British Steel faces administration (and French emergency medical services)

(Paul Flinders) #1

When are the Brexiteers going to own up and take responsibility for the damage that they have done to the country and its economy - much of it already irreversible.

(Mat Davies) #2

It is all just Project Fear, but if it were to be true it wouldn’t be Brexit’s fault obviously!

(Paul Flinders) #3

I realise your reply is intentionally ironic but yeah, right, just like JLR’s, Honda’s and Nissan’s decisions were nothing to do with Brexit (hint, it was a big factor even there were other reasons).

(Graham Lees) #4

If the Brits continue to press the self destruct button (such as electing Farridge in the EU elections) they deserve everything that is coming to them.
Time and time again I hear from people who have managed to ‘escape’ the UK saying that they will never go back. The country is well and truly f*cked.
At a cardio clinic appointment today, I spoke to a fellow Brit who, some time ago, visited his MT complaining of indigestion. His MT packed him off to Urgence in Angoulême with a letter which was closely followed with a helicopter ride to Bordeaux. 3 days later he was out of Soin Intensif having had a triple bypass with a short period on the recovery ward and then off to 3 weeks ‘re-education’ at La Rochelle. He was saying that he had no idea of a heart problem beforehand but that he has friends in the UK who have been waiting over a year for such a medical procedure with no sign of any progress.
I just can’t believe what the Conservatives say any more about the NHS being the best in the world. They seem to be missing out that vital word - third as in third world…

(Peter Jackson) #5

I suspect that it’s nothing to do with Brexit but the plants inability to make steel at a competitive price, coupled with the pensions deficit that makes it un appealing to most companies to take it on. The proposed merger with Thyssenkrupp was blocked by the EU competition commission earlier in the month.

(Simon Armstrong) #6

Woops - look what they just bought…

(Graham Lees) #7

that’s not a simple as you make out…
From a report by Bloomberg:

“Tata Steel could find it difficult to divest Tata Steel Europe in the near term in view of the European Commission’s approach to same geography mergers of such a scale,”

(Peter Jackson) #8

I used to work for Reuters so feel this is more appropriate :slight_smile:

Thyssenkrupp abandoned its long-planned merger of its steel business with the European operations of Tata Steel, which would have created the region’s No.2 producer after ArcelorMittal, due to opposition from European Union regulators.

(Paul Flinders) #9

The ultimate truism of everything is “it’s more complicated than you think”, frequently even if you tak account of the fact that it’s more complicated than you think.

This, of course is the downfall of Brexit - the lure of apparently simple solutions to complex problems.

I suspect that the MT did an ECG which showed he was in the middle of a heart attack, if that were the case the treatment on the NHS would be pretty similar.

All of these things tend to be complex (see my point above) - in British Steel’s case the shrinkage of the domestic market and inability to compete with China on top of years of lack of infrastructure development almost certainly underlie its current situation.

But Brexit will have played a big part in finally putting the boot in.

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(Graham Lees) #10

Utter rubbish (sorry to disagree Paul)
Few, if any MTs would have access to an ECG (mine doesn’t). The ECG would have been done in Urgence.
My transfer to BDX was by road from the same hospital in the dead of night (no pun intended, thankfully!).
I’m just telling it as it was told to me (with no embellishments).
My own experience of health care here in France leads me to say that I have received exemplary care here in France at every stage of my various ailments and am 100% pleased with the service I have received.

(Jane Williamson) #11

The samewith Bombardier in Northern Ireland.
Whilst Brexit may not be the ultimate cause of its parent company closing down its operation there, it most certainly will affect the likelihood of the operation achieving a sale and the ultimate loss of jobs.

(Paul Flinders) #12

Well, I suspect I have the experience to read between the lines of this story :slight_smile:

I am quite certain that the story is true as told - although I suspect (because of the triple bypass part) that it was a few years ago.

In that case they would be less well equipped than many, even most, UK GP practices - this 2008 paper showed that some 85% of GP practices surveyed had access to a 12 lead ECG and 45% had a defibrillator - 10 years down the line and with complex electronics getting cheaper all the time and the introductions of automated defibrillators I would expect the number of practices with a 12 lead ECG machine to be higher and the number with a defibrillator to be 100%, or very nearly.

UK ambulances carry ECG’s and some have equipment to tramsmit the trace to the emergency department for instant confirmation of the diagnosis so that fibrinolytic (clot busting) drugs can be given.

Admittedly small practices, even single handed is much more common for GPs in France so perhaps it is less likely that they will have an ECG machine.

However ECG or not I am quite certain that the MT in this story made a diagnosis of a heart attack or myocardial infarction - or it will have been in amongst his(or her) thinking. In any event only some MI’s cause the classical ECG changes of “ST elevation” - these are called STEMI’s (ST Elevation MI) - there are also non-ST Elevation MI’s (or NSTEMI’s).

“Indigestion” is a pretty classic presenting symptom but it is usually possible to tell the difference by asking the patient questions about the nature of the discomfort, when it occurs, what brings it on, what mekes it better, how long it has been present today, severity - all the things medics learn to ask patients about pain. It might have been that the grey, ashen faced patient in fromt of him was all the MT needed to see.

But, I know with absolute certainty that the MT diagnosed an acute problem because

He sent the patient to the emergency department!

Most doctors will not do that unless they think the patient actually needs the emergency department.

Done afresh or repeated together with blood tests (the commonly used one these days is a Troponin).

Once diagnosed patients will then be offered treatment with “clot busting” drugs (STEMI, where it would take more than 2 hours to get to the catheter lab) or (preferably) taken to a cardiac catheter lab for cardiac angiography and stenting (insertion of metal tubes to widen the blood vessels and improve blood flow to the heart muscle itself).

All this has been standard practice for more than 10 years in the UK.

These days “PCI” in a catheter lab is the preferred approach. About, say, 15 years ago surgery and coronary artery bypass grafting was the thing and, to be fair not everyone got a CABG during acute treatment for MI, it depended on severity and response to medical treatment.

The big bottleneck for CABG’s is ITU time as all patients need a period of intensive care afterwards, after than it was numbers of surgeons.

But with the advent of PCI techniques which any suitably trained cardiologist could do the number of cath labs massively increased with access to stenting being much better - so no-one should really be waiting too long for a procedure these days.

The people you refer to waiting for bypass grafts would have had stable angina and therefore not too urgent.

One amusing thing about the advent of PCI was that we had trained a whole lot of cardiothoracic surgeons to increase the availability of bypass grafts - but when they actualy qualified everyone was doing PCI and there was hardly any demand for their skills - sad but it occasionally happens in medical manpower planning.

So, your friend was treated acutely because he had an acute myocardial infarction and would, broadly speaking have had the same treatment from the NHS.

The people who were waiting were in a different group where, to be honest, the NHS went through a phase of not having enough capacity - but one way or another this was fixed.

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(Nellie Moss ) #13

My colleague was at work a few months ago on nights ,middle of the night she got a phone call from her husband to say he had bad chest pain had tried fizzy pop and milk, it wasn’t responding and he was starting to feel really ill. Their son rang the ambulance (following a panicked phone call from his mum) then poor Mandy had to talk to Jamie who was walking around outside the house shouting he didn’t want to die while he waited for the ambulance. Fortunately they weren’t too long As soon as he was on the ecg it was ‘Right mate we are off to Blackpool ( 24 hour cardio thoracic)They blue lighted him to the Vic past the hospital were his wife was working and he was straight onto the table where he had two stents. Time from onset of chest pain to being back on the ward ? Three hours
I would be very concerned if a GP practice did not have access to an ecg machine

(stella wood) #14

IMO the MT knew something was wrong, that needed investigation sooner rather than later… hence the letter and instructions to go to A&E.

A letter, taken to A&E… is the best way of getting investigation done immediately. Sometimes this course of action is necessary to cut through waiting time (which does exist in France for all sorts of things).

If the MT really thought “heart attack” IMO he would have called the pompiers/ambulance… not let the patient take himself to hospital…:thinking: just saying…

(Paul Flinders) #15

Ah, I must admit I read “packed him off” as “in an ambulance”, not “under his own steam”.

Either way the point that I am making is not invalidated - Graham’s original post seemed to be saying that the same situation was handled with a long wait in the NHS but swift action in France. I am trying to point out that I don’t think it was the same situation and, had it been, the treatment in the UK would have been the same swift action that unrolled in the case of Graham’s acquaintance.

Any GP who “packs a patient off” to A&E will send an accompanying letter.

(Nellie Moss ) #16

Yes I assumed packed him off meant in an ambulance

(stella wood) #17

Not necessarily… been sent to A&E with a letter…once for myself… and another time accompanying a friend… both were important, but not life threatening…

(Nellie Moss ) #18

It happens frequently but in nursey mode I took it a chest pain patient would be sent in proper transport

(Geof Cox) #19

I’m in a good position to compare the French and UK health services, since I’ve been treated over the last 3 years for the same cancer my father suffered in the UK.
Soon after my treatment started I saw a UK news item on a new diagnostic technique, which couldn’t be rolled out because the UK didn’t have the equipment or trained staff. It was the diagnostic procedure I had just had here in France.
My subsequent experience was that apart from the staff - who were great, both here and in the UK - everything else was better in France: organisation (waiting), equipment, buildings, and especially all the other stuff that makes hospital bearable - single rooms, wifi, free parking, the food! The post-operation care at home was also exemplary here.
Personally, in the light of this experience, I wouldn’t move back to the UK (or indeed out of France) because of the health service alone.

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(stella wood) #20

Yes, it was not made clear… ambulance/pompier should have had him in-hand at the MT surgery… and then, whilst liaising with the hospital medics… he would have been transported directly to wherever most appropriate.

It sounded like he got to Angoulême only to be moved on… albeit by helicopter…

We’ve had the helicopter land on our football field, several times over the years… to transport an emergency…