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Questions Of The Day (Politics)
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Wile E. Coyote


In: Arizona
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Mick Harper wrote:
Mick wrote:
Now we gotta find out why.

Hospital administrators do not administer hospitals, they keep them running for the convenience of whatever group has the most power. Which is neither (a) hospital administrators nor (b) Richmond House. The medical staff make sure that every procedure, however marginal, is carried out while patients are easily available i.e. occupying vastly expensive ward beds.


The UK has just about 2.5 hospital beds per 100,000 population, the European average is about 4.5, France approaches 6, Germany approaches 8.

So I would be surprised if we are doing this. It looks more like we don't have a bed blocking problem. Despite it being orthodoxy.

The problem is that administrators and politicians are currently obsessed about bed blocking. To them this is the "magic pony", we need fewer beds in larger, more efficient hospitals. This will save money. So they think. The logic is, if we could have discharged Dinky Bodsworth, that would free up 1 bed for an additional 2 days for Sergio Batista. This is no doubt true... but the problem is also, if you discharge Dinky and she is in the back of an ambulance a few days later, wating for Sergio or Harjit to be discharged, then this is actually not efficiency. It might well be the case that our high readmissions back into hospital within 30 days of discharge is a much better test of our efficiency, or not.

Rule 13: it is a net saving in both time and money to do a job holistically and well whist patients are in hospital, as you then cut down on readmissions.

Rule 1. In case you were asking (you were not) is that we need to be spending more money on keeping folks out of hospital, not waiting for them to become so ill they need hospital or A and E, and then discharging them out so quickly as they will possibly then need to be readmitted.
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Mick Harper
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In: London
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The UK has just about 2.5 hospital beds per 100,000 population, the European average is about 4.5, France approaches 6, Germany approaches 8.

A most intriguing statistic, and presumably the key to the solution. Since everyone is spending roughly the same on health and are experiencing roughly the same health outcomes, it would seem we are doing something decisively different but to no decisive effect. Remember the AE rule: one input, one output? Well, someone or something is not behaving AE-erlly. During Covid I seem to remember that nobody had much spare capacity so my argument at the time -- the NHS is designed to be permanently at bursting point so coped well, Euro-hospitals are not, so fared badly when when they were -- appears to have some merit.

It looks more like we don't have a bed blocking problem. Despite it being orthodoxy.

To be more accurate, 'bed blocking' is one of the myriad ills the NHS complains about from time to time. When the system is breaking down/has broken down, it bursts at every joint, like a submarine plunging to the depths.

if you discharge Dinky and she is in the back of an ambulance a few days later

Ambulances backed up outside Casualty was, however, a new one. And a quite sensational one in terms of wasted assets and poor health outcomes. Did it get solved or did the twenty-four hour news-cycle just move on?

it is a net saving in both time and money to do a job holistically and well

True, but surely a quite unrealistic ambition. Not just technically but administratively. Though the NHS -- especially if it could be plugged into the local authority care home and home visits regime -- is ideally placed to achieve it, if it is achievable. We must remember to keep the joined-up nature of the NHS when dismantling it.
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Wile E. Coyote


In: Arizona
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We also need to have an honest debate (ie agree with Wiley) that you cannot have an additional 500,000 folks (net migration) in the country without having some sort of formula for an increase in NHS spending. This is a bit potty, we can agree migration is good (we have an ageing population, these folks work hard) or bad (they are destroying our way of life) but it's the equivalent of setting up 270 GP practices and a few hospitals every year. You ain't going to do it on last year plus inflation, or rather we ask the NHS to do it. because it's a temporary blip but there again, the population growth from 1995 to 2020 was 9.1 million. You won't solve these type of problems by more efficient use of beds. You have to significantly fund increases.

Give the NHS a funding formula that recognises we have had steep rises in migration and population growth.
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Wile E. Coyote


In: Arizona
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Or, and this method I prefer, let's let the companies and universities that want to get more students and workers in (nothing wrong in that) work with private insurers to provide private health care. Too dificult you say? Well they manage to offer private health care to their managers, so why not? I am sure health care providers and insurers would see a profit in it. Of course this might put off some from coming, but then they are not using the NHS. Sorry, but why should non-UK citizens be registering with GPs and using the NHS so that universities can attract students and companies pay their workers less?
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Mick Harper
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Newsnight said it's the equivalent of another Liverpool every year, though many of us would have preferred a less frightening simile (or is this a metaphor?) Most government programmes have a formula that ratchets these things up every year automatically and then there's a grand sorting out every tenth year when the Census unveils the truth (or do I mean 'truth'?) Migration, beng mainly illegal (or do I mean unpopular?) is a prime candidate for careful ignoral. Thank God so many doctors are slipping through.

That would be the Anglican God since the countries who trained them are absolutely steaming about it. Their patients are less bothered, all being over here being treated by them.
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Mick Harper
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Though it does raise another aspect of the self-regulatory nature of the NHS. I began this piece by saying how we never used to visit the doctor because 'there's a lot of it about' was all we got, but nowadays -- and I know this from personal and family anecdotal evidence -- you don't see the doctor because you can't get an appointment.

And has it had any medically deleterious effect? Well, put it this way: our weekly Zoom meetings are getting to be like Agatha Christie's Ten Little Indians. That's right! It's the World Cup!
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Mick Harper
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Spot The Villain Competition (dénouement)

If you live in a country full of (a) ripe fruit and (b) ripe fruitcake liberals, you have to (c) pay temporary imported workers the local national wage which is (d) ten times greater than their local national wage, meaning (e) there is intense competition for the jobs. Let us observe who is responsible for resolving this situation. Is it the employers? No.

Ross Mitchell, the managing director of Castleton Fruit, said it employed nearly 1,000 people each year, of whom more than 70% returned. The farm had 106 workers this year from Indonesia, 70 of whom were still there. He said they worked an average of 41.81 hours, with an average weekly gross pay of £450.68, before charges such as accommodation costs were taken.

But he knew who was

Mitchell said the farm was concerned about “payment demanded by third-party agents” and that they relied on “approved agents to have carried out due diligence to ensure that the workers are not paying excessive fees”.

Which they were. Remember "The Indonesian worker had paid a local agent in Java more than £4,650 to come to Britain."

Mitchell immediately reported it to the agent, the authorities and customers. “We had hoped the relevant bodies would have dealt with this issue.”

Ooh, a relevant body. Liberals love 'relevant bodies' because they provide a cut-out between having your fruit and eating it...
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Mick Harper
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More than 1,450 Indonesians have come to Britain under the seasonal worker visa, according to the latest figures. They were supplied by AG Recruitment, one of four UK agencies licensed to recruit using the scheme.

It's an approved body. Here's another one

The Gangmasters and Labour Abuse Authority (GLAA) has been investigating AG’s Indonesian recruitment since the Guardian revealed in August that workers reported taking on debts of up to £5,000 by unlicensed foreign brokers to work in Britain for a single season. AG denied any wrongdoing and said it knew nothing about Indonesian brokers charging money.

An approved body supervised by another approved body knowing nothing about something that was such common knowledge it had even reached liberal HQ in Farringdon Road is one of the best examples of careful ignoral to be printed this week in Farringdon Road. Exactly why the Guardian did not and never will explore the real issue will be forthcoming when this AE-ist has had his brekkie.
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Mick Harper
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Liberals don't care. Not really. They are (no, really) human beings so the pursuit of happiness is their number one goal in life. Essentially this comes down to living a life of ease and comfort, like non-liberals, but without the guilt, which non-liberals don't suffer from. Or at any rate not this one -- they have different guilt issues, often to do with foetuses apparently.

Liberals understand that fruit has to be picked. They understand that British people won't pick fruit for love or money. They understand that the world is full of people who will pick British fruit with love for money and so long as the money goes to foreign gangsters and not into the pockets of anyone in Britain (in the form of cheaper fruit) liberals are content. The guilt is assuaged.

When I say 'content' I do include frequent exposés in liberal organs but always in a way that ensures the status quo ante continues. Which it will do until and unless, say, British approved bodies take over the governance of Indonesia and even then probably not since the current Indonesian government can do nothing about it. In fact definitely not, because supply-and-demand is a force stronger than any government, short of a really totalitarian one. When it comes to liberals and their guilt complexes, don't rule that out.

The other thing you have to rule out is not paying Indonesians the British national wage but applying supply-and-demand, so everything would go to Indonesian fruit-pickers. We'd never hear the end of that. You may be sure the phrase 'slave labour' will figure prominently.
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Wile E. Coyote


In: Arizona
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Mick Harper wrote:
Liberals don't care. Not really. They are (no, really) human beings so the pursuit of happiness is their number one goal in life. Essentially this comes down to living a life of ease and comfort, like non-liberals, but without the guilt, which non-liberals don't suffer from. Or at any rate not this one -- they have different guilt issues, .


The thing that depresses Wiley is this switch away from a zealous concern over local issues, zebra crossings and so on, which was noble if irritating, to a concern with personal identity issues, which is just irritating. We need many more beautiful flower girls and far fewer haughty professors trying to educate them.
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Mick Harper
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Do you really mean 'flower girls'? This used to be a synonym for 'prostitute' because you couldn't be charged with soliciting if you went up to somebody and said, "Flower for your buttonhole, sir?" and when he said, "How much?" and you said "A shilling for basic, two bob for extras" and he said, "I'm the leader of the Liberals and it's not our fault you're having to pay tuition charges," and you said, "Sorry, Mr Gladstone, I didn't recognise you. One and six, all in."
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Mick Harper
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With Ben Chu at the Newsnight Wall

Today Ben was telling us about the rail strikes and how they were about pay, but more than pay. The Great One then took us into the intricacies of guardless trains and staffless stations. He very fairly set out the ins and outs of both and why the railway companies and the unions are at such loggerheads about both.

What he failed to mention is that it is no business of the unions. The franchise-holders have a contract with the government (and the people of Britain) to provide rail services. That's it. It's us that decides whether we want guardless trains and staffless stations (and cheaper tickets) or whether we don't. The unions are against both for obvious reasons but the idea that they will strike if they don't get their way is quite preposterous.

In deep parenthesis I should point out that the real reason the rail unions are prepared to court massive unpopularity (with their own members as well as us) over these relatively trivial matters -- both of which have been settled without any difficulty years ago and over 90% of the network -- is that drivers, guards and ticket office personnel tend to belong to three different unions, so
* if you have to have a guard, you can't start a train without one
* if you have to have ticket office staff, you can't open a station without one
* if neither is needed, the withdrawal of labour won't even be noticed
* but closing down ten per cent of the network still works wonders.
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Wile E. Coyote


In: Arizona
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Mick Harper wrote:
Do you really mean 'flower girls'?


Yes, Eliza was a Cockney flower girl when she went to Professor Henry Higgins.

Yes, I do believe that your social warriors are involved in a similar Higgins type quest to educate us all into polite society.
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Mick Harper
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Fruit-Picking for Fun and Profit

How then to solve the perennial problem of perennial immigration, that is to take care of seasonal work that won't be done by the natives? We could, with no great loss, simply abandon the sector. Or at any rate that part which cannot be mechanised to the point where horny-handed Britons can do it. It is often pointed out that the entirety of agribusiness is less important to the economy than... [fill in something derisory: computer games, stately homes or whatever]

Not possible. There's too much countryside and it is woven too firmly into the warp and woof of Old England to be abandoned. There will always be hops to be picked by cheery, pearly-coated Indonesians. Who can be rounded up for the local national wage (plus a bit, plus a good bit, but not too much or criminal gangs will do the selecting), put on RAF transports (on secondment to MAFF), scattered the length and breadth of caravan parks (on fruit farms) and then taken home again. They can bring the family if they like, treat it as Cockney hop-pickers did. It's all a matter for them, the fruit farmers and the supervisory bodies.

That's never going to happen either. We must have expensive fruit, fearful pickers, enriched criminals and the British minimum wage. It's woven into the warp and woof of Liberal England.
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Wile E. Coyote


In: Arizona
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There were 40,000 seasonal work visas for migrants avaialable in 2022, and no doubt more for 2023, so by the time the locals have been skilled up, away from their life on benefits and anti depressants, then the crops will be in. We could also get refugees to do the picking rather than send them to Rwanda, but then folks would complain that they were stealing our jobs......

The real problem is that by sending off all our children to university, we have detroyed what used to be known as the "dignity of labour". For some reason which I can't fathom, barwork or barista are acceptable as, say, a university job (not a long term career) but strawberry picker is not. If the govt worked with farmers to put on free entry indie festivals for those that helped get the crop in, it would be a start, as young people like music, mud, tent sex and drugs.
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