The Thin End

There is more evidence today that that NHS savings are putting patient care at risk. A review by the Care Quality Commission (CQC) suggests that quarter of hospital trusts in England are at raised risk of providing poor care. The findings are based on monitoring by the Care Quality Commission (CQC) of a host of data, including death rates, serious errors and patient surveys. It found 44 out of 161 trusts fell into the two highest risk categories. Responding to the CQC’s review of hospital trust data in England, Dr Mark Porter, Chair of BMA Council said:  "Having this array of information in the public domain is an important step towards improving transparency across the NHS, informing and empowering patients and shining a light on hospitals which are not performing to the standard we expect. "Hospitals are large, complex organisations so we need to avoid oversimplifying or reducing vast amounts of data to a simple band or rating. "It goes without say...

There has been much concern expressed that the Lobbying Bill could limit the campaigning activity of charities. Now, doctors’ leaders have warned that the Government’s proposed legislation lacks clarity, is excessively bureaucratic and could severely limit organisations, such as the BMA, campaigning on public health issues, including smoking, during an election year. The warning comes in a new BMA House of Lords’ briefing, released today (21/10/13) ahead of an important debate in the second chamber on the Transparency of Lobbying, Non-Party Campaigning and Trade Union Administration Bill on Tuesday 22 October 2013.  The Lobbying Bill would severely limit the ability of charities to campaign in a year in which there is a general election. The proposals have received widespread criticism and most recently from the Joint Committee on Human Rights and Lords Constitution Committee amid concerns that the proposals will curtail public debate by preventing charities, pressure groups, t...

The political obsession with the 'squeezed middle' hurts the poorest. It is understandable. Whichever political party can appeal most to the middle income earners is likely to win the next election. Sadly this is why some in the Labour party appear ready to abandon the poor. You don't win elections by being compassionate and understanding about poverty. So, Labour's Rachel Reeves, Labour's shadow work and pensions secretary,   vows to be tougher than the Tories on benefits and force the long-term unemployed to take up 'work offers' or lose their benefits. Labour is now in the same unethically divisive  game played by the Tories, to portray the unemployed as work-shy  'scroungers' or 'benefit cheats'; it is the 'workers' versus the 'shirkers' divide. It is an easy story to buy into. We all know (don't we?) people who are on the dole who don't look for work and live in a 'benefits culture'. There is work o...

The labour market statistics published today by the Office for National Statistics continue to show the massive regional variation that has become a familiar feature of this recession. As the UK climbs out of recession the benefit in terms of jobs is largely experienced in the South East. The disparity between the South East and the rest of the country grows. Unemployment is almost twice as high in the North East. The unemployment rate in Great Britain was highest in the North East (10.3%) and lowest in the Sout East of England (5.9%). The Claimant Count rate in Great Britain was highest in the North East (6.5%) and lowest in the South East (2.4%). Another familiar feature is the large numbers working part-time or with temporary employment.  The increase in employment is welcome news and another indication that the UK is edging out of recession. But there is a caveat, and it is again the regional disparity. The increased employment is largely in the South East. And th...

Today there was a momentous decision from editors of some key medical journals. Editors of The BMJ, Heart, Thorax, and BMJ Open say they will no longer consider for publication any study that is partly or wholly funded by the tobacco industry. Writing on bmj.com today , in a hard hitting editorial, they say the new policy is consistent with those of many other journals and demonstrates their commitment to ensuring that - as far as possible - their journals publish honest work that advances knowledge about health and disease. Critics may argue that publishing such research does not constitute endorsing its findings, but the editors believe this view “ignores the growing body of evidence that biases and research misconduct are often impossible to detect, and that the source of funding can influence the outcomes of studies in invisible ways.” They argue that, far from advancing knowledge, the tobacco industry “has used research to deliberately produce ignorance and to advance its ul...

With more people living longer, much of the concern about the future of social care has been focused on a growing elderly population.  But more young people than ever before with a range of life-threatening or life-limiting conditions are living into adulthood, and the need for planned social care is vital for this transition. Within my lifetime I have seen a fundamental shift in attitudes to and life expectation for those with life-limiting disabilities. None gives a better example than changed approaches to Down's syndrome where it is now understood that with support those affected can expect to have productive and independent lives into adulthood.  But what most often provides the key to coping with adulthood is available support and advice. The support charity  Together for Short Lives is calling on Peers to amend to the Care Bill today (14 Oct) to ensure a generation of young people with life-limiting conditions do not have to face a "cliff edge" in their c...

The International  Monitory Fund (IMF) have adjusted estimates for economic growth . Whilst growth worldwide is projected to fall, the IMF now predict UK growth to rise faster than its previous forecast. The IMF says it expects the world’s economy to grow by 2.9 percent this year—below the 3.2 percent recorded last year. Growth is likely to be driven by advanced economies, while the performance of emerging markets will be weaker than expected. Osborne has seized on these new projections as further evidence that the UK is on the right track , and as a justification of the governments austerity programme. But is 'growth' the best measure of social and economic well being? Isn't it time we learnt the lesson that the answer to that question is that it is not? Economic growth is 'good' because it leads to increased jobs and wealth. But distorted growth can lead to greater economic inequality and increased social injustice. There is an argument that if the wealthi...

Coronary heart disease now costs the NHS £1.6bn a year to treat and costs the UK economy around £10bn. Yet when was the last time your doctor told you to take more physical exercise?  Your GP may weigh you, take your blood pressure and pulse. You might be on repeat prescriptions for drugs. But a new review of evidence published today on  bmj.com  suggests that physical activity is potentially as effective as many drug interventions for patients with existing coronary heart disease and stroke. Are we overdependent on drugs? The researchers argue that more trials comparing the effectiveness of exercise and drugs are urgently needed to help doctors and patients make the best treatment decisions. In the meantime, they say exercise “should be considered as a viable alternative to, or alongside, drug therapy.” Physical activity has well documented health benefits. Our sedentary lifestyles may be killing us, yet statistics from the British Heart Foundation show that i...

It is of course the standard interviewer ambush, what is the price of a loaf of bread or a pint of milk? Few politicians can answer such a question unless well-prepared. On its own the answer or lack of it reveals little of substance. Yet it matters in a time of austerity, when the poorest are being pressed the hardest and made to pay for the financial sins of others. A hard pressed mother or father watching the pennies is very much aware of the price of a loaf of bread. I should say they know the price of loaves of bread and they know the price of having to choose the least nutritional option. So when politicians demonstrate their inability to answer, it demonstrates their distance from the hard realities of life. They clearly do not understand the pain and suffering of the poorest. If there is an economic recovery, it isn't yet being experienced by people in general who are still feeling financially squeezed. And this is the problem for the coalition. The feel good factor...

The attitude and policies of this government to the poorest and the least fortunate takes us back to the days of the Poor Law. Putting the poor to work is possessed of an attitude that the poorest are feckless and work-shy and must be put to work for their own benefit. It is not only a divisive approach, setting the more fortunate against the least fortunate, but it is profoundly unethical and counter-productive. It has its populist appeal. But it is profoundly wrong. It tars the majority of unemployed with the brush of the minority. I hear it said commonly in radio phone in programmes 'there's plenty of work out there if only they were willing to look for it.' And that about sums up as much as they 'know'. They know if for sure; there is work out there. Of course there is, but where is it? Unemployment is said to be falling. The headline figures demonstrate this. But it is not falling uniformly across the country. In some regions it has risen and not fallen. ...