Is the NHS really safe in Tory hands?

First topic message reminder :

Here is a news item from North Yorkshire which never made it onto the national headlines

A York-based practice has written to its patients offering them a range of minor treatments privately, claiming they are not funded by the local NHS.

Doctors' leaders said this could be the start of a worrying trend due to the squeeze on finances and NHS overhaul.

The letter, seen by the BBC, said local health chiefs had stopped funding a range of services, but added they could still have them done privately at a number of clinics, including one owned by the practice.

These included removing skin tags from £56.30 to treating benign tumours for £243.20.

Dr Richard Vautrey, of the British Medical Association, added: "The dire finances of many trusts means that many more NHS treatments are likely to become unavailable in the future".

The 1200 deaths due to poor care happened in 2006 at a pure NHS hospital (Staffordshire).
Germany lets private companies run their service on behalf of the state as does France. It seems to work for them.

tlttf wrote:The 1200 deaths due to poor care happened in 2006 at a pure NHS hospital (Staffordshire).
Germany lets private companies run their service on behalf of the state as does France. It seems to work for them.

Nobody claims the NHS is perfect, and poor care is poor care. However, under a private regime you'd simply hide the problem - people with complex conditions with a low chance of successful treatment wouldn't be treated, because failure would spoil the figures and be considered too expensive.

Staff in a privatised hospital would also be paid less and fewer in number, and therefore have lower morale and be more prone to error. 65% or so of the costs of an NHS hospital are pay costs, and if a private provider wants to provide services more cheaply than a non-profit organisation, it's going to have to cut pay levels and staff numbers to carve out a profit margin.

The situation under private providers would be worse, but less visible. Winterbourne View was a private facility, suffered exactly the problems of low pay and poor staff quality/engagement - and look what happened there but was only exposed by investigative journalism.

The 1200 deaths due to poor care happened in 2006 at a pure NHS hospital (Staffordshire).

tlttf. Totally misleading, as we have come to expect from you. For a start, who the hell are you to quantify “deaths due to poor care” as opposed to deaths which would have occurred anyway? Secondly, the various press reports on this case talk of “between 400 and 1200 more patients dying between 2005 and 2008 (not in one year) than would be expected for the type of hospital”. Thirdly, such ‘excess’ death statistics did not appear in the final Healthcare Commission report, because as I’ve said, they are unable to separate them from deaths which always happen in hospitals.
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The privatisation of hospital cleaning by the Tory governments of Thatcher and Major, with long-term contracts, wouldn’t have helped with accountability for cleanliness. Nevertheless, what happened in one hospital in and around the middle of the last decade, however awful, is just anecdotal evidence in the context of a national system of health care. More relevant is that before this despicable government came to power, waiting times for operations had been reduced on average from two years to four months and patient satisfaction was at an all-time high of 88%.

The privatisation of the NHS, for which the Tories have no mandate, is being undertaken quietly (with a news blackout from the BBC, now that the corporation is in the hands of Tories such as Chris Patten). The Tories aren't interested in public healthcare; as with so many other state assets, they're flogging off the NHS to party donors, in a move which is nothing short of corruption and for which Cameron should end up in the dock one day. Most Tory politicians and their wealthy supporters use private medicine; they hate the NHS. They opposed its creation, causing Nye Bevan to call them “lower than vermin”. They see it as socialism and so they‘re ideologically opposed to it.

The Tories have undermined the NHS at every opportunity, and papers released recently show how Thatcher would have loved to have abolished it. John Major neglected the infrastructure, leaving hospitals in an appalling state and with such a shortage of nurses (because the pay was kept ridiculously low), that when Labour came to power they brought in 12,000 from the Philippines to fill the gap while new British ones were trained. So I for one won’t take any lessons from Tories on the NHS, especially those who play fast and loose with the truth.

Sorry Ivan that it took 3 years to kill the vulnerable and not 1 year. Speaking of privatisation how many hospitals are now on the verge of bankruptcy thanks to Labours PPI system?

Tlttf what a twisted comment......."Sorry Ivan that it took 3 years to kill the vulnerable and not 1 year".

Are you suggesting that there was a prolonged campaign of neglect against a group of individual patients with the sole aim of causing death?

Wasn't it Major who introduced PFI scheme's as a way of repairing the years of neglect to hospital buildings?

tlttf wrote:Speaking of privatisation how many hospitals are now on the verge of bankruptcy thanks to Labours PPI system?

In reality? Zero.

The NHS ran a surplus in the last financial year of £1.6bn - and that's on top of the £2.5bn or so that the Treasury either 'clawed back' or siphoned out of the NHS to prop up the social care system that is collapsing because of their cuts to local government.

The idea that a particular hospital is bankrupt, or unsustainable, or failing or whatever other buzzword we hear touted is an entirely political construct, not an actual reflection of reality. It makes perfect sense to treat the NHS as a whole - after all, it's still officially one entity.

The decision not to is a political expedient not an inevitability.

tlttf wrote:Sorry Ivan that it took 3 years to kill the vulnerable and not 1 year. Speaking of privatisation how many hospitals are now on the verge of bankruptcy thanks to Labours PPI system?

In 1992 PFI was implemented for the first time in the UK by the Conservative government of John Major.

Now this is more worrying for the nation if this manages to happen.

You couldn’t make it up

January 15th, 2013 by Susannah Compton

**UPDATE: Within minutes of 38 Degrees members starting to contact Monitor, they told the Guardian they’d changed their position and “will not be recommending that private sector providers should be exempt from paying corporation tax.” That’s a brilliant win! But so far they’ve only ruled out exemptions for Corporation Tax – keep contacting them and demand they rule out ALL tax breaks for private health companies.**

Revealed: private health companies taking up NHS contracts are lobbying hard for special new tax dodges. You couldn’t make it up, but that’s what a new government review of competition in the NHS is considering.

More of an issue than nitpicking individual hospitals and systems.

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Hunt: "Paperless NHS in five years"


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No mention of what Jeremy *unt plans to do when ObamaCare becomes fully established and all former NHS Medics have fled to America.

"Paperless NHS in five years"

Wasn't that the idea of the much critisied Labour NHS computer system of a few years back?

oftenwrong wrote:-
Thatcher would have liked to privatise the NHS, but feared Civil commotion. What made Cameron decide that he could get away with it?.

Firstly, by gagging the BBC with the help of his stooges like Chris Patten. There was a virtual news blackout on the passage of the NHS Bill through Parliament. One lady on Twitter was in the 'Question Time' audience on one occasion and was told not to ask any questions about the NHS.

Secondly, Cameron hasn't privatised the NHS all at once but by stealth, piece by piece, so that we don't notice any sudden changes. The NHS logo will no doubt continue to be displayed for some time to come.

I remember this being discussed on the MSN boards before the last election, when it transpired that Cameron had had a secret meeting in Westminster with 'Nurses For Reform'. The plans for privatisation had been worked on for years by Lansley, who even received donations from a private healthcare firm for his own office. The Tories told us nothing of their intentions before the election because, as Michael Portillo said on 'This Week', they'd never have got in if they had.

The Latest from Eastleigh Infirmary

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" There - full frontal lobotomy complete. He be voting Conservative in no time..."

Popularly described as the "Conscience Removal" procedure.

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As you can see on the Open Democracy site, and on Shibley Rahman’s excellent blog, the government is trying to slip through a catastrophic and previously-denied NHS measure into law.

Exploiting provisions written into last year’s much-despised Health and Social Care Act (HSCA), along with a little-known Parliamentary procedure, the government is attempting to slip its competition measure into legislation ‘under the radar’ of public awareness so that by the time we know it’s happening, it’s too late to do anything about it.

Then-Health Secretary Andrew Lansley’s HSCA contained a provision that the NHS Commissioning Board (NHSCB) and Clinical Commissioning Groups (CCGs), who commission health services, must not

use anti-competitive behaviour which is against the interests of people who use such services.

In response to concerns raised about the risk of coercion to introduce competition, Lansley sent out a letter to prospective commissioners that included the following, very clear statement:

I know many of you may have read that you will be forced to fragment services, or to put services out to tender. This is absolutely not the case. It is a fundamental principle of the Bill that you as commissioners, not the Secretary of State and not regulators, should decide when and how competition should be used to serve your patients’ interests. The healthcare regulator, Monitor, would not have the power to force you to put services out to competition.

The new regulations, which will force almost all services to be put out to competitive tender, show this assurance to have been a shameless lie.

In order to push these new rules into law with minimal resistance, current Health Secretary Jeremy Hunt is using a Parliamentary ‘dodge’ to bypass the usual democratic processes of debate and voting. This procedure, known as ‘negative resolution‘, means that the new rules do not need to be discussed or voted on. Instead they will automatically become law 40 days after being laid down, on 1. April.

However, all is not yet lost. MPs have the right to request a motion (a procedure known as ‘laying a prayer’) annulling the change within the 40-day period – and if this ‘prayer’ is supported by enough MPs it could force a Commons debate and vote.

But this is not easy to achieve – according to Open Democracy it is 10 years since it was successfully done in the House of Lords and 30 years in the Commons. We need to galvanise massive Parliamentary support to achieve it – and at the same time to use every other available tactic to stall or subvert the new set of rules that the government is dishonestly attempting to sneak through. Here are some ideas (feel free to add your own via the comments function!):

Write to your MP

First and most obviously, in order to achieve the groundswell of support for a motion to annul this anti-democratic move, we need to let MPs know that the public is aware of the government’s sleight of hand and that we want it blocked. Go to [You must be registered and logged in to see this link.] enter your postcode and it will provide you with the details you need to write to your MP and demand that they take action. No matter which party your MP belongs to, please do this – if even one or two Tory MPs can be persuaded to do the right thing, it could make all the difference.

A Labour commitment

If the government succeeds in forcing through this legislation, it’s essential to minimise its effects between now and the next election. If Ed Miliband and Shadow Health Secretary Andy Burnham make a firm, public commitment now to overturn the rules and cancel any and all contracts awarded under the new rules if Labour are elected in 2015, it may discourage some private companies from attempting to win them in the first place, knowing that they won’t have time to profit from them.

Whatdotheyknow.com won’t allow you to contact the Labour leader and his Health colleague via the site unless you live in their constituencies – but you can still email them at the addresses below to call on them to make a solid, public pledge, so they know that they will have public support if they do so:

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Please write an email today and address it to both.

Closed tenders

The new rules state that any new contracts must either be awarded to ‘any qualified provider’ (AQP) or put out to competitive tender. But there may be an option to minimise damage to the NHS until the rules can be overturned. I’ve worked with competitive tenders and I know there are two varieties of competitive tender: open and closed.

If the rules require CCGs to put all services out to competitive tender, they should still have the right to issue a closed tender – one in which only invited bidders can participate. They can then invite only true NHS bodies to bid for the services. As long as more than one bidder is invited, this should still meet the definition of ‘competition’ – and keep the services within the NHS whichever bidder wins.

You can download a list of prospective CCGs along with the populations they’ll commission for and the Primary Care Trusts (PCTs) they’ll be replacing here. Find out who will be your local CCG(s) and write to them, telling them you expect them to stand up for the NHS in this manner or any other that will achieve the required goal, and that putting out open tenders or using the ‘AQP’ route is not in ‘the interests of those who use [these] services‘.

If these options are not successful or not feasible, there will be other routes that are. We must expect creativity, commitment and courage from our politicians and the CCGs (primarily made up of GPs under the HSCA) to defend the true principles of the NHS by whatever means necessary until this robber-regime can be ousted.

Please act now to get the message across.

Just off out to a meeting with Andy Burnham, our local MP and the Labour candidate for a nearby constituency in 2015 to talk about Labour's stance on, and plans for, the NHS. I'll let you all know how it goes.

I'm sure a negative can be found, though it will take some serious looking!

Transformed: The failing NHS trust taken over by private firm has one of the highest levels of patient satisfaction

Hinchingbrooke Hospital is ranked one of the highest for patient happiness and waiting times
It was on the verge of going bust when it was taken over by Circle last year
It is the first NHS trust to be run entirely by a private firm

By Peter Campbell and Sophie Borland

PUBLISHED: 00:37, 23 February 2013 | UPDATED: 00:39, 23 February 2013

The first NHS trust to be run entirely by a private firm has one of the highest levels of patient satisfaction in the country.

Hinchingbrooke, a hospital in Cambridgeshire with 160,000 patients, was on the verge of going bust when it was taken over by Circle last year.

But NHS figures show it is now ranked as one of the highest for patient happiness and waiting times.
Hinchingbrooke Hospital, the first NHS trust to be run entirely by a private firm, is ranked as one of the highest for patient happiness and waiting times

Patient satisfaction: Hinchingbrooke Hospital, the first NHS trust to be run entirely by a private firm, is ranked as one of the highest for patient happiness and waiting times

The company running the trust has slashed losses at the hospital by 60 per cent and will soon begin to pay off burgeoning debts built up over years of mismanagement. The takeover deal, which saved the hospital from closing down, is seen as a blueprint for the future of many NHS trusts.

The George Eliot Hospital in Warwickshire is already considering adopting the model.

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At a guess Ivan will state "still more lies from the mail" (words to that effect).

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A more local, and possibly more accurate account - showing that there is still a significant measure of doubt as to whether this model is really going to be the best in the longer term.

Personally, I would never accept any single newspaper's account of anything - it's always better in my view to check several accounts if you want to be reasonably confident that you understand the situation; and the Mail IS notoriously biased and not famous for its intelligent comment.

Sorry, I seem to have lost my miraculous ability to post hyperlinks, but the link is easy enough to find on line

BTW ttlf, I think you may find that the verbatim quoting of a newspaper article breaches copyright.

BTW ttlf, I think you may find that the verbatim quoting of a newspaper article breaches copyright.

boatlady. Under fair use rules, it’s possible to use quotations or excerpts, where the work has been made available to the public, as long as no more than is necessary is included, and the source of the quoted material is mentioned, along with the name of the author:-

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However, not for the first time, tlttf is giving us cause for concern over copyright. I’m not happy with his latest post on three counts, but if we delete it there will no doubt be shouts of bias.

Firstly, all quoted material should be posted in italics or a different colour to indicate that it is a quote and you’re not trying to pass it off as your own work. Quoting is okay up to a point, copying isn’t, it’s called plagiarism. If in doubt, just post one or two sentences and a link.

Secondly, quotes must be no longer than 14-15 lines. It’s not entirely clear in tlttf’s post what is quoted and what are his own words. As this is a marginal case, I think we can let it stand.

Thirdly, good practice is to write a post using your own words and maybe adding a quote to support an argument, not to replace it. I must confess that sometimes, usually for reasons of time, I just post an extract from a source along with the link, in order to try and stimulate discussion.

I must urge all members to make themselves familiar with the rules before quoting from external sources, which are likely to be copyrighted:-

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Nice to see that nobody (boatlady excluded) actually reads the message but hey lets shoot the messenger.

Boatlady, if you check on the internet you'll find lots of info regarding the hospital, the fact that I chose one source is neither here or there, the message is a private hospital (more of a co-op actually) is outperforming the NHS hospitals and doing it cheaper.

tlttf wrote:I'm sure a negative can be found, though it will take some serious looking!

Transformed: The failing NHS trust taken over by private firm has one of the highest levels of patient satisfaction

I'd be very interested to know what the staff satisfaction is like. If that side of the equation is wrong, patient satisfaction won't last.

I don't think anyone is saying that a private company can't know how to treat patients and keep them happy. What I at least say is:

- a hospital can treat more patients if it isn't taking out a profit margin
- if it's going to treat the patients at the same cost as a non-profit hospital, it is extremely likely to do so by cutting staff wages, numbers or both
- the missing question is 'who's not getting treated?' An entity wishing to make profit is inevitably going to face the temptation not to treat those whose condition is complex, chronic and/or expensive to treat, in order to maximise those profits

I have other objections, but those three are enough to convince me that the profit-motive has no place in health at the sharp end.

tlttf
I think the point I was making is that the Mail is not necessarily the optimal source in this situation - i would have been more impressed had you cited additional sources as the Mail's reportage is notoriously one-sided. I did, in point of fact also look at the Mail's coverage - nicely written, but failing to report any of the negatives as far as I could see.
Unison members working in the hospital clearly take another view (and I guess their opinions also have relevance as they see how this is playing out 'on the ground')
Also, it's quite possible that the new owners have invested big and slashed deep in order to make a good showing at the end of the first year - it remains to be seen whether this 'improvement' can be sustained in the long term.
I would also want to look into Steve's question above - who's NOT being treated? Some conditions are chronic, expensive and unrewarding to treat, but in a good health service one would expect that those conditions too would receive excellent care - again, this is something that will emerge in the longer term, hence my comment that it is not yet clear that private ownership of hospitals is the way forward.
I guess the litmus test would be if patient satisfaction was at the same high levels and the hospital remained financially viable after 50 years or more - at any rate I need more than a year to convince me.

Let's face it, privatisating the NHS (which the Tories didn't dare to mention at the last election) is just right-wing ideological dogma and a means of rewarding some of the financial backers of the Tory Party. By the time that Labour left office in 2010, patient satisfaction with the NHS was at an all-time high of 88% and waiting times for surgery had been reduced from two years to four months.

Anyone who believes that private healthcare for all is a good idea should talk to somebody who lives under such a system. You could start by listening to what Shirina has to say about medical care in the US:-

Even in a nation that charges a 50% tax rate on income to pay for all of those free services, no one will ever find themselves owing more taxes than they can pay and then being denied services. This means that even the poorest among those citizens can still walk into any doctor's office or hospital and receive the care they need, not just the care they can afford. When health care costs are a product of market forces rather than taxation, sick citizens are faced with a flat fee which, by its very definition, is regressive. The result is that health care services costs X, and if you can't afford to pay X, then you're essentially screwed. That, if nothing else, justifies NHS.

There is absolutely NOTHING about our system that is superior to yours in Britain unless you're sitting in the higher echelons of the executive food chain. To those fat cats counting their money, a for-profit system is utterly brilliant ... but not so brilliant to the 13 year-old who died because of an infected tooth. Did I mention that America's health care system is horrifically inefficient, too? A massive chunk of the expenses incurred by patients are due to administrative costs. Yeah, that's right ... the cost of shuffling papers around. If you want a job in America, become a medical biller. There is such a huge demand for people who write and send bills to the patients that patients have to pay extra for their care in order to pay for the huge numbers of people employed to ... wait for it, wait for it ... bill you!! I mean, seriously, how stupid is that? And you think NHS is inefficient?

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If Private medicine were to receive the column-inches enjoyed by the NHS in media such as The Daily Mail, people might not be quite so desirous of exchanging it for the status quo ante.

FACT 1. Most Doctors and Nurses working in Private Hospitals are NHS-trained.

FACT 2. Most Doctors, technicians and Nurses working in Private Hospitals also have NHS contracts.

FACT 3. If something goes wrong in a Private Hospital which they cannot treat, the patient is transferred to an NHS Hospital.

FACT 4. Private Health Insurance becomes more expensive with the onset of old age.

FACT 5. Private Health Insurance is only ever for twelve months at a time, and may not necessarily be renewable.

FACT 6. Private Health Insurance NEVER covers pre-existing complaints.

FACT 7. Private Health Insurers are in business to show a profit. They are not a Public Service Organisation.

7 bullet points that I can get right behind

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Along with many others, I’ve written recently about the Tories’ covert attempt to slip through ‘secondary legislation’ (Statutory Instrument 257/2013 or SI257) under the Health and Social Care Act 2012 that will force Clinical Commissioning Groups (CCGs) to consider private providers for all health contracts, in spite of emphatic assurances during the passage of the then-Bill that CCGs would not be forced to do this.

I’ve also written about how Labour are fighting this undemocratic stealth-move, which will be a disaster for a truly-public NHS if it passes.

Yesterday, Labour made one move in its bid to get these regulations killed at the Parliamentary stage – an ‘early day motion‘ (EDM) calling for them to be ‘annulled’. LibDem MP and Health Select Committee member Andrew George deserves credit for supporting the motion, which vastly increased pressure on Health Secretary Jeremy Hunt and his health team. If more of his party colleagues showed similar backbone the NHS would be in better circumstances.

Here is his contribution to yesterday’s Commons debate (emphasis mine):

In spite of my right hon. Friend’s earlier comments, I am afraid that the regulation that implements section 75 of the Health and Social Care Act 2012 does not maintain the assurances previously given and risks creating an NHS that is driven more by private pocket than concern for patient care. Will the Secretary of State please withdraw that regulation and take it back to the drawing board?

Health Minister Norman Lamb responded:

We are looking at this extremely seriously. Clear assurances were given in the other place during the passage of the legislation, and it is important that they are complied with in the regulations.

On the back of this statement and later comments from ‘government sources’, the newspapers are reporting this as a reprieve:

government sources said Hunt was prepared to review the regulations to satisfy the Lib Dems

However, this is by no means the reprieve that some appear to consider it. At best, it’s a lull – but the motion did not go to a vote and an EDM would not have been binding on the government even if a vote had taken place and gone against them.

Lamb’s statement that the government is taking the matter ‘extremely seriously’, and Hunt’s decision to ‘review’ SI257 to ‘satisfy the LibDems’ in no way mean that the government has given up on its aim to carve open the NHS for its private backers to feast on.

The Tories have ‘form’ for giving assurances that would then be ignored. At the launch of Lansley’s NHS Bill, the government promised that its changes to the NHS would be driven by the wishes of clinicians. Yet when every association of NHS professionals except one (and even the one was doubtful) said his Bill would be a disaster for the NHS – the Bill was forced through anyway.

In terms of securing the NHS against the government’s planned ‘carve-up’, a comment about ‘reviewing’ SI257 is not worth the breath it took to say it.

Hunt – for whom the phrase ‘a fox in the chicken coop‘ might have been written – will simply seek some form of wording that will allow the LibDems to acquiesce while achieving as much as he can get away with of the government’s obvious aim of forcing privatisation on the NHS.

Earlier in the debate, Hunt made the following statement (just after his ridiculous attempt to equate private health providers like Virgin, Serco and Circle with children’s and mental health charities):

The reality is that those regulations are completely consistent with the procurement guidelines that his Government sent to primary care trusts. He needs to stop trying to pretend that we are doing something different from what his Government were doing when in fact we are doing exactly the same.

Does that sound like the statement of a man who is in two minds about what he wants the result to be, or who is taking seriously the resistance to his secondary legislation?

Jeremy Hunt and his party will never back down willingly on SI257 – their financial backers would never tolerate it. They will abandon it only with their collective arms twisted so far up their backs that they can scratch the tops of their heads.

So it’s absolutely essential that all those who care about the NHS as a public service that will be there, free at the point of need, for us and the generations to follow, continue to resist, and to apply pressure in every available way.

Given that Hunt’s immediate aim has to be to find wording that will preserve the key aims of his legislation but will let the LibDems toe the line, our immediate aim has to be to put pressure on every LibDem MP, to make sure that they don’t settle for being fobbed off with some conscience-salving ‘weasel words’ and instead advise Hunt that they will vote against his measure if he proceeds with it.

So, if you live in a constituency with a LibDem MP (or a pro-NHS Tory, for that matter, if such a thing exists now), please email him or her urgently and tell them that you expect them to resist this damaging legislation designed to line the pockets of private health providers.

You can find out the contact details of every MP here. Jump in!

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It’s been announced this afternoon that Monitor, the regulatory body for NHS Trusts, has begun the process of putting Mid Staffs NHS Foundation Trust (MSFT) into administration. Once this process is approved, which may only take a couple of weeks, the administrators of the Trust will have 150 days to come up with proposals from a range of options including the complete closure of the Trust. One option that is not included, however, is the continuation of MSFT in its current form.

Reports on the decision focus on the Trust’s financial struggles and Monitor‘s statement that MSNHS needs to cut costs by 7% in order to be financially viable.

Sounds like a serious situation, doesn’t it? But as its Annual Report almost a year ago showed, Mid Staffs was already embarked on a Cost Improvement Programme (CIP) to save 6-7% a year – and had achieved its target of £6.4m in the 2011/12 financial year.

Not only that, but the Trust’s board had already agreed a Clinical Services Implementation Plan (CSIP) to save 6% per year from 2012 to 2015. Cumulatively, this process would save far more than 7% – and, crucially:

within the plan is a three year financial strategy from February 2012 through to March 2015. The CSIP and financial strategy has been supported by the Trust Board and was approved by Monitor, Commissioners and the DoH at a meeting on 30th January 2012

Just over a year ago, Monitor approved the board’s 3-year plan – yet now it has changed its mind and considers MSFT ‘unsustainable’.

Without question, MSFT is a ‘struggling Trust’ in financial terms. But it has been working to – and achieving – a plan that would bring it to a stable financial footing. A plan that was approved by Monitor and the Department of Health for 3 years and is now being cut short to put the Trust into administration.

This sudden change of ‘heart’ (if such a word can be applied to an organisation of which a witness at the Francis inquiry said ‘Monitor misses nothing – as long as it’s financial’) clearly gives away the intent behind the government’s apparent humility concerning the events at Mid Staffs, which was worrying from moment David Cameron ‘ate humble pie’ in his Commons statement about the Francis report.

Reports on MSFT unfailingly mention the myth that basic care failings at Mid Staffs resulted in ’400-1200 avoidable deaths’ in the Trust’s hospitals – even though this claim was completely unfounded from the moment the Daily Mail and Daily Telegraph began to trumpet it, and even though the Francis Report itself does not support it.

Even the BBC have propagated the myth. The BBC News channel’s announcement of the administration decision began by referring to the Trust as a place where ‘hundreds of needless deaths’ took place, while the article on the BBC News website which I’ve linked above states:

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This constant media focus on something that never actually took place is carefully fostered by the government in its language and stance – because it forms the cornerstone of a modus operandi, a method of operation, that the government is going to add to its general and pervasive assault on the NHS as a national, public institution.

The failures at Mid Staffs took place over a period that ended 3 years ago. The Trust now scores better than the national average in terms of its clinical outcomes and mortality statistics (correcting its statistical coding meant that it scored better than average on mortality even during the ‘problem’ period).

Yet only now, less than 3 weeks after the publication of the Francis Report, is Monitor choosing to put the Trust into administration – a decision that makes it extremely likely that the Trust will be broken up (or other Trusts around it will be broken up, as the government insanely did to Lewisham because of failings at South London).

Once the break-up is achieved, the hospital will either be handed over to private health companies to ‘save’, or else its services will be downgraded to simple, profitable ‘production line’ services such as hip and knee replacements (just as Jeremy Hunt announced will happen to Lewisham‘s successful hospital) – making it perfect for private companies to acquire and make money from without having to provide the complex, expensive treatments that we’re entitled to receive from true NHS hospitals.

If you’ve been wondering why Hunt and Cameron wrung their hands over the Francis Report and announced that 14 more hospitals have similar ‘death rates’ to Mid Staffs (though the stats for these are probably no more reliable than they were for MSFT) – wonder no more.

The over-eager rapidity of the decision to put into administration a Trust that is recovering in both financial and clinical terms betrays the government’s real agenda – the real reasons for their tactical posture on MSFT so far.

With an adverse spotlight once again on MSFT, and colluding media constantly ignoring the actual findings of the Francis report to foist the ‘unnecessary death’ myth onto a public that is ignorant of the facts, who is going to care if Monitor decides to put the Trust into administration. ‘Surely we’re better off without it, anyway?‘

Mid Staffs now. Then one by one the other 14 Trusts that have been targeted for the ‘unnecessary death’ slur will be systematically tarnished in the public consciousness by the collusive media, while ministers ‘regretfully’ advise that

we have to take steps to protect the public!

and, one by one, those Trusts too will come under Monitor’s baleful gaze.

Illusory problems will become ‘fact’, agreed 3- or 5-year plans will be trampled on, and we’ll suddenly find ourselves down by 15 hospitals – almost 10% of the total.

There are many fronts in the government’s all-out war on the NHS, but this one – the opportunity to take out 14 NHS hospitals that belong to us, the public – is a ‘wet dream’ for a party that has lusted for the destruction of Labour’s (and the UK’s) greatest achievement since it was founded.

Bevan said that the NHS would survive as long as there are people prepared to fight for it. This dishonest smear-campaign is the latest phase in the Tories’ attempt to distort the perception of the British public until there are none, or too few to mount an effective resistance.

We must not – must not – fall for the lies. Stafford is the battleground – and for all our sakes we need to stop the plan from succeeding there.

As widely anticipated ....

NHS trust may face administration

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Hunt's NHS: coasting?

My wife came home from work last night ‘too tired to chew’. She’s a nurse, and she’d just completed a ‘double’ shift – leaving home at 6am and getting home at 9.15pm after a solid shift of almost 14 hours on a ward full of ‘dependent’ patients.

She came in, and I asked if she wanted me to warm something up for her to eat. ‘No, I’m too tired to chew‘, she said – and it wasn't humour. She then warmed up some instant porridge that she could eat with minimal effort before having a quick bath and then going straight to bed. She’s on another ‘double’ today, so she couldn’t do anything else before sleeping in order to be ready.

It hadn’t even been an unusually busy shift – just ‘par for the course’ on a ward that has about 8 patients for every qualified nurse, and almost all of them with conditions that make them ‘high-dependency’, needing help with even the most basic functions.

Earlier today, in a speech to the Nuffield Trust, Health Secretary Jeremy Hunt criticised NHS hospitals for ‘coasting’. In his considered opinion,

too much of the NHS is focused on doing just that ['not coming last']. Not on achieving world class levels of excellence – the gold medals of healthcare – but meeting minimum standards, the equivalent of ‘not coming last.

and

The weeds of failure grow more quickly in a garden of mediocrity.

Hunt was comparing the NHS to Olympic athletes. Since it was unthinkable, he was saying, that an Olympic athlete would train with the aim of ‘not to win, but to not come last’, we should also expect NHS hospitals to aim for not only excellence but constant improvement.

The thing that strikes me most about the whole, fatuous speech – and it really shouldn’t, because it’s entirely normal in the way this government treats the targets of its measures – is the blatant skewing of any semblance of truth or sense, but stated as if it’s the most unarguable, self-evident thing in the world.

Elite Olympic athletes are singled out, given support, funded - everything is set up to give them the best possible chance to shine for personal and national glory. The best training facilities are provided. And when the government wants a greater chance of success, funding is increased – often massively.

How far would Olympic athletes get in pursuit of excellence if they were underfunded? If their fellow team-members progressively disappeared and their coaches were removed? If they were forced to compete not just in their chosen specialism, but to stretch themselves to cover 2, or 3, or more related events – if every sprinter, for example, was forced to become a decathlete?

This NHS is under sustained, multi-fronted attack by a party whose ideology simply cannot tolerate the existence of healthcare free to all at the point of need. Only politics prevents the Tories from immediately abolishing the NHS. As former Tory minister Michael Portillo put it:

They did not believe they could win an election if they told you what they were going to do.

So the attack has to be multi-faceted, progressive and ‘kept under the radar‘ as much as possible – and it involves a constant ‘drip, drip’ of poison in the ears of the British public to erode support and affection for the NHS, with occasional intensification to prepare the ground for a new phase of the assault.

You see, the Tories want Olympic glory – so they’re prepared to pay for it. They don’t want an NHS free to all – so they’re not.

Elite athletes work hard – but everything is set up to give them the best chance of success, and they are lauded and feted in front of the country. The NHS, by contrast, is starved of funds (no matter how the government tries to twist the figures), under-staffed – and vilified by craven government ministers whenever it’s politically convenient or possible to do so.

Hunt spoke of a need for ‘continuous improvement’ and said that it’s just not good enough to be ‘good enough’. He even dared to use Mid Staffs as an example of what happens when hospitals settle for ‘mediocrity’ – even though the real story of Mid Staffs is one of gargantuan efforts on the part of health staff preventing an increase in the death rates in spite of desperate under-staffing and cuts.

The daily reality of the NHS is one of constant, untrumpeted hard work that routinely goes ‘above and beyond the call of duty’ - in spite of being treated as a punchbag by politicians who’ve never known hardship. Or hard work, in many cases, for that matter.

Nurses and other healthworkers give their best on a daily basis – without glory, without high financial rewards, without the support that they should expect as a right from those at the top, and usually without even recognition or thanks.

Here are some examples that are known to me personally – and which deserve a wider audience, just like the millions of other such acts of dedication that I don’t know about:

• a ward manager who was asked by the the hospital’s senior matron to release a nurse from her ward to help out another ward that was struggling. The manager knew that her own ward was already overstretched – so after a 10-hour shift she went up to the other ward and worked another 4 hours to help out. Unpaid.

• a healthcare support worker who, at the end of a 13.5 hour shift, stayed another hour rather than leave a distraught, bereaved relative before her family could arrive to grieve with her.

a nurse phoning her ward at 3.20 in the morning, in spite of only finishing a late shift the previous evening, to make sure a patient’s belongings had been brought up from Accident & Emergency.

a nurse working on a ward where the patient to nurse ratio is regularly 12:1 - double the recommended level, but battling hard to keep things from collapsing altogether.

• a nurse (my wife) who regularly cries quietly into her late-night cup of tea over the death or fear of a patient with whom she’s ‘connected’ in order to provide some human contact and comfort, even though she knew they were terminally ill.

• and it’s not just nurses and healthcare assistants. 2 doctors – SHAs or ‘senior house officers’ who regularly stay back 3 or 4 hours after the end of their shifts, to make sure that everything is done that needs to be done.

I think you should hear from a couple of those people in their own words. First, our HCSW who phoned the ward in the middle of the night:

Something so trivial yet it worried the hell out of me, I couldn’t sleep thinking that he won’t have anything in the morning and his bag may get lost. Lol. I had actually took it up with him, DOH! but when your busy, your heads trying to think of a billion things to do. I’m a HCSW..I’ve been kicked, punched, verbally abused and bitten, yet nothing is done about it, just recorded and that’s it! I sometimes wonder why on earth I do this job, but the simple fact is I love it. I love interacting with the patients, caring for them no matter how vunrable they are. Sitting with a dying patient and comforting them through their final hours and most of all saving someone’s life. These are the most rewarding things about my job.

And our nurse who faces caring for twice as many patients as she should be:

it is virtually impossible to provide the sort of care that everyone should be able to expect. I have to prioritise on a daily basis and I very rarely go home feeling that I have done a good job. I never leave work on time, my breaks are unpaid (except for a 10 minute tea break) and as I don’t get time to take more than a sandwich on the run break, I am giving the Trust my time every day for nothing.

The reason I carry on working is that I consider myself to be a good nurse, and I try to make a difference to some-one’s life every day. However, I can’t begin to tell you how angry it makes me to see the demonisation of the NHS and nurses in particular as if we are the main reason why the NHS doesn’t always perform as well as it should. There are few jobs where people would put up with the conditions that we have to work in under a constant barrage of criticism. The danger as I see it is that people will be put off going into nursing – I know many colleagues who have left to go into other jobs where they don’t go home at night worrying about the dear old chap in bed 1 who may not be there when you go in for your next shift.

(If you want more examples of the real story of the NHS, I’ve written two ‘day in the life of an NHS nurse’ posts, which were two of the most-read posts on this blog last year – you can read them here and here.)

The weasel words and self-serving distortions of Jeremy Hunt and his ilk are on our TV screens and in our news media every day. The words of the people he denigrates and undermines are not. But there’s no doubt about which should be listened to and trusted.

Hunt and his party are seeking every way possible to kill the NHS in a ‘death by a thousand cuts’. Whether it’s downgrading Lewisham because of problems at another Trust, or propagating a death-myth and then putting Mid Staffs into administration even though the Trust has stuck to a plan agreed with Monitor and the Department of Health – or making an utterly spurious comparison between athletes and the NHS as justification for whatever he’s planning next – it’s clear that the Tories’ aim is the end of the NHS as we know it.

The NHS is not ‘coasting’. It’s sinking.

Holed beneath the water-line by by a hundred Torypedoes – as the Tories then mock, deride and impede the heroic efforts of those who are trying to bale out the water, keep our national flagship afloat, and to keep things ‘good enough‘ against all the odds.

And those efforts are heroic. Olympic athletes achieve great things – but they do it for their own glory and fulfilment.

The real heroes are the hundreds of thousands who give their time and hard work – at great emotional cost and for little reward or recognition – because they care.

We fund and fete our athletes to give them the best chance of success. If Mr Hunt wants more from the NHS, he needs to put his money where his mealy mouth is and stop trying to cut the legs out from under the heroes who really matter.

SK. as you are may be aware I am also a nurse but now working in a private nursing home after 28 years in the NHS the last 10 being as ward manager.

I like to think that I led the ward team by example, there was never a job or task that needed doing that I didn't do, even down to taking out the dirty laundry...I strongly believed that if staff saw me doing they couldn't say it wasn't their job....

I also remember the time when I didn't leave work at the right time, of waking up in the middle of the night worrying that there was something I hadn't done or because I had suddenly thought of some thing that I needed to do the next day....

You wife has my deepest admiration for carrying on under the increased pressures this government has put on the NHS...I retired 2 months after they came in 'power'.....

As I said earlier I now work in the private sector in a nursing home for the elderly, I am contacted to work 30 hours a week and my shifts are all 12 hours long with 60 minutes of unpaid 'breaks' so I work from 7am to 8pm...we have just one trained nurse on duty for a 20 bedded ward.....

Last night I got home at 10pm I live 10 minutes walk from where I work but I had called out a doctor, the second visit of the day (Different surgeries though), to see one of my elderly patients how had developed a severe chest infection and I knew she would be the 10th on the ward to be put on antibiotics and that it was vital that the be started immediately so I stayed, rather than leave it to the night staff.. The doctor came at 9.10pm and wrote the prescription which I then went to the local 24 hour chemist and collected it....

This was the 6th, 12 hour shift I had worked since last Friday....

Earlier in the day I had the dismemberment of being bawled out, by the new 'operations manager and new home manager, both of whom only started in the home on Monday, in the corridor of the home for the failure of the delivery of some medication from the local chemist, which should have been ordered on Wednesday (my only day off)...This was right out side the room of the patient whose medication (food supplement) had not been delivered, at the time the relative was in the room with the door open.....I must admit I took two steps to walk away, not only from the managers but also the job, but no I stepped back and had to listen to criticisms of my performance....

Am I a bad nurse? Am just coasting? Do I really care about my patients?

Do any NHS staff have to put up with the remarks of someone who has never worked in the NHS or even healthcare?

Jeremy Hunt career profile..
After university Hunt worked for a short period of time as a management consultant, and then decided to pursue life as an English language teacher in Japan. Whilst living in Japan he became a proficient speaker of the Japanese language and enthusiast of modern Japanese and other east Asian cultures.
On his return to Britain he tried his hand at a number of different entrepreneurial business ventures, including a failed attempt to export marmalade to Japan. Hunt joined Profile PR, a public relations agency specialising in IT which he co-founded with Mike Elms, a childhood friend. With clients such as BT, Bull Integris, and Zetafax Profile did well during the IT boom of the mid-1990s. Hunt and Elms later sold their interest in Profile to concentrate on directory publishing. Together they founded a company now known as Hotcourses, a major client of whose is the British Council. Hotcourses has subsequently provided financial support to Hunt's parliamentary office.

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When the kids were small, she worked in a private care home for a few years - fortunately one run by decent people. The bad examples in the private care sector are a clear demonstration of why it's far better to have health and care in the public sector.

I'm sorry you've had to put up with crap from know-nothings - unfortunately, throwing crap is a standard know-nothing tactic to cover for the fact that, yes, they know nothing. Hunt is a perfect example.

And one nurse for 20 beds is insane - another reason to keep things public and properly regulated.

Interesting, irrespective of the source!

Blame Labour for Mid-Staffs scandal... says ex-Labour Health Secretary Frank Dobson who warned Tony Blair against introducing targets and competition in hospitals

Warned against 'mad rush' for more competition and targets in hospitals Says Blair ignored him and gave his job to crony to force through change
Successors Milburn and Hewitt were 'obsessed' with breaking up NHS

By Simon Walters

PUBLISHED: 23:18, 9 March 2013 | UPDATED: 23:20, 9 March 2013

Comments (22)
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Warning: Frank Dobson told Tony Blair of the risks of his NHS reforms

A former Labour Cabinet Minister broke ranks last night and disowned Tony Blair’s government for the ‘reckless’ NHS shake-up blamed for the Mid-Staffordshire hospitals scandal.

Frank Dobson, Health Secretary from 1997-99, said he warned Mr Blair that a ‘mad rush’ to bring in more competition and targets in hospitals could harm patients. But Mr Blair ignored him and gave his Cabinet job to a crony who agreed to force through the changes.

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tlttf. There's no problem with posting an extract from a newspaper article, I do it myself frequently. However, you could at least respect your readers enough to tidy it up by cutting out extraneous material and repetition. Furthermore, displaying adverts for a newspaper’s links to Facebook and Twitter, however unintentional, contravenes Forumotion’s rules. So please take the trouble to edit your posts in future.

Read almost any article in ‘The Daily Mail’ and you find it littered with emotive adjectives such as ‘crony’, ‘obsessed’ and ‘reckless’, all designed to guide your thinking to the paper’s point of view. Blatant propaganda.

Dobson was peeved that Blair twisted his arm and made him stand for Mayor of London in 2000, when he finished third. You would expect Dobson to be negative about his successors as Health Secretary, just as Thatcher never stopped sniping from the sidelines when John Major was Prime Minister.

Step aside from right-wing tabloid propaganda and look at the facts. The NHS was not privatised under Labour, but it is being privatised by stealth now. Labour used the private sector to supplement the NHS and speed up treatment, not to replace it. The “reckless NHS shake-up” is happening now - the biggest reorganisation of the NHS since its inception in 1948 – and after the lying scumbag Cameron had promised to do nothing of the sort. That’s the story, not all this squalid tittle-tattle about Dobson, which is just old-hat and another diversion from the real issue. No, it's not very interesting.

Back in the early 1990's there were targets but they were more to do with statistics than anything else......

The Trust I worked for would record the fact that a patient had been moved from one of it's wards to another of it's wards as a discharge from one and an admission to another so that the patient was counted as two patients having been treated. this of course suited the Government of the day when it was able to claim that record numbers of patients were being treated.....

They also at that time did a kind of 'time and motion' study to identify how many staff were needed to maintain safe care but after a short time when it started to show that there were not enough staff it moved the scoring system to get the answer it wanted.

From what this Government is saying targets only began in 1997 they never existed before hand.........

".... all the other industries now being enjoyed by their respective shareholders ...."

Said shareholders being now principally German, French, Spanish or American and so perfectly happy for prices (therefore dividends) to be permanently set at the maximum the market will stand.

What a good idea Nationalisation was!

I was always under the impression that when 'Investment' for improvements was needed there was a new stock issue made ...

Now it's just hike the price to the consumer and tell them there will be improvements in 10 years time....if your lucky.......

If any politician has to tell you that something is safe in their hands - it isn't....

With the immanent transfer of funding control to GP's which as the government has often said means the patient own GP will have more say in where the funds are spent. How many of us are aware of where our GP's the priorities?

Have these GP groups openly said what they see as the main issues facing their patient groups?

Is just another case of one group, this time GP's spending money on what they see as the main issues and to hell with what the patient thinks?

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That's gonna cost! Unwinding the Management Companies which GP panels are setting up could involve eye-watering compensation claims.