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Showing posts from 2015

Overturn the tables of the money changers

This is the season to be jolly, and I wish all readers a prosperous and rewarding new year! I thank you all for taking the trouble to read Song of Life in 2015.

You will forgive me if I say that our celebration of a new year should be tempered with the knowledge that so many are suffering the consequences of austerity. Poor working people have been made to take the blame for the financial crash and the actions of irresponsible bankers. Their prospects in 2016 are not good.

The NHS is at breaking point. Social justice is being eroded. The social care system is crumbling.  2016 will be the year when local taxes will rise to pay for government cuts - more families will lose their homes.  There will be more NHS rationing as 'efficiency savings' create post-code lotteries in health care. The poorest local authorities will find the most difficulty meeting social care needs. It is likely that more residential home providers will go bust. Happy New Year!

Christmas and New Year are tim…

The case for mandatory folic acid fortification?

The UK’s failure to fortify flour with folic acid has caused around 2000 avoidable cases of neural tube defects since 1998.  This is the conclusion of research published online today in the Archives of Disease in Childhood.

The researchers say that the UK should now follow the lead of the US and 77 other countries  in legislating for mandatory fortification of flour to curb the associated toll of fetal and infant death and disability.

Folic acid is a B vitamin which is vital for the formation of red blood cells.

The UK has rightly been cautious about making 'medicines' or dietary supplements mandatory.  In medical ethics we emphasise autonomy and the right to make decisions about one's health and treatment. Autonomy is a fundamental principle of modern medical ethics.  It sets a high ethical threshold, and a key concern must be that the benefits of mandating medicine should be sufficient to breach this fundamental principle.

To a large extent this is a utilitarian ethical …

NHS 'winter crisis' due to Tory cuts.

The 'winter crisis' in the NHS is a crisis of the government's own making. It is the result of the real cost of the £20 bn efficiency savings forced on the NHS. This is the truth behind the headlines of bed-blocking. The bed shortage is because we don't have enough beds to cover increased demand over the winter.

This is the reality. OECD figures show that in England and Wales there are just 2.95 beds per 1,000 people. This compares with 6.37 in France, 7.65 in Austria and 8.27 in Germany. And before the Scottish Nationalist Party pipe up, the Scottish Government figures show their figure is down 21% compared to 2004. But England and Wales are way behind the 4.95 beds per 1,000 in Scotland. Nevertheless, Scottish hospitals have shed beds at a faster rate than almost anywhere else, with more than 5,000 disappearing in just seven years. In North Wales more than 400 beds have been lost over the last five years.

In response the government would say it is due to “ong…

More for less is no solution in the NHS

The audacity of Chancellor Osborne knows no bounds. Having starved the NHS of much needed funding he now says: 'We have a clear plan for improving the NHS. We’ve fully funded it.'

Nothing could be further from the truth.

Britain's National Health Service is in a financial crisis with more Hospital Trusts in deficit and creeping privatisation eating at core provision.  Despite the government giving £3.8 bn funding up front, NHS England is expected to find a further £22 bn in efficiency savings over the next five years on top of the £20 bn already found. As shown in a previous article, this is affecting front line services with increased waiting times and bed shortages.

Mr Osborne wants to avoid last Christmas' headlines of an NHS unable to meet demand.

Last December, NHS England figures show, the numbers of patients waiting on trollies in A&E trebled from just over 13,000 to 38,848.  Now, the government is trying to avert another Christmas crisis by providing extra …

Let's break the cycle of poverty and disease

The House of Commons Health Committee has called for urgent action on childhood obesity.  Childhood obesity is increasing at an alarming rate. One fifth of children are overweight or obese by the time they start school, and this increases to one third by the time they leave primary school.


The cost of childhood obesity is an example of the short-sighted madness of Osborne's austerity programme.  The consequences of obesity on health will cost more in the long run than any saving he makes by cuts in welfare and support.  It is a foolish strategy.  The Health committees report demonstrates this in stark terms.




The government spends just £638 m per year on obesity prevention, yet the cost to the NHS of obesity and its consequences coupled with type 2 diabetes is a staggering £13.9 billion each year, and the cost to the economy is estimated at £27 bn.

The Health Committee  are right when they say that childhood obesity is a complex problem which will need action across a number of are…

The Emperor has no clothes

John Berger wrote that the poverty of ‘our century’ (he was referring to the 20th Century) is unlike that of any other. ‘It is not, as poverty was before, the result of natural scarcity, but a set of priorities imposed upon the rest of the world by the rich.’ He went on to say that the modern poor are not pitied but held responsible for their own condition.

We see this writ large in Cameron's austerity Britain.  The poorest are not only being made to pay the price for the failings of an irresponsible financial system, they also have been stereotyped as undeserving, work-shy and dependent on benefits.  It is a stern message without hope -  more poverty will drive them to help themselves out of poverty.  The Secretary of State for Work and Pensions has said as much - he wants to make those on benefits 'better people'.  It is as if the poor must be saved from themselves, or from 'welfare dependency' by a 'cold turkey' of reduced benefits.

So what of the bankin…

"Efficiency saving" has undermined the NHS

The government has announced extra money up front to avoid a crisis in the NHS. That much is welcome news. But it comes with a further tranche of 'efficiency savings' of £22 billion. This is on top of the savings of £20 bn over the last five years. But what have been the consequences of these 'savings', and where has the money gone? If savings were made, then why are so many Trusts in financial difficulty?

Last year the House of Commons Health Committee warned that the targets of these savings were 'unsustainable' after hearing evidence from NHS finance directors. The committee also criticised the Government's lack of transparency over how the money saved had been used, raising the issue that the Department of Health handed back billions of unused NHS budget back to the Treasury each year.
It certainly begs the question of why so many Trusts are in deficit when they have made such big efficiency savings.  What is the truth behind these savings?

Efficienc…

Osborne fails on social care

George Osborne has missed the mark on tackling the growing social care crisis.  He has failed to provide a coherent analysis or strategy to deal with the problem. We need a national strategy.

The crisis in social care funding was recognised by the Chancellor of the Exchequer  in his autumn statement today.  He announced that local authorities will be allowed to increase council tax by up to 2% to help meet social care needs.  This appears a good move. It is a step, but much more is needed.
It is anticipated that the new social care "precept" in council tax of up to 2% will allow local councils to raise £2bn for social care. It is good that more money will be available,  but I anticipate a fundamental problem with this approach.

Not only does need varying geographically, but those areas with the greatest needs are not those with the greatest potential for raising revenue. It may exacerbate the north-south divide in resourcing.

Data from the ONS and from the National Audit…

Let's stop blaming patients for lack of care

'Bed-blocker!' This is the new, dangerous and pejorative stereotype in the NHS - elderly people with nowhere to go, occupying hospital beds. Sadly, it has become an accepted story.  It is a cover for the reality of a shortage of beds and an NHS in crisis.

In its simple form,  'bed-blocker' is an epithet used to suggest someone occupying a bed in a hospital unnecessarily,  preventing someone else receiving necessary treatment. It presupposes they are not ill and don't need treatment.  Yet evidence shows that many are sent home seriously ill.  Yet, 'Bed-blocker' has now entered our pejorative lexicon.

Earlier this year it was revealed that more than one million hospital bed days were lost because of 'delayed discharges' during the preceding 12 months.  Now, that is a lot of hospital bed time! It represented an increase of 20 per cent in a year, and it is now at a record level with a cost to the NHS of £287m.  Headline news.  So what is the reality beh…

Privatisation threat to NHS grows.

The Tory government has pushed the NHS into a deficit crisis and sewn the seeds of its destruction. Am I being melodramatic? Possibly, but let's consider what has been happening in the NHS over the last five years.

The NHS is under threat not simply from underfunding and deficits but also from a growing privatisation of its services. Figures released last year  by the BMA showed the extent of creeping privatisation in the NHS under the Health and Social Care Act 2012, and it is set to get worse.

The investigation by the BMA found that a third of NHS contracts have been awarded to private sector providers since the Health and Social Care Act came into force.

The BMA council chair, Dr Mark Porter, said at the time:

“These figures show the extent of creeping privatisation in the NHS since the Health and Social Care Act was introduced. The Government flatly denied the Act would lead to more privatisation, but it has done exactly that.

"Enforcing competition in the NHS has not onl…

Work Capability Assessment undermining mental health

Since 2010 the Work Capability Assessment (WCA), has been used to assess the eligibility of claimants for out of work disability benefit.  In introducing WCA the government claimed it was a measure to get more people back into the workplace and help curb the government’s rising welfare bill, with the implication that many of those on benefits were 'shirkers'.  It was all part of the government's political narrative of 'workers' versus 'shirkers'.

The government were warned by health professionals that the harsher assessments would have major impact on mental health.

At the outset there were problems with the way fitness to work was being made and doubts that those making the assessments would have the necessary expertise and experience to make an assessment of how any particular mental condition impacts on the life of the claimant.

Doctors and disability rights organisations have long voiced fears that use of the tough new criteria to measure incapacity t…

The Ticking Clock of Social Care in Crisis

George Osborne is ripping out the very fibre of our social being and selling it off to the highest bidder.   But as a business model it stinks. Social care is a failing business.  Social care is in crisis.

Earlier this year Age UK warned that the social care system in England is on the brink of a 'cataclysmic' collapse with cuts in funding leaving the system unsustainable.  They warned the government that the 'clock is ticking'.  As a result many families will be facing unpalatable decisions about the support they will need, and where local authority provision fails, the vultures of a rampant private care system will hover. 
You might think that all this could at least be ameliorated through careful planning, but many families find themselves in unforeseen situations when NHS care comes abruptly to an end.  When a relative goes into hospital in a critical condition, but there is little doctors can do so they are returned home with the anticipation that domiciliary nurs…

Who pays for the damage of 'free' global markets?

Some of my recent blogs have been about markets. This is no exception. The point I make is that the neoliberal view of 'free markets' meeting needs is a myth.  Markets are neither 'free' and nor do they meet social needs or environmental health - the neoliberal view has no need for  'social need'. It speculates on the future without heeding the consequence. It simply considers social need as aggregate individual need.

But as I pointed out in my previous articles, social need is more than the sum of aggregate individual need, and the problem with the 'free' market is that it has no 'social conscience' - there is no market measure or price for social need.  The neoliberal wants a 'reduced State' which means substantially reduced public spending.  Many are appalled at poverty levels increasing, yet there is no market for 'ending poverty'.  Growth without social provision won't meet social need. But let's take another example…