Armchair politics


Leaving aside from the way his tie and cup seem to mysteriously match, I hope that the barrista has ensured to add some non-milk ‘froth’ to the inevitable soy-mochachino he is slurping down.


Hit him!
Hit him!
Just fucking hit him!


Don’t think many are pleased to see Mcvey back


Next borough to me, she is odious and crap, surely a winning combination for a May Gov’t.

She has nice tits though.



Are you auditioning to write for The Spectator?




Toby Maybe? It’s got a nice ring to it. You’re hired


So are you.



From The Telegraph. Clearly Mrs May isn’t Brexity enough for them at the moment.



Hold the front pages: UKIP member in racism scandal


Jo Marney reportedly said Ms Markle would “taint” the Royal Family, that she had a “tiny brain” and that black people were ugly.

I love the irony of this self-evidently brainless bimbo attacking someone for having a tiny brain.


Reminds me of Lembit Opik and the Cheeky Girls, although that was just embarrassingly funny rather than embarrassingly disgraceful.



I’ll put this link here for want of a better place to put it. Note the call for students from my local NHS trust amongst others. Walking through the hospitals here this week and seeing the strain/chaos has been frightening. To all things to deteriorate to this level is simply not forgivable.



Are they legally allowed to work unsupervised in A&E not being qualified yet?

I remember years ago being told people in the US were reluctant to stop and help someone injured as they could be sued if the person died with them not being qualified medical personnel.


I don’t know. I suspect that they would not be fully insured, but am not sure. One of the nurses who was looking after me in July 2016 was a trainee who was still doing her degree, but she was just about finished with her studies.

Either way if I can’t get seen by a pain specialist via oncology two days running despite waiting a total of 12 hours over two days, and at the same time the trust is asking for volunteers, then you know the place is under terrible stress.

I was warned when I was working in the US in 1988/89 to be careful about taking someone ill to hospital as I might be liable for their medical expenses if they had no insurance. I don’t know if that was a wind-up as I never was in the situation, but it came up on about three occasions in my first few weeks in NY.


This is always the worst week in the year for acute hospitals, they have people still in beds that had to be admitted between Christmas and New Year when social care shuts down, and then everyone seems to be able to live with whatever they’ve got until Jan 2nd when they all rock up at A&E and a higher proportion then get admitted for assessment or treatment. By this week that workload has filled every bed going but the capacity to get complex/ older patients out of hospitals hasn’t got up to speed. Then add flu and other cold weather problems which disproportionately affect the elderly and there you have it, this years crisis.

The problem is the ever rising tide of demand which health and social care are not funded (or have had funding cut) to deal with. So where does this inevitably go - to GPS who won’t cope with the surge in demand and then all routes lead to hospital which can normally manage but which the surge exposes all the frailties in terms of staffing and capacity.

Third year nurses are perfectly safe to work in A&E (technically they would be under the supervision of the A&E lead consultant and acute medical physicians) but having had the pleasure of running an A&E, and separately running a hospital, it’s not where I would point them to alleviate the problems. I’d have some help get the complex patients ready to be discharged from wards to free up beds, and the others supporting and maintaining care for patients who end up in corridors, chairs and places in a hospital where you wouldn’t want to put patients even overnight, and who can easily get overlooked vs patients in core wards and assessment areas - the space between A&E and medical wards which contains the highest clinical risk. This would free up experienced A&E nurses to triage what’s coming in through reception and the waiting room and turn round the c 25% who really don’t need emergency acute care. If I’ve made it sound very simple well in essence it is but it’s fucking difficult in practice to co-ordinate.


The NHS suffers, of course, from the serious problem suffered by every service organisation whose business varies seasonally: when the demand is at peak there needs to be enough resource to cope. But when the demand slackens off that resource becomes under-used. It finds ways of occupying itself and if it’s smart it picks occupations which the public hadn’t realised were needed but which they quickly come to regard as really valuable (I don’t know, maybe screening programmes or cataract surgery or joint replacement or infertility treatment or loads of other desirable but non-critical activities). The problem is that now the resource which might have got us through winter has been diverted into growing the range of healthcare instead and come the first week of the new year we’re back in trouble.