Long term readers of The ThunderDragon will know that the Dragon is a volunteer with St John Ambulance. And, if you've got a particularly good memory, you'll remember that I've been on several duties with the man himself.

I'm still hard at work volunteering, including my latest role doing Patient Transport work - mainly inter-hospital transfers and discharges. Sometimes, it's great fun - a talkative old lady who needs a lift home. Sometimes, with High Dependency work, it's particularly sad.

Of note was one job a few weeks ago.

We went to the ward to collect this frail old lady, who literally was no more than skin and bones. We had to be really careful sliding her from bed to our stretcher so as not to cause injury. She was also not able to talk. I don't know what her medical conditions were exactly, but she was only able to mumble.

It makes it so awkward to know what to day. Obviously, you tell the patient what you're doing - "We're going to sit you up now" etc. But, during the journey, I had to try and make conversation. I couldn't leave it as silence - it makes the patient feel unwanted. What to talk about though? Is it going in? Does she understand it? There's no way of knowing.

And then we left her at this nursing home, to sit in her bed, with only a carer to talk to her and notice her once in a while. Perhaps she had family to pop in once in a while. Perhaps not.

It's sad.

It's a real problem though. Say she did have family. No doubt they feel extremely guilty about leaving her in such a home. But, if one of your parents gets to the stage when they need 24hour care (especially if you're an only child as myself) what can you do?

I'm sure that everyone would want to look after them personally. Think about it - your Mum looked after you in your formative years, you'll be reciprocating. But, even as a trained Health Care Worker, I'm not sure I could cope. Giving up a job, all social life, devoting your time - and instead of there being progress as there is with tending to a baby, things get harder. There's an end with looking after a child - a bouncing toddler walking for themselves and starting to talk. The only end with caring for an elderly relative is a funeral.

I don't have statistics or anything, but I'm sure that most people at some point have to say enough is enough and put their relative into a care home. But, where? You don't need to read many ambulance blogs to hear about "Don't care homes" - I've seen them myself - but it can be difficult to spot them on a 'visit'. Regardless of that, there'll never be someone with the constant supervision that you can offer at home. The elderly far too often find themselves lying, staring at the ceiling, as all of their hard earned savings flow away into paying for such an life.

You can see a lot doing my 'job'. You learn to take most of it without much effect - it's not callous, it's the only way. But, every time I see one of these patients, I think of the sad and meaningless existence many people suffer in the last months of their life. That's the thing that gets me.

Asp

Why oh why oh why?

How can this possibly be justified in any way? It really does seem that smokers are the whipping-boys at the moment. Consider this: the smoking ban, raising the legal age of purchase to 18, and now requiring a licence. All points to one end aim: making smoking illegal.

I really don't like smoking. I consider it a horrible and disgusting habit. But I also think that it sure as hell isn't up to me to tell smokers whether or not they can smoke. An age limit - and proof of age being required before cigarettes being purchased is surely enough? If they want to smoke, they've made their aim pretty clear by asking for cigarettes at the counter. Why is a licence to do this - especially at time of purchase - at all necessary or justifiable under anything bar dictatorship?

Totally illiberal and totally wrong.

Rights and responsibilities for entitlement to NHS care?! We pay our taxes which pays for the NHS. So why on earth should we have any "contract" with the NHS that requires that we change our lifestyles in order to receive the healthcare which we have already paid for?!

Whether you smoke or are overweight, so long as you pay your taxes, there is no reason how or why you should not get the healthcare which you have already paid for. You have the right to get free healthcare from the NHS whether or not you have a perfect healthy lifestyle - that's the whole point of the NHS! Healthcare free at the point of delivery as required. Otherwise what's the point of paying taxes for an NHS that you won't benefit from?

If you are a British citizen and require healthcare, you are entitled to it from the NHS. No ifs or buts about "responsibilities" that require people to change their lifestyle before treatment. Of course they should take change their lifestyle to be more healthy, but that should not be part of any requirement for free healthcare from the NHS - it has already been paid for.

There is no choice about whether or not you pay tax for the NHS, so the NHS should have no choice about whether to treat you. If the NHS wants to become a conditional service, then it should be privatised.

So in a "clampdown on spending" the NHS has turned a £547m deficit last year into a £1.8bn surplus this year. But at what cost to the public? Why do they have this money if not to spend it and use it on bettering facilities and patient care? if they don't need it for that, cut taxes and give it back to the taxpayer!

However, is this surplus good for the NHS? I doubt it. How could it have turned a large deficit one year into an even larger surplus the next year without something happening to the level of service provided? This "clampdown on spending" has probably led to a lack of investment where it is needed and sacking [or just not recruiting] staff wherever possible, no matter the effect on the overall level of care to the patients.

For this financial turnaround in the NHS to have happened to such a large degree is impossible without the lowering of standards. After all, there's no other way that they could have done this since all their income comes from our pockets!

It may look good on the news for the NHS to have a surplus, but it's not good for the NHS on the ground.

Source: BBC

I have man-flu, so I'm dying.

A young Jehovah's Witness has died after refusing a blood transfusion after giving birth to twins. It is, obviously, a terribly sad occasion for the entire family, especially since it should have been such a joyous one.

But they - and she - made a choice, their choice, with the full knowledge of the dangers. We can say that it is stupid etc. all we like, but the choice can only be made by her, her husband, and her immediate family. It is not up to us to approve or disapprove of their perfectly legitimate life choices. They have chosen to follow a particular faith that does not allow blood trandfusion, and chose to die rather than break it - a decision that I am sure was not taken lightly.

She, and they, amde their choice. We can certainly consider it wrong and stupid - and I do. But it was her choice to make, not mine or anyone elses. She had chosen to sign a piece of paper refusing any blood transfusion, and no-one has the right to break that, except maybe her husband if she was incapable at that point in time.

What if she had been given a blood tranfusion? How would she have felt if her right to choose to refuse treatment was overruled? We don't know - but her husband and family might. And they chose not to break her wishes.

Her body, her faith, her life, her choice.

Source: BBC

Well, that's what they are saying. Along with eating red meat [so they want you be a vegetarian], any extra salt intake, and drinking sugary drinks [which presumably includes fruit smoothies?].

Frankly, it's all a load of bollocks.

One report says "don't do (a)", another says "don't do (b), but do do (a)" and yet another says "don't do (c) but do do (b)". It is pretty much all contradictory in one way or another. Just think of it this way - if you don't die one way, you'll die another.

But my problem is less with these studies and more with the way they are presented. They are always portrayed as incontrovertible fact - if you drink alcohol and eat red meat, then you will get cancer is the message they give out, whether or it is actually intended. But, really, none of these make a difference. You could follow the guidelines to the letter and yet still get cancer, or not bother at all about it and never get it.

Whether or not they intend it, it is how it is reported and how people interpret it. I am extremely sceptical about all of these types of reports, especially since it has been revealed that the recommended alcohol limit was just a guess. The "findings" from these reports are of no use to the general public, especially announced like this.

The best way to live a healthy life is to take everything in moderation - except moderation itself, of course.

This isn't paternalism, and it certainly isn't libertarian!

How can this be defended, at all, and by anyone? The proposals are absurd and certainly cannot be said to fit under the term "libertarian paternalism". The libertarian bit, for starters, is just utterly opposite to this very idea. And neither it is paternalistic because paternalism isn't that totalitarian.

This is nothing short of a totalitarian idea. Despite the charade of a claim that this is "preserving individual choice", that individual choice is subject to their approval - certainly if you want to smoke it is. Why should I have to apply, and pay, for a permit to allow me to kill myself with tobacco smoke? Why should there be an "exercise hour" that I choose or not choose to participate in? If I want to exercise more than walking to the fridge to get another beer, I will as and when I want to. Not when the State says I should.

This idea is proposing nothing short of a totalitarian state, where you can't do anything without the permission of your "betters" who run the State. This is an Nanny State proposal, and any claim that it "preserving individual choice" is utter bollocks. It quite obviously isn't.

It's not paternalistic, it certainly isn't libertarian. It is nothing short of totalitarian.

They didn't know - or couldn't be bothered to work it out - so they just made it up!

So those bastards just made up a drinking limit and then stuck to it. A limit that is stupidly low and, actually, nothing more than a so-called "intelligent guess" made by people who must have been deeply stupid. They then passed off their guess as incontrovertible fact.

It really pisses me off that "a feeling that you had to say something" on behalf of the Royal College of Physicians led to the constant demonisation of anyone who exceed these limits. They "were really plucked out of the air. They were not based on any firm evidence at all" and yet became the foundations of decades of government policy on alcohol.

What this shows is that these arbitrary statistics on so-called "healthy" levels of various substances are utter bollocks. Based on estimations and on the "average" person, they are next to useless at the best of times, and even worse when they are said to be, or taken as, incontrovertible facts.

Source: The Times

Why wasn't this possible before? It seems absurd that surgeons weren't allowed to practise on cadavers. These people have left their bodies to medical science. They obviously wanted their body to be used in order to save lives, however it may be done. After all, far better that than having surgeons practice whilst operating on live people!

Under what basis was it illegal for surgeons to practise chopping up dead bodies? It really doesn't make any sense to me - but at least it's fixed now.

Source: The Times

I can't see what that problem is here:

Oh come on! Get off your ridiculous high horse. It is a joke to raise money to save a hospital. There are far, far, more distasteful things that happen every day without any intent to do good. It is because Labour have failed to manage the money they have pumped into the NHS properly that such are campaigns are necessary.

What if it was two Labour MPs. Would Unison be complaining then? Bollocks would they be. They'd be lauding them for doing a public good.

Even if the particular calendar may be ill-advised, it is an attempt to a lot of good and to, in the end, save lives. Sex sells, and it's as simple as that.

Source: BBC

A Labour policy I agree with!

Excellent. This is what should happen. I blogged about my support for this idea when it was first suggested by the Chief Medical Officer, Sir Liam Donaldson, and even before that, when the issue was raised by the controversial kidney game show in the Netherlands.

Of course this is subject the various caveats, such as that the opt-out system is very easy and openly available and that the family of the deceased have the right to prevent organs being used unless that person has explicitly expressed the wish that their organs be re-used. That way, anyone who explicitly doesn't want their organs to be used to save another person's life can ensure that they are not.

The proposal makes complete sense - it will save lives and should reduce the cost to the NHS of supporting those who need organ transplants, and then enable them to be productive members of society again. It's a win-win situation.

Source: The Telegraph

Go to hospital under the alcofluence of incohol and you'll have to pay for it - again - if the Lib Dems get their way:

Not only is this a bad idea, it's pretty stupid too. First problem: define "drunk". Does this mean the consumption of any alcohol? A certain number of units? A concentration in the blood? How can you define "drunk" and where will you draw the line between not having to pay and paying? Second problem: if injured "drunks" don't go to A&E, what are they going to do? If they have to pay, many simply won't. This could well cause their injury to get worse or possibly, in extreme cases, cause death.

Unlike the idiots who made up this policy, I have had experience with drunks as a first aider with St. John Ambulance. Most of them don't want to go to hospital no matter what they have done - from cuts that need stitches, to suspected fractured bones, to stab wounds - and this idea that if they do go that they will have to pay for it would just mean that they certainly wouldn't, and could thus seriously damage themselves.

The NHS is pad for by taxes, everyone's taxes - taxes that include that levied on alcohol. Saying the drunks should have to pay for their treatments removes the very point of a publicly-funded health service. It also sets a dangerous precedent: smokers should have to pay for lung cancer treatment because they knew the risks; alcoholics should have to pay if they have liver problems; and then, eventually, old people should have to pay because they should have known better than to get old. if the NHS is funded by taxpayer's money, no British citizen should be charged at the point of delivery for health care by it. We all pay for it - to different extents, true - but we do all pay for it. And thus drunks - or any other group defined in this way - should be charged at the point of delivery for the healthcare that they have already paid for.

At least we know that they want Charles Kennedy to pay for his healthcare...

Sources: The Times, The Guardian, BBC