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Tag Archives: pressure

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

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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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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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