Ritalin, the new Soma

There is a piece in this week's Health Service Journal on the level of prescribing of Ritalin. The area with the highest level of prescribing has a rate 23 times higher than the area with the lowest level. This means that in the Wirral, 144 out of 1000 children were prescribed Ritalin in 2007 - that is one in seven. Isle of Wight was second with one in nine. The lowest area will have a rate of about one in 160 children.

There is no way that this drug is being used to treat a medical condition for most of these children, it is being used to treat a social condition. This is straight out of Brave New World.

If there really was this level of ADHD in these areas then this should be treated as an epidemic with the seriousness of Avian Flu or Foot and Mouth. Of course there is no such problem, just a lost generation.

Reducing the NHS's Carbon Footprint by clamping

This was in the news earlier this week and I should have blogged it then. It does make you wonder what planet some people are on, clamping ambulances at the hospital will not solve the parking problem, bring in more revenue and it will not reduce the carbon footprint of the NHS...

Richard Smith on Comment is Free

Richard Smith, Chief Exec of United Heath Europe has a piece on the Guardian's Comment is Free site. He is, of course, putting the case for companies like his to get more profit from taxpayers. Advertising they used to call it... Anyway his posting does not mention his vested interest at all and has sparked a deluge of criticism.

This is a selection:

alasdaircameron:

Richard Smith is executive director of Unitedhealth Europe, a private healthcare provider seeking to make huge inroads into the UK NHS 'market'.

Yet again the Guardian has somehow decided to give him a platform to tout for business.

n.b. Unitedhealth in the US (tha parent company) don't do universal provision, have a record of trying to wriggle out of treaing those taking up its policies, and in February 2008, New York State Attorney General Andrew M. Cuomo announced that he was conducting an industry-wide investigation into a scheme by health insurers to defraud consumers by manipulating reimbursement rates. The announcement included a statement that Cuomo intended "to file suit against Ingenix, Inc, its parent UnitedHealth Group (NYSE: UNH), and three additional subsidiaries."

Just what the UK needs. Richard Smith can dress it up all he likes, and theorise that the private sector can do public service ethos, universal provision, all cheaper, and still return a profit for shareholders. The specific corporations looking to storm into the UK do NOT have a track record to justify this idealised view that the private sector is always best.

BishopHill (this is brilliant):

Private companies undoubtedly improved delivery of gas and electricity services.

viridios (me):

I must say firstly that the lack of acknowledgment of Richard Smith's position in United Health is bizarre. It took me two clicks to find the page where his seriously vested interest is shown. While the bias in the article was clearly evident, there was no clear declaration of the interest behind it. CIF should do better than this.

To suggest that the NHS is inefficient and needs propping up by bringing in the private sector is simply untrue. The lack of historic investment has meant that the excellent service the NHS has provided over the last 60 years has been done so on a fraction of the funding of most comparable countries. Low levels of funding are not indicative of inefficiency of the organisation - in this case the opposite is of course true.

Private provision of health care is wrong for many reasons, most of which have been covered already (cost, profit, inefficiency - I smiled at the comment that the electricity is supplied more efficiently now that it is privatised, I noticed such an increase in the quality of the electrons coming out of the fuse box!!!).

If anyone wants an example of a world class health care system that is completely state funded and state provided, yet spends less as a proportion of GDP and far less in cash terms than the UK, then look at Cuba.

Two issues need further highlighting in this debate. Firstly the lack of accountability already in the NHS suffers further erosion with private companies. For example, who is held to account for the problems that United Health may cause for patients? The professional bodies are certainly still there and do a useful job, but what if it is a more systemic issue - how can people effect change?

Private provision adds another barrier to an already unaccountable system. What people want (and need) is more of a say in local health care services not less.

Secondly, the principle of what health care should be has received little attention. Are we looking for cash cows for shareholder? Do we want to buy and sell bits of health care? Do we want to know that part our care comes from one provider and another part from another company, neither of which share information? Do we want to accept that taxes go to shareholders? Do we want health care to be a commodity to be bought and sold?

I want health care to be focussed on providing effective, efficient and seamless care to those who need it. You don't get this with the private sector.

BMA BACKS GREEN POLICY ON NHS MARKETISATION

The Chairman of the British Medical Association, Dr Hamish Meldrum, has called for an end to "the damaging market in healthcare once and for all," at the Association's conference in Edinburgh. The Greens are the only major party to have consistently opposed the internal market, and today Principal Speaker Caroline Lucas MEP welcomed Dr Meldrum's comments.

Dr Lucas said:

"The BMA and the Green Party want to see the founding principles restored to our National Health Service. It was built on an understanding that caring for the sick is a shared national endeavour, not a battleground for competition and profiteering. But the marketisation instituted by the Tories and extended by New Labour has begun to undermine those foundations.

"Dr Meldrum does not exaggerate when he calls the internal market a 'shoddy supermarket war'. And as with supermarket wars, shareholders benefit while customers - patients - suffer.

"The modernisation of the NHS should strengthen, not dismantle, its public service ethos. Local health centres should bring more services from major hospitals closer to patients, not hoover up GP surgeries and make services more remote. Co-operation, not competition, should guide the development of our health service, and patients should control their treatment through a genuine partnership with their doctor, not a bewildering and wasteful internal market."

ENDS


See BMA Press Release

BMA calls to an end to marketisation

Get rid of the market in health care, says doctors' leader (issued Monday 07 Jul 2008)

"A call to get rid of the damaging market in healthcare once and for all came today (Monday 07.07.08) from BMA Chairman Dr Hamish Meldrum in his keynote speech opening the Association’s annual conference held this year in Edinburgh."

Well said! The health care market serves the interest of a few at the expense of the many. The idea that people want to choose between a range of health care providers is simply false, people want to know that the local hospital is clean and efficient and able to treat their problem.

The claim on the HSJ website that competition improves efficiency and can be used as a stick to instigate changes is a self fulfilling prophecy. The purchaser - provider split introduced by the Tories means that health care commissioners have no direct accountability or control over services and have had to invent ways of levering change. The quick solution is to scrap the purchaser / provider split and abolish the market - Doh! (or should that be DoH???)

Polyclinic doublespeak

Apparently on the Andrew Marr show today: "Lord Darzi said no practices would be forced to shut due to the 150 new centres which will house doctors alongside other medical staff."

Not according to Pulse: "Nearly 40 GP surgeries are set to close in just one PCT in a dramatic illustration of the effect on local general practice of the drive to introduce a network of polyclinics.

"Patients in Haringey, north London, are taking to the streets this week in protest at plans to consolidate 57 existing surgeries into 20 health centres – which came as NHS London formally decided to press ahead with its polyclinic plans across the capital."

The rhetoric / reality gap widens...

SOCPA, 42 days and the Department of Health

Have just returned from a successful demo outside Richmond House, the headquarters of the Department of Health. The Greens were out in force and our principle speaker, Derek Wall was interviewed by the mutlitude of press.

It seems that the police hadn't been told about the protest in advance and this was my first time breaking the law on protests within the vicinity of Parliament. Does that make me a terrorist or just an anachist? Anyway the police turned up quickly rather than detaining us all for the next 42 days they were happy for us to continue protesting for nearly an hour.

As any reader of this blog knows, we want an end to the creeping privatisation of the NHS and a return to public ownership. We don't want a big centralised monolith though, the NHS should be accountable to local government (I think it should be renamed the Local Health Service).

The event was organised by the Keep Our NHS Public campaign, and my thanks to Wendy and Alex who drive the campaign so effectively.

Branson Pickle

Branson Pickle has been created by John Spenser following his short time with Virgin Healthcare, one of the new bread of BigHealth companies.

"This web site covers a number of areas of concern relating to Virgin Healthcare and the wider Virgin Group and is written by John Spencer who worked for Virgin Healthcare until his resignation in February 2008.

"If there is any doubt about the accuracy or truthfulness of the contents of this site, (including the transcripts of covertly made phone calls) you might ask why Virgin have not produced an injunction aginst this site."

He goes into fine detail about the ethical problems he faced at Virgin - it is fascinating reading.

GREENS' BIRTHDAY PRESENT TO THE NHS: AN END TO LABOUR'S PRIVATISATION

On the 60th anniversary of the NHS, the Green Party has called for a return to its original principles of public provision of healthcare, run for patients not profit, and free at the point of need. Greens will be joining the Keep Our NHS Public protest [1] outside the Department of Health at Richmond House on Friday 4th July at 4pm.

Green Party Principal Speaker Derek Wall said:

"Nye Bevan's legacy is being dismantled slowly and deliberately under New Labour's privatisation agenda. Brown has mortgaged our health with PFI, and handed cash intended for healthcare over to corporate shareholders. His latest idea of closing GP surgeries and replacing them with privatised polyclinics is shocking but not surprising.

"Our birthday present to the NHS must be to turn this around, restore its founding principles, and kick out the corporate profit makers. That means keeping our hospitals public, ending the closure of GP surgeries, and properly valuing the staff of this defining public service.

"The modernisation of the NHS should strengthen, not dismantle, its public service ethos. Local health centres should bring more services from major hospitals closer to patients, not hoover up GP surgeries and make services more remote. Co-operation, not competition, should guide the development of our health service, and patients should control their treatment through a genuine partnership with their doctor, not a bewildering and wasteful internal market."