NHS - TIRED OF WAITING

Regular readers of this blog will know there are 2 topics guaranteed to instantly rile me into revolutionary mode – these are Energy and the NHS. When these subjects are on the blogging agenda, look out!

Neatly shoehorned on the front page of today’s Telegraph between Trump and Tehran was this little gem:

Today's  Telegraph

It’s not a crime to tidy up information on a company database. Getting rid of unnecessary data, duplicate or defunct records is considered good housekeeping to ensure your golden records remain exactly that - current and uncluttered.

The tabloids are right to cast aspersions on NHS record keeping because when it comes to anything health service related, it’s not always what the doctor ordered.

Since the hand grenade has already been lobbed then I’m going to take this opportunity to add the view from the pleb on the street free and gratis to the mix.

I’d like to focus attention on some of the reasons quoted in the reportage as contributing to removals from waiting lists. Here goes:

Going Private – It’s no surprise that private healthcare insurance or treatments are on the increase given the length of time most of us are expected to wait before we can access the NHS. It’s completely unreasonable to expect patients to grin and bear it for months even years when pain becomes so excruciating that it begins to impact mental wellbeing and quality of life. Believe me, I know what it’s like to live with daily chronic pain as I’ve been doing so for around 20 years.

Pathways to care are as long as the Great Wall of China, many offering a whole host of ineffective remedies or self-care advice when what is needed are physical medical interventions or surgery to deal with the root cause. Wait and See is the NHS mantra. What for? Going private not only gives you a fast-track pass to wellbeing but does so in a way that is not a ‘one size fits all’ approach. What’s more, you don’t even need private health insurance because most private hospitals/clinics offer interest free self-funding options for treatment.

The other reason peeps are going private is not always through choice but because over the years, the NHS has been sneakily offloading treatments into the private sector (ear syringing/dentistry etc). Bean counters decreed that GPs should no longer treat or prescribe for small, routine ailments forcing us all into the hands of private pharmacies who are more than happy to empty your purse for you. Although sometimes this can work in your favour especially if the over-the-counter remedy is cheaper than the average cost of a prescription which is now almost £10 per item.

Expect this trend to continue particularly when care is fully offloaded into the community. Any ailment categorised as being a result of natural ‘wear and tear’ or due to old age such as arthritis or conditions for which the NHS currently see as having no cure are likely to be added to this heap. The list of what you’ll be required to pay for will just grow and grow and grow leaving hospitals to deal with emergency life-threatening care only. All routine stuff will eventually be privatised.

Death – A direct consequence of the ‘Wait & See’ approach to healthcare and probably the NHS’s preferred outcome since it results in a permanent solution to any further expenses being incurred. The House of Lords may be deliberately scuppering the Assisted Dying Bill but who needs a trip to Switzerland when you’ve got the NHS. Almost everyday there’s one story or another about some poor bugger who died as a result of poor untimely diagnosis by doctors ie Sepsis. Sad but true.

Technology – Can’t kill you but it sure as hell contributes to a digital death since most of us lose the will to live trying to grapple with the whys and wherefores of new online portals to access healthcare.

It wouldn’t be so bad if someone actually phoned you to ask if you still needed a place on the NHS waiting list but most of the time, your spot has to be re-confirmed using a URL link sent to a smartphone. The elderly, techno luddites or even those peeps like me who don’t want a smartphone fail to understand why they suddenly aren’t in the treatment queue anymore all because they didn’t know what to do with a text message or couldn’t respond electronically.

I appreciate the NHS need to find out if anyone’s fallen into the first two categories but generic texting is not the answer for everyone.

There’s something this reportage hasn’t touched upon but I’m going to throw this out there anyway now I’m on my soapbox and that is a move towards more ‘evidence based’ treating of conditions.

Many a time I’ve read reports in the media about some new drug, therapy or treatment for specific conditions which NICE (National Institute for Health & Care Excellence) has decreed is either too expensive or doesn’t have enough specific concrete evidence to back up using it.

I have to chuckle every time I see NICE mentioned because it’s the only corporate entity that fails to live up to its name!

How much ‘evidence’ is enough to warrant prescribing new medications or treatments? How is this ‘evidence’ gathered? And how long a period should it be gathered for before NICE can make a decision on whether or not to offer it to patients? How many more questions can I squeeze into one paragraph?

Everything ultimately boils down to money, something the NHS struggle to manage almost as ineffectively as their patient database. Health outcomes should not be determined by an ROI (return on investment) algorithm. For someone with a chronic or terminal condition, an improvement even by a small percent can have a huge impact on their quality of life, something which I feel NICE fail to take into account because they’re too busy staring at the bottom line.

Fiddling patient waiting lists is the least of our worries. What is more important is challenging the status quo to get speedy diagnosis and access to effective treatments.

PUMP UP THE PROFITS

War! What is it good for? Lining people’s pockets.

Since war broke out in the Middle East, the neighbourhood grapevine is full of nothing but chit-chat pertaining to the price of fuel or more specifically how much it’s gone up in the past few weeks.

‘Oooooh, it’s just blatant profiteering’ screech the already squeezed top, middle and bottom in response to headlines concerning the price of a barrel of Brent crude. It’ll soon be cheaper to buy said barrel of oil than a litre of diesel the way things are going.

Just a quick visual reminder of where money goes when you fill up your tank. This nice little pie chart taken from the Petrolprices.com website clearly shows the various components that make up the cost of a litre of fuel.

Breakdown of the cost of fuel

Before war broke out, I paid a visit to my local supermarket filling station and paid about £1.44 for a litre of diesel. Curious to find out how this breaks down, I’ve used the percentages in the above pie chart to produce my own table showing exactly who is getting what every time I buy a litre of diesel.

Who gets what when I fill my car

Unsurprisingly it’s not petrol retailers who are trousering the lion’s share of pump prices but the Government.

More than half of the cost of a litre of fuel (54.5%) goes into Treasury coffers so the higher the price per litre, the more money flows back to the Chancellor from fuel duty and VAT.

Savvy petrol retail companies can hedge against rising wholesale costs with exchange traded futures, a stock market instrument that allows you to buy an asset for a set price on an agreed date. Unless you are simply speculating on oil price movements, you can take physical delivery of the asset (petrol or diesel) at an agreed future date. Such trades enable buyers of commodities to lock in cheaper prices for items they might need later on.

I suspect many petrol retailers probably bought their fuel many months ago when wholesale prices were considerably cheaper so agreed there is a degree of profiteering by anyone who hedged against price fluctuations and is now using older fuel stocks.

However, if you were not smart enough to hedge in advance then finding that extra cash to fund supplies at increased wholesale costs is definitely going to eat into your profit margin meaning any differences are likely to be passed straight down the line.

As the Government are not going to forego their slice of the pie any time soon and petrol retailers won’t want to compromise their profits then ergo it follows that motorists must pick up the tab.

Fuel duty raises a huge chunk of cash, somewhere in the region of about £24 billion quid every year. Persuading everyone to drive electric cars is pushing down revenue generated by fuel duty. Unless the Government can find a creative way of recovering that lost duty from electric car drivers then it will no doubt use the war to make hay whilst the sun shines.

I hope the Reevester uses that unexpected bonus from fuel duty/VAT receipts to provide much needed support particularly to those living in rural communities reliant on oil fired central heating.  However, as spring moves into summer then it follows less folks will be using heating so I suspect the Government will adopt their usual lets wait and see approach before rushing to spend any money.

When you stop to crunch the numbers, is it any wonder then that petrol retailers are just a little bit grumpy at being accused of profiteering when in reality it’s more of a case of the political pot calling the petrol forecourts kettle black.

THREE WEEKS TO GO

A few drones appear to have flown over the office at the weekend completely re-arranging our workplace layout. Some might say for the better as magically the room visually appears much larger just by having moved a few desks and filing cabinets. It’s amazing what a simple re-shuffle can do to increase available space.

However, it seems the music on the furniture merry-go-round stopped leaving me almost without a chair to sit on. My desk has been shoe-horned into the ‘Billy no-mates’ corner, a space so cramped that I’m considering changing my name to Sara Dean (sardine). It’s a desk with a view of our customer car park since it’s now right by the window. Whilst that might sound idyllic to some peeps, having sat in a chilly draught all morning I can assure you it’s not. No doubt when the low springtime sun re-appears, it’ll be like working under an interrogation spotlight.

The plastic desk bubble I’d desperately clung onto since Covid gone. How will I keep everyone’s germs out now? Thanks to a daily cocktail of vitamin supplements I’d successfully gotten through those winter months carefully dodging all the coughs, sniffles and squeaky bum episodes brought in by the hoi polloi but without my plastic protector, I may as well be wearing a ‘party here’ badge inviting all microbes round for a intimate tete-a-tete chez moi.

Thank goodness I’ve only three weeks of viral exposure and chilblains left to endure. If I hadn’t already handed in my notice, this definitely would have been the final straw.

Mrs Fannypack's survival tips for cold office workers

YEAR OF THE WAR HORSE

Looks like 2026 is shaping up to be the Year of the War Horse now that Trump has decided to bomb the crap out of the Middle East for reasons known only to orange jelly babies.

Great film and book

Entertaining sub titles on the Beeb’s morning news reportage – HMS Dragon still docked at Pompey apparently waiting for a beautician. Hilarious! Clearly the AI subtitle monkey can’t distinguish between the words ‘munitions’ and ‘beauticians.’ 

I think I prefer their erroneous version because the thought of going to war without perfectly manicured nails, exfoliated skin or unwaxed upper lip is just unthinkable.

Profiteering at the pumps, inflation wave and energy price cap increases all heading our way just when I thought the UK might have been turning an economic corner. It’s another one of those unfortunate setbacks for the Government and personal finances - life won’t be getting any cheaper any time soon!

However, global conflict is no excuse for changing one’s plans. Prices may rocket but I’m still heading for the exit come what may. We'll just have to manage somehow.