Tag Archives: monitor

Can Parliament’s bars let us know how many post-10pm drinkers catch Covid-19, please?

NOTE: Shortly after I published this story, Parliament’s bars announced that they will stop selling alcohol after 10pm. The reason?

MPs said the rules risked making Parliament look “ridiculous” to the public.

That was very much my intention when I wrote the following:

I think it’s great that Parliament has put up its own bars as testing-grounds for the effectiveness of the 10pm pub drinking curfew.

It seems the bars on the Parliamentary estate – the Members’ Dining Room, Adjournment, Smoking Room, Terrace Pavilion, Pugin Room and Members’ Tea Room are exempt as they provide a food and bar service:

A spokesperson for the House of Commons confirmed that the new restrictions on hospitality do not apply to the venues on the parliamentary estate, saying: “As catering outlets providing a workplace service for over 3,100 people working on the Estate, the current regulations on hospitality venues do not apply to Commons facilities.”

Some have said this is another example of Boris Johnson’s cronies setting one law for us and then breaking it themselves. Many of them made reference to Orwell’s Animal Farm (which may soon be banned under Gavin Williamson’s new education rules):

Others disagree with the Animal Farm reference. I haven’t read it so I’m not in a position to comment.

But I do hope that the authorities at the Parliamentary bars keep us appraised of how their brave effort to keep our democracy in alcohol goes.

They will of course be keeping details of everybody who enters, in case Covid-19 breaks out in one, several, or all of these bars.

I expect regular updates. If they show no infections, we’ll know that it is safe to open all the rest of the UK’s pubs for normal hours again. Won’t we?

Source: Parliament bars exempt from 10pm curfew | The Independent

The ‘diabetes tax’: Some patients must pay £1,200 a year for tool Theresa May said was freely available on the NHS

Theresa May: She might get her FreeStyleLibre diabetes tool on the NHS, but her government has made sure many members of the public have to pay a fortune for it.

An apparently innocent interlude in Prime Minister’s Questions has opened up a potentially-huge controversy for the Conservative government.

Labour MP Steve McCabe noted that Theresa May uses a FreeStyleLibre diabetes tool, which monitors her condition and warns her when she needs medication. He asked when it would be freely available on the National Health Service. Here’s the dialogue, from the official record of Parliamentary affairs, Hansard:

Steve McCabe (Birmingham, Selly Oak) (Lab)

“Even the Prime Minister’s fiercest critics—I believe she has a few—must be full of admiration for the way in which she manages her diabetic condition and holds down such a tough and demanding job. I understand that she benefits from a FreeStyle Libre glucose monitoring system. Wouldn’t it be nice if she did something to make that benefit available to the half a million people who are denied it because of NHS rationing? Perhaps we could call it “help for the many, not the few”. [907106]

“I thank the hon. Gentleman for his comments. I do use a FreeStyle Libre, and it is now available on the national health service, but it is not the only means of continuous glucose monitoring that is available on the NHS. Yesterday I saw a letter from a child—a young girl—who had started on the FreeStyle Libre, but, because of the hypos that she had been having, had been moved to a different glucose monitoring system. There is no one system that is right for everyone; what is important is that those systems are now available on the NHS.”

Technically, she was correct and the FreeStyleLibre is available on the NHS.

But, thanks to Tory meddling, its availability to people with diabetes is based on a postcode lottery.

You may remember that Andrew Lansley’s hated Health and Social Care Act of 2012 imposed Clinical Commissioning Groups on the NHS. These are local organisations that decide which services should be available to patients in their areas, based on the amount of money that is made available to them. The creation of CCGs was justified with a claim that GPs would serve on them – but in fact GPs are far too busy and the work seems to have devolved to businesspeople.

Unite the Union surveyed the 3,392 CCG board members in 2015 and reported that 513 were directors of private healthcare companies: 140 owned such businesses and 105 carried out external work for them. More than 400 CCG board members were shareholders in such companies.

As a result, trust in CCGs’ ability, or indeed willingness, to provide the best-quality healthcare their budgets can afford is low. It seems the bias is more likely towards offering private firms the contracts they want, in order to appease shareholders who sit on these groups.

The FreeStyleLibre – together with those who use it – appears to be a victim of this system.

While it is nominally available on the NHS, as Mrs May claimed, it is not available to huge numbers of NHS patients because the CCGs in their area simply haven’t offered to pay for it. Instead, they have to fund it themselves at a cost of £100 per month.

That’s a “Diabetes Tax”, if you like, of £1,200 per year.

This information comes from a segment of the BBC’s Politics Live that I was lucky enough to notice:

Here’s the clip the programme put up on Twitter, in which Type 1 diabetic Tessa Nejranowski destroys Mrs May’s claim:

So there you have it:

Mrs May lied to Parliament. FreeStyleLibre is not available on the NHS – at least, not everywhere in England – and where it is not, people have to pay £1,200 a year to have it privately. That’s a “diabetes tax” imposed on people with the condition by the Conservatives.

And it’s about as strong an argument as any for the dissolution of the CCGs and the repeal of the Health and Social Care Act 2012. But you’ll have to wait for a Labour government before that happens.

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Apprentice death could have been prevented – but government couldn’t be bothered

The late Cameron Minshull: This 16-year-old was killed when he was dragged into a lathe due to poor health and safety measures.

The late Cameron Minshull: This 16-year-old was killed when he was dragged into a lathe due to poor health and safety measures [Image: Daily Mirror].

Work placement providers’ duty of care for people on apprenticeships and other government-sponsored work placements is being questioned after a factory boss was jailed over the death of a 16-year-old youngster.

Cameron Minshull was dragged into a lathe because he was wearing ‘unsuitable’ ill-fitting overalls which hung from his wrists and had not been trained to use the machine, Manchester Crown Court was told.

At the time, he was being paid just £3 an hour, after being rushed into a placement by recruitment agency Lime People Training Solutions – which puts people into apprenticeships in order to get public money from the Conservative Government’s Skills Funding Agency, according to the Daily Mirror.

The factory owner was jailed for eight months and his son received a suspended four-month prison sentence after admitting health and safety offences.

But Lime People Training Solutions was let off with a £75,000 fine – equivalent to its for putting around 17 youngsters in work placements – after denying any such breaches.

This happened because the government isn’t interested in health and safety. It considers calls for proper monitoring to be over-bureaucratic and burdensome.

On the Health and Safety Executive’s website, in the page dealing with work experience, HSE chair Judith Hackett states: “Work placement arrangements are too often seen as over-bureaucratic and burdensome, putting off potential employers.”

She continues: “Employers should already be managing the risks in their workplaces and are best placed to assess whether or not they need to do anything additional for a new young person joining them.”

And she states: “Schools and colleges… should not be second-guessing employers’ risk assessments or requiring additional paperwork.”

This next part is absolutely appalling: “An appreciation of risk and how to deal with it can be one of the biggest benefits offered by a placement.”

Is this appreciation to be gained through the death of an apprentice?

Work placement organiser companies are told: “If you are advised that a particular placement is not possible due to health and safety, the person giving you that advice may well be wrong – there are very few work activities a student cannot do due to health and safety law.

“Remember that the placement provider (employer) has primary responsibility for the health and safety of the student and should be managing any significant risks.” The only step the organiser is advised to take is to talk through the work required of the apprentice/person on the work placement, and discuss relevant precautions. There is no requirement to ensure those precautions are in place.

So that’s all right then. There’s no need to worry about health and safety concerns; they are somebody else’s problem.

Employers are told: “Under health and safety law, work experience students are your employees. You treat them no differently to other young people you employ.

“Simply use your existing arrangements for assessments and management of risks to young people.”

There you have it.

There is no legal requirement for extra measures to ensure the health and safety of young people placed with employers – and nobody checks an employer’s practices to ensure they conform with legal requirements.

The death of Cameron Minshull could have been prevented – but the government couldn’t be bothered.

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Is this the kind of NHS hip replacement operation that Lord Carter thinks is too pricey?

Earlier today, Vox Political reported that Labour’s Lord Carter had claimed some hip operations were “costing more than double the amount that they should, with some expensive replacements not lasting as long as cheaper ones”.

A quick stroll through the Internet has now turned up an example of the kind of operation it is likely he meant – and, don’t be surprised, it’s by a private healthcare company.

The report is a few years old (from 2012) but there’s no reason to believe standards have improved at all. Here’s what the Daily Mail had to say about one person’s experience:

Mrs Collett had been sent to the Haslar Hospital in Portsmouth, under a contract agreed between the NHS and Netcare, a South African health company.

When she came round from the surgery, she was shocked to be told she’d suffered a third-degree burn to her foot, which was scorched almost to the bone.

But worse was to come. She was also in constant pain from her hip replacement.

Within two months, it dislocated twice.

Mrs Collett says a GP told her the prosthesis in her leg was too short and was also loose because insufficient cement had been used to fix it.

The Mail reckoned 17 per cent of hip replacements were being carried out privately in 2012. It seems doubtful that this number has fallen in the years since.

Private healthcare is now monitored by the Care Quality Commission – but that organisation has itself come under fire for failings of its own.

A report by the Centre for Health and the Public Interest, dated August 2014, states very clearly that the NHS is gambling with patients’ health every time it passes them on to the private sector:

The same requirements to report incidents do not apply to private providers as they do to the NHS, which in itself makes it hard to monitor how safe or otherwise private services are. Information about clinical negligence claims against private providers are not publicly available, as they are in the NHS.

Patients themselves have fewer rights in the private sector. Whilst there is a general requirement to operate a complaints procedure, unlike the NHS complaints procedure, those used by private providers afford no statutory rights to the complainant and there is no recourse to the Health Service Ombudsman in the case of private care. There is no statutory requirement to provide for independent advice and support with complaints which is the case with the NHS. Consequently it is much harder to hold a private provider to account.

Even taking legal action for clinical negligence against a private provider is more problematic than with the NHS, where everything is overseen by the NHS Litigation Authority. A claimant against a private provider can be faced with complications over whether it is the hospital or the individual surgeon or sub-contractor who is liable.

All too often, in addition to the patient who is harmed through no fault of their own, it is the NHS which ends up picking up the pieces (and the tab) when things go wrong in private healthcare.

Worse still, the Conservative Government is clearly complicit in this failure of care:

Bizarrely, as recently as [2014] the Government passed the Care Act, which exempted providers of privately funded care from the new criminal offence for providing false or misleading information to the regulators. As if this could only happen in a publicly run service.

So, if you’re an NHS patient sent to a private hospital for a hip replacement, you could come out in worse condition than you went in, with very little ability to gain financial redress or even to have the mistake corrected – and this is the way the government wants it.

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NHS privatisation: Are there ANY ‘qualified providers’?

zcoalitionfailNHS

Qualify v. To give eligibility.

It seems there are very few, if any ‘qualified providers’ from the private sector currently working in the English National Health Service, according to the latest issue of Private Eye (#1382, p38).

It states: “When the government decided to flog off large chunks of the NHS, it insisted that private providers must ‘qualify and register’ before being allowed to offer NHS-funded services.

“But the NHS regulator Monitor never carried out the promised ‘assurance process’ to test whether providers were suitable or not. It confirmed that it held no register of ‘any qualified providers’ and a spokesman even said it would ‘love to know where there is a list’.

“Monitor only licenses organisations that hold NHS contracts worth more than £10 million a year. This leaves the vast majority of smaller ‘alternative’ providers and non-profit businesses unchecked.

“NHS England doesn’t check them either. Not only does it not hold any list, but it has also stopped providing support to local clinical commissioning groups to enable them to check the credentials of companies that are bidding for contracts. It has closed its online ‘Any Qualified Provider Resource Centre’, along with the Supply2Health website which at least listed contracts and current providers.

“All that can be found after a determined trawl through the Care Quality Commission website is a cobbled-together list of 41 mainly small-care providers, many of which have not been inspected, leaving the issue of whether they are ‘qualified’ open to question.

“Responsibility for deciding who ‘qualifies’ to carry out NHS work falls therefore not on those who are supposed to scrutinise and regulate NHS services but on local health purchasers. As the Health and Social Care Act doesn’t define what ‘qualified’ means, health ministers have neatly opened up a postcode lottery in healthcare when certain companies may be accepted as qualified by some local commissioning groups, but not others.”

In fact, it’s worse even than that.

Clinical Commissioning Groups (CCGs) were sold to the public on the premise that they would be composed of doctors – mainly GPs. But the CCGs’ own management teams are in fact steered by private sector consultants – McKinsey, Ernst & Young, PricewaterhouseCoopers, Capita, you know the names because they belong to all the usual suspects (see NHS SOS, Jacky Davis & Raymond Tallis (editors), pp24-25). Some of these organisations provide their own healthcare services, creating an opportunity for corruption that makes utter nonsense of the assurance ‘no decision about me, without me’ made by Andrew Lansley when he was pushing the Health and Social Care Act through Parliament.

So, if you live in England and you are told you need a health service that is only offered by a private provider – you demand to see proof that they are qualified to run the service. Who checked them? To what standard? Don’t be fobbed off with an assurance that the CCG has given them the thumbs-up – ask what organisation advised the CCG. Get to the bottom of the matter.

You might find that your ‘qualified provider’ doesn’t have any qualifications at all.

And then who’s liable if your treatment goes wrong?

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Battle is joined – for the future of your NHS

n4s_nhs1

This week the Labour Party will be launching its formal defence of the National Health Service, after the Coalition government stealthily slipped a “negative resolution” to enforce privatisation onto the books before the Parliamentary recess.

The resolution, as mentioned in a previous Vox article, will force clinical commissioning groups (CCGs) in England to introduce competition to provide all services for which it is practical (in other words, almost everything), whether or not they believe it to be in the best interests of all concerned.

Its arrival means either the government lied when it gave the promise that neither the Health Secretary nor Monitor would be allowed to force health commissioners to put services out to competition, or it has decided to break firm, formal promises, written by Andrew Lansley in a letter and spoken on the record in Parliament.

Labour’s Shadow Health Secretary, Andy Burnham, has announced that the party will ‘lay prayers’ against the resolution in both Houses of Parliament, and will fight “tooth and nail” to defeat it.   He has repeated his firm, unambiguous commitment to repeal the 2012 Health and Social Care Act as a priority once Labour is back in government, and to restore the lead on the commissioning of health services to local government.

If Labour win the next General Election, he will reintroduce a preferred provider policy that will allow genuine NHS organisations to be named as the providers of choice, thus ensuring that the NHS remains, at its core, a public institution. This will restore the NHS to leadership of health service provision, alongside local government as the commissioning lead.

But by that time much irrevocable damage will have been done, so concerted interim action is needed – and it is heartening that CCGs in Haringey and Bristol are already leading the way.

In Haringey, the CCG has been persuaded by campaigning organisation 38 Degrees to adopt amendments to its constitution, ensuring that they will only invite competition to buy services where “necessary or appropriate”. Contractors/providers must be “good employers” – be reputable, meet tax and NI obligations and keep to EO legislation. Other amendments exclude companies convicted of offences, and   prohibit companies that use improper tax avoidance and off shore schemes.

That is just the start of the battle for the NHS – but it’s a good one, and an example that can be taken forward.

Haringey has accepted that there is a case for arguing that awarding tenders to private providers will cause genuinely public structures to atrophy as funds are taken out of the public health economy and turned into private profits. This would be to the long-term detriment of the NHS, meaning an award to a private bidder is worse value, even if the headline price is lower.

If you are in England and concerned about the decline that the government’s negative resolution will instigate, why not get in touch with your own local CCG, ask them to examine the actions of their colleagues in Haringey, and politely request that they go and do likewise?

Expect much more on this issue in the future. It will be published here as it becomes available.

Internet surveillance plan will extend – not create – a communications ‘police state’

Nobody should be looking forward to having Big Brother watching us through our monitors, but he’s already reading our mail and listening to our phone calls.

Government monitoring of our mail and phone messages has been going on for years, and Theresa May’s plan to monitor every UK citizen’s online activity is merely an extension of this.

It’s still an unwarranted invasion of our privacy, but when has any government ever let that stop it?

According to the BBC, the current government’s plans mean service providers will have to store details of internet use in the UK for a year, to allow police and intelligence services to access it.

It will include for the first time details of messages sent on social media, webmail, voice calls over the internet and gaming in addition to emails and phone calls.

The data includes the time, duration, originator and recipient of a communication and the location of the device from which it is made.

Hold on, did I say “for the first time” details of messages on social media?

What about the police who called on a female disability activist last week, in her home at midnight, in relation to comments she’d posted on Facebook about the Department for Work and Pensions’ cuts?

According to her account on the Pride’s Purge blog, “They told me they had come to investigate criminal activity that I was involved in on Facebook… They said complaints had been made about posts I’d made on Facebook about the Jobcentre.”

(All right, I know what you’re going to say – those posts were publicly-accessible. The point is that the police are already using social media to target people – in this case, an innocent woman)

According to Peter Fahy, Chief Constable of Greater Manchester Police, the planned legislation is “absolutely vital” in “proving associations” between criminals, and it was often possible to penetrate the top of a criminal gang by linking “foot soldiers” to those running operations.

Is this in the same way the police were able to use the postal service to target terrorist gangs? Because I’ve got a story about that.

It concerns a young man who was enjoying a play-by-mail game with other like-minded people. A war game, as it happens. They all had codenames, and made their moves by writing letters and putting them in the post (this was, clearly, before the internet).

One day, said young fellow arrived home from work (or wherever) to find his street cordoned off and a ring of armed police around it.

“What’s going on?” he asked a burly uniformed man who was armed to the teeth.

“Oh you can’t come through,” he was told. “We’ve identified a terrorist group in one of these houses and we have to get them out.”

“But I live on this street,” said our hero, innocently. “Which house is it?”

The constable told him.

“But that’s my house!” he said.

And suddenly all the guns were pointing at him.

They had reacted to a message he had sent, innocently, as part of the game. They’d had no reason to open the letter, but had done it anyway and, despite the fact that it was perfectly clear that it was part of a game, over-reacted.

What was the message?

“Ajax to Achilles: Bomb Liverpool!”

Expect further cock-ups of similar nature, pretty much as soon as the current proposals become law.