Sunday, 8 May 2011

The NHS - Coalition Agreement.

22. NHS
The Government believes that the NHS is an
important expression of our national values.
We are committed to an NHS that is free at the
point of use and available to everyone based on
need, not the ability to pay. We want to free
NHS staff from political micromanagement,
increase democratic participation in the NHS
and make the NHS more accountable to the
patients that it serves. That way we will drive up
standards, support professional responsibility,
deliver better value for money and create a
healthier nation.

• We will guarantee that health spending
increases in real terms in each year of the
Parliament, while recognising the impact this
decision will have on other departments.
• We will stop the top-down reorganisations
of the NHS that have got in the way of
patient care. We are committed to reducing
duplication and the resources spent on
administration, and diverting these resources
back to front-line care.
• We will significantly cut the number of health
• We will cut the cost of NHS administration
by a third and transfer resources to support
doctors and nurses on the front line.
• We will stop the centrally dictated closure of
A&E and maternity wards, so that people have
better access to local services.
• We will strengthen the power of GPs as
patients’ expert guides through the health
system by enabling them to commission care
on their behalf.
• We will ensure that there is a stronger voice
for patients locally through directly elected
individuals on the boards of their local
primary care trust (PCT). The remainder
of the PCT’s board will be appointed by the
relevant local authority or authorities, and
the Chief Executive and principal officers will
be appointed by the Secretary of State on the
advice of the new independent NHS board.
This will ensure the right balance between
locally accountable individuals and technical
• The local PCT will act as a champion for
patients and commission those residual
services that are best undertaken at a wider
level, rather than directly by GPs. It will also
take responsibility for improving public health
for people in their area, working closely
with the local authority and other local
• If a local authority has concerns about a
significant proposed closure of local services,
for example an A&E department, it will have
the right to challenge health organisations,
and refer the case to the Independent
Reconfiguration Panel. The Panel would then
provide advice to the Secretary of State for
• We will give every patient the right to choose
to register with the GP they want, without
being restricted by where they live.
• We will develop a 24/7 urgent care service in
every area of England, including GP out-of-
hours services, and ensure every patient can
access a local GP. We will make care more
accessible by introducing a single number
for every kind of urgent care and by using
technology to help people communicate with
their doctors.
• We will renegotiate the GP contract and
incentivise ways of improving access to
primary care in disadvantaged areas.
• We will make the NHS work better by
extending best practice on improving
discharge from hospital, maximising the
number of day care operations, reducing
delays prior to operations, and where possible
enabling community access to care and
• We will help elderly people live at home
for longer through solutions such as home
adaptations and community support
• We will prioritise dementia research within
the health research and development budget.
The Coalition: our programme for government 25
• We will seek to stop foreign healthcare
professionals working in the NHS unless they
have passed robust language and competence
• Doctors and nurses need to be able to use
their professional judgement about what is
right for patients and we will support this by
giving front-line staff more control of their
working environment.
• We will strengthen the role of the Care
Quality Commission so it becomes an
effective quality inspectorate. We will develop
Monitor into an economic regulator that will
oversee aspects of access, competition and
price-setting in the NHS.
• We will establish an independent NHS
board to allocate resources and provide
commissioning guidelines.
• We will enable patients to rate hospitals and
doctors according to the quality of care they
received, and we will require hospitals to be
open about mistakes and always tell patients if
something has gone wrong.
• We will measure our success on the health
results that really matter – such as improving
cancer and stroke survival rates or reducing
hospital infections.
• We will publish detailed data about the
performance of healthcare providers online,
so everyone will know who is providing a
good service and who is falling behind.
• We will put patients in charge of making
decisions about their care, including control of
their health records.
• We will create a Cancer Drugs Fund to
enable patients to access the cancer drugs
their doctors think will help them, paid for
using money saved by the NHS through our
pledge to stop the rise in Employer National
Insurance contributions from April 2011.
• We will reform NICE and move to a system
of value-based pricing, so that all patients can
access the drugs and treatments their doctors
think they need.
26 The Coalition: our programme for government
• We will introduce a new dentistry contract
that will focus on achieving good dental health
and increasing access to NHS dentistry, with
an additional focus on the oral health of
• We will provide £10 million a year beyond
2011 from within the budget of the
Department of Health to support children’s
hospices in their vital work. And so that
proper support for the most sick children
and adults can continue in the setting of their
choice, we will introduce a new per-patient
funding system for all hospices and providers
of palliative care.
• We will encourage NHS organisations to
work better with their local police forces to
clamp down on anyone who is aggressive and
abusive to staff.
• We are committed to the continuous
improvement of the quality of services to
patients, and to achieving this through much
greater involvement of independent and
voluntary providers.
• We will give every patient the power
to choose any healthcare provider that
meets NHS standards, within NHS prices.
This includes independent, voluntary and
community sector providers.

Friday, 6 May 2011

A history of mechanical calculating devices

Today I gave a talk to a group of Cambridge maths students on the history of mathematics. It was an exhilarating and exhausting experience. I've been asked to put up a video of this, unfortunately the best I can do is a rather poor camera-phone video, which may make understanding me difficult. But there's a lot in the slides so I've uploaded them too. Thanks to everyone there, especially the person to my left who keeps interrupting with corrections and clarifications that I really needed. He is of course the legendary Prof Piers Bursill-Hall whose lecture series this was.

Sadly due to battery life limitations I can only give you the 1 hour 10 min talk and not the much more interesting 40 min question and answer session afterwards where I really showed up how shallow my research was. Abraham Izrael Stern especially, I make the claim that he's doing something really important, but I've done almost no research into the guy's life and impact, that needs serious work. But this is such a vast topic that in the Q&A afterwards a phd thesis and a whole seminar of talks were identified of extra study that could be done. Which sounds great to me ... you know, after exams and stuff.

My slides:

Monday, 2 May 2011

Cognitive blind-spots – a request for help

Cognitive blind-spots – a request for help

So, the last few days I've had fun trying to get a new phone. There was epic fail, during which I discovered that never having owned a credit card was a bad move on my part. That's not the interesting thing though. I cant go back in time and change the fact so there's very little point in worrying about it, except that it's representative of a category of error. And this is where I need your help.

You see, it's not that I made an incorrect judgement, that implies making a judgement. With me and credit cards that's not the case. I have never decided not to own a credit card. Up to a week ago, say, I had not even considered it. It's not that I sat down, weighed up the pros and cons and made an error. It's that I never sat down and the default option was worse. Nobody has ever asked me “would you like a credit card”, I've never had that prompt to consider the things. Oh I grant you I know they exist, there those things that all the people I know who are in a financial mess have, but I've never thought that it's something I could own.

So, I'm now worried that there are other things that it's never crossed my mind to do. Other things that some people do that I've never thought about like … well that's the thing. I can hardly give an example of a mental blindspot, a thing I've never thought about. The whole point is I'm not aware of it. But, for instance, someone who'd never travelled and hence had never though about owning a passport and so hadn't thought about other uses for one. I've tried to think about tools people use to solve specific problems that I've not considered, the best candidate I can think of is life insurance. I've never sat down and asked myself if I want to be insured against injury or death. It may well be that I should get insured, the fact that I've never given it the most cursory consideration means that if so I'll commit another error.

So everyone. Tell me, are there tools, things that you have that help you, even very rarely, that not everyone has? What are they? Tell me especially about things like a driver's licence or a CV that are clearly designed for one task but which can be used for something else. The odds are that's the kind of thing that someone who's not wanted to drive or not wanted to get a job wouldn't have thought about. That's the kind of thing that lends itself to becoming a blindspot.