Emperor's New Clothes: Tailor speaks again!

Chris Ham in the Guardian:

The time for grandstanding about the bill has passed. The challenge now is to carve out a path to implementing the reforms that brings about necessary improvements in patient care at a realistic pace. If this means modifying the direction and speed of change in response to legitimate concerns, then it will be a small price to pay to deliver an outcome that is good for patients.

Hermitage Museum ©2008 Am Ang Zhang

Market Forces and Choice is suppose to give us better value with our shopping, the OFT judged that nine companies OFT colluded to rig the price of cheese and milk in 2002 and 2003. The scandal is thought to have cost consumers about £270m. The OFT had intended to fine the guilty parties more than £116m, but reduced the penalties after a period of consultation. The consumers did not get any of the millions. Yet the NHS Reform is still pushing ahead with similar ideas.

Not that long ago: the same tailor!

Surely the Emperor must now listen to one of his own tailors: Prof Chris Ham

Parliament debate: Public Bill Committee

Chris Ham"May I add something briefly? The big question is not whether GP commissioners need expert advice or patient input or other sources of information. The big problem that we have had over the past 20 years, in successive attempts to apply market principles in the NHS, has been the fundamental weakness of commissioning, whether done by managers or GPs, and whether it has been fundholding or total purchasing."                             

Developing integrated care in the NHS: adapting lessons from Kaiser

“………The barriers include government policies that risk further fragmenting care rather than supporting closer integration. Particularly important in this respect are NHS Foundation Trusts based on acute hospitals only, the system of payment by results that rewards additional hospital activity, and practice based commissioning that, in the wrong hands, could accentuate instead of reduce divisions between primary and secondary care.”

Guardian: OFT dairy price-fixing fine

Emperor’s New Clothes: Regulators, Competition & Choice

Emperor’s New Clothes: Modern Era & The NHS

NHS-Kaiser Permanente: A Class! Seriously!

NHS: The Way We Were! Free!
FREE eBook: Just drop me a line with your email.

Email: cockroachcatcher (at) gmail (dot) com.

Looks & Nature: Warthogs & Politicians

In nature, there is no good or bad, just survival.

The same could be said of the looks of the animals.

Warthog, Kruger National Park, South Africa©2004 Am Ang Zhang

My own experience is that very young children are not put off by ‘ugly’ and ‘scary’ looking animals such as the Warthog.

The popularity of the latest series of children’s book, The Gruffalo is a very fine example of this.

The Warthog actually belongs to the domestic pig family and is only an herbivore. The most amazing thing about this animal is that it could go for months without drinking water and it did so by tolerating a higher body temperature and it could be very hot in Africa.

Coming to think of it, it looks a bit like the Gruffalo! Who said there is no such animal as a Gruffalo?

Indeed looks could be deceptive, just take a look at our politicians and what they are doing to our NHS. Give me a Warthog any day!

Nature Posts:

It’s a Bird, a Reptile, a Mammal: It’s Platypus

ECOLOGY: First Bees, Now Bats. 

Paraguay: Technology Meets Ecology 

Hong Kong: Humpback Whale

Tasmania: Whales & Dolphins-Mother & Baby

Toucan: Darwin & Infra-red Technology

Introducing Pre-school Kids to Nature

NHS: Götterdämmerung & The Ruling Class

Götterdämmerung at the Metropolitan Opera opens on the 27^th of January 2012.

As we are ourselves experiencing the worst from our ruling class over the NHS and its so called reform, Wagner’s opera is an uncomfortable reminder that we should never have trusted the ruling class.

Even before the new Bill is passed, changes were in place in the NHS that will make it impossible to go back. Much efforts by the modern day Brünnhilde will be in vain and the old NHS will end up destroyed.

The NHS as we know it will soon disappear. Wagner’s opera will always be there.

The cycle concludes with a cataclysmic climax of betrayal and loss as focus shifts from the realm of the gods to the power and ambition of human beings. It is left to Brünnhilde, in the legendary Immolation Scene that brings the cycle to a close, to restore balance to the world. Metropolitan Opera

The Ring of the Nibelung and The Ten Commandments
By Alan Wagner 01 Apr 2004


Alan Wagner delves into the moral and spiritual core of Richard Wagner's colossal masterwork.

Little in art created by a single mind compares to the sheer size and scope of Richard Wagner's Der Ring des Nibelungen. Only a genius with a hint of madness could have conceived anything this colossal, let alone willed it into completion over twenty-six years of gestation and creation.

Furthermore, its 18 hours comprising a single music-drama have gripped every generation since its 1876 premiere with incredible power, unleashing a torrent of commentary. In order to so possess both artist and audiences, Wagner's Ring clearly must be more than a simple sword-and-sorcery epic about giants, dwarfs, gods, and heroes.

And it is. Within that immense journey from the dawn of consciousness to the obliteration of an entire cosmic order there is a compelling moral core. However, even though the composer and his audience were unavoidably enmeshed within a Christian European milieu, it is far from your mama's Sunday-school lesson, a long way from the Ten Commandments, those pillars of Western ethics.

Wagner's philosophical convictions underwent similarly significant refashioning. When he began the Ring, he was influenced by Ludwig Feuerbach, whose principal tenet, explicated in The Essence of Christianity, was that man created God, not the other way around. Religion merely reveals truths about mankind's needs, and its most meaningful revelation is that God is love. Therefore, the pathway to salvation, personal and societal, is love.

In early drafts of the Ring, the liaison between Siegfried and Brünnhilde brought about a triumphant ending for Wotan's sovereignty. However, by 1854, when Wagner first read the masterpiece that impacted his thinking ever after,

Arthur Schopenhauer's The World as Will and Representation, he was already disillusioned about the perfectibility of either mankind or civilization. The Buddhist-like pessimism of Schopenhauer set the seal for Wagner, and he slid the metaphysical center of the Ring from Siegfried's death to where, as he wrote to his friend August Röckel, "Wotan rises to the tragic height of willing his own destruction."

I will try and look at it from the Child Psychiatrist’s perspective.

The dark side of the gods: (it is sometimes easier if one take GODS in the Ring to mean those in POWER. For the characters read here.) In fact, the gods need not work at all, the Nibelungs work almost all the time.

Disrespectful Wotan is hardly revered unanimously, and even he acknowledges higher authorities. Erda knows things he doesn't; his almost bureaucratic dominance derives solely from treaties engraved in runes on his spear, treaties to which he is subservient.

Born liarsCharacters lie as it suits them. Events are initiated by Wotan's spurious promise to the Giants to pay them by giving them Freia in exchange for building Valhalla, a promise he knows he cannot keep, as she is the indispensable symbol of love whose golden apples keep the gods alive. His shady ally, Loge, is defined as a double-dealing trickster. Brünnhilde breaks her promise to her father to allow Siegmund to be killed in combat. Mime makes dissembling a veritable life's work, ably carried forward by his nephew, Hagen, in Götterdämmerung. 

Contemptuous

Brünnhilde disobeys Wotan, and his grandson Siegfried destroys his power. Mime, who raises Siegfried from infancy and even makes him toys, is treated with disturbingly cruel contempt by the bumptious hero. Hagen, whom Alberich sired via gold-empowered lust as a tool to retrieve the Ring for him, mutters that if he succeeds he will keep it, not hand it over to his Nibelung father.

Thieving & Misappropriation 
……. misappropriation, of persons or of things, provides much of the plot machinery. First, Alberich plunders the Rhinegold, and afterward, theft of others' possessions, including the Ring, motivates action upon action. 

Incest and other illicit sexThe teasing of Alberich by the Rhinemaidens which leads to his abjuring love--love, not lust. The definitive heroine, Brünnhilde, and her Valkyrie sisters are the offspring of an adulterous liaison between Wotan and Erda; Wotan also illegitimately fathers the Wälsung twins by a mortal. Sieglinde's infidelity is excoriated by marriage-goddess Fricka, as is her violation with Siegmund of an even more basic taboo, incest. But Wotan defends the twins ("…those two are in love") and, like most audience members moved by the ardent love music, views both transgressions kindly. 

Homicidal

Fafner kills his brother Fasolt, the first victim of Alberich's curse, and we are off to the homicide races. Hunding slays Siegmund, only to be destroyed by Wotan's contempt. Siegfried kills Fafner, the Giant-turned-dragon, and then, after realizing that Mime is trying to poison him, kills him as well. By the time the gods' destiny climaxes, Hagen has murdered both Siegfried and Gunther and is himself drowned by the Rhinemaidens. Eventually Brünnhilde sets Valhalla ablaze as part of her self-immolation upon Siegfried's funeral pyre ("Thus do I hurl the torch into Valhalla's proud-standing stronghold") and all the gods die.

Greed, greed, greed!Finally, "coveting that which is your neighbor's" is pretty much the whole raison d'être for the Ring story, starting with Alberich's desire for the Rhinemaidens, then for the gold they guard. Thereafter everybody seems to want what doesn't belong to him or her: the Ring, a sword, a treasure, someone else's wife, sheer power. 

Yet in spite of Wagner's wholesale abandonment of the Decalogue, the bastion of Western morality, Der Ring des Nibelungen generates explosive ethical and metaphysical impact. He started with the absorption, fusion and reinvention of myriad legendary sources, and layered Schopenhauer's philosophy upon Feuerbach's. In Art and Climate Wagner wrote, "there is no true freedom except that which is common to all mankind... The redeemer is therefore love… starting with sexual love, [it] strides forward through love of children, brothers and friends, to universal love of humanity." The emphasis is his. Yet, some years later he wrote to Mathilde Wesendonck, "I can conceive of only one salvation. It is Rest! ...The stilling of every desire!" 

Wagner once wrote to Röckel, "I have come now to realize how much there is, owing to the whole weight of my poetic aim, that only becomes clear through the music." He later described the discontinuity between his "rationally formed ideas" and "the exquisite unconsciousness of artistic creation… guided by wholly different, infinitely more profound intuition."

Music alone would now convey the message. The last moments of Der Ring des Nibelungen are given entirely to the orchestra: there is too much weight for words. Something greater than the story, richer than all the sources, probably better than Wagner himself knew, is brought to a healing close with a tender statement of a motif heard only once before in the Ring, when Sieglinde learns she is bearing her child of love, Siegfried. It is the motif of Redemption Through Love. 

How wonderful it is to wait this long for the protein to be activated.

In the end, Wagner fashioned a masterwork of such extraordinary strength that it transcends analyses, personalities, philosophers, his own prejudices, and even his total disregard for Judeo-Christian society's standards of ethical behaviour.
Out of the highest art came a truth beyond even his explanation. 

Ring Synopsis: Das Rheingold Die Walküre Siegfried Götterdämmerung

If they are not RULING, where are they?

The Guardian

“Interestingly, former health ministers have done particularly well. The ex-health secretary Patricia Hewitt earns more than £100,000 as a consultant for Alliance Boots and Cinven, a private equity group that bought 25 private hospitals from Bupa. After leaving the department, her predecessor, Alan Milburn, worked for Bridgepoint Capital, which successfully bid for NHS contracts, and now boasts a striking portfolio of jobs with private health companies.”

Alan Milburn

Following his resignation as Secretary of State for Health (to spend more time with his family, his partner is a hospital doctor), Milburn took a post for £30,000 a year as an advisor to Bridgepoint Capital, a venture capital firm heavily involved in financing private health care firms moving into the NHS, including Alliance Medical, Match Group, Medica and the Robinia Care Group. He has been Member of Advisory Board of Pepsico since April 2007. Wikipedia

 Alan Milburn now also holds a place on the board of PepsiCo as an advisor.        Wikipedia

Patricia Hewitt

In January 2008, it was announced that Hewitt had been appointed "special consultant" to the world's largest chemists, Alliance Boots. Such an appointment was controversial given Hewitt's former role as Health Minister, resulting in objections to her appointment by members of a Parliamentary committee. Hewitt will also become the "special adviser" to private equity company Cinven, which paid £1.4billion for Bupa's UK hospitals.

In March 2008, it was announced that Hewitt will join the BT Group board as a non-executive director.[40] She joined the group on 24 March 2008. In July 2009, Patricia Hewitt joined the UK India Business Council as its Chair.

[edit]Stepping down

In May 2009 The Daily Telegraph reported that Hewitt claimed £920 in legal fees when she moved out of a flat in her constituency, stayed in hotels and then rented another flat inLeicester. Claimed for furniture including £194 for blinds delivered to her London home. In June 2009 Hewitt announced that she will be stepping down from the House of Commons. She said she was leaving the Commons for personal reasons as she wanted to spend more time with her family.   Wikipedia

 

A culture of corruption pervades the links between government and business, fuelled by and fuelling privatisation. These relationships are – as Adam Smith put it – a conspiracy against the public interest.

Ex-NHS: Patricia Hewitt: now with Cinven (Bupa Hospitals)

Simon Stevens: now with UnitedHealth

Wagner website.

Ring Synopsis: Das Rheingold Die Walküre Siegfried Götterdämmerung

Independent: Mariinsky Ring

Other Opera Posts:

Nobel: Kandel and Lohengrin

Lohengrin: Speech Disability, Design & Hypertension

The Dark Side: Il Trovatore

Doctor Atomic

Illness and MoralityLunar Eclipse

Genius & NHS: Surplus Hospital Consultants

                                    US $ 50,000 for Stent Procedure©Am Ang Zhang 2011

In most western and not so western countries the demand for Hospital Specialists (Consultants in England) has never been higher.

Check out the Mayo clinic.

A friend had a STENT procedure (like the one Prince Philip had) for a reasonable US $ 50,000.  I worked out that his cardiology specialist is earning a humble $10 million a year.

You begin to get the picture that for a long time, NHS is extremely good value.

Looks like some genius is on the verge of doing away with at least 49% of these Hospital Consultants: E. & O. E.

Medicine / Cardiology

Medicine / Cellular Therapy

Medicine / Endocrinology, Metabolism, and Nutrition

Medicine / Gastroenterology

Medicine / General Internal Medicine

Medicine / Geriatrics

Medicine / Haematology

Medicine / Infectious Diseases

Medicine / Medical Oncology

Medicine / Nephrology

Medicine / Neurology

Medicine / Pulmonary, Allergy, and Critical Care Medicine

Medicine / Rheumatology and Immunology

Obstetrics and Gynaecology / Gynaecologic Oncology

Obstetrics and Gynaecology / Maternal and Foetal

                                        Neonatal-Perinatal Medicine

Obstetrics and Gynaecology / Minimally Invasive Gynaecologic Surgery

Obstetrics and Gynaecology / Reproductive Endocrinology and Fertility

Obstetrics and Gynaecology / Uro-gynaecology

Ophthalmology / Corneal Ophthalmology

Ophthalmology / Glaucoma Service

Ophthalmology / Neuro Ophthalmology

Ophthalmology / Paediatric

Orthopaedics

Dermatology

Pathology / Pathology Clinical Services

Paediatrics / Allergy and Immunology

Paediatrics / Children's Primary Care

Paediatrics / Endocrinology

Paediatrics / Gastroenterology, Hepatology and Nutrition

Paediatrics / Haematology - Oncology

Paediatrics / Infectious Diseases

Paediatrics / Paediatric Blood and Marrow Transplantation

Paediatrics / Pulmonary

Paediatrics / Rheumatology

Psychiatry and Behavioural Sciences / Adult Psychiatry

Psychiatry and Behavioural Sciences / Geriatric Psychiatry

Psychiatry and Behavioural Sciences / Child & Adolescent Psychiatry
Psychiatry and Behavioural Sciences / Addiction Psychiatry

Radiation Oncology

Radiology / Cardiac and Thoracic Imaging

Radiology / Mammography

Radiology / Neuroradiology

Radiology / Nuclear Medicine

Surgery / Cardiovascular and Thoracic Surgery

Surgery / Neurosurgery

Surgery / Otolaryngology-Head and Neck Surgery

Surgery / Paediatric General Surgery

Surgery / Plastic, Maxillofacial and Oral Surgery

Surgery / Surgical Oncology

Surgery / Urology

Surgery / Vascular Surgery

Surgery / Bariatric Surgery


 NHS & The Mayo Model: What if!

NHS Hospitals: Still Needed?

A closer look:

©Am Ang Zhang 2005

I wrote a while back about: ?A National Car Service.

NCS (National Car Service)?

Imagine a society where you take your beloved car to a Private Garage for some repair work and it turns out that the Private Garage did a very bad job and did serious damage to the engine, transmission and other unknown bits. Now imagine that there is a State run National Car Service that will put right everything and at no cost to you and no charge to the Private Garage that did the damage in the first place.

Would it not be wonderful?

The Telegraph:

Doctors continued operating on Kelly McLure, 31, after she suffered her cardiac arrest at the private Belvedere Hospital, in Kent, it was claimed.

Southwark Coroner’s Court was told paramedics were kept waiting for 45 minutes despite insisting on taking her straight to A&E.

Instead Dr Edward Latimer-Sayer, her surgeon and Dr Ahmed el Sayed Moustafa, the anaesthetist, continued with the routine nose and chin procedure after stabilising her.

Mrs McLure, known as Kat, suffered brain damage during the operation on November 22, 2005. She died six months later.

The Herald Scotland:

In 2002, Denise checked into a private clinic for what should have been a straightforward procedure to remove fat from her stomach. Afterwards she spent six weeks in intensive care (in NHS hospital), the surgeon having repeatedly punctured her bowel.

In the next seven years (again under the NHS) she endured more than 20 operations to repair the damage before succumbing to meningitis in 2009. She was 43.                             

                                                                                                  

Read all about it here>>>>

The surgery was performed by Dr Gustaf Aniansson (from Sweden), at the private Broughton ParkHospital near Preston, Lancashire. Dr Gustaf Aniansson took himself off the GMC register so that he could not be struck off and it was believed he continues to practice in Sweden.

In the new world order of our NHS, private provider (AQW)for commercial reasons need not let the public have access to information about their activities etc, and even the doctors they provide. As they say, be very afraid.

Dr Phil Yerboot is very direct:
In  Boob Jobs and One Night Stands

The PIP breast implant scandal rumbles on with a seeming stand-off between the Minister of Health and the principal users of these implants, Transform and The Harley Medical Group.

Transform has nothing on its website (that I could find) to inform patients about the PIP implant issue. The Harley Medical Group does so here, but feels that this is a problem that it wishes to lay on the MRHA for licensing the PIP implants. Both are interesting organisations, with peripheral clinics where early consultations with Nurse specialists are followed by surgery at a few central hospitals. The Transform group lists its Surgical staff here. I could not find similar information on the Harley Group website, though they do state that their surgeons are on the UK Specialist Register as Plastic Surgeons, this may well be because of recognition in another EU state. Several on the Transform website seem to have only Specialist Training as General Surgeons.  The Transform Surgeons have mostly trained overseas and are not rooted in the UK medical culture in the same way as most BAAPS members, most of whom have past or present substantive NHS Consultant posts.               

It is my understanding that if there is just one fully registered surgeon prepared to be clinically responsible, ANYTHING GOES.  For all we know, it could be someone from Sweden and that someone could at short notice resign from the GMC.

Perhaps SoS will have to set up an NBS, National Breast Service soon.

Right now, we still have the NHS, the National Health Service. It is free even if the damage was done by a private doctor and treatment will be for as long as it takes. The private doctor will not be charged any fee and some even continues to practice here or in other countries.

Soon, such a National Health Service may not be there! That is how the government is going to save money.

NHS Reform & Hospital Consultants ...

Private & NHS: Choice & Consultants

NHS Reform: The Plot Against Consultants!