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Galen

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  1. I am sure Dr Rankin of MEDS will have take due cognisance of the BMA 2018 Guidance which includes the following advice "The informality and real-time nature of social media are two of its strengths but they are also potential pitfalls. Medicine can be a challenging and stressful job and while it may be tempting to let off steam or ‘speak your mind’......., . A good rule of thumb is don’t post when angry, drunk or emotional and don’t say or reveal anything on social media that you wouldn’t be happy to see printed in a newspaper.You have rights to free speech but they are not absolute. Remember that defamation law applies online – avoid adverse comments about individuals or organisations, which could be perceived to be gratuitous or unsubstantiated" source https://www.bma.org.uk/media/1851/bma-ethics-guidance-on-social-media-2018.pdf Given the political wriggling at today's Coronavirus Update I would not be surprised if our clinicians received an email from the Cabinet Office reminding them of their responsibilities in respect of using various mediums to express their views/concerns with an emphasis to discuss this with their line manager first before psoting. To avoid highlighting medics specifically, the rest of the public service could also be recipients. This would then give added leverage to any future disciplinary matters insofar as insubordination of refusing to comply with a reasonable request e.g. resorting to social media in an official capacity and bringing the organisation into disrepute. Regretfully I have seen this happen elsewhere and would not put it beyond some of our elected.
  2. Galen

    Death & Dying

    If medicine was a science then the same thing would happen to everyone. The reality is that it does not. A simple example, being giving an aspirin to one person cures their headache, given to another person they have an anaphylactic reaction. Medicine is (obviously) based on scientific principles, but the 'art' is knowing what it will do to the individual given that each of us has a personal chemistry. ( The British Medical Journal article at https://mh.bmj.com/content/27/1/42 gives some insight into this)
  3. Galen

    Death & Dying

    Whether we like it or not, theses difficult times are going to see some of our loved ones depart before their time. Medicine is an art, not a science, and our gallant NHS staff can only do so much. As Benjamin Franklin once noted there are only two certainties in life, death and tax. I recently lost my Dad. While we both knew it was coming, we obviously did not know when. When it did, it was swift - a matter of days from when I got the phone call to get over to the UK to be with him in his last hours. In the previous months before he passed I was fortunate that I had had what some call the 'difficult conversation'. Consequently, I knew things such as he did not want to be resuscitated, what kind of funeral he wanted, and what care he wanted for my Mum (she has several chronic comorbidities and Dad was her 24/7 carer) and some other details. Talking about such subjects was not easy, and I was not trained in how to conduct them, but both Dad and I knew we had to discuss certain matters if his wishes were to be respected. While Dad had a Will, it had been written 25 years ago, and certain other things were now more important, such as donations he wanted to make to certain charities that had helped him in his twilight years. Given these increasingly uncertain times, is now perhaps the time we all had a little honesty with our loved ones so that if the inevitable does come unexpectedly, then we will know how to ensure their wishes can be honoured? While not an easy conversation to have with young or older people, perhaps organisations such as Hospice, Cruse etc. could give some advice before it is too late.
  4. Thanks John for the list, is this one you constructed or has someone else started it?
  5. Thanks DragonS - it is that type of thing but a bit more structured, and as part of the general information that is made available in these difficult times alongside other pertinent information, rather than having to dig around on a particular radio site - no disrespect to Manx Radio. Personally, I would have thought IoMG with its vast IT GTS service, and with so many of its staff working from home, would have done something as a public service but maybe I am stretching my expectations.
  6. In these every changing times, is anyone aware of a IOM central services directory where the details of who and what is open, when and to whom, available online? For example, while the Island's stores have made certain hours available to NHS staff/ elderly people, each company has, understandably, different times and on different days. One location where you could see all the information in one place would reduce wasted trips and unnecessary contacts? I appreciate that this would need initially require some effort to be set up, and while potentially prone to pranksters, one would hope that most people would be responsible and allow our local providers to appeal to a wider audience. It may even reduce those who feel the need to panic buy.
  7. As we have an interim DHSC CEO who is only on Island 3 days a week, this presumably will mean she will have to self quarantine for 14 days every time she comes over. Meanwhile IOM Govt will be paying her a monthly salary for what could be less than 6 days work per month. The Isle of Man, where you can......
  8. Some acknowledgement has to be given the fact that generally people are living longer, more treatments are becoming available, and understandably, many people want every change in their health status checked out for fear it is something sinister. This is driven in part by the public health messages based around improving awareness and media stories of people ignoring a particular symptom and prematurely facing the grim reaper. Reluctantly perhaps, but the fact has to be recognised that our bodies are not designed to live forever and certain lifestyles, coupled to a range of environmental factors (e.g. pollution) impact on its ability to remain disease free forever. Added to which, due to litigation, the medical profession is increasing being forced into having to adopt defensive medicine approaches to their daily practices so, if sued, they can stand up in court and show despite having carried out tests A, B & C, and scans X & Y, the untimely departure of the patient was due to factors outside their control. Such wide scale testing takes time and money and can mean delays in getting results, but also often means some people are being tested for things they may have, including what they may be actually suffering from. While it may be unpalatable to some, medicine is an art not a science (though based on scientific principles) and each of us is a chemical factory that deals differently with what we put into our bodies and the lifestyle we lead. Add into the mix some genetically inherited aspects, and the fact that many people are now living into their 80's and beyond is quite an achievement. No matter how much money is given to health services it will never be enough to meet an increasingly insatiable patient led demand. Also bear in mind that over 70% of the routine cost of care in acute hospitals is salaries and wages. Our geographical isolation means to get good medical people costs more as they are often sacrificing considerable career opportunities such as working in teaching hospitals or being involved in research as opposed to routine working in district general hospital such as Nobles. Further, with the population size of the IOM, gifted clinicians do not get to see the wide range of particular conditions in a population of 85,000 as they do in a population of several million. Also, as is found with other occupations on the Island where there is a shortage of staff, not all families settle easily into the IOM for a range of factors that our politicians appear to fail to grasp or are willing to address. At the end of the day, perhaps 'carp diem' is the best mantra to adopt, as one day all of us will be leaving the mortal coil.
  9. Part of the problem relates to events back in 2013/2014, when Mark Lewin (ex COO of Sefton Hotel, Nat West/RBS 'change manager', and now CEO Dept for Enterprise) was put in charge of Govt IT. To make "savings" he recommended it was centralised along with the health IT budgets, with some health people who had knowledge and experience of health and health IT being made redundant. The proposal was fully supported by that well known 'IT expert,' 'ex-IOM banker' and Treasury Minster, Eddie Teare. Any suggestion that Teare and Lewin had a long association stemming back to the banking world (IOM Bank, Nat West, RBS) being apparently spurious rumour and the decision to centralise IT made purely on a "economies of scale" basis. Given the hospital had in those days some 150+ IT applications, the new Government Technology Service (GTS) organisation struggled to cope as those came from health into GTS were deployed on other non-health projects, and non-health people (the former Government Information Systems Division staff - aka 'ISD') were deployed on health IT 'to gain experience'. Sadly many of them saw the hospital as no different to other IT systems and failed to appreciate that there were vulnerable patients on the end of virtually all the IT applications. I understand that following Lewin's departure to DfE, his 'folly' was recognised and health IT are now back as a semi-autonomous organisation with some of their own staff, but without the budgets they used to have, and so struggle. The messaging system is but one victim, but I am told there are others mainly because many of those staff (including contractors) who have been involved in the last five years did not fully understand the inter-relationships that go in the health world and see each IT system as discrete and rarely inter-related. Unpicking the mess, takes time, money and knowledgeable staff being properly managed - all aspects which are in short supply apparently.
  10. No matter which option is gone for we the motorists will pick up the tab, but for all we know the insurance industry might offer to do it for considerably less than 10% at no cost at all :-)
  11. Why no move to getting the insurers to collect car tax? Insurers know the vehicle and engine size, can find out its emissions easily enough and the IOM Govt can provide the emission banding charges. With this information insurers just put the road tax cost onto the vehicle's insurance. Many people pay their insurance monthly anyway, so depending on the vehicle it could be just a few pounds more per month. For the gas guzzlers, their insurance will not be cheap anyway so it is a direct consequence of having a large vehicle ie more expensive insurance and road tax. Insurers then issue IOM residents with a disc that verifies holder has insurance and paid their road tax, and if someone drives without disc then they can be done on 2 counts and thus face bigger fines. This might encourage those who currently feel they are exempt from paying to start complying. At year end, insurers pay IOM Govt the road tax they have collected less say 10% for admin, issuing disc etc, but can offer other services eg. discounted house insurance to reduce overall insurance costs to IOM residents to help keep costs down. This could make it worth insurance companies participating in such an approach as they may attract additional business. Those companies not interested lose business to those that are willing. IOM Govt is relieved of all the transactional costs, can make saving in manpower and admin, and still get more or less the same income less the 10% (or whatever) they have paid the insurers to provide the service. Not having a car tax disc on display has cost the UK Govt £m and caused all sorts of confusion to car owners. So why not keep it on show to immediately identify vehicles are paying their road tax and are insured? I accept it would take a bit of initial organising but is not beyond the wit of 'Mann' surely?
  12. In the last year I have raised it with 3 politicians including the CM and they not interested in the slightest in regulating the "God squad" - 'a step too far and not required'. They are not even prepared to require that the religious people carry visible ID. Nevertheless, our politicians are happy for charities to have to get a licence (and carry ID) to go door knocking, and delighted to ban cold callers as long as they are not from religious groups, or themselves when electioneering. IOM ICO, an arms length agency of the Cabinet Office (and therefore not truly independent of the politicos, unlike the UK) does not appear, so far, to wish to use GDPR to ensure that our data is being properly managed by those of us who tell the religious door knockers to get lost. The political hypocrisy on this and a number of other issues is incredible. But regretfully we get what we deserve - after all we voted them in!
  13. I am a little surprised our local Information Commissioner has not been vocal about a degree of regulation of the doorstep religious groups must comply with thanks to GDPR https://www.telegraph.co.uk/news/2018/07/15/jehovahs-witnesses-must-ask-permission-collecting-personal-data/ https://gdpr.report/news/2018/07/12/jehovahs-witnesses-suffer-smite-via-the-wrath-of-european-privacy-laws/ This also makes interesting reading https://avoidjw.org/en/policies-procedures/general-data-protection-regulation/ GDPR is a step in the right direction, but classing religious groups as cold callers in a similar way to those attempting to sell other services on the doorstep would be a good way forward. Perhaps JW could comment on the legality of such groups arriving unannounced and uninvited on the doorstep vis a vis a private householders right to privacy under the Human Rights Act.?
  14. Bringing the family to the door is perhaps intended to show that the particular religious group is all inclusive and family friendly - or it could be because the parents can't get baby sitters while they do their religious endeavours? In fairness it was a Saturday morning when 'they called'. The kids though were only toddlers. I felt really sorry for them, but perhaps that is the parent's ploy to reign you in!
  15. Equally sickening is when you get the whole family at the door, father, mother and 2 kids as I had a few months ago. I am not anti-religion, each to their own. But I do object when religious people come uninvited to my front door and I have no legal mechanism to stop them. Yet, according to Mr Perkins MHK, if they offer to clean my gutters (and this is not an euphemism), this would be deemed cold calling and I would have a legal remedy. The politicians aren't interested in legislating to regulate them for fear of upsetting other religious groups, and the Police are understandably too busy dealing with criminal activity. However, posing as a JW or other group, and wandering around estates going up to people's doors and having a look around to see if anyone is in, gives criminals the ability to to 'case a joint' without raising too much suspicion and in the knowledge that most people will just see them as religious zealots. Perhaps the spate of burglaries we had a few years ago was carried out with the assistance of religion and who those who committed the crimes were 'spirited away'?
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