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Mothers and baby buggies- Mark 2!

Today a Court in the UK has ruled that mothers with baby buggies must give up space to wheelchair users on buses. In my opinion, a great decision and the ruling should be expanded to other areas of life.

I have for a long time been concerned about how mothers with baby buggies are becoming more exasperating by the day. From, amongst other things, trying to use the buggy to stop traffic, trying to place a monopoly on car park spaces and claiming right of way for direction of travel on a foot path even though the path is wide enough to accommodate several people, the sense of entitlement is bewildering and worrying. I know that not all mothers are like this but the experience of the wheelchair user who could not get on a bus because the mother with a buggy refused to offer up space appears to be a snap shot of the changes in Society where personal rights/self style entitlements seems to be skewed towards the ridiculous.

My gym for example has designated spaces for mothers with children between 09.00 and 17.00 daily. I was in the gym one morning at 06.45 and parked in one of ‘those’ spaces. I returned to my car at 09.05 and was given the most filthy look and a load of muttering from one of these mothers. My question was that why did I have to put up with that experience when I pay full wack to use the gym and dare I say, probably pay a much higher subscription to use the gym at any time compared to this individual who would only use the gym at off-peak times. I must say I was totally miffed but decided to bite my tongue. I guess she thought she was entitled to say something just because she had a child in a buggy! Surely it could not be all down to manners (or lack of) but understanding that the spaces provided are discretionary and not enforceable by law! Mothers and buggies ought to be aware of this and understand that being pregnant if not being ill, having a baby in a buggies does not make then disabled or incapable and having a baby does not mean that they automatically lose sight of what is right and wrong!

Health Tourism in the UK

At last the UK government is taking this issue seriously! It has been a growing problem for many years and nobody has had the guts to confront it squarely until now. Well done to all those involved. I do not see a problem with providing 2 forms of identification to either receive or provide care. The only question I have is will that identification requirement be flexible enough to ensure that the vulnerable are not penalised?

I do however, have serious concerns about the impact of political correctness as shown by the British Medical Association (BMA) announcements over the last few days as they wheel out the usual mantra of undermining the doctor/patient relationship when they are being asked to be ‘gate keepers of care’ and that the proposal is disproportionate to the money saved by such measures and that the Government should concentrate on increasing the budget for health care. Not only do I find this frustrating but wonder on which planet this Organisation is on! Firstly they are always asking for increased funding and that in itself is not a bad thing, but trying to frustrate any means of plugging any ‘leaking funds’ that could be ploughed back into the healthcare system is a step too far. Secondly, I do not suspect that the Government is going to ask individual Doctors to ask patients to produce their ID before direct communication; this is an administrative duty that their administration staff are more than capable of doing. So where is the problem? The BMA has got to remember that general taxation pays their wages when they work within the public sector such as the NHS and therefore they have an obligation to ensure that it benefits those who pay the taxes. The world does not revolve around the lives and whims of Doctors!

By all mean express concerns about Government activity but surely grown up behaviour does not include opposing measures for the sake of opposition! The BMA must realise that increased funding for a public service requires increased taxation. How much more tax can the public (Middle class/ Just About Managing class) pay? Let common sense prevail and take measures to plug the holes from which funds are seeping away from the system, surely that has got to be a good position to start from when trying to increase funding availability! Increased funding through a budget is a totally separate political argument and must not be allowed to blur the argument on health tourism.Come on BMA get a grip!!!!!


British EU Referendum

I thought democracy is about having a Government of the people, by the people and for the people. Where has it all gone wrong?!?????????!  From where I stand the EU is not of the people, certainly not run by the people and definitely not for the people. HELP!!!

What’s in a name?

I made a decision the other week and it solved a daily minor irritation. I decided never to answer the question….So where do you come from Doc? I now reply that I never answer the question because I never ask my patients that very question.

I never ask it because very rarely does it have any bearing on clinical presentation (Unless there is a hereditary angle I am trying to explore) and frankly it is none of my business and feel that it is equally none of my patients’ business where I come from. As far as I am concerned I speak the Queen’s English uphold the ethics of the administration of Health Care and go to great lengths to achieve an acceptable ethical outcome. Where I come from is my personal information and as far as I am concerned if respecting patient’s privacy is important, patients need to respect the privacy of the clinician!

Phew………Feels good to get this one off my chest!

Free speech!

I was involved in a mini discussion a few days ago, it was a normal discussion amongst colleagues but unbeknown to me I had been dragged into an argument about the right or wrongs of a particular treatment approach for a client; it became rather heated at one point.  Upon reflection I came to the conclusion that we were all right in our views because even though we approached the problem from different angles the outcome would be the same.

This kind of argument is considered ‘normal’ in my profession but I realised that some of the comments made were a bit harsh to the point of being rather rude. I asked myself if the individuals concerned would only accept the ideas put forward by the other and consider it be free speech if that point of view was agreeable to the other. Dare I say that I can just imagine the results of the heated discussion brewing over into professional politics. I’ll keep you posted if there are any developments!

I cannot help but be a bit controversial here and say the same can be said on the issue of climate change and in our case in the UK, the European Union. Now I do not say that global warming does not exist but the spurious arguments banded around does not in my opinion help the cause but only an entrenchment of views. Frankly speaking it’s happening and the question ought to be; What are we going to do about it without rely on another country to either make the first move or stifle their developement to appease others? Similarly the European Union thing is descending into a farce because I for one do not know enough about it and can  no longer trust those that know to have a sensible debate that could inform me of the right decision to make. Over the coming months I fear that there will be mud-slinging from both sides of the argument; one side talking about cheap holidays etc and the other about immigration etc.! God help us, I need a paracetamol just thinking about it!! At the end of the day is there a link between creating a trading cartel to exclude the developing world and poverty, a cause of mass economic migration? Just a thought!

BA. To fly or not to fly…………..What’s the answer?

I have just returned to work after the one and only proper break I get each year and feel like I never went away. In fact I am already looking forward to my annual holiday in August 2015!

My holiday usually gets started when I have parked the car at the airport long stay car park when I begin to afford myself the luxury of slowly switching off my little grey cells and just following instructions. This year I actually decided to pay for a premium service to get us through the usually labourious securtiy checks etc; I was feeling really good by the time my wife and I got through to the departure lounge at Gatwick airport and looked at the flight board for the gate number of our flight to Bermuda. My heart raced a little faster as it showed the expected take off time correct as we were led to believe.

Then the problems started….
The flight time started to change as if by the actions of a poltergeist, firstly to a later hour, then to another and then for a further hour. It was scheduled to be flying out 3 hours later than we were told at this point. Off I go to the main information desk to find out what was happening only to be told that there was a technical fault; we were each given a £10 food voucher. 2 hours later I go back to the desk to ask why a further delay had been shown on the board only to be told that the technical fault could not be fixed and that a replacement aircraft was on its way from Heathrow. A further hour and we were told the replacement flight was delayed because of bad weather at Heathrow?!?- Anybody know the distance between Heathrow to Gatwick? The way they were saying it suggested they were in completely different time zones! Anyway by this time everyone due on the flight is getting rather annoyed, mainly because the inconvenience was not big enough for the BA duty Manger to come and tell us what was happening. She eventually did but gave us a completely different account of what was happening to whch we were led to believe by the informaton desk. By the way in the midst of all this I enquired why it was left to the passengers to find out what was happening rather than BA making announcements…………….I was told that BA does not do that sort of thing! can you believe that? We were then given another £10 food voucher each and asked to keep an eye on the flight board. Great!!

We eventually got away 6 hours later than scheduled. My wife and I (and several other people) had sat in the departure lounge for over 7 hours!!

We lost half a day of our holiday, had a cramped flight, made me rather irritable all holiday and worst of all made me feel jaded at the start of what is supposed to be a new working year………..Just fantastic!! So the question is ‘BA; Fly or not fly? What is the answer?’

Buggies and children!

Is it just me or am I missing something?

The number of mothers using children in push buggies to stop the traffic. Driving home from work, on a number of occasions (with increasing frequency) I notice some mothers trying cross the road with a child in a buggy literally inches from the passing traffic…………its scary, very scary! I hate to think how many children are going to grow up with a recurring dream of machines passing at speed in front of their faces.

Is this a lack of awareness or ‘I don’t particularly care’ attitude? What I do assume is that the children concerned have no say in it. I don’t mean to have a go at anyone but surely its a matter of common sense not to put a child in danger. Maybe I am getting too old and not moved on with the times, I don’t know but if I was sitting in a buggy like that I would be absolutely petrified. To make things worse sometimes the mothers are actually speaking on a mobile phone at the same time! Now, I do not want to see similar rules as those for driving and using a hand held device but surely pushing a buggy without due care and attention deserves consideration don’t you think?

Shopping and the spread of germs!

I have become increasingly disturbed by my shopping experiences………….not that I do a lot as it is one of my pet hates. Anyway I was in a well known branded store, had collected my food items and proceeded to the checkout to depart with some hard earned cash. The initial part of the transaction went very well and I was thinking ‘ wow, great efficiency’. The checkout lady actually asked me if I wanted some bags and offered to put the purchased items of food in them. What followed next was what I can describe as a scene from a horror show in slow motion. Now, I am not an over the top clean person but what I do object to is taking someone else’s germs home. The checkout lady proceeded to lick her fingers……yes, lick her fingers, you know, like she has just finished eating a kebab, and then picked up my food items and placed them in the bag!! At that point I am thinking ‘OMG!!’, I am going to put some else’s dry saliva (it would have dried before I got home) into my fridge. I, of course declined to take the items home and swapped them for new items and checked my self out with the self checkout facility! With flu and other transmittable diseases what a way to spread an epidemic!?!?! You guys had the norovirus yet?

If the supermarket wanted to force people to check out their own shopping what a great way of doing it? I cannot understand why the checkout ladies/gentlemen cannot be provided with a moist sponge, you know like the ones we used to find on post office counters. Saves a lot of bother and most certainly will make me personally feel more comfortable next time I am eating a loose pear from the fruit basket!

Language barriers and consent to treatment

One of the fundamental issues in healthcare delivery is the ability to administer treatment with the full consent of the individual after being provided with enough facts to make a sound decision to accept/participate in treatment. Sounds like a very good idea to meet the ethical code of practice. However, the very large elephant in the room is the that fact that as clinicians we are beginning to see an increase in patients who do not have English as their first language. I have begun to wonder what support I would get if such a patient, on reflection, at home after treatment decides that he/she was not entirely sure what was going on because of the communication barrier. What would happen if such a patient decided to raise a complaint because their expectations do not match realistic outcome? What is the realistic outcome of any intervention within the concept of accountability and responsibility? It is a large and ‘ugly’ elephant that I fear is going to make an almighty mess when the ‘you know what’ hits the fan. Help!!!

Colleagues giving freebies

Hi……..was I missed? Its been a long while since I posted my last blog. Its been very busy lately but one thing that continues to stick in the back of my throat is the way in which generic exercise sheets are being dished out like sweets by General Practitioners and the misguided help they get from my colleagues who devise the so called exercise sheets! The problem has always been that as a Musculoskeletal Physiotherapist it is frustrating to not only be referred a patient whose problem has become chronic because of the ‘try these exercise first and if it does not work we’ll refer you to the Physio’ routine but also find out the belief system of the patients has been altered by the delay and the increased discomfort caused by that delay. In other words, they are upset and ‘cranky’ because of the pain/discomfort and irritated if the pace of outcome does not match their expectations which have become over exaggerated.I am not aware of any other profession that would devise self help manuals to prevent/reduce proper access to skilled personnel/clinicians and I certainly don’t know of any GP in particular who would devise a general leaflet on remedies for ailments. That’s right, they will not do this because of the fear of litigation! What’s different for Physiotherapists; we do have autonomy of practice and exercise is not the panacea for all problems!! Its about time we as Physiotherapists stopped believing that we are doing everyone a favour by developing and aiding in the distribution of these silly leaflets and started to take back control of what we do best- restoring human movement or are we saying that our clinical diagnosis is not relevant? As it is most medical diagnoses are not 100% correct; a testimony I can hear most MSK Physiotherapists agreeing to! It’s about time we got a grip!