Epistatacadam

Not a lot to say about myself. Worked as GP in valleys, then public health something to do with data of health events. Ignored mainly, you're advised to do the same. Meanwhile if you fancy seeing what I'm thinking this is quite a good place happy to be corrected as I don't know as much as I think I do. It's a common male fault. 🤣

Last Notes

2025-09-25 07:36:31 UTC

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Perhaps the lesson is that all companies with a turnover of more than say £1m must have suitable cyber insurance cover for their suppliers or they are compulsory wound up. We do it for drivers, why not for the drivers of the economy.
The premium could even be taken by the treasury based on a market assessment undertaken by actuaries. We do it for pensions and sickness insurance. By spreading the load costs are reduced.

2025-09-07 10:40:40 UTC

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What Emma misses out in her piece is how massively skewed income is in the UK the vast majority receive well under the average (mean) income. Thus I would expect, if the state system of mutual aid was working for the distribution of benefits to citizens to match that income disparity. It doesn't which is why people are so angry, they know they will never get their fair share, but the fact the rich, especially the very rich, don't pay their fair share is studiously ignored.

2025-07-18 07:31:45 UTC

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I think she missed out the sensible option. Give everyone a sceptical degree of trust. As sources prove trustworthiness, they earn higher trust.
However, whilst being proven right improves trustworthiness slowly & incrementally, being wrong once wipes your slate to zero trustworthiness.
Being first to broadcast the latest press release without checking if it is in fact raining, is a recipe for public distrust.
Local reporters may be the answer.

2025-06-28 09:24:17 UTC

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I prefer the "taking in neighbours washing" to service economy. It is al discretionary spending. If say the big four finally got treated the way they treat customers, their partners would be broke virtually overnight. If market managers were regulated tightly their profitability would vanish. LIBOR anyone, ....

2025-06-15 17:35:29 UTC

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Assuming the benefits diffuse through society. When growth is associated with transfers from the poor to the rich as is policy in the USUK at present, I suspect the inequality shuts down growth by reduced demand. We shall probably see in the US branch soon.
The World bank report was fascinating but is data from less developed (global pollution load?) countries, so may have very different dynamics to old smoke stack imperial states. 2/n

2025-05-07 08:57:21 UTC

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As a balancing comment, following thalidomide and other harms to infants in the womb accidents, it is often considered unethical to conduct trials on non pregnancy related conditions in women of child bearing age. That does rather remove a large chunk of the population from the potential pool. That doesn't fully explain the problem I know, but it isn't entirely unethical to exclude women from trials. Especially if the study/treatment is to be long term.

2025-05-02 08:05:30 UTC

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perhaps just bringing social care back into the NHS as the Godber reforms of 1970s did, until LAs demanded it back.The funding is from Government fiat money balanced by tax rises so it's no inflationary. Would help deal with the poverty wages in social care issue too.

2025-04-28 09:32:31 UTC

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Even if the treatment had no effect because diagnosis is earlier, survival to the same age of death is extended. We should ideally look at age of death as a result of treatment. For many cancers, the gains in life expectancy are marginal, but regrettably quality of life maybe worse for a considerable period of time, plus those misdiagnosed......
Tertiary prevention, is action taken to prevent a known complication but has no effect of life course.
It is essentially palliative.
End.

2025-04-28 09:27:17 UTC

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Secondary prevention is early detection of disease, to prevent the development of serious illness, or for adults delay that serious illness.
Thus childhood metabolic disorder screening is excellent as by relatively cheap interventions serious consequences that both shorten life & create disability are prevented. Phenylketonuria, and thyroid disease of the newborn are 2 classics.
Screening in adults for cancer is complicated as early detection and treatment must extend survival
2/3

2025-04-28 09:21:29 UTC

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I should perhaps explain primary prevention is to stop you getting the disease. So preventing people inhaling cancinogens, either at work (asbestos) or leisure (tobacco products). Or Immunisation against infectious diseases, polio is a great example, so for our US readers is measles immunisation. Stops death permenant disability and handicap in the immunised individual.
Food and Water hygiene are in this category too, hence the failure of Water cos is increasing NHS costs.
1/3

2025-04-24 12:12:43 UTC

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my only disagreement with him is the long held myth that you get better quality care and outcomes at centralised hospitals. We know because the data consistently shows it that outcomes improve until the hospital gets too big. What is too big? That depends on the condition. For some the number of patients seen per year is quite small 5 or 10 typically, for others it's higher possibly 50 or so.
Centralised centres for rare conditions is sensible, but for most 1/2

2025-03-27 08:01:26 UTC

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what would be interesting is what proportion of GDP has been spent on supporting financial services, eg by quant easing, by interest on debt, and subsidies to privatised industry etc. I suspect it dwarfs health and social care. Perhaps, that could be cut, or the profits taxed so marginal rate is similar to that experienced by a worker on minimum wage and universal credit.

2025-03-22 18:05:04 UTC

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or alternatively bring 45% rate down to £100k, and a super rate of 60% from £200k and perhaps 75% above £300k.and so on. Bare in mind that median annual income in the UK is £37k so perhaps 3* median i.e. £112,290 should be the first step up, £224,580, the second and stepping up by an extra 15% for every ,triple of the median wage. The rate for the rich is then set by employers, not the chancellor and paying the lower wages more will also benefit the bosses.

2025-03-22 17:00:14 UTC

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I suspect increasing taxation on those earning over £100k per year would be very popular, perhaps bring back the very high rate for those with incomes from all sources over£250k.oh and lift capital gains to the same as your top income tax rate.

2024-09-08 09:46:36 UTC

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A there used to be auch beloved tribe in the NHS called Records Clerks. They were like librarians. If you had the patients name their records could be found remarkably quickly. At the NHS' inception the GP record was designated the long term record, from cradle to grave. However, due to political changes, and misunderstanding of privacy laws GP notes are no longer comprehensive.
And yes I agree it's slow but at least it's possible.

2024-09-03 07:21:29 UTC

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I'd like to see directors have their limited liability protection mostly removed. So when a company goes bust, eg. Big bank Lloyds, National West etc or Water Companies eg Thames, Welsh Water previously, or big shops eg.BHS. the Directors responsible do not escape with massive spoils some of the interest on which they graciously put towards the workers pension fund they stripped....instead they and their families feel the pain as everyone else in the business does.