Andrew Langsley Gets the Rap

I've just come across this video via Dr Grumble and ABetterNHS. I am totally shocked, scandalised and flabbermagasted at the rude, disrespectful and scatologial content. And that's only the White Paper I'm talking about. On no account should you listen to this denigration of our great Health Leader and his wonderful plans for the NHS. Do you hear me?

Don't Just Stand and Moan, Do Something

Lots of negative vibes today on the Health and Social Care Bill. There were two votes lost; one at the BMA yesterday and the vote on the Opposition Day debate today. Much moaning and ochoning about Hamish Meldrum and people feeling sorry for themselves is going on. One poster is even going round putting up 'NHS 1948 - 2011'. You could be forgiven for giving up, couldn't you?

Well, maybe you could, but it's not me that's going to do the forgiving. And I'm not down. I'm angry. At you. Yes, you in the white coats. Let me tell you why.


Things are tough just now. Sure, we'd all like to throw in the towel. That's how government works. They move fast to convince you that there is no point in attempting to counter them. Well, tell me this. Where the hell was everyone at the BMA's meeting yesterday? I've seen more people turn up at a meeting of the Tunbridge Wells Socialist Workers Association. Where were the rest of you to vote down Hamish Meldrum's appeasement policy? And if you couldn't get in, why were you not crowded outside the doors waving banners and shouting for the cameras? Do you think that it doesn't matter? Well, it damn well does. You lost one of the most important votes in the history of the NHS yesterday, because you didn't turn up.

Don't moan to me about Hamish Meldrum. Or Andrew Lansley. Or Nick Clegg. You have no one except yourselves to blame for the vote yesterday. And if you sit around moaning about how its all fixed and it's all going the one way, well, I've got news for you. It's always been like that. People only win against government when they do the one thing that they don't expect - they keep going.

This fight isn't over.The bill is still at committee stage in the Commons. It's got a third debate coming up and then it has to go through three debates and a committee stage in the Lords. There is still a lot to play for. And you've already given up, have you? You know,last week several thousand people died in a tsunami in Japan and they are facing nuclear meltdown. Whatever you are facing just now, it's not that. Get a perspective on the situation for God's sake.

What everyone has to do right now, is to do what they can.Get off your bums. Write those letters. Sack Hamish Meldrum. March on Parliament.Send a submission into the Parliamentary Committee here. Go and see your Lib Dem MP and threaten to disembowel them if they don't vote the right way in the next debate.Play the percentages and the cards you have, even if you think they're crap. If you think you're not going to win, then that means you've got nothing to lose by playing. Just do it.

This is the biggest fight in the history of the NHS. Are you really going to duck out of it? Are you going to go down without a fight? If it does go, in years to come, when your children asked what you did to save it, are you going to say, 'I gave up?' Are you going to sit and moan in a corner with your hands over your eyes waiting for the big bad privateers to come, or are you going to come out all guns blazing and fight them to the last bullet?

Let us go out and meet them. And the next person to moan about the BMA vote is going to get a copy of the White Paper shoved up where the sun don't shine..

Myth Busting and the Conservatives

Dr Grumble has had a letter from 'Call me Dave' regarding myths about the new NHS proposals. One would have thought that he had written it himself. He might have done but it is a cobbled version of a 'myth busting' document on Conservative Home. If you click here and then click on the 'Health and Social Care Myths PDF' to the right of the screen, you'll be able to uncover 20 myths about the NHS.

Warning; make sure that you are not holding anything hot or drinking anything, otherwise it will end up all over the computer screen.

She Must Be Mad(3) - Letter on GP Commissioning

Got this letter printed today in the Herald (one of Scotland's broadsheets)on GP commissioning. It is done from the Scottish perspective and the attempt here to try and introduce private companies into GP practices. For those of you who don't mind signing in to read the letter (it's free for the Herald) the link is here. Otherwise, here is the text of the letter below.


In March 2007, just a couple of months before the May elections, a small but significant fight over the future of the NHS took place in Scotland. SERCO, a utilities company, attempted to take over Harthill GP practice. It was unsuccessful, partly because it was publicised and partly because an election was looming. This was the first attempt by a private company to take over a GP practice in Scotland. Since then, legislation has been passed by the current Scottish government to prevent future occurrences of this nature.

England has not been so lucky. For some time now, companies like United HealthUK (a subsidiary of United Health in America), Atos and others have been taking over the running of GP practices in England. When this happens, the next move is generally to ‘hollow out’ the practice by replacing partners with salaried doctors and doctors with nurse practitioners. Drugs companies often link up with these practices, paying large sums of money in return for use of the practice as a shop window for their brand of drugs. Astra Zeneca was partnered with SERCO for example. The old, the chronically ill and the disabled are not welcome at these practices, because they drag the profits down.

Now the final nail in the coffin has come in the shape of the NHS White Paper and GP commissioning. Handing over control of the NHS’s budget to GP practices might seem a great idea, until you realise that you are not handing it to GPs, but to anyone who happens to be running a GP practice. In England this can be a GP, or United Health or Richard Branson under the guise of Assura UK. This means that these companies, not GPs, are going to decide how hospitals, mental health and elderly care are funded and who is going to provide services such as pharmaceuticals to them. To this already toxic situation is added the possibility that the purchaser and the provider can belong to the same company. Serco run facilities management in Leicester Royal Infirmary and Norwich and Norfolk University hospitals; if they move into GP practices in the area they could be both commissioning care and providing it. As ordinary GPs cannot possibly run their practices and the whole of healthcare commissioning for their area at the same time, these companies will be brought in to do it for them and this conflict of interest will arise.

This bill, if passed, will mean the end of the NHS. It will be a franchise owned by myriad private companies, funded by public money. Strategic health planning and regulation will be a thing of the past as services get splintered between competing health care organisations. The recent divesting of NICE’s powers to regulate prescription drugs and the proposed lifting of the cap on private patients being treated at NHS hospitals will mean a market free for all. Although this bill is currently for England and Wales, nobody in Scotland should delude themselves that it would not cross the border if it was enacted there. Harthill is the proof of that. For anyone who cares about the NHS, now is the time to lobby MPs and take a stand.

Rationing - It's Here

A very important post by Witchdoctor. Rationing has arrived. Read it here.

So, What Are We Going to Do?

I've just finished reading 'A View from the Foothills'. This is an account of Tony Blair's government spanning 1999 - 2005 and is written by Chris Mullin, MP for Sunderland South. He's an intriguing character. He started off his career as a journalist and was involved in getting the Birmingham Six case reviewed. He supported Tony Benn against Michael Foot. He voted for the Iraq war on condition that it was approved by the UN. When it wasn't approved, he voted against it. He was one of the lowest claimers for expenses and provoked a few laughs when it was revealed that he had a £45 licence for a black and white telly. He refused to use a ministerial car on grounds of opulence and expense and had a running battle with his office over his non use of a pager. He's a very human person, not entirely a hero, but not belonging to the dark side. He's the type that if something unpopular were done, he would sometimes rebel, but if he didn't, he would drag his heels, leak a document and stick a spoke in the smooth wheel of government. He is, in short, like most of us.

One of the votes that I checked out of interest was the Legislative and Regulatory Reform Act 2006. It would take too long to tell you everything about this, but basically it gave ministers powers to exise laws from the body of legislature that had become outdated or unnecessary. However, the way that the original bill was worded would have in theory handed powers to the prime minister allowing him to abolish anything from not crossing the quad with a sword, to habeas corpus. Its nickname was 'The Abolition of Parliament Bill'. The Lords were responsible for its emasculation eventually, but it caused a storm in legislative circles.

Now here's the intriguing thing. Chris Mullin voted for this bill. This is someone who voted against 48 day detention, stop and search and so on; all the things you would expect a left leaning journalist and former editor of the Tribune to do. There's only one conclusion that I can draw from this; Chris Mullin didn't actually know what he was voting for. There was no reason for him not to rebel; by this time he had become a backbencher again. So why didn't he know what it was about? That's quite simple. It wasn't in the papers. It was not talked about. The bill was highly technical. It never made it out of the legislative chattering class. It wasn't on the radar, so it didn't exist. It was just a question of turning up for the vote and that was it. If he had known what it entailed, there's no doubt in my mind that he would have voted against it.

Was this remiss of him? Of course not. MPs deal with tonnes of stuff every day. They agree on most things; we only see the debates where they don't. And government is an ever shifting landscape. A cabinet minister is lucky if he stays in the same post for more than a year. That's nowhere near long enough to learn the brief. And if it's not in the papers, then there's only one other way that it would have been brought to his attention and that was through his constituents. It would have taken a lawyer to turn up and explain the implications of the bill to him blow by blow; then might he have understood what it was all about.

This is my fear about the GP commissioning bill. To put it bluntly, we are losing the media war on this. There is no way that we are going to get the public to understand the implications of this bill in time through the media. Half the media are biased,the other half don't understand and the third half are too lazy to find out. We are not going to do it in time through our blogs, although more curious souls will find accurate info on how this is really going to work. It is not going to be done through the medical colleges because they're still trying to get their s** together and it's going to be a feeble 'I protest' that you used to get from that poor prosecution lawyer up against Perry Mason. So what are we going to do?

There's only one way to tackle this now and that is to go behind enemy lines. Yep. We need to go to our MPs' surgeries. That is the only guaranteed means of delivering our message on GP commissioning. The media won't, the colleges won't and the BMA won't. We must do it. And this is how;


First, get a retired doctor to go to the MP. That way there's no backlash on someone's job.

Secondly, if possible, get a group of doctors to go.

Thirdly, take a one page briefing with the main points laid out in easy to read English and in bullet point style.

Fourthly, back it up with written letters and repeat visits to that surgery.

Now, this isn't going to work for all MPs. Some will vote for the government regardless. But I want you to consider this; of the 650 MPs who represent us, how many do you think have a clue what this is about? And of that 650, how many would vote against it if they understood the implications? I knew diddly squat about health politics five years ago and it's taken me a while to get my head round it. Why should it be different for anyone else who's not a medic?

One last point from Chris Mullin's book. The day before the vote on Iraq, he phoned round party activists and constituents who had come to him about it, because he was undecided as to whether he was going to rebel. Once he had spoken to them, he made his mind up and voted against the war.

Levinas said that it is the face that forbids us to kill. Snipers know this rule; they are more likely to shoot someone far away than someone at close range. Chris Mullin was wavering in the face of disapproval from the great and good in his party; but hearing the voices of those in his constituency kicked him into touch again.

Right now our MPs need to see the face of their doctor. Not the lazy overpaid Daily Rant version of doctors, but the ordinary one of their local GP who (in most cases) has treated their family from cradle to grave. And we need to remember that MPs have faces as well. Like most of us, they need encouragement to do the right thing. Conscience is not an individual choice, but it is influenced by those we know and those who love us. Formal battles take place in parliaments and palaces, but ultimately all struggles begin at home. And that is where we need take this battle now.