News from Nowhere 93 December 2020

Primary Care Notworks

Is a failing network a notwork? An indignant NfN mole pointed out that the top-down pressure to create Primary Care Networks will result in organisational changes that ignore that relational nature of primary care. Scarcely had he spoken than Birmingham University released an evaluation of four PCNs which revealed confusion over the purpose of PCNs, tensions between practices that have been “forced” to work together and increasing workload for staff.

Tensions regarding the purpose of the networks “arose time and time again”, while some interviewees felt the networks were being sold as a “cure all” within primary care. A “large proportion” of practices interviewed felt that no real progress had been made in changing service delivery since PCNs were launched in July 2019. Some felt that PCNs were actually a step backwards, compared with previous forms of primary care collaboration. 

Source:  Jasmine Rapson    Confusion and tensions over PCNs despite their ‘early operational success’    HSJ   10 November 2020

My Little Crony   

Not just about health, but irresistible nonetheless. See the web of connections between Tory politicians and companies being awarded government contracts during the pandemic, at Sophie Hill’s website:

Vaccines: Did somebody say “means of production, distribution and exchange”?

With Covid-19 no one is safe until everyone is safe. That principle has been endorsed by the UK Government, which has recognised Covid-19 medical products as “global public goods”. 

Sarah Champion MP (Labour chair of the international development committee) and Wendy Chamberlain MP (LibDems) have called on the Government to improve transparency of vaccine research in the UK, particularly with financial reporting. The Government should also champion the use of the legal safeguards that all World Trade Organisation members can implement to override patent monopolies if public health is at threat – Germany, Australia, Canada and Israel have already taken steps to do this. 

Finally the UK Government should support the proposed waiver of all intellectual property monopolies relating to COVID-19 tools, medicines and vaccines. Not only will this help speed up R&D but it will also make products more affordable by enabling generic competition to help drive down prices.

Tax and spend

Take a look at this graph on attitudes towards taxation and spending on health, education and social benefits, 1983-2019, from the recent British Social Attitudes report. 

NfN reads it as showing two things: 1) more favoured additional tax and spending during Conservative Governments (1983-1997, 2010 to date), but keeping tax and spend at the same level rose in popularity under New Labour’s largesse; and 2) the proportion wanting lower taxes and less public spending never rose much beyond 10% – so why are we afraid of them?


Source: British Social Attitudes 37  NatCen social research 37 ( 

Risky businesses

In the previous News from Nowhere (92) we noted an economist’s view on the futility of balancing health against the economy during the COVID-19 pandemic. A study from the USA may or may not cheer him up. 

Interviews with a large and representative sample of the US population suggest that only 36% agree with him. These risk-minimizers are reluctant to accept any increases in COVID-19 risks, regardless of the economy.

Slightly better news is that about 26% were waiters, strongly preferring to delay reopening nonessential businesses, independent of COVID-19 risk levels.  These were mostly low-income, non-white, salaried employees with little interest in opening restaurants, nail parlours or gyms. And, since they already are at or below the poverty line, economic recovery holds little promise for them. 

Another 25% were recovery-supporters, concerned about economic recovery. This group would accept a cumulative percentage of Americans contracting COVID-19 as high as 16% to shorten economic recovery from 3 to 2 years. The final openers group (13%) prioritized lifting social distancing restrictions and accepting COVID-19 risks greater than 20% to open earlier rather than later, regardless of the impact on poor families.

Source: Reed S et al   Willingness to Accept Trade-Offs Among COVID-19 Cases, Social-Distancing Restrictions, and Economic Impact: A Nationwide US Study   Value in Health 2020; 23 (11):1438-1443 

Herb Immunity

A puzzled NfN stalwart left an online spat with anti-vaxxers when the topic of ‘herb immunity’ came up. Was it a reference to Big Pharma minting money, or an obscure critique of Sage? Neither, it was a typo.

Read more News from Nowhere and articles on the NHS in ERA 3 at

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