Posts Tagged ‘Nhs Reforms’
Just days ago we codgers offered prayers of thankfulness to Bert the Weather God when he spared us the wrath of St Jude. Clearly our heads were insufficiently bowed for last night he atoned for his sin of omission. We arrived at the allotments to find roofing felt scattered in all directions, and flower tubs rearranged in the manner of a modern art masterpiece. No prayers soared skyward this time, just a wide selection of colourful curses.
As we set to work we did find time to remark on the reappearance of two fallen stars. Sven Goran Eriksson has apparently published a kiss-and-tell account of his relationships with Nancy Dell’Olio, a Romanian former gymnast, a Swedish hotel worker and Faria Alam, the former secretary of the Football Association. He apparently “became tired” of them all, perhaps he simply became tired? But it is good to know that the highly paid England managers do allow themselves the occasional break from the offside rule.
The other resurrection features Michael Howard who now occupies himself by dressing up in ermine. He is hell-bent on the need for a “debate about the past”, the past of no less a star than Tony Blair. His Lordship wants us to realise that under Labour public money was strewn around like confetti. How that will help the present situation is less than clear, perhaps he believes that our dear leader has become so besotted with his former hero that he feels a compulsion to follow suit?
If today’s headlines about NHS ‘reforms’ are any indication he may well be right. At long last someone has realised that the new Commissioning groups are comprised mainly of executives that previously ran the now defunct Primary Care Trusts (PCTs). A logical development since no one in the know really believed Lansley’s nonsense abut GPs running the new creations, given that they are already rather busy and, in any case, have no desire to become bean-counters. But 489 of the PCT stars were first made redundant and rewarded with six-figure “golden goodbyes” !
As a former PCT chairman I was invited to the farewell party staged by our local body. No one seemed unduly upset, but at the time I assumed this was due to the large cheques handed to them earlier. But they knew something that I didn’t. Within weeks most if them were hired by the new ‘Commissioners’. If ever there was a scandalous waste of public money this was it!
Clearly these NHS employees should have been transferred into the new operations. I would go further and contend that the new organisations should not have been created since they are a mirror image of the ones they replaced. Each PCT had what was called a Professional Executive Committee, the majority of which comprised GPs nominated by local practices. They allocated funding to both hospitals and community services and had absolute authority to do so.
What they decided was in theory approved by the Strateguc Health Authorities which have also been replaced (by bodies carrying the NHS prefix re-employing the same people), but which in practice seldom intervened. Nothing has changed fundamentally but millions have been poured down the drain. Our headline does a disservice to Baldrick, even he would have recognised that this cunning plan was plain daft!
But even the madness of Andrew Lansley pales into insignificance by comparison with the EU saga. Today we learn that Abdulla Ahmed Ali, the ringleader of a suicide plot that could have killed 10,000 people, has gone to the Euripean Court of Human Rights to claim his rights were infringed by publicity before he was convicted of conspiracy to murder. Appeals have already been dismissed by Britain’s highest courts and now the bill for his conviction, already over the £100 million mark, will be increased. More importantly our justice system will once again be undermined.
Cue Chris Grayling, the Justice Secretary, who once again pledges to end the “dogma” emanating from Brussels that assumes “more Europe is always best” on everything from human rights to prisoner voting, whole-life tariffs and welfare reform. How he proposes to do this given that, like Sven, the Lib Dem and Labour parties have been seduced, is less than clear.
How about nominating Andrew,Lansley, who is currently not meaningfully employed, for the post of EU President when it becomes vacant next year? he could keep our tormentors occupied for yonks on rearranging the deckchairs on the EU Titanic, and prove once and for all that only idle hands find time for mischief!
THOUGHT FOR TODAY; ” Business is the art of extracting money from another man’s pocket without resorting to violence!”….Max Amsterdam
A vigilant soul spotted torches piercing the darkness on the allotments last night and rang the police. The beat Bobbie arrived and duly discovered that it was us. Together with two of my fellow codgers I was engaged in locking the hens in for the night, somewhat later than is our custom. We had watched to the end the second of two T20 quarter finals on the giant Sky screen in our local hostelry, and had lost all sense of time as we lingered to mull the game over.
But all ended happily. The dreaded foxes had not arrived and the officer contented himself with the comment that he might have guessed that it was “you daft sods”, rather than a clandestine meeting of UK Uncut. In fact he interrupted an interesting conversation on the subject of the games politicians play, perhaps an appropriate theme for debate in the darkness.
We had noticed with some surprise a prediction by the one and only Boris that the Conservatives are now on course to secure a huge overall majority in 2015. As we have demonstrated previously this is a mathematical impossibility given the distribution of seats. So why is the craftiest fox of them all sticking his neck out so temptingly? The answer soon came. Boris is creating an expectation that cannot be met in the hope that Tory party members will decide to dispense with the services of our dear leader, thus opening the door for a new saviour.
This morning Prince Charming received a helpful hand from an unexpected source. some days ago we complained that taxpayer’s money was being shovelled in the direction of an American expert in Healthcare Improvement. We suggested that the Cameron/Hunt motive was to land yet another damning assessment of the NHS to add fuel to their campaign of privatisation. We were probably right to suspect that, but both we and they were very wrong in anticipating that Don Berwick would join the orchestrated chorus of condemnation.
The report published this morning concludes that “NHS staff are not to blame – in the vast majority of cases it is systems, procedures, conditions, environment and constraints they face that lead to patient safety problems”. It suggests that from the government down, leaders must abandon blame and “trust the goodwill and good intentions of staff”.
The report goes on to say; “Neither at Mid Staffordshire, nor more widely, is it scientifically justifiable to blame the staff of the NHS or label them as uncaring, unskilled or culpable. Good people can fail to meet patients needs when their working conditions do not provide them with the conditions for success”.
Some critics have suggested that Berwick is light in regard to specific recommendations but we codgers, several of whom have extensive experience of the NHS, believe that he has focussed on the major problems. He has identified nurse staffing levels as critical, and he has questioned the wisdom of having three regulatory bodies, none of which co-operates with other, and all of which consume hours of every executive’s day with endless forms and bureaucratic irrelevances.
Dr Clare Gerada, chair of the Royal College of GPs, is delighted by the emphasis of the report. She says that at last we have a report that “tells it as it really is”. Berwick, she says, “recognises that we do not get it right every time but he also acknowledges that a blame and shame culture is not the best way to bring out the best in NHS staff so that they can provide compassionate patient care”.
True to form Jeremy Hunt was quick to claim that this has been his view all along. Really? Just months ago he pandered to the likes of the Daily Mail by talking of “coldness, resentment, indifference, even contempt” when referring to NHS staff. He spoke of “a kind of normalisation of cruelty where the unacceptable is legitimised and the callous becomes mundane”. His words infuriated and demoralised clinical staff whose numbers have been cut to the point where individual patient attention is impossible.
Austerity is one thing, saving lives another. The time has come for point-scoring politicians to stop their endless attempts to use our greatest asset as a political football. They should content themselves with ensuring that Foundation Trusts are properly established and leave the management and publicly-elected governors to get on with it. They should stop pretending that the NHS funding is ‘ring-fenced’ and recognise that imposing £20 billion in ‘efficiency savings’ are cuts by another name. They should regard protecting nurse and doctor numbers as a greater priority than shielding tax-avoiders, even if they happen to be party donors.
I spent many years in the NHS and have never recognised the uncaring staff described by Hunt and his friends. Given the staffing levels needed, and left alone, we still have the makings of a health service capable of coping with the ever increasing demands being placed on it. Of course we must remember that in industry 98% achievement always attracts rewards, in medicine 2% failure is the stuff of headlines.
The government hoped that the findings of a renowned expert such as Don Berwick would finally put the NHS in the dock, thus opening the door for ever more private contracts. Instead he has placed them in the dock and delivered a verdict of guilty!
I was searching my mind for a punch-line and, as I did so, happened to spot a statement issued yesterday by Monitor, the so-called regulator. It calls for a further 4 per cent cut to nursing posts over 2014-15 and 2015-16. Berwick is right, bean counters can damage your health!
THOUGHT FOR TODAY; ”We support Professor Berwick’s call for patient care to be made paramount and for a culture of support, not blame, to empower staff” …Mark Porter, chair of council at BMA
Even the prospect of the Test Match, about to start at Old Trafford, was driven from our minds by the news that Jeremy Hunt has been defeated in the High Court. Regular readers will recall that every member of our allotments gang responded with a tenner to the appeal from campaigning group 38 Degrees who wished to join with the people of Lewisham in seeking legal redress against the Health Secretary’s decision to downgrade the casualty and maternity services at the successful and highly-regarded Lewisham hospital.
The proposed changes were part of a wider ‘reform’ of services in the capital, after the financial collapse of the neighbouring South London Healthcare NHS trust (SLHT). Hunt appointed a special administrator to the SLHT and suspended the directors. He then took the astonishing decision to close services elsewhere with a view to forcing patients to travel to help offset the financial losses. It clearly escaped his mind that the result would be, to quote Dr Louise Irvine who led the mass protest in Lewisham, that people would have to travel ” a long, long way further to get access to vital services”. And long delays in getting to an A & E unit mean one thing – avoidable deaths.
38 Degrees saw this as the perfect test case, and set about raising £20,000 to establish a legal team. Its advice was heartening, Hunt was acting illegally. Yesterday brought the long awaited hearing at the High Court, and thousands demonstrated outside.
Mr Justice Silber ruled that Hunt had acted outside his powers when he announced to parliament in January that casualty and maternity units at the highly rated Lewisham hospital would be downgraded. The judge went on to say that the Secretary of State had unlawfully breached the provisions of the National Health Services Act 2006.
Dr Irvine paid tribute to the thousands of local people, community groups, GPs, hospital doctors, nurses, and other health professionals who, together with 38 Degrees members, had donated to make this landmark victory possible.
Of course everyone knows that ministers hell-bent on the privatisation of the health service will already be plotting an appeal and counter-moves. But this victory has great significance. It shows that vast numbers of people are appalled by what the government is doing to the NHS and, given support, are prepared to stand up and be counted. Politician’s main concern is for their own skins and they will recognise the political dangers in continuing to destroy local emergency services. What Lewisham did yesterday will act as a precedent.
We all recognise that the NHS faces perilous times and must become more administratively efficient. But services such as A & E are too important to be left to the whims of an ass such as Jeremy Hunt, who clearly isn’t even aware of the limits of his powers. The time for people power has arrived, the NHS belongs to us all and we must take heart from this evidence that if we fight we can win!
The small part we codgers played in this affair has helped to restore our battered sense of pride. We all smirked somewhat when Lord Howell of Poshtown, the father-in-law of Gorgeous George Osborne, told the nation that fracking should be confined to the desolate North East and its equally desolate peasants. Yesterday he apologised and explained that he had meant to refer to us lot in the North West!
THOUGHT FOR TODAY; “This is a tremendous victory for all who campaigned for this well-run, successful hospital to remain open. The mobilisation of the public has been extraordinary. Real questions must now be asked about the decisions being taken by this government in relation to healthcare!”…..Rosa Curling from law firm Leigh Day
Even the thunderstorms won’t come to Wigan. The end of the heatwave has proved something of a dry squib in our neck of the woods, no thunder and not much rain. In fact we are less than sure that the heatwave has ended at all, for many a droplet of sweat descended from ancient brows as we cleaned out the hens this morning.
Having decided that the new baby should be called Marmaduke we quickly moved on to other topics today. The former bankers amongst us – who now claim to have been estate agents – are appalled at Gorgeous George Osborne’s £130 billion gamble with the housing market. They seem convinced that his concept of a mere 5% deposit on homes up to £600,000 is going to rebound in rocketing house prices and a further giant increase in debt.
Those who once worked for the NHS, including yours truly, are besides themselves with incredulity at the near-panic regarding the shortage of consultants in A & E units across the country. Unsafe, scream ministers. Of course it is unsafe but they are the people that brought it about. The cost of the crazy Lansley reforms plus the imposition of £20 billion of ‘efficiency cuts’ has impoverished most Foundation Hospitals. The worse than useless regulator Monitor has enforced the budget cuts, and hospitals have been forced into staff reductions. And since consultants are the most expensive employees they have been the obvious target. Well done Monitor, we wouldn’t trust them to regulate our hen-runs.
Frankly it is time for politicians to stop playing politics with so many key services. And pigs might fly, I hear you say. But the suggestion is a logical one since the outcome of the 2105 electon is a mathematical certainty. I say this having had dinner yesterday with a friend who is a bigwig of the Institute of Mathematicians. John loves maths in the way that most of us love cricket or ferret-racing. He delights in explaining such mysteries as why when the captain of a Jumbo jet calls for a doctor there is always one amongst the 365 passengers. Last night he was in expansive mood on the subject of our electoral system.
Very simply, the battleground on which British elections are fought advantages Labour. Its vote is distributed more efficiently than that of its main rivals. While the Conservatives stack up support in seats they already hold, Labour’s vote is spread more evenly. John Major would have won the 1992 election by some 60 seats, rather than by 21, had the Tory vote been spread as evenly as Labour’s. Today there is great excitement in Tory circles at the news that their party is almost level with Labour in the opinion polls. But here’s the rub. Level ratings wouldn’t come close to delivering the Cameroons a Commons majority, to achieve that they would need a double-figure lead and that isn’t going to happen.
Mr Cameron knows that, and that is why he sought to bind the referendum on AV, which the Lib Dems wanted, with a smaller House of Commons. That would have greatly reduced Labour’s statistical advantage. But the deal collapsed, ostensibly because Clegg et al were offended by Tory attitudes to AV. In reality the likelihood is that Clegg saw the present distribution of seats as his guarantee of sufficient seats to make certain another coalition.
Our dear leader knows only too well that he faces mission impossible if an overall Tory majority is the aim. In addition to the spread, he also faces the ‘nibbling’ effect of Ukip and the fact that Left-wing Lib Demmers have drifted toward Labour. If the graph sketched by John is any guide, it is psephologically impossible for him to deliver a working majority for the Tories.
All of which proves just how uudemocratic is our first-passed-the-post system. It also suggests that when he told Andrew Marr, on Sunday, that he aims at a Tory victory he was acting as if from the Pinocchio school of truth-telling. He knows it, his bankbenchers know it and Nick Clegg knows it. They all know that for the next two years the PM has no alternative to saying one thing and planning another.
We are likely to see a kind of two-step dance. Cameron and Clegg will seemingly step back from each other before once again joining hands. They will wish to demonstrate two things. The parties are seperate entities, but they are working together in the national interest, irksome though that may be.
Both Tory and Lib Dem party members will be less than happy when 2015 brings a re-run of the Rose Garden love-in. But what alternative will they have?
All this assumes mathematically that Ed Milband is not able to make huge inroads in Tory and Lib Dem seats. That sounds as likely as the Aussies winning the Ashes series for any party only one term out of office has enormous problems in proving that it has changed its spots.
So, on the assumption that the maths are correct, we are set to endure two years of futile political abuse and points scoring. Not a happy thought is it?
THOUGHT FOR TODAY ” It is far from impossible that, come 2020, Mr Cameron will have equalled Margaret Thatcher’s tenure in Downing Street – without having won a single election to compare with her hat-trick!”……Paul Goodman of ConservativeHome
Expect a group of grumpy old men to be doing cartwheels at the news of a birth, be it Royal or otherwise, and be disappointed. But all of my fellow codgers were happy to wish the new Baby Cambridge well when we gathered to clean out the hens this morning. Having said that I must confess that the first rain for weeks pleased us even more. No lugging of watering cans today, just as well because it remains oppressively sultry.
As in every section of our society views on the monarchy vary amongst our gang. I confess to being completely mystified as to why people would camp outside Buck House at the announcement of the birth of a baby, particularly since the proud parents are not even there. But the fact is that thousands have done so, proof positive that the Royals remain popular amongst many of their ‘subjects’.
At the time of the Queen’s coronation in 1953, it is said a third of her subjects believed she was there by divine right. Be that as it may, every home with one of the new-fangled TV sets was beseiged. It was a fairy tale of the beautiful young princess who became a Queen, accompanied by her handsome Prince. Now she has become the ultimate celebrity, crowd-puller, and national product endorser. Any new member of the family she heads can never escape the public gaze, however much he and his parents wish it, for he’s part of the compact that preserves the monarchy.
But inevitably the arrival of a new heir to the throne has re-opened the long-standing debate. On last night’s Newsnight a leading republican set out to ridicule the concept of a wealthy privileged family which automatically inherits supreme power. She coveniently ignored two realities, one being that the role of monarch in today’s world invloves no real power, the other being that the Windsor dynasty is today more popular than at any time in its history.
No rational person can easily defend the concept of near-worship that some apply to Royalty, or the endless and outdated procession of Lords and Ladies. Equally difficult to defend is the extent of privilege at a time when many can only survive by using food banks. But the problem facing anyone inclined to pursue that argument to its ultimate conclusion is the question of the alternative.
Today’s polls tell us that the Queen has a 90% approval rating. Such a level of support was unimaginable at the time of Her Majesty’s ‘annus horribilis’, the year the serial infidelities of her children were exposed in titillating detail, Windsor castle caught fire and a mutinous public refused to pay for restoration. A crop of books predicted the end of the monarchy, and a republican reviewer optimistically observed that theoretical discussion of monarchism was bound to lead many to discover that they were republicans at heart. It never happened.
Many believe that the turning point was the death of Diana. Suddenly the ‘firm’ was obliged to open up to the latent affection that lay out there. They did that magnificently, and as the Jubilee celebrations demonstrated the vast majority of the British public love the concept of a head of state far removed from the divisive, and frequently corrupt, world of party politics. It is perhaps significant that leading American statesmen yesterday made clear that whilst few of their citizens have so much as heard of David Cameron, countless millions follow the story of the UK Royals with avid interest. Perhaps their experience with the likes of Nixon and George W Bush have destroyed their republican dream?
It was Prince Philip who, some years ago, made the case for a monarchy more clearly than anyone has done before or since his famous interview. “It is”, he said, “ not so much a question of what we do, more one of what we prevent!”. He was surely right. Any presidential election would inevitably involve politicians. Their standing in the public view has never been lower. From Iraq on, they have lied and practised deception and greed on an unprecedented scale.
We codgers would like to believe that when, some fifty years hence, yesterday’s baby ascends the throne Britain will still be a state that has at its apex a respected individual free of political taint. Sadly none of us will be here to witness it.
Certainly there is nothing to suggest otherwise right now. It would seem that even politicians recognise that. Yesterday 216 MPs supported a motion demanding that the NHS should “no longer be used as a political football”, and called for a “cross-party approach” both now and in the future. The motion was perfectly timed in terms of the new debate about the monarchy.
Th NHS was another institution revered by the public. Politicians have destroyed it. The public is in no mood to give them even greater powers to destroy all that once put the great in Great Britain!
THOUGHT FOR TODAY; ” Whilst the nation is told to cringe at new blue blood being delivered in a private hospital, the nation’s red blood, in the form of NHS Plasma Services Ltd, is being delivered to Bain Capital, run by a US hedge fund!”…….John Medhurst
The Ashes series starts today and for once cricket buffs will not be casting wary eyes up yonder. On days like this it feels good to be alive and the old codgers were a cheerful bunch as the daily ritual of hen-cleaning got underway. But we were few in number, for Albert is in Porthmadog and several others are on their way to Trent Bridge.
Few expect this series to be as thrilling as some of its predecessors. It is unwise to underrate the Aussies but today’s challengers look less of a threat on paper. Either way we already have a talking-point, the authorities have banned Billy the Buglar. Those of my pals with tickets are less than dismayed by that, although the lad does play remarkably well. When, in the past, I have complained at the antics of his colleagues in the so-called ‘Barmy Army’ I have been subjectd to a barrage of abuse. The Army, I am told, is highly valued by the players and does much to raise money for charity. But so do many of those who prefer to focus on the cricket. It is a classic example of the two sides of human rights!
Of far greater import is the latest -ruling by the European Court of Human Rights. Yesterday it decided that a “whole life” tariff, which forces murderers to die in jail, was “inhuman and degrading”. It was responding to an appeal launched by Jeremy Bamber, who killed five members of his family in 1985. The decision means that some of Britain’s most notorious killers such as Peter Sutcliffe and Ian Brady could be granted permission to seek parole. They have the right, said the Judges, to hope.
In contrast their victims have had their hope of life taken away. Small wonder that Paul Bone, the father of Pc Fionna Bone, whose killer, Dale Cregan, was given a whole life tariff last month is “disgusted and appalled”. His reaction is similar to that of every relative of victims. Unsurprisingly the response from politicians is equally hostile.
Prime Minister, Home Secretary and Justice Secretary all expressed fury but have no right of appeal. The latter, Chris Grayling, said the original authors of the human rights laws, which were drawn up in the Fifties to avoid a repeat of the atrocities witnessed during the Second World War, would be “spinning in their graves”. The British people, he added, “will find this ruling intensely frustrating and hard to understand”.
We codgers agree. The European Court constantly fails to demonstrate balance. So preoccupied is it with the rights of criminals that it seems to have lost all sight of the rights of victims. Surely the time has come to say that enough is enough, our own courts are perfectly capable of ensuring that justice is seen to be done.
This is yet another dreadful judgement from a discredited court. There have been the ludicrous ruling regarding votes for long-term criminals, the obstruction of the deportation of terrorist suspects, and a host of others. Yet only Theresa May has been brave enough to suggest that the powers vested in Brussels be taken back. Surely that is the only logical course, always provided that the powers are taken over by our courts rather than politicians who are less trusted than even the European judges.
Harsh? Just take a look at anything they handle. The NHS is a good place to start. We now learn that Lansley’s reforms have already cost the service £1.7 billion. The cost is far higher than expected because – surprise, surprise – nearly 3000 of the people paid handsome redundancies have since been rehired. Chairman of the Commons public accounts committee, Margaret Hodge, complains that the reforms are merely an expensive “merry-go-round”.
Baldrick could have foreseen that!
THOUGHT FOR TODAY; ” Celebrity is nothing. What does it mean? Very little. Cancer is very real!” Sir Michael Parkinson
On sunlit days such as this you can bet your last Lady Gaga record on the BBC van arriving at the allotments. Not the Beeb but Bert’s Big Cones, an ice cream van owned by Bert Street - an endearing character if ever there was one. Bert has much in common with our dear leader, both men are inclined to make hasty judgements, to rant, and to ignore the old maxim about stopping the digging when you find yourself in a hole. Of course the implications in the case of David Cameron are rather more important.
Today we learn that he has jerked into life over the latest lobbying scandal, but appears to have failed to tell his Lib Dem pals of his cunning plan. He has also dragged the question of trades unions into the proposed solution, thus destroying the chance of achieving cross-party consensus. He has also reaped the ‘reward’ from allowing the loopy Andrew Lansley to reform the NHS. Headlines scream of A & E waiting times being the longest for ten years, with the situation rapidly going out of control. No fewer than 40% of hospitals report that the effect of Lansley’s £20 billion ‘efficiency savings’ is a sharp reduction in doctors and nurses. In Bert’s case he has run out of cones on the hottest day of the year, in Cameron’s he has run out of clinical staff. In both cases the blame, it seems, lies elsewhere. In Bert’s case it is down to his wife, in Cameron’s Grumpy Gordon is revealed as the culprit.
But in fairness to both of these endearing idiots, it has to be said that compared to Network Rail (NR) they are relatively competent. NR is heavily subsidised by the taxpayer and has a, er, dismal track record. It has recently received warnings from the Office of Rail Regulation about its trains-on-time performance, with long-distance train punctuality being particularly singled out. It also failed last year to meet its financial efficiency and asset stewardship targets. In fact the only target that it met was the one relating to passenger satisfaction, and no one seems clear as to who they asked, certainly not the commuters who each day take part in a version of the sardine-maker’s outing.
But it seems that, like Bert and our dear leader, the modern equivalent of the Fat Controller knows a thing or two about looking after number one. The chief executive of NR, Sir David Higgins, has trousered a bonus of £100,000 to go along with his £577,000 salary. His five top directors have landed an average of £60,000 each.
Asked to explain such generosity with taxpayer’s money ministers said that had NR met its targets the bonus would have been far higher. So that’s all right then.
We know that it is politically incorrect to talk of lunatics having taken over the asylum, but we can think of no phrase more appropriate for Britain 2013!
THOUGHT FOR TODAY; “None of what they have announced has been agreed. We will not be part of any sort of grubby political deal to attack the unions. This has not been agreed with Nick Clegg!”.. Lib Dem spokesman on learning of yesterday’s Downing Street briefing on anti-sleaze.
Having ccompleted my ‘shift’ on the allotments I am shortly heading off to have lunch with two old friends from my NHS days. I have little doubt that the fate of our health service will be on the agenda. In common with the vast majority of those who dedicate themselves to the cause it is highly likely that my friends share my feeling of absolute horror at what is happening.
This morning we learned that Sir David Nicholson has at last decided to step down from his key position as NHS chief executive. The great mystery is why he has taken so long to find his sword, and why he will hang around until March of next year. I always feel sympathy for anyone who loses their job, but in this case my tears will be few since Sir David will have the consolation of a pension pot worth almost £1.9m. There is also the inescapable truth that he has failed utterly.
Many of those who have campaigned for a new NHS head have focussed on Nicholson’s role in regard to the Stafford Hospital scandal. But to me that is the least of his failings. It was he that introduced the destructive idea of a £20bn efficiency saving, a ridiculous concept that allowed politicians to claim that NHS funding has been ‘ring-fenced’. The reality is that Trusts have been driven to cut staff numbers and already almost 10,000 nurses have been shown the door. One doesn’t have to be Einstein to work out that services inevitably suffer.
In my view Nicholson’s other major failure was his bland acceptance of the so-called reforms of Andrew Lansley. These have caused chaos and even our dear leader was eventually obliged to move Lansley on. Any leader worth his salt would have stood up to be counted rather than comply with plans that he must have realised were a recipe for disaster. And until the NHS is led by someone prepared to fight his or her corner the service will continue to be used as a football by politicians on the make.
This was very apparent on Newsnight last night when Jeremy Paxman chaired a discussion on the collapse of A & E services. The doctors argued that the situation is now unsafe, with a reduced number of clinicians being swamped with increasing patient numbers. The politician said that we have to find a way of joining up the various services. What on earth does this mean? The situation is easily analysed, we now have too few A & E doctors and nurses facing increasing patient volumes due, in part at least, to the inefficient privatisation of GP out-of-hours services.
The answer is equally obvious. GP out-of-hours services must be located alongside A & E units giving everyone needing help a well known location where they can be seen by the appropriate people. Where this is in place the result is a vast improvement in waiting times and the end to the new era of ‘who do we contact’ which is now perplexing patients and is leading to dangerus situations.
It will take a braver man than Nicholson to bring this about since privatised profit-making companies will be unable to accept the concept of diagnosis and treatment taking precedence over costs.
Meantime Jeremy Hunt is too busy playing politics to actually do anything. He is pointing a finger at the ‘new’ GP contract introduced by the Blair government. It was ill-advised but are we really going to solve the crisis by constantly arguing about something that happened ten years ago? Clearly the Daily Mail intends to, for this morning it runs a story about GP’s “Refusal to do their jobs”. Have the writers seen at first hand the pressure that GPs are now working under, a situation made much worse by the decision to impose on them the task of commissioning?
To add to the general feeling of unreality now being experienced by many in the NHS we now have Mike Farrar, who is merely the chief officer of the NHS Confederation – a sort of unadmired Union acting for NHS Trusts – being given headlines for his loopy idea of patients being obliged to email their symptoms to their doctors. The majority of patients are inevitably elderly and would find this impossible. It is also highly dangerous, diagnosis by remote control is not to be trusted.
One can bang on for ever but I won’t. Suffice to say that Nicholson’s exit is a moment of opportunity. We are in the last-chance saloon for a service that is critical for every family and we need an experienced clinician in charge, someone prepared to dismiss crazy ideas from politicians.
We also need a halt right now on so-called efficiency cuts and an end to privatisation. Ministers would be better, and more safely, employed tackling tax-avoidance! Upset Amazon or let patients die?
THOUGHT FOR TODAY; ” Hospitals are at breaking point. The A & E care now being provided is frequently unsafe as a result of toxic overcrowding”…Letter to government of yesterday from senior doctors at 20 major A & E unit.
One news story above all others dominated our chatter on the allotments this morning. Sir Fergie, the patron saint of all codgers, has announced his retirement. We can easily understand the reasoning, but we are disappointed for here was living proof that old ‘uns can hold their own in the new whizz-kid age. We had expected him to carry on into his eighties and to continue to yell abuse at referees from his wheelchair. But God help whoever takes over for Fergie is to join the Man Utd Board!
Meantime our dear leader is in yet another hole. Nigel Lawson’s attack on the EU has fired up the many Tory MPs who see a legal commitment to a referendum as the only hope of slowing down the rise of Nigel Farage. And there is growing uproar in Westminster about the strange treatment by the police of Nigel Evans. David Cameron must be feeling the onset of Nigelitis. The only available cure is to apply for the Old Trafford vacancy. At least he would then hear crowds singing his praises, something less than likely in his present role as Nick Clegg’s dad.
Of more immediate concern to us codgers is the growing evidence of an impending collapse of our GP services. We are all ancient now and, between us, could write a book about the important part played in our lives by what we grew up to call our family doctors. Until recently the familiar figures were always there when we needed them,, and always knew our family history, a key factor in diagnosis. Now the traditionally small practices are being merged into larger impersonal ones where you seldom see the same doctor twice in what feels like a production line. And where one senses a weary resignation, a feeling that retirement cannot come too soon.
So what has happened? Until fairly recently most GP practices comprised partners, with the occasional use of locums to cover holidays. The first change was the ending of the obligation to provide out-of-hours services. Then came a massive increase in the amount of non-clinical work imposed on partners. They now face additional responsibilities such as staffing, performance management, premises and accounts, and the advent of commissioning and the transfer of more work from secondary care is the last straw. Oh yes, and GPs are to face regular revalidation.
Seeing patients has become but one of many tasks and many GPs are retiring early rather than deal with rising bureacracy, stress and burnout. Some of our brightest doctors are going to work abroad and we will soon be back to “golden handshakes” to recruit GPs to high-demand areas.
One early outcome of the new pressures is a shift away from partnerships towards salaried roles. A salaried GP, or a locum, can see their pateints and deal with their associated paperwork. And that is it. The majority of young doctors are now female and they tend to opt for salaried positions. To be able to afford them, partners are having to cut back on what they pay themselves to maintain practice solvency. Not surprisingly partners do all they can to cope without recruiting additional staff.
This crisis is building at a time when hospitals are under great fnancial pressure. The result is that GPs have lost their intimate link with consultants and have to contend with patients waiting sometimes months for specialised help. To make things even worse GPs are no longer allowed to make referrals to specific consultants, and have to explain to patients that private medicine is the only route that enables them to do that.
Thanks to Lansley’s so-called reforms GPs now face an even greater embarrassment. Patients are becoming aware that the new commissiong groups are now responsible for regional budgetry decisions and are beginning to question whether the doctor’s motives are always in their best interest. Throw in the inevitable growth of postcode medicine and the near-total collapse of care for the elderly and disabled and the picture of chaos and general disgruntlement is complete.
What is now happening is that we are training doctors only to offer them working conditions so hostile that they leave or go into private practice. Personalised care by a GP who knows his or her patients will disappear. Smaller surgeries will no longer be viable and will be swallowed up by larger impersonal organisations with little continuity of care. As practices struggle to survive incomes will diminish, but at the same time the government expects workloads to continue to rise when practices cannot recruit or retain staff.
What is now happening is unrealistic and unsafe and risks destroying a vital service that we have always taken for granted. However ministers choose to dress this process up it is really about saving money. This is happening alongside a marked reluctance to address tax-avoidance which is costing the treasury countless billions.
Yesterday tax experts representing most of our large tax-avoiders visited Downing Street. They offered voluntary co-operation, a sort of ‘God make us honest, but not just yet’. It won’t do and a government committed to retaining essential services would have shown them the door!
THOUGHT FOR TODAY; ” Given the scale of cuts it is increasingly difficult to shield vulnerable people from the effect. Some of the peple we have responsibility for may be affecetd by serious reductions in services – with more in the pipeline over the next two years. Councils plan to make £800m cuts in adult social care over the next 12 months. Around £104m of this will be made through the complete withdrawal of services”….Sandie Keene, president of the Association of Directors of Adult Social Services.
We spent much of the time devoted to hen-cleaning this morning with our minds elsewhere. We were trying to work out just how Ian Duncan Smith would manage to survive on £53 per week. We failed. We even resorted to my Gran’s method involving a row of tins on the mantelpiece. But by the time we had put enough in the containers marked gas, coal, electricity, bus fares, washing powder and soap the amount left for the food tin would only stretch to a packet of crisps. We can only conclude that he is a good deal cleverer than us.
If we are honest we have to acknowledge that there are many aspects of his welfare reforms that are beyond our understanding, but it does seem certain that one hell of a storm is brewing. Our dear leader tells us that the Churches are out of touch and that the great British public is solidly behind IDS and all his works. We suspect that it will prove to be a zillion miles behind him when the first stories of chldren on the streets hit the headlines. But we only suspect, what we know for sure is that the death of the NHS will be an equally big issue come the 2015 election
This is not the first government to launch a massive top-down reorganisation of the health service, but it is the first one to do so whilst imposing massive ‘efficiency savings’. The result is that the service is already in meltdown. And yesterday it underwent its greatest upheaval snce 1948. Mis-sold as putting GPs in charge of the budget, most GPs say it does nothing of the kind; only a third told a Pulse survey that they are gaining more power.
Instead GP leaders say blame is devolved without power, their relationship with patients poisoned by mistrust. The GP is now the rationer, not the patient’s advocate. And given the reductions in funding measured against the increasing demand of an ageing population they see no prospect of developing the community alternatives to hospitals of which ministers talk.
There are many worries surrounding the GP issue. Least monitored of all health professionals, over a third of them have financial interests in private healthcare ventures. Suddenly they are open to suspicion of conflict of interest on several fronts. But that is their worry, not ours. Ours centres around the dictats they have to follow in regard to bringing in maximum competition.
The new Commissioning groups will have no altetrnative to offer all services to all prospective providers. NHS services will find themselves bidding against the likes of Virgin Care or the giant American United Healthcare. They are likely to cherry-pick easy and profitable services – outpatients, diagnostics, routine surgery and simple treatments – leaving behind A& E, cancer, complex surgery, the elderly, the mentally ill. NHS hospitals will in effect be left with that which is unpredictably expensive. The best estimate is that at least half will become financially unstable and liable to closure.
In an attempt to save themselves, many of the threatened hospitals will take up the Lnasley plan to re-allocate up to 49% of their beds to private medicine. One way or another the number of hospital beds available locally will reduce dramatically.
The trend is already underway. Figures for 2011-12 from analysts Laing and Buisson show that the English NHS increased its private purchasing by 10.7%. Since private companies will use the NHS logo you will not know who is providing the service, and you will have no way of knowing how much profit is being made since such information is covered by confidentiality clauses.
Ministers will follow the lead of Labour’s Patricia Hewitt in trumpeting the value of competition. But health is not a market and fragmentation will destroy the cohesion and local availability of services. It will also substantially increase postcode medicine, where you live will determine your fate.
Not surprisingly many will argue that the Staffordshre experience demands that changes be made. They are right and given local mismanagement a case could be made for total privatisation of the whole hospital. But private providers are not interested in total responsibility. Therefore failing managements must be replaced rather than pardoned on the basis that nurses were solely to blame.
Those that understand the NHS know that these issues are not the only threats. Two weeks ago the government abolished networks. Over the past few years I have been involved with the cancer version. It has integrated services across regions and shared resources and skills. Many patients have benefited. Lives have been saved. Now it is gone and the excellent nurse in charge sent packing.
Sorry about the air of doom. But that is how it is. The bumbling ministers of the last Labour government and this one have succeeded in destroying the NHS. MPs in constituencies that lose their hospitals will pay the price come 2015.
But it is all of us that will pay the ultimate price!
THOUGHT FOR TODAY; ” But the privilege and pleasure, That we treasure beyond measure, Is to run on little errands for the Ministers of State”…W S Gilbert: The Gondoliers
We codgers have followed with great interest the story of Pope Benedict XVI, and it had been my intention to focus on that this morning. But it will have to wait for something of immediate urgency has come to our notice. It triggered angry words as we cleaned out the hens, in fact so preoccupied were some of us that the normally cautious Tom forgot to duck when entering his hen-run. Blood everywhere. Jack was once a football ‘physio’ and Tom went home bearing enough Vaseline to grease an axle.
On many occasions we have banged on about the potential affect of the Lansley reforms on the NHS. When the national protests reached their peak, our dear leader ordered a pause in the preparation of the bill. Expecting fierce opposition from the Lib Dems, he was reportedly surprised they accepted relatively minor amendments. What swung them, and many of the protest groups, were public assurances from ministers that seemed convincingly cast-iron. When the Tory health minister Earl Howe steered the bill through a rebellious Lords, he promised : “Clinicians will be free to commission services in the way they consider best…they will be under no legal obligation to create new markets…this will be made absolutely clear through secondary legislation”. Now the legislation is open to public scrutiny and we know that the government lied!
It is only when you read the document that the dangerous truth emerges. Commercialisation and competition is written into its key section 75. It opens up virtually all of the NHS to public tender in a market supervised by Monitor. The new bill will be embraced by EU law and the new clinical commissioning groups (CCGs) will be obliged to advertise every service to any bidder. When Andrew Lansley told (in writing) every CCG that they would not be obliged to fragment services by putting them out to tender he was lying, gambling on no one reading the small print until it was too late.
And a second lie has emerged as the result of a reaction from the Royal College of GPs. From the outset we have been told that the reforms were aimed at “putting GPs in the driving seat”. Given that they already seemed up to their ears in work it sounded unlikely, but the government regularly produced one family doctor on TV to reinforce its claim. It was at it again this week, announcing more commissioning groups approved: “All 8000 GP practices in England will be members of a CCG, putting the NHS budget in the control of frontline clinicians for the first time”.
Dr Clare Gerada, head of the Royal College, immediately denounced this as “disingenuous” since all GPs are legally forced to join. Only a small minority of the CCGs are led by GPs, most are “not involved or in favour”. And, like us, Dr Gerada is shocked by the section 75 requirement for every service to be tendered out. She was even more shocked to learn that the role of Monitor, described by Lansley as “to promote competition” was quietly amended, after the Bill’s passage, to read “to prevent anti-competitive behaviour”.
In effect we now have the NHS budget in the hands of local bodies which include virtually no actively involved clinicians. They in turn are legally obliged to put every NHS service out to tender. There can be only one outcome; widespread privatisation and postcode medicine. Throw in the one thing we already knew – that the Bill releases the government from any legal obligation to provide medical care – and you have disaster writ large.
We are all guilty of saying little against this death-sentence for the NHS. It will soon dawn on Lib Dem MPs that they have been duped. They may pay a political price but that will be no consolation when, to quote one local GP, everyone wakes up to find that private companies are closing and centralising services to regional centres unaccessible to many.
We know from examples such as Mid Staffs that the NHS needs tighter controls. What we didn’t know was that abolition based on lies was on the way!
THOUGHT FOR TODAY; “When you say you agree to a thing in principle, you mean that you have not the slightest intention of carrying it out in practice!” ….Otto von Bismarck
Very cold but dry this morning. But as we cleaned out the hens we cheered ourselves with the thought that each day brings Spring a little closer. Albert was quick to respond to any signs of raised spirits by telling us that there is heavy rain on the way. Hopefully his chickens are incapable of understanding his pronouncements, for our knowledge of avian treatments do not extend to infectious depression. If egg production is any indication all is well for, surprisingly, egg production remains high during what experts tell us is the annual ‘switch-off’ period.
As always on Thursday mornings our chatter focussed on the weekly ritual of Prime Minister’s Question Time. Yesterday’s comedy show provided a classic example of the farcical nature of politicians in action. QT itself consisted, as always, of a shouting match between dashing Dave and Ed the Eagle Miliband. Labour’s Michael McCann beat them both for the best gag when he asked if Atos had passed Richard 111 as fit for work. But it was Earnest Ed who managed to turn our dear leader’s features a strong shade of puce when he remarked that the Tory leader should be content that he has almost half of his MPs behnd him.
Our dear leader bellowed. “I am”, he screamed “a marriage man. I want to defend marriage, to encourage marriage, to defend marriage, any sort of marriage!”. Suddenly we had a vision of Cameron as Marriage Man, a superhero who leaps into action whenever marriage – straight, gay or transgender – is under threat. He wears grey, striped figure-hugging underpants, a black cape with tails and a silk topper. Young folk would call him on his Marriage Mobe.
Great fun, proof positive that our leaders really are at war with each other. Not really, for next up was the Mid Staffordshire hospital report. Suddenly we had Dave and Ed, united in solemn contemplation. Ed nodded approval as our dear leader made his public apology. He is brilliant at heartfelt apologies for things that are not actually his fault. Perhaps years later we will get an equally moving and sincere apology for having spent 33 months making the economy even worse than it was.
But by now any sense of theatre had vanished for we were into the inevitable talk of action based on the report by Robert Francis QC on the 31-month inquiry into the appalling failures of the Mid Staffordshire NHS Foundation Trust. To those of us with extensive experience of the NHS it is really a collection of what Basil Fawlty would call the bleeding obvious. Sadly it lacks bite. Yes, the culture needs to change but no, the people responsible for that culture are the wrong people to lead its change. Of course there should be criminal proceedings and of course Sir David Nicolson is not the right person to head up the Department of Health.
But when, oh when, will someone grasp that one body of people make or break our hospital services. The report does mention in passing that there are now almost one million ‘healthcare assistants’ employed on wards. It goes on to suggest that they need training. Wrong. They shouldn’t exist at all. As we have pointed out before on this site they are seen as a cheap alternative to qualified nurses, and as more and more real nurses have been shown the door, they have been entrusted with patient care for which they have no qualifications and, in many cases, no sense of vocation.
I have banged on about this before but yesterday evening something happened that prompts me to risk repetition. I had a telephone call from a Ward Sister in the Midlands. She has for some time been in despair at the reduction in qualified nurses at her disposal. Now she has been told that each ward cluster is to be managed by one Sister instead of three. The long-standing practice has been for each of the eight-hour shifts to be under the control of a Sister. Now two of them will have no Sister present and will rely on a Staff Nurse assisted by, mainly, unqualified staff.
When I chaired an NHS Trust I maintained constant contact with the Sisters. They are invariably highly qualified and dedicated, and see their role as ensuring that all of the nurses reporting to them behave professionally and with compassion. Anyone who has watched the BBC series about the true story of Midwives/Nurses in the fifties will know that the Sisters were the driving force, the ones feared yet respected by staff and patients alike. That is how it was, that is how it continued to be before successive idiotic politicians decided to ‘reform’ a service that they simply did not understand. Labour reduced the nurse-to-patients ratios, the coalition has made things even worse by enforcing massive cuts.
Yes, there need to be changes to management styles - as Francis rightly points out basing healthcare on financial considerations alone is bound to fail. But until someone has the wit to return to a significantly higher ratio of real nurses to patients and to ensure that every shift is in the charge of an eagle-eyed Sister problems will continue. At the very least the government should ask the public if it is comfortable with the conseqences of endangering lives by cutting nurse numbers. Given the waste apparent in so may other facets of the nation’s life they would, one suspects, receive a clear answer.
I know this sounds very simplistic but those of you who have recently spent time as an in-patient will probably accept its validity. Unless of course you are able to afford private hospitals where the Matron and her Sisters have their fingers on every pulse!
THOUGHT FOR TODAY; “The mind is a superb instrument if used rightly. Used wrongly, however, it becomes very destructive. To put it more accurately, it is not so much that you use your mind wrongly – you usually don’t use it at all. It uses you. This is the disease. You believe that you are your mind. The instrument has taken you over!”…..Ekhart Tolle in ‘The Power of Now’
It seems that we are in the new age of love confessions, a time in which everyone must punctuate every conversation with Mills and Boon-like statements confirming their undying love for their partners. I have to confess that, like many of the new-age ‘breakthroughs’, it has yet to catch on amongst the allotments codgers.This morning we enjoyed cleaning out the hens without being soaked in the process, but it has to be said that not one amongst us made reference to the undying love referred to by a host of MPs during yesterday’s same-sex marriage debate. We have clearly missed out somewhere along the way since both those for and against the new Cameron mission seemed overwhelmed by love which passes all human understanding.
Perhaps I should move on quickly before she-who-must-be-obeyed decides to seek retribution. I will only say that I and all my pals, were fascinated by the portrayal of marriage by straights and gays alike. Unending rapture, gazing into each other’s eyes, a quickening of the heartbeat when the onlyone on earth for us approaches. One MP mentioned Alice in Wonderland, our thoughts exactly.
The thing that struck us most yesterday, apart from our dear leader’s latest demonstration of his capacity to upset his MPs and party members – was the repeated claim that this whole affair is proof positive that the new age of democratic equality has arrived. Democratic? We hate to nit-pick, but where was the subject of the redefinition of marriage mentioned in either the election manifestos or the coalition agreement? As with NHS reform and a host of other major initiatives we were not give so much as a hint.
Equality? Perhaps gay people are feeling more equal this morning but their numbers are greatly exceeded by all those who are not. An ideologically driven government has done enormous damage to the welfare state, demonised the poor and set in motion a massive restructuring of the NHS with the clear aim of limiting fast service to those who can afford private healthcare. Throw in the soft-pedal approach to tax avoidance, bankers bonuses and the rest and the resulting picture is hardly one of increasing equality.
And what if anything is being done to ensure democratic equality to all those hounded so disgracefully by the media. Yesterday the government suffered a huge defeat in the Lords. Peers voted by 272 to 141 to introduce a low-cost arbitration system for victims of press defamation, and a system of press regulation which represents the statutory rubicon David Cameron has vowed not to cross.
Lord Fowler, a former Conservative party chairman said; “The Leveson report was published at the end of November. We have waited and waited for action. Instead, some newspaprers, sensing a weakness of intent, have continued to attack Leveson in the most lurid and extreme manner”. I am sure that Norman Fowler knows perfectly well what is going on.
Our dear leader can introduce a zillion new forms of marriage, but only the chattering classes will take heed. But vast numbers are right now viewing what they see as the slow death of equality. Many see the attempt to kick Leveson into the long-grass as part of that.Wealthy and powerful press barons are calling the tune. It is a strange form of democracy.
Whilst all this is going on the political benefits are falling Ed Miliband’s way. Critics say that he simply adopts policies that have the greatest public appeal.They are right. But isn’t that what true democratic equality involves?
TOMORROW WILL BRING THE LAUNCH OF A NEW SERIES OF ‘THOUGHTS FOR TODAY’, FEATURING DIFFERENT VIEWS ON THE ART OF LIVING. DO JOIN ME THEN!
Bit of everything ths morning! The overnight snow had frozen and the wind was fierce enough to send into orbit the new roof panels we had secured over the hen runs just days ago. Someone in the vicinity of Manchester Airport is probably hoarding panels prior to flogging them back to B & Q, from whence we will undoubtedly re-purchase them. We haven’t consulted Inspector Knacker given his recent habit of tazering tottery old boys in Chorley.
In the unlikely event that Chris Huhne reads this blog, he may be pleased to learn that the codgers tended to respond to the press coverge of his misfortunes with cries of hypocrits. Reporters are not renowned for their Mother Theresa qualities but that hasn’t stopped them feigning horror at the thought that anyone should tell a lie. We have to confess that faced with the same quandary, and with the wife on board, we would have considered doing exactly what he did. We wouldn’t have done so not because we are more honest, but because we would have had enough commonsense to realise that getting her to take the rap was potentially suicidal.
It is of course slightly worrying that someone considered clever enough to be a leading minister should be so daft. But he has provided us with a fascinating spectacle. We now face a bye-election in a Lib Dem seat where the challenge comes from the Conservatives. Lose this and even Clegg will find it hard to placate his party activists!
But our worry is focussed elsewhere. Tomorrow Robert Francis QC, who chaired the £13million Mid Staffs hospital inquiry, is expected to give a damning critique of the institutional failings throughout the NHS that enabled the tragedy to take place. Expect much talk about Strategic Health Authorities (SHAs) and targets. In my experience as a Trust Chair the SHAs have little, if any, influence on what happens in a hospital. In fact I was never able to etablish what purpose they actually served since all of the eternal influence came from Monitor, the Foundation Trust regulator. And their interest was purely financial.
Yes, the imposition of countless targets by the Department of Health plus the constant interference on finance by Monitor was an irritation, but a good management team would never allow these to affect patient care.
Clearly the Mid Staffs management was totally incompetent. But they after all are pen-pushers, what caused so many deaths was the acute shortage of real nurses. The key word here is real. As a result of the £20billion cuts – constantly described by the Blue Peter presenter Hunt as efficiency savings – hospitals across the NHS are being obliged to reduce the number of qualified nurses they employ. 7000 have already gone. In their place low-cost Healthcare Assistants are being employed. They are untrained, unskilled and dangerous.
Until University degrees became a requirement for nursing, wards included far more qualified nurses than is now the case, and these supervised trainee nurses who carried out the menial non-medical work but were highly motivated to learn. Since the vast majority that take up nursing as a career see it as a vocation it meant that everyone in the team under a Sister were dedicated to their patients.
Now it is not unusual to have up to twenty patients in the care of one trained nurse and a number of untrained employees, many of whom see what they do as simply a better alternative to working in Tesco. Yes, there are some that are ambitious but they are quickly re-routed to University.
There are undoubtedly many problems building in the NHS as a result of the Lansley reform fiasco. But the big risk to patient safety lies in the falling number of caring, higly skilled nurses.
Of course doctors are important but most patients see them once per day for a few minutes. The key figure always was the experienced nurse many of whom were, frankly, way ahead of junior doctors in spotting developments.
I have spent many years touring wards and can assure you that unless there is a change to the present approach on nursing numbers, and standards, patients will die unecessarily. I guess our lives are in the hands of Jeremy Hunt. Not a happy thought!
TODAY’S INFAMOUS QUOTES RELATE TO FAME AND CELEBRITY; ”Are you Robert Mitchum? Well, somebody has to be”….Robert Mitchum “A guy came up to me in a filling station and said, “Hey, you look like that Hugh Grant. No offence”…….Hugh Grant “To be popular, one must be a mediocrity”….Oscar Wilde “You know what I hate most about being a public figure? The public!”…..Howard Stern “Celebrity opens doors and lowers drawers”……Eddis Izzard “You can’t get spoiled if you do your own ironing”…..Meryl Streep “The crowds cheered me as I passed by but they would be just as noisy if they were going to see me hanged”….Oliver Cromwell “There is only one thing worse than being talked about and that is not being talked about”….Oscar Wilde “When everyone is somebody, no one’s anybody”…..W S Gilbert “Movie stars wear sunglasses even in church. Perhaps they imagine God will recognise them and ask for their autograph”…..Fred Allen “He is remembered chiefly as the man about whom all is forgotten”…….Nicholas Betley ooooooooooooooooooooooooooooooooooooooooooooo
Acording to the weathermen heavy snow was due at 11.00am, so we hurried our hen-cleaning with a view to avoiding being buried alive. The Met Office is seldom as precise as this, and by the time you read this you will know just how wise they were to be so on this occasion. Our problem is that we have reached the stage of believing absolutely nothing that we are told.
If we codgers are in anyway typical a state of cynicism stalks the land. It is hard to put the finger on the origins of this common mental state, but the Leveson Inquiry gave us some pointers. Day after day brought clear evidence of both newspapers and politicians having reached the point where pure invention is the norm. Even worse we realised that the links between sections of the press and politicians run deep, where the latter will jump through a thousand hoops to win support and the twisting of news to manipulate the public will.
The odds are that the perceived need to hold on to the support of Murdoch and the like is driving our dear leader and his colleagues to go to any lengths to ensure that Leveson’s recommendations are not implemented, and that the press barons will be left to exercise their own controls. One wonders if this was on the agenda just days before Christmas when Gorgeous George Osborne visited New York for a get-together with Robert Thomson, the new chief executive of the company that will control all Murdoch’s newspaper operations in Britain and the US. After a great deal of denial the Treasury spin-doctors have finally admitted that the meeting took place.
Meantime the press shows little sign of reform. Today’s Telegraph carries a four-page diatribe about the Swansea ball-boy who was booted by a Chelsea player on Wednesday evening. His parents climb from rags to riches, his own penchant for fast cars and daring emails are all investigated in minute detail. Invasion of privacy still seems to be the order of the day even amongst the so-called quality press. And the coverage of our dear leader’s promise of a referendum on Europe has had all the organs slanting the story to suit their own political agenda. Thus we ‘learn’ that Angela Merkel has welcomed ‘Dave’s ‘ plan to reform the EU. In reaity she said nothing of the sort, but favours must be repaid.
It is in regard to the dismantling of the NHS that the politicians and press alike are really having a field day in the lying stakes. Tomorrow will see thousands march through the streets of south-east London to protest aginst “ludicrous and highly dangerous” plans to close the A & E department at Lewisham Hospital. So intense is the anger that Millwall’s home match has been brought forward to tonight, and the club has made clear its view of the plan – “scandalous”.
The truth is that the closure is aimed at resolving the financial crisis at the neighbouring debt-mired South London Healthcare NHS Trust. The truth is that that hospital will not be able to care for the 125,000 patients of Lewisham. The truth is that ambulances face a one hour journey, and that local people seeking non-emergency medical help face the frightening prospect of having nowhere to turn to without first undertaking lengthy bus or car trips through congested traffic areas.
What we are being told is that this is all part of a plan to create bigger, and more technically efficient, crisis centres. South London isn’t that and there will be no local non blue-lights centre in Lewisham, something that the Department of Health claims is part and parcel of the move toward a new approach to emergency medicine. This pattern is set to be applied right across the country. It is based on an outright lie.
Unknown to most is the fact that the NHS ‘reforms’ are in the hands of management consultants who are rubbing their hands as the juicy contracts roll in. McKinsey is at the forefront of the plan to create a “commissioning market” and it pocketed the best part of £3million for last year alone. The work is led by Dr Penny Dash who was head of strategy at the DoH before movng on to the NHS competition regulator and promoter Monitor. Wheels within wheels, all well greased.
Come the election the NHS, not the EU, will be the major issue. There will be a new political party comprising clinical consultants. They will face a tough challenge as the politicians lie and their media friends oblige with tales doctored not by clinicians but those of the spin variety.
It is hard to know where all this will end, the country is in the last-chance saloon but has little awareness of the truth on any issue. Perhaps the only hope lies in the fact that today’s new generation do not read newspapers and have little respect for politicians.
Meantime we can console ourselves with the old adage that the truth will out. But when?
TODAYS QUOTES ARE ON MONEY! “In the midst of life we are in debt”…..Ethel Watts Mumford “Why is there so much month left at the end of the money?” …..John Barrymore “The difference between outlaws and in-laws is that the outlaws don’t promise to pay it back”…..Kin Hubbard “I once gave a waiter a tip – I told him never to step off a moving bus”…..Groucho Marx “My problem is how to reconcile my gross habits with my net income”….Errol Flynn “I gave him an unlimited budget and he exceeded it”…..Edward Williams “Saving is a fine thing – especially when your parents have done it for you”…..Winston Churchill “I’ve got all the money I need if I die by four o’clock”…..Henny Youngman “When a man tells you he got rich by hard work, ask him whose”…..George Bernard Shaw