Toronto city council: put down the crack pipe

[Massive Quasars]

If you're (through your own laziness) not going to contribute to centralized government funding, why should you benefit from it?

This is a governmental problem out of your control, for the most part. It doesn't help the situation to fret over it and potentially affect the quality of service you provide your patients.

Why, for example, should a pensioner with a lifetime of national insurance contributions behind them have to suffer excruciating pain (which is easily surgically remediable) for 6 months while languishing on a waiting list because the hospital trust's had to use up money, staff and beds to treat junkies, drunks and end-stage smokers?

This must be frustrating, but in responding to the percieved problem are you doing more harm than good? I wrote above that this is largely out of your control, but you could contribute your small part (in various ways) to changing the laws, better reflecting just service in your view.

[Massive Quasars]

I treat them anyway and they get the same standard of care. Get off your brainiac moral high horse.

I probably sound like an ass from your end, but you may not notice how your underlying perceptions affect your standard of care (granted, if at all).

[[xeno]Julios]

the whole point of initiatives such as those under discussion in this thread is reduce the overall harm to society.


Supporting such an incentive means that your tax dollars have to go to work towards paying for those sterile crack pipes. Not sure what your point in this thread is (Geebs).

[Geebs]

This is a governmental problem out of your control, for the most part. It doesn't help the situation to fret over it and potentially affect the quality of service you provide your patients.

In england, the government are in the habit of making pronouncements about how they're making the health service better through reference to some completely meaningless and made-up measure of "quality", while blaming the staff for shortcomings. Failure to meet these targets means we get out funding cut; meeting them means we get our full funding and possibly the opportunity to get patronized by the government. This means that I'm on the cutting edge of the funding problem in the NHS every minute of every day. Damn right I fret.

I'll give you a nice circular example. The government has decided, entirely arbitrarily, that nobody can spend more than four hours in an A&E department without counting as a strike against the hospital - regardless of their reason for attending. So if you have a hangnail and turn up by ambulance at 4 in the morning, you have to be seen and discharged within 4 hours or the hospital's funding can potentially suffer - even if all of the casualty doctors are tied up with patients who are actually sick. Because it takes several days to get an appointment with a GP, and people know that if they go to casualty it will take at most 2-3 hours to get seen, they turn up in droves - including utter cunts who turn up at 6 in the morning with chronic problems "because I wanted to beat the queue". Since the 4 hour limit was imposed, we've seen attendances go up by about 20,000 patients per year. This means that my department has had to vastly increase staffing just to keep up (bear in mind we also have a very diverse immigrant population and hence language difficulties take up a great deal of the doctors' time).

Many of these patients have trivial or made up problems - coughs and colds, etc. Many of them are repeat attenders who turn up every day - drunks, druggies, loons (not mad per se, just crazy).

The practical upshot of this is that:

a) every single time I have my time wasted, the hospital risks having its funding cut.
b) care for those who need it most is far from optimal. Since anyone who turns up has the right to be seen, we have to wade though all the crap to get to the patients who are sick.

[Geebs]

Supporting such an incentive means that your tax dollars have to go to work towards paying for those sterile crack pipes. Not sure what your point in this thread is (Geebs).

Is there some huge problem with cold sores in the crack smoking commuity that needs to be addressed?

[Massive Quasars]

....

You probably cannot help but fret over the situation, as I could probably not help but cripple someone who has done me wrong in some very serious way, despite my better judgement.

I'm not sure if you're revealing your honest views or simply venting on a message board after a long day. As a doctor practicing in a hospital you may have some sway with officials and the media regarding the dire straits you're in. This is cold comfort perhaps, but as I see it you have 3 viable options. Continue working under ineffectual management and bear it, continue working while voicing your concerns publicly and loudly, or quit and find a better work environment. The very last option will hurt patient care in the short term, but as care gets worse people will likely respond affecting change in the government, the end result possibly being better care in the long term.

[losCHUNK]

legalise all drugs and the problem shall sort itself

[Geebs]

....

You probably cannot help but fret over the situation, as I could probably not help but cripple someone who has done me wrong in some very serious way, despite my better judgement.

I'm not sure if you're revealing your honest views or simply venting on a message board after a long day. As a doctor practicing in a hospital you may have some sway with officials and the media regarding the dire straits you're in. This is cold comfort perhaps, but as I see it you have 3 viable options. Continue working under ineffectual management and bear it, continue working while voicing your concerns publicly and loudly, or quit and find a better work environment.

I have one viable option. My point is really that, if you try to be completely objective and detached about this sort of thing, where the interests of one person are diametrically opposed to those of another person and you can't fulfil both, you're just wanking.

The very last option will hurt patient care in the short term, but as care gets worse people will likely respond affecting change in the government, the end result possibly being better care in the long term.

Yeah, right

legalise all drugs and the problem shall sort itself

Decriminalizing users would be worthwhile, but I think you may be underestimating how much worse the problem could get. If you were to legalize them past a certain age, in the same way as drugs and alcohol, and keep stiff penalties for adults supplying children, then maybe it'd work.

[Massive Quasars]

I have one viable option. [my emphasis] My point is really that, if you try to be completely objective and detached about this sort of thing, where the interests of one person are diametrically opposed to those of another person and you can't fulfil both, you're just wanking.

Which is?

Yeah, right

I qualified the statement with the word "possibly", perhaps you're overly cynical after working in the system for however long it's been. It could be a slow and painful process but reform of some sort may be expected to come out of it.

[Geebs]

Which is?

Put up with it. Quite apart from anything else, I have to make a living. I know that might seem a conflict of interest, but hey, I think I'm morally entitled to try to prevent myself from starving to death :icon25:

I qualified the statement with the word "possibly", perhaps you're overly cynical after working in the system for however long it's been. It could be a slow and painful process but reform of some sort may be expected to come out of it.

Reform is going in the direction of increasing "stealth" privatisation.

[Massive Quasars]

Put up with it. Quite apart from anything else, I have to make a living.

Fair enough, hopefully your health won't suffer in such a work environment.

Reform is going in the direction of increasing "stealth" privatisation.

The Canadian system may be headed that way as well, at least partially. Our public healthcare here is in at least as poor shape as in the UK, probably worse.

[4days]

Is there some huge problem with cold sores in the crack smoking commuity that needs to be addressed?

that's what i was wondering - is there a lurgey that you can catch from crack pipes, what do you need a sterile pipe for? maybe in toronto, they fill/light the pipe and then stab themselves in the eye with it or something.

anyway - doesn't seem like a bad idea. if it gives you a means of keeping tabs on users and stops them going into grocery stores to buy/steal stuff to light up with then fine.

they had a similar thing running in nottingham (uk city), was all good until it turned out the leader of the project was a crack dealer.

[Canidae]

Sadly, MQ has chosen the detached from reality position, attacking those on the frontline like Geebs who is telling him these sort of bullshit political solutions are not working, like this latest initiative adopted by Toronto City Council won't either.
I'm thinking you want to avoid the "kneejerk " reaction, that is agreement with me, in favour of the party line of hear no evil, speak no evil, puff, puff, pass.
Its too bad because I was hoping that you'd spend a little time and let me know the Vancouver perspective of radical programs such as these and how badly I've heard they are going in your neighborhood.
The Toronto Drug Strategy that was adopted by city council is nothing more than a make work program for special interest groups who don't give a shit about nor consulted the community and the victims of drug abuse.
Vancouver has shown how bad these misguided programs are with these so called needle exchange programs actually INCREASING the sharing of needles between HIV infected users and uninfected user thus spreading the deseases with the availability of injection needles and encouragement to use drugs.
Montreal has a program giving out needles and they have twice the rate of infection compared to those not in the program.
What is even worse is giving out needles has converted those who smoked or snorted drugs like coke into hardcore injectors making their lives even worse, which contrary to Jug's hopes for these programs so you can imagine what giving a crack pipe will do to those in Toronto.
Giving a needle or pipe is a symbol of encouragement to drug users that what they are doing is OK and is irresponsible whether your helping distribute, voting for fools in office supporting these programs , or supporting them with tax dollars.

Geebs is correct that these drug users are like misguided children who need some tough love for what they have taken in selfish pleasure in the high they get and then expect society to pay their rent, give them a job as they shove aside the elderly at the health trough.
I'm sorry MQ but this is not a "governmental problem" its a medical problem with political noses in the health trough interfering with the medical professionals ability deal with the issue which requires what Geebs is talking about ,triage, to solve.

Vancouver has the highest crime rate in the areas where government programs encourage drug use instead of prevention.
We don't need to turn Toronto into that.

[[xeno]Julios]

if what u say is true, canidae, then yea i think it's a bad idea. And I hope you realize that this whole tough love ideology is also a psychological theory, that may or may not explain people's behaviours.

[Tormentius]

Its too bad because I was hoping that you'd spend a little time and let me know the Vancouver perspective of radical programs such as these and how badly I've heard they are going in your neighborhood.

Here's a Vancouver opinion for you: the junkies are still cluttering the streets and the problem hasn't appeared to decrease in the slightest since the needle exchanges started up. We can wax philosophical all night on the issue but the point is that these people choose their lifestyle.

To make it even better, a couple years ago our *brilliant* city government decided to shut down the areas where the junkies congregated. The result is that they scattered like cockroaches to all ends of the city and a lot of good neighborhoods have since gone downhill. Prevention and rehabiliitation is what is needed IMO, not coddling.

[Massive Quasars]

if what u say is true, canidae, then yea i think it's a bad idea. And I hope you realize that this whole tough love ideology is also a psychological theory, that may or may not explain people's behaviours.

He throws up some potentially damaging stats, that if accurate, would hurt the case for such programs. I made the point of not explicitly voicing support for the programs themselves but the motivation behind them to explore all viable options.