Gavan McAlinden

@RobLaurensonD4P Check again. After seventeen years of examining, leaving home for countless weekends to spend examine surgeons in training, I can assure you that we sacrifice our own time, without pay. Travel expenses are reimbursed if supported by receipts.

Wow. The NHS pays for examiners for secondary care specialty postgraduate exams. But not for GPs. GP registrars fork out.

@rebecca_ryder21 @halseyhands1 Having done this recently in our theatre, took the clock down, took a battery out of a battery pack from a piece of disposable equipment (we save the battery packs for re-use), set the time and put back on the wall. No cost.

NHS hospital: I noticed the clock on the wall showed the wrong time. A nurse told me they knew, but they wouldn’t report it because replacing the battery through the NHS would cost £70. A £2 battery... £70. How? Why? That's when I began to dig further. 🧵

@MartinSLewis @KemiBadenoch I have always wondered why a “loan” was linked to the inflation rate and not the BoE lending rate… On an unrelated note, I wouldn’t want to be holding that loan book.

The problem with @KemiBadenoch proposal to cut Plan 2 loans interest rates is it is too late for most. While I've long campaigned against above inflation interest rates on student loans, so much interest has already been added to people's accounts that cutting it now, while psychologically appealing, won't reduce by a penny the amount lower and middle earning graduates repay. While it would be nice to do, assuming they're not planning to spend unlimited funds, or say reduce the actual debt owed, in my view a far better use of the same funds would be to massively increase the repayment threshold (the opposite of what @RachelReevesMP is doing with the disgraceful and damaging freezing of the threshold). Plan 2 loans were always set up so that most would not repay in full over the 30 years before it wipes. For them it works like a hefty 9% additional tax above the repayment threshold (though psychologically it's a nightmare for many to see the interest grow and grow even if they won't pay it). The only people who would financially benefit from lowering interest rates to inflation at this point, would be those who earn enough to clear what they owe in the 30 years before the debt wipes. Currently that's predicted to be only the highest earning (or lowest borrowing) 20% to 30% of graduates, but with lower interest maybe it'd be 30% or 40%. For the rest, the bulk of lower and middle earning graduates, lowering interest rates won't help. They'll still repay the same for the next 30 years. Yet if you used the same money to increase the threshold so repayments were say 9% of everything above £40,000 (and index link that) rather than the current £28,400. Graduates would have up to £1,000/yr more disposable income each year. Plus this way many of those who didn't get a graduate premium (ie financially benefitted from their degrees) wouldnt be paying.

@DrLKVaughan @drokane @ShaunLintern One has to remember that not all bone cement produces the same results. The prevalence of this product is also due to superior very long-term results.

@ShaunLintern This is an inevitable consequence of GIRFT. Which pushed HARD for reducing the number of suppliers on the grounds of cost. The risk inherent in that is supply chain.

🚨 BREAKING: Hip and knee ops across England will be rationed by the NHS as a major supplier of cement used in orthopaedic surgery has suffered an outage that could last months. To protect emergency trauma patients hospitals will be told to prioritise patients by NHSE today:

@rbarbosa91 Used a Gigi saw for many years for removal of components in Revision Knee Arthroplasty, though now use sharp AO osteotomes. First saw one used by my late father, a country vet, to assist in delivery of a dead calf.

🧵regarding the Gigli saw: A simple but effective tool for cutting bone. As usual, we'll go over its design, how to use it, and why such a basic device still exists in the surgical toolbox in 2026. We'll also cover its history and the tragic fate of Leonardo Gigli. (1/ )

@AutoInfatuation We put 105k miles on it. Really just routine maintenance. My sister still has one which is a 2009-10. Only downsides are a large turning circle and not a sports car, but you wouldn’t expect it to be.

@gmac012 Good feedback indeed. I’ve always found a reason not to buy a Volvo but think that needs to end.

You can only have one of the following SUV’s/4x4’s for Family stuff and general day to day duties. What are you having? 2007-2011 BMW X5 E70 30/35d (Ideally SE spec as pictured for me, Pan Roof, Comfort seats & HUD would be great) 2007-2010 Jeep Grand Cherokee Overland 3.0 CRD (Bi-Xenon’s & Sunroof are a must for me) 2005-2011 Mercedes-Benz ML W164 3.0/4.0 CDI or 5.0 V8 if you’re lucky. (Had two of these and really liked them, most are low-ish spec, high spec ones are harder to come by but worth it) 2009-2014 Volvo XC90 2.4 D5 5-Pot Auto. (SE Lux trim with the Dynaudio, Sunroof, Light Leather & Bi-Xenon’s for me spec wise)

GP independent contractors are best placed to run practices in NI if adequately resourced. Flexible, cost effective and never in deficit. The contract hand backs are a symptom of crisis. Treat the problem not the symptom GP investment is key. pulsetoday.co.uk/news/northern-…

Atmosphere electric as Bob Dylan launched into this.

@ojedathies Never looks that easy in real life.

It ain’t called HARDware removal ‘cause it’s easy!! (For those of us who treat fracture-related infection #FRI, this is a normal day in the office)

@LUDENClassics Bentayga?

Can you guess what car this is from AutoTrader's AI highlights....?

The govt should find 100 small things that piss people off & fix em, such as… Ta to @politico for the vid, at its Labour fringe event, I explained that as big changes take time, govts should also have a team focused on small winnable change. What little fixes'd you want?

@bolderston_mark 205 1.9 GTi. Never had one but drove one. Exhilarating! Friend had a 5GT Turbo. Preferred the 205 by a long way.

@EamonnMallie @fannin_shauna A fabulous wordsmith in both English and Gaelige. The words of plays he translated stay with me after almost 50 years.

‘THE HILL HEAD’ BY HUGH MURPHY,….. ⁦For ⁦@fannin_shauna⁩ and others who wanted to get the text of Hugh’s poem here it is courtesy of his daughter Sharon McKenna. … Thanks. Eamonn.

@generalorthomd @rkh_md @FractureDoc @davidhcmd @InvictaOrtho @orthotraumamd @JanetConwayy @CherneySteve @traumaticum Gross-Kempf as others have said. Not slotted at the top so it will take the extractor bolt well. Make sure you clear around the top of the nail so you don’t take out the GT. A more straightforward extraction than a Kuntschner.

Need some help. What nail is this and anything specific needed to remove it for THA? Implanted in 1993 in the US. @rkh_md @FractureDoc @davidhcmd @InvictaOrtho @orthotraumamd @JanetConwayy @CherneySteve @traumaticum

@hjluks This is why I decided to specialise in revision hip surgery decades ago - job for life!

@Only9built @MarkHaydock5 The Wolseley is the winner.

I’m at that point in my life where these are far more exciting to see than any megabucks supercars.

How did The Open move 250K people? By @CyclingUK_NI “there will be no public car parking available at Royal Portrush or the immediate surrounding area” “consider using public transport” “those staying in the local area should consider active travel”. sluggerotoole.com/2025/08/02/sol…

@welovedonegal Atlantic Drive

Today's #WhereInDonegal from #WeLoveDonegal 💚💛 coming up in 50mins (9am) so still time to have a guess at yesterday's. Where in #Donegal is this? CLUE: I was looking for SPECIFICALLY (A_____ D_____ ) but will now accept the name of the village leading to it. #Ireland .

@welovedonegal @ThePhotoHour Happy for you to use it!

@gmac012 @ThePhotoHour Fantastic shot Gavan! One for my site WeLoveDonegal.com if you wish? Credited to you of course.

Good #Sunday 20th #July morning from beautiful #Donegal 💚💛 Today's #GoodMorning pic is of Na Dúnaibh / #Downings #beaches #trees #nature #reflections #tweeds #Ireland . @ThePhotoHour