Then I decided to use the MyEnergi eddi device to control the hot water tank.

PV feeding an immersion made financial sense when exports were "deemed" (e.g. 50% of generated under the old FIT arrangement), but now I think many people are on an smart export guarantee tariff, so every unit not exported means a reduction in income - it effect it costs about 15p/kWh to heat water that way (compared with maybe 6p ish to do it by gas (depending on boiler efficiency etc)). Environmentally it's swings and roundabouts of course, but quite likely your kWh might be better spend displacing a kWh of gas fired electricity generation (at perhaps 60% efficiency)  than gas fired local hot water generation (at perhaps 90% efficiency). Depends on your gas boiler of course - if yours still has a pilot light, I guess it's not in the efficient condensing category...

Another approach (which I've got) - is to have solar thermal panels in tandem with PVs (if you've got the roof space of course) - simple thermal panels get many more kW out of a sq m of roof than PVs, even if it's only "low grade" energy as warm water, it's perfectly useful for heating (even pre-heating) a stored hot water system. In my case it feeds a thermal store that provides space heating as well as domestic hot water - so the thermal panels make a contribution to the underfloor heating in winter too.

   - Andy.

Hello Chris:

There is no such place as paradise.

I will start putting up my hurricane window boards, in the next few weeks.

Peter Brooks

Palm Bay 

oddly I do live in the UK, and like it, but  I will say dentistry is very variable. Twice now, once in Essex and once in Hampshire, I have been told that my current NHS dentist is going private, and I should find another or re-join as a private patient.

In both cases the nearest NHS dentist with space being over 50 miles away, I have reluctantly gone private, and in the second case, when I had children,  there was an offer to keep the children as NHS while still at school, which really meant until 16 ,then the same applied.

There is no obligation, other than reputation, to retain old patients, the decision is purely commercial - private patients clearly pay better. And indeed getting an appointment is now easy, they are seldom unable to fit you in,  just expensive, though I do wonder what is happening to the teeth of those less able to pay.

Being born in Yorkshire I grumble at paying 85 quid each for an inspection and prod about or whatever the next one will be, but having a decent job I can at least afford for all of us to be checked annually. Others I suspect wait for symptoms.

I have not yet reached a state of health where I actually need to know my GP, but I am not convinced that by I am there will be a great deal of support there either.

Considering the no of folk turned away each year applying to study medicine and dentistry, compared to say engineering, part of the answer to me is obvious - not it seems to the politicians.

Mike.

mapj1 said:

Considering the no of folk turned away each year applying to study medicine and dentistry, compared to say engineering, part of the answer to me is obvious - not it seems to the politicians.

More medical school places! Hang on, it is already happening (under the last government): https://www.gov.uk/government/news/350-extra-medical-school-places-allocated-in-nhs-training-boost.

One of the other problems is that being a full-time partner in (NHS) general practice is no longer attractive, so there may be more doctors who work a total of fewer hours.

so there may be more doctors who work a total of fewer hours.

Still not seeing the problem in training more folk. -a larger pool of qualified people doing a 4 day week able perhaps with the offer of overtime to come in if there is a crisis. I'm not suggesting lowering the intake standard, but not turning away folk who could.

Rather that 350 extra places it seems like not enough -  just adding a few hundred on what that article suggests is 7500 training places a year is an increase of about 5% - the sort of figure that gets lost in the tides between individual years in other subjects.

Looking at the same thing another way, what is a reasonable  MTTF of a UK GP ?

Apparently the UK has about 38 kGPs in the NHS at the moment and about half as much again working but not in the NHS. Then there are all the other sorts of doctor a medical student may become that are not GPs.

Assuming no career changes  then maybe very roughly one NHS and half a private kGP retires and must be replaced per year.

Retirement ages and lifesyles are changing that and that 1k5  figure is clearly an hopelessly low estimate  as this suggests a job continuity like no other field.  Folk take sabbaticals, move abroad, have families, get ill you name it  so that covers another factor of 2 or 3 probably, and ignoers all the other roles, then that 7k5 medical student figure is not looking overly generous.

I'm not sure that we should expect total career lock-in from a degree choice - no other subjects do - not all folk who do maths degrees in the UK  (comparably about 8000  of them each year apparently) go on to be professional mathematicians, or even maths teachers - you need to train quite a lot more than you need.

Mike.

As regards seeing a GP - After a certain age (maybe 45) everyone needs to see a GP or equivalent)- it is called preventative medicine- every six months. For men that includes a PSA test.

A large proportion of Primary care medical staff here in the US are nurses with advanced medical degrees in selected areas. I had my six monthly check up last week with my female Advanced Primary nurse. It has been shown from research that women are better than men as they listen to their patients with more "eye to eye" contact time.

I would't even attempt to explain the US Medical systems, as it is so different from yours.

Peter Brooks

Palm Bay 

Peter Brooks said:

As regards seeing a GP - After a certain age (maybe 45) everyone needs to see a GP or equivalent)- it is called preventative medicine- every six months. For men that includes a PSA test.

See an actual doctor?  Fat chance.

My old GP retired several years ago, so I was allocated a new one in the practice.  I have never seen him (or her - I don't know as I have never seen them).  I'm not convinced that there are actually any GPs any more in the particular surgery I go to.

It seems to be staffed by nurses who use instant messaging to chat to a remote GP somewhere.  For all practical purposes, the nurses are prescribing medicines now.  The GP is only there to approve it.

Hello Simon:

The advance medically trained nurses provide a regular nurse with an upward path for advancement from just doing bed pans!

If a medical problem comes up, one is booked into seeing an actual specialist doctor (example procedure for fixing ingrown toe nails).

Scripts for medicines are issued without a doctors approval BUT only after getting "buy in" from the patient.. 

Peter Brooks

Palm Bay 

Simon Barker said:

For all practical purposes, the nurses are prescribing medicines now.

Very highly (and appropriately) qualified Nurse Practitioners, though?

Chris Pearson said:

One of the other problems is that being a full-time partner in (NHS) general practice is no longer attractive, so there may be more doctors who work a total of fewer hours.

My former GP is a similar age to me, and retired about 5 years ago (under age of 50) to move on because of unnecessary issues and pressures in the profession at the current time. There are a multiplicity of issues for those in the profession.

gkenyon said:

Very highly (and appropriately) qualified Nurse Practitioners, though?

I'm sure they are.

gkenyon said:

Very highly (and appropriately) qualified Nurse Practitioners, though?

I'm sure they are.

We also have them trained for Cardiology.

Peter Brooks

Palm Bay