[low&slow]

The age group is important because it is likely that spread within schools will lead to spread within families and thus the wider community. That in turn will have an impact on both hospital admissions and deaths. It is also becoming clear that Covid affects cells in the brain which may have unlooked for long term impact on the young.

Cases have been increasing in school age children for a month now & there's no corresponding increase in adult case rates apart from a very slight uptick in ages 35-49 who are, of course, the age group most likely to be living with a teenage child. It seems that vaccination is preventing exponential transmission in adults, rendering the near hysterical calls for further lockdowns irrelevant.

It could be argued that vaccination means that most adult cases are now asymptomatic and therefore not tested or diagnosed. Frankly, I'm fine with that. I have huge sympathy for the immuno-suppressed & those that cannot receive a vaccine for medical reasons but life has to go on for the rest of society.

Regular testing seems to have been successful at reducing transmission in Scottish schools, finding those infected & getting them to quarantine before they infect other people. Hopefully the same strategy will be effective in the rest of the country; time will tell. In the meantime regular testing will inflate case numbers.

The large numbers spouted in the media need to be de-coupled from earlier in the pandemic. We are now doing routine mass testing of the unvaccinated, something adamantly opposed earlier, and the majority of the population have been vaccinated, greatly reducing the risk of serious illness and hospitalisation. We could follow other countries & just not test, case numbers would improve dramatically but I'm not a fan of ignorance is bliss.

[Flyin'Dutch']

... a great many GP practices.,, ]

Must be nationalised.

And I say that as a committed, absolutist, libertarian, capitalist. Enough is enough. If we're going to have a National Health Service, GPs need to be under State control with State wages and State performance standards, instead of this ridiculous shillyshallying situation that we have now.

Or, man up and give the service that customers want.

Never going to happen.

There must be a reason that reason that the GP layer in the health service in all countries that I know of is by self employed medics.

[low&slow]

then died from other pre-existing illness within 28 days of a positive Covid test.

If you believe that, then I'm afraid you've bought into the anti-restriction propaganda. The "they were at death's door" argument is untrue, and it's a bit weird to think that many thousands of people just happened to die of something else after catching covid. It's maybe more of the case that with vaccination, the sicker people and the unvaccinated are dying to a much larger extent than pre-vaccination, but one shouldn't think for a moment that people are catching covid and dying of something else.

I don't think it's weird at all. We know that vaccination is about 60% effective at preventing infection, we know that the vast majority of breakthrough infections are mild or asymptomatic. The vulnerable elderly will have been double or triple vaccinated by now, unless they have reasons not to be. The ONS hospital survey linked to above points out that in the 7 days to 16th Oct '21 0.024% of all 75 to 84 year olds were diagnosed with Covid. Extrapolate that over a year & that's 1.25% of 75-84 year olds being diagnosed (not dying, diagnosed) with Covid. I don't think that it's unreasonable to believe that many of those diagnoses will have been picked up due to hospitals routinely (sensibly) testing patients admitted for other reasons. Sorry to be unpleasant but what proportion of 75-84 year olds can we expect to die in any given year?

I'm not anti-restriction. I started using face masks long before they were required, much to the amusement of my local corner shop. I began my own quarantine a week before the first lockdown. I am fully aware of my own personal responsibilities towards the society that I am a part of but the time has come to accept that the paradigm has changed.

[low&slow]

... a great many GP practices.,, ]

Must be nationalised.

And I say that as a committed, absolutist, libertarian, capitalist. Enough is enough. If we're going to have a National Health Service, GPs need to be under State control with State wages and State performance standards, instead of this ridiculous shillyshallying situation that we have now.

Or, man up and give the service that customers want.

Never going to happen.

There must be a reason that reason that the GP layer in the health service in all countries that I know of is by self employed medics.

For once, completely, utterly, totally agree.

The problem with GP services is that the NHS monopsony dictates the contract that GPs work to, they are already effectively nationalised. The result is another NHS 'triumph' of central planning. We had a glimpse of this at the beginning of the Covid vaccination effort with 15 or more certificates/qualifications required before otherwise competent people were allowed to contribute. Totally bonkers but "thems the rules." The bureaucratic requirements imposed mean that GP practices are merging into ever larger practices to take advantage of economies of scale. Any chance of a newly qualified doctor opening a new practice are quashed by the overheads of conforming to NHS rules. The result is that you have less and less choice. Interacting with your GP is like dealing with our friendly aviation regulator at Gatwick, you just take what you can get & be grateful.

Many pages back FD explained how things work in Germany. As is common in most of the world doctors are not contracted to the state, they are independent practitioners. So long as they conform to normal medical practice they can run their business any way they like. You visit them, they issue an invoice to whoever is paying. Can't get an appointment? Go to another clinic, they get your money instead.

This sort of patient-first attitude is completely anathema to the bureaucratic classes that run the NHS. As far as they are concerned "public service" means "the public exists to serve us".

[eltonioni]

... a great many GP practices.,, ]

Must be nationalised.

And I say that as a committed, absolutist, libertarian, capitalist. Enough is enough. If we're going to have a National Health Service, GPs need to be under State control with State wages and State performance standards, instead of this ridiculous shillyshallying situation that we have now.

Or, man up and give the service that customers want.

Never going to happen.

There must be a reason that reason that the GP layer in the health service in all countries that I know of is by self employed medics.

I fear that you are absolutely spot on FD. In which case, we should privatise the whole of the NHS and treat providers as just that on behalf of customers. Let the undoubted talent do its thing instead of having it hogtied by the ridiculous machinery of State and the vagaries of political whims.

[StratoTramp]

@Paul_Sengupta

Re: "get back to it..." I should have said continue to get back to it - No more lockdowns and being told which parts of my life and activities are deemed essential by the government.

Yes, We are certainly pretty close and free the moment but let's not go backwards.

I think I mean it in a broader sense also rather "get back to work" also, like you I've been there throughout.

We can't forget a lot of people have lost jobs or businesses have been shut over the last 2 years. They may struggle to get over it / get back. Even the ones on furlough unless they've been studying or keeping brains active.

A lot of this has screwed those early in their careers too. If you are out of work for 6 months the probably of you getting a new job is reduced by something like 50%. This is magnified if you are young.

I think careers are a bit like compound interest. There's been two years without a "contribution" and it has effects forever more down the line (lower trajectory).

https://www.health.org.uk/publications/ ... tal-health

Lizard people report:
https://www.weforum.org/agenda/2016/08/ ... long-time/

I suppose the age thing was a bit of a non-sequitur. but if the average age of death from covid is 85 it's still miles up for 60.

[johnm]

There is a long history of lousy purchase specs and targets as an infantile mechanism for "managing" public services.

For those youngsters who may not know this goes back to one M Thatcher and loony left local authorities (famously Islington and Liverpool) in 1970s and 80s

It was a reasonable idea in many ways but it has been so badly implemented and messed about with over time through posterior covering by inadequate "managers" that it has completely lost its way.

We need to get back to respecting professionals. putting them in charge and finding ways to deal with the odd rogue sensibly. Having patients as essentially "retail consumers" of a soviet style monopoly is frankly insane.

[Flyin'Dutch']

I fear that you are absolutely spot on FD. In which case, we should privatise the whole of the NHS and treat providers as just that on behalf of customers. Let the undoubted talent do its thing instead of having it hogtied by the ridiculous machinery of State and the vagaries of political whims.

Sweetheart, you seem to forget that the subject of the current discussion is just that.

Privatised and providers treated as just that on behalf of customers.

The providers seem however about to vote with their feet, that is those who have not already left for pastures green, sunlit uplands if you want.

Just as 'providers' in other areas, self employed or not, have moved on..

It is lucky for HMG that the BMA is a toothless tiger.

Imagine a powerful ad campaign across all media making it clear that the current healthcare provision is the best hard working staff can deliver in the framework set out by the government.

[kanga]

.., man up ...

what proportion of active GPs are men ?

[very few in our large local practice, far fewer than when we first registered with them ~50 years ago!]

[Flyin'Dutch']

.., man up ...

what proportion of active GPs are men ?

[very few in our large local practice, far fewer than when we first registered with them ~50 years ago!]

40% male

https://www.statista.com/statistics/698 ... specialty/

[Paultheparaglider]

I think we should introduce compulsory vaccination for everyone over the age of five. I would also include younger children that attend preschool, or who want to mix with other children.

I don't know anyone personally who has died from the vaccine, just a few sore arms. There seem to be some rumours floating around on the Internet of blood clots and heart issues, but again, I know nobody personally in that category. In any event, I had my jabs and was OK.

The same goes for booster jabs. Compulsory.

That way we can get back to normal. Any kids that have serious side effects can be given a free iPad and a Netflix subscription. That won't cost much as I don't personally know any in that category.

The advantage of this is that we can completely forget about covid passes and all that nonsense because we will know everyone is jabbed. This will save a fortune.

In any event, people who have decided not to get vaccinated don't share my view that getting vaccinated is important, so who cares what they think. The science is very clear on this one.

Let's just get this done, and save Christmas while we still can.

[Propwash]

what proportion of active GPs are men ?

[very few in our large local practice, far fewer than when we first registered with them ~50 years ago!]

It is the same in our practice. My long-standing male GP, who whilst I saw only rarely did at least know me, retired about 5 years ago. He took, as I understand it, early retirement because of changes being introduced in the practice with which he wasn't comfortable. Since then the practice has expanded, moved to smart new premises and we were informed that we no longer had a named GP. The majority of the doctors now seem to be female, several work only part time, and it is highly unlikely that you will get to speak to the same GP twice, even if under a course of treatment. I now feel like a commodity rather than a known patient, and speaking to friends at the same practice I am not alone.

Individual GPs may well be hard-working but the system no longer seems to serve the patients/customers best interests but those of the practice; things are arranged for its convenience rather than ours and the pandemic has simply highlighted that even more.

Being under-resourced, as I have already said, is common in public service right across the board, including the security and defence sectors; health provision is not unique in that, and in fact continues to do far better than several other sectors. The political resistance to hold a critical and wide-ranging review into how the NHS now operates in a rapidly changing world, including managerial structures, waste-management and funding, is a large part of the problem. It does somethings very well, but it is not, and should not be treated as, a sacred cow beyond reproach. The world has changed dramatically since the NHS was founded and it would be astounding if the original model was still fit for purpose today. With ever-escalating costs of medical treatments and an ageing population, left unreformed in scope and ambition, the NHS will eventually either collapse or bankrupt the country. Which would we prefer I wonder?

PW

[StratoTramp]

It will never end at covid. Mandatory medical Interventions will not end well. It's about more than saving Xmas, more like the next 2 decades. Forced anything is not how the west, democracy and freedom work.

Why not accept you cannot control things so much? Run your own life I'll run mine. The government represent us. Though I've clearly been duped by Bo "libertarian" Jo.

2 years of life on hold, plus voluntarily taking a vacinne that I probably wouldn't have needed, as well as convincing my family too is enough of a compromise position for me please. My brother had a complication with little blisters forming all up and down his legs. Not death for sure but they do happen.

Most people have done their bit. Whilst It's a nice idea to protect others, I cant control how much they eat or drink to excess, do not exercise, take drugs, drive dangerously, smoke, do not look when they cross the road, leave oil cookers on whatever. Why should covid vaccination be any different? They will most likely die of other things which I have no influence over. I can't run around each day worrying if every little step and action might kill 0.2% of people on a single factor of covid. The balance is way out and not pragmatic. I wouldn't wish or think of demanding that they spend every second thinking of my wellbeing.

Perhaps mandatory blood sugar readers and diet apps to protect the NHS next. It's not sci-fi, China strips its people of access to credit, housing or health perks if they associate with the wrong people, do the wrong thing. The state shouldn't be able to endlessly interfere and nanny with our lives.

Look at the dross they (BEIS) put out or the DVLA frustrations on this forum not being able to get a driving licence. The state shouldnt govern our lives they are incompetent. It basically keeps the unemployment numbers down:

https://order-order.com/2021/10/20/beis ... nt-flyers/

Sometimes it makes me think we should just let China take over. So many people want to be told what to do and instructed on how to live rather than make there own choices. Which is just nuts in a literate and educated country. Yes we are not all health in professionals. But we have other professions and are not thick health is not the only lever in how to live a good life.

Repeating myself now. But we need a hollistic view rather than just myopically (my favourite word) focusing on this single issue which has "only" killed 0.2% of people in the UK. We needed it at the start. We still need it now. But it's all the news talks about.

I need to add this thread to "stop engaging" list one like the Track Greta one, it's all been said.

[Bill McCarthy]

Remoteness can have distinct advantages - I can phone up our doc and more or less see him that day, or the next, or chat about the problem over the phone whether to come in or not. Alas, he is of that age that retirement is creeping up on him.

[johnm]

Almost all my interaction with our GP by phone or txt, prescriptions are electronically transferred to the local pharmacy. I basically set out symptoms, the answer is usually pretty obvious to him and couple of texts is enough to reach agreement on what we do next.

I don't understand the urge to attend a surgery or hospital other than when there's little option and all other avenues have been explored. They are nasty dangerous places full of sick people