An apology

I wish to extend an apology to the international readers of my blog. Over the last few weeks, domestic politics has impinged mightily on the blog, resulting in most posts being about politics rather than medicine. I hope to return to more usual stuff soon, but not much at the moment.

In summary, the NHS (National Health Service) was set up in 1948 to be a state funded comprehensive health service, paid for out of general taxation, and available to all citizens of the country, regardless of income and circumstance. It has survived many changes, but has stayed largely intact. This may change in the next few months, if the current Right-wing coalition Government gets its way.

The argument for this Bill is based on a number of lies.

Lie 1. There will be "no top-down change in the NHS". This was Mr Cameron making fake promises before the elction. This change is so big and so top-dowm that, according to the CEO of the service, "It can be seen from the moon".

Lie 2. Change is essential. No organisation like the NHS avoids change. But not enforced, ideologically driven change. Chang should be gradual and consensual.

Lie 3. There is widespread support for these changes from those working in the NHS. This is so laughable to be contemptuous.

Lie 4. There is too much money spent on bureaucracy. The NHS is the most efficient service in Western Society, spending 5% on administration.

Lie 5. Our outcomes are inferior to other health systems. There are some outcomes that are better, and some that are worse. Everyone can pick areas of variation.

Lie 6. The private sector delivers more efficient care. The private sector delivers queue-jumping, shag pile and pot plants. It selects low-risk patients, and abandons the others.

There are other ongoing lies peddled by those with a vested interest in seeing the NHS broken up. I can be more neutral as I will earn a professional income whether I work in the Private sector or the Public sector.

The NHS is at risk, and we must act to protect it from the privatisers and the asset-strippers. If you want to see what this process results in, look at the railways.

Signs of panic

Pile of Rubbish

Well, well, well.


Things are beginning to happen. There seems to be developing panic in the Department of Health. Mr Lansley's wretched Bill is likely to face some further amendment to placate Liberal Democrat peers in the House of Lords.


I see this report in the Observer, and it an indication of huge concern. But not for the Nurses, Midwives and many doctors. We are all pleased to see that the Bill is in trouble.

The Bill is one of the biggest crocks of shite in living memory. Amendment is not enough, it needs to be scrapped.

Who the Hell are they?

They represent themselves......

I wake up to find that the BBC are splashing with the news that a group of GPs have written to the Daily Telegraph. They are from an organisation called the NHS Alliance, which is a self-selected group of people who are keen on commissioning. I cannot see the names of those who have put their names to the letter, but could have a good stab at who they are.

The headline includes suggesting the NHS is in "peril" if we do not proceed with the new Bill.

This is, of course, the exact reverse of the truth, and the NHS alliance represent nobody but themselves. I am sure they have been prodded into doing this by the Department of Health. Their lead GP is Dr Michael Dixon OBE. He has been at the barking-mad end of General Practice for along time, supports and promotes the nonsense of 'Integrated Health', has an OBE and wears a bow tie. He does not represent anything except himself and his rather ridiculous organisation. The RCGP (Royal College of General Practitioners) represents rather more, and in a recent poll 90% of GPs were against the Bill.

The BBC have been duped into giving this fringe organisation more credibility than they deserve. The peril will be listening to them.

A busy bee

How I see Mr Lansley

Andrew Lansley has been busy this week. Not only has he been insulting the Nurses and the Doctors, but he has also been bullying the Royal Colleges to change opposition to the Bill (shamefully, this worked).

Now he is setting up a company to help flog off the NHS land.

Do any of the doubters have any doubts now?

The Tories are Privatising the NHS, and the project is close to completion.

It was our NHS.

Not for long.

Offensive?

Mr Andrew Lansley, the Secretary of State for Health, is not having a good time. His supporters are now largely in the rank of the Conservative party, and he has signally failed to make the case for his new Health and Social Care Bill, which the media still say will put 'GPs in charge of using NHS money, to organise services.

I'm a GP and I should be pleased to be in charge of trying to get the best service for my patients, and I am convinced that it will do no such thing.

Three reasons:

1. Impossible to meet increasing demand with decreasing budget
2. 5 New extra layers of bureaucracy
3. 60% of the Budget is decided before GPs even get to sit down at the table.

Mr Lansley has resorted to playground bully tactics of calling people names. He has been pretty offensive about the nurses, and how he is piling more of his bile onto the BMA. He doesn't like the BMA because it disagrees with him and his shrinking cabal of zealots, chancers and doctors on the make.

If it is a good Bill, persuade me as to its virtues, Mr Lansley - don't call me names.

Mr Cameron found one GP supporter and.......ooooops!

David Cameron (our current Prime Minister) was playing politics yesterday. He had primed his answer to the leader of the opposition, by having a GP supporter who happened to be based in the constituency of the Leader of the opposition.

Take that, Ed!

Except that his sole supporter in Doncaster is, ermmmmm, not there any more. In fact he has left the Clinical Commissioning Group altogether and left the area.

Never mind, Mr Cameron, your make-believe supporter might have supported you in the past.

Now go and find another ordinary GP who agrees with you [those with MBE, OBE and CBE need not be mentioned]. You might need to go further afield than Doncaster.

Arm Twisting

Shiny shiny things   

The Medical Royal Colleges are in a situation where they can significantly affect the future of the passage of the Health and Social Care Bill. They will be releasing a consensus statement today in their guise as the Academy of Medical Royal Colleges.

Already we have the Surgeons getting cold feet, and also I receive reports of the Physicians and the Obstetricians/Gynaecologists considering their positions.

I understand that the colleges are reconsidering, following "heavy lobbying" from Andrew Lansley, the Secretary of State for Health. Lobbying consists of carrots and sticks - offers and threats - enticement and bullying.

A row of beans

The offer is concessions on aspects of the Bill. We know that this will largely be cosmetic, and the shiny shiny concessions will be taken up by the more pliant or venal in the Royal Colleges.  "Oooh look! Shiny shiny concessions!" We all know that they will only amount to a row of beans.

What threats does a Secretary of State have for these organisations? Reduction in funding? Questioning their charity status? Threats of lack of preferment?

If the Surgeons, Physicians and Obs/Gynae people refuse to stand up to the evisceration of the NHS by the Government, can we at least know the reasons?

The proper reasons.

The Conservatives, the Liberals. the Private Health Industry, the "Future Forum" and ...... the Royal College of Surgeons

Statue of John Hunter FRS

These are the people who love the new Health and Social Care Bill.

The rest of the people who work in the Health Service (all the other Royal Colleges, the Nurses, the Midwives, the Unions and around 95-98% of doctors) are solidly against it.

Why are the Surgeons in support of the Bill. Is it because they all want knighthoods? Is it because they see a big commercial opportunity for themselves? Is it on a point of high principle?

I think we can all do the maths.



Are there surgeons out there who disagree with their college's principled stand?

It's not just me.

Received an e-mail today from a doctor not too far away in a Deanery not too far away.

It reads like this

There is still a real chance that the withdrawal of the Health and Social Care Bill can be achieved, through the concerted opposition of the medical profession. In this, the position adopted by the Royal Colleges within the next few days will be crucial. This misguided and damaging Bill, for which there is no electoral mandate, is now opposed by the BMA, the NHS Consultants' Association, the Royal College of Nursing, the Royal College of Midwives, Unison and Unite. The Royal College of GPs has surveyed its members and found them to be overwhelmingly opposed. If they are joined by the other Colleges, surely it will become almost impossible for the government to continue to ignore the opposition of healthcare professionals.

What is at stake is nothing less than the survival of the NHS as a comprehensive and universal public service.

If you share my concerns about the Health Bill, I would urge you to write urgently to the President of your own College. A website has been set up to help you do this, and can be accessed via the following link: http://callonyourcollege.blogspot.com/

Apologies to those of you who have already been forwarded this link from other sources, and to GPs who may feel that their College has already sought and represented their views.

Thank you,

Jonathan Folb

Consultant Microbiologist, Liverpool

I do agree with him.

Good Diagnosis

African Sun

Some of my patients travel abroad, and one chap has recently been away to West Africa. Being a sensible fellow, he took preventative treatment for Malaria.

Nothing terribly exciting or novel about that.

Except that when he started his tablets, his skin rash on his face got better. He had not been to see anyone about the rash.

He came to see me to discuss it, and whether it was a coincidence, or whether it was the African Sun that had improved his skin.

Pills

Tablets or African Sun?

The answer was that it was the tablets. He had been taking Doxycycline for Malaria prophylaxis, and the skin problem was a condition called Rosacea.

Doxycycline is used for both.

A good, DIY diagnosis!

Please E-Mail - send Bill to the dustbin of history.

Where the Bill deserves to go.

I have seen this in the Ferret Fancier blog, and have done what he suggests: I have e-mailed the academy of Medical Colleges and my own Royal College to express my strong opposition to the recent Health Bill.

I have written my own e-mail with my real name and qualifications to do this. May I suggest you do the same?

Here is Ferret's suggestion:

Lansley's disastrous Bill appears to drifting towards the rocks, the BMA, RCN, RCM, Unison and Unite already oppose the Bill.  The Colleges are not covering themselves in glory with their failure to oppose the Bill.

Now is the time for them to stand up, be counted and represent their members and the people of this country by openly stating their opposition to this destructive and incoherent Bill of idiocy.

It will not take long to email the Acadamy of the Medical Royal Colleges and your specific Royal College President to pressure them into opposing the Bill, so get emailing and do it now:

Everyone:(AOMRC) academy@aomrc.org.uk

Medics:     enquiries@rcplondon.ac.uk

Surgeons:   president@rcseng.ac.uk

GPs:        president@rcgp.org.uk

Anaesthetists: president@rcoa.ac.uk

Psychiatrists: cchurchill@rcpsych.ac.uk

Here is a brief letter template:

"Dear President

I am writing this email to complain about your abject failure to oppose Andrew Lansley's Health and Social Care Bill.

If you fail to publicly oppose this Bill then I feel you are failing your members, your patients and yourself.

Yours."

Storm Clouds

The storm clouds are now gathering. My God, it has taken them long enough.

A committee of MPs, led by a Conservative, have started to savage the Health and Social Care Bill. This wretched piece of half-arsed legislation, cooked up in secret by a zealot, his office partly funded by a private health, and dumped on unsuspecting public is now needing life support.

The Royal Colleges are due to meet soon to decide their attitude to the Bill (really slow and really late).

The storm clouds are gathering.

Information for politicians

I came across this the other day, and I think it has since been updated.

It is a graphic illustration of the support for the Government's Health and Social Care Bill (HSCB).

It really is quite simple.

2,000 up!

Well, I'm rather amazed.

I've finally hit a personal milestone. 2000th Blogpost!

It didn't seem possible when I started the blog that I would still be posting.

But here we are!

This Blog started in March 2008, so that is more than one post a day, on average.

I am a bit of windbag, clearly!

Rather a nasty man.......

Offending the nurses....?

Further to previous posts, we have the rather embattled Secretary of State for Health, Mr Andrew Lansley MP, indicating that the reason for the change in the stance of the Royal College of Nursing to the NHS Bill is because they:

"want to have a go at the Government because of issues like pay and pensions."

This is really a rather offensive comment. The RCN is notoriously supine when it comes to any form of action, industrial or not, and to suggest this is their motivation is really rather an unpleasant assertion.

Mr Lansley needs to question the whole nature of his bill, which is very little to do with giving front line workers a say in how the money is spent, but everything about privatisation by the back door.

Offending the nurses is a really bad move.

If Lansley and his Bill survives I would really be surprised.

Proud Parents

The story goes like this:


Two parents at the final parade of their son who is finishing as an army officer at Sandhurst.


Mum: "Oooh look, Bill, they're marching by"


Dad: "Yes, they're all out of step except our Johnnie"

It is becoming clearer, by the day, that the opposition to the latest Health Bill is growing. The official backers of the Government's position are disappearing.

98% of General Practitioners in a recent Poll are against the Bill.

The Royal College of GPs is.

The Royal College of Nursing is.

The Royal College of Midwives is.

The British Medical Association is.

The Consultants' Committee is.

The Health Unions are.

That is a degree of unanimity that is hard to get over any subject. I find it difficult to understand why this opposition to a fundamental piece of legislation isn't all over the media. We are seeing the slow dismantling of an essential part of the fabric of our way of life.

It is as if Messrs Cameron and Lansley are at the parade ground, and saying that everyone is out of step except them.

Don't

Hello, is it me you're looking for? 

There may be new examples of the genre, but I will illustrate my point from songs from my youth.

Never have a song in the charts that asks a question.

Do ya think I'm sexy?

Hello, is it me you're looking for? Asks Lionel Richie?

NO.

Do ya think I'm sexy? Asks Rod Stewart?

NO WAY.

Are there other more recent examples?