David Cameron & Mental Illness: Panama & Professionals!

I am back after traversing the Panama Canal.

Panama Canal © Am Ang Zhang 2011

It is a common practice for politicians to ignore professional advice. Sometimes they might get away with it; sometimes it led to failure, gross failure as in the case of the French attempt at building the Panama Canal.

Can we really learn anything from such a colossal failure?

Panama Canal © Am Ang Zhang 2011

Most people probably know about the French failure to build the Panama Canal. Many thought that this was due to yellow fever and malaria which were diseases thought to be due to some toxic fume from exposed soil.

Extracted from the Official Website: Panama Canal Authority /French Construction

The engineer was no match for a career politician:

“There was no question that a sea level canal was the correct type of canal to build and no question at all that Panama was the best and only place to build it. Any problems – and, of course, there would be some - would resolve themselves, as they had at Suez.”

                                                

                                                                                       

Panama Canal © Am Ang Zhang 2011

“The resolution passed with 74 in favour and 8 opposed. The ‘no’ votes included de Lépinay and Alexandre Gustave Eiffel. Thirty-eight Committee members were absent and 16, including Ammen and Menocal, abstained. The predominantly French ‘yea’ votes did not include any of the five delegates from the French Society of Engineers. Of the 74 voting in favor, only 19 were engineers and of those, only one, Pedro Sosa of Panama, had ever been in Central America.”

The French failed in a spectacular fashion.

Cost to the French: $287 Million (1893 dollars) or $6.8 Billion (2007 dollars)

Many reasons can be stated for the French failure, but it seems clear that the principal reason was de Lesseps’ stubbornness in insisting on and sticking to the sea level plan.  But others were at fault also for not opposing him, arguing with him and encouraging him to change his mind.  His own charisma turned out to be his enemy.  People believed in him beyond reason.

Could any of us learn anything from this experience?

Panama Canal © Am Ang Zhang 2011

Dr Grumble went VIRAL in  A reader writes

“If we all take the view that Lansley's bill is unstoppable then it will be. The arguments for privatisation of healthcare just do not stack up. The emperor has no clothes. If enough people were to point that out this bill would drop dead in its tracks.”

So what about David Cameron and Mental Illness?

No, I am not suggesting anything at all although you might think so if you roll back and listen to what he said in 2009.

"…….There will be no more of those pointless reorganisations that aim for change but instead bring chaos……."

No, it is about Bupa:

The Guardian: Bupa cuts off mental illness payments after two years

Now will Monitor be doing anything about that? I doubt.

Why: Dr David Bennett may be too busy counting all his money!

But hang on, the NHS is really safe in David Cameron’s hands as there needs to be hospitals taking back patients that Bupa does not treat.

Told you: The NHS is not going to be privatised! Not all of it any way.

My guess is that NHS 111 will be. Oooops: there may be new jobs for people to call NHS 111 as £25 a go can soon mount up and it is impossible to monitor.

Oooops, did I say Monitor? Yes, Monitor may be re-launched as a QinetiQ styled company as there is so much money to be made from fining NHS Foundation Trusts. Dr David Bennett is not a medical doctor. He was with McKinsey. Perhaps he still is!!!

But, David Cameron, thanks for your faith in the NHS. And do not worry, after two years, we will be there. 

Hermione: "You pay a great deal too dear for what's given freely". -

(Act I, Scene I). The Winter’s Tale.

David Cameron & The NHS: Abandon! Abandon! Abandon!

Panama Canal: Diseases & Failures.

NHS: Can we learn from Obama?

Anorexia Nervosa & Safety Net: The NHS.

The Cockroach Catcher: NHS & McKinsey: Barracuda & Nye Bevan Curse

Others:

Obama Health: Health Insurance Reform

NHS 2011: Ownership & Integration or A New Brand?

NHS 2013: Please Don't Cry!

It is a common practice for politicians to ignore professional advice. Sometimes they might get away with it; sometimes it led to failure, gross failure as in the case of the French attempt at building the Panama Canal.

More:  Learning from Panama History: Politician vs Professionals

So, please don’t cry!

© Am Ang Zhang 2012

Lith Style Photographic work.

Latest from Allyson Pollock.

No Public Accountability:

………As for public accountability, there is none. Commercial contracts are redacted so that crucial financial information is not in the public domain. Government departments and companies refuse to release the necessary information on the grounds of commercial confidentiality and allow companies to sequester their profits in offshore tax havens. NHS staff transferred from the public to the private sector see their wages and benefits eroded. But all this is nothing compared with what is in store for patients.

In the new world it will no longer be possible to measure coverage or fairness. Former NHS hospitals, free to generate half their income from private patients, will dedicate their staff and facilities to that end, making it impossible to monitor what is public and what people are paying for.

Market Concept:

The belief that markets distribute resources more efficiently is the basis of regional economic agreements like the European Union as well as policies imposed on developing countries by the World Bank and IMF. Britain led the way, starting with gas, water, telecoms and railways. By 2004, the whole of Whitehall was committed to putting corporations in control of what had formerly been publicly administered services. This year it is the turn of the NHS.

Loss of public control means higher cost and fewer services, as we have learned from the toxic record of the US corporations which are now part of England's new healthcare market and helped design it. Billing, invoicing, marketing and advertising will add between 30% and 50% to costs compared with 6% in the former NHS bureaucracy.

Fraudulent Billing & Embezzlement:

Patient charges will become commonplace. Fraudulent billing and embezzlement will become endemic. Take HCA, one of the largest and most profitable US chains and controlled by private equity firms including Mitt Romney's Bain Capital. In 2006 HCA International described its first joint venture with the NHS, the PFI University College London Hospital (UCLH), as "the establishment of Harley Street at UCLH".

HCA-UCLH provides cancer treatment to those who can pay from the 15th floor of the hospital. But currently some of HCA's American hospitals are under investigation for refusing care and performing unnecessary investigations and treatment, including cardiac surgery. A decade ago it paid the federal government $1.7bn to settle fraud charges, while former chief executive Rick Scott – now the Republican governor of Florida – managed to avoid prosecution.

This is the pattern elsewhere. Unitedhealth, which is currently providing services to the NHS, paid hundreds of millions of dollars in settlement of mischarging allegations in the US; Medtronic paid $23.5m for paying illegal kickbacks to physicians to induce them to implant the company's pacemakers and defibrillators; GlaxoSmithKline and Abbott paid $4.5bn in fines relating to improper marketing and coercion of physicians to prescribe antidepressants and antidementia drugs respectively. Novartis, AstraZeneca, Pfizer and Eli Lilly have all paid large fines for regulatory breaches.

The list is not exhaustive. In the absence of information and strong laws to prevent corporate crime and tax evasion, England's business-friendly environment is rapidly becoming a banana republic. Franchising is not an easy win for the public. It is a profit opportunity for big business in whose interests healthcare is increasingly being run both at home and abroad.

On PFI: 

Strangled by PFI debts and funding cuts, NHS foundation trusts compound their problems by entering into joint ventures. The great NHS divestiture, which began in 1990 with the introduction of the internal market and accelerated under the PFI programme, now takes the form of franchising, management buyout and corporate takeovers of our public hospitals. 

Virgin has been awarded £630m to provide services to vulnerable people and children in Surrey and Devon. 

Circle has been given the franchise for NHS hospital Hinchingbrooke and is now struggling to contain its debts. London teaching hospitals are merging to give them greater leverage for borrowing and cuts.

First Emperor, Animal Farm & Allyson Pollock

"Since it was Pollock's views on the PFI that so upset its proponents, it is worth summarising them briefly. Costs are now intrinsically higher, because of capital borrowing at higher rates than those available to government, because of cash hungry consultancies and the vast transactional and monitoring costs of countless contracts, and because—for the first time on a large scale in the NHS—commercial profits must be made. To accommodate all these new costs clinical services have been scaled down, while matching assumptions about increased efficiency are only variably delivered. All this, along with the rigidity of a trust based strategy for building hospitals and the locking in effect of contracts fixed for decades, seems to Pollock and many others at best a bad bargain, at worst a naive betrayal that opens the NHS to piecemeal destruction and the eventual abandonment of its founding principles. And all over the country PFIs—greedy, noisy, alien cuckoos in the NHS nest—gobble up its finances and will do so for the next 30 years.”

Next 30 years!

Metronet

Ernst & Young was paid £33m for handling the administration of Metronet, the company which left the maintenance of two thirds of the London Underground in limbo when it collapsed.

The failure cost the taxpayer up to £410m, the National Audit Office also disclosed in a highly-critical report released today.

'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,' the NAO said.

The government had to shell out the £1.7bn to cover Metronet's debt obligations to its lenders, which would have been paid back over the course of the 30-year contract if the company had not collapsed.

E &Y paid £33m for Metronet administration

Professionals vs Politicians: Panama Canal & NHS

It looks as though the NHS Bill will become law as Spring arrives in England. This is despite genuine concerns expressed by most of the doctors in general practice and in hospitals up and down the country. 

Anyone reading about the doctors objections should realise that contrary to spins by the government, doctors stand to gain the most from the reforms.

So we could in the years to come face our grand children and say, we did try to preserve it but like the French Government of the Panama Canal time, they did not listen.

It took some years for the true reason for the French Politicians refusal to listen to the Professionals: Corruption. But that is a different story.

I think I know what is going to happen in a few hours. In a few hours' time, the government is going to lose some of the best valued doctors in the civilised world. In a few hours' time, the good will that kept our NHS going for many years would be gone. In a few hours' time, medicine in this country will..................

Panama Lesson:

It is a common practice for politicians to ignore professional advice. Sometimes they might get away with it; sometimes it led to failure, gross failure as in the case of the French attempt at building the Panama Canal.

Can we really learn anything from such a colossal failure?

Panama Canal © 2011 Am Ang Zhang

Most people probably know about the French failure to build the Panama Canal. Many thought that this was due to yellow fever and malaria which were diseases thought to be due to some toxic fume from exposed soil.

Extracted from the Official Website: Panama Canal Authority /French Construction

In 1879, Ferdinand Marie de Lesseps, with the success he had with the construction of the Suez Canal in Egypt just ten years earlier, proposed a sea level canal through Panama. He was no engineer but a career politician and he rejected outright what the chief engineer for the French Department of Bridges and Highways, Baron Godin de Lépinay proposed, a lock canal.

The engineer was no match for a career politician:

“There was no question that a sea level canal was the correct type of canal to build and no question at all that Panama was the best and only place to build it. Any problems – and, of course, there would be some - would resolve themselves, as they had at Suez.”

“The resolution passed with 74 in favour and 8 opposed. The ‘no’ votes included de Lépinay and Alexandre Gustave Eiffel. Thirty-eight Committee members were absent and 16, including Ammen and Menocal, abstained. The predominantly French ‘yea’ votes did not include any of the five delegates from the French Society of Engineers. Of the 74 voting in favor, only 19 were engineers and of those, only one, Pedro Sosa of Panama, had ever been in Central America.”

The French failed in a spectacular fashion.

They did not listen to the Medical Profession:

Diseases like yellow fever and malaria played their part as a sea level canal involves a good deal more digging.

The discovery of yellow fever being carried by mosquito must be credited to one Cuban physician:Carlos J. Finlay.

For twenty years of his professional life, he stood at the center of a vigorously debated medical controversy: the etiology of yellow fever. Finlay believed that it was waterborne and carried by common mosquitoes: Stegomyia fasciata.

Finlay's advice and experiences proved invaluable to the United States Army Yellow Fever Commission. When the Commission decided to test the mosquito theory, Finlay provided the mosquitoes andWalter Reed of the Commission wrote triumphantly after the success of the experiments of inducing yellow fever by mosquito bites, ‘The case is a beautiful one, and will be seen by the Board of Havana Experts, to-day, all of whom, except Finlay, consider the theory a wild one!’ The US experiments vindicated Finlay's two-decade-long struggle.


Reed acknowledged that ‘it was Finlay's theory, & he deserves much for having suggested it.’

William Crawford Gorgas wrote of Finlay:

"His reasoning for selecting the Stegomyia as the bearer of yellow fever is the best piece of logical reasoning that can be found in medicine anywhere."

The discovery by Major Ronald Ross that malaria was transmitted by mosquitoes (Anopheles)had tremendous impact on the Panama Canal. 

Crude oil was used on stagnant water to prevent the mosquito proliferation and nets were used to protect workers. Quinine was extensively used to treat malaria. A lock canal was eventually built by the Americans. 

Some say that a large part of the eventual success on the part of the United States in building a canal at Panama came from avoiding the mistakes of the French. Knowing the causes of diseases must have helped.

David McCullough in his book "The Path Between the Seas" wrote: "The fifty miles between the oceans were among the hardest ever won by human effort and ingenuity, and no statistics on tonnage or tolls can begin to convey the grandeur of what was accomplished………It is a work of civilization."

Cost to the French: $287 Million (1893 dollars) or $6.8 Billion (2007 dollars)

As we stand on the verge of possibly irreversible damage to one of the hallmarks of what it is to live in a civilised country, it is time to rise up and defend an institution that was built by our parents and our grandparents and which we owe to our children and our grandchildren to maintain and to pass on to them and to their guardianship.    Prof John Ashton

Abolish NHS: Allyson Pollock BMJ 2011

Panama Canal: Medicine & Human Endeavour

We learn little or nothing from our successes. They mainly confirm our mistakes, while our failures, on the other hand, are priceless experiences in that they not only open up the way to a deeper truth, but force us to change our views and methods. 

C.G. Jung

Jung was referring specifically to psychotherapy with those words. But why should this principle not be applicable to politicians?

  

Panama Canal © 2008 Am Ang Zhang

Most people probably know about the French failure to build the Panama Canal. Many thought that this was due to yellow fever and malaria which were diseases thought to be due to some toxic fume from exposed soil.

In 1879, Ferdinand Marie de Lesseps, with the success he had with the construction of the Suez Canal in Egypt just ten years earlier, proposed a sea level canal through Panama. He was no engineer but a career politician and he rejected outright what the chief engineer for the French Department of Bridges and Highways, Baron Godin de Lépinay proposed, a lock canal.

The engineer was no match for a career politician:


“There was no question that a sea level canal was the correct type of canal to build and no question at all that Panama was the best and only place to build it. Any problems – and, of course, there would be some - would resolve themselves, as they had at Suez.”


“The resolution passed with 74 in favor and 8 opposed. The ‘no’ votes included de Lépinay and Alexandre Gustave Eiffel. Thirty-eight Committee members were absent and 16, including Ammen and Menocal, abstained. The predominantly French ‘yea’ votes did not include any of the five delegates from the French Society of Engineers. Of the 74 voting in favor, only 19 were engineers and of those, only one, Pedro Sosa of Panama, had ever been in Central America.”


The French failed in a spectacular fashion.


Diseases like yellow fever and malaria played their part as a sea level canal involves a good deal more digging.


The discovery of yellow fever being carried by mosquito must be credited to one Cuban physician:Carlos J. Finlay.


For twenty years of his professional life, he stood at the center of a vigorously debated medical controversy: the etiology of yellow fever. Finlay believed that it was waterborne and carried by common mosquitoes: Stegomyia fasciata.


Finlay's advice and experiences proved invaluable to the United States Army Yellow Fever Commission. When the Commission decided to test the mosquito theory, Finlay provided the mosquitoes andWalter Reed of the Commission wrote triumphantly after the success of the experiments of inducing yellow fever by mosquito bites, ‘The case is a beautiful one, and will be seen by the Board of Havana Experts, to-day, all of whom, except Finlay, consider the theory a wild one!’ The US experiments vindicated Finlay's two-decade-long struggle.


Reed acknowledged that ‘it was Finlay's theory, & he deserves much for having suggested it.’


William Crawford Gorgas wrote of Finlay:


"His reasoning for selecting the Stegomyia as the bearer of yellow fever is the best piece of logical reasoning that can be found in medicine anywhere."

The discovery by Major Ronald Ross that malaria was transmitted by mosquitoes (Anopheles)had tremendous impact on the Panama Canal. 

Crude oil was used on stagnant water to prevent the mosquito proliferation and nets were used to protect workers. Quinine was extensively used to treat malaria. A lock canal was eventually built by the Americans. 

Some say that a large part of the eventual success on the part of the United States in building a canal at Panama came from avoiding the mistakes of the French. Knowing the causes of diseases must have helped.

David McCullough in his book "The Path Between the Seas" wrote: "The fifty miles between the oceans were among the hardest ever won by human effort and ingenuity, and no statistics on tonnage or tolls can begin to convey the grandeur of what was accomplished………It is a work of civilization."

Links

Interesting Data
Smithsonian Institute
Web Cam

Panama:

Panama Canal: Diseases & Failures.

Loquat, Winter Melon & Sapote

Coffee in Panama – Faking Is Not All Bad

Learning from Panama History: Politician vs Professionals

The Cockroach Catcher on Amazon Kindle UK, Amazon Kindle US

Gesha Coffee & Myrtilles Sauvage

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 Gesha 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.

© 2010 Am Ang Zhang

Panama:

Panama Canal: Diseases & Failures.

Loquat, Winter Melon & Sapote

Coffee in Panama – Faking Is Not All Bad

Learning from Panama History: Politician vs Professionals

The Cockroach Catcher on Amazon Kindle UK, Amazon Kindle US