Squabbling about the NHS.
What has happened to the Socialist Health Association? Readers of HM may be aware that the SHA is affiliated to the Labour Party, but that position may be under challenge after recent events. Private Eye picked up on a story about the sacking of the SHA’s only member of staff, concluding that the “once respected Socialist Health Association is looking peaky. If not dead, it’s certainly in a coma”. The SHA replied with a lengthy damage-limitation statement, pointing out (accurately in the view of News from Nowhere’ s moles) that the SHA was more active than in the past. However, this may not mean much, given that the SHA has been moribund in the past (with a few energetic local exceptions). Previous Labour Secretaries of State for Health habitually avoided reliance on the SHA for expert policy advice. Michael Meacher had a kitchen cabinet of three academics, Robin Cook spread his net wide across the big battalions (the BMA and it’s like) whilst Frank Dobson encouraged a range of policy committees with wide membership. The SHA’s difficulty has been that its close connection to Labour means that it is used as a platform for internal Labour squabbles as well as a ladder for the ambitious, leaving less time and energy than it needs for serious policy work. Members’ concerns not been dealt with to everyone’s satisfaction, and elections for Officers and Central Council members have been cancelled, foregoing an opportunity to clarify what has been going on. According to NfN moles, there is nervousness in some quarters about some pretty barmy conspiracy theories being aired too much, and silent running seems to be the current tactic.
All this amounted to nothing very much until UNISON threatened to withdraw funding (said to be about £6,000 a year) over the sacking of the part-time organiser. This snippet of news seems to have encouraged journalistic digging, which revealed that the Chair of the SHA was also chair of Wavertree Constituency Labour Party – then represented in Parliament by one Luciana Berger. A possible link between the SHA and arguments about anti-semitism was irresistible to The Mail on Sunday (which denounced the SHA chair as Berger’s ‘tormentor’), to the Spectator and to the Jewish Chronicle: https://www.thejc.com/news/uk-news/revealed-mcdonnell-s-meetings-with-rothschild-conspiracy-theorist-1.480255. The Observer followed on.
This put the Council of the SHA into a difficult position, because front bench Labour politicians are likely to distance themselves from yet another anti-semitism charge, dumping the SHA as they steer away. A Council statement endorsing the SHA chair’s commitment to the NHS was pointless, the charge being something else entirely. The prospect of the SHA being disaffiliated from Labour, at least until new leadership election are held, is being discussed seriously. Private Eye’s judgement that the SHA is “now not only useless but dangerous” may overstate the Association’s plight, but an anonymous insider may have hit the right note: “At a time when the SHA could have been a valuable source of experience and knowledge to assist the Labour Party with some tough issues around policy it decides instead to descend into farce and factionalism”.
Follow the money 1!
According to the Health Service Journal (March 7th 2019) Princess Alexandra Hospital Trust in Harlow has identified a ‘blended funding model’ as the preferred way to develop a new facility in east Harlow through a new “regional health infrastructure company” (RHIC) that would use a mixture of land sales, capital funding from the government, and private income to build a new facility. A survey conducted in 2018 said 45 per cent of its estate was rated as unacceptable or below for quality.
The government has ruled out further use of the much-derided private finance initiative (PFI/PF2) for new buildings, but RHICs have been proposed by ‘Community Health Partnerships’, a government subsidiary, as a way of raising private capital for NHS infrastructure projects in a new form of public-private partnership. According to the HSJ, ‘Community Health Partnerships’ plans to establish six such RHICs in England. If the Treasury can sort out the accounting and keep the development off the public expenditure account, that is. Don’t hold your breath waiting for this, but do appreciate the creative re-badging of PFI.
Follow the money 2!
The pharmaceutical industry has stalled in recent years, but the money is moving again. Neuroimmunology is attracting attention both from Universities and industry, an example being the government-funded UK Dementia Research Institute.
Drug development in neuroimmunology is expected to grow substantially in the 8 major markets (US, France, Germany, Italy, Spain, UK, Japan, and Australia), fuelled by deeper understanding of underlying pathologies, advances in neurogenetics, and the potential to develop drugs with targeted therapy mechanisms. New advances in neuroimmunology may also help physicians make decisions on combination therapies.
Drugs in the pipeline are predictable, for Alzheimer’s disease (AD) and Multiple Sclerosis (MS), but no doubt there will be other spin-offs, even if efforts to cure Alzheimer’s Disease or MS fail. For more details, please visit: Neuroimmunology Drug Development
National Health Executive has picked up a CQC story (7/3/19) about private ambulance services being used by the NHS, arguing patients are being put at risk because of insufficient staff training, unregistered ambulances, and poor safety procedures. The CQC has urged private providers and commissioners to do more to make patients safe after its inspectors found a number of problems. Many private ambulance services have a poor understanding of governance and weak recruitment processes.
According to NHE “many private providers offered no or very limited staff training, and concerns were also raised over the management of medicines – with some services showing a lack of understanding around controlled drugs and the need for safe administration and storage”. The CQC reported alarming cases of poor practice, such as one private ambulance provider who left “an extremely confused dialysis patient” wandering the streets after the crew didn’t make sure he had got to his home safely. In other cases, a provider was based in a hotel room and did not store controlled drugs appropriately; a paramedic left their drug bag under their bed in a B&B; and another held morphine books with pages missing and incorrect entries. The report said some patient transport services were operating in a manner “more like a taxi” than an ambulance service. Source: http://www.nationalhealthexecutive.com
If you think the NHS provides poor quality care have a look at 2018 Shkreli Awards (https://lowninstitute.org/shkreli-2018) from the USA — a top ten list of the worst examples of profiteering and dysfunction in health care. Go to their website to see the full list of awardees, chosen by a panel of patient activists, clinicians, and health care journalists.
Among the top ten this year: