Sunday, January 25, 2009

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

Sunday, January 18, 2009

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

Tuesday, January 6, 2009

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 4th 2009

According to the Ministry of Health in Gaza as reported by the UN Office for the Coordination of Humanitarian Affairs (OCHA) on January 4th 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 3rd 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 4th) 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 4th 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 2nd 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.

Saturday, January 3, 2009

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

Thursday, January 1, 2009

Long term care: who should pay?

This is a graph showing Population: by gender and age, mid-2007 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."