Medication of the masses

Being a lowly Green I rarely achieve a national media hit but yesterday I spoke with a journalist from The Times who was writing a piece on whether selenium should be routinely added to wheat and, given the recent furore in Southampton where the residents will soon be medicated with fluoride whether they like it or not, I thought I'd say a little more on why it is wrong to mass medicate people.

For me, the issue is not one to be fought on whether the populations that are medicated would have an overall benefit, whether the increased toxicity of waste water will impact on the environment, or about individuals who will suffer the consequences of receiving a drug or supplement that their body doesn't need. For me, the issue is about choice vs techno fixes.

I am very aware that there are health issues to be addressed within the wider population. Anyone walking down a high st in Britain can see the obseity epidemic unfolding in our communities. Not only are people consuming too much, but many are consuming the wrong types of food. Others are becoming restless, depressed, anxoius and stressed. I could go on and on...

There are three broad approaches to health care. Firstly we can simply pick up the pieces when it has all gone wrong, just as the NHS often does. Secondly we can educate, incentivise and make it easier for people to make healthy choices. Thirdly we can force everyone to take preventative medication, supplements etc.

The power to take individual decisions and to make choices as long as those choses don't harm others is of great importance to me. There is a saying "Do as you will but harm no one" which I particularly like. The Green Party goes further: "The Green Party affirms the importance of individual freedom and self expression. We believe people should be free to make their own decisions on matters which do not adversely affect others. Its importance lies in valuing the opportunity people have to make their own decisions, accept responsibility for them and develop in their own way."

Primum non nocere translated as "First do no harm" should be at the root of health care. Should the needs of some outweigh the damage to others that mass medication can cause? Even if the vast majority benefit from the medication, should we harm the few? I think the answer is still no.

More difficult is if there is no possible harm to anyone or anything by the mass medication. Despite this being very unlikely, I would suggest that mass medication still removes the ability of individuals to choose. We need to make mistakes in our lives, to learn from them and to make better choices next time. This is a bit 'school of hard knocks' but it beats medication of the masses anyday.

Finally, the EU agrees with me... Article 5 of the EU Convention on Human Rights and Biomedicine says: "An intervention in the health field may only be carried out after the person concerned has given free and informed consent to it."

Vote Margaret Haywood for the Nursing Standard's Nurse Awards 2009

Margy was struck off for whistleblowing and is appealing against the decision next month. Please support her by voting for her here.

We need a new national campaign to protect whistleblowers as current legislation is clearly not working. Anyone who is prepared to stand up and be counted should be valued not punished.

US attacks the NHS

The debate about changes to the US health care has kicked off in a big way. They aren't even bothering with lies or statistics, they have gone straight to the damn lies. The US media seem to be on a bit of a roll, even claiming that Stephen Hawking wouldn't get any care if he lived in England. I know the US media seem to think the outside world doesn't exist, but I think Mr Hawking might be this side of the pond.

This piece in the Guardian should be read for the comments as well as the article. One of the best comments is from yogibear: "It's an interesting feeling to be on the receiving end of such misinformation.".

However, Obama and British government do seem to be sitting on their hands in the face of the Republican lies. They need to show some backbone and expose them.

How can any sane person be happy with the most expensive healthcare system in the world, consuming around 15% of their GDP and that still does not provide care for 40 million Americans?

Six new rights - spin not substance

So are the new 'rights' for patients being unveiled by Gordon Brown anything but spin? He has promised to scrap unpopular targets in favour of a list of rights that patients can demand:

• An operation within 18 weeks of patients first seeing their GP
• A free health check-up for all at the age of 40
• Treatment from an NHS dentist
• Die at home if they suffer from a long-term medical condition
• See a cancer specialist within two weeks
• Be treated in accident & emergency departments within four hours.

They all sound great but strangely familiar, except perhaps for NHS dentistry. Firstly, I doubt very much whether these targets will be scrapped in favour of a 'patient' right. I can't see Brown trying to defend himself on why he doesn't know what the length of waits are and I can't see Burnham not getting concerned if the number of people waiting 18 weeks waits was to increase.

Of course ministers will keep a close eye on these areas and they will come down hard on hospitals and PCTs who are seeing increasing waits. Laissez faire is not something that Labour are good at. It would be quite a bizzarre state of affairs to have a government in a position that it doesn't monitor and manage key indicators of accessibility for NHS service.

This is clearly spin rather than substance, but that said, making it clear what patients should expect is welcome.

The dentistry right is the interesting one. Access to NHS dentistry is extremely patchy across the country and needs significant investment and time to get it right. How many people will have their right to an NHS dentist met by a dentist 20 miles away?

HEALTH SECRETARY’S ‘VESTED INTERESTS’ IN SOUTHAMPTON’S WATER FLUORIDATION SCHEME

Green MEP for the South East Caroline Lucas has challenged the Secretary of State for Health Andy Burnham over his position as vice president of the British Fluoridation Society – at a time when health authorities in Southampton were giving the green light to a “mass medication” water fluoridation scheme.

The Health Secretary was instrumental in proposing the inclusion of compulsory water fluoridation in the Government’s 2003 Water Act. He resigned from this position in recent weeks, but Dr Lucas MEP today joined with UK Councils Against Fluoridation (UKCAF) to question why Mr Burnham’s links with the Society were not included in his register of interests, despite strict Parliament regulations stating such interests must be declared.

Dr Lucas MEP said: “It is of great concern that the Health Secretary was able to closely align himself with a body whose sole business it is to promote water fluoridation, at the same time that he was due to make key decisions about the future of the UK’s water supply. Parliament’s regulations on MPs’ interests are supposed to prevent alliances which can fundamentally inform policy – but clearly they are not fit for purpose.”

Earlier this year, the Green MEP warned that the region’s health authorities were setting a “reckless precedent" for future fluoridation schemes in the South East with their decision to press ahead with fluoridation plans in Southampton.

Although 72% of people in Southampton voted against fluoridation in a poll conducted by the Strategic Health Authority, the SHA is pressing ahead with the scheme. A legal case regarding the highly criticised consultation process has been announced and legal aid has been obtained by the person bringing the case against South Central SHA.

Dr Lucas MEP commented: "The ill-advised decision to implement water fluoridation in Southampton demonstrates contempt for the views of many local people - and for the evidence against fluoridation itself.

"Water fluoridation has simply not been proven to be effective for teeth, and some studies have indicated links between fluoridation and serious ill health effects, including thyroid problems, skeletal fluorosis, bone cancers and mental problems.

"The scheme in Southampton amounts to a mass medication of the population. I have made a formal complaint to the European Commission regarding the failure of the UK Medicines and Healthcare Products Regulatory Agency (MHRA) to properly classify hexafluorosilic acid, used in fluoridation of drinking water under the UK Water Act 2003, as a medicinal product. The correct classification would likely mean the UK’s water fluoridation schemes would contravene EU law.

“In place of mass fluoridation, the UK Government could be improving the health of our teeth through targeted schemes such as providing free toothpaste for poor families. This decision in Southampton sets a reckless precedent for future fluoridation plans in the South East, and we must be vigilant of further attempts to affect our water in this way."

ENDS 

Notes to Editors

For more information on UK Councils Against Fluoridation, visit www.ukcaf.org 

Letter to Indy on dentistry

Letter to the Independent on the new dentistry report:

Sir, The renewed debate on NHS dentistry is very welcome and Professor Steele's report contains some useful ideas, however unless the government addresses the real problem that many people simply can't afford to pay for dental treatments, improvements in dental health will not take great leaps forward.

Dentistry could easily be funded through taxation and be free at the point of need, making it a universal service and not one that is 'expensive or slightly less expensive'. Free access to dentistry would cost a fraction of the money spent on NHS IT or running the NHS market, yet would deliver massive benefits to the people who need it most.

It is time that the government addressed the real problem, that NHS dentistry fails the primary test of NHS services - it is not free at the point of need.

Stuart Jeffery
Health spokesperson for the Green Party

European Federation of Nurses

With elections approaching fast lots of groups start calling for pledges from candidates and health care is no exception. Dignity and care in health care is essential, but lacking in many areas and certainly has suffered at the altar of NHS finances. Fortunately there are good people out there who are willing to take a stand at the risk of their own career. Margaret Haywood is on of them.

This pledge campaign came in to me by email and like many that I come across, is a no-brainer and should be supported

Stuart

EFN European Election Manifesto

With up to 6 million nurses within Europe, the European Federation of Nurses Associations (EFN) and its members are a significant voting force.

The EFN members are calling on MEPs to support three priorities and use their influence to help:

ü	Implement the European Directive which regulates the Mutual Recognition of Professional Qualifications (DIR 36).
ü	Plan the EU Workforce for Health to meet citizens’ needs.
ü	Deliver Quality and Safeguard Patient Safety.

The EFN members are taking action

· Questioning MEP candidates about how they will influence the EU’s impact on health and employment;

· Engaging with the press on the significant issues MEP candidates need to address;

· Rallying members to make their vote count.

Act now!

For more information visit: www.efnweb.eu

NHS privatisation is barmy says BMA chair

Hamish Meldrum's letter in the Guardian is well worth a read. The BMA have been very hit and miss in the past over the question of privatisation. It is great to see such a strong statement by their chair.

"The suggestion that privatising further aspects of public services would save money is barmy economics (Treasury report suggests cutting thousands of public sector posts, 22 April). Instead of employing the staff and running the service yourself, you would simply be handing the cash to someone else to do so. Where is the sense in pouring money into the clutches of the private sector, whose prime motives are usually founded on making profits for their shareholders?"

BNP nurses should be banned from nursing

Police officer are banned from being members of the BNP or promoting the BNP and yesterday UNISON voted unanimously to call for BNP members to be banned from nursing.

I find it hard to imagine how a profession that has been built on caring and compassion can be compatible with racism. As a registered nurse myself, I would find it very difficult to understand how an openly racist nurse could provide care to without discrimination.

Well done to Unison (which I have recently rejoined after the debacle of the Unite elections), and I hope the NMC take heed of this call.

Green New Deal for the NHS

Today, the Green Party will launch a powerful bid to influence the health agenda towards the next general election.

The Green New Deal for the NHS proposes an extra £500m a year for maternity servces, plus £1.8bn a year for dental care. Most of this would be paid for by savings of £1bn on getting rid of Independent Sector Treatment Centres, and a further £1bn or more saved by scrapping the health care market.

There would be one-off costs of £1bn for reorganisation and at least £12bn to buy back the private finance initiatives, but liberating the NHS from PFI payments would save £1bn a year. So the Green New Deal for the NHS would pay for itself in the medium term, say the Greens.

On maternity services, the Greens' £500m stimulus would create a single-tier approach for all mothers:

 * A wider range of birth choices - including home birth for all women who want it.
 * All women to be entitled to support from a single midwife throughout each pregnancy.
 * A major recruitment drive for midwives.
 * Medical interventions to be significantly reduced.
 * Culture change throughout the NHS so that birth is treated as a normal event - not an illness - in which mothers are empowered and able to be in control.

The extra £1.8bn a year for dentistry would restore the principle of dental care free at the point of access, with an end to the severe difficulties many people are now facing in attempting to find an NHS dentist.




Dignity, compassion and accountability

But improving the health service isn't just about wise spending and better access to services, say the Greens. The Green New Deal for the NHS would also improve the accountability of those services, along these lines:

 * The NHS to be accountable to local government and thus to local people.
 * An end to the purchaser/provider split so that public health, service planners and providers of care are under local government.
 * The NHS to have centrally-defined minimum standards and national agreement on which treatments are available.
 * Local people and clinicians to have a real say in how and where these services are delivered.

Finally the Green New Deal for the NHS would restore and develop a culture of dignity and compassion in the UK's health service, the Greens say:

 * Health services must meet the needs of patients, not the needs of the market and corporate shareholders.
 * Maternity care must meet the needs of women and their babies.
 * Patients suffering with poor mental health must get a real say in the way they are treated. They must be told their diagnosis and must be able to set advance directives that spell out what type of care they want when they are ill.
 * There must be legislation to prevent discrimination against people with mental illness.

Caroline Lucas MEP, Green Party leader - who is widely tipped to become the first Green MP at Westminster in the next general election - said today: "We need to protect and improve the National Health Service, and we need to stop it being used as a vehicle for private profit. We believe the public wants this too. So we're throwing down the gauntlet to the other parties, to match the Green Party's commitment to the NHS."




Note

1. The report can be found at [http://www.greenparty.org.uk/reports][1]

Greens on Maternity

A new policy report from the Green Party will demand radical improvements in UK maternity services.

A Green New Deal for the NHS (1) will demand a single-tier approach for all mothers, funded from the public purse:

* A wider range of birth choices - including home birth for all women who want it
* All women to be entitled to support from a single midwife throughout each pregnancy
* A major recruitment drive for midwives
* Medical interventions to be significantly reduced
* Culture change throughout the NHS so that birth is treated as a normal event - not an illness - in which mothers are empowered and able to be in control

The Greens announced these policies on the day that a study was published in the British Obstetrics and Gynaecology Journal showing that home-birth is no more dangerous than hospital birth, for "normal" pregnanices - something Greens had long claimed, and which has now been demonstrated in a study of half a million births in the Netherlands.

The party's recent spring conference decided the Greens must take the lead in proposing huge improvements in UK maternity services. The conference debate was told:

* In 25% of NHS trusts intervention rates are double the targeted rates
* There is a severe shortage of midwives within the NHS
* The proportion of women giving birth by caesarian section remains at twice the target rate suggested by the World Health Organization
* The bill for medical negligence in childbirth rose almost 60% from 2005 and 2007

NHS maternity services need to change direction towards midwife-led, women-centred services that provides medical interventions only when necessary.

The Greens estimate that the dramatic improvements in maternity services proposed in A Green New Deal for the NHS would cost about £500m.

Green Party leader Caroline Lucas MEP, who is widely tipped to become the first Green MP at Westminster in the next general election, said today: "The UK must achieve the best possible standards of maternity care. Currently, due to shortage of funding, shortage of midwives and excessive interventions, we are far behind where we ought to be. The Green Party will fight the next general election on this platform - huge improvements in the NHS, and not least in maternity services."

Note

1. The full report A Green New Deal for the NHS is scheduled to be published on Friday 17 April.

URL: http://www.greenparty.org.uk/news/15-04-2009-maternity-services.html



Published and promoted by Tracy Dighton-Brown for the Green Party of England & Wales, both at 1a Waterlow Road, London N19 5NJ.

NHS Dentistry

New Green Party policy report to reveal some startling new figures on NHS dentistry:

 * 55% of NHS practices are not taking new patients
 * Little more than two-thirds of children visit NHS dentists - and it's getting worse
 * Access to NHS dentistry is down to "geographical accident"

A new policy report to be launched this week by the Green Party will reveal startling new figures on the state of NHS dentistry, based on Freedom of Information Act research.

And the new report - A Green New Deal for the NHS - will show that just £1.8 billion a year would make NHS dentistry "a service that Britain can be proud of."

The report will show that:

 * Between 55% and 60% of NHS practices are not taking new NHS patients.
 * Access to NHS dentists can range from 1 dentist per 1,000 people - to as little as one-quarter of that, depending on where people live.
 * Some Primary Care Trusts have no NHS dentists taking on new patients.
 * The percentage of children who visited NHS dentists fell from 70.7% in March 2006 to 69.0% in June 2008.
 * Less than half of the adult population is accessing NHS dentistry, and the numbers are continuing to decline. 


Green Party health spokesperson Stuart Jeffery said today:

"The dental service received £2.1 billion of direct funding in 2007/08. If the current NHS dental service was provided free at the point of use, the total cost to the NHS would increase by £531m to a total of £2.6 billion.

"If the NHS wanted to provide free dentistry to 75% of the population (from the current 50%, assuming that some people will want to remain private), the total level of funding would need to increase from £2.6 billion to £3.9 billion. As the NHS currently provides £2.1 billion, an increase in funding of £1.8 billion would be required for patients to have dentistry free at the point of access.

"It seems little to ask to restore NHS dentistry to what it should be - a service that Britain can be proud of."

The full report _A Green New Deal for the NHS_ will be published later this week.

URL: http://www.greenparty.org.uk/news/2009-04-13-dentistry.html



Published and promoted by Tracy Dighton-Brown for the Green Party of England & Wales, both at 1a Waterlow Road, London N19 5NJ.

Cooperation and Competition Panel Consultation

This is from the excellent NHS Support Federation:

From NHS Support Federation, a founder organisation of Keep Our NHS Public

NHS services are now to be provided by a wide range of organisations all competing within a market. The new Co-operation and Competition Panel for NHS-funded services is to help deliver the supposed benefits of competition. It will investigate potential breaches of the Principles and Rules as defined by the Department of Health. It will also advise the Department of Health and the foundation trust regulator Monitor. The Co-operation and Competition Panel is a misnomer as its remit is weighted so heavily in favour of promoting competition, whilst neglecting the considerable benefits of cooperation.

We need your help to respond forcefully to the Panel's current consultation and to lobby MPs. Please write a letter objecting to the imposition of competition and commercial values on the NHS and raising the crucial questions listed below. Send your letter to the Co-operation and Competition Panel at the address below and a copy to your MP.

Send to: Interim Guidelines Consultation, Cooperation and Competition Panel, 1 Horse Guards Road, London, SW1A 2HQ or email consultations@ccpanel.gsi.gov.uk. Respond by 30 April.

Points to make:

1. Will the panel ensure that the alternative of a publicly led service is included in consultations about future tenders?
2. Is the duplication of services to produce choice a good use of resources which constitutes economic efficiency, especially given that the benefits of competition in healthcare are unproven (indeed Minster of State Ben Bradshaw said that the "mix of competition and co-operation in the NHS is a unique model in the world")?
3. Will the tendering process be fair and transparent, with no discrimination against NHS organisations in favour of either commercial or voluntary bodies or social enterprises?
4. Will the public be consulted on an ongoing basis about local tenders e.g. via local involvement networks (LINks)?
5. Will the panel foster co-operation not only between commissioners and providers, but between providers, a hope expressed by Richard Taylor MP in a debate in Parliament on 24 February?

It is vital to protect and promote a publicly led NHS which has an ethos which is truly patient-centred. We must insist to the Panel that our objections to the notion of a health service based on a competitive market are widely shared. With your help we must ensure that our views are not ignored.

You can see the consultation paper, the four guidance documents which are the subject of the consultation, and the response template at http://www.ccpanel.org.uk/reports-and-guidance/guidance-documents.html.


Please send us copies of your letters or emails. Thanks for your help.

NHS Support Federation

NALM Conference

The National Association of Links Members conference today seemed like a great success. It looked packed with people, I'm guessing around 250 attended and depth of questions and level of debate from attendees was excellent.

I spoke last on the panel session, having been preceded by Cyril Chantler (Chair of the Kings Fund), Barbara Young (Chair of the new Care Quality Commission), Norman Lamb (Lib Dem health spokesperson) and David Pink (CE of National Voices).

The one question that stuck in my mind was why are most councils ignoring LINKs (or at least not giving it the high priority it deserves)? It does seem puzzling that a system that should give voice to patients and public about local NHS services is not being driven hard by many local councils. I would have thought they would jump at the chance to do this.

Letter to the Telegraph

Sent to the Telegraph this morning:

Sir, Karol Sikora's suggestion for a US style health care service to prevent a recurrence of the disaster at Stafford is misguided at best. The US system has allowed 40 million people to have no access to health care while costing the country proportionally 50% more than the UK system. US market inefficiency and their profit driven culture will not benefit the NHS or its patients and certainly would not prevent another Stafford.

Stuart Jeffery, Health Spokeperson for the Green Party

Stafford solution is not a two tier NHS

Karol Sikora's piece in the Torygraph calling for a two tier NHS and wider market reforms to prevent a repeat of Stafford are truly repulsive. While his article rightly blames a combination of policy changes and top down targets for the dire state of the hospital, his solutions would lead to a far greater unnecessary deaths.

He is calling for Primary Care Trusts to compete alonside health insurance companies as commissioners of health care, claiming that this will lead to greater efficiency driven by competition of the market. Ignoring the fact that market economics has been shown to fail both people and planet and simply provide for the rich and privalidged, Sikora's suggestion that we adopt the US model of health care will simply leave us with a health care system resembling the US.

The US system has workers living in fear of losing both their jobs and their health care, it has 40 million people with no access to health care at all as they fall between state provision as they earn too much and private provision as they can't afford it. The US system also costs 50% more than the UK system (as a proportion of GDP) - how can this be considered more efficient?

Sikora also claims that depoliticising the NHS will make it more accountable, but to whom would it be accountable? Not patients, not ordinary people, not voters... Ah yes: shareholders! And we know what shareholders are interested in - profits.

Sikora's vision is one of a two tier health care system where the rich get treated in plush surroundings and ordinary people have to make do with a poor service. If you are rich and think this is a good idea then you might like to consider what will happen when your share portfolio crashes and you lose you job as a banker...

Bizarrely Sikora goes on to imply that junior doctors should not be concerned with racial equality, communication, hygiene or avoiding ageism. Does he really think that patients are just hunks of meat to be practiced on?

As the US increasingly questions the wisdom of its own dire health care service, the UK should remain true to the great principles that underpin our NHS. The NHS should provide an equitable service for all - Sikora's vision will not lead there.

Fluoride = sticking plaster with side effects

South Central SHA's decision to fluoridate Southampton's tap water is dangerous, undemocratic, potentially illegal and a 'sticking plaster with side effects solution'. Southampton Primary Care Trust has failed to provide adequate NHS dentistry for its residents as a Freedom of Information request revealed that 76% of its NHS dentists are not taking new patients. Other dentistry data released today has shown that less than half of adults are using NHS dentists and the proportion of children accessing NHS dentistry in Southampton has fallen by 2.4% over the past two years.

Trying to fixing NHS dentistry problems by un-ethical and potentially illegal mass medication is simply wrong. Southampton needs to fix its access to dentistry. Only having 24% of its dental practices taking on new patients means that many poorer people are forced to go without dental care. Today's statistics have also shown the proportion of children accessing NHS dental care has fallen by 2.4% over the past two years. Despite this appallingly poor level of provision in Southampton, the local NHS has opted for a sicking plaster with side effects solution.

Fluoridating water is one way of medicating people without their permission, and the European Convention on Human Rights and Biomedicine distinctly states that individuals have the right not to be medicated without their consent. Fluoride has well documented and dangerous side effects, it is wrong to expose people to these against their will. This appalling decision also seems to have been taken without any regard for the voice of local people, the majority of whom were opposed to mass medication with fluoride.

Notes:

1. FOI response to the Green Party dated 3rd Feb 2009 showed that of
Southampton PCT's 25 NHS dental practices only 6 were accepting new
patients in December 2008.
2. http://www.ic.nhs.uk/statistics-and-data-collections/primary-care/dentistry/nhs-dental-statistics-for-england-quarter-2:-30-september-2008

Greens welcome public debate on assisted suicide

The Green Party today welcomed the Royal College of Nursing's decision to launch a public consultation on assisted suicide.

The Greens reiterated their concerns about the legal uncertainties that relatives face. The Green Party supports a clear, safe and open framework for people to be able to make decisions about when and where their life ends.

Fear and misery

Stuart Jeffery, health spokesperson for the Green Party of England & Wales, said today: "The lack of a coherent framework for assisted suicide in this country is causing fear and misery for many people.

"With families breaking the law by helping their loved ones attend clinics such as Dignitas, the UK's arcane laws are a real threat even though no one has yet been prosecuted.

"This law puts undue pressure on people already facing a difficult decision. Who would want to relieve their own suffering in the knowledge that their loved ones could end up in jail?"

Safeguards

Mr Jeffery, who is a registered nurse, continued, "People with terminal illnesses should be able to make clear and rational judgements on when and where their lives end, provided there is a clear framework of safeguards to prevent abuse. These safeguards must include a cooling off period, independent assessments, counselling and discussion of alternatives, and ensuring that illnesses such as depression are treated so that they do not impinge on the decision."

Protect the vulnerable

He concluded: "We must have a clear legal framework in this country to overturn the bizarre and damaging system that currently exists. We must have a system that protects the vulnerable and ensures that needs and wishes are met."

Notes:

1. RCN consultation: http://www.rcn.org.uk/aboutus/policy/consultations/current_consultations.

2. Over 100 people have travelled abroad for assisted suicide. There have been no prosecutions for people accompanying them.

NALM AGM and Conference

Interesting conference coming up!

NATIONAL ASSOCIATION OF LINKs MEMBERS

NALM AGM and Conference will be held on April 2nd 2009

Woburn House, near Euston Station in London

We are delighted to announce that the first NALM AGM and Conference will be held on April 2nd 2009. We hope very much you will be there to support and build NALM. All members are welcome and the conference is free to members. The conference will formally and democratically develop the process of building a national 'grassroots' voice for LINKs’ and help to develop ways for all LINks and LINks’ members to communicate with each other and with regional and national policy makers. We want to stimulate new and more powerful approaches to public and user involvement. We want to build NALM into a major grass roots body of LINks that can significant influence government policy at national and regional levels. The conference will give us an opportunity to promote diversity amongst the membership of LINKs and build our collaboration with National Voices and other national organisations. Please sign up for the Conference; raise the Conference with your LINk and ensure that you put in a bid to your host for funds to cover your fares to London and any other expenses.

Malcolm Alexander, Chair

Conference Programme

10.30 am Launch – Professor Sir Cyril Chantler, Chair King’s Fund

10.45 am Stephen O’Brien MP, Shadow Minister for Health

11.00 am Baroness Young, Chair, Care Quality Commission

11.15 am David Pink, Chief Executive, National Voices

11.30 am Stuart Jeffery, Health Spokesperson, Green Party

11.45 am Open Forum –LINks members Contributions and questions to speakers

12.15 pm to 1.00pm Workshops led by LINks members

LUNCH

2.00pm LINk Member – name to be confirmed

2.15pm Graham Box, Chief Executive, National Ass for Patient Participation

2.30pm Sue Slipman, Director, Foundation Trust Network, NHS Confederation

2.45pm Peter Walsh, Chief Executive, Action Against Medical Accidents

3.00pm Open Forum – LINks members contributions and questions to speakers

3.30 – 4.30pm AGM

NHS constitution is no defence against commercialisation

From the NHS Support Federation:

Responding to the signing of the new NHS constitution, the NHS Support Federation is warning that it is too weak to protect the core ideas behind the NHS against the impact of commercialisation.

“Government lawyers will have been working long and hard to ensure that the NHS constitution cannot be used to stop its commercialisation programme, but it is this precisely which is the greatest threat to the values and principles of the health service.

“The first test for the NHS constitution will come quickly as the plan to extend competition and patient choice will in fact bring greater unfairness, poorer care for some patients and waste public resources.”

The Federation believes that the terms of the constitution are at odds with the impact of government policy. The NHS constitution states that "The NHS is an integrated system of organisations and services bound together by the principles and values now reflected in the Constitution". In reality the NHS is becoming more fragmented as more commercial providers are contracted to run NHS services.

However the public cannot use the constitution to defend the core values of the NHS unless it counts in law. The Federation is calling on MPs to look at this aspect as the new Health Bill passes through Parliament.

“The current economic crisis shows that we cannot rely on commercial companies to act in ways which protect the public interest. Yet the government is placing commercial values at the heart of the NHS. It is doubtful that the NHS constitution will be any match for the large corporate interests currently looking to run NHS services.”

- Paul Evans, director of the NHS Support Federation

Exhausted surgeons - no thanks

Letter to the Telegraph in response to this article:


Sir, Call me boring an old fashioned but if I need an operation I would rather not have it performed by a surgeon who is into his 49th working hour that week!

Comments that hospitals will be fined for allowing staff to work more than the 48 hour working maximum are, of course, inaccurate as the 48 hours are based on average hours. With proper investment and good planning, reduced total hours should enhance patient care not reduce it. In any case would prefer my operation done by someone who is not exhausted from over work.

It is important to remember that European Working Time Directive is for the protection of everybody. Improving working conditions and safety in the NHS should be key aspects of healthcare policy. Fortunately our Green MEPs, unlike their Tory and Lib Dem counterparts, voted to avoid exhausted surgeons and physicians.

Stuart Jeffery

Health Spokesperson for The Green Party

Health information on Gaza

This summary on health in Gaza is from the excellent people at Medact. Please write to your local paper, MPs, MEPs, embassies etc. This war must stop now.

Recent information directly related to health in Gaza

January 4^th 2009

According to the Ministry of Health in Gaza as reported by the UN Office for the Coordination of Humanitarian Affairs (OCHA) on January 4^th evening, 491 people have been killed and approximately 2,400 persons have been injured during the military operations of the last 9 days. At least 20% of the fatalities and 40% of the injuries are women and children. As of January 3^rd Magen David Adom reported 46 injuries (5 moderate, 4 severe) and 4 fatalities over the past week on the Israeli side.

Gaza has 700-1000 chronic medical patients who had been receiving ongoing treatment in Israel and East Jerusalem each month. There are presently no referrals through the Erez checkpoint (or any other since the land invasion).

(Reasons for being unable to transfer people have been the subject of complex debate but in the present land offensive no-one can move anyway).

There is presently (evening Jan 4^th) almost total blackout in the governorates of Gaza, North Gaza, Middle Area, Khan Yunis. Prior to this hospitals had already been operating on backup generators for their electricity during blackouts. At Shifa hospital there are 70 patients in intensive care and 30 in neonatal care who would be affected catastrophically if the generators fail.

Even before the recent escalation industrial fuel was needed for Gaza Power Plant and ten transformers needed replacing to restore electricity to 250,000 people in central and northern Gaza. This effects water, sanitation, and hospitals including intensive care and operating rooms.

An ambulance from AlAwda hospital was shelled on the morning of January 4^th seriously injuring 4 medical staff.

On 21 December OCHA reported that approximately 20% of Gaza’s ambulances are grounded due to the dearth of spare parts.

Nutrition: the food the UN World Food Programme was trying to distribute prior to the land invasion should have been distributed in the October –December cycle.

Water and sanitation: on January 2^nd airstrikes in the Al Mughraga area damaged a main drinking water pipe cutting the water supply of 30,000 people in Nuseirat Camp. There is growing concern that current military operations could damage the sand walls of the Beit Lahiya sewage lagoon causing a sewage overflow putting 15,000 people and agricultural areas at risk.

Warning leaflets dropped to warn people to evacuate are reported as causing confusion and panic among the civilian population (OCHA Gaza Humanitarian Situation Report 3 January 2009). Gaza has a population of 1.5 million people in an area 25 miles long and 3-7 miles wide.

Branson on MRSA - letter to the NT

Following comments on the Nursing Times website, this is a letter to the NT:

Dear Editor,

Peter Carter’s comments about Richard Branson’s lack of insight into HCAI control are very welcome. Branson has continuously slated dedicated NHS staff over the past few months, and has even suggested that the NHS should have the same level of safety as the air industry, despite being a very different beast. Of course, Mr Branson ignores the damage that the air industry does, while direct deaths from accidents are rare, the impact of air travel on the climate is large and growing.

Strangely though, Mr Carter’s list of interventions that reduce HCAIs do not seem to include bringing cleaners back into the NHS. The need to reverse the years of outsourcing of cleaning services has never been higher – contractual control of cleaning can never be as effective as direct control. This outsourcing has been one of the most damaging NHS policies of the past 25 years.

The NHS can and must do better to reduce the level of infections but Richard Branson should not only listen to infection control experts before making such suggestions like blanket compulsory screening, but he should set his own house in order too.

Stuart Jeffery
Health Spokesperson for The Green Party

Long term care: who should pay?

The Torygraph reports today that adults could be forced to take out private insurance to pay for 'nursing home' costs in the future. Of course, the paper is missing the distinction between nursing care and residential care that we have in this country (currently the nursing aspect is broadly covered by the NHS and the 'non-health' aspect is paid for either by individuals or social services), but that is not really the problem.

Clearly there are a very difficult questions to be answered on how long term care is funded but also how it can be delivered.

Should people pay for it themselves (currently they pay out of their savings / house sale until they are down to £22.k savings)? The government is considering forcing people to take out private insurance to pay for this. The suggestion in the article is that critics are claiming the NHS already has enough money and long term care should be paid for out of this, is simply barking mad. These 'critics' have obviously failed to have any insight into health care - do they really want NHS services to be cut? Perhaps they want to pay healthcare staff less?

So is private insurance the right way to go?

Firstly private profit from health care: the short answer is NO! But the private sector can do it better the privateers / capitalists will be screaming... as history has taught us time and again they can't. Just look at the US if you want to find out why private insurance should have nothing to do with healthcare (15% of GDP, tens of millions without access to health care etc.).

Secondly, if you want a form of insurance to cover long term care then taxation is easily the best option. Progressive taxation is fair and just, ensures that 'premiums' are used for care - not profit, and ensures that care provision can be controlled to a democratically agreed standard (i.e. fair and equitable).

Strangley the Shadow Health Minister doesn't like Labour's idea. Strange because it is a real Tory type policy. He doesn't suggest an alternative so I guess his comments are just political sour grapes. The Lib Dem health guy, Norman Lamb, seems to be suggesting that the current system is OK but not enough money is being spent. I'm not sure he is suggesting more taxes to cover this or more money from individuals...

I think a much more demanding question is who is going to provide this care when the population bubble centred around the current 41 year olds hits 80 ish. The proportion of people in caring roles will soar and it likely to be in crisis.

This is the start of the article in the Telegraph:

"Taxpayers would have to pay hundreds of pounds in premiums every year while working, and would receive payouts if they later have to move into a nursing home.

"The radical plan is being considered by ministers as a way to tackle the system of long-term support for the elderly in England, which is widely considered to be unfair, underfunded and too complex.

"Currently thousands of middle-class pensioners are forced to sell their homes to pay for nursing home accommodation - which can cost £700 a week - while a postcode lottery of eligibility gives people in some parts of the country far more free help than elsewhere."