There is a point beyond the point of no return: it's the point at which even those with deep vested interests in refusing to admit one is indeed beyond said point of no return can no longer ignore the obvious.
It was reached by Prime Minister Boris Johnson this week, when he was roundly booed by onlooking crowds as he went in to the celebration service for Her Majesty The Queen's Platinum Jubilee at St Paul's Cathedral.
A quick statement of the blindingly obvious: the kind of people who go to see these kinds of Royal events are rarely from left-wing political fringes.
When, as a nominally Conservative Prime Minister, you've lost this crowd (as Mr Johnson evidently has), then you're done. The political undertakers are measuring you up, and people are working out how much swatches of your very expensive designer wallpaper will fetch second-hand.
The PM had further Royal shade thrown on him at the event by Buckingham Palace's choice of Biblical text for his reading: a passage from Philippians 2. "Do nothing from selfish ambition or conceit, but in humility regard others as better than yourselves. Let each of you look not to your own interests, but to the interests of others".
Ouch, Your Royal Highness. Ouch. Our monarch may grind slow, but she grinds small.
Committee On Standards in Public Life chair Jonathan Evans joined in the fun, telling BBC Radio 4's Today programme that questions must been raised over whether proper standards are being upheld in government.
And the die-hard leftie radicals of Mumsnet prompted the PM to have to deny being an "habitual liar" during an interview this week. Yes, of course that 's a perfectly normal thing for the political head of the country to need to do.
Health Week (again)
But good news was on hand, as Tim Shipman of The Sunday Times revealed that we are once again going to be treated to another Government 'Health Week', to distract from the political omnishambles.
Again? So soon? We must have been very good children. As 'Cut' readers will recall, the Government's last Health Week in December 2021 was an enormous success.
Sadly, bad news followed close behind, as the same paper's rather more reliable Shaun Lintern revealed that the Government's fictional 'forty new hospitals' project (on about whose non-existent nature I have been banging for some years now) is not proceeding as planned.
This is not new news: Health Service Journal has been covering the non-progress of these. But it is now mainstream national news, and that matters.
I've tracked the gradual emergence of overt and righteous scepticism in the national media about the Fictional Fab Forty/Forty-Eight in this column and elsewhere for some time now. I may even have bored some readers by so doing. So it goes: unfortunately, you have to make the same point a lot of times before people actually notice it.
Pay and conditions
This excellent piece by Ben Zaranko of the Institute for Fiscal Studies brings the issue of public sector pay back to our attention. The COLIC of the UK economy (cost of living inflation crisis) is biting us all, and a workforce in health and social care that has just been through the strains of the pandemic is likely to be unimpressed by any proposals for pay restraint - which is what our dear chums the Treasury Munchkins will certainly make.
Conditions for those working in the service are tough, as highlighted by this thread from an experienced out-of-hours doctor. And Gareth Iacobucci of the BMJ has carried out this excellent investigation into the increase in violent attacks against NHS staff in general practice.
The Royal College of Emergency Medicine's new ‘Beds in the NHS’ report shows that 13,000 staffed beds are needed in the NHS to drive meaningful change and improvement, such as to constitute a significant improvement in A&E waiting times, ambulance response times, ambulance handover delays, and a return to safe bed occupancy levels.
The RCEM report details that since 2010/2011, the NHS has lost almost 25,000 beds. Since that time, the service and its staff have faced accumulating pressures resulting in a sharp increase in long-waiting times; ambulance handover delays; delayed ambulance response times; cancelled elective care operations; and unsafe bed occupancy levels
No doubt Health But Social Care Secretary Sajid 'The Saj' Javid will be asked about his workforce plans at his Health Select Committee appearance on Tuesday afternoon, following NHS England's Pope Amanda Pritchard. There is no quick fix available on workforce, as Professor David Oliver's latest BMJ column reminds us.
WHO's right about Covid deaths?
I reported the WHO findings about Covid19 excess deaths a couple of weeks ago, which gave the UK a better performance ranking than many expected. Much crowing followed on the WHO's estimated data, including from the PM and Alan.
So it was interesting to note that Nature features editor Richard Van Noorden picked up on the fact that scientists working on that WHO study acknowledged errors in their work, and revised excess death figures for Germany down by 37%, and those for Sweden up by 19%.
Cronyvirus and coronamillions update
David Conn of The Guardian reported that the House of Lords standards commissioner has launched an investigation into Conservative peer Lord Chadlington (Peter Selwyn Gummer) for potentially breaching financial conduct rules, relating to the award of £50 million of government contracts for supplying PPE during the pandemic.
Lord Chadlington recommended to the government S G Recruitment (a company that was part of a group in which he was a director and shareholder) to his fellow Tory peer, Lord Feldman, who was working for the Department of Health and Social Care as an unpaid adviser, the piece adds.
After Lord Feldman referred SG Recruitment to the “VIP lane” for politically connected companies, it was awarded two PPE contracts.
The Alan comeback
Our hero continues to let us down disgracefully, with only ther vaguest of self-promotion this week.
However, I hear that The People's Partridge's recent appearance at the 'How The Light Gets In' Hay Festival saw some robust audience feedback to his 'woe is me' schtick about the difficulty of his job as Health Secretary during the pandemic.
Perhaps history will repeat itself, and footage will follow?
Recommended and required reading
Stop whatever you're doing now, and go and read this notes/blog hybrid from Sheffield Director of Public Health Greg Fell about what should be the public health approach in the forthcoming Health Disparities White Paper. Health has felt like a wasteland of ideas for some time now: this is full of good ones.
Equally a must-read is this data analysis piece by the FT's John Burn-Murdoch on the problems ailing the UK's healthcare system.
The Nuffield Trust's latest piece on the use of financial incentives to recruit and retain staff concludes that evidence on their cost-effectiveness is lacking.
Strong Guardian report of a conference presentation into the extremely dangerous situation as regards sleep-deprived, night-shift-working hospital staff being as risky to themselves and others as drink-drivers.
Punchy BMJ editorial says that the General Medical Council has lost the respoect of the profession.
The Financial Times reports that Francis Maude is to review the functioning leadership of the civil service. Yet again.
Actuary John Roberts returns to the fray with this unpdate on the hasn't-completely-disappeared-in-reality Covid19
An interesting warning from researchers on the quality of clinical trials