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The future of hospitals under the Tories

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The future of hospitals under the Tories

Post by skwalker1964 on Tue Nov 20, 2012 11:45 am

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Let me start this post by congratulating new Labour MP for Corby, Andy Sawford – who does come up in this post, and Labour’s 13 new Police and Crime Commissioners, who don’t. It amazes me that any PCCs were elected from the party that has slashed police numbers and devastated their morale, but I guess you can fool some of the people some of the time, and some are too blinkered to see what’s going on. Politics is a funny old game.

I’d also like to recommend anyone who’s interested to start listening to some Radio 4 shows on politics: Today in Parliament, Weekly Parliamentary Review and Week in Westminster, which you can get here. They can only be summary shows, but they do touch on things that you can then follow up on later yourself to find more. This article, and others, have started like that for me.

An informed people is dangerous to despicable governments.

Now, to the main event. I’ve written often on how this government has lied in Parliament – on economics, on employment, on the NHS, and many other things. But it’s relatively rare to find them blatantly lying to their own MPs – perhaps because most of the questions from the Tory back-benches on most issues (except the EU) tend to be tame, ‘tee-up’ questions designed to allow ministers to posture about the issue in question.

However, on 9 Nov a Tory MP asked a real question, and actually did his real job of standing up for his constituents. Philip Hollobone, MP for Kettering, challenged Health Minister Dr Daniel Poulter on plans by ‘Healthier Together’ to drastically slash health provision at Kettering General Hospital. Mr Hollobone highlighted risks to patient safety and the increased burden to health staff of having to negotiate an often-gridlocked road to the next-nearest hospital, as well as underlining the critical importance of KGH to his constituents, before stating emphatically:

"The nub of the points that I want to make is that local people simply will not put up with any prospect whatsoever of any downgrade to the accident and emergency facilities or the maternity wing at Kettering general hospital. Those are two highly valued, much prized departments and whoever plans the future of the hospital simply must not downgrade those two vital facilities, because they do a fantastic job in very difficult circumstances."

What followed was quite stunning in its arrogance and mendacity. First, Poulter lied to his own MP, after a smug, condescending ‘welcome’ of his comments:

"I reassure my hon. Friend that A and E and maternity services at Kettering hospital are safe. The Prime Minister has put that clearly on the record, and I confirm it again today."

Mr Hollobone’s concerns stemmed from a leaked report by Healthier Together which outlined a range of options for cuts to services in the region, top of which was a reduction of 515 beds – 78% of its total – at KGH. The 2nd highest-ranked option would involve a reduction of 229 beds, also at KGH. If facing a massive reduction in beds in both of the 2 most-preferred options is ‘safe’, then ‘at risk’ must be something indeed. The regions 5 hospitals are expected to save £48m, so the cuts are going to fall somewhere, and Kettering is both first and second in the list of ways to achieve it.

Then followed an intervention from Labour MP Lillian Greenwood:

"Whatever the Minister says, is it not a fact that in the official documents, the “best” option is downgrading Kettering general hospital’s accident and emergency, maternity, children’s and acute services, and cutting a significant number of beds? How can he say that those services are safe?"

To which Poulter responds both by treating her with condescension and by misdirecting via a subtle change of terminology:

"The hon. Lady is turning this into a political debate, which is exactly what the Labour candidate in the Corby by-election has done. That is completely wrong and what she says is not true—it is scaremongering. There are no official documents at the moment because there is no consultation of that nature at the moment. There is no NHS consultation. Perhaps she should focus more on Nottingham, which is where her constituency is. I am sure her constituents would rather she were on the train back to hold a constituency surgery, which is what I will be doing after this debate, rather than making silly, ill-founded and mistaken political points about matters that bear no resemblance to her constituents’ concerns. I hope she will draw a lesson from this. I know she has been put up to making that point, but this is not the time."

In other words, he starts with ‘it’s none of your business and you have better things to be doing than being here challenging me’. A shade short of ‘calm down, dear’, but incredibly smug and condescending. He then says that, because there is no ‘consultation’ at the moment, there are no ‘official documents’, but this is patent nonsense.

In this setting, a ‘consultation’ is a discussion with staff and public about implementing decisions that have already been taken, about the impact of, and best route to achieve, those decisions. But the fact that the leaked document lists options rather than firm decisions does not in any way prevent the document being ‘official’.

On the basis that no decisions have been taken yet, Poulter accuses Labour of ‘scaremongering’. But to any right-thinking person it’s perfectly obvious that such documents and their contents are absolutely of public interest exactly because they might lead to changes that will massive impact the local populace. Publicising and opposing those options is exactly the job of local politicians – it’s their duty, not scaremongering.

Poulter then goes on to tell an outright lie:

"The hon. Lady’s point was ill-founded. There is no consultation active in Kettering at the moment. There were some leaked documents about a range of options, which incorrectly set a number of hares running. The Labour candidate in the Corby by-election has already retracted his position. My hon. Friend has held the debate today because of that scaremongering, and because he is such a strong advocate for the needs of his patients in Kettering and his hospital. He wants to reassure them that Kettering hospital has a viable future."

‘Consultation’ and ‘a viable future’ are meaningless words and phrases that don’t in any way say that the cuts that Mr Hollobone fears won’t happen. But Andy Sawford, then Labour candidate and now newly-elected MP for Corby, who highlighted the proposed cuts, has not ‘retracted his position’.

As of now – 8 days after Poulter’s statement that Andy Sawford had retracted, here is a snapshot of Sawford’s own website:

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You can click on the image to see the detail, but here’s what it says:

"Our Hospital is under threat. Labour’s Andy Sawford is demanding that residents of Corby and East Northamptonshire are told the facts about an official plan which could see Kettering Hospital massively downgraded.

The plan – to plug an annual shortfall of £48 million in funding over five hospitals in the region including Kettering – was revealed at a meeting of the Kettering Hospital Trust members and staff earlier this week.

Stunned staff at Kettering Hospital were told to expect major cuts to A&E, maternity, acute and children’s services at TWO of the five hospitals. Officials admitted that the axe could fall on Kettering with hundreds of beds and potentially thousands of jobs lost.

Labour’s Andy Sawford says:

“Under this shocking plan, Kettering Hospital could be downgraded to little more than a cottage hospital.

“My children were born at Kettering Hospital. It’s where they took my grandad when he had a heart attack. Like my family, most people in the Corby area rely on Kettering General.” "


Does that sound like a retraction to you? And bear in mind that, while Poulter was responding to an intervention from a Labour MP, Poulter was still answering the question from his fellow Tory, Philip Hollobone.

For good measure, Poulter then repeats his obfuscation around a ‘formal consultation’, before making a statement that makes all his assurances absolutely meaningless:

"In my hon. Friend’s region there are considerable distances between the hospitals involved and, if at some point in the future a consultation opened up, those greater travelling distances between hospitals would be taken into account as it may impinge on patient choice."

To summarise in plain English: ‘We’re willing to tell you, on the record, that Kettering General Hospital is safe at this precise moment, but only because the formal consultation process hasn’t yet begun – but if it does, then we may well decide to go with the options to slash the number of beds. If we do, then we’ll consider the problems it’ll cause – but we may well do it anyway.

Some reassurance.

I don’t know much about Philip Hollobone beyond this exchange, but he appears to be prepared to challenge his own government for the sake of his constituents, and that’s extremely commendable. His principled stand has exposed the complete moral bankruptcy of his front benches, showing them to be willing to misdirect, mislead and even lie to one of their own MPs.

His stand has also set an example that MPs everywhere, of whatever party, should be copying. In stating that his constituents will ‘simply not put up with’ an attack on their local health facilities, Hollobone is correctly identifying a deep resource of local passion and determination that will exist in every community to defend its health resources and its hard-working health staff.

The scandal of this government’s attack on the NHS is compounded by the complicity or passivity of local politicians and NHS Trust executives who have either remained silent or – as in the case of the Trusts in the South-West and North-East among others – have enthusiastically collaborated with the government in its drive to slash health provision for ordinary people.

What we need to see and should be seeing is MPs, local councillors, health executives and unions uniting and flatly refusing to accept that health spending, staffing levels and services need to be cut, rather than looking for ways to achieve the government’s aims for it. Every person who cares about the NHS, whether they work in it or have political responsibilities or not, should be fighting this government’s attack and saying, clearly, simply and emphatically: NO! You don’t get to do that in our region, on our watch. If necessary coming out onto the streets to protest and to blockade until the government admits that it has no mandate for the changes it is making out of ideological desire rather than genuine necessity.

Let’s tell our MPs – of whatever party – that we won’t accept anything less than all-out resistance – and this lying, unprincipled government that we’ve seen its game and we’re not having it.
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Re: The future of hospitals under the Tories

Post by oftenwrong on Tue Nov 20, 2012 12:40 pm

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The Health Minister comments.
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Mocked by a 'policy wonk' for defending the NHS. Doing something right then!

Post by skwalker1964 on Thu Nov 22, 2012 9:02 am

As usual, see original at [You must be registered and logged in to see this link.] for links:

I’ve been mocked by an ex-Dept of Health policy advisor for my recent post on Kettering General Hospital and the lies Tory health minister Daniel Poulter told to one of his own MPs about plans to downgrade the hospital.

Joseph Farrington-Douglas, who used to be Chief Health Advisor to John Healey (when he was Labour Minister for the NHS) tweeted this message to his followers on Monday:

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Here’s his comment in plain text, in case you have any problems with the image:

Silly HIMBYist Save Our Hospital shenanigans. An MRSA on all their houses.

An MRSA is Mr F-D’s attempt at a humorous variation on ‘a plague’. It stands for ‘multiply resistant staphylococcus aureus’ – the drug-resistant ‘superbug’ that regularly kills people in hospitals – especially if the private cleaning contractors cut back cleaning to enhance profits. So it’s nice of him to wish it on people who are trying to protect hospitals. Classy, even.

I must be doing something right – being mocked by a right-winger who’s happy to see our NHS broken is something I consider a badge of honour.

Unfortunately – as so often happens – when we point one finger at others, we point 3 back at ourselves, so Mr F-D’s ‘insult’ reveals a lot more about him than about me. Especially since HIMBY – ‘happening in my back yard’ – is laughably inaccurate in the case to which he’s referring.

According to Google Maps, I live 185 miles from Kettering General Hospital. My back garden (the first two houses of my life had yards, but not this one) measures about 50 feet in length, and it would take me over 3 hours to get there on a good traffic day. If I had a back yard that big, I’d be ashamed to be hogging it all for myself.

So my comments about, and defence of, KGH – or for that matter the health-workers of the 20 Trusts in the south-west who have formed a cartel to strip away essential pay and conditions from their employees, has nothing to do with them being in my ‘back yard’.

No – I made them because sticking up for the NHS, for its hard-working staff and for the patients it cares for, is the right thing to do. I made them because my own research and that of others shows clearly that this government wants to dismantle it for reasons of ideology and greed that have nothing to do with necessity or what’s best for patients. I made them because the NHS is vital to the ordinary people of this country who can’t afford private healthcare (and the exclusions enforced by private health insurers make the policies next to useless anyway), so defending it is a moral imperative. And I made them because the NHS is this country’s greatest achievement – one which small-minded, venal men and women want to dismantle because they place their own wealth and profit before the welfare of millions.

That said, even if you’re a person motivated solely by self-interest, unless you’re extremely rich you still should be defending the NHS. The current wave of attacks may not be happening to a hospital in your back yard – but if the government and its private healthcare backers are allowed to get away with it now, sooner or later your nearest hospital is going to become a target.

So, if you’re a HIMBY, a NIMBY or just someone who’s unwilling to be fooled and robbed by those who are meant to be protecting the people of this country, you should be defending the NHS against what this government and its sympathisers/supporters are doing.

The fact that Mr F-D thinks otherwise tells you all you need to know, really. Well, that and the fact that he chose to ridicule supposed HIMBYism when the main thrust of my post was that health minister Daniel Poulter was prepared to lie to one of his own MPs – yet Mr F-D had nothing to say about that at all.
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Re: The future of hospitals under the Tories

Post by bobby on Thu Nov 22, 2012 10:40 am

Unfortunitely Steve, "lying" is part and parcel for the Tory led Coalition, I'm certain they dont even recognise a lie, to them its politics.

By the way Steve, you are definitely doing something right.
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Lewisham: closure plan sets precedent that shows it unnecessary

Post by skwalker1964 on Thu Jan 31, 2013 12:14 am

From my latest blog at: [You must be registered and logged in to see this link.]

Lewisham: closure plan sets precedent that shows it unnecessary

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I came across a very interesting snippet in the transcript of last Monday’s House of Lords debates, which drew my attention to something I hadn’t been fully aware of before.

You may already have heard about the government’s planned closure of the Accident & Emergency (A&E) and maternity units at Lewisham NHS Trust, and about the mass protests of residents against the closures, as local people are trying to prevent the government from closing facilities that are crucial to the health and wellbeing of surrounding community.

What you might not be aware of is why the government wants to close these critical units.

In the Lords the other day, Labour peer and former Minister Lord Tomlinson challenged a government representative about the closures:

Will the Minister accept that the proposals to close the excellent and much-admired accident and emergency hospital in Lewisham, and to downgrade its maternity services, have been made not because there is anything wrong with the hospital but because a government-appointed administrator has said that that should be done in order to help the neighbouring National Health Service trust, which has run up £130 million-worth of debt? Will she accept that closing and downgrading good facilities is an act of almost criminal stupidity, which leads to nothing but increased health inequalities when the Government’s objective is to reduce them?

Yes, you read that right. Lewisham A&E – which only months ago underwent a multi-million pound upgrade – is to go because of debts at a completely different Trust., to which it is unconnected except by virtue of being part of the same National Health Service.

It’s well-known that time is of the essence when it comes to treating emergency cases – any additional delay can worsen outcomes drastically, even resulting in death (just think of the ‘Act FAST’ advertising campaign stressing the importance of urgent recognition and action in stroke cases). The people currently served by Lewisham A&E face having their lives and health put at risk by a longer journey for treatment at a unit elsewhere in London, while mothers and babies face a greater threat if there are complications during labour.

But as well as ignoring the wishes and welfare of people in and around Lewisham, the government is also demonstrating the truth of something which it generally tries to deny. The administrator placed by the government in charge of South London Healthcare Trust (SLHT), the ‘financially-challenged’ Trust mentioned by Lord Tomlinson, has recommended closure of facilities at neighbouring Lewisham because this will apparently help the SLHT.

The government – for its own venal purposes – has been insistent in treating hospitals and Trusts as individual organisations, each with its own budget and its own responsibilities. But by considering the closure of facilities at one Trust for the sake of another, the government is recognising the principle that the NHS is one organisation, and individual Trusts are all part of a single whole. Like a field of mushrooms that are really all part of the same system.

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And that simple fact, obvious to everyone who truly loves the NHS, but denied by this government up to now, means that the closure of any facilities in Lewisham is completely unnecessary to save the South London Trust.

Why?

As I showed in a post last month, the NHS ran at a surplus last year of £1.6bn - enough to clear the South London debt more than 12 times over. Rather than use this for the good of patients or to solve the debt problems of struggling hospitals, the Treasury stole (or ‘clawed back’, as it calls it) at least £1.4 billion to add to its ‘savings’ from the government’s brutal cutbacks in order to fund tax-cuts for the wealthy.

There is plenty of money within the NHS to make SLHT’s debt problems a dim and misty memory. All the government has to do is start treating the NHS as a whole and not as a range of individual, fragmented pieces, and then use the surplus as needed to restore health and balance to the system.

That the government is making a choice not to do so shows the utter falseness of the Tories’ claim to value the NHS and of their promise to protect it. It also gives away their strategy to break the NHS up into ‘manageable portions’ that they can starve into submission and then dispose of piecemeal to their friends and backers.

But in even considering the SLHT administrator’s recommendations for Lewisham, the government is unwittingly admitting that the NHS is one entity, with each part linked to every other, and the whole organisation responsible for supporting every part.

Admitting, too, that there is no need to close anything at Lewisham. I hope the campaigners can take the government’s own precedent to mount a strengthened legal and political challenge to the government’s attack on their services and wellbeing.
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Re: The future of hospitals under the Tories

Post by oftenwrong on Thu Jan 31, 2013 11:29 am

Note the date on this announcement, just a few weeks after the creation of the Coalition.

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Sir David Nicholson will no longer be responsible to any Government Minister after April 2013, and has already indicated a desire to close ALL Hospital A & E Departments.
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Re: The future of hospitals under the Tories

Post by skwalker1964 on Thu Jan 31, 2013 11:45 am

oftenwrong wrote:Note the date on this announcement, just a few weeks after the creation of the Coalition.

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Sir David Nicholson will no longer be responsible to any Government Minister after April 2013, and has already indicated a desire to close ALL Hospital A & E Departments.

Thanks for the pointer - I hadn't seen this before. Haven't time to read it in full now, but at a glance can't find where it indicates he won't be responsible to government or wants to close all A&E?
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Re: The future of hospitals under the Tories

Post by oftenwrong on Thu Jan 31, 2013 12:08 pm

"In April the Commissioning Board will take over responsibility for all NHS services in England from the Department of Health. It will be accountable to Parliament but not to Jeremy Hunt, the Health Secretary."

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The comment by Nicholson about "the difficult task of closing A&E" was, I think, in a Sunday Times interview. Material from News International is available on the internet to subscribers only.

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Re: The future of hospitals under the Tories

Post by skwalker1964 on Thu Jan 31, 2013 2:06 pm

Thanks, OW!
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Re: The future of hospitals under the Tories

Post by tlttf on Fri Feb 01, 2013 7:06 am

Since the clinical staff (at last) have come forward with logical reasons for keeping Lewisham open, I was under the impression that it is being left open and upgraded again?

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Re: The future of hospitals under the Tories

Post by skwalker1964 on Fri Feb 01, 2013 12:37 pm

tlttf wrote:Since the clinical staff (at last) have come forward with logical reasons for keeping Lewisham open, I was under the impression that it is being left open and upgraded again?

The local clinical staff have always argued that any closure or downgrade will be bad for the local people. Hunt just went and found other, non-local, clinicians prepared to say it would be better for South London overall - like the 'experts for hire' in a lawsuit, I guess, you just find an expert whose opinion fits your intention.

You might be thinking of Hunt's announcement in the Commons that he's going to keep the A&E on a 'reduced basis', able to treat 75% of the people it currently treats. That's exactly what the administrator recommended - Hunt just used a better-sounding way of describing it. A turd by any other name...
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Lewisham decision exposes Hunt's NHS 'ratchet' con

Post by skwalker1964 on Fri Feb 01, 2013 12:49 pm

Original including many links is at [You must be registered and logged in to see this link.]

When I was a kid, I was fascinated by a set of ratchet spanners and screwdrivers that my dad had. All these tools had a little ‘switch’ that you could flip from one side to the other to change the way that they turned. Set the switch in the right position and the tool would only turn freely in one direction – with a very satisfying series of clicks – and would lock in the other. This meant that you could set a spanner, for example, so that no matter which way you turned it, you could only tighten the nut and not loosen it.

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The great Tory ‘NHS ratchet con’

In a tool, this was a very useful feature. But it only worked if you set it right, and it wasn’t suitable for every job.

Jeremy Hunt’s speech yesterday on the South London Healthcare Trust (SLHT) issue – which was in fact more relevant to the fate of University Hospital Lewisham - was both a massive disappointment to campaigners fighting to save services at Lewisham and an object lesson in the modus operandi of how the Tories are busily attempting to fool the British public whenever it comes to the NHS.

This ‘MO’ amounts, in effect, to a ‘ratchet’ con – one in which the Tories have set the switch to allow movement in one direction only, and have locked it from moving in another, far healthier direction. They cover this by claiming that their actions are the only viable course, and that they are for the greater good.

Another way to understand the con is to think of fuel and energy prices. The watchdog may have ruled yesterday that we are not being ripped off by petrol companies, but everyone knows that whenever oil prices fall, the prices at the pump fall much later, or not at all. Petrol companies justify this by saying they have to use up reserves they’ve purchased at the old, higher price.

But when oil prices rise, that argument magically doesn’t apply. Forecourt prices rise immediately, with the petrol companies seemingly feeling no need to use up reserves built up at the lower prices before increasing prices to consumers. The same phenomenon prevails in the utilities sector and in many others, with prices rising whenever 'necessary', but never falling when they could. It’s a clear ‘con’, no matter what official decisions might say, and ordinary people pay the price.

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Hunt: only allowing NHS funds and services to move in one direction

As I wrote yesterday, there is more than enough money ‘in reserve’ in the NHS to resolve SLHT’s problems without any need to downgrade services at Lewisham. More than 12 times more than enough.

Hunt claims that

only by looking beyond the boundaries of the trust to the wider health community could he put forward a viable solution.

He is absolutely correct. But not by ‘reconfiguring’ (i.e. cutting) services in well-performing areas adjacent to SLHT, as he has done.

The NHS ran at a surplus last year of £1.6 billion. A fraction of that sum would clear the operating debts of SLHT, if allowed to move in that direction. It would probably be far more than enough to clear the outstanding ‘Private Finance Initiative’ (PFI) money owed by the Trust completely – and a few years’ accumulation of the NHS’ regular surpluses could clear the entire PFI debt of all affected NHS Trusts. IF it was allowed to flow to where it would do so.

But Hunt and his party have set the ratchet in the other direction. The government chose to ‘claw back’ last year’s NHS surplus – an act that even an NHS executive who supports the government’s overall plans for the NHS called (privately) ‘theft‘.

The Tory ‘ratchet’ allows the money and services to be taken away, but not to flow back in – and not just in Lewisham. This can be seen all over the NHS, as facilities and services are given to private contractors that will be very hard ever to take back, even under future governments, as buildings and land are sold off that will be far more expensive to buy back when needed, while the funds siphoned away, and local hospitals are closed in the name of ‘improvement’ while the wishes of local people are ignored and derided, and ministers lie even to MPs of their own party.

CLICK: Huge NHS surpluses are ‘clawed back’ by the Treasury.

CLICK: Lewisham is downgraded, with A&E and maternity services cut to the most basic level (no matter how Hunt tries to frame it in weasel words), to make up for SLHT’s ‘failure’. Government says it’s the ‘only viable option’.

CLICK: A hospital is closed or skeletonised, forcing local people to travel miles further for treatment, and putting lives at risk.

CLICK: GP services are bought by private companies using the NHS logo for camouflage.

CLICK: A whole NHS hospital is given to a private company for it to run for profit. Even though it is off-target in its finances, it keeps it and demands to take over more Trusts.

CLICK..

CLICK..

CLICK..

Each ‘click‘ seems such a small little sound amid the noise of daily life and news, and might even seem reasonable at first glance. But the accumulation of all the clicks is an ever-tighter grip on our NHS – and a near-irrevocable erosion of the NHS as it was created to be: a service free for all at the point of need.

Make no mistake, what’s happening in Lewisham is not ‘the only viable option’. It’s a choice – and it’s based on ideology and greed. The Tories could easily flip the ratchet-switch and channel surplus funds to resolve the issues at SLHT and else – but they choose not to.

What is being done to the NHS in Lewisham is a louder ‘click’ than many. We need to hear it, take notice and recognise what it both signifies and symbolises – the mores and actions of a government that spouts empty words about patient choice, protecting the NHS and the best interests of the people it should be protecting, but is following its own, far darker agenda.

That dark agenda is to bleed the NHS dry, no matter what the consequences for ordinary people, until it’s just a husk that can be broken up and devoured by the private health companies that have poured vast funds into Tory party coffers.

Lewisham campaigners are not fooled by Hunt’s ploy and weasel words, and are going to continue to fight. Whether you live near Lewisham or not, it’s in your interests to give them your full and active support – and to find out what’s happening in your own area, as the effects of the Tory subterfuge are being felt almost everywhere, if you know to look for them.
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Re: The future of hospitals under the Tories

Post by oftenwrong on Wed Feb 06, 2013 5:33 pm

Many Opinion-formers have told us that the next General Election will be fought on, and decided by, "The Economy".

Today's accumulating news concerning NHS failure, however, might suggest a different Public preoccupation. Maggy knew that, but the Posh Boys haven't understood. In fact it's not easy to identify anything which Cameron/Osborne/Clegg triumvirate HAVE understood about the mood of the Electorate. Root-and-branch Tories are becoming restless, as well they might.
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Are you scared to go into hospital?

Post by Papaumau on Sat Mar 30, 2013 1:39 pm

Is the British NHS and its hospital system starting to fail?

"What with overtired doctors and surgeons, chronic privatisation on as many services as possible, real nurses getting very thin on the ground, the rise of antibiotic-resistant superbugs like MRSA , and what is known as hospital acquired infections or, ( HAIs ), running rife, it is now a very dangerous thing to do to have to go into hospital for just about anything".

Do you agree with this statement, or do you think that these problems are being blown up out of all reason ?

Regards....

Papaumau.
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Re: The future of hospitals under the Tories

Post by skwalker1964 on Sat Mar 30, 2013 4:21 pm

Papaumau, I posted this article earlier today that bears on your question. Original including a couple of links is at [You must be registered and logged in to see this link.]

Francis 243 - 0 Hunt: NHS staffing, wilful ignorance & a plan

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Jeremy Hunt’s announcement in Parliament last Tuesday on the changes he is planning in the wake of the Francis Report into events at Stafford Hospital was remarkable for two things: the complete absence of the key factor that Robert Francis identified as being at the heart of the poor care at the hospital and as clear a case of “giving away the ‘master’-plan” as you will ever see.

Or not wish to see, since for all Hunt’s timorousness and petulance it will be an absolute disaster for hundreds of thousands of people.

The problem that never was, or ‘out of sight, out of mind?’

Hunt prefaced his announcement of his measures by genuflecting before the altar of the Francis report:

I also pay tribute to Robert Francis QC for his work in producing a seminal report that will, I believe, mark a turning point in the history of the NHS…Our actions must ensure that the NHS is what every health professional and patient wants: a service that is true to NHS values, that puts patients first, and that treats people with dignity, respect and compassion..The Government accept the essence of the inquiry’s recommendations and will respond to them in full in due course.

Always good to make a show of piety. Unfortunately, as we’ll see, Hunt’s devotion to Robert Francis’ is mere lip service for form’s sake – and for the sake of a goal which has nothing to do with putting ‘a service that is true to NHS values, that puts patients first, and that treats people with dignity, respect and compassion.’

Hunt then goes on to list the 5 ‘key’ areas that he is addressing, based on the Francis report – a list in which something is conspicuous by its utter absence. Let’s take a brief look the areas he did mention, quoting his own (weasel) words:

1) preventing problems from arising by putting the needs of patients first
2) detecting problems early
3) taking action promptly
4) ensuring that there is robust accountability
5) leadership.

Can you see what’s missing? Here’s a clue.

Francis 243 – 0 Hunt

In the three volumes of his report and his executive summary, Robert Francis mentions a certain word no less than 243 times. That word is:

staffing

That’s 243 mentions of that exact word, broken down as follows:

- Executive summary: 11
- Volume 1: 82
- Volume 2: 117
- Volume 3: 33

That is not counting the various mentions of similar terms referring to the same issue, such as ‘staff levels’, staff numbers’, etc which would take the total far higher. 243 mentions of that particular word:

Staffing

Jeremy Hunt paid tribute to Mr Francis for his work and the report that resulted from it. He said the government accepted the report. He said the government would act upon it.

How many times did he mention ‘staffing’ in his announcement?

0

Yes, zero. None at all. But perhaps he just didn’t use that term – perhaps he said ‘staff numbers’, or ‘complements’, or just ‘numbers’, or some other variant?

How many times did Mr Hunt refer to staff numbers in any way during his speech?

0

Hmmmmm. Do you get the feeling that there’s a subject he wants to steer clear of?

In every single one of his five ‘keys’ that will ‘mark a turning point in the history of the NHS‘, the notion of understaffing is conspicuous by its absence. What we get instead is a series of measures designed to give the impression of doing something popular (and largely impractical) while actually leading toward an ulterior motive that’s been common in almost every action of the Tories in government toward the NHS.

Here’s how Hunt elaborated on his 5 ‘action points’:

Prevent problems arising by putting needs of patients first

According to Hunt,

people have suffered on such a scale and died unnecessarily

and

To prevent problems from arising in the first place, we need to embed a culture of zero harm and compassionate care throughout the NHS

I have news for Mr Hunt. ‘Zero harm’ is already deeply embedded in the culture of NHS workers, from doctors’ vow of ‘first, do no harm’ downward. But if hospitals are seriously understaffed, the best intentions and efforts are doomed to fail often. But Mr Hunt knows that and isn’t unhappy about it, as we’ll see.

To achieve this ‘new’ culture, Mr Hunt proposes to make would-be nurses work as health-carers for a year in order to get funding for their nursing degree is deeply impractical and a way to provide cheap cannon-fodder to those hospitals who can afford it. Impractical because many hospitals are not going to be able to pay an influx of additional health-care assistants, so places will be in short supply.

Unless of course, he expects them to work for nothing – which wouldn’t be very surprising, really. No, hands-on caring should be part of nurses’ training, like it used to be – not a prerequisite for getting on a course in the first place.

Detecting problems early

Hunt said,

the most important thing that the country should know is that when it comes to failures in care, the buck stops in one place

Well yes, Mr Hunt. Except it should be the Health Secretary.

Instead, Mr Hunt has decided to create a new ‘Chief Inspector of Hospitals’ – which fits perfectly with the Tories’ love of devolving blame. No amount of inspection, though, will allow nurses and doctors to do more than is humanly possible. The Health Secretary is imposing an official to to detect failure without addressing the core reason identified by Robert Francis for poor care.

Setting up to fail – and making more sure failure is caught’, in other words. Which leads us to the 4th – and central – measure Hunt outlined.

Take action promptly

Hunt said,

The problem with Mid Staffs was not that the problems were unknown; it was that nothing was done.

The problem with this is that, although it’s part of the popular perception fostered by the media, it’s simply not true. Martin Yeates, the former chief executive of Mid Staffs, instigated a series of checks that ensured that if Doctor Foster Intelligence alerted them of any increase in death rates, cases were reviewed by other doctors to make sure there were no issues. Two surgeons were removed from their posts because of poor technique uncovered.

But Mr Yeates was forced to step down – by the rage and furore surrounding issues that he was taking steps to address – to the dismay of staff at the hospital who could see that he was doing a good job.

Hunt went on,

No hospital will be rated as good or outstanding if fundamental standards are breached, and trusts will be given a strictly limited period of time to rectify any such breaches. If they fail to do that, they will be put into a failure regime that could ultimately lead to special administration and the automatic suspension of the board.

Ah, now we come to the nub. Hunt has tried to be subtle, but in fact he’s given away his game like a poor poker-player. Hunt is trying to dress up his ‘turning point in the history of the NHS‘ as a plan constructed for the good of the NHS’ patients and potential patients. But it’s nothing of the sort.

What it is is quite simple, really:

1) Ignore the central cause of poor care in the NHS, leaving hospitals underfunded, under pressure and understaffed.

2) Appoint an inspector to make sure that the resulting, inevitable failures are identified more quickly and are ‘shouted loudly’.

3)Take action. Action to address funding and staffing issues so that people dependent on a failing hospital receive better treatment? Nope.

Mr Hunt is going to ‘save’ the NHS, and ‘save’ the people who depend on hospitals, by giving them a short time to solve their problems without the remotest hope of the means of doing so – appointing more staff. And then he’ll put them into ‘failure regimes’ and administration.

Instead of having a struggling hospital, local people will have no hospital at all, as the one they’ve relied on is shut down, or broken up and absorbed into other, more distant hospitals or bought up by private health companies.

Just ask the people of Stafford what that feels like. While you’re about it, ask them whether they feel ‘saved’ by what’s being done to their local hospital and services – and why thousands of them are signing petitions, protesting, delivering leaflets and appealing to politicians and lawyers to help them genuinely save their hospital.

He marched them up to the top of the hill..

Mr Hunt’s 5th point was leadership. But ask any general what his chances of success are if he’s starved of the weapons and materiel he needs to fight the battle. By wilfully ignoring the most crucial issue identified by the Francis report and doing nothing to address the staffing shortages and the funding issues that create them, Hunt is merely setting up the NHS to fail, ensuring failure is punished by counterproductive measures – and leading the NHS into a dead end where it can be picked off, piecemeal.

The blueprint

As I predicted a month ago, the Tories see Stafford as an opportunity and a blueprint. Stafford hospital has been turned around completely and is now among the best district general hospitals in the country – and is about to be closed down, unless its local people are able to save it against the odds.

In his speech, Hunt said,

I want Mid Staffs to be not a byword for failure but a catalyst for change

Stafford could actually be the blueprint for a big, positive change in the NHS – a blueprint titled ‘How to turn around a struggling hospital’ – but that opportunity is being thrown away by the plan to break it up.

Instead, Hunt plans to use the same ‘identify, target, denigrate, close‘ model that has been used to attack Stafford to attack other hospitals – and has targeted 10% of England’s hospitals for his first phase.

Hunt called what happened at Stafford

a betrayal of the worst kind

But it wasn’t – there’s a far greater betrayal couched in Hunt’s words and intentions. A betrayal that involves taking away people’s cherished, vital hospitals – and telling them that he’s only doing it for their good. A betrayal that dresses up a plan to inflict deadly wounds on the NHS that will lead to many deaths and much misery as one motivated by the desire to improve people’s lives and health.

A betrayal that knows exactly what is needed to address the problem – and ignores it completely.

Francis 243 – 0 Hunt.

Don’t forget.
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Re: The future of hospitals under the Tories

Post by boatlady on Sat Mar 30, 2013 4:30 pm

Strangely enough, my neighbour has just been back and forth to hospital to have a new power pack for her pacemaker. I've been taking her and, although everyone was clearly working VERY hard, it's been quite impressive that they've all had time to sit down and talk her through the procedure.
She had it done as a day patient, and I felt content that proper infection control was observed, and that she was fit to leave when they discharged her.
I think maybe, for older and frailer people with less social support, hospital may not be such a positive experience. With all the day procedures and minimal invasive surgery going on, maybe hospitals just aren't geared up for longer term patients any more..
Th investment (rightly enough perhaps) has mainly gone into the higher tech stuff.
Of course, in my younger day, we had the cottage hospitals where people with longer lasting illness requiring mostly nursing care could be cared for nearer their own home, with regular visits from family and friends to keep an eye on things and provide the social support without which the task of nursing can become so much more time consuming.
Sadly, those hospitals disappeared in the early '90's, and I think that was about the time NHS care began to be criticised
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Re: The future of hospitals under the Tories

Post by oftenwrong on Sat Mar 30, 2013 5:13 pm

More people die in Hospital than in any other location.
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Re: The future of hospitals under the Tories

Post by skwalker1964 on Sat Mar 30, 2013 6:31 pm

Indeed! Which point is made by one of the interviewees linked here:

Then and now: two faces of BBC on Stafford NHS deaths
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Re: The future of hospitals under the Tories

Post by Papaumau on Sun Mar 31, 2013 1:40 pm

Thanks for that skwalker1964. I am sure that many people like us are not being taken in by the propaganda spewed out by this cruel and useless government.




Boatlady.....

I am sure that many thousands of British people have some very good compliments to say about the professionalism of the nurses, doctors and consultants in our British NHS hospitals - including me BTW - as these wonderful people give some excellent care IN SPITE OF the damage that is being done by government on the hospital infrastructure.

The points that I make in my thread-start, ( above ), are things that have developed in modern mass-medicine because some of these non-clinical people are not doing their job right and because cleanliness - or the lack of it - is now being delivered by private cleaning companies that pay their workers the minimum-wage and push them so hard that they simply cannot clean the places they should, efficiently enough.

Also, the overuse of antibiotics in the animal-husbandry industry and in the GPs surgeries is meaning that many antibiotics that used to work now don't.

The rise of the HAIs and the Methicillin-Resistant Staphylococcus Aureus or MRSA-types of bacteria now mean that simple infections that used to be easily-treated are no longer - in many cases - treatable any more.

All of this means that instead of hospitals being places that people go into to get better, they are now, in many cases, becoming places where people CATCH new infections and diseases.

That cannot be allowed to go on, as if it is, people are going to start to resist going into hospital at all.

Regards....

Papaumau.
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Re: The future of hospitals under the Tories

Post by Ivan on Thu Jan 23, 2014 10:47 pm

Clause 118 would leave no hospital in England safe

Extracts from an article by Benedict Cooper:-

“Rules are pesky things when you’re trying to get things done. Especially when it comes to health care and you’re making such big changes that they can be ‘seen from space’. But for Jeremy Hunt et al, they’re more of a bore, not real obstacles. If the rule book tells them they can’t do exactly what they like, it’s very simple: they just rewrite it. It’s a luxury of the rich and powerful when irritations like Lewisham happen. The public claimed a victory, Hunt feigned defeat. But it was only a simpering type of defeat; he knew he’d be back.

Clause 118 of the Care Bill will allow Hunt and any future health secretary to close any hospital or department in England with very little trouble at all. No consent from the clinical commissioning group (CCG) which runs it (despite the new 'autonomy' they’ve been granted), no sound financial basis for the decision, nor true democratic approval required. Only a tedious consultation process with the local yokels to sit through and you’re done.

For a party which received only 36.1% of the vote in 2010 and is now squirming away in an uncomfortable coalition, ignoring the wishes of the medical profession, its own CCGs and the general public to bring in more centralised control and a privatised system, might just seem like arrogance. But the history books, like the rule books, are written by the winners. With Clause 118 due to be sealed in the next few weeks, the government might well be justified in a little swagger, knowing the book is nearly closed on the NHS once and for all.”


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Re: The future of hospitals under the Tories

Post by oftenwrong on Fri Jan 31, 2014 12:45 pm

But a Glimmer of Hope: (?) The Competition Commission (former Monopolies Commission) has been investigating private hospitals.

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Re: The future of hospitals under the Tories

Post by Ivan on Sat Feb 15, 2014 2:05 pm


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Re: The future of hospitals under the Tories

Post by oftenwrong on Sat Feb 15, 2014 6:01 pm

Reach for your smelling-salts when someone takes a job "for no pay".
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Re: The future of hospitals under the Tories

Post by bobby on Fri Mar 07, 2014 6:39 pm

Hospital closures. The amendment is number NC16. If passed, it would replace clause 119, aka the hospital closure clause, of the Care Bill, wich would allow the bastard Jeremy Hunt to close any hospital he wanted.
I live in Surrey and it is the County where the most privatisations have already taken place, many more and there won't be any NHS left in this County
I like many have received a message inviting me to send an e-mail to Johnathan Lord my Local MP with regards to the hospital closure clause. I have of course sent the e-mail. What I want to know is why do we have to hear about such things from anyone other than the Official Opposition party "Labour".
For such a bill to be passed would spit in the faces of the entire Nation, yet I haven't seen anything about it other than Ivan's post and a message from 38 Degree's.
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Re: The future of hospitals under the Tories

Post by bobby on Fri Mar 07, 2014 9:23 pm

I have received this e-mail from Johnathan.

"Jonathan Lord MP
Member of Parliament for Woking
House of Commons
London, SW1A 0AA

Tel: 020 7219 6913
Fax: 020 7219 5198


Many thanks for taking the time to write to Jonathan Lord.

We have to advise you that Jonathan is attending to an urgent family health matter and will not be able to attend to his parliamentary and constituency duties for the immediate future.

Jonathan will try to read all emails, but please be advised that only urgent and important matters involving Woking constituents will be prioritised. It may not be possible to respond to all correspondence. Please ensure that you have provided your full constituency postal address.

If you are a Woking constituent who has contacted Jonathan regarding an urgent and important matter and do not receive a reply within 10 working days, please email a reminder and we will do our best to get back to you.

Jonathan would like to thank all of those who have kindly offered their best wishes to his family during this difficult time."

Bloody convenient that considering there is only a couple of days left before the bill is voted on. I wonder just how many more of the Tory scum will not be available to respond to their constituents concerns re the Tory plan for closures and privatisations of the NHS.

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Re: The future of hospitals under the Tories

Post by oftenwrong on Fri Mar 07, 2014 10:48 pm

Nuffink to do wiv me, Guv - I weren't even there!
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Re: The future of hospitals under the Tories

Post by Ivan on Sun Mar 09, 2014 12:13 pm

Even the IFS, Nuffield and the Competition Commission admit that there is precious little demand for private healthcare
 
Extracts from an article by John Ward:-
 
Between 1997 and 2011, public spending on health grew so quickly it stunted the growth in the private health sector. This suggests that NHS patients were satisfied enough with their treatment not to go private. The effect seemed lasting: even after the banks dropped us in it and budgets were cut, the market for private health spending continued to shrink, despite it being given some £5.6bn worth of business by the NHS itself after 2006. An IFS/Nuffield report last year concluded: “There is evidence of some substitution between public and private funding, with people who might previously have paid to go private becoming more likely to use the NHS.”

Once the Tories got into power, NHS budgets were frozen in real terms – and are down when set against rising demand - while the amount passed over to the private sector leaped (during 2011/12) to £8.7bn. The government, as represented by the smarmy, mealy-mouth Jeremy Hunt, tries hard to keep our eyes off this ball: when given a level playing field, the NHS provides a very real threat to the private sector - and to all those MPs who represent its interest.

In starving the NHS hospitals of money (and then looking sad when they have to go into administration) the Tories are tilting the playing field in favour of the private sector. Yet again, the Conservative Party is miles away from supplying what 93% of the population wants: a publicly provided health service as opposed to one based on insurance and private fees.

 
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Re: The future of hospitals under the Tories

Post by oftenwrong on Sun Mar 09, 2014 1:42 pm

That much became public knowledge when BUPA sold all its hospitals in 2010.

By Manchester Evening News
Comments

Bupa to sell hospitals
17 Apr 2010 20:41

BUPA has agreed to sell its hospitals business in a private equity deal worth £1.44bn. The operation, which consists of 25 acute care hospitals and one treatment centre, has been bought by European buy-out firm Cinven .

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Re: The future of hospitals under the Tories

Post by Ivan on Tue Mar 11, 2014 11:07 pm

So there we have it. Clause 119 (previously 118) of the Care Bill was passed by the House of Commons by a majority of 58 votes today. Only six Tories and one Lib Dem MP, Greg Mulholland, had the guts to vote with Labour against it. Jeremy Hunt, who hates the NHS and was the co-author of a pamphlet back in 2005 which called for its fragmentation, can now shut any hospital that he likes, regardless of how successful or even solvent it might be, with only cursory local consultation.
 
That’s yet another example of why the Coalition Agreement is such a sham:-
 
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And another illustration of the wrecking ball which Cameron is taking to the NHS:-
 
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If Putin passed a Clause 119 abolishing local democracy in Russia, the BBC would no doubt call him a dictator, but when Cameron does it to our NHS the BBC barely mentions it.
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Re: The future of hospitals under the Tories

Post by astradt1 on Tue Mar 11, 2014 11:38 pm

The Libdum MP, Paul Burstow, who tabled the amendment which 38 Degrees members got behind - decided to drop his amendment before it came to a vote. He said he was doing this because the government had promised changes which addressed his concerns.
 
One has to wonder what HIS concerns were?
 
Yet another case of a LibDum saying he would do one thing and then does the total opposite...
 
The Mail ('wash my mouth out with soap and water') head lines are:-

Ministers get sweeping new powers to shut hospitals or wards: New law will allow units to be closed within 40 days
Law passed after closure of Lewisham A&E in London ruled illegal last year
It would allow successful wards to be closed if it is needed to pay off debt
Labour accuses health secretary Hunt of 'changing the law to get his way'
Tory MP Sir Tony Baldry warns many hospitals could be at risk under the law

Health minister Dr Dan Poulter insisted the new powers would only be used ‘in the most exceptional circumstances’, where patients’ lives were at risk or a trust had failed financially.

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Re: The future of hospitals under the Tories

Post by boatlady on Wed Mar 12, 2014 8:13 am

I despair
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Re: The future of hospitals under the Tories

Post by Redflag on Wed Mar 12, 2014 9:37 am

When are you lot in England going to get off your butts and do something about this Tory gov't that is rushing to sell of the UK NHS to the private health care sector.   I do not have to worry as I live in Scotland and our NHS comes under the Scotish Parliament but with September the 18th coming I just wonder if like the Tories Salmond would do the same thing to Scotland privatize  our part of the NHS.

With clause 119 being passed by the Tories and the Fib-Dems I hope they both lose lots of seats in the Local & EU elections in May, but I am sorry to say the only way you will save YOUR NHS is to get rid of this shower of power hungry Dick Heads sooner rather than later, you can not afford to wait until May 2015 something needs to be done NOW or by the time of the 2015 general election the only people that will be alive will be the Tory voters.   With so many foodbanks and the sick and disabled been picked on welfare being cut to the bone the Tory intension is to kill us all off, I am lucky I have a way out by voting Yes in our upcoming referendum and yes it would be a leap in the dark, but how many others in Scotland  are thinking the same way as me.

So once again I will repeat myself there is only one way to get rid of this shower of VILE NASTY SCUMBAGS is GENERAL STRIKE with the NHS gone you have got nothing else to lose, if England starts the Scots will join you in soladarity that is what happened when Thatcher brought in the Poll Tax, we started the protests here in Scotland and then England joined in when you got the poll tax one year later,Thatcher soon withdrew he Poll tax because she knew at the next G.E. she would have been out on her earhole. headbang headbang headbang 
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Re: The future of hospitals under the Tories

Post by oftenwrong on Wed Mar 12, 2014 11:15 am

Curious quotation of the week:

"Health minister Dr Dan Poulter insisted the new powers would only be used ‘in the most exceptional circumstances’, where patients’ lives were at risk or a trust had failed financially."

"Patients whose lives are at risk" are more likely to be found in a hospital than in any other kind of building.
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Re: The future of hospitals under the Tories

Post by bobby on Wed Mar 12, 2014 11:20 am

"Health minister Dr Dan Poulter insisted the new powers would only be used ‘in the most exceptional circumstances’, where patients’ lives were at risk or a trust had failed financially."

And of course with these Tory led Coalition bastards cutting everything in sight, there are bound to be more hospitals failing financially aren't there.
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Re: The future of hospitals under the Tories

Post by Redflag on Wed Mar 12, 2014 7:26 pm

bobby wrote:"Health minister Dr Dan Poulter insisted the new powers would only be used ‘in the most exceptional circumstances’, where patients’ lives were at risk or a trust had failed financially."

And of course with these Tory led Coalition bastards cutting everything in sight, there are bound to be more hospitals failing financially aren't there.


Bobby there is a list published by Hansard it tells you all the Tories & Fib-Dems that voted for clause 119, which gives the CHUNT the OK to shut any hospital that takes his fancy, I suppose he will have been contacted by one of the Tory party donors (private health care sector) they will already have there eye on the hospital they want and with most of the Tory MPs having shares in the private health care it will not take long for the CHUNT to start to sell off YOUR NHS pokenest 
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Re: The future of hospitals under the Tories

Post by Ivan on Tue Aug 05, 2014 2:35 pm

The proposed 'changes' to the Charing Cross hospital should concern us all

From an article by Stefano Hatfield:-

Before the May local elections, Cameron visited Hammersmith and Fulham – then a flagship Conservative council – to court voters. He attacked the local MP: “Andy Slaughter is not giving the true facts. Charing Cross hospital will retain its A&E and services, it will still be a very good hospital with a fantastic cancer care unit.”

Last week, those 'facts' were announced. The hospital is to be demolished; more than half the land sold off for development; A&E, neurosurgery, stroke and urology services will move; and the rebuilt hospital will see in-patient bed numbers fall from 360 to 24. Some services will transfer to far-off St Mary’s, Paddington – which is already operating at 'maximum utilisation'.

Before the election we didn’t know the half of it. But the greater the obfuscation, the more we see its purpose. In May, much to its shock, that flagship Conservative council was voted out of office because voters did not trust its motivation and plans for the local NHS. But it’s too late for the hospitals, too late for the community. All this will go ahead without public consultation, and despite 100,000 signatures opposing the plans. It is a triumph for dogma and doublespeak that would leave George Orwell despairing. And, if it can happen in West London, it can happen near you.


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Re: The future of hospitals under the Tories

Post by stuart torr on Tue Aug 05, 2014 3:20 pm

I'm afraid Ivan that you cannot believe a word Cameron says that comes out of his arse.
Ever since the tories came into power, after any election they always try to privatise the nhs.
Thatcher (rip) was the main one when she was in power, this idiot that we have now is just as bad if not worse.
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Re: The future of hospitals under the Tories

Post by oftenwrong on Tue Aug 05, 2014 5:35 pm

Charing Cross Hospital (in Hammersmith, not at Charing Cross) is a key site for the teaching of medical students from Imperial College London. What happens to that arrangement?
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Re: The future of hospitals under the Tories

Post by stuart torr on Tue Aug 05, 2014 6:28 pm

Your guess is as good as mine oftenwrong, but knowing the tories they will want to keep that as an icon.
So it will be moved to one of the top London hospitals that they don't plan to knock down?  scratch 
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Re: The future of hospitals under the Tories

Post by Ivan on Wed Jan 07, 2015 9:04 am


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Ivan
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Re: The future of hospitals under the Tories

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