It struck me that you might want to open your village hall or community centre so I thought I’d guide you through the new rules which are at https://www.gov.uk/government/publications/covid-19-guidance-for-the-safe-use-of-multi-purpose-community-facilities/covid-19-guidance-for-the-safe-use-of-multi-purpose-community-facilities
First there is a series of warnings.
Many community facilities are also workplaces and those responsible for the premises should therefore be aware of their responsibilities as employers. The government is clear that no one is obliged to work in an unsafe workplace.
Organisations also have a duty of care to volunteers to ensure as far as reasonably practicable they are not exposed to risks to their health and safety and are afforded the same level of protection as employees and the self-employed. [As an aside that came as a surprise to me, I didn’t realise the self-employed were entitled to any level of protection. Heigh-ho, live and learn.]
You should also consider the security implications of any changes you intend to make as a result of COVID -19. [Whose security? National Security, are we worried about terrorist threats here? Or just make sure the building is locked properly overnight?]
After telling us to be aware of “2 metres distancing (or 1 metre with risk mitigation)” we get to the nitty-gritty.
“From 4 July, users of community facilities should limit their social interactions to 2 households (including support bubbles) in any location; or, if outdoors, potentially up to 6 people from different households. It will be against the law for gatherings of more than 30 people to take place.”
So whilst you can have up to thirty people in your village hall, this is only possible if they come from no more than two households (plus their support bubbles. Between ourselves are bubbles all that structural? I for one wouldn’t want to be supported by one.)
Actually the ‘support bubble’ is “if you live by yourself or are a single parent with dependent children”. So each support bubble can add one adult and an unknown number of children.
Then you get to this bit.
“However, premises or locations which are COVID-19 secure will be able to hold more than 30 people, subject to their own capacity limits, although any individual groups should not interact with anyone outside of the group they are attending the venue with – so in a group no larger than 2 households or 6 people if outdoors.”
As far as I can make out, if your village hall has a several meeting rooms which don’t force people to mix with other groups, you can have people in these meeting rooms and as long as each group is no more than thirty strong you can have more than thirty in your village hall. But each room can only be used by people from two households (and one assumes support bubbles, but it doesn’t actually say.)
I will pass over the section on entrances, exits and queue management.
Then we get to your relationship with other ventures in the area.
“The Individual businesses or venues should consider the cumulative impact of many venues re-opening in a small area. This means working with local authorities, neighbouring businesses and travel operators to assess this risk and applying additional mitigations. These could include:
Further lowering capacity – even if it is possible to safely seat a number of people inside a venue, it may not be safe for them all to travel or enter that venue.
Staggering entry times with other venues and taking steps to avoid queues building up in surrounding areas.
Arranging one-way travel routes between transport hubs and venues.
Advising patrons to avoid particular forms of transport or routes and to avoid crowded areas when in transit to the venue.”
So according to this the manager of the community centre will talk to the manager of the cemetery on one side and the school on the other and they’ll work together to fix their opening times, and take control of the pavements outside marking lanes for people to walk. At the same time they’re making sure that they don’t all come on the same bus. (To be fair, with a village hall in a rural area, there won’t have been a bus since some time in the last century.)
Who wrote this? What planet are they living on?
So let us take our village hall booking secretary. He or she is probably at home as they’re likely to be over seventy and they’re taking telephone bookings. Let us call them Pat Smith
The phone rings
“Pat Smith here.”
“Hi Pat, I’ve heard the hall’s open so we want to book a room for history society meeting.”
“How many are coming?”
“Haven’t a clue Pat, you know how these things are.”
“Well how many households might come?”
“Well everybody is a member of a separate household.”
“Well you’ve got two households with their support bubbles. That probably means no more than four of you. But apparently six can meet outside to perhaps you could leave a window open and the others can stand outside?”
“Well I suppose if the speaker shouts everybody will be able to hear him.”
“No shouting, the guidance states, ‘All venues should ensure that steps are taken to avoid people needing to unduly raise their voices to each other’.”
“Right you are Pat. Will you collect the money?”
“No I cannot leave the house, just push the money through the door as usual.”
“We’ve got our key so we’ll let ourselves in.”
“Yes but how are you getting there?”
“Well I was just going to walk.”
“Could you walk via Biglands Farm. It means you avoid the school and the bus stop because we’ve got to avoid transport hubs.”
“But it’s an extra three miles.”
“Oh and can you delay your return until 11pm because the Flower circle is meeting and you know how long it’ll take for some of them to walk home.”
“How come the Flower circle is meeting in the village hall, there must be a dozen of them and they’re all in different households.”
“They’re not meeting in the village hall. They’re meeting in the queue outside the chippy. They can stand a meter apart and talk for as long as they like.”
The whole document runs to 3620 words. Christian charity demands that I spare you the rest of it. But trust me it doesn’t get any better. There’s even an enforcement section which promises poor Pat Smith, “serious fines and even imprisonment for up to 2 years”.
It has to be said that people who’ve seen this have commented on it. But actually when I read it I just thought, ‘same old same old.’
I have spent a lot of time working with Defra over the years, as part of the consultation process. In reality a lot of this means going through draft regulations and draft statutory instruments correcting them.
You see, left to their own devices, the civil service seem to produce stuff like that I’ve just critiqued. I may have been unlucky in dealing with Defra and the RPA but a lot of their stuff starts off just like this. If you work your way through a document and you don’t discover clauses that contradict each other, clauses that are impossible to obey and others that are impossible to police or even measure, then you’ve probably got a version that’s already been consulted on previously. I’ve seen clauses in draft regulations which were actually worded to be diametrically opposed to the regulation they were implementing. I’ve seen stuff that has just been copied and pasted out of a previous document and put into this one, even though it was agreed to drop it when the previous document was scrutinised.
I realise that there isn’t time for a full consultation process on these documents, but please, could we just have a grown-up with some experience of the real world go through them with a thick red pen crossing out bits and annotating it.
Let’s be sensible here. “The Individual businesses or venues should consider the cumulative impact of many venues re-opening in a small area”
So why are all the shops in the town centre open at the same time?
“Arranging one-way travel routes between transport hubs and venues.
Advising patrons to avoid particular forms of transport or routes and to avoid crowded areas when in transit to the venue.”
Well Tesco doesn’t do it. Walking down the main street in town to get to the bank, none of the shops or institutions I went into advised me, “to avoid particular forms of transport or routes and to avoid crowded areas when in transit to the venue.” So if HSBC or Tesco don’t have to do it, why does poor old Pat Smith?
We cannot have six standing in the village hall car park, but if you stand in the queue at a takeaway you can have any number of you meeting.
Frankly it’s no wonder people have lost patience with it all.
♥♥♥♥
So if you do want to reopen your village hall, I recommend you read this first. It’ll be absolutely no help whatsoever but it has the advantage of being comprehensible, amusing and well written.
We continue to explore the wit, wisdom and jumbled musings of Tallis Steelyard. In this invaluable publication Tallis Steelyard discusses the ways in which a writer can bring their work to the attention of the masses and more importantly, sell the book to them. As well as this, we have the importance of getting home under your own steam, music and decorum, brass knuckles for a lady, and of course, a few simple spices.
Surely this is the one essential book that every aspiring novelist should both purchase and study.
As one reviewer commented, “Tallis Steelyard: A Guide for Writers, and Other Stories by Jim Webster is as advertised, a collection of stories with different themes. I will look at only a few of the twenty-six tales. The School for Assassins under the title Tidying Up Loose Ends is remarkable in its tone. In some areas of Tallis Steelyard World, purposeful and planned killing is accepted; it is the casual acceptance portrayed in the story that I find worthy of attention. There are several sections on writing (per the title). Tallis will comment on the associated functions of publishing and promotion. If you are a writer, an avid reader, a reviewer, a publisher, or a person who attends events for the free food and drink, these sections are not to be missed. Readers may find themselves portrayed in one of the groups. The section on writers who write about writing for fun, profit, and financial independence will stick in my mind for a long time. Webster uses humor rather than a direct assault on the commission of scams by charlatans. I believe the author is holding back on “saying what he really thinks.”
The unsurpassed beauty of Tallis Steelyard creations is the elegant language used with precision to separate the occasional absurd from the daily mundane then remixing to produce entertaining stories. I like to select favorite quotes because there is no better way to illustrate what I find to be a unique writing style. This five-star collection reminds me of a quote from a film (possibly paraphrased). “Life is like a box of chocolates. You never quite know what you are going to get.” (Attributed to F. Gump). Readers will find literary candy of many varieties in this “guide.”
The importance of getting home under your own steam ***** Readers might guess by this story’s title that there is alcohol involved. True, but it was Bongo’s birthday. The passing of years brought Bongo to maudlin reflection on a boring life. Tallis and company decided that if Bongo could be transported home on a palanquin carried by a score of naked harlots, at least the birthday party would be a point of interest in Bongo’s otherwise humdrum life.
I will point out one feature of why Tallis Steelyard stories are great. Look at the word “naked;” it is OK to free associate. Then “By the time the wine was finished I was somehow surrounded by nearly three dozen young women dressed much as nature had intended.” (Kindle location 53). Further interesting imagery comes to mind. The narrator is not vulgar or offensive and does not employ “shock” terminology to describe weird situations. Bongo’s wife was not offended; readers should follow her example.
Not perhaps the best location ***** Sneal, a wandering merchant spent a day traveling on his way home through the unfamiliar countryside in the hope of discovering new markets for his goods. He ended the first day by spending the night at an inn located in a tree. After traveling the next day, the same thing happened. Same inn, same customers, same barmaid. The third day was a repeat of the earlier two. Finally, he arrived home. How did this happen? Cue the scary music. What happened when he recounted his adventure to Tallis?
The frantic scribblings of a novelist ***** This chapter is the first of several observations related to the lives of a novelist or a poet. Tallis offers contrasts as he pities the unfortunate novelist. Poets are superior in their social lives and sufficiency of income. Tallis said so. This section and the following five sections explore the world of writing. Quotes that stick in my mind follow.
There in Black and White ***** One of my pet peeves is discovering that after I download a Kindle book, 20% of it is devoted to promotion. Tallis points this out with “There is a feeling amongst publishers that the reader doesn’t really want the book they’ve purchased, but instead in point of fact wishes to peruse an assortment of other books that the publisher has available. Pictures of these and even sample chapters can in extreme cases double the size of the book.” (Kindle location 181).
Learning from others ***** Writing books from the comfort of home while in any state of dress and personal hygiene imaginable can bring instant and immense wealth. All one must do is follow the advice of proven authors. Tallis looks at the advisors as “a community of writers writing books about how to sell books that were bought largely by people who were interested in writing books about selling books.” (Kindle location 244).
Nobody does it like that anymore ***** Tallis does not dismiss time tested good advice. Departing from tongue-in-cheek humor, Tallis notes, “Writing is just another craft like joinery or metalwork, the more you do it, the better you get.” (Kindle location 271).
The uncompromising principles of the successful writer ***** Tallis consults a printer to find out the kind of literature that sells best. “This is what feeds the press Tallis my boy, cheap stories of forbidden vampire love, or demon love, or love with a score of fantastical, imaginary, or hopefully extinct creatures. (Kindle location 331).
A distinct shortage of assets ***** Many authors assure readers that reviews are vital to an author’s success. How can an author get reviews quickly? Tallis would “ instruct (the printer’s) domestic staff and secretary to write glowing reviews of his work under false names” (Kindle location 401).
Subsequent stories address other topics as Tallis leaves the subject of writing out of fear of appearing maudlin. Any would-be writers should continue reading the rest of this collection to pull themselves out of any depression caused by an examination of prospects for fame and riches in their chosen profession.
At the end of this Tallis Steelyard set of musings, I am left with only one question not addressed in this examination of the world of writers. Why does an author choose to sell a novel for USD 1.26?”
Tagged: civil service, defra and the rpa, mindless bureaucracy, transport hubs, when in transit
Jim Webster 
And you’ll be supposed to do a risk assessment based on this…
You can indeed, go to https://www.hse.gov.uk/simple-health-safety/risk/risk-assessment-template-and-examples.htm to start 🙂
Oh dear…. 😉
should keep you out of trouble for weeks.
Nobody gets hurt anymore because nobody does anything because we’re all struggling with the risk assessments 😦
Ah… that’s what they’re up to. A covert extension of lockdown 😉
Well seriously, the rules were written to be impossible to use
A church has to have a system of putting hymn books into quarantine, have the place deep cleaned when anybody has been through, separate doors in and out
And of course liaise with others to make sure we’re not filling transport hubs with traffic etc
I haven’t noticed tesco quarantining cans that people have picked up and put back down again
And in our local tesco there’s one door. Yes there’s a tape down the middle but you’re still not two meters from the person coming the other way.
The rules were basically written to be unworkable, whether that was their intention or not
That’s going to be very awkward for all our medieval churches…
But nothing new that bureaucracy works without recourse to common sense.
, I’ve worked out how we can take communion together again.
Forget opening the church. Just have a serving hatch in the wall and the vicar can pass out to each communicant as they shuffle past a tiny plastic sample glass of the wine and a piece of bread on a serviette.
It’s not a church, it’s a takeaway, and because we’re queuing at a takeaway we can stand at a meter plus and there’s no limit to how many of us gather.
Or give everyone a BLM placard, then the rules won’t apply.
I looked at the ‘excess deaths’ on https://www.euromomo.eu/graphs-and-maps/
There is normally three weeks between an outbreak of infections and an increase in ‘excess deaths’
The BLM protests had no effect on excess deaths
It may have been than an increase in infection was among young people who had it but never even showed symptoms
Of course many of the free churches have been distributing individual portions for many years… and some Anglican ones could be adapted easily enough. So, knock the glass out of Aldingham’s leper squint, bring people in the west door serve them at the east end (where the wall is thick enough effectively to distance communicant from priest) and take them out of the south door.
Better entirely outside so you don’t have to disinfect between them!
It is ruddy ludicrous.
funny you should say that 😦
Unbelievable. Mark you, I haven’t ‘lost patience with it all’ since I never had any patience with it to begin with. Stupid lockdown.
Yes, our bureaucracy hasn’t exactly covered itself in glory! 😦
Hilariously helpful and tragic companion piece to your previous pieces on the highs and lows of village hall management. Top shelf.
Yes it is all getting a bit silly 😦
Unlike most of your readers, you *have* dealt with the RPA, Jim, so you’ve probably plumbed the depths of governmental ineptitude. I’m not impressed with Pat’s geography, though… doesn’t she know that Biglands Farm is up near Wigton? It’s a heck of a walk 🙂
I tried to keep it generic, I didn’t want it traceable to any particular village hall, 🙂
Pat Smith wouldn’t have thanked me if she’d had even more paperwork to fill in
Oh, just to add, somebody sent me the text of the President and vice President’s speeches at the Methodist Annual conference. Very impressive indeed
Whoops! This Methodist hasn’t read them yet.
They’re worth the effort 🙂
I cannot cope with all the increasingly complicated rules, so I’m staying home until life becomes half way normal again…
No! Don’t let them win. Get out there and break some rules!
Walk along the street whistling cheerfully. I don’t think it’s actually illegal but somebody will disapprove 😉
We tend to do what’s best for us, rules or no rules!
In a courteous and very English fashion 🙂
I suspect that’s what they hope 😦
That’s actually the focal point of government guidance.
Ohh dear, Jim. They are tying themselves up in knots (no change there) and trying to take us with them!! Stand firm I say and wave a ‘common sense’ placard…
revolutionary talk there 😉
Start bringing common sense into the civil service regulation and it would be the end of civilisation as we know it 🙂
I have been known to live dangerously 😉 Love flowing up to you all, Jim. x
Thanks Jane, we’ll check in the regulations, there’s probably a forty page annex detailing how we have to cope with love 🙂
Well depending on how Jane expresses it, there’s definitely a risk of droplet transfer 😉
🙂
Chuckling…. 🙂
🙂
The Red Queen could believe three impossible things before breakfast, IIRC (it’s been a while). Maybe that’s the facility needed here.
If there’s liability involved, then there is an out for every possibility, so it’s not their fault.
We have a bunch of bureaucrats making life complicated here – and the coronavirus is surging in the reopened states – so we’ll just go to the safest position, and stay there. It can’t (I hope) last forever.
eventually there’ll be enough of the population immune and it’ll fade.
At the moment there is suspicion that in the UK twice the number of people are immune than they first thought. Merely having antibodies isn’t a sign of immunity, a lot of people have the necessary T cells, mainly because coronaviruses are so common.
So it may be that in Europe what we’re seeing is small outbreaks as the last pockets that weren’t infected get the virus. But there’s no sign of deaths rising but deaths are a lacking indicator
But the regulations do look like frantic ‘back covering’ with no regard to what is and what is not possible
‘Endemic’ may be the best we get. Immunity is not guaranteed (other coronaviruses that cause the common cold do not create long-lasting immunity).
For herd immunity, it is estimated that 80-90% of the population may need to be immune, especially for such a ferocious virus.
We’ll see. We have a half-year of data. That’s not enough for anything.
The States is doing everything wrong (though the governor of California, who promised to close things down if there were problems, is indeed closing things down).
125k+ dead is a high price to pay for stupidity and the appalling lack of common sense. It’s like pouring fuel all over a house and not expecting any little spark to set the whole thing off.
I’m not going out.
Our facility has just canceled food in the dining room (which it had cautiously opened) – we’re going back to delivery only to every single apartment (>250) in the place because the county isn’t taking chances. Which is fine with us – we’ve been eating at home even while other were going to the dining room.
The problem is that much more draconian rules apply the minute a community like ours has a single coronavirus case among residents OR staff. Management is hoping to avoid that undesirable status – people planning to move here will look askance at us if we have any cases.
No vaccine, no leaving.
The problem is that it isn’t ‘ferocious’ in that when we started mass testing it was discovered at the time that 80% hadn’t got symptoms and didn’t seem to develop symptoms
Certainly in children it will rip through a school and very few of them suffer anything. We suspect it hit one of our local schools in early/mid march and it was only once people started talking about corvid 19 that people at the school started going sick, because otherwise it was something they were coping with, like a mild cold.
With regard to immunity, the suspicion is that far more people have immunity naturally, perhaps because of other coronaviruses. This could explain why America has it so bad at the moment, your continent might have missed one of the last colds.. Also looking at factors that make it worse (or at least increase the death rate, you have a lot of poverty, BAME people and poor housing (or at least very dense housing)
125k + dead is indeed a high toll. It seems to dwarf the 44k reported in our own (UK) daily statistics… until you remember the relative sizes of the populations. Do that, and our death toll looks almost five times heavier than yours. I shudder to think what the situation must be in poor countries.
Your death toll has the same root cause: ignoring the scientists because it is politically expedient.
Wish the politicians paid for their OWN bad choices, instead of enabling those who kill by ignorance and deliberate ignoring of public health authorities.
Actually when you read the minutes of the SAGE committee that advised the government (now published) there wasn’t much demand for lockdowns (as opposed to social distancing) and the big fear was that there is only so long people would lock down
The minutes are quite interesting reading
https://www.gov.uk/search/transparency-and-freedom-of-information-releases?organisations%5B%5D=scientific-advisory-group-for-emergencies&parent=scientific-advisory-group-for-emergencies
IF people would do the protective measures faithfully and completely, lockdown would possibly not be required for senior communities like mine.
But when the outside world seems to glory in getting as close as they can to each other, without masks, and with no inhibitors, the vulnerable can’t afford ANY chances.
Surely it would benefit the vulnerable if a lot of the non-vulnerable got the virus and established herd immunity? Given a vaccine may not be a possibility, we can’t all hide away for ever.
That is one reason why there was going to be lockdown. To protect the vulnerable. If there is no vaccine then the virus will spread. Even if stamped out in a country as it was apparently done in New Zealand, it’ll come back in with tourists so you have to lock down the frontier.
How many of the vulnerable are sacrificed to the eventual herd immunity, and whether a particular section of the population is disproportionately targeted, and whether YOUR loved one is one of the involuntarily ‘sacrificed’ is exactly the point.
The number of deaths in the elderly, ill, and disabled is the measure.
In those of us like me, chronically ill (I have ME/CFS) but with a potential lifespan of another 30 years, the willingness of the general population and the politicians to throw me under the bus reminds me of the AIDS debacle.
Spare me your hopes for herd immunity – and do some research on how long that actually takes – it can be years.
Society is judged by how well it takes care of the most vulnerable. That’s how archaeologists can tell if a society was advancing: by the healed bones of the dead they can deduce if an injured person lived long after the injury – or not.
There’s an interesting article here on that very topic: https://lockdownsceptics.org/how-should-we-value-the-lives-of-those-most-at-risk/
Life’s a risky business, and no one gets out of here alive.
In the link, “since demand for healthcare is, in effect, limitless if ‘free’” is a faulty premise. Ergo, all reasoning after that point is faulty.
Health ‘care’ has a huge personal cost, having to do with accessing it, and the recovery time from it – or we wouldn’t have things like hospice, which are partly chosen, partly assigned when there’s nothing the medical profession, an interested party if there ever was one, thinks it can still do.
You have to look at such benefits as the lowered total cost when preventive care is offered to all – vaccinations are a prime example, as well as treating infections, etc., before they become hospitalization cases.
Life’s a risky business – but this is an extremely uneven playing field, and that’s the unfair part. Not that people who have co-morbidities die at a higher rate – that’s expected – but that it is so disproportionately higher, and that many of those people would have had useful, pleasant, and long lives without the case of coronavirus the plumber brought in.
Nothing in life is fair. Some things are much unfairer than others.
As the owner of a long-time illness (30+ years so far), who still managed to do many things, including bringing up the children she had when she came down with ME/CFS while presenting at a PHYSICS conference, for goodness’ sake, I can tell you that my life has worth and value, and I don’t like arbitrary cutoffs by age, for example, when the young people standing between me and a ventilator, just for an example, are there because they went to a party and drank themselves into a stupor, and managed not to kill themselves while driving home in that condition.
The US has healthcare FOR PROFIT. It has been shown easily that it would cost 1/4 what we pay to have it be nationalized – the other 3/4 of the expenditure is going into such things as excess and unnecessary paperwork – and the pockets of people who own the companies and the stock.
And disproportionately affects poor people – which is a real scandal in a democracy. We should at least be trying.
Just with regard the numbers, whilst US healthcare is ridiculously expensive, you could have a top of the range European style system for half the price, rather than a quarter
But certainly nobody in the rest of the world can see why they would shift to an American type system
Also the hospice movement took off in the UK in a big way AFTER the establishment of the NHS. It wasn’t the cost of end of life care that was the problem, it was that hospitals were not very good at offering it, so in the UK we have at least 220 hospices, all charities. With that we’re about the same as Germany (where their law is different and they also have ‘palliative care wards in hospitals)
As somebody who had a mother die of cancer in our local hospice the work they do is amazing
Hospice properly done has to be an amazing gift. Hospice for profit, such as what Medicare pays for, has to be erratic.
I’ve heard good and bad things. What my MIL got was horrible.
In the UK they’re just charities who raise money from private donations, running charity shops etc. I have a vague memory that the government does provide a little funding from time to time, much as they do for other charities
Since hospice care is medical care at the end of life, shouldn’t it be covered by your NHS?
Keeping dying people comfortable can require drugs and other medical comfort measures that civilians aren’t qualified to provide.
It might be a charity in the US, with its messed up ‘health’ care, but I don’t see why it isn’t part of ordinary medical care in your system.
You can die in hospital if you want.
When somebody comes to ‘end of life’ there are various options. A lot of people want to die at home and there are various charities (Macmillan Nurses) who help you do this. They can work with your GP to make sure you get the proper medication.
Or you can go into a hospice, where again you get the medical care you need, and the staff have more time to actually care for you.
Or you can die in hospital which a lot of people regard as the lesser option. But it’s the option open to everybody. The main issue is that hospitals are busy and focussed on healing and don’t have time to just sit with patients who are not going to heal.
My father died in hospital because the treatments they had could no longer work and twenty four hours after being admitted he was dead. In reality they’d have been better off leaving him to die at home, but he was never conscious once he arrived at hospital (that wasn’t the medication that was just his condition)
Staying at home depends on the ability of someone to care for you. I don’t understand why the NHS doesn’t take care of you at home if you want them to. Why is hospice ‘charity’? End of life is still health care.
Are the hospices government supported, and available to all?
I guess I just don’t understand your system. Here a lot of hospice is a charity, but we don’t claim (horrible system, ours) to have healthcare for all, as you do.
I hope some of the turmoil here is people being fed up with many things, and wanting a change. Including universal healthcare – we’re the only developed nation without it. Maybe we serve as an example – and if WE had a universal system, then ALL of them would start cutting budgets. Dunno.
The NHS was set up to provide a safety net, something ‘free at the point of use.’ But there have been a long series of compromises. At the very start the doctors point blank refused to be conscripted into being government employees. They were professionals so GPs surgeries and Dentists are private businesses which accept contracts from the government for some work.
But the state provides the basics. If you want cosmetic treatments only some of them come from the state (because they’re a mental health issue. The state only provides so many cycles of fertility treatment.
Underlying all this is the fact that pensions, health care and the NHS take about 48% of government spending. When health care was free at the point of use government learned, as early as the 1950s that there was no limit to the amount people wanted
If you need ‘end of life care’, the state provides it. In hospitals.
But a lot of people don’t want that. They want it at home or it a hospice. The state has set up a system. You can use the system or you can do your own thing.
But you wrote before that the hospitals don’t have the time for people in hospice care! That seems awfully mean to a dying person who doesn’t have another choice.
I don’t get the concept of ‘no limit to the amount’ of healthcare people want. Most people don’t want to go to the doctor! They go because they have to. And if it seems like there’s no limit to what they want, I bet it’s because what’s provided is very stingy in the first place.
But what do I know. I have not gotten my money’s worth out of private insurance for the thirty years I’ve had ME/CFS – they pretend it doesn’t exist, and make it impossible to see anyone who know anything.
You’ve never lived in a country where healthcare is ‘free’
This is written from an American point of view but it seems pretty fair
https://www.vox.com/2020/1/28/21074386/health-care-rationing-britain-nhs-nice-medicare-for-all
It’s all lovely in principle, but your system has many flaws there is no appeal from, including the way people who need more healthcare support just to live are given rationed care by healthy able-bodied people looking to control the bottom line.
I’m not saying we’re better – far from it – but we’re going through more rounds right this minute of psychiatrists telling people with ME/CFS that they need to exercise more (GET is DANGEROUS for us), and that it’s all in their heads (CBT misused to gaslight people with a physical illness into thinking they can fix it with platitudes), because that’s cheaper for the NHS.
Each system has its particular failures. I’m sure yours is still much better than ours – but I have too much information about my little corner, and you’re supporting fake pseudo-scientific processes for pay. I’m sorry – I didn’t choose to be sick.
The English version of English includes a word many of us don’t know. A ‘qualy’ (or ‘quality adjusted life year) is a tool used to measure not just how many extra days a therapy will keep a person breathing, but how much benefit will flow from that extra time. From memory, a qualy costs something in the low tens of thousands of pounds… or did before covid-19 struck.
It is not a choice made by the person, but by other healthy able-bodied people – that’s the problem. I don’t know the solution, but I’ve been chronically ill for over thirty years (lost my career as a research physicist at Princeton because of it) – but I have NEVER questioned the quality of my life.
Given that resources are (always and everywhere) limited, I wouldn’t want to be the one who had to calculate who was treated, with what – and who didn’t receive treatment. One might imagine that a cancer patient would want extra weighting for cancer treatments, a multuiple sclerosis patient would prioritise MS treatments… and indeed an ME/CFS patient would place special value on treatment for those conditions. Clearly the decision can’t be left in the hands of the patient (unless, for their own reasons, they conclude that the time has come to *stop* treatment, and comparing one condition with another can be like comparing apples with cricket balls. What’s needed is a system which recognises the limitations of the system in its totality while bringing as great a level of objectivity as possible to the decision making process. This, I understand, is what a QALY attempts to achieve.
The principles are good; the execution is often very unfair. It would deny care to Stephen Hawking. And the system has a tendency to deny even relatively small expenditures to make life worth living for some of its citizens.
We call that eugenics, however they want to call it.
There are ALWAYS going to be people who need more care, more help with education, more equipment, than others.
The care of some of those people leads to advances in medicine – as medicine is forced to admit their standard care is useless.
No with qualy, relatively small expenditures will get nodded through.
It is the advances in medicine which have brought about the need for rationing. Forty years ago people just died whatever. Now you can save them, sometimes quite cheaply. But then they go on to cost you more and more.
You forget that it isn’t a person making the decision, it is the State. The state is the one who says to a generation of young men, “right we’ll have you lot, waste four years of your life, and a quarter of you will come back dead or maimed.” The State doesn’t care about you.
The process is at one level mathematical. It boils down to “We could keep these six people alive for another year, or we could improve maternity provision in this area and this would improve the life chances for scores of children and would equate to hundreds of years with better quality of life.
Then the political moves in. Somebody in need of funding starts shroud waving, fills the newspapers with photos of the cute kid who is going to die because minsters have decided not to pay for their treatment. This comes as a surprise to ministers who have never heard of the child because decisions like this are taken at a very local level. SOMETHING MUST BE DONE and money that might have gone to care for the elderly or something else gets poured into buying a drug which might keep a few cute kids alive a little longer.
Sorry if I’m coming across as cynical here
Cynical? No, I don’t think so. It comes down to, ‘Something must be done: this is something: we’ll do it.’
sadly yes
Realists are cynical.
There is a process for those six people denied care: get around the official system, including by going viral and embarrassing the officials. It is a time-honored method.
OFTEN it reveals basic inequality in the system, inequality which needs to be addressed.
OFTEN the inequality comes because the people making decisions NEVER include those who are actually sick – they look on from a position of privilege and health, and make decisions which affect OTHER PEOPLE’S LIVES.
The system has to be re-examined constantly – or it gets too smug.
of course. But then that is one reason why we have the arbitrary figure of qualy
It gives the state something to stand behind.
It means that the officials can turn to the minister who wants a quick hit of popularity and say, “Yes, you can do that, but that means you automatically do this and that means these people miss out
It is convenient – for SOME. As a person with problems left in the NOT some category, I have to keep insisting they re-examine their assumptions because they are not fair.
I did NOT choose to be this way. Someone else might be a paraplegic because they did NOT choose the truck that came barreling down the wrong side of the freeway when one of those drunks got behind the wheel.
And the whole point is that much of it could happen to ANYONE, at ANY TIME. Wouldn’t you like to know your government, the one that takes all your tax money, might actually have YOUR back?
I guess that makes me a gadfly. So be it.
With the paraplegic who was an accident victim the medical treatment would be automatic. Actually it would be far cheaper than the drugs some people need for, for example, cancer. The main cost for the paraplegic would be living costs after the medical treatment and that would be a legal case and compensation which is a totally different debate.
The State doesn’t have to be fair. The state merely has to be able to justify the decisions for majority support.
At the moment there is a major debate, in that if you have to go into a nursing home with MS then all your costs will be paid. If you have dementia, it’s not a medical condition because it doesn’t respond to treatment and the state will only pick up the bill once you’ve sold your house etc to cover costs. This is widely seen as unfair.
The argument is raging as I write and my gut feeling is that there will be some compromise. The problem is, covering the total cost of ‘elderly care’ is huge. It’s even more complicated because the system is separate from the NHS and it is a right ‘buggers muddle’ to use an old English phrase. Previous governments have kicked it into the long grass on the grounds that it’ll be somebody else’s problem. But it is going to have to be tackled this decade.
“The State doesn’t have to be fair. The state merely has to be able to justify the decisions for majority support.” Is that why democracy is the worst form of government apart from all the others?
probably. It’s why democracy can degenerate into the dictatorship of the majority. It’s one reason why the church should never have power and should be wary about being fashionable 🙂
Somebody has to speak for those who have no voice
We knew the cost of elderly care would be huge – so we took out, and paid for, long term care insurance, so that we’d have a choice of where and how.
Not everyone can afford that, of course. In fact, most people don’t have that much put away for retirement even, and depend on their families. And some people are rich.
I don’t know where ‘fair’ is, but to me dementia IS a medical condition – something going wrong with the body.
Medicare covers NO long term care UNLESS you are destitute and then you go on Medicaid, after you have no assets left.
The problem is that we, the world of people, are setting up systems to take care of us – and there isn’t a clear answer to who gets what from whom – except that the rich seem to be raping every government on the planet except possibly the democratic socialist Scandinavian countries.
Is it fair that someone lives in a palace with servants – from the time they are an infant?
And yet, what do finite humans do except try to leave all their money to their heirs?
We won’t solve this one, but need to keep working on both these questions, and how to provide better care at some level for everyone.
BTW, MS doesn’t get better, and is only slowed by treatment.
The vast majority of people want to see their children and grandchildren get a better start than they had.
Also when it comes to saving, remember that the US ‘tax freedom day’ is April 16th, in the UK it’s May 8th. (Apparently in Sweden it is July 18th)
I suspect that housing costs in the UK are higher than in the US (but it’s difficult to get a proper comparison.)
So in the UK you don’t have the same money to put away for elderly health care. Indeed people feel that because they’re paying more tax, that they’ve already put the money away for elderly health care
We don’t have the money BECAUSE of how we choose to collect and use it, and because the rich have fooled everyone into believing they have our best interests at heart – their tax rates here are ridiculously low. I’d happily make tax day Dec. 15th, if it meant people were not hungry, cold, sick, or uneducated.
What is meaningful in an American context doesn’t necessarily ring true elsewhere. In this country the rich who are a problem aren’t necessarily those with a lot of money.
For us, a lot of them are transients, they spend time here because we are a safe country with the rule of law and aren’t going to extradite them to be murdered by a tyrant.
There are two classes who are beginning to be disliked. One is the large UK companies like facebook and amazon who don’t pay tax on the money they take off us
The other are those in this country who have safe government jobs, steady money and index linked pensions. They’re the ones who retire at 55 and 60, paid for by tax payers who will work pretty much until they die
The ones in your safe government jobs with early retirement must really stick in the craw. We have that here – certain professions retire with full pensions after 20 years – and get to be supported the rest of their lives, whole second career and all. Must be nice.
We have it but the French have it worse. As far as I can make out a lot of protests are because people in certain jobs retire on good pensions in their fifties and the government cannot afford it any longer
It is as hard for the middle class to give up those nice retirement benefits they have ‘earned’ – by following the system and putting in their time, as it is for the rich to give up some of their wealth.
I think part of it is that we’re ALL insecure of what will be coming in the future (and now we are all panicked by the pandemic), and need to have as big a cushion as we can manage so we won’t run out of care in a system that doesn’t do very well in general.
Insecurity breeds grasping. Fear is not always logical.
The big problem with them is the culture of entitlement, it’s theirs by right
Sometimes those rights are grandfathered in – to make it easier for the next generation. No one is entitled to anything, but contracts and promises are made. Politicians have not been willing to bite the bullet EVER.
Politicians tend to be part of the same class
We were warned: the … you will always have.
Sometimes I wonder what good comes out of humans that balances the enormous bad He allows.
I’m just re-reading Philip Yancey and it’s fascinating to see things from the perspective of somebody who comes from that background
My apologies, Jim – I hope you hadn’t been intending to do that months ago!
no, I hadn’t given them any thought. It’s just when they landed back, somebody somewhere commented on something and because I’d not got round to putting them away, I read them 🙂
I took a look. As a practicing liberal Catholic who actually believes, I find it odd when non-Catholics refer to ‘the church’ – and ‘Christians’ – as if they were a thing, and that thing monolithic.
Most Protestant churches and belief systems make me scratch my head. Mainstream Anglicans and Episcopalians and Presbyterians are closer to what I understand, but the ‘Evangelicals’ are aliens in human clothing. And there are SO many divisions among them all.
Don’t get me wrong – the divisions in the Catholic church are significant and deep and destructive, too, but we have some structure going back to Peter. I find that comforting.
I started the Look Inside on the second listing, and was immediately confused. This writer seems to think (I may be reading it wrong, and it’s late) that evangelicals are bringing ‘the church’ to South America. Forgive me, and it was badly done and with the wrong intentions (making the people easy to dominate in many cases), but Christianity (back when there was only our version) came to Latin America from the Catholic Spain and Portugal in the form of priests and nuns who preached the Gospel and taught.
Anyway, I don’t associate with what many people now see as hate-filled neanderthals. I only see them in their screaming form in phone video recordings supporting their demigod, DT.
Thanks for an interesting look. I’m backing slowly out because it’s way over my simple power to comprehend. Forgive my flippant attitude about something so important.
Remember that when people refer to ‘the church’ as a monolithic entity they’re merely copying Paul in Ephesians or Jesus in Matthew 16:18 where he says “And I tell you that you are Peter, and on this rock I will build my church, and the gates of Hades will not overcome it.”
Indeed when the word ‘church’ is used it is normally a translation of the Greek ecclesia which means ‘called-out’
Actually when Christianity came to the US, it was after the sad ‘great schism’ with the Greek Orthodox .
I like the comment Billy Graham made when somebody accused him of setting the church back 50 years. He said “I am deeply ashamed. I have been trying very hard to set the church back two thousand years.”
His version of setting the church back has worked, evilly, in this country. He has made the term ‘Christian’ despised, and everything Christ stood for ignored by his ‘Christians.’ He has set them to hating.
Billy or Franklin?
Both. It’s hubris-based. With no one above them, they have done as they pleased. The wealth displayed is the key, as well as the sexual behavior of many: they are not following Our Lord’s example.
Franklin is just then next order of magnitude worse.
Viewed from this side of the pond it feels like comparing apples with cricket balls. I heard Billy in person back in 1989 – and feared the worst kind of hyped-up American (sorry!) razzmatazz – probably complete with cheer leading girls in short skirts etc. What I actually got was a solid expository sermon on a Bible passage that I, even as a Methodist minister, didn’t know too well – but which connected with the hearts of thousands of people. I had huge respect for him, but am sad about how his son has turned out.
Throwing out 2000 years and comparing himself to St. Paul is the hubris.
Yes, there are MANY things wrong with the church, and the Protestant Reformation pointed many of those out.
Yes, churches need to get out of the business of politics and property.
But after a certain point, schism each time two parts of an organization disagree shows the complete lack of understanding of the ‘love your neighbor’ message, and ends up with way-out groups that handle snakes, scream at anyone different, and support Trump: there is no mechanism for bringing meaning back to its origins.
Wealth and ministers should NOT be associated. It’s Animal Farm all over again.
IMNVHO.
That’s why I’d suggest you read the second of the two Yancey books because he tackles that head on
Sorry. Not enough brain power – and zero interest. My beliefs are going to have to stay where they are, and may God have mercy on my soul. Do you have ANY idea how many books are out there with spiritual or religious topics?
If I do more reading it will be Thomas Merton, the Trappist who wrote The Seven Storey Mountain (and considered it his worst book).
They conflate their modern single-parish church with early Christianity, while having almost zero overlap in values.
When Protestant churches disagree, they split, and each faction goes its way.
Reminds me of The Screwtape Letters.
Actually it’s the other way round. When a child is Baptised, that child is baptised ‘into the church’. Not into a denomination
There is no ‘church’! The Catholic church acknowledges other denominations’ baptism – many of them don’t return the courtesy. I’m not getting into these topics – I haven’t the standing OR the understanding capability. You do – go right ahead.
There is a debate in this country, should people with ‘self inflicted’ conditions be treated? After all they ‘chose’ to be sick. We’re talking about those who’ve drunk too much, smoked, or are grossly overweight.
So far the debate seems to be, we treat everybody.
But on the edges you’ll get people told “You cannot have the operation until you’ve lost weight because otherwise your chances of survival are too low.”
I knew somebody like that. Unfortunately given his heart condition, he couldn’t exercise to lose weight and I’m not sure whether he’s currently still alive
Give people drugs which make them fat – and then deny them care because of it.
When I see the stories of English school teachers who drink themselves blotto on their weekends, I think exactly of that: should they get care. I would love to be ABLE to get blotto by drinking.
More stupidity is attached to excessive drinking than to any single other human choice. But Prohibition had to be repealed because it led to worse behavior – bootlegging and crime.
What we do to cigarettes – make them expensive by taxation – seems to help some.
OTOH, taking away a ciggie and a pint from people who haven’t a lot else to get pleasure out of shows flaws in other places in the system – education, opportunity, the necessity to earn a living.
The empathy that comes from someone beating the odds is part of what makes and keeps us human.
We have to keep questioning the decision-making process, and whether it is even remotely fair. That’s all.
The system works best if you’ve got sharp elbows, are educated and ‘know your rights’ or at least can convince some poor sap sitting in an office that their life will be easier if they just give you want you want
Actually it probably works better than most systems for the poor because the rich just go private. Which is fine, because they’ve already made their contribution to the NHS
So the rich person who goes private pays for their treatment and mine. Especially if they go across to the US to get the treatment
It’s not a perfect system by any means. All political parties admit there are improvements, but the NHS has become a fetish and one party claims sole ownership of it and demonises the other party. “Three weeks to save the NHS” has been a general election slogan for at least forty years.
So reforming it is now fraught politically as well
Part of that is because the demonised American system is held up to the British people as the alternative
This gives some idea as to how NHS funding has changed over the years
https://www.nuffieldtrust.org.uk/news-item/70-years-of-nhs-spending
https://www.kingsfund.org.uk/publications/hospital-activity-funding-changes
I’ll check them out. Thanks.
Sorry I missed out the source for the figures for health care cost
https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita
Even if they did the protective measures properly, you’d still run the risk from children, who are too young to understand and very rarely show any sort of symptoms.
Then people forget physical spread without people. There was this test done
https://www.bionews.org.uk/page_150227
Thanks for the link – I have boosted it.
I pointed out that your own behavior should pretend, where possible, that the virus is everywhere (other viruses are, too).
If everyone had learned to follow even just the minimum protections of washing your hands and not touching your face, we’d have a lot less disease.
You’re never going to avoid everything – but reducing transmission does help your immune system handle what inevitably comes in without getting so overwhelmed.
Bureaucratic arse-covering, at its finest. 😦
Sums it up nicely