Tag Archives: Health

UK must spend more on the vulnerable

March 16, 2015MusingsArticle, Benefits, Children, Disability, Editorials & reply, Health, Letters, Main section, NHS, Politics, Poverty, Social exclusion, Society, The Guardian, UK news, Welfarediana Stone

Again this is very important and worth a wider audience.

This article titled “UK must spend more on the vulnerable” was written by , for The Guardian on Monday 16th March 2015 19.53 UTC

Day in and day out, we work with hundreds of thousands of vulnerable children facing many difficulties like abuse and neglect at home or problems at school. While the state currently spends nearly £17bn per year on social problems affecting children and young people, the support they get is often too little, too late. ncreasing early help for families should be a top priority. It will save millions of children from suffering needless trauma and will save money in the long run.

We want all political candidates in the 2015 general election to commit to championing early support for children and families.

Our charities understand the pressures on vulnerable children and families. That is why we are committed to providing a range of services at an earlier stage that help children and families cope better with life’s challenges. But we can’t do this on our own.

By making a commitment to early intervention, politicians can help lead a real, lasting, cost-effective transformation to the lives of vulnerable children across the UK, now and in the future.
Sir Tony Hawkhead Chief executive, Action for Children
Javed Khan Chief executive, Barnardo’s
Matthew Reed Chief executive, The Children’s Society
Peter Wanless Chief executive, NSPCC

• We write as organisations working with children and pensioners, disabled people and those with long-term health conditions, in- and out-of-work families, and those experiencing or at risk of homelessness. We have sent a letter to the leaders of the three main parties calling on them to commit to restore the value of all benefits, and to maintain this in real terms in the next parliament and beyond.

The UK’s social security system provides essential support to many of the people with whom we work. It should guarantee their dignity, protect them against poverty, and enable them to have a basic standard of living.

Adequate social security provision benefits all of society, not just those who rely on it at any one time. If we do not protect the value of all benefits, significant numbers of people will be unable to participate fully in society, an outcome that surely none of us desire.
Alison Garnham Chief executive, Child Poverty Action Group
Caroline Abrahams Charity director, Age UK

Heléna Herklots Chief executive, Carers UK

Lesley-Anne Alexander CBE Chief executive, Royal National Institute of Blind People

Jon Sparkes Chief executive, Crisis

Matthew Reed Chief executive, The Children’s Society
Javed Khan Chief executive, Barnardos

Mark Lever Chief executive, National Autism Society
Disability Agenda Scotland (six member organisations)
Jolanta Lasota Chief executive, Ambitious About Autism
Fiona Weir Chief executive, Gingerbread
Geraldine Blake Chief executive, Community Links
Howard Sinclair Chief executive, St Mungos Broadway
Sir Stuart Etherington Chief executive, National Council for Voluntary Organisations
Liz Sayce OBE Chief executive, Disability Rights UK
Rick Henderson Chief executive, Homeless Link
Aaron Barbour Director, Katherine Low Settlement
Andy Kerr Chief executive, Sense Scotland
Anna Feuchtwang Chief executive, National Children’s Bureau
Marcus Roberts Chief executive, Drugscope

• On 19 March I will protest against benefit sanctions with Unite Community outside the DWP, whose ministers are in denial about the link between suicide and sanctions. Most people are in debt when the sanction stops all their income. Debt is unavoidable because housing and council tax benefits have been cut leaving the remaining benefit incomes in work and unemployment to pay the outstanding rent, created by the bedroom tax and £500 benefit cap, and the council tax, plus court costs and bailiffs fees. Otherwise the sanction forces them into debt because they have no money on which to survive. That is the trap set by parliament for honest citizens who feel obliged to pay their debts; some despair and many call on their GPs. The NHS is now to receive an extra £1.25bn for mental health services while the DWP is creating an ever greater demand for them.
Rev Paul Nicolson
Taxpayers Against Poverty

In answer to a parliamentary question by Stephen Timms MP, to the DWP, answered by Esther McVey MP, on how many people have been refused hardship payments since 2012, she answered that the information is not available. It is time that it was.
Gary Martin
London

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The biggest privatisation in NHS history: why we had to blow the whistle

March 16, 2015MusingsArticle, Comment, Health, Hospitals, Kate Godfrey, NHS, Older people, Opinion, Society, UK newsdiana Stone

Another reason why we should all keep our eye on the ball

This article titled “The biggest privatisation in NHS history: why we had to blow the whistle” was written by Kate Godfrey, for theguardian.com on Monday 16th March 2015 12.16 UTC

I’m not a journalist, but as of this morning I know what it feels like to be part of the biggest leak in NHS history.

Published on openDemocracy, the memorandum of information for the £700m sell-off of Staffordshire cancer services is now available for the 800,000 directly affected and 3 million indirectly affected patients to read online.

That document, together with others relating to the joint £1.2bn privatisation of cancer and end-of-life services in Staffordshire, was sent to me. They are commercially confidential, secret agreements that will rebuild NHS services for hundreds of thousands of people, but are for the eyes of the bidding companies only.

Not only is this the first billion-pound NHS privatisation, it is the first time that it has been deemed acceptable to put care designed to meet the needs of our most vulnerable patients on sale.

Uniquely for a privatisation on anything of this scale, there has been no public consultation, simply a series of weak “engagement” events led by paid “patient champions”. For the past year unpaid patients have not been able to have their say. Thanks to the brave person who shared the documents, now they can.

The background is this: Staffordshire commissioners want to hand the management of all care for cancer and end-of-life patients to a private company, a “prime provider” that will take responsibility for the delivery of care, subcontracting and performance management.

There are lots of firsts here. It is the first time that cancer or end-of-life care has been contracted out. The first use of the prime provider model on anything like this scale. The first privatisation without formal consultation. The first huge international NHS contract that could fall under TTIP. Transfer these services out of the NHS now, and we may never get them back.

The leading bidders are all US private healthcare companies, some of them implicated in failures of care elsewhere. One is Optum, the US brand facing allegations over the American hospice-packing scandal. (Optum is defending itself against the allegations.) It is the first time that the commissioning responsibility held by local clinical commissioning groups (CCGs) – the right to spend a billion pounds on behalf of the NHS – will simply be gifted to a private company.

And it looks like it will be a private company. There are clauses in the published document that simply have no place in a project that will stay within the NHS. Bidders are encouraged to explore a “VAT efficient model”. Not only is this disturbing in its own right, but NHS bodies don’t pay VAT. This is a strange level of detail to find in a document that is otherwise so imprecise.

There is no plan here, no benchmarks against which a bidder could be selected; just a hope that the shape of the contract will resolve itself as bidders make their own suggestions and time goes on.

To me, it looks as though local commissioners simply got bored, and decided they didn’t want to be responsible for cancer care any more. To the health expert John Lister, it looks worse. He says the contract is “no more than a blank cheque for whichever private firm is the most ruthlessly willing to cut services to shore up their own profits”.

The winning bidder will be free to decommission or disinvest as they like – cutting contracts with local hospices, therapeutic providers or even frontline healthcare such as radiotherapy and surgery. The bidder could simply replace them, delivering services such as radiotherapy themselves, further fragmenting the services that mean most to patients. Or they could just squeeze existing contracts. No payment structure is specified. Bidding companies can decide for themselves what they are worth, as long as their fees are self-funding within the current budget. Based on similar health privatisation contracts, £100m in fees is the minimum that a private provider will accept. This money will be diverted straight from funds currently spent on frontline care.

Those hospices and providers will be told that they can still provide care – it just has to be for 20% less, with the remainder meeting the fees of the winning bidder. They might just reduce costs, or they might cut services that cancer patients depend on. It is the postcode lottery written into an NHS contract.

The question the document doesn’t even try to answer is why. Commissioners’ own figures show cancer care in Staffordshire to be above national average. Only one of the four CCGs backing the change list cancer as an area where they could make significant improvement. There is no clear case for change, but there is an opportunity.

Time and time again we have seen Staffordshire used as the proving ground for the 2012 Health and Social Care Act. Cancer and end-of-life privatisation has been introduced here because it was politically convenient. Our history is used against us; our patients pay the price again.

Not only was there no formal consultation, but local patients were meant to get no say on this contract at all. The original plan was to sign the deal in March – before people could have their say at the polls. Labour has said it will not let the project go ahead.

The campaign group I work with – Cancer Not For Profit – fought for more time. When the awarding of the contract was put back until June, we thought that we had won a small victory.

Our source heard differently. The project wasn’t delayed, they were told, but simply hushed up. The political implications of pushing through the biggest privatisation in NHS history two months before a general election were too serious. It had to move forward with speed, and if the contract lacked benchmarks or risk management, forget it. It could all be resolved later. (It is the essence of contract law that weaknesses are generally not resolved later.) The only thing being delayed until after May was the announcement, which would now be made in June. And then a gamble that a new government couldn’t go back on a contract already awarded.

“I’m going to publish,” I told the source. “Tell me if you don’t want me to publish.” I never heard from them again.

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Where in the world are people most depressed?

November 8, 2013MusingsArticle, Blogposts, Datablog, Depression, Health, Health & wellbeing, Life and style, Mark Rice-Oxley, Mental health, Society, World newsdiana Stone

In Battersea, well perhaps not 😉

This article titled “Where in the world are people most depressed?” was written by Mark Rice-Oxley, for theguardian.com on Friday 8th November 2013 15.56 UTC

For those who think of depression as a byproduct of the vapidity of western materialism, this latest study by researchers in Queensland might come as something of a shock. Depression simply isn’t that picky. And when it comes to depressive disorders, parts of north Africa and the Middle East suffer more than North America and western Europe.

According to the researchers, who gathered pre-existing data on clinical diagnoses up to 2010, Algeria, Libya, Syria and Afghanistan fared worse for the cumulative number of years their citizens lived with the disability of depression (YLD). (For the Middle East countries, bear in mind that this relates to data gathered before the Arab spring turned lives upside down).

Japan fared the best, along with Australia and New Zealand. The researchers caveated their work by acknowledging that data is patchy from some parts of the world. Intriguingly, the UK and US – countries in which reporting on mental illness and cultural reflections of depression are rapidly multiplying – appear to be far less badly afflicted than parts of Africa and eastern Europe.

The second interesting breakdown (no pun intended) of the data concerns age.

YLDs by age and sex for MDD and dysthymia in 1990 and 2010 — YLDs by age and sex for major depressive disorder and dysthymia (milder depression) in 1990 and 2010. Click on the image for a full-size graphic Photograph: info:doi/10.1371/journal.pmed.1001547

The gender graph contains few surprises – women appear to suffer about twice as much as men, reflecting most major studies into the incidence of depression. But the age analysis shows the extent to which depression is becoming a young person’s affliction. People aged 20 to 24 suffer most, closely followed by the generation immediately senior to them. By the time you get to 50-year-olds, where existential questions might start to press, rates dwindle. Above 60, they ease off quite sharply. There may be comfort in growing old after all.

So is depression on the rise? Again, you would think so from the proliferation of reporting and analysis about the disease. The researchers say yes and no: depressive illness is the disease with the second heaviest burden on society, with around one in 20 people suffering. But if it is getting worse, they say, it may be down to demographics.

“Whilst burden increased by 37.5% between 1990 and 2010, this was due to population growth and ageing,” they say. “Contrary to recent literature on the topic, our findings suggest that the epidemiology of both major depressive disorder and dysthymia (milder depression) remained relatively stable over time.”

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