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Editor's Corner: A Letter from Across the Pond


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Prof Paul A. Corris
Senior Editor, ISHLT Links Newsletter
Freeman Hospital
Newcastle University & CT Centre
Newcastle Upon Tyne, UNITED KINGDOM
paul.corris@ncl.ac.uk




The UK braced itself this Christmas for wind and rain and with the inclement weather duly arriving, experienced floods and wind damage particularly in the south west. Perhaps the weather was reflecting a rather tumultuous year in many respects and you may recall my letter from June where I indicated that all was not necessarily well with Nye Bevan's baby, the newly reformed NHS. A potential winter crisis looms with many forecasting major delays in acute care for patients presenting to emergency departments and a general all-pervading view that there will be a significant tightening of belts in anticipation of further financial famine (alliteration at its best?) despite an apparent upturn in our economy in 2014. Health care reform is of course not only a matter of debate in the UK. The Patient Protection and Affordable Care Act nicknamed "Obamacare" has provided a plethora of tumultuous political debate, though in my humble opinion from this side of the pond it would appear to be based on sound principles. It would almost certainly have received approval from Benjamin Franklin, a man described as having the ability to "illuminate enlightenment without heat". Though such a plaudit lacks something in scientific rigour and as a result may have been disapproved of by Franklin himself, we all recognise its value and how Obama could do with this skill just now.

My last letter was written during an unprecedented summer of sporting success for Great Britain, but sport is a fickle beast that can turn heroes into zeroes in the twinkling of an instance or the turning of a ball. Yes it all went from feast to famine, and so quickly.

Murray's run of four grand slam finals ended in shock fashion when he lost a US Open quarter-final in straight sets to Swiss No 2 Stanislas Wawrinka. You could perhaps grant him that after the heights he had scaled at Wimbledon.

But what of the England cricket team? They were heading out to Australia, fit, healthy and supremely confident of becoming the first side to win four successive Ashes series since Victorian times.

For WG Grace, read Alastair Cook. History was about to be made. Even Greg Snell and Allan Glanville feared the worst.

Well we now stand on the threshold of a whitewash defeat being 4 games to nil down with one test to play. There is even talk of passports being removed from players and reentry to Great Britain refused as in days gone past when a one way ticket to Australia was the norm. Before I incite more comment may I add that is only for the current members of the England team not to have been born in South Africa, a subject for another dispatch?

The New Year beckons and one of the quaint British traditions relates to the fervent debate in some circles as to who in public life might gain an award in the New Year's Honours list. Point is that the widely held view that Murray A, Cook A and indeed Beckham D would receive Knighthood's in Her Majesty's New Year Honours list for outstanding service both within and outwith sport now seems dead and buried. Poor Dave Cameron, our headmaster whose confident assertion over the summer that young Murray deserved the School's highest accolade now must recognise the perils of such off the cuff remarks particularly when the staff room, where such matters are decided upon, remains divided on so many issues. David also feels the hot breath of fellow Etonian and Oxford graduate Boris "the Mayor" Johnson on his neck exuding apparent hunger and desire for his role. Boris for Prime Minister makes for ugly reading and contemplation though it would at least open the doors for Eddie Izzard who has expressed his wish to become Mayor of London and who might just rival Dick Whittington's popularity and legacy in the role.

Sadly I digress but to realign the concept of an honours system that in part is used as a political pawn (or should I say prawn) to curry favour to gain popular vote and reward political support seriously flaws its purpose. The stuffed shirt view from the Cabinet Office that such honours should reward both the common and uncommon man or woman for sustained services above and beyond rather than a popular short lived triumph seems sensible. We await the publication of the list though will not be lying awake pondering the matter.

What then to conclude these views and musings from a small island, with due reference to Bill Bryson, the ex-Chancellor of Durham University, author and supporter of the Cystic Fibrosis Trust. If 2013 was characterized by tumult then will 2014 offer any more stability? Unlikely seems the answer. With a world cup in Rio (soccer for North American readers) sporting fans have much to savour and debate. Perhaps the haunting image of England losing in the semi-finals in a penalty shootout offers the best potential for a predictable sporting result, though a major reversal of fortunes can and does occur. Remember the phoenix rising from the Ashes as discussed earlier? What of the Patient Protection and Affordable Care Act? Obamacare attracted over one million registrants in December 2013 and its on line registration glitches seem to have been solved. A near-term test for the programme will come on the first day of 2014, when those who signed up before last week's deadline begin to draw medical benefits under the reforms. Critics will be watching to see how the system works for Obamacare users who require medical attention in the early days of January. Problems are likely to be seized upon by Republicans and others on the right, while a smooth roll out of this next phase of the President's reforms would help the Democrats make their case to the electorate during the mid-term elections next year.

As Mark Bertolini, the chief executive of giant insurance provider Aetna said earlier this month: "The big moment of truth is 12:01 AM on January 1, when a mother is standing in a pharmacy, with the baby in her arms, trying to get her script filled."

Indeed.

Disclosure Statement: The author has no conflicts of interest to report.




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