Tag Archives: Department of Health

NHS suggests taking drug instead of exercising

A woman on a treadmill (Original caption: &quo...

Every hospital gym has a treadmill - one of best exercises for osteoporosis.

 

 

 

NHS says take drugs

rather than change life-style

 

Strong people will weep.  Yet another drug is being lauded for NHS patients, without working out if there could be a safer and more sensible alternative that doesn’t rely on drugs.

Recent Media is full of benefits of Servier’s drug Protelos to  slow the progress of osteoarthritis (OA), the wear-and-tear disease that destroys joints. It is already given to some patients with Osteoporosis.

And the cost?  £1 per patient per day or £365 per patient per year.  Unless you get side effects (but dealing with these hasn’t been factored into the equation).

As usual the NHS have leapt at this.  Their thinking seems to be it’s better to stuff us full of drugs, rather than spend time talking about changing our life styles.

 

Alternative

W~ell, I upset the cosy NHS apple cart on its rounds.  Instead of dutifully taking the granules of Protelus (Strontium ranelate) for Osteroporosis, which incidentally contains elements that can spontaneously combust (so my scientist nephew tells me),  after these sachets made me incredibly sick, I looked for alternatives.

I went to Austria and Italy where they prescribe exercise classes to help cope with Osteoporosis.  Threw out the pills and packets, and came back to London with a sheet of exercises.  My insurance company paid for a year’s classes at SixPhysio,  and at the end my DXA scan showed 21 % less bone loss;  I am now Osteopeanic instead of Osteoporotic.

Went to see local NHS hospital – but they don’t have any plans to offer simple exercise classes.  However, they assured me that “WHEN you get a fracture, the hospital can deal with this”.  Cost?  Around £12,000 per patient.

So that’s fine then.  The NHS would love me to keep on taking the drugs, with what end result I dread to think.  But GP isn’t happy that I have thrown out the sachets and am sliding in to exercise classes.

£4 million for innovative solutions to tackle healthcare problems

And the latest from LaLa land might be just what we want:  the government has announced £4 million of funding for businesses “to develop cutting-edge ideas to address some of the biggest health problems of our time”.

With money to splash around, (as long as it isn’t to do with healthcare?), The Department of Health (DH) has opened two new competitions, with up to £2 million of funding each to develop technological and innovative solutions that can:

1. Change people’s behaviour in order to reduce the impact of obesity and alcohol related diseases.

2• Improve the number of patients taking their medication as prescribed.

But suggest classes that hospital Physiotherapy Departments could easily start up, to help patients with hip and other problems, Osteoporosis, etc (probably 8.4 million of us) and offer patients an inexpensive way to use hospital gyms under supervision, and the DH’s Press Office is thrown.  The idea for classes are innovative, make full use of equipment that is often lying idle, would cost far less than £7 a week for a class – but this isn’t ‘innovative’ enough.

Some fluffy bunny from the DH’s Press Office says she will “get back to you”, but I am not holding my breath.

What is happening

So it’s left to the private providers to step in and offer suitable classes.  Not the sort of multi-billion private provider that LaLa’s minions wants to deal with, but a sensible, down-to-earth Yoga and Pilates team who specialises in running classes for local people, offering an inexpensive way of healthy living.

Noni Beasley is an energetic trainer who zips around Kensington and Chelsea on her bike, and is setting up Yoga and Pilates classes at the new Earl’s Court Health and Wellbeing Centre.   She and her partner, Mymuna, are full of enthusiasm and already have an enthusiastic following in the area.  But they could do so much more if LaLa would realise that supporting grass-roots initiatives such as these are far more use and much more cost-effective.

But then Noni’s classes will cost a few pounds per person – well below the cost of Protelus.

Noni Beasley  nonibfit@gmail.com   07757 180303

Earl’s Court Health and Wellbeing Centre, 2b, Hogarth Road, London SW5 OPT.  (Opposite Underground Station)

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La La Lansley finally comes up with sensible idea

James and his snowman (from the 1982 film) mee...

La La in disguise? Wikipedia

Dept of Health

agrees £20 million funding

 

Over the Christmas period, the august Dept. of Health got into the spirit of the season.

And the Department came up with funding to provide Snow wardens, winter workers and community angels to help with shopping and heating homes and provide assistance across the country during the cold weather.

£20 millions was promised to 163 Councils in Government funding. This will enable them to run innovative schemes to help vulnerable people keep warm and safe, and prevent people needing to go to hospital during the winter months.

Schemes include:

Wakefield’s Snowbell Responders will offer free emergency heating, home insulation, visits by a handyperson, benefit checks and home fire safety checks. This scheme, which has received £90,900 from the Department of Health, will help almost a thousand households in Wakefield.

Community Angels in Cumbria will encourage people to look in on their neighbours. Homeless people will be helped into housing and urgent heating and insulation help will be provided for vulnerable people. Cumbria’s bid totals £377,500.

Blackburn’s £114,500 bid will recruit Winter Buddies to help vulnerable people access support services. And emergency packs containing a fleece, hot water bottle, thermal socks, hot drinks, soups and low energy halogen heaters will be distributed.

Lambeth has been given £131,000 for a Winter Workers team to carry out welfare visits, do shopping, walk pets and collect prescriptions. Three hundred Snow Wardens will provide cold weather assistance if it snows. And a handyperson service will help promote energy efficiency, install draft proofing and provide practical aids such as thermometers and body warmers.

In Christmas mood, Lansley said, “Severe winter weather is a real threat to vulnerable people. People are more likely to suffer heart attacks and strokes, respiratory illnesses can get worse, and there is the risk of falls on slippery ground.

“Every vulnerable person needs help in winter, whether it’s help with shopping, heating the home or making hot meals. We asked councils to come up with innovative ideas to look after their communities and have made £20 million available to fund their plans. I welcome how local authorities, together with charity partners like Age UK and the Community Foundation Network are putting support networks in place. This funding will equip those services to respond to needs and emergencies.

“From mending boilers in Blackburn to walking labradors in Lambeth, this money will make a huge difference to tens of thousands of people this winter.” Age UK is building on this with its own Spread the Warmth winter campaign which aims to help 360,000 older people keep warm and well in the winter months.”

Mind you, as with all Government schemes, it’s not as kindly as it sounds.  It is estimated that over £850 million is spent by the NHS each year as a result of the impact of cold housing on people’s health.

More information:

The Warm Homes Healthy People http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_130564

Or contact your Council, or local Age UK branch.

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What future is there for NHS?

Food for thought

~ for the Future

The current malaise in the NHS is dragging patients down.

They say they are fed up with nurses and doctors looking grey, over-worked and dispirited.

  • And even more fed up with longer waiting times,
  • being told the post-code lottery means they don’t get a drug,
  • or shuffled laboriously through the system to get what should be simple tests.

It is OUR NHS – isn’t it about time we said “enough is enough”?

 

Brave Soul

Dr Kailash Chand, a GP in the north of England, has started a government email petition.   If he gets 100,000 signatures, this automatically  forces a debate in Parliament on the Health and Social Care Bill.

No doubt his bosses won’t be pleased with him (the Dept. of Health doesn’t like those who speak up), but if you want to support him click through to

https://submissions.epetitions.direct.gov.uk/petitions/22670

 

What else?

It is time to challenge the myth/mantra repeated time and again by NHS staff – French care may be better but it is more expensive.

When you compare like for like (i.e. if you take out of the equation all the private rooms, home care, massages etc. the French receive ) and work out who pays what – the French and ourselves are paying pretty much the same.

Perhaps we could go back to a report, written in 2008, for the think tank Reform.  What Prof.Nick Bosanquet, Andrew Haldenby, Laura Hurley, Flavia Jolly, Helen Rainbow and Prof. Karol Sikora wrote is worth re-reading, as a basis for patients to challenge just what is the NHS and La La doing with OUR  money?

The typical UK patient  pays around £2,250 per individual per year, so that everyone is covered by the National Health Service.

So the thoughtful report should be required reading for Cameron and Lansley;  instead of repeating “European healthcare is better”, and leave it at that – perhaps instead of devising all his time and money wasting plans, Lansley would take on board what the Reform Report says – and ACT on it.

So why change?
Over many years, Reform says academic studies have pointed to a gap in performance between the UK and other countries.

Health outcomes are difficult to measure, but the UK delivers a poor level of social equity despite having universal provision.  Other countries have systems that rely on part tax funding – part personal insurance funding for health care.

International options point to two key conclusions:

1.    Drawbacks of voluntary coverage concern both effectiveness – due to the problems of adverse selection – and equity. The only major developed country which operates voluntary health insurance is the USA, and that country is itself divided as to the wisdom of the policy. The NHS does provide cover to every UK citizen (although not for every condition), and that is a valuable strength.
2.    In recent years new insurance-based systems, in particular the Netherlands, have been created. Systems with strong insurance characteristics, such as France, Germany and Switzerland, are reforming in order to manage demand and continue to deliver a better standard of healthcare than the UK. The UK looks out of line with global developments.
The Prime Minister claimed that the NHS was “the best insurance system in the world” because, in systems with greater insurance elements, the costs of healthcare could bankrupt families on normal incomes.

Reform says people living in countries such as France, Germany, Switzerland or the Netherlands have the same kind of protection as the Prime Minister described, including cover against the very high costs of catastrophic illness. The task for the NHS is to combine its universal base with the focus on the patient evident in other countries.

Insurance incentives have the following advantages:

> they provide reasons for individuals and authorities to value the long term;
> they achieve greater value;
> they incentivise individuals to participate in their own healthcare;
> they remove unequal access to treatment; and
> they de-politicise healthcare.
Insurance-based systems are closely focused on individual patient outcomes as healthy patients cost less. This means a focus both on general well-being and on ensuring customers that do become ill recover in the shortest period of time.
In other words, an insurance-based health system encourages preventative medicine – something sadly lacking in the NHS.

Ending the postcode lottery
In insurance based systems patient entitlement is defined, and patients are aware of what drugs and treatments they have access to. This empowers patients and makes the system inherently patient centred, and would overcome the current difficulties in the NHS where some patients in one area have access to treatment while other do not.
The key elements of insurance success
We have seen the advantages of insurance incentives. However, there are a number of crucial elements that are required to make an insurance system work.

Firstly, it is important that a sufficient range of providers are able to operate in the market. Secondly, the core system of compulsory insurance needs to cover the vast majority of health problems to ensure that it is for only a minority of conditions that people are buying healthcare for through self-payment or supplementary insurance. Thirdly, people have to be incentivised to prevent abuse of the system. Finally, information and capability to use that information must be present.

Incentives to stop abuse of the system
People may have an incentive to abuse an over-generous system of provision.

In 2004 the average French GP prescribed drugs worth €260,000 a year and the French used three times as many antibiotics as the Germans.  The French have tried to tackle this problem of overtreatment by requiring co-payments for many drugs and GP visits.

One academic has estimated that between 20 and 30 per cent of healthcare funds in America go toward unnecessary treatments which can in fact have a detrimental effect on public health.

UK families already spend £1,600 per year on healthcare
Reform research shows that the average household invests significant amounts privately on their own health. At a conservative estimate the average household is spending £1,200 a year privately on core areas of healthcare, including private hospital treatment, dentistry, optometry and over the counter medicines.

Alongside this spending individuals are also spending a considerable amount a year on improving their own lifestyles through diet and exercise.The average family spends around £400 annually on areas such as gym and sports club membership as well as complementary therapies.

The basic healthcare package in France, which includes the cost of social security contributions and the cost of a basic supplementary insurance, is £2,021.46.

This is a comprehensive package which covers the cost of consultations, pharmacy, dental costs, surgical costs, hospital stay and ambulatory transport amongst others. Furthermore, the French state currently guarantees patients access to all cancer treatments, including experimental ones.

The option to top up for luxury services or rare drugs
Supplementary insurance would cover a wider range of health treatment and pharmaceuticals that are not available in the core package. Supplementary insurance could be purchased for an additional charge from the Health Protection Providers.

Based on supplementary insurance in other countries, examples of cover might include:
> Additional surgery e.g. additional eye surgery during a cataract operation to alleviate the need to wear glasses.
> Drugs not available in the core package.
> A higher standard of hospital accommodation, such as a private room.

Competition
An essential element of a system that acts as an insurer is competition. Competition drives efficiency and quality of services for patients.   However, competition has to be on a level playing field, and signs are that current plans for commissioning services won’t take into account all the factors.

Role of government
Now, this is where it gets interesting.  I can never understand how a politician, with no training whatsoever, can suddenly find themselves managing a health budget of billions.  No company would run this way.  Yet the NHS expects a rookie Minister to know how to commission health services.

Reform suggests the role of the Government would be considerably reduced.

It would have a regulatory function to ensure that all Health Protection Providers and service providers were of sufficient quality. Further tasks would include allocating contracts for emergency services and deciding the budget of the service on a five year cycle. The reduction of this role would eliminate the need for regional agencies i.e. Strategic Health Authorities.

This would depoliticise the running of the health service, and remove it from the political cycle.

The authors
Nick Bosanquet is Professor of Health Policy at Imperial College London and Consultant Director of Reform.
Andrew Haldenby is Reform’s Director.
Laura Hurley was an intern at Reform during the summer of 2008.
Flavia Jolly was an intern at Reform during the summer of 2008.
Helen Rainbow is Reform’s Senior Researcher specialising in health.
Professor Karol Sikora is Medical Director of CancerPartnersUK and a consultant in cancer medicine.

Report costs:  £20.00
Reform, 45 Great Peter Street, London, SW1P 3LT
T 020 7799 6699
info@reform.co.uk
www.reform.co.uk
ISBN number: 978-1-905730-12-4

Hacked off NHS moles are coming up from their tunnels

See http://www.nhsManagers.net

 

 

This website is well worth watching.

Edited by Roy Lilley, PPA ‘Columnist of the Year’ – Finalist, he manages to make sense of what is happening to the  Health Bill, that LaLa doesn’t want you to know.

Golden sieve

Image via Wikipedia

Roy’s latest article comments that in this new commercial world, if the Department of Health were looking for a logo, they could do no better than “choose a gold plated sieve”.

Why? Roy says “there’s been another major leak”.

Then says, “you have to ask why people leak things.

Why do they risk disciplinary action, maybe even their jobs and careers to do it?

It’s easy to think it is because people think something is wrong and they want to bring it to wider public attention. It’s a bit about that but I think it is more”.

It takes a lot to shove a document into a scanner, put it on a stick, take it home, set up a Hot Mail account with a gobbledygook name and send it out. You have to be brave, determined and thoroughly aware of what you are doing and the consequences. And, you have to be pretty hacked off.

On a Scale of 1 – 10

It is impossible to measure ‘hacked-off-ness’. For convenience I have invented the Lilley Hacked-Off Scale; one to ten. Judging by my post-bag I take the general level of most readers hacked-off-ness to be about eleven out of ten. I’m thinking of recalibrating already.

I don’t think anyone has recovered from LaLa’s pledge of no more top-down reorganisations only to be faced with the lunacy of what followed; redundancies, 364 pages of Bill and the ‘Pause Fandango’.

Then a creeping realisation that the NHS will have all of its hospitals run off-shore as FTs, community services hived-off and the excesses of Monitor who seems to think the NHS should be run as a utility company.

Channel 4 gets in on the act

Throughout it all I was daft enough to think GPs would come good and do the right thing. That went out of the window when Ch4 did its Go-Johnny expose and Lovely-Jubbly appeared in the NHS lexicon.

Well, Ch4 have done it again. Any thoughts that GPs would have any real influence over commissioning has gone out of the same window. Somebody who is about 15 on the ten scale of hacked-off-ness has leaked a document. They made a programme insert about it on the Ch4 news, last night.

We have a copy; here it is. It is the final draft of a document being developed by the DH called ‘Towards Service Excellence’.

http://www.channel4.com/news/leaked-document-shows-how-doctors-can-profit-from-nhs-reform

In any other setting it would be comical in that it recognises what we all know; GPs can’t commission healthcare or run commissioning. Under the arrangements proposed in the document they will have precious little to do with it. It understands that buying healthcare has to be done at scale and pretty well reinvents SHAs.

PCTs will keep going, providing interim commissioning ‘support’, doing what the GPs know they can’t do, but it is clear that the expectation is they will prepare the way for the private sector to come in and take over most of the commissioning and back office functions and provide a service to several CCGs. An elaborate pathway is mapped out for their entrance. PCTs may have a shot at evolving themselves into commissioning support businesses but they won’t stand a prayer against the McKPMGs of this world.

The document makes depressing reading

Not depressing because it is about the private sector.  Depressing in that it describes a convoluted, wasteful, labyrinthine attempt to stick together the broken fragments of the NHS and put it back on the shelf, where it started.

It has a desperate tone and seems to me to be driven by the knowledge that the NHS is on the brink of a nervous breakdown. If you are a Go-Johnny you won’t like it either. It describes an NHS far removed from LaLa’s original idea.  GPs will have little to do with anything.

I read it more in sorrow than in anger. What a terrible waste of money and time this has been.

As Roy says, take some time, see for yourself what it says and whisper a silent thank you to the brave soul who was hacked-off enough to see if you’re as hacked-off as they are.

 

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Are you waiting for NHS treatment?

Philips MRI in Sahlgrenska Universitetsjukhuse...

Image via Wikipedia

Is NHS Restricting scans

and tests?

 

All over Britain people are waiting – and waiting – for referral letters for tests, scans and treatment.

Are these delays a cynical way to extend payment times?

By the time you get your long-awaited appointment, the fee for this will  probably be charged to next year’s budget.

Surveys

Recent press articles show a quarter of PCTs are looking at ways they can reduce the numbers of patients GPs send for extra investigations. Several are also setting upper limits for “excessive” use of tests, while others have blocked GPs from directly referring patients for tests.

Looking at the mass of emails I receive,  showing results of surveys, etc.  extracts from the deluge showed that

  • of the 116 Primary Care Trusts contacted, 28% said they had either started looking into how many referrals GPs carried out across their area, or were planning to do so
  • A quarter are helping practices reduce ‘inappropriate’ access
  • Nine Trusts said they had found surgeries that either sent too many or too few patients for tests
  • Two Trusts are considering introducing upper and lower targets
  • Five PCTs have scrapped direct access altogether to at least one type of test.

If you want evidence, Google the above lines – and you will get it in spades.

Royal College of GPs are worried

Dr Claire Gerada, Chair of the Royal College of General Practitioners (RCGP) criticised the move saying, “This is about money and finances driving behaviour by the PCT – not about putting patients first.”  And yet isn’t it their members that stand to gain if GPs have access to commissioning?

Call me naive, but when I can’t even get an appointment with my usual GP, and end up seeing a Locum who tells me that they are going to have to cut down on drugs, etc – yet are spending a huge amount of senior GP time bidding for the new consortia – it does raise questions in my mind.

Dr Chaand Nagpaul, a senior member of the British Medical Association (BMA) has also commented saying that restricting access to scans risks “turning back the clock” on plans to diagnose disease early. He said, “An intelligent approach would be to have guidelines for appropriate use of diagnostics and incorporate them into the pathway.”

Patients should have tests needed

Yet more evidence that the cuts to NHS funding are beginning to have a detrimental effect on services for patients. GPs should not have to be in the business of rationing out referrals for tests. If patients need tests, they should be able to access them when they need them and not be forced to wait while the GP’s referral quota is renewed. Early diagnosis is important for many diseases including cancer, and delaying diagnosis could have dire consequences.

It happened to me

Last winter I might – just might – have had a return of cancer.  I was OK in my mind, but all signs pointed to needing a rapid diagnosis.  But delays, missing letters, doctors not available, referral letters not sent, and most important of all – the ommission of the word ‘cancer’ (for which my doctor spent half an hour apologising) meant a wait from October to January.  So if it happened to me – what about others?

I still haven’t been able to get my head around the fact that when I complain, I am told that “not to worry, we can deal with it” is supposed to reassure me.  But I don’t want to end up as another statistic trotted out by La La Lansley when he tries to blame us for not coming forward early enough for cancer disagnosis.  Cynical manipulation I call it.

The Department of Health must ensure that tests are not rationed, and that funding and resources are in place to ensure all patients have access to the care they need.

For more information, please visit http://www.telegraph.co.uk/health/healthnews/8748093/NHS-managers-restricting-access-to-crucial-scans-and-tests.html

 

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Update on NHS fiasco

The Department of Health headquarters in Whitehall

DH HQ Wikipedia

Cameron and Lansley are facing massive opposition to NHS changes

Latest ‘Initiative’ is two month wait – then they are going out to consult with patients

 Considering Lansley had his mega-expensive tour of UK last summer, then there was a ‘consultation’ – one wonders what on earth they do with their time? 

Perhaps they need to have their ears syringed?  Or, as the decal goes in souvenir shops – “what don’t you understand about NO?

 It’s all thanks to good old People Power – petitions and letters to MPs are making them tell their masters to call a halt to the senseless roller coaster of NHS reform

and make the Government plan much-needed changes in a slow, methodical and thought-out manner.

My dream to reform NHS

The NHS desperately needs local avisory boards of local business people, to award contracts and hire and fire administrators as needed in their area.

Get locsl CEOs / reps from local branches of John Lewis (who give workers a stake in their own firm), and reps from Sir Terence Leahy (late CEO of Tesco and one of most successful businessmen in UK), Edward de Bono (famous for Lateral Thinking – and the NHS needs this), Gerry Robinson (who famously asked why the NHS almost closes down on a Friday), and a few other heads of successsful companies,  to join an NHS board as non-Executive Directors.

I would love to see Alan Sugar spend five minutes in my local Foundation hospital – his beady eyes would spot where money is being wasted in a nano-second.  Walking through this hospital, one can see where cuts could be made, and contractors should be told to honour contracts.  But if you have had a medical training – when did your tutors have time to give you a crash course in Business Administration?

The NHS should take advantage of some of the good private sector health services;  but how can a politician know which companies provide good value for money?  Often it seemed to get an NHS contract you had to know Tony Blair, and produce beautiful balance sheets – but no-one cared about the appalling service some of these companies gave patients.  Hence the private sector got a bad name – when it was the fault of NHS administrators choosing the wrong companies.

Then, if it is decided we need one,  the Government could appoint a Minister of Health to go round the country shaking hands and buttering people up – but tell these Ministers to take their amateur hands out of the till.  How can we expect MPs, who today seldom have any background in business, to understand balance sheets, contracts, etc?

Leave the medical profession to get on with running its own service, free from worries about apportioning budgets. 

And bring back Matron.

David Cameron talks about the Big Society – but I reckon Mr. and Mrs. Average are so fed up with the way Government (of whichever party) is wasting their hard-earned money, that they are now making voices felt;  Big Society or no.

No-one would deny the NHS is drastically in need of reform.  Doctors tell me they are waiting for the whole service to  collapse; patients see waiting times climb again, cancer patients find the promised Two Week wait for diagnostic tests is cycnicaly swept aside – now it applies to the FIRST alert – after that further tests are delayed and delayed;  and reports are coming in from all over the country about lack of care, lack of resources and operations being postponed or even denied.

When Andew Lansley announced he was going to get rid of many of the Administrators in the NHS, everyone was happy – except cynics like myself.  Realising that any Administrator on a six-figure salary wasn’t that stupid to sack themselves, we wondered how the administration was going ensure that the cuts didn’t  affect their cosy inflation-proof salaries and pensions.

In our neck of the woods it soon became obvious.  Senior physios, OTs, Community Nurses, etc. who, having worked in their jobs very efficiently for years, were probably now in charge of a team.  Bingo – they were classed as ‘administrators’ – and easy to get rid of.

But People Power might just have done enough to convince David Cameron that the NHS reforms could be his ‘Poll Tax’ downfall.  Currently the papers are full of reports, comments and high-powered letters – telling the Government they MUST think again.  So much so that Cameron is having to climb down.

38 Degrees

The people behind some very successful recent petitions are scenting victory.  After previously getting a very good response, they are asking the public again to “Click here to send your MP a message re NHS reforms. Over 30,000 38 Degrees members already have, but as the decision approaches each message that comes in could be the one that tips the balance:
http://www.38degrees.org.uk/NHS-email-MP

Who’s agin’ Lansley’s proposed reform of NHS?

Lansley’s co-workers in Whitehall are distancing themselves – a sure sign that things aren’t going well.  When you get to talk to the workers in the Dept. Health’s press office, they don’t even bother to hide the fact that he is very, very unpopular.  At least the message has got through that journalists were getting fed up with the constant press releases we found in our email, lauding another ‘Lansley initiative’.  Whitehall now resounds with the sound of these being dropped – hard.

The Liberal Democrat spring conference voted overwhelmingly to reject the Government’s health reforms.

The British Medical Association (BMA) held an emergency meeting in London to vote on a motion “to oppose the [Health and Social Care] Bill in its entirety”, and sent a message to the Department of Health highlighting the concerns of the medical profession.

Do politicians lose touch with reality – whilst they build their little Empires?

The public are getting angry, and so are major health organisations and associations, with the way the Government has promised so much, without actually working out who or what is going to pay for this.  The consequence is there is a huge round of ‘robbing Peter to pay Paul’ going on in the Dept. Health, now that the financial wizards have told Lansley what’s what. 

The Department of Health  (DH) seems to be going back on Cancer Drugs Fund pledge.  The Patients’ Association say the DH is being accused of going back on this initiative by clawing the money back from Primary Care Trusts by cutting their budgets.

Lansley can’t even get it right – after years of planning in opposition

He had seven years in the Health seat in Opposition – one questions what on earth he was doing with his time  not working out what is needed, that’s for certain.If he had bothered to work things out before, he could have saved a lot of paper, hot air and broken promises.

Two more health organisations are refusing to sign up to the government’s “responsibility deal” on public health, increasing the pressure on Lansley over his strategy of allowing the food and drinks industries to help form health policy.

Diabetes UK and the British Heart Forum, members of the panel looking at food and obesity, said they would not sign up to the deal which is being launched by the government. Their decision follows a walk-out by six leading health organisations who had been sitting on the alcohol panel.

As the Patients’ Association say, “the refusal of eight mainstream health organisations to participate in Lansley’s public health agreement is an embarrassment for the health secretary. Shadow health minister Diane Abbott said the government’s approach was “a favour to their friends in big business … The truth is that you cannot conflate corporate responsibility with public health”.

Royal College of Physicians, the Institute of Alcohol Studies, the British Liver Trust, the British Medical Association, Alcohol Concern and the British Association for the Study of the Liver wrote to Lansley telling him that they could not support the alcohol deal, which would not help reduce illness and deaths from drinking.

Bring in the Big Boys

How on earth politicians, with no knowledge of business finance, expect to be catapulted behind a massive Whitehall  desk, then run a ‘firm’ with an annual budget of over £20 billion, beggars belief.  Before they have even had time to count the square footage of their carpet, and learn the name of their drivers, they have to face allocating millions of pounds for different services.  No company would last long with this type of ridiculous administration.

Those that do understand finance, the House of Commons public accounts committee, had bad news for Lansley in its  latest report showing that NHS productivity has been declining for the last 10 years in spite of increased pay for doctors and other staff.

Whilst the last Government was throwing money around on glitzy new ‘health centres’, no-one set up a solid foundation to provide working capital to keep all the ‘toys for boys’ and their big machines, actually working once past the unveiling and celeb promotion stages.

So sign the petition – and get the Government to think rationally (if it can).

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Latest from Mad Hatter's Tea Party – a.k.a. Dept. Health

The Department of Health headquarters in Whitehall
The Tea Party is somewhere in here   Wikipedia

LINks to be scrapped despite saving £126 million

I read this headline several times –
but yes, the Patients’ Association confirms it’s true.

The Department of Health has released official figures that estimate the money saved by Local Improvement Networks (LINks) was £126 million in the year 2009-10.

A matter for congratulation – surely?  Er – no. Not in today’s mad NHS world.

The Dept. Health says despite this, LINks are to be scrapped;   according to Government plans LINks will now be replaced by *NEW*  new local HealthWatch bodies!

In other words, throw the baby out with the bathwater, scrap whatever worked well, and start all over again.  Just because somthing things didn’t work as well as others.

Imagine what that’s going to cost?

  • Printing, sign writing for all the new signage, etc
  • New Admin staff (on lovely pension and benefits packages, and yes, they will be allowed to keep their redundancy payments when they are transferred over from old LINks).
  • Another Minister is probably hiding in the side-lines to take over, and he/she will need staff, pension plan, etc. etc.  not forgetting adding to the Whitehall driver pool.

Alice would be astonished – I am speechless.  (Some would say that’s a good thing).

Also puzzled.  Surely if part of an organisation has managed to make savings of £126 million, best solution would be to keep the LINk teams that perform well – and scrap the others?

Or am I missing something somewhere?

What are LINks?

LINks were set up in 2008 to allow members of the public and community organisations to improve health and social care services through patient and public feedback to NHS bodies.

However, they have had varied success. Patients’ Association (PA) say, “We have received many calls to our Helpline questioning the effectiveness of LINks, and feedback about successful LINks suggests that a great deal depends on the commitment of individuals”.

However, in our area (Kensington and Chelsea in London) the administration staff work extremely well.  Sitting on the cancer sub-group, we have been asked to comment on the Quality Assessment reports of local hospitals, and were able to point out that one hospital that is particularly bad re mixed wards, hadn’t put anything in report on when they were phasing these out;  we also had numerous other comments to make – which hospitals have taken on board and have had meetings to tell us what they are doing to improve.

And we are setting up teams to go into specific groups to alert them to cancer screening.  Thanks to our Administator, Paula Murphy and her team, letters have been sent out on our behalf which have produced excellent results.

What’s happening

Now, the Government proposes to replace LINks with local HealthWatch bodies, which are to act as ‘consumer champions’ for NHS services.

The Patients Association agrees with the Government that LINks have been disappointing as a group, but are concerned because HealthWatch bodies will be established under the Care Quality Commission (the body that regulates the NHS).   This sounds like a very incestuous relationship, and  calls into question their scope, independence and transparency.

On this issue, Katherine Murphy, the Chief Executive of the Patients Association, said, “How can the Government say they are going to be independent voices of patients, when they are actually part of the regulator?”

It is vital that there is a strong and independent patient voice that has the opportunity to genuinely shape local services in the NHS if it is to become truly patient-centred. As we found when we looked at hospital QA – reports can fudge issues – but patients KNOW what isn’t working –  and if needed reforms are set out,  we certainly questioned the QAs we were given, sending them back to have more data included, or to make them give better explanations.

In moving forwards with abolishing LINks and setting up HealthWatch, the Department of Health must consider the independence of this patient voice as a priority.

But, having watched Whitehall for many years,  I give HealthWatch two years before the next Minister wanting to’make his/her mark’  decides Healthwatch isn’t working, and sets out to change this.

Or – will someone please get John Lewis, Gerry Robinson or any other top company boss in to tell the little Whitehall mandarins how to run a large organisation?  Because this lot seem as profligate as the last with OUR money.

The PA are battling furiously on behalf of patients, and would welcome new members – see  www.patients-association.com

For more information, see http://www.guardian.co.uk/society/2010/dec/29/nhs-local-improvement-networks-links-scrapped.LINks to be scrapped despite saving £126 million

Enhanced by ZemantaIncidentally, Google for once wasn’t much help.  Keying in ‘Getting rid of LINks’  – it came up with lots of advice on how to stop porn sites linking in.  But nothing on ‘our’ LINks.

White paper or blackout?

Conversation between doctor and patient/consumer.
Image via Wikipedia

A personal viewpoint


Andrew Lansley’s attempt to reform the NHS is foundering.

Announing he is getting rid of a layer of Administrators, those who know the high-ups in the NHS realise they didn’t claw their way up by pussy-footing around.  But will have ensured they have cast-iron contracts.  Or re-named their post so they step side-ways.

Sure enough, in our area we hear that 126 senior nurses, CNS, Physios, etc. are about to be ‘lost’.  But then they are ‘team leaders’ = administrators (for the tick box gurus), so that’s all right then.

Have you managed to see your GP recently? Or is the practice involved in ‘meetings’ about Lansley’s Pathfinder scheme, where GP practices are going to take over from PCTs?  If your practice is applying for the new scheme, you might only see a Locum drafted in whilst ‘your’ GP attends meetings.

White Paper

Reading the pages of the White Paper, I thought maybe I had missed the point.  To my simple mind it was re-inventing the wheel, but in a square form.  So I must have got it wrong, hadn’t I?

Then the Patients’ Association send a press release, saying:

  • The White Paper lacks detail on two important areas: complaints handling and the regulation and appraisal of individual healthcare professionals.
  • The PA is concerned that the logistics of delivering and implementing the proposals outlined in the White Paper have not been considered in full. There is a lack of detail on how the Government will engage with the public regarding the proposed changes. Many patients are despondent regarding the White Paper consultation process and believe that the ideas proposed are already being turned into policy.

And I realised that it wasn’t just me – thousands thought the same way:  it was the usual, typical waste of time devised by a politician.

The problem with politicians is they are appointed to Ministerial posts, with no previous experience.  In the run-up to the election, Mark Simmonds, MP, seemed to have grasped what the NHS needs.  He spoke very effectively about cancer treatment, and there was a feeling amongst those who heard him speak that he did know what he was talking about.

Come the new appointments after the election, and he is nowhere.

The Patients Association publishes its response to the NHS White Paper

On 11 October, the Patients Association published its response to the consultation on the NHS White Paper on the proposed restructure of the NHS
Our response is based on the results of our members’ survey and we would like to thank everyone who took the time to answer the survey – this is your response.

The White Paper has promised a more patient centric service which has been welcomed by the PA but you have expressed deep concerns over how this will be taken forward. Such statements about patient involvement in their own care cannot not simply be rhetoric but must translate into action.

You also have deep concerns on whether GPs are really the right people to hold the purse strings. GPs are trained as doctors not administrators and there is a worry that they will have to sacrifice clinical time to perform administrative duties.

There is a danger that GP commissioning will increase the postcode lottery. We are also very concerned that GP commissioning may lead to a conflict of interest which would lead to GPs seeking the cheapest care rather than the best care for their patients.

We hope the Department of Health will consider the views of patients thoroughly and thoughtfully.

Er – I can see yet another time-wasting ‘Consultation’ coming up – or, horror of horrors, Lansley may repeat that awful Away-week exercise he indulged in last summer.  On second thoughts, I think that was such a disaster he won’t.  Unless his ‘official’ photographer wants the work.  Yes, it isn’t only Cameron – every Government department has them.


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Didn't someone at Ministry of Health say they were cutting down?

Andrew Lansley, British politician and Shadow ...
Image via Wikipedia

Public Health England – A new service to get people healthy

Yet another daily ‘initiative’ from Andrew Lansley – setting up another organisation:  Public Health England.

Does anyone else wish the Dept. Health would get on with dealing with the NHS and its problems, rather than come up with these interminable ‘initiatives’?

The Press Release says, “this will be part of the Department of Health – to  ‘supervise health programs (sic) in the country like vaccination drives, screening for condition and family nurses’.

Er – isn’t this what the NHS is supposed to do already?  And if they are going to copy American spelling, what about copying U.S. best  medical care?

I notice the Welsh and the Scots have decided not to be involved.  Do they know something we don’t?

What’s it going to do?

Lansley says, “a radical plan to go further and faster in tackling today’s causes of premature death and illness and reduce health inequalities, with a public health service to make it happen”.

Public Health England will be created as a service that gives more power to local people over their health, whilst keeping a firm national grip on crucial population-wide issues such as flu pandemics.

Yet, anyone who believes that this will actually mean us patients can actually have more control over how and where our money is spent – dream on.  Instead, I see this a yet more chances for little Empire builders to get their hands on emergency cash, whenever there is a supposed crisis.  Anyone remember Swine Flu?  Asian flu?  etc. etc.  No-one has told us how much those panics cost us.

The White Paper, Healthy Lives, Healthy People also sets out how funding from the overall NHS budget will be ring-fenced for spending on public health – a recognition that prevention is better than cure. Early estimates suggest that current spend on areas that are likely to be the responsibility of Public Health England could be in the range of £4 billion.

They say, “for the first time in a generation, central Government will not hold all the purse strings”.  But as patients we won’t get to say where the money is spent:  “the majority of public health services will be commissioned by Local Authorities from their ring-fenced budget, or by the NHS, all funded from Public Health England’s new public health budget”.  So instead of Whitehall spending our money, it’s local NHS Admin – in my book that is same i.e. we don’t get any say in how the money is spent.

Mr Lansley said:

“Too often in the past, public health budgets have been raided by the NHS to tackle deficits. Not any more. The money will be ringfenced to be used as it should be – for preventing ill health.

“People’s health and wellbeing will be at the heart of everything local councils do. It’s nonsense to think that health can be tackled on its own. Directors of Public Health will be able to champion local cooperation so that health issues are considered alongside housing, transport, and education.

“Everyone should have services tailored for them, at the right times in their life from the professionals closest to them. With local authorities in the driving seat, supported by the latest evidence on behaviour change from Public Health England, we will start seeing significant improvements in the nation’s health.”

Oh Lansley – will you still be Minister when your chickens come home to roost?

What Government will and won’t do

The Government will take a less intrusive approach, staying out of people’s everyday lives wherever possible. This follows a model called the Nuffield Council of Bioethics Ladder of Interventions, which means that instead of reaching for choice-limiting regulations at every opportunity, the Government will employ a range of evidence based approaches to improve health.

Lovely long words – what it really means is local officials get to dip their fingers in the pie.

Local control, better health

Directors of Public Health will be employed by the Local Authority and be the ambassadors of health issues for the local population. In practice, this means that they will lead discussion about how the ring-fenced money is spent to improve health. This will include influencing investment decisions right across the Local Authority, with the goal of enhancing health and well-being.

Crucially, they will be able to make sure that public health is always considered when local authorities, GP consortia and the NHS make decisions.

To make sure that progress is made on issues like obesity and smoking, Public Health England will set a series of outcomes to measure whether people’s health actually improves.

Bemused?  So am I – but supposedly you can get answers by emailing  ndsenquiries@coi.gsi.gov.uk

And am I out of order, thinking it would be better if Dept. Health staff attended to in-trays, rather than spending time in focus groups, meetings, etc. thinking up new ideas?  We don’t need them new ideas, there were enough of those in the past that went nowhere.  What we need is a sensible overhaul of the present system.

And this wonderful whitewas won’t do anything to save the jobs of 126 Senior Nurses, CNS, head of Physio teams, etc. who are about to lose their jobs in our area.  They are deemed to come under Administration – and Cameron in is warped wisdom said that he wanted to get rid of a layer of Admin.

Hasn’t anyone told him he is a babe in arms when it comes to dealing with the NHS top brass?

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Help for when you leave hospital

The Department of Health headquarters in Whitehall
Dept. Health  Wikipedia

Department of Health announces £70 million help after illness

There is ‘new’ cash in the kitty to enable the NHS to support people back into their homes after a spell in hospital.

“Re-ablement” packages give people who are leaving hospital after illness or injury help and support for six weeks. Through re-ablement, people are helped to settle back into their homes, perhaps by changing their home environment so they can get around better or providing daily visits and support.

So if you are about to go in to hospital for yet another operation, consider if you are going to need support when you come home – and apply before the cash runs out!  This might be too late for many of us, but if you are facing yet another op., then now is the time to start applying.

Re-ablement can offer savings to the health and social care system by ensuring that people get access to care that will prevent them from getting into difficulties and having to go back to hospital. The Government wants the NHS, councils and local voluntary organisations to work together to ensure that local people get a seamless service after discharge from hospital.

The extra funding will be allocated to Primary Care Trusts (PCTs) to be spent this financial year across the health and social care system. PCTs will work closely with hospitals and local authorities in delivering this. It will enable local areas to help thousands of people and ensure services are in place by the time the NHS picks up new responsibilities in April 2011 for patients’ first 30 days at home after hospital discharge.

Minister Andrew Lansley said:

“Too many patients don’t get the seamless effective service they should when they leave hospital. They leave an environment in which they have been cared for around the clock to go home, sometimes alone, with no help. Too often they end up back in hospital because they haven’t had help readjusting to life at home. In fact we’ve seen a 50 per cent increase in the number of emergency readmissions in the ten years from 1998. We need to do more to prevent this from happening.

“From next April, the NHS will have new responsibilities for people’s care needs for 30 days after they leave hospital. This new funding will mean people will benefit right now and around 35,000 will start to get the help and support they need.

“Re-ablement will give opportunities for the NHS and councils, by working together locally, to make savings. Services of this kind have shown dramatic benefits in supporting people and cutting readmission to hospital. Our objective is for people to be once again independent, in their own homes.”

According to Dept. Health, this additional funding for re-ablement has come from savings from central Department of Health budgets.   Now this is where it gets a bit worrying – where have these savings come from?  If the Government had managed to make £70 million from somewhere, don’t you think this would have been trumpeted from the rooftops?

Or has the massive army of Administration that runs the NHS looked in the backs of drawers and under mattresses to come up with this cash pile?  I think we should be told.

But in the meantime, if you have to go back in to hospital – this might sugar the pill when it comes to discharge.

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