Tag Archives: health record

Greatest Coalition Failures: National Health Service

zcoalitionfailNHS

National Health Service staff went on a four-hour strike today (Monday) against a pay freeze which has meant one in five of them have had to take other jobs in order to make ends meet.

Health Secretary Jeremy Misprint Hunt, whose 10 per cent pay rise on his ministerial salary of around £140,000 is safe, said the health service could not possibly afford to add one per cent to workers’ pay. The minimum starting salary for a registered nurse is £21,478; Hunt’s pay rise alone could cover a one-per-cent increase for no less than 65 such nurses, and they are by no means the lowest-paid NHS workers.

The strike has come as The Times newspaper claimed that “senior Tories have admitted that reorganising the NHS is the biggest mistake they have made in government,” with at least £5 billion a year wasted on inefficiencies.

The paper’s online version is hidden behind a paywall, but its front page states: “David Cameron did not understand the controversial reforms and George Osborne regrets not preventing what Downing Street officials call a ‘huge strategic error’, it can be revealed.

“The prime minister and the chancellor both failed to realise the explosive extent of plans drawn up by Andrew Lansley, when he was the health secretary, which one insider described as ‘unintelligible gobbledegook’.

“An ally of Mr Osborne said ‘George kicks himself for not having spotted it and stopped it. He had the opportunity then and he didn’t take it.’

“The admission came during an investigation by The Times that has found at least £5 billion is wasted every year on inefficiences, such as overpaying for supplies, out of date drugs, agency workers and empty buildings, a study carried out for ministers said.”

The report raises several questions. Firstly, if Lansley’s reforms were a mistake, that doesn’t mean Cameron and Osborne would have proposed anything better. Tories are almost universally dedicated to the end of the National Health Service and the worsening of working-class health.

Secondly, if David Cameron did not understand Lansley’s plans, why did he allow them to go through? As Prime Minister, he is responsible for the activities of his government and a lack of comprehension indicates that he is not fit for the role – and never was. Is it possible that Cameron was swayed by the fact that Lansley was his mentor at the Conservative Research Department and he thought he owed a favour?

Thirdly, if Gideon didn’t spot it, what does that say about his abilities as Guardian of the Public Purse? (Actually, here’s a link to an article about his abilities in this regard. Read it and weep, George!)

Finally, and perhaps most importantly: How did the government let the NHS fall into this terrible condition? For the answer, we have to go back, again, to the Coalition Agreement.

22. NHS

The Government believes that the NHS is an important expression of our national values [From this we may conclude that the Tories (and their little LD friends) decided to change the NHS and make it reflect their values]. We are committed to an NHS that is free at the point of use and available to everyone based on need, not the ability to pay [Fail]. We want to free NHS staff from political micromanagement [Fail], increase democratic participation in the NHS [Fail] and make the NHS more accountable to the patients that it serves [Fail]. That way we will drive up standards, support professional responsibility, deliver better value for money and create a healthier nation [Fail].

  • We will guarantee that health spending increases in real terms in each year of the Parliament, while recognising the impact this decision will have on other departments  [Vox Political has just spent several weeks demonstrating to the BBC that this has not happened].
  • We will stop the top-down reorganisations of the NHS that have got in the way of patient care. We are committed to reducing duplication and the resources spent on administration, and diverting these resources back to front-line care [Andrew Lansley’s Health and Social Care Act 2012 was the largest top-down reorganisation ever imposed on the National Health Service. It was also gibberish (as top Tories now concede) and has cost the service more money than it could ever hope to save].
  • We will significantly cut the number of health quangos [Clinical Commissioning Groups are quangos – so in fact it seems likely the number has increased].
  • We will cut the cost of NHS administration by a third and transfer resources to support doctors and nurses on the front line.
  • We will stop the centrally dictated closure of A&E and maternity wards, so that people have better access to local services [The Coalition government has never – let’s have that again: NEVER – refused permission for a plan to close A&E wards].
  • We will strengthen the power of GPs as patients’ expert guides through the health system by enabling them to commission care on their behalf [This refers, again, to CCGs. In fact, overworked GPs do not have time to plan and commission services, and have handed responsibility over, in most cases, to private health companies. This has opened the way for a huge amount of corruption, as these companies may commission services from themselves. More than one-third of doctors who are board members of CCGs have financial interests in private healthcare (NHS SOS, p 5].
  • We will ensure that there is a stronger voice for patients locally through directly elected individuals on the boards of their local primary care trust (PCT). The remainder of the PCT’s board will be appointed by the relevant local authority or authorities, and the Chief Executive and principal officers will be appointed by the Secretary of State on the advice of the new independent NHS board. This will ensure the right balance between locally accountable individuals and technical expertise.
  • The local PCT will act as a champion for patients and commission those residual services that are best undertaken at a wider level, rather than directly by GPs [Fail. This hasn’t happened]. It will also take responsibility for improving public health for people in their area, working closely with the local authority and other local organisations [Fail].
  • If a local authority has concerns about a significant proposed closure of local services, for example an A&E department, it will have the right to challenge health organisations, and refer the case to the Independent Reconfiguration Panel. The Panel would then provide advice to the Secretary of State for Health [Fail. The right to challenge seems to have been introduced but has been ineffective].
  • We will give every patient the right to choose to register with the GP they want, without being restricted by where they live [Fail. In fact, the Coalition has given GPs – or rather, CCGs – the right to choose the patients they want, meaning they can exclude patients with expensive, long-term conditions. This has an effect on the promise to provide care to everyone that is free at the point of use, of course].
  • We will develop a 24/7 urgent care service in every area of England, including GP out-of-hours services, and ensure every patient can access a local GP [Fail, for reasons indicated above]. We will make care more accessible by introducing a single number for every kind of urgent care and by using technology to help people communicate with their doctors [The service was launched in 2013 and was a complete and utter failure – it could not cope with demand on any level].
  • We will renegotiate the GP contract and incentivise ways of improving access to primary care in disadvantaged areas.
  • We will make the NHS work better by extending best practice on improving discharge from hospital, maximising the number of day care operations, reducing delays prior to operations, and where possible enabling community access to care and treatments.
  • We will help elderly people live at home for longer through solutions such as home adaptations and community support programmes.
  • We will prioritise dementia research within the health research and development budget.
  • We will seek to stop foreign healthcare professionals working in the NHS unless they have passed robust language and competence tests.
  • Doctors and nurses need to be able to use their professional judgement about what is right for patients and we will support this by giving front-line staff more control of their working environment.
  • We will strengthen the role of the Care Quality Commission so it becomes an effective quality inspectorate [The CQC has been rocked by the revelations of one cover-up after another, involving physical and psychological abuse of clients]. We will develop Monitor into an economic regulator that will oversee aspects of access, competition and price-setting in the NHS [Monitor has been turned into the enforcer of the government’s privatisation initiative].
  • We will establish an independent NHS board to allocate resources and provide commissioning guidelines [This is NHS England, which now takes decisions that would once have been in the hands of doctors. It can intervene in the running of any CCG, forcing changes where they don’t fall into line. It rigidly enforces spending limits].
  • We will enable patients to rate hospitals and doctors according to the quality of care they received, and we will require hospitals to be open about mistakes and always tell patients if something has gone wrong.
  • We will measure our success on the health results that really matter – such as improving cancer and stroke survival rates or reducing hospital infections.
  • We will publish detailed data about the performance of healthcare providers online, so everyone will know who is providing a good service and who is falling behind.
  • We will put patients in charge of making decisions about their care, including control of their health records [Jeremy Hunt wanted to sell your health records to private companies. Although the scheme was put on hold in February 2014, it seems to be running now. Your health records may already be in the hands of private companies].
  • We will create a Cancer Drugs Fund to enable patients to access the cancer drugs their doctors think will help them, paid for using money saved by the NHS through our pledge to stop the rise in Employer National Insurance contributions from April 2011.
  • We will reform NICE and move to a system of value-based pricing, so that all patients can access the drugs and treatments their doctors think they need.
  • We will introduce a new dentistry contract that will focus on achieving good dental health and increasing access to NHS dentistry, with an additional focus on the oral health of schoolchildren.
  • We will provide £10 million a year beyond 2011 from within the budget of the Department of Health to support children’s hospices in their vital work. And so that proper support for the most sick children and adults can continue in the setting of their choice, we will introduce a new per-patient funding system for all hospices and providers of palliative care.
  • We will encourage NHS organisations to work better with their local police forces to clamp down on anyone who is aggressive and abusive to staff.
  • We are committed to the continuous improvement of the quality of services to patients, and to achieving this through much greater involvement of independent and voluntary providers [Fail. The introduction of independent (read: private companies) and voluntary providers has been a costly disaster].
  • We will give every patient the power to choose any healthcare provider that meets NHS standards, within NHS prices. This includes independent, voluntary and community sector providers [Not true. The patient never has a choice].

The comments (in bold, above) relate only to a few of the calamities that have been forced on the NHS by the Coalition government (you may be aware of others) – and it is important to add that these took place only in England, where the Coalition has control. Health in Scotland, Wales and Northern Ireland is a devolved responsibility but the Tories and Liberal Democrats have tried to influence the provision of services by restricting the amount of money available to the other countries of the UK.

In addition, fears are high that the proposed Transatlantic Trade and Investment Partnership between the European Union and the United States of America will “lock in” the privatisation of health services, as corporations will be allowed to sue national governments if they impose changes that would affect a company’s profits. These claims have been rubbished by the European Commission and Tory ministers – but they would, wouldn’t they?

In summary: The last four and a half years have witnessed a sustained attack on the National Health Service in the United Kingdom, by a government that won most of its votes on a claim that it would protect and strengthen that organisation. It was a lie that has caused misery for millions – and is likely to have cost many, many lives.

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Do parents even know their children’s school data has been given away?

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Fellow blogger and Vox Political reader Owen Boswarva has delivered frightening proof of the way parents have been sidelined by Michael Gove’s Department for Education, in order to give away – not even sell – confidential information about our children to private companies.

Mr Boswarva said he had written a blog post about the issue last year, in which he stated his concern about “the low profile of DfE’s NPD initiative. Most of the consultation responses are from organisations with an interest in re-using the data, leavened by some cautionary advice from civil society groups. There are only a couple of responses from schools and a half-dozen or so responses from individual parents (consistently opposed to the proposals).” [Emphasis mine]

“There appears to have been no concerted effort to bring the consultation or the NPD initiative to the attention of parents or pupils (i.e. the data subjects themselves). This is a quote from one of the parents who did respond: ‘I am shocked and appalled that I wasn’t notified about this consultation through my child’s school — I read about it on Twitter of all things. A letter should have gone to every single parent explaining the proposals and how to respond to this consultation.’

“(Now imagine that sentiment amplified via Mumsnet …)”

His full article is available here and makes absorbing reading as it features all of the responses to what the DfE (laughably) called its “consultation”.

In his comment to VP, Mr Boswarva wrote: “Some civil liberties organisations (including Big Brother Watch) did respond to the DfE consultation… The implemented access regime is not quite as bad as the original proposals, but I agree we should be concerned.

“For me the main issue is that parents (and pupils themselves, who are the actual data subjects) are unaware of how the personal data is being shared with third-party organisations.

“There was no press release or any other broad communication to the public when access to NPD data was expanded. (It’s worth noting that most of the broadsheets [newspapers] have been given access to Tier 2 pupil data themselves, so they are probably not keen to rock the boat.)

“If you want to get into the detail of what DfE is up to with the NPD, try this Deloitte report: National Pupil Database: Exploiting the benefits of releasing the data.”

I have yet to do so (time being against me) but I invite any readers with an interest to download the report, go through it, and report your findings.

I’m off to find a contact address for Mumsnet.

Addendum: I’ve amended this article after Mr Boswarva contacted me to point out that the DfE isn’t, in fact, selling pupil information – the department is giving it away for free. In my opinion this makes its actions even worse. What do you think? (Thanks are due to Mr Boswarva, whose full communication should appear in the comment column below.)

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School pupils’ details are being given away by the government

Selling their future: Michael Gove's Department for Education has put pupils' confidential information up for sale.

Selling their future: Michael Gove’s Department for Education has put pupils’ confidential information up for sale.

Thanks are due to the Vox Political reader who flagged up the fact that, while plans to sell British citizens’ health records and tax details are currently delayed or in consideration, confidential information about our children is already being passed on to private companies.

Researchers and third-party organisations can apply for detailed information from the national pupil database (NPD), covering pupils at schools and colleges in England.

This includes test and exam results, details of prior attainment and progression at different key stages for pupils in the state sector, attainment data for students in non-maintained special schools, sixth-form and further education colleges, and information on pupils in independent schools, where available.

The database also includes information about pupils’ characteristics, such as gender, ethnicity, first language, eligibility for free school meals, special educational needs (SEN), and pupil absence and exclusions.

Why would anyone want to use such information commercially?

Extracts of this data are available for use by any organisation or person who, “for the purpose of promoting the education or well-being of children in England”, are conducting research or analysis, producing statistics, or providing information, advice or guidance. To whom?

The available data is arranged into ‘tiers’, as follows:

  • Tier 1 – the most sensitive personal information
  • Tier 2 – other sensitive personal information, including less sensitive versions of tier 1 data
  • Tier 3 – school-level data
  • Tier 4 – other pupil-level data, for example, attainment, absence and exclusions

Users can even request bespoke extracts, with a member of the NPD Data Request team on hand to advise on the approvals process, and whether the information requested is available.

The NPD is also linked to the further and higher education sectors, using data from the individualised learner record (ILR) and Higher Education Statistics Agency (HESA) student record.

Users can request linked information in the following combinations:

  • NPD linked to ILR data
  • NPD linked to HESA student record
  • NPD linked to both ILR and HESA
  • Individualised learner record linked to HESA student record

You will not be consulted on whether you wish to allow your child’s information to be given away.

This means a huge amount of information about your children is now available to third parties and – considering the government guidance note from which this information is drawn is almost a month old – may already have been handed over.

Confidential information on – for example – exam and test results, special educational needs, absence and exclusions, and eligibility for free school meals could have a serious impact on a pupil’s prospects in adult life, if used to inform organisations that are hiring school leavers, for example.

There are safeguards. Organisations requesting information need to demonstrate that they comply with all relevant requirements of the Data Protection Act 1998, including proving that they are registered with the Information Commissioner’s Office to process personal data or fall within an exemption, have appropriate security arrangements in place to process the data, intend to use the data only for a specified purpose, will keep the data only for a specified length of time, and will not share the data without our prior written approval.

Considering this government’s track record, how safe does that make you feel?

If you want to read the guidance note yourself, it may be found here.

Addendum: I’ve amended this article after Owen Boswarva contacted me to point out that the DfE isn’t, in fact, selling pupil information – the department is giving it away for free. In my opinion this makes its actions even worse. What do you think?

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