EAT IT! EP by My Pizza My World Review
Punk rock and folk music have a common heart. They share a singalong-round-a-campfire mentality. Things are a bit rough round the edges. There’s an understanding that its time to talk about real issues with honesty. And both are a bit niche; you aren’t going to be hearing either on Radio 1 any time soon.
My Pizza My World embody this heart. They are the proud sole proponents of the laughing, self-deprecating genre of pizzacore; and the message is clear – music is awesome, but let’s not take ourselves too seriously, right? They are currently in the middle of a shambolic tour across the US, playing in squats, tattoo parlours and bars, spreading a message of hope, grounded in reality.
A passing moment,
A missed connection
Something gone before you ever knew you could grasp it.
I’m not totally sure what random combination of searches led to me stumbling upon their EP on bandcamp, but I do know that I love it. The plaintive pitunkerings (yes, yes, not a ‘real’ word) of a banjo, accompany a delightfully homemade-looking upright bass and a tenor ukelele, as their joint female/male vocals ring out and “refuse to waste away”.
The second track “Forgotten” stands out, and has led to me wandering around the house humming the vocal line. It reminds me a little bit of “Restless”, by the shortlived Hot Water Music side project, Rumbleseat. Less of the thudding momentum of Rumbleseat, but similarities none-the-less. The friendly parp of a trumpet on “No Time for Cryin’” also sticks in your head rather enjoyably.
A fragile mindset
Teetering on a hilltop,
Built of stones of regret over a sea of broken glass.
My thoughts on Eat It? Pick it up. Its not the best recorded EP ever, but the lo-fi works in its favour, reminds me of listening to old blues records from the 20s. The lyrics might be pretty far from Blind Willie Johnson’s material 90 years ago, but the discontented souls sound smack-bang the same. Don’t get me wrong, they know how to play, and they can sing too, but that kinda misses the point. With music like this, its not about how well you can play, all that matters is that you are.
…but darlin’ you know me too well – cause I’d rather be lost here then forgotten.
Following on the heels of my determined decision to become fit, slim and healthy a couple of years ago, I’ve been running pretty regularly. Since then, I’ve clocked up roughly 700km of sweaty boring hours, and have even begun to find it less boring, if no less sweaty.
Last year I completed my first Triathlon, and yesterday I managed my first proper 10K road race, running with some of my colleagues from The Beacon Medical Practice. I thought I would share a little about it below…
My friendly local medical practice, as part of encouraging holistic healthy living, offered to book anyone who wanted to run onto the Lincoln 10K. Nine of us ran it, ranging from an ultramarathon runner to first timers, so the pressure was nice and low.
I… didn’t do any. I meant to, but this year has been pretty rough so far. I’ve been ill quite a few times, had a scary exam to prepare for, and suffered from a fair bit of stress/tiredness. Looking back over my fitness log, I’ve been managing around 2-4 shortish runs a month since the new year. Probably enough to maintain fitness, but definitely not improve.
I’d hoped to put in some serious practice, but instead, a week before the race I found myself texting my sports performance specialist friend Jon, asking “How do I knock 5minutes off my personal best for 10K in a week”. I settled on the following plan
|Monday||10K at race pace|
|Tuesday||5K at race pace|
|Friday||10K at pace|
Regarding nutrition, I ignored this in the days leading up to the race, but on the morning of, I had a quorn and halloumi omelette, plenty of protein and fat, with some carbs in the form of a pack of mints.
I had planned to eat a slice of toast with jam as well, but felt a bit full following the omelette, and felt longer acting carbs vs running whilst overfull was a difficult call. Should have got up earlier, and kicked off with some porridge…
It was a great race overall, and my first real experience of the need to pace more carefully.
The first kilometre, I got much too excited by the atmosphere, and the people around me to overtake, and pushed a bit too hard. My earphones fed back to me that I’d managed a 4 minute 11 km, so I made a conscious effort to slow down over the next 2km, picking slightly slower people in the field and keeping pace with them.
I settled into a rhythm, and generally just found 3-5km great. However, I hit the halfway mark, and hit a mental wall, struggling to keep my pace, which was apparent by around 7km, where I’d started to drop from 4:30-4:40s to nearly 5min per kilometre.
Talking myself out of the doldrums, I was able to pick up the pace again at 8km, but then hit more of a physical wall – I’d been pushing pretty hard for 35 minutes by now, and there weren’t any reserves left in my legs. Over the final 2k, I didn’t get my usual burst of energy with the end being in sight, and clocked up my slowest times, at 5:08 and 5:16.
It was a great race overall, and my first real experience of the need to pace more carefully. I think that if I hadn’t had a pacing reminder early on, I’d have carried on pushing a bit too hard, and really crashed later on around 6-7k, almost certainly harming my time overall. As it was, I probably ran it a bit too much as a 5K, with a PB for my 5K time too!
I wonder if fitting in some complex carbs in the morning would have sustained me a little better – difficult to say, I suspect it wouldn’t have made much difference either way.
I was aiming for a sub 50 minute time, solely to beat my brother’s time from his 10K last year. On Monday, 6 days before, I ran a practice run in 55 minutes, which was not terribly encouraging.
What did I manage? Not just one, but two personal bests! New PB for 5K at 22 min 44 seconds and for 10k at 46 minutes 46 seconds. I came 717th out of 4,682 (15th centile).
Bad Medicine: Why the doctors are striking.
I am a big believer in Good Medicine.
Notice the capital “M”? We all know about “medicine”, which often takes the form of tablets that help you to get better. But Medicine is the art of getting people better. Learning Good Medicine is a process of skilled training that takes doctors decades of experience, practice, mistakes and reflection.
Good evidence = Good Medicine
It is impossible to practice Good Medicine without evidence – a fact that is drummed into us at medical school. Science is the reason doctors don’t try to cure impotence with electrocution, cure migraines by drilling holes in people’s skulls, and never encourage people to drink their own urine.
Look at some of these examples, to see how important evidence is:
Why do we ask Mrs Jones to take tablets for blood pressure?
Because the evidence shows that it reduces her risks of strokes, heart attacks, heart failure, kidney failure, and lots of other nasty things.
Why do we use paracetamol when little Timmy is burning up with his sore throat?
Because the evidence shows us that it relieves distress in children with raised temperatures.
Why does Mr William’s GP always ask him about smoking?
Because evidence shows that simple advice from a GP nearly doubles the chance that Mr William will quit in the following year.
Being a good doctor means practising Good Medicine. If we are going to take risks with people’s lives, we need to be sure that what we are doing is helpful; I’m sure you agree.
The government doesn’t have good evidence
Unfortunately, there is a problem. The NHS isn’t run by nurses, and doctors, and pharmacists, and radiologists, and dieticians, and the many, many other professionals who understand that evidence is the most important underpinning of everything we do together.
The NHS is run by politicians. Politicians like David Cameron, and Jeremy Hunt. Politicians who don’t seem to understand that Medicine without evidence is Bad Medicine. We, the doctors, are terribly concerned, that the politicians are in a hurry.
We want a 7 day NHS. Oh yes! We want a better health service, no doubt about it. But “7 day health service” is a buzzword. On its own, it doesn’t mean anything. Even if Jeremy Hunt sits on the toilet one morning, and has a brilliant idea, its very important that we test his idea.
Many of you will remember the incident in 2006 in London when a new drug, TGN1412, was given to 6 men, all of whom nearly died, with multiple organ failure. Ultimately, there was several problems with that trial, but a fact point is: aren’t you glad they didn’t try that drug on thousands of people at once?
The government isn’t proposed untested drugs, but it does want to roll out a junior doctor contract across the country, without testing it first. The junior doctors are concerned that it runs the risk of making problems much worse. Why is there such a hurry to take action without getting more evidence first?
What evidence we do have doesn’t support the government’s claims
Mr Hunt claims he has evidence that 11,000 people die each year due to weekend staffing. But let me read you a line from the conclusion of the very report he is quoting:“It is not possible to ascertain the extent to which these excess deaths may be preventable; to assume that they are avoidable would be rash and misleading.” In other words, he is claiming the study as strong evidence to support his actions: but the report makes it very clear that it is absolutely not.
Mr Cameron wants us to “become the first country in the world to deliver a truly 7-day NHS“. But he talks about 24/7 GP practices, despite the initial evidence we have not supporting this in practice. The Public Accounts committee grilled policy advisers on what their cost-benefit analysis evidence was, to discover that they haven’t done any. They asked a key question: “If you don’t know in broad terms what the answer is, how can you be doing the policy?”.
We would agree, strongly. If the government doesn’t know its changes will save lives, how can they be implementing them?
Why the junior doctors are striking
The government has said they are going to force a new contract onto doctors. But they don’t have any evidence that the new contract will save lives. We, the doctors, are very concerned that it will cost lives, and we keep saying it, but the government isn’t listening to us.
Knee jerk decisions?
That’s Bad Medicine.
Actions without evidence?
That’s Bad Medicine.
Changing the NHS that 53 million people rely on without trialling to see if the changes are harmful?
That’s Bad Medicine.
Bad Medicine kills people. Support your junior doctors, and tell the Government we want a safe, evidence based NHS, and we are willing to take the time to do it properly. #notsafenotfair
Drunks and Dragons: A prediction
Since Autumn, I have listened to 67 episodes of the Drunks and Dragons podcast. I’ve never really had any experience with Dungeons and Dragons, and found myself listening to this rather silly and pretty enjoyable podcast on the topic.
Given that I’ve now racked up around 94 hours of listening – nearly 4 full days of my life – I’ve become pretty attached to the characters, and their stories. There are currently about 150 episodes recorded, so I’m nearly halfway through. I thought it would be fun to make a few guesses about what happens in the next 70 chapters…
Firstly, Fennekin is going to be a bad guy. Think about it: House Vidalis fell due to one person playing with the Braisier of Worlds, and they are about to hand over that, AND TWO MORE super powered magical objects, to Fennekin. The players haven’t really thought about that, and I predict its not going to go well for them.
Secondly, their boat… I’m not sure if they need to make any more long boat journeys, I wonder if they will lose the boat, sink it, or generally have it disappear from the story in a slightly unimpressive way.
Thirdly, money. Jennifer is apparently keeping track of all the money, first mentioned around episode 40ish I think. Despite this, I don’t think she has mentioned money even once on the podcast since then, and I suspect that there will be at least one occasion where money is discussed, no one will have any idea and the Math Song will need to be played for a short period.
Aludra will die. Not full on die and leave the show, but I don’t think she’s been unconscious, or reached quasi death in a battle yet; so I predict she has it coming.
I also think that she will have a romantic liaison. Thom has had, well, loads of those, both consensual and borderline so – as well as likely with inanimate objects – but self titled “busty wench lady” Aludra hasn’t moved into the battlefield of love. I’m not sure about it, but I’d like to believe that her character will be fleshed out a little bit more in that way.
I also think that Jennifer Cheek will continue to roll worse and worse, until they have to stop letting her take place in any kind of battle scene at all. Put it this way: the odds of rolling two critical fails in a row are 400:1, but for her, I’d give it about 5:1.
I think Thom will get a ranged weapon. The group don’t have any traditional ranged weapons. Yeah, they have spells and things, but I’d love a bow and arrow. I think it would be a nice feature to add in, and I recall Mike actually mentioned the possibility around episode 50, so yeh, let’s see if that develops.
He will build his weird creation at some point, out of all the rotten body parts. I think it’ll be a really disappointing NPC, almost embarrassingly ignorable. I don’t think it will be the subject of Aludra’s romantic liaison, but I cannot be sure that Thom won’t try his luck with it.
I also predict that Thom will have an argument with Blood Drinker at some point – not a big one, but one that is RPd out, and will likely end up with Thom killing something he didn’t really want to kill. Not that Thom will spend long grieving about that…
We will discover the truth behind Harper’s dark past – but it will turn out not to be as dark as it should be.
Consider Harper’s predecessor Tum, who died in episode 30. He has his entire village and family killed in front of him by winged beasts, leading to an orphaned childhood, destitute in the city, and eventually forced by circumstance to join the crazy Thumble clan and spend every week in an arena murdering his brothers and sisters. Harper’s back story would have to be pretty awful to match up to that, and I don’t think it will.
However, once his dark past is revealed, I predict Harper will chill out a bit. To be honest, I miss Tum, because he was a bit more chilled and easygoing – like Tim Lanning – and I feel at the moment the PCs can’t really just relax and have fun in a pub. I look forwards to a more fun Harper.
Bucky is the ridiculous adopted Githyanki son of Thom and Aludra, and is an NPC.
Despite Thriftynerd pronouncing Bucky to be a “level 0”, I think Bucky will be involved in an attack in future. It’s clear, from the intense amount of training he is receiving from his father, Thom, that he will gain some skills. My prediction is that he will kill something – if only a minion – with his battle crazed great sword.
Obviously Daisy is magic. I suspect she is probably the chief bad guy for the entire overarching storyline. She’ll destroy them all.
Thanks for reading. Feel free to make a comment about how wrong you think or know I am. I’m not going to read the comments until I get to episode 150, so feel free to drop spoilers!
Starguild: Space Opera Noir review
I’ve spent the last week reading this RPG, and concurrently listening to the new Dream Theatre album, “The Astonishing“. It’s a great fit since its an operatic concept album about a oppressive dystopia in the future!
Press play on the left to share my soundtrack whilst you read!
What’s it all about?
Starguild is an tabletop RPG – a role play game. To those of you unfamiliar with the concept, RPGs are games where you meet with friends, create characters and play through stories that are derived mostly from your imagination.
An RPG consists of two basic components: the setting, and the rules.
The setting is the context in which you play the game. A Star Wars RPG is based in a galaxy far, far away, a Hobbits RPG is based in Middle Earth, an RPG about being a doctor seeing patients is based in a hospital, etc.
The rules are the framework that help you to play the game. Some have very intense, detailed rules for every tiny possible occurrence, others give the merest hint of a structure, allowing you to mould the gaming system to flow and adapt to whatever you feel it needs.
Welcome to Omega Centauris!
Before I get into the theme presented in this game, two admissions.
Firstly, I’m a relative newby to RPG, having only really become interested in it over the last 6 months. In that time, I’ve read a fair few rule books, and listened to around 150 hours of roleplay podcasts – Drunks and Dragons shout out! – and even played a little Hero Kids with my 5 year old son.
Secondly, I’m partial to a nice bit of space opera. I’ve always loved Red Dwarf and Hitchhiker’s Guide, always been more of a fan of Space Marines than Lizardmen. I’ll always pick up a book about plucky intergalactic ruffians, but am unlikely to wade all the way through Lord of the Rings again. Thus, Starguild is already pretty much up my alley.
You could literally set anything in this game: multi-ship, high-tech space battles; highly social political wrestling, emotions on tenderhooks; even a fantasy style rags-to-riches story on one of the less developed worlds.
In the last week I have read all 238 pages of the prerelease copy that Alex, the creator, kindly sent my way. The galaxy presented in Starguild is one of opportunity, inequality, and flexibility.
There is an overarching storyline of human existence in Omega Centauris, with a very readable backstory – the 10 pages of Campaign history are perfect for bringing the galaxy to light, and pretty great prose in their own right.
What I love is how they aren’t prescriptive at all – you could literally set anything in this game: multi-ship, high-tech space battles; highly social political wrestling, emotions on tenderhooks; even a fantasy style rags-to-riches story on one of the less developed worlds.
There’s a detailed explanation of tens of planets, providing you with plenty of room to set your story literally anywhere you fancy, and loads of features in the rules that allow your characters to be shaped by their environment. For example:
The Lord here runs a semi-feudal style of government. There are strictly defined lines of communication and citizens are expected to show loyalty to their immediate overlords and through them up to the Lord. Technically anyone can be called upon to do any service, although this is used sparingly except in times of emergency.
Alongside these patches of flavour text are nearly 100 “adventure seeds” – ideas to help you kick start a new plot twist or campaign. Here’s a sample from Erith:
The annual pageant of flowers takes place – street parties and dancing and fun. But which is, unbenownst to non-residents, actually a form of wedding ceremony for those who get involved…
Overall, the flavour I get from Starguild is a universe I’m keen to visit. I think there’s plenty of hand-holding, if you want it – just use one of the detailed, multi-scene sample adventure to get you started. Yet, for those of us keen to run before we can walk, there’s enough ammunition to let you start imagining a story with a very helpful backdrop to orientate yourself.
How does it play…
Simple answer: no idea! I’ve not played it yet.
Starguild is based on the d20 Open Game license that Wizards of the Coast released back in 2000. So, if you’ve played Dungeons & Dragons, or many similar games, you’ll have at least a foothold into the basic structure of play.
What appeals to me is the adaptation of the engine to fit the theme. From the kickstarter page:
“The game treats social conflict – the ability to alter someones emotions and thinking – just as importantly as the more traditional kinds of conflict of fist and gun.”
This appeals to me. I’ve enjoyed listening to D&D podcasts, but I find the battles a bit unfulfilling.
- In a fight in D&D, two characters fight over about 50 turns, with magic spells, and special moves. They have a number of hit points, and slowly wear down the other player’s hitpoints until someone dies.
- In real life, when two people fight, they each have a knife, it lasts about 2 minutes, and someone gets rather injured.
I’m sure you could try to play Spaceguild the D&D way, but it seems much more focused on the social dramatics, and the intensity of choice in high pressure situations. That rather appeals. I know I’m roleplaying as a fictional personal, in a made-up situation, in a fake galaxy, in my imagination – but I want to feel like disturbing a guard and getting shot is as weighty as it would be in real life.
As a new player, the various sections on guilds, weapons, vehicles, etc… all seem well put together, but I don’t think I’ll have a real handle on it until I put a game together. I definitely feel these rules explain the system enough that I wouldn’t have any big problems running a game. There is also an excellent set of reference table appendices and a comprehensive index – too often lacking in rule books.
From giving it a read, and comments from others, it seems like the addition of “Conviction” is an interesting feature, where you gain conviction points for doing actions that fit with your character’s personality. For example:
“Vargon, (a noteably strong character) nonchalantly crushes cans in one hand, whilst waiting for the action to start”.
You keep tokens to represent your conviction in front of you as a visual reminder, and you can spend it to help you out, such as adding a D6 to the score of a D20 role. I feel like conviction could be gamed quite easily – “Vargon quickly crushes 4 cans, gaining 4 points” – but if you use it in the spirit of the game, it rewards you for roleplaying, and even the advantages it gives can be RPed to cohese the theme even better…
Vargon tries to kick the door down. The DC is 20, and he rolls 12. This, plus his physique (1) + his characteristic of being “burly” (+2) = 15. He spends a conviction point, bunching up his huge arms to increase his effort to the extreme, and rolls a D6, which gives him a +5, just making the DC… and the door tears off its hinges, leaving the gang free to run into the corridor.
Go on, support it.
All in all, I’m excited about Spaceguild, I’m keen to play it with some friends and I think it will look fantastic with more artwork, once the kickstarter is finished.
Speaking of that, why not support it now…
Board Games in February!
I love spending time with people, and I love being decimated by them in games of strategy, humour and imagination. Hence why I’m a proud member of…
Meeting on sporadic nights in and around Boston, we get to try out various exciting new games. All games are fully explained by
nerds experienced board gamers, and beginners are welcome.
Go on… join the group on Facebook!
We’ve play games like Settlers of Catan, Lords of War, 6nimmt!, Carcassone, Coup, 7 Wonders, Dead of Winter, Android: Netrunner, Between Two Cities, and Discworld: Ankh Morpork. In other words: no Monopoly, just fun new table based explosions of co-operation and competition.
After missing a month revising for my big scary GP exam final, I was keen to make up for it with an evening of calculated victory…
Pairs is a great little card game, perfect to pick up in about 2 minutes, and immediately leads to countless moments of groaning, and fraught decisions.
It has a simple premise: avoid getting a pair. The deck is made of numbered cards – there is one card labelled 1, two cards labelled 2, three labelled 3… all the way up to ten cards labelled 10.
You are both dealt one card to start, and then take it in turns next, either deciding to take another card, or wimping out and folding. If you draw a pair, the number of that pair is added to your score. If you fold, your lowest number card is added to your score. First person to a certain number, depending on player numbers, loses.
As an example, let’s watch some Hobbits playing…
Bilbo gets a 3 to start. He takes another card, he now has 3 and 8.
Frodo gets a 10 to start. He takes another card, he now has 6 and 10.
Bilbo feels fairly confident – another 3 isn’t likely to come up, although 8 is fairly common. He takes another card, he now has 3, 7 and 8.
Frodo is a little more concerned, as 6 is moderately common, and 10 is very much so. However, folding would give him a score of 6, so he takes another card. He now has 6, 9 and 10.
Bilbo takes another card, after deliberating whether or not to fold and keep the 3 for his score. He now has 3, 7, 7 and 8. He got a pair of 7s, so the round is over, and his score is now 7.
Frodo is relieved, since he would have probably chosen to fold next turn. As he didn’t fold, his score remains 0, and he is in the lead. The next round begins…
Nick and myself played a few rounds of Pairs whilst we waited for the more temporally retarded members of the group. It became immediately clear that Nick secretly moonlights as a Vegas card shark, since he started counting cards on our very first run through. However, there’s enough luck that you can never be sure of any decision, and it certainly passed 20 minutes quite happily…
Fleet Wharfside is a game of trading seafood, and gaining victory points. Sounds dull, right?
You are a fish trader with two options: visit the wharf (docks) and pick up some fish/crustacean cards, or visit the market and pick up contracts to sell the fish.
Three nice mechanics:
- You buy new contracts with fish. The cost of those contracts steadily increases, and you can trade down nice fish for cheaper fish, but not the other way.
- Many of the contracts have bonuses, such as letting you pick up extra fish each turn. This is great, but has the effect that you also don’t want to finish the contract, because then the bonus ends. This is a problem because…
- …there are victory point awards for being the first to finish each size of contract. The quicker you finish, more points you get. You can also win points for having the most King Crabs (think longest road award in Settlers of Catan).
There are no negative scores for unfinished contracts or fish in your hand – its a simple thing, but it definitely takes the pressure off a bit.
A recent Kickstarter purchase by Craig, it was a nice moderate intensity game to kick off the evening. They played it last week, and felt the King Crabs didn’t add much. However, my royal shellfish earned me around 10 points on their own. When the final scores were tallied up, I won with 55 points, closely followed by Craig at 50, then Nick and Simon trailing somewhat behind. KC For The Win! (tshirts pending…)
Not a game I’ll rush out to buy, and a little light on player interaction, but I’d be happy to play it a few more times, for sure.
Playing Coup last month was a moment where I finally got my hands on a game I’ve heard loads about but never played. That crown has been thoroughly stolen with the legendary “King of Eurogames“: Agricola.
There’s too much detail to cover here, but I’m going to try to do it in 10 steps:
- You are all farmers. Presumably in Europe. Somewhere
- You have to develop your farms. To do this, you can plough fields, build up your house, or fence pastures.
- Each thing you build can make more stuff. Fields = crops, house = family members, pastures = animals.
- You only get to do one action per turn, per family member. So, for most of the game, that’s two actions per turn.
- Everyone else is fighting you for the same actions. By the time 4 people have taken half their actions, everything really good on the board will be taken, and you’ll have to wait until the next round.
- When harvest comes, you have to feed your family. Food is a challenge, and the more family members you have, the worse that challenge is. Fail to feed your family and suffer a heavy penalty…
- As the game progresses, more action cards will be revealed. This allows you to do more exciting actions. Unfortunately, harvest gets more frequent too, so you are constantly trying to rustle up enough food.
- Each player has a stack of possible occupations and minor improvements. You can activate these, sometimes for a cost, for specific advantages – say you collect more stone, or you get some fences later in the game.
- There is a central pool of major improvements anyone can build. They give you bonus victory points, and allow some more powerful specific actions.
- Its simple enough to grasp quickly, and complex enough to be really masterful. None of your plans will quite work, and you will have a half empty farm with no crops, hardly any sheep, and then run out of food and get punished with a begging card. It’s perfectly possible to end a game in negative points.
I can see why gamers love this game. Chance plays just enough of a part to keep things fresh, but not enough to hold back great strategy. Interaction isn’t very direct, but when you only have two actions, and the player to your right takes ALL THE WOOD JUST BEFORE YOU WERE ABOUT TO… its fair to say there is a reasonable amount of competition present throughout gameplay.
Who won our game? Obviously Craig did. Craig with his vegetables, and 6 stone houses, and his pigs and his cow and his army of little Craigs somehow feeding themselves despite the sheer impossibility of that task.
I really enjoyed Agricola. I spent quite a lot of today thinking about how I’d play differently, if it would be possible just to focus on one task, on having thousands of fences, and hundreds of sheep, or having a huge field brimming over with corn.
So, in conclusion: Craig got more points than everyone else added together, but it probably doesn’t count because he smells faintly of cabbages. Agricola is awesome. Spending time with friends and playing board games is, as ever, brilliant. And that, at nearly midnight, was that.
What next? How we save the NHS.
The Government, and Jeremy Hunt, have said they will impose the new Junior Doctor contract.
In so doing, they continue to demonstrate their disappointing lack of respect for the commitment and intelligence of the 53,000 junior doctors who work for the NHS, not to mention the 377,000 nurses, 97,000 senior doctors and 74% of of the general public who seem to understand that if we lose significant numbers of juniors, the whole system will collapse…
So, what’s next? We could get all angry; but we have a responsibility as doctors. We have a duty to remain professional, to protect patients, and to save the NHS. We want to prevent damaging, poorly thought out reforms, whilst holding strong to the cornerstone of modern medicine: evidence based practice with patient care as a priority.
Action One: Give them some evidence.
There are three simple things we can do to make the Government see the scale of the problem. None of these will cause you trouble with your training, and most importantly, none of them will impact on patient care.
Firstly, go online and apply for a GMC Certificate of Good Standing. This is the form you need for working in another country. It’s simple and free to do, just visit GMC online.
Even if you are not currently planning to leave the country, it gives you faster options if the situation worsens, doesn’t commit you to any action, and demonstrates a potential intent to leave. 200 JDs getting a certificate each week makes headlines (see right). Imagine the news that 98% of junior doctors are considering on leave the country?
Next, my dear colleagues, its time to actually fill in those breach forms. I’m not talking about one annoying F1 kicking up a stink. I’m talking about the 10,000 unpaid hours we logged in 5 days in October. Of course we can’t work to rule – we all feel pressured into working extra hours by our caring attitudes and the low staffing levels: leaving work on time would put patient safety at risk.
However, a BMA coordinated hospital-by-hospital submission of breach forms daily from every ward gives clear evidence of how hard we already work. Put patients first and work late unpaid – most of us regularly do – but let’s let everyone know about it!
Warn them you are thinking about quitting. We need a BMA sanctioned letter for us each to send to our training deaneries, line managers and rota co-ordinators, along the lines of “I am writing to warn you that I am incredibly concerned about the actions of the Government in imposing a new junior doctor contract. We are concerned that the new contract is not evidence based, and comprises a significant risk to the stability of the NHS. In solidarity with many of my colleagues, I wanted to give you the courtesy of telling you that we are considering our options, resignation from our posts being a distinct possibility. We do not feel it would be professional for us to accept a contract that may do so much harm to patient safety and staff morale“.
This gives the Government, and just as importantly, the newspapers, lots of clear evidence that many doctors are talking seriously about leaving, and how much time we are already giving out as goodwill.
They will be more effective if well organised: delivered piecemeal they would lack the impact of an orchestrated BMA campaign. I really call on the BMA to use its management skills to deliver a focused, media savvy approach.
Action Two: Strikes
The problem with strikes is they provide a risk for patient safety. So does the new contract, but I know that many of us feel uncomfortable with the fact that withdrawal of emergency care is likely to increase that risk significantly.
How about we take the moral upper ground and plant a massive “Doctors care about the NHS more than we care about money” flag in it?!
My proposal? We start one week, full strike for all of us – no money – but we still provide emergency care – for free!
That’s right. We say “We can’t afford to let the NHS die, but the NHS can’t run without us”. We have a picket line for awareness – but with just 6 people on it at any time. Everyone else goes to work in A&E. No routine work, but emergency care is filled with professionals in tshirts saying “I’m not getting paid today, I’m working for free because I want to save the NHS”.
And we co-ordinate this with the senior doctors and nurses and other unions. Because if we let them gut the junior doctor contracts, they will go after the consultants next, the nurses next. The BMA needs to talk to the other unions, promise that if they stand with us, we will stand with them if the Government tries any similar nonsense with them.
Let’s get the hospitals filled with unpaid volunteers who love the NHS. With junior doctors, and nurses and consultants and porters, all volunteering, all saying “This is not about money, its about saving the NHS“.
Action Three. “The Nuclear Option”
And after one week of this emergency care only strike action, if still the Government persists, the BMA co-ordinates a mass resignation from all junior doctors. We sign the forms, give them to our BMA rep, and they deliver 500 at once to every trust in the country at 9am on the same day.
It’s actually fairly low risk for us.
Firstly: the Government can’t let it get that far. Even our enormously foolish health secretary knows that.
Secondly, if they do, your trust will immediately need to hire a locum to fill your job. So, you’ll likely get paid more for a few weeks, and once the dust settles, they’ll have to let everyone back onto their training schemes. It may even be possible to negotiate immediate new locum contracts for all resigning doctors, given that trusts will appreciate that they have no other option…
Demonstrating our joint commitment
So, there you go, a three step plan to saving the NHS.
I desperately feel we need this level of clear, co-ordinated campaign from the BMA. It demonstrates to the Government that we are serious, that we know how to plan and organise, and that we are willing to push very hard in the interests of patients, staff morale and a national health service that still has a heart beat.
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