David Oliver
@mancunianmedic
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NHS Dr 35 y. Covid wards++ Gov, policy, academic, officer roles. Byline: @BMJ_latest . Columns: health press, papers. @mjauk . Manc-in-South. MCFC. Craic. Schlock
South East, England
Joined June 2014
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this is the most sinister thing i have seen on twitter today
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It has not escaped my attention with the Lucy Letby verdict and reporting that the consultants in the department repeatedly raised concerns about her and were warned by managers to stop complaining "or there would be consequences" for *them*!
When will NHS execs learn?
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how on earth did we ever get to the stage when it was removed?
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"50 year old Karens" keep families, society and workplaces going and hold them together - not least as parents, grandparents, carers, local volunteers/activists and key employees/bosses
Society would be much the poorer without them
So back off
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"We will shorten, narrow and cheapen training, dump responsibility and cost onto employers and ignore what expert clinicians outside government roles are telling us is required"
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BBC reporting a national guide dog shortage
But the government have proposed to
Shorten guide dog training from 2 years to 6 months
Provide an apprentice route for fast track dog training
Have guide dog associates to be supervised by actual guide dogs
Introduce guide cats
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I often look at the multimillionaire Tory front benchers and think "how that rich?" (especially unimpressive ones)
Jenrick qualified as a solicitor in 2008. Worked in commercial law till 2014 then became an MP
yet he reportedly owns 3 properties with a net value of £6m
How?
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Let us never forget that the Tories actually DID make Truss and Johnson Prime Ministers!
Let us never, ever forget that Starmer and Labour tried to make this man Prime Minister
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speaking to a consultant colleague today - two children are doctors (FY1/2 level) & both are going to leave medicine cos can't even afford so much as rental on a basic flat and after 5-6 years on a study/content rammed degree course that rejects 85% of applicants and needs A A A*
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OK
I will say it
I have severe doubts about switching a conventional 5 to 6 year medical degree (not just for people with first degrees in STEM subjects but all) to 4 years, about further shortening postgraduate training and about the crazy gimmick of "doctor apprenticeships"
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It has only taken me 58 years including nearly 35 as a working nHS doctor to realise that if you get hit with a virus you are better off resting up and staying at home or else risk the whole thing dragging on for far longer
Docs are shockers for feeling guilty and poor self care
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The Bibby Stockholm could be moored on the Thames at Westminster
And used as the London residence for Tory MPs with constituencies too far to commute to
Although i suspect they'd want to check it for fire risk and legionella before moving in
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the only thing necessary for the triumph of evil is for NHS executives to tell clinical staff to shut up and stop complaining
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"assigned"??
It isn't the fucking sorting hat from harry potter
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@RoshanaMN
i have just been reading his tweets
he is a religious fundamentalist who believes in complete subjugation of women to their husbands and that this is what god wants for them
vile. Mind you. That kind of thing ain't confined to christianity
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One of my medical colleagues today told me a patient has said to her that during Covid restrictions "people became a hunk, a chunk, a monk or a drunk"
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anyone who thinks junior docs are making things up about PAs taking operating theatre/minor procedures/clinic slots because they are embedded and not on on call rotas, and then leaving al the ward jobs to the actual doctors should speak to the docs affected
It is very real
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i think it would be good for every NHS manager who has a clinical degree to be made to keep their clinical registration
that way they would still be subject to GMC/NMC codes
and they would have to do enough hands on clinical work to keep registration/revalidation
Win/Win
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within 1 minute of Steve Barclay going on with
@SophyRidgeSky
#ridge
she stops him and says "yes. you've got your headline in now can we answer the question"
I can't imagine Laura K/Fiona Bruce doing that to a Tory - even though Victoria Derbyshire certainly would
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call me old fashioned
but if i had a teenager who had been abused by a much older man
i might report it to the police
before telling The Sun
(which routinely posted semi-naked pictures of female teens on Page 3 for years)
Priorities, innit?
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I have been an NHS doctor in acute care since 1989
My then girlfriend and now wife now thinks that all those times i disappeared for a whole weekend in the hospital i was having an affair
Cheers. Wes
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Just a reminder that this man - at the start of his disastrous reign of error as education secretary scrapped the schools building programme within weeks of taking up office (with cummings at his side).
Concrete achievements
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The embargoed press release for the
@NHSEngland
Long Term Workforce Plan on Thursday was released 12 hours before the actual 151 page plan (which people had neither seen nor read at that point)
The gushing, cheerleading, uncritical praise in numerous quotes was a serious mistake
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there is a special place in hell reserved for qualified nurses and doctors who leave clinical practice go into pure executive, national or regulatory roles and then bully/threaten/silence or slave-drive their former colleagues as they focus on "managing upwards"
Betrayal
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#covidinquiryUK
Hugo Keith KC totally humiliating Hancock by quoting from mis meticulously sourced 572 page book detailing events in the Covid response just after Hancock claimed he had no documentation and no recall
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I am so old, i remember when lots of Australian and Kiwi doctors used to come and work in the NHS
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In Room 101
Patients with money & snobbery who insist on going private
Get too sick for any private hospital to cope with so they come to us
We rescue them
And even when they are still too sick/complex insisting on going private again
And wanting us to be a concierge
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I worked as A&E SHO at Manchester Royal in 1991 and one of 7 SHOs was a dentist "Phil Hollows" ( perfect name)
Cos he was already a dentist & had more money and nicer clothes and was 4-5 years older than us 25 year olds he was like The Fonz
He just turned up in Times Letters
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@MichelleMone
only it turns out that Mark Williams Thomas and his team made the Youtube documentary without making it in any way clear to experts like me who were interviewed in good faith that we would be used to try and lend credibility to your cause or that your company was funding them
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anomalies in AfC banding
Ward manager with years of experience, in charge of a ward/a big ward team/budget all year round
Is on a band 7
But so is newly qualified PA without the same experience or responsibility
Newly qualified SALT/Physio/OT with a 3-4 year degree -on a 5
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Sunday Times story on unqualified Banker Richard Meddings - the
@NHSEngland
chair spending 11 hours in local A&E with his wife & experiencing things first hand but not telling the staff what his job was
Speaks volumes. No NHS clinical staff would recognise him or know his name
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I know and respect and admire plenty of journalists and count a fair few as friends
But if i see one more right wing journo saying that NHS clinicians are nothing special for working nights and weekends with sick/dying people because they had to work overnight on stories..
🤦♂️
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I have heard tell:
1. Hospital trusts will pay nursing/AHP/medical agencies higher rates to fill unfilled shifts than they are prepared to pay their own staff to take them on
2. Would rather leave shifts unfilled than pay enhanced rates to staff on own payroll
Fair comment?
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OK I'll say it
The number of stranded patients in hospital waiting for a glacial response from under-resourced social care and community health
Is making the job a miserable groundhog day of apologising to people we can't help for things we can't control
Burnout fuel & grim
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i hear radiographers are only providing a skeleton service today
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Never underestinate the strong bond between consultants and nurses they have worked alongside for years and years together through plenty of shared stress, trauma, laughs , ups downs, shared history and memories. Strong solidarity and loyalty
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clearly, a serial child killing nurse is a very rare thing
But clinical staff who raise concerns/blow the whistle being slapped down/silenced/warned/disciplined/constructively dismissed
And trusts being more concerned about news management/bad news suppression is all too common
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It is precisely 1 year since i resigned from RCP President-elect & never started
I was pretty ill before & after and then having got better, spent the next 9 months boring the arse of myself, my wife and everyone else i know beating myself up over it
12 months is enough
End of
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the being duped and manipulated is understandable
but the slapping down and silencing and warning senior doctors who still practiced clinically (unlike Ms Rees) when they raised concerns is not understandable
2 separate things
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Anger as NHS Car Parking Scandal Worsens
With patients shelling out £146m to private companies
(Not to mention staff being "fined" for parking at their own workplace while doing shifts)
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No useful purpose served by weaponising grim conditions for junior doctors in 70s/80s/90s to attack current generation who also face a whole set of challenges - some old, some new
"Think you have/had it hard?" race to the bottom intergenerational culture wars help nobody
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letter in the paper today pointing out that if you go on NHSE websites and look for information on cervical/ovarian cancer it avoids saying "women" or "females" yet if you look for prostate cancer it quite openly says "men"
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why the fuck is michael mosley on as the expert talking head on the NHS
he barely used his medical degree to practice medicine
got rich outside it by flogging health lifestyle stuff
likewise Lord Bethell who was an unelected junior health minister with no relevant background
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So far I have done 34 years in the NHS and 6 years getting degrees to join. Put together with my father who did 37 yrs & 5 Yr degree (we overlapped for first decade of my career). And my grandparents who grew up poor remembered when it wasn't there.
Grateful to be on board
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DIY mare
I manage somehow to put a new seat on the small downstairs loo
But in pulling myself off the floor in a confined space, i pull the sink off the wall (it appeared to have been glued on by the plumber)
This is why I don't do DIY
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If PAs are medical practitioners practising medicine how come a dr cannot be employed as one?
An Advanced Nurse Practitioner or Paramedic Practitioner can still decide to work as a jobbing nurse or paramedic on a different band
And i cannot get a job as a physio or nurse
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58 today
Where did all that time go?
I do seem to have indestructible perma-hair mind you despite being twice as fat as i was in the 1980s
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"I will GMC you"
is the new
"I will DATIX you"
Both piss poor behaviours
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maybe NHS England can announce a standard national colour scheme for Fridges so each profession and grade can know which is their fridge
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when i was getting the coffees in for my team today at the end of our ward round, none of them had heard of the film "Groundhog Day"
Mind you, a few weeks ago, none had heard of Rex Harrison or My Fair Lady
My cultural reference points clearly receding in rear view mirror
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I got a "CC Everybody" email this morning from Amanda Pritchard reminding me to put shoes and a shirt on before coming into work and to avoid drinking neat scotch from a bottle on my ward rounds or chatting up CQC inspectors and asking them out mid-inspection
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And Yet Old Etonian Boris who read Classics at Oxford and wrote Torygraph/Specator Columns and came from a posh background was not?
Starmer is from an ordinary background, went to a day school, did his first degree at Leeds
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On acute take it seems that Covid (of the respiratory/hypoxic/admission-requiring kind) is making a modest come back
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this would certainly "energise" me
sprinting for my life right out of the door, out into the street and breathlessly coming to rest several streets away, once i could be sure i was safe
just like enforced group dancing at medical conferences
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is there any skilled, learned, safety critical profession where shortening training, reducing training requirements, or replacing wherever possible fully qualified graduate professionals with less qualified or trained ones will improve the quality or safety of services?
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George Osborne is a malign Mr Benn figure
He becomes Chancellor with no background in economics
Editor of Evening Standard with no background in journalism
Banker with no background in banking
Chair of trustees of British Museum with no background in museums/history/archaelogy
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Just trying to get home after 12 h of strike cover in A&E /AMU. All roads round house closed cos deep flood. Back in hospital early tomorrow. Option is either get hotel or park car a mile away . Get into trainers and trackies and walk home. Dont want wife facing flood alone.
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it will be tempting on tomorrow's ward round to start announcing the blood results or obs numbers in Darts Announcer mode
Sodium "One hundred and forty six"
Haemoglobin "Eighty Eight"
O2 Sats "96"
etc
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i always ask patients on the fracture wards how they came to break the bone
Today for 3 femoral fractures i had
1 "Trying to kill a spider"
2 "Trying to mow the lawn"
3 "In the DIY centre car park"
These are activities best not indulged in, I say
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Doing 12 hours at the hospital tomorrow so having the big day a dsy early. Very rare indeed for us to sit at table
It is Buble Belt here
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shit sleep quality
year after year after year
corrodes your wellbeing
makes it hard to find energy to exercise
or eat well
or shift weight
or do work requiring long periods of sitting still and concentrating
it is an embuggerance
and very hard to fix
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i am not against calls for professional registration and regulation of NHS managers. But in so so many recent scandals (includling the Letby case) the "managers" where nurses, midwives and doctors. And professional regulation and registration did not prevent the problems
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Cannot stop coughing
Had to get out of work this lunchtime to avoid infecting anyone else
And also cos voice gone
When this happened same time last year
It was RSV
And i ended up in hospital for 3 nights with pneumococcal pneumonia and on 40% FiO2
Let's hope no repeat
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#bbcnewsnight
Tory lad saying "we built the Nightingale Hospitals really quickly" (so we can do the same for migrants)
Hmm except the Nightingale hospitals had lots of beds but no staff, and between 9 of them barely took 1,000 inpatients at a cost of c £1m each
Think again mate
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it happened repeatedly during the pandemic peaks when staff complained about inadequate PPE or access to testing
and it has happened in any number of high profile dismissals of whistleblowers
the NHS top down, command and control culture that regards clinicians as "challenging"
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Note to Daily Mail editors
"Earns more than the Prime Minister"
Is and always has been a ridiculous comparison
The PM's pay artificially depressed by political sensitivity, the job comes with two free residencies and even bad PMs stand to make £millions when they leave office
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David Oliver: Why shouldn’t doctors defend our distinct professional identity?
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I can feel an FOI request coming on to
@NHSEngland
asking for their risk assessment/risk register and comms plan re ending new registrations with practitioner health programme
i wouldn't be surprised if it turns out that these documents don't exist
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given that they were forced to write a letter of apology to Lucy Letby by trust managers from nursing backgrounds, i could easily see how GMC "be kind" duty could have been weaponised against the paediatricians at Chester
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Immigration did *not* cause
1. Deliberate, serial decisions to cut hospital bed numbers
2. Cuts to support grants for local government (and hence schools, social care, libraries, leisure, public health etc)
3. Population ageing
4. Failure to solve social care provision/funding
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You refused to negotiate on pay unless they called off the strike first
You only made the offer 56 hours before the start of the proposed action
Bad faith, disingenuous nonsense
We're working hard with
@NHSEngland
to mitigate the impact of junior doctor strikes this week.
@BMA_JuniorDocs
declined my offer to enter formal pay negotiations and I urge them to reconsider, pause strikes and come to the table - as the other health unions have.
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I see my medical colleague (female consultant, south asian heritage) has this mug
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"Don't bring me problems. Bring me solutions"
= "Do my job for me, even though I am paid more than you. You are inconveniencing me"
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doctors
If you are going to do TV interviews in your scrubs and steth when you are in your place of work - all good (and the programme makers like it)
but don't FFS be caught wearing your steth and scrubs when you are obviously at home
looks like posing
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i wouldn't vote for her if she stood for the parish council and the only other candidate was an 11 year old
Would you vote for Suella Braverman if she was Prime Minister?
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Why do people have "child with x condition on board" stickers on car rear windscreens.
Who is thinking "you know. I was planning to ram you at high speed like a Roman warship, or throw a bucket of custard through your open sunroof. But now I have seen that sign, I'll stand down"
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patient to me today
"I can't go home at the moment"
me "why not?"
"I have a lot of neighbours who read the Daily Mail"
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huge amount of respiratory infections around this week in acute care
RSV
Flu
Covid-19
Bacterial pneumonia
COPD exacerbations
It is everywhere
"Thoracic Park"
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Bloody GMC!
It has nothing to do with her fitness to practice
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One of the most astounding things about the post office scandal - among many - is the notion that suddenly "discovered" that c 1 in 8 of their own front of house staff were crooks and that it only came to light cos of the new software
So improbable as to be patently ridiculous
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2-3 years ago i saw a couple of GPs (as a patient) and asked why they seemed relatively happy
"I have given up being a partner do do salaried work"
Today i saw a GP (as a patient) and asked her why she was fairly upbeat "Cos i gave up salaried to do pure locum work"
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"Call the Midwife" has been slipping topical content in to the scripts i see
Nurse Phyllis Crane "As far as i am concerned, nursing is a vocation, not a career and i don't like any suggestion that we are financially motivated"
Cheers, Phyl. That was helpful
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my bit for
@bmj_latest
this week
I have avoided commenting on RCP business since i was last an officer in 2019 but recent developments show embarrassing ineptitude and tone-deafness
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Feeling my age
Not only did no-one on my ward team remember "Grange Hill" "just say no" or Cilla black "blind date"
But now Sarah Green off Blue Peter and other kids' TV, who was a crush for so many teenage lads in the early 1980s is on "pointless celebrities"
I is old
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Lee Anderson described in today's Sunday Times as
"An empty space, where a man should be"
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If i could give one useful piece of unsolicited advice on twitter it is to be very careful not to get drawn down a rabbit hole of prolonged engagement with accounts that are clearly not good faith
It will waste your time, wind you up, not change their stance and will please them
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Big parallels between relentless undermining of the BBC until claiming the model is defunct (much to delight of private health sector lobbyists and right wing press)
And what they have done the NHS
Neither were broken in the 1st place. Both respected/cherished
Vandalised
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@FiveTimesAugust
having looked after 100s of people who died from covid completed 1000s of death certificates in my career (in the UK - which you are writing about) i am wondering what source of information you have that tells you NHS doctors were engaged in mass fabrication of causes of death?
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Lots of ill-informed letters in
@thetimes
letters about GP access
"Make all UK medical grads stay in the NHS for 5 years"
(It takes at least that and usually longer to become a qualified GP)
"Make GPs do at least 5 clinics a week" (Even if they do 3.5 or days they do already)
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@ShelaghFogarty
my understanding of the regulations around The Equality Act is that it allows for reasonable, proportionate adjustments and differentiation for people with protected characteristics (as opposed to discrimination) - *not* changing the entire lexicon for the sake of less than 1%
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Hello paper, my old friend
I've come to work with you again
Because the EPR was creaking
Breaking down while we were sleeping
And Cerner software problems still remain
A billion pounds, the licence
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FFS! A caller on with
@NickyAACampbell
calling to "bring back matron!"
They never went away. They just don't look like this any more
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i have never fathomed why a professionally successful financier already worth £millions and never needs to work again wanted to be Prime Minister when he seems to have no particular mission or coherent ideology. He has succceeded at everything he has done, so why pick failure?
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The Co-Op had 99p packets of Angel Delight right next to the milk today
Who could resist a bit of 1970s culinary nostalgia
Breakfast of champions
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and i am now hearing that the medical director suggested referring the entire paediatric department of consultants to the GMC
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