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. 🤣

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Last Notes

2025-12-15 16:31:27 UTC

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@nprofile…35ec does he see your posts?

2025-12-15 10:09:00 UTC

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@nprofile…hzyj The JiT philosophy depends on regular predictable arrival of stock and demand. But demand/need in health care is both clustered (infectious causes) and random (though not actually memoryless) and affected by seasonal factors. All told the modelling of it is a nightmare. Not even telecoms companies manage the new year's eve rush, which is predictable and inevitable. Often takes days for texts to arrive! And the peak demand moves location in a defined way. Health care is much harder.

2025-12-11 20:17:18 UTC

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@nprofile…35ec @nprofile…j258 @nprofile…zr34 exceptional music, from an exceptional band.

2025-12-09 15:26:55 UTC

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@nprofile…hzyj in this case I am pretty certain it's the view of the minister and his peripherals, that is setting the tone, and if he just told his Principal Sec that he wanted to know how many we needed to ensure everyone had access to an NHS Dentist, then the costs would be with him in hours, he could pressure the treasury by a gently asked question in HoC preferably by an opposition Member. The pressure would then be on HMT to find it, as it did from things they want. Might improve their polls

2025-12-09 11:26:45 UTC

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@nprofile…hzyj Sounds a typical DH approach. Delay making it possible to appoint the needed qualified people so as to save cash this financial year. Of course the treatments required become more extensive so each one costs the purse more, but never mind the suffering "We've got to balance the books!"
Sometimes it think DH should be renamed Department for Extending Suffering, but I believe DES is already occupied....

2025-12-06 09:19:52 UTC

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@nprofile…hzyj perhaps if the UK breaks up, NI joins Eire, so becomes a member, Scotland gets it independence, and is allowed back. Then Wales post independence, leaving the toxic English to stew alone in the world for a while. May open negotiations on any terms.

2025-12-06 08:29:08 UTC

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@nprofile…hzyj I noticed that they sent questionares to more than 5,000 GPs. I wonder if that was 5001, 5499, or even 5999! Taking the lower figure they got a 15% response rate. So not even close to being representative. On top of that the one sided response could suggest that those who believed MH problems are over diagnosed were more likely to respond. A totally meaningless survey, and another example of the lousy standards of reporting currently common in the BBC.

2025-11-14 16:46:00 UTC

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@nprofile…35ec A risk she would have felt worth taking. And in hindsight might have saved the Queen's son and heirs a considerable problem

2025-10-11 15:48:03 UTC

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@nprofile…pgwc Not only Biden and Trump, is all I'm saying. We have it here in the UK too. There are lots of people going on about herd immunity as if it was a real thing, only if no migration either way and no births, in your population, and the mixing has to be specified too. Since Corona virus immunity is short lived even vaccinate and relax won't work as you think.

2025-10-11 15:06:51 UTC

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@nprofile…pgwc I wish it was a simple as politicians mishandling COVID. It's time medical experts recognised Immunisation only strategies never work, never have. We tried it with smallpox, measles and Rinderpest. By using community action plus immunization we Eradicated both Smallpox and Rinderpest. Measles is resurging only because we relied on an immunisation only approach. How many have to be disabled for health departments to give up their fascile belief in herd immunity. It's fantasy.
Mask up.

2025-10-05 10:52:29 UTC

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@nprofile…gq86 @nprofile…y9m5 @nprofile…60lz No Proscription of Steven ten names group though they have a habit of repeated demonstrations at certain key locations aimed at making groups fearful and altering public policy. And have harmed people in the past.....
Now what adjective describes a group like that?

2025-07-21 07:23:05 UTC

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@nprofile…60lz The last time there was a crisis in maternity services. We had the Peel report.
It closed local maternity homes & centralised labour wards. This led to the phase of active management of labour. The rights and wrongs of that have never been properly resolved, but clearly what's happening now is untenable. We train midwives, but don't employ them & maternity departments are understaffed.
If ever there was a case of short termism costing more, investing in healthy babies is cheaper.

2025-06-30 09:50:51 UTC

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@nprofile…n2nf what baffles me, is how they can say they want more babies born (who need care for at least 16 years), Education for hopefully 40+ years, healthcare to prevent illness that will kill or cripple them. Whilst at the same time saying a) we can afford more education, healthcare, or social care, b) the support we give to disabled productive people must be cut, c) the country is full and we must reject immigrants, especially those fleeing persecution or poverty, who drive growth!

2025-06-10 17:34:32 UTC

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@nprofile…60lz or west of Reading for that matter. 😉

2025-06-10 09:19:10 UTC

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@nprofile…60lz have we decided on the long term repository for the waste yet? Or is that in the another government's problem drawer. A possible solution, place the repository on the property currently owned by cabinet members, if there is no problem with the repository, presumably no loss in the value of their assets, however in the real world .....

2025-05-14 09:23:36 UTC

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@nprofile…9c0g regardless of the genocide claim, targeting hospitals and people within them is a war crime in itself. Something Israel has been boasting about. So presumably the UK govyis happy to ignore the rules of war. I'm glad none of my family is still in active service for the crown, as without the rules of war, the wounded have no succour, and do more die needlessly. UK forces put at mortal risk for no reason, just to defend government ministers.

2025-04-28 09:27:17 UTC

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@nprofile…60lz 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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@nprofile…60lz 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

2025-04-28 08:20:16 UTC

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@nprofile…60lz importantly less start treatment than join the queue, so the queue length will rise hyperbolically.
Further, delayed treatment is always worse treatment so it takes more resources to complete the treatment if ever. Thus a short term investment in increasing staffing and facilities would be expected to reduce costs in the future.
Health is not a zero sum game
Primary prevention eg. Immunisation is a classic example.
Secondary prevention - most screening increases service costs.

2025-03-27 08:01:26 UTC

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@nprofile…60lz 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.

2025-03-11 11:37:52 UTC

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@nprofile…60lz just for fair comparison more of East Anglia should be included, swapped for much of the west country.. East Anglia is the bread basket of England, the west Country more livestock orientated.

2025-03-09 09:56:45 UTC

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@nprofile…60lz I'm not sure the lowly staff at DWP are to blame for the evil policies of ministers under pressure of the rentiers in HMT, of which the Chancellor is the chief cheerleader.

2025-03-09 09:23:35 UTC

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@nprofile…g95x not to mention the Welsh 20mph default speed limit, has saved lives already, as well as reducing accidents. Seems doing sensible things does actually improve both life and the economy.

2025-03-05 19:14:31 UTC

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@nprofile…60lz as I posted about MPC salary adjustments due to BoE interest rates.
Perhaps something similar to chancellor's remuneration from the state. The percentage cut in DWP benefits investment, is taken from the Chancellor's and all treasury ministers and senior staff, total remuneration. So ministers feel slightly connected to those who's fate they are deciding.

2025-03-02 08:37:07 UTC

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@nprofile…60lz seems to fit the current NHS to a tee. Starting from the bottom, a blame culture, all the way up to high turnover, some of which is written into law. Newly qualified Doctors get 6 month contracts, as a matter of routine. And even if you get a longer contract residents are rotated and that may mean moving long distances between jobs....

2025-02-14 09:11:52 UTC

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@nprofile…60lz I see collapse of cashless transactions very soon. Goodbye touch and go, chaos in London on transport, coffee shops, and pubs.
The tragedy is that a lot of less wealthy people will have their money stolen. The rich will inevitably be protected.

2025-02-10 09:47:34 UTC

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@nprofile…60lz Having worked in a rural area, whilst I'm sure most child poverty is in urban areas, simply because most people live in urban areas. Rural poverty is often worse, as there is no support network, and the state requires attending remote centres to even submit a claim. 4 bus rides over 8 hours with three children to get to DWP office, then a return trip the next day as the last bus leaves at midday.....so the poverty is simply unrecorded and unrecognised.

2025-02-09 09:07:54 UTC

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@nprofile…60lz a great song to sing inwardly at my bosses latest unreasonable demand, in the days when I had paid employment. It made me smile which really drove them up the wall!

2025-01-04 10:35:22 UTC

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@nprofile…60lz not blaming you, the problem is those in Whitehall or similar have little real grasp of the effects of many infectious diseases on localities, similar to the media reports of a whiteout when a light covering of snow settles on the home of the big smog!

2025-01-01 09:42:48 UTC

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@nprofile…60lz I'm far from convinced the data will be any use to big pharma, as to be useful they would need to know a lot of personal detail. ( As I found out doing clinical trials) However, having good access to NHS data might permit 'blue sky thinking' to be undertaken on an ecological basis. However, my experience is that with the existing protections in place, new ideas get squashed as there is no published evidence to support them.
The NHS had accidently become hostile to original research.

2023-09-24 09:38:15 UTC

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@npub1g0t…tvm4 it was always for most people an imposed, by cunning, mechanism to reduce employers liabilities, to enable shareholders and executives to picket more money.
Hence the judges had to introduce a new category of worker to explain that apparently "self-employed" were "employees" who evaded social security benefits, whilst they're employees evaded NI contributions.

2023-09-18 09:52:16 UTC

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@npub1g0t…tvm4
Maintaining things in status quo requires a lot of resources. Living things spend a lot of energy on homeostasis, so when overwhelmed collapse suddenly. If you have had the misfortune to watch someone with bacterial meningitis you will know what I mean, they're unwell but ok, then minutes later they are at deaths door.
All should read Richard Cook's papers to see how linear thinking mucks up healthcare. Summary in his 1998 paper;
https://www.researchgate.net/publication/228797158_How_complex_systems_fail

2023-08-13 21:37:34 UTC

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@npub1g0t…tvm4 doesn't that penalise new entrants, who have to finance their start-up business with loans, often secured on their home. Whilst big corporation can borrow more cheaply and can touch up shareholders for a few million more...

2023-08-08 08:21:56 UTC

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@npub1g0t…tvm4 clearly not an educational institution then. The mark of a good university is that it accommodates multiple views so that debate can improve thinking for all. Hence the importance of free speech for all at university including the staff. But no one has the right to shoot for in a crowded space.
The misunderstanding at the Philadelphia court House is a classic example, there was a fire but the order was not for the troops holding the protesters from there court House....!

2023-08-08 07:53:53 UTC

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@npub1g0t…tvm4
Clearly led by false prophets, then!
How do we get enlightenment into the treasury and the political elites? I hesitate the suggest re-education camps, as I suspect they don't work and ARE terrible in other ways.
Perhaps starting with primary & secondary education, by liberating teachers from the national curriculum and treating them as professionals again.

2023-08-07 22:03:50 UTC

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@npub1g0t…tvm4 if they aren't sure of the cause: how can they be sure of the treatment?
In my own field medicine, you make a differential diagnosis and wholly treating the most likely, you try to disprove the less likely ones. It seems economists don't accept they may be wrong, but unify their current thoughts Must Be Right! Until proved wrong and are promptly denied.

2023-08-05 09:10:56 UTC

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@npub1rvw…xgew @npub1g0t…tvm4 my only caution is that like all weather patterns the Med is a complex adaptive system so except in the short term where current trends is a useful indicator the medium term is unpredictable. It could get suddenly very hot, or equally due to sidying weather, suddenly very heavy rainfall with excess fresh water, or massive sea level rise with the Sahara becoming fertile again...
Playing with the planet's weather is a silly dangerous game, but Homo Inprudens likes it!

2023-08-05 06:47:30 UTC

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@npub1vxj…ffly @npub1cm5…ragm @npub1g0t…tvm4 population reduction is already happening! Many countries now have policies to support bigger families. The natural net repro rate for humans is a little over 2 so population is stable or falling. The increase is a transitional state. But most politicians want to provide Panem et Circenses via Ponzi schemes.
We need to reduce our footprint on the earth, it can provide comfortable life for us all but not if those who have most demand 10 times their share.