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If the NHS is 'broken' it's all just part of the plan

15/3/2017

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Death by 1,000 cuts. That’s this government’s prescription for the NHS.

And, in one variant form or another, for pretty much everything they have responsibility for that bears the word “service”. Education; libraries; social housing; prisons; the police; you name it.

That’s not to say they want to see the end of all these valuable things entirely. They just want to replace the spirit of service with the spirit of free enterprise. Which is not the same thing at all.

The drive to convert public institutions into private money-making schemes has been central to Tory policy since the rise of Margaret Thatcher. It was just as brutal in her day, but there’s an added sneakiness about it now. The honest word “privatisation” is hidden behind the weaselly euphemism “reform”.

Faith schools, so-called “free” schools (there’s a classic piece of Orwellian doublespeak for you), Theresa May’s beloved grammar schools, academies and that most disturbing of trends the multi-academy trust are all semi-disguised steps on the route to privatising the whole education system.

The “right to buy” masquerades as a help to ordinary people. In fact, it’s a way of transferring public housing stock into private hands. So wages – or housing benefits – go into the hands of private landlords rather than being reinvested in more and better social housing.

A few cash in at the expense of the many. Tory philosophy in a nutshell.

Meanwhile, in America, Trump’s puppetmaster Steve Bannon has all but admitted that the president’s cabinet nominees were deliberately chosen to dismantle the departments they head. Rather like Jeremy Hunt here.

Hunt’s policy is surreptitious but clearly defined – and though he hasn’t exactly admitted it, it’s working well.

Run a service into the ground, deprive it of resources, disrupt it through supposed “reforms”, mistreat and demean its professionals. Then say it’s “broken” and needs fixing.

Which is a pretext for handing it over to companies whose interest is not in providing a good service but in making a good profit.

Talk of the NHS seems so often to revolve around how much money goes into it. But what that simplistic formula overlooks is the crucial matter of where the money goes.

If the answer to that is “private firms”, then someone somewhere is taking money from your National Insurance payments and pocketing it as profit.

And they might not even be British pockets, if Trump’s limp handshake with May means what it appears to.



Two things some other people may be used to happened to me last week for the first time:
  • I turned round in the park when someone called my name, only to realise a moment later that it was their dog they were yelling at.
  • Then a young man offered me his seat on the Tube. Nice to know there are still some polite youngsters out there. But do I really look that old or infirm? In another 20 years, maybe – but then, I don’t intend to be travelling in London in 20 years’ time.

While I was in the Smoke, I took in the Royal Academy exhibition Revolution: Russian Art 1917-1932. It’s a big exhibition in every sense, well laid out, utterly fascinating and more varied than you might expect. As always at such events, though, the sheer press of people makes it difficult to take in properly the works on show – and tiring to try.

After soaking in the tragic story of bright hopes and horrific outcomes, the ultimate irony comes right at the end. Beyond the end, in fact, as you are funnelled out through the gift shop. Capitalism’s final revenge.

Russian Revolution colouring-in book, anyone?

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The doctor who gave up drugs - and why

29/9/2016

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Do you suffer from Walking Deficiency Syndrome, or Hyper Sitting Syndrome? These conditions have been named by Sir Muir Gray, former NHS Chief of Knowledge, as two of the greatest causes of ill health in Britain.

He was on BBC1 last week making his point to Dr Chris van Tulleken, presenter and title character of The Doctor Who Gave Up Drugs. He was dangerously sitting down as he spoke – and so, presumably, were most people watching.

Van Tulleken, who is rapidly becoming one of the most compelling characters on telly, was on a mission. He wants the country’s GPs to provide a real “health service”, not what he calls a “drug-prescription service”. And he wants us all to cut down on the drugs we take – an estimated 100,000 tablets in an average life.

Towards the end of his two-parter he offered a group of chronic pill-poppers a “miracle cure” for just about everything. Well, for obesity, joint pain, heart and stroke risk, type 2 diabetes and depression. Walking. A daily good brisk walk.

Hooray for me. Because I get that already. But most people, it seems, don’t. Most people would rather get a pill from the doctor to tackle their aches and pains.

But here’s the thing Dr Chris and his selected experts found. Painkillers don’t work. Not for long, anyway. Over time they actually make things worse.

In episode one we met Wendy, who had been taking pills for 20 years for shoulder pain. More and more pills – but she still had the pain. Over a two-week trial she took a mix of real and dummy pills. There was no corelation at all between the ups and downs of her reported pain and the fact that after a few days she was taking only placebos. She couldn’t tell the difference. Her drugs were costing the NHS a bomb and doing nothing to help her. After a few weeks off the pills and on a course of exercise she started showing real improvement.

Then there was Sarah, addicted to antidepressants after being on them for eight years from age 16. Still stuck in a grim life of depression. Living, as she put it, “in a chemical fog”. Dr Chris started weaning her off the pills and put her on a course of invigorating wild swimming in cold water. Which is great as long as she can get child care for the delightful toddler who is also a key component of her treatment, as well as a potential impediment to it.

Crystal had a life ruined by unexplained pain. After 20 years of dependency on a 30-a-day pill habit she could hardly walk and had real difficulty with stairs. Dr Chris’s unlikely prescription was a course of kung-fu training – which seemed to be working a treat.

All this miracle-working takes time and attention from the doctor. And when you only have 10 minutes at most for each consultation, that’s not possible. It’s so much quicker and easier just to write out a prescription.

And then there’s the constant advertising pressure from the drug companies, applied both to the GPs and all the rest of us.

Drug research is expensive and it’s done a lot to make our lives longer and more comfortable. But it’s also got us hooked on a massive dose of things we don’t need – at best.

The Doctor Who Gave Up Drugs was first-rate telly, but a tiny prick in the arm against the might of the pharmaceutical industry. It opened such a can of worms that I’ve only scratched the surface in my synopsis here. And I want to know a lot more.

If he’s to do any real good, Van Tulleken needs a series of Bake Off longevity and popularity. Real reality TV. That’d be worth sitting down for.
 
 
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So will Labour now set aside its internal bloodletting and get back to the real job? We can but hope. The need for an effective Opposition has never been greater.

Meanwhile, the view from Scandinavia is interesting. It’s a part of the world renowned for being saner, happier, politically smarter than most others. And much of the Brexit talk has been about whether Britain should follow the Norwegian model.

So here’s Dr Jonas Fossli Gjersø, a historian at the London School of Economics: "From his style to his policies Mr Corbyn would, in Norway, be an unremarkably mainstream, run-of-the-mill social democrat. His policy platform places him squarely in the Norwegian Labour Party from which the last leader is such a widely respected establishment figure that he became the current Secretary General of NATO. Yet in the United Kingdom a politician who makes similar policy proposals is branded an extremist and a danger to society.”

Norway has had 50 years of Labour government in the 71 years since World War II. According to the United Nations it has the highest human development of any country in the world.

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Chucking billions into private pockets is no prescription for the NHS

22/4/2015

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I liked the pictures of the three women leaders – Natalie Bennett of the Greens, Plaid Cymru’s Leanne Wood and Nicola Sturgeon of the SNP – hugging at the end.

I wondered if the image of those three approaching Ed Miliband to shake hands, while Nigel Farage stood isolated and aloof, was a true sign of things to come.

And I found the way Farage fell out with the studio audience fascinating.

Is the BBC really a left-wing bastion, as Farage, Jeremy Clarkson and their right-wing ilk believe? Or does it have a pro-establishment, anti-left bias, as some on the other wing have long felt? Maybe the fact that both sides seem to think the Beeb is against them shows Auntie is getting something right.

But the most telling moment in last Thursday’s Westminster debate was the moment chairman David Dimbleby lost it.

“We’re not debating the NHS!” he shouted, rebuking Miliband and Farage in particular, but all the others too. Oh yes we were, David, whether you liked it or not.

It’s interesting – as Bennett pointed out in the previous TV debate – how the health service has become the dominant issue in this election.

Last time out we had posters of David Cameron assuring us the NHS would be safe in his hands, and no one seriously challenged him on it. Since when, while cuts have fallen heavily in so many areas, it’s the future of the NHS that has become public worry No.1.

Many thousands of doctors, nurses and patients will take to the streets on Saturday to make that point in another national day of action against further cuts and privatisation.

Labour is justifiably proud of its heritage as the party that created the NHS. Unfortunately, the heritage of 1945 is not one the modern party does much to live up to.

The Conservatives say they have spent more on the NHS each year since 2010 and promised to put in another £8billion over the next five years if they’re still in power.

But it’s not just about how much money is spent. It’s how it’s spent, and where it goes.

More and more public cash – the money you and I pay through taxes for the services we rely on – is going into private hands. That’s money lost to the service, siphoned into shareholders’ pockets.

It applies equally to everything from housing to public transport, energy to emptying the bins. But it shows up starkly in a service already stretched by an aging population, better (but pricey) treatments keeping people alive longer, and the axing of social services looking after the ailing and elderly outside hospital.

Ever since Margaret Thatcher set about demolishing or flogging off national services of all kinds (“the family silver” as that old Tory Harold Macmillan memorably put it) the idea has stuck that “the market” somehow finds the most efficient way of doing things.

So why have overheads gone from taking three per cent of the NHS budget to 15pc since it was opened up to the “internal market”?

When John Major introduced the Private Finance Initiative in 1992, Labour warned that it was “privatisation by the back door”. But the Labour government that came in five years later opened that back door much, much wider.

It still stands wide open, letting in a cold draught that has left the whole NHS shivering and sick. Unhappily, neither of the parties responsible shows any interest in closing the door now.

Apart from the Americans – who seem to relish paying through the nose for an inferior service which can render the poorly destitute – most of the world still envies us our health service. But for how much longer?


It's the planet, stupid


If your doctor got every diagnosis completely wrong, would you keep going back?

So why would you trust economists and politicians who seem to get their economic forecasts right about as often as hens grow teeth?

This question is put, in different words, in a recent review of the book “It’s the Economy, Stupid: Economics for Voters” by Vicky Pryce, Andy Ross and Peter Urwin.

The authors seem to assume elections are decided by how well the economy is doing. Or, rather, how well or badly voters can be persuaded it’s doing.

Whether or not you think the economy’s doing well largely depends on which witch doctor you happen to believe.

Whether you think things like health services, railways, schools and prisons will be better run by the state or private companies.

But also on personal things such as whether you have a job. And if you have, how well paid it is and how secure you feel in it.

If it really is all about the economy, though, how depressing is that?

How much better if we could take a longer and broader view. Not just the money in our pockets for the next five years, but the long-term well-being of all, regardless of race, gender, creed – or species.

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    Aidan Semmens, blogger

    the Semmens blog

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