Tag Archives: bma

Brexit-prompted tube shortage means UK doctors can’t do blood tests

Scheduled blood tests are being cancelled across the UK and doctors are being forced to make hard decisions about what to do if they lose the ability to provide life-saving diagnostic testing due to a Brexit-prompted shortage of blood collection tubes.

Becton Dickinson, the NHS’s main supplier of blood collection tubes, has been blamed for the shortage, with the manufacturer suggesting the post-Brexit HGV driver shortage could be to blame, according to iNews.

The Department of Health and Social Care is desperately trying to play down the crisis, saying everything is being done to eliminate the shortage.

But NHS England has released new guidance that aims to reduce the use of blood tubes to the bare minimum, suggesting that the issue is serious.

And bosses of the British Medical Association – the doctors’ trade union – are furious. Their press release on the situation makes this abundantly clear [boldings mine]:

“The BMA says the shortage of blood tubes across hospitals and GP surgeries is now severe and if the NHS does not reduce the amount being used in the coming days, even the most clinically important blood tests may be at risk.

“Doctors at the BMA have already made plain their concerns about the implications for patients and their anger that this shortage has been allowed to happen in the first place. However, in the absence of a plan to bring in alternative supplies before the middle of next month, the situation is now urgent. The BMA is urging all doctors to follow the NHS guidance and carry out only the most critical of tests for the time being.

“Dr David Wrigley, BMA council deputy chair, said: ‘This crisis has put doctors and their patients in a terrible, unenviable position. No doctor knowingly undertakes unnecessary blood tests and to now have to ration all those we are doing, as well as cancel hundreds more, goes against everything we stand for as clinicians.

“‘However, if we don’t try to follow the NHS guidance, it’s clear we will get to the point where even the most clinically urgent of blood tests may not be able to be done as we simply won’t have the tubes for the blood to go into.

“‘We are at a very perilous point and it’s surprising that NHS England hasn’t declared a critical incident given the very strong possibility that NHS organisations may temporarily lose the ability to provide lifesaving diagnostic testing. We also call on NHS England to commit to the changes that are needed for their guidance to be properly followed by doctors, and provide patients with detailed, easily accessible information about the situation.

“‘Many GP practices – like mine – will now have to spend hours assessing which already scheduled tests can or cannot be cancelled and this takes time away from frontline patient care when it is most needed. Cancelling tests makes patients anxious and can mean a missed diagnosis.’

“Dr Vishal Sharma, BMA consultants committee chair, said: ‘The very suggestion that an acute hospital trust needs to reduce testing by 25 per cent is highly alarming. However, to try and avoid a situation where there are simply no more blood tubes, we have no choice but to now make very careful decisions about which tests to carry out.

“‘It is shocking that this situation has been allowed to develop – in particular, the apparent over-reliance on one manufacturer and the woeful lack of any kind of reserve supply. The manufacturers should also have to explain how they allowed stocks to run so low that patients will now suffer as a result. If we don’t get on top of this shortage – and quickly – then we could very easily end up in a catastrophic position, particularly in hospitals where patients come to serious harm.’”

“Severe… anger… terrible, unenviable position… goes against everything we stand for as clinicians… Perilous… can mean a missed diagnosis… highly alarming… shocking that this situation has been allowed to develop… Woeful… catastrophic… patients come to serious harm.”

And it is – apparently – a result of Brexit. And the “politicians” responsible for it couldn’t care less.

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Coronavirus: Medical groups unite to condemn bulk ‘Do Not Revive’ plan for sick and disabled people


This should be seen as absolute proof that it has been a policy to deny coronavirus care to people with long-term illnesses and disabilities.

This Writer has noted some scepticism in the responses to yesterday’s article about the GP practice in Wales that wrote to people with ongoing medical conditions, telling them that equipment used to treat coronavirus is being rationed and they were not likely to be treated if they contracted the disease. Instead, the letter asked them to sign a form directing medical staff not to attempt to resuscitate them if they succumbed to the virus.

My own attitude to this is clear: as we have all paid into the National Health Service, throughout our lives, we all deserve the best possible care available from it. I asked: do politicians and royalty get preferential treatment? If so, why?

Also, just because a person has an underlying condition, that doesn’t mean they won’t be able to shrug off the virus, given the same help that is provided to everybody else.

Now the British Medical Association, the Care Provider Alliance, the Care Quality Commission and the Royal College of General Practitioners have released a joint statement, saying more or less the same.

Here’s the statement:

It reads [boldings mine]:

The importance of having a personalised care plan in place, especially for older people, people who are frail or have other serious conditions has never been more important than it is now during the Covid-19 Pandemic.

Where a person has capacit, as defined by the Mental Capacity Act, this advance care plan should always be discussed with them directly. Where a person lacks the capacity to engage with this process then it is reasonable to produce such a plan following best interest guidelines with the involvement of family members or other appropriate individuals.

Such advance care plans may result in the consideration and completion of a Do Not Attempt Resuscitation (DNAR) or ReSPECT form. It remains essential that these decisions are made on an individual basis. The General Practitioner continues to have a central role in the consideration, completion and signing of DNAR forms for people in community settings.

It is unacceptable for advance care plans, with or without DNAR form completion to be applied to groups of people of any description. These decisions must continue to be made on an individual basis according to need.

It’s saying that any policy requiring medical staff to write off any individual – of any age and condition – as untreatable without discussing their situation with them is wrong.

If the government has handed that down to healthcare providers as a requirement, then it is wrong.

If anybody has already died as a result of such a policy, then those responsible must be identified and must pay the appropriate penalty.

This is real. It is important. It could be deadly. Don’t let the Tories get away with it.

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Protest today against work capability assessment creator

Mansel Aylward, former chief medical officer at the Department of Work and Pensions: Architect of misery?

Mansel Aylward, former chief medical officer at the Department of Work and Pensions: Architect of misery?

The Disabled Activists’ Network Cymru (DAN Cymru) is organising a vigil and protest against a decision by the Socialist Health Association to give a platform to Sir Mansel Aylward, the man behind the Department of Work and Pensions’ Work Capability Assessment.

Data released by the DWP last month show that thousands of people have died after being found “fit to work” by the deeply flawed WCA, which was introduced by Sir Mansel while he was Chief Medical Officer of the DWP.

A statement by DAN Cymru declared: “As disabled people we are dismayed at the lack of solidarity shown to us by Socialist Health Association through their decision to give legitimacy to Sir Mansel and the discredited ‘biopsychosocial model’ of disability on which the WCA is based.”

The biopsychosocial model on which the WCA is based is a brainchild of the US medical insurance industry, particularly Unum, which funds Sir Mansel. Unum Provident Insurance were fined $31.7 million in 2003 in a class action law suit in California for running ‘disability denial factories’ in which they use the pseudoscientific and discredited biopsychosocial model to deny medical insurance payouts to thousands of ill and disabled Americans.

Dr Liza van Zyl, a disabled member of DAN Cymru, said: “A lot of disabled people who become involved in DAN Cymru initially found us when they were searching the internet for ways to commit suicide because the DWP stopped their income after the WCA found them fit to work.

“The WCA has been the cause of so much suffering and destitution of disabled people in Wales. It is staggering beyond belief that the Welsh Government has appointed the man responsible for the WCA to chair Public Health Wales.”

Rob Marsh, convenor of DAN Cymru said: “The biopsychosocial model is a cargo-cult science with no credibility in the medical and scientific establishment.

“The British Medical Association has condemned the WCA and called for it to be scrapped. The BMA has found that eight out of 10 GPs report that their patients find the WCA and the DWP-administered benefits system so stressful that it causes mental ill-health in those patients who did not previously have mental health conditions.

“And over half of WCA assessments are overturned on appeal, at huge cost to the taxpayer. It is staggering that Aylward is considered an appropriate person to advise the Welsh Government on public health and disability matters”.

A summary of the Work Capability Assessment, the Biopsychosocial model of disability, and its introduction into the UK welfare system by Sir Mansel Aylward can be found here.

The protest will take place at 6.30pm today (Tuesday, September 8) outside the Unison Wales offices on Custom House Street, Cardiff CF10 1AP.

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Doctors to be briefed on life-saving work capability assessment rules

Dr Mark Porter, chair of the BMA, announced that all doctors would be advised of the potentially life-saving regulations.

Dr Mark Porter, chair of the BMA, announced that all doctors would be advised of the potentially life-saving regulations.

Doctors’ union the British Medical Association has finally agreed to brief every GP in the UK about regulations that campaigners believe could protect disabled people facing the controversial work capability assessment.

The rules state that a claimant should not be found fit for work (regulation 29), or placed in the ESA work-related activity group (regulation 35), if such a decision would pose “a substantial risk” to their “mental or physical health”.

These regulations are well-known to grassroots and social media campaigns, but campaigners including Black Triangle (BT) believed that many GPs were still unaware of them. They have been trying to persuade the BMA to inform GPs about the regulations since August 2012.

The timing of the BMA’s decision is interesting – nearly three years after originally being asked to publicise the regulations, and right before a general election.

As Black Triangle’s John McArdle told the Disability News Service: “A lot of lives could have been saved in that time and a lot of people could have been saved from trauma and destitution.”

He went on to say that the move was “better late than never”.

Dr Mark Porter, chair of the BMA council, said: “The BMA position remains that the work capability assessment process should be scrapped with immediate effect and replaced with a rigorous and safe system that does not cause avoidable harm to the weakest and most vulnerable people in society.

“The BMA has consistently lobbied politicians on this issue in the past few years and will continue to do so.

“We will ensure that our members are informed about the current regulations around work capability assessments, so as to help patients get the best outcome for their needs.”

The work capability assessment has been linked with relapses, self-harm, suicides and other deaths among those who have been assessed.

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Tories say the obese should ‘lose weight or lose benefits’. Pot, kettle, black

This man receives more than £150,000 from the state per year, and is warning other obese people to lose weight or lose benefits. Looks like he's desperate to lose his own when they come up for review in May!

This man receives more than £150,000 from the state per year, and is warning other obese people to lose weight or lose benefits.
Looks like he’s desperate to lose his own when they come up for review in May!

The Conservative Party seems determined to sink itself into the deepest, blackest hole ever created by a political organisation for itself.

While other parties unveil attractive policies designed to bring voters onboard, the Tories have said they want to remove benefits from people they have decided are fat. Here’s the Independent story, and for good measure we’ll throw in the BBC‘s coverage too.

You might be thinking to yourself, why not? They’ve already attacked people on Jobseekers’ Allowance, ESA and DLA as scroungers; they’ve pushed pensionable ages back by years; and they’re about to attack people who are on pensions, already. Why not continue proving what a bunch of spoiled little schoolboys they are by picking on fatties as well (oh, along with druggies and alkies)?

Perhaps because, as ‘Neti’ pointed out on Twitter: “Medication can mean that people gain weight and not be overeating.”

Exactly so. It seems the Tories are spoiling for a fight with the British Medical Association which, in 2013, said calls by Tory-held Westminster Council to cut the benefits of overweight people who refused exercise regimes were “draconian”.

Here’s another voice from Twitter – John Wight: “Tories now attacking obese and others on sickness benefit. Another wheeze designed to appeal to smug middle classes.”

Quite. Adding insult to injury is the fact that the policy has been announced by David Cameron, himself no stranger to a large meal.

camdrink

… Or drink.

“It is not fair to ask hardworking taxpayers to fund the benefits of people who refuse to accept the support and treatment that could help them get back to a life of work,” he said.

Fair enough. So if Cameron can’t slim down by May 7, we’ll know that he doesn’t want the support of our public money any more and he wants to go back to a life of work.

His career was in public relations, unless the memory cheats.

It seems likely he may have blown his chances of going back there.

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Are local doctors being wrongly blamed for the Tory NHS crisis?

150110AnE

Accident and Emergency admissions, compared with the target for those to be seen within four hours. This target was reduced from 98 per cent when the Coalition Government came into office.

It’s too simplistic to blame GPs for the increased pressure on hospital Accident & Emergency departments, according to the British Medical Association’s deputy chairman.

Dr Khailash Chand says the crisis is just a symptom of much bigger problems facing the National Health Service due to “political mismanagement of healthcare”. That’s right – he blames the Coalition Government.

GPs aren’t to blame, he writes in GP Online, because they have been facing the same increasing workload as A&Es: “We are in a situation where the NHS is like a balloon, where every part is under pressure. If you poke one part of the system, it bulges out somewhere else.”

The reason for the problem, he reckons, is the “savaging of local government budgets in the past four years and hence the cuts to adult social care”. With less investment going into preventing people from needing primary health care, casualty departments are facing ever-increasing pressure and “exit blocking” (you might know it as bed-blocking, in which the elderly and frail in particular are unable to leave hospital because nobody is available to look after them) is on the rise.

That’s very interesting, from the perspective of a person living in Wales. We’re told that the Welsh Government prioritised social care over the NHS, at least in the early years of the Coalition Government, and that this has led to the problems being experienced in hospitals in south Wales. The response to the claim, used by this blog, is that it takes time to get the proper procedures in place and that positive results may come in the future, if nobody loses their nerve and reverses the policy. Meanwhile, more money has been found to fund the NHS in Wales, meaning it receives between 20-25 per cent more cash now than in 2010-11.

It seems Dr Chand agrees: “The failure to implement policies that promote the integration of health and social care is lamentable, and an opportunity lost. If we are to tackle the increasing demands of an ageing population, we need a considered, holistic solution that is backed by an unambiguous, integrated plan produced in consultation with patients, the NHS and local authorities.

“Attributing this major failure of policy to the NHS staff ignores the basic reasons that explain why the system is so strained.”

He writes: “The key is to ensure that there is properly resourced community care, both to provide better and more care to ailing patients in their own residences and also to facilitate early discharge from burdened hospitals.

“The government must develop long-term and short-term strategies to address the staff shortages across the NHS, and invest in systems and measures that direct patients to the service or setting that is right for them.

“The NHS reforms have categorically failed to address this issue, and indeed might have indirectly contributed to the rising tide of emergency admissions by reducing resources within the NHS.”

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Will the government really penalise GPs whose patients opt out of data sharing?

n4s_nhs1

It seems the government has found a way to dissuade GPs from letting patients opt out of having their medical records sold to private firms – the threat of penalties or even an investigation into the way they run their practice.

Vox Political revealed earlier this month that the government is planning to make a profit from selling the private records of NHS patients in England to healthcare and pharmaceutical firms.

The records are said to be ‘anonymised’, but in fact anyone buying your details will be able to identify you.

The system, originally called the General Patient Extraction Service (GPES), now the Health and Social Care Information Centre, may also be described as the care.data scheme. Health Secretary Jeremy Hunt wants you to think the information will be used for medical research and screening for common diseases, but in fact it could be used by private health companies as evidence of failures by the National Health Service, and could help them undercut NHS bids to continue running those services – accelerating the privatisation that nobody wanted.

Patients have the right to withhold their data, but they must specifically inform their medical practice of their wishes. This is why medConfidential created a web page containing a special opt-out form, along with a form letter in various formats, allowing patients to opt out themselves, their children and any adults for whom they are responsible.

Now GPs are living in fear of reprisals if they don’t deliver enough details to the new system.

According to GPonline.com, Health minister Dr Daniel Poulter failed to rule out penalising GP practices with a higher-than-average proportion of patients opting out of new NHS data sharing arrangements.

In a written answer to Labour MP and health select committee member Rosie Cooper, Dr Poulter also refused to say what level of patient opt-out from the scheme would trigger an investigation.

Asked whether practices would be penalised, who would investigate practices with a high opt-out rate, and at what threshold this would apply, Mr Poulter said: “NHS England and the Health and Social Care Information Centre will work with the BMA, the RCGP, the Information Commissioner’s Office and with the Care Quality Commission to review and work with GP practices that have a high proportion of objections on a case-by-case basis.”

Ms Cooper took this as an admission that GPs were “being threatened and bullied into ensuring patients don’t choose to opt-out”.

Reacting on Twitter, NHS national director for patients and information Tim Kelsey ruled out fines for practices where large numbers of patients opt not to share data. He wrote: “Nobody is going to get fined if patients opt out.”

None of this offers a good reason for you to leave your medical records unprotected – in fact, it gives you more reasons to opt out than before, and might provide GPs with the excuse they need to retaliate.

Doctors have been pushed further and further by the Conservative-led government’s changes to the NHS. For example, they were told they would have a greater say in where the money went, as members of Clinical Commissioning Groups (CCGs), but that was not true – they don’t have the time to take part in such decisions so they have been handed over to firms that are often part of the private companies now offering services to the NHS (for a price).

Now they are being told they may face reprisals if they do not betray the principle of doctor-patient confidentiality.

But you can only push a person a certain distance before they push back.

How will NHS doctors in England respond?

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How can we believe the government’s ‘health tourism’ statistics?

"It's my policy and I'll cry if I want to" - or is Jeremy *unt simply responding to criticism of his bid to climb on the anti-immigration bandwagon?

“It’s my policy and I’ll cry if I want to” – or is Jeremy *unt simply responding to criticism of his bid to climb on the anti-immigration bandwagon?

A speech by Iain Duncan Smith is immediately reminiscent of a wasp negotiating its way through a bulldog’s digestive system; there’s a lot of droning and implied pain, but through it all you know exactly what the outcome will be.

From this starting point, one may liken a speech by Jeremy Hunt to a hippo having an unhappy bowel movement as a result of an unwise dietary choice; much clumsy blundering in the wilderness and a fair amount of distress – which may be transferred to any poor creature unlucky enough to get in the way.

It seems that migrants and visitors from abroad who use the NHS are now facing the full onslaught of the Health Secretary’s metaphorical indigestion, with nary a bucket of Rennie in sight – except in this case the cure would be a set of reliable statistics covering the use of NHS services by our foreign-born friends.

Armed with new reports by independent firms Prederi and Creative Research, the Health Secretary (and well-known misprint) believes ‘health tourism’ is costing the NHS £2 billion every year – and has announced that he plans to claw back around £500 million of that money.

A BBC report states that ministers believe some of the spending is unavoidable but “it would be realistic to save a quarter. Savings would come from deterring so-called health tourism, recovering money owed by other countries and a levy on non-European temporary residents”.

But the cost of health tourism, as set out in the report, is tiny – at a maximum of £80 million it would be four per cent of the estimated total loss – and this is based on evidence which even one of the reports’ authors, Prederi, have admitted is incomplete. On its own, it could not possibly generate the saving demanded by the new policy, nor could it justify the claim that £2 billion is currently being lost.

That is not the point, though. This is about getting the NHS on the anti-immigration bandwagon.

The study has been released to coincide with the Immigration Bill, which (surprise, surprise) includes plans for a £200-per-person-per-year charge for temporary migrants to use the NHS during any stay lasting between six months and five years.

The Conservative-led Coalition government says this could recoup around £200 million per year, but this is clearly nonsense.

Put yourself in the position of a person from abroad, considering an extended stay in the UK. If an extra cost of up to £1,000 for a five-year stay was added to the trip, out of the blue, would you go ahead with it? Or would you consider other destinations?

Alternatively, if the trip could not be avoided, would this not make you more likely to use the NHS, in order to simply get your money’s worth? The trouble with this is that such a person would not know the cost of a consultation. According to Dr Chaand Nagpaul, chairman of the British Medical Association’s GPs committee, the cost of a single hospital outpatient appointment would equal the £200-per-year levy.

And then there is the administration cost. New Statesman revealed that the chair of the Royal College of GPs, Claire Gerada, has warned that the cost of administrating the new system could outweigh the savings, while also increasing public health problems such as TB by deterring temporary migrants from seeking treatment when they first fall ill. This gives rise to the possibility that we are facing another Tory policy that could have deadly consequences for the population.

This is not a plan to deal with health tourism at all. This is an attempt by an increasingly-desperate Conservative Party to claw back some of the voters who have (themselves) migrated to UKIP because of fears that have been planted in their minds by political spin-doctors, rather than any real threat – the phantom problem of immigrants getting benefits they haven’t earned.

Health tourism is not costing the UK £2 billion a year, and the measures outlined by the government will not stop it, or save any lost money. If anything, it will cost the country millions of pounds.

But then, when has Jeremy Hunt bothered with the facts, when he can have his way simply by playing on people’s fears and manipulating their beliefs?

This is why reference was made, at the top of this article, to Iain Duncan Smith – another Tory minister who won’t let thousands of possible deaths interfere with his beliefs.

Hands off my medical records, Jeremy!*

The two-fingered salute: Jeremy *unt displays his high regard for the NHS patients whose details he wants to steal and sell to private business.

The two-fingered salute: Jeremy *unt displays his high regard for the NHS patients whose details he wants to steal and sell to private business.

Conservatives. They think they own everything – including your medical records.

If you live in England, Jeremy ‘The Misprint’ *unt wants your doctor to send your confidential patient record to a national database, from which it will be sold on – sold on to make money for him, mark you – to “approved” private companies and also universities.

The system is called the General Patient Extraction Service (GPES) – although exactly who it serves is entirely up for debate. You may also see it described as the care.data scheme.

He thinks this gross abuse of patient confidentiality is a good idea. But then, he’s a Tory and therefore thinks he has a God-given right to take anything, from anyone, if they have less filthy lucre than himself.

According to the Daily Mail – and you know the Tories have lost the plot when even the Heil weighs in against them – the *unt wants us to believe that the information will be valuable for medical research and screening for common diseases.

And an NHS England spokesman told the paper, “The programme will provide vital information to approved organisations about the quality of health services.”

Oh really?

So in fact this information could be used by private health companies as evidence of failures by the National, publicly-funded, service, yes?

How would it help in screening for common diseases? This information becomes freely available without any data having to be sold – how else would we know when an epidemic breaks out?

And how is this valuable for medical research – beyond the possibility that the now-infamous ‘job offer’ for people to take part in human medical experimentation may be targeted at particular individuals, according to medical records that they thought were only available to their own, trusted GP?

Doctors say Mr *unt and NHS England have failed in their duty to publicise the plan in a proper and reasonable way, that patients are not getting an “informed” choice about the matter, and that patients could be identified from the data with any information other than that on common conditions – which, we’ve already established, becomes public knowledge anyway.

Some Local Medical Committees (LMCs) are already discussing whether to opt out of the system – and this blog would urge all the others to do the same.

If you are concerned about this gross invasion of your privacy, you can contact your own LMC and request that they opt out. Contact details can be found on the British Medical Association’s website here.

*In fact he won’t be able to get his filthy hands on them anyway because I live in Wales. The title is for effect.