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Everything posted by uro_who

  1. https://twitter.cohttps://twitter.com/DHSCgovuk/status/1243541321601748993?s=20m/DHSCgovuk/status/1243541321601748993?s=20
  2. We've just changed the rules to only count those who are tested and die in hospitals. Community deaths excluded. So those who are very elderly, infirm, who are very unlikely to get to ICU or improve in hospital, many in nursing homes will not even be counted.
  3. It'll be at least 3-4 weeks before the lock down has an effect on ICU admissions due to incubation and disease course. My guess is we have probably baked in significantly more deaths than Italy. It's hard to say though as testing regimes are so different. I'd suggest that a well observed lock down is essential. I'd also suggest that catching it at any age is Russian roulette, although clearly the odds are worst if you get it on the way to collect your pension!
  4. As a 52 year old surgeon married to a 50 year old anaesthetist none of this feels the slightest bit like over emotional nonsense. Nor does it to our two school age children. We already have multiple colleagues off, some pretty ill and one in his late 40's in intensive care. Obviously many more people we work with will end up very ill or dead. People forget that about 15% of those that contract it require hospitalization for O2 etc and 5-6% ICU to stay alive. It's worth multiplying that by the number of people in the town you live in and then considering the average city of 500,000 would have an ICU of about 25-30 beds and skilled staff to match. Those numbers are very different. For clarification, I don't want clapping, or for health care workers to be called heroes, but I'd like a huge ramping up of PPE, and when the dust has settled it would be nice if our pay could vaguely catch up with inflation, as a 30% pay cut since 2007/8 followed by being surrounded by utter misery at work is an unhappy combination. WRT the downgrading from HCID, it's simply because the huge numbers of cases would make the bio-security requirements impossible to provide especially with the current level of kit and PPE the NHS has.
  5. This is exactly the plan. The NHS is (amazingly I know) falling behind the spending needed in other countries to keep healthcare afloat. I have been in healthcare now for for 30 years. There is no doubt that we are a much fatter nation with multiple illnesses that make treatment more complex. In the old days patients were routinely denied treatment for being too fat or smoking. Outcomes were worse and the illness was not life threatening. We used to make value judgements about peoples quality of life and whether we ought to strive to hard to save them if it was very poor. Now nearly everyone gets all of the stops pulled out (ITU/ICU, major surgery) no matter what. The sort of ops that they are probably talking about postponing are the knee endoscopic checks on morbidly obese people. This is a common procedure. The question is why is the knee painful. Oddly enough usually because the person attached to it is literally three times heavier than the joint was designed to take. The whole 'don't deserve treatment' thing is a cul de sac however. I'm not overweight, I don't smoke but I do like skiing. Should I have to pay my own costs if I break my leg pursuing a dangerous sport? Overall the NHS is being set up to fail, tariff (the amount paid to hospitals) is falling every year whatever the politicians tell us. There are 30% less beds than there were. Social care is on its knees. We are being softened up for partial privatisation and partial insurance model. The US management consultants that have benefited from this over the years in the states are all over the government and NHS at the moment. If you doubt my conspiracy theory you simply need to check out the career of the man who is currently the CEO of the NHS https://en.wikipedia.org/wiki/Simon_Stevens_(NHS_England)
  6. Except the BMA have no control over the number of doctors trained at all. It's simply the government. In fact the BMA regularly point out in consultations that more doctors (specifically GP's) are needed and that the UK is under doctored compared with many EU nations. Training numbers have recently been increased (as they have been repeatedly over the years). Even with the introduction of the decidedly dodgy 'private medical schools'. This year, as medicine is becoming a less popular career there were actually medicine places available on clearing.
  7. I do agree though I'm not a fan of in work tax credits. Seems like a subsidy to business owners rather than anything else.
  8. Last time I looked public sector pensions where 1.8% of GDP and due to fall to 1.4% of GDP over next few years. And that was before my pension value was decreased by a couple of £100k;-) Oh yeah and I do fund my pension, its not my fault they don't save/invest the money. Welfare and state pension is a different matter, they do cost a lot but it depends on what kind of country you want to live in and how young and healthy you are now as to whether you think they are a good idea or not. The only way to become richer as a nation is to make more goods and services I'd have thought. So policies which stimulate that are a good idea. They will however have a long payback time, something which as a country we are rubbish at managing (quick sell up to a US/Chinese/Indian/Japanese firm) on both a private/corporate and governmental level. Anyway I've drifted off topic - this is bonds, apologies. I'm a listener on that topic as I don't understand as much as I'd like to.
  9. You've lost me. Are those really the best way to stimulate growth?
  10. There is no pay rise its a slow motion paycut dressed in political bullishit. Back on topic those Foxtons and Countrywide graphs are quite spectacular.
  11. I know this is a macro discussion but boy do I feel this graph. I work as a hospital doctor and my real terms take home is down 15% since 2008 and 30% since 2003. Obviously I'm quite some way off the poverty line but it certainly feels different in the Who household. Unfortunately (for me rather than the tax payer) I cannot see any chance of an up swing in the foreseable future unless I follow many of my colleagues to Australia to double my wage or the middle east to multiply it by 5 not including the tax free benefit.
  12. I totally agree. I think that one way to recreate this is to allow zoned development at cross roads and t junctions. I live in rural Derbyshire and there is simply tons of potential for developing in this way. Most villages derived from hamlets and most hamlets started at road junctions. My guess is that you could allow the initial development of 6 houses per x road and 4 per t, with further planning permission at regular 5 year periods or so. The rules would be pp given over to individuals rather than builders, no single builder/architect to build more than one house at each site, each house must be individual. Obviously there would be nimby uproar but oddly enough not all of us want to live on a site vacated by a factory in a grim bit of town, with no scope for growing veg in the garden and living on top of each other in a virtually detached house. [declaration of interest: my mother in law was a town planner and I live near Derby, a town destroyed by town planners in the 60s. A whole Georgian square bulldozed for a centre of town dual carriageway]
  13. A bit like the war on terror? You have to comply with your loss of liberty and increased monitoring for your own benefit.
  14. Gosh that sounds awful. What happened there (don't answer if you can't face it).
  15. None of the above (well not quite). HMG announced a paycap of 1% for public sector workers. This time of year all of the stakeholders regarding public sector pay increases provide submissions to the pay bodies (arms length quangos setup and appointed by HMG) The unions ask for inflation based pay rises. The employers say no pay rise. the government has submitted no pay award at all unless automatic increments go. Medical staff have not had automatic increments since 2003. But I don't think anyone in government or the Treasury has bothered to read the contract!
  16. Technical analysis in terms of candlesticks, supports resistances etc has some basis of fact as its a measure of crowd psychology. It's most powerful effect however is that 75% of market participants use it, meaning it's a self fulfilling prophecy. Not all patterns are created equal however, some chart/candlestick patterns have 80% predictive power others hardly any. Even with those that predict well, if you are nervous in taking profits and don't close losing positions at the correct point when losses come then you will still lose money! It's all a difficult mix of macroeconomics, crowd and personal psychology. All wrapt up in a zero sum game.
  17. It's simply technical analysis. The DOW is just above the 2007 peak and has only been blown back up there by the printing of dollars. All of the market participants know that. They also know that all of the other market participants know that. All are unsure whether the market can continue to rise or will simply fall back down to trough levels. Investing in the stock market at the moment is a very 50/50 decision. It is going to oscillate wildly around this hugely significant limit/support. It will either crash to the floor, or if it gets a head of steam fly to the moon. Either way it's going to be terrifying and as someone who has made good money out of TA over the last 5 years my decision on long or short at the moment is out. It's simply too dangerous for the return. For longer to medium term Google how much the US debt stands at. See if you can work out the effect of that over the next 15 years.
  18. I've been calling patients from the hospital as telephone appointments for 10 years. As I say, it won't save any money unless half the hospital is closed down. In fact it's worse for the hospitals finances as a face to face appointment is about £80 and a telephone appointment is only £25. Yet the cost remains more than £100. The story wasn't about patient convenience (important though that is) it was about saving money.
  19. Evening. I'm a surgeon and I know quite a bit about medical IT. I do skype for my PP's as they are dotted all over the country and world. Works nicely. I doesn't however save any costs. The cost of having a doctor is nothing to do with the physical costs of the patient being sat in front of you but everything to do with the costs of: The PFI contract Hospital IT FM contract Chaplaincy Accounts department Billing department Library HR Procurement Labs Risk Management Communications Gardening Library R&D etc, etc, etc. In my humble establishment we get paid £77 for an NHS follow up, it costs £112 for me to see the patient. I cost only £7.50 of that, the rest is overhead. In fact the only thing that brings cash in is the cost of the patient parking in the hospital car park! Skype will not make the blindest bit of difference unless most of the rest of the hospital is closed down and I do skype consultations from my kitchen. But I will be calling the FD of the Whittington tomorrow with a much better idea!
  20. They've done it in the past. Last time it was only 0.6% but imagine what those nice bankers could do with 10% Let the banks go bust.
  21. I've never bothered with gyms. Takes too long to drive over, get changed, bump into 3 people from work who want to bend your ear. Followed by shower, get changed, drive home. Instead I cycle to work, bought a turbo trainer that runs tour de France etc dvd's, a concept 2 rowing machine second hand and a skierg over the last 10 years. Much better value, more efficient and residual left in the kit. Less fit girls at home though (other than the wife -sorry darling). Much fitter now than ever in my life.
  22. I agree its a complex situation and I also agree that governments don't always spend money wisely. There are of course buts however. First, we have a national balance sheet and if amazon, apple, google etc are selling books, computers and advertising that was previously based in the UK (and tax paid on all) are not paying anywhere near the same amount of tax as UK based companies, we are going to become centrally short of cash. The answer is in part to continue to cut costs but in the final analysis tax to real physical humans like you are me will be increased. Second, my part time job is running a social enterprise which provides healthcare to those with chronic diseases using the assistance of computer technology. I've largely funded it from my income. It could save the NHS £1/2 billion per year. Can I get to see anyone in government about it? No. How many times had google met with government ministers in the first 4 months of the year? Eighteen times. With a $45billion cash pile they could walk all over our little SE and if they do the long term UK employment, chance for us to build expertise and commercial advantage in a area which will become huge will be lost, along with all of the income associated with it. I think the objection is that they are gaining huge market share with the ability to pay hardly any tax. Give UK businesses the same opportunity and see how we'd do. If we don't change the law then we can all expect to have a poorer future. For the avoidance of doubt I totally agree that we need to sack all of the 5 a day and diversity officers etc. but this is a different argument and not exclusive.
  23. Try all grain. Even better and only 15p a pint. I've got to stretch out my public sector salary until the next increment kicks in.
  24. +1 Unfortunately we are getting the health service that the daily mail deserves.
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