It was with great dismay that I read that NICE is to be divested of its power to act as regulator for drugs for the NHS. This is to be handed to GPs as part of the commissioning deal and will leave NICE as a pretty toothless organisation, ready to be thrown on the quango bonfire.
Those who read me regularly will know that I have a chequered attitude to NICE. On the one hand, I was furious about the blatantly political attempt to remove all dementia medicines from prescriptions. At the same time, I do recognise its value as a negotiator with pharmaceutical companies about the price of their drugs. Drugs in America can cost five or six times what they cost here, because there is not a national regulator between the companies and the patients. Removing this guard dog is going to make the price of drugs in Britain shoot up and place GPs in the invidious position where they might reject one drug, but the GP next to them might prescribe it.
But there is another element to this move. Some time ago I did an post on the European Cross Border Directive and the dangers inherent in this for the NHS. One of its proposals was for prescriptions written in one country to be recognised in another. I wondered aloud how this would work given that NICE did not permit the same drugs under prescription that other countries did. I think we have just been given our answer. The removal of a national regulator to be replaced with local ones, is turning the NHS into a group of health care organisations along the lines of the American HMO. Many GP practices are run by the likes of United Health and Atos; they also have their favourite drugs companies who pay them big bucks to promote their brands. This move is more dangerous than it looks.
Europe marches on. The franchising of the NHS marches on. The vultures are gathering..
Monday, 1 November 2010
Sunday, 31 October 2010
A Story for Halloween..
Pat Diver, the tinker, was a man well-accustomed to a wandering life, and to strange shelters; he had shared the beggar's blanket in smoky cabins; he had crouched beside the still in many a nook and comer where poteen was made on the wild Innishowen mountains; he had even slept on the bare heather, or on the ditch, with no roof over him but the vault of heaven; yet were all his nights of adventure tame and commonplace when compared with one especial night.
During the day preceding that night, he had mended all the kettles and saucepans in Moville and Greencastle, and was on his way to Culdaff, when night overtook him on a lonely mountain road.He knocked at one door after another asking for a night's lodging, while he jingled the halfpence in his pocket, but was everywhere refused.
Where was the boasted hospitality of Innishowen, which he had never before known to fail? It was of no use to be able to pay when the people seemed so churlish. Thus thinking, he made his way towards a light a little farther on, and knocked at another cabin door.
An old man and woman were seated one at each side of the fire.
"Will you be pleased to give me a night's lodging, sir?" asked Pat respectfully.
"Can you tell a story?" returned the old man.
"No, then, sir, I canna say I'm good at story-telling," replied the puzzled tinker.
"Then you maun just gang farther, for none but them that can tell a story will get in here."
This reply was made in so decided a tone that Pat did not attempt to repeat his appeal, but turned away reluctantly to resume his weary journey.
"A story, indeed," muttered he. "Auld wives fables to please the weans!"
As he took up his bundle of tinkering implements, he observed a barn standing rather behind the dwelling-house, and, aided by the rising moon, he made his way towards it.
It was a clean, roomy barn, with a piled-up heap of straw in one corner. Here was a shelter not to be despised; so Pat crept under the straw and was soon asleep. He could not have slept very long when he was awakened by the tramp of feet, and, peeping cautiously through a crevice in his straw covering, he saw four immensely tall men enter the barn, dragging a body which they threw roughly upon the floor.
They next lighted a fire in the middle of the barn, and fastened the corpse by the feet with a great rope to a beam in the roof. One of them began to turn it slowly before the fire. "Come on," said he, addressing a gigantic fellow, the tallest of the four--"I'm tired; you be to tak' your turn."
"Faix an' troth, I'll no' turn him," replied the big man.
"There's Pat Diver in under the straw, why wouldn't he tak' his turn?"
With hideous clamour the four men called the wretched Pat, who, seeing there was no escape, thought it was his wisest plan to come forth as he was hidden.
"Now, Pat," said they, "you'll turn the corpse, but if you let him burn you'll be tied up there and roasted in his place."
Pat's hair stood on end, and the cold perspiration poured from his forehead, but there was nothing for it but to perform his dreadful task.Seeing him fairly embarked in it, the tall men went away.
Soon, however, the flames rose so high as to singe the rope, and the corpse fell with a great thud upon the fire, scattering the ashes and embers, and extracting a howl of anguish from the miserable cook, who rushed to the door, and ran for his life.He ran on until he was ready to drop with fatigue, when, seeing a drain overgrown with tall, rank grass, he thought he would creep in there and lie hidden till morning.
But he was not many minutes in the drain before he heard the heavy tramping again, and the four men came up with their burthen, which they laid down on the edge of the drain.
"I'm tired," said one, to the giant; "it's your turn to carry him a piece now."
"Faix and troth, I'll no' carry him," replied he, "but there's Pat Diver in the drain, why wouldn't he come out and tak' his turn?"
"Come out, Pat, come out," roared all the men, and Pat, almost dead with fright, crept out.
He staggered on under weight of the corpse until he reached Kiltown Abbey, a ruin festooned with ivy, where the brown owl hooted all night long, and the forgotten dead slept around the walls under dense, matted tangles of brambles and ben-weed.
No one ever buried there now, but Pat's tall companions turned into the wild graveyard, and began digging a grave.Pat, seeing them thus engaged, thought he might once more try to escape, and climbed up into a hawthorn tree in the fence, hoping to be hidden in the boughs.
"I'm tired," said the man who was digging the grave; "here, take the spade," addressing the big man, "it's your turn."
'Faix an' troth, it's no' my turn," replied he, as before. "There's Pat Driver in the tree, why wouldn't he come down and tak' his turn?"
Pat came down to take the spade, but just then the cocks in the little farmyards and cabins round the abbey began to crow, and the men looked at one another.
"We must go," said they, "and well is it for you, Pat Diver, that the cocks crowed, for if they had not, you'd just ha' been bundled into that grave with the corpse."
Two months passed, and Pat had wandered far and wide over the county Donegal, when he chanced to arrive at Raphoe during a fair.Among the crowd that filled the Diamond he came suddenly on the big man.
"How are you, Pat Diver?" said he, bending down to look into the tinker's face.
"You've the advantage of me, sir, for I havna' the pleasure of knowing you," faltered Pat.
"Do you not know me, Pat?" Whisper--"When you go back to Innishowen, you'll have a story to tell!"
During the day preceding that night, he had mended all the kettles and saucepans in Moville and Greencastle, and was on his way to Culdaff, when night overtook him on a lonely mountain road.He knocked at one door after another asking for a night's lodging, while he jingled the halfpence in his pocket, but was everywhere refused.
Where was the boasted hospitality of Innishowen, which he had never before known to fail? It was of no use to be able to pay when the people seemed so churlish. Thus thinking, he made his way towards a light a little farther on, and knocked at another cabin door.
An old man and woman were seated one at each side of the fire.
"Will you be pleased to give me a night's lodging, sir?" asked Pat respectfully.
"Can you tell a story?" returned the old man.
"No, then, sir, I canna say I'm good at story-telling," replied the puzzled tinker.
"Then you maun just gang farther, for none but them that can tell a story will get in here."
This reply was made in so decided a tone that Pat did not attempt to repeat his appeal, but turned away reluctantly to resume his weary journey.
"A story, indeed," muttered he. "Auld wives fables to please the weans!"
As he took up his bundle of tinkering implements, he observed a barn standing rather behind the dwelling-house, and, aided by the rising moon, he made his way towards it.
It was a clean, roomy barn, with a piled-up heap of straw in one corner. Here was a shelter not to be despised; so Pat crept under the straw and was soon asleep. He could not have slept very long when he was awakened by the tramp of feet, and, peeping cautiously through a crevice in his straw covering, he saw four immensely tall men enter the barn, dragging a body which they threw roughly upon the floor.
They next lighted a fire in the middle of the barn, and fastened the corpse by the feet with a great rope to a beam in the roof. One of them began to turn it slowly before the fire. "Come on," said he, addressing a gigantic fellow, the tallest of the four--"I'm tired; you be to tak' your turn."
"Faix an' troth, I'll no' turn him," replied the big man.
"There's Pat Diver in under the straw, why wouldn't he tak' his turn?"
With hideous clamour the four men called the wretched Pat, who, seeing there was no escape, thought it was his wisest plan to come forth as he was hidden.
"Now, Pat," said they, "you'll turn the corpse, but if you let him burn you'll be tied up there and roasted in his place."
Pat's hair stood on end, and the cold perspiration poured from his forehead, but there was nothing for it but to perform his dreadful task.Seeing him fairly embarked in it, the tall men went away.
Soon, however, the flames rose so high as to singe the rope, and the corpse fell with a great thud upon the fire, scattering the ashes and embers, and extracting a howl of anguish from the miserable cook, who rushed to the door, and ran for his life.He ran on until he was ready to drop with fatigue, when, seeing a drain overgrown with tall, rank grass, he thought he would creep in there and lie hidden till morning.
But he was not many minutes in the drain before he heard the heavy tramping again, and the four men came up with their burthen, which they laid down on the edge of the drain.
"I'm tired," said one, to the giant; "it's your turn to carry him a piece now."
"Faix and troth, I'll no' carry him," replied he, "but there's Pat Diver in the drain, why wouldn't he come out and tak' his turn?"
"Come out, Pat, come out," roared all the men, and Pat, almost dead with fright, crept out.
He staggered on under weight of the corpse until he reached Kiltown Abbey, a ruin festooned with ivy, where the brown owl hooted all night long, and the forgotten dead slept around the walls under dense, matted tangles of brambles and ben-weed.
No one ever buried there now, but Pat's tall companions turned into the wild graveyard, and began digging a grave.Pat, seeing them thus engaged, thought he might once more try to escape, and climbed up into a hawthorn tree in the fence, hoping to be hidden in the boughs.
"I'm tired," said the man who was digging the grave; "here, take the spade," addressing the big man, "it's your turn."
'Faix an' troth, it's no' my turn," replied he, as before. "There's Pat Driver in the tree, why wouldn't he come down and tak' his turn?"
Pat came down to take the spade, but just then the cocks in the little farmyards and cabins round the abbey began to crow, and the men looked at one another.
"We must go," said they, "and well is it for you, Pat Diver, that the cocks crowed, for if they had not, you'd just ha' been bundled into that grave with the corpse."
Two months passed, and Pat had wandered far and wide over the county Donegal, when he chanced to arrive at Raphoe during a fair.Among the crowd that filled the Diamond he came suddenly on the big man.
"How are you, Pat Diver?" said he, bending down to look into the tinker's face.
"You've the advantage of me, sir, for I havna' the pleasure of knowing you," faltered Pat.
"Do you not know me, Pat?" Whisper--"When you go back to Innishowen, you'll have a story to tell!"
Saturday, 11 September 2010
Sick Notes - A Very Useful Book
Back to normal, or something approaching it. I thought I'd start by reviewing Tony Copperfield's book 'Sick Notes' which I promised to do before events overtook me.
There's been a lot of reviews of this book, some complimentary and some less so. It's a breeze to read. It ain't Dr Findlay and it's not high literature. But what it actually is, is a very useful book. This book paints in squirming detail the day to day idiocies of the modern NHS that have resulted from policies on high, and the endless battle to try and find a human path around them. From the form filling, to waiting list protocols to choose and book; Tony Copperfield gives the worm's eye view of them all and therein lies the book's true value.
The accepted books on the politics of the NHS are Allyson Pollock's NHS PLC and John Lister's 'The NHS at 60; for Patients or Profits'. But neither of them are easy reads. 'Sick Notes' is, and of the three books, this is the one that I would give to a lay person or MP to read as an introduction to the present chaos within the NHS. (Then I'd give them the other two).
This is a political book that's easy to read. Give it to your non medic pals the next time they start moaning about GPs. Give it to your MPs. Send a copy to Andrew Lansley. They'll read and understand. And maybe, just maybe, they might do something about it.
Monday, 6 September 2010
Thank You
Just to say thank you for all the condolences that I received, both by blog and email. It truly is a comfort at this time. Normal blogging will resume in the next couple of days, but in the meantime, have a listen to Paulo Nautini's rendition of Autumn Leaves, a song about his grandfather. And have the Kleenex ready..
Monday, 30 August 2010
An End and a Beginning
You may or may not have noticed that it is a while since I did a post. There's been a reason for this - just after the last post that I did, my mother, whom I had been caring for, passed away. She had been pretty ropey since March and I had been expecting it, but it was a shock just the same. I was going to do a blog post and then I couldn't. Neither did I want to move on as if nothing had happened and casually drop it into the blog somewhere as if it was of no consequence. So I waited until I was ready.
The past few weeks have been pretty weird. Up until a few weeks ago, I had a solid identity as Mum's carer. The house was like Hotel Central, with a steady procession of district nurses, carers and doctors dropping in and out. I had a limited amount of time in which I could go out and always had to be back for a certain time. Now they have all melted away and I feel like a satellite that has dropped out of orbit. Life has rewound to thirteen years previously, when I had finished my degree and diploma in music and I didn't have a clue where I was going with it. And yet..
And yet, how different the landscape looks. How different I am. Thirteen years ago, I would have never thought of getting involved in politics. Now I can't imagine not being involved and wonder why other people take no interest. How many fears that I had, seem childish now. And how I have learned the value of everything. There is nothing like the suffering of another, to teach you what's important and what's not.
In being a carer, I have learned to care. In some ways it's not a very pleasant thought. I wish that I could have learned this without the ugly twist of fate that gave my mum Alzheimer's. Nonetheless, it happened and I and others are changed as a result. And it has been a comfort that Mum herself never wasted a moment of the life that she did have. She was something rare; a great teacher and was the difference for many people who could have gone either way. That is her legacy.
So as I say I am back (and not back) to where I am. And I turned 40 last week. Does life begin now? Where am I going? We'll see. But this time round, I hope I have the tools to make better choices than I did back then.
It's a dangerous business, going out your door. You step onto the road, and if you don't keep your feet, there's no telling where you might be swept off to.
Rest in peace Mum. You should; you've no regrets. And keep an eye out for those of us still travelling along..
The past few weeks have been pretty weird. Up until a few weeks ago, I had a solid identity as Mum's carer. The house was like Hotel Central, with a steady procession of district nurses, carers and doctors dropping in and out. I had a limited amount of time in which I could go out and always had to be back for a certain time. Now they have all melted away and I feel like a satellite that has dropped out of orbit. Life has rewound to thirteen years previously, when I had finished my degree and diploma in music and I didn't have a clue where I was going with it. And yet..
And yet, how different the landscape looks. How different I am. Thirteen years ago, I would have never thought of getting involved in politics. Now I can't imagine not being involved and wonder why other people take no interest. How many fears that I had, seem childish now. And how I have learned the value of everything. There is nothing like the suffering of another, to teach you what's important and what's not.
In being a carer, I have learned to care. In some ways it's not a very pleasant thought. I wish that I could have learned this without the ugly twist of fate that gave my mum Alzheimer's. Nonetheless, it happened and I and others are changed as a result. And it has been a comfort that Mum herself never wasted a moment of the life that she did have. She was something rare; a great teacher and was the difference for many people who could have gone either way. That is her legacy.
So as I say I am back (and not back) to where I am. And I turned 40 last week. Does life begin now? Where am I going? We'll see. But this time round, I hope I have the tools to make better choices than I did back then.
It's a dangerous business, going out your door. You step onto the road, and if you don't keep your feet, there's no telling where you might be swept off to.
Rest in peace Mum. You should; you've no regrets. And keep an eye out for those of us still travelling along..
Sunday, 27 June 2010
The Royal Twitter
Inbetween all the argy barging, politics and serious stuff on the net there are those sites that aren't trying to change the world, but do add to the gaiety of the nations. (Not that England will be feeling this way after their drubbing by Germany. And I think it's time to tell Wayne Rooney to make an effort when he's playing internationals or at least to look less ugly.) But in the general gloom, her Majesty (we are led to believe) tweeted this message;
'I tweet to you now as your Queen. And thus I say to you, this country is still great. Have heart. Or at least a pimms. God bless you..'
God bless, your Majesty. Mine's a Blossom Hill. I'm cheap that way..
Thursday, 24 June 2010
Some Good News
After all the gloom in the blogosphere, I thought it was time to have some good news for a change. John Winton, who is part of our campaign network and who was running in the health board elections in Fife, won a seat. Not only that, but he was the first to reach the quota (after 35 counts, dear God.) This means that there is now at least one honest person on Fife Health Board.
Here's the list of those who were elected with the count stage they were elected at;
John Winton - Scottish Health Campaign Network 35
Elizabeth Adams -fundraiser for Maggies, Victoria hospital 37
Ann McGovern – leader of Fife council (labour) 51
Peter Adams – UKIP 52
Harry Blyth - councillor who represented Leven (labour)54
Susan Archibald – disability discrimination campaigner 54
Dave Stewart – chairman of NHS Fife’s operation division 54
Jayne Baxter 54
Margaret Harper- worked for Tayside NHS as a nurse; now in clinical governance 54
Ian Lowles- retired consultant 54
Arthur Morris- consultant plastic surgeon 54
Norma Wilson – medical secretary 54
And here's some of those that weren't elected;
John McKenzie Kirkaldy councillor (labour)
Fiona Purdon Glenrothes councillor (labour)
Harry Wills – Lib Dem candidate
Carole Patrick – deputy manager of CVS Fife
Ad Johnson – racial equality service based in Kirkaldy
Antony Payne – chairman of the Ecology centre in Kinghorn
Steven Marwick – son of Tricia Marwick , MSP
So what can be learned from these results and what do they mean for future health elections? I think the following conclusions can be drawn;
1) Belonging to a political party helps, but it is not a shoo in. Being a councillor or a candidate in another election doesnt mean you're going to get a seat on the health board. You need to be well known, as well as have the party rosette. Anne McGovern was the leader of Fife council; she also cared for her husband who had MS and died in 97.
2) Belonging to a campaign group helps, but only if it has a connection with health. John Winton from our group, Elizabeth Adams from Maggies and Susan Archibald who won a famous disability discrimination case got seats. Carole Patrick of Community Voluntary Services, Ad Johnson of the Racial Equality Service in Kirkaldy and Antony Payne of the Ecology Centre, didn't.
3) People like doctors. Two retired consultants, Ian Lowles and Arthur Morris got in. I'm told by my spies that they're good guys.
4) Being someone's relative is not a guarantee of a seat. Steven Marwick, son of Tricia Marwick MSP, didn't get in.
5) The Health board has influence but doesn't have as much in terms of bodies to vote as it thinks it does. None of their candidates made it into the top four, probably due to their crowding the paper with candidates and splitting their vote.
6) Crowding the paper with candidates doesn't work for either politicians or the health board. Politicos should take note of Peter Adams the UKIP candidate. He won a seat, because his vote was united. Labour and the health board lost seats, because they put in too many candidates and split their vote.
So what Fife have ended up with is a pretty eclectic bunch from all areas of the health and political spectrum. There's a fair balance between users, campaigners, professionals, politicos and management. That's actually how it should be. This is actually an election with a level playing field and I think NHS Fife will be much better as a result. It will mean that the flow of information will improve to all these sectors of health and that the health board will no longer have the ability to slap 'commercial confidentiality' on PFI projects and the like.
What of the turn out? 13.9% in Fife; 22% in Dumfries and Galloway. Slightly disappointing, but it was a trial run, with a huge ballot paper (60 candidates in Fife, 70 in Dumfries and Galloway). I can see the ballot papers getting smaller and the vote getting bigger as people get used to it.
Anyway, congratulations John. I'm sure there was a universal groan from the health board management when they heard the result and that's how it should be. Go gettem..
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