Gadaffi, mad as a bucket of eels though he is, generally obliged. There is no guarantee that the insurgents will. Therefore our foreign policy should be to make a lot of ambiguous noise and high-flown rhetoric about saving lives, humanitarian objectives and the like but do nothing to displace the devil we know until an alternative that will cede the three points above emerges. 

As much as my heart wants to see the dictators fall in Libya, Bahrain, Saudi Arabia, Syria and Kuwait, it must be the job of government, and of the Foreign Secretary, to take a far more pragmatic and self-interested view.

Tuesday, 15 March 2011

Midsomer fantasy

I suppose I've seen some half dozen episodes of the 81 broadcast since 1997 of 'Midsomer Murders'. To be frank, I've never even remarked the racial composition of the cast - the improbable number of murders in a fictional county is the thing that strikes one. It's a bit of harmless fantasy, with Morris dancers and nice scenery. It doesn't surprise me though that Brian True-May, one of the creators, has been suspended for pointing out that there are no black faces in Midsomer. 

In reality, of course, the Manor House would be occupied by a drunken gay Saudi Arabian prince who beats his serfs to death and crashes Ferraris around the place, the post office would be run by a pair of fraudulent Nigerians and the corner shop by a rapacious Asian charging £3 for a loaf of bread. By the same token, 'Eastenders' would depict gangs of Pakistani youths stoning tourists on 'Jack the Ripper' walking tours, the call of the Muezzin behind the Queen Vic and a bloke who sells fraudulent postal votes to bent council candidates and 'Emmerdale' would feature slave-gangs of Vietnamese cockle-pickers living in plastic sheet shanties in ditches, a black crack dealer with a 9mm pistol and shared tips on defrauding the Housing Benefit in the pub. Which would have closed, because of the smoking ban. All the soaps would feature the popular loathing of the political class - and I've rarely seen such depth of hatred as there is now - and frustration with the Londoncentric media class who lie, distort, omit, fabricate and twist reality to fit their cosy presumptions about 'real' Britain. 

Somehow I don't think they really want reality depicted on TV at all, and those now calling for soaps and fantasies to reflect real life need to think very carefully about the consequences if they do. 

Monday, 14 March 2011

Guardian's timing as bad as ever

On the day that the cross-party People's Pledge is launched, the corrupt tax-avoiding GMT rag the 'Guardian' has chosen to launch a rolling feature entitled "The new Europe - getting to know our neighbours better"

I wouldn't bother with the Guardian's take if I were you. Here's Raedwald's alternative take on our Euro neighbours

Part 1 - The Hun

Since the wall came down, the Hun has been divided into Wessi Huns and Ossi Huns. Ossi Hun women line the highways to Poland dressed in micro-skirts with ineptly bleached hair seeking trade from TIR truck drivers, whilst Ossi men slump at home in crumbling 'Eric' Soviet Paradise apartments watching Philippine-made LED TVs wearing nylon pullovers patterned by a Chinese sweat-shop boss on acid. In the East, Prussian militarism has been killed for ever, and the population has reverted to the sort of stubborn peasantry it was before Frederick the Great had an effect. Since the Holocaust killed off all Prussia's finest musicians, comics, actors and creatives it's a fairly dull and joyless place. 

The Wessi Hun retains the proclivity to remove clothing at the slightest excuse, and large areas of forest are designated for the disport of naked Huns. The mullet remains the favoured hairstyle, and the Mercedes the favoured vehicle. The average mass of a Wessi Hun these days is about 18 stone, and they are often a light orange in colour. The species is known for hoarding, and may often be observed burying caches of pickles, gold etc. The Wessis have grown extremely rich selling machines for making other machines to China, but now that China is making its own machine-making machines this wealth may diminish. 

Both Wessis and Ossis delight in a dish of 'bratties' - Bratwurst with Sauerkraut - washed down with a few litres of lager-beer. Since they killed all their Jews, their musical tastes have become primitive and undeveloped, tending towards the boom-booma-boom Eurovision Europop. The Hun has not produced a single rock group of any note since 1945. They have a few buildings of note, constructed since 1945, and these have been designed by British architects for the same reason. 

The population is not breeding well, reproducing at under the replacement rate. Around 5m prime breeding males were killed in the last war. They have therefore imported Turks. The toilets are extremely clean, almost fetishistically so, and many have an 'inspection shelf' for the scrupulous Hun to examine his or her stool before flushing. The population as a whole may appear docile, but the Hun harbours quiet ambitions to lead Europe through the EU; paradoxically, it was one of the original intentions of the EU for that institution to keep the Hun down. 

Next - The Kermits

People's Pledge

There's not generally much common ground between leftie Mark Seddon and this blog, but in the case of the cross-party initiative to sign voters up to pledge to vote only for candidates at the next election who vow to support a referendum on the UK's membership of the EU, I'm happy to sign-up.

Free trade and no tariffs, yes. A common European cultural heritage, yes. A European identity, yes. The loss of British sovereignty and of control over our fish, our border and our laws, NO.   

Sunday, 13 March 2011

Hutton - Stupid, Stupid, Stupid

The insanity of Socialism is given full vent in a piece by Will Hutton for the Observer today in which he writes without a hint of irony
Only governments can trigger the investment in the physical, social and human capital necessary to support growth. Only government can redistribute the income needed to alleviate poverty, and promote more equal opportunity.
No no no. This is errant nonsense. Let's take them one by one. Physical capital - it was not government that built, crewed and filled merchant ships that built trade, not government that founded markets, not government that built canals and railways, not government that planted fields, not government that built shops and stores and warehouses. It's certainly not government that builds social capital - in fact the effect of big government is to destroy social capital by displacing the Burkean horizontal ties of family, neighbourhood and community by the sterile anomie of individual relationships with the State. And it was not government that developed indentures and apprenticeships, training and education, founded grammar schools, endowed universities, trained cadets for the merchant service, engineers for the workshops or managers for trade and industry - all this investment in human capital was done by, well, capitalists. All that's required for all this private capital investment to flourish is the maintenance of a system of law - that's all we require of Hutton's State. But like the besotted kommisar who believed that tractor production increased when Stalin smiled, Hutton is utterly blind to the reality of our economy. 

And as for government redistribution alleviating poverty, has Hutton forgotten already the gross failure of thirteen years of redistributionist policy under Labour? A failure so startling and clear that poverty and inequality actually increased under Labour?  

Hutton was at the heart of the cancer known as 'the new public management' that sought to destroy local autonomy and grass-roots democracy in favour of a central and Statist universal model of governance, with local councils totally in thrall to the central State. Together with the corrupt, destructive and discredited Audit Commission and the rapacious tentacles of the PwCs, KPMGs and Deloittes, Hutton and his risible 'work foundation' were part of a determined effort to destroy Britain's capacity for local governance. We now have a chance to make a final bonfire of Hutton's evil and all its like - let's not waste it.