Heading into autumn - what next?

[bramling]

It's been great the last few weeks with the media being distracted with other matters. Now however the usual suspects are back screaming and the Ferguson is being wheeled out. I will be interested to see how Javid's teleconference plays out tonight, he is certainly different to Hancock. Kwarteng certainly came out swinging this morning and Playbook seemed to think any fresh restrictions are a way off...

Trouble is with this government that means nothing. Didn't we have Gove intimating one day that masks weren't going to happen, then it got announced the very next day.

Having said that, I don't sense a "mood" for more restrictions at the moment, and given how more and more people don't seem to be wearing them this includes masks.

 

[greyman42]

Definitely bring back the masks if it means places stay open and nobody has to go back on furlough. Pubs/coffee shops/cinemas and the like may lose a little trade here and there, however 99% of those I've asked say there's nothing worse than driving/walking past shut establishments during normal hours.

They have never got rid of masks in Scotland and it has not made one bit of difference.

 

[bramling]

They have never got rid of masks in Scotland and it has not made one bit of difference.

Absolutely. People seem to be latching on to measures without a shred of evidence they're actually effective. Surely it's abundantly obvious by now that masks are merely a comfort blanket?

 

[DustyBin]

Sounds great but what does it actually mean? What level of fatalities can we tolerate as a price for 'living with Covid'? The level of tolerance is bound to vary significantly from person to person.

As you’ve alluded to I think it’s difficult to put an arbitrary figure on it. As a rough “guide” for want of a better word I think we need to look at other nasty endemic illnesses, and also excess deaths. We also need to consider the average age of a covid death; at 84 it’s beyond average life expectancy. That’s not to say these people don’t matter, of course they do (and @35B has previously raised the issue of life years lost), but this is certainly a consideration within medical settings. Should the same apply to covid restrictions? There’s certainly an argument to say it should.

There’s no easy answer, however as you asked the question my honest answer is that I don’t believe the current level of fatalities warrants government intervention. I think we’re still stuck with the mentality that covid deaths are preventable and therefore unacceptable, which in turn stems from the virus being new and a misguided belief (from some quarters) that it will “go away”

And upon whether we consider unvaccinated adult deaths as part of such a tolerance. Respectfully, I don’t think we do — national policy on restrictions cannot be driven by the outcomes of this very small group.

As I’ve said before I can’t agree with you on this; given the toxicity of the whole debate I think it’s dangerous to send the message that unvaccinated people don’t matter. I actually know where you’re coming from but I think we need to be careful. Plus I think the vast majority of unvaccinated people are also anti-restriction anyway.

 

[duncanp]

According to the Daily Mail, backbench Conservative MPs are pushing back against the demands for further restrictions, saying that we could have an endless cycle of imposing restrictions in the autumn and lifting them in the spring, for the foreseeable future.

They are also saying that we cannot allow our freedom to go about our daily lives to be compromised simply because the NHS cannot cope.

I agree with both these points.

If the NHS is "broken" we need to fix it. This may involve extra money, but it is essential that there is a plan put in place to make sure that the extra money is spent on improving patient care.

Backbenchers today hit back at the NHS demands, claiming that U-turning on freedoms could result in an endless cycle of lockdowns every year. Health and Social Care Committee member Paul Bristow slammed NHS bosses for trying to 'bounce Government into restrictions'. Steve Baker said: 'We cannot allow the liberties of the people of this country to be a tool of NHS capacity management.'

This article from the I newspaper illustrates some of the bureaucracy within the NHS, with organisations such as NHS England, NHS Employers, NHS Providers and NHS Confederation, no doubt all with their own admin staff paid for from the public purse, and all with their own agendas.

How can you have a situation where "NHS England" had no prior warning that "NHS Confederation" was going to call for Plan B to be implemented?

What really needs to happen is that there should be one body in charge, namely "NHS England" and that the government agrees with NHS England a set of metrics that will be reviewed continuously, with criteria agreed for when each measure under Plan B will be implemented, and just as importantly when each measure will be lifted.

As a former Blair aide, Matthew Taylor knows how to use the NHS brand to push for Covid Plan B

Just as former NHS England CEO Simon Stevens did, Taylor knows how to work within Whitehall

inews.co.uk

The political background of Matthew Taylor means he knows what he’s doing with Covid Plan B push​

Just as former NHS England CEO Simon Stevens did, Taylor knows how to work within Whitehall

The public can be forgiven for being confused by the alphabetti spaghetti of acronyms and organisations that has sprung up around the NHS in recent years. We have NHS England, NHS Employers, NHS Providers and NHS Confederation.

So it was perhaps no surprise that the latest broadside from Matthew Taylor, who leads the NHS Confederation, was represented in media shorthand as “NHS chief urges ministers to deploy Covid Plan B”.

Although the confederation is a membership organisation for leaders of primary and secondary healthcare, it’s very much not NHS England, which is the central, overall body in charge.

But Taylor is shrewd enough to know the power of those three little letters in his group’s name and has accordingly maxed the pressure on Boris Johnson and Sajid Javid over the key health issue that will affect millions of us this winter: just whether and when new Covid restrictions will be needed to protect the NHS.

I understand that NHS England had no prior warning of Taylor’s latest salvo, in which he called for an immediate return to mask wearing, working from home and even avoidance of indoor gatherings.

But Taylor appears to be saying things that he knows new NHS England chief Amanda Pritchard cannot. Pritchard is new to her role and prefers to do her lobbying of ministers in private.

In fact, Taylor seems to be modelling himself on Pritchard’s predecessor Sir Simon Stevens, who was a past master on the politics as much as the daily running of the NHS and wily operator on the media and among MPs.

Like Stevens, the NHS Confederation boss is a veteran of the Tony Blair No10 operation and knows how to work within Whitehall, its Chinese walls and how to stretch the envelope of his role’s limits.

Like Stevens, Taylor is similarly respected as a cross party figure (who advised Theresa May on workers rights). It’s no wonder his Plan B call has got the major attention he wanted

 

[nedchester]

According to the Daily Mail, backbench Conservative MPs are pushing back against the demands for further restrictions, saying that we could have an endless cycle of imposing restrictions in the autumn and lifting them in the spring, for the foreseeable future.

They are also saying that we cannot allow our freedom to go about our daily lives to be compromised simply because the NHS cannot cope.

I agree with both these points.

If the NHS is "broken" we need to fix it. This may involve extra money, but it is essential that there is a plan put in place to make sure that the extra money is spent on improving patient care.

He right, we cannot allow the NHS to be used to dictate freedoms in the wider community.

But there does need to be a greater investment in the NHS to allow it to cope and yes this may mean more tax being paid (which I suspect is not what the Tory backbenchers will want)

 

[adc82140]

He right, we cannot allow the NHS to be used to dictate freedoms in the wider community.

But there does need to be a greater investment in the NHS to allow it to cope and yes this may mean more tax being paid (which I suspect is not what the Tory backbenchers will want)

The NHS is an inefficient, bloated behemoth. It doesn't need more money. It needs rebuilding from the bottom up and running properly. There is too much local policy built around personalities and egos rather than best practice. There is a culture of "not my job", and "that's someone else's problem"

 

[big_rig]

Sounds like the announcement today is mostly about some new anti-viral medication, maybe more vaccines.

It will be interesting to see what the public narrative is more generally. Broadly speaking I think it was the below and it was very difficult for anybody to get traction to the comtrsey

Lockdown 1 - New scary, deadly virus
Lockdown 2 - ‘Firebreak’
Lockdown 3 - Keep numbers down while the vaccine rollout is done

The narrative for the desired lockdown 4 by the various ‘experts’/Doctors on Twitter with books to sell seems to be something like ‘the purpose of life even with vaccines is to protect the NHS first and foremost and everything else must be suspended every single year, forever.’ Covid response has only really ever been about politics and that doesn’t sound like a political measure likely to get much traction.

 

[NorthKent1989]

the NHS should not be allowed to dictate terms on how we deal with Covid or how we live our lives, I don’t see why we should keep putting our lives on hold for an organisation which clearly isn’t working anymore, they need more investment but they need to go back to do what our taxes pay them to do and act like a health service and get a grip

 

[bramling]

He right, we cannot allow the NHS to be used to dictate freedoms in the wider community.

But there does need to be a greater investment in the NHS to allow it to cope and yes this may mean more tax being paid (which I suspect is not what the Tory backbenchers will want)

Not having spent £70bn on furlough might have been a start.

This is now the problem - having essentially wasted a load of money on that (I won't go so far as to say it's *all* a waste, but it should never have lasted as long as it did), tax rises are a hard sell. Backed into a corner I think is the expression.

A year ago they might have got away with a hypothecated "NHS Covid emergency extra capacity tax" if it avoided lockdowns. I don't think they will now, as people have been sold that the vaccines are the exit route, and expect that political pledge to be honoured.

 

[Ianno87]

There is a certainly debate to be had about where we draw the line as to what is the NHS's "Day job" and what it should reasonably be able to cope with without having to affect our general freedoms (and it be given the resources it needs to deal with this).

Clearly we had to jump over that line in March 2020, and Jan 2021 lockdown was keeping us the right side of the line until vaccine rollout was sufficiently progressed.

I mean, if we were fully serious about "protecting the NHS" we're so paramount, we'd make smoking, alcohol, and private motoring all illegal.

Not having spent £70bn on furlough might have been a start.

Except you'd have just spent £70bn on Jobseekers payments instead. And then ****ed the recovery of the economy when businesses had to recruit from scratch to get going again.

 

[yorksrob]

I don't think anyone can say restrictions have had a positive impact on mental health, that much is pretty much a given, except perhaps for people who enjoy being cooped up indoors getting very little out of life.



We are now getting towards the 2-year mark. If the NHS wants us to again make fundamental changes to the way we go about our lives, they need to make a damn good case for why capacity continues to be an issue. There's already been quite a big lack of accountability in this respect, and the longer this goes on for the more difficult it is to justify.

Whilst accepting that it's never quite this simple, clearly some of the £70bn spent on furlough could have been used to uplift NHS capacity.

Instead of putting "Thank you NHS" on train destination indicators (yes GTR!) or people putting blue hearts on their social media, how about holding the NHS to account?

There certainly needed to be a marked increase in the intake of medical students last year, as well as an increase in recruitment more generally.

 

[Bantamzen]

Except you'd have just spent £70bn on Jobseekers payments instead. And then ****ed the recovery of the economy when businesses had to recruit from scratch to get going again.

If by JSA you actuality mean Universal Credit, then nope. UC doesn't pay most people anything near 80% of their previous income.

 

[Ianno87]

If by JSA you actuality mean Universal Credit, then nope. UC doesn't pay most people anything near 80% of their previous income.

You're forgetting that the 80% furlough was capped to a maximum amount - so lots of people got much less than 80% of their original salary in practice. It's still a hefty bill either way.

Furlough at least had the benefit that people could be remobilised quickly in the majority of cases (relatively few people were on Furlough long term, mainly because their business simply could not trade at all), that would not be the case with UC. Some people on this forum forget how privileged they are in this regard (whilst their own industry, quite rightly, got unprecedented amounts of government subsidy.... "I'm all right, Jack" and all that)

There certainly needed to be a marked increase in the intake of medical students last year, as well as an increase in recruitment more generally.

Who really wants to be a medical student? Long hours, generally treated like crap, etc etc.

Lots of people do it selflessly (which is very noble), but there's only so many such people...

 

[Bantamzen]

You're forgetting that the 80% furlough was capped to a maximum amount - so lots of people got much less than 80% of their original salary in practice. It's still a hefty bill either way.

Furlough at least had the benefit that people could be remobilised quickly in the majority of cases (relatively few people were on Furlough long term, mainly because their business simply could not trade at all), that would not be the case with UC. Some people on this forum forget how privileged they are in this regard (whilst their own industry, quite rightly, got unprecedented amounts of government subsidy.... "I'm all right, Jack" and all that)

Yes it was capped, to £2,500 pcm. UC would not pay most people anything like that.

 

[johntea]

When (if) are they planning to roll out the 'booster' jab to more groups?

I had mine done at the same time as my flu jab which seemed to make a lot more sense than making a double trip (it was an optional choice)

If they start to introduce 'Plan B' or similar however then I'm in a pretty strong mind to decline any further boosters in the future!

 

[Drogba11CFC]

Sounds like the announcement today is mostly about some new anti-viral medication, maybe more vaccines.

It will be interesting to see what the public narrative is more generally. Broadly speaking I think it was the below and it was very difficult for anybody to get traction to the comtrsey

Lockdown 1 - New scary, deadly virus
Lockdown 2 - ‘Firebreak’
Lockdown 3 - Keep numbers down while the vaccine rollout is done

The narrative for the desired lockdown 4 by the various ‘experts’/Doctors on Twitter with books to sell seems to be something like ‘the purpose of life even with vaccines is to protect the NHS first and foremost and everything else must be suspended every single year, forever.’ Covid response has only really ever been about politics and that doesn’t sound like a political measure likely to get much traction.

Any doctor with that agenda should be struck off.

 

[bramling]

Except you'd have just spent £70bn on Jobseekers payments instead. And then ****ed the recovery of the economy when businesses had to recruit from scratch to get going again.

Not if things hadn't been shut down to the extent they were, especially this year. I see no reason why, for example, hotels couldn't have remained open, even if not all their facilities were able to be available.

Here we've just had a load of people go straight from furlough to retirement, hardly the best use of taxpayers money.

March 2020 was "we need to buy time to allow us to understand what on earth we are dealing with and work out where we go from here". It was unacceptable for January 2021 to be essentially a (slightly watered down) repeat performance, the focus should have been on getting on as much as possible.

 

[quantinghome]

Yes it was capped, to £2,500 pcm. UC would not pay most people anything like that.

Yep. UC is £325 per month for a single person (was £412 until last month). No doubt that the furlough scheme was generous - whether that generosity was justified is a different question.

 

[bramling]

You're forgetting that the 80% furlough was capped to a maximum amount - so lots of people got much less than 80% of their original salary in practice. It's still a hefty bill either way.

Still more than would have been the case on universal credit. Not that I'm necessarily advocating that though, I'd rather many of these workplaces hadn't been closed down, especially after September 2020.

(whilst their own industry, quite rightly, got unprecedented amounts of government subsidy.... "I'm all right, Jack" and all that)

Parts of which industry have contributed very heavily towards economic growth over many years, and will no doubt continue to do so in the future.

 

[Ediswan]

Who really wants to be a medical student? Long hours, generally treated like crap, etc etc.

Lots of people do it selflessly (which is very noble), but there's only so many such people...

Medical schools have been getting many times more applications than they have places for a very long time. Whatever the problem is, it is not a lack of people wanting to be doctors.

 

[Bantamzen]

Medical schools have been getting many times more applications than they have places for a very long time. Whatever the problem is, it is not a lack of people wanting to be doctors.

I think it might be something to do with a lack of something that rhymes with honey...

 

[yorksrob]

Who really wants to be a medical student? Long hours, generally treated like crap, etc etc.

Lots of people do it selflessly (which is very noble), but there's only so many such people...

True as that may be, there are generally more of them than the Government will fund places for.

 

[nlogax]

Medical schools have been getting many times more applications than they have places for a very long time. Whatever the problem is, it is not a lack of people wanting to be doctors.

More GPs are leaving the NHS or retiring than there are newcomers taking their place (obviously) in spite of full medical schools and a merry band of doctors-to-be in the wings. There is a long-standing issue with GP retention in the NHS and the pressures on them during the pandemic have only exacerbated the situation. This is pretty much a perfect storm.

 

[Freightmaster]

More GPs are leaving the NHS or retiring than there are newcomers taking their place (obviously) in spite of full medical schools and a merry band of doctors-to-be in the wings. There is a long-standing issue with GP retention in the NHS and the pressures on them during the pandemic have only exacerbated the situation. This is pretty much a perfect storm.

In that case, what is the solution?




MARK

 

[Wilts Wanderer]

In that case, what is the solution?

MARK

Elect a government that doesn’t have a track record of treating them like a political football? My sister is a doctor and she was appalled by the government’s approach to the pay and conditions dispute a few years ago - she showed me some of the proposed work rosters and it had really basic errors such as omitting transition periods to enable sleep pattern changes when going from night to day shifts.

 

[35B]

In that case, what is the solution?




MARK

Take the politicians out of health care, and recognise that Nye Bevan deserved to have been ignored, not venerated.

 

[nedchester]

More GPs are leaving the NHS or retiring than there are newcomers taking their place (obviously) in spite of full medical schools and a merry band of doctors-to-be in the wings. There is a long-standing issue with GP retention in the NHS and the pressures on them during the pandemic have only exacerbated the situation. This is pretty much a perfect storm.

My son throughout his A Levels wanted to do medicine. He did a number of placements in hospitals and saw first hand how hard medics work. Just before his uni application went in (pre-Covid) he decided that the hours worked by junior doctors were massively excessive for the reward. He changed to dentistry as 1. The hours were less 2. The money was better.

He's now training to be a dentist (also in short supply).

So there may be a large number of applicants but some can become quickly disillusioned.

Take the politicians out of health care, and recognise that Nye Bevan deserved to have been ignored, not venerated.

Taking politicians out of a lot of public services would make matters better!

 

[nw1]

When (if) are they planning to roll out the 'booster' jab to more groups?

I had mine done at the same time as my flu jab which seemed to make a lot more sense than making a double trip (it was an optional choice)

If they start to introduce 'Plan B' or similar however then I'm in a pretty strong mind to decline any further boosters in the future!

Re the booster jab I do find it a little hard to understand why they are prioritising healthy people just over 50 over anyone, of any age, that have to work with people as part of their job.

If you are say 52, fit and healthy do you have a real serious risk of getting Covid at a dangerous level? (I'm not denying this, just asking). Surely if the principal aim of the booster jab is to stop the spread, they'd be better off giving it to say teachers, shop workers, pub and restaurant workers, etc - of any age.

I'm not saying that I know the answer to this, but it's an interesting question.

 

[35B]

Re the booster jab I do find it a little hard to understand why they are prioritising healthy people just over 50 over anyone, of any age, that have to work with people as part of their job.

If you are say 52, fit and healthy do you have a real serious risk of getting Covid at a dangerous level? (I'm not denying this, just asking). Surely if the principal aim of the booster jab is to stop the spread, they'd be better off giving it to say teachers, shop workers, pub and restaurant workers, etc - of any age.

The vaccination programme worked quickly and effectively because it used readily available data to allow prioritisation decisions to be made. We don't have ID cards, or other compulsory registration, so trying to link up factors like employment to work the prioritisation would have choked the rollout - whereas the NHS's patient records allowed a pretty good view of age and key health conditions. I'd expect the same to apply to boosters - they've got the dataset, so they can just work through the list.

As I understand, that prioritisation choice covered virtually all of those at seriously increased risk, even though there were some around the edges who arguably should have ended up in a different priority group.

As for the risk by age, it rises dramatically by age - I'm 47 and an otherwise identical 52 year old would have a much higher risk from Covid.