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Galen

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  1. From what I understand there are also increasing staffing /recruitment problems with dentistry and community pharmacy due to the relevant professionals going back to the UK/Ireland/ Europe. They are apparently fed up with they way they are being treated and with the Covid restrictions resulting in them (along with everyone else) not being able to see family member they are 'upping sticks'. They may have the potential to earn more here but end up spending a lot of it going back to see family and friends. When you then add into the mix the issues over shortage of teachers and other professionals such as vets, along with a lack of affordable housing, the Island is rapidly losing any attraction it had for professions to come and live here. Perhaps that is why Sir Jonathan, Andrew Foster or Ms Magson only visit!
  2. Galen

    Manx Care

    Looks as though Manx Care has upset the Information Commissioner https://www.inforights.im/organisations/latest-news-updates/2021/sep/enforcement-notice-issued-to-manx-care/
  3. To be clear, he was ringing door bells and engaging with people and not just pushing leaflets through doors. I know this as following his 'chat' with me he then went and round the corner and then went to my front door where he rang our door bell and started his 'spiel' with my wife - who kindly pointed out I had already spoken to him. His wandering around the estate without a mask didn't particularly bother me, but the door bell ringing and engaging with people did, as there are a number of elderly and vulnerable people in our neighbourhood, who still are shielding as they harbour a genuine fear of getting covid (I know this to be the case as my wife and I do still do their shopping for them.) As to the suggestion of bullying, I would remind you that one persons bullying is another person's assertion. I reserve certain assertions for dealing with uninvited, persons who cold call proffering goods or services with little or no knowledge of my needs or wants but are attempting to assert (or in your words, 'bully' me) me into taking/ buying/ believing. Finally, if your re-read my post, you will note that I merely pointed out to the gentleman that his daughter's performance as Commissioner does little to inspire me that she is capable of being a politician.
  4. My understanding has always been Directors of Public Health do not need to be medically qualified - though many are. Non-medically trained persons, but with a Masters in Public Health can (and are) appointed by some UK health care organisations to the role.Generally speaking their interests are in the health of populations, how diseases spread and can be controlled, what vaccine rollouts should be etc. and are not involved with individuals or small groups or people with similar conditions. Whereas, Medical Directors do need to be medically qualified and while perhaps having specialised expertise by virtue of their medical training, oversee all the medics in the establishment in which they work, usually a Trust - which can comprise of several hospitals. Such individuals take the collective view of their clinical colleagues and then decide what policy will be etc. I am sure Wrighty will correct me if things have changed!
  5. Yesterday, I found an elderly gentleman wandering around our estate looking lost. As it was a warm afternoon, I was concerned he may have sauntered out of a care setting without a carer or relative being aware and may be disorientated. Adopting appropriate social distancing I approached him asked if I could be of assistance. Bemused, at being approached I was promptly thrust a piece of paper and told he was campaigning on behalf of his daughter - Alison Lynch. Wearing no face mask, (which he took umbrage at being asked why not when he was canvassing on doorsteps) I asked a few simple questions pointing out, in my experiences, Ms Lynch's abysmal performance as Chair of Marown Commissioners. Daddy, unhappy that his daughter could be anything but perfect, stated that the Commissioners are very limited at what they can do. When I suggested that performance in parish pump room politics can often be a indicator of potential ability at national level I got a 'nil response' - a glazing over - a trait inherited by Ms Lynch in my limited dealings with her as a Commissioner when faced with a reasonable question that requires a specific answer. Reading Mrs Lynch's A4 flyer (which starts with an apology apparently I was out when Alison called!) full credit must be given to the fact that unlike some other candidates' literature, it uses a readable font and has the capital letters in the right places. It was interesting to note that Ms Lynch has conveniently omitted portions of her previous employment which I understand includes being a civil servant - embarrassment of having a 'dark past' I wonder? The flyer also included reference to the hospital nursing occupation of her spouse which is curious as I would have thought voters were more interested in the candidate not their partner. Or is having someone in the family who is affiliated to health a 'go faster' stripe in our political advancement? In concluding, as with the other literature that to date has been thrust into hands or pushed through my letter box, there was no colouring section, but in keeping with tradition there was a picture - presumably in case voters forgot what the candidate looked like or needed something during the winter months to hang by the fireplace to warn the children to keep away - something I feel many Middle voters will be doing!
  6. In relation to personal emails outside of Govt, as I recall, as with the use of telephones (mobile and desktop), IOM Govt used to permit 'minimal personal use' and written advice was given to staff and periodically reinforced. In other words, the occasional use, such as in an personal emergency, or making medical appointments, was acceptable, but it was with the understanding that staff would not use it unreasonably. It also came with the understanding that as personal emails and internet use were being carried out on the Govt equipment (phone, computers and IT systems) it could (and was) scrutinised for abuse of use and for abusive content. Further, staff had to accept the content of personal emails generated on Govt equipment or sent through its systems, 'belonged' to Government and subject to its policies and procedures including confidentiality aspects. Most Govt staff understood 'the rules' and kept personal use to a minimum and increasing saw little point in using the Govt systems as personal mobile phones became more widely available, with increased functionality that often surpassed that of Government equipment. However, as is always the case, there were a minority who saw the rules were there to be broken. When called challenged they pleaded all sorts of mitigating circumstances to the point where in some departments personal use of the Govt email system was banned as monitoring became a nightmare and wasted considerable time. Employees personal of the Internet was supposed to be only permissible during break times. Nowadays, it is probably now a situation were 'use and abuse' is tolerated as actively monitoring and then subsequently taking any action over abuse is just not worth the effort other in extreme cases. Personally, irrespective of any cost to the tax payer, I think any employee using Government email or Internet services other than for work related purposes, is unwise and should use their own devices whenever possible other than in genuine emergencies. In this way there is clear separation between work and private use.
  7. I wonder how many of our 'great and good' were aware of this, and if so, whether it was taken into account in respect of the control measures that were put in place https://www.theguardian.com/world/2021/apr/18/obscure-maths-bayes-theorem-reliability-covid-lateral-flow-tests-probability
  8. 'Them' would be the Department chaired by the Minister and attended by the Departmental Members (i.e. Politicians assigned to the Dept) and the various Heads of the Divisions. Depending on the decision to be taken, if it were political, then the Minister would have to sign off as legally he/she is accountable. For routine admin things the CEO can approve as long as there are no direct political implications that could backfire on the Minister/Members. The Minister is the quasi equivalent of a Chairman of a company in the private sector. Further, a IOM Govt Minister can decide which CEO he will will /will not work with especially when a IOM Govt CEO post falls vacant. Irrespective of who is the best candidate, if the sitting Minister does not like the best person as determined through interview / psychometric testing etc, he can state he wants "AN other" of those shortlisted and it goes to them - even although the Minister in rarely in a Dept more than a few years and the CEO can be there for decades!
  9. In pulling together some earlier points I think you will find that Dr Couch qualified as psychiatrist and not a psychologist. He then went into tax for one of the big oil companies ending up here as Assessor of Income Tax. Medics traditionally qualify with two first bachelors degrees (usually medicine and surgery) and given the length of study (5 years) are awarded the honorary title "Dr". Some then do doctorates as shown by the post nominal 'MD' if the doctorate is in medicine or 'PhD' if in another subject. Some do academic endeavours outside of medicine and can get PhDs too as Dr Ewart has! Some medics on retiring, and removing themselves from the GMC register, (as registration costs) cease using the title "Dr" but others retain it. Dr Couch does not appear on the GMC register but has kept the title. Dentists, who study usually for the first two years of their 5 year degree alongside medics and then specialise 'above the neck' traditionally were not given the honorary title 'Doctor' until a few years ago when as I recall, they complained to some EU Board who considered the medical qualification equivalence of EU member states so that clinicians could work in other EU countries without having to take additional exams (unlike the USA where medics can be qualified in one state but not the adjacent one!). As many EU countries called their dentists "Dr" similar to the medics, UK dentists were allowed to use the title without further qualification, training or study. This is why IOM dentists can call themselves 'Dr'. Psychologists on graduating are not called 'Dr' (unless they do a post graduate qualification at doctorate level) but on becoming professionally qualified (ie experience plus relevant experience and CPD) can apply, are vetted and interviewed, and if approved can become Chartered Psychologists. This is their professional qualification and is in keeping with Chartered Accountants, Chartered Engineers etc and as with most other professions, are required to undertake CPD activities which are monitored for suitability, have a code of ethics and their names on a public register. As to Directors of Public Health (affectionately known in some quarters as 'The Drains Doctors' after the findings of the 1980 'Black Report' which stated the importance of good housing and sanitation in keeping populations healthy) do not need to be medics, though many are. You can become a Director of Public Health with a Masters Degree (usually in Public Health) but also have to have considerable relevant training as one IOM Director of Environmental Health with a Masters in Public Health frequently would tell anyone who would listen! Pub Health Doctors expertise is the health of populations whereas the hospital doctors /GPs specialise in individuals and their health. As to IOM CEOs of health service, in the last 25 years, none as I recall have been medically qualified, a couple have had first degrees but not in health, and one a HND and a certificate in management for attending a one week's course at the Kennedy School of Management, Harvard.
  10. While no fan of any our politicians, I feel that credit is due for the way that they, supported by public servants generally, got the Island through the first phase of Covid. Sustaining that level of input to further phases of the pandemic was never going to easy and, for some, the toll is being being seen with the proverbial 'fraying around the edges' becoming increasingly evident. There is always going to be egos bounding around when major events occur, but a mature government should be able to forecast that and make the necessary adjustments. The fact that it would appear that they either didn't or were too arrogant to think they did not need to, is now being played out in public. The 'blame game' rarely has outright winners, and most of the time everyone loses, and in this instance it may, regretfully, be the entire Manx nation.
  11. 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.
  12. 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)
  13. 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.
  14. Thanks John for the list, is this one you constructed or has someone else started it?
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