Marmora Man

TopTree Wrote: ------------------------------------------------------- > Where in East Dulwich is it? Or is this just a > paid advert? If you were to read the post it's in Piccadilly Circus - hence posting in the Lounge as a matter of interest not related to East Dulwich. I make the remarkable assumption that those of us that live in / near East Dulwich occasionally venture outside its confines. As for it being a paid advert - buck up. I've been posting on here for > 4 years with nary a hint of a paid nterest.

Just a note to say that I had a great pre theatre dinner at this, relatively, new brasserie near Piccadilly Circus. It had a great buzzy atmosphere, fantastic service, a fairly small and affordable menu of brasserie classics. Asanadded bonus there was a pianist and, later, there was to be a jazz singer in a small adjacent bar with stage and also a properly dark and romantic cocktail bar. Give it a go - they deliberately keep a number of tables unreserved for walk ins.

And meanwhile "over the hill" in HONOR Oak Park a Sainsbury's local is being created with no fuss

DaveR Wrote: ------------------------------------------------------- > It's worth being clear that competition and the > profit motive can bring benefits even without > conventional private sector involvement. The only > essential requirement is a minimum number of > different providers who are independent of each > other, and who each gain from their own > efficiencies i.e. if they save money they keep it. > Some or all of the providers can be > not-for-profit organisations - they still compete. As indeed is the organisation I work for - it's a "not for profit", a "Social Enterprise" or a Charity depending upon your point of view. However, it competes for NHS work but re-invests any surplus back into the business of providing top quality healthcare.

WorkingMummy - you state that NICE was once "wholly independent" - that was not the view of clinicians when it was introduced, nor of PCTs responsible for commissioning services. NICE was, and still is, seen as part of the "cost control" arm of centralised NHS command and control management systems. You describe the "theory of competition" as bollocks - I return your compliment, your ideas and description of the NHS is not just bollocks, it's rosy minded, idealistic, ignorant bollocks. You describe an NHS that I, for one, just simply do not recognise. As for the NHS being the only good reason to pay tax - why should we all, pay yet more tax from our increasingly hard pressed incomes, to see it wasted through inefficiencies, downright poor management and complacency? NHS spending has tripled in real terms in 15 years - outcomes have, overall, remained the same and in some very well publicised cases been diabolical. As a general point for every ? raised in taxes the government manages to purchase roughly 70p worth if goods, due to the costs of collecting the taxes, general bureaucracy and Victorian processes and a compete inability to procure goods at a competitive price due to the Civil Service's lack f skill and knowledge in this area. Tescos, Sainsburys, Waitrose et al use their volume buying power to press down on costs. The NHS has yet to organise a truly effective central buying process for drugs, prosthesis, laundry, food or other simple goods. The profit motive drives efficiencies - state monopolies don't seem to bother - they just ask for more tax money - apparently believing it to be a free good.

Today's NHS headlines - across the NHS, on average, less than 67% of NHS staff would recommend their own hospital to family & friends. In some cases less than 40% would recommend their own hospital. My wife, a nurse, says she would not recommend certain wards at her hospital - a major and historic London teaching hospital. While the NHS is capable of delivering a fantastic service there are clearly parts of it that are broken. Soft hearted rhetoric about it being "the envy of the world " (I have travelled widely and never, never has anyone said to me - I wish our country would set up a nationalised state run health service) or "the jewel in Britain's crown" don't help. As Loz said above - and I implied in my initial post, judicious use of competition, private and charity services to improve healthcare for all is the way ahead and not dogmatic ideology.

Don't do it - manicured walks are far less fun.

WorkingMummy said "You privatise a system, you introduce the interests of corporate business and you remove money from the system in the form of profit". As opposed to the NHS where money is wasted within the system through inefficiency, over staffing, poor contracts, high salaries and the like.

I don't have time to respond in detail. Those that know me will recognise my position - the NHS is not unconditionally good /beyond reproach and private provision is not unconditionally bad. Had the N. Staffs debacle occurred in any other sector or industry under private management there would have been wholesale sackings, a media hue and cry and probably (and appropriately) charges of corporate manslaughter. Because it happened in the NHS little of this has occurred, tho there are the beginnings of an attack on senior NHS management. I know, and so do almost all professionals in the healthcare sector, that "there but the grace of god" go a significant minority (and, appallingly, possibly even a majority) of NHS /public sector healthcare organisations. I work in the independent (but charitable) healthcare sector. Our immediate response to the Francis report has been to review out whole way of working, to conduct staff forums at every workplace, to ensure that the current, and very live, whistleblowing policy is re publicised to every member of staff, to reinforce our 18 month old Modern Matron and company "Way of Caring" philosophy and values are stressed at every level. All this has happened despite the fact that our patient satisfaction surveys indicate a 98% satisfaction (good or excellent) with only two (2) hospital acquired infections occurring in the last 12 months and no (zero) unexplained or unexpected deaths in a national private hospital business that treats 200,000 + patients a year, 25% of which are NHS funded. Given the choice would you prefer to be treated in one of my hospitals, at no charge and funded by the NHS, or in N. Staff? My group is the true face of the alleged "privatisation" of the NHS. We can do it better, faster, in cleaner surroundings, with better outcomes and at lower cost. The NHS is one of the last bastions of a 1940's ideal of state provision that has failed us all. A comprehensive mixed economy of healthcare incorporating public, charity and private sector (roughly speaking the European model) is the way forward. Ignore left wing rhetoric that the state knows best - support quality and caring wherever it is provided and ignore / avoid bad practice.

Otta Wrote: ------------------------------------------------------- > MM, I should have been clearer. I know what a > target is, and agree that we all have them in work > and in life. > > What I dislike is when a load of performance > indicators get set, but it costs a fortune and a > load of adminh time to actually monitor and record > the progress. That to me is a waste of time which > could be used more wisely elsewhere. An accountant that helps me came up with a great quote "you can't fatten a pig by weighing it" - which sums up what is often bad about today's performance management culture - too much time weighing and not enough time feeding.

Otta - getting rid of targets is impossible. We all work to targets. I plan to get home tonight in time to cook dinner, that's a target. My company would like me to make a a certain % profit margin on operations, that's a target. HospItals want the ratio of qualified nurses to patients to be appropriate, that's a target. Targets per se are not a bad thing. Bad targets, poorly thought out targets, improperly implemented targets are a bad thing. Targets are just another word for objectives. I'd acknowledge that under the previous administration, and regrettably not rescinded by this one, there were way too many government targets for the public sector. Nevertheless, well set and thought out targets can bring clarity and a sense of purpose, and achievement, to any task. Don't knock the measure - knock poor management.

Not sure if this is a "true dit, no sh1t" but .... I have read that in Russia the word for Railway Station is BOK3an [can't quite reproduce the cryllic alphabet here] - pronounced "vokzal" which sounds remarkably like Vauxhall. This is because in the 19 century a Russian delegation came to inspect the new British railways and were taken to Vauxhall. They thought "Vauxhall" was a generic term for a railway station and called the Russia equivalents 'vokzals' when they were built. As I said not sure if this is true but I do hope so.

lane lover Wrote: ------------------------------------------------------- > The main issue with NZ are the locals. > > From experience, the West Island is far better in > terms of job and lifestyle - and the people far > more accommodating. Err - I thought it was North & South Island - where's the West Island?

As ever - I'm seeking EDF advice on IT matters - I know someone will have the answer. Whenever I click a link in an e-mail my system default gives me Google Chrome rather than my preferred Safari or Firefox. How can I disable GC or enable Safari / Firefox as the default setting? Thanks MM

A friend of mine and dedicated Scot went out to NZ on a 5 year contract advising the government on prisons and rehabilitation policies. Still there having become a naturalised New Zealander with son, who joined then out there, now married to a NZ girl. He obviously liked it - the big surprise to me was to hear about some very tough drug and gang warfare issues that went on in NZ prisons - so law enforcement might be a challenge?

Tom Micklewright Wrote: ------------------------------------------------------- > If you are interested in hearing about meat free > lifestyle come along to the next Dulwich Veggies > meeting - all welcome But if you prefer meat there's a good stables on the South Circular.

Lowlander Wrote: ------------------------------------------------------- > > Of course the nicest way to arrive in Istanbul is > through Sirkeci railway station from Greece or > Bulgaria. > I agree entirely - and it's worth bearing in mind it's very easy and more fun to travel all the way by train from St Pancras. No. 63 bus to thEre from ED and it's public transport all the way to the Blue Mosque - beats air travel every time and it is a very fine city to spend a few days in. With my monicker I just had to go there. To be fair last time in Istanbul I left by Turkish Air ( Business Class ) to Cairo and all was very pleasant and relaxing. I don't recall the decor or colour scheme.

I have long been a strong proponent of nuclear power. It's safe, reliable and, relatively, cheap. The clean up costs are vastly overstated simply because the majority of the public and far too many decision makers are I'll informed and equate reactors with weaponry. Having lived cheek by jowl with a working nuclear reactor for the best part of a 20 year navy career I am fully confident that they offer the best way ahead for the safe provision of energy over the next 50 years. By which time I have every confidence that science and mankind will have solved the nuclear fusion challenge which will, in turn, solve the nuclear waste problem. T'will also reduce the argument for mediaeval technology of windmills blighting our countryside. It's not often you find me arguing alongside Monbiot & Hugenot.

AirJordans... Wrote: ------------------------------------------------------- > Hello... > > Does anyone know of any good loan companies that > allow you to borrow over 2years from amounts > starting from ?1000... Banks

Best eaten at sea, in the open air, during a morning watch as the sun comes up. The salt spray adds an extra tang.

MrBen Wrote: ------------------------------------------------------- > woodrot Wrote: > -------------------------------------------------- > ----- > > I have always found they react warmly to a gift > of > > Nazi gold > > I might skip that one today Woody. But joking > aside, what's the truth/history on that? I don't know the true history on that but recently, travelling thru' Switzerland on the way to the ski slopes I wondered why, of all middle European nations, Switzerland was the only one not to be invaded by Nazi Germany during WWII. It's not a area that the many WWII histories that I've read ever touch on.

Mine starts with thick cut smoked streaky bacon - never back bacon the flavour is in the fat streaks. Place it in a hot oven for approx 10 mins until edges are just crisping. Rest on kitchen paper to soak up excess fat. Place several slices into a freshly cut (and ideally freshly baked, heavily buttered, soft white roll. Eat - I prefer no sauces but it should be accompanied by a strong coffee or, on high days and holidays, Bucks Fizz. Great after a long night out with friends. There used to be a Transport Caff off the A74 just south of Glasgow where I used to eat, what I recall as, the perfect bacon sarnie on the way back to University / Navy after climbing weekends in Scotland.

aquarius moon Wrote: ------------------------------------------------------- > Vegetarian bacon > > in Warburtons half & half bread, with Pure soya > spread > > & brown sauce this cannot be a bacon sarnie. Pigs must be involved at some stage of the preparation.

SJ: 1. " Unless I see doctors, nurses and patients united in support of closures I'm still smelling something more than "rationalisation" - doctors, nurses and hospital staff are no more selfless when it comes to possible loss of jobs, position or power than union or non union members of a car production line or a chocolate factory. Their opposition to change (NOT closure as LondonMix has pointed out) should be considered with this in mind. 2. I understand what the promises are. Does it not bother you that they might not happen? Not from any ideological viewpoint. But from a "history shows.." perspective You're too objective surely to deploy this hackneyed argument against change. You would despise an old Tory like me for putting it forward.

SJ - it's been an open secret in the healthcare community of London that a rationalisation of London services is long, long overdue. Once upon a time there were many small separate health authorities covering London, almost as manay as there were hospitals and most of these hospital came into being organically via local actions of charities, local authorities and local benefactors rather than as part of a "plan for London". The health authorities reduced to became four and then one. Still, the senior management and politicians ran scared of the necessary re-organisation of the hospitals. Now, admittedly on the back of a financial failure, there is an opportunity to start the needed changes in SE London, similar changes are being debated in NW London (albeit at a lower temperature at present, tho' the debate has had its moments). The three closest hospitals to this postcode are amalgamating into one organisation - Kings, Guys and St Thomas' hospitals will be under the same management soon. Expect changes and consolidation - it's not ignoring peoples choice, its not top down management, it's not cost saving made necessary by Coalition cuts, it's not "stealing" services from the community - it's common sense. EXAMPLE: Less than 5 years ago most London hospitals provided, via their A&E departments stroke care. Paramedics and Ambulance services were directed to take stroke victims to the nearest A&E. Now there are just 5 specialist stroke units across LOndon. Costs have fallen, expertise has increased and lives are saved on a daily basis by driving to the specialist centre rather than the closest centre. The loudest argument of the "Supporters of Lewisham Hospital" is proximity - it's a rubbish argument in the healthcare world.