Tag Archives: NHS IT

The foundation of a blame game

It was the Independent that gave the headline ‘Tens of thousands of operations cancelled because of staff shortages and faulty equipment, NHS figures show‘ by Vincent Wood about 13 minutes ago, and the by-line gives us ‘Labour blames ‘Tory cutbacks running our NHS into the ground’‘ did anyone catch that? Did anyone catch the issues that were given over the last 5 years, not eventual new issues bu the Conservatives, but the destructive path of Labour? “The Labour party bungled the option to get part of the technological solution implemented that could have helped the NHS (perhaps you remember the loss of roughly £11.2 billion in NHS IT restructuring)” did you think that a loss of £11.2 billion is easy to wipe away? That loss hit out into every corner of the NHS, £11.2 billion in IT, in Systems never delivered and the need to do something, so as Labour make some claim as we see printed: “The simple truth is under the Tories, patients wait longer and longer for vital care. This general election is about the future of the NHS and ensuring quality care for all. Labour will fully fund our NHS, recruit the doctors and nurses we need and safeguard our NHS from a Trump deal sell off that could cost the NHS £500 million a week” my question becomes: ‘Will any Labour MP connected to the initial NHS spending disaster be removed from politics?‘ it is a fair demand, is it not? And as I see “The figures were compiled by the Labour party, is based on responses from 82 per cent of hospital trusts” I wonder what else they wrote up and connected down, now we cannot keep on bringing up the £11.2 billion, but it had to come from somewhere, did it not?

And how did we get to “staff vacancies continue to put the health service under strain, with the NHS reporting last year it was short of 100,000 staff including 10,000 doctors and 35,000 nurses“, shall we take a look at the state of things in 1997 – 2010? Then we also need to look into the state of things from 2010-2019. Shall we take a look on the changes required in 1997-2010 and the impact of the Economic meltdown? Now the second part is not on the heads of labour, but there was a definite impact, it is so easy for Labour to make a definite push to ignore that and in the years when it mattered Labour squandered £11.2 billion, that is a whole boatload of systems and thousands of nurses and doctors. Interesting how they ignore that part of the equation.

So as Labour hides behind “the statistics obtained via a Freedom of Information (FOI) request” shall we ask to include the amount they squandered? And whilst were at it, let’s take a look at the squandered part compared to that nutshell trust charity requiring ‘the amount needed to repair faulty equipment across the service provider at £6bn‘ let’s see what is left when we compare one to the other, it seems that Labour is all about forgetting one element in this equation.

The article (at https://www.independent.co.uk/news/uk/politics/nhs-operations-cancelled-tens-of-thousands-official-figures-tories-damage-labour-a9183636.html) has a few more idle hands in all this and I am not stating that the Tories are entirely innocent here, but the joke that is regarded to be Labour’s shadow health secretary seemingly decided to ignore the heart ship that £11.2 billion squandered had on the services of the NHS, in addition the loaded debt on the government corporate credit card did not help any, in that regard the Tories are not innocent, i am not claiming that, but the ignoranus that is Labour better get their part right, because the people should be aware of that £11.2 billion fuck up called Labour IT plan, and the issues from there were widespread because that amount had to come from somewhere. And when we start looking at the surplus that the Labour party should have created but did not we will get to an amount that is a lot less representative of what actually should be the consequence of the NHS, amounts and numbers of staff that has been too low for almost 2 decades. When we look a NHS Digital we get that (at https://files.digital.nhs.uk/publicationimport/pub00xxx/pub00912/nhs-staf-over-1996-2006-rep1.pdf) we might think that a good job was achieved with “The number of staff in the NHS has grown every year to 2005 with a small fall in 2006. The workforce is now 27% larger than in 1996“, yet how many SHOULD have been added? When we look at ‘Total staff employed 1,338,000‘ this includes ‘professionally qualified clinical staff 675,000‘ is that not a low number? Remember the earlier ‘the NHS reporting last year it was short of 100,000 staff including 10,000 doctors and 35,000 nurses‘ how come that this number is so divergent from the initial numbers that at the end of Labour was given? How many positions got fired? Yes, there is something wrong and a place like the NHS is dependent of what the government has available and that part is also missing from the equation, so when we start drilling down the numbers Labour comes off as insincere and the usual yokes that they are. All yellow, icky and not really to any point are they?

Oh, and the numbers also calls into question that training places are lacking in a few corners and degrees, so as we are looking at that part too, how did Labour address that in their term? It is important, not because it stops Tories being responsible, it does not, but it does show a systemic problem in the matter and that goes beyond the political element here, there was a shortage for funds and the so called British professional medical degrees should have made a larger and louder complaint in all; this, perhaps it was done, perhaps it was not, but the article does not give light to any of this and it relates to a direct quote that Vincent Wood relies on. And it all related back to the failings that Labour introduced in their term from 1997-2010, so this issue is a lot larger than anyone realises and leave it to the Labour party to add their own failures onto the Tories back, it merely makes no sense to do so, the numbers are out there and it is time to hit Labour with the long term damage that they pushed onto at least half a dozen directions, or did you think that tapping the £11.2 billion NHS vein was the only bloodletting they allowed for? I also believe that certain questions need to be asked towards British Medical Association chair Dr Chaand Nagpaul. He was a topic of investigation in my article ‘As a Puppet‘ in May 2017 (at https://lawlordtobe.com/2017/05/18/as-a-puppet/) when I also had a go at the Labour manifesto, I also wrote at that point: It states: “The people of Britain are rightly proud of the NHS and we will invest £12 billion over the next five years to keep it working for them“, so we get a little over £6 million a day, or slightly more than £200 million a month, so where does this £350 a week ‘pledge’ come from? The independent (at http://www.independent.co.uk/news/uk/politics/conservatives-must-make-manifesto-commitment-of-350m-a-week-for-the-nhs-say-doctors-a7739401.html) shows us: “Doctors, academics and public health officials have called on the Conservative Party to include in its general election manifesto a commitment to spend £350m a week on the NHS, in keeping with the notorious posters of the Vote Leave campaign“, which makes me wonder where the actual pledge comes from. So it seems that Dr Chand Nagpaul and Norman Lamb are both missing a few parts here (I am happy to be proven wrong)“, so not only is the claim debatable, yet I wonder what the numbers then and now represent, yes a 2017 number in this day and age will show a total lack of change towards today, is that the case? From my point of view Dr. Chand Nagpaul has a few explanations to make and I get it, he is watching his own turf and what he’s in value, there is nothing wrong with that, but how much has he achieved in spreading the love of budget? And all this is also linked to the January 2017 article where we see: ““Coventry and Warwickshire NHS chiefs fork out £340,000 for advice on how to SAVE money” (at https://lawlordtobe.com/2017/01/15/the-views-we-question/)“, so how much money was forked out by NHS chiefs on how to save money and how much did they safe in the end?

There are a few issues that are open all over the NHS and the Labour party, but in case you were not aware, I am happy to inform you.

Have a great Monday! #Justsaying

 

 

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Update to include monsters

I was thinking of some of the old games I used to play, especially one I never mastered. The game was released in 1985; I played the Atari ST edition. The game was called ‘Balance of Power‘ and it was basically the east versus the west and through the interface you could interfere (take control of) the balance of power between east and west. In the end I got overly comfortable to the expression “You have ignited a nuclear war. And no, there is no animated display of a mushroom cloud with parts of bodies flying through the air. We do not reward failure“, yes diplomacy was never my forte. There was an update 5-10 years later when the 1990 edition was launched, I never played that edition.

I believe that the world is ready for a true update of that game. When we add the atrocities by Turkey only a few days ago, when we add the Khashoggi debacle and the impact of social media and spin doctors at the heads of media outlets we see that the world has changed to a much larger degree and the impact of what actually could happen is perhaps worthy of a new game. We need to see and play with the impact of ISIS minded forces as political parties play with the impact on a global stage. The fact that the USA is no longer a real superpower and the fact that the treasury of Saudi Arabia, the consumer base of India as the technology footing of China are much larger influences than foreseen; we get to debate a much larger spectrum of what the balance of power looks like. I believe that when the people see the impact of these elements, we see that the world reshapes almost like some Sim City version with larger repercussions. When we consider the global powers of Google and Facebook we see that the game of world politics gets filtered by economic markers. The evolution of what was once regarded as the ‘Balance of Power‘ is optionally now the stage for a larger form of balance (or is that a forum of balance) staged in a collection of seesaws where one resets the balance of two others. the old balance of power staged on the bear and eagle are outdone, less valid, the entire proxy war between Saudi Arabia and Iran clearly shows that and the impact of the media as they filter the news is also a larger impact and we have never been able to truly look at the impact there is, hence the idea of a new Balance of power, optionally called: ‘the Power to balance powers‘, the optional new truth that Turkey is the fourth power to instigate multiple genocides (America as it degraded the population of Native American tribes to zero, as well as the Catholic powers who removed well over a dozen civilisations, and Russian combined actions in 1931 and 1932) is something we need to consider in a much larger scope.

It is this stage where we look at the news and we are confronted with ‘The Kurds’ commander in chief explains why his forces are finally ready to partner with Assad and Putin‘, I have no way of seeing how this plays out, but there will be larger repercussions on many stages. It is time that the youth takes a serious look at the large issues that their parents are dumping on their doorstep, we need to figure things out and it is time that this is done out in the open, no longer hidden behind a screen of media filters and silencing diplomatic teams as they are trying to remain ‘non-accountable’ towards actions chosen.

The problem is not merely that we ignore the actions; the larger stage is that all kinds of ‘compromises’ are being made for the long term and the next generation needs to learn what those repercussions are and I believe that the right video game could do this. The previous generation was apparently taught that evil should never be allowed to win, yet 25 years after WW2 we all became complacent and we thought that evil was gone, evil never is and we all have optionally become part of evil as we condone the actions of many, hide behind the shallow needs that social media offers and we remain unaware as the news is decided by the wealthy (read: corporations) as they became the shareholders, stake holders and advertisers; they get to tell the media and the news what is important, what is filtered out. That is the stage where the balance of power can educate a lot of people just how dangerous our status is at present, not dangerous as if a war comes, we are beyond that, I mean dangerous as we have set the stage for multiple generations of anger, hatred and feelings of revenge, and a growing lack of tolerance towards one another. It is almost like a 4 seat seesaw and each of these seats is the balancing point for another seesaw, it becomes a game of trying to stay balanced, it also means that there is a lack of movement available, which implies that some parties will be about claiming actions when none (or that specific one) was not available.

when we see the media, we are pushed to the question ‘What is the omitted Information that Remains Missing?‘, this is a spin on two levels, the first is ‘Which question should have been asked?’, which brings us to ‘Has a quote or testimonial been taken out of context?‘ this is harder to answer, but it is an influence, which gets influenced by: ‘Is someone approaching the issue from a different set of values?‘, as well as the stated answers ‘Are the claims supported by well-done research as well as based on reliable sources?‘ and that is the foundation for merely looking at the media how it filters information, the entire stage becomes a much harder game to program, yet should it not be done because of that?

And that is all before we get to the political and diplomatic stage on “If the answer is not helpful, can we change the question to make it so?” these two elements interacting in media causes all kinds of communication (read: presentation) issues whilst both sides remain intentionally ignorant to the equation. The next generation needs to be educated on what a mess this generation is creating. That part is seen (only in part) with: ‘12 Hours. 4 Syrian Hospitals Bombed. One Culprit: Russia‘ (source; NY times), with the quote “The Russian Air Force has repeatedly bombed hospitals in Syria in order to crush the last pockets of resistance to President Bashar al-Assad, according to an investigation by The New York Times“, which was set to events on May 5th 2019, many newspapers gave that information when it happened, the repeat from the NY Times gives us the quote “Russia’s position as a permanent member of the United Nations Security Council has shielded it from scrutiny and made United Nations agencies reluctant to accuse the Russian Air Force of responsibility“, this is important as the United Nations Security council is now presented as an umbrella that offers a shield from actions it was supposed to stop, a stage we knew existed, but not to the degree we see now.

So when we see the NY Times quote: “Nabad al Hayat Surgical Hospital in southern Idlib Province served around 200,000 people before being destroyed in a Russian airstrike on May 5” which comes with assisted high resolution graphics of 40 mega pixels or better whilst we look at the exploding hospital, we wonder how lucky that photographer was, or perhaps someone knew in advance what would happen, we are left with too many questions and no real explanation that fits the morality and values within us.

It is becoming more and more important that we see the world as it is now being pushed by the monsters among us, we like to set the stage to merely Iran, Turkey, ISIS and Hezbollah, yet the real monsters are the ones claiming to fight the atrocities and in the end merely facilitate to it, it goes beyond the wear events, the technological feats we see in regards to 5G is also a global impact, and we can go on and on on all the events that are part of the stage, and it would soon become too complex. Perhaps that too would be the strength on any new version of ‘Balance of Power‘ the fact that too many issues are intertwined for several reasons. Yet when we add greed to the mix, the game becomes awfully transparent, add to that the actions by some making claims that they cannot prove; the created stage of carefully phrased denials, all out in the open and when we ask specifics we are left with half-baked answers that are not answers at all. This is a part that plays a role in all this, we seem to forget that governments have a duty to properly inform us, yet in the listing from government, through corporations to media to the viewer, we forget that there are three iterations of information, all bound by their own personal issues. It is almost an applied variation from Mark M. Lowenthal ‘Intelligence: From Secrets to Policy‘, the application of stages towards the drive of any policy (governmental or not) is also baked into the media and is subject to what we are allowed to see. Consider that impact, as well as the impact of data on the whole, it might become a massively complex new game, yet when we are able to show the impact of these elements to the people, we would optionally get a much more informed person, one who ends up asking the right questions, the questions that politicians, CEO’s and CFO’s fear. When that part comes out in the open, we get a first stage to truly fix things.

Yet with my sense of humour, we should make a lot more space to include the stages that Darrell Huff introduced us to when we were given ‘How to Lie with Statistics‘, and this gets us to today, we know that the balance of power is not merely what we have, what we get and how we get there. There is an internal stage where political power is also set to the stage of people in jobs (as enabled consumers) that was proven ages ago. Yet how that stage is managed is an entirely different matter. the pushed stage where enablers, facilitators and consumers become the ‘have group’ the rest will be the ‘have not’ group.

As we got told today (source: the conversation), we see this stage in Australia, “Centrelink generally requires evidence of looking for 20 jobs per month in order to keep receiving Newstart“, that sounds fine in theory, yet in the applied practice we see that the job search government links to a job search collector, whilst the seeding player of this group is another matter. So when we look at IT jobs in Sydney we see: ‘594 jobs with 715 positions‘, with the largest bulk (over 90%) being Adzuna, yet the reviews from some are stating that this source is riddled with ‘scam’ mentions, as well as overly positive claimed stages. There is a larger issue afoot and there is not enough scrutiny, even as the people can go to really valid places like Indeed, LinkedIn and Jora; the choice we see in the governmental site calls for question of scrutiny.

Why on earth did I mention that?

We see that the balance of power is set to what is done and what can be achieved, yet when we are confronted with a stage that is not available or realistic, how will we interact? When we are set in a stage of age discrimination on a stage where our issues are not heard, or set in a long winded stage of registration where the IT parts fails too often, the government gets to optionally report that no complaints were received. In Australia the mess with Centrelink data matching, the failing Biometrics Identification Services, the UK failures on IT in the NHS and the list goes on where the costs keeps on adding billion after billion, that directly impacts a government, its budget and its waning options, very much issues on a larger scale and the claim we see with “aggressive ICT outsourcing has led to agencies being left at the mercy of external vendors“, whilst there is no proof that growing the internal options would not have resolved the issue. It is a stage where corporations have a hold over the government, pushing cheaper solutions (another reference to age discrimination get pushed to the backbench and no solutions come forward. this is a direct application of the earlier mentioned ‘in the listing from government, through corporations to media to the viewer, we forget that there are three iterations of information, all bound by their own personal issues‘, which in the application of the Balance of Power means that corporations have a much larger option to disable or limit government actions. That is what the impact of corporatocracy is. In the original games there was no real corporatocracy, nowadays there is. The US is perhaps the strongest example and the impact we see in the FDA and DEA (see yesterday’s article) as well as the ATF limited through the powers of the NRA and by corporations addressing attachments to governmental needs we see a larger impact of where governments show limitations on the world stage.

Yes, the entire game has become a lot more complex which in the end leads us to the question, is any application of the ‘Balance of Power‘ still actual and realistic? That is partially seen in 2013 when the NY Times gave us: “Eight major companies, led by Google and Microsoft, are calling for tighter controls on surveillance of their customers’ data by governments“, yet the opposite was never put in place, the existence of Cambridge Analytics, the application of selling consumer data as well as the abuse of data collection through apps has never been stopped. We get all kinds of options to market through mined data giving a larger rise to corporatocracy, whilst the media remains silent on the dangers of corporatocracy. So when we see ‘This is what happens when corporations run the government‘ (Washington Post, March 2019) and ‘Australia’s march towards corporatocracy‘ (the conversation Feb 2017) we see merely two mentions on Google search page one, whilst he situation set the stage that there should have been dozen of clear mentions and investigations, yet the media seemingly have almost zero mentions, how is that? I think that there is a clear stage where corporations do not want to see any mention if possible and as I mentioned earlier ‘in the listing from government, through corporations to media to the viewer, we forget that there are three iterations of information, all bound by their own personal issues‘, and here we see how ‘through corporations to the media‘ is directly inhibiting exposure. The Balance of Power would be an awesome game if we can incorporate it into a new game, especially when we see how the media and corporations make sure that a lot of the information will not be shown, active censorship in nations that proclaim freedom of speech and freedom of expression, when you own the printing house you get to tell the people what they care about, we apparently forgot about that small part again and again.

It is the beginning of a rigged game where the next generation gets to pay for the screw ups of the current generation, feel free to ignore or deny that, yet when we consider the US with a debt of $21 trillion, the EU has around € 10.1 trillion and on a global scale we see that the Global debt had reached an all-time high of $184 trillion in January 2019, we see that the Balance of Power is a term that has become debatable, a stage where banks are basically in charge, limiting or directing the options that any government is allowed to consider. The original game never anticipated that reality, but there you have it. John Perkins tried to inform the audience with ‘Confessions of an Economic Hit Man (2004)’, yet even after Berrett-Koehler published it, gaining an instant bestseller, whilst the major U.S. media refused to discuss Confessions or the fact that, because of it, terms such as “EHM” and “corporatocracy” were now appearing on college syllabi. A stage where the media claiming to advocate freedom of speech, whilst we see that its absence is allegedly corporation controlled, a direct (still alleged) piece of evidence showing that whatever balance of Power we envision, when it is set to nations and governments we get less than 50% of the players in view, making a larger injustice to the people.

In this, I wonder who exactly the real monsters are; are they identified by the acts of nations like Turkey, Iran and North Korea, are they the acts by organisations like ISIS, Hezbollah and Hamas, or are the corporations and the media they control a lot less innocent in all this. Will the next generation be ready for what we, the current generation have facilitated for?

I honestly do not know.

 

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The political blame

I love the Guardian for the most. They have a good grasp of things and we might not see eye to eye on certain matters at times, their opinion is still valued as it enables me to critically reassess my own view. It is the opposing part that got to me this morning as I read an article a mere 4 hours old. The title alone woke me up. With ‘Despite Hammond’s threat, the Tories cannot be trusted to end austerity‘ Richard Partington makes a dangerous statement. Does he imply that the Conservatives love austerity too much (not entirely false), is he making the statement that Labor (the Jeremy Corbyn facade) is likely to end it immediately placing the UK in even more danger? There are several ways to see this. The article with “Chancellor hints that a no-deal Brexit will mean an unwanted extension to austerity“, which is absolutely true in a few ways, still that extension of 2-3 years will be better than the ECB push to set the stage for 15 years of additional austerity. And when we are treated to “The chancellor is likely to argue that money has been set aside for a no-deal Brexit, but should it be avoided, he can use these funds to end austerity. The thinly veiled threat – coming on the day of the crucial vote on whether to leave without a deal“. From my point of view, whatever is in reserve is essential to reduce debt as soon as possible. You see £2.1 trillion in debt is a killer. The interest alone will be well over £210 billion each year. So every month £17.5 billion is required to be set aside (all speculated on interest being a mere 1%), lowering that requirement as soon as possible is the only way to survive whatever comes next. Germany did massively push austerity around 2010 and the debt (as well as the interest) went down. We acknowledge that Germany was in a much better place (export wise), yet the truth in undeniable, the debt is killing the people of England and it needs to stop. Irresponsible acts by Labour in the past got us into this mess and Labor is just too stupid to see the danger that they are exposing their citizens to, it must stop and that was for me the largest reason to embrace Brexit, even now when we see: “For the most part the Conservatives have recycled savings from austerity into tax breaks for the better off” we should get angry, not because of the falsehood, but because of the presentation. You see, any austerity will affect the better off a lot less than the others, there is no denying it. If only Labor had not gone overboard spending the way they did (apart from the £11.2 billion NHS IT fiasco), they had no clue what they were doing and gave us this death through poverty sentence. The banks are all on the side of Labor as they are making bankers rich whilst these bankers do not have to do anything at all, the long term commitment to £17.5 a month does that for them.

Then we get even more fuel with: “Analysis from the New Economics Foundation this week shows that raising the tax-free personal allowance to £12,500 and higher-rate income tax threshold to £50,000 will cost as much as £30bn. The financial benefit of the increases have benefited higher-income households most and further stoked inequality“. In the first, no one, not even the rich oppose the £12,500 part, the part that predicts the cost to be £30 billion is misrepresented as that also includes the losses by those who went from £11,850 to £12,500, and this is the largest part. These so called ‘rich’, an interestingly small number basically gaining a mere £3,650 to be taxed lower earning them £700 over a year, whilst the even wealthier group did not gain the additional benefits as their tax bracket remained the same. As for the numbers in 2017 only an estimated 364,000 (out of 68 million) made over £150,000 a year. An additional 4.2 million got to the £50,000 range. those people are not gaining £30 billion, the benefit is mostly there for the lowest range being the largest group by far and Richard should be ashamed of himself trying to push buttons in that way.

Inequality has been there for a while and it is not due to the tax regulations as such, it is due to Labor (and Conservatives) being cowards and not adjusting the tax machine to make large corporations making pay their due. When we see Google, Amazon and others paying a mere 1%, we need to hang those policy makers in Piccadilly square. That is the real culprit, but it is likely too uncomfortable for Richard Partington to point that out, he likely has well paid friends in large corporations. We can agree that “The deficit is still expected to remain as high as £19.8bn in 2022-23 according to the Office for Budget Responsibility, the government’s own tax and spending watchdog“, and guess what, properly taxing large corporations would have taken care of that and optionally reduced austerity as well, yet policy makers are unwilling to try that as they fear large corporations walk out. So what? Let them go and forsake a 68 million consumer base, they will learn soon enough when that move goes tits up for them.

It is not all him though, Richard is allowed his view (even the ones I very much disagree with), and the issue goes beyond certain people. Consider just a year ago when we were ‘informed’ on Apple at Battersea Power Station, a luxurious setting of hundreds of millions, of course they do not have to pay for it, as the tax payers gets to pay for all the taxation that they do not have to pay at that point. It gets even worse when we see the quotes in the Apple Insider. It is developer Simon Murphy that literally gives those readers with the prospect of them moving to plan B: “We’ll give [Apple] that building at the end of 2021. That’s what everyone is very confident about at this stage“, so not only did they short social housing by 40%, they also give away a place to large corporations? No one is asking questions on every level of government at this point (at https://appleinsider.com/articles/18/09/22/construction-delays-leave-apples-iconic-london-battersea-offices-in-doubt)? It seems that the way we do business has to change quite a lot and it is time to slash freebees to zero for the largest corporations. It is not only the Guardian though; we see a changed stage when we go to the Financial Times. They start (at https://www.ft.com/content/b2225c56-419c-11e9-b896-fe36ec32aece) with: “With economic risks again mounting, the EU needs new instruments” and that is merely the beginning. In addition to all the massive blunders they had by fictively keeping an economy running, by pumping 3 trillion into it, we now see: “reviving part of its stimulus programme after two years of weaning the eurozone off easy money — took markets by surprise. It should not have done. Signs of eurozone weakening, especially in Germany, and in key partners such as China, had been evident for months. Once the US Federal Reserve signalled a pause before lifting rates again, the ECB became likely to follow suit. In his final months in the role, ECB president Mario Draghi is clearly trying to get ahead of events“, form my personal point of view, Mario Draghi (and the ECB) are merely trying to keep the gravy train rolling and pushing the EU citizens into deeper debt with no option to get out, Brexit is the only way to cut that anchor. The ECB has become that irresponsible. It becomes an even larger problem with “By promising a new round of cheap long-term loans to banks willing to expand lending, moreover, the ECB will enable Spanish, Italian and other banks to roll over funding they have already received, some of which is set to mature“, so not only is it failing, the stage that the new debts are there to cover old debts is even more ludicrous and it should be to every person who read that. That is the push we see and we need to get out of it, these debts do not make governments better, they do not set the stage for an actual economy, it merely deposes nations to be ruled by banks, when any population is set to the stage where they are contributing to any economy by being a consumer against those who are not and regarded as a burden, at that point do we see that people are truly no longer equal, we are merely facilitating to the need of the balance of corporations and bankers are placed above the law and above any consideration. So at what point did we see elections that place banks and bankers above the law? And this is merely the beginning; we see part of this shift when we consider the words at CNBC by Invesco’s Kristina Hooper at a deeper level. She starts with: “I don’t think the slowdown is going to be that bad as we sit here today, and certainly that’s not what we got from the ECB [European Central Bank] in terms of their downgrade of growth forecasts“, yet when we see: “Now that we have the European Central Bank piling on, that raises questions about what’s going on. What are central banks worried about that is causing them to make rather dramatic pivots?“, that was actually simple, the ECB is dead scared of the ‘R’ word, it is ‘recession’ that scares them. Recession is on the horizon and basically the large four are all hit by it, or are optionally hitting it next quarter (France, Germany, Italy and UK), and for the ECB that is a problem, it would truly show that their policy was a failure, no matter how you dashboard the results into a precisely sliced and diced result that shows only positivity, the cost of living and the quality of life are impacting all and austerity is not a merely a dirty word, it is at this point a cause of suicidal depression for the many confronted with it. If only large corporations had been truly decently taxed, we could have avoided so much pain. We see even more in the end when we are treated to: ““China is employing a lot of stimulus both monetary and fiscal,” said Hooper. “We could actually see signs of some improvement in economic data in China.”” She is only partially right. China is not impaired with 26 anchors all trying to keep the EU boat on their needy little turf; in addition China has taken the lead in IP and Patents making a huge difference, in this America and the EU have fallen far behind. I have seen them ignore billions in IP merely because iteration is the prospect of long term management for large corporations nowadays in an age when these people are left without ideas, we see them surpassed by players like Huawei and Google leaping ahead and now we see the terms like ‘protectionism’ and how bad it is. On the other hand there is a solution against it, the Americans merely had to accuse Huawei as a national security danger and as long as they do not have to prove it can they get away with it, the moment they fail that they lose a lot more than merely an industry (in all fairness they do not really have any credibility left, so there is that too). There too we see issues; as John Bolton (the Trump geriatric solution to national security) gives us through the Sydney Morning Herald: “Bolton also offered blunt assessments on China’s island and military base building in the South China Sea and raised concerns “Manchurian” chips in Huawei technology could be activated for espionage” in this ‘could‘ is the operative word, there is no evidence, and as far as I can tell there never was. This too links to economies and economic welfare, Huawei leaped forward whilst the bulk of all economies were based on iterative progress. Why do you think that places like Google and Huawei truly leapt forward? Their rise is all about actual innovation, not iterative marketing. This makes for all the difference. And linked to all this is something truly away from the UK. With ‘STC, Huawei complete first indoor 5G trial in the Middle East‘, when we are treated to “Saudi Telecom Company (STC) and Chinese vendor Huawei confirmed they have completed what they claim to be the first trial of indoor 5G in the Middle East region. During the trial in Dammam, STC used 100 megahertz in the 3.5 GHz band on the 5G network, and achieved a peak user downlink throughput of 1.3 Gbps” with the additional “STC said it currently provides 5G coverage in more than 450 locations across Saudi Arabia” and this relates directly to the EU and the UK. To have an economy growing you need to be ahead of the curve and both are no longer doing that in several fields. Even as I personally understand and accept the statements by Alex Younger (fearless leader of MI-6); we accept his position and he is not wrong, but it is inconvenient for the economy. The others are merely supporting fear mongering absent of evidence and it is about to cost them. You see, 5G is the economy maker and even as I have well over 2 billion in IP value ready to stage to those with the proper offer, I am but one person and I am not alone. 5G will drive IP and it will push new borders in IP, specifically in trademarks, a shift we have not seen ever. In all this, we see the stage where not only will we see the technology shift where Saudi Arabia is surpassing the US technologically, they now have the stage where they can push and own a 500% growth all over the Middle East, America lost out by being stupid and complacent in an industry where free runners set the stage, not those that rely on status quo. The UK (and the EU) will either catch up, or be regarded as lost for consideration.
At some point people there will push for political blame, I do not think that this is a great idea, but that is what will happen soon enough and at that point, all those who gave rise to John Bolton and the US administration will face a massive setback, to be removed from consideration in a world where they once had mighty voices, the funny part is that every success that we now see by Huawei and Saudi Arabia will be another nail in their coffin. A coffin soon to be named ‘rented by [irrelevant person]‘. What a legacy to have in an age where political delays were the foundation of austerity through improper taxation of corporation. There is more than one setback on the location called Lake Iteration; I saw that coming a mile away. Too bad that those relying on status quo never realised that blinkers of that nature is only to stop wearer of seeing the bigger play-field through the adaptation of fictively removing fear, fear keeps us on our toes, it makes us consider what others do and why they do it; with blinkers we only see what those in charge of us want us to see and that is a large limitation, it makes us focus on what is in front of us and we seem to forget that we are not alone, by not seeing that others pass us by and we only see that whilst we watch their asses rush forward at that point will we consider picking up the pace, picking it up way too late. That too is part of any economy, it is the essential part of being ahead of the game and the ECB is seemingly all about a horse named ‘banker’ to get that advantage and it is costing us. You see, it is not about Huawei having this advantage, it is about the realisation that British Telecom is no longer in the place where Huawei now is. All whilst there is plenty of documentation that the US has been accusing Huawei since before 2012 and up to now, no evidence has ever been produced. So whilst we can go back to the quote from October 2012 with: “American companies and its government should avoid doing business with China’s two leading technology firms, Huawei and ZTE, because they pose a national security threat to the US, the House of Representatives’ intelligence committee will warn in a report to be published on Monday“, consider the options, is US Intelligence this bloody inefficient and incompetent, or was this about something else? The leaping headway approach by Huawei was visible 7 years ago and in that time nothing changed. That non change is important for the people to realise; it is the UK economy that is getting hit time and time again. If you wonder why austerity takes this long (and longer still) consider the steps that industries had not taken, investments not done and we see non-stop tax relief for those sitting still (read: sitting on their hands). the issues are directly connected and when we realise that Germany has decided not to ban Huawei (a nations decently paranoid on security), when we watch the German economy pick up sooner we all know where to point the finger, we point it at the inactive and the exploitative, when we link names to those connected there, that is when we see a first sign of carefully phrased denials and weighted mention of ‘miscommunication between parties’. At that point, will you be forgiving and accept the ‘moving forward’ excuse, or will you hold them and their tax policies to account to a much larger degree?

Stop blaming the rich, they already got there! You need to go after those facilitators, those looking for free scraps and scraps through inaction; those are the ones you want to make suffer for your delayed and optionally permanently deleted so called ‘quality of life’.

 

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Healthy or Smart?

Earlier (16.4 hours ago roughly) I talked about the NHS, more important about an article in the Guardian about the NHS. An article that I considered to be a sales pitch, and not a very good one. Today I am taking a look at the ‘Smarter Health: boosting analytical capacity at NHS‘ pdf. First we need to take a look at the players, you see when we read a story we need to know what the story is about, the first step here is to take a look at who is telling us the story, because that matters, especially in the world we see today. The front page gives us the people involved:

Beth Simone Noveck – a Professor at NYU, director and co-founder.
Stefaan Verhulst – Chief Research and Development Officer of the Governance Laboratory at New York University.
Andrew Young – Associate Director of Research at The GovLab, and in addition, he is NOT the Managing Director of APY Consulting Ltd, who has the same name, but looks a few decades older.
Maria Hermosilla and Anirudh Dinesh are also directly linked to Govlab and it is Juliet McMurren who is a bit of a mystery. Perhaps she is merely a minion in that digital publishing machine, but her name pops up in a few papers, but only at the introduction, perhaps she is the one putting the reports together.

You see, if the story is everything, we need to see the storytellers in their environment, because they are setting the stage on how we should see the information given to us. This is given to us from the very beginning as the headline in the executive summary tells us: “It would be impractical and prohibitively expensive to fulfill all of NHS’s analytical needs through more hiring“, which is exactly what I raised yesterday, in addition, I did mention that part as well, just the pathway that follows is not the pathway I trust. I believe that some skills should be managed inside the NHS. I do not trust the outsider telling me how it is, especially after consultants walked off with a large slice of £11.2 billion whilst the NHS has nothing to show for it. In addition, having outsiders access to NHS data is even scarier to me than losing those billions. You see, once the data is out there, the people whose data is out there get to be the victims of dangers they never signed up for. As I see it, once copied the NHS becomes useless to them and whomever walks away with that ends up diminishing the value of the NHS and those people even more. That is in my view a big no-no! (I am not accusing Govlab of having done anything immoral or questionable), I am merely raising the issue.

I notice that part of the paper is what we read yesterday in the Guardian. It makes it easier for me as I had already crossed off several issues on my list and I stand by these elements. Yet, the report is not all bad, it is illustrative in parts, but also suggestive and that lack of clarity is never part of a good paper.  The reader tends to go from assumptions and that goes to either too positive or too negative, there is never ever a balanced in-between there.

When they give us: “The NHS should also create a variety of online knowledge networks of those inside and outside of NHS, especially in UK universities, who possess the skills and willingness to help the NHS with their data analytical questions. For example, last week the Rockefeller Foundation launched the Zilient platform to connect resilience practitioners, and the GovLab and Justice Management Institute launched DataJustice. Both are designed to connect networks of professionals for mutual learning“, which could be novel, were it not that I actually gave a similar (less eloquent) idea on June 29th 2014 in my article ‘What’s in a health system?‘ (at https://lawlordtobe.com/2014/06/29/whats-in-a-health-system/), where I state: “What if we take the next generation in solutions and take away 30% of that workload? When people ask which company will do this, the answer should be ‘None!’. The UK is filled with universities, some of them regarded as the most prestigious and brightest on the planet. Consider that most IT people, might claim experience, yet their drama skills are the only ones that improved for the most, is it not up to the Universities, those who are introduced to the newest ideas, design a solution that would make the work of the doctors and nurses at the NHS better, slightly more efficient and a truckload of less hassle! Is that such a tall order? We will get to the solutions if we are willing to navigate other options. We have seen that the current path is not a success; new methods might not be a failure. It is a road that politicians should be willing to go, if only to make sure that a possible solution was not overlooked“, I admit, not as eloquent, but pretty much the same story and it came whilst the NHS was 2.5 years further away from the ‘Abyss of non-existence’ it finds itself in front of at present.

So let’s take a look at the recommendations, and the first one gives us: “The NHS should build a Project Marketplace like the environmental protection agency’s one EPA Skills Marketplace and help supply find the demand“, so how do these outside talents not cost the NHS? Even as it hides behind ‘help with specific assignments, the skills marketplace helps to match talent to those opportunities to use it‘, you see, the more specific a need is, the more expensive such an expertise tends to get. The more generic and shallow, the less need for such a marketplace, more important, as a little more is asked on what needs to be done, the costs of these people will rise substantially and it tends to rise fast.

The second recommendation gives us “The NHS should construct an NHS Data Lab modelled on the Ministry of Justice Data Lab to make better use of sensitive administrative data“, which also sounds nice, but data labs cost, there is hardware, there is software and hiding it all in some cloud with questionable security will not be a solution, in addition, IT gets stretched even further and there is a difference between ‘better use of sensitive administrative data‘ and ‘safe and responsible use of sensitive administrative data‘, they are not the same, not by a long shot. In addition, I already made that point effective enough in the previous blog. The third one counts “The NHS should build an employee expert network like health and human services’ HHS Profiles and help the demand find the supply across the NHS“, which is what I partially raised when I opted for ‘low level‘ people in my previous blog. Yet this issue is correctly raised and if recommendation is started on yesterday by the NHS HR, than that would be an excellent idea as well. Adding a training path where some can learn skills like Q-Software, data cleaning skills and data capture skills, that might not be the worst idea either as it allows for an IT growth path. There are plenty of NHS volunteers, who are now retired, but still desire to be engaged, not everyone is doing that holding a set of people skills, some are happy to do other tasks. In addition there is the Employer-supported volunteering path, where Market Research and Data employees could spend a few hours a week working on the NHS systems, helping and teaching to create dashboards. In that HQIP Director Dr Danny Keenan might hold his hand up as high as possible to get started on the communication issues he currently states to have. Recommendations 4, 5 and 6 are basically skill finders in another dimension, so having that crossed off with HR to set a proper visibility path should solve all these issues. Option 7 gets us “bring in more talent from outside, including from the private sector“, which is a cost and not a small one either, that is depending on the needs there are. Recommendation 8 is the one that stopped me. You see ‘Open Data Learning Hub‘ I almost like I mentioned earlier, but here we see ‘data scientists to grow its data science community‘ with the added quote “Each toolkit includes the original data and step-by-step instructions for using the data to conduct sample analyses, create visualisations from the data and connect interested data scientists“, which makes me wonder, have they considered that the cost here will increase dramatically fast? In addition, how many data scientists are there now? If there are a few, why a training growth path was not initialised a few weeks after the first data scientist was hired. Because from some of the required trivial reports, those people are really expensive to use for making the ‘basic’ reports. Now, there is a part that I am not aware of, but recommendation 8 is leaving me with questions. If there are proper data scientists, why was growth not acted on long ago, if there are no Data scientists, that open learning hub will attract experts stating that ‘it is a complex issue‘ on too many projects, making this a marketing jump to hiring people, which is not the path we want to go through. Recommendation is just dangerous. As I stated, I have no faith in certain groups and ‘exchange data to help solve public problems. These collaborations focus both on sharing data but also on sharing talent‘, yet when certain ‘assisting‘ experts in the insurance world have been accessing the data sets, once they have the aggregated data they need, they will fall from vision like snowflakes in a summer sunshine, this recommendation is one that should be rejected as soon as the rejecter has read the words. It reads like Recommendation 10 is a potpourri of some of the previous recommendations, yet again we see “a “conversational” infrastructure to a secure physical infrastructure for managing data to tap the best know-how outside NHS on an ongoing basis“, which is pretty much an introduction towards hiring external consultants, which was a bad idea from the very beginning. The entire papers is followed by a score of issues, some I blew away in the previous blog article, some are there to (as I personally see it) illustrate fortune cookie wisdom, which is always debatable and will always be used out of context. An examples is: ‘We are achieving 1% of the potential to improve people’s lives‘. When we see ‘Healthcare data in England is collected, published and used by a variety of institutions, each of which has its own cadre of statisticians, analysts, and economists‘, there is the implied part, but the actual scope who is collecting what and who is collecting it for private organisations and insurances is equally left out there. As we see the groups we also see quotes like “Among its staff are approximately 150 people who hold the title of analyst for NHS England, including those in an operational research and evaluation unit created in 2014. NHS England publishes indicators on performance and satisfaction data about patient experience, bed availability, and wait times, and administers friends and family satisfaction testing“, yet when we see the group ‘Clinical Commissioning Groups‘, we get to see “We know there is lots of information on quality out there but don’t know if all NHS staff, such as clinicians, commissioners and service managers, are equipped to access and analyse it for both operational and improvement purposes, nor do we know if it meets people’s requirements, says one of NHS England’s clinical leads“, which beckons the question, did this clinical lead not know who to ask, what to ask and when to expect an answer? This reads like a ‘let’s set the premise of ignorance‘, whilst the systems in place would (read: should) have been there to inform the participants. This is not a paper on informing, this reads like a paper on creating doubt, preferably a paper pushing towards the recommendations regarding hiring and sharing, which is I admit is a speculation form my side. Yet it is strengthened when we read the premise with NHS Digital, where the language is phrased as “NHS Digital has a statutory monopoly over the collection of certain kinds of data, and over 300 professionals work on the collection and analysis” as well as “Of this group, approximately 250 are classified as analysts, whose work is focused on this routine and statutorily-mandated data collection and the publication of statistical reports“, whilst we get the implied accusation of “NHS Digital has not made much use of predictive modelling to evaluate innovations, conduct experiments or design new models of clinical care“. It seems that at New York University, the weight of a loss of £11.2 billion has no weight at all. That from a nation that has accumulated a debt of $20 trillion, should they be regarded as the experts? So when we read “no mandate—to translate that into policy recommendations nor to do research, according to Dr John Varlow, Director of Information Analysis at NHS Digital. In total, the organisation has 2000 professional staff, most of whom focus on information technology and the maintenance of NHS websites“, I need to wonder if that was the full part of the contribution of Dr John Varlow. Especially when we consider the work that maintenance of NHS websites requires. How many pages, what hardware infrastructure, more important, what other tasks are part of their workflow. An issue (as I personally see it) intentionally set outside of proper dimensionality. So when we consider the ‘produces over 250 annual official publications on topics from GP earnings to drug use among school children. These reports are accompanied by data in formatted Excel spreadsheets and machine-readable comma separated variable (csv) text files. Anonymised population-level data is available both on the NHS Digital website and on data.gov.uk‘. The reader should realise that this adds up to a little over 20 reports a month, that needs exporting, cleaning (personal data markers) set into final data forms and uploaded to the proper places. It should come down to one person does this full time, but the reality is that 1-2 other employees need to check this, to make sure identity sensitive data is not there.  In addition we need to consider ‘NHS Digital publishes over a thousand indicators‘, which we can accept as a given, but based on whose recommendations? When is the policy to publish set through political means and requirements?

This gets me to the subtitle ‘The current emphasis on performance analytics needs to expand to predictive analytics, simulation and modelling‘, on what premise and whose budget? Whenever we see a statistician running around with a massive erection shouting  ‘predictive analytics‘ and ‘modelling‘ it is usually because the linked implication that this additional work usually comes with a not to modest pay rise. When ‘simulation‘ is thrown into the mix, it tends to link to either resource needs, budgeting or failure analyses, which now implies that hiring becomes almost essential as these people were either hired from the start, or the skill set was not deemed essential, so raising it here raises a lot more than the reader will fathom. So when the writers decide to add Tim Kelsey on page 37, they should have considered the Guardian (at https://www.theguardian.com/society/2015/sep/17/cameron-adviser-leaves-controversial-nhs-data-scheme-private-sector), where we see: “Kelsey was appointed to the Cabinet Office in 2012 as the UK’s first transparency and open data director. However a few months later he joined the NHS, where he was the driving force behind care.data. The programme was supposed to be in place in 8,000 GP practices by 2014 but has been beset by controversies since its launch last year. It was finally put on hold after a series of blunders exposed serious problems relating to the confidentiality of patient information“, there we got the issues that the Guardian headlined with ‘NHS patient data to be made available for sale to drug and insurance firms‘ and ‘Privacy experts warn there will be no way for public to work out who has their medical records or how they are using it‘, which is actually an issue I raised more than once. So is Professor Noveck soliciting for data? Because there have been more than one marker in that paper to see as a consequence and the US in general is still massively horny for the UK NHS data sets. The report goes on for a total of 82 pages. In total it is actually a good sales pitch, but with my utterly paranoid mindset of once that data is no longer just with the NHS, the people relying on it will prefer to be dead than have to live through the aggravation that insurance companies will push them through. The page 78 mention of “the NHS could use this Brain Trust to expand its expertise outside its institutional borders. A pilot deployment would make it possible to determine empirically whether technology can bring expertise in from the outside efficiently” continues that path, because Brain Trust and expertise requires data access to set into a result. In addition ‘pilot deployment would make it possible to determine‘ tends to come with data attached, or accessible. I am not convinced that juice will be worth the squeeze and until the ghosts of data loss are set to rest (which is unlikely to ever happen), the entire sales pitch, no matter how good cloaked in 78 pages is one that the NHS needs to walk away from really fast. The PDF is at http://www.thegovlab.org/static/files/publications/nhs-health.pdf, so I will let you all decide how paranoid I am. The fact that the NHS did this with NYU and no critical report from, for example the University of Cambridge or the University of Westminster is actually an issue that a few others should make (just two of a collection of worthy investigative parties).

So is this ‘Smarter Health’ report healthy or smart? At present I fear it is neither!

 

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