Defend Max Pemberton - Go Spartacus

I have just received from a reliable source that Richard Branson is spitting teeth about an article printed in the Telegraph on Sunday by Max Pemberton. What Pemberton is saying is fairly unremarkable; it's just what everyone else in health has been saying about what a crock of crap the Health Bill is. What is remarkable is that apparentlyBranson is demanding a half page reply; and that a high court injunction was served on Sunday to try to prevent the article being published. Branson is said to be unhappy too about tweeting on the subject and Max could be facing heavy costs because of this; £90 000 has been mentioned as a ballpark figure.


Now we really can't have this at all. I mean, what has the world come to when we have a potential headline 'Leftie Telegraph in Sue Threat by Branson over NHS'? There's really only one answer to this and that's to go Spartacus on it. Is the battle for the NHS over? No. We have only just begun to fight..

Of Conscience, Compromise and the Oaths which Bind Us

“When statesmen forsake their own private conscience for the sake of their public duties, they lead their country by a short route to chaos.”

More years ago than I care to remember, I was given ‘A Man For All Seasons’ by Robert Bolt at school to study for my English Higher. I am an avaricious reader of books, but I seldom read a book more than once. This book was different. It’s not what you would expect – although it’ s about a Catholic saint Sir Thomas More- it’s not a hagiography. What it is, is a study of the maxim ‘Every man has his price’. More was unique, Bolt argues, because there was a part of him that simply was not for sale. Against the backdrop of the Tudors and Henry VIII, Bolt states his case in stark beautiful language. And this week I returned to it. I was prompted both by the circumstances surrounding the Health and Social Care Bill and a post by Dr No, on what course of action we could or should take, now that the HSCB has been passed. Should we continue to resist and disrupt the bill by any means? Or should we accept it, and try to minimise the harm to the patient? To answer that, we have to look at just what exactly has happened to Westminster and how that has affected what has happened this week.

After the Westminster elections in 2010, the Lib Dems joined the Conservatives in a coalition. I was initially shocked by this. I shouldn’t have been. It simply crystallised something which I had been thinking for a while; that there had been a change in the kind of person entering politics at top level in Britain. People are very cynical about politicians and I understand this, because many politicians are self seeking. However, what you also find in politics are many idealists. You find idealists in politics because it is a place where ideals can be given shape, where the plan of a city can become bricks and mortar, where a vision of humanity like the NHS can become a reality. Politics is both a haunt of demons and a cloister of saints. The difference between the self seekers and the idealists in politics is this; self seekers are content simply with the trappings of power. The title, the money and the fancy cars are enough. But an idealist is not interested in these things. To them, the prize is having the power to change things. For a self seeker, the illusion of power is enough. For the idealist, political power is a tool for change.

That was why I was so shocked. The Lib Dems for the first time, had been handed the opportunity to hold the reins of power. To make a difference. They could have done this by playing honest broker and allowing the Conservatives to form a minority government. They could have voted with the things they liked and against the things they didn’t. They could have stopped student fees, the Welfare Reform Bill and of course, the Health and Social Care Bill.

They went into coalition and substituted the reality of power for its illusion. And to myself, the voters and the grassroots members of the Lib Dems and the Tories, this was totally incomprehensible. It could only mean one thing; that Westminster had been completely, utterly subsumed by self seekers. Some have talked of a tri-partite system, but this is not the correct way to understand what has happened. What has happened is that slowly but surely, these three parties have been taken over by the same elite of corporate lobbyists representing the biggest commercial interests in our country and they are now ruling in complete defiance of the wishes of the electorate. They do not listen to us and they do not listen to the grassroots members of the parties they supposedly espouse. There is always tension between the top and bottom of a political party, but the root has now become separated from the branch. They are accountable to no one apart from themselves and this malaise has spread from the second estate to all the others. Think on this week. First of all, government ignored the rule of the courts to print the risk register. They put themselves above the law. Then they sent out riot police to meet a handful of protestors opposing them and abused the proper function of the police. They shut down the BBC on commenting on the passage of the bill. Did you know that we were the first in the world with a police force and a broadcasting company ? Do you have any idea how respected both of these are; our police for being one of the few forces that has doggedly refused to go quasi military and arm itself and the BBC, for being a voice of freedom in countries that have none? And yet in the UK, its voice has been silenced.

So should we resist the change? To me, the answer is clear; we must. There is a time for compromise and there is a time when in truth we are no longer compromised; in truth we are corrupted. We must oppose this, because it isn’t simply about party politics; it’s about who we are and what our values are. I’m going to make a confession now. Last year, after the Lib Dems joined with the Tories, I joined the SNP. I did it because I could see no other way of tackling the toxic mire that Westminster had become. And yet, I have realised something this week. I also did it because I am British. Because I wanted to preserve the things I value about Britain, especially the NHS , in Scotland. And I have never felt so British as I have this week as I have watched our courts, our police, our BBC and our NHS being trashed in such a vulgar and disrespectful way. How sad that in the Queen’s Jubilee Year, when the Queen renews her coronation oath and re-dedicates herself to the preservation of our laws and constitution, that they are trampled underfoot in an unparalleled act of cultural vandalism. It is shameful.

In this week when the Queen renews her oath, I would urge doctors to renew theirs; the oath to first do no harm and to consider if they can truly keep this oath under the law that has just been passed. What it means if they cannot keep that oath. I’ll leave you with More’s/Bolt’s take on it.

When a man takes an oath, he's holding his own self in his own hands. Like water -and if he opens his fingers then-he needn't hope to find himself again..

The Health and Social Care Bill - Unhealthy Consequences

Do read Jim and Margaret Cuthbert's excellent article 'Unhealthy Consequences' on how the Health and Social Care bill could affect public expenditure, the Barnett Formula and the budget of Scotland.

All is Not Lost?

I was directed towards this letter in the Guardian written by Shirley Williams. Perhaps the Lords are planning to mug Andrew Lansley over tea and scones after all.

Perhaps all is not lost.

Study Used to Promote HSCB is Flawed, Says Allyson Pollock

Do take time to check out this analysis of the Zack Cooper paper, 'Does Hospital Competition Save Lives?' by Allyson Pollock et al. This was the study used to promote the Health and Social Care Bill with regard to 'choice'. Allyson Pollock concludes that it was flawed. You can reach the paper via the Scottish Health Campaigns Network's website here.

The Summer Soldier

These are the times that try mens’ souls. The summer soldier and the sunshine patriot will, in this crisis, shrink from the service of their country; but he that stands by it now, deserves the love and thanks of man and woman. Tyranny, like hell, is not easily conquered; yet we have this consolation with us, that the harder the conflict, the more glorious the triumph. What we obtain too cheap, we esteem too lightly; it is dearness only that gives every thing its value. Heaven knows how to put a proper price upon its goods; and it would be strange indeed if so celestial an article as freedom should not be so highly rated.

I turn with the warm ardour of a friend to those who have nobly stood, and are yet determined to stand the matter out: I call not upon a few, but upon all: not on this state or that state, but on every state: up and help us; lay your shoulders to the wheel; better to have too much force than too little, when so great an object is at stake. Let it be told to the future world, that in the depth of winter, when nothing but hope and virtue could survive, that the city and the country, alarmed at one common danger, came forth to meet and repulse it. Say not that thousands are gone, turn out your tens of thousands; throw not the burden of the day upon Providence, but “show your faith by your works,” that God may bless you. It matters not where you live, or what rank of life you hold, the evil or the blessing will reach you all. The far and the near, the home counties and the back, the rich and the poor, will suffer or rejoice alike. The heart that feels not now is dead; the blood of his children will curse his cowardice, who shrinks back at a time when a little might have saved the whole, and made them happy. I love the man that can smile in trouble, that can gather strength from distress, and grow brave by reflection. ‘Tis the business of little minds to shrink; but he whose heart is firm, and whose conscience approves his conduct, will pursue his principles unto death.

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We are fighting with pens, not swords. We will not lose our lives as ordinary soldiers do. All we need to do is write. Can we not do that much? Can we not keep going? Are we going to give in to despair?

We lost in the Commons. We now march to the Lords. Adopt a Lord. Keep writing. Keep fighting. And keep the faith we need to save the NHS.

Health and Social Care Bill - Letter to the Herald

This is my bit to help the campaign against the HSCB. I got this letter printed today in the Herald, a broadsheet in Scotland. Hope the Scottish MPs are all paying attention.

*******************************************

Dear Editor,

Today the most important vote on the NHS since its inception takes place. After a 'pause for reflection' the Health and Social Care Bill returns to Parliament for its third reading. It remains unchanged in substance despite the protests of the BMA, the RCN and various other medical and political bodies. If it is passed, the duty of the health secretary to provide healthcare will be abolished and the NHS will be handed over to private companies to commission healthcare as they see fit, together with an annual budget of £80 billion. It will be the end of the NHS.

This is not a policy that has been sprung on us suddenly by David Cameron. Since the early 90's, the NHS has gradually been taken over by private concerns.The buying up of primary care services, particularly GP practices was permitted and it is this that has led us to the present situation. If GP commissioning is passed then effectively the companies that own the GP practices, will be deciding what healthcare services are provided. As they also provide many of the services that they commission, it means that they can be both purchaser and provider in many areas. This built in abuse means that this bill is the precise opposite of what it is deemed to be. It is the gifiting of a blank cheque to private companies, guaranteed by public largesse, because the NHS is too large to fail.

Although this bill is for England, it will severely affect us in Scotland if it gets passed. As those who are disabled and chronically ill get turned away by the new profit based services in England, they will look north to where those services are still available. Scotland will find itself in the invidious position of either allowing them to come north for treatment and risk our services getting swamped, or turning away some of the sickest and most vulnerable in our society. There is a third choice, and that is for all of our Scottish MPs to turn up today and vote against this iniquitous bill. The NHS is not the property of government or private companies - it is our NHS.

Do You Want to Do Something to Save the NHS? Of Course You Do!

My third post in twenty four hours; howzat? Well, the internet lines are buzzing just now and there's a lot going on. If you're looking for something useful to do about the Health and Social Care Bill, then you could do worse than visit this link and pick a task. You could email your MP. You could adopt a peer (but you don't have to keep them in the house). You could read up the latest erudite articles on the situation. If you were really charitable you could leave a comment on the Scottish Health Campaigns Network site that wasn't spam. Or you could make a donation and pay someone else to worry about it.It's all here from the NHS Support Federation. Go on. Do something. Not a lot. Just a little. And if a lot do a little then it's lots. I think..

The Health Bill Will End the NHS - Official Report from 38 Degrees

Have just received word from 38 Degrees, who are campaiging against the Health and Social Care Bill. They paid for legal advice on the possible consequences of the HSCB, and their lawyers have concluded;

a) This does signal the end of the Health Secretary's duty to provide healthcare;

b) It will open the NHS to privatisation and by that route, exposure to European competition rules for service procurement.

You can find the full report here. Please read it and email your MP. We've got seven days until the next vote on this. We can't slack now.

Ones and Twos - the Nail in the NHS's Coffin is Still There

In March, the eagle eyed Dr No wrote this blog post on what he termed 'the secret nail in the NHS's coffin'. This was a reference to a change in wording from the 2006 National Health Service Act Section 1. Section 1(1) and (2) of the 2006 Health Service Act reads as follows;

1 Secretary of State's duty to promote health service

(1) The Secretary of State must continue the promotion in England of a comprehensive health service designed to secure improvement—

(a) in the physical and mental health of the people of England, and

(b) in the prevention, diagnosis and treatment of illness.

(2) The Secretary of State must for that purpose provide or secure the provision of services in accordance with this Act.

Under the new wording originally proposed by the Health and Social Care Bill, it would look like this;

1 Secretary of State's duty to promote health service

(1) The Secretary of State must continue the promotion in England of a comprehensive health service designed to secure improvement—

(a) in the physical and mental health of the people of England, and

(b) in the prevention, diagnosis and treatment of illness.

.

(2) For that purpose, the Secretary of State—

(a) has the public health functions conferred by this Act, and

(b) in exercising functions in relation to a body mentioned in subsection (2A), must act with a view to securing the provision of services for the purposes of the health service in accordance with this Act.

Now, we have been banging on about this 'act with a view' phrase for the past while. It has got to be changed. We said so to the government. And the government via the DoH's Future Forum report has come back with this;

"The role of the Secretary of State

The policy is that the Secretary of State will be responsible – as now – for
promoting a comprehensive health service. The wording of section 1(1) of the 2006 NHS Act will remain unchanged in legislation, as it has since the
founding NHS Act of 1946. This will be underpinned by the new duties that
the Bill already places on the Secretary of State, around promoting quality
improvement and reducing inequalities."

Section 1(1) will remain unchanged. That's very good of them, seeing as they had not changed Section 1(1) in the first place. But what about Section 1(2), where the weasel phrase 'act with a view' cropped up? Are they going to go back to the original wording 'must for that purpose provide or secure the provision of services' ?

Guess what. It doesn't say. I think our dear government is hoping that we get our ones and twos mixed up and not notice that they have made a promise to keep precisely the same wording that they had for Section 1(1) anyway, while not promising to change the wording of Section 1(2).

The nail is still in the NHS's coffin. We must act and get the word round as quickly as we can and make it as public as we can. We are at the most dangerous moment in this debate, because Labour and the Lib Dems are in a position where they can say that the government has agreed to reforms under pressure and support the Health and Social Care Bill, rather than having to go back to the drawing board again. We have to anticipate that and make sure that there is no hiding place for the opposition on this issue and that they cannot walk by on the other side. This is serious. This is fundamental. This is the end of our health service if we don't manage to prise this nail out of the wood. Let's get to work now.

One to Watch - Professor David Kerr

Have just been looking at the list of people who have been picked as the' listening panel' for the Health and Social Care Bill. One name jumped out at me - Professor David Kerr. He is simply listed as Professor of Cancer Medicine at Oxford, and you might think that was enough to be getting on with. But there's more to Prof Kerr than that. He has been an advisor on health for Andrew Lansley for the past year. Before that, he was up in Scotland (he is Scottish) and produced a report for his namesake Andy Kerr, (who was the Scottish Health Minister at the time) called, 'Building a Health Service Fit for the Future.' This report became the blueprint for Andy Kerr's 'slash and burn' approach to level 3 hospitals across the central belt in Scotland and led to the absolutely disastrous approach to A&E provision in Glasgow, where only two hospitals are going to be A&Es. Believe me, it's not enough. My own hospital Monklands, was threatened and if Labour had not been put out in 2007, our A&E would have been shut as well. After the SNP got in, he went south and has now cropped up in the middle of another melee - the Health and Social Care Bill.

So why has a man who was advisor to Labour in Scotland, now advisor to the Conservatives in England? The more cynical might venture that this is because there is barely a fag paper's difference in policy between the two. But there's another reason. Kerr is the classic outsider. He is Scottish. He was at one point allegedly, a card carrying member of Labour. And he has been brought in for the same reason that Maggie Thatcher, a woman and non Etonian was put in charge of the government and Field Marshall Haig, who was merchantile class was put in charge of the troops in the First World War. There's unpleasant business afoot. An outsider is needed to do it. Thatcher was brought in to crush the unions. Haig was brought in to preside over a bloodbath. Kerr has been brought in I believe, to close hospitals.

This man is your hatchet man. Watch him.

A Glimmer of Hope?

Something interesting is going on at the Daily Mail just now. Not just the fact that one reader made a sensible comment on nurse staffing levels, but I have been reading this article re Rachael Woollaston's opposition to the Health and Social Care Bill. (Rachel Woollaston is a Tory MP and also a GP. What's very interesting is the comments below the article. Here's a selection. (warning; put hot drinks down and make sure you are not within reaching distance of a half brick.)


"What a dangerous precedent giving GP the power to wheel and deal with our lives. The main focus should be on provide healthcare to their patients and not with the financial cost of this care. If GPs start controlling the budget then they will fundamentally try to preserve it by outsourcing to the cheapest providers, which may not be the best, efficient or closest to your local area."

"In recent years GPs have changed from, mainly, dedicated family doctors to group practices whose principal aim appears to be financial profit rather than care of the patient. They are subcontracters to the NHS and are therefore autonomous, hence their refusal to implement the NHS requirement of giving patients access to a GP within 48 hours. Given control of vast sums of money it is probable that much will be diverted into their own pet schemes rather than in improvement of patient care and treatment. Just note how much the practice nurses now do compared with their GP bosses! Andrew Lansley is riding headlong into trouble!"

"Whilst I strongly support getting rid of layers and layers of bureaucracy in RHAs, PCTs and even in the Dept of Health, Dr Wollaston is correct and Lansley's proposed changes to the NHS are likely to end in more tears simply because GPs are in the business of practicing medicine and dealing with illnesses by dishing out pills and potions and not spending much of their time fiddling budgets. Giving GPs £80bn a year to pay for consultant appointments, tests, procedures and operations is a bit like putting Dracula in charge of a blood bank."

"I would not allow my Bank Manager to decide if I had appendicitis or IBS and I'd rather my GP wasn't responsible for massive amounts of NHS budgets as she has no qualifications to suggest that she is any more competent to spend the money than I am. To say Cameron is out of his depth is the understatement of all time."

Ok, ok. Now calm down. These people are against Andrew Lansley's reforms. They are not against them for the reasons that you would like them to be against them (the idea that GPs are all greedy mercenary profiteers who only care about profits), but they are against them. In fact, out of 42 comments only six were in favour and they were the worst rated comments on the board.

For the past couple of years, Daily Mail readers have been fed a diet of anti -doctor stories and the Mail has pandered to natural Conservative instincts. They get paid too much. There's too much bureaucracy. They're incompetent and don't know what they're doing. They are autonomous and are not in touch with local needs. Now, suddenly, those same people that have been so denigrated are to be handed £80 billion of public money to do with as they like and naturally DM readers don't like it. Because these doctors are greedy, wasteful, uncaring, autonomous operators, aren't they?

I think the propagandists have made a booboo. One the one hand they want to kid on that commissioning is being handed over to nice fluffy GPs, not private companies. On the other hand, they wanted to reduce the reputation of GPs to soften up the ground for the reforms when GPs protested against it. They've been caught between two stools.

There is another element here and it's a point I made in this post. Being a Conservative pre -Thatcher, didn't mean being in favour of profiteering. The characteristics of old Conservatism are thrift, value for money and small government. This bill goes against these instincts. Rachel Woollaston has pointed that out and with Cameron trying to make capital out of condemning PFI as wasteful, he is going to find it very difficult to justify the White Paper.

Things are taking a new turn. I think saving the NHS is not going to be a battle between different political parties, but it is going to be grass roots versus leaders. The Conservatives are now joining in and in that, I can see a glimmer of hope.