Trust me Mr Hunt, I’m an NHS patient

Since last August I’ve sent Jeremy Hunt 57 tweets over 57 days, a few emails and one blog (Trust me Mr Hunt, I’m a junior doctor’s mam) and no response from him. Granted his department has emailed me back, but that doesn’t count. One email even said: “This may not be the reply you were hoping for.” So here is part two of my series of NHS blogs – even if it’s not what you were hoping for Mr Hunt.

Every time I’ve sat down to write this blog, I haven’t known where to start. And I really still don’t – because the NHS is in one, big, bloody mess. Every week, every day something hits the news about the patients and staff caught up in the quagmire and the demise of it. It’s like a game of Jenga. Piece by piece our NHS is being taken apart.

I have needed and used the NHS for the past 57 years. And when I returned from living in Athens for three years in 2010, the NHS was high on my list as a reason to come back. And now? Now a system so revered by the rest of the world, is on its knees. The situation was so bad the other week that the Red Cross described the state of our health service as a “humanitarian crisis”. Theresa May said the situation was “overblown” by them and Hunt had the gall to say in the House of Commons, that a “few areas” were of concern. He definitely becomes Pinocchio in that building, as it transpired later that day that in fact 20 hospitals had been put on a “Black Alert” (or on an “OPEL 4 Alert” as hospitals have been told to call them. Campaigners claim the ban on the term Black Alert came about to spin the NHS out of crisis). A Black Alert is the most serious alert; meaning a hospital is “unable to deliver comprehensive care and there is increased potential for patient care and safety to be compromised.” Out of 120 trusts, almost half have declared a major alert during January this year.

But whatever the semantics or codes used; the NHS is in crisis and healthcare practitioners (HCPs) and patients have taken to Twitter, with #NHSCrisis … to illustrate the fact. A litany of atrocious situations has been described. Trawl the hashtag on Twitter or read the chronicles on the internet to find out. Three news reports have particularly upset and outraged me.

Firstly, a mother released the photo of her child with suspected meningitis – lying on a makeshift bed – made out of two plastic hospital chairs pushed together.

Secondly, in November 2016 patients waiting on trolleys for over 12 hours, after a decision was made to admit them, totalled 456 – the second highest figure on record, 16 times higher than in November 2015.

And finally cancer operations have been cancelled. It is a humanitarian crisis – where’s the humanity or dignity in any of this? It’s criminal.

After the denial, came the deflection from May and Hunt. But none of the above is due to lazy doctors or GPs who already work all hours; nor due to people using A&E for a sore finger; nor due to tourists abusing the system (They account for 0.3% of the NHS budget) or immigrants (who contribute to our NHS) No; all of it is due to a shortage of hospital beds – we have fewer beds per head of population than our neighbouring European countries. All due to chronic underfunding – we spend less on healthcare, as a percentage of GDP, and have fewer doctors and nurses (part three on nursing out next) per head than many of those European countries too. Thousands of HCPs warned us last year though. Kevin O’Kane (consultant) was one, who simply summed up the situation last August in a tweet: “Too few doctors; too few beds.” He continued describing the problem: “Places for medical courses through clearing; deliberate underfunding and swingeing cuts.” Speaking with my son recently, who has just finished 6 months in A&E as part of his training, he said: “Not enough beds for older patients with complex needs.” (Can I add he looks dreadful too – exhausted due to a gruelling shift pattern. That’s the mam coming out in me again).

The emails I received from the Department of Health (DoH) extolling Hunt’s and the government’s intentions, made particular reference to the lie that they are investing £10bn in the NHS. Even their own Tory MP Sarah Wollaston, who chaired a cross party Health Committee, refutes it.

The emails failed to mention: the social care cuts of £4.6bn meaning discharged patients can’t get home to be further cared for; failed to mention the cuts in mental health staff and beds meaning distressed patients having to travel up to 100 miles and be away from family; failed to mention funds for mental health not being ring fenced; failed to mention Virgin Care managing over 230 NHS and social care services over the past 6 years meaning Richard Branson has secured contracts worth £1bn; failed to mention outsourcing of administration services meaning referral letters go to the wrong address causing patients to wait longer for specialist appointments; failed to mention PFIs (private financial investments that were used to build hospitals) continuing to accrue interest meaning the debt to the NHS is worth billions – think the biggest Visa credit card ever; failed to mention that they can advertise the sale of NHS contracts, the latest one is a transport contract worth £515m, meaning for-profit businesses can capitalise on a broken system; failed to mention the American companies who have their fingers in pies over here already, such as Bain Capital and United Health; failed to mention that DoH reported £8.7bn of NHS funds went to private companies in 2015/16; failed to mention nearly 100 GPs less in England in Sept 2016, than in 2015, meaning Hunt’s GP recruitment isn’t going too well; failed to mention GP surgery closures due to lack of funds, meaning loss of vital primary care and GPs having to take out personal loans to pay for redundancies; failed to mention rising business rates for some hospitals, our Specialist Emergency Care Hospital in Northumberland faces an £8m bill over the next 5 years, due to a 50% increase; failed to mention Sustainability & Transformation Plans (STPs) in the 44 “Footprint” areas in England, needing to find “efficiency savings” of £22bn, as part of the Five Year Forward View – some of the plans sound commendable, but some also mean cuts – e.g. by 2021 7k NHS jobs and 500 beds are to be cut in North West London (as part of the  £1.3bn savings that have to be found) and in rural South Devon four community hospitals are to be replaced by Wellbeing Hubs (part of their £557m savings) and failed to mention that £2.3m will be spent, in London alone, on management consultants for these STPs.

And definitely would have failed to mention May going cap in hand to see Trump last week, with the possibility of our NHS being on the trading table. And definitely would have failed to mention the revelation 2 days ago, that NHS England’s budget will face a reduction of 0.6% per head in 2018/19. So that IS one big £10bn lie. Expect another email from me Mr Hunt.

No wonder I didn’t know where to start… and I could go on and on.

While Hunt and May deny and deflect. It’s patients and frontline staff who take the brunt. The NHS in England sees one million patients every 36 hours. There are potentially 65 million users of the NHS. And ironically, because we have a population that lives longer, more people are using it today than they were in 1948 when it was founded by Labour. This poses a huge challenge for the NHS, hence the STPs. But why should health trusts and patients and staff bear the load of underfunding?

Yes, it’s in one big bloody mess, but through it all staff show care and tenacity. Someone who encapsulates what our NHS is all about at its best, is Dr Kate Granger, the doctor who pioneered #hellomynameis … simple words, a simple phrase, but they introduce a healthcare practitioner to a patient, a person and open the door to a dialogue. They begin the message: I care; you count.

Sadly, Kate died in July last year, from a rare terminal cancer, but her legacy carries on through that phrase by her husband Chris Pointon and every single doctor, porter, nurse, GP, physiotherapist and consultant who says it. No lip-service. It is part of person-centred care. My new dentist used it the other day when I met her for the first time. Hospitals, clinics and surgeries are less intimidating because of this person-centred care that pervades medicine today. Couple this compassion with collective knowledge, evidence-based practice, skill, training and the ability to stay awake for 12 hour shifts and you have our health service – one that is free at the point of use; publicly funded … you have OUR National Health Service. It says – we have your back. And every HCP busts a gut every day to deliver it. I think it was Ghandi who said: “A nation’s greatness is measured by how it treats its weakest members.” I want our NHS to continue for this very reason.

Trust me Mr Hunt; this is what the world reveres. What decent people revere. As a patient this is what I revere. This is what I need for me and my family and future generations. The NHS needs to be run efficiently, we would all agree, but like education our health is not a commodity… to be sold to the highest bidder.

Trust me Mr Hunt; as a patient I would like safe, non- urgent or elective 5 day care with 24/7 emergency care. I would like to carry on seeing my own designated GP, who I have built a relationship with, during the week, as I want continuity of care. Mr Hunt, you must know that a pilot study of 7/7 GP care showed it didn’t work – people failed to attend weekend appointments and it wasn’t financially viable. If I need urgent care then I know to seek it through a pharmacist, walk-in centre, GP OOH (Out Of Hours) or NHS 111 service. Although at the moment some don’t seem too healthy, eg in North Tyneside, three walk-in centres are being reduced to one (£904m of health & social care savings need to be found in this Footprint. Big question – are the walk-ins part of the STP? Answers are hard to come by).

I don’t need a truly 7/7 NHS. I need the services we already have to be robust and easily accessible and well-resourced and to carry on being publicly funded. Stop claiming you are fulfilling the promise of a 7/7 NHS, made in some general election manifesto in 2015, and that the electorate want or need it.

My part one NHS blog was viewed nearly 2k times and was all about my perceptions as the mam of a junior doctor. At the end I asked you Jeremy Hunt, our Secretary of State for Health, if you would recommend a medical career, without any caveats, to your own children? In the light of the above and the fact that your own constituency’s hospital, the Royal Surrey County Hospital, was also on a Black Alert, then I am now asking you: “Would you recommend using the NHS to your family, Mr Hunt? Would you, without any reservations?”

I’m imploring you to properly fund our NHS – cancelling the PFI debt would be a good start. Remember you are a civil servant to serve and represent us as a member of parliament, even if the Health and Social Care Act of 2012 does absolve you of total responsibility for our health. It is a political choice as to how you and your government spend our taxes and how you fund OUR NHS. But first you have to acknowledge you are part of the problem, in order to solve the problem.

Realistically? I think this will fall on stony ground… Hunt will carry on being self-serving and he will let the removal of the Jenga pieces to continue. And when it all tumbles, it will allow the full privatisation of the NHS to happen, with every Tom, Richard B and Harry running off with the pieces. A private health insurance system is not a pretty sight. Costs are the biggest cause of bankruptcy in the US. And people with a pre-existing condition, are uninsurable, or at the very best have much higher premiums. Healthcare can’t be paid for by insurers, because insurance needs appropriate risky ratios to succeed. Healthcare becomes a utility, instead of a right. It isn’t a pretty sight.

So now I implore you – the electorate – to keep making some noise by going on Twitter and Facebook, blogging, writing newspaper and journal articles, chatting to friends and family, petitioning, joining campaign groups and unions, getting involved in the next consultation phase of the STPs, lobbying your MP about funding and supporting the NHS Bill (to stop further dismantling and privatisation of the NHS and reinstate it as an accountable public service). Write to or email Hunt about anything NHS.

Engage. Spread the word.

Resist against cuts and closures now before anymore happen. Protest. Demonstrate. Go to the big #OurNHS demo on 4 March in London – backed by Unite, the BMA and the People’s Assembly. If you can’t go, then attend any local events ahead of the march and rally. Publicise and report the big demo on social media and inform mainstream media.

Basically bug the hell out of all of the political parties. Oust the Tories. Go on… you know you want to. It’s what most of us are hoping for.

Patient feedback (Uncredited)    Featured image Junior Doctors
You can follow Wendy on her twitter at @Erriwend and at her webpage #CreativeGeordie

I Don’t Want To Go Forward To The Past (I Want To Go Back To The Future)

Like around 16.1 million others I awoke on Friday 24th June 2016, bewildered, astounded and profoundly saddened at the EU referendum result to leave, the detailed outcomes and what was soon to be the consequences that my fellow citizens had unleashed on the United Kingdom based on lies, innuendo and speculation.

There are 100 things that could be said that are wrong, that were worrying and manifested before during and especially after polling day. I will focus on a few only as the chain of events unleashed since Friday is filling up every space the internet can cram it all into.

The country I loved has changed overnight, the people I would have always trusted and respected as a default have made me question that approach and I have made a decision to be more discerning with every person I interact with. I don’t want to go forward into the past, I want to go back to the future, the future we were about to embark on as a country.

 

  • The murder of Jo Cox, she must never be forgotten. A statue in her honour should be prominently displayed in Westminster for all to be aware of her life and her work. When the British Constitution books of the future are written I believe that students should know what happened to her and why.
  • The racism and casual references to immigrants and negative connotations linking crime, terrorism and world war three to people who are our neighbours, our friends, relatives and in my case my own parents.
  • The young people, the 16-18 year olds who didn’t get a vote at all unlike in the Scottish Independence referendum, and the 18-24 year olds of which 75% of them voted to remain.
  • The lies: all of the money we would be getting back to spend on the NHS, the Turkish people flooding in when they  join the EU, the trade agreements that we can make because “they need us more than we need them” and the lies, damn lies and statistics, resulting in a leave campaign where experts were dismissed as gloom merchant stick in the muds who should be ignored. Then the 90% of press reporting.
  • The behaviour and attitude of politicians who put their own party and their electoral opportunities before the good of the country, posturing, evading, scaremongering on an unprecedented scale both disingenuous and in some cases cruel. The oxygen of publicity given to hatred, liars, apologists and racism by foreign owned newspapers, bitter political editors (one in particular), hidden agendas and weak know it alls.

 

I can’t see a progressive future for the country with hatred and division being sanctioned, young peoples’s views being ignored, finger in the air see which way the wind blows politics rather than a determined plan of action. Since when did our vision become based on “well we’ll see what happens shall we?” Since when did we arrive at a point where many people couldn’t care how much regret and pain these events would cause?

We have allowed ourselves to be caught up in a nightmare, led by people at the front (not leaders) chanting “I want my country back”. What are they talking about?

A country that sat within the world of division and hate, the Berlin Wall still standing with countries run by Communist Dictators and the U.K. on the other side of that wall, Apartheid regime in South Africa with Nelson Mandela still in prison and our Government doing deals with the oppressive regime, Northern Ireland and the troubles with all of the atrocities that we never thought would come to an end or a different type of country back. The country of the Coronation, the Festival of Britain , the Swinging Sixties, village fetes and long hot summers. That isn’t the same childhood I had being the son of two immigrant parents, for although we had lovely tolerant friends and neighbours and lived in a wonderful place, there was often an ignorant bigoted comment, but as the European relationship improved so did life for my family improve, but let’s not paint a picture that I heard recently (which I will paraphrase) of “let’s get back to the days of those nice immigrants we used to have, not these sponging terrorist types we have these days”.

Get real shall we.

We had a vision that the world saw at the opening ceremony of the Olympics less than four years ago, a progressive tolerant nation, one that extolled the virtues of our diversity and inclusive practical approach to disability and equality, not just tolerance but celebration.

I want that country back, the United Kingdom that held hands with the rest of the world, we are a forward thinking nation who has instantly gone from standing in the front row of the family photograph, being at the main table for the family decisions, and one of the central players in the biggest economic and political union in the world to be out the back with the empties in one fell swoop. The genie can never be put back in the bottle.

I feel that we have lost something precious that can’t now be replaced. My passport was British and European Union and that was how I identified myself, a British member of the European Union. My family are still members of the European Union but I am not.

I’m not a sore loser but I admit we’ve lost much more than we’ll ever know and yes, it hurts.

You can follow Joseph Conaghan on twitter at @ConaghanJoseph and at his blogpage  Joseph Conaghan’s Blog:JOE BLOGS 

HISTORY OF THE EUROPEAN CONSTITUTION

The Treaty of The European Steel and Coal Community was signed in Paris on 18 April 1951 and came into force on 25 July 1952.

The Schuman plan as it was called was approved by the French Government on the 9 May 1950. Although reaction to the proposals was mixed some believing a new steel company cartel was being formed and others believing that the plan represented American control over Europe, public opinion was generally favourable even though the full significance of the plan was difficult to grasp. The European countries that had been approached had no wish to be left on the sidelines in the rebuilding of Europe. The ratification of the Treaty establishing the European Coal and Steel Community (ESCC) was reached without any major obstacle in any of the six countries (Germany, France, Italy and the Benelux countries), signing the treaty.

This document is considered the foundation document of the European Union.

The Treaties of Rome, following the success of the (ESCC) (and the failure of the European Defence Community), the two communities initiated the organisation of the economic and atomic energy areas. The Treaty of the European Economic Community (EEC) and the Treaty of the European Atomic Energy Community (EAEC) were both signed on 25 March 1957 and came into force on 1 January 1958.

In April 1955, the foreign ministers of the six (Belgium, France, Germany, Italy, Luxembourg, Netherlands) meeting in Messina, resolved to work together towards closer economic integration. Paul-Henry Spaak, the Belgian Minister for Foreign Affairs was named head of a committee charged with preparing a report on the topic. This Report, which was delivered in May of 1956, recommended the creation of a common market for all goods and services, based on a customs union with a common external tariff. It also proposed a union in the field of nuclear energy.

The Treaties of Rome consist of:

  • The Treaty establishing the European Economic Community (EEC);
  • The Treaty establishing the European Atomic Energy Community (EAEC) or (Euratom);
  • A Convention on certain institutions common to the EEC, the EAEC and the European Steel and Coal Community (ESCC).

The UK joined the EEC in 1975, the Prime-minister at the time being Sir Edward Heath.

The Single European Act, apart from minor modifications, this Treaty was the first major reform of the European Union since the 1950s. The SEA introduced measures aimed at achieving an internal market (for instance harmonisation) plus institutional changes related to these (such as generalisation of qualified majority voting and a co-operation procedure involving the European Parliament). It also provided legal form for European Political Co-operation (EPC). The SEA was signed in February 1986 and came into force on 1 July 1987.

During the time of Prime-minister Margaret Thatcher.

The Maastricht Treaty. The Treaty on European Union initiated the road to political, economic and monetary union. It was drafted at a historic juncture when the re-unification of Germany and the fall of the Soviet Block made a re-thinking of the European Project necessary, among several significant innovations such as EU citizenship and the EMU. The Treaty of Maastricht created the so-called three pillar structure. It was signed on 7 February 1992 and came into force on 1 November 1993.

During the time of Prime-minister John Major

The Amsterdam Treaty. Enlargement towards the East and several issues on the EU agenda prompted the negotiation of the Amsterdam Treaty just four years after the conclusion of the Treaty of Maastricht. Negotiations, however, took place in a less optimistic climate. The Treaty of Amsterdam opened the way to re-enforced co-operation but it failed to solve institutional issues created by the forthcoming enlargement. It was signed on 2 October 1997 and came into force on 1 May 1999.

During the time of Prime-minister Tony Blair.

The Nice Treaty, dealt mainly with the institutional adaptations required for the expansion of the Union to twenty-five Member States. These issues had remained un-resolved with the Treaty of Amsterdam and they provided the background for one of the most difficult negotiations in the history of the Union. The Treaty was signed on 26 February 2001 and came into force on 2 February 2003.

Again during the time of Prime-minister Tony Blair.

The EU Constitution. Towards the end of the Twentieth Century, it became clear for a large number of European leaders that the EU required a re-foundation and renovation that included the distribution of competencies, simplification, and the incorporation of The Charter of Fundamental Rights, the Convention on the future of Europe produced a fully-fledged proposal for a Constitution or Constitutional Treaty for Europe. Italian and Irish presidencies had led the negotiation and final approval of this document. On 29 October 2004 the Heads of State or Government of the twenty-five member states and the three candidate countries signed the Treaty establishing a Constitution for Europe which has never been ratified.

Again during the Time of Prim-minister Tony Blair. However, please note this Treaty was never brought into full force and effect.

The Lisbon Treaty. This Treaty was initially known as the Reform Treaty and is an international agreement which amends the two treaties which form the constitutional basis of the European Union, The Treaty of Lisbon was signed by the EU Member States on 13 December 2007, and entered into force on 1 December 2009. It amends the Maastricht Treaty and the Treaty of Rome. At Lisbon the Treaty of Rome was re-named the Treaty on the functioning of the European Union. Prominent changes include the move from unanimity to qualified majority voting in at least forty-five policy areas in the Council of Ministers, a change in calculating such majority to a new double majority, a more powerful European Parliament forming a bicameral legislature alongside the Council of Ministers under the ordinary legislative procedure, a consolidated legal personality for the EU and the creation of a long-term President of the European Council and a High Representative of the Union of Foreign Affairs and Security Policy. The Treaty also made the Union’s Bill of Rights and the Charter of fundamental Rights, legally binding. The Treaty, for the first time, gave member states the explicit legal right to leave the EU and a procedure to do so.

Charter of Fundamental Rights of the European Union enshrines certain political, social and economic rights for European Union citizens and residents into EU Law. It was drafted by the EU Convention and solemnly proclaimed on 7 December 2000 by the European Parliament, the Council of Ministers and the European Commission. However, its then legal status was uncertain and it did not have full legal effect until the entry into force of the Lisbon Treaty on 1 December 2009.

During the time of Prime-minister Gordon Brown.

POINTS TO NOTE:

There are a few points to note in relation to the development of the European Union:

  • The original Treaty was put in place to create a common economic policy to help rebuild Europe after the Second World War.
  • The original Treaty was between six of the worst affected countries.
  • The UK consented to join the EEC at a time of great financial disadvantage in this country (I remember, I was there). It was believed that a bigger common market would provide a bigger trade voice in the world than every country working on its own.
  • The monetary union has proved a huge stumbling block for the European Union, as was warned at the time of the union. The reason why the UK has not joined the currency union.
  • The Common Agricultural Policy has provided subsidies to farmers, however, the policy was not thought out clearly enough, in the early years, we had Butter Mountains etc. This policy does really need to be looked at properly.
  • The Treaty of Lisbon has really proved to be a two-edged sword. On the one hand, it does strengthen the core of the European Union and the common trade policies. It also increases the free trade area for goods and services. The free movement of people allows UK citizens to travel and work freely throughout Europe as well as the other way round. On the other hand the creation of a central EU Parliament and some of the structure of the EU outlined in the Lisbon Treaty is very difficult for individual governments to stomach. To the minds of some, the parliament creates a centralised government for Europe, and in their interpretation lessens the role of the individual state governments.
  • Within the Lisbon Treaty there are sensible guidelines in respect of votes cast by MEPs.
  • The European Union has a separate legal identity.
  • The Charter of Fundamental Freedoms referred to in the Lisbon Treaty referring to the European Union cannot be construed as being the same as the European Convention of Human Rights or the European Court of Human Rights. The European Union and the European Court of Human Rights developed along separate routes.

I started this research because I wanted to understand why the Government wanted to abolish the Human Rights Act and start again. Except with reference to the Treaty of Lisbon I can still see no reason why we require to abolish the Human Rights Act.

As I have stated above, the European Court of Human Rights is separate from the European Union. It is an independent court. The judges that sit in that court represent different nations in Europe.

A judgement is not made by one judge but by three independent judges to ensure the legal reliability of a judgement.

The UK was a founder member of the Council of Europe, a major contributor and signatory to the European Convention of Human Rights, however it was not a signatory to the founding treaty of the European Union, therefore, it can reasonably be construed that even if the UK were to leave the EU individuals would still have a right to be represented at the European Court of Human Rights which protects every European citizen within a country that signed the original European Convention of Human Rights Charter.

The other question I faced in respect of human rights law yesterday was with regard to jurisdiction.

The Human Rights Act ensures that a case has to be taken through all due process of law within the country of origin before it will even consider a case. There are reasonable safeguards in place to ensure that all sides of the argument are considered before a case is even allowed to fall within the remit of the European Court. Cases are heard in the Country of origin.

Here are some points to note:

  • In the UK, there are separate legal procedures in Scotland and England.
  • A new Bill of Rights would have to be adapted to Scottish Law in Scotland.
  • You do not have to abolish the Human Rights Act to create an independent Bill of Rights for the UK.
  • The judiciary in England and Scotland are independent from Government.
  • The European Court is an extra safeguard for an individual against violation of human rights by the state.
  • It can be construed that the European Court is also an extra safeguard helping the UK judiciary to remain independent, thus enabling UK judges to make sensible, balanced judgements.

My plea to our own Scottish Government as well as the UK Government is quite simply please do not abolish the Human Rights Act. You see, it is easy to opt out and take the wide path. It is easier for a Government, because it makes the route for their policies smoother, to say let’s do away with a perfectly workable law and create something that suits our purposes, even if it knows that it is not going to be in the interests of the people of their Nation, as well as not being cost effective. The much more truthful, rewarding route is to find a real policy that works for everyone, building on what is already in place. Put the people first in this instance please.

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