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Plague and pestilence: a medieval reality check


Blog headlines

  • Structuring a PCN Social Prescribing Service for the post COVID world
    25 February 2021

    This week we have a blog by Nick Sharples.

  • Community-Oriented Integrated Care
    18 February 2021

    The blog this week is a short extract from a paper considering an approach primary care networks could use to move towards community-oriented integrated care.

  • Strategy Unit releases opensource model for planning vaccine centre capacity
    11 February 2021

    This week's blog is from The Strategy Unit who are sharing an opensource model to help with vaccine centre capacity planning.

  • Time to talk day
    4 February 2021

    A small conversation about mental health has the power to make a big difference.

  • Supporting Staff: the emergence of ‘long-covid’
    28 January 2021

    As we are now well into a second, or is it now the third, wave of Covid-19 it is becoming apparent that Covid is something we have not experienced before and it has unique implications for staff management. It is not just the possibility that staff may become acutely ill with the virus, but that for some they may go on to develop persistent debilitating symptoms that will affect their ability to go back to work. This article looks at the implications of long-covid for HR and service managers when looking to support health care professionals (HCPs) return to work.

  • Link of the week: Clinically-Led workforce and Activity Redesign (CLEAR)
    21 January 2021

    This week we are sharing a link to the Clinically-Led workforce and Activity Redesign (CLEAR) site that is funded by Health Education England.

  • So much more than an extra pair of hands
    14 January 2021

    The introduction of the additional roles reimbursement scheme for primary care networks has started to grow capacity in general practice to address the unsustainably high workload that has put so much pressure on GPs.

  • Primary Care Networks – how did we get here?
    7 January 2021

    This week we are sharing a blog by PCC’s chairman David Colin-Thomé.

  • A year like no other
    17 December 2020

    On 5 July 1948 the NHS was born, over the last 72 years challenges and changes have been remarkable but the service has probably never been tested as much as in the last nine months. There have previously been numerous re-organisations, multiple changes to hospitals, mental health services and a shift from the family doctor towards more integrated primary care services delivered by a range of professionals. However, rapid transformation of services to embrace digital technologies, and a shift change to work differently has been forced upon all areas of the health service this year.

  • Guest blog: David Hotchin
    11 December 2020

    This week we have a guest blog that was submitted to us by David Hotchin, written by a retired friend....obviously, he's used a little poetic licence.

  • What now for commissioning?
    3 December 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What White people don’t see
    26 November 2020

    This year’s Black History Month (BHM) has, unfortunately, in its shadow another example of why campaigns like this exist.

  • Primary Care: Why don’t we talk about Racism?
    20 November 2020

    Rita Symons is an ex NHS leader who is now a leadership consultant, coach and facilitator. Her work is mainly in the NHS and she is an associate for PCC offering facilitation, coaching, strategy development and team development activities. She is a concerned but hopeful world citizen and combines work in the NHS with a board role in a non for profit organisation and an interest in writing.

  • Primary Care and the Health of the Public
    12 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What now for primary care
    4 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • Boosting your resilience
    30 October 2020

    The last year has been a difficult one, who would have imagined last Christmas that we would have been in lockdown, with the NHS seriously tested by a global pandemic. So much change has happened and the resilience of people working in and with health and care services has been seriously tested. Resilience is our ability to deal with, find strengths in and/or recover from difficult situations. Its sometimes referred to as “bounceabiliy” – but bouncing in what way?

  • Link of the week: National Cholesterol Month
    23 October 2020

    Every month or week of the year seems to be an awareness week, October has more than its fair share.

  • New redeployment service offers talent pool of motivated, work-ready individuals
    15 October 2020

    People 1st International have shared some of the work they are doing to support people displaced from industries due to the Covid-19 pandemic. There is an opportunity for health and care services to benefit from this workforce.

  • Link of the week
    9 October 2020

    Article published in the BMJ looking at the ability of the health service to quickly bounce back to pre-Covid levels of activity and considers if it is desirable.

  • Virtual Consultations– the patient perspective
    2 October 2020

    This week Jessie Cunnett, director of health and social care at Transverse has shared this article.

Thursday, 4 April 2013

Plague and pestilence: a medieval reality check

As 1 April 1349 dawned, darkness descended upon the land. Babies mewled in their cradles, dogs whimpered at the door, porridge burned on the stove, milk turned sour, horses took fright, church steeples collapsed, ponds and rivers froze and a bitter wind rattled the windows of hovels and ale houses.

Locusts laid waste the crops, rats devoured the grain, wolves destroyed flocks of sheep and wild bears roamed villages making off with children, the old and infirm. 

It was just as the Royal College of Witches had predicted: the health and social care reforms – the most sweeping and radical changes since Magna Carta - heralded the end of the world. 

For the ordinary hard-working serf family, the change may not have been obvious. 

Plague and pestilence had been cropping up on and off for as long as anyone could remember. 

It didn’t help that the latest wave of public concern coincided with a period of general economic hardship, which started when the barons lost all the tithes in a game of cards and told everyone else to tighten their belts to make up for it. 

Local services had started to fail in some areas. Anyone seeking an expert in potions, spells and the application of leeches might need to travel the distance of several villages to find a witch. 

Out-of-hours services were criticised for using poorly trained old hags in place of properly qualified crones. It didn’t take a genius to see that lack of groats was only partly to blame. 

The authorities had announced measures to deal with the problem, including new taxes on firewood, nursing mothers and those whose poor lifestyle choices resulted in avoidable cases of leprosy, typhoid or bubonic plague. 

Itinerant workers from neighboring villages were to be discouraged from upsetting the fragile local job market with a range of disincentives including moderate use of cudgels, spells in the stocks and packs of dogs. The dogs also proved useful in weeding out skivers, the inability to run fast enough signaling a general weakness of character.

Most radical of all, there had been an overhaul of the system for procuring medical services with witches at the heart of the new commissioning arrangements. The witches were to be accountable to the peasantry through so-called local healthmobs, which were empowered to deal with any shortcomings in services.  

Enlightened as they were, none of these measures addressed the underlying problem that peasants were living longer but not healthier lives. 

Their poor health made them useless for productive toil, while the cost of keeping them alive put an increasing burden on the rest of the village.  

Health bosses came to rely on rearranging the system for procuring witches’ services. This made very little difference to anyone in the long run, though it was upsetting for some of the witches at the time.

If the world feels different post 1 April 2013, remind yourself that the baby probably has nothing more serious than colic, that the dog never did like the postman, that the milk was past its sell-by date and that it’s been the coldest March for centuries.  

tonyjones says:
Apr 05, 2013 08:31 AM
There was also fear in the land. The Health Ombudsman promissed higher levels of complaints against health professionals would be addressed, a new regulator to the scene CQC promissed to close poor quality practices & one Mr Francis promissed a no harm culture in our hospitals with lots of whistleblowing & attachment of blame. The consequence of all these things was yet a further increase in fear which contributed to yet more risk averse behaviour throughout the land thuis filling the overcrowded hospitals & putting poor serfs at yet more risk.
b_devine61@hotmail.com says:
Apr 05, 2013 09:13 AM
Never a truer word spoken in jest.
The very heart of the system is being tinkered with, the jewel in the crown (note the olympic opening creemony what if they had used this as the script)is being sold off sliver by sliver.
 Private enterprise is good, when thought through, we now have GP's commissioning the entire service.

Rather like me being asked for my in flight meal choice and then being asked to fly the plane.
Great blog as always.
alisongs@btinternet.com says:
Apr 05, 2013 09:24 AM
For all you Discworld fans out there (yes, you - I know you're there): can we please borrow Grannies Weatherwax and Ogg for a bit? We need witches who are not afraid to bring their hearts and humanity to work as well as headology