Tag Archives: Sussex

Thomas the Tank wreck

Parents will have seen a program if they have kids, they all love to see that cheeky tank engine. The simple life in the town of Knapfort, or is that Nap Forth? The complication of not getting uncoupled, and even as it was merely an episode one, the not so young population might remember the rap edition of this Thomas (at https://www.youtube.com/watch?v=ETfiUYij5UE), so in all this. Is it about the music or the story? Consider that, when we see the Guardian claim ‘Revealed: NHS cuts could target heart attack patients in Surrey and Sussex‘ (at https://www.theguardian.com/politics/2017/jul/14/revealed-nhs-cuts-could-target-heart-attack-patients-in-surrey-and-sussex). So when we see “Organisations in the area are considering limiting angiogram and angioplasty despite positive evidence for procedures” should we be surprised? You see, I have had one, I understand that it is at times essential and that it is needed to assess the situation. We might see: “Hospitals routinely use an angiogram to assess the health of a patient’s heart“, so there is not surprise here. Yet when we see “Patients at risk of a heart attack could be denied vital tests and potentially life-saving operations under NHS plans to make £55m of budget cuts in Surrey and Sussex, the Guardian can reveal“. Why is anyone surprised? You remember that vague promise from some politician named, I think it was Jeremy Carbonite? Labour was going to hire a thousand nurses. So with what money were they going to do that? The NHS is out of cash and out of options. Whilst we see the NHS being politicised, everyone forgot that whilst those optional solution bringers remain talking, not much gets done whilst they talk and whilst they contemplate the decisions that need to be made; no resolutions and the money kept on draining for another 5 months. So we might feel sorry to the smallest degree for Tory MP Sarah Wollaston, with the mention of “the secretive cost-cutting regime which the NHS is imposing on 14 areas of England in an attempt to save £500m – because it involves “draconian” cuts to services that will hit patient care“, which is fair, it is Draconian and nobody wants it, but as the politicians were shouting at each other time went on and nothing was done, the changes for long term gain were all not done, pretty much none of them. Perhaps Labour can help? Do they not have a leader named Jeremy Carbonite? Is Carbonite not a backup program? Perhaps he has a backup option? He was so ‘speechy’, so clear on what needed to be done. So, Jeremy, what would you do next? Spend more money? It’s gone, your Labour predecessors took care of that, to have an NHS, you need an actual economy, if your side had not wasted the massive chunk of a £trillion in total, there would be options to move the track. Did you think of that as you paraded your addition of 4 figure amounts of nurses, police officers and others?

Did you think that the governing party was not aware of the issues? Did you think that those who are governing are not aware of the fact that the NHS is ending far below the line of zero before the end of quarter three? When we see the quote “Hospitals routinely use an angiogram to assess the health of a patient’s heart. The number of people in the UK undergoing angioplasty has risen eightfold since the early 1990s to almost 100,000 a year, reflecting its growing popularity as a non-invasive alternative to a heart bypass“, we understand that it is routinely done (I had one), oh wait! I never had an angioplasty, I had an angiogram. So why is the Guardian just shovelling two issues together on a pile making it seem as one? Perhaps it is done to make it all a little more trivial? When we consider that an angioplasty is set at roughly £17,500, we see that this procedure alone would cost £1,750,000,000 annually, that is a lot of fish and chips repair, or am I trivialising here? So how much are the costs of an angiogram? One source gave me £5,529, so how many a year operations are needed of those and why was there one number, but not the other? It should be a larger number of ‘operations’ needed, but with the cost being merely a third, the impact is less severe. None of that part matters when it is needed, yet what does matter was given to us in 2010 by USA today. Here (at http://usatoday30.usatoday.com/news/health/2010-03-10-heart-angiograms_N.htm) we see a point that matters. With “A troublingly high number of U.S. patients who are given angiograms to check for heart disease turn out not to have a significant problem, according to the latest study to suggest Americans get an excess of medical tests. The researchers said the findings suggest doctors must do better in determining which patients should be subjected to the cost and risks of an angiogram. The test carries a small but real risk — less than 1% — of causing a stroke or heart attack, and also entails radiation exposure“. Now, we get that it is an American source on US patients, and not on UK patients, yet there have been correlations in health care in many nations, so it is not without merit to state that there is the chance that the same issue to some extent in the UK is taking place. Now, in the NHS age where £500 million in cost cutting, is it such a stretch to cut the one procedure that is seemingly only actually required in 1% of the cases? I am not stating that it is a great idea, yet if we accept that we need to get £500 million down, going after the 1% group might be one of the better ideas. In all this Labour should not object, a truckload of their politicians have made a career out of going after the 1% group their entire life, so there should be a consensus on both sides on the isle on this subject! The quote that is hugely helpful is ““We have to rationalise cardiac investigations and treatments. There’s variation of 60% to 70% between hospitals. We’re looking into why that is. Who in future won’t get an angiogram? That’ll be up to cardiologists,” said one senior doctor“, which makes perfect sense and as we accept that there will be a group of people that goes through one way of treatment, some of this will be done because a doctor had a certain education from a certain medical school, another takes route 2. I am largely convinced that both paths have merit and are in the best interest of the patient. In addition, when we see the 60%-70% variation, what happens when we drill down deeper and set it against the years of practice of the cardiologist. Will there be clustering? I am not stating that any of them are wrong. Yet, is there a chance that a junior cardiologist would see a few more (perfectly valid) reasons to do the cardiogram? I am not stating, not judging, I am merely asking. You see, as stated by: ‘the Guardian can reveal‘, yet that part they did not reveal. Why not? Perhaps the data was missing, yet the article on how “NHS organisations in Surrey and Sussex are considering restricting the number of patients who have an angiogram or an angioplasty” it would have been nice to see more than merely quoting “I don’t think that these extra cuts are reasonable. You can’t justify £500m to the DUP while taking another £500m out of the English NHS“. When we see the numbers I see that £500 million can be cut from one side where the costs are implied to be £1.75 BILLION, meaning that here we see that cost cutting is met whilst that budget remains to get 72% and none of the other parts are affected.

So cutting 28% from a program, whilst one of the other considerations is ‘Shut beds or even whole wards in community hospitals‘. It is merely a good idea to contemplate what could be cancelled, postponed of even considered in other ways. Another part that is true, yet limited to merely a small paragraph is “Saving the £55m this year will prove to be a false economy that costs the NHS more money in the long term, warned Nigel Edwards, chief executive of the Nuffield Trust health think-tank” Now, we might think that Nigel Edward is talking politics to the people that hire his consultancy (which is fair enough), yet he has a point and the point he is trying to make has been proven again and again. Yet, the NHS needs a massive overhaul and for the longest of times, people seemed to have been merely talking about it. Is it mere complacency or is there more? Consider the American source 17 years old gave us a 99% not needed rate. There is no evidence (at present) that this is as high in the UK, yet when we see “rationalise cardiac investigations and treatments. There’s variation of 60% to 70% between hospitals“. In an age of cost cutting that 60-70% is an enormous amount of variation and until properly looked at that data there is no way to tell how valid it is in the end.

The article merely gives us a lot more questions than they answer. That is gotten from the final part with “A Department of Health spokesperson said only that “Given the NHS budget has gone up by £6 billion in the last two years in real terms NHS England and NHS Improvement are ensuring that local areas spend their increasing share equally based on best clinical practice.”“, and in addition we see the mention of Tory MP Sarah Wollaston and “while taking another £500m out of the English NHS“, whilst at the end we see “Jeremy Hunt, the health secretary, declined to comment on the £55m cuts“. In addition there is “under NHS plans to make £55m of budget cuts in Surrey and Sussex“, so the article does not give us many things. Like why these two counties have to cut a little over 10%, the final part is given in the weirdest of ways. Now, it could be merely the reporter having a creative thought. If that is not the case, the entire issue in the NHS is a lot weirder and even more problematic than the Guardian could have revealed. The issue “The bodies made clear that they have to contemplate such controversial measures because NHSE and NHSI have told them to save the £55m. Despite already having “ambitious financial plans for 2017-18”“, so here we see part of a larger problem. We have seen for the longest time that the NHS over overspending, that the cash is gone and that cuts were needed, we have all seen that news for about 2-3 years and here we see “ambitious financial plans for 2017-18“. So based on what budget were those ambitious plans conceived, perhaps on a gurney with a few nurses (a somewhat speculative imaginative thought)?

The clarity of the problem has been there for the longest of times, the governing bodies need to take several matters a lot more serious, and in all this the shifting numbers, the mentioning of the blended events and numbers give rise to several other questions too. All this because certain numbers were thrown at the readers, yet the overall numbers called in questions from the very first moment and as such the article (in my humble opinion) merely stats that there is a lot more wrong at the NHS than most people realise, with all that, caught in the middle are the doctors and nurses. None are getting hired in addition and there are issues for the doctors two, so when they rightfully demand that these ‘ambitious financial plans for 2017-18‘ are being made public, what kind of a story will they receive? The tension should be an interesting one as the pay rise for health care workers was capped at 1%.

So as we conclude today’s event, we all need to take a long hard look at the decision makers in the UK NHS, they are seemingly wasting too much time of the preferential prospect of presentation, whilst the reality was never a given element of that presentation at all. The fact that there are actual issues rising to the surface of the NHS, whether already looked at or not, when we see the amount of issues linked to high variations, in an age where costs are cut to the extent they need to be, is it not weird that those numbers had not be properly looked at and reported on at least 2 years ago? The 2010 article is indicative of that to at least some degree. You see, if it had been, that that would have been evidence that could have been added to this article. The fact that it was not gives rise to the questions I added and in all this it took not that much time. Now in all fairness, to add 30% on a £105M cut. Yet in all this, there is still the issue with the £1.75 billion of angioplasty in the UK.

In addition, to add the amounts that are added, how was it decided where they would fall?

Now we get that there are issues in several places and some would state ‘It will be alright‘, and ‘things will get fixed‘. Yet from my point of view and from the issues presented there are merely more and more questions coming up and it seems to me that the growing issues with the NHS is due to inaction, not merely through cut backs. That is one actual clear given, the issue at that point is not how we can solve the NHS issues, it becomes how can we temper towards zero the amount of idle time and inaction, not in the staff, but in the governing and infrastructural sides.

The additional part that was not seen at present is the realisation that the NHS issue will tighten, and get worse for the next foreseeable future (up to 5 years), you see, the turnaround will take longer with every delay and the recovery from any delay will take longer with every delay we see. The second part that we will be shown with the time to come is that there is a growing concern that the UK aging part has been shelved with the NHS for too long, so in about three years we will see that the NHS geriatric division is not up to scrap and there will be additional increasing pressures on the NHS soon thereafter.

 

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The reality for poor London

It is not a new concept, people who are getting drowned through greed, yet as the Guardian in a video shows us: (at http://www.theguardian.com/uk-news/video/2014/nov/21/new-era-residents-fight-us-owners-westbrook-london-estate-video), the dangers where greed will not turn people homeless. In addition, the people behind it, Westbrook partners are hiding behind walls and the law. Here is the first part I object to. The law is a shield of protection for victims, not a cloak of unaccountability for the greed driven. However, part of the article that is not shown is the fact that the UK government might have fumbled the ball in a massive way here. I reckon that David Cameron has to attack these issues immediately, because if left untouched, the move from all parties INTO UKIP might be one we have never ever seen before in the history of politics.

So what is actually the case?

Westbrook Partners has been buying real estate on a massive scale; London, New York and Tokyo have been met with a spending spree on acquiring real estate. Buildings have changed ownership, but this change has a difference. This is done for investors of American workers Pension funds (to name but one). They bought property as mentioned in Hackney (inner east London), the residents were told that the rents will now go to market value, this is stated to mean that rents will triple almost overnight, how is that even close to acceptable, moreover, how many will be left to afford such a rent? Consider a rent of 2,500 pounds a month, this comes down to $4,500, I have had decently good paid jobs in IT, but I cannot afford those levels of rent, not in the best of days. Hackney council is currently expecting Westbrook to issue eviction notices. This is worse than just a bad nightmare; dozens of homes will be uprooted for what? Replacement by high rise new building, offering a massive boost to Westbrook Partners, which by the way is a US firm with offices in the UK.

It is not just the immorality of it all, consider that investment firms are now focussing on lower yield options, lower yield locations. Is this because the American wells have dried up? Now, I know that for the most, these things are not an option (or were not an option) in Amsterdam. When Amsterdam saw the 70’s boom in London, they made sure that these dangerous times could not happen there, but it is not a given for all buildings in Amsterdam (outside of the inner city). Consider other places where governments have been lacks with affordable housing. With this I mean Melbourne, Sydney AND Brisbane in Australia, Rotterdam, Delft and Leiden in the Netherlands, Several places in Germany and a few other places. When Westbrook and companies like them start changing the game to this extent, what will happen to the population at large? San Francisco had some events in this direction as Google expanded its views, but this is only the tip of the iceberg, now it is not just housing for a large company, now it is about returns for investors, how long until that part collapses leaving people not just in a state of destitution, but homeless as well?

When we see the article, we see the American Workers Pension Funds, with an image of fire fighters, did these fire fighters know that they are not just saving people, but for their retirement, they are making them homeless too? So is there an issue? Well, Yes!

The issue is at present that what is being done in not illegal, but highly immoral. To force a population out of an area, because of income is like stating that the poor are not allowed in London in any way, how is that not discrimination?

More interesting is how Westbrook was unreachable by the Guardian, their website views like a two page joke giving no information at all. When has an investment firm hiding behind wall of unreachability ever been a good thing? Goldman Sachs has been bad news on a global scale, yet they at least remained reachable. This new era of Westbrook is something entirely different. To see just how dangerous this rent rise is, take a look at the image on this link http://www.theguardian.com/society/2014/nov/19/new-era-estate-scandal-london-families-international-speculators, even more interesting is how the New Era estates included a minority share by Conservative MP Richard Benyon, who is pulling out this month, when confronted with these levels of changes. We might think of blaming it all on London’s Westbrook Principle Mark Donnor, but is that fair? Consider that this mess is the continuation of a mess which I witnessed for well over 22 years! Prices in London have always been outrageous and now that the wells are drying up, rental spaces are one of the few low return yielding options. Both political parties should have harshly intervened long before 1995, but they decided not to, now we see a new iteration which could break the London infrastructure. If you wonder why, then let me explain.

London needs workers, they always needed them and most of them live a long way from London, yet now we see a new group, those on a ‘higher’ lower income like Nurses and some tradies who lived in places like Hackney, as they are evicted, they will move further away and they will try to seek work in a place that is not London, as London faces a rental crash, it will also face a workers crash as people are less willing to live 2-3 hours away from work, we see the need to find other avenues to contain their work-life balance, that means working somewhere else. You might think that this is exaggeration in regards to 92 households in Hackney, but do you think it ends here?

If we consider the quote “The letter said they had secured an agreement not to increase rents again until 2016. However, it added: “Since this week’s departure of the Benyon Estate we understand the council have now been informed that Westbrook no longer plan to honour that plan, and have been told that their plan is to refurbish the current estate in its entirety and then rent all the properties without secure tenancies at market rent levels, with no affordable housing”“, we get another view, we get the view of several investment firms seeing what could be acquired in London for refurbishment and upgrades to market value housing. Consider areas like Paddington and Kilburn, what happens when they get refurbished into market value? In addition, when we see “Councils are acquiring properties in Kent, Essex, Hertfordshire, Berkshire, Sussex and further afield to cope with an expected surge in numbers of vulnerable families presenting as homeless as a result of welfare cuts from next April” (at http://www.theguardian.com/society/2012/nov/04/london-boroughs-housing-families-outside-capital), is this perhaps just the beginning? What happens when the situation goes from 92 households, to 992 households? What will happen to the smaller businesses as these places are all upgraded? The London economy is an interaction of classes and groups, when the city changes the dynamic that has worked for decades, we see a change in culture and options for all workers involved, moreover, what can we expect to see when these locations start to lose the reliability it has had for so long towards an entire iteration of workers and traders. Once that is changed, other elements will become in play as well, then what will happen?

In my view, David Cameron will need to make large strides in changing a current approach, to allow for long term sustainability. If not, we will see entire areas no longer in a state of survivability. These events that Westbrook has started will also make a change to the policies that London Lord-Mayor Boris Johnson is trying to introduce. No matter how strong the need for a living wage is, as Westbrook is pushing for market values, we will see a living wage that needs to go from £8.55 to £18.55, which is something that is not just unrealistic, it will be totally unmaintainable. The fallout will be long term.

In the end the UK government did this by not acting and others might be in the same predicament soon enough. I will be honest and state right here that no one anticipated the fact that rent would ever become the preferred return on investment for investment companies, which is an entirely different conversation I will have with my readers at a later stage. A change none saw coming, but now that it is here, it will prove to be additional hardship on the Conservative party, whilst giving even more options to UKIP.

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