Save It Or Cure It (Part Two).

In my last post I went on at some length about the tenor of the debate taking place about the future of the NHS. I outlined a few of the reasons, as to why it has cost so much to achieve so little, as regards the outcomes that were planned but never bore fruit. Never, except in the febrile minds of those Doctors and Politicians who conjured the concept of saving the 'proles' from themselves, by constructing a paradigm of ill advised and incentivised protocols, founded in 'bad science' or even no science.

Well, I have no particular desire to save it, and I'm pretty sure curing it is a lost hope, much like attempting to cure pancreatic cancer. The odds are stacked against it. All this 'bullshit' about the "the NHS belongs to the people" is rhetoric for consumption by the public to conceal the truth about a bureaucratic organisation, that is inefficient, uncaring and dedicated to maintaining the privileged position of the medical profession, no matter how poor or dangerous they are. It lacks any humanity, treating those who are old, pregnant, those with disabilities, mental and physical, and often the injured, with callousness and at best indifference. Legions have  been sacrificed in the A&E departments, the long stay hospitals, the orthopod wards. It almost ceases to exist at weekends and holidays, except for the ill-paid and untrained nursing assistants, locum doctors and spotty FY1's and 2's. And yet it costs more and more despite this lack of care and consistent under achievement.

The scandals that have broken over the years, constantly fade from view and the NHS is consistently held up to be precious and worthy of merit despite the fact that the very existence of these appalling debacles in care indicates the lie this is. Every politician within the ranks of every party wants rid of it and they collude together to bring about it's demise and have done so since the turn of the century. The critics of reform are just 'spinning' for appearances sake. The reforms have to be done by stealth, and creeping Privatisation or 'Marketisation' are the tools. Yet this will change nothing, except of course to make it even more expensive than it is now. The same medic's will be working for Mammon as they did for God, wielding the same indifference, stupidity and sometimes open cruelty, as before.

Sentimental and complacent attitudes abound about the NHS on every side, taking no account of it's sheer inability to fulfill any of it's promises to treat people with care and with safety. On many occasions it has lied and certainly obfuscates interminably. Not only have Doctors been proven as liars they have been given a right to do so by the lack of any law that stops them (see will powells' story). The NHS and the Doctors constantly and callously reinforce prejudice's against a large parts of society who are undeserving of their venom. The overweight, those who stray beyond arbitrary and unproven limits on the consumption of fats, drink, meat, butter, salt et al. All are stigmatised, patronised, even dehumanised by the constant vilification of their lifestyles despite there being considerable evidence that following the dogma of the DoH is at least as dangerous as not doing and sometimes more so.

The Institutions of the State set up to oversee the NHS from the Complaints system, to the Health Care Commission to it's successor the Care Quality Commission have been singularly and spectacularly unable to curtail it's worst practises and expose it's failings. Quality and Care are in fact an anathema to the NHS which not only robs its patients of dignity but on a number of occasions actually takes their lives. The culprits rarely are found let alone brought to anything vaguely resembling ordure. Medicine is the only section of society where causing death does not automatically invite investigation and prosecution (well alright the Police as well).

Some may view this as extreme but if we are ever to curtail the power of Physicians and those who invest undeserved benevolence in them we need to be extreme. So let's start all over again. Right back from the basics of curing the sick and caring for those in distress and danger, to the best of your ability. Not just to the end of the shift, nights and weekends excluded, even if you do have a private clinic to get to, or you've got a speaking engagement for 'Pharma' in Berne. Give back to the patient the respect they deserve as the paymaster, and stand up and be counted on their side, instead of just taking the money.

So let us not Save It, or Cure It, just slip in the syringe driver of oblivion you are so fond of using and kill it!
Oh, and by the way, I want my money back!

For George.

Do We Save It Or Cure It?

The NHS, that is, now that the Future Forum has rendered it's report, to a somewhat baffled, bored or bemused public.

Saving it seems to be the view of the liberals (not the Liberals) who not having sampled it's wares often, (they're mainly healthy and in BUPA), but fervently do believe in it, in the sort of soft, warm and cuddly world in which they live, with their Volvo's, Labradors, wholemeal bread and 2.4 brats. Slagging off the ConDems somewhat flawed paradigm, for the NHS is almost a badge of honour among them..

The Neo-Liberals on the other hand, want to reduce it to the Purchasing Department of NHS plc, because (surprisingly) the paradigm they've constructed to prevent illness, in advance of it occurring hasn't actually worked. In truth, most of the political input to Healthcare is a 'busted flush' such as mammography, which has done nothing to reduce breast cancer incidence, and has often done more harm than good, as eminent breast Surgeon Michael Baum opined back in 2008. The position has deteriorated in the intervening years with more being spent to produce worse outcomes. And QOF (The Quality and Outcomes Framework) has assumed the mantle of a policy to keep UK 'Pharma' afloat, and reward GP's for achieving dubious surrogacy of health, than making any significant inroads into heart disease or indeed any disease of civilisation, such as Cancer, Diabetes or Stroke. In April the Kings Fund condemned it (QOF) for not having "improved health outcomes or reduced health inequalities". (please forgive me quoting from them).

Even more sadly, the health care unions have not raised the game, but generally portrayed themselves as a bunch of greedy militants, undeserving of their pensions, thus playing right into the sights of the Daily Mail assassins. When in truth the average 'coalface' worker in the NHS is poorly paid, often badly treated and gets a quite low provision in pension compared of course with the management. The 'elite' seem to be little affected by the proposed changes, and seem to move seamlessly into new roles to help forge the brighter future that we are told will be the reward for NHS reform (yeah, and the cheques in the post etc, etc).

As I have previously said the debate has sunk to a level of a 'war' between opposing armies, with Steve Field's lacklustre crew attempting to treat for an armistice, but only achieving surrender, with a few crumbs for the Dem's in the Coalition of Toff's. Little to nothing has been done to assuage the inroads made by PFI into an already 'stretched' budget. Nothing said about savings that could be made by shifting the paradigm to actually care for the sick, injured or dying, rather than medicating the population with the flawed output from 'Pharma'.

Structured targeting with science based interventions into disease, needs to be based upon evidence, not dogma and flawed or even falsified trials that pervade medical journals. Always, we are presented with a polemic by both politicians and most in health care. They will have no truck with opposition to flawed and often dangerous policies or protocols. We are patronised and vilified, lectured and harangued, always to reduce this or increase that and the net result to date has been somewhat less (health) for somewhat more (money). Just take this pill and you'll live forever (but your life will be miserable). As the funders of ... well everything, we deserve better.

Nowhere to Hide Now!

Some news today that many of us have been awaiting, often with many false dawns, I might add, but always with hope that one day, Will Powell's long and damaging campaign (for him and his family) for a statutory duty of Candour, might be over. If the Condems do this one thing, they will, leave Doctors and others in Healthcare, who lie, about their failings, even on oath, with nowhere to hide. I give below the press release from the NHS Justice Group;-

"Dear Group, and our friends the Cure the NHS campaign groups,

The news I have been anticipating for ten years is upon us all. I do apologise for the gigantic text but here it is. Please circulate to your groups as appropriate:

News release from NHS Justice Group.

Mr William Powell our Lead Campaigner on the Issue of Duty of Candour who has waged an almost single handed campaign for decades is now nearing completion of his massive effort for all of us.

“Good for us, Good for the Country and Good for the Profession”.

Here are links to his story and the unflagging support he received from Diane, aka ‘The Boss’ over those long hard fought years. They are worth looking at.

http://www.nhsjusticegroup.co.uk/photos/willdianewords.html - The Story
http://www.nhsjusticegroup.co.uk/photos/willandboss.html - The BAFTA Award
http://www.nhsjusticegroup.co.uk/photos/mrandmrspowellwords.html - The Freedom of Information Award
http://www.nhsjusticegroup.co.uk/photos/robbiewords.html  - Robbie

AvMA PRESS RELEASE For immediate release
GOVERNMENT APPLAUDED FOR INTRODUCING A "DUTY OF CANDOUR"
In its response to the NHS Future Forum report published today, the Government has finally committed itself to a Duty of Candour in healthcare - an enforceable duty to be open and honest with patients or their families when things go wrong. Although the detail of how the new duty will work is not yet known, it is described as a new contractual duty on healthcare providers. Additionally, the Government has said that it will give legal force to patients' rights in the NHS Constitution, which also covers being honest about mistakes.
Peter Walsh, Chief Executive of AvMA, said:
"This is great news - potentially the biggest breakthrough in patients' rights and patient safety since the creation of the NHS. The devil will be in the detail. The duty must be clearly set out in statute and organisations who fail to comply must be held to account. But we are extremely grateful to the Government for having listened. This new duty should be known as "Robbie's Law" in honour of Robbie Powell, the young boy who became the symbol of our campaign and whose family have done more than anyone to raise awareness for the need for change".

ENDS

Regards

George Kuchanny NHS Justice Group Webmaster."

I can add little to this, except to invite others especially Doctors, to join in my congratulations.

21st Century Health Care?

Upon arrival back at the hovel, a few days ago I perceived that the answer 'phone was flashing a message. Pulse racing with anticipation, I scrolled through the interminable menu at BT to retrieve it and lo' it was my friendly neighbourhood Health Centre, inviting me to call them to arrange a 'health check'. How sweet, how kind, that they should be so concerned about my health and well being (sic).

This same provider of Primary Care, that fails to provide any help or support for she whom I care for, in the lack of any provision of testing strips to monitor her blood glucose, will not prescribe any Colpermin for my IBS, failed to help with my severe PTSD beyond a referral to a community mental nurse for an assessment, eight weeks down the line, when I was already in such anguish that I could barely function. Never reminds us of the need to get an HBa1c test for my loves NIDDM (Type 11 Diabetes). Looks askance when I suggest a (25)OHD test for her, to ensure her levels (Vitamin D3) are improving from the appalling low level of last year. In fact unable (or unwilling) to support any of the interventions that are useful or sustaining of health, but can find time and funds to fulfill the the needs of the prospective rewards available under the Quality and Outcomes Framework, if they can undertake a number of tests (on me) that will assist in achieving the practise goals.

I gave the matter some thought, for about ten seconds and thought 'f**k 'em, why should I help them earn some extra cash when they provide no real support, for mine and my partners problems. She will not take Diabetes drugs, and prefers to control NIDDM, with diet, exercise and supplements. Yet, to ensure that this is containing the disease, which it is, we need to undertake at least two or three tests per day. The cost of the test strips is £28.00 per 50. By buying on-line I can reduce this to £21.00 per pack, but that is still £31.50 per month. Vit D3 and Omega 3 supplements plus Vit C and ALA adds at least another £20 a month. Add to that my Colpermin at £21.00 per month and before we know where we are a £100 is gone. I do get a free prescription for the rather dubious pleasure of dosing my self for Glaucoma, which I've had for 25 years, with a prostaglandin analogue. But hey, I've been paying the State for over 40years, with taxes that make my eyes water, is it not about time I got a little back? But no, if you don't take hypoglycemic agents, you don't get free strips; it's a sort of punishment perceived somewhere in the DH, that is basically saying to those who won't tread a certain path, to the wheelchair into the dialysis suite, that we won't play ball with you. This is despite the fact that all the indicators are that a 'low carb diet' is just as effective but less dangerous than the DH recommended protocols.

No, the simple truth is that the NHS and all pretty much who sail in her, have their heads stuck so far up their own backsides and that of 'Big Pharma' that not only can they not see the wood for the trees, they lost sight of the wood itself. They are not interested in outcomes, only dubious 'surrogate' markers of alleged, sometimes invented diseases. When some 'wet behind the ears' locum GP tells me that fat (not even cholesterol), could be clogging up my arteries, and cause heart disease, and that 130/60 is a high BP, I feel like strangling her with her own stethoscope. So if they want to monitor my BP and do a lipids test, and ascertain my alcohol intake, more to make the what, £136 a point for QOF (average would be about £250,000 a practise all told) than for any regard for my health. Then I could be lectured about my lifestyle, at a level about that of a 12 year old, so I could then retort that 'I wear shoes older than you and was studying biology and biochemistry before you were born' and 'you can't change the rules of human metabolism just because of the rubbish you learned by rote a med' school'. Life is too short and I need to keep my BP down (allegedly).

IFFI, GAVI, GSK and Benevolence.

Acronyms abound in the world of Medicine and Health care and these few have been in the news of late due to the statement from Andrew Witty, (current salary £2.3million) CEO of GlaxoSmithKline, that they are going to make available to the Global Alliance for Vaccines and Immunisation, their Rotovirus vaccine at  'cost price'. That is said to be £1.50 ($2.50) a dose, but they already receive 'advance market commitments' (cash up front) to develop vaccines for GAVI, so the benevolence assumed is somewhat less than the statement suggests.

My feeling is that this has little to nothing to do with the charity of 'Big Pharma' but is more likely to be linked to the need to rebuild the business of GSK, after the appalling Avandia debacle, which has wiped the last quarter profits in 2010. Witty has a plan to 'save' GSK from the decline in markets, brought about by 'Pharmas' inability to come up with any really useful drugs for some time, and the expiry of patents on some of its money spinners this year and next.

So, whilst forcing back a tear, I will move on to the infection that they are trying to prevent; Rotovirus. It is a disease of childhood generally, a type of Gastroenteritis, that responds well to simple hydration therapy and most children will have had it at least once before five. It is alleged that up to half a million deaths could be prevented by the use of a vaccine for the Type A virus, which is the one responsible for 90% of cases. These deaths mainly occur in emerging nations and this may because of poor hygiene but studies have shown that the rate of infection varies little between nations so this seems unlikely. The death rate is very low, at about 1 in 73,000 cases, provided the child is kept hydrated. This vaccine is not generally available in the UK, as a childhood vaccine.

The early vaccines used were shown to be effective but Wyeth's Rotashield, was withdrawn in 1999 after it was shown to cause serious bowel obstructions in 1 in 12000 cases. GSK produced Rotarix in 2006 which is the type being offered at this much reduced cost. This too was withdrawn in 2010 after batches were shown to be contaminated with a porcine virus but re licensed when GSK successfully persuaded the FDA that this content was 'harmless' (sic). But these problems did highlight the view held by many, that some vaccinations employed in pediatrics, are needless intrusions into the formative immune system of young children often on somewhat dubious medical grounds. We seem to feel that children should be saved from the possibility of almost any infection and are ready to dose them with myriad vaccines at very early ages, in a pursuit of this rather dubious goal. Often having an infection, so long as it is not serious or life threatening, is a better way of providing immunity than undertaking multiple vaccination protocols.

I, as many will perceive, am not a lobbyist for GSK, or indeed any of 'Big Pharma'. They have consistently failed to place patient safety at the forefront of their operations and it is said that little more than half of the supporting trials that should go on after approval, to ensure efficacy and safety, go unreported and little publicity is afforded to any information that shows a new drug to be worse than an older one. 'Picking' and 'cherry' are the words that spring to mind, or perhaps 'publication bias' would better describe it.

I would also like to throw some light upon the vehicle chosen to deliver the beneficence of the West into the Third World. IFFI (should that be 'iffy'?) is the International Finance Facility for Immunisation and is the funding vehicle for GAVI. Funds from donors are channeled into IFFI, which raises bond issues which are backed by the countries who have pledged future funding. It's a sort of Public Private Partnership, with Goldman Sachs, Deutche Bank and HSBC amongst others selling bonds which yield a return for investors. GAVI  then uses the income stream to pay 'Pharma' for it's products and research to allegedly save people from the ravages of disease in far off countries, we used to colonise. To be frank I find the structure somewhat puzzling to fathom, but Bill Gates is one of the funders, so it's has to be OK then (sic).

A conference, fronted by (call me Dave) Cameron is taking place in London on the 13th June, where he is expected to promise additional funding for GAVI. GSK and no doubt Andrew Witty will be there, although GSK's place on the GAVI board is now being handed over to Johnson & Johnson's Swiss subsiduary. Why they ever had one in the first place amazes me. Maybe that's why the bulk of the money from IFFI goes to Western 'Big Pharma', whilst the emergent drugs industry, in poorer nations, who allege they can make and sell most of the products utilised by GAVI at much lower prices, never get a look-in. All sounds like some elaborate Government sponsored 'Ponzi' scheme to me. Pretty much like the 'Private Finance Initiative' or 'Independent Sector Treatment Centres'. I notice the US will not back these 'bonds', nor are they allowed to be sold in the US, nor do they seem to contribute to the fund. Although most of the money in the fund, finds its way there anyway, because that's where 'Big Pharma' lives.

Why does misery always have to generate a profit?