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wrighty

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Everything posted by wrighty

  1. wrighty

    Good Music Never Dies

    Is anyone here except me aware of Haken? My current favourite band. They’re labelled as ‘prog rock’ but there’s lots of jazz, electronic, funk, a capella in there. This 22 minute epic is outstanding, the culmination of a concept album.
  2. wrighty

    Man waves knob at traffic

    If he could do that, I suspect Gladys would change her so far negative/dismissive opinion of him.
  3. wrighty

    Fracking off Maughold Head?

    And now a numerical error - it was two letters
  4. wrighty

    Private medical care terminated at Noble's!

    I realised. I was trying to give him a nudge to the correct answer which is of course Cuba.
  5. wrighty

    Private medical care terminated at Noble's!

    Hmmm, I thought that was a pretty iconic image of Fidel Castro I posted.
  6. wrighty

    Private medical care terminated at Noble's!

    Clues: Canada is correct, btw, although they just cross the border into the US both patients and doctors.
  7. wrighty

    Private medical care terminated at Noble's!

    I'll try and explain the funding, and perhaps answer some of the points made here. One of the main points is that income from private practice didn't/doesn't go direct to the hospital/DHSC - it goes to treasury. You might argue that it's all one government pot, which of course it is, but that doesn't help when it comes to balancing budgets. So, the running of PPU costs money - staffing it mainly, but also heating, lighting, maintenance etc. This comes from a hospital budget. This is largely the same, irrespective of whether or not the PPU ward is full of private patients or NHS patients. If you're a private patient and you have a procedure, there will be several bills to pay (it may all be combined into one fixed fee - I'm not sure as I've not done any private operating since 2011) - surgeon's fee, anaesthetist's fee, 'hotel services', theatre charges, implant charges, drugs, dressings, tests... Surgeon and anaesthetist tend to bill separately - we can set our own fees, guided by published figures various insurers pay for whatever procedure - and the rest is bundled together by the hospital. To give an example of a hip replacement - all in it might cost a patient about £7000 - Surgeon bills £850, anaesthetist maybe £500, theatre costs about £1500, ward stay about £500 per night, implant costs maybe £1200... (These figures are illustrative, and not an offer!) All but the surgeon and anaesthetist fee will be paid to the IOM gov. For government there are other private practice income streams apart from procedures - if I send a patient for a scan there will again be two charges - one for the scan (which goes to IOM gov) and one for the radiologist reporting on the images. When I do a clinic on PPU I rent the room at an hourly rate - something I pay monthly to IOM gov. And of course I'll pay tax and NI on my private practice earnings, again to IOM gov. So private practice brings income to the government, but running the PPU comes out of the hospital's budget. In the grand scheme of things one offsets the other. To answer WTF's question, I don't know if or when income became less than running costs, but from the hospital's perspective it's always been a 'loss maker', as is the NHS in general if you want to look at it that way. I can therefore see why the minister and CEO want things to change - by revamping PPU and the brand, setting out a code of practice, and having a more standalone unit. This could be run as a business distinct from Noble's hospital, even if it is on the Noble's site, and it should be a cash generator for IOM gov to invest more in the NHS. The announcement and implementation however has been handled very badly resulting in, so far, one consultant resignation and much disquiet amongst others. To my knowledge (I've said it again) there has only been one resignation, but there are certainly fears that there may be more. It seems to me that the plan has been rushed through without proper (any?) consultation, as evidenced by 'clarification' announcements by both the CEO and the minister in the past few days. And it's not just the consultants that are affected - nursing staff and admin staff on PPU are affected too, even if they're not being made redundant they are being moved around possibly to areas they don't want to go. Personally it doesn't affect me much - many years ago I was advised by one of my consultants to never rely on private practice income for your mortgage/school fees etc, consequently I've never been an 'enthusiastic' private practitioner even though it's nice to have. I do sympathise with some of my colleagues however, particularly those that have moved here relatively recently at considerable personal and professional risk, and were assured at their interview that private practice was encouraged. PS - For 10 points, can anyone name the other countries in the world where private practice is banned?
  8. wrighty

    Private medical care terminated at Noble's!

    Complete fabrication. There has been, to my knowledge, precisely one resignation as detailed in the paper.
  9. wrighty

    Man waves knob at traffic

    More than anything I’d suggest this chap needs help with his alcohol problem.
  10. wrighty

    Animal News

    I think ‘fake news’ is the phrase that pays for that website.
  11. wrighty

    Animal News

    https://worldnewsdailyreport.com/florida-man-falls-victim-to-leprosy-after-sex-with-armadillo/ Bestiality wasn’t best for that guy
  12. wrighty

    Flat Earth?

    I’d like to suggest that before there’s any further discussion regarding ‘flat’ or ‘curved’, contributors should familiarise themselves with the appropriate definitions. This set of lectures should suffice. Please don’t post again unless you hold a recognised qualification in differential geometry
  13. wrighty

    F1 2018

    Unlike some local events, this new series will probably have a more F1 attitude to safety, so I suspect your fears are unfounded.
  14. wrighty

    Private medical care terminated at Noble's!

    You're missing the point. The costs, y, are well known - it's the salaries of all the nurses, therapists, domestics, and admin staff on PPU, plus the heating/lighting costs. These don't change dependent on whether the unit is full of PPs or NHS patients.
  15. wrighty

    Private medical care terminated at Noble's!

    OK, I'll spell it out. Income from Private Practice = x Cost to run PPU = y Net income = x-y, which if y > x is a negative number representing a saving from DHSC's budget if PPU is closed. The money that is now leaving the island to private providers in the UK does not come into this calculation.
  16. wrighty

    Private medical care terminated at Noble's!

    I’m not going to speculate here on the motives behind this, but I would like to point out the difference between private practice and the PPU. PPU is often (almost always) used as an overspill NHS ward. The costs of running it are largely staff. The revenue from private practice is not adequate to pay for the running of PPU, so closing it, while suspending private practice, will save money. Moving the staff from PPU to other wards which are short will also save on agency costs. So that’s the financial argument. We’ll have to wait and see if reducing Noble’s by another 15 beds mid-winter will have an impact on patient flow.
  17. wrighty

    Banksy

  18. wrighty

    Montserrat Caballé dies at 85

    David Bowie was not a great singer in my opinion - creative genius, songwriter, performer, musician etc., but not a brilliant vocalist. Freddie, in the view of almost everyone, was a great singer. Voice, live at least, was not so good in his latter years, but listen to his early stuff. Montserrat Caballé saw fit to share a stage with him - QED.
  19. wrighty

    Montserrat Caballé dies at 85

    Freddie did a pretty good job I think, so did she apparently. On radio 4 this morning the newsreader announced they sang this at the opening ceremony of the 1992 olympics - the year after Freddie died
  20. wrighty

    Ryder Cup

    Golf is a rich sport. She's half blind. Got to be worth a go? But I think you're right - as small as the risks are, watching golf is not risk free, and spectators know that. Unless she can prove that either the player taking the shot or the organisers were somehow negligent she shouldn't win. I predict an undisclosed out-of-court, no liability admission settlement.
  21. wrighty

    Flat Earth?

    He’s not arguing with me - I saw an opportunity for a mildly amusing observation, I wouldn’t contribute to this thread otherwise. PGW is being deliberately obtuse for sport, either that or he has a screw loose. Either way there is no point arguing with him. I’ve asked China before why he seemingly continues to do so. In the 277 pages of this thread so far it is clear that, just as I couldn’t teach my cats to solve a Rubik’s cube, no-one is going to get PGW to post anything approaching rational discourse.
  22. wrighty

    Flat Earth?

    So his honesty varies due to the rotation of the spherical earth and the tilt of its axis with respect to the plane of the orbit? Or do you have another explanation that fits with his observed probity variation
  23. wrighty

    Flat Earth?

    Comparison is usually with a snooker ball. Link here. Apparently earth is as round as a snooker ball - the ‘oblateness’ of the spheroid is minuscule - but it’s a bit rough, due to the mountains and stuff.
  24. wrighty

    dogs on leads?

    Woody = Woodhouse? Related to the late Barbara? is there no limit to your talents and knowledge Woody2???
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