Tuesday 23 February 2021

#Covidroadmap etc

Just to get it off my chest. To place my view on record :

Covid road map etc. There are some who want to speed things up - some who want to go slower. There are some who want to score political points of course and others focused on their journo careers. There are misfits pedaling conspiracy theories and arm chair experts without credible qualification. There are those keen to display their wisdom of hindsight. The vast majority I think are like me. They recognise it is a hard balance to strike. In life we have to make judgements based on character assessment. On that basis I am happy to follow the clear advice from Sir Patrick Vallence the CSA and Chris Whitty the CMO. They are highly qualified mature people who take their responsibilities very seriously. They have access to the best information to make proper judgements and I trust them to try and make the right calls to the best of their considerable ability.

Thursday 11 February 2021

#NHS reform (again!) with an article written by Allister Heath

This is a brief blog to put down a marker. I hope there will be a meaningful debate.

The backdrop.

The Tory gov't has just announced they will shortly be releasing a "white paper" setting out proposed changes in the way the NHS is organised. (White papers are policy documents produced by the Government that set out their proposals for future legislation. White Papers are often published as Command Papers and may include a draft version of a Bill that is being planned)

This is the rationale in precis form :

Health and care services will work more closely together under plans to reform the NHS in England, the government has said.

Health Secretary Matt Hancock will set out plans for a "more integrated, more innovative and responsive" NHS.

He said he wanted to target "burdensome bureaucracy".

The shake-up will see the law changed to reverse reforms of the NHS in England introduced under David Cameron in 2012.

The full white paper - which sets out the proposed future legislation - will be published later.

Ministers believe the changes will put the NHS in a better position to cope with an ageing population and a rise in people with complex health conditions.

One-in-three patients admitted to hospital as an emergency has five or more health conditions, such as diabetes, obesity or asthma, up from one-in-10 a decade ago.

Those working in the health service said many of the rules in place were time-consuming, frustrating and stressful.

Nigel Edwards, of the Nuffield Trust think tank, said the changes would be a "re-wiring behind the dashboard" and should not be too noticeable to patients.

While it was not a "magic bullet", it could help different parts of the system work more closely together, he added.


The reforms by Mr Cameron's government in 2012 saw the creation of NHS England - to run the health service - and the scrapping of primary care trusts in favour of GP-led clinical commissioning groups to organise local services.

Under the latest proposals, there will be "enhanced powers of direction for the government" to "ensure that decision makers overseeing the health system at a national level are effectively held to account".

Instead of a system that requires competitive tendering for contracts - sometimes involving private companies, the NHS and local authorities will be left to run services and told to collaborate with each other, says the draft White Paper, designed to set out proposed legislation.

There will also be more focus on GPs, hospitals and social care services working together to improve patient care.

The paper stresses that the Covid pandemic "demonstrated plainly that this broader approach to health and care is not only desirable, but essential".

This is what I want to say on this issue at this time.

 

1) In my opinion competitive tendering made sense because NHS managers (as most public services) are wasteful, not businesslike and get ripped off too easily. Encouraging them to seek out value needs to remain part of the process in my view.


2) However the tendering process is bureaucratic and time consuming and possibly taken too far. 


3) If various parts of the NHS/Social Services have their own budgets it can follow that there can be issues over who picks up the bill. This is a real problem. For instance it led to the bed blocking issue - hospital managers wanting to move elderly patients off the ward asap and social services managers not wanting to take them. (because of the impact on their respective budgets).


4) The covid emergency has shown what is possible. The need to establish Nightingale Hospitals is perhaps the best example. The gov't took charge. They cut through the red tape. A job that might have taken months even years - took just weeks.


5) It is also clearly understood that many patients need multi dimensional care and that requires barriers to be broke down and everyone working together in common purpose. What might be happening now is they are competing with each other.


SO it is legitimate that these issues are tackled and resolved but this is where the politics start. This is where so much time and energy is potentially lost. This is where petty politicking is likely to be seen at its worst. This is where we get exasperated!


To avoid my immediate exasperation I have copied and pasted an article written by Allister Heath 10/2/21 Daily Telegraph. AH's article covers the points I would wish to make but in much better prose - ha! 


Here it is :


There is a gigantic, corrosive lie at the heart of British politics, an untruth so great, so debilitating that it all but guarantees that we will remain unprepared for the next calamitous pandemic. This falsehood, propagated principally by Labour but in which the Tories have been complicit out of cowardice, is that any criticism of the NHS’s performance or administrative structure is tantamount to attacking doctors and nurses.

In this nonsensical, binary world of the Left-wing imagination, you either believe that the NHS is the best possible healthcare system, improvable only by increasing its budget, or you stand accused of hating the very people who have put their lives on the line, working night and day in ICUs, and in vaccination centres. You either worship at the altar of NHS orthodoxy, insisting that it has nothing to learn from any other country, or you are an ungrateful monster, secretly obsessed with importing America’s dystopian healthcare system into Britain.

There is no space for those of us who are in awe at the selflessness of medical professionals, who believe that NHS workers are heroic and often underpaid by international standards, who reject the insane US mish-mash and yet who believe we need to improve the way we deliver, manage and finance universal healthcare in Britain, for the good of patients, the country and medical staff.

Yet in the secular, intolerant religion propagated by Labour’s cultish fundamentalists, anything other than unconditional, total adulation of the status quo must be punishable by cancellation. The double-standards are staggering. Patriotism is generally taboo for the Left: they keep telling us how much better Europeans are at everything, from making cars to the generosity of their welfare state. Yet the NHS is the one exception, their own cricket test: to suggest that we could learn from Germany, which has suffered fewer Covid deaths, where 60 per cent of hospitals are private, where citizens choose between a hundred competing insurers, each with different healthcare plans, is to commit an act of heresy. When it comes to healthcare, Labour are nationalistic little Englanders – particularly when the party is struggling in the polls.

Take the character assassination meted out to Kristian Niemietz of the Institute of Economic Affairs think tank. His rather mild report on how healthcare systems coped with the pandemic concludes that “there is nothing special about the NHS”. It fared worse overall than many, but not all, other countries. He concludes that, when it comes to its performance relative to others, “there is no rational basis for the adulation the NHS is currently receiving, and no reason to be ‘grateful’ for the fact that we have it [rather than a different kind of health system].” This triggered a maelstrom of confected fury: Labour’s deputy leader Angela Rayner claimed he said “NHS staff don’t deserve our thanks”, a scandalous misrepresentation of what Niemietz actually argued.

But why are the Tories allowing this madness to continue? They have successfully made the NHS their own again, most spectacularly with Vote Leave’s co-opting of the health service. They ought to be spending some of this capital now: to ensure we don’t implode again come the next pandemic, Tory policy cannot just be about centralisation – including the reversal of previous reforms – and cash.

Tragically, the party seems not to fully grasp the power of its own history in this area. There is an intriguing black and white portrait hanging on the wall of Matt Hancock’s Whitehall office: it is of Henry Willink, a long-forgotten Tory MP the Conservatives ought, by rights, to be talking a lot more about. As Winston Churchill’s health minister, he is the true inventor of the NHS: it is he, rather than Labour’s Nye Bevan, who should be a household name. Willink’s white paper, a National Health Service, was published in February 1944. That plan was far superior to the version Labour eventually delivered.

In his Five Giants, Nicholas Timmins recounts how Willink’s plan backed a mixed economy for hospitals: some would be public and others private, though working for the NHS. Crucially, it was “in the most embryonic of forms... an outline of the internal market that the Conservatives finally introduced into the NHS in 1990.”

In fact, the proposal was even better than that: while municipal hospitals would be taken over by 30 or so boards, “voluntary hospitals” would have been free to contract with them for services. We would have ended up, like in Germany and other nations, with the majority of hospitals privately owned and the NHS the main purchaser; care would still have been free for patients. Willink’s overall vision was imperfect, but it was far less rigid and monolithic than what we ended up with. It would have allowed evolution over time, been far more resilient and open to private sector ideas, money and technologies, and many of today’s problems would not exist. The private-public partnership that did so well with vaccines would have been the norm, rather than an amazing exception.

Yet Bevan dismissed Willink’s brilliant compromise as “no scheme at all” when he became health secretary. He decreed that all hospitals should be nationalised, an idea occasionally floated since the Thirties but that had never been part of any government or party proposal. This was a socialist putsch by Bevan which, together with a deal he struck with the Royal Colleges, was to lock in a one-size-fits-all system almost no other nation adopted. Willink slammed the hospital nationalisations in the Commons in May 1946, warning that they “will destroy so much in this country that we value” and be a great loss to local communities, to no avail.

The other great, intolerable lie in British politics, therefore, is that the Tories have never believed in the NHS. They obviously do: they commissioned its original blueprint. But there must be more than one way to be pro-NHS and pro-universal healthcare: it is morally right to reform a system that doesn’t work as well as it could.

The conspiracy of silence, the bullying, the dissembling: all must end. We need to be able to have an honest conversation on how to improve the NHS. It could be through a Royal Commission; perhaps there could be a referendum. But Covid has shown beyond any possible doubt that change there must be, and that demagogues must no longer be able to halt it.

At this point I can feel I have contributed at least something to the debate and I can do little more. I believe in the principal of the NHS. Surely we all want what is best for the NHS to enable it to uphold its wonderful principles. For that we have to open our minds and be objective.


Wednesday 3 February 2021

#DefundtheBBC

Yesterday I came across a Facebook discussion group called " Defund the BBC ". This was for me - and joined. 

On acceptance I made the following two posts and feel better for it.

Post 1

BBC no doubt relieved when covid came along to fill the Brexit news gap. Gave their smug liberal elite journos something else to try and undermine the gov't with using wilfull negativity and anti gov't bias. The majority electorate are having none of it. BBC in freefall. The licence fee is justified as an effective way of funding the BBC's public service remit. As the BBC are no longer fulfilling that remit because they are acting as a de facto political party pushing their own agenda/manifesto - they no longer warrant the licence fee privilege and should secure their funding from those that want to support them. That is definititely not me.

Post 2 

The BBC is badly guilty of pursuing a policy of social engineering. The BBC is driven by a woke Londoncentric liberal elite exploiting the BBC's privileged position as a public service broadcaster to indoctrinate the public with their particular view of how we should think and act. This must end - it is an abuse of their remit. Defunding the BBC is the surest way forward. They can then derive their funding from their supporters - rather than from people like me who despise much of what they promulgate. They are damaging and undermining our nationhood, our history, our democracy and what we stand for.

Less than 24 hrs later the posts have had over 600 likes etc, drawn 53 supportive comments and 68 shares.

Unless the BBC makes radical editorial and programming changes the momentum is rising to end the licence fee privilege. Of course there are other reasons too - many feel the programming is just poor value compared to the increasing diverse ways of finding content and should no longer be compulsory.

I am really hoping Andrew Neil's GB News will pile further pressure on the BBC as viewers desert in their droves. Great to see Ouestion Times viewing figures plummet. It is exactly what the editors deserve as a result of their woke liberal elite bias.

BBC Declared Most Biased News Service By The British Public (thepointnews.uk)

Monday 1 February 2021

#Covidvaccinations - the row with the EU (& the Americas Cup!)

It is early Saturday morning and still lockdown. I am just back from my early morning bike ride along the seafront. It was not the usual gentle saunter. The wind was strong and blustery. What was unusual was the driving rain because it usually comes from the west or more specifically the south west. Today it was easterly. What made it worse is my gears have started to slip on my old boneshaker - so it was a hard high gear all the way. It woke me up!

I have several blogs on the go - and this blog was not one of them. It is a queue jumper - so it can only be a short one as I have set myself decorating objectives for the next few days and I am already behind - ha (as usual). 

Before I write about the vaccination row and want to just say something about the totally absorbing Americas Cup regatta being played out in New Zealand. The races take place at between 3 and 4 am UK time. Unless the British boat is sailing I would not set the alarm but quite often a wake up about 4.30 anyway. I did this morning and watched the semi final races beween Italy and the USA. If you have been following the AC you will know American Magic all but sunk 10 days ago following a spectacular capsize. They have pulled off something incredible to be racing again. However the Americans were trounced by the Italians. The Italian boat will now go through to face the unbeaten British boat in the Prada Cup final.

I just want to make a couple of observations. The British boat has a defined leader - skipper Ben Ainslie and his right hand man - the tactician Giles Scott. Both are British - and who is running the boat is clear. Both are totally committed to bringing the AC Trophy back to where it all started 170 years ago - GB.

However Italy and the USA boats have joint skippers or joint helms and on each of these boats one of the leaders is a paid recruit from another country. Jimmy Spithill the lead on the Italian boat is Australian and the American lead helm is Dean Barker - a New Zealander.

My general point is I cannot see how joint skippers / joint helms can work better under pressure than a defined skipper. It is bound to create communication and relationship issues. I also cannot understand how employing a "foreigner" on the boat as a lead (albeit a very talented one) will not detract from the momentum of a national cause.  Of course I am supporting my nations boat - Ineos. I am delighted to see we have clarity regarding leadership and that that leadership is British. I firmly believe these will be the defining factor and Ineos will beat the much improved Luna Rosa in the final ( they looked slick in the semi against American Magic but at no time were they under any sustained pressure from the under performing US boat. )

Now what I really wanted to quickly write about - the EU vaccination mess.

I will quickly summarise what has happened :

  • Many countries - and most notably the UK invested in, formed collabarations with and ordered and paid for vaccination doses - long before the vaccines were proved to work or were authorised for use.
  • This was a gamble but a gamble based on a fundamental realisation that ultimately the only way out of this pandemic is/was by vaccination and there would be a scramble for vaccinations .
  • This push for a vaccine and its manufacture required collaboration between government money and resources, research bodies and big pharma.
  • The UK have been outstanding at achieving this and have been nimble, pragmatic and decisive.
  • The EU by contrast have been the opposite - indecisive, bureaucratic and high handed with big pharma.
  • Consequently the UK have taken delivery of good supplies of vaccine and have commercial contracts in place and the EU largely haven't.
  • Now nations within the EU who were part of the 27 nation EU joint vaccination task force are asking where is our vaccines - because the British have theirs!?
  • Obviously the EU will not admit they have messed up especially when it is the UK (who has recently left the EU) that has done a better job. So what have they done?
  • They have demanded to queue jump.
  • They have threatened to impound vaccines being manufactured in the EU by big pharma rather than let big pharma fulfill their legally binding commercial contracts.
  • They have assumed the war time right to take over the manufacturing facilities themselves.
  • They announced (and then quickly backtracked) that they were going to break the Brexit agreement regarding the customs rules regading NI - effectively creating a border.
  • And perhaps the most sadly - the most pathetic - President Macron of France stated the Oxford Astra Zeneca vaccine that much of the row has been about does not work properly.There is no science behind his claim and ironically he said it on the day the EU authorities authorised its full use! I suppose he is trying to compensate for not ordering it promptly (as the Brits did) by saying it is no good. Dangerous if it was not laughable and nonsense.
So what to take out of this debacle :

The UK gov't were castigated at the time by remainer types for not joining the EU Vaccine Procurement Programme.

Labour MP Catherine West, shadow minister for Europe: the decision is “dumb and dumber” Bianca Jagger: Johnson is “endangering people’s lives” “Comedian” James Felton: how “to kill your citizens” just to stuff the EU Lib Dem Health spokesperson Munira Wilson: “it’s unforgivable”
Corbynista MP Bell Ribeiro-Addy: “yet again [the government] is putting ideology before saving lives? “Comedian” David Schneider: it’s like an episode of “”Who cares if you die as as we Brexit”. Not joining EU scheme proves “Brexit is a death cult”. James O’Brien — ad nauseam
Then there’s the abuse heaped on Kate Bingham, former head of UK’s vaccine task force at the centre of our success, just because she’s Tory MP’s wife. Pretty good case study of everyday sexism. LD “leader” ED Daley: she “must resign”. Johnson’s “dodgy cronyism” is a “disgrace”
Labour MP Zara Sultana: “Bingham must step aside” Labour Deputy Leader Angela Rayner: “This cronyism stinks” Runnymede Trust even goes to court to get her appointment declared “unlawful”. James O’Brien — ad nauseam

However Boris Johnson understood there was urgency required and he appointed an industry specialist tasked with leading our vacccination task force. He understood the EU would be bureaucratic and slow. He was right. The UK were pragmatic and nimble and look where we are now - compared to the EU.

This issue has also shown in many peoples eyes that the EU Commission are self serving bullies in the way they have conducted themselves since they came under pressure from the EU nations on lack of vaccination supply.

So where are we now ?

Well the EU leadership have just about offended and undermined everyone including all parties in Ireland and N Ireland.

They have undermined confidence in the corporate world that the EU can be relied on as a place to do business in an orderly way.

They have exphasised to Brexiteers and many remainers that the UK decision to leave the EU was undoubtably the right one and they have reunited many in the UK in common cause.

They have also shown that Boris and his team have played a blinder. It has also evidently taken some gloss off the SNP's referendum/rejoin the EU position.

That the UK is a force in life sciences.

There is evidence that many businesses have rejected project fear in the UK and can see the UK steaming ahead as an open trading nation engaged with the whole world. By contrast they can see an increasingly disparate, inward looking, self serving bureaucracy that is the EU.

As a fundamental leaver I take satisfaction in this.

However we must move on. The Johnson gov't has been firm, clear and magnanimous. It is clear to everyone that while any governments first priority is to safeguard its own citizens, vaccination only makes longterm sense in handling a pandemic if the vaccine can be rolled out worldwide. Obviously it is important to the UK that the EU countries have an effective vaccination roll out as soon as possible. To this end the UK is a world leader and I am sure will do everything it can to help including making excess vaccine available to other countries.

It is sad to see the Oxford Astra Zeneca get so much negative publicity from the EU commission - particularly as the Oxford University stipulation was Astra Zeneca must make the vaccine available at cost only to poor nations. (ie non profit making) and they have done so much great work so quickly.