Thursday, January 15, 2009

[barefoot doctors] primary health care


This was more than a little interesting about the state of medicine in China when the communists came to power on the backs of the peasantry:

With trained doctors in short supply, the central government in 1951 decided that basic healthcare in the countryside should be provided by health workers rather than by fully trained physicians. In 1957, there were more than 200,000 such "village doctors" whose administration was under the responsibility of the local authorities.

While these village doctors had received only basic training and could not treat complicated cases, their impact was considerable and especially so in preventing minor ills or wounds from developing into complex medical problems and in implementing nation-wide vaccination campaigns.

After the cultural revolution, they were allowed to upgrade to be local village doctors but then:

The rural health system started to collapse in the late 1970s and early 1980s as a result of China's economic liberalization and the privatization of agriculture ... many diseases that had been eradicated re-emerged in the countryside.

Primary care, even in the cities, is almost non-existent and with no independent doctors or neighborhood clinics, people have to go to hospitals even for simple healthcare needs.

With hospitals told to finance their own costs and 79% of the population having no health insurance, the burden on the average Chinese is considerable, with the result that many simply cannot afford any healthcare at all.

Primary care in the UK is eerily reminiscent of the Chinese situation:

The NHS inherited a maldistribution of resources, especially in London. where the main hospitals were concentrated in the centre of the city. London's lack of adequate primary care coverage and over-reliance on hospitals for treatment have created recurring problems.

The Labour government in the 1970s attempted to redress the balance by transferring resources from hospital care to primary care, limiting the growth of better served regions, and favouring the development of some underfunded specialties, like medicine for the elderly. This led to hospital closures. The policy was continued by the Conservatives in the 1980s.

As a person who doesn't use the health services [touch wood], I can't comment on how bad it is in the UK but it doesn't seem to be running much better than in China.

[restrategizing] this blog in the coming weeks

Many bloggers don't feel the need to explain but I'd prefer to, if only for the benefit of friends who check in here to see if things are all right.

I've been right in the middle, since last Friday, of the process of shifting house and a couple of job nibbles have come up, meaning train travel. The effect on the blog is unfortunate.

While I still have substantial internet access these few days, there'll be some posts of the kind readers know but more erratic this week. Sometime this weekend it's going to change and until BT or whoever give me a connection, it's going to be from the library for the hour they let you have. The new connection won't be for some weeks as there are other priorities like getting house things in, so this might even run up to my birthday.

Visiting fellow bloggers is going to be the main problem. Posts can be pre-prepared and put up in a couple of minutes but visits take time and my blogroll is long. My priority order is going to be to visit the most regularly interactive with this blog, mybloglog visitors, sitemeter referrals, Bloghounds and then the main and second lists. Aim is to get round to the latter once a week and the main people every day.

Can't see any other way to do it but at least the blog won't be dead.

[cheerful news] if you're a favoured bank

This was interesting to me on the personal level:

Bank of America (BAC.N) is close to receiving billions of dollars of support from the U.S. government as it tries to digest Merrill Lynch, the investment bank and brokerage it bought on January 1. Merrill has billions in troubled assets -- ranging from commercial real estate to subprime mortgages -- that suffered during the brutal fourth quarter.

Isn't that nice? So now the taxpayer over there is expected to shell out for some takeover, merger or other corporate move its directors decide on. The bank can move with impunity, knowing they're going to be "bailed out" along the way.

It would be nice to have a business where the government takes such a kindly interest in my welfare rather than slug me for every dollar/pound they can get their hands on.

And what of Mandy's £20bn? Favoured sons, eh?

By the way, the "personal level" was referring to when I went for a position and we were assured that BOA was the safest bank in the world. Is that right? Doesn't need a bailout then, does it?

Wednesday, January 14, 2009

[ambience] would you wander around central town at night

Should be rocking - instead, nothing


The bulk of the day was spent in town and it brought some things home with a vengeance.

The area is well planned. We have Asda, Tesco, Aldi and carparking space for anyone. The arcade is sane, with shops people would actually want to buy from and the sprinkling of coffee concessions are enough. Asda has a nice caf too.

On the other side of the complex are the high street banks, solicitors, estate agents and so on. And don't forget the market and other supermarkets. Truly, anything you need is in here and not at an exorbitant price. It's not spread out but contained within a walkable distance. It really feels nice in there during the day.

So it all looks roses, yes?

Well, on paper, maybe. What is not immediately apparent though is that the council, in wanting to become local letting agents and landlords, have shrunk the market area and dictate what can and can't be sold, have exorbitant pay and display parking fees and avid parking officers who jump at writing tickets to slug the motorist crazy enough to venture into the shopping area.

My mate said that the market area used to be far bigger but the council couldn't control that completely so all market stalls were brought within a purpose built barn area, complete with those metal roller garage doors which come clattering down at 6 p.m. on the dot and open again at 9 the next morning. The area is dead between those hours.

No one wants to park there during the day, especially with a shopping park not so far away with free parking, no one wants to have the doors closed on them late afternoon and there is nothing but Asda to take you into the centre of town in the evening. Asda apparently begged the council not to charge for parking but the council weren't interested - there were pound signs in the eyes.

I wandered through the market last Friday, the day when they get their greatest number of people and the main stalls at the front with the food concessions etc. were lightly visited but the stalls further towards the back, which cost £30 a day - they were totally empty. Not a sausage. Apparently the by-laws and fees have surgically incised any desire on any potential vendor's part to sell what you're told you may in that place.

It's estimated that it is not the economic crisis, it is council action and Gordo's laws which have resulted in only about 60% of the projected numbers visiting the centre of town, the council therefore making a substantial loss and having made it, refusing to change its policy, believing that better times are round the corner.

Russia

I'm hesitant to put the Russkies up as a positive comparison, as much of what they touch turns to ashes but compare the two approaches in this.

In our town in Russia, Moscow money came in and wanted to set up a complex, a shopping village. All right, they built an Imax, various other things and then the main shopping centre on two stories, very modest. So, late evening, being a bit bored with tele at home, you could, for example, take your car down there, park for free and approach this broad brass and glass entrance way.

Immediately inside, on the left, is a giant DVD, CD and video lending and buying shop. On the right is a Japanese sushi bar which has international cuisine, graded from an excusive part to the cafe type part. Further along the ceramic tiled foyer are the fast food concessions, including pizza, tables and chairs, a two cinema area with the latest releases, ten pin bowling, a bar, a coffee shop and a late night supermarket. Up the stairs are the boutiques and flea markets.

The place is warm and welcoming and not only that, it has the main hockey stadium and skating rink nearby and is served by a four laned road bridge from the other side of town. The place rocks.

Now I come back to our town over here. For what, apart from taking the car to the chippy and back, would anyone want to go down there at night for? For what would you want to stroll about with your better half? Where are the shop windows to look in, with their inventive displays? Where are the early evening kids amusement places?

Where's the ambience? There's about as much ambience as a caravan park or an airport.

And why is this so? Because the people in charge, who make the rules about who can be where and what they can sell are local government, not businessmen, not entrepeneurs. Why, oh why, are these people in charge?

[litter] a symptom of deeper issues


Not sure if reducing litter and graffiti reduce serious crime but IMHO, there is a correlation between rubbish on the streets, graffiti and a sick society, at least at the micro-level.

Of course many are sick of it and want campaigns like this:

Keep Britain Tidy have launched a renewed campaign to clean up the UK's dirty streets to coincide with the first anti-litter act exactly 50 years ago to this month. It aims to restore a sense of community pride and encourage everyone to clean up their patch. Across the nation, community groups, schools and businesses have pledged support. It's hoped more than 10,000 clean-ups will take place and half a million bags of litter collected.

It's not just the rotting fish head effect which leads to the conclusion that "a sense of civic pride is doomed", i.e. if the head's rotten, the rest follows suit. It's also people's change in values over the past two generations, since the 50s. This blog has consistently maintained that the Christian ethic was certainly not followed in past decades but at least it existed and kids at least knew about the sermon on the mount and the ideals they were supposed to live up to.

The gospels have no monopoly on charity and kindness but they were a major force in limiting people's excesses on a day to day basis in this society. Someone said to me yesterday: "If you found a million pounds on the street, would you hand it in?"

Today - I'm not so sure. If you did, you're likely to be subject to investigation, acquire a police record and will be under surveillance from there on in. You'd not get any reward for your altruism. In the late 60s, I'd probably have handed it in and something nice might have come from that act.

You can't expect people to act with dignity if they're robbed of it but this is a two way street. Whilst the government's policies have been criminally negligent, the societal attitude of "why should I work when no one cares and I'm drawing tax-payer's money to keep me in this lifestyle" is equally culpable.

Just removing benefits is not going to achieve anything other than starvation in the short term. It certainly was the case five years back that you could have found work if you really tried, if you retrained but that is not the case now. Even with your worthless NVQ, there are 500 applicants for every position you go for.

Frankly, I find it galling to hear politicians and civic groups calling for civic pride, as if it is something which exists outside of the context of society. It's the same, to me, as that annoying song "don't worry, be happy", sung to someone who's just lost his job. In that glib cliche is lack of understanding and lack of caring.

The permanent and cynically unemployed underclass, including many single mothers and Rab C Nesbitts who consider society should be supporting them is also balanced by a new class of people today really wanting the dignity of their skills set recognized but literally unable to get anyone to take them on.

Mandelson's £20bn to stop businesses going to the wall should have been injected years back when there was still some real money in the economy. £5mn is a small business? This is just a cynical ploy for the collapsing infrastructure of medium and large business. Small entrepeneurship is already dead in the water.

Step One - get these bstds out. Step Two - Cameron gets rid of adversarial politics and creates an assembly style legislature, with him at the top if he likes [for now]. Step Three - cut the crippling taxes but at the same time educate people that their lifestyle is going to change, to contract, in line with their real incomes.

[from russia with love] on the ground today


Report just in from Russia through friends and the dollar looks to be 31,56 [artificially held], there's snow on the ground and the mood is depressed. The Ukraine/Russia thing seems to be the fault of both, according to my sources.

Local issue - the mad plan for closing bridges and rerouting traffic through the remaining two arteries into the city seems to have been dropped for lack of money so the crisis does have a silver lining. My favourite trams are almost phased out in favour of the soulless buses. Big stores [equivalent to Asda] are doing well but lesser stores not.

There's a lot of business going on at the upper levels but they're trying to prevent a repetition of the payments crisis and no one wants to return to the bad old days. People are digging in and hoping to keep their jobs.

So, not a lot different to over here in Britain, it seems.

Tuesday, January 13, 2009

[boycott] one of the few legal weapons


There's a lesson in this for Britain and the U.S.

Thousands of motorists have fled the Sydney Harbour Bridge after its cash booths were removed last weekend [choosing] to find alternative routes into the city after the Harbour Bridge moved to fully electronic tolling on Sunday, Roads and Traffic Authority figures reveal. Road experts say it is because many motorists have refused to buy an electronic tag, and, in the short term, the trend is likely to worsen.

There are very few specific ways for citizens to show great displeasure with the tag and control society in all three countries but the Aussies at least have one now where they can show their feelings. It will be interesting whether boycotts also start in Britain on the more iniquitous new laws and procedures.

[polo lingo] the art of the puerile

"Ugggggh!"

"Take that, Sooty."

[black cap] better on the head

You know those very weird moments when you lose something and it turns up in a completely unexpected place?

Just happened.

We went shopping and stopped off for chish 'n fips and I took off my black cap in the chippie and put it in my pocket but realized it was a bit loose in there. Never mind. Got back in the car with the packets and away we went. Back home, we unloaded the car, put everything away and made ready to watch a film.

I took the jacket off and put it on the chair and that's when I realized the cap had gone. I checked the pocket it had been in, checked the other, checked inside the jacket, checked outside and followed the trail back to the car, checked inside the car where I'd been - nothing.

Not a sausage. Deep gloom.

That cap has a history. It's been with me in Russia for over a decade, to many other countries and it has a history of being lost and turning up in very strange places. It was lost in Sicily last time and turned up on a stone wall.

After the film now, I was made an offer - you want to go down to the shop again - it might be in the gutter, the cap. Nah, it'll be gone. No, let's go. OK, went to put my jacket on and the cap was in the end of the sleeve.

Go figure.

Monday, January 12, 2009

[popularity] the fickleness of a nation

Unpopularity

When you're out of favour, you're really out of favour.

Former PM John Howard lost his seat as well as the election for the party. Then came the Barack Obama tiff over Blair House.

Now it's a flight of passengers angry that they had to wait because John Howard was on the flight. I think this is completely unfair on the man. Australians made their feelings known at the election but that's no reason not to accord a former PM, of whichever party, the dignity of ordinary protocols.

There is a military protocol that when you salute, you are not saluting the man, you're saluting the rank and the station. It should be the same here.

This is not to say he should be accorded personal respect - I think he should - but he should be accorded dignity, just as all should be according to their roles and achievements.

PC madness

In Oz, "the reign of exclusive clubs offering men-only admission to their influential ranks may soon be over. Victoria's Attorney-General, Rob Hulls, has signalled he would favour putting an end to protections that allow private clubs to be excluded from equal opportunity laws."

Can you imagine one of those feminist covens at seats of higher learning, where they decide which texts to rewrite next, being enforced under that law? Equal opportunities is one of the most abused laws in Britain and Australia and it's in the hands of entirely the wrong people to "positively discriminate" towards the wrong people and against the indigenous citizen.

Look, if I want to be in a club for all men or if a ladyfriend wants an all girl club membership, then why the hell not? What business is it of government?

Housekeeping

I don't want to run a separate post but I'm looking to close the deal on a house tomorrow and that's taking time. There are many negatives such as it being a long way out of town and in the middle of ongoing building around the area plus some other down things. What it does have is a good sea view, is new and it's quite snug.