Monday, 5 April 2010

It's election time

So, the're off.

And who should you vote for, now that you won't have the chance to vote for the SAVE BEDFORD HOSPITAL PARTY?

Well it's simple really. Vote for whoever has the best chance of getting rid of this nasty, spiteful, incompetent Labour government. That may vary from place to place, so use your judgement and common sense.

Sunday, 28 March 2010

Is this what you really want?

Patients' groups expressed horror at the "sick experiment" in which NHS managers have agreed to pay £38 for every casualty that ambulance staff "keep out of Accident and Emergency" (A&E) departments after a 999 call has been made.

The tactic is part of an attempt to manage increasing demand for emergency care amid failings in the GP out-of-hours system.

Documents seen by The Sunday Telegraph disclose that staff at Britain's largest ambulance service have been encouraged to maximise the organisation's income, by securing payments for diverting patients to telephone helplines.

The bonuses are among dozens of schemes being tried out by ambulance trusts across the country as they attempt to improve their emergency response times and help A&E departments meet controversial targets to treat all patients within four hours of arrival.

Another plan uncovered would see thousands of 999 calls currently classed as urgent downgraded so that callers receive telephone advice instead of an ambulance response.

The changes were due to be introduced across the country this week, but the Government committee governing ambulances has delayed its decision amid safety concerns.

Last week, an investigation was launched at the ambulance trust piloting the scheme following the death on Thursday of a man whose case was referred for telephone advice when an ambulance should have been immediately dispatched.

Sunday, 7 March 2010

Coming to a hospital near you

The catastrophe of Stafford Hospital, where hundreds of patients needlessly died, was an entirely predictable result of this governments target driven obsessions.

Much of what happened at Stafford happened, and continues to happen, elsewhere, perhaps in diluted form (think, perhaps of Stoke mandeville and Maidstone).

It was headline news for 24 hours, but how have we allowed it to slip away. When are senior members of the SHA,, of the Department of Health and health ministers going to be held to account?

Monday, 1 March 2010

You have been warned

"Transforming" & "Vertical Integration".

As in "Transforming" Community Services.

Every PCT in the land has been ordered by the DoH to complete the purchaser-provider split within the next 8 months, by divesting itself of all its community services. These must either be set up as independently-contracting cooperatives ("Social enterprises"), or handed over in their entirety to an alternative contractor.

Such organisations will inevitably be too small to be financially viable, so the preferred solution, & inevitable doom, is for "Vertical Integration" - in plain English, a hostile takeover by the local Acute Trusts.

The Trusts, of course, have perverse incentives NOT to provide community service, but to get everyting transferred to in-patient care, especially as non-elective emergencies to get the massively increased PBR tariffs.

So, in translation, "Transforming" means utterly destroying.

As a means of providing care, or saving money, it is barking mad.

But as a means of fattening up the acute trusts for eventual privatising, it is a brilliant way to give them abusable & highly desirable monopolies.

And in the meantime, as a side-effect, the eligibility of the employees of the divested services for the NHS pension is already being questioned with a view to being cancelled - potentially setting a dangerous precedent for existing GPs & future employees of privatised trusts.

So be advised, this is not going to go away, with or without a change of geovernment. It is civil service policy & not open to democratic debate.

Wednesday, 24 February 2010

Gordon Brown a bully?

Amusing comment on Channel 4 News. The staff at No 10 said Brown had a ferocious temper but none said they would describe it as bullying. One said he didn’t have the empathy to bully!

Tuesday, 23 February 2010

Meanwhile at Stafford Hospital

The NHS Trust running Stafford Hospital spent £628,000 boosting its image in a 3 year period when it was embroiled in a scandal over dismal standards of care.

Over the same period that Stafford Hospital is accused of causing between 400 and 1,200 avoidable deaths the parent Trust spent tens of thousands of pounds on a PR agency….advertisments and ‘marketing management costs’.”
Stafford Express and Star, Feb 23rd

and in London...

Dr Anwara Ali, a Labour councillor in Tower Hamlets and the face of the NHS's East End campaign on breast cancer (see below), has switched to the Tories.

Dr Ali, who is the borough's lead Cabinet member on health, told the Evening Standard today:

“I have been a lifelong Labour supporter, but I believe the country cannot afford five more years of Gordon Brown.

“As a GP working on the frontline in the largest practice in the East End, I have become increasingly disillusioned with Labour’s failure to reform the NHS. The past decade has seen this government waste millions of pounds on bureaucracy in hospitals.”

“Gordon Brown’s obsession with top down targets and a tick box culture has ruined the moral and goodwill of the national health staff. Ill health and early death in the East End is a direct result of Labour’s failure to bring real reform to the NHS.”

Wednesday, 17 February 2010

The hazards of alternative medicine

A practitioner of Chinese medicine has pleaded guilty to selling a banned substance to a woman who went on to develop kidney failure and cancer.

Ying "Susan" Wu, 48, of Holland-on-Sea in Essex, has been on trial at the Old Bailey for selling pills containing aristolochic acid to a civil servant.

The judge said he accepted Ms Wu had not meant to harm, and that the case highlighted the need for regulation.

Ms Wu has now been given a conditional discharge.

Patricia Booth, 58, took the pills, bought at Chelmsford's Chinese Herbal Medical Centre, for over five years. She was in her mid-40s when she first sought help from the centre in 1997 for stubborn patches of spots on her face.

The Old Bailey heard the products had been advertised as "safe and natural".

But they contained a substance - aristolochic acid - which when she was first sold them, should only have been given under prescription, and which was later banned.

Traditionally this would be used maybe once or twice by a doctor who would know about its toxicity, but sometimes it might get into a formulation which is then used by somebody who doesn't have this wealth of experience
Professor Monique Simmonds

The court heard Mrs Booth became ill months after she stopped taking the pills. She was diagnosed with kidney failure, and later with cancer of the urinary tract - both allegedly caused by the pills.

The grandmother, who used to manage a government office of up to 60 people, currently goes to hospital three times each week for dialysis.

She had told the court that she had been advised to take about 30 tiny brown tablets three times each day, returning to the shop every two weeks to buy up to three bottles at a time. She became friendly with Ms Wu, who was employed at the shop as a "Chinese doctor" until it closed in 2003.

Ms Wu, who had initially denied the charges, pleaded guilty to selling prescription only medicines without authorisation and to selling a banned substance.

Thursday, 11 February 2010

How can this happen in the 21st century?

An independent inquiry into Stafford Hospital – where patients were starved, dehydrated, left in agony, and told to lie in their own faeces – has heard how:

* The hospital's emergency assessment unit was so unsafe that staff branded it "Beirut";

* Job cuts left nurses so overstretched they became "immune to the sound of pain";

* Receptionists decided which casualty arrivals should be seen first, based on a "gut feeling" of who looked the most unwell;

* When hospital bosses were given notice of a damning inspection report, published last year, they responded by hiring a public relations team and promised to "get MPs on side";

The inquiry, led by Robert Francis QC, was ordered following last year's damning Healthcare Commission report in which regulators described care of patients at Mid Staffordshire Hospital trust as the most appalling scandal they had ever encountered.

More than 900 patients and families, and scores of staff, have given evidence to the inquiry, which is examining the care of thousands of patients treated between 2005 and 2009.

Findings of the inquiry, which were handed to ministers on Friday, are expected to focus on how a culture of "fear and bullying" prevented failings from being exposed.

Mortality rates suggested that there were at least 400 more deaths than might have been expected in a three-year period, while relatives told how their desperate loved ones had been left to drink from flower vases.

In the wake of the scandal The Sunday Telegraph launched the Heal Our Hospitals campaign, which is calling for a review of hospital targets to make sure they work to improve quality of care, and which has been backed by more than 5,000 people.

Closed sessions of the inquiry heard how patients were left in agony, screaming for pain relief, while others were left without medication, food and drink, and left on commodes for long periods.

Basic hygiene was neglected, with one female patient left unwashed for the last four weeks of her life, the inquiry heard.

Nurses told how pressure to hit a Government target for all patients to be treated within four hours of arrival at A&E meant that patients were moved when they were soaking wet, or were left in an assessment unit for hours, or even days, without proper care.

In evidence, staff were highly critical of senior managers who enforced 160 job cuts to cut costs as the trust applied for coveted "foundation status".

When the status was awarded, staff were rewarded with £25 Marks and Spencers vouchers, to the disgust of many, the inquiry heard.

An obsession about the project blinded the board to the problems being suffered by patients, doctors said.

A former hospital worker described how in a conversation about hygiene, Martin Yeates, chief executive until he resigned last May, said the hospital "could not possibly" keep its lavatories as clean as those in the local Asda supermarket.

Staff giving oral evidence to the inquiry reserved much of their strongest criticism for Jan Harry, the trust's director of nursing from 1998 to 2006, when disastrous changes to the organisation of wards were introduced, and plans for swingeing job cuts agreed.

Mrs Harry, who was chief nurse when the trust decided to axe 52 nursing posts told the inquiry that she could not recall the decision, and was "not aware" of plans to drastically alter the ratio of trained to untrained staff.

She also said she had not been involved in separate discussions about 20 job cuts - a situation she admitted was "extraordinary".

Mrs Harry said it was not her job to monitor standards on the wards – a claim later described as "absurd" by Dr Peter Carter, general secretary of the Royal College of Nursing.

Toni Brisby, a former trust chairman, said the evidence provided by Mrs Harry was "at odds" with her recollection that the head nurse had been a strong advocate of proposals to change the way nursing was provided, and had assured the chairman that the loss of 52 posts would not harm patient care.

During the inquiry, Mrs Harry said she had no major concerns about the care provided at Stafford Hospital.

Mrs Harry left the trust "by mutual agreement" in June 2006. She told the inquiry that savings from the ward reorganisation had been "fortuitous" and that changes had been intended to improve patient care.

She said she wanted no part of the trust's financial recovery plan.

In previous evidence to the Healthcare Commission, she said resulting cuts to the number of qualified staff had not been her intention, and occurred after she left the trust.

A year after her departure, she was hired by Dudley Group of Hospitals trust to run a cost-cutting programme as it prepared a bid for foundation status.

After the trust won the status in 2008, its inspection rating dropped from good to weak, and last autumn it failed a basic hygiene inspection, though it has since improved.

Mrs Harry went on to work at Salisbury Foundation trust as interim director of operations between December 2008 and May 2009.

Her replacement at Mid Staffordshire Hospitals, Dr Helen Moss, who left in December to take up a training role across the East Midlands, was criticised by some staff for not acting quickly enough to tackle problems uncovered, but others praised her attempts to make changes.

Helen Morrey, director of operations at Mid Staffordshire trust from 2006 until last year, admitted "risk assessments" about the impact of job cuts were inadequate and accepted responsibility for a failure to thoroughly investigate complaints by patients.

Ms Morrey was put on paid leave last July, before leaving the trust in November.

Kate Levy, the trust's head of legal services, is currently suspended over allegations that she asked for a rewrite of a damning report into a patient's death because she did not want the trust to receive "adverse publicity".

Antony Sumara, who replaced Mr Yeates as chief executive of the trust, said the organisation was committed to work "openly and transparently and will tolerate nothing less from our staff".

Julie Bailey set up the campaign group Cure The NHS after the death of her mother Bella at Stafford Hospital in 2007.

The campaigner said the hospital's treatment of patients had been "absolutely horrific," while those who tried to speak out had been silenced. The group is calling for a public inquiry into the supervision of all hospitals.

"Our biggest concern is that this could happen again, elsewhere, unless an inquiry looks at how this was allowed to happen; the system of regulation, the role of the Department of Health, and its ministers. Nothing else will do," she said.

Tuesday, 19 January 2010

Spending like there's no tomorrow

This morning’s Independent contains an almost incredible splash that £26bn has been wasted on IT projects over the last decade. It's a litany of binary bungles - the incompetence: staggering; the forecasting: inept; and the planning (or lack of it): simply shocking. Contending with such absurdity whilst staring down the barrel of a £175bn deficit, you don’t know whether to laugh or cry.

Let me take you on a whistle stop tour of dud investments made on our behalf. The major culprits are the NHS’ national IT programme (over budget and late at £12.7bn and used by only 160 health organisations out of 9,000), the MoD’s defence information infrastructure (over budget and late at £7.15bn and which was commissioned without a pilot) and the ID cards scheme (£2bn over budget and virtually scrapped at any rate). The government enjoys an impeccable reputation for throwing good money after bad bureaucracy; all three examples are evidence of the blinkered approach Labour still takes and the system that facilitates that approach.

In many ways, the modest examples of waste are more indicative of what is wrong with our bureaucracy and why it needs reform. In 2006 the DWP introduced the benefit processing replacement scheme, the aim of which was unclear; three months later it emerged that the scheme had been dropped, having already cost £106m. Money was spent for the sake of it on a gimmick that was quietly dropped after initial applause had subsided. Indicative of the Civil Service’s inability to cost anything, GCHQ decided to move its computer systems at an estimated cost of £41m; the final reckoning exceeded £300m. But the cream of the jest is the Department of Transport’s shared services centre. Bright and breezy analysts opined that rationalisation would save £51m; eventually the scheme cost £81m, but it was not without its benefits. After a little application, the unfulfilled vehicle licensers of Swansea came to enjoy Goethe in the original: the programme communicated in German.

Friday, 15 January 2010

The hazards of over eating

A floor collapsed beneath a group of about 20 members of Weight Watchers as they gathered to compare how many pounds they had shed over Christmas.

Members of the weight-loss club were lining up to compare readings on the scales when they heard a bang as the floor came away from the walls of their meeting room in Växjö in southern Sweden.

“We suddenly heard a huge thud – we almost thought it was an earthquake and everything flew up in the air. The floor collapsed in one corner of the room and along the walls,” one of the those present told the Smålandsposten newspaper.

They abandoned the room as the floor started to give way in other areas.

Tuesday, 12 January 2010

Sign of the times

I was driving to work in Bedford this morning when I found myself behind a Group 4 security vehicle taking prisoners to Bedford prison. Someone had written in the dirt on the back of the vehicle "Caution, may contain nuts".

Watch out, the taxman's about

HMRC, desperate to make up for lost tax revenue from the recession are launch9ing a new blitz, initially to target doctors and dentists.

Doctors and dentists were identified yesterday as the first groups that HM Revenue and Customs inspectors would target.

Other white-collar workers including solicitors, barristers and accountants were expected to be targeted in coming months in what inspectors have named the “professionals campaign”.

Previously the revenue has focused on people in blue collar occupations, such as publicans and taxi drivers, when fighting tax evasion.

It was disclosed yesterday that attention would switch to the accounts of professionals earning more than £100,000.

Tens of thousands of individuals were expected to be audited.

Experts accused the Government of unfairly seeking “easy pickings”.

They suggested that the decision to chase high-earning professionals for unpaid taxes had been forced on the revenue by the Treasury, in an attempt to raise funds to reduce the national debt.

The revenue said a “significant” minority of medical professionals were engaged in tax evasion.

Examples cited included not declaring fees for private work done for medical care providers, payments for private consultation work or cash sums for drafting medical reports. Under a three-month amnesty, hospital consultants, GPs and dentists have until March 31 to make a voluntary disclosure about any income they have not declared.

In exchange, they will have to pay the outstanding tax. They will also face a fine of 10 per cent of the amount owed — but the action will stop there.

However, anyone who refuses to disclose their unpaid tax, and is caught after the deadline, faces criminal prosecution and up to seven years’ jail. They could also find themselves “named and shamed” on the revenue’s website.

Tax inspectors can issue formal notices asking people to hand over bank statements and business records if they believe they have grounds for suspicions. They can also legally inspect business premises using their civil powers. Tax evaders could also be identified through their previous tax returns.

Mike Wells, the revenue’s director of risk and intelligence, said: “I strongly urge any in this group [the medical profession] who think they may have outstanding tax liabilities on their income to get in touch with HMRC and get their tax affairs in order simply and on the best available terms.

“The message is clear: contact us before we contact you.”

Phil Berwick, the director of tax investigations at the law firm McGrigors, said targeting the medical profession alone was “without precedent”. “It is people who are going to be averse to naming and shaming and probably in a position to make a payment to the revenue,” he said.

“By offering an amnesty, HMRC is hoping to get a significant amount of tax into the Treasury’s coffers very quickly and at a reduced cost to itself. The parlous state of the public finances and the pressing need to reduce the deficit has probably forced HMRC’s hand to an extent.”

The middle-class initiative follows a previous revenue amnesty scheme to allow people with offshore bank accounts to declare how much tax they owed and pay a small fine. About 10,000 people made use of the scheme.

Richard Limburg, from Vantis Medical Group, the accountancy firm, added: “It is likely that HMRC sees the medical profession, especially consultants, as easy pickings and this could raise substantial amounts.”

A British Medical Association spokesman said doctors with concerns should consult a financial adviser. A spokesman for the British Dental Association said: “This plan serves as a useful reminder of the importance of ensuring everything is up to date.”

Sunday, 10 January 2010

Poetry corner

Proof that Gordon Brown cannot do anything right. Brown, fresh from surviving the Hoon-Hewitt assassination attempt, tells us that the poem Invictus by William Ernest Henley is his inspiration.

"Out of the night that covers me,
Black as the Pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.

In the fell clutch of circumstance
I have not winced nor cried aloud.
Under the bludgeonings of chance
My head is bloody, but unbowed.

Beyond this place of wrath and tears
Looms but the Horror of the shade,
And yet the menace of the years
Finds, and shall find, me unafraid.

It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate:
I am the captain of my soul".

Who else was inspired by that poem? Not just Nelson Mandela, it transpires.

Psychopath Timothy McVeigh, who chose it as his final statement before he was executed in 2001 after killing 168 people in Oklahoma.

You'd have thought Downing Street might have thought this one through a little bit better, rather than choosing the convicted terrorist's poem of choice.

Thursday, 7 January 2010

Go for it

Prof Tim Briggs, medical director of the Royal National Orthopaedic Hospital (RNOH) in north London, will challenge the former minister Tony McNulty as an independent candidate for Harrow East with the aim of securing the future of the institution.

The RNOH, which treats 60,000 patients a year, is in a state of disrepair and costs millions of pounds to maintain every year.

Prof Briggs has campaigned for nearly 15 years to secure money to rebuild the hospital on its current site in Stanmore.

But his lobbying has failed to secure the £60m needed from the strategic health authority, NHS London.

Mr McNulty holds the seat with a 4,700 majority.

Professor Briggs said he was giving the Government “one last chance”. If the Health Secretary Andy Burnham did not give him a firm commitment at a meeting this week, he would stand against Mr McNulty, he told the Independent on Sunday.

NHS London said: “It is clear that the RNOH NHS Trust provides a high-quality service but from an inadequate site. NHS London and Department of Health colleagues are currently reviewing the business case and the trust is responding to a number of points that we have raised for clarification."

Tuesday, 5 January 2010

An invitation

Would you like to write a piece for this website (anonymously if you wish). Please e-mail me on with your ideas.

Friday, 1 January 2010

A moneyspinner for 2010

Secretary of State,
Department for Environment, Food and Rural Affairs (DEFRA),
Nobel House
17 Smith Square
London SW1P 3JR

16 May 2007

Dear Secretary of State,

My friend, who is in farming at the moment, recently received a cheque for £3,000 from the Rural Payments Agency for not rearing pigs. I would now like to join the “not rearing pigs” business.

In your opinion, what is the best kind of farm not to rear pigs on, and which is the best breed of pigs not to rear? I want to be sure I approach this endeavour in keeping with all government policies, as dictated by the EU under the Common Agricultural Policy.

I would prefer not to rear bacon pigs, but if this is not the type you want not rearing, I will just as gladly not rear porkers. Are there any advantages in not rearing rare breeds such as Saddlebacks or Gloucester Old Spots, or are there too many people already not rearing these?

As I see it, the hardest part of this programme will be keeping an accurate record of how many pigs I haven’t reared. Are there any Government or Local Authority courses on this?

My friend is very satisfied with this business. He has been rearing pigs for forty years or so, and the best he ever made on them was £1,422 in 1968. That is – until this year, when he received a cheque for not rearing any.

If I get £3,000 for not rearing 50 pigs, will I get £6,000 for not rearing 100?

I plan to operate on a small scale at first, holding myself down to about 4,000 pigs not raised, which will mean about £240,000 for the first year. As I become more expert in not rearing pigs, I plan to be more ambitious, perhaps increasing to, say, 40,000 pigs not reared in my second year, for which I should expect about £2.4 million from your department. Incidentally, I wonder if I would be eligible to receive tradable carbon credits for all these pigs not producing harmful and polluting methane gases?

Another point: These pigs that I plan not to rear will not eat 2,000 tonnes of cereals. I understand that you also pay farmers for not growing crops. Will I qualify for payments for not growing cereals to not feed the pigs I don’t rear?

I am also considering the “not milking cows” business, so please send any information you have on that too. Please could you also include the current Defra advice on set aside fields? Can this be done on an e-commerce basis with virtual fields (of which I seem to have several thousand hectares)?

In view of the above you will realise that I will be totally unemployed, and will therefore qualify for unemployment benefits.

I shall of course be voting for your party at the next general election.

Yours faithfully,

This originally appeared in the Guido Fawkes blog