Schrödinger’s Virus

Great Britain

Summer, distinguishable from spring by nomenclature only, gave us a better manifestation of philosophical pessimism than Schopenhauer ever came up with. And as it shrivelled and dribbled away it seemingly took with it Covid, which has largely vanished from British front pages even though the infection rates on our overcrowded little island are higher than almost anywhere in Europe. In fact, the UK has among the highest number of coronavirus cases on the planet.

This ghostly there-but-not-there effect manifests itself in busy maskless streets, maskless theatres, superspreader student parties and overflowing hospitals. But instead of causing mass panic, no-one appears in the slightest bit worried. I imagine a scenario where other countries (Canada most probably, and New Zealand) would be zipping themselves into Hazmat suits while we merrily cavort with trays of canapés.

The casual attitude is largely to our PM telling people to wear masks if they want to, apparently thinking that around seventy deaths a day is an acceptable figure. Schrödinger’s Virus appears and vanishes; although the number of infections is through the roof, the number of deaths has fallen as the virus moves down through the unvaccinated age brackets. Yet all this is due to change again. Like others who are in the ‘extreme high risk immunosuppressed’ category I was vaccinated very early, back in January, and that vaccine is now hitting its sell-by date.

It means I need a booster, but they haven’t begun rolling out yet, and who even knows if they will? Our PM has yet again flip-flopped on much-needed vaccine passports, cancelling them once more. Is this a new kind of micro-responsive governance or the sinister manoeuvring of a classic Tory agenda; to restore the dying class system? Every bill seems designed to widen the gap between rich and poor. Right now, international travel is much as it was in the 1950s – extremely costly and painfully slow, hindered by Brexit and mismatched Covid rules.

Another thought springs to mind. After visiting the excellent ‘Nero’ exhibition at The British Museum, the parallels between classics-loving Johnson and the boy emperor become clear. Nero/Johnson, famed as much for his hair as for anything he uttered, built vast, pointless vanity projects to appease the people while he hid his nefarious dealings. He did not fiddle while Rome burned; he simply wasn’t in town. Nero was of course murdered at 30. That system of efficiently realigning political policies is no longer open to us.

 

50 comments on “Schrödinger’s Virus”

  1. Stu-I-Am says:

    If Johnson’s goal is to bring the NHS to its knees so that he can claim full privatisation is the only solution, he couldn’t do a better job, thanks to his co-conspirator, the coronavirus. That only around 7% of fewer beds are now occupied by COVID patients belies the fact that this seemingly small percentage is an unacceptable proportion of the now approximately 85% occupancy rate of hospitals in England and about the same elsewhere in the UK.

    This has a pronounced knock-on effect since COVID patients need more support from fewer, overburdened doctors and nurses as well as services in general. The upshot is that the number of non-emergency procedures and operations remains about 10% below pre-pandemic levels with the number of people already waiting for treatment in England alone is at a record high. And winter (officially…) hasn’t yet started, with its ills. There is no question ‘Schrödinger’s Virus’  is very much alive. It’s just having a more widespread impact beyond its infection rate.

  2. John Griffin says:

    The only reason it hasn’t been fully privatised YET Stu is that some sectors (e.g. my daughters premature baby ICU) have no clear profit to be made. Virgin Health and United Health visited 3 years ago and walked away. Babies with a 50% chance of survival, often with insanely litigious parents and vampire lawyers in attendance, are not commercially viable. Thanks to privatisation, my daughter has had to hide dead babies away from other parents since the mortuary is Capita (I think) and ceased 24 hour staffing long ago. So they can’t take a body down until it opens at 0700, and after 1800 they have to accommodate otherwise. Likewise staffing is a lottery, as the agency nurses – often paid poorly, while the firms take £1000 a shift for a nurse, £3000 for a doctor – turn out to be less use than the cleaners, necessitating a sudden double shift as no competent staff are present to take over. My daughters view is that apart from ICU, A&E and the demented on ward, the NHS has gone.

  3. SteveB says:

    I don‘t think there is any agenda, just chaos

  4. Liz+Thompson says:

    Shame about murder going off the agenda. I used to think Michael Gove might stab him in the back, but he chickened out. Though would any of those waiting for an opportunity be any better? I doubt it.

  5. Brooke says:

    Don’t confuse “plan,” “agenda,” and “intentionality.” The intention can be to create chaos, and then walk in with “I have a plan to solve this….”
    Don’t confuse the care system with the payment mechanisms. United Heatlh (US company) doesn’t give a damn about components of care. It only cares about the insurance piece.
    I awoke this morning to BBC news saying BJ was “putting the finishing touches” on plans for handling Covid vaccinations for children. I maintain my stance on the value of the guillotine.

  6. Wayne+Mook says:

    At the moment he seems intent on ripping the Tory party apart too, but then the only thing Starmer seems to have on the agenda is doing the same to the Labour party (Does anyone actually know of a policy he has? Apart from getting rid of the left, although he’s done a little u-turn as he’s beginning to realise he’s disenfranchising the young, although he does appear to be taking the working class for granted again, no red wall lessons it appears.)

    Thinking of political expediency doing the bump, I’m reminded of the film ‘The Death of Stalin.’ It always gets out of hand, next thing you know they’ll be blaming Nick Clegg.

    Wayne.

  7. John Hudson says:

    I live on Tyneside and had the same feeling on a recent visit to London! When Johnson decided that masks would be optional, I ordered a supply of FFP2 masks to replace the simple washable ones. Visiting the V & A Museum, I went into a special exhibition. I was alarmed to see the number of maskless people there crowded into narrow spaces clearly not allocated to allow social distancing, and left in a hurry. I’m now disillusioned with the V & A: I really thought they would know better.

  8. Helen+Martin says:

    Our provincial vaccine passport went into effect today and the news is on with protesters yelling that there is no pandemic and vaccination is your choice so the passport shouldn’t exist. They just don’t get the fact that if you don’t get vaccinated then the requirement for the passport protects YOU. Public health is provincial and Quebec, Ontario, and New Brunswick all are introducing them. The covid stats are still news, our public health head & minister of health will be on tv at 3pm with status reports. The coffee time discussion yesterday was answering passport questions for a couple of people without the easy means to do so and the one lady who was physically present thinking that we were reopening this week actually got a printed copy of hers because our IT person printed it for her. One text to the group said that we were obviously a full service congregation. One person, though, said that her Alberta relatives have one member in a coma, at least one other member sick and a number of people also refusing vaccination. It’s a mix and I think we’re getting close to publicly shaming anti-vaxxers. Don’t know how that will go down.

    How could Boris go out in public looking that much of a jerk?
    I’m currently re-reading B&M and have reached The Burning Man. When I first read it I felt that it reflected the Occupy movement and events vividly but wondered how that would stand up after a few years. The answer is that the chopper blades, flames, and roaring crowds of the book take me right back to the news broadcasts of the day, to say nothing of the fact that we have these protest rallies (much smaller, of course) and similar stupidity going on now.

  9. joel says:

    we’ve got governors who are threatening to punish people/cities for requiring vaccines…we’ve got a govenor who will pay people to sue anyone who helps someone get an abortion after 6 wks but he refuses to mandate masks in schools and in fact has been pushing to punish schools who are mandating them…life is only important in the womb…once you’re out you are screwed…sadly i think all the big civilizations and countries will destroy themselves…so best to enjoy what is left of life

  10. Stu-I-Am says:

    Johnson’s seemingly inordinate need to be liked or, what appears to be an excessive desire for approval, has to be a dangerously motivating factor in his cavalier attitude toward COVID precautions and related science-based restrictions. Since loyalty rather than competence appears to be the guiding principle in selecting his advisors and cabinet, this certainly assures him of a large measure of the continuing approval he craves, which he doesn’t seem to be getting from the British public according to a YouGov survey at the end of August.

  11. Brian says:

    I assume that, given recent events, this blog is now an Osman-free zone.

    I fear that even this comment might get me blocked.

  12. John Howard says:

    Don’t worry Brian… Admin is a benign overlord. You may find your library card “marked” now and see people whispering to each other behind their hands as you pass by but worry not. It’s not you. Honest.

  13. Keith says:

    The number of people dying from Covid seems to have become a quick little side-note after each daily BBC news update. Terrible!

  14. Cornelia Appleyard says:

    ‘Johnson’s seemingly inordinate need to be liked or, what appears to be an excessive desire for approval, has to be a dangerously motivating factor in his cavalier attitude toward COVID precautions and related science-based restrictions.’

    Exactly.
    Have you seen the documentary about his mother? His very odd childhood may explain some of this.
    I’m not suggesting that it excuses his behaviour.

  15. Peter+T says:

    There are two objectives in vaccination. The first is to prevent spread. For this, the vaccine doesn’t need to be very effective. The second is to protect the individual who is vaccinated. The same sort of argument applies to masks. Most, including medical ones, prevent spread rather than protect the wearer; fine particle masks are required for that. And the virus, though initially airborne, eventually falls on any convenient flat surface and accumulates there, making touch potentially far more dangerous than inhalation. Such situations are very difficult for people who make decisions wholly through self-interest and stupidity.

    It’s very difficult for them to understand that vaccinating the young is totally justified as it stops them infecting everyone else, especially as they know that the death of one young person falsely attributed a vaccination side-effect could cost two votes. It’s even harder for them to appreciate the value of the AstraZeneca vaccine as no one is making a pot, well actually a mountain, of money out of it.

  16. Stu-I-Am says:

    Although Nero didn’t fiddle (the ‘fiddle’ hadn’t been invented yet) and was conveniently out of town when Rome burned, the government led by its first chair violin seems intent on blithely bowing away while the UK burns with COVID. It escapes me how it is that Scotland will require proof from potential patrons that they have been fully vaccinated (with exceptions and exemptions) before they can enter nightclubs and many large events from 1 October, whilst England has now dropped (excuse me, put ‘in reserve’) a similar scheme, it had supported only two weeks earlier. And this whilst the uptake of vaccinations in the 18-30 age range — the very group most likely to engage in socially risky behaviour — has stalled or is dropping.

    As for that ‘freedom’ thing — as it is, you have to show a PASS-accredited (the national proof of age scheme) photo ID of some kind to confirm age in order to be admitted to nightclubs, shops, pubs, cinemas and other places which sell age restricted products and services. An imperfect system certainly, but a real-world attempt by the Scots to actually attempt to keep entertainment venues open, as opposed to ‘We just shouldn’t be doing things for the sake of it or because others are doing….’ according to the health secretary. Yes that’s right, those ‘others’ are trying anything that might stop the spread of the virus. (sarcasm supplied). Obviously the Scots have discovered that COVID doesn’t follow the dictates of governmental wishful or ‘magical’ thinking.

  17. Stu-I-Am says:

    @admin. Good news (for now at least…). It looks like you will get that COVID booster jab.

  18. Helen+Martin says:

    When they announced the booster jab for various categories yesterday we were given a detailed explanation for why boosters, probably in the hope that they could slow down demands for the extra shot by people who don’t need it – or not yet anyway. So they can’t win, they’re protested against for demanding people get vaccinated and then rushed by people wanting the extra one. Can we all stand back for Chris and his peers and then show our vaccine passports before trying to persuade governments to be sensible.

  19. admin says:

    Everyone seems keen for me to have a bash at Richard Osman but he seems a top chap, showing grace and even expressing some mystification about his own success.

    If the NHS was to be judged by my GP surgery it would be considered the best service in the world. My GPs have;
    Called me in Barcelona to tell me about jabs.
    Tracked down medications that my specialist doctors have failed to mention.
    Come around my house when they couldn’t get hold of me.

  20. Brooke says:

    Mr. Fowler: Follow your excellent GPs’ advice. On the other hand, a panel of physicians and vaccine researchers have published Lancet article saying boosters are not needed by those for fully vaccinated and otherwise healthy. This follows JAMA article saying same. For those interesed in topic and trying to decide, there’re assessments of potential side effects of a booster (e.g. STAT mag in USA, the Conversation).
    The salient points from articles are: the vaccinations rates seem to plateu at 60-65% thus leaving room for the delta, lambda and mu variants; politcal and economic self interest pushed powers-that-be to lift mask and social distancing restrictions; and behavioral stupidity, e.g. back to the bars, let’s go to the super spreader event, etc.
    The dinosaurs had an excuse for extinction; we’re just stupid.

  21. Jan says:

    It’s great to know the NHS surgery is serving you well Chris. and that folk are still going out of their way to help.

    Let’s face it NO ONE really knows what this winter will bring (although I expect the maths has been done and the figures sat on on as they look so scary). Awful to say it and this is just a worms eye opinion keeping safe now is just going to be down to each individual. Which don’t make life any easier for the immuno compromised.

    It’s trust to common sense unless you are resident in one of a number of city locations likely to be heading for local lockdowns No use getting too involved with the politics. Let’s just get through it. Best of luck to us with that!

    I like that Mr Osman he’s shrewd enough to Know he’s been lucky and either decent or clever enough to let his audience know at the same time

  22. William says:

    I really do not got this obsession with having a go at the Conservatives. You really think it would have been better with Corbyn in charge?
    The NHS is a moneypit that needs a complete overhaul but politicians on all sides are too vote sensitive to take action. Meanwhile Doctors as arrogant as ever cannot be bothered to see the people who pay their wages face to face.

    Pretty sure the old insurance system was no worse. Privatisation is not always a bad thing if we have a system that works more efficiently.

  23. William says:

    The reason fewer people are wearing masks is because people make their own choices. Do we really want to carry on in crisis or accept a semblance of normality is required.
    We do not publish daily and obsess over road deaths, flu,cancer etc. So let’s have some balance here. We all knew Science was the only way out of this mess. The rest, NHS, masks isolation just help keep people alive until we are all vaccinated with regular boosters if necessary.

  24. Stu-I-Am says:

    @William You seem to overlook the fact that a highly-transmissible virus (and those that may be on their way) delights in a false sense of ‘normal.’ There is no ‘normal’ in a pandemic and no amount of wishful thinking is going to change that until the rate of infection has significantly slowed and vaccination uptake, especially within the 18-30 group is where it should be. Apart from ‘breakthrough’ infections, the issue is not only easy transmissibility, but providing the virus with a readily available opportunity to mutate in an unvaxxed population. You have a ‘choice’ whether you get infected or get a ‘breakthrough’ infection. You don’t get to choose for others. And btw, seasonal flu has been controlled and is now far less dangerous than the COVID variants (we know) and road deaths and cancer are not transmissible the last time I checked.

    Yes, we would all like to return to our former ‘carefree,’ ‘unfettered’ lives. The virus could care less. And that ‘obsession’ about bashing Conservatives you mention. Let’s be clear— it is a specific group of Conservatives in the central government who insist on politicizing a public health crisis or engaging in magical thinking when not. The PM made sure that any competent Conservatives who somehow happened to fly under his sycophantic radar, were summarily removed. Local governments, by and large, have fortunately been a much needed counterbalance to this dithering and outright incompetence.

  25. Bruce+Rockwood says:

    Compare the California recall results with what the idiots in Florida and Texas are doing and with Boris. People aren’t all stupid, just enough to make it worse for everyone. I’m just back from ten days in for bypass surgery, ,and they are still dealing with having to isolate a patient who came in after me because a nurse treating her was unvaccinated and tested positive. Is it ideology, deliberate disinformation, or the revenge of Gaia?

  26. Stu-I-Am says:

    @William Rant, Part II If we truly want to get back to a semblance of pre-pandemic normal, we will have to continue to do ‘abnormal’ things like get vaccinated, wear masks indoors and otherwise when in close contact with others, socially distance and in general, as Jan suggested above, use common sense leavened with some basic scientific guidance. The more consistently we do these things, the sooner that normality will begin to appear in sharp relief in place of the present mirage. The problem is, of course, that ‘common sense’ appears to be in short supply in some quarters or worse, is being willfully ignored for some perverted notion of personal freedom. I’m sure I need not remind anyone that freedom always comes at a cost, and this time around that ‘cost’ is being aware of how your actions affect others and most importantly, acting accordingly, even if it is somewhat inconvenient.

    Now as for the NHS privatisation issue, I do agree with you that neither side seems to have the political will to right the ship — as if this is a political matter or one of retaining/gaining power and not the health of their constituencies. But to my way of thinking, privatisation, and partial privatisation in particular, is an especially fraught ‘bypass’ or diversion around the NHS problems. We’re already seeing a gradual privatisation or hollowing out of the system under the cover of the pandemic and the danger is that the conversation about this complex issue will continue to be more about saving money than more efficiently delivering healthcare.

    Specifically there is every reason to be concerned about a hybrid system, not only from the standpoint of private firms ‘cherry-picking’ the most profitable bits (as John Griffin points to above) by skimming off the profitable patients and the profitable services — but that the private system would almost certainly draw off resources from the public system. The bottom line, however, is that unless we believe, without any empirical evidence whatsoever, that for-profit organizations have some secret of efficient operation not known to the not-for-profits, it makes no sense to suppose that, given the same payment system and the same patient population, the for-profit organizations can provide similar services while still extracting their profits and business costs from the system.  Again, the overarching issue is the political will to fix the NHS, I believe, not necessarily to replace it with something that could too easily become the expensive mess that is the US system.

  27. SteveB says:

    The secret of being a not-for-profit orgamisation is to cream off all the profits in inflated salaries, suppliers who are owned by the employees and charge inflated prices, and all the other bs that goes on in ‘not for profits’

  28. Stu-I-Am says:

    Off topic (I think I can hear the sighs of relief from here…). Just saw the Branagh ‘Belfast’ (don’t ask…) and very simply, I was moved — not a small thing in my case when it comes to most films. It’s the (semi-autobiographical) story of a young working class Belfast lad coming of age during The Troubles, as did Branagh. Yes, as might be expected, there are a few maudlin bits here and there and an occasionally ‘too adorable’ moment or two, but all in all a simple pleasure, beautifully acted and shot in lush b&w. Opens in the UK/US/Canada on 12 Nov. Europe/Oct.-Dec.and Australia/New Zealand in January, 2022. The official trailer link follows:

    https://www.youtube.com/watch?v=Ja3PPOnJ

  29. Stu-I-Am says:

    Sorry — apparently the link to the ‘Belfast’ trailer in my previous comment doesn’t work. Try this one:

    https://www.youtube.com/watch?v=HcYh5Lfy1PI

    If this also doesn’t work, do a search. There a number of the trailers available on line.

  30. Glasgow1975 says:

    Scotland isn’t faring any better actually. The numbers are worse than England despite mask mandates supposedly remaining, visiting my local supermarkets now it’s about 2/1 masks and they don’t even bother pretending with their daisy lanyards. Vaccine passport may be coming but in reality it’s a shambles. Theatres have reopened yet large numbers of people had the wrong details and still needed to submit to a test. Whilst queuing. Outside. In the rain. The SFA say they are unworkable, and since most ‘mass events’ will be football matches, probably have a lot of sway with TV’s Nicola Sturgeon as to whether a U Turn or some modification is forthcoming. That’s all on top of the fact that passports were unworkable until recently anyway as the separate, Scottishy vaccine roll out relied upon posted letters and a printed bit of paper was your only proof. Which many people found wasn’t accepted when they got to their destination in the sun… but I’m sure it must have been Westminster’s fault somehow. It always is…

  31. Cornelia Appleyard says:

    ‘Meanwhile Doctors as arrogant as ever cannot be bothered to see the people who pay their wages face to face.’

    Most have been seeing patients face to face throughout the pandemic when necessary.
    Do you think immunosuppressed patients should be sitting in the same waiting room as people who may have the virus?
    Don’t forget it isn’t so very long since Jeremy Hunt was saying that GPs were behind the times and should be offering online consultations instead of wasting paeople’s time by making them attend the surgery.
    The pre NHS insurance system definitely wasn’t better – many people weren’t covered, and couldn’t afford to see a doctor. The disintegrating care sytem demonstrates that profit and health care don’t fit together well.

  32. Brooke says:

    What Cornelia said–amen.

  33. Peter+T says:

    “The NHS is a money pit.”

    Taking care of the health of 60 million inevitably costs. The problem is that people, especially the wrong people know that it’s a money pit. Some want to grab some of it. Was it Dickens, “Go somewhere where there’s a lot of money flying about and get in the way of some of it.”?

    Others decide it’s a good idea to control the costs. Well it does sound like a good idea. There are some situations where the costs are what I call bums on seats: you have N essential people who occupy X amount of space and require Y amount of supplies to do their job. And you can’t do much to change any of these, certainly not the people and the space. You can introduce Z administrators and/or divert the time of the essential people to control costs and make the whole thing far more expensive and far less efficient. This is nothing to do with being public sector as it was rampant in the multi-national that I worked for years ago. Of course, you can control the costs of the supplies, for the NHS that’s medicine, diagnostic equipment and the like. The NHS runs a ruthless cost-benefit programme to do that and receives a lot of criticism for it.

    When I was a child the NHS was thriving. Our local GP had no office staff. He and his partner shared a surgery and a waiting room. You turned up, morning or evening, without appointment, and shuffled along seats as he worked through his patients. The doctor not in the surgery was doing home visits. If you fell off the dining room table on a Sunday afternoon, you could go to a call box and arrange a visit for the application of vinegar and brown paper. Next time you see your GP, ask him how he spends his hours. That’s just GPs; the same applies to the whole system.

    Do I blame the Tories or Labour? Well Mrs Thatcher was the queen of cost control and Mr Blair the champion of keeping it.

  34. Stu-I-Am says:

    I find the human mind (among too many other things) and words especially, in this agglomeration, endlessly fascinating — to which those of you who find yourself nodding off after the second paragraph of one of my comments here can attest. So — since I’m certain there are still some out there in the ether surrounding this blog (on both sides of the issues) whom we haven’t yet pissed off with the preceding discussions of the pandemic and the NHS — I suggest we remedy that by moving on to gender-neutral, non-binary or ‘neopronouns’ and reclaiming the use of ‘they/them’ as a singular pronoun, in particular. This is now only ‘semi-controversial’ since the last major dictionary (the American Merriam-Webster) accepted this neopronoun two years ago. Unknown gender has always posed a problem in modern written English.

    The singular ‘they,’ however, was readily used by such literary greats as WS, Jane Austen and Emily Dickinson and, in fact, can be traced back to ‘The Canterbury Tales’— used not to be gender neutral, but to describe a specific role. It wasn’t until the 18th c. onwards that we started using male pronouns when describing someone of a non-specific gender in writing. Many linguists now expect “they/their/them” to become generally acceptable because they are already embedded in the language and part of the grammar. The jury is still out, however, on the hundreds of new gender neutral pronouns developed and in development. Linguists abhor a vacuum (even an imaginary one).

    For example, the so-called ‘noun-self pronoun,’ in which a pre-existing word is drafted into use as a pronoun. Noun-self pronouns can refer to animals — so your pronouns can be ‘bun/bunself’ and ‘kitten/kittenself.’ Others refer to fantasy characters — ‘vamp/vampself,’ ‘fae/faer/faeself’ — or even just common slang, like ‘Innit/Innits/Innitself.’ In addition, there are ‘unthemed’ pronouns, ‘non-English pronouns (e.g. Dutch ‘hen / hun / zich’), ‘nature’ pronouns (‘sol/sun/sunself’) and my personal favorite, ‘royalty-themed’ pronouns (‘ki/kin/kins/kingself’). Is that a collective groan I hear ? Or has my goal of pissing off those untouched by the preceding discussions been met ? It would be interesting to hear our favorite man of letters’ point-of-view.

  35. Peter+T says:

    As in the dog bit their dogself in the tail?

  36. Stu-I-Am says:

    @Peter+T Give the man a stuffie of his choice!

  37. Peter+T says:

    Give the personself a stuffie of their choice?

  38. SteveB says:

    Regarding the nhs

    There are certain limits beyond which an organisation cannot spend money effectively. These have to do with all sorts of structural limits, as simple as order and invoice processing for example. So: When Gordon Brown threw money at the Nhs what 20 years ago it simply wasn’t possible to spend the money effectively. And at that point, all the leeches started to attach themselves to this new money stream. I saw that happen. And I think things have just progressed from there, though it’s many years since I had any direct contact. However I think that flood of money created a sickness that simply developed since.

    On top of that was the distastrous buy now – pay later public-private partnership that he brought in – the later is now. Finally, because it became obvious money was being wasted, they brought in reams of new paperwork to control it. That created yet more overheads.

  39. Stu-I-Am says:

    @SteveB To your point about spending money effectively, my view is that it is less a function of structural limits (what an organisation can spend, I presume you mean) than how the funds are spent. For example, as much as it may go against the ‘conventional wisdom’ of a great many, the NHS may well be under- rather than over-managed. That is, the very large annual sums spent on external management consultants by the component bodies of the NHS (which has doubled since 2010), strongly suggest they have too few good planning and finance people and first-rate internal consultancies of their own.

    A study published earlier this year found that among 120 trusts in England alone, the widespread use of management consultants was almost exclusively linked to prior use, despite a lack of positive performance outcomes. In fact, policy initiatives, such as outsourcing and private financing of hospital buildings had worse outcomes for efficiency when carried out with the help of consultants’ advice. Although a minority of NHS trusts experienced some improvements in efficiency, these were the exception rather than the norm, according to the research.

    So why this ‘addiction,’ as one study participant posited ? Suggested reasons are: the appeal of having a prestigious resource available which will rarely ‘bite the hand that feeds it,’ cosy relationships with consulting firms because of ‘revolving door’ appointments and so-called ‘business envy’ in the public sector. Whichever the reasons, it has become clear that despite successive health secretaries attempting to rein it in, the use of consultants by the NHS has become so entrenched as to be virtually inviolate.

  40. Stu-I-Am says:

    @Peter +T Be careful I have seen this kind of idée fixe develop before and it doesn’t end well. ( ͡~ ͜ʖ ͡°)

  41. Helen+Martin says:

    The they/their as a single rather than solely a plural I think I could get used to fairly easily because English is just too messy without. The use of “dogself” is disgusting. Sorry. “King” is masculine singular and the language covers that. “Queen” has other uses but your subject should be clear without resorting to artificial constructs. The chief aim should be clarity so writing a sentence to make one’s meaning clear should not be a problem. (There, I use ‘one’ automatically without even thinking about it and I don’t see what problem there is about it.)
    Steve, we all have to deal with government as opposed to private services and there are standard arguments which often tell you which way the proponent tends to vote. Nevertheless, without supervision no system functions efficiently, but the more layers of reporting and supervision there are beyond a minimum you lose efficiency, too. We were told, once heart and other transplants became possible, that the services covered by our national health would have to be cut back. You show me a politician or voter that would agree to that. The procedures and ailments that are covered have definitely increased the load on the system as have pay increases and inflationary costs. That is not a criticism, just a statement of fact. The cost is what it is and trying to whittle it down by closing hospitals (centralising) cutting the number of team members (efficient use of staff) and privatising purchasing will all do very little to reduce costs and may put the morale of those working in hospitals at severe risk.

  42. Stu-I-Am says:

    @Helen+Martin I believe the use of ‘king’ or ‘queen’ as a ‘neopronoun’ — although unlikely to be widely adopted — could be used by someone who identifies as gender fluid, bigender or transgender. My take on gender neutral pronouns or neopronouns is that you are welcome to call yourself whatever you wish and expect to have that respected by others, so long as you are consistent, patient and communicate your preferences clearly. And, of course, you can’t expect the cisgender community at large to willingly embrace those preferences. Empathy is a lofty but elusive goal.

  43. SteveB says:

    Stu-I-Am in your reply you are talking nonsense sorry.
    If you can process 1000 invoices per pay, just for example, that’s a structural limitation that takes time and investment to increase. And in purchasing (and recruitment) in the nhs back then there were many such limitations. So the money was wasted on parasite companies that sprung up like mushrooms
    I used to work for oil firms in the north sea and the same type of thing happened there. People would budget impossible timetables, because they didnt think about structural limitations in what these timetables meant had to happen.

  44. Peter+T says:

    We should not confuse consultant with contractor.

    A contractor is more someone you hire in to do something for you that you probably could do but do rarely or can’t be bothered to do or learn how to do. Or a friend that you want to give other people’s money to.

    The NHS should know what a consultant is (or should be) as the world of medicine almost defined the term! It is someone who brings specialist expertise. You hire them to do things that you and few others can do, provide knowledge that you don’t have. Beyond that, they can provide a second opinion or validate what you do to some certifying authority. As Harry the spymaster in the TV series ‘Spooks’ once exclaimed, “Can someone tell me something that I don’t already know or that they haven’t just found with Google?” Harry was in need of a consultant. Sherlock Holmes is a consultant (or as he prefers consulting) detective and I’m a consultant engineer. The thing we (and the medics) have in common is pulling people out of the nasty stuff.

    Who shouldn’t be passed off as a consultant: someone to share out the spondulix. An old Dutch colleague once commented that a loud mouth seems to go a long way in covering incompetence, but it’s not a desirable feature.

    To me ‘management consultant’ is an oxymoron. If you don’t know how to run your business, how do you expect some outsider to know? That’s especially true when the outsider is a bunch of bright twenty year olds who’ve never even managed a market stall but happen to have swung jobs with one of the big names that I shouldn’t mention. You’d do better with Derek Trotter or even better ask some of the unfortunates who work for you!

    Here’s an example of doing it wrong. A local authority adopts a new waste re-cycling regime. They hire in a consultant to set it all up. The information they send out to local residents is incomprehensible and no one understands how to separate out their waste. And all this is in spite of the fact that the re-cycling consultants themselves hired in a public information and communication consultant who just happened to be the leader of the local authority. The project may run slowly, but the money circulates faster than a dose of the … .

  45. Brooke says:

    Mr. Fowler: Sorry I missed this–Conversation UK , you’re on list of top 5 autimn crime reads! Great write up.
    Congratulations.

  46. Stu-I-Am says:

    @SteveB I fail to see how there are’… certain limits beyond which an organisation cannot spend money effectively’ that is not how you spend the funds you receive to affect those limitations. You ‘spend’ one way or another to manage those limits better — either by increasing the efficiency of the organisation with the budget you have or you outsource, presumably at a better cost and for greater efficiency. Of course, a third option is to increase the budget.

    You seem to be complaining about what may be/have been unrealistic expectations by upper management of the organisations as they are/were,and — rather than attempting to manage these expectations internally (increased funding/staffing etc.) — using those external ‘parasites,’ as you call them, to do so. So before you call anything ‘nonsense,’ it would have been helpful if you had been clearer about what exactly you were taking issue with from the start: was/ is it the unrealistic expectations, the ‘solution’ of outsourcing, or both ? In any event, whatever your actual complaint(s) are/were — my point about needing to have better internal planning, financial management and internal consultancies is valid, if for no other reason than to mitigate those very issues.

  47. Stu-I-Am says:

    @Brooke I ‘second the emotion.’ Especially like the last line of the review: ‘ Let’s pray there’s a little more life to be drawn out of these enthralling creations of Fowler’s absurdly fertile imagination.’

  48. Pauline Wallin says:

    I have just discovered these postings which make me feel like a kid who has wandered into cocktail party. What a fascinating bunch you all are. I am a recent devotee of chief adult, Christopher Fowler and his wondrous Bryant and May mysteries. Long may he continue.

  49. Stu-I-Am says:

    @Pauline Wallin. Yes — we’re ‘legends in our own minds.’ Welcome.

  50. Helen+Martin says:

    I asked our minister for help with these neo pronouns . He was delighted I was in a discussion about it so I may end up learning more about this than I really intended. Thank you for all this, people.

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