The Sick Man is Getting Better - Scotland's Health Improves

Now, I don't want to be cynical, but is it a coincidence that these figures have been released in Scotland, just a few days after the BMA called for action on alcohol advertising?

New figures published yesterday show 12,770 deaths were registered from April to June this year, a drop of 5.4 per cent compared to 2008.According to the General Register Office for Scotland, that was the lowest total recorded for “at least” 30 years, and just over 3,000 less than the same period in 1979.

And the number of Scots falling victim to the “Big Three” killers has shown a drop compared to last year.

Heart disease deaths fell by nearly 11 per cent, stroke deaths by almost seven per cent, and there was a 0.6 per cent decline in the number of people dying from cancer.


Scottish Daily Express

Well, maybe it is too much of a coincidence. But it's a very welcome one. Big government went out of favour in the eighties, but these figures would suggest the smoking ban is working and that there is a place for the 'nanny state'. Perhaps we should be less afraid of being censorious in our attitude to smoking and drinking. Break out the Schloer..

Disappearing Headlines - the Elderly Care Cover Up

Yesterday, I was going through the BBC health RSS feed. Near the top was a report that in an honesty test, 58% of people thought it was ok for a care home nurse to persuade an elderly person to change the will in the carer's favour. The story was headlined with this statistic. I was going to do a post on it and then I was distracted. Some hours later, I came back to the feed and at first I couldn't find the story. That was because it was now headed, 'Women judge, but do they convict?' Today, I went back and found that the story was 21st on the RSS list, way below older articles on swine flu and others.

It's not the first time that this has happened with the Beeb. The Stafford story disappeared off the radar after two days. This story about people with learning disabilities being starved to death, was mentioned first in a news trailer and reported on third. Now this. I note it's also well below the article on assisted suicide; wouldn't want anyone to make a connection between changing wills and helping the old dears on to inherit, would we?

I don't know what's more shocking to me. The fact that nearly two thirds of people think it's ok to swindle an old lady, or the fact that somebody very well connected seems to be leaning on the Beeb to cover it up. The older I get, the more I understand the function of the court oath,' The truth, the whole truth and nothing but the truth'. To be dishonest you don't actually have to lie. It's enough to change a headline or move a story down the RSS list. This is one honesty test that the Beeb has failed miserably.

Words of Wisdom from Allyson Pollock

Do have a look at Allyson Pollock's excellent article on the McKinsey report. I found myself nodding like a punk rocker all the way through it. Why can't everyone be like her? Reminds me of something my dad's headmaster used to say;

'As Jesus Christ said and I very much agree with him..'

How to Save Money on the NHS -Managers versus Staff

The esteemed consultants McKinsey recently held a stakeholder summit for management and staff from the NHS.Much fat,carbs and black forest gateau was consumed. The idea was to have a brainstorming session with blue sky thinking in order to effect a step change within the culture of the NHS. Or to put it another way, they wanted to know how to save money. The managers got together and made up one list. The staff got together and made up another. Yours truly was sneaked a copy of the result which I print below.

Managers list of Money Saving Ideas for the NHS

1. Sack 1.5 million staff by 2014, leading to a saving of approx £75 billion
2. Remove any patient from GP lists whose case notes are more than 1/4 inch thick.
3. Put all patients in hospitals, out into B&Bs in the community and let social work pay for them.
4. Let that nice man Richard Branson in to run GP practices with lots of nice potted plants and flip charts.
5. Pay out the £50 billion to managers for being so clever at doing all these things.

Staffs' List of Money Saving Ideas for the NHS

1. Sack anyone with the word 'facilitator' in their job title.
2. Sack anyone with the word 'Donaldson' in their name.
3. Firebomb all Darzi clinics.
4. Put a Doomsday virus into the 'Connecting for Health' supercomputer. On the other hand don't bother; it'll not be noticed amongst all the others.
5. Put in the Tower anyone who uses a beard, jumper or hot air balloon in an attempt to appear friendly and engaging.

There was also one other paper found, but nobody knows who wrote it, except that they signed it 'Cassandra'. Their list said,

1. Use the government's newly acquired control of the banks to give back the profits made on re-financing PFI deals;
2. Employ more frontline staff to improve productivity and ensure patients are not hanging about in hospitals when they don't need to;
3. Get the government to reduce the capital charge or abolish it altogether. This means that city hospitals especially are paying out an inordinate amount on the value of their property. At the very least, charge hospitals on the actual value of their equipment for the capital charge, not what it costs to buy new.
4. Provide some proper step-down beds and continuing care beds in whats left of the old day and continuing care hospitals and don't take up room in acute care.
5. Instead of trying to build a massive supercomputer that spotty faced teenagers can hack into when they're bored, build a number of smaller localised computer services in each county, like wot the Jocks are doing. And the next time Accenture breach their contract sue them for £1 billion, not £63 million.
6. Abolish the internal market in the NHS and bring back the health boards. That will get rid of the endless paper trail following every purchase, every patient, every tender and it will get rid of the accountants, lawyers, middle managers and alternative health care providers that know diddly squat about health that hang on to that system. All things being equal, you should be able to halve your admin costs from 12% to 6% by doing this.

Cassandra indeed..

Vote for Margaret Haywood -Support Our Whistleblowers

Margaret Haywood, the nurse who blew the whistle on poor standards of care for the elderly on Panorama, has been shortlisted for the Patients' Choice for the Nursing Standards Nurse
Awards. You can vote for her here. If you do nothing else this week do this; Margaret Haywood lost her job whistleblowing and it's important that we show our support. And do pass the message on..

Playing at Doctors -Big Pharma is Coming to Town

I'm a suspicious sort of soul. When choosing between cock up or conspiracy, I always go for the latter. It does mean that sometimes you are pleasantly surprised when things do not go as badly as you think; but more often it means that you're right and everyone hates you for it. So it came about that when the 'minor ailments' service was brought in in pharmacies, I began to be suspicious. On the face of it, it sounded like a good idea. GPs really don't like being phoned up every five minutes to write out prescriptions for Calpol and the like, and there's no doubt that it did take a burden off them. But it's what went with that. Consulting rooms. Prescribing powers. Hmm. Was this about convenience or was it the government's idea for further dilution of the GP service?

The answer came this week. Lloyd's the big pharmacy chain, has applied to be an 'alternative medical services provider.' It is going to set up consultation rooms where a patient can speak to a virtual doctor online. So instead of going to the doctor you can go to the pharmacist and at the same time you can buy all your lovely drugs from Lloyds instead of those boring generic ones you can get at the local dispensary. Great.

It's going to be particularly interesting how this is going to pan out in Scotland. The SNP has a policy against privatisation in the NHS and in 2007 the attempt to bring in SERCO for Harthill GP practice was closed down very quickly. This is opening up another front and is a direct challenge to the SNP's current attempts to amend the GP contract that allows this. There was always a danger that this would happen, because although the Scottish Government can change our legislation, European legislation states that any business worth more than a certain amount had to be open to tender. GP practices could get round this by being small and it was thought that the relentless march of the health centre and the resulting merging of practices would be the way big business would worm its way in. It looks like they've found a back door. Instead of having to deal with GPs and persuading them to shift to new premises they're doing the process the other way round. And we are going to lose GPs and dilute the service we have.

It was a conspiracy. I was right. And I hate that I'm right..

A Toast to the Scottish Government

There aren't a lot of bright spots in healthcare at the moment, what with Daniel Hannan slagging off the NHS on American tv and the political parties rushing to its defence while simultaneously privatising what's left of it. But today there was a good news story. The Scottish government has brought in measures to restrict the sale of alchohol to one place in supermarkets, to ban irresponsible drinks promotions and loss leaders, and is following up with proposals to price drinks according to units instead of classification. This means that sights like this are going to become a thing of the past. I'm sure there are folks out there who are disappointed not to find their regular Lambrusco beside a pair of rolling skates in Tescos, but otherwise I think it's a good day for Scotland and a gold star for Nicola Sturgeon. It looks like we have someone fit for taking on the big drinks companies at last.