RE: Eugenics : the thread

Seconds out, round three!

“Moaning about too many managers is a common thing. But look at it the other way. One of the reasons the NHS is perpetually short of cash is that it is extraordinarily inefficient. Appointing people who will increase efficiency and reduce needless costs is the way to change this, surely?”

Do you expect people at ground level to do anything else but moan about managers when our bright eyed boy “I’ve got a degree in electrical engineering you know” decrees in all his wisdom that it is perfectly safe and proper to have one staff nurse, one student and a health care assistant to work a 10 hour night shift caring for thirty four patients. On the night I’m describing only four of these patients could be left to their own devices. All the rest needed some kind of attention either hourly or two hourly. Bright eyed boy also says “when you’re doing nothing, clear out the linen cupboard, tidy up the day room and put some new posters up.” This man, among many others, did nothing other than to increase the wage bill.
Yes, if you can find management who will increase efficiency without any detrimental effect on the standard of patient care would be welcomed. As a nurse you do your training and become a nurse to help people, they talk about hands on care. Get to the level of senior staff nurse and that becomes a thing of the past, beaurocracy and politics take over. I’ve known really good experienced nurses leave to work on the tills at Marks & Spencer because they would be better thought of.

“A good example is when communities save up to buy a scanner or some such. Fine, except that they only buy the scanner.”

They shouldn’t need to do that. One less nuclear submarine would buy and maintain all the imaging equipment needed.

“But we all hear stories of plastic washers costing £10 and other parts being preposterously expensive. This is because the NHS is being taken for a ride. Given the estent of the problem, it must only be down to corruption within the NHS. Getting new people in to do these jobs is a good way to tackle it. Nurses would scream bloody murder if the government launched a corruption which hunt!!”

Naively, I thought it was the super efficient management and accountants that ran the budgets. As for nurses screaming about a corruption witch hunt I rather think they’d be cheering in favour. Nurses stand to make a lot from corruption, after all, I’m a multi-millionaire from selling cardboard bed pan liners on the black market!

“Most accountants within the NHS are not qualified. Don’t you find that shocking? No wonder budgets are poor. The budgeting process within the NHS is dreadful – I know, I studied it. Anyone advocating this at a similar size organisation (eg. Coca Cola or Ford) would be
instantly sacked!”

Yes it is shocking that the NHS chooses to hire non-qualified accountants, the same thing about our bright eyed boy earlier. His total hospital knowledge and experience came from a two week induction. Now Hospital Trusts are allowed to raise their own money from selling their services to other trusts, it is now a business so let’s do some sacking. Patients are no longer patients, they’re clients.

“Hence my argument – start recruiting quality personnel. All managers should be appropriately qualified:

Qualified Accountants (ACA, ACCA, CIMA)
Lawyers,
Actuaries,
Senior Clinicians

Otherwise the financial framework will prevent the NHS doing
its job.”

I totally agree, do you fancy Alan Milburn’s job?

Regards,

kev35

RE: Eugenics : the thread

Mongu, ready for round two?

“Okay kev, fair enough. As long as you don’t think I’m some
kind of unfeeling monster.”

How could I, you’re an accountant…LOL. If you worked at ground level in the NHS you’d know what I mean.

“I’m just trying to see the big picture. I mean, those in charge don’t care about individuals. They haven’t got the time. That’s why politicians kiss babies, to fool everyone. The way I see it, Revenue = X and so, Expenditure must also = X. That precludes the caring “everyone must be cared for” attitude in my opinion.”

But everyone has to be cared for, that’s the whole point. If to make the books balance means giving the required treatment to only one of two patients who need it, who is going to make the decision? You can bet it won’t be the management. As an example, your father is in hospital and in need of life saving treatment and the bean counters deny it on grounds of cost, can you honestly tell me you’d say “well, sorry dad, but because the NHS employs so many managers they can’t afford the drugs you need so you’re going to die, but never mind they’ve built a lovely car park and conference centre.” Another example of inappropriate use of funds occurred a few years ago at Leeds railway station. Disabled people were advocating the need for passenger lifts for people in wheelchairs. This was denied on the grounds of cost. However, the station operator spent I believe around twenty thousand pounds on a garden type seating area where they could wait for their train on a platform they didn’t have access to!

“It’s all down to resource allocation – which is the first thing you learn on any Economics course.”

Exactly, but why spend the money on inanities like a manager to manage the bed linen, who then needs two assistant managers and a team of staff to count sheets and pillowcases? In a hospital I once worked in the medical services manager had a wonderful track record in retail management.

“Greater revenue = greater care. I live on the Isle of Man. The government has money coming out of it’s ears and they are in the middle of building one of the best hospitals in Europe as a result. Recruting staff, too.”

That’s how it should be, but there are not many areas which can boast that kind of investment. The NHS was founded on the idea that medical care would be available to everyone and would be free at the point of delivery. That ideal was destroyed by a Conservative government which
allowed prescription charges to rise from 25p to over 5 pounds an item.

Regards,

kev35

RE: Eugenics : the thread

Mongu,

“When I was describing some mentally disabled people as cabbages, I wasn’t advocating euthenasia. I wasn’t even considering stopping them being born – I was just pointing out that our mental definitions of what mentally disabled equals were, initially, different.”

That is exactly part of the problem, there are just too many different definitions of what constitutes a mental disability and too many ways to grade it. There is no consistency.

“What is wrong with the term cabbage? It is well understood. I think you’ve got a bit of the dreaded political correctness creeping in to your thinking. In my mind, cabbabge = persistent vegatative state. Whether or not there are varying degrees of PVS is one for the quacks, not me. It doesn’t look like there is.”

What is wrong with the term cabbage? Well, it is nothing to do with political correctness, it’s more a case of having a bit of thought and compassion for the victim and their family. Imagine this, Doctor enters an office… ‘Good Morning Mr & Mrs Jones, I’ve just seen your son Jimmy and I can confirm he is a cabbage. Goodbye.’
Yes there are problems with PVS, I’ve already mentioned locked in syndrome and this has eventually been diagnosed in a number of your ‘cabbages’. This is where someone who has lost almost all motor function still has awareness of their situation and the ability to understand it. Communication may only be made through eye movement or the slightest twitch of a limb. It has been missed many times over the years but shows just how difficult it is to ascribe the term cabbage to anything other than the green thing growing in the garden. Incidentally, the term cabbage, spelt CABG, is used by the medical profession to describe the operation, or the recipient of, a Coronary Artery Bypass Graft.

“And what precisely was wrong with Lady T??”

Please, can I come back on this one later?

“I don’t think there is much room for feelings here. That is for the “carers” amongst us. You’re probably one, whereas probably I am not. Maybe that’s why you’re in nursing (I think?) and I’m an accountant. I tend to take a wider view, which is necessary, but then again a caring view is also necessary. My point is that both philosophies are important.”

There is only room for feelings here, we’re talking about fellow human beings. It all comes down to feelings. Those of the patient, their family, carers (such a dirty word)are all paramount in a society which bases itself on being able to provide for it’s members needs. Has someone abolished the meaning of compassion, of duty of care recently? To answer your question I was indeed a nurse working at some time or other in most specialities before finally working with young people with learning disabilities and their families. I don’t work now due to ill health. (Ironic or what?)
Can I look at the funding issues later as well?

“Sorry to ramble a bit and also sorry for the ambiguous nature of the arguments. It’s not a subject which I am able to articulate well, to be honest!”

Don’t apologise for stating things as you see them. As for your articulation? Well, you’re keeping me occupied. I don’t think either of us will change the others viewpoint but it is good to discuss controversial issues like this one and I am thoroughly enjoying it!

Regards,

kev35

RE: Is Hollywood working together with the Pentagon?

I thought the pentagon was in Hollywood?

Regards,

kev35

RE: Eugenics : the thread

Mongu

“What I mean by “menatally disabled” is people who are cabbages. I wasn’t thinking of autistic people when I said they don’t contribute to society.
Maybe my personal definition of “mental disability” was too skewed towards the cabbage end.”

Cabbage, a wonderful expression to use to describe someone less fortunate than ourselves. But when does a person become a cabbage? The next question would be to ask if they have locked in syndrome? Are there degrees of being a cabbage? Should euthanasia be considered? If so, when? And how can we be sure we’re not administering euthanasia to someone who is locked in? How do we grade mental disability in a fair and constructive way? How do we integrate the disabled into society? The law states every child has a right to an education, even to the profoundly disabled. We can’t even properly diagnose some of these people so how are we do accurately evaluate their educational and developmental needs?

(Answers on a postcard to the World Health Organisation!)

“Does this affect the “value” of a person? I am not sure, to be honest. Lady T is more valuable than me (at least, she was) but then again she was truly outstanding. The other 99.999999999% of us are not more valuable than me. The question is – does it work the other way round? I’m afraid that is a very hard question to answer! Of course, you ad I are less valuable than Mrs. Thatcher – but is
anyone else less valuable than us? I truly have no idea.”

NO!!! That is an outrageous statement to make. The woman who single handedly destroyed a country’s coal and steel industry? How can she have more worth than anyone else? That woman managed to bring a new definition to the word hatred. It is a difficult task to say whether one person has more value than any other, but if that’s how you look at society, ‘I’m more valuable than him or her’, it must be a sad and strange life. I know and am confident of my own worth but don’t feel the need to compare myself with anyone else.

The disability angle is down to degrees as is the question of value or worth of any individual. The eminent neurosurgeon saves hundreds of lives during a career, but without someone to sterilize his instruments his patients would all die of infection. But how about the others, the radiographers, sonographers, nurses, cleaners, cooks, physios, OT’s, social workers and Uncle Tom Cobbley and all it wouldn’t even be worth him picking up the knife.

To some degree, we all depend on each other, and that means we all have value. If you want or need to quantify that value, you’re a better man than I am.

Apologies again if I have misinterpreted or misunderstood you, this is something that I am very passionate about and you can probably tell all this comes from the heart.

Regards,

kev35

RE: Eugenetics : the thread

Mongu,

“Of course mentally disabled people can enrich our lives. All I meant was that this is an individual thing; they are unlikely to contribute to society as a whole.”

But that’s the point, we are all individuals.

So now you are breaking society down into groups. Those with disabilities, those without. Those who abide by the law, those who break the law. Those who are wealthy, those who are not. Those who work, those who are unemployed. You can’t break things down to that level. You can’t say that those who are wealthy all contribute to society as a whole, there are those who don’t. It all comes back to individuality. No one group contributes as a whole.

I know a young autistic man who has found work consistent with his disability, he is a shelf stacker in a supermarket, but this work is consistent with the abilities that the disability has left him with. Ten years ago you wouldn’t have imagined this possible. He earns his money, pays his taxes and saves or spends the rest, just like anyone else. I think and believe all people with disabilities, no matter how profound, contribute to society. At the lowest level they provide employment for a team of carers, educators and support staff.

I always remember someone saying to me look past the disabilities and nurture what abilities are there.

But this has nothing to do with eugenics in the manner in which it was first envisaged.

Regards,

kev 35

RE: Eugenics

[updated:LAST EDITED ON 26-07-02 AT 10:07 AM (GMT)]Mongu,

Let me start by saying how sorry I am for your loss.

“I am still curious as to what exactly eugenics is.For instance, if parents have a designer baby (ie. preselection of attirubutes) is this a similar thing?”

Eugenics in the fashion that I am talking about was considered during the early part of the 20th Century and it was proposed that all people with mental disability in particular be segregated from society and even segregated by sex. This segregation was to bring to an end thepossibility of any child of the future having a mental disability. Hitler was taking it even further with the Aryan ideal of a race of pure humans.

“You could even stretch the argument a little with reference to selective breeding to achieve a desired result – like with race horses. Is this similar?”

In the broadest sense, yes it is. Sacrificing a foetus because it is likely to have ginger hair is disgusting and I don’t think we have any right to interfere.

“Kev, you mention that some disabled kids are remarkable. I
agree – my cousin was mentally disabled from birth, but he was a happy presence until he died in his mid 20’s. If they aren’t mentally disabled, they may even contribute something to society as a whole.”

AAAAARRRGGGHHHH!!! You were doing ok up till that last line. People with mental disabilities can enrich our lives just as much as someone who has no disabilities. A few years ago I took a group of kids on holiday to an outdoor activities centre. Several of the staff had learning disabilites but worked fine both in that environment and amongst society in general. In fact, one of the waitresses was leaving that week to work as a silver service waitress in a country house hotel. two years later I was told she had become a supervisor. So, obviously it depends on the degree of disability.

“But, what if your doctors told you and your pregnant wife that your child was going to be disabled – but that, hypothetically, you could alter his genetic basis to remove the disability. You might kill off a genius, or you might bring joy to someone eho otherwise would be at a disadvantage. What would you do??”

This is not in my opinion eugenics as such. Society deems we have a right as prospective parents to terminate a pregnancy if there is some kind of defect discovered. I’m not sure whether I agree with that or not. Rabie mentions amnioscentesis for prospective Down’s mothers and can in some cases offer a termination. All I can say is I have never met a person with Down’s syndrome who I believe should not take their rightful place in society. As for the prospect of terminating a foetus who is known to have serious disabilities then it is I suppose a matter of deciding how serious it has to be before they are viable.

“I appreciate that such personal stuff is a step removed from wholesale mass eugenics ala Hitler or Churchill. But the
morality sems vaguely similar.”

The similarity is only very vague. Nowadays we are looking at individuals on individual merits. Churchill was looking to segregate and incarcerate a whole element of society while Hitler preferred wholesale slaughter.

Haven’t we come a long way from ‘Euro bashing’?

Regards,

kev35

RE: Anti terror war-Isrealis style.

Skythe,

With the amount of force used in this incident you have to admit it was only to be expected that Israel would be condemned for it. With Israel having probably the most combat ready armed forces in the world and the success of your special forces in numerous operations, couldn’t this man have been targeted in a better way than this?

I’m not arguing against the legitimacy of this man’s assassination, just questioning whether it is now Israeli policy to use an anvil to crack a peanut?

Regards,

kev35