Tag Archives: Health and Social Care Bill

Cabinet reshuffle: Does Cameron think he’s the Joker?

Today’s blog entry will be relatively short. I had an operation on my leg yesterday (September 4) and it seems to be affecting my ability to think.

… And if you think that’s bizarre and illogical, let’s have a look at the decisions made by David Cameron in yesterday’s Cabinet reshuffle!

Firstly, the really shocking news: George Osborne is remaining as Chancellor of the Exchequer. Not really news, I know, but at the outset it makes a mockery of a process that is supposed to be about improving the government of the UK. Osborne’s policies are a disaster; he has sent British industry nosediving while increasing borrowing by £9.3 billion in the last four months. He was booed when he got up to give out medals at the Paralympics and he was booed at Prime Minister’s Questions today. But he remains in the Number Two government job.

Also remaining in post are Home Secretary Theresa May and Foreign Secretary William Hague; Education Secretary Michael Gove surprisingly keeps his brief, despite having proved by his activities that he is not up to the intellectual challenge (see previous Vox articles).

And Iain Duncan Smith will remain at Work and Pensions – oh yes he will! – despite having been offered Justice by David Cameron. This shows the weakness of the Prime Minister. As LabourList’s Mark Ferguson put it: “Cameron tried to move IDS. IDS said no. Cameron said ‘ah…um…ok’. Weak, weak, weak.”

Fellow Tweeter Carl Maxim added: “Iain Duncan Smith was offered a job at Justice but refused to take it. Therefore his benefits should be cut.”

And a fellow called ‘Woodo’ tweeted: “Gove and Duncan-Smith to stay in roles to ‘get the job done’. ‘The job’ being making educating poor kids harder and killing off the disabled.”

Biggest winner in the reshuffle has to be former Culture moron – I mean secretary – Jeremy Hunt, who has been moved up to take the Health brief. This has been seen as a reward for his work on the phone hacking controversy that led to the departure of former News of the World editor Andy Coulson from the Downing Street press office, and to the Leveson Inquiry into the behaviour of the media.

This seems a nonsensical move. Leveson has ordered not only Cameron, but Cameron’s friends Coulson, Rebekah Brooks (who now faces criminal charges for her part in phone hacking), and Hunt himself to give evidence in hearings that were highly embarrassing for those under scrutiny.

Hunt’s own close connections with Rupert Murdoch, whose News Corporation owns the papers that were mainly responsible for the crimes, is well-documented, and led to this tweet from James Lyons: “BREAKING – Rupert Murdoch to buy the NHS.”

This may not be far from the truth. Hunt co-authored a book dealing with the NHS at length, with Daniel Hannon MEP who called the NHS a 60 year mistake. The book states: “Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain“.

He reportedly tried to remove the NHS tribute from the Olympic Games opening ceremony and his record in government is as dodgy: he voted to halve the time allowed for an abortion from 24 weeks to 12. His support of homeopathy has also attracted ridicule from some quarters.

Hunt’s arrival at Health follows the ejection of Andrew Lansley, the man who worked for eight long years on his Health and Social Care Bill, that effectively privatised health care in England. This work constituted the biggest lie this government ever sold to the public – that the Conservatives would safeguard the well-loved 64-year-old national institution. His reward? Demotion to become Leader of the House of Commons.

Former employment minister Chris Grayling, a man who believes bed and breakfast owners should be allowed to ban gay couples, has been promoted to the Justice brief. In response, one tweeter asked if Cameron will be building more prisons.

This means the oldest Cabinet member, Kenneth Clarke, has been ejected from Justice. David Cameron reportedly tried to sack him outright, along with departing Conservative co-chair Baroness Warsi, but ended up compounding his weakness by creating new roles for them instead. Clarke will be a minister without portfolio (although it is believed he’ll be sticking his oar into Osborne’s business at the Treasury), and Warsi will be minister for faith and communities.

Nick Parry tweeted: “Now ‘Baroness’ Warsi really knows what it’s like to be Northern and working-class – she’s been made redundant by the Tories.”

And Rory Macqueen asked: “Who has replaced Warsi in the <issue off-the-shelf statement about “Labour’s union baron paymasters”> role? It looks really challenging.”

That would be tireless self-promoter and foot-in-mouth artist Grant Shapps.

Scraping the bottom of the barrel… The new Transport secretary, Patrick McLoughlin, is afraid of flying.

And the former minister for the disabled, Maria ‘Killer’ Miller, is the new Equalities minister. She’ll be victimising women, gays and ethnic minorities as well, from now on. If you think that’s harsh, bear in mind that she voted for a (heavily defeated) proposal to stop abortion providers like Marie Stopes counselling women, and is on record as being in favour of defining homophobia, racial hatred and prejudice as ‘freedom of speech’.

Beyond that, we’re into comedy territory. For example, Mid Wales Labour member Ryan Myles said: “Apparently David Cameron was planning on moving Eric Pickles but couldn’t afford the crane.”

All in all, it’s been a wholesale replacement of anybody with talent, by idiots. The tweeter who identifies himself with Yes Minister lead character Rt Hon Jim Hacker MP summed it up perfectly: “Expected a night of the long knives, may just be a morning of insignificant pricks!

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.

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.

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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