Sunday, March 25, 2007

Global Warming


This article from the Washington Post I think sums it all up!

Global Warming's Real Inconvenient Truth
By Robert J. SamuelsonWednesday, July 5, 2006; Page A13
"Global warming may or may not be the great environmental crisis of the next century, but -- regardless of whether it is or isn't -- we won't do much about it. We will (I am sure) argue ferociously over it and may even, as a nation, make some fairly solemn-sounding commitments to avoid it. But the more dramatic and meaningful these commitments seem, the less likely they are to be observed. Little will be done. . . . Global warming promises to become a gushing source of national hypocrisy.''
-- This column, July 1997

Well, so it has. In three decades of columns, I've never quoted myself at length, but here it's necessary. Al Gore calls global warming an "inconvenient truth," as if merely recognizing it could put us on a path to a solution. That's an illusion. The real truth is that we don't know enough to relieve global warming, and -- barring major technological breakthroughs -- we can't do much about it. This was obvious nine years ago; it's still obvious. Let me explain.
From 2003 to 2050, the world's population is projected to grow from 6.4 billion people to 9.1 billion, a 42 percent increase. If energy use per person and technology remain the same, total energy use and greenhouse gas emissions (mainly, carbon dioxide) will be 42 percent higher in 2050. But that's too low, because societies that grow richer use more energy. Unless we condemn the world's poor to their present poverty -- and freeze everyone else's living standards -- we need economic growth. With modest growth, energy use and greenhouse emissions more than double by 2050.
Just keeping annual greenhouse gas emissions constant means that the world must somehow offset these huge increases. There are two ways: Improve energy efficiency, or shift to energy sources with lower (or no) greenhouse emissions. Intuitively, you sense this is tough. China, for example, builds about one coal-fired power plant a week. Now a new report from the International Energy Agency in Paris shows all the difficulties (the population, economic growth and energy projections cited above come from the report).
The IEA report assumes that existing technologies are rapidly improved and deployed. Vehicle fuel efficiency increases by 40 percent. In electricity generation, the share for coal (the fuel with the most greenhouse gases) shrinks from about 40 percent to about 25 percent -- and much carbon dioxide is captured before going into the atmosphere. Little is captured today. Nuclear energy increases. So do "renewables" (wind, solar, biomass, geothermal); their share of global electricity output rises from 2 percent now to about 15 percent.
Some of these changes seem heroic. They would require tough government regulation, continued technological gains and public acceptance of higher fuel prices. Never mind. Having postulated a crash energy diet, the IEA simulates five scenarios with differing rates of technological change. In each, greenhouse emissions in 2050 are higher than today. The increases vary from 6 percent to 27 percent.
Since 1800 there's been modest global warming. I'm unqualified to judge between those scientists (the majority) who blame man-made greenhouse gases and those (a small minority) who finger natural variations in the global weather system. But if the majority are correct, the IEA report indicates we're now powerless. We can't end annual greenhouse emissions, and once in the atmosphere, the gases seem to linger for decades. So concentration levels rise. They're the villains; they presumably trap the world's heat. They're already about 36 percent higher than in 1800. Even with its program, the IEA says another 45 percent rise may be unavoidable. How much warming this might create is uncertain; so are the consequences.
I draw two conclusions -- one political, one practical.
No government will adopt the draconian restrictions on economic growth and personal freedom (limits on electricity usage, driving and travel) that might curb global warming. Still, politicians want to show they're "doing something." The result is grandstanding. Consider the Kyoto Protocol. It allowed countries that joined to castigate those that didn't. But it hasn't reduced carbon dioxide emissions (up about 25 percent since 1990), and many signatories didn't adopt tough enough policies to hit their 2008-2012 targets. By some estimates, Europe may overshoot by 15 percent and Japan by 25 percent.
Ambitious U.S. politicians also practice this self-serving hypocrisy. Gov. Arnold Schwarzenegger has a global warming program. Gore counts 221 cities that have "ratified" Kyoto. Some pledge to curb their greenhouse emissions. None of these programs will reduce global warming. They're public relations exercises and -- if they impose costs -- are undesirable. (Note: on national security grounds, I favor taxing oil, but the global warming effect would be trivial.) The practical conclusion is that if global warming is a potential calamity, the only salvation is new technology. I once received an e-mail from an engineer. Thorium, he said. I had never heard of thorium. It is, he argued, a nuclear fuel that is more plentiful and safer than uranium without waste disposal problems. It's an exit from the global warming trap. After reading many articles, I gave up trying to decide whether he is correct. But his larger point is correct: Only an aggressive research and development program might find ways of breaking our dependence on fossil fuels or dealing with it. Perhaps some system could purge the atmosphere of surplus greenhouse gases?
The trouble with the global warming debate is that it has become a moral crusade when it's really an engineering problem. The inconvenient truth is that if we don't solve the engineering problem, we're helpless.

Monday, March 05, 2007

Lack of local engagement

Local MP, Graham Stuart, has written to every Parish Council in the Beverley & Holderness Constituency asking for their support in his campaign against the local PCT’s plans to close every bed at Withernsea, Hornsea, Beverley and Driffield Community Hospitals.Graham has asked each Parish Council to write to the PCT to oppose the bed closure plans and to confirm with him that they have done so.Graham said:“We need to show unanimous and overwhelming public opposition to these plans and if Parish Councils show that they are all opposed to the closures then this is a powerful argument against the PCT which is supposed to make changes with people and not just for them.“If the PCT refuses to listen to the people, then the evidence of overwhelming opposition from Parish Councils and other voluntary groups will give me a strong case to put to the Secretary of State to ask her to intervene.”

What is going on with our local hospitals

Protester's blanket rejection of bed cuts

Alexandra Wood A town councillor took to bed – to highlight the plight of the East Riding's community hospitals.
Brent Roach was wheeled in an old hospital bed to the side entrance of the headquarters of East Riding Primary Care Trust yesterday in a demonstration that drew more than 200 protesters.They are angry at the PCT's plans to axe 14 NHS beds at Driffield's Alfred Bean Hospital – and those at three other community hospitals in the region – and replace them with 60 beds at hospitals in Bridlington, Goole and a third unspecified location, and 40 others at private care homes.Coun Roach said: "Today's turnout shows what a huge strength of feeling there is in the community against these cuts, which we don't believe make sense. We badly need to retain all these beds in community hospitals throughout the East Riding. They are vital for recuperative care of patients after they come out of the main hospitals and before they return home."We believe shifting beds into the private care sector is totally uneconomic, because the beds will have to be paid for even when there are no patients in them.
"On the other hand we've seen little evidence of the savings that were meant to be made when the two trusts merged last year to form the new PCT."Unfortunately in the NHS too much money is going on personnel and not enough on patient care."We would question why the PCT is still operating from two headquarters if they are under so much financial pressure."The PCT's interim chief executive Claire Wood, went out to meet protesters who handed her a letter.She said: "We are encouraged by the interest that local communities are taking in their local health services and offer assurance that all views received will inform the final decisionon the proposed model of care." Another demonstration is planned for early next month.

Sunday, March 04, 2007

Doctors chaos 'is worst crisis to hit NHS'

Doctors chaos 'is worst crisis to hit NHS'
By Celia Hall, Medical Editor Daily Telegraph
Last Updated: 12:49am GMT 04/03/2007



The chaos created by a new training system for young doctors is the "biggest crisis to hit British medicine", a leading surgeon said yesterday.


Prof Gus McGrowther: 'This is the biggest crisis to hit British medicine since the start of the NHS'
The new system, being investigated by the Royal College of Surgeons, has left thousands of junior doctors without jobs as trainee consultants.

Their current posts will end in August and fears are growing about how hospitals will cope.

The despairing and increasingly angry doctors have set the date for a London protest march and are taking legal advice about the equity of the new system. A fighting fund has been set up.

On Monday all the medical royal colleges will meet to discuss the crisis.

Hundreds of junior doctors, who have spent many years and thousands of pounds on training, have inundated The Daily Telegraph website to tell of their despair.

Rob Henderson, a senior house officer, said: "Hospitals run because of the goodwill of the doctors, evidently this has now been shattered and with it patient care."

Sarah Cregan, wrote: "I have spent 10 years training to be a doctor and have invested not just my own time and money but that of my family's including grandparents. I feel very let down."

The fury of scores of young doctors came as Prof Gus McGrowther, professor of plastic and reconstructive surgery at Manchester University, said he was profoundly concerned about the effect of the new system on patients as well as on medicine.

"This is the biggest crisis to hit British medicine since the start of the NHS," he said. "We are sacrificing thousands of young doctors who are partially trained and committed to a career in the NHS.

"We have 200 doctors who would like to be plastic surgeons and 50 jobs. Of these 150 are already very well qualified and already members of the Royal College of Surgeons.

"They have spent an enormous amount of money creating this new system and the whole thing is spiralling into chaos. It is quite immoral to inflict this on motivated young doctors. I cannot find a single doctor who is happy with this flawed process and ultimately it is the patients who will suffer."

Bernard Ribeiro, the president of the Royal College of Surgeons, wrote to all members on Thursday listing five "fundamental difficulties" in the system.

There have been 30,000 applications for 22,000 consultant training jobs under the Modernising Medical Careers scheme, accessed by the website called the Medical Training Application Service.

"For 18 months I have tried to get this system modified and the number of surgery places expanded," Mr Ribeiro said. "I have not succeeded. This system must be reviewed urgently.

"One problem is the website, which is open to the whole world. Anyone can apply. But the application forms are designed to be so unbiased that you could quite easily get an EU candidate offered an interview when a better qualified, British trained doctor is ignored."

In the new structure doctors do two years of "foundation" training and then apply for consultant training to become specialist registrars. The first foundation trainees are now ready to move to the registrar stage but they are clashing with the senior house officers from the old system.

There is also an unknown number of EU and overseas doctors in the mix. Mr Ribeiro said the heavily criticised application forms might be suitable for the foundation trainees but took no account of the experience and qualifications of the older SHOs.

"We need a different system for the SHOs as the new system is phased," he said.

Problems listed by the royal college are: "woolly" questions on the application forms; concern that qualifications have not been taken into account; concern about the adequacy of training for assessors; inconsistent rating and errors in reporting the results.

The fury of scores of young doctors came as Prof Gus McGrowther, professor of plastic and reconstructive surgery at Manchester University, said he was profoundly concerned about the effect of the new system on patients as well as on medicine. "This is the biggest crisis to hit medicine since the start of the NHS," he said. "They have spent an enormous amount of money creating this system and it is spiralling into chaos."

A spokesman for the Department of Health said: "It would be irresponsible to halt the interview process at this late stage. We cannot know whether the wrong people were invited for interview until they are interviewed."

Tony Blair's official spokesman sought to play down the crisis, saying: "The main thing is the overall number of doctors, as with nurses, has gone up."

A DOCTOR COMMENTS

I have a medical degree from london, a "golden london SHO rotation" disctinctions throughout medical school, 100% in my medical and surgical finals (i joke you not), all my postgrad exams, posters, papers in progress, a pan-london audit etc etcAnd I have sat in front of the computer all day - waiting to see whether this incompetent system has granted me a future in medicine. I'm still waiting.All day the website had been plagued with problems, doctors rushing from one computer terminal to the other trying to pretend their looking at blood results when in fact they are looking for a glimmer of hope that they still have a career, or job in the NHS come August.Do you want to hear the biggest joke. In 2009 the EWTD says doctors have to reduce their hours. A year ago official figures predicted hospitals wouldnt have enough doctors. When they make 6000 of us unemployed this summer and we all pack up our lives and move to america or australia - within a year they will be "flying in SHOs" from abroad to meet the staffing crisis. For a huge price no doubt. Not very smart.And now I will continue to stare into my computer screen to see if a dedicated intelligent doctor has to "sign on" in August.Well done Blair.Well done Patricia Hewitt.How are you going to spin this one to the patients?????SHO soon to be unemployed.