Junior Doctor's contracts petition

[jjlynn27]

turbobloke said:

jjlynn27 said:

Back on topic. Explain 'new staff'?

On one hand you have researchers from WHO (World Health Organization) who did research that found NHS to be the most efficient HS in the world (among developed countries).

That's back off topic but good news.

jjlynn27 said:

On the other, you have someone who types can't spell 'hospital' and lacks an ability to use spell checker, saying that NHS doesn't need budget it has, together with 'it's all political'.
Who do you think is correct?

I think you're making a big deal out of typos. The letters o and i are next to each other on the keyboard, you must have noticed. As to spell checking a post, do you not have a tense checker? People in glass houses should have one.

jjlynn27 said:

JH ignore those recommendations and offered 11% basic pay rise.

Most probably other PHers assumed you had a sticky letter d on your keyboard and didn't mention it. Clearly you had nothing better to add than pick somebody up on a typo.

As far as your post went and as far as the report from WHOever went, did the report examine the political angle to the recent JD strike vote and associated street protests? If not it's irrelevant in terms of influencing views about whether somebody is correct over the political aspect. Having seen the placards and heard the chants - see earlier posts - there's an obvious political side to what's going on.

For the record I don't believe everything that the WHO says and will take statements one at a time on their merits. They have their own agenda and a degree of self-interest as happens with such bodies.

jjlynn27 said:

There are undoubtedly savings to be made within NHS. Salaries and conditions of 55000 staff are not one of them. Forgetting for a second that government has touted this changes as 'cost neutral'.

There's massive waste and fraud which are good places to start before salaries, and which credible analysis with the required level of detail has shown that the proposals are in fact not cost neutral? I'm aware that politicians and Unions are hardly the most truth-addicted people around so if you can offer any pointers to that type of analysis it might help.

It should be quite obvious that English is not my native language. The point about comparing an opinion of a random who can't spell and WHO researchers is still valid, no changes there. You've ignored the point that JH ignored recommendations and went with 11% offer. The calculations based on 15% were touted as 'cost neutral'. What do you think would happens if you change that 'increase' to 11% while keeping other numbers in the offer the same. You didn't understand the research that you were quoting and that was pointed out to you by few posters. You don't believe WHO and american researchers who must have hidden agenda, and you ask if they've taken into account 'political agenda'. After trying to decide what is PHers job, you asked to be provided with actual figures. You didn't understand the difference between deaths on weekends (which are btw lower than deaths during the week) and deaths for patients admitted on weekends.

You agree with Goss and quote Rush Limbaugh. But WHO has an agenda.

[MTech535]

REALIST123 said:

jmorgan said:

spaximus said:

As I keep saying there are huge issues in the NHS the Doctors are not one of them. Click on the link below to see the unreadable clock.


http://www.itv.com/news/west/2014-06-02/250-000-sp...

Jebus. Someone needs a rocket where the sun don't shine. That is an immense flight of fancy and the person that signed off on that needs a reality check.

But it's only a 'small percentage of the arts budget'......

....and we wonder why there's no money?

Why has no one picked up on the part where the local planning committee insisted on a 1.5 million arts project as part of planning approval?

[turbobloke]

jjlynn27 said:

It should be quite obvious that English is not my native language.

Given the size of PH it's not others' native language either. Obvious typos are still obvious.

jjlynn27 said:

The point about comparing an opinion of a random who can't spell and WHO researchers is still valid, no changes there.

It's not, given that WHO didn't consider the political angle of the current strike vote in their report. The random person could be correct, and in this case (regarding a political aspect) they are.

jjlynn27 said:

You've ignored the point that JH ignored recommendations and went with 11% offer.

I can assure you I haven't.

jjlynn27 said:

You didn't understand the research that you were quoting and that was pointed out to you by few posters.

Research? OK. All I can recall pointing to is C4 FactCheck and inviting others to comment, then following up with the UCL study which, at the time and now (below) I understand well enough.

jjlynn27 said:

You don't believe WHO and american researchers who must have hidden agenda, and you ask if they've taken into account 'political agenda'.

It was obviously tongue in cheek given that the question didn't need to be asked. Putting WHO against a PHer on different topics makes no sense. The WHO report was written before the current dispute and therefore couldn't possibly consider it. As a result, the WHO view on the NHS has nothing to do with the potential accuracy of a PHer indicating that there's a political side to the current fiasco. Obviously, there is.

jjlynn27 said:

After trying to decide what is PHers job, you asked to be provided with actual figures. You didn't understand the difference between deaths on weekends (which are btw lower than deaths during the week) and deaths for patients admitted on weekends.

PHers can take any job they like and get an offer for You telling me what I understand and don't understand is faintly ridiculous and massively biased. The responses to my posts haven't achieved anything.

ucb said:

turbobloke said:

Because I've linked to more than one piece of credible UK research which shows than a weekend excess of over 3,300 deaths each year could be avoided if for example Saturdays were more like Mondays in hospitals.

That's your error. There's no evidence that the deaths are avoidable, just that they exist.

There is such evidence.

http://www3.imperial.ac.uk/newsandeventspggrp/impe...

"The authors suggest poorer access to hospital services and variations in staffing levels at the weekend may be contributing to the difference in death rates."

Ignore weasel words. Remove the contribution, lower the rates.

Link said:

Dr Paul Aylin, the senior author of the study from the Dr Foster Unit at Imperial College London, said: "We estimate that there were over 3,000 more deaths than expected at weekends in 2005/06 compared to weekdays - more than the number of people dying in road accidents in 2006. Clearly this is a significant number of people and we need to get to the bottom of what this means. Staffing levels are often lower at weekends, with fewer senior medical staff around, and some specialist services are less available. We believe this may be contributing to the increase in mortality rates on Saturdays and Sundays but we would like to see more research'

Another study should look at how many researchers don't want more grant funding for their research or indeed related research by others that they can respond to.

Also feel free to point out other variables beyond a combination of access to specialist services (people) and staffing levels (people) once accessed that the researchers missed. By improving access to specialist services and staffing levels at the weekend the situation would be like a weekday scenario, and the weekend death rate is significantly higher (7%, over 3000 deaths each year).

turbobloke said:

As per my post it's about patient outcomes.

A study by Imperial College London looked at emergency admissions in England in 2005/06. It found that the odds of you dying in hospital were 10 per cent higher if you were admitted at the weekend. A follow-up study by the same research team looked at planned operations rather than emergency cases, and tracked how likely patients were to die within 30 days of having the procedure. The odds of dying within a month of the operation were 82 per cent higher if it was done at the weekend, compared with Monday. Several reviews of studies from different countries have found the same thing.

Also it was said:

If you were actually reading those same studies, you'd find that authors explicitly warn against drawing conclusions that those rates are such due to clinical staffing levels.

Another miss by a mile. What I've read across the piece says the opposite of that.

"The study's authors, from the Dr Foster Unit and the Department of Acute Medicine at Imperial College London, say the higher than expected mortality rates they identified during the period may be linked to less consistent specialist services such as diagnostics at weekends and a decrease in the availability of senior hospital staff."

If a weekend event becomes the same as a weekday event feel free to indicate how it remains different and why outcomes would remain different. You could try getting a grant.

jjlynn27 said:

The higher rate of patients dying who are admitted over the weekend is observed everywhere in the world.

We agree

jjlynn27 said:

You agree with Goss and quote Rush Limbaugh. But WHO has an agenda.

That makes it sound like I agree with everything from Limbaugh - I've not said that and I don't but I may agree with some of what he says on some topics - and also implies that Limbaugh's agenda makes everything he says wrong, which would be another sloppy generalisation. My approach is to take what anyone says and analyse it before making my own mind up.

If there are any typos above, be merciful oh great pedant

Edited by turbobloke on Saturday 21st November 11:47

[jmorgan]

MTech535 said:

REALIST123 said:

jmorgan said:

spaximus said:

As I keep saying there are huge issues in the NHS the Doctors are not one of them. Click on the link below to see the unreadable clock.


http://www.itv.com/news/west/2014-06-02/250-000-sp...

Jebus. Someone needs a rocket where the sun don't shine. That is an immense flight of fancy and the person that signed off on that needs a reality check.

But it's only a 'small percentage of the arts budget'......

....and we wonder why there's no money?

Why has no one picked up on the part where the local planning committee insisted on a 1.5 million arts project as part of planning approval?

I have heard of that before, it has been rumbling on in the press for a good few years, as well as new carpets for example when none are needed, replacement kitchens when they were replaced the year before. The waste is, as far as I can gleam, immense.

[littlegreenfairy]

I have a bit of insight into the waste as spent 18 months in an NHS project looking at spending and efficiency. When I left nothing was put into place as 'that's not the way we do it'.

Think of the most wasteful thing you can and then blow it up past your worst nightmare and you won't come near the haemorrhaging of the NHS.

[Downward]

littlegreenfairy said:

I have a bit of insight into the waste as spent 18 months in an NHS project looking at spending and efficiency. When I left nothing was put into place as 'that's not the way we do it'.

Think of the most wasteful thing you can and then blow it up past your worst nightmare and you won't come near the haemorrhaging of the NHS.

Interesting
What were your conclusions ?

We have had this service although it costs circa £1500 per day per person + expenses from the big 4 financial houses.

[mph1977]

littlegreenfairy said:

I have a bit of insight into the waste as spent 18 months in an NHS project looking at spending and efficiency. When I left nothing was put into place as 'that's not the way we do it'.

Think of the most wasteful thing you can and then blow it up past your worst nightmare and you won't come near the haemorrhaging of the NHS.

yep ...

do something with evidence base and cost saving benefits , brief it out , with notices and still the mindless morons go back to the old ways ... (sadly including Health professionals even quite highly graded ones)

Edited by mph1977 on Saturday 21st November 14:21

[MTech535]

Yes please, any suggestions gratefully received. I have to come up with 10% savings this year, as I did last year, and the year before that, and the year before that, etc. Really struggling to come up with ideas at the moment.

[ucb]

ucb said:

turbobloke said:

Because I've linked to more than one piece of credible UK research which shows than a weekend excess of over 3,300 deaths each year could be avoided if for example Saturdays were more like Mondays in hospitals.

That's your error. There's no evidence that the deaths are avoidable, just that they exist.

There is such evidence.

http://www3.imperial.ac.uk/newsandeventspggrp/impe...

"The authors suggest poorer access to hospital services and variations in staffing levels at the weekend may be contributing to the difference in death rates."

Ignore weasel words. Remove the contribution, lower the rates.



That's not evidence. That's somebody guessing.

Edited by ucb on Saturday 21st November 14:35

[Ali G]

Downward said:

littlegreenfairy said:

I have a bit of insight into the waste as spent 18 months in an NHS project looking at spending and efficiency. When I left nothing was put into place as 'that's not the way we do it'.

Think of the most wasteful thing you can and then blow it up past your worst nightmare and you won't come near the haemorrhaging of the NHS.

Interesting
What were your conclusions ?

We have had this service although it costs circa £1500 per day per person + expenses from the big 4 financial houses.

Would those be the big 4 accountancy firms?

If so, you have, should we say, been on the wrong end of a negotiation.

That said, I'd hazard a guess that, effectively, one big 4 partner would be lining the pockets of another big 4 partner at taxpayers expense.

Edited by Ali G on Saturday 21st November 16:25

[turbobloke]

ucb said:

That's not evidence. That's somebody guessing.

It's a conclusion based on research evidence, you must have missed it previously. If you'd had much by way of experience of publishing papers, or indeed had learnt anything from doing so, you'd be aware of the penchant for weasel words by reviewers in order to get a conclusion through - in any case I refer you to my earlier point that the research identified differences between weekend and weekday operations that relate to specialist facilities being available (staffing) and medics being available (staffing). Other differences include the letter S as the initial of the day for Saturday and Sunday. So if you eliminate the (meaningful) differences and make a weekend day the same as a weekday, via staffing, what do you think would happen to the weekend fatality rate? If you think it would remain the same, then clearly you need to explain what variables were missed by the researchers to account for that. Otherwise it's you doing the guessing, to suit your bias.

At the present stage, this is merely academic

The junior doctors may get sympathy from fellow travellers and Labour supporters who are yet to come to terms with the election defeat, but I'd wager an unprescribed antibiotic that a lot of sympathy was lost when the overtly political messages appeared alongside a natural desire for the deposit on their next Porsche. Any benefit of the doubt I had for their cause was lost when their political slogans and chants revealed another side to the claimed grievance. They won't care two hoots for that, but the esteem in which the medical profession has hitherto been held won't return once lost.

[barryrs]

jjlynn27 said:

barryrs said:

That table is taken from the DDRB report and it reccomends options C & C+ so I don't know where the 11% comes from?

Considering the BMA withdrew from negotiations over 12 months ago I wonder if they really know what's being proposed or just objecting because Torys innit.

JH ignore those recommendations and offered 11% basic pay rise.

The BMA left talks when government said that it will not negotiate on 22 out of 23 proposals. Any continuation of talks is preconditioned by that. BMA offered to continue talks with involvement of ACAS (spelling?) government refused.

In case I wouldn't be surprised if JD's and the unions aren't being played.

I'm expecting to see a last minute increase in pay rise offer to a level in accordance with the DDRB recommendations and should that be refused they will be portrayed as the new greedy bankers.

[Slartifartfast]

[quote]There is such evidence.

http://www3.imperial.ac.uk/newsandeventspggrp/impe...

"The authors suggest poorer access to hospital services and variations in staffing levels at the weekend MAY be contributing to the difference in death rates."
[/quote]

MAY = conjecture
This is not evidence of evidence!

Sorry, can't fathom the formatting codes

[turbobloke]

All the quotes mixed up said:

There is such evidence.

http://www3.imperial.ac.uk/newsandeventspggrp/impe...

"The authors suggest poorer access to hospital services and variations in staffing levels at the weekend MAY be contributing to the difference in death rates."

MAY = conjecture
This is not evidence of evidence!

Sorry, can't fathom the formatting codes

Don't bother with the formatting.

Firstly the point about common use of weasel words in that context has been made already.

Secondly all you have to do is describe the other variables that could explain the difference between weekends and weekdays other than the differences pointed out by the research team (basically, medic staffing levels) if it's so obvious to you it should be easy.

[spaximus]

jmorgan said:

MTech535 said:

REALIST123 said:

jmorgan said:

spaximus said:

As I keep saying there are huge issues in the NHS the Doctors are not one of them. Click on the link below to see the unreadable clock.


http://www.itv.com/news/west/2014-06-02/250-000-sp...

Jebus. Someone needs a rocket where the sun don't shine. That is an immense flight of fancy and the person that signed off on that needs a reality check.

But it's only a 'small percentage of the arts budget'......

....and we wonder why there's no money?

Why has no one picked up on the part where the local planning committee insisted on a 1.5 million arts project as part of planning approval?

I have heard of that before, it has been rumbling on in the press for a good few years, as well as new carpets for example when none are needed, replacement kitchens when they were replaced the year before. The waste is, as far as I can gleam, immense.

The point I was making is that there are lots of examples like that across the NHS. As one other poster said, why not have standardised design, for hospitals and schools as they also seem to be in a war of one-upmanship in design at huge cost. We seem to now have hospitals and schools which are form over function but that is seen as acceptable by those signing the cheques, where as paying Doctors and nurses what they deserve is not.

As for the arts being part of the planning condition, it is insane but there you have one publically funded body telling another one they must spend £1.5 million for art, neither having to pay for it themselves.

[Ali G]

C2H5OH, possibly.

No graphs of consumption v days of week, though.

[Downward]

Ali G said:

Would those be the big 4 accountancy firms?

If so, you have, should we say, been on the wrong end of a negotiation.

That said, I'd hazard a guess that, effectively, one big 4 partner would be lining the pockets of another big 4 partner at taxpayers expense.

Edited by Ali G on Saturday 21st November 16:25

Hmm yes there is closed competition in this area between the big 4 so they know each other's rates and over inflate them

[turbobloke]

Ali G said:

C2H5OH, possibly.

No graphs of consumption v days of week, though.

Or if not alcohol how about the athlete's curse of wrongly timed nooky. Both pieces of research could be problematic. Staffing hospitals at weekends to the same level as weekdays seems a better bet but the govt would need to incentivise the private sector to get the tax-take up first.

Meanwhile...

NHS Medical Director Prof Sir Bruce Keogh did his best to keep up a facade of uncertainty around preventability but let the cat out of the bag when he said:

There is an avoidable ‘weekend effect’ which if addressed could save lives. This is something that we as clinicians should collectively seek to solve.

Note the use of a weasel word even so..."could" was used when of course if the 'weekend effect' was eliminated then by definition it would, not could, save lives.

Edited to remove a typo and remove an opp for pedantry. Other typos are available.

Edited by turbobloke on Saturday 21st November 18:53

[Ali G]

Downward said:

Ali G said:

Would those be the big 4 accountancy firms?

If so, you have, should we say, been on the wrong end of a negotiation.

That said, I'd hazard a guess that, effectively, one big 4 partner would be lining the pockets of another big 4 partner at taxpayers expense.

Edited by Ali G on Saturday 21st November 16:25

Hmm yes there is closed competition in this area between the big 4 so they know each other's rates and over inflate them

The term cartel may have some relevance.

However, perhaps of greater concern to taxpayers, may be whatever relationship CFO may have with advisors appointed.

The same concern exists for shareholders and regulators iro auditors/advisors.

[IanA2]

https://www.youtube.com/watch?v=ve1sevQpQLQ&ap...