Slugger O'Toole

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Crubeen has commented 212 times (0 in the last month).

1. Comment on The solution to the A+E problems lies outside A+E
   on 23 March 2012 at 2:14 pm

   Turgon,

   There’s no shortage of beds but there’s an acute shortage of staff … apart from management- those whose function is to abuse and massage statistics to prove that there is no problem at all in the NHS that cannot be cured by pouring more money into management.

   A few weeks ago, on a Friday night, my daughter (who is chronically epileptic and profoundly learning disabled) suffered a seizure of a type we have not seen before and was taken by ambulance to AAH. A&E was bunged to the gills and out again – far too small for what it is asked to do. For the first time ever, A&E could not allocate any place for her and, as she came out of seizure she became more and more agitated and was detaining an ambulance crew who could and should have able to have been away on another call.

   Fortunately we were able to get her onto the ward quickly where she settled (though suffered another seizure later). She was discharged on Saturday morning by a Consultant in the course of his full ward round. If the staff are there, whether in A&E or on the ward (and there is no acceptable reason they should not be there) patient throughput and turnaround can be achieved. It is preferable that our “wee un” be cared for at home – indeed we have taken her home on occasion where the ward staff were more than willing to keep her for a further period. Nobody ties up beds other than poor hospital management.

   The fundamental problem with healthcare is that it has lost its way and forgotten its purpose. GP practices are not concerned with health – they are profit centres where treatment is driven by extra payments for target achievement than the best interests principle. Indeed GPs are no more than licensed drug peddlers and good health and drugs are not compatible.

   One solution would be to turn all A&E units into minor injury units and then have Major Trauma Units – admission primarily by ambulance. Joe Public, with his broken wrist or drink induced muddle would avoid Major Trauma Units lie the plague and they could do their job without hindrance. A&E units could then stream their admissions into those who have genuine complaints and those who are self injured i.e the drunks and hypochondriacs. The former are treated expeditiously and the latter simply observed until such time as they sober up and either go home or are capable of being treated.

   We need to fashion A&E services in the way the military deal with their casualties on the battlefield – paramedics at the front line to stabilise and triage with casualties then directed, on merit, to the appropriate next stage of treatment – the aid station or full hospital.

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2. Comment on The solution to hospital bed crises: not necessarily more beds
   on 21 January 2012 at 2:36 am

   Turgon,

   “The health service needs to worker smarter rather than harder.”

   It certainly is not doing that and it’s costing a helluva lot of money not to do that.

   Why do people clog up A&E … apart from those needing urgent heroic intervention? They go because there is nowhere else to go that they can be certain to be seen and treated.

   Why are there so few A&E departments? Everybody wants to practice medicine at the edge of the envelope in the most heroic way possible with the greatest number of tests and interventions so costs of the equipment etc dictate fewer and fewer A&E departments. If, at midnight, blood is spurting from a minor day-surgery procedure that has gone wrong (not uncommon) the patient doesn’t need to attend a major trauma centre – he needs a reasonably competent doctor who can shoot local anaesthesia and thread a needle to stop the flow.

   There’s a joke at the Pentagon that as aircraft costs increase the numbers of aircraft procured decrease and will inexorably reach the point where only one aircraft can be afforded … the Air Force to have it on Monday and Tuesday; the Navy to have it on Wednesday and Thursday and the Army to have it on Friday and Saturday with Sunday reserved for maintenance.

   Health care is heading that way … as you have so expertly pointed out. We soon will have one A&E for the whole of NI and no beds because we really don’t need them, because care in the community is better etc etc.

   Health care is far too important to be left to the professionals in healthcare … it’s long past the time that the long suffering public was given the power to demand the healthcare it wants and needs. In other words, the Health Service needs to be looked at by non-healthcare professionals who would be better placed to construct an efficient and economic model that responded to the needs of the people.

   The service badly needs to be simplified and integrated so as to eliminate duplication and waste. You advocate, for example, a further cost in extending social services’ input to clearing hospital beds. Would this not be better done by Community Nursing without a need for Social Workers? Could the money saved not be better utilised?

   Would it not be better to have Health Centres open on a 24/7 basis providing treatment for minor injuries rather than have over-stretched A&E departments? Considering that there already are after-hours GP services being funded, the cost implications are not great.

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3. Comment on Ireland vindictive treatment of soldiers who ‘deserted’ peace for war…
   on 21 January 2012 at 1:26 am

   Sliabh,

   “Jaan did so well because the racist whites under estimated the yella man.”

   I surely love your version of history … it is so at variance with fact.

   As Dread has pointed out, the Japanese ran riot in the first few months of the war in the Pacific because of a sneak attack on the US Navy at Pearl Harbor. They rightly estimated that the US would not tolerate their colonialist ambitions in SE Asia any more than it supported re-establishment of European colonial ambitions there post war .. or, for that matter, Communist colonialist ambitions.

   There is no evidence that the looting or mistreatment of Japanese property or bodies was ordered, supported or sanctioned by military authorities or that they did nothing to stop it. This being the case, one cannot equate these crimes with those perpetrated by the Japanese with the active connivance, if not support, of the appropriate authorities. The Japanese regularly and in cold blood, executed Allied POWS whereas the Allies did not.

   Japanese equipment was as good and in most cases better than Allied equipment in 1941 – they had actively flouted agreements and been arming themselves in secret for a war of aggression. Where they fell down was in their use of such equipment – damage control on their warships was extremely poor and they had almost no provision for picking up downed aircraft crews, highly trained and, as events were to prove, irreplaceable.. They never, for one moment, thought that the US was reading their secret coded communications or that US troops were the equal (never mind better than) theirs. Their cockiness was such that a single regiment landed on Guadalcanal in August 1942 thought it could, by virtue of superior moral power, destroy the US 1st Marine Division, only to be comprehensively slaughtered over one night of combat action.

   It was the US Navy at the Coral Sea and one month later at Midway that stopped the Japanese advance. The cream of their naval aviation was destroyed at the latter encounter and they had no replacements coming through in either aircrew, aircraft or carriers.

   In short, the war exposed not the superiority that you (and he) attributed to the “yella man” but a cockiness that was ruthlessly exploited to bring about his richly deserved downfall.

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4. Comment on “We were neutral for one purpose and that is that we were Britain’s home defence”
   on 19 January 2012 at 11:37 am

   “As you probably know, on VE Day, a gang of Unionist students at Trinity, who forgot to fight for King and country, ran riot, burning the tricolour and flying the Butcher’s apron. Really very much like the Francoistas in Cadrid and Barcelona after they fell.”

   Would this refer to the undergraduates who flew the Allied flags outside Trinity and tossed a smouldering Irish flag into the street whereupon two students from University College burnt a British flag in College Green? And one of these students was a future Taoiseach!

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5. Comment on Ireland vindictive treatment of soldiers who ‘deserted’ peace for war…
   on 19 January 2012 at 12:43 am

   Sliabh,

   What are your views on the Irish who enlisted in the US armed forces during WW2? I know that some from Northern Ireland did so and were inducted and trained here before being sent overseas. I have no knowledge of any from the South but there may have been some

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6. Comment on Ireland vindictive treatment of soldiers who ‘deserted’ peace for war…
   on 19 January 2012 at 12:36 am

   Sliabh,

   The point was that Yamashita did not whup Dugout Doug … ’twas the other way round.

   The Philippines fell in 1942 because the US fleet, having been put out of action at Pearl Harbor, was unable to mount the planned counter attack to reinforce the Philippines in the event of war.

   As for “supremacist asses” you would go a long way to find any race more convinced of its innate superiority than the Japanese militarists prior to and during WW2.

   What antics did the Marines get up to?.

   And I assume you accept that the treatment of the “deserters” was vindictive and petty in the extreme sense of both of those words.

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7. Comment on Ireland vindictive treatment of soldiers who ‘deserted’ peace for war…
   on 18 January 2012 at 9:42 pm

   “Yamashita was a not notorious war criminal . He was hanged because he whipped McArthur.”

   Actually, “Dugout Doug” whupped Yamashita in the Philippines in 1944-45.

   “The British army: officers and men. Maybe I should read up more on Waterloo or Stamford Bridge. After Singapore, the headless chickens of the British Army did what they were told. The German NCOs on the other hand… ”

   Did what they were told. Not a lot of them refused duty in the Einsatazgruppen.

   “All I can say is: thank God Dev saved many Irishmen from all of that.”

   Did he indeed!?! Or perhaps his policy was informed by a need to assert Irish independence and a need to keep the Nazi menace out of Ireland. The former was the legacy of centuries of British rule and the latter was pragmatic. The record shows that had the Germans invaded Ireland the British Army (post 1942 – the US Army) would, according to pre-arranged plans, have crossed the Border to render assistance to the Irish Defence forces.

   Devalera paid his respects to the German legation according to protocol on the death of the German Head of State – there is, I believe, evidence to suggest that he regarded the films coming out of such as Belsen as British propaganda. Outside of closed circles the extent and depravity of German crimes was little known – hence the need for Nuremberg and the trials in the Far East in respect of Japanese criminality.

   The treatment of the Irish deserters was vindictive and petty. Americans who defied US law to go fight for the Allies prior to Pearl Harbor were quietly taken into the US Armed forces e.g. the Eagle Squadron become the embryo of the 4th Fighter Group. Given that the Irish Free State did not become a combatant this option was a non-starter but given that those “deserters” fought against one of the most evil systems that ever existed, there is and was a very clear case for quietly forgiving and forgetting. They did not fight against Ireland’s interests – indeed they fought for the interests of common decency.

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8. Comment on Quote of the day…
   on 9 January 2012 at 10:45 am

   “Anything you say before ‘but’ in a political statement doesn’t count.”

   Are not the words “before” and “but” redundant?

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9. Comment on Now Tony, how do you make these figures add up?
   on 9 January 2012 at 10:26 am

   I would venture to guess that this is a type of holding company that administers all of the various commercial and/or other activities and that, probably for tax reasons (if not confidential ones) it is efficient to set off various kinds of expenditure through this company’s accounts.

   The accounts referred to are not the “tax return” – they are the statutory audited accounts of a limited liability company that, by law, must be filed at the Companies’ Registry on an annual basis and is open to public inspection. Tax returns are confidential and not published.

   Most of the other commercial affairs of this individual, if indeed there are any, would appear to be conducted through organisations or sole traderships that are not obliged to publish accounts.

   Tax avoidance is entirely lawful. This individual is subject to UK tax and we have no reason to doubt that his income tax affairs, as an individual, are other than above board. His financial advisers have, doubtless, ensured that all his business affairs are conducted in a tax-efficient way. People who think that almost £8 million of expenditure requires some form of public explanation have never read the Companies’ legislation and are just plain “sticky beaks,” with no right whatsoever to query this or anything else that relates to the affairs of this individual.

   HMRC are, I would think, no less effective and efficient in dealing with this individual as they would be with anybody else and we should only regard that business with Goldman Sachs as an aberration which, unfortunately, got into the press.

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10. Comment on Thoughts on Prescription Charges
    on 9 January 2012 at 10:07 am

    Turgon,

    Instead of prescription charges why do we not cease and desist from taking drugs which, in most cases, are not at all necessary and not conducive to good health?

    Very many hospital admissions are iatrogenic in origin – medical treatment has caused the condition that requires hospital admission to treat it. How many years ago was it that doctors in Israel went on strike … and the death rate declined? How many people are put on medication … and more medication to counter side-effects … and more medication etc ad infinitum and how much better off would they be if they never had taken medication in the first place? My mother (RIP) was one of them – eventually had to be taken into hospital to be detoxed. Tough old bird that she was, she defied the prognosis and went home in one piece … but that over-prescription cost her a kidney and nearly terminated her life prematurely.

    Figures – in 1990 -15.9 million prescription items; in 2009 – 33.8 million prescription items. The population in 1990 was 1.6 million; in 2009 it was 1.8 million. Costs – in 1990 -£111.5 million; in 2009 – £416 million. Is it not time that we terminated the “health hustle?”

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