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Tag Archives: doctor

Let’s support people who stand up against bad government

10 Monday Feb 2014

Posted by Mike Sivier in Benefits, Disability, Health, Media, People, Politics, UK

≈ 18 Comments

Tags

benefit, benefits, care.data, Coalition, congenital, Conservative, Democrat, Department, Disability Living Allowance, DLA, doctor, Dr, DWP, fight, General Patient Extraction Service, Gordon Gancz, government, health, Health and Social Care Information Centre, Health and Work Service, heart, Jeanette Johnston, kidney, Lib Dem, Liberal, lung, Media, Mike Sivier, mikesivier, news, occupational health, oxford, paper, Pensions, people, Personal Independence Payment, PIP, politics, pseudonymise, sick, social security, Tories, Tory, transplant, unjust, Vox Political, welfare, work, Workington


A principled stand: Dr Gordon Gancz, of Oxford, is fighting the government's plan to sell his patients' confidential records to private companies for profit.

A principled stand: Dr Gordon Gancz, of Oxford, is fighting the government’s plan to sell his patients’ confidential records to private companies for profit.

A refreshing change seems to be sweeping through local news media here in the UK, with stories starting to appear about people who are fighting unjust behaviour by the government.

The rest of us should support this.

For example: Workington woman Jeanette Johnston, 29, had a job until recently but has been forced to give it up due to congenital health problems which mean she has already had a kidney removed and will need a heart and lung transplant in the future.

She had been receiving Disability Living Allowance but this was stopped last August after aids including bed ladders were fitted at her home, following recommendations from an occupational health expert.

DWP advisors told her that the benefits would stop until she was reassessed for the Personal Independence Payment (PIP) – and she has now spent half a year waiting for that appointment.

Jeanette’s tale raises several questions. Why does it take so long for anyone to have the now-legally-demanded medical assessment of their disabilities? Could it be because benefits are stopped until those assessments take place, and it is a chance for the government to claim benefit savings? This seems extremely likely.

Also, Jeanette’s benefit was stopped after living aids were installed in her home on the advice of an occupational health expert. The government has just announced a plan to let employers send occupational health experts to advise workers who are off sick for more than four weeks. Does this signify an intention to deprive people of sickness benefits?

Finally, we should note that Jeanette’s condition is serious, involving a heart condition – and it is entirely possible that the stress of trying to make ends meet could worsen her health enough to hospitalise her or even end her life. Is this the government’s intention? If so, then we should all be asking questions about criminal intent.

Elsewhere – in Oxford – a local doctor is defying plans to collect patients’ confidential information and sell it to businesses.

Vox Political has reported on the plan many times in the past, focusing on patients’ right to ‘opt out’ of the scheme, called variously the Health and Social Care Information Centre, the General Patient Extraction Service or simply care.data by the government.

The records are said to be ‘pseudonymised’ by the government – an attempt at hiding patients’ identities that, in fact, allows anyone buying the information to work out the personal details of everybody on the list if they so choose.

Oxford GP Dr Gordon Gancz said: “It removes my right to protect my patients’ confidential information.” He has vowed to take the government to court if it takes action against him.

Both of these stories have been reported in the local press, where the online versions have ‘comment’ columns to which readers can post opinions. It seems likely that the papers involved will also have letters pages.

If you believe that the delays caused by the government disability assessment system are dangerous, you can say so – directly, to the newspaper. If you believe that Dr Gancz is right to protect his patients, you can say so – directly, to the newspaper.

I’m not going to urge you to go and do it because – as we all know – the Department for Work and Pensions took a previous comment of this kind as evidence that I was co-ordinating a campaign of harassment against it (new readers: this is not a joke!) and a future such incident would not help anyone.

But it seems likely that a few words of support for these people, in the pages of their local paper, might help rouse other readers into declaring their own opinions.

It is easy to keep people quiet about controversial changes when they think they are the only ones who are concerned; it’s not so easy when people have evidence that others feel the same way.

What are you going to do?

Follow me on Twitter: @MidWalesMike

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A&E fears fall on deaf ears

05 Wednesday Feb 2014

Posted by Mike Sivier in Conservative Party, Cost of living, Health, Labour Party, Law, Liberal Democrats, People, Politics, Poverty, Public services, UK

≈ 15 Comments

Tags

A and E, A&E, accident, admission, afford, ambulance, andy burnham, breakdown, Care Quality Commission, CCG, clinic, clinical commissioning group, Coalition, competition, Conservative, cost, cost of living, CQC, crisis, Democrat, doctor, eat, elderly, emergency, frail, government, health, heat, hypothermia, increase, Jeremy Hunt, law, Lib Dem, Liberal, listening exercise, malnutrition, Mike Sivier, mikesivier, National Health Service, NHS, pause, people, politics, poverty, prescription, pressure, queue, rickets, scurvy, sick, Social Care Act, spin, Tories, Tory, trust, Victorian, Vox Political


Andy Burnham, Shadow Health Secretary: He'd rather listen to real doctors than spin doctors.

Andy Burnham, Shadow Health Secretary: He’d rather listen to real doctors than spin doctors.

The title of this article should seem brutally ironic, considering that the Coalition government famously ‘paused’ the passage of the hugely controversial Health and Social Care Act through Parliament in order to perform a ‘listening exercise’ and get the views of the public.

… Then again, maybe not – as the Tories (with the Liberal Democrats trailing behind like puppies) went on to do exactly what they originally wanted, anyway.

Have a look at the motion that went before the House of Commons today:

“That this House is concerned about recent pressure in Accident and Emergency departments and the increase in the number of people attending hospital A&Es since 2009-10; notes a recent report by the Care Quality Commission which found that more than half a million people aged 65 and over were admitted as an emergency to hospital with potentially avoidable conditions in the last year; believes that better integration to improve care in the home or community can relieve pressure on A&E; notes comments made by the Chief Executive of NHS England in oral evidence to the Health Select Committee on 5 November 2013, that the NHS is getting bogged down in a morass of competition law, that this is causing significant cost and that to make integration happen there may need to be legislative change; is further concerned that the competition aspects of the Health and Social Care Act 2012 are causing increased costs in the NHS at a time when there is a shortage of A&E doctors; and calls on the Government to reverse its changes to NHS competition policy that are holding back the integration needed to help solve the A&E crisis and diverting resources which should be better spent on improving patient care.”

Now have a look at the amendment that was passed:

“That this House notes the strong performance of NHS accident and emergency departments this winter; further notes that the average waiting time to be seen in A&E has more than halved since 2010; commends the hard work of NHS staff who are seeing more people and carrying out more operations every year since May 2010; notes that this has been supported by the Government’s decision to protect the NHS budget and to shift resources to frontline patient care, delivering 12,000 more clinical staff and 23,000 fewer administrators; welcomes changes to the GP contract which restore the personal link between doctors and their most vulnerable patients; welcomes the announcement of the Better Care Fund which designates £3.8 billion to join up health and care provision and the Integration Pioneers to provide better care closer to home; believes that clinicians are in the best position to make judgements about the most appropriate care for their patients; notes that rules on tendering are no different to the rules that applied to primary care trusts; and, a year on from the publication of the Francis Report, notes that the NHS is placing an increased emphasis on compassionate care, integration, transparency, safe staffing and patient safety.”

Big difference, isn’t it?

From the wording that won the vote, you would think there was nothing wrong with the health service at all – and you would be totally mistaken.

But this indicates the sort of cuckooland where the Coalition government wants you to live; Jeremy Hunt knows what the problems are – he just won’t acknowledge them. And he doesn’t have to – the media are run by right-wing Tory adherents.

So here, for the benefit of those of you who had work to do and missed the debate, are a few of the salient points.

Principal among them is the fact that ward beds are being ‘blocked’ – in other words, their current occupants are unable to move out, so new patients cannot move in. This is because the current occupants are frail elderly people with no support in place for them to live outside hospital. With no space on wards, accident and emergency departments have nowhere to put their new admissions, meaning they cannot free up their own beds.

Health Secretary Jeremy Hunt had nothing to say about this.

Andy Burnham, who opened proceedings, pointed out the huge increase in admissions to hospital accident and emergency departments – from a rise of 16,000 between 2007 and 2010 to “a staggering” 633,000 in the first three years of the Conservative-Liberal Democrat Coalition government.

Why the rapid rise? “There has been a rise in people arriving at A and E who have a range of problems linked to their living circumstances, from people who have severe dental pain because they cannot afford to see the dentist, to people who are suffering a breakdown or who are in crisis, to people who cannot afford to keep warm and are suffering a range of cold-related conditions.”

He said almost a million people have waited more than four hours for treatment in the last year, compared with 350,000 in his year as Health Secretary; the statement in the government amendment that waiting times have halved only relates to the time until an initial assessment – not total waiting time. Hospital A and Es have missed the government’s targets in 44 of the last 52 weeks.

Illnesses including hypothermia are on the rise, and the old Victorian ailments of rickets and scurvy are back, due to increased malnutrition.

Hospitals are filling up with the frail elderly, who should never have ended up there or who cannot get the support needed to go home because of a £1.8 billion cut in adult social services and support. This, Mr Burnham said, was “the single most important underlying cause of the A and E crisis”; ward admissions cannot be made because the beds are full. The number of emergency admissions of pensioners has topped 500,000 for the first time.

Ambulances have been held in queues outside A and E, unable to hand over patients to staff because it is full. That has left large swathes of the country — particularly in rural areas — without adequate ambulance cover.

The government is downgrading A and E units across the country into GP-run clinics, while pretending that they are still to be used for accidents and emergencies – in the middle of the A and E crisis.

People in England are reducing the number of drugs they are taking because they cannot afford to buy them. Families are choosing between eating, heating or other essentials, like prescriptions.

Competition rules have been stifling care, Mr Burnham said: “The chief executive of a large NHS trust near here says that he tried to create a partnership with GP practices and social care, but was told by his lawyers that he could not because it was anti-competitive.”

He added: “Two CCGs in Blackpool have been referred to Monitor for failing to send enough patients to a private hospital. The CCG says that there is a good reason for that: patients can be treated better in the community, avoiding costly unnecessary hospital visits. That is not good enough for the new NHS, however, so the CCG has had to hire an administrator to collect thousands of documents, tracking every referral from GPs and spending valuable resources that could have been spent on the front line.”

And the health trust in Bournemouth wanted to merge with neighbouring Poole trust, but competition rules stopped the merger taking place.

Mr Burnham demanded to know: “Since when have we allowed competition lawyers to call the shots instead of clinicians? The Government said that they were going to put GPs in charge. Instead, they have put the market in charge of these decisions and that is completely unjustifiable. The chief executive of Poole hospital said that it cost it more than £6 million in lawyers and paperwork and that without the merger the trust will now have an £8 million deficit.

“The chief executive of NHS England told the Health Committee about the market madness that we now have in the NHS: ‘I think we’ve got a problem, we may need legislative change… What is happening at the moment… we are getting bogged down in a morass of competition law… causing significant cost and frustration for people in the service in making change happen. If that is the case, to make integration happen we will need to change it’ – that is, the law. That is from the chief executive of NHS England.”

The response from current Health Secretary Jeremy Hunt needs to be examined carefully.

He said more than 96 per cent of patients were seen within four hours – but this conforms with Mr Burnham’s remark; they were seen, but not treated.

He tried to rubbish Mr Burnham’s remarks about scurvy by saying there had been only 26 admissions relating to scurvy since 2011 – but this misses the point. How many were there before 2011? This was an illness that had been eradicated in the UK – but is now returning due to Coalition policies that have forced people into malnutrition.

He dodged the issue of competition rules strangling the NHS, by saying that these rules were in place before the Health and Social Care Act was passed. In that case, asked Mr Burnham, “Why did the government legislate?” No answer.

As stated at the top of this article. he did not answer the question of the frail elderly blocking hospital beds at all.

The vote was won by the government because it has the majority of MPs and can therefore have its own way in any division, unless the vote is free (unwhipped) or a major rebellion takes place among its own members.

But anyone considering the difference between the Labour Party’s motion and the government’s amendment can see that there is a serious problem of perception going on here.

Or, as Andy Burnham put it: “This Secretary of State … seems to spend more time paying attention to spin doctors than he does to real doctors.”

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Will the government really penalise GPs whose patients opt out of data sharing?

30 Thursday Jan 2014

Posted by Mike Sivier in Business, Conservative Party, Health, Politics, UK

≈ 21 Comments

Tags

anonymise, bid, bma, British Medical Association, bullied, bully, Care Quality Commission, care.data, CCG, clinical commissioning group, common, company, Conservative, Daniel Poulter, data, disease, doctor, Extraction Service, firm, form, General Patient, government, GP, GPES, GPonline.com, health, Health and Social Care Information Centre, healthcare, inform, Information Commissioner, investigate, investigation, Jeremy Hunt, letter, medConfidential, medical, Mike Sivier, mikesivier, National Health Service, NHS, opt out, penalise, people, pharmaceutical, politics, private, privatisation, privatise, profit, RCGP, record, reprisal, Research, Rosie Cooper, sale, screen, secretary, sell, share, sharing, sick, sold, threat, Tim Kelsey, Tories, Tory, undercut, Vox Political


n4s_nhs1

It seems the government has found a way to dissuade GPs from letting patients opt out of having their medical records sold to private firms – the threat of penalties or even an investigation into the way they run their practice.

Vox Political revealed earlier this month that the government is planning to make a profit from selling the private records of NHS patients in England to healthcare and pharmaceutical firms.

The records are said to be ‘anonymised’, but in fact anyone buying your details will be able to identify you.

The system, originally called the General Patient Extraction Service (GPES), now the Health and Social Care Information Centre, may also be described as the care.data scheme. Health Secretary Jeremy Hunt wants you to think the information will be used for medical research and screening for common diseases, but in fact it could be used by private health companies as evidence of failures by the National Health Service, and could help them undercut NHS bids to continue running those services – accelerating the privatisation that nobody wanted.

Patients have the right to withhold their data, but they must specifically inform their medical practice of their wishes. This is why medConfidential created a web page containing a special opt-out form, along with a form letter in various formats, allowing patients to opt out themselves, their children and any adults for whom they are responsible.

Now GPs are living in fear of reprisals if they don’t deliver enough details to the new system.

According to GPonline.com, Health minister Dr Daniel Poulter failed to rule out penalising GP practices with a higher-than-average proportion of patients opting out of new NHS data sharing arrangements.

In a written answer to Labour MP and health select committee member Rosie Cooper, Dr Poulter also refused to say what level of patient opt-out from the scheme would trigger an investigation.

Asked whether practices would be penalised, who would investigate practices with a high opt-out rate, and at what threshold this would apply, Mr Poulter said: “NHS England and the Health and Social Care Information Centre will work with the BMA, the RCGP, the Information Commissioner’s Office and with the Care Quality Commission to review and work with GP practices that have a high proportion of objections on a case-by-case basis.”

Ms Cooper took this as an admission that GPs were “being threatened and bullied into ensuring patients don’t choose to opt-out”.

Reacting on Twitter, NHS national director for patients and information Tim Kelsey ruled out fines for practices where large numbers of patients opt not to share data. He wrote: “Nobody is going to get fined if patients opt out.”

None of this offers a good reason for you to leave your medical records unprotected – in fact, it gives you more reasons to opt out than before, and might provide GPs with the excuse they need to retaliate.

Doctors have been pushed further and further by the Conservative-led government’s changes to the NHS. For example, they were told they would have a greater say in where the money went, as members of Clinical Commissioning Groups (CCGs), but that was not true – they don’t have the time to take part in such decisions so they have been handed over to firms that are often part of the private companies now offering services to the NHS (for a price).

Now they are being told they may face reprisals if they do not betray the principle of doctor-patient confidentiality.

But you can only push a person a certain distance before they push back.

How will NHS doctors in England respond?

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How much can YOU pay? A&E charges would speed NHS privatisation

05 Sunday Jan 2014

Posted by Mike Sivier in Conservative Party, Corruption, Cost of living, Health, Liberal Democrats, People, Politics, Poverty, Public services, UK, USA

≈ 35 Comments

Tags

accident, CCG, charge, Chris Ham, clinical commissioning group, Department of Health, doctor, emergency, expensive, Freedom of Information, GP, health, healthcare, hospital, insurance, Kaiser Permanente, managed care, Managed Care Organisation, market, MCO, National Health Service, NHS, Personal Care Budget, private, privatisation, top-up, UK, undercut, USA


Health-CARE? It seems increasing number of GPs want the person on the stretcher to stump up a fiver or a tenner before the medical staff in the photograph can begin treatment.

Health-CARE? It seems increasing number of GPs want the person on the stretcher to stump up a fiver or a tenner before the medical staff in the photograph can begin treatment. (Image: BBC – intentionally left fuzzy to preserve anonymity of those involved)

It is strange that more has not been made of the revelation that one-third of GPs apparently believe a £5 or £10 charge should be imposed on everybody turning up at hospital Accident and Emergency departments.

This seems to be a clear next step towards the marketisation of what used to be the National Health Service, disguised with a claim that it would “reduce frivolous use of the NHS and the growing pressure on emergency departments”.

It seems that a poll of more than 800 doctors found 32 per cent said “fees would be the most cost-effective way of cutting the number of people who go to A&E, who could have gone to their GP or a pharmacist instead or did not need medical attention at all”. Presumably they have already tried simply telling people what to do, then.

The story in The Guardian states that “specialists believe between 30 per cent and 40 per cent of all visits are unnecessary and that many patients could have sought help elsewhere because their illness was minor or not urgent”. That leaves 60-70 per cent of visitors paying extra for services their taxes have already funded!

According to the book NHS SOS (edited by Jacky Davis & Raymond Tallis; published by Oneworld), the plan is to convert the publicly-funded nationwide health service into one of “managed” care along the lines provided by Kaiser Permanente in the USA.

This is based on a flawed use of figures (p.39) so Kaiser is in fact far more expensive, but that didn’t stop then-Department of Health strategy director Chris Ham from defending the claims and allowing Kaiser to emerge as the model for NHS reform. This was seen as particularly useful for those with cash to invest in the company or other MCOs (Managed Care Organisations) as they reaped huge profits – until market saturation, government and employer schemes to keep health care costs down, and a series of scandals made the pendulum swing the other way. Then these companies started lowering patient benefits, increasing premium fees and withdrawing from unprofitable markets, and this is very similar to the current situation in England.

Finally, these firms began to expand internationally, to countries including the UK, where the NHS was seen as a hugely attractive business opportunity.

MCOs decide how services are organised and funded for their clients, through contracts with selected providers and rigorous control of hospital admissions. This seems uncannily close to the work of Clinical Commissioning Groups, which were set up under the pretext that they would allow GPs to control budgets, but in practice allow the money to be controlled by private firms that have been hired by overworked doctors – as was always intended by the Tory-led Coalition government.

Government regulations mean private companies must be allowed to bid to provide as many services as possible. Freedom of Information rules mean they can find out how the public service operates and then undercut its bid. Without funding, the public service will close, leaving the way clear for the private provider to pump up its prices – so they will eat up more and more of the limited NHS budget. But which services do they choose?

They choose those that are easiest and cheapest to provide – the services that provide the most opportunity to make a profit.

Accident & Emergency is not one of those services. It will remain with the public sector providers who are being “continuously cut and squeezed into downsizing, mergers, centralisation and closures”, reducing care to “short-staffed, overloaded, ‘centralised’ units”, covering “only those services that the private sector does not wish to provide” (ibid, p.18).

How can services like A&E continue, if the private operators are taking all the cash? The only answer, it seems, is to bring in health insurance. That is the plan, at least – and the proposed A&E charges seem intended to be a palatable way of opening that door to a public that would once have treated the very idea as anti-British and voted the government that proposed it out of office for a considerable period of time.

Next it seems likely that “top-up” insurance will be offered to people whose complex ongoing conditions qualify them for so-called Personal Care Budgets. The budget money will be limited, forcing patients (or rather, customers) to “top them up” with insurance.

Be very clear on this: You are not looking at the thin end of the wedge. The wedge has already been driven in and England is well on the way to having a privatised health service, with the NHS as nothing but a brand under which taxpayers’ money can be handed out to private firms that handle only the simplest procedures.

The intention, it seems clear, is to allow publicly-funded services to wither over a period of time, in order to soften you up – make you more receptive to the idea of paying for healthcare that once was free but may not even be available in the future if you don’t come up with some cash.

Are you going to sit there and wait for that to happen? Private health care, and health insurance, is far – far – more expensive than the NHS, which was the most cost-effective and efficient health provider in the world until the Tory-led Coalition got hold of it. Don’t believe the propaganda – the service had record satisfaction levels in 2010.

You can still stop the rot. To find out how you can work to reverse the damage being done to the most cherished organisation in the UK, visit www.keepournhspublic.com and www.nhscampaign.org.uk

If you’re living in Wales, Northern Ireland or Scotland, don’t think that devolution of healthcare will save you because it won’t. Budgets are already under pressure from Westminster and the Tories will do whatever they can to force regional governments into the same, or similar, patterns.

One of life’s certainties is that you will become ill at some point. Don’t wait until that happens, because it will be too late.

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Soon you will have to prove your nationality before receiving NHS treatment

31 Tuesday Dec 2013

Posted by Mike Sivier in Conservative Party, Democracy, Health, Immigration, Liberal Democrats, People, Politics, UK

≈ 42 Comments

Tags

Andrew Lansley, ausweis, benefit, benefits, Coalition, Conservative, David Cameron, deficit, Democrat, disability, disabled, doctor, fair, freedom, Germany, government, health, immigrant, immigration, jackboot, Liberal, long term, Michael Schumacher, migrant, Mike Sivier, mikesivier, national, National Health Service, nationality, Nazi, NHS, nurse, official, people, politics, prove, refuse, sick, tax break, Theresa May, top down reorganisation, Tories, Tory, totalitarian, treatment, UK Border Agency, Vox Political, wealthy


'Papiere, bitte!' An NHS nurse checks a patient's claim to be British in the Conservative-Liberal Democrat idea of a 'fair' NHS.

‘Papiere, bitte!’ An NHS nurse checks a patient’s claim to be British in the ‘fair’ NHS of the Conservative-Liberal Democrat Coalition government.

Suppose Michael Schumacher had moved to Britain and had his accident here after new government plans for the NHS were put in place – would he have been refused treatment?

Admittedly, that is a bad example to use. Mr Schumacher is undoubtedly wealthy enough to buy any healthcare he needs, and we should not wish poor treatment on him in any case.

It does show up the poverty of the Conservative-led government’s moral attitude, though. The fact that he is German adds another dimension, in that his people may have a particular aversion to any situation in which their papers are demanded by officials before they are allowed to do anything.

The proposals demonstrate the depths to which the UK is falling under the current despotic, unelected right-wing administration and the petty would-be tyrant at its head. We are drifting ever-closer to totalitarianism and comparisons with 1930s and 40s Germany are becoming ever more accurate.

They mean patients admitted to hospital in an emergency would have to be able to prove they are not immigrants, or be refused possibly life-saving treatment.

Ask yourself this: Before you leave your house, do you make sure you have papers on you that prove your nationality? If it isn’t a part of your daily routine, then under our government of new totalitarians, it will be.

Is this so far from the Germany of 70 years ago, where the phrase “Ausweis, bitte” was not only a part of daily life but a hallmark of the Nazi government?

Do we really want that here? Are we really saying we will allow an unelected regime to impose it on us?

Never mind the pretext that it will save money that would otherwise be spent on people who do not deserve the care and will not pay their debt – this is about our freedom.

Do you want to trade your freedom for a saving that isn’t even worth very much – around 1/240th of the yearly national deficit at the current level – and will not benefit you in any way at all?

The government says nobody will be denied medical care – but it also said it would not impose a top-down reorganisation of the NHS, and how long did that promise last? Andrew Lansley had been working on it for many years before that infamous campaign announcement was made, but was under orders not to speak about it until a Conservative-led government was firmly installed in office and nobody could do anything to stop it.

The government says the changes will ensure that the system is “fair” – but then, this government has a strange notion of fairness. According to David Cameron, it is fair to deny life-saving benefits to the disabled and long-term sick in the name of deficit reduction, while granting huge tax breaks to the spectacularly wealthy that ensure the deficit will not go down.

I don’t even know what my NHS number is – but soon I will have to, in order to satisfy Britain’s new immigration officials, otherwise known as doctors and nurses.

Perhaps the government is hoping to make a saving by scrapping the UK Border Agency that Theresa May has so hopelessly failed to reform into an effective force (but I doubt it). Perhaps she was wrong to criticise the previous Labour administration about it as harshly as she did.

Perhaps they will use the money they save to buy jackboots.

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Our entertainers give us facts while our politicians have nothing to say

15 Sunday Dec 2013

Posted by Mike Sivier in Education, Health, Media, People, Politics, Public services, Television, UK

≈ 29 Comments

Tags

andrew neil, budget, celebrity, comedian, companies, company, contract, dirt, doctor, education, entertain, famous, filth, firm, government, GP, inspire, inspiring, Interest, invest, Kate Nash, Media, Michael Gove, Mike Sivier, mikesivier, National Health Service, NHS, Norman Lamont, politician, pressure, private, privatisation, privatise, ring fence, Rufus Hound, Sam Michell, stealth, surgeries, surgery, test, The News Quiz, The Powder Room, This Week, Vox Political


Speaking their mind: Rufus Hound and Kate Nash had the courage to speak their mind about the NHS and education - but they don't have enough influence to change government policy. What will it take?

Speaking their mind: Rufus Hound and Kate Nash had the courage to voice their opinions about the NHS and education – but they don’t have enough influence to change government policy. What will it take to make that happen?

This could have been designed to follow my rant about politics being about perception: In response to a news report that NHS doctors’ surgeries have been found to be filthy, radio listeners were treated to a lengthy monologue on why the media are running down the health service to make it easier for the government to sell it out from under us.

This lesson was delivered, not by an eminent politician, but by the comedian Rufus Hound. He was speaking on Radio 4’s The News Quiz.

And he said: “Does this not scare anyone, though?

“There are a lot of stories coming out at the moment about all the ways that the NHS is failing. At the same time there is privatisation by stealth. Now, if you’re a conspiracy theorist, maybe those two things just resolve themselves. If you’re a normal person, you’ve got to become a conspiracy theorist, haven’t you?

“The number of contracts being put out to private companies has gone up through the roof. All of the pre-election promises of no privatisation of the NHS, and that the budget would be ring-fenced – it was ring-fenced but not in real terms, so it is a cut in the truest sense…

“The NHS is being sold out from under us, and yet all the stories that come out from the powerful oligarchs who run the media are either about how it’s failing and how much better off we’d be if it was privatised, or why privatisation can’t happen quickly enough for any one of a number of other reasons.

“The reason those surgeries are filthy is, there’s not enough investment to keep them clean and tidy. The argument isn’t ‘privatise’; the argument is ‘invest more’.

“In the Olympics, there was that big moment where they had ‘NHS’ and everybody stood up and applauded, and I think it was Norman Lamont who said, ‘The nearest thing the British people have to a religion is the NHS’ – and we’re just letting it go.

“People should be on the streets.

“And I realise that, for this to make the edit, it should have a punchline.”

He knew, you see. He knew that this great speech was in danger of being lost if it wasn’t sufficiently entertaining.

Thank goodness producer Sam Michell kept it in, but it should not be up to an entertainer like Rufus to tell us these things. Such matters are the province of politicians. The simple fact that our representatives aren’t “on the streets” with us about this says everything we need to know about them.

Here’s another example: Education. I was in the unfortunate position of having to sit through Andrew Neil’s This Week on Thursday evening. I’m not a fan of that show, but it meant I was lucky enough to see former pop starlet Kate Nash, there to talk about her film (The Powder Room) and modern manners, slip in a quick observation about education that undermines everything ever said by Michael ‘rote-learning-is-the-only-way’ Gove.

She said, “There are certain things we need to be addressing, that are being completely missed – and that’s to do with education being inspiring and interesting for young people, rather than just about purely passing tests and pressure.”

She hit the nail on the head without even looking; Gove couldn’t find it with a map and a guide.

Again, she is an entertainer; she should not be having to say these things, but we should be glad that she did. The moment was glossed over entirely in the BBC News website report of the debate. Perhaps we should be happy that they didn’t edit the comment out altogether (it starts around two minutes, 15 seconds into the video clip).

We are left with politicians who refuse to do their duty and defend our services from those who would destroy them, and celebrities who are left to pick up the slack – if, with a biased media, they can find a way to keep their words from ending up on the cutting-room floor.

What hope can we possibly have that anyone with any clout will defend our beloved, but beleaguered, taxpayer-funded services?

Worst of all is the fact that it falls to people like myself to even write about these matters, and we all have lives of our own. Rufus and Kate made their speeches on Thursday; it is now Sunday, and I could not have written this article any sooner.

We’ve all heard that a lie can travel around the world several times before the truth has got its boots on. This is because the liars own the media, and those of us who are interested in the truth have small voices, are easily ignored, or can be dismissed because “it’s only entertainment”.

At least high-profile figures have a better chance of being heard. There will be those telling Rufus and Kate and who knows who else to get back in their box and shut up, but I won’t be one of them. I think we should be “on the streets” with them.

I’m wondering if any more members of ‘The Great And The Good’ will have the bottle to speak their mind.

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By their own standards, Coalition ministers should be in prison

25 Monday Nov 2013

Posted by Mike Sivier in Benefits, Conservative Party, Cost of living, Disability, Economy, Employment and Support Allowance, Health, Labour Party, People, Politics, Poverty, UK

≈ 27 Comments

Tags

"duty of care", allegation, allege, allowance, appeal, Atos, Barack Obama, benefit, benefits, Co-op Bank, Coalition, cocaine, Conservative, criminal, Department, destitute, destitution, disability, disabled, doctor, Ed Balls, employment, ESA, fit for work, government, Group, health, Iain Duncan Smith, IDS, ill, insecure, insecurity, jail, Jeremy Hunt, manager, Matt, Mid Staff, Mike Sivier, mikesivier, minister, mistreat, money, National Health Service, neglect, NHS, Northern Rock, nurse, observer, patient care, Paul Flowers, Pensions, people, politics, prison, Professor Don Berwick, returned to unit, Ridley, RTU, scandal, serious, sick, social security, stress, support, target, Tories, Tory, tribunal, unemployment, vexatious, Viscount, Vox Political, WCA, welfare, wilful, work, work capability assessment, work-related activity, WRAG


131125criminality

Everyone should agree that the Tory fuss over former Co-op Bank chief Paul Flowers is an attempt to distract us all from a more serious transgression that they themselves have committed.

Flowers, who is also a former Labour councillor, was arrested last week after being filmed allegedly handing over money to pay for cocaine.

The Conservatives have spent the last few days working very hard to establish a link, in the public consciousness, between the criminal allegations against Flowers, the Co-op Bank’s current financial embarrassment – believed to have been caused because Flowers knew nothing about banking, and the Labour Party, which has benefited from loans and a £50,000 donation to the office of Ed Balls.

This is unwise, considering a current Tory peer, Viscount Matt Ridley, was chairman of Northern Rock at the time it experienced the first run on a British bank in 150 years. He was as well-qualified to chair that bank as Paul Flowers was to chair the Co-op. A writer and journalist, his only claim on the role was that his father was the previous chairman (apparently the chairmanship of Northern Rock was a hereditary position).

Ridley was accepted as a Tory peer after the disaster took place (a fact which, itself, casts light on Conservative claims that they were going to be tough on bankers after the banker-engineered collapse of the western economies that started on his watch). The Conservatives are currently obsessing about what happened between Flowers and the Labour Party before the allegations of criminality were made.

Ridley is listed as having failed in his duty of care, which is not very far away from the kind of responsibility for the Co-op Bank’s collapse that is alleged of Paul Flowers. (Source: BBC Any Questions, November 22, 2013)

In addition, the Co-op Bank is not the Co-operative Party or the Co-operative Movement, and those two organisations – one of which is affiliated with the Labour Party – must not be tarred with the same brush.

The Tories are hoping that the public will accept what they are told, rather than digging a little deeper for the facts.

There’s no real basis for their venom; they ennobled a man who presided over much worse damage to the UK’s financial institutions, and attracting attention to criminal behaviour by members or supporters of political parties would be a huge own-goal.

Therefore this is a distraction. From what?

Cast about a little and we discover that Jeremy Hunt is threatening to create a new criminal offence for doctors, nurses and NHS managers if they are found to have wilfully neglected or mistreated patients – carrying a penalty of up to five years in jail.

The law was recommended in the summer by Professor Don Berwick, a former adviser to Barack Obama, who recommended criminal penalties for “leaders who have acted wilfully, recklessly, or with a ‘couldn’t care less’ attitude and whose behaviour causes avoidable death or serious harm”.

Some of you may be delighted by this move, in the wake of the Mid Staffs scandal – even though questions have been raised over the accuracy of the evidence in that case.

But let’s look at another controversial area of government – that of social security benefits for the seriously ill.

It appears the Department for Work and Pensions, under Iain Duncan Smith, is planning to remove financial support for more than half a million people who – by its own standards – are too ill to seek, or hold, employment.

Apparently Smith wants to disband the Work-Related Activity Group (WRAG) of Employment and Support Allowance (ESA) claimants, because they aren’t coming off-benefit fast enough to meet his targets.

The Observer‘s report makes it clear that the arguments are all about money, rather than patient care. Smith is concerned that “only half of WRAG claimants are coming off-benefit within three years, and hundreds of millions of pounds are being tied up in administration of the benefit, including work capability assessments and the appeals process”.

No mention is made of the fact, revealed more than a year ago, that many of those in the WRAG in fact belong in the Support Group for ESA (the group for people recognised to have long-term conditions that are not likely to go away within the year afforded to WRAG members). They have been put in the WRAG because targets set by Smith mean only around one-eighth of claimants are put into the Support Group.

The knock-on effect is that many claimants appeal against DWP decisions. This has not only caused deep embarrassment for Smith and his officials, but added millions of pounds to their outgoings – in benefit payments and tribunal costs.

Not only that, but – and this is the big “but” – it is known that many thousands of ESA claimants have suffered increased health problems as a result of the anxiety and stress placed on them by the oppressive process forced upon them by Iain Duncan Smith.

This means that between January and November 2011, we know 3,500 people in the WRAG died prematurely. This cannot be disputed by the DWP because its claim is that everyone in the WRAG is expected to become well enough to work within a year.

These are not the only ESA claimants to have died during that period; a further 7,100 in the Support Group also lost their lives but are not used in these figures because they had serious conditions which were acknowledged by the government and were getting the maximum benefit allowed by the law.

What about the people who were refused benefit? What about the 70 per cent of claimants who are marked “fit for work” (according to, again, the unacknowledged targets revealed more than a year ago by TV documentary crews)?

We don’t have any figures for them because the DWP does not keep them. But we do know that many of these people have died – some while awaiting appeal, others from destitution because their benefits have been stopped, and more from the added stress and insecurity of seeking work while they were too ill to do it.

Now Iain Duncan Smith (we call him ‘RTU’ or ‘Returned To Unit’, in reference to his failed Army career) wants more than half a million people – who are known to be too ill to work – to be cut off from the benefit that supports them.

Let’s draw a line between this and Jeremy Hunt’s plan to criminalise medical professionals whose wilful, reckless or ‘couldn’t care less’ attitude to patients’ needs causes avoidable death or serious harm.

Clearly, such an attitude to people with serious long-term conditions should be carried over to all government departments, and yet nobody is suggesting that the DWP (and everybody who works for it) should face the same penalties.

Why not?

By its own admission, choices by DWP decision-makers – acting on the orders of Iain Duncan Smith – have led to deaths. We no longer have accurate information on the number of these deaths because Smith himself has blocked their release and branded demands for them to be revealed as “vexatious”. No matter. We know they have led to deaths.

If doctors are to face up to five years in prison for such harm, then government ministers and those carrying out their orders should be subject to the same rules.

By his own government’s standards, Iain Duncan Smith should be in prison serving many thousands of sentences.

Consecutively.

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DWP calls in Rentadoc to harass the sick off-benefit

04 Monday Nov 2013

Posted by Mike Sivier in Benefits, Business, Conservative Party, Disability, Employment, Health, People, Politics, UK, unemployment, Workfare

≈ 41 Comments

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Ingeus out of favour: This image was found on a site protesting against Workfare and demonstrates the high regard in which it is held by previous users of the Ingeus service.

Ingeus out of favour: This image was found on a site protesting against Workfare and demonstrates the high regard in which it is held by previous users of the Ingeus service.

Perhaps we’re jumping the gun with the headline but alarm bells tend to go off when you read that “people on sickness benefits will be required to have regular meetings with healthcare professionals to help them with their barriers to work”.

Everyone working on Employment and Support Allowance should already know what everyone receiving it knows – it’s more a bloodbath than a benefit.

This is down to the attitude of the healthcare professionals already working on it – the people who (and God forbid you should ever ask to see their qualifications) automatically sign 70 per cent of claimants as ‘fit for work’, whether they are or not, and tell most of the rest they need to be work-ready within a year.

The result? Mental breakdowns, depression and suicides; physical breakdowns, worsening of existing conditions, and premature deaths. By the thousand.

These are the people who ask claimants when amputated limbs are going to grow back, and who tell people with Parkinson’s disease and multiple sclerosis that they’ll be fit for work within six months.

If you did (God forbid) ask them where they got their qualifications, it was probably the Teaching Hospital of Noddyland.

“People on sickness benefits will be required to have regular meetings with healthcare professionals to help them address their barriers to work – or face losing their benefits [italics mine] – in a two-year pilot scheme in central England which begins in November,” the DWP press release states.

Isn’t this what happened with people on Jobseekers’ Allowance? Suddenly they had to start fulfilling lots of pointless extra requirements or their benefits would be withdrawn? Part of that is a regular meeting in which – as far as we can ascertain – innocent people are harassed, threatened and abused by DWP employees who are themselves, it seems, millimetres away from nervous exhaustion brought on by the pressures of the job.

Claiming benefits, it seems, is now an endurance test: Who cracks (up) first?

Now, for 3,000 people in the work-related activity group for ESA in the Black Country, Derbyshire, Leicestershire, Northamptonshire, Lincolnshire, Nottinghamshire, Rutland, Staffordshire and Shropshire, there’s no relief even if they have a nervous breakdown and have to claim ESA on mental health grounds.

“People involved in the pilot – who have all been assessed as being able to work at some point in the future – will have regular appointments with healthcare professionals as a condition of receiving their benefit, to focus on helping them move closer to being able to get a job.”

There you go – all judged as able to work in the future. Presumably Iain Duncan Smith has taken a look at their files, glanced into his crystal ball, and declared that he has a “belief” in their fitness to work. If any of these people are reading, please contact this blog if you have a progressive health condition that won’t ever improve.

Because the meeting is a condition of receiving benefit, anyone attending can expect to be treated abominably. This is not about helping you back to work, or even back to health; it’s about kicking you off-benefit and nothing further. The aim, as with JSA, is to cut claimant numbers and thereby cut spending.

“It’s really important we give people who are disabled or have a health condition the support they need to get into work if they are able,” said employment minister Esther McVey who knows nothing about this at all (despite having been minister for the disabled).

“Traditionally, this help has tended to be work-related, but this pilot will look at whether a more holistic approach is more successful in helping people to manage their conditions and so break down their barriers to work.”

The biggest barrier to a person with a disability getting work is the fact that the Conservative-led Coalition government has been closing down employment opportunities for them and removing incentives for employers to take them on.

The healthcare professionals will be provided by Ingeus UK – a welfare-to-work provider that has been involved in the Work Programme – you know, the time-wasting scheme in which jobseekers are taken off the unemployment statistics while they learn simple skills that, in fact, most of them already have.

The company’s website is very slick but contains no information about the number of doctors in its employ.

Oh, and guess what? The company is half-owned by Deloitte, one of the ‘Big Four’ accountancy firms that currently writes British tax law to make avoidance easy for the big corporates. How much tax has Ingeus paid lately?

“Everything we do is results driven”, the site declares.

One wonders what Ingeus will do when the casualties start piling up.

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How can we believe the government’s ‘health tourism’ statistics?

23 Wednesday Oct 2013

Posted by Mike Sivier in Benefits, Conservative Party, Health, Immigration, Law, People, Politics, Tax, UK

≈ 13 Comments

Tags

abroad, administrating, administration, belief, bma, British Medical Association, Claire Gerada, Coalition, Conservative, cost, Creative Research, deter, discourage, doctor, Dr Chaand Nagpaul, fear, foreign, government, GPs, health, Iain Duncan Smith, immigrant, Immigration Bill, Jeremy Hunt, levy, migrant, Mike Sivier, mikesivier, National Health Service, NHS, non-European, phantom problem, Prederi, public, report, resident, royal college, secretary, spin, TB, temporary, Tories, Tory, tourism, treatment, tuberculosis, UKIP, visitor, Vox Political


"It's my policy and I'll cry if I want to" - or is Jeremy *unt simply responding to criticism of his bid to climb on the anti-immigration bandwagon?

“It’s my policy and I’ll cry if I want to” – or is Jeremy *unt simply responding to criticism of his bid to climb on the anti-immigration bandwagon?

A speech by Iain Duncan Smith is immediately reminiscent of a wasp negotiating its way through a bulldog’s digestive system; there’s a lot of droning and implied pain, but through it all you know exactly what the outcome will be.

From this starting point, one may liken a speech by Jeremy Hunt to a hippo having an unhappy bowel movement as a result of an unwise dietary choice; much clumsy blundering in the wilderness and a fair amount of distress – which may be transferred to any poor creature unlucky enough to get in the way.

It seems that migrants and visitors from abroad who use the NHS are now facing the full onslaught of the Health Secretary’s metaphorical indigestion, with nary a bucket of Rennie in sight – except in this case the cure would be a set of reliable statistics covering the use of NHS services by our foreign-born friends.

Armed with new reports by independent firms Prederi and Creative Research, the Health Secretary (and well-known misprint) believes ‘health tourism’ is costing the NHS £2 billion every year – and has announced that he plans to claw back around £500 million of that money.

A BBC report states that ministers believe some of the spending is unavoidable but “it would be realistic to save a quarter. Savings would come from deterring so-called health tourism, recovering money owed by other countries and a levy on non-European temporary residents”.

But the cost of health tourism, as set out in the report, is tiny – at a maximum of £80 million it would be four per cent of the estimated total loss – and this is based on evidence which even one of the reports’ authors, Prederi, have admitted is incomplete. On its own, it could not possibly generate the saving demanded by the new policy, nor could it justify the claim that £2 billion is currently being lost.

That is not the point, though. This is about getting the NHS on the anti-immigration bandwagon.

The study has been released to coincide with the Immigration Bill, which (surprise, surprise) includes plans for a £200-per-person-per-year charge for temporary migrants to use the NHS during any stay lasting between six months and five years.

The Conservative-led Coalition government says this could recoup around £200 million per year, but this is clearly nonsense.

Put yourself in the position of a person from abroad, considering an extended stay in the UK. If an extra cost of up to £1,000 for a five-year stay was added to the trip, out of the blue, would you go ahead with it? Or would you consider other destinations?

Alternatively, if the trip could not be avoided, would this not make you more likely to use the NHS, in order to simply get your money’s worth? The trouble with this is that such a person would not know the cost of a consultation. According to Dr Chaand Nagpaul, chairman of the British Medical Association’s GPs committee, the cost of a single hospital outpatient appointment would equal the £200-per-year levy.

And then there is the administration cost. New Statesman revealed that the chair of the Royal College of GPs, Claire Gerada, has warned that the cost of administrating the new system could outweigh the savings, while also increasing public health problems such as TB by deterring temporary migrants from seeking treatment when they first fall ill. This gives rise to the possibility that we are facing another Tory policy that could have deadly consequences for the population.

This is not a plan to deal with health tourism at all. This is an attempt by an increasingly-desperate Conservative Party to claw back some of the voters who have (themselves) migrated to UKIP because of fears that have been planted in their minds by political spin-doctors, rather than any real threat – the phantom problem of immigrants getting benefits they haven’t earned.

Health tourism is not costing the UK £2 billion a year, and the measures outlined by the government will not stop it, or save any lost money. If anything, it will cost the country millions of pounds.

But then, when has Jeremy Hunt bothered with the facts, when he can have his way simply by playing on people’s fears and manipulating their beliefs?

This is why reference was made, at the top of this article, to Iain Duncan Smith – another Tory minister who won’t let thousands of possible deaths interfere with his beliefs.

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Clueless Cameron – as tired as his policies?

01 Tuesday Oct 2013

Posted by Mike Sivier in Benefits, Conservative Party, Cost of living, Doctor Who, Education, Health, Liberal Democrats, People, Politics, Poverty, Tax, UK, unemployment, Workfare

≈ 11 Comments

Tags

Bank of England, benefit, benefits, Coalition, Conservative, David Cameron, David Tennant, Democrat, doctor, Doctor Who, free school meals, government, GP, Harriet Jones, hours, income, interest rate, Labour, Lib Dem, Liberal, long term, low, married tax allowance, Mike Sivier, mikesivier, opening, people, plastic bag, policies, policy, politics, Prime Minister, surgeries, surgery, tax, tax credit, tired, Tories, Tory, unemployed, unemployment, Universal Credit, Vox Political, wage, Welsh Government, work, Workfare


Tired old Tory: Is this David Cameron or Ken Clarke? [Picture: BBC, augmented with help by Ian Davies]

Tired old Tory: Is this David Cameron or Ken Clarke? [Picture: BBC, augmented with help from Ian Davies]

David Tennant’s outstanding run as the title character in Doctor Who began by ending the career of fictional Prime Minister Harriet Jones with just six words to an aide: “Don’t you think she looks tired?”

The character had been PM for a very short time but had made serious errors of judgement. In that respect – and that alone – she is the David Cameron of the Doctor Who universe.

Cameron and his cronies are currently wheeling out a succession of policies that they want us to believe are new. The latest of these, according to the BBC News website, involves extended opening hours for local doctors.

That’s right – he’ll be piloting a £50 million scheme in nine areas of England where surgeries will be able to bid for funding to open from 8am to 8pm, seven days a week.

Perhaps he’s hoping that our memories have suffered rapid ill-health recently, because this is nothing but an old Labour scheme, painted blue.

Labour offered GP practices extra money to open later in the evening and on weekends, and most surgeries tried it out – until lack of demand meant funding was reduced and hours cut back.

Many surgeries still offer out-of-hours appointments – so it seems unlikely that there is any need for Cameron’s version at all…

… unless he is considering making an appointment for himself. Look at the image. Don’t you think he looks tired?

Other policies introduced during the Tory conference include the indefinite extension of Workfare for the long-term unemployed, which is nothing more than an underhanded plot to make it seem that joblessness has dropped, allowing the Bank of England to raise interest rates, as this blog revealed yesterday.

And the much-touted but low-paying married tax allowance turned out to be even lower-paying for the low-waged who are already receiving help through tax credits, which are due to be phased out in favour of Universal Credit, paid to people whose incomes are low after tax. Their higher after-tax income means their UC will drop by £130, making them just £70 per year better-off.

Meanwhile, the ‘free school meals’ policy unveiled by Coalition partners the Liberal Democrats has also left a nasty taste in peoples’ mouths. It turns out that the number of people receiving such help is about the only indicator of low-income households available to school authorities, and is part of how schools show regulators that SAT results are not their only priority – they are doing their best in areas where parents are out of work. Losing that marker means schools in challenging circumstances will be unable to demonstrate their situation and will suffer as a result.

That leaves just the new tax on plastic bags in England, which is an idea the Coalition stole from the much-maligned Labour Welsh Government – another Labour idea the Tories have adopted (and this should serve as a warning sign for Labour: When Tories adopt your policies, you have drifted much too far to the right of the political spectrum).

Clearly the strain – of trying to dream up new policies that will make his party look good – has taken its toll on clueless Cameron.

Don’t you think he looks tired?

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