More on TTIP

Jeane Freeman putting the case very eloquently, on what the NHS in Scotland is facing despite the best efforts of Andrew Neil to patronise her.

TTIP - the Final Piece in the Privatisation Jigsaw

If a week is a long time in politics, then four years must be an eternity. I wrote this post in May 2010, just after the Lib Dems sold their soul to the Conservatives for cabinet seats and chauffeured cars. I predicted the end of the Union coming, and four years on, unless our canvassing on the ground is very wrong, that is precisely what is about to happen. I'm going to make another prediction and I do it with a very heavy heart - I now predict the end of the English NHS. And that is because of a trade deal that is being negotiated right now called the Transatlantic Trade and Investment Partnership, or TTIP for short.

The purpose of this treaty is effectively to set up a common market between America and the EU. It is to free up the trade of goods and services and remove current barriers. It would also allow American companies to bid for contracts in the EU. So far, so good. But what distinguishes this trade deal is an instrument called investor state dispute settlement or ISDS for short. This allows a foreign company to bring a case against the government for deprivation of trade. This covers a wide range of possibilities. For example, if a government in a fit of environmental friendliness, decided to put a green tax on electricity or gas, that company might sue the government for loss of profit. Then again, the government might raise the minimum wage, or bring in new health and safety regulations - any of these might be a trigger for this. The cases are heard in arbitration courts and there is no real comeback for a government, because once it has signed one of these agreements, commerical law is the battleground on which it is fought, not any other. It is the subversion of a country's sovereign powers by commercial interests and it's coming to a country near you.

So what has this to do with health? Well, health contracts are included. Yep, all those ones being tendered out now to private companies. In the TTIP, there is scope to exclude health, provided that your health service is publicly run. But that is now not the case for the English NHS and even if Cameron wanted to do this (which he doesn't ) he can't.

Now, you might think that this is one of these moments when all the devolved countries in this sceptred isle sit back in a superior manner in the safety of their public run health services. But actually we can't. Because under TTIP, the UK is the member state and Scotland, Wales and Ireland are regions of the UK. Which means that our health services are under threat as well and that all our efforts to keep the privateers out will have been for nothing; they will be able to bid for our contracts whether we like it or not. The English NHS was taken over by stealth; ours will be taken over by brute force.

Over the past few weeks in Scotland, this threat to the NHS is filtering through the broadsheets into the tabloids and is doing the rounds of social media now. Labour have been an absolute total disgrace, saying that there is no threat to the NHS in Scotland while simultaneously saying down in Westminster that there is. Because there's one very obvious escape route to this and that would be for Scotland to vote yes in the referendum. And that would give Scotland the status of a country and the ability to say 'Naw' to neoliberalism. The alternative is to rely on a Labour victory at the next election (aye right) or for BoJo and Nigel to suddenly convert into social democrats overnight. As over 200 parliamentarians down in Westminster now have connections to private health companies and Labour's resident numpty/scapegoat Alistair Darling has been called out on having a nice wee dinner with Cinven and paid £10000 for opening his gub at it, the odds are not good. Scotland is getting ready to bail out and to leave the English to try and sort out the sorry mess that is Westminster.

It's not without regrets. I remember the Britain I grew up in; of free university education, public utilities, the Royal Mail, the NHS. I wish I could bring it back. I can't. I see a long dark road ahead for English politics and  hard times for the English people.


Scotland is about to find its voice. It is the people of England who have not spoken yet. You need to speak now. Loudly.

It Might be Debt, It Might be Small Boys - Tim Fortescue

"If we could get a chap out of trouble, he'd do as we ask forever more.."

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Dr Phillipa Whiteford - Vote Yes for the NHS

Whether you are yes or whether you are no, watch this video by Dr Phillipa Whiteford. This is a masterful summary of the steady unravelling of the  English NHS and the dangers that the Scottish NHS is facing from Westminster.

21st Century Britain and Foodbanks - All That's Changed is the Date

This video is one of the most uncomfortable and compelling 10 minutes I have experienced in a while. Watch it and weep.

Medical Mystery

Name me a medical condition that affects 2% of the UK population, that has no NICE or SIGN guidance, that only offers only a partial screen and bloods on the NHS, that has only one medicine approved for treatment for the RCP, (which was never formally trialled, but was 'grandfathered by the FDA) and where doctors who attempt to give their patients other medications that work for them are reported by other doctors to the GMC.
Stuck? Watch this video or if you don't have time, here's the transcript.
Can anyone explain this?

Chocolate Survival Rate on Wards

It's always amused me that in the Harry Potter books, the cure for depression caused by Dementors (horrible creatures that suck all the happiness out of you) is chocolate. A group of doctors have taken this a step further and conducted a study on the median survival rate of a chocolate on a ward, whether Quality Street was preferable to Roses and who were the biggest guzzlers. I'll leave you to find out the answers here.
Now where did I put that Tunnock's teacake?

Why so Shy?

Happy Christmas and New Year to everyone. I've polished off the last of the chocolates and felt like a class traitor for watching Jools Holland on Hogmanay instead of BBC Scotland's offering, but it's their own fault. Can anyone at the Beeb please explain to me why it is that when all the Scottish/Irish bands in the world are congregating on Glasgow for the Celtic Connections Festival, that they can't invite some half decent bands on their channel? Brewery/ piss up etc?

Anyway, enough of that. As it is, I would like to ask the Beeb something else of a little more import. This article cropped up on Christmas Eve re a nursing home in Halifax called Elm View. It's the usual depressing story of neglect/sub-standard care. What is unusual about it, highly unusual, is that the care owner and the care manager got 12 month jail sentences.

Whoah! 12 months? When did that last happen? I think it was Mid Stafford and that took a massively raised mortality rate for that to occur. So was this a major news article?

Well, no. It stayed on the regional page, quite low down the Beeb's list of articles and by Boxing Day it was buried. I kept an eye on it in case it was just a matter of them garnering more details, but no. It hasn't re-appeared since. The local paper has more detail on it here.

So what's going on? The Beeb and others have revelled in stories of neglect of old people in homes and how the Can't Quite Cope Care Commission have been toothless tigers. Now they've found their teeth and it's banished to a back page? Isn't this what you wanted and isn't this a good sign that finally the law is starting to take the care of old people seriously? What's going on?

Answers on a postcard please.

I Think Continually of Those..

I think continually of those who were truly great.
Who, from the womb, remembered the soul's history
Through corridors of light where the hours are suns
Endless and singing. Whose lovely ambition
Was that their lips, still touched with fire,
Should tell of the Spirit clothed from head to foot in song.
And who hoarded from the Spring branches
The desires falling across their bodies like blossoms.

What is precious is never to forget
The essential delight of the blood drawn from ageless springs
Breaking through rocks in worlds before our earth.
Never to deny its pleasure in the morning simple light
Nor its grave evening demand for love.
Never to allow gradually the traffic to smother
With noise and fog the flowering of the spirit.

Near the snow, near the sun, in the highest fields
See how these names are feted by the waving grass
And by the streamers of white cloud
And whispers of wind in the listening sky.
The names of those who in their lives fought for life
Who wore at their hearts the fire's center.
Born of the sun they traveled a short while towards the sun,
And left the vivid air signed with their honor.

(Stephen Spender)

Rest in peace, Madiba.

Haw Naw...

Haw naw,  h-aah n-aah (Scots). A different outcome was expected.

I thought that someone would have announced this by now, but nobody has. So just in case you missed it, Prof Steve Field has become the chief inquisitor, - sorry inspector of GPs for re-validation.

Right, I'll go and get my coat now...

The Importance of Being Honest

A solitary truth-seeker who is unsupported either by tradition or community will degenerate into

mere eccentricity, eventually to be intimidated and crushed by the organized power of
 untruthfulness.

Read this and more here. Courtesy of Cybertiger in the
 comments section at Dr Aust's Spleen.
 Relevant in science, Stafford and politics too I might add.


Update: yes, I've noticed the wonky font, but left it because it added
 to the message. 

Good Lord! Crowding the House..

I said in my previous post that health politics had become interesting again. Well, hard on the heels of the Lewisham victory, another interesting thing has happened. Jeremy Purvis has become a Lord. He was one of a batch of three Scots consisting of Annabel Goldie (former leader of Scottish Conservatives, quite fun and tells naughty jokes when she's had a sherry, or so I'm told) Willie Haughey (gave £1million to Labour) and the aforesaid Jeremy. So who is he, I hear you ask?

Well, first of all, he hasn't been a leader, not even of the Lib Dems of which he was a member in Scotland. Nor is he rich (not as far as I am aware). And he's not even 40 yet; he's a bit young to be in fair round belly with good capon lined. But he is known for other things. He put forward the bill 'Dignity in Dying' in Scotland a couple of years before Margo McDonald took up the standard. And at first I thought this was why he had been made a lord. But recently he has become involved with an organisation called Reform Scotland. This is a sister to  Reform  in London. Both are rather ill disguised right wing think tanks although they both insist that they are independent. Jeremy Purvis's involvement at the moment is with a campaign called 'Devo Plus' which basically doesn't want to go the whole way on independence, but would like greater fiscal powers for Scotland (though they are rather vague on what those would be. I am not sure if Jeremy Purvis is a full member of Reform Scotland; when I clicked on his name on their website, no biography came up..

 But devolution isn't the only thing Reform Scotland has an opinion on. They produced  this report 'Patient Power' in 2009. In it they support abolishing GP boundaries, setting up tariffs, creating a purchaser/provider split in the Scottish NHS, ending the ban on commercial companies taking over GP practices and introducing insurance based (sic) funding for health. (Apparently National Insurance doesn't count; they mean private insurance, but I think they don't  want to use the 'p' word). Oh, and to have not-for-profit commissioning trusts acting as honest brokers. Sound familiar?

Now this is all rather predictable from Reform Scotland (and from Reform).  What would you expect when its director and head of research were both political advisors for the Scottish Conservatives? What isn't so predictable is Jeremy Purvis' involvement in it, let alone being sent down to the Lords. And I wonder just exactly what is going on, but I feel it's nothing good. This is going to be one to watch for the Scottish NHS rather than England. And watch we will. As one of the less friendly churches in the neighbourhood said above its door,' You have been photographed twice and identified.'..

When was the Last Time a Health Minister Lost in Court?

Sometimes, just sometimes, something happens to give you hope. Today has been a huge win for the NHS and a shot across the bows for would be privatisers. Lewisham hospital campaigners won their case at court, which stated that Jeremy Hunt had acted illegally by attempting to downgrade Lewisham A&E. The rationale behind this was that it was being done because a neighbouring trust, South London Healthcare Trust, was in deficit. Two things can be taken from this.

1. The devolving of the health secretary's duty to provide healthcare backfired on Hunt today. The key element in the judge's ruling, in his own words were, "I considered that it was the absence of support from the local GP commissioners which constituted an additional reason why the decision of the Secretary of State cannot stand."

2.  This means that it may be possible to use GP commissioning against the privatisers. It remains to be seen what is going to happen to the rebellious GPs who would not give their consent to this, but it means that the fight for the NHS is not over, and we could be looking at the health equivalent of a guerrilla war, trust by trust. It vindicates Dr No's surmisings that if the rank and file GPs refused to cooperate, the government could not win.

3. We are fighting a new kind of media war. The BBC and others did the usual 'la-la-la-nothing-to-see-here' rubbish which we have become used to over the past three years. The health news today was completely dominated by an article on assisted suicide and yet another article on Stafford. I have no objection to either, but when was the last time a health secretary or any cabinet secretary defeated in court? The Beeb previously ignored a 30 000 strong march of protestors through London about Lewisham. But here's the important point. 38 Degrees funded this court action. And this means that those of us fighting for the NHS have found a way round the problem of all the placemen that the government put in the Royal Colleges and other institutions. It is possible for those of us so minded, to act together and get a result without having to go through the colleges or any of the normal channels. And a result can be got without help from the Beeb. A new frontier has opened via the net and the government is going to be hard pushed to fight it.

Health politics has just become interesting again...

History is Written By - Bloggers or the GMC?

It's the end of a tumultous week on two fronts. Firstly, the Health and Social Care Act has come into force. Secondly, the GMC has issued 'guidelines' on the use of social media. These two events are not unconnected I think.

This is not the beginning of the end for the NHS. I thought it was until I read Cockroach Catcher's post on the situation. His point was quite simple but compelling. The NHS will not end, because private companies need their parasite. They need the NHS to sweep up mistakes, take patients they won't and provide emergency care which their insurance won't take a bet on. They are not in truth the true market, because the true market stands on its own feet. They are simply profiteers. That may not seem like much of a comfort, but it is, because it means that the NHS structure however hollowed out, will stay in place. People are always going to need emergency care. Emergency care means ambulances, blood banks, intensive care and the system that goes with that. Not to mention the training of doctors and nurses, which is another of those tiresome jobs that private firms just don't want to know about. That means that a good part of the NHS will stay in place because it has to and that in turn means that at some point, we could reverse what has just happened. It is not going to be easy and will probably take years, but it can be done.

The other aspect of the HSCB, is that it is not happening everywhere. It is not happening in Scotland, and that means politically that there is a point of comparison between the old NHS system and the new all-singing-all-dancing one in England. If things go wrong, it can be compared. If England runs short of doctors, then they can look and see if it's happening in Scotland. If people are not getting treated for chronic conditions and they are in Scotland, then again there is an unfavourable conclusion that can be drawn on the new system. I am beginning to think that Scotland may have a key role to play in any efforts to reverse the situation in England, and I think we should do all that we can to help you on this.

Which brings me to the second tumultous event this week; the GMC's 'guidelines' on social media. Why does this link? Well, what happens next depends on what story is told. When things go wrong with the new system (and they just have as Dr Zorro has pointed out with NHS 111) then someone needs to tell people why it went wrong. As we move away from the traditional NHS, the private companies are going to have fewer opportunities to blame mistakes on the NHS. And as that evolves, there will be more of an effort to conceal the truth and suppress those who would tell it. That's us folks, the bloggers, tweeters and facebookers. Our chance to reverse this situation depends on our ability to report what is happening. A paper trail or at least an electronic one needs to be laid on the new NHS and the mainstream media ain't going to do it. The emasculation of the BBC on the HSCB's progress through Parliament is a sad testimony to that and Witchdoctor has just written a chilling post on how a small group of interested parties managed to give us a regulated press. And that means we have to find a way round the GMC's guidelines.

I intend to keep blogging. I am not a doctor and the GMC has no hold over me. I hope those who are 'old and bold'; those who have retired, will also do the same. NHS Blog Doctor, if you're out there, now would be a good time to show yourself. And I am willing to offer a platform to any practising medic who has something to say on this blog.

Some years ago I was in a country far from here. (I don't want to say where, because it might affect people close to me). In this country, clothes and food were six times cheaper than they are here. But there was one item that was the same price as it is in Britain and that was books. That meant that for people in that country, that information was six times as expensive to obtain as it is here and out of reach for many. The rulers of that country well understood that information is power. So do our rulers. It's time to defy them. As we say in Scotland -

FREEDOM!!

Cui Bono? The Interested Parties..

So how did the Health and Social Care Bill get through? This list here might tell you.
 One thing I can't make my mind up about. Did these people end up in private healthcare because they joined the government, or did these people end up in government because they were in private healthcare? You decide..

How We Were..

Courtesy of the Wellcome Library on Youtube.

'When the rest of the world sleeps, a call may come from the sick or those in trouble - a call that cannot be disregarded.'


That call is now.

The Daughter of Time

Francis Bacon (1561-1626) Novum Organum:

With regard to authority, it is the greatest weakness to attribute infinite credit to particular authors, and to refuse his own prerogative to time, the author of all authors, and, therefore, of all authority. For, truth is rightly named the daughter of time, not of authority. It is not wonderful, therefore, if the bonds of antiquity, authority, and unanimity, have so enchained the power of man, that he is unable (as if bewitched) to become familiar with things themselves. 


Some years ago, I was clearing out the loft in our house. It's not very comfortable; there is enough head room to sit in it (while avoiding the swinging light bulb) but no room to stand. I was going through a pile of mildewed books that my mum and dad had collected and was sorting them into 'will-never-notice-it's-gone' to 'don't-even-think-about-chucking-this-out' piles, when I came across a book called 'The Daughter of Time' by Josephine Tey. Intrigued, I opened it up and for the next hour I sat cramped in the loft and read it.

 The story is obstensibly a fictional one, but it is actually an examination of the facts surrounding the disappearance of the princes in the Tower and whether Richard III did indeed have them killed or if someone else did it. The book concludes that it was Henry Tudor that did it and it convinced me, but I'll leave you to read it. What was more important about the book was the care that the author had taken to put together her case and her ability to look beyond what had become an accepted truth - that Richard III had killed the princes. I didn't realise how important the book was to me until today, when it was confirmed that the skeleton found under a car park , was that of Richard III. To prove it, the archeologists found the location of a long demolished church, compared DNA from a relative, re-modelled the skull and analysed the wounds, which had come from a battle.

Why is it important to me? Because of this. So much of your time as a politician is spent creating paper trails about what actually took place and so much of your time is spent reading trails that others created in the hope that someone one day would actually seek out the truth. Sometimes the creators don't even know they are doing it; but when they do their job exceptionally well it can really matter. For example, I didn't realise how important maps were, until I had to research the land that a local school was getting built on. Then I understood why my father had held onto old maps of our town and why someone had to collect them in case they needed to be checked. Again, I was looking for the history of the local canal, which tied into it and I spent a couple of months trying to get an out-of-print copy of a book on the subject, only to discover it in a cupboard in my own house. My dad had bought it when it had first come out and had kept it.

Recording is so important. Libraries are so important, because when a myth has built up, they can contain the means by which to find out the truth. It can be painstaking and bitsy, but it is there. And sometimes just one sentence can make all the difference in an account. In the Daughter of Time, it was a casual reference in a history book to Henry Tudor systematically killing all claimants to the throne after he had taken it that made the difference. For me, it was a single detail on one of those maps that became vital.

The truth is out there. But it depends both on those who record it and those who seek it and sometimes it can take centuries for it come out. Truth is the daughter of time and depends on the pedants and hoarders of this world to keep it safe. I now wish that I had not been so casual in throwing out so many of my parents books. And I am glad that I kept 'The Daughter of Time'. It taught me far more than I thought.

London is on the March

Here come the first casualties of the Health and Social Care bill. Thousands are marching today to save Lewisham A&E, which was going to be downgraded to shore up the neighbouring South London Trust (which they are not part of). The item's six or seven down the Beeb's list just now - apparently a shrieking tennis player doing the dying swan in Australia is more important.The terminology is also infuriating.Since when did trusts make profits or losses? They are either funded or underfunded. Auntie please take note. But it's started, and these people will not be ignored. If only they had understood what was happening last year and come out in those numbers..

A Job for Dr No?

It's the New Year - time for pastures new, striking out, going where you've never been before... How about a nice GP job on the isle of Arran? I can highly recommend the island itself. And there's a helicopter. Just wondering where Dr No is..

So Beautiful

I was going to post a Christmas carol here for the season. Then I came across this and just had to post it. Wishing you all a very Merry Christmas and a Happy New Year..