Penguin68

The stark reality is that if you need to see a GP urgently ... But only at certain ED surgeries - many do offer real 'same day' appointments - mine does for instance, for 'urgent distress' (i.e. actually being ill). This will either be immediately face-to-face or a telephone consultation - often all that is needed. I only have to wait any length of time if I want to see a named doctor - and then this will be about something routine - i.e. care review of a long term condition, when I am looking for continuity of care. That is why the DMC saga is so annoying, even in ED it doesn't have to be like that - it's not just 'the way it is' in SE London.

Absolutely yes - the 'research' published by Andrew Wakefield has been shown to be rubbish, and withdrawn by its publisher, and Wakefield has been struck-off. There is NO evidence that the MMR jab causes any problems, and, in so far as any vaccination could be an issue, having separate jabs rather than the combined MMR would be more, not less likely to cause these problems. Protecting your child from measles and mumps will save them from the possibility of nasty complications (and both diseases are unpleasant to have, even if no complications arise), and rubella, while itself quite a mild infection, can lead to dreadful disability if caught by a pregnant woman. Because of the stupidity of parents earlier on you cannot rely on herd immunity, in London, protecting your children if unvaccinated. You are lucky to have a doctor who is bothering to remind you of this. Follow his advice.

Plusnet is wholly owned by BT - but operated at arms length. Like any ISP/ broadband provider (save those providing satellite broadband, which is very expensive, or mobile broadband - slower and also often more expensive than e.g. fibre services) it has to have a physical link into the house - it uses telephone lines (as do most providers other than the former NTL Cable company, now re-branded as Virgin, who uses cable access). Hence you have to be getting telephony from someone for them to be able to connect to you. Almost all domestic physical connexions (other than cable TV) are eventually provided by BT Openreach, the provider of wholesale local network to BT Retail as well as to most other non cable ISPs. Just out of interest, emergency services (999) are only guaranteed delivery over a hardwired phone using a landline, because landlines are powered from exchanges which have back-up battery systems in case of power failure. Even if you lose power in your home, a hardwired phone will still work - wireless handsets rely on the base station to be powered, the exchange power won't be sufficient to run those. Mobiles will of course continue to work, if you have power, and signal!

BT started in the telephone business - its delivery mechanism to the house is via telephone lines - Virgin started as a cable business, its delivery is via coaxial (was anyway) - the engineering in the BT Network is enhanced telephony, that of Virgin enhanced cable. Hence BT charges for the (telephone) landlines it uses to deliver services - broadband with telephony; Virgin offers broadband with cable. It's the way their network topologies were designed and work. For Virgin it's actually more difficult to provide telephone services over their sort of network - hence they are happy not to have to. For BT it's the telephone network which forms the backbone of their delivery system, - although now there is Fibre to the Cabinet (FTTC) they offer hybrid systems - but the twisted pair going into the house is essentially part of the telephone network, which additionally (with the right electronics) carries broadband.

Sorry - I think I had read that piece and sort of forgotten its origins.

Good piece - you might want to think that with the Grove abandoned, the Dog shut and being rebuilt as a reduced pub with rooms and the Half Moon in doubt, the Dulwich Estate has managed to blight every decent sized pub (EDT an exception, and not that large) in the area. And the Estate doesn't own the EDT site. Are they secretly teetotal Quakers?

20 years and more ago the early inoculations were covered off (as far as reminders) by the Health Visitors (do those still exist?) with the pre-school reminders coming from the surgery, if memory serves. The schools then handled school-time inoculations - such as the TB one. We had to fill in a form each year for the school saying which inoculations had been done, which also acted as a reminder. Since then I think more inoculations have been introduced (my eldest, certainly, was pre-MMR) and surgeries have been incentivised by payments (I believe) if they achieve the right percentage of inoculation take-up - so presumably in their best interests to remind. I think things like tetanus boosters were alway going to be down to parents to remember.

This water-logging was on established graves, not new ones. One's 30 years and more old. I think the new asphalt is important as regards draining and run-off.

I have recently been walking around Camberwell Old Cemetery, and have noticed considerable water-logging of graves - and that at the top of the hill. I suspect that the recent tarmacing of the pathways will have exacerbated the problems of water run-off - many of the graves (including depressions of burials now unmarked) were ponds. The problem of water-logging will be exacerbated down the hill particularly where trees (which are fine sinks for water) are removed - thus making the proposed new (or revived) areas for burial even more prone to flooding and water-logging, as I would imagine there will be a lot more tarmac put down for pathways to support vehicles (hearses etc.) in the new burials. Do you know whether there have been proper hydrological surveys done of the site, and forecasts of impact once the existing scrub woodland is removed? I suspect this could be an additional argument that those wishing to preserve the woods may wish to put forward.

So, if your child is over 3 years and 4 months and hasn't had their pre-school immunisation or are overdue any others and you want them to have it, make sure you make an appointment. This is a really worrying development to the DMC saga - childhood immunisation is vital (and I think is one of the things GP practices are specifically paid to do, but I am happy to be corrected here). If these are not happening there may be a real problem of local epidemics (where 'herd immunity' is compromised). Normally injections would be handled by the practice nurse, rather than GPs, but it is easy for parents to forget (or simply not know) the relevant timings.

It is well within permitted development so won't need planning approval. If you want it certified as a permitted development (you will if you ever want to sell) then you still have to submit plans etc. to the council - and permitted development or not it must still be built to building regs. Even if it doesn't need planning permission per se it still needs to be viewed and OK'd by the planning department. Which means you will need proper professional plans if you want it to go through smoothly.

Having read this thread, and its many predecessors, it appears that there is little issue with the quality of the medical staff at DMC (indeed some praise for some) - it is their availability which is an issue. This appears to be a function of either/ and poor resourcing or poor processes & systems. Unlike many GP practices which are partnerships, the salaried doctors will not also (I am guessing) form part of a practice management team, so there is little they can do to improve things. For whatever reasons it is the business model being employed which is failing patients here - poor resources and/ or poor management systems will not be improved by adding (as the practice appears to be trying to do) to patient numbers by further recruitment. One might suggest it is doctors and office staff they need to be recruiting, not patients. Indeed a focus on business diversification before the core business (GP-ing) is remedied seems a policy of madness. Offsetting your over-trading by pushing customers onto other business (those designed to remedy out-of-hours and emergency surges of need) is a short term remedy only - true as a business modelled on customers not using it (the ideal GP practice has very large numbers of extremely well patients who never book appointments or need treatment) you can get away with this for a short time - but a consistent failure to deliver against your contract with the NHS will, eventually, catch up with you, even in this gentlemanly world of second, third and fourth chances. Sadly, GP capacity in ED means that the entire patient list will not be able to vote with their feet. There is a shortage of GPs in London in particular - and getting to see doctors is not ideal in any surgery (although many locally are much better) - but this is no excuse for DMC to be such a performance outlier, even in a stretched area.

I think you can only now go to the Lister if you have a recommendation from your GP. So, a bit of a Catch 22 when you can't get to see or talk with one.

I could perhaps have added to my post above on GP earnings that another nice little earner is diversification - in DMCs case I believe a well staffed pharmacy - not only can you expect to 'pick-up' all (or at least most) practice prescription sales but pharmacists can also sell OTC medicines and products and pharmacist only medicines - here medical 'advice' can lead directly to a sale - if you reduce the amount of NHS paid-for advice (doctors, nurses) you can boost sales here. You can also offer therapies - again often paid for by the client. A surgery becomes a useful hub on which other, non NHS businesses, can be built. A canny business might even over-prescribe into 'its' pharmacy to generate extra revenue. However, as GP practices do have a 'budget' out of which prescriptions are taken (I believe) you would have to get the modelling right here to make real money, although I am not sure what actual remedies are taken against GP practices that bust their prescription budgets.

The GP practice will get paid on a capitation basis, and additionally for achieving government targets, such as inoculation levels, health checking older patients etc. GPs may be partners (they get a share of the dosh) or salaried GPs (get paid a wage by the practice owners/ partners). Locums will be salaried. The practice will pay their administrators, receptionists, clerks etc. and practice nurses. Midwives and Community (used to be District) nurses are I think employed directly by the NHS but may work out-of GP practices. Where a practice (or several practices) are owned by one person (or a company) they make their money out of the difference between what they get from the NHS contract and what they pay-out for staff and premises. The headline figures quoted for GP's earnings (?100k and over) can be much less for salaried and locum GPs - particularly if young. If you have a large capitation and a (relatively) small wages bill it can be very lucrative to own GP practices.

Actually, it is sort of annoying when commercial vehicles are being regularly parked even just over-night in wholly domestic (residential) streets - particularly when these are over-large and take up more than one normal domestic car space (smaller vans aren't an issue). A neighbour runs a business where he has his own (family) car - fine - but where two huge white vans (two car lengths long) are also regularly parked up - blocking parking for the residents who live around me. A wholly residential street is slowly turning into a lorry park (effectively). It is of course entirely legal but it is also somewhat inconsiderate. The vans are away during the day (except at weekends), of course, but if they get back before the residents do...

When this is in place, people who forget, decide not to go or otherwise unnecessarily waste this precious resource should be dealt with firmly. Give DMC the option of fining patients who miss appointments and Dulwich will be beggarised in a month. Most people (given DMCs appointment system) will be dead or better by the time the appointment arrives. If you're better, a doctor's appointment slips below the radar unless reminded (when it's weeks ahead). When a business (and that's what GP practices are) treats you shabbily you don't much feel like treating them any better. Do, please, remember that DMC is not a charity, it's not even (like a hospital) part of the NHS, it's a private business contracting with a government department to provide services - it's an outsourcer - if they run their business badly (and they do) they should be given no rights or leeway to punish the customer when the customer treats them with the disdain and lack of 'business efficiencies' that they seem so happy to dish out.

One thing you need to do, if it hasn't already happened, is to get her 'confusion' properly diagnosed - there are numbers of causes for this, and not just the dreaded Alzheimer's or vascular dementia, some (such as infections, poor diet, dehydration etc.) are eminently treatable. If she does have long-term neural deficiencies these can be ameliorated (somewhat) and she should be being 'treated' by psychiatric services to ensure that she is in the best possible condition. Many times people cope better when in their own (well known) homes - so if she wants to stay down south her quality of life may still be better than living closer to you somewhere she doesn't know, and without any of the people she knows. If she is neurally confused she may lose memory triggers by moving which would otherwise help her cope much better. Unfortunately, whilst I live in ED I had to cope with similar problems to yours with my mother in another town (Midlands, not up North) so although I can say that the people in Kings here (who initially diagnosed her when she was staying with me) were very good at diagnosis, I cannot comment on local treatment or support. She did return to her own home, with support, and her last years (until the last months) seemed to provide her with reasonable life quality.

On the basis that this isn't just a wind-up - this is a highly populated, inner city borough; any crime is of course unfortunate, particularly if you are a victim, but the incidence of crime here is, if anything, less than many other comparable areas. The 'bin raiding' may be about identity theft, or it may be about people scavenging items that have been thrown away. Considering the bin raiders have been seen with trolleys I would suspect the latter. Any assault is of course hugely unpleasant, but the groper appears to be a one-off (who has made several assaults) and hasn't actually physically harmed anyone - i.e. caused actual bodily harm (psychological harm is of course less visible, and may take time to develop). It was undoubtedly a sexual assault, the perpetrator has been well described, is likely to be caught and may himself be a damaged individual (to explain, not excuse, his actions). The victims are properly distressed, but there is no pattern of different perpetrators doing this. This is not an awful place to live, and people here do like to complain.

More what the councillors think they can get away with Considering the surprise often evidenced by the councillors who post on this forum, I suspect it is what the council officials think they can get away with (possibly a specific cabinet member as well in some cases).

Hi P68, You don't know me very well. Ah, that would be in reference to my saying " I am sure that if he is aware of manipulation to change the game he will wish to resist it, going, as it does, against the wishes of a significant majority of electors polled at the time " I had thought that I did know you well enough to assume that, but, in your own words, obviously not. Hey ho

I'd suggest you get all forms sent to the registered address That was precisely my thought, but when I asked I was refused - because I was not the person in question on whose behalf the error had been made - it is she and she alone who can request the form, which I was told (initially) she must do by phoning in working hours and then (if my experience is anything to go by) hanging on for 15 minutes listening to anodyne Southwark Council recorded messages before speaking to a live person. In the end I had to talk to 3 separate executives (in the laughingly entitled customer service department) before one admitted that she might be able to e-mail them to ask for the papers to be sent to the registered address, but that only she could do this. Of course the 'data protection' shield is complete cr*p - since all I was asking for was the forms for her to fill in - but that's what the apparat gets up to when they can. Voter Registration Day? Voter Horsesh*t more like.

Yesterday was Voting Registration Day - a good day to receive from Southwark notification that one elector in my household had had her postal vote removed (not at her request) and had been set back to 'Polling Station' - since she will not be in London on the day of the General Election (or for weeks around that - hence the need for a postal vote) that means that her vote has actually been taken away from her, on Voting Registration Day. Of course, I cannot get this corrected - she only can do this ('Data Protection') - apparently pointing out that there is an error (and a simple check of the paper trail showing no request to change voting method status isn't sufficient) - and not being about in London this will prove complex and difficult, although it may be possible (not confirmed) that it can be done by e-mail (oh yes, the system, and I use that word advisedly, to allow changes on the internet doesn't allow for that change to be made). So, another victory for the apparatchiks over the concept of democracy. You now have to go to extra lengths to get corrected a mistake made by them which will effectively disenfranchise you. Oh, and the final absurdity - she had just completed and sent in a form to record her signature so that her postal vote could be validated! You couldn't make it up!

I am not sure the issues you are talking about are necessarily to do with the BT broadband service per se - I also am having drop-out problems with my main PC (ethernet) - whilst other wireless devices (phones, laptop, another PC, tablet) remain firmly connected. This suggests that my problem is either terminal equipment hardware or software related (probably a software clash somewhere). By the way, if you have a dual band router (the modern BT supplied ones are) it is likely that your printer is only single band, so that may be dropping out as the router cycles to a band the printer can't read. Someone from HP explained it all to me once.

smokers are actually doing us all a favour by creating employment for doctors and nurses who'd otherwise be scrounging benefits on the dole? Smokers are actually doing us a favour by dropping dead early and quickly (rather than requiring expensive late life care) - also by not taking up too much pension (if any), so leaving more for the rest of us. Us old non smokers are in fact offering greater employment opportunities to medical and care personnel by lingering on for ever and needing so much support - quick heart attacks and strokes contributed by the smokers are much less demanding on NHS (and DHSS pension) resources.