El King’s Fund acaba de anunciar que Chris Ham será el próximo director de la institución sustituyendo a Niall Dickson.

Ver la nota de prensa de King’s Fund y las declaraciones de Chris Ham.

Hello there!

If anyone wanted proof that Labour have lost the plot when it comes to targets, agencies, QUANGOs and the like need only see today’s stories about the hospitals in Essex (read the story here). One which was rated as “Good” last month has in fact been found this month to have: “Floors, curtains and equipment stained with blood; soiled and stained mattresses; and re-use of tubes and other items designed to be thrown away after each patient.”

Such major and blatant hygiene failures do not happen overnight, so demonstrate admirably how the tick-box  troopers employed by government at all levels is all too often not adding any real value or honesty to the quality of our public services. Last week we found out that a similar exercise in local government is costing us all £4billion every year!

And who is accountable for the actions of these bodies? 18 months ago, our application for funding for a permanent traveller site was decided upon by the minister in the Department of Communities and Local Government. If we didn’t like their response, we could get MPs to question it in the House of Commons, and we could vote them out at the next election. Now though, these decisions are taken by the Homes and Communities Agency. No accountability, no democratic control.

Plus I bet that no ministers or civil servants were replaced by this newest QUANGO!

The next government needs a genuine bonfire of both QUANGOs and targets. Ministers should take decisions and should do so quickly, openly and where the public can have control over it at the ballot box. Otherwise what is the point of democracy?

TTFN
Gareth.

 Thanks to David Ellis for this.

Back in July this year, the Nuffield Trust, an influential health service think-tank, published a report suggesting that NHS Trusts should become a business in the John Lewis mould. This, they claimed, would boost staff engagement and raise productivity by 4 or 5 per cent. It is, in fact, privatisation.

It is believed that this suggestion, one of several of its type in the snappily named report `NHS Mutual: Engaging staff and aligning incentives to achieve higher levels of performance’, is almost certain to make it into the New Labour manifesto in time for next year’s general election.

The department store John Lewis is held in trust for its employees who are then entitled to a share of the profits. This incentivises its staff to take an active interest in the business and to sell more merchandise. However, the NHS is free at the point of delivery. It is funded by National Insurance Contributions. The type of pressure on NHS staff to maximise their profits will be somewhat different to those experienced by John Lewis workers.

By turning workers involved in publicly-funded care services into profit hungry mini-capitalists they will be incentivised not to provide a better service but to deny service, to deny medicines, to not make referrals, to diagnose the cheaper illness, to close that ward, that wing, that hospice, that hospital. All in the name of an annual dividend paid out of that part of the budget that remains unspent. Obviously, you could circumvent that problem by making the customer king. That is, make them pay then the staff would have to earn their profits. That, however, would be the end of health service delivery at the point of use and in reality the end of health service for the ordinary worker.

It will be necessary to oppose to this manifesto policy during the election with a socialist policy. Such a policy would demand workers’ control of the NHS Trusts. If demoralisation and lack of engagement really are endemic amongst NHS trust staff, as the mainstream press have suddenly and conveniently discovered, then not privatisation but workers democracy is the only solution for both them and the communities they serve.

Whilst remaining socially owned and publicly funded either by national or local governmental forms, Trust board members and managers at every level within the Trusts need to be elected by the workers they manage. Elected staff bodies should be responsible for appointing junior managers and setting their pay whilst managers at senior level should be elected directly following a short campaign in which they outline their plans and the remuneration they are seeking. These elections would be scrutinised by the staff body and the victors should be instantly recallable and subject to re-election perhaps every four years though obviously it will be up to the staff themselves to set the rules and time limits. This would act as instant anti-dote to the endless and meaningless staff consultation that currently poses as workplace democracy in the NHS.

Patients and their relatives must of course be given a more powerful voice in the day to day running of the hospital. Their input and advocacy will do a great deal to keep both managers and staff on their toes and prevent any bureaucratism or cynicism from creeping in. It would, in that sense, help a great deal if workers had a genuine work/life balance, provided they’ve got a job, which allowed them to take a more active approach to the institutions that care for their sick and for their children.

Of course, the Tory manifesto won’t be proposing anything quite as coy as this backdoor version of privatisation coming as it does clothed in the language of staff productivity and morale. For that reason the Tories must be immediately stopped at the ballot box. They are looking for a political mandate that will allow them to go much further, much faster. Labour will find it much more difficult to finally destroy the NHS. Either way, however, before, during and after the election NHS workers must prepare to resist privatisation, defend social ownership and prepare for workers’ control. Naturally this campaign could be greatly advanced if it could gain the support of the Health Service unions.

A friend of mine who changed her name a few months ago received a phone call from Charing Cross yesterday to inform her that her deed poll (which had been seen and approved of in her presence by both receptionists and medical staff working at the clinic) was “inappropriate”. As such, they will revert to using her male name in correspondence.

She says that: I have found out that my deed poll is ‘inappropriate’ because it has not been signed by, and I quote, the “Government Deed Poll Issuing Authority”.

They didn’t like her deed poll because she printed it herself, using a free template (similar to this one). A lot of young trans people do this because we often cannot afford to “buy” a deed poll. Others on low income or benefits are likely to use these deed polls too.

These documents are widely accepted. My friend whose deed poll was not good enough for Charing Cross has successfully changed the name on her driving license with hers, for example.

Apparently this wasn’t a one-off case. My friend pointed out that she knew others with similar deed polls which had been accepted by the gender clinic. She was informed: “then they are most certainly in our pile of deed polls to return and names to revert to the original name on the deed poll.”

I honestly don’t know what the hell they think they’re playing at. My own DIY deed poll was used to change my name with a university, the NHS, a couple of banks and on my passport. I fail to understand what makes Charing Cross gender clinic so special that they get to not-accept someone’s (perfectly legal) change of name, just because it hasn’t been witnessed by a solicitor.

This policy seems to demonstrate once again that Charing Cross do not have their patients’ best interests at heart. Rejecting deed polls like this will be a blow to many trans people who already have low confidence or self-esteem, and could be dangerous for those who have already changed their name and are living “stealth” if the clinic sends them correspondence addressed to their old name.

http://www.dailymail.co.uk/news/article-1231150/Mapping-strain-NHS-243-sick-babies-treated-London-hospital-ward—just-18-mothers-born-UK.html#comments

Of all the disgraceful articles the Daily Mail has ever published throughout its miserable existence, this piece of awful journalism, that basically tells us nothing at all, is probably the worst. Congratulations on reaching a new low. The comments on the article are especially worrying (see below).

This is RUBBISH. I am an immigrant in Greece, I have to pay for any treatment I receive, I don’t expect the Greek tax payer to pay for my treatment like the immigrants in the UK.
– Roly, Corfu, 27/11/2009 6:28

Just maybe that’s because Greece doesn’t have an equivalent national health service. It’s hardly that Roly is paying more for treatment than his/her Greek counterparts. It’s not some racially-based two-tier system of payment, which appears to be the favoured choice for most Daily Mail readers.

We are not talking of Europeans who get reciprocal care as we would in their country, or those who live here and pay taxes, or those with insurance.
It is commonly known that some women from Africa and some countries in Asia treat London maternity units as their own.
– Jennifer, Yorkshire, 26/11/2009 19:43

Oh. So Jennifer is clearly fine with white people using our health services as long as no dirty ‘darkies’ do. Blatant racist.

English is our national language and it is the only language that should be in offical print. Our fight back has got to start somewhere, with our lanuage.
– Fed up with it all!, Lancashire, UK

Not only is this comment massively irrelevant but also just a little ironic. I somehow doubt that Fed up with it all! will be leading such a fight back.

There are British infertile couples on a very long waiting list that are turned away because there’s not enough money in the kitty to treat them but there’s enough to treat the fertile ones from overseas

- Sally, Ibiza Spain, 26/11/2009 18:59

That’ll be because IVF treatment is far more expensive than the care needed in a routine birth Sally (clearly one of the many Daily Mail reading expats who have bizarrely ended up living away from the motherland. Probably getting some kind of neo-colonial kick from it though).

The comments continue in this predictable, tedious way. All seemingly assume that these ‘foreign’ mothers are scrounging from UK taxpayer money, as though nobody born overseas can work and pay tax in the UK. Pretty weird really. Homogeneous white populations outside of the major British cities have clearly led to a country riven with ignorance and racism. Solution? More immigration please.

NHS workforce planning: Limitations and possibilities
Authors: Candace Imison, James Buchan, Su Xavier Publisher: The King’s Fund, November 2009   ISBN: 978 1 85717 587 5   No. of pages: 54
Report online (pdf 435 kb)

The Telegraph reports that appalling care, filthy wards and complacent management at Basildon and Thurrock University NHS Hospitals FoundationTrust have led to the deaths of up to 400 patients a year. The Care Quality Commission discovered a litany of negligence issues.

Extract from the Telegraph article:

“Katherine Murphy, director of the Patients Association said: “Yet again patients are being neglected. Lack of monitoring, lack of help with feeding, lack of dignity, avoidable pressure sores. How many times do the public need to keep hearing about this before the Government is embarrassed enough to do something about it?

“We’re sick and tired of NHS managers and senior staff walking away unscathed when families are left with a life sentence of grief.” “

It is routine for complaints about hospital care to be treated dismissively, denied and not acted upon. Until negligent personnel incur sanctions appropriate to the seriousness of the negligence and its outcomes, negligence will continue to flourish and increase. Healthcare staff are allowed to get away with appalling treatment of patients; they believe themselves to be safe from both censure and sanction. Over the years I have had two erring health professionals say to me that there was no point in my making a complaint about them because it would not do any good at all. – And therein lies the reason there is so much negligence by healthcare workers and so much needless suffering by NHS patients.

If negligent, uncaring, complacent staff were to be tried in a criminal court and found guilty of grievous bodily harm or whatever appropriate charge were to be laid, and received an appropriate sentence, these awful cases would become rare indeed.

Instead we have the useless inhouse system in which the usual complaints procedure is to ignore the complaints except perhaps to victimise the complainants.

CBT in the British NHS: Vague imposition or imposition of vagueness? European Journal of Psychotherapy & Counselling, Volume 11 Issue 3 September 2009 , pages 323 – 339

David Pilgrim – School of Social Work, University of Central Lancashire, Preston, PR1 2HE, UK

Abstract:

The multi-faceted controversy created by the ascendance of cognitive behaviour therapy (CBT) in the British mental health industry is outlined. The historical and philosophical nature of this controversy is traced, by looking at CBT as a psychiatric form of treatment and eclectic form of applied psychology. CBT has become a policy battleground, which can be understood by putting its modernist credentials and its appeal to rationalism, pragmatism and techno-centric optimism into a mixed pre-modern and post-modern context. Given that there are diverse representatives of these realms of belief alive today in our society, the current singular policy emphasis on CBT is anti-democratic and insensitive to diversity. The paradox of this restrictive policy is that CBT itself is now a very diverse set of practices held together mainly by a faith in evidence-based practice. Consequently, a version of pluralism is being tolerated on the supply side of mental health services but a full offer of true choice is not being made on the demand side.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

♥31♥

31Lovin These Scarves

Crowded

No Wonder The NHS Is Knackered

Mapping out the strain on your NHS: 243 sick babies treated in one London hospital ward…. and just 18 mothers come from Britain

Countless red dots scattered across the world map on the wall of a NHS hospital reveal the story of the changing face of Britain. Each dot denotes the background of a mother with a baby in the neonatal ward of London’s Chelsea and Westminster hospital. The map was put up by hospital administrators to ‘celebrate the ethnic diversity’ of the sick children treated there, each at a cost of £1,400 a day. It shows dramatically how the NHS now treats patients from every corner of the globe. The 243 mothers are from 72 different nations. They include Mongolia, the remotest regions of Russia, Japan, Africa, South America, swathes of Asia, Australasia and even Papua New Guinea. Only 18 mothers said they were from Britain. The women were invited to put a dot on the map to ‘represent’ their home country. One, a London-born mother of a baby treated there earlier this summer, sent the Mail a photograph of the result.She said: ‘Almost every cot and incubator at this wonderful unit was occupied by a baby with a foreign mother. Interpreters were on hand to make sure the mothers understood the doctors.’Babies’ lives are being saved and that is a good thing. Yet this seemed like a free-for-all.’

It is impossible to say how long each of the mothers has been in this country. But the fact is only a fraction of them declared themselves as having a British background.In theory, only a woman who has lived here legally for a year or has a student visa lasting more than six months is entitled to free NHS care when giving birth.

Yet few hospitals are prepared to turn away a pregnant patient in the late stages of labour. Indeed, the Government recently issued an instruction telling them to admit such women without question. Health Minister Ann Keen pronounced in July: ‘We remain firmly committed to the requirement that immediately necessary or urgent treatment should never be denied or delayed from those that require it.’ Many nurses and doctors on the NHS frontline believe her words were dangerously naive, even an explicit invitation to heavily pregnant women to fly to Britain to have babies. Some have arrived at Chelsea and Westminster – and other London hospitals – straight from the airport with the ticket tags still on their suitcases. Mothers-to-be target this country as ‘health tourists’ for a variety of reasons. Some do so because they face a difficult birth and want expert care unavailable in their home countries. Others have been told by doctors abroad that their baby will be born with a profound illness, needing a lifetime of treatment and medicines. They know the NHS will provide this with few questions asked even if the bill reaches millions of pounds. Chelsea and Westminster said the hospital cared for patients from many different backgrounds, reflecting London’s population. The map was intended to illustrate the diversity of the families of babies on the ward The Chelsea and Westminster Hospital’s neonatal ward treats 500 newborns each year from London and the south east. Many of the babies have been born prematurely or have inherited illnesses. They include those with ailments such as sickle cell anaemia (which is prevalent in African and Mediterranean communities, while almost unknown among those of northern European heritage), the HIV virus passed on from the mother, as well as deafness, blindness and devastating neurological problems common among ethnic communities in which marriages between cousins are the norm. Today nearly 25 percent of babies in Britain have mothers who were born abroad. In London the figure is 50 percent. The boroughs of Newham and Brent have the highest percentage, 75 percent and 73 percent respectively. Even in Chelsea (an area less associated with immigration) the figure is 67 percent, according to a recent Government report. Britain’s population is expected to grow from 61 million to 74 million over the next 20 years, the Office for National Statistics said last week. The estimate is based on both the continuing high birthrate of migrant mothers and levels of immigration as well as the longer life expectancy of the entire population. Meanwhile, at least three million foreigners have settled here legally since 1997 – a rate of 700 a day. Nearly a million more are living here illegally, the Home Office has admitted. Bliss, a campaigning charity supporting families with premature and sick babies, recently said that the NHS needs 2,700 more neonatal nurses to cope with growing numbers of baby births. They now total 791,000 a year, up 33,000 from 2007. Back at the Chelsea and Westminster Hospital, the colourful world baby map, proudly displayed on the wall for three months, was recently removed during construction work. Last night, a spokesperson for Chelsea and Westminster said that the hospital cared for patients from many different backgrounds, reflecting London’s population. The map was intended to illustrate the diversity of the families of babies on the ward.Chelsea and Westminster Hospital is a specialist referral centre and cares for patients of many different backgrounds, reflecting London’s very diverse population.
The hospital also issued the following statement: ‘  ‘Of the 550 babies admitted to our Neonatal Intensive Care Unit (NICU) every year, a very small number of these are overseas patients. In 2009, there have been just two overseas admissions. ‘The map was placed in the NICU nearly four years ago to provide the families of the babies we care for, as well as staff, with an opportunity to indicate their background if they wished. It is not an indication of country of residence or citizenship. ‘It was intended to illustrate the diversity of staff working on the unit and the families of the babies we care for, to encourage everyone to reflect on different cultures, in a fun and informal way.’Chelsea and Westminster Hospital’s NICU provides intensive care, high dependency and special care facilities for babies and is a specialist referral centre for neonatal surgery.’

Extremely Talented…But Mad As ABag Of Badgers

Just moments after finishing a note-perfect performance on live American television, Susan Boyle was seen on television breaking down in tears. The 48-year-old had been enjoying lunch with fans at the Rock Centre cafe in New York’s Rockefeller Centre. But she appeared increasingly withdrawn and started to tremble and suck her thumb. Then, visibly overcome with emotion, she bowed her head and began to sob.

H & S can sometimes go too far….and make itself look a total arse.….My Opinion…It looks crap !!!!

Health and safety forces council to swap traditional Christmas tree for £14,000 ‘traffic cone’

Health and safety-approved fake Christmas tree after being told a real one was a danger to the public.The traditional Norway fir tree, that costs about £500, has been axed this Christmas in Poole in Dorset amid fears it would fall over in high winds.So officials have defied the recession and forked out for the artificial 33ft tall tree that is shaped like a traffic cone and has no branches or decorations.

The tree is the brainchild of Poole’s Town Centre Management Board, an organisation made up of businesses and the local council. They say it costs them thousands of pounds a year in erecting and making safe a real Christmas tree and so decided to come up with a cheaper option. Although a 30ft real tree is about £500, it costs another £3,500 for specialists to decorate, light and install it using a cherry-picker. Susie Squire, of the Taxpayers’ Alliance, said: ‘You are still talking about a difference of £10,000. ‘I don’t think the people of Poole will feel very festive when they think that £10,000 could have been spent on tax cuts or public services.’ Richard Randall-Jones, the town centre manager, defended the new tree. He said: ‘People think you can just go into the woods, chop down a tree and put it up in the high street. But if it blows over and kills someone then somebody is liable for it. ‘We are a coastal town and so we have strict health and safety guidelines around making the Christmas tree safe due to the high winds we suffer. ‘We have to have guy ropes and hoardings to stop it from falling over and hitting somebody. ‘Last year the board said they and the public didn’t like all the ropes and hoardings around the Christmas tree, they looked ugly. ‘So I was tasked with finding a solution and we came up with the cone tree. ‘Children can walk right up to it and touch it and have their picture taken next to it. It looks really pretty with the lights on at night. ‘I challenge anyone who can find a better tree in the area.’ The cone tree is weighed down with two tons of ballast to prevent it from toppling over and it has speakers hidden inside that plays Christmas carols.

And Sting Looks Sh*t



Scottish Fruitcake Recipe

You’ll need the following:
1 cup of water
1 cup of sugar
4 large brown eggs
2 cups of dried fruit
1 teaspoon of salt
1 cup of brown sugar
Lemon juice
1 cup of nuts
1 bottle of whiskey.

• Sample the whiskey to check for quality.
• Take a large bowl. Check the whiskey again. To be sure it’s the highest quality, pour one level cup and drink. Repeat. Turn on the electric mixer, beat one cup of butter in a large fluffy bowl. Add one teaspoon of sugar and beat again.
• Make sure the whiskey is still okay. Cry another tup. Turn off the mixer. Beat two leggs and add to the bowl and chuck in the cup of dried fruit. Mix on the tuner. If the fired druit gets stuck in the beaterers, pry it loose with a drewscriver.
• Sample the whiskey to check for tonsisticity. Next, sift two cups of salt. Or something. Who cares?
• Check the whiskey. Now sift the lemon juice and strain your nuts. Add one table. Spoon. Of sugar or something. Whatever you can find.
• Grease the oven. Turn the cake tin to 350 degrees. Don’t forget to beat off the turner. Throw the bowl out of the window.
• Check the whiskey again and go to bed. Who the hell likes fruitcake anyway??

A YouGov survey, on behalf of the Know Your Limits campaign shows that 19 per cent of adults in England who exercise regularly and drink alcohol admit to taking exercise or playing sport in order to “make up” for having drunk a lot of alcohol in the previous few days. The story has been covered here and here.

The tendency to ‘work out the alcohol’ is even more prevalent among heavy drinkers: the survey shows one in five English adults are drinking more than double the NHS recommended limits and, of those who also exercise, over a quarter (28%) admit doing so to make up for their drinking.

This compares to just 10 per cent of people who exercise and drink at ‘lower risk’ – those who do not regularly drink more than 3-4 units a day for men, and 2-3 units a day for women.

According to a recent report, the NHS is falling behind Europe to implement new technologies that would benefit patients’ recovery time or quality of life. Barbara Harpham, Chairman of the Medical Technology Group and Chairman of Heart Research UK said

Slashing budgets is counterproductive as modern technologies help thousands of people stay in work and out of hospital. We already lag behind much of Europe, with problems like hospitals denying patients NICE-approved technologies because they lack the facilities or staff to support their use.

Conversley, NICE has recently refused to approve two more cancer drugs claiming that they would be too expensive to provide under NHS funding. Ssorafenib (Nexavar) for liver cancer and (so far)  bevacizumab (Avastin) for metastatic colorectal cancer have both been refused.

It’s seems to me that whether NICE refuses to approve a drug or whether the NHS won’t pay out for it, patients in this country will continue to be denied life-prolonging or life-improving treatments.

The Report “Medical Technology – Can We Afford To Miss Out?” indicates that three times more cardioverter-defibrillator (ICDs) were installed in Germany last year compared with the UK, despite the device being approved by NICE.

The HSJ website this morning discussed a DH report on the state of the NHS Constitution. In short, it appears that while SHA’s are pleased with the constitution, the NHS front line are not particularly enamoured with it. Many do not feel that they are ready for it, many feel that they have already done it, and not even half of staff are aware of the constitution. What strikes me about the article is a quotation from the report itself:

‘A key challenge is therefore to move the NHS away from seeing the NHS constitution as a box that has already been ticked, to something that is vital and fresh.’

Why? If it isn’t fresh, why try to view it as such? Looking at the NHS Constitution for England itself, staff ‘responsibilities’ can be summarised thus:

Be accountable for your actions

Comply with health and safety

Comply with your employment contract

Don’t discriminate

Respect confidentiality

Don’t lie on your application or when doing your job

Note that none of these actually concern treating patients; those fall into the category of ‘expectations’ that staff should ‘aim to’ achieve. Consider this: staff are told to ‘aim to’ treat patients well, but only after they have been hit with a list of ‘duties’ that are legally unavoidable anyway. It’s unsurprising that a constitution stressing legal, bureaucratic and administrative duties should be ignored by frontline professionals who would rather spend their work day caring for patients.

IMPROVING YOUR LOCAL N.H.S. (National Health Service) and the services it provides is in all our interests. Everyone at some stage in their lives will need the help of the N.H.S.

Patient Opinion is a service that uses your experiences and stories of using health services in order to help other patients and bring about improvements. By simply sharing your opinion on what was good and what could have been better can have a dramatic affect on services.

You can view what others are saying about your local hospitals and health services. But importantly you can very easily add your story, compliment, concern or experience of a particular service in four quick and easy steps.

You have to provide your post code, e-mail address and give a first name which can be a nickname and tick boxes to indicate what your story is about. You will be asked for a password which will allow you to access the website in the future. It is a simple and quick process.

Your story is then looked at by Patient Opinion and the story published unless it contravenes their terms and conditions. Patient Opinion ensures that your story is seen by the right Managers and professionals in your local NHS that can make a difference to services provided.

Example of a story posted on Patient Opinion by Daisy Day Care (as the patient’s nickname) about Castle Hill Hospital

What I liked: I would like to take the opportunity to thank all the staff who made me feel very comfortable and relaxed. It was my first time ever under general anaesthetic, i was never left alone and a special thanks to the nurse who was lovely, kind,caring and had to endure me babbling rubbish and asking for a beer when i came around (sorry). I left feeling very assured that i had been in safe and professional hands and when i return for further treatment i will have no worries or anxiety. Thankyou all for you’re care.”

The following links give further information about what patients, carers and others are saying about local hospital services:

Castle Hill stories

Hull Royal Infirmary stories

Patient opinions can also be shared over the phone on tel: 0845 113 0012.

Other useful information: NHS Choices

This uncertainty with C is doing my head in. I spent this afternoon looking online and through Yellow Pages for private clinical psychologists in my area and found the sum total of two such half-decent practitioners, one of whom I’ve already seen (!). I then tried to work out if I could even afford weekly private therapy whilst unemployed – it can be done, in the most literal of senses, but it’ll take about half my monthly earnings to finance it.

Maybe I am overreacting and maybe C has no intention of ending this herapy in January, unless there is some miracle (and if there is some miracle then it is obviously fine to finish in January – but of course there will not be). But the mixed messages from him are sublimely frustrating – “don’t worry, we will never just suddenly end things” and “we will get there” versus “you know this is a finite process on the NHS,” yadda yadda yadda.

Partly the annoyance is with him and partly it is with this stupid bloody system. Sometimes I think we’d be better off with private healthcare after all.

On the one hand, C is the person that makes the immediate decisions on how long he sees his clients (as far as I can tell, anyway), so he could just say to me, “let’s keep on meeting for the next six months,” or whatever. He refuses to lay down any long term plans, ostensibly as he feels it is important to work to short-term-ish goals. I disagree, but at least he has a rationale, and in any event I am no psychologist. However, if therapy is coming to an end in about five weeks then what is the rationale for that when I am clearly still a nutjob?

On the other hand, C is constrained by all the financial bullshit of the NHS, not to mention the ludicrousness of the service’s inherent bureaucracy. No doubt he has targets and timeframes, must palm off the stupid mental within a few months cos the trust can’t (won’t) pay for the stupid mental any further than that and if he hasn’t cured the stupid mental in that time then he is an evident failure, don’t you know. Targets, man, targets!

The problem with this is that it will end up costing the health service much more in the long-run, and perhaps in more ways than one.

Let me break it down.

1. I am 26. I have been utilising mental health services on the NHS since I was 13. Had I seen a proper therapist for a proper length of time then, how much money could they potentially have saved themselves? Instead, as this post attests, six different public sector salaries were funded, some of the resources of which were devoted to me. Epic fail. (Of course my own money was spent on three other therapists because of the NHS inadequacies. Epic fail again). The point is, one way or another, I will end up back at the GP’s or psychiatrist’s office begging for help yet again, and we’ll be back to square one. Why not just agree a sensible timeframe with someone I know and trust – and clear things up to whatever extent that is achievable – now?!
2. I am so mentally and – yes – emotionally fragile as things stand that if therapy ends in the near future I am convinced I will end up in the bin. One hour of C’s time per week versus 24 hour care by several RMNs, psychiatrists and auxiliaries. Which one sounds cheaper to you?
3. A third possibility, and this may be seen as a threat which it is not intended to be, is that I finally can’t cope and do myself in. When my mother and A instigate litigation against the NHS, as they inevitably would were this possibility realised, even if the NHS won hands down, they would be forking out a fortune to fund their fuckhead solicitors. I used to work for litigation solicitors specialising in the public sector. I know what they charge; even for minor cases that are easily contested and won, it is a bloody fortune. That’s not even including barristers’ fees if it came to court, or out-of-court settlements.

Other points to consider are the following:

1. Dr C is constantly reminding me that psychotherapy is the “mainstay” of my treatment (rather than medicine), yet it seems to be her intention to see me long-term, albeit hopefully only for monitoring purposes once a suitable cocktail of drugs is found. How can therapy be the mainstay of my treatment if I am only seeing her, who only deals with the medicinal and organic sides of things?
2. I know I’ve ranted about this before, but it so utterly and completely fills me with disgust and contempt that I have worked in both full- and part-time capacities since I was 14, and given 11% of my salary to the health service since I was 16. I had two major breakdowns, including this one, during that time – but it still amounts to, I think, eight years of work. When you think about it, is it really that different from US health insurance? Maybe the percentage figure is lower, but then my employers had to pay a percentage of my salary for my insurance also. So why would I get medium- long-term therapy in America, but I can’t here?
3. I am familiar with people in other NHS trusts that have been guaranteed therapy of at least a year and a half on the health service. Now, one person I can think of has a lot more issues than I do, and so that’s fair enough – however, that individual is one of five people I can think of off the top of my head. I would hasten an educated guess that I have much more psychological baggage than each of those other four, but if not, certainly two or three of them anyway. Why, then, is it OK to fuck me about? (Incidentally, I noticed none of them had any trouble seeing psychiatrists either, so maybe my trust is just shit. Now it sounds like I’m playing a teenage game of “but they’re allowed it, so why am I not” – but I hope I’m not. I’m just genuinely mystified as to why my case is different).
4. As stated yesterday, I have been mental for many years. I received my first diagnosis (clinical depression) 13 years ago or so, but as I have discussed here at other junctures, I was mental well before that. Normal children don’t try to amputate their limbs. Normal children don’t hallucinate. Normal children aren’t obsessively paranoid. Normal children don’t deliberately coop themselves up in the house, listen to Bach, read Grey’s Anatomy and seek out the company of the elderly for intellectual discourse. They go outside and play with their friends. So when I said ‘13 years’ yesterday, I probably really meant 23, to be honest. Point being, how can two decades of madness be alleviated in less than a year? It’s fucking preposterous.
5. If I had a physical ailment, the NHS would treat me until it was cured, or, were it chronic, then indefinitely. I am not asking for indefinite treatment for my psychological difficulties, make no mistake. But the striking inequalities between the health service for physical health and the health service for mental health disgust me.

In any case, I cannot see why C has to keep reminding me that the psychotherapeutic process is finite. Of course it is fucking finite, I am not stupid – and I certainly don’t want to be in need of it indefinitely as I want to be able to manage my conditions by myself. However, for the NHS’ sake as well as my own, surely that finity (if that’s a word) ought to be directly correlated with the progress of the patient? Surely it is the height of irresponsibility to discharge someone that is clearly still fucked up and only going to, at best, waste more resources?

Fuck it all to hell. I feel like emigrating.

i am so hate dering at shaw trust in norwich, when i have get in touch with tanya (bob marsh helper) and said i have an interview for the 26th November (today is 25th Nov) which is short notice for me and they didnt sort out a signer in time!!

so lame!!

also for the NHS norwich admin training on the 30th nov 2009 and which they had not enough funding for a signer too not even from access to work too!!

what the hell going on with you PEOPLE!!

last warning!!

Another day, another political row about the government’s free social care at home for the elderly plan. Today, it’s how the plan is being funded.

While the government has been criticised for thus far being oblique about where the money will come from to fund the plan – they estimate it will cost £670 million per year, but others think it will be much higher – now they are starting to say where money will come from, they are garnering more criticism.

Health minister Andy Burnham, as reported in today’s Times on the eve of the publication of the Social Care Bill, says that “£60 million would be diverted from the health service’s research and development budget and £50 million from public health promotions.”

Inevitably, scientists have warned against cutting research budgets. The current research budget is more than £1 billion per year, so that cut is hardly a drop in the ocean.

Research is key for the future of healthcare and should be considered an investment – having drugs that cure is cheaper than the cost of lengthy treatment – and cuts should be avoided if possible.

However, the money will have to come from somewhere – if the Bill actually gets passed before the election, which is not guaranteed – and tough decisions will have to be made about which budgets get cut. It’s what we have government for; they make the hard decisions so we don’t have to.

It could be that funds are found from elsewhere. For example, a productivity drive in the NHS is expected to make up to £20 billion in efficiency savings in the next 4 years, which would more than pay for the Bill.

But wherever cuts come from to fund the free personal care plan, someone is going to be left unhappy. Well, almost; nobody has criticised the plan to save £60 million by cutting down on management consultants. Strange, that.

There has been some strong media and patient outrage in the UK over a decision to not make available Bayer’s Nexavar, a drug for terminally-ill liver cancer patients, through the National Health Service.  UK’s National Institute for Health and Clinical Excellence – referred to as the NHS’ drug rationing body by the UK media – says the drug’s price does not justify the benefits that it provides.  Nexavar costs 36,000 pounds a year (Rs 27 lakh). It extends survival by an average of about 3 months, and is the first to do so for liver cancer.

NHS could end up paying as much 9 million pounds on treating 600-700 patients a year who qualify.  Bayer has offered to give every fourth packet of the drug free but that would reduce the cost to 7.7mn pounds which is still pricey the NHS feels.

Bayer plans to appeal the decision.

The decision has health activists and patients up in arms. (See here and here). NICE has been roundly-roasted for putting a value on human life, so to speak. Note that neither of the articles that’s linked to above has a single talking head asking Bayer to bring down the price of the product.

Now consider what happens in India.  First of all, none  except those whom the government employs expect it to pay for drugs – whether for common cold or cancer.  80 per cent of our healthcare spend is out-of-pocket, among the highest rates in the world.

However, companies receive plenty of flak from the media for price increases (not that it stops many of them).

Indeed,  over the decades the government has conveniently shifted the onus of providing affordable drugs onto the drug industry.  How has it done this?  One, in the early seventies it liberalised the patents regime so that generics of globally under-patent drugs could be freely launched in India.  Two, it did little to raise the bar on quality. Indeed, once a drug was on the market for five years a new manufacturer did not even have to approach the central regulator for a quality approval – it simply got a manufacturing licence from the state.

As a result,  India has multitudinous copycats of a good number of drugs giving it the distinction of having among the lowest drug prices in the world. But quality is still a problem especially outside the metros. In fact, it is this inability of the government to guarantee quality that has allowed companies to charge an artificial premium for ‘brands’ – even though in a patents-free market there were hundreds of copycats of each drug. Brands are after all associated with quality.

So a strange duality exists in the country. Yes, it has some of the lowest drug prices in the world but to be sure of what they are getting, especially in life-and-death situations, consumers – rich or poor – still pay a fat premium.  Besides, when the markets are not large enough – such as for rare diseases – generics will not be found.

In recent months, a small attempt is being made in government to make amends.  The ministry of chemicals and fertilizers’ Jan Aushadhi pharmacy outlets provide unbranded medicines at far lower prices by using bulk sourcing.  Last heard, this was making slow progress for want of real estate and suppliers. The government also wants to pay for cancer drugs (currently a few hospitals like Tata Memorial funded by the Department of Atomic Energy subsidise medicines) but hasn’t yet begun.

As an aside, Nexavar – which is patented in this counry to Bayer under India’s tightened patent rules of 2005 -  is currently the subject of a lawsuit here.  Bayer has sued the Indian drugs regulator to prevent it from approving a Cipla generic which will probably be cheaper. And surprisingly, senior government counsel seems to be missing in action from the court proceedings.

True, it’s not all hunky-dory in the west as the Nexavar debate shows. Governments and insurers flush with funds to pay for healthcare have pushed prices to record highs to the point where countries are now feeling the pinch.  But India can learn from those mistakes and start forgeing its own system tailored to meet its needs.

And not sometime in the future. Today, right now, this minute.

Heather Walker, Communications Manager, Action for M.E. has advised me, this morning, that the minutes of the last meeting will be delayed.

Shortlink: http://wp.me/p5foE-2qt

Ms Walker writes @ 25 November

On behalf of the APPG on ME Secretariat, my apologies for the delay in the production of minutes of the last meeting.

We are still awaiting arrival of the verbatim transcript, kindly produced by a Hansard stenographer, on which the minutes are based.

As has been pointed out, the APPG has a policy that any comments on the APPG minutes and transcript be sent in to the APPG Secretariat one week before the meeting. The meeting scheduled for Wednesday the 2nd of December would therefore indicate a deadline for comments and amendments to be submitted by Wednesday the 25th of November

The delay means the usual procedure will have to be changed – what to will depend on when the transcript and minutes become available.

We will circulate them as soon as possible.

Meanwhile, the agenda for next week’s meeting is as follows:

1. Welcome by the Chairman
2. APPG Report on the Inquiry into NHS Services
3. Speaker: Mike O’Brien MP, Minister of State for Health Services
4. Minutes of the last meeting
5. Matters arising

- APPG legacy paper (in preparation for the General Election)

- New research: murine leukaemia virus-related virus (XMRV)

- Accessibility of venues for future meetings

6. Welfare update

- Employment and Support Allowance

- Welfare Reform Bill

7. Any other business

8. Date of next meeting

Heather Walker

Communications Manager
Action for M.E
Direct line: 0117 930 1323

Action for M.E. is the leading charity dedicated to improving the lives of people affected by M.E.
Action for M.E., Canningford House, 38 Victoria Street, Bristol BS1 6BY, 0117 927 9551
Registered charity number: 1036419. Registered in Scotland: SCO40452
www.afme.org.uk

Family Receives Thousands Of Cards From Strangers

http://www.clickondetroit.com/news/21522646/detail.html

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Thanks to all who sent cards

R.I.P Noah

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With Love & Bright Blessings

“Help Save Our Mother Earth”

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Interesting story from the excellent Sam Coates in today’s Times about Health Secretary Andy Burnham falling out with Blairites like John Hutton over apparently planning to freeze the private and voluntary sector out of providing NHS services. Opponents of the move say the Government has “bowed to pressure from the unions”. I suspect the unions would have a good laugh at the suggestion, but that is neither here nor there.

I’m not sure how much of Burnham’s plan is new. He already said in a speech to the King’s Fund in September that the NHS was the “preferred provider” of health services and that outside providers should only take over where an NHS trust was failing badly. He then confirmed this in a letter to Brendan Barber and with NHS chief exec David Nicholson.

Moreover, there’s one big caveat to this policy – and one which is exercising the big unions at the moment.  As David Nicholson said in a subsequent letter, Burnham’s policy doesn’t change the ability of NHS trusts to exercise their “right to request” powers to become a social enterprise, run at arms’ length from NHS management.

Social enterprises as the Department of Health understands them can be for profit. And when the contract to run them runs out, after three years, they can be bought by a private company. I did a story about one such trust last month.

Unions like Unite complain that this move to a social enterprise contradicts government policy that the NHS should be the preferred provider. They seem to be overlooking, or ignoring, Nicholson’s letter. There is a government-approved way of privatising NHS trusts – and it’s not going anywhere.

I was having a chat with a financial auditor the other day and he was telling me of some interesting stories (yes, there are some) that he has come across in his many years of auditing. Something that really astounded me was what he told me about his time auditing NHS hospitals. There are millions if not billions of pounds sitting in NHS bank accounts which they are not allowed to touch – in fact they are never allowed to touch it. The reason? Well, consider the following situation:

A very generous person leaves £10,000 in their will to Ward 24 of a certain hospital because that hospital looked after their husband so well when he was seriously ill. If that ward closes or if that hospital closes then you can’t go back to the person who left that money in their will and ask them “what do you want to do with it now?”. They are dead, they can’t answer you. Because no further instructions can be given by the donor nothing can be done with the money, ever! The money just sits in trust in a bank account and gathers dust. The NHS can spend any interest but cannot touch a penny of the original donation because they cannot use it for any purpose other than the purposes specified by the original donor. Mad!

A few months ago, after the MP expenses scandal, politicians were bending over backwards to promise reform. Yet despite all the grand speeches, when plans for new laws were announced in last week’s Queen’s speech, there was no mention of real change. It’s clear now that if we’re going to get reforms moving in parliament this year, it’ll have to be through people power.

Next week, the names of 20 MPs get pulled out of a hat. The ones at the top of the list will have a chance to propose a new law, with a real chance of it being voted through. The Citizens’ Convention Bill would give us a chance to get a recall law brought in. Together we need to convince MPs that they should propose the Citizens’ Convention Bill, and that means proving it has popular support.

We’ve been working with Unlock Democracy since June to put pressure on MPs to support a Citizens’ Convention law. A Citizens’ Convention would mean people outside the Westminster bubble were given the power to propose changes, like a recall law, which Parliament couldn’t ignore. We’ve seen now that if we leave it to politicians, real change simply won’t happen.

Public pressure is working. Thousands of us contacted our MPs during the last parliamentary session and 155 of them from all the parties signed up. The more people that write to an MP, the more likely they are to support the campaign. With your help we can turn this from an idea into actual law.

The 20 MPs with the chance to propose laws are picked next week, so the next few days are critical. Please email your MP today:

http://www.38degrees.org.uk/convention1

Thanks for getting involved,

David, Hannah, Johnny, Nina and the 38 Degrees Team

With Love & Bright Blessings

“Help Save Our Mother Earth”

http://twitter.com/ICareDoYou

http://helpsaveourmotherearth.com

http://myspace.com/helpsave0urmotherearth

http://blogs.myspace.com/helpsave0urmotherearth

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