The NHS, Again

The BBC reports that
'Family doctors are not prepared to shore up an emergency healthcare system left unsafe by "political meddling", a GP has warned'

Whilst there may be some political problems, the main problem with emergency health care is the total abrogation by most GPs of any responsibility for their patients' care outside surgery hours. In the case of my local surgery the hours are from 8:00 am to 6:30 pm, Mondays to Fridays. This is just fifty two and a half hours out of a total of the hundred and sixty eight hours in a week. So for over one hundred hours a week, plus Bank Holidays, they offload the responsibility onto someone else. Nice work, if you can get it!

But who is that someone else? Last time I needed an emergency doctor of a weekend and phoned the surgery, there was a recorded message giving me a number to phone which belonged to an out of hours service run by a company called Harmoni. We have used this service twice in the past, on one occasion they sent a doctor who came about three hours later, and on the other, we were advised to go to our local A&E. But looking at the surgery website this morning whilst ordering a repeat prescription, I found this new instruction:

Out-of-Hours - Evening & Weekends

For medical advice when the surgery is closed please call 111

So patients are now told to phone the 111 number, which replaces the old "NHS Direct", rather than a company providing the surgery with an out-of-hours service, a company which presumably had some contractual obligation to the practice and indirectly with their patients.

Now one phones an NHS organisation, with the result that if the person manning the phone decides that you need medical attention, rather than just advice, you will be referred to A&E. And, of course, if one can't drive, there is no option but to call an ambulance. In our case, the A&E at the nearest hospital was closed earlier this year and we now a choice of two other hospitals which are considerably further away. As far as I can ascertain, neither of these have had their facilities upgraded to cope with the extra workload, one of them in fact coming under a different Health Authority.

Whilst one can't blame GP's for the A&E closures, I believe that we can blame them for for the poor availability of out of hours medical services. With six or more doctors at the local surgery, I can see no reason why they should not provide the out of hours service for their patients on a shift basis, particularly as they live nearby and have all the patients' records available for consultation.

So whatever the BMA GP chairman says, I still believe that it is the GP's who are largely, but not entirely responsible for the present problems.

Perhaps our doctors might like to think about the public perception of teachers once they became unionised. In my younger days, the most respected people in our community were the local doctors and schoolteachers. These days, teachers are seen as just local council jobsworths, and our doctors are rapidly heading the same way. Is this what they really want to be, just civil servants providing a service during office hours?

Is the Conservative Party in Terminal Decline?

The Conservative Party is steadily loosing members at constituency level. Although they never announce their membership numbers, various media sources suggest that the membership has probably fallen to probably a tenth of what it was in Margaret Thatcher's days and is now at around the 100,000 level.

Today, we have Lord Howe, the traitor in Mrs Thatcher's cabinet, telling David Cameron that he has lost control of the party, a report that follows closely on one which suggests that a senior party member has referred to the ordinary members as being swivel-eyed loons.

Now I have always believed that it is the members of any organisation who appoint the organisation's leaders and decide its policies and it is for the appointed leaders to do their best to carry out those policies and not produce new policies without the approval of their members. If for some reason, the members are pressing for a policy which the leader is unwilling to pursue, the normal procedure would be for that leader to resign, or in the limit for the members to put forward a vote of no confidence and require his resignation at a special meeting.  Indeed this has recently happened at a (non-political) organisation to which I belong where the chairman stood down because he disagreed with the policy required by members. All very democratic and as it should be.

But somehow with politics, the whole scenario is turned upside down. Once a leader is appointed, he takes it upon him self and his cronies to decide policy and expects the members to support him, even if they disagree. He is expected, in Lord Howe's words, to control the members, who, in the view of an unidentified party official are "swivel-eyed loons"

Now, I have never been a member of a political party, but were I a member, I would expect my views to be taken into account on a democratic basis when deciding party policy; I would certainly not pay my subscription in order to be told how to think, and to be just seen as an available pair of hands to stick leaflets through letter-boxes. Pay £25 to the Conservatives for that privilege - they must be joking.

So where is the Party going? We now have two right-wing parties, the Tories and UKIP. The Tories like to see themselves as "centre-right" and in general are little different from the Blair administration. With Labour moving steadily leftwards under Miliband, this centre-right position is also moving leftwards and now is probably more left wing than, say, the post-war Atlee administration. Meanwhile UKIP is picking up traditional right-wing Tory policies and is probably in the same position in the political spectrum as the Tories were immediately after WW2. According to a recent poll they are now attracting something in excess of 20% public support.

A lot will depend upon how UKIP performs in next year's elections for the European Parliament, but if they do well, there is no doubt that many more will support them at the next General Election. So unless those at the top of the Conservative Party come to their senses and start putting forward true Conservative policies, we could be looking forward to a long period with Labour in power, essentially as happened in Canada when the right wing split into two factions. There, the right only got back to power once there was agreement between the two factions and a leader appointed who returned to true Conservative values. This, as Nigel Farrage has made clear, won't happen here whilst Cameron is leader of the Tories.

The grass-roots, the paid-up members of the Conservative party, will soon have to decide what to do about Cameron and his out of touch old-Etonian clique. The sooner the better; I've no desire for a Labour government.

The Ugly Face of Scottish Nationalism.

No, I am not referring to Alex Salmond aka "the wee eck", although he would be unlikely to get into a list of the hundred most good looking Scots, but to what happened in Edinburgh when the leader of a United Kingdom political party visited the City for a press conference.
According to the Guardian, which is hardly pro-UKIP, Nigel Farrage was threatened  by "activists in the radical left pro-Scottish independence movement" when visiting Scotland to support a UKIP candidate who is standing at a by-election.
Note the Guardian's description, they were Nationalist and they were left wing, that is National Socialists otherwise known a Nazis. They used exactly the same tactics as Hitler's Brownshirts, which is violence against any opponents. These are Scotland's new Nazis, using similar tactics against the English that Hitler used against the Jews, tactics which were tacitly supported by the Wee Eck when he refused to condemn what had happened and suggested that it would be safer for UKIP not to enter into Scottish politics.

I would like to remind the Wee Eck that

• Scotland is still part of the United Kingdom, regardless of what some Scots seem to think.
• The Union Flag still remains the flag of the whole of the UK.
• Scotland elects a (disproportionately high) number of MPs who sit in the UK parliament and have equal rights with all other MPs.
• Any person or party may stand for UK elections in any part of the country, regardless of where the party originated or where they are born.

I would also remind BBC Scotland that they are funded by licence payers' money and have a duty to be impartial and objective, and their interview with Nigel Farrage hardly seemed to be either. The belief that the English should not get involved in Scottish politics is ludicrous whilst Scotland remains in the Union; on that basis will the BBC be campaigning for only English born candidates to stand for English seats? Of course not, that would be racist. Seemingly however that doesn't matter as far as BBC Scotland is concerned.

The Nationalists are having a problem as those who support the union slowly squeeze information out of the reluctant SNP.  Issues such as the EU, defence, currency, and pensions now have more questions than answers, and even those who support independence are beginning to question whether they would want Salmond to lead them in an independent country.

The Nationalists' problem with UKIP is not that it may be attracting that many votes, but that it is attracting attention to these questions and in particular that of the EU. Salmond has made it quite clear that he wants Scotland to be in the EU, although it is far from clear whether Scotland would be admitted automatically as a consequence of having been part of the UK, but one thing that is clear is that all new countries in the EU must sign up to the Euro.

UKIP is making many Scots seriously think about the hard facts of independence. Do they want to be in the EU as the Wee Eck proposes? Do they want the Euro? What happens if you believe as a Scot that the UKIP's vision of Britain outside the EU should also be that of an independent Scotland? Which is to be preferred, remaining part of the UK outside the EU, or being an "Independent" Scotland within the EU ? UKIP also seems to be attracting votes from both the Tory and the Labour parties, which could be attractive to many Scots.

In the past I have spent a lot of time in Scotland, both working and on holidays, and I have always enjoyed my time there. But ever since Scotland got its own parliament I have tended to feel that the English are becoming less welcome. Last year, after visiting the Wallace Monument, we returned to our car which has the Union Flag stuck over the EU symbol on its number plates and a Scot pointed to the flag and said they we don't want your bloody sort up here. Well after yesterday's Nazi display, he can be quite certain that we won't be visiting Edinburgh this year.  Southern Ireland is back on the agenda, we have found it very welcoming in the past in spite of out Union Flag, and more to the point I prefer Jameson Whiskey to the Scottish product. And there is the attraction of real Irish Guinness, not the English made substitute!

Oxford Paedophile Ring

Seven men were convicted this afternoon at the Old Bailey of various offences against six girls whom they held prisoners and subjected to gang rape and other indignities over a period of up to ten years. One doesn't need to guess from which part of the world that they, or their families, originated.

In many ways this is far, far, worse than the kidnapping of the three teenagers in the United States. The six girls concerned were vulnerable teenagers, some of whom were in the care of the Oxford County Council whilst others came from broken homes. They were the very children that our child protection services are supposed to be safeguarding.

The Telegraph reports that "Police had known about the activities of the ring for years but took no action, allowing the abuse to continue for nearly a decade"  and that "One of the victims described how she was even threatened with arrest for wasting police time when she tried to report the abuse".

Of course there may be some small justification for the police ignoring the situation. as since the Macpherson enquiry, the police have gone out of their way to avoid getting involved any case which might have racial implications. Too often are they accused of racism when it comes to things like "stop and search". Too often are the statistics examined by the "liberal" media to "prove" that the police and justice systems are racist. In any case, from their point of view, if the Child Protection Services didn't seem worried, why should the police give the matter priority.

But when it comes to the council Child Protection Services, I can see no justification whatsoever for their inaction. They were responsible for the girls, who had been put into care for their own protection because their behaviour was out of control, and yet they totally failed in their duty.
Seemingly, some lived in a council provided care home, but nobody actually looked after them. They were known to be taking drugs, drinking, smoking and were absent from school, yet they were just treated as "bad girls" and ignored. Hardly keeping them under control and protecting them. Some of the girls were placed in a  privately-run home by Oxford County Council, a home which was closed down after shortcomings were discovered.

But what about the reaction of those authorities? We just get the usual statement of regrets:
"Thames Valley Police and Oxfordshire County Council social services deeply regret that this activity wasn't identified sooner and that we were too reliant on victims supporting criminal proceedings, and that they suffered a terrible ordeal."
I suppose it was something that we didn't get the usual "Lessons will be learnt", but that is not much comfort to the girls either way.

The police have also arrested another nine men from the same area as part of the overall operation, so this may just be the tip of the iceberg; one of the girls claimed that dozens more girls were involved. Local sources suggest that more investigations are taking place in the Slough and High Wycombe areas so it seems that this story has a long way to go.

My question is whether there will ever be a proper inquiry into the shortcomings of the police, the Crown prosecution service and most importantly our child protection services? Heads should roll, but they never do; meanwhile the elected police commissioner for the area is apparently more concerned with his chauffeur driven car and office than looking into matters of public concern.

Sentences have yet to be passed; I know what I'd do given half a chance, but unfortunately it is illegal. No doubt they will be sentenced to terms of imprisonment, in comfort complete with halal meals, at our expense, but will never be sent back to where they belong as their human rights probably won't allow it. What about these girls' human rights?

I despair of my country.

The Patient Experience

Following a couple's complaints to a local hospital about the treatment of their young daughter and the alleged rudeness of a female doctor, the hospital in question issued a statement saying that
"The issues raised are now being handled by our patient experience team and will be thoroughly investigated.".

"Patient Experience Team"!   What on earth is happening to our hospitals?  Oh for the days when, if there was a problem, one just had a quiet word with the Matron and it could usually be resolved there and then. I just wonder what this "team" costs?

See the Daily Telegraph here

More NHS Fines.

Yesterday, I wrote about proposed legislation that will introduce fines in the event of NHS Trusts providing incorrect data as to mortality rates. This follows previous arrangements where they were to be fined for failing to provide single-sex wards.

Today, The Mail reports that Ambulance Trusts are being fined for waiting outside overcrowded casualty units, something that is hardly under the control of those running the ambulances. Apparently the contracts impose fines of £200 for every patient who has to wait for longer than 30 minutes for admission to A&E, and £1,000 for each patient forced to wait more than an hour.

Now whilst I have every sympathy for the patients having to wait for admission, the duty of the ambulance crews is to get the patients to hospital as soon as possible, and it is surely the fault of the hospital if they cannot be admitted. If fines are to be levied (and I still think that this is the wrong approach), surely the fines should be imposed on the Hospitals whose A&E departments are unable to admit the patients. I can now visualise the ambulances turning off their "blues and twos" and going the long way round when they hear over the radio that the A&E is packed, simply in the hope of avoiding fines.

For once I agree with Shadow Health Secretary Andy Burnham said that depriving one part of the Health Service of money as a ‘punishment’ for delays beyond its control was divisive and counterproductive.

If anyone should be fined, it is those managers who are responsible for the closure of  A&E departments at hospitals around the country. We have an increasing population which is getting progressively older, we have GPs who only do a five day week and rely, effectively, on A&E for out of hours cover, so what do these NHS managers do? Close about half of our A&E departments! But logic no longer applies in the NHS and it's a win-win situation for the Treasury who will recover some £90 million if the Mail's figures are correct. Do our Eton educated Ministers really believe that depriving NHS Trusts of money will make them more efficient? Or is it what they were taught on their PPE courses at Oxford?

The NHS madness continues.

Fines for Hospitals.

Proposed legislation has been published by the Government covering healthcare in England and, according to the Daily Mail, one of the provisions is that
"Hospitals that give false information about death rates will face unlimited fines under a package of new powers aimed at preventing another Mid Staffordshire-style health scandal."

I have never seen the point in fining a state run organisation as all that happens is that less money is then available for the organisation to carry out its work. Unlike a public company, there are no shareholders who will take a cut in dividends, or customers who will go elsewhere.  For example, hospitals have been instructed to get rid of mixed-sex wards, and can be fined for failure to comply. However, as the hospitals claim that the reason that they have been unable to make the necessary changes is lack of money, fining them is hardly likely to improve the situation.

Fining a hospital does not affect the hospital one little bit, it is a fine on all the unfortunate patients who happen to live within the hospital's catchment area.

It is those responsible who should be fined, the administrators who fail to carry out their duties; administrators to whom "administration" and politically correct statistics are more important than the patients. Provision of incorrect statistics is surely "misfeasance* in public office" which is a criminal offence, and in my view those administrators responsible for issuing the instructions should be prosecuted. It should also be possible for the Regulator to double check the statistics by collating the information shown on the death certificates relating to deaths at a hospital, bearing in mind that it is also an offence to provide false information to the Registrar, and thus any doctor providing the Registrar with an incorrect cause of death could be in trouble.

No new laws seem to be required, as the existing ones, properly applied, appear adequate; certainly fining the hospital will do nothing to help the patients.

* Misfeasance is to take inappropriate action or give intentionally incorrect advice.