Monthly Archives: February 2012

Welfare reform: will the Lords hold their nerve?

Today (February 14), the House of Lords will be debating the Welfare Reform Bill from 2.30pm. This is the Bill they sent back to the Commons with seven amendments, which MPs reversed out of hand. The government went on to state it would us ‘financial privilege’ rules to push the legislation through Parliament in its original form – an entirely undemocratic move that has led many to question the legality of the government’s tactics, and some to call for the Queen to deny Royal Assent to the Bill, on the grounds that it will not have been passed “in good faith”.

I think we all know by now that the aim of this Bill is to harm disabled people. The government has tried to create a myth about them being “benefit scroungers”, sponging off the State, but that has not succeeded with anyone other than readers of the Daily Mail. Ministers just want to take money away from those who are least able to defend themselves. Shame on them.

The question now is whether the Lords are prepared to stand up to the Coalition. Will they oppose the derisory attitude of their counterparts in the Commons, or will they just roll over and let democracy die out? How do they feel about the fact that their amendments were overturned? What do they think about the ‘financial privilege’ furore?

I suppose we’ll find out this afternoon, starting at 2.30pm.

For those of you with a deeper interest in the issues, I urge you to read Sue Marsh’s Diary of a Benefits Scrounger, but I will leave you with a quotation from today’s column: “At some point we must say “enough”. At some point, we have to accept that we have a broken system, broken procedures and that “majority rule” is not enough. If we have no checks and balances, no way to influence outcomes or mitigate harm, then the Commons is effectively a dictatorship – once elected free to wreak havoc wherever they see fit. Nothing in a manifesto, no hint of things to come, just a majority, cobbled together to deny process.”

I warned last week that we are seeing the signs of a dictatorship here. Do you really want to live under tyranny?

NHS changes – how much power do GPs need, anyway?

This might be controversial but it occurred to me that ‘comedy’ David Cameron and Andrew Lansley have been pinning much of their hopes for the Health and Social Care Bill on a perception that local doctors – GPs in their parlance – are best-suited to direct where spending on healthcare actually goes.

I’m not convinced that’s true. Why are people at the entry-level of the NHS being acclaimed as experts?

I suffer from a condition known as cluster headaches. Every couple of years, I get fast-onset, extremely painful one-sided migraine headaches at a rate of four or more every day, for a period lasting up to three months. It’s a rare condition – only around 50,000 people in the UK get it, which means very little research has been carried out.

When I went to my local doctors’ surgery with it, the GP I saw thought it was just a severe headache and told me to take some aspirin.

Aspirin won’t touch cluster headaches. By the time the drug takes effect, the headache is far too well-entrenched for it to make any difference at all. If I had accepted that doctor’s advice as being the best, most expert diagnosis available, I would have condemned myself to spending a quarter of a year in agony, every two years.

Instead, I went back, got properly diagnosed, and was put on injections of a substance that costs something like £25 a shot – which also raises questions about how much GPs will be willing to spend on a patient when they hold the budget.

Mrs Mike has a condition whereby the intervertebral discs – the shock absorbers between vertebrae – at the bottom of her spine have disappeared. There is an operation available on the NHS that would replace these discs with artificial ones, but this was never mentioned to her and I only found out by typing ‘intervertebral discs’ into the search box on the NHS website. Now, there might be a good reason for keeping this from her, but I doubt it.

Now these examples could be shot down by any critic as anecdotal, but there is evidence that this sort of thing is widespread.

Dr Phil Hammond, speaking on the Radio 4 show Heresy, tells us: “If you go to Dr Google, or his friend Professor Wikipedia, you have a 58 per cent chance of getting it right. Doctors are marginally ahead at about 75 per cent.”

And they tend to look up your ailment on the Internet as well! “Doctors use search engines too; it’s quite common for doctors to use Google,” said Dr Hammond on the same show. “If you look at their computer screen, you’ll actually see them typing… I had a mate who was a pain specialist… and he was teaching a junior doctor and a women came in who had Wartenberg’s Neuritis. He was looking at his notes before she came in and said to his junior doctor, ‘Look, I’ve never heard of this; let’s look it up on Wikipedia.’ They look it up, they make notes, and this woman walks in and says, ‘I’m terribly sorry; I was waiting outside and I heard you say to your junior doctor, you’ve never heard of Wartenberg’s Neuritis, you were going to look it up on Wikipedia. I thought I ought to warn you – I’m the person who wrote the entry.”

So we should not be hailing GPs as the experts who need to have control of NHS budgets. They’re not the experts. The experts are the consultants, surgeons or whoever, to whom they pass you if they find they can’t write a prescription to get rid of you.

The Bill must be scrapped. If we let the Tories make fools of us, it may be the last thing we do.

NHS London risk register exposes Tory threat to healthcare

It seems the London NHS Risk Assessment that was sent to the central Department of Health civil servants drawing up the Risk Register & Report (the document that Andrew Lansley refuses to publish, contrary to a ruling by the Information Commissioner), has been leaked and is now public knowledge.

According to the information in this document, London NHS’s Risk Register explicitly warns that the financial viability of the Tory NHS Bill is seriously questionable, predicting “deteriorations in the financial positions of one or more NHS organisations”.

Practices could go bust or require central intervention to prop up their financial position.  The Risk Report also warns of economic ‘slippage’ & ‘cost pressures’ arising.

The London NHS risk report categorically states that commissioning groups run by GPs may “not be able to secure [services] […] within the running cost range”.

This means the “quality” of health care may be “poor”.

Please ask your MP to sign this Early Day Motion calling for the Risk Register to be published.

The Cabinet splits – are we looking at another Torygeddon?

It seems David Cameron didn’t make such a good job of revitalising Conservatism after all.

Three Cabinet ministers have gone to Tory Blogsite ConservativeHome to vent their frustration at the comedy Prime Minister’s refusal to listen to their concerns about Andrew Lansley’s Health and Social Care Bill. “One was insistent the Bill must be dropped,” the blog post by Tim Montgomerie states. “Another said Andrew Lansley must be replaced. Another likened the NHS reforms to the poll tax,” which was disastrous for the Tories in 1990.

So you see, they’re all in it together (as the saying goes) when the going is easy, but once the headwinds start coming in, the rifts start to show.

And now we have three Cabinet ministers splitting from their PM and his Health Secretary. Does anybody remember a time in the mid-1990s when John Major had a similar problem with three members of his Cabinet? He said at the time: “You have three… members of the Cabinet who actually resign… I could bring in other people. But where do you think most of this poison is coming from? From the dispossessed and the never-possessed. You can think of ex-ministers who are going around causing all sorts of trouble. We don’t want another three more of the b*st*rds out there.”

That seems to be exactly what Comedy David has to deal with, though: “Three more of the b*st*rds”. From his point of view, at least.

His loyalty to his Health Secretary (and former boss at the Conservative Research Department) might be praiseworthy in another context. Here, it seems likely to split his party – because, when members of the Cabinet start to rebel, the writing’s on the wall.

Look at Major’s premiership. With him, the problem was Europe. Right-wingers in his Cabinet caused disruption that became an ideological rift, at a time when New Labour was on the rise. Ministers were caught having extramarital affairs and accepting cash for questions. His party became associated with greed and arrogance and the public deserted it, leaving it in the backwaters of British politics for more than a decade.

One only has to glance at the ‘Comments’ column of Mr Montgomerie’s blog to see that the rifts are still there; Cameron only ever succeeded in papering over them.

The Health Bill is hugely divisive: “Abandoning the bill is not an option – it’s philosophically right, and killing it would give Miliband a huge boost,” claims one (deluded, in my opinion) correspondent.

But another says: “It has suffered death by a thousand amendments. It has become an incoherent mess.”

Another simply asks: “Is the bill the new longest suicide note in history?”

Many have taken the opportunity to voice their opinions about other issues; once a split has been identified, they’ll pour all their grievances through the gap.

Europe remains a hot topic: “The Conservatives have already lost the next general election because of the EU and the false promise that Cameron made to get votes for his party. It is quite plain now that he did not intend for there to be a referendum on the EU and has reneged on the voters – they won’t vote for him again,” according to one correspondent.

The popularity (or not) of individual members of the government is still creating splits: “The fact that [Oliver] Letwin was so heavily involved does, and has, worried me,” writes another. “The guy is very bright, but not in a way people on the street would appreciate, or like. He was also heavily involved in ‘bomb proofing’ the Poll Tax legislation was he not?”

The crucial problem for the Conservatives now is the harm this has done to their electability – a problem that was due to worsen with the publication of a report by the right-of-centre thinktank Reform, saying the government’s entire ‘reform’ of public services is being undermined by the Department of Health’s management of NHS changes.

According to The Guardian, “The Scorecard report on 10 government departments with responsibility for different areas of public sector reform also singles out the prime minister for criticism for personally intervening with detailed promises on issues such as waiting times and nurses visiting patients’ beds every hour. The criticisms by Reform will be particularly damaging because they accuse the health bill of causing exactly the opposite of what it is intended to achieve – holding back reform of the NHS and damaging services for patients.”

Tories like power, and they’ll turn on anything that might get in the way. “The plan needs to be to win a working majority in 2015, and prevent Prime Minister Miliband,” as yet another ConservativeHome correspondent put it.

But Mr Cameron likes power too – even the semblance of it that he’s got now. So, even if he can’t get his legislation passed with any degree of confidence in it, he’ll cling on to what he’s got for all he’s worth.

I reckon we’re looking at another three years of ‘lame duck’ leadership before the electorate can take him out and (metaphorically) shoot him.

As the saying goes.

Carving up the NHS is Cameron’s vanity project

The more we find out about Andrew Lansley’s Health and Social Care Bill – his bid to privatise the NHS – the more childish it all seems.

This has been a week of shocks for the architects of the Bill, starting with the revelation that a Conservative ‘insider’ had described Mr Lansley as “a disaster” who, far from winning over critics of the Health Bill, has managed “to further annoy and alienate NHS staff”, and that a Downing Street briefing had called for him to be “taken out and shot”.

“Health reform should have been carried out by stealth,” said one strategist, according to an article in The Times.

It seems that many of Mr Lansley’s changes could have been carried out without primary legislation, thereby avoiding the glare of the public spotlight and all the adverse publicity that has come with it. Nevertheless, the idea of fundamental changes to our greatest national institution taking place covertly is outrageous and Jon Trickett MP, Labour’s Shadow Minister for the Cabinet Office, has written to Cabinet Secretary Sir Jeremy Heywood, seeking reassurance that “there will be no such covert attempt to bring about fundamental change in the ethos or the care offered by our National Health Service”.

In fact, changes have already been implemented by the government – at considerable cost to the taxpayer – without waiting for the Bill to finish its passage through Parliament and get Royal Assent. Apparently these things are mere formalities for our Coalition leaders (who, let’s not forget, are composed of members of two political parties who could not win the confidence of a majority of the electorate on their own).

But a judicial review, to establish the legality of these moves, is now a distinct possibility.

The decision to implement as much as he has without waiting for the bill’s royal assent is a “flagrant flouting of parliament”, according to Polly Toynbee in The Guardian. But while a U-turn would be embarrassing, failing to do so would be worse, she argued.

Andrew George, the Lib Dem MP and member of the health select committee, put it like this: “It will now cause havoc either way, but going ahead is even more catastrophic”.

Even Tory commentators have turned on the Bill. Craig Barrett, writing in Tory blog Egremont, said: “The fact that many of the reforms do not even require primary legislation makes the resulting headache look embarrassingly self-inflicted. Without a proper mandate, it looks undemocratic.

“For the good of the NHS, Andrew Lansley must admit defeat and head to the backbenches.”

Hundreds of thousands of doctors, nurses, midwives and others have called for the government to abandon this proposed legislation before it does great harm to the NHS. The British Medical Association and the Royal College of Nursing have voiced concerns, and the Royal College of GPs wrote last week to Mr Cameron to ask for the bill to be scrapped. The Faculty of Public Health became the latest healthcare body to call for the Bill to be dropped, “in the best interests of everyone’s health”.

Downing Street has insisted that Mr Lansley and his reforms have the Prime Minister’s full support, though.

At Prime Minister’s Questions, Mr Cameron said his government was increasing its spending on the NHS, while the Labour administration in Wales was making cutbacks. It is easy to dismiss this criticism, though – the cutbacks in Wales are entirely due to cuts in funding from Mr Cameron’s own Westminster government.

The government has offered more than 100 concessions in an effort to get the Bill passed, but this did not stop the House of Lords passing another amendment when peers discussed it on Wednesday.

So – as one can see – there’s a huge amount of opposition to this Bill. It is seen as undemocratic. Only a tiny minority of healthcare professionals want to see it implemented, and they tend to belong to the administrative side – the bean-counters and pen-pushers, rather than the medical practitioners themselves. And Mr Lansley’s time as Health Secretary has been a “disaster”.

Why, then, do both he and our comedy Prime Minister persist with it?

Well, it’s their vanity project, isn’t it?

It’s their attempt to write their names into the history books – the biggest change to the National Health Service since it was created in 1948 and, they hope, the blow that will lead it into a long-drawn-out death, to make way for private health companies and block millions of people from receiving health care of any kind in the future. You just won’t be able to afford it.

In short, they want to graffito “David and Andrew were here” across the face of Britain’s biggest and best-loved national institution, and they’ll do it at any cost.

Childish.

Welfare Reform Bill: a request for information

In April last year I wrote to my MP, Roger Williams (Liberal Democrat) regarding the Welfare Reform Bill and changes to Disability Living Allowance. He had sent me a letter from Maria Miller (a DWP minister, I believe), claiming that it should reassure me. It didn’t.

Now, as the government is ramrodding this vile Bill through Parliament using a procedure that is not valid (as far as any of us can tell), I’d like to resurrect some of the issues I raised with him then, and ask whether any of them have changed in the 10 months since.

If any readers have answers for me, or stories about their own experiences, please send them to me via the ‘Comments’ box at the bottom of the page.

‘According to the letter,’ I wrote, ‘there will be an “objective assessment of an individual’s need”, developed alongside “a group of independent specialists in disability, social care and health, which includes disabled people”. Who are these independent specialists? To which organisations do they belong? Are any of them members of groups which have previously criticised the assessment of Incapacity Benefit claimants, on which the DLA assessment will be based? This letter does not provide that information.’

Does anyone know, today, who these people might be?

‘The letter states: “I can assure you that it (the allegedly-objective assessment of an individual’s need) will not only take into account physical impairments, but also mental, intellectual, sensory and cognitive ones. We also recognise the importance of ensuring that it effectively takes account of variable and fluctuating impairments.”

‘Before continuing, I would like to point out that taking information into account is not the same as making a decision based on it, and this comment cannot, therefore, be taken as an assurance of fairness.

‘As I understand it, the assessment will be carried out with the help of a computer, as has been the case with Incapacity Benefit since the new assessment for that benefit was introduced. Is this really the best way of analysing a person’s fitness for work? I don’t think so, and neither do charities working with the disabled, who have described it as a “blunt and unsophisticated tool”.

‘Let’s stay with the Incapacity assessment for a while. I think it is useful to use it as a way of gauging how the new DLA assessment will work because the latter will be based on the former. Since its preliminary rollout in 2008, we have all heard how people with terminal cancer have been found fit to work. In addition, people with mental health problems have complained their condition has not been taken seriously, and people with complex illnesses report that the tick-box system is not able to cope with the nuances of their problems. “Ensuring that it effectively takes account of variable and fluctuating impairments”? It doesn’t seem likely, in my opinion. Certainly not “effectively”.

‘A revised, even more stringent version of the assessment means blind claimants who can get around safely with a guide dog will be forced onto jobseekers allowance, as will deaf claimants who can read and write. Taking into account sensory impairments? Do you think this claim is justified?’

Is this still true?

‘To continue receiving benefit, a person must score 15 points. However:

‘*Claimants who can’t walk but who can use a manual wheelchair will no longer score points;’

Still accurate?

‘*References to hands have been removed from the picking up activity specifically in order to make it harder for amputees to score points;’

Is this still the case?

‘and *Some activities have simply been cut from the test altogether. For example, the activity of ‘Bending and kneeling’, for which 30 points are currently available, is to be completely removed for ‘health and safety reasons’ as people should not ‘bend forward when lifting’.’

Is this still the case? It seems strange to cut something from a test for health and safety reasons when at-work threats to a person’s health and safety are precisely the reason they are taking the test!

‘Half of all the scoring descriptors for mental health and learning difficulties have also been axed, making it much harder to get benefit for people with conditions such as depression or anxiety.’

Still true?

‘At the end of each session, the computer program generates a 25-page report summarising the person’s general state of health, and fitness for work. People with severe health problems who have been given zero points say that they have told their assessors what was wrong with them, and been met with a “computer-says-no” response.’

Still true?

‘Receipt of DLA means many claimants can also get free improvements to their homes from Social Services,’ I wrote. ‘How are disabled people supposed to get these improvements if they are downgraded to Jobseeker’s Allowance, which provides a lower amount that will be entirely spent on subsistence?’

I added that there is a level of vindictiveness in the assessment system, also.

‘The Guardian has reported on one man who was given only nine points in his first WCA, but went to tribunal, where the judge found him eligible for the higher level of benefit. Shortly after the tribunal he was called for another assessment, and this time was awarded zero points. At the time the article was printed, he was waiting to appeal a second time.

‘Part of the assessment has assessors extracting information sideways from claimants. People are asked: ‘Do you watch EastEnders or Coronation Street?’ If they say yes, then that’s interpreted as meaning they can sit in a chair for 30 minutes, and that they can concentrate for 30 minutes, and the assessor can then put this on their profile as indicating they are able to work. Ability to watch a TV show does not equal ability to work.

‘Assessors observe the claimants’ demeanour during the test. One report, explaining why a woman with mental health problems had been found ineligible for the benefit, states as justification that she “did not appear to be trembling . . . sweating . . . or make rocking movements”. The DWP manual states “rocking may indicate anxiety”. It may indeed, but this is not – and should not be interpreted as – the only possible indication of anxiety.

‘Let’s get back to the letter,’ I wrote. ‘It states: “Currently there are 11 possible different rates at which DLA can be paid, which makes it complex to administer. We are proposing two rates of benefit payable for each component. This will simplify the overall structure and make it easier to understand.” Hold on a moment! So what this means is the current system involves a bit of thought on the part of administrators that, reading between the lines, the current government is not prepared to support. Simplifying the structure would mean fewer different rates of payment – so there’s a saving to be made there – and also there will be a need for fewer people to administrate the system – so there’s another saving to be made.

‘This is all about money, isn’t it? Mr Grayling can carry on that there are no targets until he’s blue in the face, but the facts are telling a different story.’

I’m willing to bet that none of the above has changed, but I’d like to read comments from people who are more familiar with the system than I am.

I’d like to leave you with this thought: In 1930s Germany, the Nazis had the Jews. In today’s UK, the Coalition has the disabled. How long will it be before someone dies?

Or has that happened already?

Mr Lansley’s UNclean Bill of health

I have trust issues when it comes to Andrew Lansley and his Health and Social Care Bill.

Mr Lansley swears blind that introducing competition will not only bring in better patient care, but will drive costs down as well.

The problem is, so much of the medical profession opposes it – including huge numbers of GPs, the people who are meant to benefit the most – that one has to be sceptical.

Also, if his Bill is so healthy, why is he – even now – refusing to publish the Department of Health’s risk report? This is the document that the Information Commissioner ordered him to release last November; according to the law (as I understand it) he is committing a criminal act by failing to publish.

I read today on the Green Benches blog that the report contains a very serious warning that Lansley’s changes will spark a surge in healthcare costs and that the NHS will become unaffordable as private profiteers siphon off money for their own benefit.

It may also warn specifically that GPs have no experience or skills to manage costs effectively.

This is a very serious matter. It means Mr Lansley – who has already criminalised himself over this, let’s not forget – could be attempting to mislead Parliament.

But let’s not get carried away. This is all speculation.

So, let’s make a constructive suggestion.

If Mr Lansley is so adamant that his Bill is going to be good for both patient care and the nation’s finances, let’s see him build a few safeguards into it.

Isn’t it time we asked what mechanism is built into the Bill to ensure that, if costs skyrocket and the quality of patient care plummets, Mr Lansley’s changes will be reversed, and the system brought back under control?

Isn’t it time we asked what penalties Mr Lansley himself will face, if the report is published after the Bill is passed and (as many fear) reveals exactly what the Green Benches blog mentions?

Isn’t it time the Tories made an effort to suggest they can be trusted to do the right thing for a change, instead of merely doing what’s right-wing?

There is also an Early Day Motion here which states “That this House expects the Government to respect the ruling by the Information Commissioner and to publish the risk register associated with the Health and Social Care Bill reforms in advance of Report Stage in the House of Lords in order to ensure that it informs that debate.”

Early Day Motions are formal motions submitted for debate in the House of Commons, but very few are actually debated. EDMs allow MPs to draw attention to an event or cause. MPs register their support by signing individual motions and I shall be calling on my own MP to support this one.

If you agree, go thou and do likewise.

Show your contempt for this arrogant dictatorship

Does anybody reading this still think the UK is a democracy?

I dare say most people are aware that the government, in the House of Commons, has reversed all seven amendments made by the Lords to the Welfare Reform Bill. This means the new benefits cap of £26,000, per family, will include Child Benefit.

The Bill will also:

  • Require cancer patients to undergo a means test for Employment Support Allowance – if they fail, they have to look for work
  • Reduce the lower rate of the ‘disabled child’ element of Child Tax Credits
  • Means test other ESA claimants every year
  • Stop young disabled people who have never worked from claiming ‘contributory’ ESA
  • Impose ‘under-occupancy’ penalties on social tenants with one spare room
  • Force single parents to face Child Support Agency charges, even if they have taken steps to reach a settlement

There is no mandate for these changes, or any of the other changes in the Welfare Reform Bill. The Conservative/Liberal Democrat Coalition does not have permission from the electorate to do this, because it was never part of either of their manifestos. This is undemocratic.

The House of Lords, in amending the Bill to prevent the measures I mention above, had been contacted by many people on benefits, and made their decision in the knowledge of the financial trauma it will cause if allowed to go ahead unchanged. This was the only opportunity the people affected by the Bill had to plead a case, and the government’s pig-headed refusal to pay attention (let’s call it a ‘not-listening’ exercise, in recognition of the sham that was carried out in respect of the Health and Social Care Bill, which is likely to cause even more harm to the honest people of the UK). The reversal in the Commons therefore flies in the face of the will of the people. This, too, is undemocratic.

Furthermore, the government has announced it will use a rule known as ‘financial privilege’ to prevent the Lords from sending the same amendments back to the Commons when they consider the Bill for the final time.

Now, Parliamentary convention has long stated that the Lords do not deliberate on “money” Bills, such as the Budget – but such legislation is never introduced to the Lords in the first place. As the Welfare Reform Bill was, there is a strong argument that this rule does not apply.

It is highly unusual for a government to introduce a Bill to Parliament with the intention of it being considered by both Houses, only for it to declare the Bill beyond the auspices of the Lords at this relative late stage in proceedings – and for this reason the whole process could end up in a judicial review.

In other words, for this to happen, it must normally be decided before a government is humiliated over its unsound policies – not after. This, again, is undemocratic.

Let’s not forget that the government falsified the results of its own consultation process about this bill. More than 90 per cent of those taking part opposed the changes in the bill but this was ignored in the report, which was intended to show that the public supported the change. It does not. This, yet again, is undemocratic.

This break with precedent could have further implications for other major government bills going through the Lords, including the Legal Aid and NHS Bills, both of which are highly controversial. Need I point out how undemocratic all of this is?

Finally, none of these measures are necessary. If the government taxed big businesses properly, instead of excusing them from paying the vast sums of money they owe, then there would be enough in the Treasury to keep benefits as they are and pay off some of the national debt. This is what the majority of the people in my country want and their refusal to do it is totally undemocratic.

If you’re not living in a democracy – and if you’re in the UK, you are definitely not living in a democracy any more – then you’re living in a dictatorship.

It is a dictatorship ruled by two parties that did not even gain a majority in the last General Election.

We have another three years of this agony, as matters stand at the moment.

All I can suggest right now is that we make our contempt for this arrogant cartel known at every opportunity. If any of the above makes you angry, make sure you’re on the electoral register and then get out and vote against them every chance you get.

There are elections in May. They’ll be a good place to start.