Monthly Archives: March 2015

Weaponising the NHS – really does seem like a damp squib of a debate at present.

The Weaponising of the NHS – really does seem like a damp squib of a debate at present. There’s even a rationing of honesty.

Laura Pitel and Lucy Fisher on 12th January 2015 in The Times: Miliband ‘wriggling like an eel’ over NHS ‘weaponisation’ says PMIsabel Hardman opines 14th January 2015: Ed has turned the “weaponised” NHS on himself

Meanwhile Morten Morland (The Times Cartoonist) gives his own view….

Quentin Letts for the Mail reports 12th Jan 2015: ‘Weaponising’ the NHS isn’t just rotten politics – it puts patients in danger, writes

Patrick Wintour for the Guardian 12th Jan 2015 comments: Labour refuses to confirm Miliband wants to ‘weaponise’ NHS in election 

TG4346249@Adams cartoon .jpg

The John Crace sketch in The Guardian 28th Jan 2015 reads:

‘Weaponise, weaponise, weaponise.” David Cameron was so beside himself with anger that Ed Miliband had told the BBC he would weaponise the NHS that he felt obliged to turn himself into an out of control red-faced Dalek and repeat the word on every occasion possible at prime minister’s questions. The threat of weaponisation was now so great, he insisted, that he was left with little option but to weaponise it himself in order to defend it from weaponisation. The NHS is now officially at Defcon 1, with a full invasion of spin-doctors imminent.

All that Miliband – looking suspiciously like the disgruntled waiter in the new Shaun the Sheep movie – had done to precipitate this was to ask how many of the A&E units Cameron had promised to keep open at the last election were now closed. “It is very simple,” he replied. “One of the most respected political journalists in Britain, Nick Robinson …” Several Tory front-benchers did their best not to appear astonished at the BBC’s political editor being described with such affection. “… has said that weaponising the NHS is a phrase that the leader of the opposition uses. Will he apologise for that appalling remark?”

With the prime minister unwilling to talk about anything except his deep sorrow at being forced to send in troops to enforce the NHS de-weaponisation, Miliband was obliged to answer his own question before asking another about A&E closures. “You dare come here with all your disgusting talk of weaponising,” Cameron continued. “Go and wash your mouth out with soap and water.”

Rather late in the day, Miliband suggested that all he might have meant by weaponising the NHS – he didn’t actually admit to using that expression, of course – was protecting it from the Tory scalpels. Had he said that a couple of weeks ago when Cameron first brought it up, the issue would have long since been dead and buried but the prime minister was now in no mood to let it go. “Weaponise … weaponise … weaponise,” he said, his voice becoming ever huskier. Automated even.

Just as it looked as if we were heading for the familiar, futile deadlock, Miliband dropped his bombshell. “This is a man who has got a war on Wales,” he announced casually. We never did get to find out the nature of this war on Wales or the number of casualties as several hundred MPs chose that moment to make grunting sounds, but it did rather seem as if the weaponisation was getting out of hand. As so often, the first casualty of PMQs was the truth.

By now the PM could manage little more than a fevered croak and his eyes kept looking towards the clock, longing for the allotted half-hour to come to an end. Realising that Cameron was suffering badly, the speaker chose to spin out PMQs by an unprecedented eight extra minutes. “Everyone seems to be having such a jolly time,” Bercow’s widening grin suggested, “I can’t bear to bring the session to an end. Has anyone got anything they want to ask the prime minister? Perhaps something on his kitchen light fittings?”

As it happened, Labour’s Dennis Skinner did have one last question. Did the PM think that he had a record as long as that of his pal, Andy Coulson? Cameron opened his mouth to try to explain that Coulson’s record was actually a great deal shorter than it might have been but the words would no longer come out. His batteries had died. The search for weapons of mass distraction was over for another week.

52126331_Matt cartoon   I'm going to weaponise my Apthy.jpg

Chris Riddell 01/02/2015

 

 

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NHS will save billions if more cycle to work

Kaya Burgess reports 30th March 2015: NHS will save billions if more cycle to work

So who will be bold enough to implement policies that really encourage cycling, even in rural areas and through the worst weathers?

Alcohol and cigarette consumption falls among commuters who start travelling to work by bicycle, according to research that has identified £2.5 billion of NHS savings that would be made if the roads were made safer for cycling.

In the survey by Cyclescheme, which provides tax-free bikes through cycle-to-work projects, more than 9,500 commuters were asked about the health benefits of cycling to work. Half reported lower stress levels since they started riding, while 29 per cent said they were drinking less alcohol. About 20 per cent were smoking less.

The research noted: “Cyclescheme predicts that even if just 10 per cent of journeys were made by bike instead of car by 2025, the NHS would save £2.5 billion and the nation would gain a combined equivalent of over a million years of healthy living.”

David Cameron pledged a “cycling revolution” in 2013, but the government has failed to match the spending levels — about 3 per cent of the annual transport budget — recommended by the Commons transport committee and The Times’s Cities Fit for Cycling campaign to make the roads safe enough to encourage more cyclists.

Meningitis B vaccine deal agreed

Jeremy Hunt announced 29th March 2015 as reported by BBC News: Meningitis B vaccine deal agreed  Good news. Progressive. The majority of the nearly 2000 meningitis children are in lower socioeconomic groups. Lets see if all the UK Regions can afford to introduce the vaccine at the same time. I expect the poorest to have the longest delay…. Now wasn’t it the media who destroyed the reputation of measles vaccination…?

Newcomb cartoon 02/23/2012

All UK babies will soon have access to a vaccine against meningitis B, after a deal with drug manufacturers, Health Secretary Jeremy Hunt has announced.

The agreement with GlaxoSmithKline will mean the vaccine can be introduced on the NHS “this year”, Mr Hunt said.

Government advisers said in 2014 that every child over two months old should be given the vaccine, but negotiations over costs have delayed this process.

Mr Hunt said it was important to get value for money.

Campaigners had warned the delays put children’s lives at risk.

The drug will now be added to the national childhood immunisation scheme, meaning babies will receive the first vaccine at two months old, followed by two further doses.

Scotland’s health secretary, Shona Robison, said the vaccine would be provided to all infants in Scotland “as quickly as possible” following the deal – which was also made on behalf of the devolved government.

A Welsh government spokesman said a price for the vaccine had been negotiated and the Welsh government was “committed to being included in the UK-wide procurement for the vaccine” and to make it available in Wales “as soon as practicable”.

Northern Ireland’s health minister, Jim Wells, also welcomed the outcome of the negotiations “to secure an effective, safe and cost-effective vaccine”.

Price negotiations

Mr Hunt said he was “delighted” to have secured an agreement with GSK – the company that now manufactures the vaccine.

It followed lengthy negotiations with another supplier – Novartis – which used to own the vaccine, called Bexsero.

GSK acquired the vaccine from Novartis, which resulted in the price of the vaccine being reduced and the deal being struck, Mr Hunt said.

Announcing the agreement, the health secretary said he was “very proud that we will be the first country in the world to have a nationwide MenB vaccination programme”.

He said that although it was “disappointing” the deal had taken so long, it was important to follow the advice of independent scientific advisors on vaccines and their costs.

“We follow that advice, because we can’t afford every single medicine, every single new vaccine on the NHS.”

Mr Hunt added: “[The deal] means we can now go ahead this year with rolling out the meningitis B vaccine and I think that’s something that families, particularly ones with young children, will really welcome.”

Sue Davie, chief executive of charity Meningitis Now, said: “To know that babies will be protected against MenB is fantastic and another great step forward in our fight against meningitis.”

Chris Head, chief executive of the Meningitis Research Foundation, said: “We are delighted that vaccinating all babies against this devastating disease is now within sight, cementing the UK’s position as a world leader in meningitis prevention.”

Linda Glennie, also of the foundation, said the vaccine was predicted to cover more than 80% of meningitis B cases.

It would protect against a more virulent strain of meningitis B increasingly found in the UK, she added.

Meningitis B is a bacterial infection that particularly affects children under the age of one. It commonly affects children under five years of age, and is also common among teenagers aged 15 to 19.

There are about 1,870 cases of meningitis B each year in the UK.

Symptoms include a high fever with cold hands and feet, confusion, vomiting and headaches. Most children will make a full recovery with early diagnosis and antibiotic treatment.

It is fatal in one in 10 cases. About one in four of those who survive is left with long-term problems, such as amputation, deafness, epilepsy and learning difficulties.

What is meningitis?

  • Meningitis is an infection of the meninges – the membrane that surrounds the brain and spinal cord
  • Meningococcal bacteria are common and carried harmlessly in the nose or throat by about one in 10 people
  • They are passed on through close contact
  • Anyone can get meningitis but babies and young children are most vulnerable
  • Symptoms include a high fever with cold hands and feet, agitation, confusion, vomiting and headaches

Q&A: Meningitis B vaccine

The Guardian reports: Meningitis B vaccine added to UK child immunisation scheme

Government reaches deal with GlaxoSmithKline on price of Bexsero, which was recommended by vaccination advisers a year ago. Lets hope there is no media sabotage..

vaccination media scare cartoon

 

Is it progressive to reduce us all to same day appointments?

Is it progressive to reduce us all to same day appointments? Progressive systems reduce inequalities. Regressive systems increase these inequalities. But the “system” concerned is not just the state, but all access to medical care, and if poor standards encourage a certain element to go privately, this increases inequalities. A fair health service, or even a discussion about one seems miles away.. When I know my own practice is busy (no reply for 10 minutes morning and evening) then I ask for a non urgent appointment by post, enclosing a stamped addressed envelope and indicating my preferred time, doctor etc. Will this type of access also be banned in a same day only system? What will I do then? As the Regional Health Services degrade, Wales in particular (the only region where numbers of GPs has fallen – see below) seems to be encouraging a perverse outcome – increased inequality of access and care, in a country rightly proud of its main social hero: Aneurin Bevan. I may be forced to ask for Private Primary Care before long.. This is the result of prolonged rationing by undercapacity.. but enhanced by technology, demographics and an inability to have the honest debate (A dishonest and covert dialogue is all that is happenning at present.. Simon Stevens says he would like to change this.)  asked for by Mr Stevens.

Sarah-Kate Templeton and James Gillespie  report in The Sunday Times 29th March 2015: Is it progressive to reduce us all to same day appointments?

MORE than 1m patients are being denied advance appointments in one of the biggest shake-ups of GP practices for decades.

The new system’s supporters say it ensures that patients who really need to see a doctor can do so.

Under the cost-cutting measure, which can save each practice up to £30,000 per GP each year, patients can no longer book an appointment in advance.

They must phone the surgery on the day they wish to see a GP and wait for a doctor to call back to assess the medical problem. The doctor may deal with the problem over the phone or, if a face-to- face consultation is needed, book the patient in for later that day.

In all, 150 GP surgeries serving more than 1.4m patients have switched to the new system, which has been introduced after training and advice by private companies.

It is in response to an increasing GP workload that has meant patients struggle to get an appointment when they want it.

Supporters of the schemes say many patients have welcomed the change because they are guaranteed to see a GP on the same day if they need to or in some cases can fix a future appointment.

Dr Peter Cairns, a GP in an Edinburgh practice, says 80% – 90% of patients are happy with the new system.

He said: “ Patients understand that switching to telephone triage [assessment] frees up capacity. If we do the triage work first, and we have people who we want to see or who want to see us, we have no difficulty bringing them in because we have capacity.”

However, others complain they can no longer book an appointment for a time that suits them. Employees may have to take a day off work because they do not know in advance when the GP will call back or the time their appointment will be.

A mother of two from Hertfordshire said she had changed surgeries after being unable to book an appointment for a non-urgent complaint. The woman, in her thirties, wasoffered a callback from a GP mid-afternoon with the prospect of arranging a consultation for later that day. As the mother had childcare commitments late in the afternoon, this was not practical.

GP leaders are also concerned the system breaks the relationship between a patient and his or her family doctor. Under the new arrangement, the patient cannot book to see a particular doctor or reschedule a follow-up appointment.

Dr Michael Dixon, a Devon GP and chief executive of the NHS Alliance, a primary care organisation, said: “For some practices offering only the same-day service, patients have to see whoever they are booked with and I think that threatens one of the most important aspects of general practice which is to offer personal and continuing care for those patients who need it.”

Dr David Haslam, a Hertfordshire GP, fears the new system marks the end of the family doctor. He said: “The heart of general practice is continuity of care by a familiar doctor, meaning we are familiar with patients without having to spend most of the appointment catching up.”

Dr Des Spence, a GP in Glasgow, says the telephone triage risks medical error. He said: “I was surprised, when I was working in out-of-hours, how often what was thought to be quite a minor condition turned out to be quite a significant one and likewise, things that were thought to be terrible over the phone, turned out to be minor.”

The Royal College of General Practitioners (RCGP) has described the end of advance appointments in many practices as “a very major change”. It says the schemes are needed because “general practice is teetering on the brink” with surgeries overwhelmed , same-day appointments gone by 8.30am and advance appointments booked weeks ahead.

Maureen Baker, chairwoman of the RCGP, said that while some practices had moved to the new system, others in the same area would continue to offer bookings and patients would be able to choose with which to register.

GP Access and Doctor First, two companies that advise surgeries on switching over to the schemes, said that once the GP had called the patient back, the patient could arrange a consultation on another day.

Baker insists, however, that in practice this can only be allowed in a small number of cases because the system relies on GPs having blank diaries.

She said: “The point with these schemes is that you don’t make advance appointments but the people know that if their day off is next Thursday, if they call up next Thursday, they will be seen next Thursday.”

Saving the NHS – Political parties are in denial over how to fund the growing pressure on the health service. We need an honest debate about new means of paying for it

It’s a scandal that the NHS is too big to fail – and the debate reveals a misunderstanding of the whole

It’s not about money – it’s about a proper debate on philosophy and overt rationing

Covert rationing…. and the “honest debate” needed to change the culture.

New NHS chief Simon Stevens backs more local hospitals and “must end mass centralisation”

 

 

No freedom of speech for Welsh Regional Health service employees. The election campaign starts with a “general gagging order”.

GUIDANCE FOR NHS WALES DURING THE UK PARLIAMENTARY ELECTION PERIOD
(30 March – 7 MAY 2015)
1. Summary
This note contains guidance to NHS employees on their role and conduct during the
forthcoming election campaign.
For the NHS in Wales it should be business as usual, however, staff should be sensitive to
activities that could be viewed as political campaigning. Staff should also be mindful of the
heightened media interest in the NHS in Wales at a UK level at this time and any decisions
that could be viewed as having a direct impact on UK Government policy should not take
place.
The general principles that should be observed during the period of the election are that, as
at other times, NHS staff should not be asked to engage in activities which could give rise to
the criticism that people paid from public funds are being used for party political purposes,
or which distract attention unduly to the election campaigns.
The principles set out in this guidance apply to the NHS at all times, but particular note
should be taken in the period between the start of the formal campaign (30 March) and
polling day (7 May).
2. Background
Health Boards and Trusts are asked to take special care during this period to ensure that
they conduct themselves appropriately. Chief Executives will wish to follow consistent
principles when responding to requests for information and access to NHS premises in
connection with election campaigns.
Chairs and Chief Executives are legally responsible for the uses made of NHS premises. It
is therefore entirely for them to decide what facilities to grant or information to release to
candidates or party spokespeople. They should, however, take the following principles into
account:-
• The NHS and its constituent bodies have no party political affiliation. Nothing should
be said or done by any member or employee in his or her official capacity that
suggests otherwise;
• NHS staff should not be asked to engage in activities which could give rise to the
criticism that people paid from public funds are being used for party political
purposes;
• Parties and candidates should be treated even-handedly;
• Party political meetings should not be held on NHS premises during the pre-election
period.Letter from Welsh Assembly to all staff:

GUIDANCE FOR NHS WALES DURING THE UK PARLIAMENTARY ELECTION PERIOD
(30 March – 7 MAY 2015)
1. Summary
This note contains guidance to NHS employees on their role and conduct during the
forthcoming election campaign.
For the NHS in Wales it should be business as usual, however, staff should be sensitive to
activities that could be viewed as political campaigning. Staff should also be mindful of the
heightened media interest in the NHS in Wales at a UK level at this time and any decisions
that could be viewed as having a direct impact on UK Government policy should not take
place.
The general principles that should be observed during the period of the election are that, as
at other times, NHS staff should not be asked to engage in activities which could give rise to
the criticism that people paid from public funds are being used for party political purposes,
or which distract attention unduly to the election campaigns.
The principles set out in this guidance apply to the NHS at all times, but particular note
should be taken in the period between the start of the formal campaign (30 March) and
polling day (7 May).
2. Background
Health Boards and Trusts are asked to take special care during this period to ensure that
they conduct themselves appropriately. Chief Executives will wish to follow consistent
principles when responding to requests for information and access to NHS premises in
connection with election campaigns.
Chairs and Chief Executives are legally responsible for the uses made of NHS premises. It
is therefore entirely for them to decide what facilities to grant or information to release to
candidates or party spokespeople. They should, however, take the following principles into
account:-
• The NHS and its constituent bodies have no party political affiliation. Nothing should
be said or done by any member or employee in his or her official capacity that
suggests otherwise;
• NHS staff should not be asked to engage in activities which could give rise to the
criticism that people paid from public funds are being used for party political
purposes;
• Parties and candidates should be treated even-handedly;
• Party political meetings should not be held on NHS premises during the pre-election
period.

No freedom of speech for Welsh Regional Health service employees. The election campaign starts with a “general gagging order”. Next employees will be asked to declare their party membership, and what will be the “punishment” or “sanctions” for those who take no notice? Fear will stop most from speaking out, but watch for those near to retirement, or even better those who have just retired.

Election promises based in unreality

AnAll political parties will base their promises in the unreality of short term solutions. 2020 is only 5 years ahead, and it takes 10  years to train a GP, and by then we may have another regime with different priorities.Orwell Quote1

Conservatives: BBC News 28th March 2015: Election 2015: Cameron to promise ‘seven-day NHS’ by 2020

Labour: BBC News 28th March 2015: Election 2015: Labour to cap private profits in NHS

This is very silly. GPs are private contractors….. Does he mean PBIT (Profit before interest and Taxation) and does this figure include drawings for directors. What about the treatment of loans and tax deductibles?

Libdems have no real policy outside of mental health (Lib Dems announce campaign for NHS to set ‘zero suicide’ goal ) other than “ringfencing” and Evan Harris 3rd March opines in The Guardian: For the NHS’s sake, we Lib Dems must ditch the health and social care bill 

I will still vote Liberal because it is becoming clearer and clearer that some form of PR is needed to de-politicise health.

Anoosh Chalekian in The New Statesman 6th January 2015 reports: What does the Lib Dems’ NHS funding pledge mean for the general election? £8bn by 2020.

The Green Party defined it’s policies in detail in 2010 and no changes seem planned.

The Scottish National Party seems short on ideas for change to make their Regional Health Service viable, and their philosophy is enshrined in their “Health and Wellbeing” policy statement. Plaid Cymru have a vision statement on Health and Wellbeing, and 12 months ago they were advocating either growth or demise of the Health Boards, but not staying the same! (Plaid Cymru call to scrap or boost local health boards – BBC).

The Information Age changes everything. We cannot obscure the truth of rationing behind an eclipse of bureaucracy and administrative procedures, or behind obfuscator jargon. In the end the truth will out, and all the statement of all the parties will be as naught.

UKIP: Leaked documents show UKIP leaders approve NHS privatisation once it becomes more ‘acceptable to the electorate’ – NHSreality disagrees if we ration overtly and after debate and planning. No sign of this so far..

Choice delusion

 

The Liberals could save your health services – give them a chance. None of the others could do this.

Why Liberal philosophies are better for the UK. Who will be the first party to re-invent a truly National Health Service?

 

 

From bad to worse: “NHS medical accidents investigation unit ‘needed'”

Nick Triggle for BBC News 27th March 2015 reports: NHS medical accidents investigation unit ‘needed’

The result of rationing by prolonged undercapacity. Does the government feel medical accidents will be less after we have imported thousands of doctors and nurses from Eastern Europe, and many other cultures, and with language difficulties?

A national body to investigate medical accidents in England should be established immediately, MPs say.

The House of Commons Public Administration select committee said the service was needed because of the scale of the problems in the NHS.

The cross-party group of MPs said the current patient safety system was “too complicated” and “took too long”.

It comes just weeks after the government announced it was considering setting up such a service.

Ministers conceded such changes may be needed following publication of the Morecambe Bay hospital inquiry into baby deaths.

The report revealed that 11 babies and one mother had died unnecessarily at Cumbria’s Furness General Hospital, but the scandal had gone unchecked for years as patients fought to expose what was happening.

The committee said this and the Stafford Hospital scandal showed there should be no more delays.

It is estimated that there are 12,000 avoidable hospital deaths every year, and more than 10,000 serious incidents are reported to NHS England annually, including 338 “never events” such as surgery being carried out on the wrong part of the body.

Committee chairman Bernard Jenkin said for years it had been “evident that the NHS has urgent need of a simpler and more trusted system”.

“There needs to be investigative capacity so that facts and evidence can be established early, without the need to find blame, and regardless of whether a complaint has been raised.”

Currently responsibility for investigating patient safety is shared between the Care Quality Commission and Parliamentary and Health Service Ombudsman at a national level and local arrangements run by NHS trusts themselves.

Peter Walsh, of Action against Medical Accidents, said changes to the system were “much needed”.

The Department of Health said it would respond in “due course”.