Tag Archives: Government

Wales wants to ban smoking anywhere in hospitals

TENOVUS CALLS FOR BAN

The Welsh Cancer Charity Tenovus wants to ban smoking at Welsh hospitals, and ask anyone who lights up a fag politely to do this outside the hospital premises.

Some Welsh hospitals have even dismantled the shelters erected to protect smokers from bad weather. And this video shows the dismantling, plus some not very happy comments from smokers

http://www.bbc.co.uk/news/uk-wales-17357406

Cancer Research UK agrees, and is mounting a campaign under the banner of

The answer is plain

 

This is the title of  Cancer Research UK’s campaign to stop youngsters taking up smoking.

At a young age, choosing which brands you consume is an important way to create an identity. And they think kids can live without tobacco branding.

Plain packaging means removing all branding from cigarette packs. This means that all packs, from all tobacco brands, will look the same.

This won’t stop everyone from smoking, but it will give millions of kids one less reason to start.

BUT – it’ll only happen with your support. Act now while the Government is listening by  clicking on

https://action.cancerresearchuk.org/ea-action/action?ea.client.id=149&ea.campaign.id=13114&ea.tracking.id=f9395bcb

and signing the petition.

Plain packs

This campaign is about smokers and non-smokers, coming together to protect the next generation from taking up the habit in the first place.

As Mary from Preston, a previous smoker comments, “I remember how important cigarette brands were to me when I first started smoking. That was 40 odd years ago: it took me several attempts to give up such an addictive habit”.

So please show your support to tell the Government that you support the plain packaging of tobacco products.

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Good week to bury bad Health Bill news

LONDON, ENGLAND - APRIL 19:  Prime Minister Da...

Cameron and Lansley may well look worried - their Health Bill has attracted massive flak. daylife

But BMA voices concerns over Health Bill

Andrew Lansley is probably breathing a sigh of relief now that Rupert Murdoch, and his battling wife Wendi, are making headline news.

Until the hacking enquiry started, every paper had a large quota of stories on La La’s Health Bill – and they weren’t complimentary.

But come the beginning of last week, all went quiet on the NHS front, when the gnome-like features of Rupert Murdoch and his avenging wife hit the news pages (hope Lansley sent a bunch of flowers to Wendi – she has kept him off many a front page).

So what many papers would have missed is :

BMA Statement on Health and Social Care Bill

The BMA has come out against the Health and Social Care Bill, and resolved that even with the Government’s amendments it cannot support the Bill.

As part of its next steps on lobbying, the BMA will publicly campaign for the withdrawal of the Bill, and also resolved to oppose the Bill until it is satisfactorily modified.

During a BMA Council meeting, they discussed the next steps on the Health and Social Care Bill, and issued a statement “given the continuing concerns of the medical profession around some key aspects of the Bill, the BMA will continue to call for it to be withdrawn, while still critically engaging with the government to achieve necessary improvements”.

Dr Hamish Meldrum, Chairman of Council at the BMA, said:  “Whilst the BMA recognises there have been some changes following the listening pause, there is widespread feeling that the proposed legislation is hopelessly complex, and it really would be better if the Bill were withdrawn.

We will continue to critically engage with Government and with the parliamentary process to try to achieve this, whilst continuing to seek further amendments to the Bill.”

The following motions were passed at the Council meeting:

Council:
1.        Considers that even with the Government’s amendments it cannot support the Health & Social Care Bill
1.        Resolves to oppose the Bill until it is satisfactorily modified
1.        Resolves to critically engage with Government to achieve improvements and to implement clinical commissioning
1.        Will continue to oppose any Bill which seeks to break down the NHS family and treat healthcare as a commodity to be bought and sold in a commercial market
1.        Believes that the NHS should be provided by public bodies or organisations controlled by professionals who also practise in them, and that the Government should rule out substantial increases in commercial involvement in the NHS just as they have a policy that schools should not make profits
1.        Whilst welcoming the new emphasis on patient choice rather than commercial competition believes that choice must not be prioritised over meeting need, reducing inequalities and optimising resources, and calls for this prioritisation of the different duties to be written into the  legislation
1.        Welcomes progress in engagement with Government on workforce and education, public health and confidentiality but recognises that further progress is needed including writing the outcomes into legislation

That this meeting of Council:
1.        recognises the medical profession’s lack of support for the Health and Social Care Bill;
1.        recognises the lack of support from the majority of GPs for involvement in GP/clinical commissioning as proposed in the Health and Social Care Bill;
1.        rejects the idea that the Government’s proposed changes to the Bill will significantly reduce the risk of further marketisation and privatisation of the NHS;
1.        agrees that the Government is misleading the public by repeatedly stating that there will be ‘no privatisation of the NHS’;
1.        calls for the BMA to start a public campaign to call for the withdrawal of the Health and Social Care Bill.

SO WE ALL NEED TO WORK TOGETHER TO GET THIS BILL FLUNG OUT – ALREADY IT HAS COST MONEY, AND LOOKS LIKE MAKING THE NHS BANKRUPT.

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Could The Apprentice do a better job running NHS?

The Apprentice

NHS needs Sugar's straight talking Flickr

Latest on Un-Healthy Bill

Go on the web, turn the sound down and re-watch The Apprentice.

Management speak is rife, and substitute an NHS manager for an Apprentice and you begin to see where they are coming from.  Scary!’

More layers – not less

Administration levels are beloved of Health Ministers since the 1960.  Doctors started to go on management courses, and came away with lots of buzz words.  They were quick to see the courses could help them build empires, and rule over plebs who didn’t go on courses, but just got on with their work, looking after patients.

Today’s Health Bill is compounding the awful layers, and the latest blog from Abetternhs says it brilliantly:  www.abetternhs.wordpress.com :

The government’s intention to privatis,the NHS continues unabated after a so called ‘pause-and-listening’ exercise in which the rarely spotted ‘future forum’ gathered opinions from carefully selected stakeholders and reported back to No.10.  (There was ONE patient included in the 46 great and good).

Of greatest significance is that the duty of the secretary of state for health, enshrined in the NHS act since 1948, ‘to provide and secure the effective provision of services’ has been delegated to an unaccountable quango called the NHS Commissioning Board. Withdrawing the duty leads to the abolition of structures and functions that follow from that duty, meaning that eligibility and entitlement to a comprehensive range of NHS services will no longer be assured.

The other significant non-change after the pause is the role of competition, which was widely reported to have been watered down, but emerges intact and probably more central than before the pause, with the Competition and Cooperation Panel (CCP) taking on the role of preventing anti-competitive behaviour. They have made it clear that they regard existing NHS hospitals as ‘vested interests’ and that competition is an unmitigated good.

Hostility to the bill is widespread in the medical and nursing professions, with the British Medical Association voting for the bill to be withdrawn at their ARM this month, and protests taking place outside hospitals throughout the country.

The question that remains more than a year after the publication of the health bill is what problems the bill is supposed to resolve. It has never been the opinion of significant numbers of either patients or professionals that the NHS was in need of more choice or competition.

From my perspective as a GP the main problems that need reform are listed below. It is important to note that the health bill fails to address any of them, and in almost every case will make the problems worse.

Collaboration. Both hospital specialists and GPs are aware of huge variations in clinical practice, but without good communication and collaboration, little or nothing is done. Evidence from the US Mayo clinic and others shows that when clinicians collaborate rather than compete, costs and clinical errors are reduced and quality increases. In the last few years we have set up historically unprecedented close working relationships between GPs and our local hospital. We have improved the quality of GP management, reduced unnecessary referrals and made sure patients are seen by the appropriate specialist without the need for repeating investigations. By introducing a range of providers to compete with NHS hospitals with the Cooperation and Competition Panel enforcing competition, the health bill will allow private providers to challenge us for colluding unfairly with each other and will fragment and disintegrate patient care. GPs should be federated so that they have to take responsibility for their peers to ensure uniform quality of care in a geographical area. The health bill encourages GPs to collaborate by setting up commissioning consortia but allows them to exclude underperforming practices and challenging patient populations allowing the creation of ‘sink consortia’ and very small consortia with an unsafe risk pool.

Management. There is a long history of animosity between clinicians and managers and between NHS managers and the public. This pariah status of managers is unwelcome and unjustified. The promise to increase clinician involvement in the planning of services in the health bill was initially welcome, but any good has been blown apart by the unjustified demonization of NHS bureaucrats, the arbitrary 45% cuts to management, the destruction of existing NHS structures at huge cost, and the replacement of 163 statutory bodies with 521 new ones.

The purchaser-provider split. The purchaser-provider split rewards hospitals for doing more and GPs for referring less. Consequently it damages relationships between GPs and specialists and hinders rather than facilitates joint responsibility for patient care because GPs suspect hospitals of over investigating and over treating patients for profit, whilst hospitals suspect GPs of holding onto patients who need specialist attention to save money. The purchaser-provider split needs to be abolished, but it is central to the market-driven health bill.
Guidelines. The National Institute for Clinical Evidence assesses the cost-effectiveness of treatments. The potential benefits are enormous. Clinical guidelines are all too often not followed because of lack of familiarity rather than clinical reasoning and there are unwarranted variations in the quality of care. IT needs to be improved to aid clinical decision making. Guidelines need to be available instantly so as not to interrupt workflow or consultation time. The health bill has lurched back and forth over its position on NICE.[3] Social policies such as a minimum price on alcohol and banning smoking have much bigger health impacts than medical interventions, but worryingly what remains cut is NICE funding for a number of important public health projects including studies into reducing harm from alcohol. Instead the government have entered into public health partnerships with the food and drink industries which have clear conflicts of interest.

Inflation. Health care costs are rising because of a number of factors including the costs of new treatments and widening diagnostic and treatment thresholds. Ageing, surprisingly makes little difference, no more than 1% per year. The health bill has no analysis of why costs are rising or what to do about it. By introducing competition and converting health care to a commodity the evidence is that costs will increase much faster than before.

Data. The outcome of health care is health gain. It is very difficult to measure health gain because of the huge numbers of variables, the social determinants of health, the subjective nature of health, the variable time-lags between interventions and outcomes and more. If we are to become more efficient, then we need also to agree on how to measure efficiency. For all the emphasis on outcomes and efficiency in the health bill there is nothing in it about how to improve the measurement of outcomes or efficiency.

Inequalities. Having worked in deprived and affluent areas I know that general practice in deprived areas is far more clinically challenging and less financially rewarding. There are serious inequalities in the resources available, the quality of care and the incentives for GPs. There is nothing in the health bill to reduce inequalities, indeed the evidence is that competition in healthcare creates, ‘islands of excellence in a sea of misery’

Accountability. There is and always has been a democratic deficit in the NHS. From the secretary of state to the GP commissioner, at every level there will be less accountability as a result of the health bill.

The specious separation between health and social care. For general practitioners and patients it is obvious that there is a continuum. When the social care of a vulnerable patient fails too often they end up in hospital where they remain at great cost until appropriate care in the community is found. There are enormous cuts to social care and the NHS will remain the refuge of those with nowhere else to go.

The opportunity to address the problems the NHS faces has been wasted by this coalition government on a neoliberal project to hand a cherished public service over to commercial interests. If the government were seriously interested in preserving a comprehensive NHS, making it more fair and ensuring it is affordable and sustainable for future generations they would be listening to people who spend every day working in it and being treated by it instead of those who see it as a business opportunity.

Could anyone persuade Lord Sugar to shoot the next Apprentice series in a hospital, and set the contestants the enormous task of cracking down on money-wasting that is rife in the NHS – from 1,000 different types of rubber glove to Gluten-free loaves costing 1000% more than in supermarkets.

 

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Government Regulates Herbal Practioners

Dioscorides’ Materia Medica, c. 1334 copy in A...

Image via Wikipedia

New Regulations for Herbal Practioners

Herbal medicine has long been a thorn in the flesh of pharmaceutical companies, watching potential clients turn away from drugs, with their many adverse side effects, and choosing to be treated in traditional ways.

However, there was not doubt that many very dubious herbal remedies were to be found on the Internet, and in back-street shops.  Some were even dangerous, and with no regulation customers had no way of ensuring what they were buying was safe.

Recently the EU – aided and encouraged by pharmaceutical companies – has been looking into banning these products.

But what the pharma companies proposed would have seen many reputable herbal remedies banned under a blanket ban, together with remedies with no proven record, but which did no-one any harm, and made some customers happy.

In a bid to outlaw some of the dubious herbal remedies floating around on the internet, the Government announced the introduction of statutory regulation of herbal practitioners in the UK.   Without this new regulation their practices would be outlawed from 1st May.

Statutory Regulations

The new College of Medicine welcomed the announcement that practitioners of herbal medicine are to be statutorily regulated.  It believes that statutory regulation is vital, if UK herbal practitioners are to continue to practise and prescribe in compliance with new EU regulations.

This decision will ensure good practice, and the provision of safe products for the thousands of patients who visit herbal practitioners every year.

The register will be administered by the Health Professions Council, the independent statutory body that ensures practitioners meet proper standards of qualifications, training, professional skills and conduct.

The move to statutory regulation of this sector is in line with the College of Medicine’s aim to develop safe and evidence-based patient choice.  Without statutory regulation, the use of traditional Chinese medicine, Ayurveda or other types of herbal medicine could have been effectively outlawed once the new EU Traditional Herbal Directive comes into force.

“The Government has put the safety and interests of patients first. This is essential if the UK is to provide safe and evidence-based healthcare choices.” said College of Medicine Chairman, Dr Michael Dixon.

Professor George Lewith, College of Medicine Vice Chair and Professor of Health Research at Southampton University, said: “Evidence for the efficacy of herbal medicines is growing; they may offer cheap, safe and effective approaches for many common complaints. The College of Medicine values this pluralistic approach to care”.

Kaye McIntosh, College of Medicine Vice Chair and Acting Chair of its Patients’ Council, said: “Without statutory regulation many herbal practitioners in the UK would have been unable to continue practising and thousands of patients would be unable to make the choice to use herbal treatments. Statutory regulation of this sector is clearly the best way to ensure the safe provision of herbal practice.”

Today’s announcement is a result of Government research and public consultation over the last decade.

“This announcement has been a long time coming, so it is now essential that the HPC moves forward as fast as possible with statutory regulation. The College would like to see swift, thoughtful and robust regulation that protects the public from adulterated products, encourages the safe practice of herbal medicine and enables the development of the profession.” said Professor Lewith.

Notes

The College of Medicine is an alliance of doctors, nurses, health professionals and scientists. Eventually patients will also be involved, as it is committed to patient centred medicine; and to improving the health, wellbeing and care of individual patients and local populations.

Statutory regulation of herbal practitioners has had the backing of a report from the House of Lords’ Science and Technology Committee and two independently chaired Department of Health working parties under Professor Michael Portillo. Following the publication of the last report in 2008, the Government ran a public consultation that elicited over 6,000 responses, the majority of which favoured this Government initiative.

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Here's where the NHS can save money

NHS Overspends £500 million on basic supplies


Now if you or I overspent by even £500 – we’d know about it.

There are precious few companies today that would allow employees to overspend by even £50

But it seems the NHS can throw £500 million around with gay abandon – and no-one seems to worry about checking the bills.

For ages I have been saying that if each Trust appointed one genuine business man or woman to oversee budgets, they would be able to show them how to save money – without all the cuts needed.

Now here comes proof:  National Audit Office (NAO) says “hospitals could be saving half a billion pounds a year if they reconsidered the way in which they purchase basic supplies”.

Why Hospitals need business-trained executives to oversee budgets

Can’t you just imagine what would happen if Alan Sugar, Nicola Horlicks, Gerry Robinson etc. cast their eyes over a hospital’s accounts?  They would soon come up with questions:  why are Trusts being allowed to order basics such as gloves, paper, etc. from different suppliers?

The NAO report “The procurement of consumables by NHS acute and Foundation Trusts” has revealed a lack of information and the fragmented purchasing attitude of Trusts. The severity of the problem is directly linked to the lack of central control over procurement. With the Health and Social Care Bill proposing that all hospital Trusts become Foundation Trusts, there are concerns this trend will accelerate.

Translation:  someone who understands accounts and purchasing should take the NHS by the throat and teach it good basic business principles.  Otherwise money is going to continue to pour down the drain.

Overspend by nearly £1 million per Trust

According to the report, the average trust could save £900,000

  • if they bought the same type and volume of products
  • and paid the lowest available price.

Could you imagine M & S or Tesco allowing each store to buy overalls, floor cleaning equipment, or any other basics from different companies?  No, a central office negotiates the price with a major supplier – and they award the contract to the company that provides the best overall product at a reasonable price.

But the NAO said “great variation in the range of basic supplies purchased by different trusts was also discovered. Trusts that NAO examined bought “

  • 21 different types of A4 paper
  • 652 different types of surgical and examination glove
  • 1,751 different cannulas
  • 260 different administration sets

Some variations were particularly striking. For example, the purchase numbers of hospital gloves varied significantly. While one trust operated with 13 different types of glove, another needed 177.

NAO concluded that “if hospital trusts were to amalgamate small, ad-hoc orders into larger, less frequent ones, rationalise and standardise product choices and strike committed volume deals across multiple trusts, they could make overall savings of at least £500 million, around 10 per cent of the total NHS consumables expenditure of £4.6 billion”.

So what is La La Lansley doing?

His office loves sending out press release after press release – but so far – NOTHING.

The head of the National Audit Office, Amyas Morse, says  “In the new NHS of constrained budgets, Trust chief executives should consider procurement as a strategic priority. Given the scale of the potential savings which the NHS is currently failing to capture, we believe it is important to find effective ways to hold trusts directly to account to Parliament for their procurement practices.”

Er – sorry.  La La has announced the Government were considering the launch of a review “to help hospitals get better value for money from procurement, drawing on the expertise of Government advisers.”

Now why do stables and bolted doors come to my suspicious mind?

So should the companies making millions out of NHS be quaking in their shoes?  Er – not exactly.  According to La La Lansley, “We are therefore considering launching a review to help hospitals get better value for money from procurement, drawing on the advice of government advisers,” he said.

So that’s all right then.  CEOs of companies that supply rubber gloves, canulas, gowns etc. can get back on the golf course – knowing full well by the time the review comes out, the next Government will be in.

What can you do?

Have a look at the names of the non-executive Trust officials of your local hospital.  Is there a noted businessman amongst them?  If so, ask them what they are doing to scrutinise bills.

If not – suggest that a noted local businessman be asked to run their eyes over the accounts – and say where they think savings could be made.

But this will be difficult.  Contracts for services from cleaning to lift maintenance are awarded to certain companies – and they won’t want to be moved.  We have been trying to find out how our local hospitals can have allowed the firm that put in the telephone system to get away with it – last time I wanted Pysiotherapy the phone rang and rang;  eventually a voice said “Accident and Emergency”.

So far letters to the Chief Executive go unanswered.

To download the report “The procurement of consumables by NHS acute and Foundation trusts”, follow the link: http://www.nao.org.uk/publications/1011/nhs_procurement.aspx
The Guardian article: http://www.guardian.co.uk/society/2011/feb/02/hospitals-waste-money-says-nao-report

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People Power triumphs!

SPAG & MP Rob Fello handing in seal protection...
Handing in Petition today    Flickr

I love it when people power gets something done!

Some time ago,  along with lots of other websites, I asked readers to click on to a Petition on the 10 Downing Street website – asking for the NHS to close down 084 numbers which cost us more than ‘normal’ ones.  It seemed cheeky that the NHS was going to get us to pay more when we used the phone to call them.

It asked you signed a petition asking the Prime Minister to “prevent local health centres and hospitals from using 08 numbers such as 0844, 0845 or 0870.”

Over 80, 000 of you clicked on to the Downing Street website – and, contrary to what people expect, Downing Street has taken note and these nasty expensive phone numbers are going to be phased out.

Today the Prime Minister’s Office has responded to that petition and you can view reply here:

http://www.number10.gov.uk/Page21836

NEVER UNDERESTIMATE YOUR POWER!

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