On 2008-06-27 12:00:24 +0100, magwitch said:

Chris Shore wrote:
"magwitch" wrote in message
...

Sorry to burst your balloon.

Sad, inexcusable and awful though those stories are, I am certain that
we could rehearse
just as many from within the NHS. I am aware of several myself.

Chris

Oh I'm sure they can and do happen to NHS patients, but these happened
entirely because of private treatment... in my mother's friend's case
because she had the cash to pay for what had already been ruled an
inappropriate (in her case) operation, and in mum's cousin's case
because he was in a private room, if he'd been on a NHS general post-op
ward, someone would have heard him fall over and he'd have been noticed
and treated almost immediately.

It's very easy to come up with anecdotes like this. Nothing is
without risk. What actually counts is outcome and that is a
statistical analysis, not an emotional one.

On 2008-06-27 10:44:36 +0100, magwitch said:

Andy Hall wrote:
On 2008-06-26 22:27:31 +0100, magwitch said:

Andy Hall wrote:
On 2008-06-26 18:32:05 +0100, Roland Perry said:

In message 486177d1@qaanaaq, at 23:40:17 on Tue, 24 Jun 2008, Andy
Hall remarked:
One can consult with virtually any consultant doing NHS work on a
private basis. The important thing is to check the credentials and
track record of the individual.

And when the track record is exemplary, and they recommend treatment in
an NHS hospital, who do you do then?

Choose the private hospital or private faciity at which they also work
after checking its credentials

A consultant friend of mine says that with private care you just get
the consultant (however skilled or distuingished) what you don't get is
the team of various professionals who work closely with him in the NHS.

On the contrary. In respect of a particular exercise, I checked that
precise point with all of the individuals concerned, especially how
often they had worked together. My findings were quite the opposite.



With a private hospital's operating theatre and rooms (however plush)
the visiting medical staff more or less rent the facilities and then go
their separate ways leaving the patient's progress to fate.

I found that not to be true either as have many friends and relatives
who have eschewed the high infection rates and poor standards of the
NHS.

Two case histories:

The first was an old friend of my mother who, like my mother, had
arthritis in her knees and went to her NHS orthopaedic consultant. He
said that a knee joint replacement would not be advisable for her (on
weight and general health grounds).

The private orthopaedic surgeon had no such qualms, so after paying him
the £30,000 fee, she had the op. After 3 weeks, an infection set in
(this was treated on the NHS as the private consultant/hospital didn't
want to know) and 6 weeks later she had her leg amputated above the
knee, this was so traumatic to her that she literally lost the will to
live and died a few days later.

Both examples are ridiculous.

The correct course of action is for the patient or their family to take
responsibility for themselves and to seek second opinions in both cases
as well as researching the risks involved.

The fact that there was such an obviously wide variance of opinion
should have rung a very large warning bell. Whether one was an NHS
consultant and the other not, can have the opposite connotation to the
private consultant being on the make as you are implying. It can
equally be the NHS not being willing to fund this procedurefor someone
of these QALYs.



The second was my mother's cousin, who'd had a routine hernia operation
privately with the usual post-op overnight stay. He got up in the
middle of the night and fell over and knocked himself out on the way to
the ensuite bathroom. As nobody checked on him during the night
(private room) he lay there for 7 hours. He spent 6 weeks on a NHS
intensive care ward, as he'd sustained some brain damage (due to being
left unconscious on the floor, not his head wound) and wasn't able to
live independently again.

I know of a similar story in a local NHS facility. The difference was
that the individual contracted an infection and is no longer with us.





Well losing a mother and providing 24/7 care for one's father certainly
burst my friend Jenny's and second-cousin Michael's for them.

Anecdotal information isn't very useful.

Before undertaking a clinical procedure, it's the responsibility of the
individual to check out the facility and the personnel involved and to
cross check that in the profession to determine track record. That
is more indicative of likely outcome.

On 2008-06-27 12:00:24 +0100, magwitch said:

Chris Shore wrote:
"magwitch" wrote in message
...

Sorry to burst your balloon.

Sad, inexcusable and awful though those stories are, I am certain that
we could rehearse
just as many from within the NHS. I am aware of several myself.

Chris

Oh I'm sure they can and do happen to NHS patients, but these happened
entirely because of private treatment... in my mother's friend's case
because she had the cash to pay for what had already been ruled an
inappropriate (in her case) operation, and in mum's cousin's case
because he was in a private room, if he'd been on a NHS general post-op
ward, someone would have heard him fall over and he'd have been noticed
and treated almost immediately.

It's very easy to come up with anecdotes like this. Nothing is
without risk. What actually counts is outcome and that is a
statistical analysis, not an emotional one.

On 2008-06-27 12:50:25 +0100, Rod said:

Brian Morrison wrote:
magwitch wrote:
and in mum's cousin's case
because he was in a private room, if he'd been on a NHS general post-op
ward, someone would have heard him fall over and he'd have been noticed
and treated almost immediately.

12 years or so back I was asleep in a ward and the elderly gent in the
bed opposite me fell out of bed and became unconscious while I was
asleep. I woke up and after a few minutes realised what had happened
(faculties tend to be impaired when ill) and had to go and raise the
alarm about his condition. The ward staff had not noticed, it later
transpired that he had been on the floor in plain view for at least 30
minutes, so being in a side room may have made little difference.


What I find interesting is that medicine seems to fail in all systems
for some patients. My particular interests mean that I hear about lots
of US cases. (OK - and Canada, New Zealand, India, Ireland, Norway,
Netherlands...) Even people who appear to have lots of money can have
an awful time getting the treatment they need. On the other hand, some
seem to get quite good treatment within NHS and similar systems. (Very
often transport issues make it impossible to simply choose the best
consultant even if they can be identified.) Seems in some specialties
it is more important who you see than how they are employed/paid for.

It's really a question of whether the individual is willing and able to
make the effort to research their condition and to identify the best
specialists to consult about it. This is not completely a money
issue,but also oneof how articulate they are and to what degree they
are willing to question doctors.



My experience is that if there is a specialty that fits your condition,
you stand a chance. If there isn't, you don't really have much of a
chance.

I disagree. The individual is responsible for their own healthcare
and should be minimising chance factors by checking out their ailments,
treatments, practitioners and facilities.




Therefore patients are forced back onto a do-it-yourself approach -
research, trial and error, alternative/complementary approaches, and so
on.

Partner and I both kneel down kiss the cable modem and say prayers
('Thank you for the internet...') every morning. :-)

Exactly, and that is the correct thing to do regardless of ailment.
Doctors are at best professional advisors.

On 2008-06-27 10:56:53 +0100, magwitch said:

Andy Hall wrote:
On 2008-06-26 23:22:11 +0100, geoff said:

Logically one would think that. I've found it to be rather
different. Certainly in large organisations in other countries it is
typical that the very top management will speak good English if the
company is a multinational as well. Otherwise they can often be of an
age where they didn't learn English earlier in life and haven't needed
to.

People who have or have had a technical role typically do speak or at
least understand English, but those who have had a role mainly
communicating with their peers may well not

It's not uncommon to have a situation where someone at senior level
does speak some English but whose juniors speak it better. He may
then choose not to do so for fear of showing himself up.

These are situations where it is even more important to meet the people
face to face to make sure that misunderstandings don't happen before
they even start. It can otherwise take a lot of time to recover,
reset expectations and continue on track.

My Dad was export sales manager for ICI Caribbean and South America for
20 years, and err... learned to speak Spanish and Portuguese (self
taught).

Purely because, when closing a deal, he could understand what they were
saying privately amongst themselves and they knew he could understand
them so they didn't try it on.

This is a good point and is the ideal. It will work for a few
countries but becomes less practical if one works in a large number of
countries, cultures and languages.

On 2008-06-27 11:12:20 +0100, "Chris Shore" said:


"Andy Hall" wrote in message news:48647258@qaanaaq...

Most people who are high enough up in the business world tend to have a
sufficiently high level command of English that I'm sure that the odd
occasion when there could be a misunderstanding could be flagged up and
further explanation given

Logically one would think that. I've found it to be rather different.
Certainly in large organisations in other countries it is typical that the
very top management will speak good English if the company is a
multinational as well. Otherwise they can often be of an age where they
didn't learn English earlier in life and haven't needed to.

This is true. However, there are very important and significant cultural
differences as well. Far Eastern and Indian cultures are much more
"people-oriented" than we are and place far higher value on relationships.

That's true in Europe as well but is apparent in different ways
according to culture.



You are very unlikely to win serious business with, for example, a Japanese
company unless you have taken the time to build a relationship with
the boss, been to dinner with him, attended to all his questions. Not
travelling to meet with him in person would haveyou written off
immediately as rude and not interested in the business. He will go with
someone else who can be bothered to go and see him. I have to
say I think he would be right!

I completely agree, and actually where there are large amounts of money
involved initially or over time, this is important evertywhere.


Dealing with non-English speakers can also be very difficult when
not face-to-face. Misunderstandings are much more common. It is
also much more embarrassing to have to ask someone to keep saying
something on the phone than in person. This makes meetings awkward
for both parties and unproductive.


Yes, agreed.

On 2008-06-27 07:56:57 +0100, Frank Erskine
said:

On Thu, 26 Jun 2008 20:37:34 -0500, Jules
wrote:

On Thu, 26 Jun 2008 19:35:09 +0100, Roland Perry wrote:
I'm on my way back from a week-long meeting where one of the hot topics
was how to make "remote participation" in that meeting better, and how
to conduct better teleconferences and so on in between meetings. It is
an entirely non-trivial task, and has defeated many attempts. One of the
most difficult problems is providing translation into six(ish) languages
on a teleconference. If you have any bright ideas, I know some people
who are going out to tender with big bucks to try to solve this.

The obvious solution is to invent a completely new business-oriented
spoken language, totally seperate from any current dialect. Everyone can
understand each other then, and no single country gains any kind of
automatic advantage...

Esperanto.

Latin?

On 2008-06-27 07:56:57 +0100, Frank Erskine
said:

On Thu, 26 Jun 2008 20:37:34 -0500, Jules
wrote:

On Thu, 26 Jun 2008 19:35:09 +0100, Roland Perry wrote:
I'm on my way back from a week-long meeting where one of the hot topics
was how to make "remote participation" in that meeting better, and how
to conduct better teleconferences and so on in between meetings. It is
an entirely non-trivial task, and has defeated many attempts. One of the
most difficult problems is providing translation into six(ish) languages
on a teleconference. If you have any bright ideas, I know some people
who are going out to tender with big bucks to try to solve this.

The obvious solution is to invent a completely new business-oriented
spoken language, totally seperate from any current dialect. Everyone can
understand each other then, and no single country gains any kind of
automatic advantage...

Esperanto.

Latin?

On 2008-06-27 11:12:20 +0100, "Chris Shore" said:


"Andy Hall" wrote in message news:48647258@qaanaaq...

Most people who are high enough up in the business world tend to have a
sufficiently high level command of English that I'm sure that the odd
occasion when there could be a misunderstanding could be flagged up and
further explanation given

Logically one would think that. I've found it to be rather different.
Certainly in large organisations in other countries it is typical that the
very top management will speak good English if the company is a
multinational as well. Otherwise they can often be of an age where they
didn't learn English earlier in life and haven't needed to.

This is true. However, there are very important and significant cultural
differences as well. Far Eastern and Indian cultures are much more
"people-oriented" than we are and place far higher value on relationships.

That's true in Europe as well but is apparent in different ways
according to culture.



You are very unlikely to win serious business with, for example, a Japanese
company unless you have taken the time to build a relationship with
the boss, been to dinner with him, attended to all his questions. Not
travelling to meet with him in person would haveyou written off
immediately as rude and not interested in the business. He will go with
someone else who can be bothered to go and see him. I have to
say I think he would be right!

I completely agree, and actually where there are large amounts of money
involved initially or over time, this is important evertywhere.


Dealing with non-English speakers can also be very difficult when
not face-to-face. Misunderstandings are much more common. It is
also much more embarrassing to have to ask someone to keep saying
something on the phone than in person. This makes meetings awkward
for both parties and unproductive.


Yes, agreed.

Andy Hall wrote:

Purely because, when closing a deal, he could understand what they
were saying privately amongst themselves and they knew he could
understand them so they didn't try it on.

This is a good point and is the ideal. It will work for a few countries
but becomes less practical if one works in a large number of countries,
cultures and languages.

http://www.theinquirer.net/en/inquir...-steve-ballmer

--
Cheers,

John.

/================================================== ===============\
| Internode Ltd - http://www.internode.co.uk |
|-----------------------------------------------------------------|
| John Rumm - john(at)internode(dot)co(dot)uk |
\================================================= ================/

I disagree. The individual is responsible for their own healthcare and
should be minimising chance factors by checking out their ailments,
treatments, practitioners and facilities.

Not something sick people may feel like doing. Great for hypochondriacs
though.


Doctors are at best professional advisors.

Nice that they can play a minor part in Superman's decision making though

stuart noble wrote:

I disagree. The individual is responsible for their own healthcare
and should be minimising chance factors by checking out their
ailments, treatments, practitioners and facilities.

Not something sick people may feel like doing. Great for hypochondriacs
though.


Doctors are at best professional advisors.

Nice that they can play a minor part in Superman's decision making though

Indeed - sick people (especially the ones I am thinking about) have
found that the disease itself has caused thinking difficulties. That
plus transport problems (as already stated), plus unpredictability of
health (minute by minute let alone day by day or week by week), plus
lack of usable research information, plus lack of expertise (on the
patient's behalf), plus GMC cases preventing doctors from prescribing as
they might otherwise, plus lack of resources due to inability to work
(long term), plus NHS limitations on referrals, plus consultant
attitudes and, quite seriously gross incompetence and ignorance. OK -
I'll stop there.

DIY medicine is where it is at. Have just awarded myself an MB in
endocrinology... :-)

--
Rod

Hypothyroidism is a seriously debilitating condition with an insidious
onset.
Although common it frequently goes undiagnosed.
www.thyromind.info www.thyroiduk.org www.altsupportthyroid.org

On Fri, 27 Jun 2008 15:23:13 +0100, Andy Hall wrote:
The obvious solution is to invent a completely new business-oriented
spoken language, totally seperate from any current dialect. Everyone can
understand each other then, and no single country gains any kind of
automatic advantage...

Esperanto.

Latin?

"Spoken COBOL"

Jules wrote:
On Fri, 27 Jun 2008 15:23:13 +0100, Andy Hall wrote:
The obvious solution is to invent a completely new business-oriented
spoken language, totally seperate from any current dialect. Everyone can
understand each other then, and no single country gains any kind of
automatic advantage...

Esperanto.
Latin?

"Spoken COBOL"


But there are so many dialects. :-)

--
Rod

Hypothyroidism is a seriously debilitating condition with an insidious
onset.
Although common it frequently goes undiagnosed.
www.thyromind.info www.thyroiduk.org www.altsupportthyroid.org

"Andy Hall" wrote in message news:4864f228@qaanaaq...


Before undertaking a clinical procedure, it's the responsibility of the
individual to check out the facility and the personnel involved and to
cross check that in the profession to determine track record. That is
more indicative of likely outcome.

In many ways, I agree. BUT, and it is a big BUT, not all those who have
to rely on the NHS for their healthcare are in a position or are equipped
to make this kind of assessment. The NHS shouldn't be abdicating this
kind of thing.

Chris

In message 48647258@qaanaaq, Andy Hall writes
On 2008-06-26 23:22:11 +0100, geoff said:

In message , Roland Perry
writes
In message , at 16:22:00
on Thu, 26 Jun 2008, Frank Erskine
remarked:
It seems amazing in this day and age that people have to travel
hundreds of miles (indeed any miles) to physically go to meetings when
they could be 'meeting' electronically, saving loads of money and
fuel.
I'm on my way back from a week-long meeting where one of the hot
topics was how to make "remote participation" in that meeting
better, and how to conduct better teleconferences and so on in
between meetings. It is an entirely non-trivial task, and has
defeated many attempts. One of the most difficult problems is
providing translation into six(ish) languages on a teleconference.
If you have any bright ideas, I know some people who are going out
to tender with big bucks to try to solve this.

Flying to meetings is often extremely necessary when someone else is
ultimately footing the bill, it becomes a much less attractive luxury
when it becomes an unrecoverable expense coming out of your own pocket

I think that that depends on the nature of the business and the
competitive pressure as well.

Most people who are high enough up in the business world tend to
have a sufficiently high level command of English that I'm sure that
the odd occasion when there could be a misunderstanding could be
flagged up and further explanation given

Logically one would think that. I've found it to be rather
different. Certainly in large organisations in other countries it is
typical that the very top management will speak good English if the
company is a multinational as well. Otherwise they can often be of an
age where they didn't learn English earlier in life and haven't needed to.

what, you mean even older than you and me ?


People who have or have had a technical role typically do speak or at
least understand English, but those who have had a role mainly
communicating with their peers may well not

It's not uncommon to have a situation where someone at senior level
does speak some English but whose juniors speak it better. He may
then choose not to do so for fear of showing himself up.

These are situations where it is even more important to meet the people
face to face to make sure that misunderstandings don't happen before
they even start. It can otherwise take a lot of time to recover,
reset expectations and continue on track.


I think a lot of it is making excuses not to change


--
geoff

In message , magwitch
writes
Andy Hall wrote:
On 2008-06-26 23:22:11 +0100, geoff said:
Logically one would think that. I've found it to be rather
different. Certainly in large organisations in other countries it is
typical that the very top management will speak good English if the
company is a multinational as well. Otherwise they can often be of
an age where they didn't learn English earlier in life and haven't needed to.
People who have or have had a technical role typically do speak or
at least understand English, but those who have had a role mainly
communicating with their peers may well not
It's not uncommon to have a situation where someone at senior level
does speak some English but whose juniors speak it better. He may
then choose not to do so for fear of showing himself up.
These are situations where it is even more important to meet the
people face to face to make sure that misunderstandings don't happen
before they even start. It can otherwise take a lot of time to
recover, reset expectations and continue on track.

My Dad was export sales manager for ICI Caribbean and South America for
20 years, and err... learned to speak Spanish and Portuguese (self
taught).

Purely because, when closing a deal, he could understand what they were
saying privately amongst themselves and they knew he could understand
them so they didn't try it on.

I experienced that when I worked in Italy

I had to tell the german partners to shut up as I understood everything
they were saying

... which surprised them a bit


--
geoff

In message 4863f829@qaanaaq, at 21:12:25 on Thu, 26 Jun 2008, Andy
Hall remarked:
The only whinging I hear, here, is that NHS dentists are underpaid.
So what would you propose?
- Pay them more
- Persuade them to work for less
- Get out of the business
Point out they can make a decent living at it, if they want to.

Except that they can't, or they would.

Only if their expectations are too high.
--
Roland Perry

In message , at 23:10:23 on Thu, 26 Jun
2008, geoff remarked:
nobody seems to have made the point that having gone into medicine,
their primary goal should be the health of their patients (hippo oath
usw), not making a healthy wage

I've hinted at that point of view several times, only to get shot down
by those who believe it's OK to charge more than many of their patients
can really afford.
--
Roland Perry

In message 4863f85b@qaanaaq, at 21:13:15 on Thu, 26 Jun 2008, Andy
Hall remarked:
Why would I want to do NHS work at all?
You wouldn't, but not everyone is like you.

Are NHS dentists easily and universally available?

How does that affect your decision to work in the NHS?
--
Roland Perry

In message 4863f8cb@qaanaaq, at 21:15:06 on Thu, 26 Jun 2008, Andy
Hall remarked:
One can consult with virtually any consultant doing NHS work on a
private basis. The important thing is to check the credentials
and track record of the individual.
And when the track record is exemplary, and they recommend treatment
in an NHS hospital, who do you do then?

Choose the private hospital or private faciity at which they also work
after checking its credentials

Even when they have specifically said they would refuse to treat you at
any such establishment because the NHS hospital has better facilities?
--
Roland Perry

In message , at 22:27:31 on
Thu, 26 Jun 2008, magwitch remarked:
A consultant friend of mine says that with private care you just get
the consultant (however skilled or distuingished) what you don't get is
the team of various professionals who work closely with him in the NHS.

With a private hospital's operating theatre and rooms (however plush)
the visiting medical staff more or less rent the facilities and then go
their separate ways leaving the patient's progress to fate.

That's exactly the situation. If the skilled and distinguished
consultant operates on you in the rented-by-the-hour operating theatre,
then goes home leaving you in the care of a bed-and-breakfast staff,
should something start to go wrong at 3am then the last place you need
to be is in a private hospital.
--
Roland Perry

In message 4863f8e7@qaanaaq, at 21:15:35 on Thu, 26 Jun 2008, Andy
Hall remarked:
I've never heard patients in the waiting room at my dentist or at
the reception bitching about paying.
That's like asking Marie Antionette if she ever heard anyone moaning
about the price of cake.

Not really. This is asking the peasants.

But the only peasants in that private waiting room of yours are those
who have self-selected themselves as being happy to pay.
--
Roland Perry

In message 4863f90f@qaanaaq, at 21:16:15 on Thu, 26 Jun 2008, Andy
Hall remarked:
Oh, no, of course, that's when he is making tea, isn't it?
Or perhaps sitting on trains, like Roland?
I'm sitting in an airport departure lounge at the moment[1]. No wifi
though, so you'll have to wait until I get home before you can read
about it!

Choose a different airline

I was at CDG, and the most obvious "different airline" to choose is Air
France. And guess what, when I flew through CDG on their prime carrier
Air France (in business class) and used their lounge, six months ago,
the lounge wifi was inoperative as a result [apparently] of some dispute
between themselves and Orange - owned of course by France Telecom.

No doubt superman Hall would have researched this all in advance and
flown with yet another airline.
--
Roland Perry

In message , at 21:01:32 on Thu, 26
Jun 2008, Tim Ward remarked:
One of the most difficult problems is providing translation into six(ish)
languages on a teleconference. If you have any bright ideas, I know some
people who are going out to tender with big bucks to try to solve this.

Erm ... the people who do simultaneous interpretation at the UN in New York
will know exactly how to do this, for example - there can't be a vast
difference between a punter choosing one of six channels on his headphones
or a punter choosing one of six channels on the teleconference. Kate has
watched them in action and says they're very impressive. But, that sort of
operation is not exactly what you might call "cheap".

I've sat in many UN meetings with that level of translation. A lot of
the time they "cheat" because the set speeches are delivered on paper to
the translators in advance. But even without that, they do a good job of
translating a moderated meeting where there's a chairman in charge.

Now transfer that to a teleconference where people in six languages are
all trying to talk over one another to get the floor. And at times of
day when translators are tucked up in bed (UN translators work 10-1 and
3-6, and not a millisecond outside).

Yes, I'm sure that someone could design an audio teleconferencing
application with six sets of audio, but no-one has, yet.
--
Roland Perry

In message , at
21:35:20 on Thu, 26 Jun 2008, Owain
remarked:
Roland Perry wrote:
... One of the most difficult problems is providing translation into
six(ish) languages on a teleconference. If you have any bright ideas,
I know some people who are going out to tender with big bucks to try
to solve this.
(And this all has to work on minimal connectivity, so no video is allowed).

If participants have /some/ foreign language skills, a real-time
transcript/summary prepared by a stenotypist (palantypist) can greatly
assist comprehension.

Yes, and transcription into English is one of the tools currently used.

However, making this available for numerous teleconferences (where the
audio quality is always worse than being in the same room) and at odd
times of day is a challenge. One that I hope is eventually met, but the
resources required are awesome.
--
Roland Perry

In message , at 23:22:11 on Thu, 26 Jun
2008, geoff remarked:
I'm on my way back from a week-long meeting where one of the hot
topics was how to make "remote participation" in that meeting better,
and how to conduct better teleconferences and so on in between
meetings. It is an entirely non-trivial task, and has defeated many
attempts. One of the most difficult problems is providing translation
into six(ish) languages on a teleconference. If you have any bright
ideas, I know some people who are going out to tender with big bucks
to try to solve this.

Flying to meetings is often extremely necessary when someone else is
ultimately footing the bill, it becomes a much less attractive luxury
when it becomes an unrecoverable expense coming out of your own pocket

Most people who are high enough up in the business world tend to have a
sufficiently high level command of English that I'm sure that the odd
occasion when there could be a misunderstanding could be flagged up and
further explanation given

The idea here is to reach out to those with neither that budget nor any
command of English.
--
Roland Perry

In message , at 18:52:55 on Fri, 27 Jun
2008, geoff remarked:
Purely because, when closing a deal, he could understand what they
were saying privately amongst themselves and they knew he could
understand them so they didn't try it on.

I experienced that when I worked in Italy

I had to tell the german partners to shut up as I understood everything
they were saying

... which surprised them a bit

A story told me last week (while I was at a meeting in Korea) by a
British colleague who speaks Dutch.

On a bus somewhere in UK, two Dutch tourists were chatting and one said
(in Dutch) "These English sure are ugly people", to which she replied
"Maybe, but some of them do speak Dutch".
--
Roland Perry

In message , at
21:30:17 on Thu, 26 Jun 2008, Owain
remarked:
Unless you can run to your own private jet
Ah, we've found some upper bound on Andy's ability to pay to get
things done quicker, have we

I was thinking along those lines but didn't like to say :-)

I daresay that having to work xx hours to hire a private jet to save x
hours[1] isn't cost-effective.

[1] Example charter of a small jet (non stand up height) for the 50 min
flight London-Paris is £3,800.

But worth it for the wifi, I suppose. They do include wifi, surely??
--
Roland Perry

In message , Roland Perry
writes
In message , at 23:10:23 on Thu, 26 Jun
2008, geoff remarked:
nobody seems to have made the point that having gone into medicine,
their primary goal should be the health of their patients (hippo oath
usw), not making a healthy wage

I've hinted at that point of view several times, only to get shot down
by those who believe it's OK to charge more than many of their patients
can really afford.

It's da way I tell 'em


--
geoff

On 2008-06-27 20:40:30 +0100, Roland Perry said:

In message 4863f829@qaanaaq, at 21:12:25 on Thu, 26 Jun 2008, Andy
Hall remarked:
The only whinging I hear, here, is that NHS dentists are underpaid.
So what would you propose?
- Pay them more
- Persuade them to work for less
- Get out of the business
Point out they can make a decent living at it, if they want to.

Except that they can't, or they would.

Only if their expectations are too high.

This makes no sense. Are you sure that you don't really mean that
you don't see why they should make more than you do?

On 2008-06-27 20:41:50 +0100, Roland Perry said:

In message , at 23:10:23 on Thu, 26 Jun
2008, geoff remarked:
nobody seems to have made the point that having gone into medicine,
their primary goal should be the health of their patients (hippo oath
usw), not making a healthy wage

I've hinted at that point of view several times, only to get shot down
by those who believe it's OK to charge more than many of their patients
can really afford.

That is not the issue. I'll spell it out for you.

- It isn't reasonable for anybody to expect the dentist to run his
business at a loss. Neither the traditional Hippocratic Oath, nor
modern equivalents requires this.

- The NHS claims to provide for dental services funded in part by
taxation collected from across the population and for an individual
through thir lifetime. Despite the promise that this should be free at
the point of delivery it is not and additional charges are made to the
patient.

- Those together fall short of the cost to the dentist of providing the
treatment properly and so he pulls out of offering it via these means.
This is much more in line with his medical commitments because it is
not the right thing to do to treat the patient poorly.

- The dentist is able and willing to treat the patient at an economic rate

- The shortfall in the funding is entirely because of government and
NHS mismanagement of our money. It doesn't allow the dentist to treat
patients properly other than by running at a loss. They aren't
permitted to charge on the basis of the NHS rate plus private top up
fee for a given treatment. Some do address this in part by treating
the children of private patients on the NHS.

You are suggesting that dentists charge on the basis of what their
patients can afford. There are virtually no businesses or services
that do that across the board themselves - even energy for the elderly
is operated via subsidy.

There would only be two ways to achieve it anyway. One would be for
dentists to reduce their fees for *all* patients. That demonstrably
can't be done without running at a loss. The other would be for
dentists to be making judgments based on the ability of a patient to
pay. Either that would involve them in huge admin to determine level
of income or be a value judgment. Neither is satisfactory and would
result in howls about means testing.

The tax and NHS systems are simply operating the means testing
centrally and basically screwing it up.

It is therefore easy to arrive at the conclusion that the ways out of
this are for the NHS to raise fees to dentists to an economic level, or
to withdraw the service altogether. In the second case, the logical
extension would be to reduce the tax take to compensate or to earmark
the money for other healthcare.

A third way would be for the NHS to fund dentistry to a certain basic
level and to permit dentists to charge top up fees set by them in order
to be able to work properly and without doing so at a loss. In
effect this is an aspect of the government provising basic level health
insurance, and the individual being at liberty to augment that.

On 2008-06-27 20:42:41 +0100, Roland Perry said:

In message 4863f85b@qaanaaq, at 21:13:15 on Thu, 26 Jun 2008, Andy
Hall remarked:
Why would I want to do NHS work at all?
You wouldn't, but not everyone is like you.

Are NHS dentists easily and universally available?

How does that affect your decision to work in the NHS?

That's something that I would never do anyway.... However, the
point here is that clearly dentists are choosing not to work in the NHS
on a very broad scale, for reasons that have been explained.

We have doctors and consultants who do, so something is clearly broken
with the funding.

It would be rather unlikely for doctors and consultants to be woolly
thinking socialists and for dentists to be hard nosed, money grabbing
*******s.

On 2008-06-27 15:56:28 +0100, stuart noble said:


I disagree. The individual is responsible for their own healthcare
and should be minimising chance factors by checking out their ailments,
treatments, practitioners and facilities.

Not something sick people may feel like doing. Great for hypochondriacs though.

The first comment is reasonable, the second stupid.

It was why I made the point that information should be sought to
whatever degree the individual and the people around them can achieve.
Unfortunately not everybody is articulate enough, or as you say be
well enough, to research and make their final decisions. However,
this does not mean that people should just sit back and accept all that
the first doctor they see says to them without question.



Doctors are at best professional advisors.

Nice that they can play a minor part in Superman's decision making though

Only a fool allows the doctor to be the decision maker without doing
further checking themselves.

On 2008-06-27 17:43:11 +0100, "Chris Shore" said:


"Andy Hall" wrote in message news:4864f228@qaanaaq...


Before undertaking a clinical procedure, it's the responsibility of the
individual to check out the facility and the personnel involved and to
cross check that in the profession to determine track record. That is
more indicative of likely outcome.

In many ways, I agree. BUT, and it is a big BUT, not all those who have
to rely on the NHS for their healthcare are in a position or are equipped
to make this kind of assessment. The NHS shouldn't be abdicating this
kind of thing.

Chris

They shouldn't be *abdicating* it, I agree, but they should be
*facilitating* it.

They are doing little bits, but it's very poorly done. For example,
for many conditions, I can go to the NICE web site and find information
for patients and guidelines for doctors. The patient material is all
very well, but has a reading age of 8 and tends to be condescending.
The clinical material is more useful because it usually has clinical
references that can be used for the basis of further research. I
would base my decision making on the latter material with input from
the doctor, not the first.

The same is true for medications. The patient information leaflet is
useful to a point, but I certainly want to run additional checks and
look for clinical information before deciding to use them or not.

It's very apparent from reading clinical studies, that the NHS is a
large process based machine. It would be surprising if it were any
different. That is why it is not a good way to *deliver*
healthcare, being far more concerned about process than outcome.

Andy Hall wrote:

Only a fool allows the doctor to be the decision maker without doing
further checking themselves.


And if your illness makes you a fool, you have to rely on them.

--
Rod

Hypothyroidism is a seriously debilitating condition with an insidious
onset.
Although common it frequently goes undiagnosed.
www.thyromind.info www.thyroiduk.org www.altsupportthyroid.org

On 2008-06-27 20:44:08 +0100, Roland Perry said:

In message 4863f8cb@qaanaaq, at 21:15:06 on Thu, 26 Jun 2008, Andy
Hall remarked:
One can consult with virtually any consultant doing NHS work on a
private basis. The important thing is to check the credentials and
track record of the individual.
And when the track record is exemplary, and they recommend treatment
in an NHS hospital, who do you do then?

Choose the private hospital or private faciity at which they also work
after checking its credentials

Even when they have specifically said they would refuse to treat you at
any such establishment because the NHS hospital has better facilities?

That would raise a red flag in respect to the rest of the information
from the consultant, because clearly he would be basing this on some
political ideology than any form of reality.

On 2008-06-27 21:14:44 +0100, Roland Perry said:

In message 4863f8e7@qaanaaq, at 21:15:35 on Thu, 26 Jun 2008, Andy
Hall remarked:
I've never heard patients in the waiting room at my dentist or at the
reception bitching about paying.
That's like asking Marie Antionette if she ever heard anyone moaning
about the price of cake.

Not really. This is asking the peasants.

But the only peasants in that private waiting room of yours are those
who have self-selected themselves as being happy to pay.

There is at least the choice of whether or not to pay.

The government doesn't offer that. It charges through taxation,
whether or not the individual uses the (broken) service and then
charges again since they have to pay for treatment out of net income.

On 2008-06-27 21:22:20 +0100, Roland Perry said:

In message 4863f90f@qaanaaq, at 21:16:15 on Thu, 26 Jun 2008, Andy
Hall remarked:
Oh, no, of course, that's when he is making tea, isn't it?
Or perhaps sitting on trains, like Roland?
I'm sitting in an airport departure lounge at the moment[1]. No wifi
though, so you'll have to wait until I get home before you can read
about it!

Choose a different airline

I was at CDG, and the most obvious "different airline" to choose is Air
France. And guess what, when I flew through CDG on their prime carrier
Air France (in business class) and used their lounge, six months ago,
the lounge wifi was inoperative as a result [apparently] of some
dispute between themselves and Orange - owned of course by France
Telecom.

No doubt superman Hall would have researched this all in advance and
flown with yet another airline.

There wouldn't have been a choice since BA uses the same lounge at CDG.

During that dispute, I used Eurostar.

In message 4865dadc@qaanaaq, at 07:31:56 on Sat, 28 Jun 2008, Andy
Hall remarked:
The only whinging I hear, here, is that NHS dentists are underpaid.
So what would you propose?
- Pay them more
- Persuade them to work for less
- Get out of the business
Point out they can make a decent living at it, if they want to.
Except that they can't, or they would.
Only if their expectations are too high.

This makes no sense. Are you sure that you don't really mean that
you don't see why they should make more than you do?

Whether they make more or less than me isn't relevant. The problem is
training up loads of practitioners (in any line of work) on the promise
of a lucrative job for life that can only be supported by overcharging
the public.
--
Roland Perry