Sep 14

 After having a better day yesterday, I also thought my gout might be coming down a bit. Not so. Today was much worse and the gout flared hard. Slightly different place. Slightly different pain. But excruciating at times.

Apparently, this isn't normal if it's being "treated".

The docs got back to me.

They will get a pharmacist to talk to me on the 27th.

So just about two weeks out.

No rush eh. Which I believe is the NHS motto. No Rush. Have You Tried Fucking Off And Dying ?

In political news new PM Starmer reckons he is going to have a general plan for everything by Christmas. One might answer why this takes so long when they had plenty of time as a shadow government to come up with a plan ready to go ? I think honestly Labour didn't have a plan. They kept their mouths shut, their manifesto bare, and just let the Conservatives implode, figuring I guess, that anything Labour would say ran the risk of sticking their foot in their own mouth. Better then to shut up and have no plan.

The downside of course is that it will take them six months to come up with a plan. Not the end of the world I suppose, but still. Not great.

Part of that plan involves the NHS. Labour have come out and said flat that the NHS is not underfunded. Period. Backed up by various people inside and outside of the NHS. And that throwing more money at it is not likely to do much. It needs reform.

Just what that reform is remains to be seen.

So far I agree with everything that's being said. Including when Starmer says the NHS is broken.

Yes.

Money won't solve it.

Within reason, yep.

Reform required.

Absolutely.

The sticky bit is what that looks like. And whether you trust the experise of the reformers to know and come up with a decent new model, and then, also have the capability to implement it.

That bit I have way less faith about. I hope. The best people are put on it, and it's pulled off. But the government - any government - don't have a great track record for this. And then there's the fact that even if they pull that bit off on their side, the NHS is incredibly resistant to change, and arguably the absolute worst case example of a business ( we'll call it that for sake of biz process re-engineering, which is what you need to do ) that needs reform. There are a lot of people related problems you run into when trying to change a business from the Old Thing That No Longer Works to the New Thing That Will be Better. People don't like change. The bigger the organisation, the more cooks you get spoiling the broth. Projects can and do collapse in the face of impossible environments. And the NHS as an org has the oldest processes that have largely not been changed since it was initially setup in the 1950's AND the number of employees it has dwarfs most other organisations. Those two things put the NHS into the worst organisation to attempt a reform with. Just IT alone, its track record of pulling off NHS wide projects sucessfully is basically zero. All of them have failed. Because of crappy IT provisioners ? It has been attempted by some of the biggest in the world, with good reputations, and all have had their asses kicked. The problem is not the IT. The problem is you have an enormous organisation that is loathe to change, resists strongly, and with highly opinionated workers that all want their bit prioritised.

It's going to take the equivalent of Genghis Khan to shove through an NHS reform that actually does what it needs to do. There will be many tears and tantrums. Epic level tears and tantrums. It will need absolute ruthlessness and without doubt people will need to be fired to compel them to get the fuck out of the way. It sounds extreme. But trust me. This is how it goes, the bigger the org, the more disruption and pushback you get.

I do not envy whoever has that project to complete. It will be a miracle if they pull it off.

So.

Today I have been in a lot of pain. I have taken to bed for basically the whole day. And felt very sorry for myself. My mental health has also tanked. Sketchy. Wobbly. Beginning to scratch the walls of proper crazy. Really not good. Losing the plot. This evening I have pulled it together somewhat. A bit more me. A bit more sane. Not losing my mind. But very fragile. Anywhere but bed giving me a mild sense of anxiety. So fucked.

Plod on. Another day tomorrow.

If and when my foot gets somewhat better, I need to go swim. Albeit. I think it's just more bullshit coping mechanisms. The underlying fact is I am fucked. But anywho. Another day.