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Books
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Review: To Kill a Mockingbird
Somehow I escaped reading this essential school text, with its story of racism in 1930s American South. Living in Northern Ireland, I draw parallels with sectarianism, with its similar bigotry and prejudice. To Kill a Mockingbird was part of a Unite Against Hate campaign event at Parliament Buildings in Northern Ireland, which I’ve written [...] read our review »
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Children of the Revolution (Bill Rolston)
What was life like for children of political activists during the Troubles? A new book by Bill Rolston and published by Guildhall Press during the summer has collected together the stories of twenty Children of the Revolution whose parents’ activities – and in many cases, imprisonment – had a significant affect on childhoods and life [...] read our review »
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The lost art of reading (or drowning in too much information)…
Here’s a great review of a fascinating book (H/T reader Rory) on how the Internet is destroying our capacity for intelligent, focused and critical thought. It opens thus: …here is the news that Ulin brings in this slim, meandering book: that reading is “an act of contemplation”; that such an act becomes more difficult in [...] read our review »
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Comment on Tom Elliott hands the poisoned chalice on
on 12 March 2012 at 9:11 pm
Alex – here’s the link to the Newsletter column arguing the UUP should go into opposition. (Don’t mention it.)
I tend to agree as Stormont should benefit from an opposition broader than the one man show that is Jim Allister. But Turgon’s point above is sound: Where Elliott did have problems, arguably his greatest, was in presenting a vision alternative to that of Peter Robinson’s dominant DUP. Other than saying ‘black’ when the DUP says ‘white’, is there a UUP narrative to provide a choice to voters? I haven’t noticed one.
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Comment on Why is it so difficult to downgrade local hospitals?
on 26 December 2011 at 10:20 pm
Turgon,
I support your general thesis, that trying to deliver fewer all-singing, all-dancing hospitals will be better in the long run. A broader range of specialties will be available on-site, 24/7 rotas will be more robust, it will be easier to recruit, etc.
I do have to take issue with your ‘four times more likely to have a bad outcome’ statement, which you come back to again and again.
The Compton Review actually says: The Royal College of Surgeons has stated that in a fragmented emergency surgical set-up a patient is four times more likely to have a poorer outcome than in a more organised model (p. 27). Note that they are talking only about surgery.
If you follow the reference in the Compton Report it sends you to a document published by the Royal College of Surgeons of England, The Higher Risk General Surgical Patient. Note that they are only talking about general (i.e. mainly abdominal) surgery.
I had a quick read through the RCS report and as far as I can see the relevant sentence is this: There are few data which compare our outcomes in the UK to other countries but one study reported that risk-adjusted mortality rates were as much as four times higher in the UK than in the US (p. 6). Note that what they are actually comparing is the UK and the USA.
If you follow up the RCS reference you find a journal article from 2003 which compares outcomes for non-cardiac surgical patients in the UK and in the US and concludes that risk-adjusted mortality rates following major surgery were four times higher in the UK cohort.
Now I haven’t read the original article from 2003 (Match of the Day starts in a few minutes) but I would like to point out that what we have here is one study from almost ten years ago suggesting that surgical outcomes are four times better in the US than in the UK. That may have something to do with ‘centres of excellence’ or it may not. It may be transferable to other specialties or it may not. I don’t think you can use it to draw the conclusion that you are four times more likely to have a bad outcome if taken to a small hospital than if driven past it to a bigger one.
There is already considerably more heat than light in this debate, so let’s stick to what the evidence actually says?
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Comment on Godot arrives: Compton Review delivers
on 13 December 2011 at 10:58 pm
pacman: Try this.
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Comment on Godot arrives: Compton Review delivers
on 13 December 2011 at 10:09 pm
pacman: There’s a strange one. The Health Committee minutes were there in all their Hansard glory, then the assembly got a new-look website and it’s all gone. But if you Google the link you’ll get the cached version.
On acute hospital provision, today’s ministerial Q&A includes the following on Causeway Hospital, in response to a question from Mervyn Storey:
Again, we go back to safety, sustainability and resilience. Decisions in the Member’s constituency will be taken by the Northern Health and Social Care Trust, which currently operates a two-site facility. It may desire to continue to do that. If so, it must ensure that having a two-site facility is safe, sustainable and resilient. If the trust decides to move to a model of one hospital for its area, ensuring that people get to that hospital must be done in a way that is safe, sustainable and resilient. If lives are threatened by the closure of a hospital, that will also be a challenge for the trust.
So the really hard decisions fall back in the Trusts’ lap. So much for political leadership.
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Comment on Waiting for Godot: Northern Ireland’s health care
on 8 December 2011 at 8:38 pm
I fear you may be disappointed, Turgon. Firstly, you’ll have to wait a wee while longer – according to evidence given to the Health Committee the Minister gets to spend a couple of weeks reading the report before any of it is made public. According to the original schedule that was through a statement to the Assembly on 12 Dec – I’m not clear whether the whole thing has now slipped a week.
Secondly, John Compton explicitly says: I do not think that it is helpful simply to enumerate a list of facilities in Northern Ireland and specify this facility here or that facility there. That is not what the review is about. So a list of hospitals to become non-acute looks unlikely.
Thirdly, if you read your way through the Health Committee discussion, most of it focuses very narrowly on saving Daisy Hill, and this from the MLAs who are supposedly the best informed about health care and best placed to see the big picture. It does not bode well for a mature, responsible assessment of our acute hospital configuration.
I predict: a bit of fudge from Compton, a huge amount of noise from Trade Unions and MLAs, and then more of the same – the gradual collapse of 24/7 services in smaller hospitals, with none of the advantages of strategic planning.
Or perhaps Godot will turn up after all.
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Comment on The TUV why it will not just go away
on 23 November 2011 at 10:02 pm
Jim Allister punches above his weight in terms of media coverage because he’s ‘the only nay in the village’ – effectively the only opposition we have and so the only truly dissenting voice around. Not sure he’d get the same airtime if UUP/SDLP finally took the plunge and formed a proper opposition. Perhaps Mr Allister should be careful what he wishes for.
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Comment on Fees gap to be paid by GB students…?
on 12 September 2011 at 1:48 pm
Sorry – that link didn’t make it through for some reason…
Possibly we could follow the Scottish model and charge higher fees to British students from outside this jurisdiction
Press release confirming this here.
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Comment on Fees gap to be paid by GB students…?
on 12 September 2011 at 1:43 pm
Possibly we could follow the Scottish model and charge higher fees to British students from outside this jurisdiction
Press release confirming this here.
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Comment on POTD – Caption comp
on 6 September 2011 at 10:49 pm
No idea what the caption is, but they obviously know something we don’t. BUY BANANAS!
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Comment on Row over opening changing rooms in Bushmills
on 25 August 2011 at 9:17 pm
The Belfast Telegraph is calling it a ‘loyalist protest’.
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