About This Blog

Welcome to James' Philosophical Agora - James' Meeting Place On-Line. (Updated June 2017)

James' Philosophical Agora’ is an on-line archive for various pieces of personal writing on mostly fairly serious subjects; yet hopefully with a few amusing or curious items and anecdotes along the way as well. Many pieces were primarily written to share with individual friends, but are made available here for any others who might find the points discussed interesting or helpful, or who are 'treading the same path' and may wish to comment or add to them.

I have a separate blog where I share my enthusiasm for the specific philosophical tradition of Socrates, Plato and Aristotle at: Socrates 4 Today

As well as leaving comments on any of the blog posts, you can also contact me personally if you would like to discuss any particular items further: jamesdelphi2000@gmail.com

Sunday, June 11, 2017

Bed Blocking in NHS and time to broaden the brief of the NHS

Time to Rebrand the NHS for the next century

Bed blocking by elderly patients in National Health Service wards is just one illustration that it is now time to ditch the NHS in favour of the 'National Health and Well-Being Service'  (NHSWB ?)  This new service should incorporate elderly onward (transitional and on-going) elderly care within its planning and budgeting, and indeed look at the Health and Well Being of the nation as a whole. This new role for the re-branded NHS could truly support people from ‘cradle to the grave’ and could move away from being the place you go when you are sick; and leave either when you are better, or staff feel they can no longer improve your physical health with treatment.

Such a bold move as outlined above while sounding expensive and untenable might on investigation prove not to need as much extra funding as one might first expect. The rational for this is briefly outlined below.

A re-branded NHS that had responsibility to provide better social care for the elderly, would at the same time be able to free up many hospital beds that had been previously blocked by elderly patients following hospital clinical treatment – for minor as well as more major issues. In addition, a slightly different ethos to health by the government; that is, a greater emphasis on prevention and well-being after treatment to avoid re-admittance, would be preferable for many reasons than simply providing treatment after people get sick or have accidents.

The fact remains that for all users of the NHS both young and old, once someone has actually been admitted to hospital bed the treatment one receives in hospital ward is generally very good. The problem for most people is to get admitted in the first place and not turned away from A & E or have an unreasonable time to wait on the dreaded ‘waiting lists’ if referred by the GP. 

For example, after several visits to A & E with my elderly mother (requiring an ambulance to be called each time, and A & E staff time to be taken up) she was finally admitted to a hospital bed and received the treatment she needed. Another quick example worth mentioning is the elderly mother of a friend of mine who following her hospital treatment would need social care for when she left hospital.  An appointment with the social care staff was arranged three days after her clinical treatment finished. The social care member of staff went to the wrong hospital for the appointment and so another appointment was arranged a couple of days after that.  This meant that the elderly lady had taken up a hospital clinical bed for a minimum of five nights before even receiving any first consultation with social care staff about what would happen to her next when she left hospital.  This is not a big deal in itself were it an isolated example, but I suspect this kind of waste of valuable clinical bed nights in hospital wards is prevalent throughout the NHS, and possibly no real fault of their own making, since they are relying on the local government social services department in order to progress the matter and clear the bed for the next patient.

There is nothing particularly difficult about arranging onward social care for these elderly clients.  It is not rocket science, particularly for a service like the NHS that can arrange complex operations and aftercare for tens of thousands of clinical patients each month. Why then do they need to be slowed down by different social services departments across the country to free up the beds.

The only problem about the current NHS arranging social care for the elderly (and onward placements for clinical patients) is that it is not in the brief of the NHS, and not part of its planning and budgeting for the years ahead to provide this kind of provision and service.

There is no need to outsource this social care provision (particularly for patients who have finished their clinical treatments in hospital) to expensive private care providers, or large cumbersome often parallel government social services departments with their own cumbersome staffing arrangements, office administration's, and priorities on their budgets and resources.  For the NHS, surely being able to clear 5 - 10,000 (?) hospital beds each night across the country would be much higher up their priority list, since it would allow in a single stroke the NHS to meet many of its other targets and goals much more easily.  Whereas care for the elderly leaving hospital is much further down the list of priorities for social services departments with many other calls on their limited resources.

It seems to me therefore, that the NHS is ideally placed, ideally staffed at management and ‘hands on’ level, ideally resourced and already set up to easily factor in to its planning and budgeting this simple provision of onward social care for elderly clients who are blocking valuable clinical beds.

I strongly suspect that a similar situation prevails in residential mental health provision, especially for younger people where clinical beds on psychiatric wards are very scarce indeed. Are these valuable bed places also being blocked once clinical care has come to an end because the onward journey of the patient is delayed several days at least owing to social services departments acting slowly and without any sense of urgency or priority to quickly facilitate the appropriate aftercare for the mental health patient?

It is time to do away with the NHS as soon as possible and welcome the creation of the National Health and Well Being Service, which will have a broader range of responsibilities including onward social care for all patients leaving clinical hospitals. In addition, it should give a new and greater emphasis on prevention and wellbeing within the nation as a whole, rather than the 'let's wait until you get sick - and then fix you up' approach that we seem to be adopting at the moment. This latter approach that we are currently adopting may well come at greater (not less) expense, with greater disruption to lives, and greater other inconveniences to all concerned.

Thursday, May 25, 2017

01 Real Sustainability - Lions or Humans ? Snakes and Bees ?

Regarding the environment I want to start a new concept of 'real sustainability', within my broader idea of 'real philosophy'; where real philosophy includes intellectual but also practical actions by us all so that any intellectual investigations we may pursue have a definite purpose in the real world.
While walking on the hillside in Delphi I was reminded of the need for us 'to share the space' of our environment and its finite resources both with one another, and other species.  As I walk along the country paths I tap my walking stick regularly to warn any snakes and other animals to move away as I approach. This is a tiny example of what I mean by 'sharing' the natural space and resources as human beings and with other species. The snakes can, for example, go back to sunbathing on the path again after I have safely passed. However, someone has just put three illegal bee hives right next to the start of the public footpath. I hope that the bees feel the same way about 'sharing space!

It may be that some people or some species (e.g human beings as a whole) will always take a bigger share of resources than others. After all, the by lion eats first from the pride, eats the most, and takes the best pieces for its meal. If human beings are just very evolved animals (i.e. 'total' Darwinism) then we cannot be surprised that some people take more resources than others. BUT - you cannot have it both ways. You cannot expect better ways of sharing to be adopted by more mere evolved animals. You can only expect and hope for that 'if' you think there is a little more to what the human being is that what Darwinism and some scientists suggest with the process of natural selection and the survival of the fittest. This raises questions about what the human being really, whether we have a human soul, and at very least, whether we should expect a species of animal like us to adopt preferable ways of living as individuals and societies that somehow have shades of 'ethics' and a higher spirit within them.

Monday, March 20, 2017

How Did The Universe Begin - What Main Options Are There ?

Is the Big Bang (or Big Blob) Theory Still the Best Scientific Explanation ?
[These short paragraphs above I hope will be sign posts for young travellers, new philosophers, and older searchers to start an enjoyable and possibly on going investigation into what the universe really is; and what our place and purpose is within it.]

If we want to know what our place is in the universe and whether we have some purpose as well as place; then from time to time all new philosophers should spend a little time at least on a regular basis, considering how the universe came into existence and what our place is in it.
Quite often people start such a process of investigation by considering the very big and cosmological theories put forward by both science and established religious traditions. It seems to me that all these theories of which there are many can be grouped into just four or maybe five main categories or types. I would like to outline these categories very briefly to you now and would welcome your suggestions and comments, especially if you think I have overlooked any category that we should included.
1.  There is the possibility at least, that the universe is eternal and unchanging. What I mean by this is a that the universe had no beginning and will have no end. It always was and it always will be the same. Well I am going to rule this possibility out straight away in my own mind, because I know that stars come to an end and go supernova, scattering their dust across vast distances in the universe and that new generations of stars are created from this dust. I also know that the galaxies are moving outwards from us - or so they say; so perhaps I should be cautious about saying I 'know' this – when I have only 'heard' this. So even if the universe is eternal, and always was and always will be, it is certainly changing and evolving as time passes by.
2. Let us also say that one possibility is that the universe is eternal, but it is changing and always evolving. If this is the case, and I am certainly not suggesting that it is; then we need to ask ourselves a few further questions in order to clarify things; or perhaps give this suggestion a few sub-categories:
   a) Did this eternal yet evolving universe have a beginning, and will it have an end?
   b) Was there a beginning, but will there be no end?
   c) Was there no beginning and will there be no end?
   d) Was there no beginning, but will it have an end at some point?
3. My third main category is that the universe came into being at some point in the past. Again I would like to suggest two further questions for contemplation to clarify this:
   a) Was it made from something? (......but then what was it made from - just smaller bits of something, in which case where did the little bits come from? This then gets us no closer to understanding really where the universe came from. It just peels another layer off the question we are trying to answer; like peeling another layer off an onion
   b) Was it made from nothing? (.... but how can something be made from nothing at all – not even specs of dust? ) Is there really such a thing as 'nothing' in science?
4. From category 3 b above there seems to be the possibility at least that the universe was suddenly made from nothing in some kind of miraculous way. My two sub categories (or rather further questions to ask oneself) in this case are
  a) Was there was some divine or mystical intervention as suggested by various religious dogmas and spitual paths through the ages?
  b) Was there was some kind of scientific, albeit metaphysical and not understood yet, explanation that caused the universe to be created in the past, but created from nothing. Keep in mind - that there is a whole line of scientific inquiry exploring what 'nothing' actually is. (Apparently, according to many top scientists, nothingness is a very strange place and does not really exist, however well we create a vacuum. There will always be electrons appearing from nowhere and then disappearing again to goodness knows where. Books have been written by top scientists about what 'nothing' actually means.
  c) Thirdly, under this main heading of the universe being made from nothing; we could I suppose consider at least a combination of my two previous sub categories above that the universe was made from nothing by some divine or at least intelligent artificer or intelligent being - but of course still adhering to basic scientific principles whether we understand that these principles or not yet.
5. Finally, we must of course mention the prevailing main scientific theory at the moment being the 'big blob' theory - or sorry - I meant to say 'big bang' theory. Essentially, this theory suggests that there was a singularity (whatever that is - but I understand it is as a big blob of very dense stuff or matter) and that this blob suddenly exploded in some unexplained and miraculous way, and gave rise to the universe and everything within it. To make the mathematical equations fit, supporters of this theory need to assume that space and time did not exist before this miraculous explosion of 'the blob' occurred.
My only problem with this theory, is where did the big blob come from, and did this big blob not exist in time and space before it went 'bang' ? For me, if you are not explaining where the blob came from then once again you have not got to the heart of the onion; and are only taking off another layer. You are merely looping back into my earlier third category above - that the universe was made from something, in this case a big blob, and not a little bits of dust or rock or whatever. So for me the big blob or big bang theory does not really get the heart of the problem. What do you think?

The above is my first group of first considerations that I would encourage any new philosophers to contemplate as part of their inquiry into the creation of the universe. Certainly, my main list of categories above still omits some important issues that we need to consider.
These secondary but important considerations include:
  a) When we think of the creation of the universe we tend to think of it in purely material ways; e.g. when did the rocks, dust, planets, and stars come into being? However, there are things in the universe that have no material substance such as radio waves, sound waves, heat and other forms of energy etc. Some people would also include 'ideas' in these non material but very real items that do not have material substance. These non-material things are important and usually we have no hesitation in saying that they exist as well as rocks stones planets etc. So the question is did the material and immaterial universe come into existence at the same time. Another way of looking at this would be to clarify a little exactly what we mean and include in the term 'universe'
   b) Another extra complication with my above list of the possible explanations for the existence of the universe is, that like most people, I have looked upwards to the stars and cosmos when thinking about this, and seem to have only considered the very big and 'cosmological' ways that the universe may have been created. One cannot really get a real grasp on how the universe was created I fear without also having an understanding and looking at the very small and mysterious world of quantum physics and the very small particles that are the basis of every material thing around us. As philosophers investigating how the universe was created, does it have any purpose, and what the place of the human being is in that universe; we are obliged to also have some basic knowledge at least of what an electron really is; and importantly, what it really is not. We must have some understanding through investigation of he very small as well as the very big.