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The Great Mass Debater

Do you actually want promotion?

So you actually want promotion?  

233 members have voted

  1. 1. So you actually want promotion?

    • Yes
      180
    • No
      52


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1 hour ago, Big Vince said:

Typical Hoggy, talking the club down again.

Can be summed up as follows:

City do have a divine right to be in L1, but not the EPL.

You know me Vince, super negative to combat some of that insane optimism you spread throughout the forum.

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33 minutes ago, hogesar said:

You know me Vince, super negative to combat some of that insane optimism you spread throughout the forum.

Beautiful to see that type of natural balance in action.

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12 hours ago, The Great Mass Debater said:

People are all different and probably the match day experience influences how you enjoy football. I've never been a regular attender of games, if geography allowed for it then it's something I would love to be part of my life. My brother in-law is a Man Utd season ticket holder and drives over 2 hours there and 2 hours back to watch them play. I have 4 little kids and could never justify that amount of time for football. 

Since the availability of online streams I have been able to watch almost all the games without it impacting family life, but of course that is a very different thing to actually going to games week in week out and sharing that with friends.

For me the Premier League used to mean I could watch matches, whereas the championship used to mean I couldnt. But I have a jailbroken Firestick now which means I can pretty much watch all games if I want, even championship.

I think if you go to games you very much live in the now. You have mentioned your own mortality numerous times, and if you have supported City for 50 odd years Im deducing you are at least 70. 

So I can understand and accept why we have different viewpoints. Its all the rich tapestry of life innit?

You're right we are all different and our experiences are different. For me the football is very much part of family life. I've not been to football without family for getting on for 40 years. There's always four of us go now but on occasion, cup games or under 23s, all 16 of us have been. It's a big part of our family life.

I don't watch streams, when we're away I usually listen to good old radio Norfolk. If we're on Sky I sometimes watch it with family but I don't have Sky at home. For me football is about being there and the tv doesn't cut it. When I was a kid we could go watch the reserves on a Saturday and there would be occasional score updates from first team games. That would be my ideal now.

I started going to games in 1967 having first taken notice of football when England won the 66 world cup. I'm not in my 70s like @TIL 1010 @......and Smith must score. and the other old codgers on here!🙃 I'm only a mere lad of 66 and fit as a butchers dog so my mortality isn't an issue. My point really amounts to everyone's mortality. We all have absolutely no idea what tomorrow will bring. This seemed to be recognised in the early days of the pandemic and forgotten just as quickly.

Anyway, back to wanting us to win, I thought that was what united City fans of all persuasions. 

 

 

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13 hours ago, The Great Mass Debater said:

Im very much a systems thinker. Im a GP and Im very frustrated in my job because I can see how the system doesnt work for patients (or Doctors) and it drives me crazy that we as a country cant make this better.

I think a number of Doctors are able to just get on with the day job, but when I see that most of my daily frustrations are a product of the system I work in, I cant just accept that and say 'it is what it is' it actively frustrates me. It's why I left hospital medicine as I was just coming home furious every day. It's slightly more bearable as a GP but I still cut a frustrated figure as if I see a system that doesnt work I want to make it better.

Im probably in the wrong job, I think I think like an engineer.

 

So similiary I see a system I think doesnt work, I will critique it from a non-partisan perspective. Regardless of my own loyalties

 

I'm pleased to meet you doc👍 It's hard to get a GP appointment these days. Maybe you could do a Friday afternoon surgery on here? I think Big Vince would make a good receptionist because what he don't know aint worth knowing 🙃

You're in the right job. We need good GPs solving our problems 💛👨‍⚕️💚👍

 

 

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Anyway, I've solved the issue for you guys.

You need to get in touch with the football league and request that they go old school with Norwich City and revert back to 2 points for a win while everyone else gets 3.

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On 21/09/2022 at 09:34, urdie_Canary said:

Yes but no.

I've been confident before under Farke and the prem seasons didn't turn out to be that great, under Smith I fear it will be even worse, but you never know... got to get there first.

If we do get promoted I feel with Smith and Shakey in charge we will have a better chance of survival with current squad plus some midfield muscle. Tin hat on👍

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57 minutes ago, SwindonCanary said:

it's as I always say, the fans prefer the Championship, but the Club requires us to be in the Premiership.

See I think this is a bit flawed.

Because the fans enjoy the Championship with a squad that was largely constructed as a direct or indirect result of Premier League TV money and parachute payments.

They wouldn't enjoy it after a prolonged period in the league, with no parachute payments. 

Even that first Farke team was half built in the 2nd year of parachute payments, and half built with the proceeds of transfers of players we signed when we had Premier League money. Maddison was purchased in the Premier League. 

We need promotion in order to enjoy the Championship, basically.

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We need promotion in order to enjoy the Championship, basically.

But would you like it if we were fighting relegation every year ? 

Edited by SwindonCanary

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51 minutes ago, SwindonCanary said:

We need promotion in order to enjoy the Championship, basically.

But would you like it if we were fighting relegation every year ? 

No pain , No gain 😉

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On 21/09/2022 at 22:08, nutty nigel said:

I started going to games in 1967 having first taken notice of football when England won the 66 world cup

I had no interest in football until Italia 90. I was 9 then and England's heroic, dramatic and unentitled run oh so close to glory is what inspired me and turned me into a football fan.

My kids couldnt care less about football. I was hoping England's recent successes would galvanise something in them like it did me, but no.

I care very little for England these days, basically because I cant identify with the players, unlike bygone eras. I feel no connection to the team like I used to

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On 21/09/2022 at 22:49, nutty nigel said:

I'm pleased to meet you doc👍 It's hard to get a GP appointment these days. Maybe you could do a Friday afternoon surgery on here? I think Big Vince would make a good receptionist because what he don't know aint worth knowing 🙃

You're in the right job. We need good GPs solving our problems 💛👨‍⚕️💚👍

 

 

Always happy to offer professional advice  😉

I was talking with my student earlier about access. Basically it's hard to get a GP appointment because demand far outweighs supply. Demand is exceptionally high because in the UK we have a Free at the Point of Access System (FATPOA). This means as Primary Care is state funded (through taxation and NI), patients have already paid for medical care, and dont have to stump up anything for it. So it's not free, but from the patient's perspective, there is no cost to going 100x per year rather than once or twice.

So if you dont have to pay anything to go, then everybody wants to go. And there will never be enough GPs to cope with such a demand.

If we changed the system so that patients had to pay £10 to see a GP we would cure the supply/demand problem overnight. People wouldnt pay £10 to come about a verruca or a cold, meaning patients that really needed GP input would be able to access the service.

But at what cost?

I do not advocate charging because people have already paid. But more than that, in countries like New Zealand, where Primary Care is private, the way most dentistry in the UK is now, you pay $60 to see your GP. GPs in NZ therefore have much quieter lives, are much less stressed and actually earn more money.

BUT, this stresses the system elsewhere, so for instance Secondary Care is state funded, so patients go to A&E instead of their GP. This happens in the UK a lot as well, but that is driven by access problems rather than financial ones. 

I do not advocate charging for appointments because I think it encourages bad practice. Right now patients invest very little in an appointment, so when they have a virus or a self-limiting condition, I have no problem with telling them that, and generally it is accepted.

Once you start operating in a system where a patient has paid a lot of money to come and see you, you start to feel like you need to give them something for their money. Something they dont need. This leads to patients having investigations they dont need (some invasive) or drugs they dont need, which come with their own risks and the risks of breeding resistant bacteria in the case of antibiotics.

In countries where patients are a source of revenue, like your mechanic it is in the clinicians interest to find as much 'wrong' as possible and do as much as possible, as it makes them money. In Italy for example they do bladder wash outs for UTI. There is no evidence-base for this, but it's a nice little earner.

 

So charging patients leads to bad practice and corruption. But even more important is that patients need to have as few barriers to seeing the Doc as possible. If you start charging, the little old lady whose 'period' has started up again might decide not to bother getting it checked, or a Mum might think 'it's probably not meningitis'.

So in order to remain accessible to these patients, we need to remain free.

 

Unfortunately we're at a point where the reality is that the main barrier to access now is not cost, but demand, and it may be worth having that national conversation about charging to see a GP in order to ensure patients who really need to see us arent blocked by all the coughs and colds who need to see noone.

What with all the GP bashing of late, which we're used to but has got a hell of a lot worse in recent times there is much talk about General Practice doing what the dentists did, handing back contracts and setting up as Private clinicians en masse.

(I dont think it will ever happen, but we've been attacked publicly far more than normal of late. All I would say is, you dont know what you've got til its gone...)

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45 minutes ago, The Great Mass Debater said:

Always happy to offer professional advice  😉

I was talking with my student earlier about access. Basically it's hard to get a GP appointment because demand far outweighs supply. Demand is exceptionally high because in the UK we have a Free at the Point of Access System (FATPOA). This means as Primary Care is state funded (through taxation and NI), patients have already paid for medical care, and dont have to stump up anything for it. So it's not free, but from the patient's perspective, there is no cost to going 100x per year rather than once or twice.

So if you dont have to pay anything to go, then everybody wants to go. And there will never be enough GPs to cope with such a demand.

If we changed the system so that patients had to pay £10 to see a GP we would cure the supply/demand problem overnight. People wouldnt pay £10 to come about a verruca or a cold, meaning patients that really needed GP input would be able to access the service.

But at what cost?

I do not advocate charging because people have already paid. But more than that, in countries like New Zealand, where Primary Care is private, the way most dentistry in the UK is now, you pay $60 to see your GP. GPs in NZ therefore have much quieter lives, are much less stressed and actually earn more money.

BUT, this stresses the system elsewhere, so for instance Secondary Care is state funded, so patients go to A&E instead of their GP. This happens in the UK a lot as well, but that is driven by access problems rather than financial ones. 

I do not advocate charging for appointments because I think it encourages bad practice. Right now patients invest very little in an appointment, so when they have a virus or a self-limiting condition, I have no problem with telling them that, and generally it is accepted.

Once you start operating in a system where a patient has paid a lot of money to come and see you, you start to feel like you need to give them something for their money. Something they dont need. This leads to patients having investigations they dont need (some invasive) or drugs they dont need, which come with their own risks and the risks of breeding resistant bacteria in the case of antibiotics.

In countries where patients are a source of revenue, like your mechanic it is in the clinicians interest to find as much 'wrong' as possible and do as much as possible, as it makes them money. In Italy for example they do bladder wash outs for UTI. There is no evidence-base for this, but it's a nice little earner.

 

So charging patients leads to bad practice and corruption. But even more important is that patients need to have as few barriers to seeing the Doc as possible. If you start charging, the little old lady whose 'period' has started up again might decide not to bother getting it checked, or a Mum might think 'it's probably not meningitis'.

So in order to remain accessible to these patients, we need to remain free.

 

Unfortunately we're at a point where the reality is that the main barrier to access now is not cost, but demand, and it may be worth having that national conversation about charging to see a GP in order to ensure patients who really need to see us arent blocked by all the coughs and colds who need to see noone.

What with all the GP bashing of late, which we're used to but has got a hell of a lot worse in recent times there is much talk about General Practice doing what the dentists did, handing back contracts and setting up as Private clinicians en masse.

(I dont think it will ever happen, but we've been attacked publicly far more than normal of late. All I would say is, you dont know what you've got til its gone...)

This is an absolute facer, but I think you have to try & disincentivise people with minor ailments from visiting their GP. I was thinking possibly a small charge, say £5 - £10, which could be refunded if there's a real problem? Defining a 'real problem' would be tricky though. Could see lots of arguments there. A lot of us only go when seriously concerned, so a small charge wouldn't put us off.

I suspect it's a low percentage of patients who take up a large percentage of time; is that correct? Obviously some will have ongoing illnesses, but what percentage would you say just go to the doctors over minor issues?

No easy answers. But something has to change.

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Good post about GP's woes TGMD.

I recall it was becoming more difficult to see a GP several years ago but the pandemic seems to have shut the door almost completely. It certainly has where I live. Fortunately I haven't needed to present myself with an ailment for some time and I'm not looking forward to the day I need to.

As this thread has now veered away from it's original heading my tuppence worth is that we all live too long. Back in the day a man would retire on his 65th birthday knowing there was a good chance he wouldn't still be around to celebrate his 70th. With all the advances in medical science since then coupled with the demonisation of smoking means that someone lucky enough to retire at 50 having worked for 30 years or so can now be retired longer than they worked. Clearly that sort of financial commitment by a pension provider is unsustainable in both the public and private sector.

The problem is we're living, or in a growing number of cases existing, too long. Perhaps to lower outgoings the government could start adding extra ingredients to the Covid boosters ? Luckily it looks as though they haven't as yet as I had my fourth jab this morning and still standing 😉

 

 

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I'm told you're supposed to get a health MOT once you pass 50, but my GP hasn't contacted me regarding this. I'm nearly 59 and my wife is nagging me to chase one up, but I'm reluctant to as I feel perfectly fine, if a little slower on my pins nowadays. But I wonder if this lack of follow through is actually building up more problems leading to the current lack of access to GP's. It's a hard one to answer, but think my tale is fairly widespread.

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43 minutes ago, ron obvious said:

This is an absolute facer, but I think you have to try & disincentivise people with minor ailments from visiting their GP. I was thinking possibly a small charge, say £5 - £10, which could be refunded if there's a real problem? Defining a 'real problem' would be tricky though. Could see lots of arguments there. A lot of us only go when seriously concerned, so a small charge wouldn't put us off.

I suspect it's a low percentage of patients who take up a large percentage of time; is that correct? Obviously some will have ongoing illnesses, but what percentage would you say just go to the doctors over minor issues?

No easy answers. But something has to change.

 

We certainly have some frequent fliers. I see one kid almost every week. How her Mum gets appointments I dont know, it has stopped though since we had a change in receptionists. 

We could change the system so that GPs receive a little less funding from the Government which is made up by the appointment fees, so that noone is profiteering - that way technically everybody pays a bit less, but the people who actually use it pay more. Downside with that is the really sick people who need multiple appointments, and also, many of the people who use General Practice dont pay tax or NI, so this would be a huge 'new' cost on them.

The increase in telephone consultations has meant better access for those who work (as now acceptable to step out of the office to take a call rather than having to take a day off) but before this the people who mainly used us didnt struggle for access (namely the retired population and kids) as they could access easily during the day.

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On 22/09/2022 at 15:07, SwindonCanary said:

We need promotion in order to enjoy the Championship, basically.

But would you like it if we were fighting relegation every year ? 

From what division?

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17 hours ago, shefcanary said:

I'm told you're supposed to get a health MOT once you pass 50, but my GP hasn't contacted me regarding this. I'm nearly 59 

You're not 'supposed' to get one as such, but we do offer one if patients want one. If you thought you were 'supposed' to have one, how come you didnt proactively pursue this?

I tend to hear things like this all the time 'nobody contacted me'. So why didnt you assume responsibility for your health rather than outsourcing it to someone else? Im your GP not your Mum! If you arent interested in your own results or health, why do you expect anyone else to be?!

Edited by The Great Mass Debater

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29 minutes ago, The Great Mass Debater said:

If you knew you were 'supposed' to have one, how come you didnt proactively pursue this?

My bad, I thought it was the GP who were supposed to contact me! I've only been going off my wife's experience, she worked in the NHS, and suggested it was shocking that i hadn't been contacted and thus should chase it up! 

It's this lack of clarity that permeates everybody's dealings with the NHS, it becomes hearsay mainly. As I said, apart from slowing down as I get older (my regular 6.5k run is taking longer most times nowadays), my health is good and recognising the strain on the NHS, haven't proactively chased it.

I am interested in being healthy; I watch what I eat, exercise regularly, have a BMI well within my target zone, and have responded to Bowel Cancer tests etc. notified to me on a timely basis.

I will now proactively chase the "MOT". 

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Our GP surgery is brilliant, I believe it is the best in the North West and pretty high in the whole country 👍👍👍

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Apologies if posted before but just come up on BBC,

Eight of the 20 Premier League clubs are being urged to ensure they pay the real living wage to all their staff.

The other 12 say they are either accredited Living Wage Foundation employers, or pay the real living wage to all staff, including subcontractors.

Staff working in a London borough will earn £11.95 an hour, or £10.90 outside of that, after an increase on Thursday.

But eight do not pay that rate to all permanent and casual matchday staff, or could not confirm if they do.

Premier League clubs spent a record £1.9bn on players over the summer.

Wonder how we would do ??? Should we be promoted of course 😎

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4 hours ago, ......and Smith must score. said:

Good post about GP's woes TGMD.

I recall it was becoming more difficult to see a GP several years ago but the pandemic seems to have shut the door almost completely. It certainly has where I live. Fortunately I haven't needed to present myself with an ailment for some time and I'm not looking forward to the day I need to.

 

 

Haven't seen a GP face to face since before the pandemic but I have a half hour slot tomorrow afternoon with GP and Cambridge students. Like with football we are all different with different needs. 

Not sure about paying simply because we'd end up with surgeries full of the rich and entitled 😯

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3 hours ago, TeemuVanBasten said:

From what division?

I wondered about this, does Swindono mean that we plummet, fighting relegation  but failing every season, or doeshe / she / it / them mean ' fight relegation every season but survive, meaning we stay in the Prem, Status improved from top 26 to top 17.?

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15 hours ago, Foxy2600 said:

Apologies if posted before but just come up on BBC,

Eight of the 20 Premier League clubs are being urged to ensure they pay the real living wage to all their staff.

The other 12 say they are either accredited Living Wage Foundation employers, or pay the real living wage to all staff, including subcontractors.

Staff working in a London borough will earn £11.95 an hour, or £10.90 outside of that, after an increase on Thursday.

But eight do not pay that rate to all permanent and casual matchday staff, or could not confirm if they do.

Premier League clubs spent a record £1.9bn on players over the summer.

Wonder how we would do ??? Should we be promoted of course 😎

With the figures clubs deal with in terms of pay, signing on fees etc and the amounts of money clubs regularly have to write off in terms of natural wastage and loss of players book values, its really hard to imagine that paying what is tuppence in comparison would make the slightest bit of difference to anyone but the employees involved.

When you're paying Ronaldo £500,000 a week, it seems ludicrous to imply that Bob the kitman can't get a few pounds an hour payrise

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2 hours ago, The Great Mass Debater said:

With the figures clubs deal with in terms of pay, signing on fees etc and the amounts of money clubs regularly have to write off in terms of natural wastage and loss of players book values, its really hard to imagine that paying what is tuppence in comparison would make the slightest bit of difference to anyone but the employees involved.

When you're paying Ronaldo £500,000 a week, it seems ludicrous to imply that Bob the kitman can't get a few pounds an hour payrise

Football's illness in a Nutshell.  

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18 hours ago, Mr Angry said:

Our GP surgery is brilliant, I believe it is the best in the North West and pretty high in the whole country 👍👍👍

Same here. If we ring our GPs’ surgery in the morning but need an afternoon appointment , we’re told to call back after lunch. If you have an urgent problem, you never have to wait. We’re looking to move house in the next year or two, but are very reluctant to move out of the catchment area.

  I don’t understand what they’re doing that others aren’t, and if there are examples like ours, why others don’t adopt their methods. I think the fact that they have a “triage nurse” helps filter calls, and you will sometimes be routed to a nurse if it’s not serious enough to see the doctor, but they’re not doing anything revolutionary.

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7 minutes ago, Nuff Said said:

Same here. If we ring our GPs’ surgery in the morning but need an afternoon appointment , we’re told to call back after lunch. If you have an urgent problem, you never have to wait. We’re looking to move house in the next year or two, but are very reluctant to move out of the catchment area.

  I don’t understand what they’re doing that others aren’t, and if there are examples like ours, why others don’t adopt their methods. I think the fact that they have a “triage nurse” helps filter calls, and you will sometimes be routed to a nurse if it’s not serious enough to see the doctor, but they’re not doing anything revolutionary.

The receptionists do the triage at our surgery when you call, is this not common at other surgeries?

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4 minutes ago, Mr Angry said:

The receptionists do the triage at our surgery when you call, is this not common at other surgeries?

Probably, but the call goes receptionist to triage nurse at our surgery, so you have someone more medically qualified making decisions about where to route the patient. Which means for the “frequent fliers” that GMD refers to, there is the chance to filter them to a nurse, or even to say “see a pharmacist”.

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