Ending GP Catchment Areas

Health Secretary Andy Burnham has announced his intention to end catchment areas of GP surgeries which restrict which surgeries you can sign up to. Part of the argument is competition which is supposed to drive up standards as people don't register at poor surgeries and part of it is to provide flexibility for people who might want to register, for instance, near their work or their child's school. It sounds OK and it might be the right thing to do but what really troubled me was the man's statement; "In this day and age I can see no reason why patients should not be able to choose the GP practice they want". The man said publically that he can see no reason not to change it. Well, since he is apparently not very clever, I will provide some, partly courtesy of people on the news article:
1) What happens with home visits if you are registered 40 miles away?
2) What happens when loads of people register near work? The local surgery might be left with stay-at-home patients with potentially a high percentage of ongoing and serious conditions to have to deal with.
3) Most council services work by areas, this might make accountability difficult.
4) If lots of healthier people decide to register elsewhere, it can cause a snowball effect because a struggling surgery now ends up with a disproportionate number of sick people who visit often and who are then even less able to deal with the work since they will get less money for their less patients but most of whom are now sickly.
5) There is no objective evidence that this technique, like schools and hospitals, actually drives up standards. The system is far more complex than that and it can be argued that the problem is related to the community being served rather than any serious incompetence on the part of doctors.
6) What happens if a surgery is oversubscribed because it is good and local people cannot register there and are forced to register far from where they live? This has already happened with NHS dentists and it was obvious there that this 'demand' did not suddenly force lots of other dentists to set up shop or to increase their staffing levels since as stated above, this is not a simple thing to do. The wage levels, general availability of qualified people and the simple practicalities of the work are big obstacles.
7) There is actually a danger that spare demand in an area is met with a practice that sets up to meet that demand with no track record in high-quality care and who might unecessarily put another practice out of business as people move to the new surgery.

There you go Andy, hopefully these few reasons why you might not want to end post code catchment areas will help you at your next meeting into the matter. I wouldn't want to think you go in uninformed and make a massive expensive cock-up on behalf of the tax-payers!

What is really valuable?

Who do you respect? If you could swap your life with someone elses, who would you have wanted to be? Edmund Hilary, Neil Armstrong, Mother Theresa, Michael Jordan?
We have a distorted way of judging other people. We think, "If only I was that person or had that person's money, I could...". What would you actually do if you had money on tap? Buy loads of junk like cars, houses, planes and yachts? Sure you would be able to do some cool stuff that you might not otherwise be able to but would that really be a wonderful life? You can't buy love but you attract a load of flies.
From a heavenly perspective, if you have led a single person to Christ, your life would be more fruitful and more valuable than any famous person who hasn't done the same. I won't name anybody because I don't know which famous people are or aren't Christians but how ever famous, rich, popular, talented or anything a person has been, however influential, whatever their famous legacy is, if they have not been instrumental in leading somebody from death to life, their life has had no heavenly value compared to your normal, run of the mill, average, obscure existence where you have actually led people to Christ. Can you imagine somebody like Simon Cowell with all his fame and fortune getting to judgement day and saying, "I wish I could swap my life with Luke Briner's so I had a lasting legacy" That doesn't seem like it would ever happen but in effect it will when we die and realise everything we had counts as nothing, only what we have invested in the Kingdom means anything!.
What does this mean? It means that the most glorious effect your life can have is taking people from an eternity in hell and leading them to Jesus who can take them into heaven. I would suggest you set your target at one person, always one person and then when they become Christians, target another. Don't try and save the world, do it one person at a time.

So Gordon is sorry then?

I read that Gordon Brown has apologized for the treatment of Alan Turing who was prosecuted for homosexual activity and committed suicide 2 years later. Gordon reckons that "while Mr Turing was dealt with under the laws of the time..." he also says, "his treatment, of course, was utterly unfair". Excuse me but who on earth is Gordon Brown to decree that all of the politicians and public petitioners of old who brought in these laws are all wrong and he is right? Why is it "of course" that liberal laws are correct and conservative ones are not?
Regardless of the actual law in question and whether I or he as an individual agrees with it, the job of the government is to execute government now not for the past. Unfortunately there aren't any of these people who died for whatever laws they used to have to appear in parliament and give Gordon Brown another tongue lashing like he usually gets in PMs Questions every week.
The government's ego knows no bounds. The wise man would have said, "sorry but what happened happened under another government in another time and I am not in a position to undo that".
Does Mr Turing deserve a posthumous honour for his work? By all means. The honour is for his achievements not his personal life whether that was 'illegal' or not but Brown, try running the country properly before muddying the waters of everything that comes your way!

Guilty till presumed innocent

Well, there is always plenty to moan about and today is no exception. Another hair-brained government scheme designed to protect child from paedophiles but which of course will cost an awful lot of money and no doubt do anything except generate more paperwork and more mistakes. The article here basically extends the criminal records check for people who drive for clubs like their children's football clulb. As if the farce of CRBs is not already understood, the problem is that the scheme has the appearance of something useful, surely we want to protect our children from abuse? Of course we do but the problem as always is in the implementation. I would like to see a cost/benefit analysis since I am sure it wouldn't hold up. Here are some scenarios:

1. Somebody has been accused of some sort of abuse and is barred from working with children. Well apart from the unacceptable presumption of guilt, it is a case of one or two false accusations and the rest of someones life is in tatters.
2. Somebody with accusations who is actually a danger (like Ian Huntley) might well not be considered a risk and be allowed to work with children which defeats the whole point.
3. The 99.99% of people who are not a danger have to pay and administer the scheme like people have to do currently for CRB checks for no reason other than a paranoid government making a paranoid society.

I would like to know exactly how many cases of abuse were caused by such scenarios in a way that this scheme would have definitively prevented. I suspect very few if any. I also do not like the line, "if you haven't done anything wrong you have nothing to worry about" because it is patently not true in more than a few instances. If I get told I have to have an ID card to work at church with children, I will stop working with children because I despise a government who is sure they know what is best for everyone and muck it up so often!

The wasted money is sickening

Right, another rant I'm afraid, this one courtesy of no-one in particular, just general incompetence and the government's love affair with wasting money at a staggering level. First let me ask a question. If you were to suggest spending money improving school buildings for economical and aesthetic reasons. What would you do and how much would it cost? I would probably spend up to about a million quid getting a national team together putting together some computer models and working out some industry standard costings for things like double-glazing and room re-fits etc and then let councils use these to work out whether certain work is value for money or not.
Now, what would the government permit? Look here. They would tell councils to look into it and assume they will spend about 3% of the money on 'consultants' which they have done to the tune of £170M. Now, I don't mind big numbers to achieve big things. Investment and all that is good for long-term situations but honestly £170M? You pay people who know how to charge large sums for knowledge that to be honest exists outside of this exclusive club of thieves. To be honest, you could pay a local experienced builder even some quantity surveyors some money or better still, provide a contract job for someone in the industry which will cost, let's say £100,000 each county council and which will not add up to anything like the money spent. But oh no, because we are the government and we can promise ludicrous amounts of money to be magic'd up from nowhere we don't care about value-for-money. God help the next government have to deal with all the debt we have accrued from the happy-go-spending Labour party.

Karma?

I told a friend about my typical but crazy journey through the "computer controlled" traffic lights of Cheltenham going to Gloucester yesterday. I met 13 red lights and 6 greens (2 of which were pelicans). He said that it was karma getting its own back on me for my anti-traffic light blog. If I believed in karma I would agree but I don't which leaves me with the belief in incompetence at County Hall (whoops, nearly misspelled it to something rude but funny!).

More data loss, again, another time, etc.

http://www.theregister.co.uk/2009/09/02/uk_eu_data_menace/
Nice, a story about another loss of important computer data, in this instance the supplier of a government gateway data system had a load of access codes on a USB stick and dropped it in a car park. Of course, the person will probably be sacked but again, I protest, that so-called system experts are missing the basics of data security. I have gone through them before but:

People make mistakes so design the system so they can't

Rather than the old excuse, "well never mind, mistakes happen" which gets touted a lot by the government (because they make lots of mistakes) we should build things in a way that prevents those mistakes or at least makes them unfeasibly hard. You wouldn't take all the windows out of a school building and then when a child falls out and dies say, "well never mind, mistakes happen". You put railings in because you know that mistakes happen, you might even put the windows back in!

Software and computer systems are no different. If you do not want people to take copies of personal data (and you generally don't) you only physically allow authorised machines to connect in and they have their USB ports and disk drives locked-out. You run in a terminal window so you cannot copy things to your local hard drive or you simply do not allow things like copy and paste. Not rocket science honestly. What happens then is that someone has to take a photo of the screen (unless you set the contrast low!) at which point you know they have done something totally unacceptable which is not the case with a USB drive ("I just needed to take this home to work on the login screen").

The principle of least privilege should be at work but I am still convinced that most IT companies don't have a clue about it.