Saturday, May 31, 2008

Peak Oil - Radical Change Req'd

Letter in this weeks Health Service Journal:


The article in last week's HSJ (15 May) on rising fuel prices and its impact on hospitals was timely and welcome. However, it only scratched the surface of the issue.

Peak oil, the main cause of the continuing rise in fuel and energy prices, has arrived. Its impact on healthcare over the coming years will be more disastrous and cause more instability than we can possibly imagine.

Peak oil is the phenomenon caused when the extraction rate, i.e. supply, of crude oil reaches its maximum and begins to slow, unlike the demand for oil which continues to rise. Rather than just scratching the surface of finding slightly cheaper suppliers, the end of cheap oil means that we need a fundamental rethink on how healthcare services are provided.

Oil sits not only at the basis of energy supply but also at the basis of food, medicine and transportation. There is a need to completely reshape how we provide healthcare, reversing centralisation, privatisation and marketisation and focusing properly on public health and public provision.

Stuart Jeffery
Health spokesperson for the Green Party

Friday, May 30, 2008

Chan Wheeler Extradited?

Probably not.. but news that Chan Wheeler has resigned have apparently thrown into question the future of his 'Commercial Directorate' - hurrah!

The government were paying him around £200k a year plus accommodation just to help privatise the NHS despite the fraud enquiry about his dealings in the US.

Well he has left for 'personal reasons'. It would be very remiss of anyone to speculate what those personal reasons might be, but would extradition for fraud count as a personal reason?

Whatever his reasons for leaving may be, the country needs to sell off the NHS to the highest bidder as much as it needs to start illegal wars in the middle east that kill 650,000 people; or build nuclear power stations to ensure future generations really suffer; or to build more airports, roads and to drill for more oil so that the climate is truly buggered.

Sunday, May 18, 2008

Migrants and health care

This is from an email from my friend:

This article, from Wednesday's Guardian, is highly relevant and the policy (RA405) adopted at Spring Conference this year states our support for the rights of migrants to healthcare regardless of status:

RA405 The Green Party will oppose any person being left destitute after a failed asylum claim or if deemed to have not applied "appropriately". Any person in the United Kingdom should be entitled to the basic necessities of life, including but not limited to food, shelter and medical care, by legal means, whether this be achieved through employment rights or public funds.

Moyra Rushby, quoted in the article, spoke at a well attended fringe meeting held by GPTU on migrant workers at that conference.

What is happening (as given in the example near the end) is truly inhumane treatment by the NHS of vulnerable people who suffer because of a system that is chronically underfunded. It is a small step from this to the idea that 'if you haven't put into the box, you aren't allowed anything out'. If undocumented migrants can't get healthcare while they remain in the UK, why should someone who has never paid taxes? Once healthcare is not seen as an inalienable human right, we are on a very slippery slope indeed.

Health, Trade and Human Rights - Theodore H MacDonald

Just finished reading this excellent book by Theo Macdonald. Somehow he had passed me by until recently, but researching Cuban health care I kept coming across his name so I thought I ought to read what he has to say.

The book deals primarily with the structural adjustment programmes enforced by IMF / World Bank. These have had devastating consequences as market based solutions have been foisted on the developing world (effectively stopping them develop). He shows the economic, environmental and social devastation caused by these programmes.

MacDonald talks of three broad areas of solutions covering political alternatives, community organisation and environmental sustainability. He covers the Red and Green agendas well in his discussions.

Friday, May 16, 2008

Publication Bias

It seems that Herceptin is not quite as good as it was made out to be. It appears that, yet again, unpublished data has been found that counteracts some of the positive results that were published. Unpublished research, sometimes know as grey research / grey data amounts to bias in the evidence.

When I put out a press release urging caution on Herceptin a couple of years ago, I received an interesting letter from Roche telling me how wrong I was!

This is from the Guardian and the article in The Lancet

Monday, May 12, 2008

Greens label Labour MP's inoculation proposal a breach of fundamental human rights

Green Party health spokesperson Stuart Jeffery today condemned a Labour MP's proposal to force parents into inoculating their children as 'shocking' and 'inherently discriminatory', accusing the Mary Creagh MP and the Labour affiliated Fabian Society of running the risk of 'holding a child's future to ransom'.

Mr Jeffery spoke out after Ms Creagh MP suggested that, in order to increase the uptake of the MMR vaccine, children who have not received all their vaccinations should not be allowed to start school. On top of this, public health expert Sir Sandy Macara wrote in the Fabian Society's magazine that the Government should consider linking child benefits to vaccinations. (1)

Mr Jeffery said

"Coming from a Labour minister and Labour affiliated think-tank, this proposal is as shocking and surprising as it is inherently discriminatory against children from less wealthy backgrounds.

"Child benefit is a life-line for poorer families. Reducing this for whatever reason simply increases child poverty, and will serve only to penalise children for the actions of their parents.

Commenting on the ethical and moral implications of the proposal, Mr Jeffery added

"A child's access to education is a fundamental human right, and one that must not be based on any external conditions, such as medical intervention. This proposal would effectively be holding a child's future to ransom.

"An effective programme of vaccination is a key plank to improving public health, and should be achieved through good clinical evidence, scientific persuasion and public trust. Forcing parents to have their children inoculated through fines and conditional terms is discriminatory and an infringement of human rights."


Sunday, May 11, 2008

Vaccine opt-out penalty

News from the BBC website this morning talks of a call by the Fabians and a Labour MP to impose fines on children who do not have vaccines.

They are suggesting the children should have to prove they are vaccinated before they start school and that child benefit is linked to vaccinations.

Surely this breaks a whole host of ethical and moral codes. Child benefit is a life line for poorer families and reducing this will simply increase child poverty, penalising children for the actions of their parents. Immumisation rates for MMR are lower in more affluent areas, where reductions in child benefit will make no difference anyway. So we have a policy that discriminates against the poor and against children.

And as for denying children the right to education - this is a human right, not a right based on some medical intervention. What next? Children excluded from school if they are not electronically tagged? Parents filmed by over 300 CCTV cameras each day... oh they already are!

Effective levels of vaccination are one of the key planks in improving public health, but should be achieved through good clinical evidence, persuasion and trust not fines, discrimination and infringements of human rights.


Saturday, May 10, 2008

Peak Oil and electronic health records

Dan Bednarz is continuing to do a lot of good work in the US spreading the word about peak oil and its relationship to health care. This piece is from a talk he gave to a group of nurses. In it he mentions that electronic healthcare records might not be possible in the future... obviously a US thing - electronic records are quite a way off all together here!

Given the need to reduce our energy use in the face of peak oil, and given that electronic records will only add marginal clinical benefit to patient care (the talk of clinicians knowing about your medical history through access to an electronic health care record is of great use in a small number of cases, but for many patients could detract from useful assessment and diagnostic thinking), do we really need to continue with them?

His main points are summarised below and the full article is available from The Oil Drum:


1. I feel safe observing that the vast majority of insurance companies, medical associations, HMOs and other hospital associations will resist facing the stark consequences of peak oil because they are benefiting from the status quo. On the other hand, those hospitals with a mission for stewardship of the earth and charitable activity are likely to be among the first to recognize the need for radical change in medical care.

2. In the same vein, it's obvious that nursing is not prospering even though it is in some ways the backbone of the system. Your profession's main themes for reforming the healthcare system should center-–I hate to use the word "should"--around radical resource conservation and efficiency, and the elimination of wasteful and environmentally harmful practices. In other words, reduce, reuse, recycle, and repair.

3. Simultaneously, there will be a political struggle for the soul of healthcare: We will look to other nations with decent health systems where three core values predominate: 1) no one goes bankrupt due to medical status; 2) no one is denied treatment for any reason, and 3) preventive and treatment medicine are integrated. This means one response to energy downturn leads to healthcare for all. The alternative to this is medicine becoming something for the wealthy few, with the rest of society receiving what amounts to triage-–or, alternatively, home care or "folk medicine." In some respects these alternatives represent the familiar themes of the Jeffersonian/egalitarian and Hamiltonian/elitist traditions.

4. By forming a coalition with public health and even some of the growing number of doctors who favor a "single-payer" system, nursing can shape the transformation of our healthcare system.

Monday, May 5, 2008

Monbiot on polyclinics

Great piece by Monbiot in the Grauniad last week. Monbiot exposes the government's drive to centralise and hand GPs over to 'BigHealth', the corporate health care companies such as United Health, Netcare, and more latterly, Virgin.

This policy screws patient care, sticks two fingers up at local communities, puts more traffic on our roads and hands vast profits to BigHealth. I acknowledge that GPs have always been outside of the NHS and have reaped gross profits in recent years, I also acknowledge that they need tackling - but not like this... GP should be brought into the NHS and paid a fair salary and surgery staff should be paid a fair salary too.

Polyclinics that consume local GP surgeries are wrong. Polyclinics that provide an additional layer of health care, such as in Cuba, are what we need. In Cuba, GPs have small practices, often single handed and looking after around 700 people (compared with perhaps 2000 per GP in the UK and 6000 per practice). They then have polyclinics to provide out of hours GP services, XRAYs, minor injuries, therapies, consultant outpatients etc. These form a bridge between hospitals and GP surgeries - this is the model that we need. Cuba has the most efficient health care in the world.

However, Labour want to make sure that their BigHealth friends rake in huge profits and stuff real people (and of course the Tories are furious about this as they never had the balls to do it, but you can be certain that despite the 'safe in their hands' crap, they would be selling the NHS off just as fast now).


By George Monbiot. Published in the Guardian 29th April 2008.
Everything is getting bigger and further away. Hospitals, post offices, schools and prisons are being “rationalised” and “consolidated”. The government says that this process improves efficiency. Instead, it outsources inefficiency: we must travel further to use public services. This is bad for the environment, bad for community life, bad for universal provision. But we haven’t seen anything yet. We are about to be confronted with the biggest shutdown of all: the government has started the process of closing England’s network of doctors’ surgeries.