Tuesday, May 29, 2012

Cyberknives: Our campaign to make sure your NHS has one.

This cyberknife shown above should be available to you and and your family if you need radiotherapy treatment to treat a cancer. It is 8 times more successful than chemotherapy. Currently, only 5 places in the UK have them. This one above is at Harley Street Private Clinic in London. Areas such as the North East, North West, South West, Midlands and Yorkshire & Humberside do not have access to this treatment. Update: NHS Sussex this morning have announced they are to buy 5 machines for their PCT. Great news for the people of Sussex (here).

What makes this even more galling is that there is currently a £169,000,000 underspend in the Cancer Drugs Fund for this year. This wasted millions should be used to buy the equipment above so that you and your loved ones can have access to this cutting edge treatment. We in Labour Left  have used the one click gadget below to tweet Health Ministers Paul Burstow and Anne Milton to ask them to use the Cancer Drugs Fund underspend to buy cyberknives. Please give your consideration to doing likewise. Many thanks.


5 NHS staffs whose morale is at an all time low

1. Derriford Hospital, Plymouth

The hospital is being asked to find £54m savings in two years. The workforce's morale is at an all time low as Serco who run the cleaning & catering contract in the hospital arbitrarily cut staff's hours by 17 leading to an annual lost of more than £7,000 a year for some staff. Hospital bosses for months refused to meet Trade Union officials until strike action was threatened. In the latest twist, just today two non-executive directors have resigned their posts at the hospital in protest at the poor running. The new chair for the hospital has just been appointed from outside the hospital with no appreciation or understanding for how hard things have been for the staff.

2. Great Royal Western, Swindon

Staff that this hospital are among the most deflated in the country. Wards have been shut down, staff have been asked to re-apply for their posts (in some cases unsuccessfully). Staff have been disciplined for their social media usage and Multi-National Corporation, Carillion, admit to bullying and shaking down the staff. The cleaning and catering staff have been on strike at the hospital for weeks now as they protest against the sacking and black listing of staff members through the courts. 

3. Robert Jones & Agnes Hunt Orthopaedic Hospital, Shropshire

The Keynon Ward was shut down over Easter and has not opened since. The staff were not informed of any decision. The budgetary pressures and staff cuts at the hospital have led to staff operating a "Work to Rule" strike. This means they only fulfill their contractual obligations at the hospital and refuse to do the normal 1000s of hours of overtime they put in without pay per month. There is a serious de-skilling programme under way at the hospital, where staff being asked to perform duties above their pay grade. Health Care Assistants are being sent on courses and asked to operate machines that a really the duties of a nurse. 

4. NHS Direct Staff, Devon

NHS Direct staff throughout the UK live in uncertain times. The 111 pilots are scary for three main reasons. Experienced staff are being replaced by telephonists with much less medical training. Staff numbers are being cut and private corporations are being invited to tender for the contracts. This led 600 staff across South Devon staging a work in protest, where they all worked free of charge for 24 hours to draw attention to the importance of their cause. Just yesterday, Serco pulled out of several 111 contracts they were bidding for after it emerged they were to be prevented from out sourcing the jobs. Serco claimed they only wanted to outsource the jobs to other NHS areas of England but ultimately the true profits would have been in using their Indian Call Centres. I hope the nurses pick up this piece of good news.

5. Springfield University Hospital, London

It might seem trivial to include these mental health nurses on the list, but please let me explain why I have done so. Nurses pay have been frozen for two years, their registration fees have climbed. Many are facing the prospect of being downbanded and as staff shortages bite they are being asked to do more. As well as this Andrew Lansley is currently waging a pensions war with NHS staff. All things considered, the prospect of £450 car parking charges being introduced at the South London hospitals represents an annual 2.5% tax for the nurses. On top of everything else, this is a cost they cannot afford. Some nurses have got in touch to say that the charges they have been asked to pay for parking their car at their hospital have topped £600 a year. The commodification of staff who do such a crucial job is a moral wrong and for all the collective funds raised, think what a boost to their morale it would be if the Health Secretary were to announce nation wide that charges were to be scrapped. After all, NHS car parks are free in Scotland.

(I was tempted to include other staffs such as the Royal Victoria Hospital in Belfast who have had to absorb an A & E Closure in the city's other main hospital. The extra patients combined with no corresponding increase in staff numbers has crippled a once great hospital. In addition, the spread of the Noro-virus throughout Scotland's hospitals especially the Royal Alexandria has placed immense strain on the workforces in Scottish Hospitals).

Monday, May 28, 2012

"It is essentially Skype messaging"

Virgin are in my bad books. First they take the NHS in York to the CCP accusing them of predatory pricing because York NHS beat Virgin to a contract by charging lower prices. Then Virgin gain 18 contracts throughout the UK to run anything from community care to sexual services. Worse still, this week, the story broke of their 5 year ill treatment of Virgin Media customers who suffer death. Instead of showing compassion Virgin go on to threaten and abuse the family members left behind to settle unpaid bills.
Associate Professor Bernard Yan using the Telestroke Service.

Now Virgin have teamed up with 7 PCTs in the NHS Lancashire area to help deliver "virtual" or "video" diagnosis. It works as follows. You switch on your camera on your computer, give me a peek & I'll tell you if your gonna have a stroke or not. Well, it is not quite like that since I am not qualified to diagnose, and they'll probably have a proper camera (or a "telekart" as they're calling it) but the basics are the same. A dude will now diagnose you down a camera. This paves the way to reduce expertise on site, to cease the employment of surgeons and simply perform diagnosis remotely. If this technology is beneficial, and it might be, use it on-site. Give the surgeon a hand held interactive device that he can carry whilst moving about the ward. The danger is the off site provision and those occasions when things go wrong.

Now here's the nitty gritty. The cameras will be placed in emergency wards of Lancashire hospitals and used in out of hours services. The whole sheebang comes complete with a help desk. The people behind this project say that its unique selling point is that if the nurse on site cannot use equipment because she has "forgotten" how to use it that this remote video conferencing will be able to help. One might be inclined to ask why there cannot be a doctor on site, and whether the nurse will not so much forget but more be a Health Care Assistant who is not trained or qualified to use the equipment. Either way, the growing use of virtual technology be it virtual wards, or video conferencing should concern us all. As the expert involved explains (I quote) "It is essentially Skype messaging" (see more here).

17,000,000 voters think Tony Blair should be tried for war crimes


In February 2010, just after Tony Blair appeared at the Chilcot Inquiry, ComRes published a poll for the Independent that asked voters if they think Tony Blair should be tried for war crimes.  37% voters thought he should, whilst 57% of voters thought he should not. 

As a percentage of voters on the electoral roll in 2010, this means that 17 million voters wanted Tony Blair placed on trial for war crimes. Those in favour were predominantly the young (those under 35) and those from northern or poorer parts of the UK.  Those who were of mind not to put him on trial were mostly the elderly, southern wealthy types. You can see the data for yourself (here).

If you want to geek out on why polling is a science not an art, and how we are able to recalibrate the polling %s into numbers of actual voters, then please follow this link (here).

3 NHS policies that should be included in Labour's 2015 Manifesto

On 24 separate occasions since the NHS Bill became law, Andy Burnham and Ed Miliband have said that they will repeal the NHS Bill. Upon closer examination of their detailed comments about what form this will take, we can say that they include:

1. Awarding the NHS Preferred Bidder Status in the tendering process. 
2. Repealing the 49% Cap of Private Sector Involvement in the NHS.
3. Preventing CCGs commissioning to themselves.
4. Reforming MONITOR but in a way that is unclear.

None of this goes far enough and to me it is no wonder that an NHS party has been formed with a view to contesting seats at the next election. Below, I outline the policies Labour should be embracing on the NHS if we are to present ourselves as a radical alternative to the Tories on Health.

1. We need to support François Hollande's attempts to enshrine in EU Law the right of all EU citizens to have access to a publicly funded healthcare system. This important principle, if agreed, would have the added benefit of reducing health tourism as well as extending the rights we have enjoyed since 1948 to other EU citizens including those in our neighbouring Irish Republic.

2. We need to seek opt outs of EU regulations 103 & 104 that open up the NHS to EU Competition Law. This can be done by legislation in the sovereign parliament exempting our healthcare from these elements of EU. It could also be further secured by coordinating Hollande's planned EU law to include protection from public health systems from competition law.

3. A De-Marketisation Act: We need to commit to de-marketising our health service. The crude image of a la carte menus of operations offered, and their prices, runs alien to the ethos of our healthcare. I should not know that £107 will get my partner a pregnancy scan. I should not know that £199 gets me an MRI scan. I should not receive brochures and pamphlets inviting me to book special rooms at a NHS Hospital or NHS Hospital Hotel for the duration of my operation. A complete an utter de-marketisation of our public healthcare is required, perhaps through a de-marketisation bill. NHS Hospitals should be cashless societies. 

It might also be necessary to explore all of the structures that Lansley's bill has created. If the CCGs were to remain then the Senate should be given teeth. Monitor could be dramatically downgraded and its powers dispersed to regional NHS Senates. Healthwatch pending its effective functioning should also potentially be retained and given powers to refer matters to the judiciary if need be.

Sick, grotesque & cynical: The spectacle of Government Ministers campaigning to save NHS hospitals in their own seats.

The government is currently engaged in rank hypocrisy throughout the UK. They have conspired to pass an unwanted NHS Bill, force £20bn of NHS cuts through and shut down many wards, hospitals and units all in the name of cost savings exercises. The spectacle of government ministers leading the campaign to save NHS Hospitals ONLY in their own constituencies will sicken many NHS activists to their very core. If these ministers really cared about the NHS, then they would have done something to prevent cuts, closures and carve ups throughout the UK, not just the areas where they seek votes.

What sickens me the most is that Government Ministers are using their own special influence within the government to cherry pick which hospitals must go, and which ones are given special consideration. So, the Trafford A & E in Greater Manchester is to be shown no mercy because it has no government minister that could save it.  Wards have been shut at The Great Royal Western, Shropshire & Hinchingbrooke. In some cases even sitting Tory MPs have joined in the fight to save their wards & hospitals but their please have fallen on deaf ears.

Yet Health Minister Paul Burstow is using the privilege of his Ministerial position to lobby for St Helier Hospital in his constituency. Many readers will feel bitter that the Lib Dem health spokesperson has brutally ignored the millions of voices who cried out to protect NHS services, yet he wishes to preserve his political future by saving the hospital in his constituency (see here).

Likewise, William Hague has been foremost among the Tory voices who showed impunity for the pleas to halt the passing of the Health & Social Care Bill and yet he has the cheek to attend and address a 4,200 strong NHS march in North Allerton at the weekend to save his local Maternity Ward (see here). Hague's posturing in terms of detaching himself from government decisions is laughable. What will concern many is that has had 4 separate meetings with Lansley to lobby for the non-closure of the Ward. The activists of Royston, Heatherwood or Trafford might rightly enquire what it is that they have to do in order to earn the same audience with Lansley? This is a classic case of one rule for all of us, and special privilege for government chums. 

70% of Homeless patients are discharged from the NHS onto the street.

The Department of Health commissioned this report (link here) into Homelessness's link with NHS Discharges. The report produced by St Mungo's and Homeless Link found that 70% of homeless people who are discharged from NHS hospitals are actually discharged onto the street. No attempt is being made to safeguard the recovering health of homeless patients. Homeless people die much younger than you and I and often carry serious illness related to dirty needle usage or alcoholism. These people need our compassion, love and support if they are to get better and get their lives on track. Research shows that family breakdown on abuse during their adolescence are key factors in their declining health.

As I have shown from other research, homelessness has risen 14% under this Tory government with more than 45,000 households being declared statutorily homeless per year. Given that the average household is 2.3 per home, we can be sure that the true figure of actual homeless people is much higher than 45,000. The figures also exclude those living in emergency accommodation,  the standard of which would actually worsen a patient's health.

What concerns me about this report is that coverage of it includes an immediate response from the government Minister (Paul Burstow). This is a cynical attempt to mitigate the fall out from the article and is a ploy that should concern all democrats. I have not included the government's response here because I think it appropriate that those interested get to read the report first.

The truth is that the government have oversaw the building of just 454 affordable homes for the last 6 months on record. They have commenced the building of just 100 Council Homes. And they are in the process of selling 591 Hectares of NHS land off to private developers. Homelessness is one statistic that this government are impervious to.

See the report (here).

Sunday, May 27, 2012

Cancer Drugs Fund under spend is costing lives

Radiopharmaceuticals more commonly known as radiotherapy is a precise/localised way of targeting cancer. It causes less damage to the tissues around the cancer area than chemotherapy because it is so precise/localised. Results show it is 8 times more successful than Chemotherapy. If you wish to geek out on original EU guidelines on the storage and safe usage of radiopharmaceuticals then please follow this link (here).

In October 2010, the Tories announced a cancer drugs fund of up to £200,000,000. This was a good decision and one which should have led to 1000s of lives throughout the 28 Cancer Network areas of England being saved. Conceivably, the £200m could have paid for this radiotherapy treatment. 

The sad fact is that there is currently a severe under spend in the Cancer Drugs Fund. Only £71,000,000 has been spent so far this year. Even the Tory newspapers accept that this is potentially costing thousands of lives per year (here). What's more, the Cancer Drug Networks of the North East, North West, Yorks & Humberside, South West and Midlands are missing out on this radiotherapy treatment. Instead patients in those regions are either being offered chemotherapy treatment, or are too ill to undergo that treatment. Especially for the latter category of patients, it is imperative that they have the radiotherapy treatment made available. Thus far, the only sites offering the treatment are 2 private clinics and three southern hospitals.

Tonight, we in Labour Left are launching a campaign to a) ensure all of the Cancer Drugs Fund is spent and that b) The spending is allocated fairly throughout the 28 Cancer Networks. This will allow local areas to decide if they wish to avail of this radiotherapy treatment. Our Chairperson, and Health Select Committee Member, Grahame Morris MP (Easington), has been making the case on the Committee and in lobbying the government for some time. Grahame argues, "It makes no sense for the Cancer Drugs Fund to under spend in this way and relinquish resources back to the central NHS pot". He also warned, "People are dying on Lansley's watch because they are not being offered treatments that could save their lives. It is an insult to their families to deny them this avenue especially when the funds are there". 

Thus far the government have shown flashes of willingness to engage on the issue. Unfortunately, of the £200m fund, the government retain £60m locally and decide how it should be spent. In addition, there is no requirement that the £140m is evenly spread, or that there is guidance given on the radiotherapy treatment. Paul Burstow claims that he is willing to set aside an additional £150m over 3 years but this has not materialized in DoH guidance on resources available for the Cancer Drugs Fun (see here).

Saturday, May 26, 2012

Tories ring fence Fat Cat NHS bosses salaries while launching a war on Nurses' wages.

These 80 fat cat jobs in the NHS earn a combined salary of almost £10,000,000 a year. They average at nearly £120,000 per post annually. This excludes pension relief, company car and bonuses. In evidence submitted to the local pay & senior salaries review, it was yesterday recommended that regional NHS bosses earning a fortune in salaries should be exempted from the regional pay review. This advice was given at the same time as plans are underway to cut the wages nurses, Health Care Assistants, porters, auxiliaries and other cleaning staff receive in the North East, North West, Midlands, South West and Yorks & Humber. This is black and white hypocrisy, inequality and double standards at its very worst. The justification for protecting high paid fat cat NHS bosses from regional pay cuts was that the roles they held were national posts not really reflective of local market conditions. Why should ordinary NHS staff lose up to 30% of the wages because they live in poorer parts of England? This could amount to a wage cut of £6,000. As I have argued many times, it is perhaps justifiable to pay those staff more, given that the need they are tending is much more acute as a result of generational inequalities.

Access the full list of high paid NHS bosses (here).

See below for a comparison in the salaries of NHS bosses in comparison to a band 5 nurse.

A step by step guide as to how Lansley is set to privatise our NHS

Every NHS Trust in England is now legally obliged to either seek Foundation Trust status or merge with another NHS Trust by 2014.  This is part of the regulations to emerge from private consultancy firm McKinsey during the drafting of the Tory Health Bill.

The problem is that 50% of NHS Trusts are failing in their application for Foundation Trust status. This is causing them as a secondary option to seek a merger. A merger, if achieved, is by no means a disaster because at least it gives the trust a chance of remain in public control. So Trafford, Northumbria, St Hellier and Cumbria are all seeking a merger with a more financially healthy NHS Trust close by.

Even if mergers are achieved, however, very often the larger Trust in the merger seeks to offload the less financially viable parts of the supposedly failing trust. For example, Trafford A & E is at severe risk of closure. It is just one of a long list of places under threat that I could bore you with. But there are other problems besides.

Even by joining another Trust to achieve Foundation Trust status, the NHS Trusts enter into a precarious standalone existence where they are expected to balance budgets year on year. These prescribed budgets are subject to annual change (often reductions) and any improvements in infrastructure must be met out of the budget. This is the reason a very many Foundation Trusts have struggled and had to be bailed out already to the tune of hundreds of millions of pounds. The government are in the midst of £20,000,000,000 cuts in our NHS, and the same figure will be applied again once those rounds of cuts have been achieved.

In addition, the government are reviewing Public Borrowing Controls. They have placed McKinsey once more in charge of deciding if NHS Foundation Trusts should be allowed to borrow less as a % of their budget. Currently the limit is 40% but a further reduction would enshrine infrastructural stagnation for NHS Hospitals and mean that all new innovations are likely to come from private investors. A NHS Trust's ability to compete for a host of NHS contracts would be severely weakened. Even more dangerously, if the new NHS Foundation Trusts find themselves unable to stick to the new tight budgetary framework, then they would be legally open to being placed into administration, declared insolvent, carved up and handed out to private investors.

If, as is likely, some NHS Trusts fail to achieve Foundation Trust status & fail to achieve a merger with a NHS Trust locally, then they will be deemed financially insolvent or quality compromised and could (most likely would) be taken into central control pending a sell off to private investors. 

On top of all of the financial risks I have just outlined there are also new developments in the expectations of standards that are sure to place hospitals under threat of takeover. Cameron yesterday boasted that his new patient surveys would be used to name and shame failing hospitals. Not to mention that previous NHS Patient Services delivered the highest satisfaction ratings in the NHS's history, Cameron is designing new criteria and formatted questionnaires that he will use to hold individual hospitals to account. 'Failing' hospitals will be taken over, and sold off. 

So you can see that NHS Trusts, Foundation Trusts and Hospitals are now under a much greater risk of private takeover than ever before. The government have the means to tighten the budgetary controls and raise the care standards/expectations and then pounce accordingly. In short, the most successful, profitable, and hospital with the highest standard care could be at risk of take over if the government tighten the budget or raise the bar in terms of service expectations. We now live in an NHS world governed by annually fluctuating whims of Tory health bosses who have only one goal in mind. to paint our NHS as failing so that private profiteers can ride in on white horses and save our ailing public health system by privatising in. There is not a single Trust in England, no matter how financially healthy and well performing it is, that could not be painted as failing with a manipulation of their budget or quality surveys.

Friday, May 25, 2012

Lansley's CCGs will cost £1.334bn a year to run.

Yesterday, the government published the list of the 212 Clinical Commissioning Groups that are to be established throughout England. Some will serve populations as low as 67,000 while other super-CCGs will cater for nearly 1 million patients. (see the full list here).

For the first time the government have published an expectation of the costs in running their new CCG structure.  A closer examination of the government's data shows that annual costs just to run the CCGs will amount to £1.334 billion a year. Over the course of a parliamentary term this is a combined running cost of £6.67bn. The chairs of the CCGs will for 2 days work a week be given £40,000 each. Two other part time staff will earn smaller sums of £25k. In terms of the calculation of the running costs, there also appears to be some disparity. By dividing total running costs by the number of patients a CCG expects to serve, we can say that some CCGs such as North Somerset CCG will cost £26 per patient to run, while other CCGs such as Brent or Lambeth will be allocated just £21 per patient. Quite why some CCGs are being allocated 25% more funds to run their CCG is not clear. 

I see no reason why we cannot call these CCGs quangos myself, which after Cameron's promise to have a bonfire of quangos one must ask if the creation of 212 CCGs was counter-productive to that goal.

The government's lack of direction in guiding CCGs on appropriate sizes and mergers has undoubtedly part caused this disparity. One of the chief consequences of it is that inequality & the post code lottery has been exacerbated because wealthier areas have joined together to form larger CCGs and excluded neighbouring GP practices from poorer areas from merging with them. Pulse have reported that the areas most likely to suffer as a result are the West Midlands, and in particular Birmingham, as well as the East of England (see more of Pulse's research here).

Virgin media threatens, fines and abuses dying customers and grieving families.

Virgin Media have a poor track record in dealing with customers who suffer bereavement. In 2011, one widow was billed £160, late payment fees and sent letters warning her that services would be disconnected because her husband had died and Virgin dragged their heels on switching the contract to her name (read about it here).

Just yesterday, another gentleman, Terence Allen, is aged 62 and has been told he has just 2 weeks to live, as he battles cancer. Virgin have refused to let him cancel his contract with them, and they insist he pays £160 outstanding (see here).

Another widow, whose husband died in 2010, has faced a 2 year battle with Virgin Media for them to refund the £36 of phone credit her deceased husband had left on his phone. As of February she had still not succeeded (read about it here).

In 2009, Virgin left a widow to organise a funeral without a telephone after they cut off the Virgin contract when they learned of her husband's death (see here). The same happened the Whitmarsh family in 2009, when Virgin charged the widow late payment fees and cut of services as they dragged their heels witching the contract to her name following the death of her husband.

None of this is anything new. Virgin have been systematically defrauding customers every penny they can manage for a couple of years now. Below, I list the 6 most common methods that Virgin Media and Talk Talk companies trade in an unethical manner.

1. Miss-selling: At the beginning of the academic term, Virgin Media sales reps went door to door selling a £32.00 p.m. package to students as the lowest possible deal on offer, when their internet clearly offering a £23.00 monthly price for a near identical package. Upon request, the students were denied information regarding the online package. This costs households £108 per year.

2. Not using direct debit: Virgin Media punish customers who prefer to pay at retail outlets by charging them an additional £5.00 penalty a month because they do not allow Virgin to take it direct from their account. This additional charging is wrong because customers are rightly scared Virgin will overcharge them without recourse for reimbursement. Thus, customers prefer to make the payment manually after they have corroborated the billing received.

3. Installation Charge: TalkTalk charge customers £50 in their first bill for installing services. This is despite the service having been available at that address before (thus minimal installation necessary). In some cases TalkTalk allow some of this charge to be deducted from the second bill which is welcome, but for the instances where the facilities are already available at that address no charge should be levied. 

4. Concealing Promotional Deals: TalkTalk currently offer a half price internet deal on their website. But if you phone to sign up to their services, the customer service agent will not offer you this deal. Instead, the internet service will be charged at full price costing the customer an extra £39.00 a year. Customer Service agents should be legally obliged to be fully transparent about the packages available for new customers.

5. Charging Customers for Sending Bills: Customers will tell you that a telecoms bill is gold dust. For those Virgin customers lucky enough to receive them, they are charged £2 a month for the privilege. For those unlucky souls who do not receive an itemised bill through the door, they are at risk of having their services cut off for non-payment of an e-bill. A stamp does not cost £2, and thus it is quite clearly overcharging customers to charge them £24 a year for posted bills.

6. Reconnect Fee: Should you ever fall foul of Virgin Media, they can at any moment cut you off without warning. In cases even where you do not wish to be reconnected (after settling outstanding sums), they automatically reconnect you, and charge you £10 for the privilege. Considering that at best reconnecting requires a simply tap of a keyboard key, the £10 charge is another form of punitive overcharging. 

Update: In terms of the miss-selling of their products, Virgin Media have been the subject of criticism from Ofcom & as well as myself below. I think they have miss sold products for years. In the course of my research today I came across the startling fact that a director on the government's Advertising Standards Authority (ASA) has actually declared Virgin Media as one of his registered interests (you can view it for yourself here)

Thursday, May 24, 2012

Labour MP, Grahame Morris, calls for tougher Gun Laws

Easington MP Grahame Morris today called for Parliamentary time to debate the issue of firearms control in the UK. See his statement in full (here)
His call follows the tragic incident in Horden on New Year ’s Day in which four members of the same family lost their lives.
Supported by Keith Vaz MP, Chairman of the Home Affairs Select Committee, Mr. Morris sought an update from the government on proposed changes to gun licensing laws and procedures. There are currently 34 separate pieces of legislation covering UK gun law.
Mr. Morris has also previously raised the issue of strengthening the link between police and the medical profession when the holder of a gun license is known to have developed mental health issues.
The Leader of the House of Commons, Sir George Young MP, speaking on behalf of the Government said he would raise the matter with the Home Secretary and ask her to write to the Easington MP.
Last week an e-petition was placed online calling for gun control and licensing procedures to be reviewed.
Mr Morris said:
 “The government is dragging its feet over firearms control. It is now 18 months since the Home Affairs Select Committee made its recommendations yet there has been no action.
 “The tragic incident in Horden on New Year’s Day highlighted a number of concerning issues regarding current licensing procedures that could be strengthened relatively simply and without controversy.”

Tuesday, May 22, 2012

Bouncing Discharges show that Virtual Wards are Dangerous & Can Kill

Get used to the phrase "virtual ward". It means caring for yourself at home. The government have come up with this innovation as a way of saving money in our NHS. They shut down wards in hospitals, reduce bed numbers and have less need to hire as many staff. The idea is that if they educate you well enough you can manage your own illness. Privately NHS staff are contacting me to express a worry about the drive.

There are two major developments that suggest this is bonkers.

1. As the link (click here) shows for Royal Hospital in Bath, up to 1 in 8 patients who are discharged actually bounce for a whole host of illnesses. This means they have to be readmitted to the hospital. In the month of December 2011, this included nearly 16% of Cardiac Patients. If you're not happy being sent home do not let them pressure you into acquiescing to early discharge.

2. A crucial pilot study of US patients (COPD) self care in the home had to be abandoned because it resulted in a spike in deaths. It was calculated that a patient was 3 times more likely to die if they were sent home to treat themselves. If there is an increased chance of death from early discharge with COPD, then logic surely dictates that there is an increased risk with other conditions including cardiac complaints. I suspect this will do nothing to curtail the growth in "virtual wards" but it is something we should all play close attention to (see that report here).

The North of England suffers 70% of NHS job cuts while Tory heartlands increase their NHS workforce

23,561 NHS staff members (net) have lost their jobs since the Tories came to power, but what I have discovered today is that the job losses have not been uniformly spread. In short, the North of England has had to bear the brunt of the job losses (experiencing 70% of the job cuts) while the South of England has suffered just 30% of the job losses.

That only tells half of the picture. When you examine the job losses by region an even more alarming picture emerges. The wealthiest, and dare I say it Toriest, parts of England have actually experienced no job losses. The South East of England has actually grown its NHS workforce since the May General Election, while the North West of England alone has experienced more than 6,500 job losses. That type of inequality in redundancy policy is very difficult to understand. The figures for job losses in the south would were actually made look more egalitarian by the inclusion of the South West. Analysts of the socio-economic profile (and voting patterns) of the South West will agree that it is much less wealthy, and dare I say it Tory, in profile than other parts of the South. 

It is interesting to note that the East of England, an area which is undergoing the fastest pace of privatisation, has actually suffered nearly 3,000 NHS job losses since May 2010. These bell weather voters switched to Labour at the local council elections, and this might give a minuscule insight into why. The East of England is clearly not getting the favourable treatment that the South West is being shown. 

This news comes on the back of two other Tory policy announcement. Staff in the South East are to be paid much much more than staff in the North of England as regional pay is phased in for 2014. In addition, patients in the South East are to be allocated an extra £1,750 per parliament. That money is to be found by cutting patient funding in the, yes you guessed it, North West/East of England by up to £3,000 per patient.

Jeremy Hunt admitted to 3 meetings with NewsCorp/BSkyB but 8 actually took place.

My own research published today on Jeremy Hunt is below, but to be frank a far more explosive piece of Hunt's financial affairs in 2004-2005 can be read on John Ward's site (here). If you only have time to read one piece, I suggest you make it his. Failing that, please see my piece below.

Jeremy Hunt's activities as Secretary for Culture, Media and Sport are quite fascinating. His behaviour as a Cabinet Minister in the first month of the first Tory government for 13 years will astound you. he is obliged to list a) the gifts/hospitality he receives b) the meetings he conducted with outside parties. Today, I have gone through his meetings and hospitality received and the results are revealing.

Jeremy Hunt's meetings with NewsCorp were the subject of a Freedom of Information request in November 2010. In that response Hunt's department withheld details of any meetings Hunt had with Rupert Murdoch, and mentioned explicitly just one meeting with James Murdoch from May to 29 November 2010. You can read that FOI response (here) where Hunt's department admitted to 3 meetings with NewsCorp/B-Sky-B & the Murdochs and compare it to the actual 8 (eight) meetings Hunt had with NewsCorp/B-Sky-B & the Murdochs below during the dates mentioned.

Within a week of taking up his ministerial brief Jeremy Hunt attended a News International dinner where he met Rupert Murdoch (May 2010 see here). Within a month of assuming his role as Cabinet Minister,Jeremy Hunt held a more private meeting with James Murdoch (see here). The contents of the conversation are recorded as "general discussion" but be under no allusion, for the only item that could have been on the agenda was the furtherance of News Corp's interests. The very next month, July, Jeremy Hunt met Jeremy Darroch of B-Sky-B and once again listed the topic of discussion as a "general catch up" (here). In August, Jeremy Hunt was at it once again. This time he met Rupert Murdoch, this time for drinks at an evening reception (here). In October, Hunt once again teamed up with Rupert Murdoch and his News Corp staff for dinner and drinks (here).  He also met News International staff twice during the Tory Party conference (here). You probably at this point will not be surprised to know that these types of meetings continued. In November, Jeremy Hunt met B-Sky-B's James Darroch again and once more his the details of the meeting were listed as a general discussion (here).

One would think that these types of meetings with News Corp/News International executives would have ceased once Jeremy Hunt assumed responsibility for his Quasi-Judicial role in the B-sky-B and News Corp merger, but you would be wrong. In many respects, the number of meetings actually intensified. Hunt met James Murdoch twice in the month of January 2011 (here). Officially, this time Hunt was able to furnish details of the meetings which he said were to outline the process for the proposed merger. Whether or not minutes for those meetings were taken, I cannot say.

Readers might also be disheartened to know that Jeremy Hunt held a meeting with John James Henry Lewis OBE in 2011. People may remember Mr Lewis as the man who a) gave Hunt £25,000. b) whose daughter of 24 gave Hunt £5,000, c) Who arranged the flights and meeting for Hunt to travel to New York in 2009 to meet News Corp and who the Tory Shadow Culture Ministers placed in charge of their tourism task force (here).

Monday, May 21, 2012

NHS 'bank style' Bailouts Reach £805,000,000 and are expected to rise by £billions

The graph above shows the total cost of the NHS Bailouts (accumulative) since 2009. In the first year of the figures, the NHS Bailouts totalled £187m, and from April 2010- March 2011, the figure jumped to £223m. Much worse than that however was the last financial year, and the first proper year of Tory cuts. The total cost of NHS Bailouts that year came to £415,000,000 which is more than the previous two years added together. 

It is the case that some of these costs are linked to the costs of PFI. Take Peterborough NHS Trust for example who needed £46m of a bail out. There's no doubt that this was as a result of a new £289m hospital opening in 2010. We cannot, however, say that all, or even a majority of the bailouts are PFI related, after all how could bailouts in one single year jump so dramatically? The truth is that there has been tougher NHS settlements as a result of government cut backs. As a proportion of GDP, health spending is falling, and we know this because McKinsey identified £20bn of cuts that had to be found. This is why hospitals such as Coventry University Hospital (here) had to ask for a £10 million pound bail out. Coventry justify their bailouts by saying that they have treated a higher number than expected of emergency patients in 2011.

To combat some of the rising costs of NHS Bailouts, the government have set aside a £1.5billion fund to deal with 7 NHS Trusts. Much of those debts (South London, Barking etc) are PFI related. What the government has refused to do is set aside money for your rank and file NHS Trusts that are ending up in difficulty as a result of tighter spending limits. They are all expected to seek/achieve Foundation Trust status by 2014. If they fail, they could be sold off or forced to merge to survive. What is by any measurement a terrifying development is the fact that 50% of Trusts who have applied for Foundation Trust status thus far have been rejected. These rejections are precisely the mechanism that will trigger the large scale privatisation of the NHS. 

If a failure to achieve Foundation Trust status does not kill off the NHS, then the government have another trick up its sleeve. They have asked McKinsey to review the Prudent Borrowing Controls (which are currently set at 40% of a NHS Trust's budget). The government plan to reduce that limit to make the financial running of the Trusts even harder to achieve. This will see more end up in financial difficulty seeking bailouts. This will make Andrew Lansley God, the final arbiter in these NHS Trusts future. I would not hold my breath in expectation that he will look upon them favourably.

New Labour's greatest shame. 95% of homes added to the housing stock were private rentals.

The graph above shows the number of homes added to the English housing stock from 2000 to 2010 by tenure.

In the last ten years of a New Labour government, we added 1.6 million homes to the Housing Stock in England. That, on the face of it, seems a reasonable achievement, but when you look underneath the bonnet the true picture is quite shameful. Of the 1.6 million homes added in the last decade under New Labour, 95% of those homes were private rental. For every 20 homes to come onto the market in the last decade, 19 of them were private rental. In that same time, private rental costs have boomed. It now, excluding energy costs, will cost you £8,700 a year just to rent an average UK property.  Is it any wonder that 41% of labour's private renting voters deserted us after 1997?
Of course, Labour's great shame is that we ceased to take a responsibility for social housing. The council house and social housing stock added, dwindled more than 320,000 during this era. The net result of this is that of the 8 million odd rental properties in the UK as of 2012, more than half of them are private rentals. The official data is only available to 2010 but as the graph above shows, the trend is clear.

A Fat Tax is just another stick to beat the poor with.

Researchers at Oxford University have proposed a 20% fat tax on sugary drinks to tackle obesity and David Cameron is reported to be considering implementing a Fat Tax as a result. Although the researchers claim this could save up to 3,500 lives per year, there is lots that is wrong with this type of tax.

(source: YG)

Calorie wise, the foods sold at upmarket boulangeries, patisserie, charcuteries and café are just as bad for you as liquid sugar drinks or 'pop'. If anything, depending upon your diet, it is arguable that fizzy drinks are less bad for you that foie gras, crepes or profiteroles. After all, if you lead an active lifestyle then a sugar drink can be quicker to convert to the energy that you need to complete your activity, whereas the saturated fats, or fatty proteins in some popular nouveau cuisine dishes could be much harder to shift. Sugar does not line the arteries in the way that saturated fats will. There's no doubt fizzy drinks can rot teeth or induce diabetes, and if taken, as they often are, by the inactive they can repidly expand the waistline. But despite their readily identifiable faults, they are morally no less of a lax decision than it would be to soak your roast potatoes in goose fat. Sadly, the latter will never be part of any fat tax initiative. 

Besides, if one examined the fizzy drinks range of products they'd be surprised to find that often the more sugary drinks are actually supposed pure apple and orange drinks that parents are likely to select for purchase in an effort to be 'healthy'. Thus, one of the main problems with a fat tax is that it is likely to be lazily applied. Strictly speaking, there is no fat in any sugar drink, yet the narrow food diet of the poor is much more likely to come under the remit of a fat tax, than the equally, if not more, fatty penchants of the wealthy. This inequality will exacerbate inequalities not tame them. And if lives are saved through the reduction of diabetes among the poor, what's to say the adverse affects off a reduced family purse will not be felt elsewhere in the family budget? Must a family go without heat an extra hour a day because of their reduced spending power as a result of fat tax? 

Surely a much better solution is to devise ways to get good foods to cost less. We discard one billion pounds worth of fish back into our seas per year. These omega rich foods are ideal fat busters yet EU law says we cannot catch them in the quantities required. Is it any wonder that the fabled English dish is now out of the affordability range of the poor? Another solution that we do not explore enough is regulating the salt that fast food companies place in their food. Sandwiches laced with more than 50% of the recommended daily allowance of salts is nothing short of a crime. Equally, should we not find a way to promote the use of Extra Virgin Olive Oils among the poor? Make it cheaper, on prescription if need be, for the fat busting qualities of that liquid gold could be much more beneficial that beating the poor with a stick for drinking liquid sugar.

Sunday, May 20, 2012

10 things you can do to halt Andrew Lansley's destruction of our NHS

1. Submit a freedom of information request. You'll receive an answer within 20 working days and if you ask the right questions you could transform supporters of the NHS's ability to fight Lansley's privatisation. I use "whatdotheyknow" for my queries as they are the most user friendly way of submitting a query. You can also browse the other types of queries asked there to give yourself ideas about how to word yours.

2. Choose a NHS provider, not a private one when you get your choice of operation. Under Labour legislation you have the right to insist that you are given the choice of opting to be treated by the NHS. So, if your operation or consultation letter arrives with no NHS choice, you can insist on being given one. This will keep demand/custom within the National Health Serivce and make it harder for Lansley to justify flogging it.

3.  Join your local LINks (soon to be Healthwatch). This patient driven body will oversee the functioning of the new health service, and how it operates in its first year 2013/4 will set the tone for its future. It's crucial that we hit the ground running by getting defenders of a public NHS onto those committees.

4. Join your local Clinical Commissioning Group. I am happy to report that we have secretly placed quite a lot of activists within the CCG structure. They feed back regularly on proceedings at the CCG monthly meetings. The intelligence link they provide, as well as action to upcoming commissioning decisions will greatly aid our efforts to prevent Serco/Virgin and others from gaining contracts.

5. Join your local NHS Trust. Membership is free and open to all. There are incentives such as access to discounts and free quarterly magazines. You have the right to stand for the Trust Board and you get a vote in those elections.

6. Make a complaint to the Co-Operation and Competition Panel. Serco are not fit to run our 111 NHS services because they cannot be trusted to keep the jobs in the UK. It's likely they'll outsource up to 40% of jobs to India. Virgin have struggled to retain NHS staff who are transferred under TUPE when they gain a contract. For both of these reasons, it is not wrong to consider making a free of charge appeal to the CCP to review commissioning decisions. In the past Virgin Care have not been shy about using this complaints system. I see no reason why we cannot do the same.

7. Join a Trade Union. Less than half of health sector employees are in Trade Unions. This makes the job of unions defending staffs interests more difficult. GMB have shown excellent leadership in sticking up for their staff who have suffered bullying in Derriford Hospital and Great Royal Western Hospital in Swindon. They certainly make the union dues well worth it. 

8. Blow your whistle. We are relying on you to keep the information flow going. Thus far, the feedback from staff, patients and activists has been outstanding. They have helped flag up threats to staff, wages, patients, hospitals etc. If you witness wrongdoing, we need to hear about it. You can be guaranteed that your identity will be kept secret. Not one whistle blower has been unmasked in any news story I have covered.

9. Support the Early Radar Detection Scheme. Over the weekend, I have been working on building a n open shared database that logs all threats to our NHS by category. This includes threats to pay, downbanding, use of workfare, bullying, ward closure, strike action, failure to achieve Foundation status, threats of hospital closure. It also includes maintaining records on Hospitals or PCTs who have faced criticisms over Financial or Quality standards. The reason for this is that we have found it easier to defend hospitals or staff where the threats are identified early. The sooner we are aware of dangers the better.

10. Become a share holder in private health companies. I am in the process of buying shares with Serco, and I intend to do the same for the other top 10 healthcare companies. This enables us to attend their AGMs and become a nuisance from the inside. It could lead to practical benefits such as forcing healthcare companies to be transparent about their salaries or quality/performance standards. The reason this is especially critical is because private health companies do not have to answer Freedom of Information legislation, nor are the obliged to follow Department of Health guidelines on whistle-blowing.

10 ways Andrew Lansley has already destroyed our NHS

The Tory Health Secretary has wreaked havoc on our NHS. Standards are falling rapidly and are only matched in their demise by staff morale. Andrew Lansley is cutting 1) NHS spending as a proportion of GDP, he's 2) cutting staffs' wages (especially in the north of England) and making 3) them work longer while paying more into their pensions. 20,000 staff have been 4) sacked and many have reported that they have been 5) bullied and forced to accept pay cuts or be sacked. He has allowed companies like Virgin and McKinsey to play a role in 6) reshaping the NHS constitution and 7) decide the future of NHS Foundation Trusts and public borrowing limits. Lansley is switching the way NHS funding is decided so that money is diverted from the north to wealthy areas of the south, thus exacerbating the 8) north south divide. Lastly, patients have suffered under Lansley's NHS. The number of 9) urgent operations cancelled has climbed and so have 10) NHS waiting lists, whilst more and more 11) hospital wards and indeed whole hospitals are being closed in the name of efficiencies. 

1. Andrew Lansley is busy cutting health spending as a proportion of our GDP (here). As the graph below shows, in less than 100 weeks the USA's state (public) health spending will over take the UK. The once mocked American healthcare system is improving, while ours is deteriorating.

2. Andrew Lansley is busy cutting staff members. About 20,000 have been sacked since he came to power, and contrary to what he'll have you believe, the number of clinical staff fell last year.

3. Andrew Lansley is presiding over an NHS that has saw the number of "urgent" operations that are cancelled rise markedly since 2010. As the graph below shows, cancellations of urgent operations are up more than 50% throughout 2011.

4. Andrew Lansley is busy cutting staffs' wages and down-banding their pay grades. His reforms of their pensions mean they'll be lumbered with a 3% tax, on top of having to retire 2 years later. Staff have been given no choice, in many cases they have been told to take a pay cut or be sacked (here).

5. Waiting lists have grown under Andrew Lansley. Not only that, more patients are seeking refuge in the private sector because they cannot wait the extra time. Figures are being falsified. Read more about it here (link).

6. Hospitals are closing and Wards are shutting down at an alarming rate. Hinchingbrooke (here), Wrexham, Royston (here), St Helier, Hetherwood (here), Trafford, Lincoln and the Great Royal Western are all going through painful processes of manufactured consultation. In many cases, decisions to close hospitals have already been made but the public are not being involved properly.

7. Andrew Lansley has given Virgin a role in re-writing the NHS constitution (see here). He's allowed 1000s of Virgin partners (here) onto Clinical Commissioning Groups where they will be in charge of spending £60bn of NHS funding (here). Given that partners share Virgin Care's profits on a 50:50 basis, the conflicts of interest that Lansley has knowingly created will accelerate the demise of our NHS and quite possibly make the damage they will cause irreversible.
8. Lansley has exempted Virgin, Circle, Serco and other private providers from having to comply with Freedom of Information legislation. The Department of Health's new guidelines on Whistle-Blowing will not apply to staff that are transferred to private providers. This means that in the cases where staff have been severely bullied by private providers as has h`ppened in Plymouth (here) & Swindon (here) there has been almost no protection for staff members. The current lawlessness in private health provision has set worker's rights back 15 years. I am happy for Serco or Carillion to take proceedings against me if they think that my report is incorrect.

9. Andrew Lansley is in the process of formulating a war of attrition against staff who work in poorer areas, and poorer patients. His ideas will exacerbate a north south divide worse than the Thatcher era and reverse the narrowing health inequalities achieved by Labour. Professor Bambra calculates Lansley's plans to switch funding away from poor areas to places where patients live longer will mean cuts of £3,000 per parliament to places like Liverpool (Knowsley) and mean a gain for patients in Surrey of £1,750. In addition, his plans are underway to cut wages for nurses who treat patients in poorer parts of England such as the North East.

10. The list would not be complete without drawing attention to the lies, secrecy and disdain for transparency that Lansley has shown for the voters. They promised no top down reorganisation, they refused to publish the NHS Transition Risk Register. In addition, Lansley went ahead in creating structures (CCGs) and abolishing some SHAs without the legislation even becoming law. In contrast, he has dragged his feet on fully developing Healthwatch, or in giving Monitor the teeth it needs to do its jnb. The void created by the lack of accountability has all too often been filled by private consultancy firms especially when it comes to deciding the future of hospitals. The Tories have given the consultancy firm about half a million pound since the General Election.

591 Hectares of NHS land to be sold to private developers. Why not use it for a housebuilding programme?

The following 348 NHS Properties are to be sold to private developers (see here). The overall amount of land NHS earmarked for sale totals more than 591 hectares and could comfortably build 15,000 properties. That would create more than 80,000 jobs. On Wednesday, I and my Labour Left colleagues will be meeting in Westminster to make the argument for a national house building programme that focuses on building affordable rental properties for the millions of working families who struggle to pay an average of £8,700 in rent per year. We think this NHS land & Ministry of Defence land, as well as empties business properties in the City of Westminster, would make for ideal land on which to concentrate a new house building programme. If you are interested in attending the Housing event, or a debate on the same day by Labour Left on how to organise to defend our NHS, then please email me on for details. Everyone is welcome.

For a report on the NHS land for sale, you should consider following this link to the Health Service Journal who compiled the data.

Friday, May 18, 2012

Soaring NHS waiting lists push private healthcare profits up.

(click on the graph to enlarge)

The 23 private healthcare companies listed above made a combined profit of £1,335,000,000 for the last accounts each of them have published all for 2010 or 2011. I will measure this year on year to watch the growing profits of private healthcare companies.

I have excluded Serco from the list because not all of their profits are made in the provision of healthcare. I also excluded addiction, cosmetics, maternity and eye clinics from the list. Some companies like Virgin are new entries into the market and so their profits are very low. Other companies with big turnovers but low profits (in fact losses) include Circle Health who operated at a loss to secure the Hinchingbrooke Hospital. In addition, I should point out that the private healthcare industry is riddled with tax avoidance, evasion and the trousering of profits. You aint no one in the health care industry if your not trying to persuade the tax man that you are making a loss. Of course, companies are allowed to offset profits against the acquisition of assets and so I would be very dubious amount how much tax many of these companies pay. 

Most private healthcare companies report that 2011 was a bumper year. Virgin, Spire, Ramsay and many other companies reported surges in their trading and profits for that year. Most companies attribute their recent surge in profits, not to the Tory Health Bill as you might assume, but rather surging waiting lists. Spire who reported their profits this week pointed out that their biggest growth sector were those people fed up with hospital waiting times and wanting to go private. Crucial question, is this the reason this young baby is now dead? Is this (see link) our first confirmed death as a result of failing hospitals buckling under the pressure of Tory cuts? The dad certainly claims so, but tonight we shold probably pause, and reflect upon a lost life before political recriminations begin.

If one was to take at face value the Coal, Iron and Steel production reports available in the Communist Archives of Soviet Russia from 1932-5 during the 'three great years', they would be tempted to view the second 5 year plan as a mesmerising success. No doubt of course it was the more successful of all the pre-war plans but factory managers falsified the reports so that they could avoid death for lack of productivity. You weren't no one if you were were not a Stakhanovite in 1930s Russia.

Since Cameron has become the Prime Minister of the UK we are witnessing something similar occur here in the UK. As you know, we in the UK rightly obsess over hospital waiting lists. Results are not recorded under the Stalinist threat of death but the success of a government can hinge upon the number of operations, waiting times, and cancelled operations. Cameron's government have responded to this challenge with an orgy of misinformation. Perhaps the most deceitful UK government we have had since WWII, they massage the truth and bend the facts to their liking. Let me outline some of the ways below that hospital waiting times, and cancelled operations are being massaged below to give you a flavour.

1. Doctors are now bribed £30 per patient to cancel their follow up appointments at hospitals and instead conduct them in GP surgeries (here).

2. Patients are offered operation slots in holiday seasons in the hope that they refuse them. When they do the clock is reset on their waiting time so that the 18 week guarantee becomes null and void. If a patient refuses then the hospital is not beholden to keep the limit.

3. As Polly Toynbee recorded (here) nurses are being leant on to actually falsify records. This meant that any patient who had gone over the 18 week limit would not be given an appointment and instead those about to break the 18 week limit would be prioritised. In some cases the failure to provide an appointment within the 18 weeks is simply wiped from the records.

4. Another trick is to provide hospital slots at the last minute without any notice which patients sometimes turn down because they and their family have either a) not psychologically prepared themselves for the operations, or b) family childcare and work arrangements are too late to finalise (here).

5. The whole process has become that distorted and cumbersome that private health care providers such as Spire have reported a boom in profits of 9.2% as people have preferred to go private than suffer the chaos of NHS waiting lists (here). Ironically, this then has the knock on effect of making waiting lists appear more successfully managed.

6. Sometimes waiting list clerks arrange a consultation meeting of just a couple of minutes where the patient is not even examined as I reported of one patient in Wiltshire and that is counted as a proper appointment.

7. In some cases  emergency patients are not even making it into the hospitals. You see as long as they never make it to the hospital they are not subject to the 4 hour A & E target for example. Instead, patients are treated in "A & E" centres or cattle sheds to you and I. Paramedics etc. cater for their medical needs before they are discharged off home again. This has resulted in a "bouncing" of discharges. Guess what, we don't measure "bounces" in the discharge system so this goes completely hidden from the records.

For an insight into the tax avoidance private health care companies engage in, visit this site (here).  For  list of the most up to date profit reports of the companies included in the graph above, see this link (here).

How much profit did the NHS make last year?