Category Archives: Post Code Lottery

Don’t believe we are rationing? Do you believe in transparency and honesty? Why not use the correct word?

Just in the last few days these news items reveal the truth. Despite this the “R” word can never be acknowledged by politicians. None since Enoch Powell has embraced the truth. (Described by Richard Smith, former BMJ editor as “the best book written on the NHS”. A new look at medicine and politics: 1975 and after. Pitman Medical 1976. 2nd edition. ) 

Link to his book published by the Socialist Health Association

Why do you think we had no PET scanners until 20 years late! Why are there waiting lists longer than any other G7 country (and the results to match)? Why have the two countries that emulated the original NHS reconsidered? (NZ and Scandinavia). Why are we only appointing 1 doctor for every 10 who apply and have been encouraged to do so by their careers officers? Why are botched operations so commonplace?  Why does the NHS Ombudsman produce reports which have no notice taken? Do the politicians read these reports?

If you believe in honesty and transparency why not use the correct word? We will never win the hearts and minds of the health service staff if politicians and media and public collude in the language of denial.

Henry Bodkin in the Telegraph 14th September 2019: NHS bosses tried to “gag” father of boy whose life was ruined in botched operation

In The Guardian 30th August 2019 Dennis Campbell: ‘Crumbling’ hospitals putting lives at risk, say NHS chiefs  –  Four in five NHS trust bosses in England fear Tory squeeze on capital funding poses safety threat

Why cannot Cheshire recruit enough GPs? Pulse reported by Lea Legraien 14th September

Why do we still get fraudulent managers promoted (The Independent 19th December 2018)

Why are half of the 4 health services’ trusts using out of date radiotherapy equipment? ( Andrew Gregory in The Sunday times 15th September 2019 )

This is particularly important for Pembrokeshire and West Wales as we have a long distance over difficult roads to travel to Swansea at present. Our planned new Hospital, wherever it is, needs Radiotherapy, Radio Isotope Investigations, and STENT treatment for Coronary Heart Disease if our options are to be the same as those in more favoured areas. I reproduce the article at the bottom of this post.

Adam Shaw for the Harrow Times reports 13th September 2019: North-West London CCGs dismiss claims of “rationing” services.

Kat Hopps September 13th in the Express reports: IVF: How NHS IVF treatment is unfair postcode lottery and keeps couples childless

A disgrace and a shame on politicians: “Surge in patients raising own cash for amputations”. Rationig by waiting and by incompetence.

Pembrokeshire Oncology cancer services in crisis

There is a “need to put doctors in charge and force them to take account of patients’ views. Cancer survival rates are (just) one of the prime examples of NHS mediocrity.”

Desperate NHS needs a desperate remedy – care is already rationed

The 3 myths of the NHS…..& …No learning from other countries – no co-payments, and more scandals..

Britain ranked last (out of 20 rich countries) by a wide margin in the number of CT and MRI scanners per head of population. Australia has six times as many CT scanners per head, and spends roughly the same as Britain on healthcare overall as a share of GDP.

Why are half of the 4 health services’ trusts using out of date radiotherapy equipment? ( Andrew Gregory in The Sunday times 15th September 2019 )

Almost half of NHS trusts are using outdated radiotherapy machines that are far less effective at killing cancer cells to treat patients.

The revelation comes days after the UK came bottom of an international league for cancer survival rates in The Lancet Oncology journal.

In 2016 the NHS said it was investing £130m in upgrading radiotherapy equipment but the figures, revealed via freedom of information requests, found 46% of trusts are still using outdated linear accelerator (Linac) machines beyond their recommended 10-year lifespan.

Dr Jeanette Dickson, president of the Royal College of Radiologists, said more advanced radiotherapy techniques enable “greater precision when targeting specific tumours and have been shown to be less harmful to surrounding tissue than older types of radiotherapy, depending on the complexities of the cancer being treated”.

Rose Gray, policy manager of Cancer Research UK, said it was “deeply concerning” to hear outdated radiotherapy machines were being used.

She said: “The NHS has grappled with the question of how best to replace outdated equipment for many years, and the government has repeatedly been urged to put a long-term plan in place.

“But . . . that still hasn’t happened. These investigation findings prove the urgent need for a solution to this persistent problem.”

In total, 57 of the 272 Linac machines used this year are 10 or more years old. One of them that is still in operation has been used for 17 years.

Dr Peter Kirkbride, the former chairman of the government’s radiotherapy clinical reference group and spokesman for the Radiotherapy4Life campaign, said: “That radiotherapy has been put on a lower footing than other cancer treatments — such as chemotherapy — by successive governments is an open secret within the NHS.”

The Liberal Democrat MP Tim Farron, chairman of the all-party parliamentary group on radiotherapy, described the figures as “shocking”.

He said they proved the investment in 2016 had been a “drop in the ocean” when compared with what is required to meet soaring demand.

Saffron Cordery, deputy chief executive of NHS Providers, which represents hospitals, added: “What we do know is that for year after year, money earmarked for capital investment has been siphoned off just to keep services running.”

An NHS spokeswoman said 80 radiotherapy machines had been upgraded since 2016 and patients were benefiting from “a range of improvements” to cancer services.

Enoch Powell 4 Supply and Demand – Rationing


A&E waiting times – are a dangerous disgrace. Casualty should be manned by more rather than less experienced doctors.

A recent admission to my local DGH A&E was an eye opener. It was as if nobody cared when a retired GP arrived at 00.30 to say he had a painful infected hand and needed an operation. The time taken to be seen was appalling, with 30 mins to see the triage nurse, 4 hours later to see the SHO and 1 hour later to see an F2 covering orthopaedics from another speciality. (Surgery). The result of a sleepless and painful night without adequate analgesia was my walking away at 06.00 (after being advised that there would be no way to see anyone before 10.00 am!) with a compartment syndrome not yet diagnosed or seen by somebody able to take action. This was a wait of 5 and a half hours, but then I got access to the specialist via my GP by barging in first thing. (GPs are not meant to be an emergency service!). She rang the consultant and arranged for me to be seen mid morning, and an operation ensued at 19.30 which was some 18 hours later than it might have been. The result, even for a doctor who presented himself, was delayed decompression of my dominant R hand, and a long recovery on antibiotics. I suspect that the pain could have been less, the operation sooner and the recovery quicker if the right person had been in A&E. 

This type of story is commonplace. Retired colleagues all tell me “dreadful” stories of their own experiences. It would have been better for me if I had travelled to a properly staffed tertiary centre than my local DGH, even though it is 90 mins away. We need honesty and transparency in all areas of health, and I suspect increased death and complication rates are already a fact if you happen to live in the wrong post-code.

Rosie Taylor in  the Times 13th September reports: Alarm grows over A&E waiting times

The number of patients kept waiting at A&E departments in England reached its highest level in a decade last year, prompting warnings that pressure on the NHS would rise this winter if it faced the “perfect storm” of high demand and a no-deal Brexit.

Patients kept waiting at least four hours more than trebled in the past five years. Last year only 88 per cent of patients were seen within four hours compared with 98.3 per cent ten years ago, according to the NHS’s Hospital Accident & Emergency Activity 2018-19 report.

Separate NHS figures show that last month was the busiest August ever.

Tim Gardner, senior policy fellow at the Health Foundation charity, said: “A no-deal Brexit would only exacerbate these pressures, intensifying staffing shortages, driving up demand for hard-pressed services, disrupting supplies of medicines and other necessities, and stretching the public finances which pay for healthcare.”

Helen Fidler, deputy chairwoman of the British Medical Association’s consultants’ committee, said: “This summer emergency departments had their busiest August on record. As we move into what will undoubtedly be a difficult winter the situation will get worse . . . A no-deal Brexit threatens to pile even more pressure on overworked staff.”

A&E attendances last month were up 6.4 per cent on the same month last year. Although doctors treated an extra 1,200 patients within four hours, the percentage of people seen within that time dropped from 89.8 per cent to 86.3 per cent.

About 24.8 million people attended emergency departments in 2018-19, a 21 per cent increase on the 20.5 million who visited in 2009-10. However, while attendances rose 2 per cent year-on-year, the population has grown by only 1 per cent a year over the same period.

Miriam Deakin, director of policy and strategy at NHS Providers, which represents hospitals, said the sheer dedication of staff was stabilising A&E performance despite a record number of patients. However, she added: “This winter will be a very testing time for trusts. We anticipate that performance will slip even further, with patients waiting longer for treatment across various services.”

Rising demand has also increased the time patients are left on trolleys. Last month 362 patients waited for more than 12 hours in A&E after it had been decided to admit them, more than double the figure for August last year.

An NHS spokesman said that in July a record number of patients were seen within two weeks of referral for urgent cancer checks, routine tests or treatment for serious mental health problems. He added: “Every part of the health service is playing its part in meeting the rising demand for care.”

Treatment or cure. In cancer the UK lags behind many other systems. No wonder nobody copies us.

It is odd for the WHO to report on the UK when it had previously said that it would report on 4 systems. The earlier the diagnose cancer the better your chance of survival. With a shortage of GPs and access to diagnostic manpower (GP, Radiology, pathology etc) it is not surprising that the UKs 4 systems perform badly. There is a post code lottery in all care, but especially cancer, in the UK. There is also a lottery in handover from oncology treatment to palliative and terminal care. Those trusts who can make this interface more humane and efficient will save more money for better outcomes for those who need treatment for cure.

update 13th September. Times leader: Cancer complacency

Image result for cancer therapy cartoon

In Scotland the Herald announces today that the UK is “Stuck at the bottom of the cancer survival league”.

And Laura Donelly in the Telegraph points out that ovarian cancer survival in the UK is equivalent to Norway 20 years ago!

in the Guardian attributes Australia’s better result to earlier diagnosis.

Cancer Research Uk reports 11th September 2019: Measuring up: how does the UK compare internationally on cancer survival?

…the latest figures, covering 1995 to 2014, reveal some stark differences in cancer survival between countries. Generally, cancer survival is higher in Australia, Canada and Norway than in Denmark, Ireland, New Zealand and the UK.

…But despite the improvements, there’s clearly more work to be done in the UK.

Science Daily comments: Cancer survival in high income countries is improving, but international disparities persist

An observational study including 3.9 million cancer cases in seven high-income countries between 1995-2014 finds that survival of seven cancers is generally improving, although the overall level and pace of improvement varies between countries and for each cancer type.

The Guardian hails the improved figures but notes how far behind Australia and Canada we are. UK Still behind…

In a world where nobody trusts any experts, who will trust the UN report? Not our politicians it seems…

Terrifyingly, according to the World Health Organisation definition the UK no longer has a NHS

To paraphrase Spike Milligan: “I told you the Health Services were all ill”.

The Brexit deadline and the Health Services planning – standards and services are going to get worse..

Image result for cancer therapy cartoon

Even London and the Home Counties are feeling the squeeze… as standards and staff numbers fall re revert to the pre-NHS divide.

Just some of the pain felt in the rural shires is now feeding into London and suburbia. Standards of staffing and clinical diagnosis and speed are all falling. The blame is long term political neglect and denial from an elected elite who always felt they had access to the best – in London. No longer… it is impossible to report on all GP surgery closures as there are so many. The reality is that private services for ambulance, GP, A&E etc will follow… Bevan wanted the same high standards for the miners as the bankers – instead the standards are falling, but as before we had a health service, the bankers can afford the private option.

Owen Sheppard for MyLondon reports 7th September 2019: West London overspends by £112m!!

GP surgeries across Surrey are facing an uncertain future, with two confirmed closures and a third possibly following suit, which are set to put pressure on those nearby.

Patients say they are worried about the pressures on neighbouring services following the announcement of closures of surgeries in Staines and Guildford.

In Burpham, a petition has been launched to save the Burpham New Inn surgery which is also facing closure.

So why are surgeries closing?

The Guildford and Waverley Clinical Commissioning Group (CCG) has cited problems with leases and premises, which have led to the closures of two practices in the area.

In Staines, the Staines Thameside Medical Practice shut on Saturday (August 31) following a decision by the doctors to end their contract with the NHS to provide GP services. This was reportedly due to personal reasons.

Patients will lose the St Nicolas branch surgery in Bury Fields, Guildford, which will close at the end of October following issues with the premises and its lease.

Guildford and Waverley CCG has confirmed the surgery will close on October 24. All services will instead be provided by the main surgery at Guildford Rivers Practice in Hurst Farm, Milford.

One St Nicolas patient, who did not wish to be named, said: “I am very upset about the closure of St Nicolas Surgery, it came as a shock.

“[I believe] this was pre-planned since last year but without telling patients previously. I have not received a letter as yet about the closure.

“I think it’s been about a year that all the telephone calls to St Nicolas Surgery have been re-directed to the general practice in Milford.

“The closure of St Nicolas Surgery will put extra pressure on other GP surgeries in Guildford as patients who are ill, disabled, elderly or who don’t drive won’t be able to get to Milford.”

The CCG has said it will work with the practice to ensure that despite the changes, patients will continue to receive high quality care.

A spokesman said: “The CCG received an application from Guildford Rivers Practice that proposed the closure of its branch surgery, St Nicolas Surgery, due to issues with the premises and the lease which was proposed to have had a negative impact on the service offered to patients.

“Following a period of engagement with patients and neighbouring GP practices, the application to close the branch has now been approved by Guildford and Waverley’s Primary Care Commissioning Committee (PCCC).”

The spokesman added: “Registered patients of Guildford Rivers Practice will remain so, following the branch closure, with GPs from St Nicholas Surgery transferring to the main site and continuing to offer appointments to patients.

“Any patients who require home visits will continue to receive these in the usual way.

“The practice is committed to providing the best service for patients by operating solely from the Guildford Rivers Practice main site and the CCG will work with the practice to ensure patients continue to receive safe and high quality care moving forward.”

The news comes as patients await the decision on the future of Burpham’s New Inn surgery. A decision was set to be made on August 28 but this has been delayed.

A spokesman for Guildford and Waverley CCG said: “The PCCC has been re-arranged to ensure every option put to the CCG is fully explored, before a final decision is made.

“The committee has been rescheduled for September 13.”

In a letter to patients sent on July 31, the CCG said it was likely the New Inn Surgery in London Road would have to close later in 2019 due to problems securing a long-term home.

The letter said the surgery’s lease was expiring and no other suitable alternative sites have been found.

Patients launched a petition to save the surgery, which has been signed by 282 people to date.


Around 4,500 patients have had to re-register with another GP surgery after Staines Thameside Medical Practice closed its doors on Saturday (August 31).

Other GP surgeries in the area are accepting new patients despite some having recently had their lists capped.

Two Staines councillors are concerned about the additional pressure on those surgeries.

Councillor Jan Doerfel, Green Party member for Staines, said: “Expecting other GP practices to absorb the additional 4,500 patients is likely to result in longer waiting times for all those affected and additional travel for those that had to enrol with those practices. This is not acceptable.”

Councillor Veena Siva, Labour member for the ward, said: “Yet another GP surgery closes. Smaller practices are closing due to underfunding and insufficient GPs which means they can no longer be run safely and sustainably.”

She added: “As it stands, it is unfortunately no surprise that there was no interest from GPs to take over the surgery when in doing so all they would face is under-resourcing, enormous pressure and stress.”

NHS North West Surrey Clinical Commissioning Group (CCG) was responsible for supporting patients as they switched to a different GP service.

St David’s Family Practice Doctor Jagit Rai works at one of the surgeries receiving patients from Staines Thameside and is a governing body member at NHS North West CCG.

Doctor Rai said: “The closure of this practice does not relate to funding or staff shortages. The CCG was disappointed to receive notification from GPs at Staines Thameside of their decision to end their contract with the NHS to run the surgery.

“They made this decision due to a change in personal circumstances that could not have been predicted or planned for. The CCG asked neighbouring practices about the option to take over the running of Staines Thameside and reviewed their capacity to take on new patients.

“The surgeries decided the best way to care for Staines Thameside patients is at their practices where they can benefit from an established team and range of services.”

It’s slightly brighter news for the residents in Chiddingfold, where a new surgery is being built after the former building was destroyed by a fire.

Chiddingfold Surgery in Ridgley Road was gutted on January 7, 2019.

Plans were submitted in March to Waverley Borough Council for the complete rebuild.

The surgery has relocated to Cedar ward at Milford Hospital, where full doctor and nurse surgeries are in place. Expanded opening hours are available for patients at Dunsfold surgery.

Update : Diane Taylor in the Guardian 8th September 2019: London GPs told to restrict specialist referrals under new NHSThe New “Rationing Plan”. Plans for new cuts sent same day Boris Johnson reinforced NHS spending commitments..

A view from Switzerland: “I would’nt put up with it for 2 seconds”… What the NHS needs is the “right sort of bureaucrat”.

The “devotion” to a non existent National Health Service is evident in every meeting where any change is proposed. Until we change the “rules of the game” our health services are set to decline compared to the private alternatives. However much money we put in we will never have equality and fairness given the current 4/5 dispensations, post code differences in quality, waiting, life expectancy, etc. If only we could “see ourselves as others see us”: devoted to a mythical concept rather than the reality of today. (Robbie Burns in Ode to a Louse.)

Janice Davis opines on September 7th 2019 in “The conservative woman”; What the NHS needs is the right sort of bureaucrat”.

HEALTH spending in England during the financial year 2018/19 was approximately £129billion, and is expected to rise to nearly £134billion by 2020. Of that, £115billion was spent on the NHS England budget, while the rest was spent by the Department of Health on initiatives, training, education and infrastructure, which includes IT and new hospitals.

In spite of that massive budget, the NHS operates under severe financial pressures. Trusts across England collectively ended up in 2018/2019 with a deficit of £571million – not a huge percentage of the total perhaps, but still an enormous amount over-spent. There is political pressure for savings, at the same time as demand is rising and the population is ageing. Some claim that treatments are being rationed, while patient care is often found to be inadequate.

It’s all looking a bit of a mess. Why? It seems to me to be the result of a gap between the political scope of the health care system and how the government is managing to finance it. Techniques and medication have developed greatly in the 71 years since the NHS was initiated. But so has the range of ‘health’ issues which the national service sees the need to treat at taxpayers’ expense. Cosmetic procedures, sex transitioning even for infants, fertility for ageing would-be parents as well as the growing costs of obesity: all would have William Beveridge turning in his grave. Then there’s ‘mental health’ – the whole nation appears to be suffering a serious nervous breakdown.

This is happening everywhere in the developed world, but one of the solvable issues in the UK is that even when the authorities have decided what the service ought to be treating, there is no consideration of either its affordability, access or even rationing. The holy cow of ‘free at the point of access’ means ‘very expensive at the point of taxation’.

It’s not for nothing that the design of the NHS is not replicated anywhere else in the world. Health care is the greediest money-eating aspect of western societies. The amount the UK spends on it should have the world salivating with envy. Instead they see an example of poor value for money.

Let me tell you about health care where I live in Eastern Switzerland. Everybody moans – the insurance premiums keep going up, and you always seem to get less cover. But health care here is superb. And everybody knows exactly what it costs, because they receive itemised statements from their insurance company. The cost of your blood pressure meds, the cost of 15 minutes with your GP, and if you’re really unlucky the cost of calling an emergency ambulance (which will turn up in five minutes, superbly equipped and manned, and will probably cost you over £1,000, because your insurance doesn’t cover it). It all makes people think, and even take care.

National Insurance taxation was supposed to pay for universal health care in the UK. But it’s not ring-fenced, and all costs now come out of general taxation, which is paid by only about 50 per cent of the UK population. All of this half of the population have the legal right of access, but far more worrying is the fact that the NHS has no mechanism for restricting access to its enormously expensive care system to those who are absolutely not entitled to it, namely health tourists who have left £150million of unpaid bills. Nigel Farage was vilified for saying that non-contributors came to the UK to get free HIV treatment. The Sun retells here the story of a Nigerian woman who came to the UK to deliver her IVF quads, two of whom died, and she left an unpaid bill of nearly half a million pounds.  Why would any taxpayer-funded organisation even contemplate this?

The Left will tell you that it’s because we are a rich country and we can afford it. The country I live in is also relatively rich, but wouldn’t put up with this for two seconds. When we moved here, we applied for the right to reside. No problem at all – except we would need personal medical insurance. Without that, the young man at the Rathaus said ‘we could become a burden on the community’. So we sorted it out. Amazingly, just a few months before, the UK and Switzerland had made a bilateral agreement whereby retired UK citizens in Switzerland and Swiss citizens in the UK would be afforded reciprocal health insurance.

This means that we can access Swiss-quality health care, paid for in part by the NHS. Everyone here has to pay upfront the first CHF 400 (£328) of health care costs per annum, and thereafter approximately 10 per cent of charges. I believe this discourages unnecessary calls on GPs and demands for medication. But what the NHS partly pays for here is very different from what it pays for in the UK. I have personal experience of both. The London hospital which sorted out my broken leg was superb until it came to the after-care. The ward was not well cleaned, the food was inedible. The woman in the bed opposite had a faithful spouse who brought her three meals a day from McDonald’s. She wouldn’t touch the slimy porridge they were serving up.

Compare that with my hip replacement operation here. The Swiss system is organised largely through subsidiarity, with cantons having financial discretion, and are not pinned down to the outrage of PFI in the UK. You can choose your GP, your surgeon, even the clinic where they treat you. The wards are immaculate, and the food is worthy of a five-star hotel, because the health professionals here know that proper nutrition is a key element in patient recovery.

It doesn’t end there. After a week of care in the clinic, you get a further three weeks of rehabilitation, with physiotherapists, a swimming pool, a fully equipped gym, and all that healthy in-house cooked food. Even visitors, hikers and families came daily to the canteen to eat the same healthy food provided for us. (They pay, of course.) And on being sent back home, three weeks of extra physio, just to make sure.

So why can’t the NHS follow the same rules and procedures in England? It’s not up to doctors or nurses – they are health professionals and care-givers. What the entire system lacks is the right sort of bureaucrats – ordinary secretaries, like the ones here who check my health card and make sure I’m paid into the system before I am treated. It’s not judgmental – it’s a case of knowing the rules and understanding how to enforce them. They are the necessary gatekeepers to control a very expensive system.

So what’s so difficult in the UK? It’s a routine job, especially if you are Swiss, and accept the importance of rules and enforcement. If UK politicians can’t or won’t work that out, I’ll happily volunteer to do it for them. Dead easy.


The train crash is coming – slowly. Despite Oliver Kamm

NHSreality would like the politicians in our liberal democracy to tell the truth. Debate is only happening where Hospital Staff, doctors and Dentists meet privately: their coffee rooms, and behind closed doors in Whitehall. Occasionally i have heard a retired chairman let it slip
: “all health care is rationed”, but there is no follow up in the implications. Thus the “honest debate” demanded by Mr Stevens 1in 2014 is refused us. In my local Liberal Party we plan a debate on these issues, and possible use of ID cards to help more fairness. Will the members turn out to discuss such an unpleasant subject? If they don’t the train crash gets closer.

We need to be prepared to upset some people – those who are knot open to logic. The result is knee jerk opportunistic locality based rationing which is unfair’.

Oliver Kamm in the Times 30th August 2019 does not seem to support this view in “Private healthcare is no match for our fair and efficient NHS”

His first paragraph ends: “There is no crisis of affordability in healthcare and the model of “socialised medicine” is actually a pretty efficient provider.” Disagree for the future. The cost of new technologies is advancing faster than any state’s ability to pay’.

T&he last reads: “The evidence is that mental disorders (40% of the spend) such as clinical depression have a big impact in reducing labour productivity, and that treatments for it — psychological therapies such as cognitive-behavioural therapy — are time-limited and cost-effective. These remedies should be offered more readily on the NHS; they would benefit public health and the economy, and they are affordable.” Agree. But they need to be offered instead rather than as additional therapies. The reasons he gives for relative efficiency are “in the NHS, there is no perverse incentive for doctors to over-prescribe. That’s not what their salary is based on. Second, because treatment is free at the point of use, this encourages early diagnosis. Third, the decision on treatment is taken by the doctor rather than the patient, which tends to contain costs.” NHSreality agrees with all this, but if we want a universal system where the rich get thie same as the poor (England v Wales, Bankers and Miners of Tredegar) we need the speed and quality of the state service to be so good that private care offers little advantage. The trend is in the opposite direction..

January 6th 2018: “The NHS is like a tumour on the public finances, expanding so aggressively that it threatens to kill other organs of state …. Better still would be a formal policy if provision is to be limited — but the politics is too sensitive”.

21st December 2018: IMF forecast is damning.. A two tier system emerges from denial… A collusion of politicians and leaders…?

Nov 5th 2018: It’s about to blow up. There is no Mr Fawkes to arrest, blame and punish (hang draw and quarter) for the coming NHS failures

March 12th 2018: No good news for those who think money is the answer….

July 1st 2018: What models of funding are best for a healthy and just society? No other country has chosen our system, even after 70 years and our Olympic boasting. The public need to be led into realising why not.

September 15tih 2018: The 3 myths of the NHS…..& …No learning from other countries – no co-payments, and more scandals..

1st June 2018: The real cost of the English taxpayer subsidising NHS Wales – is twice the official figure

May 15th 2015: Britain ranked last (out of 20 rich countries) by a wide margin in the number of CT and MRI scanners per head of population. Australia has six times as many CT scanners per head, and spends roughly the same as Britain on healthcare overall as a share of GDP.

May 1st 2015: NHS funding advice: GDP worth debating… Showers of money will not work..

Nov 22nd 2014: When and who will eventually speak out honestly? 10% now to 20% of GDP by 2061

October28th 2013: GDP and GVA differences across the UK – a threat from Scottish Independance

Ju;y 18th 2018: Brexit dividend for NHS is a fallacy, says OBR

July 21st 2019: The value of the UK’s health information – and only partial value at that.

Sept 28th 2018: Taxes must rise to pay for NHS funding, Lagarde says. Tax changes need to be considered as a whole.

July 2nd 2018: NHS at 70: Five medical experts diagnose NHS problems – and prescribe cures. The BBC is a government organisation, and funds the Radio Times. It cannot be expected to give credence to rationing overtly.

27th May 2018: Some of the options, all unpleasant, for raising money for the UK Health Services. Tax reform – “fishing for funds” in the Economist

May 25th 2018: Tax rise for NHS can’t be put off much longer

24th May 2018: Addressing the “black hole” in the health budgets – wait for political denial.

25thi April 2018: The NHS at 70: Loved, valued, and too costly (print version) / affordable (on line version) – even the experts don’t know where to stand. The core principles need to be changed..

March 27th 2018: Ten year budgets, fiscal vaccinations: these are all the dying suggestions of a system designed to fail.

March 26th 2018: “An illusory technical excape from spending choice”, “a fourfold revolution is required”, “clumsy and unreliable”…

March 23th 2018: Is Hyporthecated tax a solution, or a distraction? NHSreality is clearly against, but it looks as if we are all going to “share” a lot more..

Feb 9th 2018: A bigger and bigger deficit in West Wales…… Now at £600 per head……

Jan 28th 2018: A cash injection alone won’t cure NHS ills. Lets be clear: there is no more money, and no Brexit dividend.

Jan 27th 2018: Other countries have sensibly funded healthcare. (Scandinavia and NZ), & “the schemes used by most countries on the Continent are preferable to the NHS model.

September 24th 2017: A 150% increase in patients going private is an indictment of the UK Health Services… Successive health ministers have ensured a thriving pprivate system.

20th September 2017: Pragmatic decisions need to be taken to insist on rationing… Are we are gullible enough to believe their lies?

September 18th 2017: Surveys of the uninformed are less valuable than those of the staff: survey doctors and nurses please Kings Fund

As it gets worse, YOU are going to have to wait longer and longer – or pay up. A “grim reality”..

Despite “adequate or average” funding, our waiting lists are much higher than average. Even communication is failing at a basic level…5

Why aren’t the UK Health Services centre stage in this election? All 4 are bust.

If the NHS really is the envy of the world, why don’t countries copy it?

…political “unsayables”. Behind closed doors nearly every politician admits that the current system for paying for health and social care is decades out of date.

4th June 2014: Denial for 5 years. On 4th June 2014 Mr Stevens asked for an honest debate…

The reality of the post-code lottery and rationing of health and social care. It will just have to get worse before the “honest debate”

Ju9ne 5th 2018: We need tax and fiscal policies that upset some!..”The role of a leader is to persuade voters of the need for reform, rather than just to follow public opinion.” but we have no leadership, and no honest debate ..

Going bust when it’s not allowed – all English Regions bar one.. The knee jerk response has yet to happen, as has the “honest debate”.

The cost of curing just one congenital disease…. The pace of advance of technology is faster than any government can afford

The good news this week – is usually too expensive. But there is hope on depression, and exchanging drugs for therapy.

The potential for ID cards in accessing health, and progressive redistribution



Hip and IVF rationing – the thin edge of a web of denial

The rationing around hip replacements not only causes pain and depression, and lack of mobility, but it accelerates ischaemic heart disease, obesity from inactivity, and diabetes. This means more hart attacks and strokes than we need to have as a nation. The profession knows all this and when we are in need we may be in a post code with well managed waiting, but we may be in a poorly managed or funded trust, perhaps with a shortage of long term staff. Manned by a succession of locums the result is more infections and complications. No wonder many people vote with their feet and go privately. They can choose their consultant, when they are operated on, and reduce risk greatly to avoid complications.

What is so silly is that the government does not admit to rationing at all. If it did we would rightly wish to know the how, why, where, when and what was not available to us all… it is only when this type of honest discussion is possible that things will change. 

In the last week I have heard first hand of different rules regarding wheelchairs for paraplegic and legless patients, hearing aids (In England they have WiFi compatibility but not in Wales) and expensive drugs for rare conditions. We have to ration overtly…

Meanwhile they will get worse, and the unofficial, unintended (presumably) two tier system will extend…Just wait until it affects YOU, or your nearest and dearest.

Max Pemburton in the Daily Mail 24th August 2019 waxes lyrical about his gran’s waiting for her Hip replacement.

On the same day in the Telegraph Dev Chakravarty asks: Why shouldn’t single women be able to have IVF on the NHS

Aside from the fact that there is no NHS, the rules in Wales and England, and from Trust to Trust and Post Code to Post Code are different.

Since it is funded by the taxpayer, there will always be a degree of rationing in the services the NHS offers patients for free at the point of use. The debate over which services it provides, based on which criteria, is therefore a constant in our public discourse. There are few areas more sensitive than the provision of IVF.

The NHS limits access to IVF in all sorts of ways in different parts of the country, but the reports that NHS South East London is to bar all single women from receiving funding for such treatment were startling. In justifying its decision, which is now under review, the authority controversially cited a document which declared: “A sole woman is unable to bring out the…

Image result for web of denial cartoon