Severe Weather - not really

For some reason the British cannot get it into their heads that the cold spell that we have been experiencing recently is not severe weather. In my past career I have spent a lot of time visiting countries that are a lot colder; where even minus 20 degrees Celsius is not regarded as severe and everything keeps running. In the south east of England and the rest of southern Britain day time temperatures rarely stay below freezing, but as soon as there is even a minor cold spell travel chaos results. Last year I was working in Hamburg during the winter and it was far colder than in the south of the UK and there was deeper snow. The Airport and roads were kept open and the trains still ran on time. What was particularly impressive was the way they kept the overground trains running when they they were using exactly the same electric third rail system as south eastern trains UK. If the German railway engineers can keep their system running then why can't the British?
This year during the cold spell we have been treated to television pictures of our European neighbours struggling to keep their public services running as if their struggles and failures are an excuse for our own. The trouble is the services, in Europe, only start to fall apart when there is exceptionally deep snow and temperatures fall below minus 20 degrees C in the day time; otherwise they can keep them going. The television also reports deaths on the street of the Ukraine but this only happens when temperatures really plummet. If Britain were to experience temperatures of minus 38 degrees C, there would be a complete catastrophe with hundreds of thousands dying as every home froze up. The rescue services would be unable to respond because their vehicles could not start and all the roads would be blocked.
During this "severe cold spell" the Met Office has given us at least a week's warning of cold but dry weather but then followed by at most ten centimetres of snow. During that period we have had ample time to put salt on all of the roads and the pavements. This salt would not have been washed away and we would have been ready for the cold snap. Equally the railways could have been better prepared. This did not happen. What happened during this time? There was nothing happening. The worst plan of all was for Heathrow airport to admit complete defeat by cancelling a third of their flights before a single snow flake fell. All the snow fell during the night when flights are banned anyway. The weather forecasts were correct, why could Heathrow airport not keep the snow ploughs running during the night? We all know the answer. There is defeatist management. There is a desperate air of decadence and a lack of management vitality. The attitude is to issue an upbeat press release rather than do something.
No doubt the government could instruct the private and public services to improve their act but why should they have to? We are not a state that should be run by diktat so private and public service suppliers should live up to their responsibilities which their counterparts, in often poorer, European states seem to manage when the thermometer strikes just zero.

Climate Change Again

I regret to say this but the message about man made climate change is not getting through. I recently had a conversation with a gentleman in a restaurant who simply did not believe that mankind could have any effect on the environment let alone an adverse one. He believed that nature was much more powerful than mankind that that the rise in the temperatures and increase in the concentration of carbon dioxide in the air was all caused by nature. Of course he was correct that the rest of nature is and always will be more powerful than mankind. We are after all part of a whole. He could not accept my argument that the present composition of the atmosphere was substantially altered in pre-cambrian times when cyano-bacteria produced substantial quantities of oxygen which lead the way to the rapid increase in oxygen breathing animals and plants on the the earth. He also did not believe that the during the carboniferous period the earth's atmosphere was also altered by substantial plant growth to produce an atmosphere which had a concentration of oxygen much higher than today. It was, as if, he believed there was a disconnection between the activities of plants and animals and the geological conditions of the planet. He also felt that there was a complete disconnection between mankind and other forms of animals and plants and that none of our activities could affect nature. When I put forward the view that the rest of nature had taken millions of years to affect the composition of the atmosphere but that man himself had suddenly, and in the course of a couple of hundred years, increased the level of carbon dioxide to dangerous levels he was non-plussed. He would not concede that we were upsetting the equilibrium of the atmosphere such that we are about to arrive at a tipping point and set in motion dangerous climate change. The message had not got through despite all of the publicity and documentaries on television about climate change. Amongst most of my friends, there is still doubt or mild scepticism about man made climate change and the message has not got through to them. These attitudes are probably dangerous and the future health of the human species will be put into jeopardy if there is not a change of opinion. There are plenty of documentaries on television which are explaining the science but of course they have to compete with the X-Factor. My colleague in the restaurant was right as nature is more powerful than us but we are not supernatural beings which are immune to the influence of nature. If we trigger off dangerous "natural" climate change will will suffer along with many other species. Nature does not care about us and will be immune to our suffering. Life will prevail on the planet for many millions of years longer but it us up to us, as well as nature, to decide whether we shall be part of that survival or not. The choice is ours: is it X-factor or science?

Doctors recommendations

These days the medical profession can hardly keep out of the news. A lot of this news is bad for the general population.

Doctors have changed their advice for middle aged people to take aspirin every day to reduce their chances of a heart attack. They now believe that the doubtful benefit of a reduced chance of a heart attack is more than offset by the dangers of internal bleeding in the stomach and brain. I never believed this advice and ignored it. All medical advice should be given based on sound evidence. It should also be given in light of the individual circumstances of the patient. No-one should be advised to take medication unless there is clear evidence that it will work and that the side effects are not dangerous. There is a lesson to be learnt here.

Some hospitals in Hertfordshire , England, have said that they will not perform operations on patients who smoke or who are grossly overweight. I was of the view that the medical profession is morally obliged to treat anyone who is ill despite their personal circumstances. We could be on the slippery slope here, with doctors refusing to treat people who injure themselves during risky pastimes. They might even refuse to treat children who fall out of trees. The whole of society contributes to the education and employment of doctors so, surely, every one is entitled to medical treatment in an emergency. There should be no room for this sort of arrogance from some elements of the medical profession.

The situation regarding breast implants or breast augmentation is egregious. I do not doubt the need for breast implants for women who have had breasts removed because of cancer. Some women are genuinely psychologically disturbed by the appearance of their breasts and should be treated with an implant. Unfortunately, most women who have had breast implants have done so for purely cosmetic or vanity reasons. This latter category have been misadvised and should not have been operated on in the first place. It is my view that doctors should not perform unnecessary operations as it is simply a waste of resources combined with the risk to the "patient". From some of my conversations with friends, there seems to be very little sympathy for women who paid for breast operations for cosmetic reasons. These women deserve to be treated, however, and should have their bodies restored to an acceptable and healthy condition. They should not be left untreated if they cannot afford restorative treatment. The cosmetic surgery industry and their insurance companies should pay for this and where this is not possible the NHS should pay.

In conclusion, no one under any circumstances should be denied health care. Some people now are suffering from internal bleeding as they have foolishly followed the advice and taken aspirin on a long term basis. Some people cannot avoid being grossly overweight despite the blandishments of the authorities to eat less and exercise more. Some alcoholics and smokers are simply addicted and find their addiction extremely hard to control. Should they be denied health care? The worst case is the breast implant problem, as many of these operations were performed purely for profit and without concern for the mental and physical health of the clients. You are entitled to health care even if you have been foolish. You are even more entitled to sound advice regarding the dangers of all forms of cosmetic surgery. Where a cosmetic treatment is unnecessary the medical profession should be obliged not to treat you.

Global Warming

Scientists have made an alarming discovery in the East Siberian Arctic Shelf. There are plumes of methane bubbling up through the shallow sea and this potent greenhouse gas is being injected directly into the atmosphere. In an area of just ten thousand square miles, one hundred "fountains of methane" have been discovered and some of them are over a kilometre across. Why should we worry? Methane is a much more powerful green house gas than carbon dioxide and over a hundred year period it is twenty times more powerful in its effect. There are literally hundreds of millions of tons of methane stored on the Eat Siberian Arctic Shelf bed alone. This is stored as methane hydrate under high pressure and low temperatures at the bottom of the sea. Global warming in the Arctic has been a lot stronger than the rest of the planet. The warming causes these hydrates to release their methane.

In the Arctic region in general there are billions of tons of methane hydrates stored on the sea bed. If, even a small proportion of this gas is injected into the atmosphere it could cause catastrophic warming by means of a positive feedback mechanism. More warming causes more melting of the methane hydrates which causes more warming yet again.

We have all been warned that excessive man made emissions of carbon dioxide are warming the planet to possibly dangerous levels. Some earth scientists such as James Lovelock believe that we have set in train irreversible consequences regarding the dangerous warming of the planet. Let us hope he is proved wrong. We need to do something to prevent the injection of billions of tons of methane into the atmosphere at all costs. A climate change agreement and treaty is badly needed.

BBC and Frozen Planet

The BBC has been criticised for "deceiving" its Frozen Planet audience. the documentary has lead its viewers to believe that its film of a female polar bear with her cubs, just after giving birth in there den, was filmed in the Arctic snows, when in fact it was filmed in a zoo in Amsterdam. For me this is an acceptable "deception" as the scene was included for illustration purposes. Why disturb a polar bear and her family in the wild? Provided all of the factual information is correct for me it is not a problem. I am sure that all wild life documentaries are to a certain extent stage managed, they have to be for continuity purposes.

Viewers of television programmes should beware though, as all programmes are to a certain extent stage managed even science programmes and the news.

There really is no such thing as "reality" television: it has been faked and the audience is being duped. You are better off not watching such rubbish.

Egypt Again

The Egyptian people are urbane and civilised. They deserve to be masters of their own destiny and be allowed to elect their own government. This is not just a luxury: it is their right. It is their right to decide how their country will be run and to vote for a new constitution. They have had to experience much deprivation, unfair arrest and violence to get this far. Let us hope there will be a peaceful resolution to their predicament and that the army cedes power to a democratic government which is elected fairly. The country can then be led to social justice and prosperity.This will not just benefit Egypt but also every other nation in North Africa and eventually the Middle East.

Zero based budget for care of the elderly

There has been much furore in the press recently about the standard of care given to the very elderly and infirm in the UK. Much criticism levelled at care workers who do not spend enough time with the aged or the infirm. Some of this criticism may be justified as the "care industry" probably employs people who just do not care and it probably has its fair share of employees who simply are criminal. Most "care workers" are probably trying to do their best under difficult working conditions.

This morning I saw a "care worker " being interviewed on television; she was obviously sympathetic towards those who she looked after. But, she explained that she was paid £2.76 per hour for the time that she spent at the patient's home only, and she was not fully compensated for the travelling time and expense when moving from one patient to another. She also averred that she was given very little time to spend with each patient and that in fact the time allocated, in many cases, was insufficient to provide an adequate service.

I suggest that the pay is inadequate for the importance and pressure of the work.

A representative of the United Kingdom Homecare Association Ltd (UKHCA) was also interviewed . He intimated that the budget allocated by the local authorities was probably insufficient to meet all the demands of home care placed on UKHCA members.

The problems are caused not just by budgetary constraints but problems of morale. The carers are expected to perform work without sufficient time allocated to complete their job to the standard expected. No wonder there is low morale given the poor pay.

There is a case for applying the techniques of scientific management to the work of carers and not just allocating work within a budgetary constraint. This just encourages bad management and the arbitrary allocation of work based on a whim and desire rather than facts from the ground. It also encourages a bureaucratic mentality of inefficiency and ineffectiveness. The aged and the infirm deserve better than this. They need to be looked after by well motivated staff who really care about them and who have the time and resources to do a proper job.

A quality standard should be set. There should then be a fair amount of time allocated for each caring task to be completed. The carer should be allowed a fair amount of time to move from one patient to another. A contingency time should be added to take account of difficulties.
Sufficient redundancy should be built into the system to allow for sickness or staff absence.
The staff should be paid a fair rate for the job and this fair rate should be independently assessed. Staff should be interviewed and selected by assessing their personality and attitude towards the aged and the infirm. From this the number of staff needed to provide a high quality service "manned" by dedicated staff ,who really care about the patients, should be calculated.

From this calculation, a budget should be built up from a zero base to include not just the direct staff costs but also the cost of administration. I suspect that this cost would be substantially higher than the budgets allocated from on high by the council and the government.

The public should be made aware of the real budget required to provide the high quality service which is expected.

A similar process of zero based budgeting should be applied to all our key services: health, the police, the army etc.

Once the budget is prepared it should be made public. The public will probably be shocked how much it costs to provide these services. But scientific management, if used effectively, could ensure optimum productivity based on facts and not just on the whim of accountants and bureaucrats wielding spreadsheets and making arbitrary decisions about "service delivery" .

The public could then make a decision of how services are delivered and at what quality level and how this is to be financed through the balance of taxation and borrowing. If we want very high levels of quality for health care, care for the elderly or policing etc. then we have to pay for it. We may have to do this at the expense of a new car or a new PC every year.

The very idea of setting a budget before the cost of job that needs to be done is calculated is anathema to good management. No wonder the care of the elderly and infirm is in such a mess. No amount of inspection or public relations statements will cure this problem. Only hard headed decision making based on the facts will go anywhere near to resolving such difficulties.

The public must make a hard choice. Are we prepared to pay the full cost for the services which we demand or do we want to pay less money for a reduced service? How is this to be financed - by charges, taxes or borrowing or a mix? Are we prepared to sacrifice the consumption of consumer goods for improved public service when budgets are stretched? It is our choice and we can only expect our politicians to follow our lead on this issue.