The Thin End

There has been in recent years concern that care in the NHS has not been sufficiently 'patient centred', or responsive to the needs of the patient on a case basis. It has been felt in care that it as been the patient who has had to adapt to the regime of care, rather than the other way around. Putting patients at the centre of care means being responsive to their needs and supporting them through the process of health care delivery.  Patients should not become identikit sausages in a production line. The nurses body, the Nursing and Midwifery Council has responded to this challenge with a revised code of practice reflection get changes in health and social care since the previous code was published in 2008. The Code describes the professional standards of practice and behaviour for nurses and midwives. Four themes describe what nurses and midwives are expected to do: prioritise people practise effectively preserve safety, and promote professionalism and trust. The

And so we turn full circle. Health care is once again being restored to local regional governance.  The announcement today that the £6bn health and social care budget for Greater Manchester will be taken over by regional councils under devolved NHS powers is in one sense good news.  Local control will allow more joined up health and social care that is responsive to local needs.  But there are concerns and these have been given by he BMA. The Tories always have a desire to mess about with the organisation of the NHS. They most often do so in the hope that it will save money - that is 'cut' NHS funding.  For this reason I am always wary of moves to reorganise health care provision.  They fiddle with the deck chairs whilst the ship is allowed to sink, and then give as a reason the sinking of the ship.  It runs a bit like this. The ship is sinking so lets reorganise all the deck chairs so that it sinks more slowly.  The ship continues to sink and so the deck chairs are moved on

With good news on the economy, with the headline rate of unemployment falling yet again in the latest figures, and with wages rising, we might all heave a sigh of relief.  Comparing October to December 2014 with July to September 2014, the number of people in employment increased by 103,000 (to reach 30.90 million), the number of unemployed people fell by 97,000 (to reach 1.86 million) and the number of people not in the labour force (economically inactive) aged from 16 to 64 increased by 22,000 (to reach 9.05 million). But the government continues to wage war on the poor by cutting benefits. Just last month there were further cuts in housing benefits to the poor.  Housing costs are a major factor in pushing families into poverty. A measure of a just society is how well the poorest do during a recession. Austerity has been unkind to the poor who have born the brunt of the cuts in welfare. Official statistics show that between 14 and 15 million people live in absolute poverty in the

Doctors’ leaders have today unveiled a major new campaign ahead of the General Election calling for an open and honest public debate about securing the future of the NHS and an end to political game playing with the nation’s health. The BMA’s campaign – No More Games – calls for: No More Games with the public’s health No More Games with NHS funding No More Games with who’s providing patient care The launch of the campaign comes as a new poll highlights a marked increase in public feeling that politicians are putting votes over patients, with 77 per cent believing political parties to be designing health policies to win votes, rather than focusing what is best for the NHS. As part of the campaign, the BMA has today unveiled a new poster at thousands of sites to bring the campaign to the public’s attention. The poster, featuring a giant toy tower representing the NHS, will feature on billboards and bus shelters. The BMA is now calling on the public to add their voices to thos

The poor pay disproportionately more to defend the rich.   The UK spends £36.4bn per year on defence.  The cost of tax evasion is £22 bn (Treasury estimate).  It seems the rich don't want to pay to defend Britain, or for British forces to play the world-wide role they do.  Yet, the rich will expect it and indeed they depend on it.  It is another example of the lack of a moral compass.  Whilst austerity hits the poorest, the wealthiest continue to benefit.  The poor subsidise the rich.  There is a dreadful dependency of the wealthiest on the poorest.  'Welfare dependency' is nothing compared to the dependency of the rich on keeping the poorest poor. But why is there no political representation of this unfairness? Where is the anger and the movement for change? For all its benefits, New Labour brought into the wealth prospectus. It brought into the false notion that with wealth would come social justice. It shook hands with the wealthy elite. The rich get a bigger say in go

UK Revenue and Customs loses billions in tax revenue each year due to tax avoidance and evasion. Meanwhile more than one in four of our children live in poverty,  that is  3.5 million children.  With an upward trend as a result of the coalition government's austerity policies this is expected to reach 4.7 million children by 2020. Millions of our children will go to sleep hungry whilst rich tax evaders feast themselves in some far away sun spot. A lack of anti-avoidance tax law and cuts to public services are contributing to the UK's yawning tax gap.  The difference between the tax that should be paid in the UK if the tax system worked as parliament and HMRC intended, and the amount actually paid is a staggering  £119 bn.  I will repeat that: £119 bn! This is the figure produced by research commissioned by the Public and Commercial Services Union and published last year. Their research estimated  that in 2013 the UK lost £73.4bn to tax evasion. Evasion is when a person o

'It's the same the whole world over...its the poor what gets the blame.' So the song goes. How true it is. Welfare 'cheats' are pursued mercilessly, the wealty tax dodgers hardly at all.  You would think that welfare cheats were costing us the earth. But they are not. The State of the Nation report published in 2010 estimated the total benefit fraud in the United Kingdom in 2009/10 was approximately £1 billion.  Figures from the Department for Work and Pensions show that benefit fraud is thought to have cost taxpayers £1.2 billion during 2012–13,  Yet, a poll conducted by the Trades Union Congress in 2012 found that perceptions among the British public were that benefit fraud was high – on average people thought that 27% of the British welfare budget is claimed fraudulently. Official UK Government figures put the level of fraud stands at 0.7% of the total welfare budget.  In contrast, it is estimated that tax fraud and tax evasion costs almost £69.9 bn per year.

The Tory party when in government always messes up the NHS. That is a given. We recall the crisis at the end of the last Tory government in 1997 with  long waiting lists and waiting times and with patients waiting on trollies in A&E because of a shortage of beds. Now we have the same long waiting lists, waiting times and patients waiting on trollies in corridors because of a shortage of beds. It is like Groundhog Day, a recurring nightmare. Tory governments should come with a health warning. Now a damning  report  says that historians 'will not be kind in their assessment of the coalition government’s record on NHS reform'. A major assessment of the coalition government's record on NHS reform by The King's Fund concludes that the upheaval caused by the Health and Social Care Act has been damaging and distracting. We recall the promise that the NHS was 'safe' in Tory hands and that there would be 'no top down reorganisation'. The history seeks

In my last post I wrote that the rich should pay more tax. The balance of the tax burden in the UK is unfair on the poorest. The poorest 10% of households pay eight percentage points more of their income in all taxes than the richest – 43% compared to 35%.  Yet, when we talk of tax it is the wealthy who scream the most.  They have become the untouchables. We can't increase tax else they 1) won't pay it (increase in tax avoidance) and 2) it is a disincentive to the 'wealth creating' rich. And so it is that the poorest have shouldered the greatest burden of the recession and it is the poorest who have payed in taxes and cuts in benefit. Is that fair? No.  Does it feature in any of the key messages from the major political parties? No. This also is the problem. We need to bring back into focus social justice at the heart of measuring outcome of economic strategy. To grow the economy is not in itself sufficient to ensure social justice. The rich simply get richer. Of cour

The rich should pay more tax. That would be fair. From the reaction of  business exectutives in recent days you would think that Labour were bent on some kind of socialist revolution.  "Red" Ed is said to be unfriendly to business. It is symptomatic of the vice-like grip the business world has on politics. You would think that the much needed redistribution of the balance of power and privilege in the UK was about to become a major political issue. It isn't. It will hardly feature in the election and the differences between the economic policies of the main political parties will be nuanced. That is not to say those nuances are unimportant, but they are hardly radical. So what are these business executives screaming about?  Once again they hold politics to ransom, and British politics suffers as a result.  We cannot address the real issues of law pay and unfairness in work contracts - 'Anti-business' the top executives will cry, and Lord Mandelson will come out

Stephen Fry asks the wrong question about God. He asks why a God would allow human suffering with diseases such as cancer.  By asking such a question he implies that the real answer is that there couldn't really be a God, or at least not a God that is benevolent.  His assumption is that if such a God existed then there would be goodness and no badness in the world.  It simply begs the question of what such goodness would be.  Goodness and badness is clearly a human viewpoint. It is 'good' that there is a world of nature, but it is also 'natural' that it changes, grows, develops and reproduces, else the world about us would not exist other than as a permanent fixed entity, and we along with it would also be fixed - no thoughts, no human decision, no cultural development, no history,  no Steven Fry. The later would, I think be very bad. All this doesn't suggest Stephen Fry is wrong to question the existence of a God. I do that also. But his question is misplac

I have come to a conclussion that the rich are a bunch of shits. You might think two things about this: 1) how did it take so long for me to reach such a conclusion, and 2) surely I don't mean all those who are rich. In truth it didn't take me so long. It has just taken me so long to say it and 'austerity' brings it out. The poor have been political fair game, particularly over the last five years of the coalition government here in the UK.  But somehow the wealthy have been 'ring-fenced'.  We have had the systematic attack on 'welfare scroungers' but little to root out wealthy tax scroungers, those who are arrogant enough to assume they owe society nothing. They are those who take but do not give back. They will make profit from other people's suffering.  They will send their children to the best schools money and privilege can buy but avoid paying for schools in general.  They will speed on our roads in their expensive, probably chauffeur driven