Tag Archives: NHS

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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Mental health or Medication

We have seen the premise in a few stages in the last decade and for the most people lean towards one or the other and that is fine, it is a hard choice to make and there is no real evidence which of the two is better in the long run. Mental health needs treatment, medication is at times not a cure, merely a way to create a timeline for treatment, or to minimise the impact of the situation. Yet there is also a medial state that is not mental health based, for example treating people with cystic fibrosis who have two copies of the F508del mutation, for them there is Orkambi. Yet, what is the status when this involves a politician? How delusional is a public speaker allowed to become before he is considered unhealthy and unable to perform his function?

That question came up when the Guardian gave me ‘Labour pledges to break patents and offer latest drugs on NHS‘ (at https://www.theguardian.com/politics/2019/sep/24/labour-pledges-to-break-patents-and-offer-latest-drugs-on-nhs). So not only is he making claims, he is basically pronouncing war on the World Trade Organisation, abolishing the TRIPS agreement and throwing it all overboard. As we realise that the World Health Organisation gives us: “As of February 2005, 148 countries are Members of the WTO. In becoming Members of the WTO, countries undertake to adhere to the 18 specific agreements annexed to the Agreement establishing the WTO. They cannot choose to be party to some agreements but not others“, the UK and the EU are both signatories, so Jeremy Corbyn is stupid enough to set a stage of war that endangers millions. To give a little consideration to the metrics, we get the numbers on Cystic Fibrosis, not merely those with these two mutations (a specific subset), we see that more than 70,000 people worldwide are living with cystic fibrosis. Approximately 1,000 new cases of CF are diagnosed each year. More than 75 percent of people with CF are diagnosed by age 2. More than half of the CF population is age 18 or older. Now this is not a good thing, we admit, yet we are looking to a population that is less than 0.001% of the entire population, more important the people that need Orkambi are a mere subset of that. And for the UK it would linearly mean that it affects only 0.1% of the 0.001% that optionally have it. That is his ‘limelight’; can someone please kick this idiot out of the Labour party (preferably out of UK politics altogether)?

And in the second part, no political party has any business being in the pharmaceutical industry, there is a reason why industrials should never have any political power (well, we lost that one ages ago, but still). His voice giving us: ‘party will create company to make cheap versions of drugs‘, whilst the metrics give us that it will be a population less than a 100 that have this version of Cystic Fibrosis that is what he is fighting for? He cannot even properly represent his constituency and now he is starting patent wars as well as a war with the World Trade Organisation on abolishing or severely changing The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS)? Not only does it not make sense, the impact could be devastating for the UK. This is a person screaming ‘election’ and then spinning silent when it was offered.

It is my personal view that UK labour is better off getting the clown Ronald McDonald to do the Labour party bidding, and it will do a better job than Jeremy Corbyn ever could. His promises are no longer empty, they are now right-out dangerous.

Pharmaceuticals

There is a larger pharmaceutical issue and it has been going on for well over a decade, the issue that patents are reapplied well over 30 years after date, often in a slightly changed form, only barely passing the innovation line is the largest concern for generic medication, yet there are dozens of examples and Orkambi is nowhere near the top 10 in this. Lyrica (Pfizer), Rituxan (roche), Cialis (Eli Lilly), Xolair (Roche/Novartis), Restatis (Allergan) are 5 of the top 10 expiring patents with a value of a little over $16 billion in total, and those owners would like a little longer exclusivity, because the expiration will hit their bottom line in a real hard way. In that list Orkambi does not even stack up to any decent degree and we have larger issues gaining patents with a generic option and Corbyn’s need to make war with TRIPS, whilst the NHS has larger issues, especially as it was Labour who botched the NHS IT project losing £11 billion and small change to the degree of several millions is not one who should be casting voices on ending patents.

The sentiment is not wrong, but the chosen field is a little beyond stupid, making us wonder whether the man is personally dealing with mental health issues. We all have had that moment where we wanted to stand in front of Dwayne Johnson calling him Tinkerbell, not really wise, but we all have those inflated moments of self, to do what Jeremy Corbyn does worse hiding behind one 9 year old with: “Luis is denied the medicine he needs because its American manufacturer refuses to sell the drug to the NHS for an affordable price“, so this is not some Cystic Fibrosis case, this is a very specific case and the medication required many millions to create and pass FDA approval. A medication for CF patients with a rare mutation. With two specific mutations in a disease that knows more than 1,700 mutations that had been found in the CFTR gene. Orkambi works for patients with the F508del mutation in both copies the CFTR gene, the most common mutation in people with cystic fibrosis worldwide. So even if it is the most common, there are 1700 mutations meaning that his war on one medication to a specific subset that comes down to a lot less than 100 patients in the UK. So this idiot (read: Jeremy Corbyn) goes to war, promising to abolish TRIPS and leaving the WTO, all for a subset of people, too small to fill a village? Now consider that the UK has Pharmaceutical interests as well, the top two players in the UK are GlaxoSmithKline and AstraZeneca representing almost £132 billion pounds, because if he does what he does, then those two will vacate as well, this is how stupid Jeremy Corbyn is, but he is hoping that you will not notice this as he is in feigned tears for one nine year old child. I only mentioned the top two, the field is larger than that, but Jeremy Corbyn is willing to throw it all in the air.

Can you please explain to me how the government budget will be met when two companies representing a taxable £100,000,000,000 leave the UK? This is the kind of short-sighted, BS carrying ventures that Jeremy Corbyn is handing its constituents. His claim is ‘In England about 5,000 young patients could benefit, but the NHS said it could not afford to pay the bill‘, if there are worldwide 70,000 Cystic Fibrosis (CF) patients the UK cannot have that many, the claim of “US drugs company Vertex priced Orkambi at over £100,000 per patient per year” might be true and for 100 patients that is still serious money, but we need to recognise that we cannot hand every working person a Ferrari, we do not have the money, and it is that extreme. We are in a position where until a patent ends, the maker gets to set the price, or not sell the product. In light of the numbers I see, I want Jeremy Corbyn to give us an exact list of these 5,000 patients and what medication they need. I reckon that the picture shifts a lot faster at that point. And we agree that larger changes are required, yet making a direct case to the WTO that patents cannot be extended above the 35 years is a lot better than abolishing the WTO. Yet Jeremy Corbyn has no options to do that, so he comes with a delusional plan to start a company that ‘create company to make cheap versions of drugs‘, whilst there are plenty of companies doing that, the case remains that patents hand exclusivity until they expire, this year 26 drugs are facing patent expiration and yet, Orkambi is not among them, but 26 patents will become generic, before 2022 42 patents will expire and that is good for a lot of people, yet this system is already in place, we do not need some delusional politician to add his need to become a rich pharmaceutical cat as well.

To be honest, I have never had such a low regard of UK Labour ever before, the fact that I have twice the regard towards LibDems than towards Labour at present is something I never thought possible in the age of Ed Miliband, whomever thought that Corbyn would be a worthy successor deserved the title ‘Joker of the Year‘, as I personally see it, it is actually that bad at present.

So whomever is happy that this optional mental health case is running the UK labour party is in desperate need of some medication (generic NHS funded options will be available).

 

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Marketing Deceptive Concepts

We are all in the lane of what is coming; the problem is that what is coming is set on the E40, the longest European highway going from Calais all the way to Kazakhstan (Ridder). So as we depart from Ridder, trying to get to Calais on this AI highway, we need to consider that at present we only got past the first 100 kilometres of a trip that will be 8,000 kilometres long and we are not driving a Aston Martin, not even a Lada, we are traversing this in a 1908 Model T, giving a much clearer indication that this trip will take years (read: a decade at the very least) at best. To be quite honest, as technology goes, we are nowhere near AI, true AI. It will take the largest players (Google & IBM) decades to get to the real AI part, and only when computers become more technically savvy and a lot faster. As such I do not see the reason for people and companies like RACGP to give us: ‘AI is coming to healthcare – and it’s here to help‘, with the quote: “real promise – of artificial intelligence in healthcare“, yet we remain fair. Dr Martin Seneviratne stays faithful when he gives us: “we’re far away from that, to be honest” and he is correct. Yet the stage is there where we see: “In this article we are listing top 15 artificial intelligence apps for android and iOS users“, as well as “an Indian start-up claiming to have built an artificial intelligence-assisted app development platform, is not in fact using AI“. It is all BS (read: Hogwash), there is no such thing as AI, it is theoretical, conceptual at best, the real deal is at least a decade away. It reminds me of some Sales Dumbo I had to deal with on how cloud computing was it bees knees. When I mentioned that there is no thing like a cloud, it is merely someone else’s computer, I was the one who did not comprehend it (in the end I was right, and he (read: it) was not). Yes, I am aware of the ZDNet article (at https://www.zdnet.com/article/stop-saying-the-cloud-is-just-someone-elses-computer-because-its-not/). We get it, it is about scalability and the scale of the cloud is huge, but still, it is a server center that is owned by someone else, and the location of that server is equally important in the data laws we see today. Because the moment China launches its own commercial cloud system, the Americans will ‘suddenly’ come with issues like cloud locations and how the Chinese government can look into every cloud account. I was not belittling anything, merely making sure that we keep focus on terms used (and awareness is often larger than anyone considers). It is the monitoring, hacked data and more important lost data. The cloud comes with all kinds of marketing hypes, but informing on the scope and warning of the dangers that poor passwords bring is often not seen.

So when we get to the Verge where we see: “The company was sued earlier this year by its chief business officer, Robert Holdheim, who claims the company is exaggerating its AI abilities to get the funding it needed to actually work on the technology. According to Holdheim, Duggal “was telling investors that Engineer.ai was 80% done with developing a product that, in truth, he had barely even begun to develop“, we see the larger deception and we also see a lack of actions by governments to a much larger degree, apparently white collar deception is OK in their books.

So when we get back to the RACG (at https://www1.racgp.org.au/newsgp/professional/ai-is-coming-to-healthcare-and-it-s-here-to-help) where we see: “‘Documentation is a constant issue, and so is having a computer separating you and the patient,’ Dr Seneviratne said. ‘The dream of this AI revolution is that it helps with the parts of medicine doctors and patients don’t like, creates a safety net for ensuring quality across the board, and gives clinicians more time to be with their patients.’“, my mind goes back 47 months, 12 days and 14.1 hours (roughly) when I designed the concept of what could be the Google Tome (I concluded that the iTome could never become a reality in an technological iterative pushed corporation), a device that would take case of part of it and help the UK NHS to get a handle on their paper mess and red tape. The device would also be a great solution for places like Scandinavia where the rural population is all over the place. There was one tiny setback, it required 5G, it was the only way to get it to work to the degree it did and 5G was nowhere near ready to the stage that places like the NHS, GP’s and clinics could be upgraded. We are still 1-2 years away, but the Google Tome would be a game changer as it worked on a very different IP. Apple would take a decently large hit as I remembered some original parts from before the PowerMac and Apple actually had the inside track, with today’s iPad they could have ruled, but in the last two years they became a mere iterative needy toddler, taking them out of the game. both IBM and Huawei are not ready for this leap giving Google an actual first position with no chance of any number two catching up for close to half a decade. My solution was not AI based, it was based on the realistic foundation of NHS administrations and to see where the obstructions were. Instead of making some political never working one system (UK Parliament spend £11.2 billion learning that it did not work), my path was to upgrade all the elements and give a new definition to speed, not the one that is founded, for downloading, but a new on access protocol that emphasises on security and data safety. In fact, the results would in theory get to the right physician 30%-60% faster. Anyone who waited for results in an NHS location can tell you what a game changer that is.

And none of this touches the 5G IP I created three years later.

But that is not what it is about, it is about the marketing ploys we are confronted with and for the most, the media greedily uses that hyped term to get traction with people, clicks and awareness, the information is less and less a concern to the larger group of media (or so it seems). The one that I got confronted with yesterday is the one that set it off. A friend (Tom Breur) wrote an excellent piece regarding Data Democracy (at https://tombreur.wordpress.com/2019/08/13/what-does-data-democracy-stand-for/). Yet in data, as I personally see it, there is no real democracy, it can be dictatorial, it can be feudal, it can even be tyrannical, but it is never democratic, you do not get a vote in that hierarchy, that is the way with data and it is the researcher who can redefine you through giving you a weight of 1 (or lower) or disregard you as inconsequential as grouping you with other user missing points of non interest. The respondent never had a voice in the matter negating the entire democracy part.

This setting was most likely started by media with their claims of “Big data’s threat to democracy becoming global problem“, and there the delusion started. Big data is never about democracy and democracy is not about data, it is about applied wisdom, they do not correlate and are even less likely one and the same. It becomes even more entertaining when we (at https://morningstaronline.co.uk/article/labour-will-ban-big-money-buying-democracy) see: “Labour will ban big money from ‘buying up democracy’“, it is entertaining and hilarious as this has been happening well over a century, long before there was a silicon based economy (not talking about boobies here). When we get: “Last November Mr Johnson was flown to New York and was paid £94,507.85 for a two-hour speech at the multibillion-dollar hedge fund company Golden Tree Asset Management“, we can argue that he was merely doing a job he was allowed to do, and that is not impeding democracy, is it? And when we see: “We are funded by workers through their trade unions and small donations, averaging just £22 in the last general election“, how much support did you give the people who voted for UK Labour without a donation? And when we see the Washington Post give us: “Data shows that an overwhelming majority of Africans believe that democracy remains the best form of government“, I might not disagree with that, yet the issue is not agreeing and disagreeing, it is the deceptive model of awareness creation that big business allows for when they buy the identities on Facebook by millions and target them with political advertisement. Even as Senators like Ron Wyden are calling to ban that, he knows he is fighting a lost war. Also, as a member of the Senate Intelligence Committee, he is watching proven CIA tactics being deployed via Facebook and he knows how efficient those can be, it is a game only the rich can play. He even hides behind “I’d rather have them do it voluntarily than requiring a law“, because there is no way that they can pass that law in time and even then there will be a dozen loopholes to circumvent the law passed via the first amendment.

It is all due to the marketing we allowed from the very beginning. there was no stop to the media, the hold on awareness versus deceptive is sketchy at best and now that there is a whole slew of iterations coming forward we see more and more deceptive conduct, yet nothing is done, there are attempts, but they are feeble at best. That evidence is seen when we consider Engineer.ai and its founder & CEO, Sachin Dev Duggal. We see the news in the Wall Street Journal as well as the Verge, yet less than 3 days ago that person won the Serial Entrepreneur award, so it seems that the players are all OK with deceptive conduct. Yet I remain optimistic, I merely have to wait to see this blow up in the faces of those sales driven CEO’s and VP’s to see that their failure gave them months of reprieve and every documented event merely sets the stage for my IP in a much more powerful way.

We need to consider that when it comes to creating awareness, the media is still accountable to shareholders, stake holders and advertisers, as such there are a lot of issues in the IT field, personally in light of recent events the do’s and don’ts of Sachin Dev Duggal take the cake. Don’t take my word for it, merely look at the Wall Street Journal (at https://www.wsj.com/articles/ai-startup-boom-raises-questions-of-exaggerated-tech-savvy-11565775004) and consider how the award two days later was still handed to Sachin Dev Duggal. Even as the man ‘hides’ behind ‘human-assisted AI‘, and when we look at the quote: “it uses artificial-intelligence technology to largely automate the development of mobile apps, but several current and former employees say the company exaggerates its AI capabilities to attract customers and investors“, we need to ask a whole range of questions, none of those are found anywhere. I am not raining on the man’s parade, but clearly no one else is either. I wonder how many righteous participators at that entrepreneurial award feel left out in the cold, a fair question if I say so.

I merely look at the marketing part of it all, when I look into the direct impact, that some marketing hypes are giving us, I tend to wonder if the need was really awareness, or confusion that was behind the creation of the hype. It is sad but that is more and more often the need to wonder when any form of media gets involved.

It is a sad evolution in the age of information as it has been for some time now.

 

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When they are merely numbers

What if lives are not set in souls, but in numbers, simple numbers? That is the setting we see ourselves in today. A special shout out to Karl Stefanovic who rightfully backed the police and launched a scathing attack on their “timid” critics. Although I would rephrase from ‘timid critics‘ and merely categorise them as ‘fear mongering scaredy cats with a lack of knowledge‘, yet that would be merely my personal choice in the freedom of classification.

Karl is correct in a few ways, yet to see that. We need to look at the other side. My training comes from NATO and I mastered several weapons, to give you a specific setting here, which with the Remington Model 700 is really simple. The drift on 300 meters is optionally no more than 1.1936″ in a nominal setting, so if I aim for the head the brain is gone, if I aim for the chest the damage is worse as that person will not be instantly dead, but they will feel the pinch of a .308 slug and at that point, most Kevlar is useless. You see at 300 Yds the bullet impacts with 1950 lbs on roughly a square inch, in an oversimplified example a 1000 Kg hammer hits a square inch of your chest at a speed of 671 metres per second, good luck getting past that feeling! The Kevlar might slow it down but the impact will be enough to turn ribs to shrapnel and cleave its way through your chest, if the bullet gets through, it will still be mostly slim and nail shaped, leaving the recipient with plenty of optionally fatal damage. A Kevlar vest (if the person has one) might stop a pistol 9mm, even a .357, but with a .308 or .338 rifle, nope, that person becomes a write off. This is how a soldier thinks, it is them/him or me/us, we do not want to die for our country we merely make the other one die for their country/cause.

The police is a different slice of cake. They are trying to protect people from harm of self and/or protect them from harm by others. The police are there as protection for civilians, innocent or not. They have a duty to arrest and Karl is right in backing the police. The News from News.com.au is giving us “They do it sometimes with the public hating them. But they’re the first you call when you need them and they were the first to respond. I salute them this morning“, he is correct! The news also gives us: “The call comes in response to a deadly attack in Melbourne’s Bourke Street on Friday by Hassan Khalif Shire Ali — a Muslim refugee from Somalia. Ali crashed his car full of gas cylinders before stabbing three people, killing prominent Italian restaurateur Sisto Malaspina“, and at this point, the question from me is ‘At what stage was the police to assume that this was a terrorist?‘ You see ‘his car full of gas cylinders‘ was after the fact, yet when did the police know exactly what was going on? The police had a direct need to incapacitate to a degree, not to kill. It is that plain and simple! Their job is to evangelise and support the law, not enforce it through violence, even as that will be essential at that point. So the call ‘Shoot him, shoot him’ might come from outsiders, yet to shoot is not an easy task for them. Let’s not forget that the public has been willing to lynch a policeman using his firearm in the past, so the police is utterly willing to leave shooting as a final resort (and so for the most they should), or until there is a clear and present danger to others and even then it will be shoot to incapacitate, which with a Glock is a little harder then you think.

When we see Nine News (at https://www.9news.com.au/2018/11/11/19/18/bourke-street-terror-attack-family-say-hassan-khalif-shire-ali-was-mentally-ill), we see: “The family of the man responsible for Friday’s attack on Bourke Street insist he was not a terrorist but a mentally ill man “crying for help”“. This is optionally true and it also gives rise to the police and the caution used. They might have noticed symptoms that clearly called for caution and refrain from lethal force. Let’s not forget that the entire Martin Place event was a clear case of mental illness, so there is a precedent in all this. It merely makes the entire event sadder on more than one level. It will undoubtedly give false feelings of guilt to the police officer who discharged the lethal shot, it will give feelings of guilt to all the police and carers on the sidelines, and they should not feel guilt in any way. This man, no matter how we slice it has taken three lives, it comes with consequences.

We might even overreact when we see: “Islamic State claimed the attack but today Home Affairs Minister Peter Dutton said there was no confirmed link to the terror group.” Yet the truth is that until people like ASIO give clear evidence that this was the case, we are merely getting an emotional push from a terrorist organisation seeking the limelight in any way they can, it will merely complicate matters in the short term and leave us with a bitter feeling in the long run. Yet we also see that Nine News is optionally wrong. As we see: “The terrorist has been named as 30-year-old Somali-born Hassan Khalif Shire Ali“, this is optionally wrong if any clear evidence of mental health is shown to be true. There is a call in the News.com.au article (at https://www.news.com.au/news/national/security-expert-says-were-feeding-the-beasts-of-terror-with-shoottokill-policy/news-story/59f2162b3427c2e2f5d0a3e6fe1babd1) with ‘Australia is “feeding the beasts” of terror and failing to prevent future attacks‘, in this Dr Allan Orr could be correct. there is no issue labeling the right person a lone wolf, or a terrorist, yet how was it done, what was planned and what was set in an emotional stage. It is order versus chaos. In addition is the man merely a terrorist because he is Muslim? Is he not merely a murderer at this point? These what I would call intentional misclassifications are also a larger problem, the media loves it to use the terrorist tag in all the wrong places and even as it is too soon to clearly determine this, we see that a police officer was used deadly force against an alleged murderer, alleged because intent needs to be shown in court, were these three people intended victims, or where they there and the man would be clearly guilty of manslaughter. In any case the police officer would be absolved of any guilt, especially if he/she had tried to resolve the issue in a non-lethal way.

There will be a political debate that is already raging on, yet the stage is larger than merely “I’ve been very open about the cancellation of visas, the numbers have ramped up, because there are some people who should not go on to become Australian citizens,” the setting of this might not be incorrect, yet when we know that ‘Permanent residency may be revoked at the discretion of the responsible Minister, for example in cases of criminal misconduct‘, if that is correct, then why would there be a political debate? It would be merely enforcing what is stated in policy, is it not?

It gets to be even more complicated when we see: “Ali was known to federal police and had his passport cancelled in 2015 amid fears the Somali-born man would travel to Syria“, the question becomes who was he going to support? Assad, Assad opposition, perhaps the direction does not matter, yet the direction does incline towards extremism, as such it cannot be ignored. It is an issue as we see that there are more sides to all this. The fact that no action was taken (apart from removing the passport) might have sufficed to some degree, his active interest to go to Syria was never explained (needed or not), if there would have been an assessment, even a mere interview and conversation on the consequence of doing that as a non-citizen might have optionally resolved the issue to some degree (highly speculative on my side). Even a limited monitoring on media and activities might have dampened the danger (or not). If these are all acts of a mental health issue, then the entire terrorist issue falls in the water and other activities might not have helped, but the knowledge of where this person was might have optionally aided the police in a few ways, and is that not important too? To give the members of the police every inch that they can use to resolve without being force to employ deadly force? It might not have been an option here, but the lack of indicators (as presently known) seems a little too staggering at present giving us the handle that not only was Karl Stefanovic correct, the officers subjected to this ordeal might be due a commendation or two (or three).

The last part is also the biggest issue. when we see both “Prime Minister Scott Morrison said he backs religious freedoms but has also called on Islamic leaders to call out the attack“, and “Those remarks that have in turn been labelled divisive by Muslim groups who say their community is not to blame for the actions of an individual and fear it could stoke Islamophobia“. It is the partial failure of Prime Minister Scott Morrison that his call, outside if the mental health scope was plain wrong. He can make that assessment after we know enough that mental health was not the stage here, and that part is still largely in question. You see, to require any religious group to lash out at mental health issues is the larger wrong and that is not seen here. Should I be wrong and the mental health part fails, then we have another issue, yet at present there has been no clear evidence to set that and whilst we accept: “Home Affairs Minister Peter Dutton said there was no confirmed link to the terror group“, yet this is very specific, was there any other data making any extremist link likely? I get the impression that this is not the case, giving us a much larger overreaction, just like the Martin Place incident of 2014.

From my point of view, we have become Muslim polarised to a much too large extent. Consider that every religion has its mental health cases. Consider (the Times, Oct 2017) ‘Mental patient murdered neighbour hours after hospital discharged him‘, also we have ‘How 18 psychiatric patients freed by one NHS Trust ALL went on to kill‘ (Daily Mail, Jan 2018), 19 people said to have killed someone, but not terrorists as they were allegedly not Muslim. Two filters of classification in a group of people that would have been a dangerous stage in any foundation, so we need to be extra careful who gets the ‘terrorist label’ as the impact is a lot larger and the negation that actual terrorists are could also endanger a lot more lives in the future.

The victims and perpetrators might merely be numbers, yet when the numbers are wrongly stacked, the people who are forced to act might wrongly do so making matters worse for everyone around and that needs to be clearly stated, as well as the fact that Karl Stefanovic made the right call in this case and that should be recognised on a national level as well.

 

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Goodness redirected

Even as I got shocked to the core yesterday with news on how certain Biological Agent accusations are going in the wrong direction (turning my paranoid into overdrive in 7.2 seconds flat), I was also slightly bewildered a few hours later on how a greed driven industry is now getting a rather large shake up. It was the Washington Post that treated us to ‘Hospitals are fed up with drug companies, so they’re starting their own‘ (at https://www.washingtonpost.com/national/health-science/hospitals-are-fed-up-with-drug-companies-so-theyre-starting-their-own/2018/09/05/61c27ec4-b111-11e8-9a6a-565d92a3585d_story.html?utm_term=.8362898ab1fe). It is a not for profit pharmaceutical company that works exclusively for hospitals. That is the first really good unbiased news of 2018. I truly wish I was part of that place. The report by Carolyn Y. Johnson gives us “A group of major American hospitals, battered by price spikes on old drugs and long-lasting shortages of critical medicines, has launched a mission-driven, not-for-profit generic drug company, Civica Rx, to take some control over the drug supply“. And even as it is for now merely the generic side of it all. We need to realise that in the UK, the NHS gives us (at https://www.nao.org.uk/wp-content/uploads/2018/06/Investigation-into-NHS-spending-on-generic-medicines-in-primary-care.pdf) and that they spend £3.5B in 2016-2017. I am using that data for the mere reason that it is more up to date and more reliable at present. Consider that an ‘island’ with only 20% of the population of the US has that bill, yet to a larger extent, they have a similar aging issue and several similarities in health care. Now consider that this is a NFP situation, so basically, we see the optional saving of close to a billion pounds a year, implying that the savings for the US should increase drastically. It is also important to see that this is merely the beginning.

So as the too laid back greed driven US pharmaceutical industry is confronted with two nightmares, the first is not merely the current generic medication part, it is that if the US and UK unite the damage increases for the pharmaceuticals. In addition to that, the Pharmaceutical industry is confronted with well over a hundred patents maturing over the next 5 years, so the generic part is increasing with leaps before 2023 and so far a lot of them cannot be ‘reset’ by altering the patent slightly and forcing exclusivity for another 15-20 years.

So there is light at the end of the tunnel, it will not happen overnight, but there is a setting that the US could remove medicine cost pressures by a much larger amount then even before. So even as we are given “Backed by seven large health systems and three philanthropic groups, the new venture will be led by an industry insider who refuses to draw a salary. The company will focus initially on establishing price transparency and stable supplies for 14 generic drugs used in hospitals, without pressure from shareholders to issue dividends or push a stock price higher“, we need to realise that this is merely the start of something much better in two directions. The first is that if the costs go down, there is more money for other hospital needs and also in the other direction, when people get affordable medication more will work on healing and in addition with added funds, the chance increases that they will adopt a healthier lifestyle and actually get better and more energised in their old age, which might change a few other things too.

Civica Rx

Yes, that will be a name to remember for a long time, especially when they start showing the results that their goals are set for. Yet this is merely the beginning. Let’s not forget that given a set of greedy hungry swine’s, when they get hungry they tend to let go of ‘morals’ and limitations, so unless severe warnings and protection is given to Civica Rx, they still have an uphill battle to fight. Forbes gives us (at https://www.forbes.com/sites/elliekincaid/2018/09/05/that-nonprofit-generic-firm-has-a-name-100-million-and-a-ceo-who-will-work-for-free/#38015e44ce06), gives us the name of the CEO Martin VanTrieste, he was also quoted with: “has agreed to work without compensation“. Now, I could never do that (due rent and such), but that shows a system where we would love to be a part of, does it not?

So when I see: “The healthcare systems involved: Catholic Health Initiatives, HCA Healthcare, Intermountain Healthcare, Mayo Clinic, Providence St. Joseph Health, SSM Health, and Trinity Health. The philanthropies: the Laura and John Arnold Foundation, the Peterson Center on Healthcare, and the Gary and Mary West Foundation“, I am actually surprised that the Bill Gates foundation has not (yet) knocked on that door offering a nice 8 figure amount, but you know, 2018 is not over yet.

So even as they start with 14 generic drugs, there is every indication that this can evolve to a number in the triple digits in the next 3-4 years making life a lot more affordable fast.

So what is the setting? Why is this given so important? Well, again we need to the UK numbers (as they are more reliable). It is not merely the setting of ‘cheaper’ that we need to realise, it is the attached setting of ‘proportion of spending on generic medicines that is in primary care, 2016-17’, which was 81% at that point. The second part is the logistics, a number that is even scarier than the margins and the exploded prices involved. You see there were 3,000 concessionary pricing requests made by pharmacists in November 2017, a few months earlier, basically before May 2017 the amount of requests made were less than 150, so an increase of 2000% of concessionary pricing requests. The impact of diminished budgets had that much a drain on logistical support for hospitals and NHS departments. When that pressure falls away, so much more can be done and that part is not visible to a much larger extent. there will remain a much larger issue when we look at the branded versus generic setting in both primary and secondary care, no one doubts that and that setting will remain, but over time that equation will change as well as speed up as the life cycle of branded patents end.

It becomes a little scarier when you consider that in the UK, Ten medicines accounted for £134 million of the net spend on price concessions. Topping this is Amlodipine 5mg, a medication for high blood pressure. This becomes important when we translate that to US numbers we can use. You see, in the United States, about 77.9 million, almost 1 out of every 3 adults have high blood pressure. Now consider when that becomes affordable and less of a drain for any health facility, the savings on this one drug could change the game for hospitals all over the US and at the same time prolong life for Americans. When we see that 18 out of 134 million is for that one prescription drug only, we start seeing the essential needs that Civica Rx is bringing to the table, and it has a much a much better impact than a salad (especially when reading about the McDonald Salads this morning).

SO what will come next? Well, they are off to a start, but I never trust anyone merely giving up their golden parachutes (referring to the current pharmaceuticals having to spread the negative news to their shareholders) and in light of the pharmaceutical patent escalations in India, I feel certain that Civica Rx is likely to face dozens of injunction meetings before the end of this year alone. After that the political engine will be turned against them as much as possible. I think it is important at that point to make sure that EVERY senator and congressman (m/f), will get the limelight set upon them to make the people aware of the elected officials that will make their lives more expensive.

Yet that is not the only part, the NHS report gives us the part that Civica Rx is trying to address as well, when the reporters investigated the underlying causes of pricing, the following parts were given on that report (attached here) on page 21.

The immediate cause of concessionary pricing is pharmacies being unable to purchase a generic medicine at, or below, the Drug Tariff price“, as well as “The Department identified three main underlying causes of the 2017-18 increase in concessionary pricing, and those three causes were:

  • The Medicines and Healthcare products Regulatory Agency and European regulators partially suspending the licences of three manufacturers of generic medicines;
  • A fall in the value of sterling; and
  • Governments and insurers in other countries putting downward pressure on the price of generic medicines, resulting in lower returns and manufacturers withdrawing from some markets or medicines: the reduced capacity and competition then increased prices within the UK market.

Now, the first is only an issue when it keeps on occurring and until more evidence is seen, the solution is not easy in this, the second is an impact, yet short lives and the US might not face that issue as it produced its own need, the UK is much more reliant on American pharmaceuticals. The setting of Civica Rx would when effective take away the cause of that element, making that a non-issue over time, it might initially still be a short term factor for Civica Rx to consider.

And it must also be stated that the elements could not be verified or quantified. There were too many elements in play in all this, but the significance on the factors seemed to clearly shown, but to the extent of how much remains a question that can only be proven over time (and with a lot more precise data).

It is my personal view that the report by Sir Amyas Morse KCB is quite extraordinary and even as it leaves us with questions (as any report does), it also raised the curtain on several issues, not merely showing the essential need of Civica Rx in any nation that is getting drained by healthcare costs, it sets the stage that the report empowers the existence of Civica Rx as well as the essential need for their sponsoring and protection ‘against’ some of the pharmaceutical companies, because generic medication or not, you introduce me to a commercial board of directors who do not care about lessened profits and I will introduce you to a group of people lying to you, it is basically that simple.

So we enter Friday with goodness form another direction, today brought to you by the Washington Post, a paper that still states that ‘Democracy dies in Darkness‘, I say that this is not entirely true, it is currently actively getting smothered with a pillow by the needy for greed and those who get their coins from a similar direction, but again, that is just me thinking with temporarily a few paranoid clouds overhead.

#MondayMorningIsOnly60HoursAway

#HappyFriday

 

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Merely a starting point

There is an interesting article at the Guardian, which we were treated to mere 6 hours ago. The article ‘Virgin awarded almost £2bn of NHS contracts in the past five years‘ seems to be rubbing people the wrong way. We see (at https://www.theguardian.com/society/2018/aug/05/virgin-awarded-almost-2bn-of-nhs-contracts-in-the-past-five-years), the setting where in “one year alone, the company’s health arm, Virgin Care, won deals potentially worth £1bn to provide services around England, making it the biggest winner among private companies bidding for NHS work over the period“. In the end, the NHS either privatises to a much larger extent, or the service stops. It is basically that simple and it is only the beginning. Even when we give the right amount of empathy to Sara Gorton, the head of health at the trade union Unison, as she states: “The company has been so keen to get a foothold in healthcare, it’s even been prepared to go to court to win contracts, moves that have cost the NHS dearly. While the NHS remains dangerously short of funds, taxpayers’ money shouldn’t be wasted on these dangerous experiments in privatisation“, is that really the case? The fact that Virgin got the contract was mainly because it could be done cheaper. I warned for certain settings as early as 2014, that certain steps cannot continue that way, changes are essential. In addition, as late as January 2017, I mentioned (at https://lawlordtobe.com/2017/01/15/the-views-we-question/), in the article ‘The views we question‘, issues like: “the document, released in December, aims to address the need to bridge the local NHS funding gap of £267 million which will exist by 2020 if services stay the same in the region” gives rise to even more worry. Not only is the NHS a quarter of a billion short in roughly 1080 days in Coventry and Warwickshire, to survive they have to move? How will that aid the people in Coventry and Warwickshire? Will they end up with any health care at all, or will the local Romani Gypsies with oils and herbals need to be relied on? You think that I am exaggerating? If so, please feel free to inform me on how those two places Coventry and Warwickshire, with 340,000 and 550,000 people end up coming up short by £267,000,000 in three years? Well if advice comes at £343,000 on private consultants, that shortage might be reached rather quickly, but that is not the story is it? The story is how funding has failed and how much more it will fail over the next three years. So, as such, is my view as I personally see it of an essential judicial public inquiry that far-fetched?“, it refers to an article in the Coventry Telegraph, so with the question on how we can save money, which was billed at £343,000 , starting with common sense might have been a first solution. In addition (at https://lawlordtobe.com/2016/02/17/behind-the-smiling-numbers/), in ‘Behind the scenes‘, we get a few truths that really hurt and that was February 2016. The Guardian then gave us: ‘Income tax must rise 3p to stop NHS ‘staggering from year to year’‘, so, how much more taxation was captured for the NHS? Remember that was 2 years ago. In addition, I had issues (to some extent) on the path that Lord Kerslake took with his papers. And all these papers and consultancies (none of them free), the proper setting for mental health care was not properly set in the dimensions of cost and forecast, now add to that the setting of taxation delays and we see that the NHS is collapsing on itself, a collapse that is increasing in speed and that is merely the last two years. So in all this, someone at Virgin woke up and called Uncle Richard and asked if he was interested in making a few billion more. The setting was always falling in this direction, and most of it was not due to the tenacity of Richard Branson, but due to the political inaction and to an even larger extent the political follies seen (NHS-IT being the main one). Consider that it took me 8 hours to figure out a technological solution that could change the entire infrastructure of data, merely because I was willing to look at the larger picture and rearrange a few settings, the solution was printed in the History of Scotland, it was THAT simple. Yet none of those IT experts had a clue, or they did but the political engine would not consider adherence to change making it a bigger folly.

Now we see: “Precise details of all the contracts are difficult to establish because neither the Department of Health and Social Care or NHS England keep a centralised record. Virgin’s when it announced plans for six branded clinics offering a range of services. However, it was only in 2010 when it bought a stake in an existing provider, Assura, that it began to show greater ambition in the market“, which shows both the data folly as well of a massive lack of transparency on the health care part (optionally parts of the NHS as well), that shortcoming is the first setting into cost cutting and it is also a direct link to where services could be bettered. The second part was seen in January 2017 with ‘Dr Sarah Wollaston, chair of the Commons health select committee, criticised the government for blaming GPs for the crisis” as well as “She said in a tweet: “Pretty dismal stuff for govt to scapegoat GPs for very serious NHS pressures. Failure to understand the complexity or own responsibility.‘, the central setting was ‘Failure to understand the complexity‘, a part that was shown to a larger extent going back to 2016, even in 2015 and 2014, there were clear signs of non-comprehension in all this and the IT folly, which the Labour government was able to grow to £11.2 billion merely added to the pressures, whilst in addition to all that is also minimised options left for the NHS. all that squandering came at a price and it seems to me that both Sara Gorton and Paul Evans seem to steer in their lanes, but are equally ignoring the setting that the opportunity for Virgin grew due to a lack of flexibility in the organisations (slightly speculative) and the political branch merely added fuel to the squandering fires. Then finally the Lord Kerslake paper, which I opposed to some extent with the equations that they had in regards to the 20 OECD countries. Here I mentioned ‘Perhaps his Lordship could give a slightly more detailed explanation for the remark “Health spending needs to rise at least in line with GDP. Arguably, we may need to go faster if we want to match European funding“. Considering that the Netherlands and Belgium are next to one another and their budgets per person are apart by a mere 49.404%‘, I believe that it is not merely the stretch of the ‘holier than thou‘ GDP, I believe that there are additional elements making the comparison for the UK not merely dangerous, I believe them partially to be unusable (well a bit more than just partially). In all these settings there has been delay on delay and in the end Virgin had to step in. The funny part is that this also opens up data and reporting centres where Virgin has a much larger trove to work with. It would end up that a new VirginAnalytics could be what Dunnhummby was for Tesco, although with a data growth close to 500% of what Tesco allowed for, there is a decent setting where Virgin creates new levels of data cohesion giving the NHS an actual first time where there is a better level of reporting transparency as well as a better quality of Dashboard presentations, which will grow Virgin even more and also allows Virgin to skim the cream of the NHS sections that will be more profitable in the mid-term range of investments, opportunities grown from political complacency as well as political indecision.

So whilst people are going emotional with slogans like: ‘Not His to Seize‘, they all forget that the NHS and its political branch did this to themselves, Uncle Richard merely picked up the pieces and made it all work. This is getting even more traction when we consider the Lancashire Post where we saw almost a month ago “Opposition politicians have demanded an urgent inquiry into the way the authority awarded a £105m child health contract to Virgin Care, only for the decision to be blocked in the High Court. County Hall is continuing to consider its options after the ruling two weeks ago, one of which could be to re-run a part of the procurement process which the judge ruled fell short of the standards required

The article (at https://www.lep.co.uk/news/inquiry-call-over-lancashire-county-council-105m-virgin-care-health-contract-1-9241205) gives rise to questions not only on the awarding of contracts, but on the entire setting on investigating the amount and not to mention the fact that the contract was awarded whilst there were two NHS trusts on it, it shows that it not merely transparency. With ““We are in a real mess and the Government needs to intervene,” said Labour leader Coun Azhar Ali“, it implies that the NHS (as well as the local government) is to some degree riddled with incompetence. I cannot come to any other conclusion. The setting we see with “Coun Fillis added: “The Conservatives in Lancashire have been stopped once again from privatising public services, in this case our children’s health services“, is on Labour, not the Conservatives. The governing party decided to push for public health privatisation, and opposing it might be valid, but that legal invoice is still due, so crying over it with ‘tide of mounting legal costs, which the people of Lancashire will have to pay for‘, especially when you consider that “in view of the ridiculous comments from LCC’s Labour group, it should be borne in mind that the decision to seek tender for the provision of health services for Lancashire’s children and young people was actually taken by cabinet in February 2017, and both Couns Ali and Fillis were members of that cabinet“, so basically it was a decision that has suddenly hijacked by a minority and they are crying for the setting of cost? Go cry me a river, please!

It is in that setting, where politicians (especially labour) was lax with spending, squandered billions upon billions and they thought the Virgin train would pass them by. Now as this is not the case, not only do we see larger changes, there is the valid concern that mere niches are saved and a much larger setting still goes into the drink. If there is one setting that might change it is by taxing every person an additional £1 per payslip to save the NHS. It seems like a little, but with currently 32.2 million people working, that could add up to £65 million per fortnight. It might not be a lot, but it is a start and with that start you can begin to create momentum for the NHS that is by the way separate from all other funding due to the NHS. The question will people accept it? I reckon that when the NHS actually starts getting healthier, they will live with the loss of £1 each person, each payslip. It might have been pennies, initially, but that was 2 years ago, now we either act or lose a lot more and this is with VirginCare in place. Without it, and with the lack of restructuring the losses will be close to monumental, the simple impact of inaction, we can argue that the Conservative government is taking the easy way out, but is there any alternative? You merely need to look at what we can call a hijack by both Couns Ali and Fillis to realise that there are two in a setting that is much larger and those loses and those legal ramifications as well as the actions that followed is more than a sign of the times, it is a sign of high cost and zero impact desperation, that whilst actual working actions to get the NHS in a better place was ignored to one side and mismanaged on the other side by Labour in the 1997–2007 frame.

At present for Virgin, VirginCare is merely a starting point that can go a much larger route within the next 4 years, in the end, without an NHS, what will people do? I wonder how many remain in denial of that setting, yet it has been a more and more realistic setting. The simple setting is that almost two trillion in debt means that annually at present £68 billion is required for interest alone. Even as Net borrowing is down to almost 28% of what is was in 2010, the setting is that there is a massive debt and it is impacting everything (and the NHS not in the smallest setting). Only be diminishing that part can the UK move forward, which is a lot better than the EU is seeing at present, their debt will make them slaves to the banks for decades. You see, linked to all this is not merely what the government has, but the fact that “The 28 member states of the European Union (EU) have a total debt burden of €12.5 trillion, which could be even bigger, according to the latest figures from the EU statistics office, Eurostat“, in light of the UK being one of the big four, it implies that the rest of the EU will have to deal with the €10.7 trillion debt. How quick do you think they will be able to deal with that? That is why Brexit mattered, in light of the NHS being cut to a bare minimum, it is more and more a setting that Europe could more likely than not end up with not having any healthcare at all, so where would you prefer to be? In light of all that, Virgin might end up with a large gain, but at least there will be some healthcare, a part that too many are ignoring. Would it have been better to keep it all in the NHS? No doubt, but if you want to eat at the Ritz, you better have a fat wallet and the governments from 1997 onwards have all been part of blunders that ended the UK at minus 2 trillion, did you think that was going to go away because the news did not make mention of it? Consider Forbes who gave us not only that French and Italian health care is really good under normal conditions, in Italy (regarding the article), “I have never heard of a child waiting for surgery on his arm.  He would have been placed on the operating room list and he would have been fixed as soon as feasible. There are plenty of more serious surgeries, like cancer cases or even cardiac care, that are put on hold for months in these types of healthcare systems“, the article (at https://www.forbes.com/sites/benjamindavies/2018/08/05/a-broken-arm-in-italy-waiting-for-surgery/#20de8a1f29b6) shows the setting in Italy, in addition, in France we have a similar setting and all over Europe there are similar pressures.

Getting back to the corporation in question, is VirginCare a force for good, or the opposite? I believe that it can be a force for good, but we need to realise that the people can only be treated when we consider that flexibility is required. The lack of resources that is already in play is one part, the political games that we see, whilst relying on the emotion of others is the second part and when the people realise that they have been had by the likes of ‘both Couns Ali and Fillis‘, and many others like them, when it comes out on the waste of resources that they enabled for, will these angry people picket at the front doors of these politicians, or is that not sexy enough?

So when we see the Virgin setting with: “We welcomed inspectors back on 4 July and they were very positive at the further progress we’d made since January in implementing our improvement plan, and gave us positive feedback about the improvements to the practice. We are awaiting the publication of an updated report in the coming months which will reflect this most recent visit“, we see that there is positive change, that there is progress. It will take time, because those expecting this change to be overnight, they are truly looney tunes. If you wanted immediate change, you should have gone after certain politicians as early as 2013, so don’t cry now, not when the choice is now limited between a crewcut and decapitation. The NHS setting is close to that extreme, and has been for some time.

 

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Data illusions

Yesterday was an interesting day for a few reasons; one of the primary reasons was an opinion piece in the Guardian by Jay Watts (@Shrink_at_Large). Like many article I considered to be in opposition, yet when I reread it, this piece has all kinds of hidden gems and I had to ponder a few items for an hour or so. I love that! Any piece, article or opinion that makes me rethink my position is a piece well worth reading. So this piece called ‘Supermarkets spy on them now‘ (at https://www.theguardian.com/commentisfree/2018/may/31/benefits-claimants-fear-supermarkets-spy-poor-disabled) has several sides that require us to think and rethink issues. As we see a quote like “some are happy to brush this off as no big deal” we identify with too many parts; to me and to many it is just that, no big deal, but behind the issues are secondary issues that are ignored by the masses (en mass as we might giggle), yet the truth is far from nice.

So what do we see in the first as primary and what is behind it as secondary? In the first we see the premise “if a patient with a diagnosis of paranoid schizophrenia told you that they were being watched by the Department for Work and Pensions (DWP), most mental health practitioners would presume this to be a sign of illness. This is not the case today.” It is not whether this is true or not, it is not a case of watching, being a watcher or even watching the watcher. It is what happens behind it all. So, when we recollect that dead dropped donkey called Cambridge Analytics, which was all based on interacting and engaging on fear. Consider what IBM and Google are able to do now through machine learning. This we see in an addition to a book from O’Reilly called ‘The Evolution of Analytics‘ by Patrick Hall, Wen Phan, and Katie Whitson. Here we see the direct impact of programs like SAS (Statistical Analysis System) in the application of machine learning, we see this on page 3 of Machine Learning in the Analytic Landscape (not a page 3 of the Sun by the way). Here we see for the government “Pattern recognition in images and videos enhance security and threat detection while the examination of transactions can spot healthcare fraud“, you might think it is no big deal. Yet you are forgetting that it is more than the so called implied ‘healthcare fraud‘. It is the abused setting of fraud in general and the eagerly awaited setting for ‘miscommunication’ whilst the people en mass are now set in a wrongly categorised world, a world where assumption takes control and scores of people are now pushed into the defence of their actions, an optional change towards ‘guilty until proven innocent’ whilst those making assumptions are clueless on many occasions, now are in an additional setting where they believe that they know exactly what they are doing. We have seen these kinds of bungles that impacted thousands of people in the UK and Australia. It seems that Canada has a better system where every letter with the content: ‘I am sorry to inform you, but it seems that your system made an error‘ tends to overthrow such assumptions (Yay for Canada today). So when we are confronted with: “The level of scrutiny all benefits claimants feel under is so brutal that it is no surprise that supermarket giant Sainsbury’s has a policy to share CCTV “where we are asked to do so by a public or regulatory authority such as the police or the Department for Work and Pensions”“, it is not merely the policy of Sainsbury, it is what places like the Department for Work and Pensions are going to do with machine learning and their version of classifications, whilst the foundation of true fraud is often not clear to them, so you want to set a system without clarity and hope that the machine will constitute learning through machine learning? It can never work, that evidence is seen as the initial classification of any person in a fluidic setting is altering on the best of conditions. Such systems are not able to deal with the chaotic life of any person not in a clear lifestyle cycle and people on pensions (trying to merely get by) as well as those who are physically or mentally unhealthy. These are merely three categories where all kind of cycles of chaos tend to intervene with their daily life. Those are now shown to be optionally targeted with not just a flawed system, but with a system where the transient workforce using those methods are unclear on what needs to be done as the need changes with every political administration. A system under such levels of basic change is too dangerous to get linked to any kind of machine learning. I believe that Jay Watts is not misinforming us; I feel that even the writer here has not yet touched on many unspoken dangers. There is no fault here by the one who gave us the opinion piece, I personally believe that the quote “they become imprisoned in their homes or in a mental state wherein they feel they are constantly being accused of being fraudulent or worthless” is incomplete, yet the setting I refer to is mentioned at the very end. You see, I believe that such systems will push suicide rates to an all-time high. I do not agree with “be too kind a phrase to describe what the Tories have done and are doing to claimants. It is worse than that: it is the post-apocalyptic bleakness of poverty combined with the persecution and terror of constantly feeling watched and accused“. I believe it to be wrong because this is a flaw on both sides of the political aisle. Their state of inaction for decades forced the issue out and as the NHS is out of money and is not getting any money the current administration is trying to find cash in any way that they can, because the coffers are empty, which now gets us to a BBC article from last year.

At http://www.bbc.com/news/election-2017-39980793, we saw “A survey in 2013 by Ipsos Mori suggested people believed that £24 out of every £100 spent on benefits was fraudulently claimed. What do you think – too high, too low?
Want to know the real answer? It is £1.10 for every £100
“. That is the dangerous political setting as we should see it; the assumption and believe that 24% is set to fraud when it is more realistic that 1% might be the actual figure. Let’s not be coy about it, because out of £172.3bn a 1% amount still remains a serious amount of cash, yet when you set it against the percentage of the UK population the amount becomes a mere £25 per person, it merely takes one prescription to get to that amount, one missed on the government side and one wrongly entered on the patients side and we are there. Yet in all that, how many prescriptions did you the reader require in the last year alone? When we get to that nitty gritty level we are confronted with the task where machine learning will not offer anything but additional resources to double check every claimant and offense. Now, we should all agree that machine learning and analyses will help in many ways, yet when it comes to ‘Claimants often feel unable to go out, attempt voluntary work or enjoy time with family for fear this will be used against them‘ we are confronted with a new level of data and when we merely look at the fear of voluntary work or being with family we need to consider what we have become. So in all this we see a rightful investment into a system that in the long run will help automate all kinds of things and help us to see where governments failed their social systems, we see a system that costs hundreds of millions, to look into an optional 1% loss, which at 10% of the losses might make perfect sense. Yet these systems are flawed from the very moment they are implemented because the setting is not rational, not realistic and in the end will bring more costs than any have considered from day one. So in the setting of finding ways to justify a 2015 ‘The Tories’ £12bn of welfare cuts could come back to haunt them‘, will not merely fail, it will add a £1 billion in costs of hardware, software and resources, whilst not getting the £12 billion in workable cutbacks, where exactly was the logic in that?

So when we are looking at the George Orwell edition of edition of ‘Twenty Eighteen‘, we all laugh and think it is no great deal, but the danger is actually two fold. The first I used and taught to students which gets us the loss of choice.

The setting is that a supermarket needs to satisfy the need of the customers and the survey they have they will keep items in a category (lollies for example) that are rated ‘fantastic value for money‘ and ‘great value for money‘, or the top 25th percentile of the products, whatever is the largest. So in the setting with 5,000 responses, the issue was that the 25th percentile now also included ‘decent value for money‘. So we get a setting where an additional 35 articles were kept in stock for the lollies category. This was the setting where I showed the value of what is known as User Missing Values. There were 423 people who had no opinion on lollies, who for whatever reason never bought those articles, This led to removing them from consideration, a choice merely based on actual responses; now the same situation gave us the 4,577 people gave us that the top 25th percentile only had ‘fantastic value for money‘ and ‘great value for money‘ and within that setting 35 articles were removed from that supermarket. Here we see the danger! What about those people who really loved one of those 35 articles, yet were not interviewed? The average supermarket does not have 5,000 visitors, it has depending on the location up to a thousand a day, more important, when we add a few elements and it is no longer about supermarkets, but government institutions and in addition it is not about lollies but Fraud classification? When we are set in a category of ‘Most likely to commit Fraud‘ and ‘Very likely to commit Fraud‘, whilst those people with a job and bankers are not included into the equation? So we get a diminished setting of Fraud from the very beginning.

Hold Stop!

What did I just say? Well, there is method to my madness. Two sources, the first called Slashdot.org (no idea who they were), gave us a reference to a 2009 book called ‘Insidious: How Trusted Employees Steal Millions and Why It’s So Hard for Banks to Stop Them‘ by B. C. Krishna and Shirley Inscoe (ISBN-13: 978-0982527207). Here we see “The financial crisis appears to be exacerbating fraud by bank employees: a new survey found that 72 percent of financial institutions say that in the last 12 months they have experienced a case of data theft by one of their workers“. Now, it is important to realise that I have no idea how reliable these numbers are, yet the book was published, so there will be a political player using this at some stage. This already tumbles to academic reliability of Fraud in general, now for an actual reliable source we see KPMG, who gave us last year “KPMG survey reveals surge in fraud in Australia“, with “For the period April 2016 to September 2016, the total value of frauds rose by 16 percent to a total of $442m, from $381m in the previous six month period” we see number, yet it is based on a survey and how reliable were those giving their view? How much was assumption, unrecognised numbers and based on ‘forecasted increases‘ that were not met? That issue was clearly brought to light by the Sydney Morning Herald in 2011 (at https://www.smh.com.au/technology/piracy-are-we-being-conned-20110322-1c4cs.html), where we see: “the Australian Content Industry Group (ACIG), released new statistics to The Age, which claimed piracy was costing Australian content industries $900 million a year and 8000 jobs“, yet the issue is not merely the numbers given, the larger issue is “the report, which is just 12 pages long, is fundamentally flawed. It takes a model provided by an earlier European piracy study (which itself has been thoroughly debunked) and attempts to shoe-horn in extrapolated Australian figures that are at best highly questionable and at worst just made up“, so the claim “4.7 million Australian internet users engaged in illegal downloading and this was set to increase to 8 million by 2016. By that time, the claimed losses to piracy would jump to $5.2 billion a year and 40,000 jobs” was a joke to say the least. There we see the issue of Fraud in another light, based on a different setting, the same model was used, and that is whilst I am more and more convinced that the European model was likely to be flawed as well (a small reference to the Dutch Buma/Stemra setting of 2007-2010). So not only are the models wrong, the entire exercise gives us something that was never going to be reliable in any way shape or form (personal speculation), so in this we now have the entire Machine learning, the political setting of Fraud as well as the speculated numbers involved, and what is ‘disregarded’ as Fraud. We will end up with a scenario where we get 70% false positives (a pure rough assumption on my side) in a collective where checking those numbers will never be realistic, and the moment the parameters are ‘leaked’ the actual fraudulent people will change their settings making detection of Fraud less and less likely.

How will this fix anything other than the revenue need of those selling machine learning? So when we look back at the chapter of Modern Applications of Machine Learning we see “Deploying machine learning models in real-time opens up opportunities to tackle safety issues, security threats, and financial risk immediately. Making these decisions usually involves embedding trained machine learning models into a streaming engine“, that is actually true, yet when we also consider “review some of the key organizational, data, infrastructure, modelling, and operational and production challenges that organizations must address to successfully incorporate machine learning into their analytic strategy“, the element of data and data quality is overlooked on several levels, making the entire setting, especially in light of the piece by Jay Watts a very dangerous one. So the full title, which is intentionally did not use in the beginning ‘No wonder people on benefits live in fear. Supermarkets spy on them now‘, is set wholly on the known and almost guaranteed premise that data quality and knowing that the players in this field are slightly too happy to generalise and trivialise the issue of data quality. The moment that comes to light and the implementers are held accountable for data quality is when all those now hyping machine learning, will change their tune instantly and give us all kinds of ‘party line‘ issues that they are not responsible for. Issues that I personally expect they did not really highlight when they were all about selling that system.

Until data cleaning and data vetting gets a much higher position in the analyses ladder, we are confronted with aggregated, weighted and ‘expected likelihood‘ generalisations and those who are ‘flagged’ via such systems will live in constant fear that their shallow way of life stops because a too high paid analyst stuffed up a weighting factor, condemning a few thousand people set to be tagged for all kind of reasons, not merely because they could be optionally part of a 1% that the government is trying to clamp down on, or was that 24%? We can believe the BBC, but can we believe their sources?

And if there is even a partial doubt on the BBC data, how unreliable are the aggregated government numbers?

Did I oversimplify the issue a little?

 

 

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