Politics, The Final Frontier (Politics)

[Tilo Rebar]

[N R Scott]

[Mick Harper]

A neat new dodge from our NHS administrators. I've got a gammy knee so I rang the hospital specialty my GP gave me (because there were "No internet appointments in this department." Strange). So I rang and was told, "You will be sent an appointment within seven to ten working days." "How long will I have to wait for the actual consultation?" "Oh, not long, we have lots of vacancies next week."

So, a good result? Well, no, when I had leisure to think about I realised that the first fishy smell was the phrase "within seven-to-ten working days". This is the "extra bogus data" that I wrote about on another thread. It is obvious that the phrase is meant to vaguely convey the idea of "within a week" but equally obvious it cannot be both within seven days and within ten days. It's one or, alas, the other. This formulation presumably means it's mostly the latter.

And then of course 'working days' means a five day week not our seven. So what you thought you heard as one week was actually two weeks ie ten working days. But hold on, there are consultants free next week. So, you can have a full medical team doing your bidding within a week but to persuade a clerk to look in his book and see that Thursday, two-thirty is available will take rather longer.

A week has gone by and my appointment has not arrived. Still that's only five working days. Let us hope the appointment doesn't arrive after the consultant is ready for me.

[Mick Harper]

I clean forgot! This outfit is working a different flanker. As most of you know, the brave new NHS gets you to a hospital consultant like this: 1) you go to your GP 2) she gives you a form (complete with a code word) with three choices of hospital 3) you look online for the one offering the quickest appointment 4) you book that appointment. Total time to get an appointment: a few hours.

This time, my GP said, "Wait a week before making the appointment so the paperwork will arrive. There's only one hospital offering this service." [I should have known!] Sure enough, they knew who I was when I rang (after waiting a week) but still couldn't give me an appointment even though they had everything to hand.

So, most hospitals will give you an appointment on a GP's say-so but no paperwork within hours. This one won't give you an appointment despite a GP's say-so plus having the paperwork within a week. Or two weeks. Or three weeks.

The point of course is that already I have been "on the waiting list" for two weeks (one week from the GP, one week waiting for the appointment) and I still haven't got the appointment. You may be sure, when the annual statistics are calculated, this mob will count waiting time from the moment I get given the appointment until the consultation. I confidently predict that will turn out to be less than a week, two at the absolute most, even though it could be as much as five weeks in reality. My leg hurts!

[Grant]

That's why management by statistics never works. Employees learn to fudge the numbers.

[Mick Harper]

That is true but it apparently requires the supervisors of the administrators to be dozing on the job since the ruses are so transparent. What is interesting from an AE point of view is that it really means that the supervisors have to be in on the scam as well.

How this oddity arises can be seen from the very similar Veterans Administration scandal in the US. Here, sick veterans were waiting month-and-years to see a doctor when the statistics showed they were waiting days-and-weeks. The situation arose because successive Congresses declined to set aside enough money so that the VA Administration as a whole (ie the administrators and the supervisors) were obliged to hide the truth from their clientele (and the general public) in order to a) earn the bonuses that were supposedly built in to ensure low waiting lists (in the case of the administrators) and b) to avoid criticism (in the case of the supervisors). Congress of course was happy not raising taxes.

It is pretty much the same situation in the NHS where it pays everybody -- right up to the Health Secretary -- to pretend the system is working. The difference in Britian though is that health is a much more political business so the whistle tends to get blown earlier. And at the very least a new scam-cycle has to be started.

Whenever I am at the receiving end of one of these scams I am tempted to remind the professional at the other end of the telephone that they are committing a criminal offence ie aiding and abetting in the gaining of pecuniary advantage by false pretences. But I never dare given the asymmetry of power between them and me.

[Mick Harper]

The best example though of this collusion-in-fudging is the Fair Trade racket.

[Grant]

What's wrong with Fair Trade? (Although, frankly I never buy Fair Trade or Organic because I think third world farmers should stand on their own two feet and I don't like produce that's got spots on it).

[Mick Harper]

The Appointments Saga Part 145

The phone rang at 9.15. Normally I don't get out of bed -- anybody who knows me wouldn't dare ringing this early -- but a premonition took me and my gammy leg to the phone.
"Michael?"
"Yes"
"Muscular-Skeletal Service here."
"Yes"
"Are you free between eight and nine tomorrow"
"Yes"
Phone goes dead.

What did it mean? I phoned several numbers until finally a Geordie voice at some nameless call centre said, "Well, it may be because they wish to conduct a telephone consultation or it may be that they will give you your appointment time to attend the hospital."
"So it will definitely be OK if I just wait by my phone between eight and nine tomorrow?"
"I expect so."
Stand by for further installments.

[Mick Harper]

[Grant]

[Mick Harper]

The NHS has come through! Sitting in my jammies by the phone at eight o'clock (did you know it's light outside at that hour?) it rang at 8.45. "Are you prepared to undertake a telephone triage, it will take approximately ten minutes?" And so it did. And I'm off to see the physio on Friday.

'Telephone triage', something to add to your stock of modernisms. I have a feeling we are going to hear more of these. Skype consultancies, that'll be next. Out-of-body procedures. Virtual life expectancy. It's a brave new world out there. Me, I'm going back to bed.

[Mick Harper]

If anyone mentions the term "affordable homes" again, I shall scream. The concept just doesn't exist. There are cheap houses, just like there are medium-priced houses and expensive houses. It is true that local authorities and national governments and property developers and housing charities witter on about them endlessly but that is for political purposes, it doesn't mean there is such a thing.

Think about the concept of the "affordable car". And then suppose car manufacturers were obliged by government fiat to build a certain proportion of cheap cars. If they could be sold at a profit then presumably the manufacturer would have built them anyway, if not then this is just a normal business tax, payable to stay in business.

And by the way, if you were lucky enough to be the owner of this latter kind of subsidised car, you would either drive around subsidised by the taxpayer or you would quickly re-sell it at a profit ie get the true cost of the car.

It's exactly the same if you manage to buy 'an affordable house' on some naice new housing estate. PS How do you qualify for an affordable house? Is it first come, first served? is there a grey market? backhanders? what gives?

[Tilo Rebar]

Drives me mad too. Homes are not unaffordable, although I think nice homes in popular areas are starting to become so.

House market prices aren't regulated, so supply and demand dictates the price of a home, whether for rental or purchase. The market is currently in the middle of a boom, fuelled by a shortage of houses and availability of cheap credit. Ideal conditions for a sellers market meaning prices will continue to rise until houses really do become unaffordable.

One solution to the problem is to build enough new houses so that supply exceeds demand, while reducing the availability of cheap credit. Another more drastic option would be to reduce the population of our country (any volunteers?). Either of these will result in a buyers market and prices will start to fall.

Can't see politicians doing anything, other than small changes to planning permission and token sops to public opinion, to change how this lucrative ~£500 billion market operates. Not that this really matters, as the housing market is not of strategic importance to the stability of our country.

[Ishmael]

This may be the greatest essay I have ever read. It has a well-deserved spot within the Applied Espistemological Library.

I Can Tolerate Anything But the Outgroup

The worst reaction I've ever gotten to a blog post was when I wrote about the death of Osama bin Laden....I didn't come out and say I was happy he was dead. But some people interpreted it that way, and there followed a bunch of comments and emails and Facebook messages about how could I possibly be happy about the death of another human being, even if he was a bad person? Everyone, even Osama, is a human being, and we should never rejoice in the death of a fellow man.

....Of the 'intelligent, reasoned, and thoughtful' people I knew, the overwhelming emotion was conspicuous disgust that other people could be happy about his death....And I genuinely believed that day that I had found some unexpected good in people -- that everyone I knew was so humane and compassionate that they were unable to rejoice even in the death of someone who hated them and everything they stood for.

Then a few years later, Margaret Thatcher died. And on my Facebook wall -- made of these same 'intelligent, reasoned, and thoughtful' people -- the most common response was to quote some portion of the song 'Ding Dong, The Witch Is Dead'. Another popular response was to link the videos of British people spontaneously throwing parties in the street, with comments like 'I wish I was there so I could join in'. From this exact same group of people, not a single expression of disgust or a 'c'mon, guys, we're all human beings here.

The author of this, perhaps the greatest essay I've ever read, pulled a fast one on me in the end and taught me something. Taught me about my own biases.