December 2024 blog
Real Emergency!
Musk and billionaires should be outlawed from influencing UK politics
SEZs should be reversed: created with no public knowledge or consent-as UK is split up into privatised zones
@European Powell is the authority on twitter
(even the Guardian refuses to inform or discuss these: A media conspiracy...???)
Starmer in bed with massive private equity company Black Rock-to buy up chunks of our NHS
The Health Secretary must have the Duty to provide a comprehensive National Health Service, and Social Care
Trump wants to use a UK-US trade deal to open up our NHS to “foreign competition.” If the Government walks into trade talks desperate for a deal, American healthcare giants could take control of parts of our healthcare system for years to come.
There’s only one way to keep the NHS out of US trade negotiations: we have to show the Government the public won’t accept it and force them to take it off the table-by joining the NHS Defenders team, you've already taken a powerful first step to doing that.
We need to act NOW to launch an all-out campaign surge to drown out Trump’s team and their army of private healthcare lobbyists. But anything we do will cost money. We don’t need millions of pounds – because we’ve got something far more powerful: millions of people who believe in the NHS. It’s going to take each of us stepping up, chipping in just a little each month, to fuel the fight against those trying to profit from our healthcare.
We do not want the US taking chunks out of our NHS!!!
Frontline staff strategy:
This does not exist-and has never existed in any congruent
form. Full pay restoration is essential, otherwise staff will leave, emigrate,
quit...!
All evidence shows that government are trying to reduce Doctors, beds,
coerce staff to LEAVE!
Simples! NHS and Social Care, Care homes require-
More Doctors
More Nurses
More beds
More ambulances
More staffed A & E cubicles awaiting triage
Assess to discharge staffed cubicles while awaiting social care plans
More NHS cancer diagnostics, oncologists, nurses.
Streeting is bonkers! There can be no improvements without releasing more money through the crackdowns below...
Why not a 3% of income for EVERYBODY, an NHS and Social Care Tax-ring
fenced...? I and most others would happlily pay this...
IF overseas tax havens are stopped,
Google, Amazon are properly taxed
All tax due is collected
Di Do's £37 billion recovered...
with care home staff on NHS paybands, with NHS wages and progression, care homes publicly owned.
Government, through Hunt's placement of Massey on GMC, through the
puppet NHSEngland, have coerced GMC,
Royal Colleges to insert PAs and AAs into the workforce.
GMC survey results out!
Nobody wants PAs, AAs-except government
and privatisers
Streeting's inquiry is simply a distraction: they will press ahead regardless...!
Assisted dying (Aided suicide)
Even if every patient received the absolute best palliative care-some patients
would still suffer unbearable pain-prostate cancer etc
Anticipating life left is unreliable-Surely-if the patient is comfortable,they
would have no requirement for assisted dying...
If in unbearable pain, or absolutely zero quality of life-most would support
aided suicide.(but-legally-can a suicide leave assetts to family)
Treasury and NHSEngland force ICBs to ration cash-Unrealistically...
ICBs forced to ration cash-unrealistically
https://mailchi.mp/edaeebf7dddb/vkfwjzkcya-2857359?e=1e37f696b0
Lord Warner blair's AQP man, returns...
UnAccountable Care DisOrganisations
are given a pot of cash-and by refusing, rationing treatment, are allowed to reduce expensive hospital care AND MAKE A PROFIT!!!
This central tenet of ACOs was summarised by ex-Labour health minister Lord Warner in 2011. Warner noted that huge US health group Kaiser Permanente had introduced integrated care specifically to reduce hospital-based care in order to be profitable in a “competitive” health market.
https://morningstaronline.co.uk/article/darzi-report-britain-set-sacrifice-more-nhs-services-create-profit
THE new government is determined not to learn the lessons of NHS history, dooming
us to repeat it. Its embrace of Lord Darzi’s “rapid investigation”
report puts this beyond reasonable doubt.
In his report, Darzi lavishes praise on Tory health policy, particularly the 2014 Five Year Forward View, its subsequent continuation, and the statutory rubber-stamping of the US accountable care organisation (ACO) system, which can be more accurately described as “cuts for cash” and was subsequently renamed integrated care systems (ICS) after bad publicity over US ACOs.
Darzi calls for Labour to continue all of this while at the same time lamenting the “massive Tory damage” to the NHS, which he appears to limit to the consequences of Andrew Lansley’s 2012 NHS and Social Care Act while discounting the hugely harmful effects of the ACO/ICS switch, which incentivises health providers for not providing care by awarding them a share of “savings” generated by doing so.
More than once, Darzi uses the rhetorical formula that “it is impossible to understand what has been happening in the NHS without understanding …” but does not nail the real fundamental issue, which is the policy influence of corporate interests, in particular the push to “move care out of hospital,” which he clearly supports and which he claims is to meet the “change in the needs of the population” that he says is “fundamental.”
The Conservatives’ ACO push has always claimed to be derived from these “changing needs of the population,” but as the constant drive to ration services, cut costs and lower the NHS workforce skill mix shows, the real driver has been increasing potential profitability.
No-one in “the population” needs years-long waiting lists, inaccessible services and a “postcode lottery,” but these are what this strategy has created. Labour has already made plain that it intends to continue this direction of travel. Darzi’s report appears tailor-made to justify it, diagnosing “problems” in line with Labour’s desired “solutions” while omitting three to four decades of cuts, closures and privatisation policy, including ACOs, as a factor.
This central tenet of ACOs was summarised by ex-Labour health minister Lord Warner in 2011. Warner noted that huge US health group Kaiser Permanente had introduced integrated care specifically to reduce hospital-based care in order to be profitable in a “competitive” health market.
In praising the 2014-onwards ACO policy, Darzi approvingly cites “pilots of integrated care [that] were well under way in 2010,” without mentioning that these pilots were set up by Kaiser Permanente and United Health based on the minimised state healthcare model they practised in the US.
This omission has been standardised in political discussion of healthcare to help misrepresent corporate-led closures and privatisation as a socially motivated response to public needs. Infamously, Tony Blair even claimed during his time as PM that closing hospitals would save lives.
Darzi’s approval of this strategy amounts to the conclusion that it devastated NHS capacity — NHS bed numbers have fallen by around half since the 1980s — so to fix the issue we need more of the same, regretting that not enough has been done to progress the reduction in hospital care: “Since at least 2006, and arguably for much longer, successive governments have promised to shift care away from hospitals and into the community” ie overload GPs
ICS and the drive to cut costs and enhance profitability have also seen the government push for the significant widening of the use of “physician associates” instead of fully trained doctors.
The government’s own analysis of the use of these “associates” instead of trained doctors says it poses a “high risk” to patients, but this has not even slowed down the plan to increase their numbers or to give them respectability by regulating them through the General Medical Council, despite vocal opposition from the British Medical Association and other expert groups.
Darzi says ICS and the resultant hospital closures are better “financially” but frames this in the language of profitability, citing brazenly that it brings a “superior return on investment” and that “the NHS Budget is not being spent where it should be — too great a share is being spent in hospitals, too little in the community.
Darzi admits that hospital services suffered during Covid but does not specify that this was the result of decades of bed-cutting policies that left us with the lowest bed count in Europe, instead claiming that it was merely a cash issue, that “austerity and capital starvation” caused the poor response.
“Moving care out of hospitals” is a euphemism for closing and downgrading hospitals, which means people losing vital hospital-based services or suffering drastically reduced access to them. To advocate a continuation of the policies that led to this situation as a means of fixing it is perverse, but this is what Darzi does.
He rules out any reversal of the bed cuts policy as a solution while using the “lack of social care” language that has always been part of the “moving care out of hospital” narrative, blaming “lack of investment and cost targets” for hospital managements reducing beds, yet Darzi still calls for more of the “care out of hospitals” that really drove the bed reductions all along.
Darzi also contradicts himself, citing GPs’ complaints that too much is being pushed away from hospitals and onto them, when this is what his report advocates: “We heard significant irritation felt by GPs who perceive that more and more tasks are being shifted from secondary care back to primary care.” He still criticises the Tories for promising “40 new hospitals,” but advocates policies to push care even further away from hospitals to “lock in the shift of care closer to home.”
Health and social care expert Caroline Molloy, has noted the significance of this language shift: “We don’t call all these cuts ‘care in the community’ any more, of course. We call it ‘care closer to home’ — which it turns out often means care a lot further away, and therefore with worse outcomes.”
Health Secretary Wes Streeting talked, even in opposition, about the “need” for more “reform” along the lines of so-called integrated care, which he explicitly embraced. Keir Starmer said last week that the NHS must “reform or die,” ignoring the fact that NHS budgets are a political decision.
It seems clear that the new Labour government intends to start where the Tories left off and bleed even more services out of hospitals. The old adage about insanity involving doing the same thing and expecting different results would apply, but only if we assume that the intent is actually to make things better rather than to enhance profitability.
Darzi’s report furnishes Starmer’s government with the excuses
it needs in order to do this, and this bodes extremely ill for those who rely
on the services of the classic NHS that was rightly considered one of the world’s
best and most efficient healthcare services.
Claudia Webbe is the former MP for Leicester East (2019-24).
You can follow on X @ClaudiaWebbe
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over £100.
https://www.telegraph.co.uk/news/2023/03/21/training-doctors-could-shortened-tackle-nhs-staff-shortages/
Major expansion in staffing needed
Mr Meddings said the NHS needed a major expansion in staffing, comparing its
workforce unfavourably to other Organisation for Economic Co-operation and Development
countries.
“We have 15 per cent fewer doctors and 25 per cent fewer nurses than the
OECD average relative to population,” he said.
Meanwhile, new census data shows that nearly half of all hospital consultants
in England and Wales were born outside the UK, along with two in five GPs.
The Office for National Statistics (ONS) figures show 47.5 per cent of specialist
doctors in England and Wales, such as an oncologist or cardiologist, were born
outside the UK.
Those born in the Middle East and Asia account for more than a quarter of such
doctors, with nine per cent from Africa and around six per cent from Europe,
the figures show.
Some two in five GPs in England and Wales were born outside the UK, according
to the data.
Mr Meddings said far more medics should be trained in the UK, saying: “I’m
struck that we have some of our brightest and best young people applying to
be doctors but what’s the percentage getting places at medical school?
Last year it was 15.6 per cent of applicants. And so then we rely upon international
recruitment,” he continued, warning this left supply chains vulnerable.
'Not about reducing the quality'
His comments came as former health minister Lord Warner, a minister under Tony
Blair, called for radical changes.
Lord Warner said: “What we’ve never done in this country is look
at whether we need to take seven years to train a doctor. France does it in
five years - and we have never done on any scale physicians’ associates
.. if you go to America you are likely to be seen by a physicians’ associate
much of the time.”
In France, trainee medics normally start working on wards in their fourth year
of training.
Think tanks have called for the rollout of shorter medical degrees, for graduates,
while Labour has pledged to double medical school places, in order to train
more medics from the UK.
Professor Dame Helen Stokes-Lampard, chairman of the Academy of Medical Royal
Colleges said new routes to become a doctor, such as apprenticeships, would
not mean a drop in standards.
She said: “This is not about reducing the quality – the required
standards to qualify as a doctor will be identical for those doing a medical
degree via the apprentice route or a traditional university degree. But it will
provide additional routes of access to training and broaden the appeal of training
to be a doctor.”
She said an expansion in roles such as physicians’ associates and surgical
care practitioners to take on tasks that could only now be done by fully qualified
doctors was necessary, given the shortages of staff.
Prof David Strain, the chairman of the BMA medical academic staff committee,
said: “There is a serious workforce crisis in the NHS that needs to be
urgently addressed, but compromising the time taken to train and educate medical
students is not the solution.”
“Any reduction in the length of training time would “compromise
education, and reduce the comprehensiveness of patient care,” he said.
https://www.wharfedaleobserver.co.uk/news/national/24736522.government-launches-review-role-physician-associates-nhs/
Report from the Frontline
I’m a paramedic. Not someone you usually expect to be emailed by? But
I’ve never seen morale so low in my team. I just had to reach out.
I won’t say where I work but, because services here have been cut so much, there’s sometimes only one ambulance on shift on a Friday night. Imagine – just one ambulance on one of the busiest nights of the week? Things cannot go on like this.
The fact is, we’ve been stuck in a cycle of underfunding which means people aren’t getting the care they need. The shocking delays I’m seeing as a paramedic, with some patients waiting over ten hours for an ambulance, are a sign of how bad the crisis has become across the board.
The new government has responded to pressure and pledged increased funds for the NHS, but from what I'm seeing it still isn't going to be enough to end the chaos in our A&E.
Stephen, this winter, Just Treatment is pushing harder than ever for the Government
to take action, so workers like me can do our jobs properly, and give people
the care they need. Please will you chip in whatever you can, and help make
patients and NHS workers' voices loud enough by funding lobbying actions and
media work?
Even the actual equipment in our ambulances has been cut. We’re getting cheaper, lower quality items that make it harder to do our job – and other equipment has just disappeared altogether.
On my toughest days, I just wish politicians could see the damage that has been done to our NHS, and the real implications it has for the patients we treat.
That’s what Just Treatment is doing. When paramedics went on strike to demand better conditions, they stood alongside us on the picket lines. Now, they’re bringing stories like these to the people in power, to make our calls for change impossible to ignore.
This winter, our movement is planning a series of bold campaign actions, and tireless lobbying to make sure the Government acts on the solutions that NHS workers like me desperately need.
Just Treatment wants to do even more outreach to bring more stories to light, and get them heard in Westminster, making us impossible to ignore. But all of that takes funding – and frankly, we don’t have long to pull it all off.
Your support today would mean the world – and give our campaign a vital boost before the Government finalises their plan for the NHS.
Thanks so much for reading – hopefully this is the last email like this I have to write. It’s a bleak time right now, but together we can break the cycle. If you can, here’s the link to donate again: https://cause.lundadonate.org/justtreatment/winter-2024-donate
Louise Paramedic
Just Treatment is fighting to put patients and the NHS before profit.
https://www.youtube.com/channel/UCZdAcTB5Hcv0Z6WN62Q3SnQ
https://t.co/zQ1JgN34w1
https://news.sky.com/story/single-women-having-ivf-triples-in-a-decade-but-nhs-funding-remains-limited-regulator-says-13260851
https://www.bbc.com/news/articles/cqxw1493v2yo
https://lowdownnhs.info/hospitals/nhs-backlog-repair-bill-soars-towards-14-billion/
Why did Wes Streeting make such a lot of noise about supporting GP services, and then let everyone down at the autumn budget?
GPs will stand up for their patients, even if Wes Streeting and the government won't.
I’ve been speaking to doctors about what’s going wrong in the NHS, and what needs to change, for a long time. I’ve had thousands upon thousands of private messages, Facebook group discussions, phone calls and emails and more. I receive messages from doctors at their lowest points; when they are most worried about their patients, the state of the service, and the welfare of their colleagues.
The things they say sit in stark contrast with the way they are often portrayed in the newspapers, which often speak about doctors negatively. The media make insinuations or downright accusations of greed, laziness and self-interest. But my experience, based on communications conducted during the height of national crises, communicated on Christmas Eve night as doctors stare down the barrel of unsafe situations, or on-call shifts when they’re insufficiently protected with safe PPE, is that doctors are mostly concerned about others, not themselves.
Doctors contact me much more frequently when they are scared about someone else’s safety than they do about their own. In general they are stoic and endure an awful lot, often silently, and often to the point at which it feels like they can’t tolerate any more. Medicine, unfortunately, can be harsh and unkind to those who practice. I can speak about this openly and without fear of any impact on my standing or reputation, because I no longer work clinically. But I used to regularly telephone the hospital wards to find out how my patients were doing because I could not sleep for worry at 2am, and I certainly was not alone.
The pressures are unbelievable, and doctors are expected to withstand those pressures. One of the jobs I did as a junior doctor involved assessing new patients as they arrived in the hospital. There was an unwritten rule that at the end of the 13 hour weekend shift, you could not leave the hospital until there were fewer than ten patients waiting to be “clerked” (assessed and examined). You’d get up and continue working until the work was done. It was absolutely brutal, and this is not an uncommon situation.
Now my understanding of medicine, the NHS, and the patchwork of healthcare delivery is detailed - intricately woven through the stories of thousands; but it wasn’t always like this. I learned gradually, through listening and seeing and building up patterns of knowledge. One of the patterns which has been the most striking to me is the absolute disconnect between what General Practitioners are actually like, and how they are perceived and framed by the press. This separation is striking and demoralising, and I think GPs have finally come to the end of their (incredibly long) tether.
Back in 2016, or even up to 2019, the GPs I heard from were often the calmest and the most stoical doctors I spoke to. GP partners in particular had seen and absorbed a lot of political change over the years and had had to adapt accordingly. Things were bad, because of the “austerity cuts”, the pay freezes, and the worsening state of their buildings, but there was the sense also that things could improve. I heard lots of ideas about innovation and new systems, lots of hope for the future of General Practice.
When doctors spoke about their unhappiness about their working conditions, GPs would often worry about the practicalities of taking strike action and the impact on their patients, with some even saying it would be “impossible”. As bad as things were, they continued to tolerate the situation; staying later, absorbing more, and stretching themselves further. One GP I know stayed in her practice for a full 24 hours one day during the pandemic, attending to essential tasks. 24 hours, without going home.
If you read the news about GPs, you might not get this impression. It has felt as if there has been a concerted campaign against General Practice for years now, a tidal wave of negativity and attacks, often misplaced, and which have led to huge amounts of stress for NHS staff working on the frontline. Things became so bad during the pandemic that a study focused on the situation was published in the British Journal of General Practice in 2022. The research, by Gilly Mroz, Chrysanthi Papoutsi and Trisha Greenhalgh, was called “UK newspapers ‘on the warpath’: media analysis of general practice remote consulting in 2021”, and the conclusion includes this quote:
“Some newspapers were actively leading the ‘war’ on general
practice rather than merely reporting on it”.
Why did this happen? Why has there been so much negativity directed at GPs, specifically? Horribly, I suspect it is for political reasons; with huge scope for privatisation within primary care, it suits those promoting the privatisation agenda to reduce the public perception of NHS GPs.
So GPs have endured an awful lot in recent years; underfunding, negativity, dilapidated buildings to work in, understaffing. But when the new Labour government came to power, it felt like things were about to change. On a visit soon after the election in July, Wes Streeting said (as reported by The Guardian) “We are committed to bringing back the family doctor, so patients can see the same doctor each appointment, fixing the front door to the NHS.” And so huge amounts of hope followed as we approached the autumn budget. Much of that hope has now been dashed, however, because Streeting is taking insufficient action in essential areas.
The new government announced a scheme to employ 1000 new GPs to bolster the primary care workforce, and devoted £82 million to the plan. But when the details emerged, a number of concerns were raised. The scheme will only apply to those who have qualified as GPs within the past 2 years. The jobs don’t look like they’ll offer long-term job security for the doctors, and there are concerns about pay parity too. This is worrying because many experienced GPs are currently struggling to find work and patients need better access to doctors. Why isn’t the new government doing more?
There are worries about the state of the NHS buildings that many GPs are working in too. Dr Margaret Ikpoh, a Yorkshire-based GP and Vice-Chair of the Royal College of GPs, spoke to the i newspaper in April and said this:
“At my practice in Yorkshire, this problem is all too evident. One of
our main sites was acquired in the 60s and has a long list of structural issues
including frequent leaks, damp walls and build ups of mould … We recently
refurbished one of our consultation rooms, only to find a huge hidden build-up
of mould had formed on one of the walls.”
The new government plan has devoted funding to upgrade 200 GP surgeries, but there are over 6000 in total, and so the improvements won’t be felt by many. GP services have been underfunded in recent years, and the BMA has been calling for additional funding of at least £40 per patient per year, but so far these calls have not been answered. And finally, significantly, the increase in employers’ costs are going to hit GP surgeries very hard. When the autumn budget announcements were made, many questioned whether GP surgeries would be exempt from the additional charges, like other parts of the NHS. Wes Streeting ruled this out, saying that they were “not formally part of the NHS”. This has sent shock waves through the profession, with fears of a significant number of closures of GP practices as a result. A headline from the publication GP Online reads:
“National insurance hike could force 600 GP practices to close ... The
vast majority of GP practices will be forced to cut staff and patient services
and more than one in 10 could be forced to close unless the government covers
the increase in employer national insurance payments from next year, a GPonline
poll suggests.”
This could be catastrophic; hundreds of GP surgeries have already closed in recent years, and we face a significant crisis with many patients unable to access their GP in a timely fashion. And things may be about to ramp up.
You might already know that GPs in England have been taking collective action since August, choosing from a number of measures to place pressure on policymakers. There is now a vote planned, to decide whether to take all-out strike action. The Telegraph reported on the situation like this:
“GPs could go on an all out strike, with a vote planned on whether to
ramp up industrial action amid a row over the Chancellor’s National Insurance
(NI) increase.
Family doctors across the country embarked on “work to rule” measures in August, with many capping the number of patients they see.
The British Medical Association (BMA) said the measures were designed to bring the NHS “to a standstill”, insisting the protests were aimed at policymakers not patients
Local committees of doctors have now drawn up proposals “to ballot the profession for more significant industrial action … Some practices say the Chancellor’s measures, combined with the increase in the national living wage could cost a practice as much as £140,000 – the equivalent of five nurses.”
In recent memory, GPs have tolerated a lot - the decimation of their working conditions, the worsening of the environments in which they care for their patients, understaffing and underfunding and media bashing to boot. They’re now pushing back, and I’m glad they are doing so, because they’re doing it for all of us. We cannot tolerate the continual decimation of the NHS, and the attendant poor treatment of workers and the public alike. If GPs decide to stage an all-out strike, we should support their demands for better funding and better pay, to enable the NHS to be restored and for every single patient to be safer within the NHS.
Streeting: Jekyll and Hyde
Trumpeted: New Deal For Working People...
but Unison striking over £100 million + privatisation plan. "For
far too long private companies have been raking in profits from NHS contracts
by running down the quality of services, cutting corners and driving down staff
pay and conditions"
Billy Fynn Razzle dazzle'm GMC llawyers:
Pretend to hold a survey, refuse to release the raw data reults, refuse to release
GMCs version of results until just beforeLords debate; then proceeds as usual
Streeting: "tell us your ideas: we will ignore you and carry on regardless..."
https://cygnusreports.org/optimistic/
Operose filching NHS data to refuse treatment
https://weownit.org.uk/act-now/tell-wes-streeting-no-new-pfi-our-nhs
No new PFI private equity finance: they take 20% interest, 7 times capital cost
Blackstone: Starmers pals-can buy huge chunks of our NHS. United Health can do the same-once they have a new CEO...
https://hansard.parliament.uk/lords/2024-12-05/debates/6743466C-AAEA-4E2C-8DB4-B0F6858F9CF9/PhysicianAndAnaesthetistAssociateRolesReview
https://go2.wilmingtonplc.com/OTM2LUZSWi03MTkAAAGXOfa7Kz-7HZKEK2HZXQdaxGOtYyj7catOmjbPjXQ_Q6u9VsCXZc2TCj9C4Avam7-ialhDa80=