NHS

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The ‘unaffordable’ NHS…

Published by Anonymous (not verified) on Fri, 07/06/2024 - 7:11am in

This is from tax lawyer Dan Neidle: I’m not talking much about the general election tax debate. Because it’s irrelevant. The few £bn being discussed is dwarfed by the actual UK tax increases over the last few years, and the further tax increases we’ll almost certainly see in the future. Perhaps tax increases will be... Read more

Breaking: Anaesthetists United take GMC to court for pushing non-doctors in doctor roles

Published by Anonymous (not verified) on Tue, 04/06/2024 - 7:19pm in

General Medical Council changed rules to allow ‘associates’ to be exempt from national standards and trusts to set own local standards

A group of anaesthetists under the name of Anaesthetists United (AU) has announced today that it has engaged leading legal firm Bindmans to take the General Medical Council (GMC) to court for allowing unqualified ‘doctors’ – so called ‘physician associates’ (PAs) and ‘anaesthetist associates’ (AAs) whose role is used to extend NHS privatisation and help private medical providers – and the Royal College of Physicians – to make bigger profits, to be confused with doctors.

The roles have also been used to avoid national standards, allowing local health boards effectively to use the roles how they wish. At least two patients, who thought they were being treated by fully-qualified doctors, have died as a result of misdiagnoses by PAs that led to no treatment being given for dangerous conditions.

The government used a backdoor ‘statutory instrument’ to push through recent changes to widen and relax the use of PAs and AAs – opposed only by independent MP Claudia Webbe. Labour then colluded with the Tories to defeat an attempt by Green and independent peers to block the legislation in the House of Lords. Actual medical professionals are horrified at the threat to patients and AU is now taking action.

The group says that the GMC is abusing the term ‘medical professionals’ to include undertrained PAs and AAs as doctors. The legal action crowdfunder explains:

The General Medical Council was given powers under the Medical Act 1983 to regulate doctors and protect the public from those falsely claiming to be qualified when they are not. But instead, we have watched with dismay as doctors are quietly being replaced by ‘Associates’. Worse still, the GMC appears to be actively encouraging this. 

We’ve listened to empty reassurances from the establishment, as the lines between the two professions have been systematically blurred.

We think patients deserve better; they should be cared for by doctors when necessary, should know who is and is not a doctor, and there should be separate regulation underpinning this.

And we’re ready to take action.

What are Physician/Anaesthesia Associates?

Physician Associates and Anaesthesia Associates are a new profession. They are not doctors, they do not have the same training as doctors, but are being permitted to take on many of the roles doctors have traditionally fulfilled. The press have reported on troubling cases. And the General Medical Council, the body legally responsible for doctors’ regulation, has now been given the responsibility of regulating Physician/Anaesthesia Associates too.

(To make it more confusing, an “Associate Specialist” is an experienced doctor.)

So how have they blurred the distinction between Doctors and Associates

Parliament originally made it clear that Associates were to be kept entirely separate from doctors. There should never have been any ambiguity as to who or what a health worker is. But instead, the GMC has made the situation vague and indistinct.

The biggest worry is that the GMC have steadfastly refused to say what an Associate can, or cannot, do to support patients. The precise term for this is their ‘scope of practice’. The GMC have even refused to hold a consultation on it, despite a statutory requirement for them to do so.

So it is left entirely down to market forces to determine scope. This favours using Physician/Anaesthesia Associates as doctor replacements. There is no good reason for this ambiguity: in comparison, the General Dental Council has strict rules on the difference between dentists, hygienists, technicians and the other professions that they regulate.

Worse still, the GMC has confusingly started to use the term ‘Medical Professionals’ to encompass both doctors and Associates. It has even issued guidance on ‘Good Medical Practice’ for both doctors and Associates to share.

We believe the GMC is simply ignoring the law on professional regulation.

You can read our legal case in more detail here.

What are we trying to achieve?

  • Clear and enforceable guidance from the GMC on the ‘privileges of members’ admitted to Associate practice, defining what they can and cannot do (their Scope of Practice) and clear rules on levels of supervision. This can be delegated to the appropriately-empowered Medical College/Faculty.
  • The current ‘Good Medical Practice’ guidance replaced by two separate sets of guidance for the two separate professions, and
  • An end to the use of the ambiguous term ‘Medical Professionals’ used to describe two separate groups misleadingly.

What have we done so far?

On 26th March we wrote to the GMC setting out our case. In their reply they answered some of our points but completely failed to address others. We feel that the only route left open to us is a legal one, and we have had expressions of interest from some top lawyers in the field.

How much money do we need?

We have been quoted the sum of £15,000 to cover the initial costs of a brief and opinion. 

We are working with John Halford of Bindmans LLP, a public law solicitor with experience in the regulatory framework on protected titles, and Tom de la Mare KC of Blackstones. Both of these are highly regarded and respected in their expertise; we need to work with the best.

It is quite possible that a strongly-worded representations from top lawyers will be sufficiently forceful to push the GMC into accepting our proposals. But if not, then the next step is court action. We don’t yet know how much that will cost, although we do know that the GMC has a reputation for spending large sums of public money on defending themselves.

Who are we?

Anaesthetists United are a group of Anaesthetists of all grades. 

Anaesthetists have a reputation for getting things done. We are the group that convened the Extraordinary General Meeting of the Royal College of Anaesthetists, which led to a sea change in the way the medical profession, and the public, have looked at the whole issue of Associates. You can read more about us as a group, and details of our core members, here.

The GMC was set up so that the public could tell who was and was not a doctor. That aim is now being undermined. We urge doctors and patients to come together and fund a legal challenge to restore faith and ensure that patient safety is never compromised. 

Thank you.

If you wish to republish this post for non-commercial use, you are welcome to do so – see here for more.

Wes Streeting seems to hate the NHS

Published by Anonymous (not verified) on Mon, 03/06/2024 - 4:41pm in

This is my YouTube short this morning:

The transcript is:

Wes Streeting seems to hate the NHS.

He's written an article for the Sunday Times saying we shouldn't worship it.

The people who work for it, all appear to be, well, mass murderers according to him.

Its managers are thugs and bullies, apparently.

And he wants us to prepare for a future where it's totally different.

What could that future be?

I am quite sure that what Wes Streeting is saying is that we should all anticipate a privatised NHS. After all, why else is he accepting donations from so many private health companies to support his campaign?

I think West Streeting is wrong. I believe in the NHS. I believe that 99.9 percent of the people who work for it are good, honest and dedicated people.

I believe that most of its managers are competent.

So, I think he's barking up the wrong tree and I believe we should all have and all believe in a state owned NHS.

If you do, please ask your candidates about this issue because it's vital to our well-being in the future.

The NHS is being dumbed down

Published by Anonymous (not verified) on Fri, 31/05/2024 - 4:36pm in

This is my YouTube short this morning:

You can watch it here.

The transcript is:

The NHS is being dumbed down.

What I mean is that people who are fully qualified in some areas, like paramedics, are seeing people in surgeries. GP surgeries where they're not fully qualified and physician associates who can do some tasks in hospitals are doing quite inappropriate things, like surgery.

This is a potential disaster in the making because if you are seen by or treated by a person who is not fully aware of all the issues that might arise as a consequence of the complaint you present with, they could miss your symptoms, they could misdiagnose you, they could as a consequence leave you with major health issues in the future.

This is a problem that should not exist.

It's the consequence of austerity.

And it's not fair to the people in the NHS who are doing this, and it's not fair to you.

Ask your politicians about it.

Venn diagrame for our times: Wes Streeting and the NHS

Published by Anonymous (not verified) on Tue, 28/05/2024 - 3:33pm in

My best hope is that Wes Streeting is incompetent, because every other option is worse given his hatred of the NHS

Published by Anonymous (not verified) on Mon, 27/05/2024 - 4:49pm in

I guess I had to talk about Wes Streeting at some time during the course of this damp squib of an election campaign, because it seems that he wants everyone to talk about him.

Streeting had article in the Sunday Times yesterday the purpose of which was very hard to discern, unless it was to:

  • Abuse the public for believing in the merits of the NHS.
  • Abuse the staff of the NHS.
  • To undermine the management of the NHS.
  • To suggest that those who have committed abuse and cover up in the NHS are typical of the organisation as a whole.
  • Lay the groundwork for the private management to the NHS, because he clearly does not believe that its existing structure is appropriate.

The first four of those suggestions are very clear from the article, a copy of which can be found here (you will have to download it to read it, I expect).

The last of my suggestions is not stated. I read it between the lines of the bullying and abuse that Streeting has to offer to everyone. In doing so,  I may be charitable in believing that he has got a big idea, even if he has not stated it. It may, of course, be that he has absolutely no idea what he is going to do at all, apart from bullying and abusing people, which is exactly what he is accusing others of doing.

I can, however, be clear about three things . The first is that he did not mention the continual under funding of the NHS by the Tories compared to the requirement for cash to meet the medical rate of inflation. He does, therefore, exonerate theories from all the apparent guilt for the state of the NHS, which is, apparently, entirely the fault of its staff.

Second, I think we can be sure he is not offering adequate new funding as a result.

Third, he does in the absence of an explicit big idea offer an extremely small idea instead, which is that he will bully and harass NHS staff into working longer hours at the weekend when they are already deeply fatigued by the demands made upon them to the extent that they are leading the service in droves, with the intention of providing an additional 2 million outpatient appointments in the NHS year, which is what his promised 40,000 extra appointments a week represent.

To put this number in context, in 2022/23, which is the last full year for which we have data present, there 124 million outpatient appointments in the NHS,  although only 95.9 outpatients actually attended, with about 8 million of the difference being explained by those who did not arrive for their appointments. I have not had time to work out the remaining reconciling item, and nor does it greatly matter because what is obvious is that the offer that Streeting is making is fairly insignificant when there are, supposedly, 7 million people on waiting lists . The additional number he proposes is also within the normal rate of routine variation in appointments offered is, such as the poverty of his ambition, which does, nonetheless, become one of the so-called headline Labour pledges.

Why make this point when superficially it would seem that all it does is confirm that Streeting is, as NHS commentator Roy Lilley calls him, a silly man without any plausible plan but with a massive contempt for the organisation that he wishes to control? I can only conclude that privatisation of the NHS is his sole real agenda because, based upon what he says in the article he wrote, including his stated desire that we end our belief in the NHS as having virtue in its own right, nothing else but a plan for that makes any sense at all.

Unless that is, Streeting is considerably more incompetent than even I have imagined, which I think is possible. In fact, that is my best hope, because every other alternative is worse.

Putting the N back into the NHS

Published by Anonymous (not verified) on Sun, 26/05/2024 - 4:55pm in

I posted this video on YouTube this morning.

In it I argue that the NHS is a mess, created by meddling politicians who have broken it into hundreds of organisations that they pretend trade with each other. The result is not efficiency or productivity. The result is an admin mess and a failure to meet needs.

The only reform the NHS needs is to get rid of this mess by consolidating the NHS into regional and national care services that treat us as whole human beings. Then we, and it, might get better.

The transcript is:

 I want to put the N back in the NHS. By which I mean, I want it to be a national health service again.

The trouble with the NHS right now is that it is fragmented into vast numbers of supposedly independent organisations.

Every hospital is run by a trust.

Every ambulance service is run by another trust.

Mental health services are run by different organisations from physical health services.

GPs are of course, independent of hospitals, and many of them are are privately owned in effect either by the people who run them or by consortiums who are now buying up GP practices.

We have a whole range of organisations working together who, however, do not deliver an N - a National Health Service - and I believe that's wrong.

We are integrated human beings. We're holistic. We have to be treated as a whole. Our needs are not to do with our thumb, or our ear, or whatever else it might be. They're actually about the whole person. Because when we're ill, in whatever way it might be, it isn't just the symptom that is affected - the particular limb or whatever else it might be. It is our whole well-being that is affected, and the NHS needs to reflect that in its organisation. So I believe that we actually need a national health services.

Now that would be a national health service for Scotland - they've already got one, but it needs to be properly funded.

And for Wales, but it needs to be properly funded.

And in England it might mean regional health services. So I'm not pretending that health services in Kent should be run by the same organisation as health services in Lancashire, because I suspect that makes no sense.

But there could be a South-East England health service, a South-West England, an East Anglian one, and a Midlands one. You get my sense. We'll go up the country until we get to a North of England health service. What follows is that those regional authorities, coupled with those for Wales and Scotland and Northern Ireland, would be responsible for delivering integrated care.

We wouldn't have the stupid situation that you might phone 111, which is one agency, who then refer you to an ambulance, which is another agency, who take you to hospital, which is a third organisation, who then discharge you to your GP, which is the fourth organisation, all of whom are billing and charging and arranging with each other in inconsistent ways.

We would have one integrated service.

I believe that is the only reform that the National Health Service requires.

The people in the NHS know this.

They know what they want to supply.

They know they want to get rid of the red tape.

They know they want to get rid of the admin.

They could do that if only we gave them the power to concentrate on health and remove all the layers of organisation which are the impediments to progress now and deliver instead integrated care for everyone.

Nationally, which would put the N back in the NHS.

Claudia Webbe MP confirms standing for re-election: ‘people need independent voice for real change’

Published by Anonymous (not verified) on Fri, 24/05/2024 - 8:31pm in

Webbe has shown she will stand for actual change that neither Tories nor Starmer’s Labour are offering

Leicester East MP Claudia Webbe has today confirmed that she will stand for re-election as an independent left candidate.

Elected in 2019, she became the first female to take the seat and the firs Leicester-born MP – and the first Black female MP – ever to represent a constituency anywhere in the whole county region of Leicestershire. Webbe was born and raised in the city and remained there to the end of her university education. Her father worked, with his identical twin brother, as an engineer’s hand at the former Wadkin Factory on Green Lane Road, while her mother – in a city famous for its garment production – was a dress maker who ‘made clothes to last’, who worked for companies like the old Fenwick and Corah & Sons.

Claudia Webbe, left.

Webbe has distinguished herself in Parliament by her fearless campaigning on local and international issues, from dangerous sweat-shop garment factories in Leicester and abroad, domestic abuse and politically-driven cuts to services, to the genocide in Gaza and the oppression of Indian farmers. She was also the only MP to speak out against the government’s dangerous plan, unopposed by Labour, to replace medical doctors with ‘physician associates’ – part of the so-called privatisation drive pushed by both main parties that she has also been vocal in opposing – helping to draw attention to the cost-cutting plan and make it the national issue it has become. She has refused to back down on these and other issues despite a torrent of racist abuse from supporters of other parties and of the oppressors.

Ms Webbe said:

It has been an honour and privilege to serve the people of Leicester East as their MP, representing all communities with passion and integrity, and I will ask them to re-elect me so that I can continue to serve their interests.

My independence means I’ll listen to local people and put them first. I’ll place people and planet over profit and vote for humanity and never against. I will work for justice for Leicester East.

I have shown that I will not stand-by silent while division and damage is done to Leicester East and the needs of the people ignored or injustice is perpetrated elsewhere in our name. After so many years of cuts and cruelty in this country, and wars overseas, the needs of ordinary people in Leicester East have never been greater to have me as their MP, who will genuinely stand up for them and what they care about, and not serve narrow party agendas or corporate donors.

My track record as MP for Leicester East shows that I understand their concerns and that I will work for the issues they care about, from low pay and exploitation in the garment industry and the closure of local services, to protecting access to NHS doctors, to speaking out for justice in Palestine, calling for a lasting, permanent ceasefire in Gaza.

With the support of the people of Leicester East I will continue to campaign tirelessly for real change, real justice and a reversal of the inequality that has enriched a few while the many struggle”.

For more information, visit claudiawebbe.org. Skwawkbox understands that a campaign website will shortly be online and that Ms Webbe will welcome offers of campaign support. Her fundraising page is here.

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Clarke: 100 MP strategy to hold Starmer’s feet to fire

Published by Anonymous (not verified) on Fri, 24/05/2024 - 7:03am in

Left strategist targets key MP wins to resist Starmer when he takes us into war or when he privatises our NHS’

Left-wing strategist Eoin Clarke, who has been at the heart of left resistance and the victories of the Corbyn period before sabotage and smears brought down the then-Labour leader, is targeting a hundred wins in the coming general election for grassroots candidates with the integrity and vision absent from what passes for the Labour party under Keir Starmer.

Clarke has laid out the target, which he has been working on for two years in a project named ‘Wag the dog’, along with a breakdown by nation of what could be achieved ‘to hold Starmer’s feet to the fire’ and resist the Establishment automaton when he tries to take the UK to war or to privatise our National Health Service:

Working with Clarke, the Ordinary Left grassroots activist group will shortly be announcing the socialist candidates, whether independent or associated with an existing party, that it will be recommending to the movement for campaign support. With the widespread disgust with Starmer over Gaza and his breaking of every promise he made to con his way into the Labour leadership, and the recent local election results showing independents and Greens surging compared to Labour and the Tories, and suggesting a potential hung Parliament, achieving the target does not look beyond the realms of possibility.

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Rarely has a man so unsuited to be Secretary of State for Health so desperately wanted that job, with the unfortunate likelihood that he’ll get it

Published by Anonymous (not verified) on Mon, 20/05/2024 - 12:55am in

Tags 

Ethics, Labour, NHS

I just posted this on Twitter:

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