Friday, 28 April 2017

Should Exotic Cancer Treatments be Provided by the NHS?

An interesting report came out today, regarding the National Cancer Fund.


It seems the initial aim was a laudible one, to provide expensive cancer treatments for patients with terminal cancer in an effeort to prolong their life. But in some cases the drugs actually shortened  their life, the exact opposite of the desired outcome.


But, it seems the outcomes didn't justify the cost. It's now been branded a waste of money. Like most knee-jerk reactions to public opinion.


This is what I've banged on about before: there needs to be a grown up debate on what the NHS is for and especially where the limits lie with respect to treatment. The NHS was initially designed to be a safety net, treating those that couldn't afford private doctor's bills.


As medical advancements have arrived, it's been assumed that the NHS will offer those as well, to the point it offers very expensive, world-class treatments courtesy of the tax payer. Can the NHS afford such expensive treatments, or should there be limits. Should people that want world-class medical care take out medical insurance instead of demanding the NHS provide it?


Take the case of the cancer drugs above. If the people are being used as Guinea Pigs for new cancer treatments, shouldn't the drug companies be funding the supply of the drugs out of their own pocket? Sure the NHS can supply the doctors and share the information gleaned from treatment, but why should the NHS actually be paying quite heavy costs for the supply of the drugs.


The fact that the outcomes in some cases were negative shows that these are not sure-fire treatments, that the drugs involved were administered without any clear benefit. In that case it's not treatment, it's a trial and the drug companies should be paying or supplying the drugs for free.


There also needs to be a debate about treatment for terminal patients. Should we be spending tens of thousands of pounds on exotic drugs to prolong the life of someone that is never going to recover? If it was a cure, then the cost may be justified, due to the reduced cost of ongoing treatment. But the money shouldn't be going into vastly expensive trials. Shouldn't that money be going into treatments with a more definate outcome and a long-term benefit, for instance hip and knee operations?


It seems to me a bit selfish for someone that already knows they are are terminally ill to demand from the NHS hideously expensive drugs on the off chance that they may (or more likely will not) extend their life by a few months at most, at the expense of providing a long-term (deceades-long) benefit to people that have other, cheaper treatments like hip and knee operations.


If you want that sort of top-class service, then buy medical insurance.


Of course I'm going to be whinged at by those that see this as a two-tier health service: the people able to afford health insurance will get better treatment, those that can't get bargain basement treatment on the NHS. But expecting the NHS to supply top-class service for the whole population is wrong too. Where does it stop? At what percentage of government expenditure do we say enough is enough?

Wednesday, 19 April 2017

Election Fever.

Well, 24 Hours ago Theresa May called a snap general election.

I can see why. There are many factions that see the PM as illegitimate. Because she wasn't voted into office, there's always that sneer that "she can't do that, she's not been elected to do it", despite her not changing the Tory direction by much and of course running with Brexit, something the people commanded Parliament to do through the referendum.

If the majority vote for the Tories again, it's a mandate to carry on with their style of Brexit. Not that there's any other flavour, other than giving in to every demand from the EU.

A mandate for the Tories will shut up the Lords. Those unelected bastards in the upper house that want to scupper the will of the people. Virtually every one of them a bag of vested corporate interests. If I had my way it would be illegal to be a director of any company and/or be paid by any company as an "advisor".

Finally of course, it'll shut up the stunted Scottish windbag Sturgeon (well here's hoping, she does like the sound of her own voice a bit too much unfortunately). Fingers crossed the Scottish coastal towns and cities will tell The Jimmy Krankie lookalike exactly what they think of getting their fishing rights back, only to give them away to Brussels again. (All I can say is thank feck Corbyn isn't the Labour leader in Scotland). Basically Sturgeon is a one-trick pony. Independence, independence, that's all she wants. Not that she has bugger all clue what she'd do with it if she got it anyway. She certainly has no idea of the cost to Scotland, that's for sure. But hey, I'm sure once the Barnett formula is abolished (the only thing keeping the miserable windbag in office and able to shout the odds) she'll love having to actually make her way in the world on her own. She's like the petulant daughter that you're about to kick out, just to make her realise the cost of living.

Of course this is a terrible blow for the Labour party. they are so disorganised and dysfunctional that they don't have a cat in hell's chance of winning. Hard core lefty support may surprise some people, but I think unfortunately that the majority of the Labour vote will go to the Liberals.

Despite what the Tories may think, I don't see Labour heartlands voting Tory. people there would rather slit their wrists than tick a Tory box on a voting form. Despite heavy pro-Brexit voting during the referendum, I believe that people won't think about that in the general election and will vote Liberal as a protest against wishy-washy London-centric Labour leadership.

If the election had been called just after the referendum, then the Liberals and Labour would have been in real trouble as the majority of the voting would have gone to UKIP. Months of division, skullduggery and loss of focus within UKIP means they won't pick up a fraction of the votes they got at the last election.

But UKIP's reason for existing (getting out of the EU) is an almost done deal. The only way I can see UKIP keeping votes is to stir up uncertainty about the outcome of the Brexit negotiations.  If UKIP can convince voters to vote for them and get them in a position so they can keep the Tories honest and keep Brexit on track, then they may succeed.

But despite the Liberals being anti-Brexit and against the majority of the people, I see them making gains unfortunately. I'm not sure how that will play out in the cut and thrust of Brexit. I mean, a re-invigorated pro-EU anti-democratic Liberal party might just grab enough headlines to fuck things up. Who knows?

That may be the downside of this election for Theresa May.

Saturday, 8 April 2017

What Has Sweden Done to Deserve This?

What has Sweden ever done to deserve a terror attack of their very own, a number of people being killed yesterday in a truck attack?

Well, despite allowing in thousands of Islamic migrants that is.

Unless it's because of the 900 or so troops deployed to Afghanistan as part of task force 47 and the Provincial Reconstruction Team in Mazar I Sharif.

But maybe allowing thousands of migrants into your country that may feel some affiliation to those people they see as oppressed by you may not have been the smartest move.

That's despite you "only" being part of a rebuilding force.

That's despite whatever you think that Islam is a "just" religion and not also a political ideology.

In fact if you start to look at the less publicised countries involved in Afghanistan as part of ISAF, then a pattern emerges. Canada, Sweden, Netherlands, Germany, Spain, Italy, Norway, Finland, and to a lesser extent Luxembourg, Romania, the list goes on.

Look at this page: https://en.wikipedia.org/wiki/International_Security_Assistance_Force and look at the list of participating nations.

Now tell me there isn't a very strong link. Maybe someone in Afghanistan holds a grudge. Someone with the ability and money to organise and finance a large number of people. As the only major source of revenue in Afghanistan at that time was Opium, then I'd hazard a guess that's where the source of the grievance lies.

Whatever.

It's all down to lone wolves and religion.

Maybe looking at the countries that haven't had their own Islamic terror attack may shed some light on the issue. Where were't they and what weren't they involved in?


Saturday, 25 March 2017

Westminster Terror Attack.

The thing about the Westminster so-called terror attack isn't that one guy off the radar actually actioned a simple plan (hire a car, buy some knives and run amok in Westminster.

It's the fact that there have been a large number of other plots that have been disrupted. We're never told how many individual plots have been stopped so we can't gauge the level of threat. I have the suspicion that if the public had better knowledge of the true number of plots being investigated and stopped, they would be calling for better protection and more positive action against those under suspicion.

As bad as the attack in Westminster is, in the great scheme of things a man with a car and a knife isn't the worst that can happen.

There are worse things in the Islamic Terrorist's arsenal that can cause more damage: a Mumbai-style co-ordinated attack by several well-armed assailants travelling up the Thames by boat into the heart of London dropping off at multiple points would be devastating, especially if the drop-off points coincided with areas of high concentrations of the public. Attacks at the O2, Excel, the Barbican, train/tube stations and tourist attractions like the London Eye and Westminster would cause untold carnage.


Tuesday, 21 March 2017

Just Sat Here Waiting....

For some crisis or other to yet again delay the triggering of article 50.

The 29th seems quite close to the end of the Month, it looks very easy for it to be pushed past the end of the month.


Tuesday, 7 March 2017

The Definition of the Word Negotiation...

A lot of political sheninnigans is going on in Westminster at the moment in order to finally get article 50 presented to the EU and Brexit under way.

It seems to me that the Lords and all the other supposedly clever people including the woman that had the Government wasting thousands of taxpayer's pounds defending their right to invoke article 50 just don't understand the definition of the word "Negotiation".

The definition is "discussion or consultation aimed at reaching an agreement". That is a discussion between two parties aimed at reaching an agreement.

The outcome of the negotiations cannot be known beforehand because that's the whole point of the negotiation: to reach an amicable agreement AT THE END OF the negotiation.

Positions cannot be agreed beforehand because items on the agenda of the negotiations are parlayed (good Piratical term) and used in the negotiations as bargaining tools.

One never allows the other side to know your strategy or at what point you would settle, otherwise there is no point negotiating. If the other side knew your strategy beforehand, it severely weakens your ability to get the best outcome from the negotiations. If you both walked to the table and both agreed terms without negotiation, how would you know you got the best deal?

You always go into negotiations with the outlook of using your strategy to get the best outcome. There are points where you may get a better deal than you would have settled for, there are other where the terms are worse than your ideal. The point is to barter and exchange until you come to an agreement that is fair to both parties under the prevailing circumstances. You plan for the worst, and use all your cunning and guile to get the best outcome.

It's like buying and selling a car. The seller asks for a sum, say £5000. You, the buyer offers £2000. Bit of a low blow, but you always start low with the aim of keeping the eventual price at the end of the negotiations as low as possible. The seller then replies with a revised request of £4000, you offer £3000 and eventually you'll most likely end up at £3500, all thing being fair. But what if you offered three grand instead of two? Would the seller counter with £4500 instead of three grand? Would you end up at £4000 instead of £2500? How would you know if £3500 or £4000 was the best offer you could have got, because you never offered a cheeky two grand bid? What if the seller knew you had £4000 in your pocket, or you knew he was desperate for cash and would sell at a lower price just to get the money? See, negotiations can be very negatively affected by knowing strategy beforehand, but also boosted if you do things right and don't give away any advantage you may have.

So for the House of Lords to force the Government to guarantee certain things before the negotiations weakens our negotiating strategy.

For some posh bird to try and force the Government to put the outcome of the negotiations before Parliament for a vote is ludicrous: by definition the outcome of the negotiations are the best available. It's take it or leave it, as the Government has quite rightly said. There is no going back to the table and re-negotiating as those blind to the definition of the word would like. We will have used all our bargaining power, all our bargaining chips, all our best efforts in getting the best deal.

By definition the EU will have also have got the best deal for themselves, they won't want to re-negotiate either. At the end the goal posts cannot be changed.

To go back would weaken our position and end up with a worse situation than the one previously put before Parliament. There is no telling the EU it is unacceptable; they won't care. Stamp your feet as much as you want THEY. DON'T. CARE.

Now can all you supposedly clever bastards just fuck off, stop trying to fuck this country up and lets just get the negotiations started without interference, eh?

I just wonder if they've ever paid the full asking price for a car without trying to get a bit knocked off the price. I severely doubt it because I know rich bastards don't get rich and stay rich by paying full price for stuff.

Which means they're trying to nobble the Brexit negotiations with the intent of denying this country the best outcome and they are beyond contempt.

UPDATE:

Yup, the Lords have proved yet again that they are a bunch of drivelling duffers with not an ounce of common sense amongst them and added an amendment that they want a "substantive" debate and meaningful vote on the Brexit negotiations. Whatever that means. When there can be none. It's take it or leave it guys... Accept the outcome of the negotiations or reject it and head for WTO rules.
Now most people would consider what they are doing as sabotaging the exit negotiations and forcing us down the worst of paths. I can't comment.



Friday, 3 March 2017

The very Ancient and Outmoded Labour Party (Part 2).

I was thinking and I think I've hit what it is about Labour that upsets me. It has failed to be aspirational. Sure, it aspires to be in power, but what after that? Nothing. Maybe it moves the deckchairs around a bit, but nothing truly inspirational. It's fiddling at the margins.

When I say aspirational, I mean for the working class it purports to respresent. What plans does it have to make the lot of the working class better?

A popular policy would be to outlaw zero hours contracts. The heinous things trap people by demanding exclusivity, but not rociprocating by providing a decent working week, every week.

In my mind, exclusivity means the company should pay the worker even though they are not working, because the company they are contracted to is preventing them from working for someone else.

If the company states you cannot work for anyone else, then they should be forced to pay a retainer to the employee. Of course minimum wage legislation means that the employee should be paid minimum wage even if they are not being used.

This is a very similar concept to the IR35 legislation that affected IT contractors.

Ok, a zero hours contract is a step up from employing people as self-emplyed contractors (e.g the so-called "Gig Economy") so the employer pays national insurance etc. but the exclusivity clause means that the employee should be paid for the time they are unable to work for anyone elase.

There should also be legislation aginst penalising people that cannot work at a certain time because they are working for someone else.

The legislation should make the agreement fair and equitable to both parties. At the moment the advantage is all towards the employer.

Another area Labour can help working people is social care. Wages in the social care sector are generally the lowest possible. A vast number of people are working for minimum wage despite having the qualifications and responsibility of administering medication and attending to the social welfare of their clients.

A move to professionalise the social care sector, maybe with union representation is sorely needed, it needs to be brought up to the same status as nursing. Having someone having access to and able to give medication including controlled drugs after a basic one day training course, or worse filling in a questionaire in my mind is just wrong. The discrepancy between social care and the medical profession is massive..

Workers in the care sector need to demonstrate a knowledge of social care and safety legislation. The basic care certificate introduced by CQC goes some way towards this, but more is needed.
More professionalism should improve wages for a sector with some of the poorest. That's what I mean by Labour being aspirational: introducing policies and legislation to improve the conditions of the poorest workers, the ones that are really being exploited.

Of course improved wages in the care sector then increases costs, but as I've previously mentioned, improved professional status will make it easier for the NHS then to take on social care and integrate it with the rest of the NHS, allowing patients in hospitals to be moved out of hospital wards.

A penny or two on income tax or national insurance to pay for the integration of social care budgets into the NHS budget wouldn't be baulked at by the majority of people. It would be a winning policy for Labour.