4th October 2016

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Matthew Syed - author of 'Black Box Thinking'
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In conversation with Roy Lilley
25th October 2016 - King's Fund - tickets here. Hurry they are whizzing out of the door!
Clap trap 
News and Comment from Roy Lilley
Stay away from Birmingham this week.  Aside from the recent town centre road works, that have turned cross town travel into a peacetime-war-zone, the Tory Party Conference has it in security lock-down.
Democracy comes at a price.  In this case the overtime bill, for the Old Bill, I'm guessing will be enough to fund the trading deficit of a small country.  

Of course, it will be another trading deficit that will be at the heart of conference discussion... ours.
When Osborne was the chancellor the Tory faithful clapped in agreement as he announced his austerity economics.  A balance by 2020 and a £10bn surplus.  Applause to the rafters.
He set about his task.  He couldn't borrow, he couldn't tax, so he cut.  Public services were shredded.  Still they clapped. 
Caught in the crossfire... the NHS.  A tiny increase, against overwhelming demand and dysfunctional social care got us to where we are now.  The faithful still clapped.
Waiting times shot through, just about every measure and yardstick going south.  Later this week expect some really bad news about cancer performance which will compound strikes, disaffection and general harrumph.
Expect Chancellor Hammond to position himself as far away from Osborne as possible.  It's a tricky proposition.  I judge the Tory conference to be in shock.  Listen for therapeutic clapping.
At the speed of light; EU changes underway, Cameron gone, grammar schools back, Johnson and Co in the spotlight, despite their Brexit lies.  They'll get a clap.
Teresa May (expect hysterical clapping at the mention of her name) going on holiday, no timetable, a likely plunge in the economy... the deficit at a £trillion-and-something and the future becoming more insecure. 
Still no clarity for the 1,00,000 plus NHS workers, who will be used as bargaining chips in the talks about who goes and who stays.  Immigration; Cue clapping.
By the time you read this Hammond will have had his day in the Birmingham spotlight.  Clap like crazy.
Tories don't know who to cheer, what to believe.  So they clap, faithfully.  You could forgive them for thinking they might have time warped back to the Labour Conference of 2010.  Tory economic policy is now Balls'.  More clapping.
How does this matter to health? 
I'll stick my neck out and say, in the Autumn Statement 23rd November; expect a bung for the NHS, to be used in conjunction with social care.  A winter warmer.  It's just a guess.  May be, deep down, I'm thinking 'guess enough' and it might happen. 
The difficulty in forecasting any 'what-might-be' is to assume anything might help.
Staffing.  Not enough nurses... austerity cuts to training budgets have got us to where we are now.  Dump nurse bursaries... more clapping.
Not enough doctors?  We have more than we have ever had... clap... but not enough to fill the gaps in the new rotas.  The strike has been won - nervous clapping, some of the Tory faithful will have children and grandchildren who are doctors...
The Tinkerman asks why we can't grow more of our own clinical staff.  Clap!  We can, but it takes time and money.
Seven day working.  A Tory crowd pleaser (off the scale on the conference clap-o-meter) but has anyone figured out how many more radiographers, pharmacists, porter's, physio's, OTs and the army of support services required?  The overtime bill will make the Brum Police costs look like small change.
The conference fringe, where the wanna-be's and the has-been's do their stuff will talk of NHS 'sustainability'... clap... new buzzword... vouchers and top-ups, draconian public health ideas and what-not.
They and the main speakers forget; conferences are all about trousers. You take your taxes from your right-hand pocket and co-payments from the left-hand pocket but it's still your trousers.  You still have to pay.
The real question; 'what do you want to pay for' is the only question that is never asked of conference audiences.  Democracy may come at a price but seldom are we asked if we are prepared to pay that price.
Conference is told what will happen and they clap.  Clap until it's not going to happen anymore, then they clap again.  Then, changes are announced and once again, they clap.  When someone says; forget all that... they clap again, until they are all clapped out.
Conference clap-trap.
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>>  Cost of patient falls - good stuff on the Academy.  NHSI are launching something or other about falls; here.  They should have aske the Academy!
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Factors influencing A&E attendances.
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Matthew Syed
Former Commonwealth Table Tennis Champion and author of Black Box Thinking

Half price tickets for IHM members
25th October
King's Fund
This is what I'm hearing;
if you know different,
tell me here
>>  I'm hearing - bad news on cancer numbers and outcomes imminent.
Dr Rodney Jones 
New Analysis
The Elephant in the Room and rising Emergency Admissions 
Need inspiration, a good idea or solve a problem
Dr Rodney Jones
More excellent analysis
This time the number of critical care beds.
Cuppa-builder's read.
Dr Sir Sam Everington
Barrister, doctor, leader.
In conversation with 
Roy Lilley
He was even a 'rough-sleeper' and charged with making fraudulent job applications to highlight discrimination.  The first medic on the scene after the 7/7 bombings.
This will be a really interesting evening.  Medico-politics, the future of Primary Care.
Tickets for IHM members half price.