The Destruction of the NHS: A Dialogue at Breaking Point

The Destruction of the NHS: A Dialogue at Breaking Point

by Nima Ghadiri

Is the NHS at breaking point?

Yes, it really is. As things stand, it will not exist in five to ten years time, and different elements of our Health Service will be apportioned as Dialysis-Plus East Coast, CrossCancer, Virgin Maternity, or whatever other word-pasticcio the “brand positioner” regorges.

With consecutive governments in seemingly total denial about the state of the NHS, the phrase “crisis point” is an understatement. We need to do something now, every month which passes brings the death sentence closer.

Ok, just…. just chill out there for a second. Are things really THAT BAD?

Chucking about numbers is often a precursor to a well-known Disraeli quote, paraphrased by Mark Twain. Nevertheless, sometimes they are needed so people can grasp what is happening.

Since 2011, there has been a 504% increase in the number of patients waiting over four hours in A&E Departments across the country, forcing Secretary of State for Health Jeremy Hunt to ditch the target.   23 hospitals were simultaneously on black alert earlier this year, which means that they “are unable to guarantee life-saving emergency care”. This included Jeremy Hunt’s own local hospital The Royal Surrey, which had 27 patients urgently needing a bed but no space.

Waiting times for surgery have been getting much longer, and 4093 urgent operations were cancelled in 2016, an increase of 27% in just two years.  Knee and hip operations are now being rationed only for those who aren’t able to sleep because of agony, using bogus “pain tests” as a differentiator.

Cancer treatment targets have been missed for four consecutive years, and services are now failing.  Mental health services are being rationed, so people who suffer are dying in their homes, unable to care for themselves.

These are frightening figures, it’s no wonder the Red Cross (who stepped in early in the year to help with a shortage of ambulances) has declared the NHS a humanitarian crisis, as people are dying needlessly in the world’s fifth-richest country…

Stop, I get the idea, things are looking gloomy all round. Surely, we have the MONEY to stop this?

Source: BMA

Astonishingly, as demand has risen hugely, funding has been cut.  Our spending on the NHS as a percentage of our GDP has plummeted below 10%.  This is a lot less than France and Germany, and amongst the lowest in the developed world.

If our national health funding matched the average amount that Europe’s 10 leading economies spend on their healthcare, perhaps we could lose this uncoveted accolade:

Source: BMA

Yes, we need more NURSES and DOCTORS!

And we are getting far less.  Medical school applications have plummeted, the proportion of med school graduates who become first year doctors has gone down from 70% to 50%, with phrases such as “in droves” and “en masse” describing the number of junior doctors leaving the United Kingdom.  Enormous rota gaps are now ubiquitous, GP vacancies have skyrocketed from 2% in 2011 to 12.2% now, and 84% of general practitioners now say that their workload is affecting patient care.

Nursing applications have fallen by 23% over the last year, and the removal of bursary funding for student nurses and midwives has sent one clear message “We don’t value you”, underlined by years of below-inflation 0% and 1% pay rises.  By 2019, NHS workers will have seen their pay capped for nine consecutive years, and nurses will have seen their pay reduced by 12%.

To add salt into these raw and gaping wounds, the Secretary of State for Health massively over-estimated nurses’ average pay this month when he was asked why so many nurses are having to use food banks.

Source: British Medical Journal

So they want things to fail, is this all about PRIVATISATION?

We don’t need to speculate about this, it’s all there in numbers, contracts, even a book with Jeremy Hunt’s name on it, calling for the de-nationalisation of the NHS.  There has been an increase in spending on “independent sector providers” of a third between 2014 and 2016, and an estimated 500% more contracts have gone private since 2012.

Source: BMA

The plan for privatising the National Health Service isn’t exclusive to one party.  The groundwork was done by the previous government, with poorly conceived “public service reforms” leading to unfettered introduction of private corporations into commissioning. It has accelerated over recent years, however.

So what are the POLITICIANS saying?

Absolutely the wrong things. For a National Health Service which is quite visibly starving, Jeremy Hunt said: “The NHS needs to go on a 10-year diet”.

Theresa May also didn’t like the Red Cross assessment of the NHS, calling them “irresponsible” and “overblown”.

The BMA has identified five key issues for the future of the NHS, and it would indeed be “irresponsible” if politicians did not address these:

Source: BMA

Are you subtly telling me which way to VOTE?

No, it’s not for me to instruct you, and people don’t like being told what to do.  Nevertheless, it’s currently very easy for the mainstream media and tabloid press to distract the general population and report on fake scandals rather than one which is very real, and affects all of us.

As long as you are aware of what is happening and can make up your own mind, then that’s already very important. If you can spread the word to others, even better.  Over the next few months we will see an increase in grass-roots movements in social media and the streets, in support of the National Health Service.  There will be a nurses’ summer of protest activity, a show of anger against pay-rise caps and maltreatment which has left 40,000 posts unfilled.

Battling a Murdoch and Dacre Press which has vested interests against the NHS will be challenging, and no doubt lies will be spun which confuse and subvert.  Tabloid journalism had a pivotal role in the Junior Doctor contracts dispute, and may do so against the nurses too. It is crucial to appreciate that supporting our nurses means supporting our National Health Service.

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[MUST READ] Coca-Cola’s secret influence on medical and science journalists

Please read this article from the British Medical Journal: http://www.bmj.com/content/357/bmj.j1638

 

This is a very important argument, and it is essential for healthcare professionals, journalists and politicians alike to make a concerted and aggressive effort to kick these sugar-peddling companies out of the sphere of academic influence.

The more overt “More Doctors smoke…” advertisements of yesteryear are thankfully a thing of the past, but the covert influence of sugar-saturated food companies is no less a threat to our health. Aaron and Siegel (1) report that from 2011 to 2015, the Coca-Cola Company and PepsiCo were found to sponsor 95 national health organizations, many medical and public health institutions amongst them. They also lobbied against 29 public health bills intended to reduce soda consumption or improve nutrition.

The British Nutrition Foundation, for example, lists amongst “Sustaining Members” Coca-Cola, PepsiCo, Kellogg, Nestle, Tate & Lyle and has “Corporate Members” British Sugar plc, Mars UK, KP Snacks, McDonalds, United Biscuits, Weetabix, Ocean Spray and many more. Although it is open to companies and corporations from a variety of backgrounds including healthcare and fitness, the actual members who have provided support read as a Who’s Who of Sugar Salesmen (2), making their promise of a “a focus on objective nutrition science interpretation and delivery” open to scrutiny. The American Society for Nutrition is no different, with an almost-identical list of names cropping up (3) for this group, which publishes the Journal of Nutrition.

Indeed, the editorial boards of top nutrition journals are littered by corporate affiliations with sweetie companies – The American Journal of Clinical Nutrition, for example, lists the likes of Mars, Coca-Cola, PepsiCo, Nestle, McDonald’s  and Ferrero amongst companies who have a relationship with members of their board (4). The ambassador’s reception may also be overflowing with hazelnut-and-wafer spherical treats at many other nutrition journals, who often  home of the Journal of Nutrition Education and Behavior, who have eight “corporate patron friends” and four “corporate sustaining friends.  (5)

It would be interesting to note how these journals consider submissions which report a detriment to health from these companies’ products, but when some of the largest nutrition journals display such a conflict of interest it must become clear to all that the Honey Pot relationship between “Big Food” and academia is poisonous and needs to be dealt with.

References:

(1) Sponsorship of National Health Organizations by Two Major Soda Companies. Aaron, Daniel G. et al. American Journal of Preventive Medicine , Volume 52 , Issue 1 , 20 – 30

(2) “Member Organisations – British Nutrition Foundation”. Nutrition.org.uk. N.p., 2017. Web. 10 Apr. 2017.

(3) “American Society For Nutrition – Our Sustaining Partners”. Nutrition.org. N.p., 2017. Web. 10 Apr. 2017.

(4) AJCN Editor Conflict of Interest Statement. (2017). Ajcn.nutrition.org. http://ajcn.nutrition.org/site/misc/EditorCOI.xhtml Web, 10 April. 2017.

(5) Nestle, Marion. Food Politics. 1st ed. Berkeley, Calif.: University of California Press, 2013. P112. Print.

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“Nazi Germany of the early 1920s” Snapshot of UK Newspapers 5th October 2016

papers

My boss is of Jewish origin, his parents emigrating from Germany and Poland. He lost relatives in Auschwitz.  He is a phenomenally loyal NHS Doctor. Earlier in the year he said that the language being used by media and politicians is eerily resembling 1920-30s Germany and the rise of the Nazi party.  I wasn’t paying too much attention, but I valued his statement as he is a remarkable observationalist .

He was right, this style of rhetoric and the undercurrent behind the statements echoes Das Reich and Das Shwarze Korps. I’ve never employed Godwin’s law before – but we are veering on the abyss which leads to National Socialism.

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Jeremy Hunt’s Seven-Day Homeopathic NHS: Just The Tincture?

Jeremy Hunt and the government appear to be on course for the world’s first routine 7-day health service. Unfortunately, this pioneering endeavour is hindered by a marked gap in resources. Currently (as according to NHS Providers) 80% of acute hospitals in England are in financial deficit, compared to 5% three years ago. Missed waiting time targets have risen from 10% to 90% during the same period. In recent years, healthcare expenditure per capita for the United Kingdom has been stagnant in comparison with other developed countries:

 

On the path to establishing this revolutionary provision, a number of steps have been taken to ensure that the foundations are as flimsy as possible. Jeremy Hunt has pushed a junior doctor contract which undervalues them and discriminates against women. He has also removed bursaries for student nurses and allied health professionals. This has nurtured an atmosphere in which applications to work abroad have skyrocketed and the portension of mass exodus hinted at in recent years may well come to fruition. Following recent events, a significant (13.5%) reduction in medical school applications over the last twelve months is unlikely to help matters.

So the question arises, how does Mr Hunt seek to introduce this 7-day NHS with negligible funding and staffing levels? And, perhaps, the answer has been there all along…

 

Back in 2007, before landing the job of health secretary, Jeremy Hunt asked the Chief Medical Officer to review three homeopathic studies. He also signed an Early Day Motion supporting the provision of homeopathic medicines (including simple saline solutions diluted to negligible concentrations) which “welcomes the positive contribution made to the health of the nation by the NHS homeopathic hospitals”, and “calls on the government to support these valuable national assets”. In 2014, he again called for herbal remedies to be made available on the NHS.

 

When one of his constituents wrote a letter to Mr Hunt disagreeing with the evidence basis for such treatments, the Secretary of State for Health responded:

“I understand that it is your view that homeopathy is not effective, and therefore that people should not be encouraged to use it as a treatment. However, I am afraid that I have to disagree with you on this issue. I realise my answer will be a disappointing one for you”

Our Minister for Magic Health’s judgement on this matter may have been influenced by another Conservative MP, David Tredinnick. Indeed, Jeremy Hunt’s request for the homeopathic studies to be reviewed was made at the behest of Mr Tredinnick, who has previously advised parliament that blood does not clot under a full moon, advocated the use of homeopathy as a treatment for HIV, tuberculosis and malaria and asked that homeopathic borax be used to control foot-and-mouth disease.

Are Mr Hunt and Mr Tredinnick on to something? The combination of drugs for treating TB vary between £5000 and £50-70000 depending on whether the variant is “normal” or “drug-resistant”. Dilution to homeopathic doses can make these expensive drugs much less costly.

Even better, nature’s finest Witch Hazel, which has been used for TB (albeit in the 19th century), comes in at a tidy £2.99 per bottle from your local chemist and can last for months if the degree of dilution is precise. It can even be grown on hospital grounds, generating further savings.

 

The workforce could also be rationalised in a homeopathic 7-day NHS. The impact of Jeremy Hunt’s contract for junior doctors (indeed, the need for doctors in the first place) can be negated by alternative healthcare practitioners, some of whom might not even require an income. A new hospital druid role potentially offsets the vast increase in applications to Australia and New Zealand and reduction in medical school applications.

Mr Tredinnick is also a firm believer in astrology as a “useful diagnostic tool” which, alongside complementary medicine, could take “pressure off NHS doctors”. As a Capricorn, the zodiac does indeed advise that his opinion should be reliable and trustworthy for Jeremy Hunt’s Scorpio. Mr Tredinnick states “I do foresee that one day astrology will have a role to play in healthcare.” Conceivably, that day may come sooner, and we will have alternative medicine permeating into our accident and emergency departments. This delightful sketch from comedy duo Mitchell and Webb might not be too far from the truth:

When the practical and economic feasibility of a routine 7-day NHS has been roundly debunked by senior doctors, service providers and analyists, it is only natural to ask how this is going to happen. Maybe, we ought to be thinking a little more naturally ourselves, and prepare for our complementary secretary of state for health to give us a very complementary 7-day routine NHS.

This article was first posted on the Huffington Post and can be found here: http://www.huffingtonpost.co.uk/nima-ghadiri/jeremy-hunts-7day-homeopa_b_12298592.html

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Hospitals in England are on the brink of collapse, warn NHS chiefs (The Guardian)

Sounds like a great time to introduce the world’s first routine 7 day health service, right?

 

Theresa May urged to boost funding or ration care to head off escalating cash crisis and avoid ‘1990s-style decline’

Source: https://www.theguardian.com/society/2016/sep/10/hospitals-on-brink-of-collapse-say-health-chiefs

The body that represents hospitals across England has issued a startling warning that the NHS is close to breaking point because of its escalating cash crisis.

Years of underfunding have left the service facing such “impossible” demands that without urgent extra investment in November’s autumn statement it will have to cut staff, bring in charges or introduce “draconian rationing” of treatment – all options that will provoke public disquiet, it says.

In an unprecedentedly bleak assessment of the NHS’s own health, NHS Providers, which speaks for hospital trust chairs and chief executives, tells ministers that widespread breaches of performance targets, chronic understaffing and huge overspends by hospitals mean that it is heading back to the visible decline it last experienced in the 1990s.

“Taken together this means the NHS is increasingly failing to do the job it wants to do and the public needs it to do, through no fault of its own,” Chris Hopson, the chief executive of NHS Providers, writes in the Observer.

His intervention comes days before the influential Commons health select committee decides whether to launch a special inquiry into the state of the NHS in England. After months dominated by the Brexit debate, the state of the NHS is now emerging as the key domestic challenge facing Theresa May’s government.

Recalling the NHS’s deterioration in the 1990s, which caused political problems for John Major’s government, Hopson adds: “NHS performance rarely goes off the edge of a cliff. As the 1990s showed, instead we get a long, slow decline that is only fully visible in retrospect. It’s therefore difficult to isolate a single point in that downward trajectory to sound a warning bell. But NHS trust chairs and chief executives are now ringing that bell. We face a stark choice of investing the resources required to keep up with demand or watching the NHS slowly deteriorate. They are saying it is impossible to provide the right quality of service and meet performance targets on the funding available. Something has to give.”

In a direct appeal to May to increase NHS funding in the autumn statement in November, Hopson warns the government will face “unpalatable choices” if the service is to keep within the existing budget. “The logical areas to examine would be more draconian rationing of access to care, formally relaxing performance targets, shutting services, extending and increasing charges, cutting the priorities the NHS is trying to deliver or, more explicitly, controlling the size of the NHS workforce,” says Hopson.

His warning comes days after the NHS posted its worst set of performance figures for services such as A&E, planned operations and ambulance response times.

Hopson blames the “full-blown crisis in social care” created by cuts to town hall budgets for causing “major problems for the NHS”, such as record numbers of healthy patients who cannot be discharged because social care is not available. This means that “hospitals are now being asked to routinely run at capacity levels that risk patient safety”.

Norman Lamb, the Liberal Democrat MP who was a health minister in the Tory-Lib Dem coalition, said Hopson’s “absolutely accurate reflection” of life on the frontline showed that “the government is in total denial about the reality of the state of the NHS and that they continue to mislead”.

“Ministers refer to ‘£10bn extra’, which to many people will seem a lot of money. But that £10bn is being stretched in a number of directions, including to pay for the seven-day NHS. Everyone who has looked into the finances of both the NHS and care system knows that this is nowhere near enough. We are the world’s fifth or sixth largest economy so it’s really horrendous that, despite our relative wealth, we have a health and social care system that is on its knees,” he added.

Chris Ham, the King’s Fund’s chief executive, said: “The clear message from the NHS leaders, doctors and nurses I’ve spoken to is that they are increasingly unable to cope with rising demand for services, maintain standards of care and stay within their budgets.

“The government must be honest with the public about what the NHS can deliver with the funding it has been given. It is simply not realistic to expect hard-pressed staff to deliver new commitments like seven-day services while also meeting waiting-time targets and reducing financial deficits.”

A government spokesman said: “We know the NHS is under pressure because of our ageing population, but we rightly expect the service to continue to ensure that patients get treated quickly.”

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