Tag Archives: Department of Health

How much can YOU pay? A&E charges would speed NHS privatisation

Health-CARE? It seems increasing number of GPs want the person on the stretcher to stump up a fiver or a tenner before the medical staff in the photograph can begin treatment.

Health-CARE? It seems increasing number of GPs want the person on the stretcher to stump up a fiver or a tenner before the medical staff in the photograph can begin treatment. (Image: BBC – intentionally left fuzzy to preserve anonymity of those involved)

It is strange that more has not been made of the revelation that one-third of GPs apparently believe a £5 or £10 charge should be imposed on everybody turning up at hospital Accident and Emergency departments.

This seems to be a clear next step towards the marketisation of what used to be the National Health Service, disguised with a claim that it would “reduce frivolous use of the NHS and the growing pressure on emergency departments”.

It seems that a poll of more than 800 doctors found 32 per cent said “fees would be the most cost-effective way of cutting the number of people who go to A&E, who could have gone to their GP or a pharmacist instead or did not need medical attention at all”. Presumably they have already tried simply telling people what to do, then.

The story in The Guardian states that “specialists believe between 30 per cent and 40 per cent of all visits are unnecessary and that many patients could have sought help elsewhere because their illness was minor or not urgent”. That leaves 60-70 per cent of visitors paying extra for services their taxes have already funded!

According to the book NHS SOS (edited by Jacky Davis & Raymond Tallis; published by Oneworld), the plan is to convert the publicly-funded nationwide health service into one of “managed” care along the lines provided by Kaiser Permanente in the USA.

This is based on a flawed use of figures (p.39) so Kaiser is in fact far more expensive, but that didn’t stop then-Department of Health strategy director Chris Ham from defending the claims and allowing Kaiser to emerge as the model for NHS reform. This was seen as particularly useful for those with cash to invest in the company or other MCOs (Managed Care Organisations) as they reaped huge profits – until market saturation, government and employer schemes to keep health care costs down, and a series of scandals made the pendulum swing the other way. Then these companies started lowering patient benefits, increasing premium fees and withdrawing from unprofitable markets, and this is very similar to the current situation in England.

Finally, these firms began to expand internationally, to countries including the UK, where the NHS was seen as a hugely attractive business opportunity.

MCOs decide how services are organised and funded for their clients, through contracts with selected providers and rigorous control of hospital admissions. This seems uncannily close to the work of Clinical Commissioning Groups, which were set up under the pretext that they would allow GPs to control budgets, but in practice allow the money to be controlled by private firms that have been hired by overworked doctors – as was always intended by the Tory-led Coalition government.

Government regulations mean private companies must be allowed to bid to provide as many services as possible. Freedom of Information rules mean they can find out how the public service operates and then undercut its bid. Without funding, the public service will close, leaving the way clear for the private provider to pump up its prices – so they will eat up more and more of the limited NHS budget. But which services do they choose?

They choose those that are easiest and cheapest to provide – the services that provide the most opportunity to make a profit.

Accident & Emergency is not one of those services. It will remain with the public sector providers who are being “continuously cut and squeezed into downsizing, mergers, centralisation and closures”, reducing care to “short-staffed, overloaded, ‘centralised’ units”, covering “only those services that the private sector does not wish to provide” (ibid, p.18).

How can services like A&E continue, if the private operators are taking all the cash? The only answer, it seems, is to bring in health insurance. That is the plan, at least – and the proposed A&E charges seem intended to be a palatable way of opening that door to a public that would once have treated the very idea as anti-British and voted the government that proposed it out of office for a considerable period of time.

Next it seems likely that “top-up” insurance will be offered to people whose complex ongoing conditions qualify them for so-called Personal Care Budgets. The budget money will be limited, forcing patients (or rather, customers) to “top them up” with insurance.

Be very clear on this: You are not looking at the thin end of the wedge. The wedge has already been driven in and England is well on the way to having a privatised health service, with the NHS as nothing but a brand under which taxpayers’ money can be handed out to private firms that handle only the simplest procedures.

The intention, it seems clear, is to allow publicly-funded services to wither over a period of time, in order to soften you up – make you more receptive to the idea of paying for healthcare that once was free but may not even be available in the future if you don’t come up with some cash.

Are you going to sit there and wait for that to happen? Private health care, and health insurance, is far – far – more expensive than the NHS, which was the most cost-effective and efficient health provider in the world until the Tory-led Coalition got hold of it. Don’t believe the propaganda – the service had record satisfaction levels in 2010.

You can still stop the rot. To find out how you can work to reverse the damage being done to the most cherished organisation in the UK, visit www.keepournhspublic.com and www.nhscampaign.org.uk

If you’re living in Wales, Northern Ireland or Scotland, don’t think that devolution of healthcare will save you because it won’t. Budgets are already under pressure from Westminster and the Tories will do whatever they can to force regional governments into the same, or similar, patterns.

One of life’s certainties is that you will become ill at some point. Don’t wait until that happens, because it will be too late.

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Schools and hospitals: Your government can’t be bothered

The modern answer to any problem: If your school or hospital is under-performing, don't try to solve its problems - close it.

The modern answer to any problem: If your school or hospital is under-performing, don’t try to solve its problems – close it.

Late last year, a high school here in Powys was tested by inspectors and found so seriously lacking that it was placed in ‘special measures’.

(You’ll be familiar with the term, dear reader, because Jeremy Hunt, the bad-for-your-Health Secretary, has now placed several hospitals in the same category. We’ll get to them soon.)

Leighton Andrews AM, who was Welsh Education Minister at the time, wrote to Powys County Council on January 7 this year, stating that he would be minded to use his ministerial powers to close John Beddoes School, which is nearly 500 years old, if the local education authority failed to demonstrate improvement by the end of the summer term.

The Council’s cabinet immediately decided to ignore any calls for improvement and instead devised three alternative plans for closure. These were outlined in a letter to the Minister on January 30.

The authority then embarked on a formal public consultation which returned an overwhelming result in favour of retaining the school but sorting out its problems – as had been done 10 years previously at the high school in Newtown, around 20 miles away.

But the council’s cabinet chose to add insult to injury, not only by going ahead with its closure plan (so much for local democracy) but also by planning to re-open the school as a second campus of Newtown High, the school that had received remedial treatment in the past and is now one of the highest-performing in Wales.

Meanwhile, in England, all 161 hospital trusts are to be inspected under a new “more robust” regime, in the wake of hysteria stirred up by Downing Street and the right-wing media about failings at 11 hospital trusts. The trusts had been investigated after the so-called Stafford Hospital scandal, as they had the highest death rates between 2010-12. The public inquiry into Stafford concluded that the public had been betrayed by a system that put “corporate self-interest” ahead of patients.

The headlines claimed 13,000 people died needlessly in 14 dangerous hospitals. Polly Toynbee in The Guardian rightly pointed out that this was nonsense: “The Tory ambush was pre-planned by Downing Street as well-primed MPs used a report by Sir Bruce Keogh, the NHS medical director, to turn Labour’s good NHS record into a liability. Labour’s outrage was not synthetic, but indignation within the NHS was even fiercer at seeing the progress of the last decade trashed. The attack was not just on Labour, but on the viability and the future of the NHS itself.

“Where did that 13,000 come from? Not from Keogh’s meticulous report. With an innocent face, the health secretary, Jeremy Hunt, protested: ‘I don’t know how that number was put out there.’ It came from No 10 briefers, and was quickly refuted by Keogh, who called it ‘clinically meaningless and academically reckless’. It was also promoted by Professor Sir Brian Jarman, author of the Dr Foster hospital guide.”

Why did the Conservatives put out the misinformation?

Readers of this blog may be forgiven for thinking it’s just another in a long line of goofs by a government that can’t get its facts right.

In fact, it’s part of the ongoing war on the National Health Service, intended to soften up public feeling and smooth the way for ever-greater privatisation.

…because we all know that privatisation works so well and is so much cheaper, don’t we (British Rail)?

There is a link between all three issues. Yes, that’s right, three – not two.

In each case, the public wanted an improved service. The onus was on the appropriate authority to get involved in the situation, find out what was going wrong, and fix it.

But Powys Council’s cabinet couldn’t be bothered – and decided to close a school instead. Closing a school wipes the slate clean and means that the council won’t be seen to have poor-performing education institutions on its books.

The NHS organisations in charge of the 11 failing hospital trusts couldn’t be bothered either – and, according to investigators, chose to cover up the failings in their systems, rather than correct them.

And the Conservative-led Coalition government certainly can’t be bothered. David Cameron and his cronies are busily selling off our greatest national asset, piecemeal, to their big business friends who intend to wring every penny of profit they can make out of it. Do you really think that health care in the UK will improve under such a corrupt regime?

This blog has roundly criticised Mr Hunt for his co-authorship of a book that criticised the NHS, before the Coalition government came to office.

In Direct Democracy, published in 2005, he told readers that the health service was old-fashioned and out of touch: “It was, and remains, a child of its time.”

Now, as local and national government neglect links up with institutionalised ass-covering to bring more and more public services to their knees, the public might well be left wondering why nobody responsible for them feels the need to put them right.

Apparently, that’s an old-fashioned notion, too.

(The first Vox Political collection, Strong Words and Hard Times, is now available and may be ordered from this website)

Lies, damned lies and… ‘forward-looking’?

Don't drool, David! Mr Cameron takes questions after his speech on immigration, earlier this week. See those white flecks on his chin? He had been spitting down his face throughout the event. Perhaps he should not allow himself to get so excited?

Don’t drool, David! Mr Cameron takes questions after his speech on immigration, earlier this week. See those white flecks on his chin? He had been spitting down his face throughout the event. Perhaps he should not allow himself to get so excited?

This week we all learned a new euphemism. From now on, it seems, the less-offensive synonym for a governmental lie will be: “forward-looking”.

As in, for example: “Part of [David Cameron’s speech on reducing immigration] is on the importance of reducing pull factors from people who may be considering coming… There is a forward-looking angle to the speech.” (A Downing Street spokesdrone)

Okay, so when he said he was giving migrants from the European Economic Area – in other words, people who already live here – a “very clear message” that there will be no absolute right to unemployment benefit, those words were referring to the future?

That’s fine, but only 0.65 per cent of the two million net migrants to the UK from countries who joined the EU in 2004 – 13,000 people in total – have ever claimed Jobseekers’ Allowance, and that figure is unlikely to rise in the future.

So for Cameron to be claiming this is an important step forward would be a li- it would be a l- It’s forward-looking??

Downing Street’s claim that there has been a 40 per cent increase in the number of social lettings to migrants between 2007-8 and 2011-12 cannot be taken as forward-looking. It’s a statistic – and a typically-distorted one.

The number has indeed risen by 40 per cent – from 6.5 per cent of the proportion of such lettings to nine per cent. All of those people qualify because they are either working, self-sufficient or have a permanent right of residence in the UK – in other words, they are not a burden on the benefits system.

Eligible foreign nationals have their housing needs considered on the same basis as other, UK-born, applicants in accordance with each local authority’s allocation system – in other words, they get no preferential treatment.

Mr Cameron also said Britain has a “free National Health Service, not a free International Health Service”. It seems likely this claim was based on concerns raised by the health secretary, Jeremy Hunt, who seems to think foreign nationals owe the health service £200 million a year, despite the fact that official Department of Health figures place the total for 2011-12 at £33 million – less than one-sixth of his claim (but still a substantial sum of money)

Mr Hunt has announced plans to limit free NHS care to permanent, not temporary, foreign nationals, on the basis of these fake- sorry, forward-looking, figures.

Mr Cameron has also announced plans regarding foreign migrants – he’ll limit their benefits. While this shows a certain consistency within the Coalition government – it is already limiting benefits for people who were born here – Cameron seems to be making no effort to tackle illegal immigration, or exploitation of foreign migrants.

But let us not criticise this new “forward-thinking” breeze that is blowing through the corridors of power without considering some of its other applications.

For example, employment minister Mark Hoban said last week, during the debate on the Jobseekers (back to the Workhouse) Bill that there were no national targets for applying sanctions against jobseekers, nor were there league tables of Job Centres, ranging from the best to the worst in imposing those sanctions.

How does he reconcile this with the leaked letter from an employee of Walthamstow Job Centre, which is 95th in the allegedly nonexistent league table – out of only 109.

The letter states: “I have until the 15th Feb… to show an improvement. Then it’s a PIP [Performance Improvement Plan – the first stage of disciplinary action for Job Centre Employees] for me… to improve my teams SBR [Stricter Benefit Regime – in other words, sanction] referral rate.” The letter went on to say the Job Centre’s manager was looking for 25 such referrals per week, from each section.

“Guys, we really need to up our game here,” the letter concludes. “The 5% target is one thing, the fact we are seeing over 300 people a week and only submitting 6 of them for possible doubts is simply not quite credible.”

Another thing that is now “not quite credible” is Mr Hoban’s claim that there are no targets and no league tables. Or was this another bit of “forward-looking” – to a time when there won’t be any need for them? Perhaps when everyone has been cleared off benefits altogether?

A leaked newsletter for Malvern Job Centre, quoted in The Guardian, also refers to the five per cent target.

Liam Byrne, the Labour work and pensions spokesman who traded away his Party’s opposition to the Jobseekers (back to the Workhouse) Bill for a nebulous promise of an independent review of back-to-work schemes, lasting 12 months and with no deadline set for the government to respond to its report, demanded that this review should be set up immediately, “so it can begin the job of putting the DWP’s house back in order” – even though it has nothing to do with the sanctions regime.

He clearly doesn’t want to rock the boat.

So we have government ministers – and a Prime Minister – determined to lie- sorry, look forward about as many policies as possible, while Her Majesty’s Opposition is determined to look the other way.

And, out in the real world… How are your finances looking for next month?

Why do we tolerate ‘slavery’ schemes that rely on secrecy?

Cait Reilly took the government to court after she was forced to stop volunteering at a local museum – with a view to getting a job as a curator – and go to work in Poundland for nothing. The government said the scheme was voluntary but – and the clue’s in the title, ‘Mandatory Work Activity’ – this is not accurate. Those on the scheme now could be stripped of their benefit for three years if they refuse to take part, so one wonders what would happen if Ms Reilly or someone like her tried a similar court action today.

It’s like the NHS privatisation all over again.This time, the Department for Work and Pensions is refusing to publish the names of charities and businesses where unemployed people – in their tens of thousands – are being forced to work for no pay, for periods of four weeks at a time.

Readers with long memories will recall that, earlier in the year, the Department of Health refused to honour a ruling by the Information Commissioner that it should publish a risk assessment on the effects of the then-Health and Social Care Bill.

The argument was that publication would discourage the civil servants who write these reports from including the more controversial likely effects from future risk assessments on other subjects. The reason that the public accepts as true is that the scale of the changes, the waste of public money in achieving them, and the amount of profit to be made by private ‘healthcare’ companies from UK citizens’ misery would be unacceptable to the British people if they knew about it.

Some details leaked out anyway and, now we are experiencing those effects, we are able to see just how accurate those predictions were (and in many cases, how far short of the mark they fell).

Both the requirement that the DoH publish its risk assessment and the demand that the DWP publish its list of businesses and charities involved in ‘Workfare’ follow Freedom of Information requests made to the government.

So much for open government. It seems that such requests are a waste of time when the government in power is determined to operate in secrecy.

Note that the government’s line on organisations taking part in Workfare is now that they “tend to be charitable organisations”. Previously we were led to believe they were all organisations that provide “social benefit”. It seems, once again, this government has lied to us (and not very well). How many profit-making businesses are involved, then, and what are their names?

The real problem with this one is that the ConDem Coalition seems to be childishly ignoring the facts of the matter, which are (i) Workfare doesn’t work, and (ii) Workfare is unpopular in the extreme.

The government’s own research shows that the scheme does not help unemployed people to get a job. Once they have finished their four weeks of work – for whichever unnameable company or, God forgive them, charity – they get thrown back onto Jobseekers’ Allowance and somebody else is picked up to work for nothing. Workfare has no effect on getting people off benefits in the long term.

In fact, the effect of Workfare on the economy is harmful. I commented yesterday on figures showing that, after Job Centre Plus staff started putting people into jobs instead of any of the government’s several work placement programmes, unemployment has dropped and productivity has gone up. I think this may be a temporary blip, with more jobs available because of special events over the summer like the Olympics, but the statistics are revealing.

The government has ploughed on, with changes in the rules a fortnight ago which mean that unemployed people who refuse to take the unpaid placements can have their JSA benefit stripped from them for up to three years.

Note (again) that one of the reasons Cait Reilly lost her court case against the government over Workfare was that the DWP claimed incessantly that the scheme was voluntary and she had the opportunity not to take it up. I wonder what would happen if someone like her took the scheme to court now?

Whatever happens next, it seems the names of the organisations taking part in Workfare (or Mandatory Work Activity, to give it its current official title) will continue to be secret. The reason? The DWP has said the programme would “collapse” if the names were made public, due to the likelihood of protests against the organisations involved.

Doesn’t that give anyone in the DWP a clue?

These schemes are totally unsuccessful and utterly unpopular with the British public.

So why persist?

I think it’s an ideological programme. The government is complaining that the benefits bill is too high and needs to be shrunk, but no employer in his or her right mind would think of paying the full amount for an employee when they can get them on Workfare instead, and have the taxpayer foot the bill.

Workfare is therefore a way of ensuring that the current lack of full-time jobs continues into the future – thereby allowing the government to use it – and the consequent, high benefits bill – as justification for its welfare benefit cuts.


Moonlighter Hunt pockets 12 times a nurse’s pay – for no work at all?

There used to be a word for it – what people did when, on top of their main job, they took on another that might be ‘sketchy’ by nature: Moonlighting.

It seems our new health secretary, Jeremy Hunt, has been moonlighting – and in a very lucrative way – pocketing £366,000 from his Hotcourses publishing firm, and a further £3,000 for lessons in Mandarin Chinese.

That’s more than 12 times the salary of the average nurse, at a time when millions of healthcare professionals are seeing their pay cut in real terms.

Let me make myself clear: I’m not opposed to people having secondary or tertiary streams of income. In these straitened times, I think many people need the extra money just to make ends meet.

Jeremy Hunt does not fall into that category.

He is now a senior government minister, who takes home an extremely large taxpayer-funded salary for that job. Anyone in his position should be devoting all of their working time to public service, and none of it to their own personal concerns.

Hotcourses tells us that Mr Hunt’s earnings with it are entirely from shares and from taking back and then renting out a building previously owned by the company. In other words, for no work at all.

I don’t care. This is still business that must take his attention away from the Department of Health. He should have left it behind.

It is obscene that a Cabinet minister is banking so much money when the people his department employs – people who work long hours under extremely difficult conditions – are taking a real-terms pay cut.

And it illustrates the contrast between pay for the highest-earning in society and the lowest. Recently we all learned that, if the minimum wage had increased in line with that of company directors, it would be nearly £19 by now.

I wonder how much a nurse’s pay would have increased, if it had been allowed to do so at the same rate?

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.

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.

Whatever happened to free speech?

The Tory propoganda machine has been at it again – hushing up dissent to the, by now, pretty much universally-hated Health and Social Care Bill.

It seems Health Minister Andrew Lansley and his departmental colleagues have been on the blower to members of the Academy of Medical Royal Colleges. One presumes from the outcome that this was to assure them that releasing a statement opposing the Bill in its current form would be bad for their health.

The statement read as follows: “The medical royal colleges and faculties of the academy continue to have significant concerns over a number of aspects of the health bill and are disappointed that more progress has not been made in directly addressing the issues we have raised.

“The academy and medical royal colleges are not able to support the bill as it currently stands.

“Unless the proposals are modified the academy believes the bill may widen rather than lessen health inequalities and that unnecessary competition will undermine the provision of high quality integrated care to patients.”

The provisional plan had been to publish the statement late on Wednesday morning, ahead of Prime Minister’s questions.

But ministers led by Mr Lansley, along with senior officials, telephoned the presidents of the colleges ahead of its release, asking them to reconsider. We’re told the statement could have had a potentially devastating effect on the government’s plans.

Now it lies unused – another example of the methods Mr Lansley uses to stifle opposition to his unreasonable plan to privatise parts of the National Health Service and put taxpayers’ money into private operators’ offshore tax-haven bank accounts (as has been previously proved).

Remember the ‘risk report’ on the potential harm that would be caused to the health service if the Health and Social Care Bill becomes law? No? That’s because Mr Lansley still hasn’t published it, months after he was ordered to do so by the Information Commissioner, Christopher Graham.

The Commissioner found the department twice broke the law by refusing to accede to two separate requests under the Freedom of Information Act to see the assessment. The Department of Health has appealed against these rulings; if the appeal falls, then its officials, and Mr Lansley, are criminals.

The BBC reported this story yesterday and the ‘comment’ column it provided instantly threw up a series of intriguing tangents.

One person, claiming to be a member of one of the colleges, stated that they voted on Wednesday, at an extraordinary general meeting, to come out in direct opposition to the Bill. The colleges’ leaders, by preventing them from doing so and not accepting that vote, were playing political games, in that person’s opinion.

Another commenter told us a decision against the Bill could still be made. It seems their daughter, a trainee public health consultant, was unable to attend the meeting at which the statement was discussed. She has been informed that her faculty is balloting all its members by post, according to its constitution and, if this is true, the results of the vote will not be known for another fortnight.

A third stated that the royal colleges had been intending to speak up to protect patients, from a position of specialist knowledge and understanding, but had been swayed from protecting patients and the NHS to protecting the government after Mr Lansley and/or his colleagues contacted them.

Back we go to the famous comment by Albert Einstein: “The world is a dangerous place, not because of those who do evil, but because of those who look on and do nothing.”

Like many others, I think the public needs to know what was said in those last-minute phone calls.

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