More Joys of EU Socialism
Or why Doc Adams will give you a shot of whisky before pulling the bullet out with a pair of blacksmith’s tongs, as explained in an article from today’s UK Guardian.
NHS hit by crisis over doctors’ hours
Most NHS hospitals in England will find it difficult to operate legally from Sunday when a European directive comes into force limiting junior doctors’ hours, a Guardian survey has revealed.
That’s right, under the EU’s new labor rules, inspired no doubt by dysfunctional French socialism, residents can’t be forced to put in all those long hours heretofore required to become a physician. Maybe next the EU will pass a law declaring all professions equally difficult and rule that anyone who makes it through pre-med is a government certified doctor, all in the name of equality and fraternity, of course.
Written replies from 75 NHS acute and specialist trusts showed 53% expect difficulties in cutting the juniors’ hours to less than 58 a week, as required by the new law.
In the US we’ve just recently limited residents to 80 hours a week, down from over a hundred, with some special exceptions for surgery programs to allow 88 hours a week. So 58 is a huge reduction in working hours, and that’s just a warm-up for the EU bureaucrats.
Although most have tried to organise shift systems to comply with the directive, many cannot find enough qualified house officers and registrars to staff them. The survey identified particular shortages in paediatrics, anaesthetics and maternity services.
It found 13 hospitals – 17% – admitting openly that they could not comply fully by the Sunday deadline. But many more gave answers raising suspicion that they will also be operating outside the law in two days’ time.
Ah, socialist excellence through forced labor shortage. If the EU keeps this up they’ll have emergency rooms posting 9 to 5 working hours. That’s no exaggeration, either. Some hospitals in Europe have warned that they may have to limit ER hours, so tourists should be advised to take care and only have accidents during business hours.
If the NHS trusts do not comply they could be prosecuted by the Health and Safety Executive and fined or – in extreme circumstances – forced to close down overworked departments.
Now isn’t that a cute government solution? Figure out which hospital or hospital department is swamped with patients and close it. I guess they don’t think a shortage of medical care is quite socialist enough and want to ensure a complete lack.
But the executive said it would wait for evidence of malpractice over several months before initiating proceedings and the first legal action is likely to be launched by the British Medical Association in local employment tribunals. It said it will “name and shame trusts which allow the new limits to reduce the quality of training”.
Did they actually say “local employment tribunals”??? Are they going to burn violators on a pyre of Marxist/Leninist books, too? And maybe the Guardian mangled the meaning of that paragraph, but aren’t they saying on the one hand that the hours will be slashed and violators slapped with legal sanctions, but any reduction in training quality will only be met by a campaign of “shame”? Obviously something thinks a properly filled out time sheet is far more important than a sick child.
Simon Eccles, the junior doctors’ leader, said: “The Guardian survey offers comprehensive evidence of the confusion felt by hospitals and doctors in training over compliance with this directive. We believe many trusts that are indicating compliance will have real difficulty due to inability to recruit the extra numbers.”
Well obviously under a nationalized system where the government has a monopoly on wages and prices, combined with chronic government spending shortfalls, makes it a bit hard to attract the best and brightest in large numbers. Especially when you can make more money dragging doctors in front of a “local employment tribunal” to accuse them of witchcraft, crimes against the worker, and disrespect for Brussel’s infallible wisdom on all things at all times.
He said the BMA has already targeted six trusts where it may intervene to protest at the hours worked in one or more specialties. “They are the ones that are showing a cavalier disregard for the law and its intention to make junior doctors’ hours safe,” he said. The BMA is not naming the six at this stage.
I’d much prefer a doctor who showed a cavalier disregard for the law than a cavalier disregard for the patients, wouldn’t you? Perhaps some of the untouchables in Brussels and their minions scattered throughout Europe should pay a visit to their local colo-rectal surgeon to hunt their missing grey matter.
Its spokesman added: “Each time hospitals breach the directive for individual doctors, they will be liable to fines of up to œ5,000 from the Health and Safety Executive. They could also be taken to employment tribunals by junior doctors.”
But of course if their case load results in so much overwork that nobody has time to wash their hands, spreading lethal drug-resistant staff infections through entire wings, well that’s just honky-dory with the government. Even today there was a new article on an innovative continuing education program for NHS workers.
HEALTH staff were invited to check their hand-washing techniques as part of attempts to keep superbug infections at bay among Huddersfield patients.
They were invited to a roadshow at St Luke’s Hospital, Crosland Moor, to check their techniques and find out more about new hand cleaning products.
Does it really sound like they need less training over there?
The directive was passed in 2000 in an attempt to stop the long-standing practice in many member states of overworking doctors during their period of training to become consultants.
For many years the medical establishment argued that long hours were necessary to give the juniors enough experience. More recently the royal colleges accepted that juniors working 80 or 90 hours a week were too exhausted to work safely and the shifts have been getting shorter.
Oh, but why listen to the long-standing arguments of the medical establishment? After all, they’re only doctors, and what would they know about socialist utopia where nobody has to work hard, fruit falls ripe from the tree, and a kiss makes everything better?
But the 37,000 juniors in England – including house officers, senior house officers and registrars – have not been entitled to the rest breaks required under European law.
Well, that’s a good thing to know if you’re seeing an obgyn, isn’t it? Make sure your appointment isn’t shortly prior to an EU mandated rest break or you’ll end up stuck in the stirrups.
The directive requires 11 hours’ rest in every 24 hours, breaks during shifts and a maximum of eight hours’ work in every 24 for night workers. Other groups of employees have a maximum working week of 48 hours and this will apply to junior doctors from 2009.
If they keep this up they’ll be down to a 35 hour residency limit in no time, and the programs that took a US resident seven years at 100+ hours a week will take 21 years to hit the same number of hours, eventually reaching the goal of ensuring that board certification coincides with retirement.
Most hospitals were preparing for the change but were caught by surprise by recent rulings from the European court that made compliance more difficult.
And this well illustrates the ludicrous nature of trying to enshrine labor policy in the EU constitution. It’s one thing to have a high court debate the constitutionality of procedures that terminate life, whether abortion or euthanasia, and quite another to hold that a health worker’s time-sheet has equal moral and constitutional gravitas.
John Reid, the health secretary, has been trying behind the scenes in Brussels to get the legislation amended and the commission has ordered a review. But he has told trusts that they must for the time being obey the law as the court interpreted it.
A Department of Health spokeswoman said: “We don’t have figures on how many trusts will not comply… We anticipate that a handful of trusts have teething problems securing compliance.”
So what will the doctors, residents, and nurses do with all their new free time? Obviously form a black market with back alley hospitals where they treat strep throat broken bones, if they can manage to stay one step ahead of the law.
The Royal College of Nursing said the Guardian survey showed the problem was more serious. Beverly Malone, the general secretary, said: “It is shocking that half of trusts admit that as of next week they will have difficulties operating legally.
It’s a brave new world where practicing medicine is a crime, all brought to you by the good folks who want to turn Europe into a socialist super-state.
“The RCN is calling on all trusts to put nurses at the heart of the solution in providing continuous patient care. We believe that expanding nursing roles offers a better way in safeguarding patient care.” Nurses could take over work previously allotted to junior doctors, she added.
So the nurses take over for the doctors, but even the nurses are having their hours cut back. Don’t worry, though, the candy stripers can fill in for them, and they guy who sticks the IV in your arm will talk about his plumping skills before he goes back to unclogging the sink so everyone can practice their hand washing skills.
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53 Comments »
The warning to tourists should be a moot point, as any inclination I had to visit Europe is rapidly waning.
Yikes time to google suplemental medical coverage for overseas ,or risk dying in the festering rat hole.
Its like watching Atlas Shrugged these days….
The funny thing is that surgical programs here in the US are starting to consider dumping accreditation so as to allow more hours for training. Surgical programs seem to be the only residencies considering that, though.
It makes sense, in a way. Surgery programs last five years, compared to internal medicine programs, which last three. That’s probably because once you’ve seen three or four cases of renal colic or asthma or congestive heart failure, you pretty much know how they should be handled. Dealing with a hot appy, or doing a lap chole, or even a whipple (surgical procedures, natch) takes more than thought- you have to perform, which means training your hands as much as your brain. The more procedures you log, the better trained you are.
Obviously, there’s a cost. Do you really want the ones cutting you open to be sleep deprived? Then again, do you want them to have inferior training? Ya pays yer money and ya takes yer choice.
Now why would I want to visit Europe? After all, I’m just one of those ‘Amis’ that has no interest in the rest of the world.
Just think – vote for John Kerry – and the rest of the Democrats for that matter – and we too can have quality European-style universal medical care.
(P.S. – Yes, I’m being sarchastic.)
Ah, the joys of, “free,” healthcare! Bring it on, Hillary!
The people in Europe do very well without some of the ignorant lil Amis!Stay home and eat spam!
It’s not a good idea to be sick in the US as well! How many street people die in the streets uncared for! Yeah, well it’s their fault we all know these lazy bones – let them all die off! If an American abroad gets killed, kill the whole world – Kill them all! But people in the US, wtf, let them die in the streets! We are fine in our lil backyards, limited and all so cozy!Lt’s have another beer and some spam – and enjoy Beaves and Butthead! Hohohoho….
yeah, get rid of everybody, except “meeeee…….” the lil American Butthead!
(This idiocy brought to you from the NW Mexican Territory of San Diego.)
yeahstayhome, be careful what you ask for …
people with better fisking skills than me please take this one. I can’t think of anything better than a rolled up newspaper to the back of his head.
Wow, yeah,way to show your insightful knowledge of America! Keen, rapier-like analysis, godlike mastery of the English language. And not a HINT of a straw man argument!
We have a saying over here about the pot calling the kettle black. Think about it.
Stayhome,
Any sources for all these street people dying. I’ll admit to a few, usually caused by alcohol or misadventure, but it’s not nearly as epidemic as you seem to think it is. It is sad when we lose one, however, no emergency room in the US would ever turn away a patient no matter their economic condition. This is the point the Emperor is trying to make, soon England and the EU may be forced to turn away patients for lack of doctors.
Lord Daeldric,
I believe this one is so stupid as to be self-fisking. any further effort would be a waste of time. Better to just extract a good belly-laugh at the little Euroserf’s expense. The poor sods haven’t abolished feudalism, they’ve merely exchanged lieges.
yeahstayhome: meds…you forgot your meds.
Listening to Euroweenies blather on about the inferiority of the USofByG-dA’s health care is boring. They know nothing about the system in place here, and I have seen several of them deny that ANYBODY can get emergency care at any hospital in the US, regardless of their ability to pay. A great number of homeless people are homeless by choice, and avoid getting the healthcare that they need.
Boy, as much as I hate to switch topics from Stay at home mom’s vise-like grasp of pseudo free-market health care, I just have to talk about the image of the EU going after unlicensed back-alley healthcare providers like the guerilla airconditioning repairman from the movie Brazil. The more I hear about the absolute stupidity the Euros are inflicting on themselves by opting into the EU bueracracy, the more it sounds like that movie. If you haven’t seen Brazil, go directly to the video store and rent it tonight. You will laugh your unsophisticated American ass off.
I’ll say this once. You can’t learn medicine in 48 hours a week. Counting call nights, 80 is barely adequate.
I don’t know how they do things in Europe, but when I was a resident safety was never an issue – you were always backed up by another resident and all of your decisions were cleared by your attending.
As is typical, my program took care of the “no doc” patients in addition to “regular” residency patients. Accordingly, we got the street people, the winos, the drug users and a collection of the poorest protoplasm with the highest comorbidity rates you can imagine. Interestingly, since 3 docs (2 residents and an attending) cared for each of them, we had the best outcomes, the shortest hospital stays, the lowest rate of readmission and the fewest complications in the community, diagnosis-for-diagnosis.
(Oh. And not that our little troll-boy would know – no one dies in the street in this country because they can’t afford medical care. They go to the ER and they get the same care regardless of their income. And no, you can’t dump patients between hospitals unless you want to get hit with a COBRA violation. Idiot.)
Did it suck being sleep deprived? You bet. I was so tired I once backed into my garage door before it had fully opened. I was so busy that I went for a couple of days living on coffee and Ensure that I swiped from the ICU. (The strawberry isn’t bad over ice.) I once called a friend in a program elsewhere just to chat. She fell asleep on the phone and began giving me correct medical orders on one of her patients, thinking that I was a nurse.
That’s the whole point. Residency sucks. Years later, I still can’t sleep more than 6 hours at a time. But I can make correct medical decisions under almost any circumstances.
Most importantly, I’m not exceptional. Every physician you see in this country who’s been through a residency will tell you pretty much the same story if you ask. Residency teaches you how how to set aside exhaustion, your personal baggage and every other distraction so that you can make good decisions at 3 am. You can’t get that from being well-rested and reading books.
The EUnuchs can play around with this system if they want. It evolved the way it did for a reason. They’ll reap the whirlwind.
Amateur. :^)
TPN and a Foley are the only way to go!
…is July over yet?
Or as I read it:
TPN και ένα Foley
I guess it’s officially a contest now to see who is going to be the designated ‘sick man of Europe.’
When you get to liking the taste of PulmoCare, lemme know. (That’s hard core.) And I’ve never had a Foley, but a Texas cath and a hole in the floorboard can make a long car drive far more pleasant.
Yes, but life as you know it has ENDED.
I don’t know much about the medical proffesion, but if you train in high-pressure situations, shouldn’t you be able to make better decisions faster in normal situations?
Not that it mattered when my grandmother died, 45 minutes after the people at the nursing home knew something was wrong she just… died. Something about blood clots somewhere, I am not sure.
The French cant even take care of heat stroke.
I know I want budget brain surgey workingon my family or friends.
I think our medical proffesion has some problems but quality is not usually the issue.
I say piss on socialised medicine…And i have paid for two kids as a young dumbass without insurance.
When I was a young man took a long time to pay it off at 50.00 Bi weekely.
But we made it and I am still glad for our health care even though it costs a bit more then I like.
LC Brian,
Question: How did you get the Greek letters to show?
Personal comment: Interesting. I can speak a little French and German, but Greek is giving me fits, for some reason. I’m trying to learn it because my in-laws are Greek, and my wife learned Greek as her 1st language.
It’s beautiful in the islands! LOL
English to Greek translation at Babelfish, then copy & paste.
LC Brian,
Σας ευχαριστούμε!
Apologies, LC Brian B, WotAP.
TPN= Total Parenteral Nutrition. Almost everything the body needs given through an IV.
Foley= A catheter that runs from your bladder to a bag via your urethra.
LC Moriarty:
Life? What is this word “life?” I hear my wife use it a lot. At least, I think it’s my wife- it’s the woman who sleeps in the same bed, so I’ll assume it’s her…
Please, Scottish Kate is going back under the knife for her leg, and I’m having both flashbacks and flashforwards.
She’s scheduled for the 9th, taking a plate and lots and lots and lots of screws out of her leg and putting in a rod.
fdcol63, say to your wife the following: (Transliterated as closely as I could for English pronunciation.)
“Thaylo na kahnoomay Ksayskeestoomay!” and see if she either:
A) Grabs you and runs to the bedroom.
or
B) Slaps the shit outta you and calls her mother.
Try it. It’s worth it.
Having TPN beats having dinner through a PEG.
..which might be how fdcol63 gets his next meal, if his wife doesn’t have a sense of humor.
dave
IOW. Socialist governments and nations around the world, Western or Eastern or non-aligned, are as anticipated HARD-PRESSED, and generally becoming HARDER and HARDER-PRESSED, to maintain local State-specific Socialism – these must either continue to engage in pervasive or massive DEFICIT SPENDING. WITH RISKS OF SEVERE TO WORSENING NATIONAL REGRESSIONS AND INFLATIONARY PRESSURES, or else adopt AMERICANISM/AMERICAN-STYLE DEREGULATION OR DECENTRALIZED METHODS, which many of the local constituencies-electors or ruling regimes don’t want to do, ERGO GET AMERICA OUT OF THE WAY AND UNDER EVERYBODY’S CONTROL VIA ANTI-AMERICAN AMERICAN SOCIALISM, AND SIMILAR SOCIALIST UNITARY GLOBAL GOVERNMENT, which for the Clintons and Clinton Left = COMMUNISM, ASIANISM AND ASIAN COMMUNIST WORLD ORDER, aka Non-Sovereign America RULED FROM RUSSIA-CHINA!
I am sooooooooooooooooooo glad I didn’t want to be a doctor when I was young.
–
I would take a TPN over ensure any day, that crap tasts like chalk.
‘Ey Joseph?
Your Dreamcoat is waiting on the coatrack near the pigpens. Check out with the valet if you’ve the nuts.
French and British medical systems are rather excitable, I agree. But a country which comes up with Beaves and Butthead as cultural icons can hardly be a guiding force for the rest of the World either. What to do? I suggest, to continue to eat lots of spam, watch commercials, and the Bill O’Reilly show to safeguard American patriotism and your mental peace. The rest of the World watches your favorite sports: Goat fucking! And IGNORES YOU! you are not important !
Peace and Amen!
Don’t feed it, people…
What? Did someone fart?
1. cankerous ass
2. sphincter surfers
3. perverted goat-fucking asswipes for Allah
4. syphilitic cheese-eating surrender monkeys
5. make love with their faces/jizz-guzzling
6. bloody anal sex with farm animals
. . .
. . .
All that is happening, in the name of the welfare of doctors and patients is a state created shortage of health providers which allows the state to ration out what health care there is left.
Just wonderful. The ‘blessed’ state creating a shortage that they can manage. How many people will die because no one is available to treat the sick and injured who dare to let that happen outside ‘business’ hours.
Death to socialism before death to humanity.
Gunsniper, I think Joeseph is on our side (anti-communist).
Who thinks Beavis and Butthead are cultural icons? I always thought they were rather immature, a fad of the teens.
I just talked to my sister about the impending hours cuts for residents in EUrope and she thinks “Thats a good idea.” I tried to explain how this was going to affect the medical system and she said “What about all the people who die from the doctors being to tired?”
Just how many people do die from doc’s being to tired? I can’t think of many situations where a patient has died from a doc’s mistakes. Getting the wrong leg and feet cut off yes, but not dying.
B.C., LC Brian, and Dave Fitz,
Jaw is now wired shut – on a clear liquid diet – and eyes are kinda puffy.
Musta mangled the translation, or she was in one of those moods.
LOL
DeathKnyte,
I would be tempted to believe that Joseph is on our side, if he would at least make sense. I have also picked out some rather nasty comments towards conservatives in some of his, um, what DO you call those things? So, until Joseph learns how to make COHERENT points, rather than just typing words at random, I’ll just *GAZE*.
Someone uphill said something about U.S. homeless dying for lack of medical care. Only if they go hide somewhere, bucky. If they are found sick they are usually taken to some facility where they are cared for better than an upstanding european in one of his socialized facilities. This has been true in the United States for as long as I remember, and I lived through the depression. Granted, if you do not have adequate insurance you will get one hell of a bill, but the same happens if you drive your uninsured $25,000 car into a tree. If you have any assets, they will collect from you.
Exalted (and soon to be former)Emperor,
I concur with your majesty concerning the EU #$%@wits attempts to improve healthcare by limiting doctor hours. But only due to the fact that their socalized system has reduced the number of people who wish to become physicians.
Actually, reducing the number of hours young physicians have to work is a good idea. Who among us would get on a plane if we knew the pilot was inexperienced, had flown 24 hours non-stop, and had a total of 4 hours sleep since their last shift? Yet, this is exactly the situation many people face in this country, and others, when they enter an emergency room at a hospital.
The trick here in the good ole’ US is that young physicians realize that their current sacrifices will be met by future reward in income, so they are willing to endure it. In the socialized EU system many talented young people are NOT willing to endure this because they know their sacrifices will not be income rewarded in the future. However, that does not mean it is a good thing to make young doctors work the kind of hours they are expected to, regardless of what older doctors may say about what was done ‘back in their day’.
How many lives would have been saved, and how much shorter would the Civil War have been, if Union generals had agreed to adopt the 44 Henry (invented in 1860) as standard issue? The Confederates who faced it (purchased at Union soldiers own expense)called the Henry; “That damn Yankee rifle you can load on Monday and shoot till Sunday.” So, elder “wisdom” is not always wise.
Merlin the Usurper (Muuwhahaha).
Sorry, posted in the wrong thread!
All health care systems suck at this point in time, not only in Europe but here in the US as well! A lot of policies need to be changed to make things work for all people! We need to improve our own system just as much as they need to improve theirs. The problem is that many people in Europe don’t want to work as employees in the health care system anymore because it is too hard to make money for nurses, for example. A lot of these jobs are done by Filipinos now.
The fact that you call it socialized medicine implies that everything in regards to trying to make health care available for all is bad. Why don’t you call public schools socialized education, public parks socialized parks, or clean air and water socialized air and water. Calling it socialized medicine has just been another way to fight the concept by labeling it as somehow Socialist or Communist. I do however think that healthcare needs to be available for all suffering human beings and that it needs to be simplified and improved at the same time. How that is going to be accomplished remains to be worked out.
The Europeans have made the first attempts to do so, it may not be perfect by far, but it also has not been a failure either.
The French did not take care of their heatwave not because they did not wan to, but becuse they did not expect it. The poor elderly people in the US die also, because they can’t afford air conditioning or even fans every year. Who thinks about people who can’t think for themselves anymore.
If the British currently don’t take care of their emergency patients during the week-ends, that may suggest that they can’t afford it anymore. It’s hard to believe this is actually happening however, and I tend to think that arrangements are likely being made for alternative care somewhere somehow.
Posted by yeahstayhome at July 31, 2004 02:11 PM
fdcol,
I had my jaw wired shut for 2 months last year. Boy was that a crazy experience. I know how much it sucks.
Here’s a great website I found that has lots of good recipes and other tips to help you through this tough time.
http://www.8weekswired.com/
Best of luck
fdcol,
I had my jaw wired shut for 2 months last year. Boy was that a crazy experience. I know how much it sucks.
Here’s a great website I found that has lots of good recipes and other tips to help you through this tough time.
http://www.8weekswired.com/
Best of luck
fdcol,
I had my jaw wired shut for 2 months last year. Boy was that a crazy experience. I know how much it sucks.
Here’s a great website I found that has lots of good recipes and other tips to help you through this tough time.
http://www.8weekswired.com
That was nice you JBeez.
Mr Minority
Merlin the Usurper (Muuwhahaha)
What is this??? I decide to take a couple days off and you go thinking you can take the Pegasus and start firing quantum torpedoes at everyone?
Git yer bo-honkus butt back in that lab where I left you! And don’t come back out until Ozy looks like himself again, instead of Dennis Kucinich!
And give Korioth his head crest back, too!!! The last thing I need right now is a p.o.’d Klingon…
what?
JBeez,
Thanks for the link. It’ll come in handy if I ever need it.
And thanks for the empathy. I was just joking about my jaw …. but I’m sorry to hear that you actually had to go through it for real.
Hope everything healed okay!
You criticise them for doing testing with an inexact science (so they can fudge results all they like, etc). You’re right.
But I think there’s more here. Why is it this failed in the Soviet Union and they still wanna do it? They think if only the science was a bit more exact, then it would work. *In principle*, they think it’s a good idea, and if it failed a few times, that doesn’t disprove the principle, it just means psychology needs to advance more.
Thus, I think we need to insist that even if psychology was an exact science, this would still be a horrible thing to do to people. The primary flaw is they are taking away freedom from people. The primary flaw is if testing is such a good idea, why isn’t everyone volunteering? (Because everyone disagrees with the central planners.)
Umm, I somehow managed to click on the wrong comment thread. Sorry about that.
JBeez,
Eeeyouch! Sorry about the jaw. I hope you’re all healed up now, with no after-effects.
Now back to our regularly scheduled fighting: OOF! SOCK! POW! BIFF! KA-BLAM!
Two applicable items.
1) I suspect that Britian may be having the same shortage of nurses that the US is encountering, and that will prevent using nurses to reduce the workloads of residents.
Given the hours(all nights, weekends, and holidays until they have almost a decade in at most hospitals), workload (patient criticality), and renumeration comparison to other medical areas such as therapist and imaging technicians are much more appealing (hospital staff subject to NWH hours may make a bit more, but rates for positions with people hours similar to the therapists et. all, can drop to about $10 hr. or less).
2) As to the resident’s reduced hours, I would suggest that two steps be immediately taken.
First, a blacklist. Antbody on the blacklist is “parked” in a hospital room instead of seeing a doctor as they are assigned a resident who has reached the mandated limitation as to hours worked and is being sent home. They can wait until next week. People on this list are any of the asshats who actually enforce this rule, and any EUrocrats.
Second would be revising just what constitutes a completed residency. Now have a point system.
1 point for each hour up to 40, 1.5 past 40 up to 60, and 2.0 points for each hour past that. Calculate what the residency requirement would accrue figuring 100 hour weeks and make that point total the new requirement. Probably the residents would scream in pain at the additional years and support the blacklist until there was enough pressure to get the requirement lifted.