Monday, 9 May 2011

UK NHS reform GP cynicism

The Royal College of General Practitioners are complaining the proposed government reforms may unravel the National Health Service. The general "idea" is to give control of primary care funding to local consortia of GP's whole then commission services. At the same time the government are proposing to introduce competition for the provision of health services.

We must not lose sight of the fact that most General Practitioners are independent contractors/partners. The GPs do not have a contract of employment with the NHS. The GPs are allowed to keep the profits they make from the fees they charge government for the provision of health services. To allow the GPs to commission their own services represents a gross conflict of interest. Their primary motive is profit. The GPs already receive a massive annual income, as a private contractors, plus many hidden state subsidies. Giving them control of the purse strings is utter lunacy.

The Royal Collage of GPs complain that competition will wipe out the NHS [reduce the GP profit], yet at the same time GP commissioning groups actively campaign to halve the staffing levels of the existing NHS Walk-In Centres. These places are nurse led, using highly skilled medical practitioners, and provide a service 365 days a year from 7am through to 10pm. They handle 90% of the cases GP's handle and in many cases treat the overflow of patients who are unable to get an appointment at their own GP. Most GP practices are open to the public for about 8 hours a day for 250 days a year. The cost per clinical consultation is at the highly available Walk-In Centres is about 75% of an equivalent reduced availability GP consultation. The GPs hate the exposure that properly qualified Nurse Practitioners can provide a good clinical service without the need for expensive GP's.

A telling statistic is the consultation duration in a Walk-In Centre is an average of 12 minutes per person. These Nurse Practitioners are very thorough. Compare that with your own visit to a GP. most of their consultations last 2-3 minutes. The error rates at Walk-In Centres are very low, which is good considering the staff have to deal with unknown patients who walk through the doors.
One of those GPs looking for closure of the WICs is a close advisor of the Health Minister Andrew Lansley. Indeed Mr Lansley has introduced him at public speaking events as a GP expert. That same person is actively involved in the management of a local new GP consortia who will commission health services including the GP practices where the advisor has an ownership/profit interest. Their recommendation is to break up the WIC in his area (about 100,000 consultations a year). The WIC has already had substantial staff cuts imposed.

Not good. These ill consider government proposals have already caused a lot of damage and unnecessary expenditure. Prime Minister Cameron promised to protect the NHS yet he seems to have put it under the control of unreformed self-interest groups.

Thursday, 5 May 2011

Why we stopped using Google Adwords

We used to use Google Adwords to advertise our business on the responses to Google searches by the public. We stopped using them. 
Why did we stop?

  • It was not the cost;
  • It was not the hit rate;

We stopped because we could not get to talk/online chat with a real person in Google about the problem we encountered. We had the wording of an advertisement rejected without explanation by Google. The advert wording was not offensive, nor so far as we could see did it breach any published Google rules. We were in fact trying to correct an entry generated by Google about our business. We keep getting calls from Joe Soap consumers asking us to fix problems with their home PC's. We don't do that. We build trading floors and data centres and we charge high fees for that specialist skill.

The only "assistance" from Google was an automatic  Catch-22 type of response referring us to the Google rules. We'd already checked those and needed to speak to a human being, but that appears to be impossible for Google. A typical response from a money rich global corporation who can afford to lose a percentage of customers through poor communication.

What triggered this blog posting? Google have emailed us an offer of £100 to start advertising with them again. The sender of the email -!! Once again automated with no contact with a human being! What a waste.


ps. I've just been told Google have sent a new email  to our director increasing their offer to £150. To think they could have avoided this if they'd decided to make it possible for us to actually chat to a human being.

Wednesday, 4 May 2011

PC Maintenance Department

I've just had one of those unsolicited calls from a bunch of crooks trying to convince me there is a virus infection on my PC. They were calling from an Indian sub-continent call centre over a very poor quality VOIP line. Their scam is to induce you to visit a webpage to check out your PC using their software. Typically your PC will become "Hijacked" until you pay some form on ransom to them to cure the problem they loaded on to your PC such as file encryption of all of your data & programs. Effectively your machine becomes unusable until you pay them. Even then there is no guarantee that your PC is left in a clean state.
Their pattern of operation is obvious:

  1. A junior member of their team calls by phone and describes themselves as the PC maintenance group. They then feed you the line that your PC has reported faults and virus's to them. They'll suggest your machine is running slowly and erratically.
  2. Next step is to get you to run a standard Microsoft tool already on the PC so you'll see routine status messages which occur (normally hidden) on every PC displayed on your screen.
  3. The next step is to persuade you to visit their website to have it scan your PC to fix the "problem". If you do that you will cause a trojan program to load on to your PC and to commence it's evil work of corruption.
  4. Then they'll tell you that you have to pay a "fee" to repair your PC.

I must tell you I hate these criminal parasites. I take every action possible to keep them talking on the phone (at their cost and time) while they try to persuade me to follow their instructions. I play the dumb user who makes loads of mistakes when entering their instructions. I don't tell them that I'm pretending my PC is running the old MSDOS 5 operating system which pre-dates Microsoft Windows. The result is that none of the PC commands they they tell me to use will ever work.  This time I had them talking for 45 minutes, with a chain of six of their "experts" before they gave up. 

Unfortunately they didn't call on a phone where I can record the conversation, but here's a typical extract from the conversation (remember I think I have a back and white character based display of MSDOS 5 whereas they think I have a standard Microsoft windows screen say - Vista.):

  • criminals: "...Do you see the start button on your PC desk top?"
  • Alaric: "No, I don't have a button on my desktop. It is just a standard office desk. There's the phone in one corner, a cup of tea in the other corner and my PC keyboard in front of me."
  • criminals: "Just click the Start Button and type..."
  • Alaric:"but I just told you I have no buttons on my desk top, it is just a desk. Ok I've pressed the button on the front of my PC and it turned itself off. Is that what you wanted me to do...?"

This went on for 45 minutes with them getting increasingly angry because I couldn't follow simple instructions. Eventually they gave up saying they'd call me back in a few minutes. Hopefully the time I spent on the phone reduced their ability to pester other people and cause real damage to those unsuspecting souls. Sadly with the British Telecom phone system it is nigh impossible to trace these criminals calling from overseas.