Sunday, October 31, 2010

NHS: Perfectly Safe?

Is the NHS safe? Of course! But at a cost………..

There is little doubt that our NHS is being privatised one way or another. See Dr Grumble.

LONDON, Sept 21, 2010

Serco said on Tuesday it had won a 300 million pounds ($468.5 million) contract to provide pathological services to London's King's College Hospital NHS Trust.
Under the agreement, Kings College will join the existing joint venture between Serco and Guy's and St Thomas' NHS Trust, creating the UK's largest provider of pathological services.
The combined service will conduct more than 10 million individual tests a year for customers in the NHS and wider health sector, the support services firm said in a statement.
Serco said the deal would contribute about 110 million pounds to its revenue over the 10 years of the agreement.

Today Serco hit the news:

Serco is to be ordered to explain to the Government why it took the highly unusual step of writing to its leading suppliers to demand that they pay a blanket 2.5pc "cash rebate" on their work this year or risk losing future contracts.

Francis Maude, the Cabinet Office minister leading the Government's efficiency drive, is furious and has ordered Serco to account for its actions. "We unequivocally disagree with and are highly critical of the approach taken by Serco," said a Cabinet Office spokesman. "Francis Maude will be calling them in to explain themselves."

Do governments learn? Perhaps not:

National Express loses East Coast line
National Express is handing the East Coast rail franchise back to the Government after admitting that funding for the distressed London-to-Edinburgh network will run out towards the end of the year.

After months of attempts to renegotiate the £1.4bn contract, the company admitted yesterday that its NXEC subsidiary – which holds the franchise – has slipped £20m into the red this year and is rapidly burning through its resources. Richard Bowker, the group chief executive, will step down at the end of August.
A publicly owned company will take over East Coast operations when NXEC hits the buffers, Lord Adonis, the Secretary of State for Transport, announced yesterday. The process of finding a replacement operator from the private sector will then start at the end of 2010.

The Guardian: Metronet
The most shocking aspect of the Metronet scandal is that not enough people are sufficiently shocked. The news that the government is bailing out Transport for London to the tune of £2bn as a result of the debacle was barely covered in the national press and was mentioned on the Today programme long before the peak 8-8.30am period.

Yes, of course, it's complicated and rather esoteric, but the pure bones of this scandal are quite simple and opposition politicians, the newspapers and, indeed, the public, should be making much more of a fuss about the waste of several billion pounds because of new Labour's love affair with the private finance initiative.

In July 2007, Metronet BCV and Metronet SSL, two companies set up to modernise London Underground’s infrastructure, went into administration when they became unable to meet their spending obligations. Their failure resulted in London Underground Limited (London Underground) having to buy 95 per cent of Metronet’s outstanding debt obligations from its private sector lenders in February 2008 rather than repaying this debt over the 30 years of the contract. The Department for Transport (DfT) made £1.7 billion of grant available to help London Underground do so.

The taxpayer has borne some of the direct costs of Metronet’s failure, including the unexpected upfront payment of £1.7bn. We estimate there has been a direct loss to the taxpayer of between £170m and £410m.

Ernst & Young was paid £33m for handling the administration of Metronet.

Are we aware how much those working for Metronet were earning?

More skilled labourers, such as signal technicians, cost up to £79.19 an hour, or £144,000 a year, based on a 35-hour week, although not all of this is passed on to the individual employee.

The "charge-out rates" - paid by Transport for London from fares and taxpayer subsidy - were agreed by London Underground in August last year after Metronet went into administration and remain in force. The company continues to carry out much of its track renewal and repair programme under the control of the administrator.                                               

……… Tony Travers of the London School of Economics said: "By the end of next year, £10billion will have been spent on the PPP, overwhelmingly from the public purse, and what the hell can we see for it - a few tiles at stations, a bit of re-railing. It's a terrible catalogue of failure."                    More>>>>>

18 April 2009

So last month the Treasury was forced to establish a unit whose remit replaces the "private" in PFI with "public". For long-standing critics of PFI, this bailout of £13bn worth of projects is the nadir of Brown's grand plan to protect the taxpayer from financial risk. Instead, taxpayers' money is being used by the government to subsidise the operation of many of the UK's largest PFI schemes.

"The financial crisis has highlighted a basic truth - that private finance is only a way to borrow money that will have to be repaid by the taxpayer sooner or later," says Stephen Glaister, professor of transport and infrastructure at Imperial College London. "Risk transfer has proved difficult or impossible, so the taxpayer has ended up bailing out the commercial failures of the PFI companies."

A dishonest system

He said: "It is now very clear that PFI has largely collapsed as a mechanism for funding infrastructure. This was a dishonest system of accounting, designed to hide taxpayers' liabilities. If the private sector cannot now come up with the money, and is unwilling to take the risks, we need to move to a simpler, more honest system of public investment for public projects."

……….The taxpayer, through the infrastructure finance unit - dubbed the "Treasury bank" - now lends directly to PFI projects and also to the EIB and government-owned banks. This money is then lent on by these institutions, at an increased margin, to the PFI consortiums. The consortiums build the project and charge the taxpayer a fee for the next 25 years for the provision of goods and services. In the case of one of the largest PFI schemes, the £5.5bn M25 widening scheme, banks are charging the PFI consortiums 2.5%, or 3.5% over the inter-bank lending rate. This is up to five times the rate payable before the credit crunch.

Now we know!!!

There are currently about 110 PFI projects in the pipeline, worth an estimated £13bn - all in line for a handout from the Treasury bank. This includes £3.5bn of waste treatment and environmental projects, £3.1bn of transport schemes and £2.4bn of schools projects. Among the largest of these are the M25 widening, Manchester Waste, the North Bristol NHS Trust Southmead hospital redevelopment, Bradford Building Schools for the Future, Victoria hospital Fife, North Tyneside housing and Croydon & Lewisham street lighting.

The Manchester waste scheme was rescued this week thanks to a £120m injection of senior debt from the Treasury bank and £40m of cash from nine local authorities in the Manchester area. The Department for Environment, Food and Rural Affairs also put in £125m.

In the end I am sure the NHS is safe: but at what cost to the tax payers!!!

NHS Posts:

Enemy Of The People: NHS, Internal Market & Safety Net

Local Authorities: NHS Reform & Iceland

NHS: Changes Or A Conspiracy Against The Public Interest

Wednesday, October 27, 2010

Vacation: Bird Photography

© 2010 Am Ang Zhang

Small birds present a great challenge. Focusing is often a problem because surrounding leaves and branches will defeat even the best autofocus system of the modern camera. This photo was taken with an older Nikon DSLR using an old manual 180mm/2.8 ED lens that is effectively 250mm. This is just about the minimum focal length one needs for this kind of photography. Manual focusing overcomes the problem mentioned earlier, and it is often useful to take multiple shots, changing the focusing minimally for each shot.

The Nikon 180/2.8 ED is arguably the best manual lens Nikon ever made!

The Cockroach Catcher on Amazon Kindle UKAmazon Kindle US

Vacation: Clouds & Heron

 It does not have to be sun and beach all the time:

© 2010 Am Ang Zhang

© 2010 Am Ang Zhang


Sunday, October 24, 2010

Quorum Sensing: Cholera

24 Oct 2010 22:38:55 GMT
Source: Reuters
A multinational medical response has slowed deaths in a Haitian cholera epidemic that has killed more than 250 people so far, but the outbreak is likely to widen, a senior U.N. official said on Sunday.

"We must gear up for a serious epidemic, even though we hope it won't happen," Nigel Fisher, the United Nations humanitarian coordinator in Haiti, told Reuters.

More than 3,000 cholera cases have been reported so far in the poor, earthquake-hit Caribbean nation, which is experiencing its second humanitarian crisis since a catastrophic earthquake on Jan. 12.

Bonnie Bassler of Princeton in her lecture:
Vibrio cholerae, like many other bacteria, uses quorum sensing to synchronize gene expression on a population-wide level. Upon infection of its human host, V. cholerae immediately initiates expression of virulence genes and causes an acute infection. This immediate use of quorum sensing stands in stark contrast to bacterial pathogens that cause persistent infections and only initiate virulence factor expression after reaching high-cell-density in the host.

I first covered Quorum Sensing in:
“Virulent bacteria do not want to begin secreting toxins too soon, or the host's immune system will quickly eliminate the nascent infection. Instead, Bassler explained, using quorum sensing, the bacteria count themselves and when they reach a sufficiently high number, they all launch their attack simultaneously. This way, the bacteria are more likely to overpower the immune system….

Then I covered Cholera in:
“Few afflictions have attracted as much attention and impacted on as many societal and biomedical areas as cholera…….The finding that cholera was due to the ingestion of contaminated water lent to the demise of the prevalent ‘miasmatic theory of contagion, set the platform for the ‘germ theory of disease,’ and promoted the growth of public health concerns for water purification and sanitation. More recent attention to this disease led to the notion of ‘secretory diarrhea’ and the translation of basic principles to the development of oral rehydration therapy and its ‘spin-offs’ (Gatorade and Pedilyte).
Stanley G. Schultz University of Texas Medical School
Cholera is caused by the organism Vibrio cholerae. Alert readers will note that Vibrio has caused much excitement because of the phenomenon of Quorum Sensing.

I well remember Hong Kong’s cholera epidemic in 1961 and the major cause of death was the rapid loss of fluid due to a specific secretive action of the cholera germ. Patients could die in a matter of hours. The medical profession has long been of the strong belief that Intravenous Fluid (IV Fluid) is the only answer. In that situation, the patient is in shock and to find a vein means a cut-down: literally cutting through the skin to find one. It is a messy business as the patient is violently pumping out fluid in the most horrendous fashion.

Johns Hopkins established a centre in Calcutta in the 1960s to study precisely a better way to replenish the fluid. IV fluids were expensive to manufacture and required medical personnel to administer. Their Clinicians sought help from basic physiology and carried out the first carefully controlled study which showed that intestinal perfusion of cholera patients with saline solutions containing glucose strikingly reduced fluid loss. Put simply, the patients could just drink a glucose and salt solution and the glucose would allow the salt to be piggy backed and absorbed, thus sparing the need to use IV fluids.

“……These compelling findings, however, did not convince the medical establishment, who remained skeptical that such a simple therapy could substitute for traditional intravenous fluid replacement in severely stricken patients under epidemic conditions in the field.”
The World had to wait for a war, this time in Pakistan, when Bangladesh fought for its independence in 1971 and 9 millionrefugees poured into India and with them cholera. When IV saline treatment was exhausted, Dr Mahalanabis, who had worked at the Johns Hopkins Centre in Calcutta, took the gamble and decided to prescribe a simple solution of glucose and salt in the right proportion for the friends and relatives of the cholera patients, thus saving at least 3.5 million people. Since that time it was estimated that such a simple and cheap remedy saved at least 40 million more lives.
No wonder The Lancet hailed the development of oral re-hydration therapy (ORT) as "the most important medical discovery of the 20th century".
The scientists at Johns Hopkins and Dr Mahalanabis received the Pollin Prize of $100,000 in 2002.


Cockroaches & Superbugs


Saturday, October 23, 2010

Trans Fat: When Zero is Not Zero

That the consumption of trans fats increases the risk of coronary heart disease by raising levels of "bad" LDL cholesterol and lowering levels of "good" HDL cholesterol is well known, but the strange thing is that almost all packaged food you look at nowadays are labelled: ZERO TRANS FAT.

How is that achieved?

On July 11, 2003, the Food and Drug Administration (FDA) issued a regulation requiring manufacturers to list trans fat on the Nutrition Facts panel of foods and some dietary supplements. The new labelling rule became mandatory across the board, even for companies that petitioned for extensions, on January 1, 2008. However, unlike in many other countries, trans fat levels of less than 0.5 grams per serving can be listed as 0 grams trans fat on the food label.

Zero is not Zero!!!

Saturday, October 16, 2010

Myrtilles Sauvage & Geisha Coffee

Years ago we spent a late autumn holiday in the French Alps. It was a wonderful time to be going on hikes in the higher altitudes. The small Alpine flowers were just in full blossom, catching the last bit of sunlight before the snow came. For those keen on photography, late autumn is one of the best times to be in the Alps.

We were at around 1500 to 1800 meters and with the help of clearly marked trails we were soon exploring walks on our own. 

On one of these walks, we noticed a family ahead of us, and now and again the children would bend down to pick something to put in their mouths.  Then we saw them: tiny blue coloured berries hiding under leaves, small leaves that varied in colour from green to reddish brown. We caught up with the family in front and asked them what these berries were.  “Myrtilles Sauvage,” they replied.  These were of course wild blueberries. They were delicious.  Soon the late afternoon mist came in and we headed back to our hotel.

Myrtilles Sauvage jam remained the family’s favourite breakfast ritual: for toast or for yoghurt.

Now, I am sitting at my holiday home and watch the same mist come in most afternoons. No, there are no wild blueberries here.  Instead there is excellent coffee.

© 2010 Am Ang Zhang
Plants have to struggle with nature in order to survive. Mist and humid conditions favour fungal growth, and so plants produce chemicals to combat them, most of the time successfully.  Myrtilles Sauvage needs to do this especially in the Alps. So do coffee plants, especially if the conditions so require. It is perhaps not that well known that cultivated blueberries often produce about one tenth of the antioxidants of the wild ones. Why waste the effort if there is no need to do so?

In fact, the coffee at the higher altitudes of around 1350-1800 meters develop the best flavour.  By comparison, some higher yield varieties do not produce as much antioxidants nor as much flavour.  The growers use fungicides to increase the yield.

© 2010 Am Ang Zhang

A few years ago, extremely wet conditions caused a serious reduction in coffee production in Central America. One variety of coffee called Geisha can cope with the moist conditions of the descending mist from the volcano in the Baru region of Panama. The average yield is lower, but the coffee this produces has been winning national and international competitions and fetching high prices in international auctions.

Recent research showed that for coffee drinkers, coffee itself supplies the highest level of antioxidants. Antioxidants disappear fairly quickly depending on exposure of the beans and ground coffee to oxygen.
American Chemical Society

We should be very thankful that these Ngobe Indian children will continue to carry on the long tradition of picking coffee in Panama.