Showing posts with label doctors' practices. Show all posts
Showing posts with label doctors' practices. Show all posts

26 September 2009

Week 40.09

Tendring Topics………on line

A Small New Friend


I have been delighted to learn, at first by text message at 5.30 a.m. a fortnight or so ago, and more recently by snail-mail, of the arrival in Zittau, Germany, of a tiny new member of the family of my friends Kornelia (Konnie) and Andreas Kulke. He is Tom Friedrich Kulke and was born on 1st September weighing, so I have been told, 3720 grammes. That is nearly three and three quarters kilos and must be round about 8 lbs. A pretty good weight, I would say.

In the picture he has closed his eyes and appears to be counting his fingers. They are all there…..all ten of them! He looks very pleased with himself, and he has reason to be, because he has been born into one of the nicest families I know. My daughter-in-law, who is not given to fulsome flattery, said of his Mum, ‘I can’t imagine her ever raising her voice in anger’. His Dad, Grandma and Auntie Ingrid, my good friend for many years now, are equally warm, generous and loving.

Below is big sister Maja, taken just a year ago on her second birthday. She is holding a greetings card from Pete, Arlene and myself and is probably thinking; ‘I can’t read German yet….and they send me a card in English!’

She tells me (through her Mum as an interpreter) that he can’t play with her yet, but he can sit on her lap. I realize that I missed a lot by not having a big sister.













The Death of a Thousand Cuts

With an election in the no-longer-distant future it is a little disquieting to find that ‘cuts’; cuts in public services, cuts in state benefits, cuts in pensions, cuts in health and education budgets, feature prominently in the pre-election speeches of leading politicians. The only cut of which we can feel there is little possibility is a cut in taxation.

It would be nice to be able to say that they aren’t necessary, but they are. The financial crisis resulted in the government having to plough millions of pounds of borrowed money into coffers that had been emptied by the folly and greed of their custodians. It has to be paid back. That, I think, is common ground. The question is, how is that burden of debt to be shared?

I would like to see, though I think it improbable that I will, the burden spread fairly across every stratum of society. Cutting the services that spell the difference between civilisation and barbarism disproportionately penalises the less well off. Cutting the national health, the education and the social services budgets doesn’t bother the wealthy in the least. They can buy their health care and the best education for their children, and they certainly never need to avail themselves of any of the social services.

They do, of course, have rather more to be stolen or vandalised than the rest of us so I don’t imagine they would be in favour of any proposed economies or down-sizing of the police force.

One substantial cut that could and should be made is disposing of, or at least declining to renew, our Trident nuclear deterrent. The ownership of nuclear weapons hasn’t yet succeeded in deterring anyone who was actually attacking us. It didn’t prevent our Turkish NATO allies from invading the Commonwealth island of Cyprus. It didn’t deter the Argentinians from invading the Falklands. It didn’t deter the Iraqis from invading Kuwait. It certainly didn’t deter the IRA or El Quaida, nor does it in any way deter the Taliban! If some other country, Iran or North Korea perhaps, should threaten ‘the west’ with nuclear weapons I am sure that there will be enough in other hands to provide Mutually Assured Destruction (M.A.D), which is really all that these weapons can offer. The Prime Minister is now talking about dispensing with one of our four Trident submarines. Well, I suppose that a quarter of a loaf is better than no bread……..but it’s not all that much better!

No politician has so far mentioned the dreaded word ‘taxation’ yet surely taxation will have to be increased. To make sure that its burden is evenly shared, our rulers should concentrate on income tax. I pay what is for me a substantial sum in income tax every year. I don’t enjoy doing so but I count myself lucky. The incomes of many thousands are too low to be eligible for tax. I wouldn’t want to have to live on such an income.

In considering income tax rises the Government should also raise the upper rates so that the seriously wealthy have to pay as large a proportion of their income as the rest of us. At the same time they should close securely those loopholes in the law by which clever lawyers and accountants can arrange for their wealthy masters to avoid (not, of course, evade – that is illegal!) payment of the taxes for which the rest of us are liable.

By its very nature it is only those who can afford to pay income tax have to do so. The same cannot be said about indirect taxation, now loved by both the main political parties but called ‘stealth taxes’ by the opposition.

I deeply resent when paying for a repair or improvement to my home, to have to pay a substantial sum of VAT for the privilege of having it done. I resent having a sum added to my insurance premiums (like a compulsory tip for bad service!) to pay the relatively new insurance tax. I heard it said during the Thatcher years that the great thing about indirect taxes was that they offered ‘freedom of choice’. If you didn’t buy the object or service you didn’t have to pay it.

The householder faced with water pouring through a hole in his roof doesn’t have a great deal of choice about getting it repaired. Neither does the motorist, or the cyclist, who relies on his machine to get to work, have much choice about taking it to the garage or work shop when something goes wrong.

I have heard many explanations of the cause of today’s economic situation. One thing is certain; it wasn’t caused by the indolence or cupidity of the poor. Yet I suspect that it will be the poor who will have to suffer most before the situation improves. Last week, in my references to songs popular with the troops in World War II, I didn’t mention ‘She was poor, but she was honest, Victim of a rich man’s whim,’ a long and lugubrious Victorian ballad of which few of us knew all the verses. We all knew the last one though, and sang it with gusto;

It’s the rich wot gets the pleasure,
It’s the poor wot gets the blame.
It’s the same, the ‘ole world over,
Isn’t it a bloomin’ shame!

And so it still is!

The Cost of University Education

Did you hear the spokesmen for the CBI (Confederation of British Industry – the voice of the employers) giving us, on tv, their views on University Education? They are quite straight-forward……tuition fees should go up, student loans should be subject to interest, and there should be fewer and smaller financial grants for students.

It always gets under my skin when I hear the middle aged, be they politicians or captains of industry, urging that heavier financial burdens should be placed on students’ shoulders, or even that the existing ones should be maintained. Those who are themselves graduates, know perfectly well that when they were students there were no tuition fees and there were generous though means-tested maintenance grants for those who needed them.

‘Pull the ladder away Jack ….I’ve reached the top!’ seems to be their motto!

There were, of course, a lot fewer university students in their day, so the burden of their tuition and maintenance was more easily coped with. I think that reduction of the number of these students might help provide a solution. The suggestion that fifty percent of school leavers should go to University has always seems to me to absurd.

Why, I wonder, is intellectual attainment treated so very differently from its physical counterpart? No one expects half of us, or very many people at all, to merit training to Olympic or international standards, in any athletic or team sport. Only the very best of the best need apply, and nobody thinks that that is unreasonable. To suggest anything similar for university selection would be to invite denunciations of blatant elitism! It really is possible to have a satisfying and well-rewarded career, and to live a happy and fulfilled life, without being able to write B.A or B.Sc. after your name. Nor, believe me, need those who can’t feel inferior.

Did you know that, every year for the past five years, no less than twenty-two students out of every one hundred selected, have ‘dropped out’ of University without ever completing their courses, despite millions of pounds having been spent by the government in attempts to retain them? These were students who should clearly never have been selected. How much money might have been saved, and how much bitter disappointment and despair might have been avoided, had their unsuitability been spotted during the selection process! Preventing the selection of potential drop-outs would subtract a worth-while sum from the total University Budget.

This is surely one avenue that should be explored before we start discouraging the applications of possibly brilliant students by burdening them with an even larger burden of debt.

An Indian Summer

We are experiencing an Indian Summer as I type these words. Whether it will still be with us when in a few days, I post them onto my blog, remains to be seen.

I had always imagined that the expression had been brought to England by returning Sahibs and Memsahibs, not to mention common squaddies, from the Indian subcontinent. Some years ago though, visiting friends from rural New York State assured my wife and I that it had American, and more sinister, origins.

Early settlers in New England had built wooden defensive stockades round their settlements, cut down the trees and cleared the undergrowth for a few hundred yards from the stockades.

Warm sunny days in late September and early October brought heavy morning mists over the forests of North America. Native Indians, tomahawks and scalping knives at the ready, could creep under cover of the mist right up to the stockade…and be up and over it before the alarm could be raised. In those days it wasn’t a case of ‘Don’t throw away the sun cream and the eye shades’, but ‘make sure your musket is ready’ when there was an Indian Summer……….. or should we perhaps now, in the interests of political correctness, rename it ‘A Native American Summer’?

19 September 2009

Week 39.09

Tendring Topics…….on Line

Unhealthy Tendring – are we oldies to blame again?

Not so long ago it was we oldies who were ‘skewing’ the statistics of educational achievement in the Tendring District. We hadn’t the paper educational qualifications of the younger generation (not even a couple of GCSEs at ‘E’ level!) and we were making the rest of the population appear more ignorant than they were. Be that as it may, I’d back an average team of over sixties to beat any similar team of teenagers-to-thirties in any General Knowledge quiz that wasn’t concerned solely with sport, pop music or ‘celebrities’!

Now we’re affecting the district’s health statistics. You may think, as I do, that the Tendring District and, in particular the holiday coast, is an exceptionally healthy area in which to live. There is little industrial pollution, weather conditions are rarely if ever extreme. We have the lowest average rainfall in England, and fresh air blowing in continuously from the sea. Clacton’s holiday publicity used to claim ‘Champagne air, Rainfall rare’. For what more could one ask?

However, a report by the British Heart Foundation reveals that more people in the Tendring District die of heart attacks than in any other part of Essex. Every year an average of 320 people in the district die following a heart attack. Neighbouring Colchester does better than us with only 203 deaths from the same cause each year.

Dr Nick Robinson, consultant cardiologist for the Essex Cardiac and Stroke Network is reported as saying, ‘Compared to other areas of Essex, Tendring has a much older population and heart attacks are more common in older people. The other reason is, that Tendring is more deprived than other areas of Essex, in terms of income and education’. Education again!……..Dr Robinson seems convinced that it is we poverty-stricken, uneducated and ignorant old pensioners who are casting a shadow over the County’s health statistics. In that connection may an ignorant old octogenarian point out that ‘compared with’ rather than ‘compared to’ is correct English usage

I hope that Dr Robinson will give the matter a little further thought. Has he, for instance, ever wondered why the Tendring District has a much older population than other parts of Essex. Couldn’t it be because we are a lot healthier than other areas? We natives (as a resident for fifty-four years I surely count as one) live longer because of that, and people from elsewhere, shrewd enough to know a good thing when they see one, move here because they believe that living in the Tendring District will probably ensure them a longer and healthier retirement.

No-one, as Dr Robinson has surely noticed, lives for ever. Tendring folk tend to die of heart attacks in their old age because previously they have successfully avoided or resisted other, often much more unpleasant, causes of death. I can imagine many worse ways of departing this life than having one’s heart stop beating while dozing in a favourite armchair. Yes, I’m well aware that not all heart attacks are like that……but we can always hope!

Is Tendring, as Dr Robinson also suggests, ‘more deprived than other areas of Essex?’ Remarks like that make me wonder if he has ever actually been here. There certainly are areas of deprivation in our district, as in any area of comparable size. I don’t think though that a visitor, driving through our countryside and our town centres, feels that he is passing through scenes of poverty and deprivation.

Less than a fortnight ago my son and daughter-in-law from Enfield, visiting me here is Clacton, remarked how prosperous and ‘regenerated’ Clacton was beginning to look, compared with some other areas with which they were familiar.

Possibly, because of the high proportion of pensioners who live here, our average income is below the national, or even the county average. The incomes of most pensioners are quite low. This doesn’t necessarily mean that we’re all living in desperate poverty. Some undoubtedly are, and I wouldn’t for one moment make light of their difficulties. They need every penny of help that they can get.

It should be remembered though, that living comfortably within one’s means depends upon outgoings as well as income. Many of us have long ago paid off our mortgages. We have no dependents and no debts. We don’t have to pay for NHS prescriptions, for bus journeys or for tv licences. Once we have made it to eighty we don’t even have to pay for our passports for travel abroad – a concession for which I have been very grateful. The fact that our actual income may be low doesn’t necessarily mean that we have a struggle for survival.

I suggest that the average age at death would be a much more reliable indicator of the general health of a district than which of a number of natural causes was most frequently responsible. None of us can hope to evade for ever the attentions of the grim reaper. I think though that in the Tendring District we manage to avoid him for rather longer than most.

I’d like Dr Robinson to come to the Tendring peninsula and have a look round. If he’s hoping for a happy and healthy professional life followed by a long and comfortable retirement, he could do a lot worse than settle here.

No more doctors’ catchment areas?

There are not all that many areas of policy in which all three main political parties find themselves in agreement. One, it appears, is that doctors’ catchment areas should be abolished, and that we should all have freedom to make our own choice of the medical practice with which we wish to be registered, no matter where it may be.

It sounds a splendid idea and there seems little doubt that it will become law in the near future. How will it work though? Do you remember when they abolished catchment areas for secondary schools and said that all parents would have the right to send their children to the school of their own choice? Those schools that were considered to be ‘good’ were quickly over-subscribed and others (like Bishop’s Park College in Clacton) that were seen as being less good, were left seriously short of pupils.

The final result was that parents lost the valuable right that they had once had, of automatic admission to their nearest comprehensive school. It was head teachers of good schools, rather than parents, who were able to do the picking and choosing. Freedom to choose whichever medical practice patients prefer could lead to a similar situation.

The idea seems to be that regular commuters might well prefer to have a doctor near their place of work rather than near their home. Nobody though, spends all their time at work, and very few people spend more time there than at home. Nor can we always choose the times that we need to see a doctor. A medical practice near the place of employment would be very handy for routine visits like blood pressure checks and ‘flu jabs, but how about more serious problems?

Supposing you work ‘in the city’ and commute there from Colchester, or Frinton or Clacton every day. You’re registered with a medical practice somewhere near Liverpool Street. I assume there is one in that area. One morning you wake up after a bad night’s sleep with stomach pains that could just be the temporary result of over-indulgence……but might not be? What would you do? Catch the 8.10 or whatever as usual, and hope that it will either get better or that you will be able to get to the surgery before it gets much worse? Or ring the surgery and ask for a home visit? It’s only seventy miles away after all!

I have an idea that giving patients ‘freedom of choice’ will turn out to be one of those well-intentioned ideas that ultimately have the opposite effect from that intended.

Successes in the Anglia in Bloom Competition

The annual Anglia in Bloom competition has surely been one of the most beneficial influences on the East Anglian countryside and townscape life in recent years. It ensures that our towns and villages get an annual floral facelift, and encourages both local co-operation and healthy competition. Chairman of the Judges, George Dawson, said, ‘The competition is not just about flowers. Many different categories are looked at including environmental quality, community involvement, biodiversity and the involvement of young people……….when everyone is involved the rewards are tremendous’.

I was glad to see that competitors in our Tendring District received their fair share of those rewards. Frinton once again set an example, gaining a gold award and top spot in the small town (2,500 to 6,000 residents) category. Brightlingsea achieved a gold award in their (6,000 to 12,000 residents) category but yielded the top place to Halstead. Clacton, a little disappointingly, missed the top award but did receive a silver in the coastal town category.

I was pleased that Kirby won a bronze award in the large village category, and more than pleased to learn that much-maligned Jaywick received a similar award in the small town group (Lord Hanningfield please note!)

Surely though, the children of Clacton’s Holland Park Primary School, and their parents, must have been the very proudest participants in our district. They were selected for having the best project in the Anglia region for children under twelve.

Congratulations to all those mentioned. I’m sure that we’ll do even better next year!

Songs of World War II

How refreshing that the wartime album of, now a nonagenarian, Vera Lynne, recently proved to be ‘top of the pops’! It is nice to know that there is still a demand for melodies that don’t assault the ear drums, and lyrics that can be heard, understood and don’t insult the intelligence.

No-one, whether in the forces or on the home front during World War II, will fail to remember having their hearts cheered during those dark days by her voice singing ‘We’ll meet again, don’t know where, don’t know when’ or ‘There’ll be blue birds over the white cliffs of Dover’. They brought a message of hope to folk who were desperately wondering whether, in this world, they would ever meet again someone they loved, and whether anything but warplanes would ever again be seen in the skies over the Kent coast.

She and her songs were loved by members of the forces. It must be said though that hers were not the songs that we sung as we marched or drove along Libyan or Egyptian desert tracks, or off duty in the canteen back in England.

I don’t, of course know what went on in the officers’ or even the sergeants’ mess, but we common squaddies favoured songs that were either quite unprintable – the unexpurgated version of ‘Bless ‘em all’, and ‘When this (censored) war is over’ sung to the tune of a popular hymn, or songs that were sickly sentimental, all about childhood sweethearts and silver-haired old mums waiting at home. ‘There’s an old mill by the stream, Nellie Dean, Where we used to sit and dream, Nellie Dean’, was, I remember, particularly popular with those who had had a drink or three!

An exception was the one song that became equally popular with the rank and file of both opposing armies in North Africa and, I think, had the most memorable melody of any song that came out of World War II. I first heard ‘Lili Marlene’ sung by captured German troops after we had taken Wadi Halfaya (Hellfire Pass) and Bardia just after Christmas 1941…….six months before the debacle of Tobruk, when most of us became prisoners! It had been broadcast by the German Forces broadcasting network in occupied Belgrade and had been an instant success.

It had a melody that stuck in the mind (it’s going through mine as I type these words!). We tried to put some English words to it, and I think that the Italians tried the same. Eventually, of course, there was an English version ‘Vor der Kaserne, bei dem grossen Tor’ became, ‘Underneath the lamp-light, by the barrack gate’. Its title was, of course, as easily pronounced in English as in German. It was added to Vera Lynne’s repertoire and became, as far as I know, the only song of World War II that was popular with both those in khaki and those in field-grey.