Foreign Perspectives

Archive for the ‘Society’ Category

A long time ago my very first job was working on medical information systems and it’s interesting to see how far along such systems have moved since that time.

The world of electronic health records software these days is all about managing patient care effectively. No more mistakes through unreadable handwriting, fewer problems through prescribing medications that interfere with existing drugs that the patient may be taking and generally more efficient management of the practice. In general terms, a massive improvement in the quality of service that you offer your patients.

Having said that, it is scary to move from paper based systems onto entirely online ones and for that you need consultancy support during the period of changeover. You’ll never regret the move though!

Geography has contributed to that sense of difference as, whilst it’s a very interesting place to go in it’s own right, it’s a unique place and not in a region that’s particularly touristy. Consequently, you’ll find that the the New Orleans tourist people are able to concentrate on the city and it’s immediate surroundings rather than the nebulous type of tourist promotion that you get in areas such as Florida.

That’s no bad thing on the whole as it’s very much a spot that deserves to be seen but it does have the downside that you need to consider booking accommodation quite a bit in advance. For example, one of the very best times of year to visit is during the annual Mardi Gras which has parades running from January 25th to February 5th but you would need to book your hotel rooms quite a bit in advance to reserve your spot (actually, now is a good time to book for next year).

The colourful nature of Mardi Gras is quite typical of the city. After all, where else do you get funerals accompanied by lively jazz music? That’s a development of the African American roots of the city but there’s an equally strong French presence felt throughout the city and it’s the mixing of such different cultures that provides the rich tapestry that is New Orleans.

Given the concentrated nature of the attractions, the hotels are pretty thick on the ground here. The varied cultures around the city is, for once, reflected in the wide range of hotel styles that you’ll come across, even within the same hotel chain. For example, you can have typically southern Style (with a capital “S”), French quarter or super-modern (with a French twist too) and that’s just a few of the hotels on offer from Marriott.

Perhaps the biggest downside of New Orleans is that the rich history of the city provides just too much too see. It would be easy to spend a couple of weeks here and barely touch the surface.

Photo courtesy of New Orleans Tourism

Despite a very misleading campaign led by Alex, he still lost which just goes to show that there are quite a number of people who mainly feel British rather than Scottish. What would have been interesting is to have been able to analyse the breakdown of voting by age as, going by the media reports, it would appear that there was a much higher “yes” vote from the younger voters which, of course, is why Alex wanted the voting age reduced to 16.

Although the “no” vote won, what’s clear is that there are an awful lot of people in Scotland who think of themselves as more Scottish than British and their needs will have to be addressed in the years to come. The various parties have made committments to do just that by devolving a lot more power to the Scottish government in the fairly near future. What’s becoming apparent is that the Welsh and Northern Ireland governments will want similar powers granted to them as well as indeed will areas within England. That’s going to make life in the UK a whole lot more complicated in the years to come if local changes are allowed in taxation and welfare provision.

Will it, for example, move to more of a federation of local governments than a union of kingdoms? If so, how local would those local governments need to be? London seems to be aiming towards it’s own governing structure but if that’s granted, what about the other major cities?

If nothing else, it’ll certainly be an interesting period with the multiple negotiations going on. Already the Northern Ireland and Welsh assemblies are holding discussions as to the way forward for them and perhaps other major regions will join in that discussion in due course.

Much as you might think that holidays have to be abroad, that just isn’t the case at all.

For every category of holiday that you get abroad, there’s somewhere that you can do the very same thing at home.

Disneyland? No, but there’s Alton Towers. Sea and sand? There’s hundreds of miles of it right around Great Britain! Cheap family holidays? Caravan Parks have long been a fixture in the UK holiday season. They provide all the facilities that you’ve probably experienced in leisure parks abroad.

What about those caravan parks though? Put the old style image of Butlins out of your head when you think about a modern caravan park. You’ll get all the facilities that you’d expect in a “normal” holiday resort from pools to modern spas along with a nightlife that would put many places to shame. As far as the “caravan” goes, think of it as a small house because it’s in a whole different league than any caravan you’ll have seen if you’ve not considered them for a few years or have only seen those being towed along the road.

And that’s just the resort. Many of them are located a short distance from major attractions offering you an additional range of activities.

Peter Robinson wrote an interesting summary of the situation with politics in Northern Ireland last week.

For those that don’t know, the government in Northern Ireland is a mandatory coalition that requires agreement on major issues. That agreement is proving to be impossible to get in the very central area of welfare reform which poses particular difficulties as Peter pointed out.

Welfare is a major proportion of the overall Stormont budget so any adjustments required to the welfare budget tend to involve large sums of money. Historically Northern Ireland has mirrored any changes in the welfare system on the mainland and the problem now is that they’re moving to universal credit and putting a cap on the benefits that a family can receive but Sein Fein don’t agree with that as they say that it imposes cuts on vulnerable sections of society. To an extent, they are correct if you take the assumption that people living on benefits are by definition vulnerable. However, to pay people what is in some cases considerably more than the same family could gain through working seems fundamentally wrong. Also worth noting is that average salaries in NI are lower than in the rest of the UK so it can pay people not to work.

In that the rest of the UK are cutting benefit payments, they are reducing the amount paid to NI by the amount that they estimate that welfare reform would save. As noted above, these are big numbers and without welfare reform these reductions are having knock-on effects in the public services provided by other areas of government in NI so, for instance, the reduction in payments to the Department of Regional Development means that they can’t afford to maintain all the street lights anymore.

However, a bigger problem is that the computer system which makes the payments is in England and supported by IT staff in England and both are in the process of being wound down as those benefits transfer to universal credit. In principle, the NI government could take over both but the money required to do that is quite staggering: Peter had been quoted £200-£300 million pounds per year to maintain them. They’re also quite old systems and he’s been quoted £1.6 billion to replace them. That’s a lot more than the NI based systems which preceeded them cost but going back to those systems isn’t a runner as the teams which supported them have long since dispersed. To give an idea of how different the scale is, the model of computer which ran all systems in the NI civil service just before they were moved to England was the same model as was used in England just to control the printers. Hence, natually, the IT teams were somewhat larger eg a typical benefit support team in NI was three people compared to 30 in England supporting their version of the system.

Finally, there’s the time issue. A decision to change to universal credit or to take over running the old systems needs to be made quite soon or those benefits affected will simply stop being paid and the deadline for that decision isn’t far off.

So what will they do? They can’t continue to not make a decision for sure but there doesn’t seem to be any clear way out of the impasse. Peter’s suggestion that they hand back welfare to Westminster is going to meet strong opposition from a range of parties. Westminster taking it back either voluntarily or compulsorily may not be easy to do either and also has a deadline as staff need trained and systems updated not to mention the reintegration of NI welfare.

What’s clear is that they need to make a decision and soon.