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.