Monday, January 15, 2018

Replying to MP fob-off over the NHS Crisis

I wrote to my MP, John Penrose (Con Weston super Mare) about the #NHSCrisis. He wrote back with the stock Tory answer, which is to quote a few figures about Government spending. (see the bottom of this post) I have written back to his secretary who sent the email, as John and I have a difficulty over the veracity of his statements about planning permission for fracking.

Dear Charlotte Beaupere

Thank you for your email.

You assert that "the NHS is not being starved of cash", and quote some numbers. However, numbers always need to be put into context.

First, on international comparisons, it is perfectly clear that the NHS is starved of cash on a per capita basis in comparison to similar countries. 

Second, it is also only too clear that NHS funding has decreased overall as a percentage of GDP since this Government came into power in 2010:

There are several other demand side factors which amount to something like an 8% shortfall in the NHS budget.
  1. PFI repayments reduce available NHS funds by about 8%.
  2. Lansley's reforms cost about £3bn
  3. Too many staff cuts has contributed to high agency staff fees
  4. "Efficiency savings" have continued to weaken the efficiency of management decisions
  5. Health inflation due to population increase adds 3-4% to NHS demand each year
  6. Local authority budget cuts lead to social care deficiencies which cause loss of available hospital beds (and the bed ratio is already at the bottom of the table of  comparable countries).
The reason for any government to exist is to protect its vulnerable citizens from significant threat.

In the case of the NHS, the Government has failed to do this, as can seen by the increase in trolley waits. Please see the attached file NHSTrolleyWaits.

All neglect of the NHS in the name of finance works against the fact that an effective health service actually stimulates the economy of a country.

In the light of these facts, I would ask again - will you ask my MP speak on my behalf to Prime Minister Theresa May and request that the NHS gets an urgent injection of funding?

Thank you

Dr Richard Lawson

On 15/01/2018 17:01, BEAUPERE, Charlotte wrote:
Dear Dr Lawson

Thank you for contacting me about NHS services. You're right that, even though there's been more money in NHS budgets than ever before, and in spite of bigger and more extensive preparations to deal with 'winter pressures' too, services have still been under pressure over Christmas.

But the underlying cause isn't that the NHS is somehow being starved of cash, as some of the more party-political commentators would like to claim. Over the last 7 years both the coalition and the current Conservative Government have steadily increased NHS funding. Despite very tight public finances, before the recent budget you and I as taxpayers were already going to spend an extra £10 billion a year on the NHS by 2020/21. And, most recently, the Chancellor announced an extra £2.8 billion over the next three years for day to day services and £3.5 billion of capital investment by 2022-23. That means 800,000 more NHS operations and treatments, plus £2 billion more on new drugs. It also means that, by 2020, everyone will be able to access GP services at evenings and weekends.

So why have services been under pressure over Christmas? The reason isn't that funding hasn't risen - it clearly has - but rather that demand for medical services has gone up even faster. That's where the NHS reform plans developed by the Chief Executive of NHS England, Simon Stevens, come in. His team says that the NHS needs to reform itself internally, to move more money out of bureaucracy and into the front line of patient care, as well as keeping more patients out of hospitals in the first place, through improved prevention and allowing more treatments to happen in GP surgeries or through district nurses at home too. He's also proposing caps on expensive agency staff (and training more NHS nurses instead) and management consultants, and introducing central procurement rules.

As you'll appreciate, these changes are fundamental, structural reforms. They aren't something which can be solved by a emergency injection of short term cash. This year's winter planning and preparations started back in April and May, so last-minute 'emergency funding' isn't the answer at all, in spite of what the email you've been asked to send me by 38 degrees would like to pretend. The NHS will need still more cash in future, and I will personally support further increases in its budget as a result. But it also needs the slow, steady, painstaking underlying reforms which Simon Stevens is proposing as well, rather than quick fixes or headline soundbites instead.

Yours sincerely,

John Penrose
MP for Weston-super-Mare

From: Richard Lawson

Sent: 09 January 2018 12:10

Dear John Penrose,

I’m deeply concerned that our hospitals have reached breaking point this winter, and I’m worried what this means for patients.

This crisis hasn’t happened by accident. In my view it is the result of NHS underfunding. Your party has been in charge of the country for the last seven years, and I'd like you as my Conservative MP to take your fair share of responsibility.

As my MP, please will you speak on my behalf to Prime Minister Theresa May and demand the NHS gets an urgent injection of funding?

Many thanks for your time - I’ll be waiting for your response.

Yours sincerely,

Monday, November 20, 2017

Will Brexiteers apologise if Brexit does damage to our nation?

Image may contain: one or more people and beard
As a Remoaner, I predict that Brexit will do Britain great economic, social and ecological harm.
As a human, I could be wrong.
So. If, as a result of Brexit, say over the next 10 years, Britain does OK economically; 
if our exports go up, if we develop full employment in a green, sustainable economy, if crops and fruit get picked, if our nurse and doctor numbers hold up, if our scientists stay here and flourish, if no major damage is done elsewhere to the fabric of our society, if Britain becomes a happier, more equal nation, showing a generous and peaceable spirit,

then yes, I will gladly apologise to every Brexiteer.
And I will continue to work for a happier Britain in a happier world, whatever happens.
Now, will you Brexiteers be prepared to stand up and make a public apology if Brexit turns into a Dog's Brexit, an economic, social and ecological mess? 

Will you?

Sunday, November 05, 2017

Like a Poppy

Perfect from root to flower.
From swollen feet,
sunk in the soft, deep mud of these raped farms
that kept you in trenches
unable to move on,

up through your leaves
dressed out in just that tone of green
that when it touched your skin
could show with certainty that death had come
to ease your suffering and take you home

up to your fragile flower
paper thin, trembling with the shock of war
and its bulls-eye, grainy and black
signing an entry wound
perfect in head or heart

that brought in sudden quiet
instant transition from the muddy hell
maybe to lightness and to Light.
Though most of you crawled off in long, slow moving pain
life slowly leaking back to earth

joining a lonely choir of screams and groans
crying for mother or for God
as you lay out in perfect agony,
hour after hour alone
waiting for death

unless some kind sharp-shooter from your side,
maddened by screaming babes,
could pin your forehead with a poppy hole
or some quiet Quaker crawled to you
to give you opium and bring you home.

Cut poppies bleed the cure for pain.
In complex shame, their head hangs down;
there's not enough in all of Flanders' fields
to meet the needs of war,
or quieten leaders' minds.

Insanity still rules the world of men
still we take perfect orders from above
' our inner selves can sense is false
still we pour out out onto the ground
a bitter sacrifice of human blood,

and trembling hearts are torn
by priests of paper power
held up to angry skies
on knives of lies and false ideas.

Still we obey.

© Richard Lawson
November 5, 2017

Friday, November 03, 2017

By how much is the NHS underfunded?


One of my patients told me Nye Bevan used to visit his house when he was a kid, and heard him say
“We have got the NHS now, but if we abuse it, we'll lose it”.

We are in the process of losing Weston A&E.
Since July, it has been closed at night, because of difficulties getting doctors.
This is a national problem, made worse by Weston's small size.

Weston always has been underfunded (and underbedded) in terms of its population relative to Bristol.

With A&E, there is always a balance to be struck between the shorter travel time of the smaller hospital,
and the more specialised treatment available in bigger units further away.
Ambulance personnel are able to make that decision - so long as they are not overworked.

Sadly, Weston's closure has done just that - put more pressure on the ambulance service.

It is all down to resources.

First, the NHS is underfunded.

In 2014 NHS spending was £3971 per capita per year

In Netherlands, Sweden and Germany the figure is five thousand odd
In France it was £4367
The EU average was £4166
and here we are, down at £3971 - £137 billion a year, seven and a half % of GDP

NHS resources have been falling since the Tories came in in 2010, and are projected to keep on falling until 2020.
This is a fall planned by Blairite and Tory politicians - so-called efficiency savings.

So far, so bad. BUT - from this level, we have further hidden cuts:

The Lansley reforms cost £3 billion - but that was just a one off. Trivial. Look at this:

Each year, the NHS loses 12% of its notional budget, because

Litigation is rising 1 billion a year
Bed Blocking (Social Care failings ) 1 billion a year
PFI 2 billion a year
Agency Staff 3 billion a year
Internal Market 4 billion a year
Health Inflation (population increase,
technology, aging) 5 billion a year

These losses add up to £16 billion a year

That is about 12% robbed from the target budget every year.
12% from a budget that is already below the EU average.

How the NHS manages to function on this level of underfunding is a huge tribute to all healthcare staff,
and a huge condemnation of the abuse that Tory politicians, especially Jeremy Hunt, have poured on the NHS.
Clearly it is not sustainable. Yet, without a milligram of irony, the current STP - Sustainability and Transformation Plans - intend to rob even more from the budget.

There is much more to be said, not least that a fifth of the NHS budget is spent trying to treat illness caused by problems like unemployment, inequality, bad housing and pollution.
Problems caused by stupid politicians doing stupid politics.

But we have enough here to know that Nye Bevan would see our leaders are abusing the NHS he created.

The question for us now is - have we got the guts to stand up and end this abuse?