Monday, July 05, 2021

Start a correspondence with your MP about NHS privatisation

 Following on from the previous post about the evidence for NHS privatisation which ends with urging people to start a correspondence with their MP asking them to work halt and reverse privatisation of the NHS, I post below a first letter to copy, amend (MPs respond better to individualised letters) and post. You can also use this excellent website, They Work For You, to email the MP, which is helpful because it follows up on the letter to find whether the MP replies. 

The idea is to start a real correspondence, not just send one letter. Insist that they answer the questions clearly and give their honest views. If they put up counter-arguments, and you don't know how to answer, post them back here in the comments, and we will find  and supply the answers.

It helps to form a local letter-writing group, and also to visit your MP individually or in groups.

It is a good idea for your group to conduct opinion polls of people in the constituency, so that you can give the MP information about the proportion of constituents who oppose the privatisation of the NHS. I will put more info about this tactic up here in subsequent posts.

Spread the word, and good luck.


[Your address] 

…. MP

House of Commons

London SW1A 0AA

 Dear...

The NHS, which provides health care free of charge at the time of need is, as you know, very much appreciated and valued by British people, and is rightly a source of national pride. Yet since 1987 it has been the subject of an extensive series of changes designed to make it possible to sell off sections of the service. It has suffered greatly from under-funding, yet there has also been a marked increase the amount of taxpayers’ money flowing into private health care corporations. There is no reasonable doubt that the intent is to abolish the model of an NHS paid out of general taxation, and to bring in some form of insurance based, private health care model.

One thing is clear: private health care is more expensive than the universal service.  The costs of invoicing for every item used, every action carried out, the cost of administration, and the constant leaching of money to shareholders, are far greater than in the NHS model.

What I seek, as your constituent, is to clarify your position on the NHS by getting answers to the following questions:

1.      Do you accept that private health care delivery is more expensive than the NHS model?

2.      Do you unequivocally support the idea of an NHS funded out of general taxation?

Thank you for your trouble in answering these questions.

With best wishes

 .......

Monday, June 28, 2021

NHS IS BEING PRIVATISED: THE EVIDENCE


Conservative politicians always try to evade, avoid or challenge the claim that they are privatising the NHS, so here this post is setting out the evidence that the NHS is in fact being privatised as briefly and simply as possible.

Conservative ideology can be summed up in the slogan that private is good, and public is bad. 

This is based on the philosophy of individualism, which believes that politics must be based on the individual. This philosophy is contradicted by biological science, which has established beyond doubt that Homo Sapiens is a social animal.  However, their false ideology is backed up by the massive power of health corporations, especially US health corporations, who have saturated the US market, and who therefore need to expand into the UK. It is very much in their interest for the NHS to be privatised. Unfortunately, big corporations can persuade politicians to see things their way by giving donations to the Conservative Party. They can also get Cabinet Minsters on their payroll. This Mirror article lists no less than 70 MPs, mainly Conservative, who have received serious money from health corporations, or have had other connections.

In 1977, Nicholas Ridley (a Conservative Minister) wrote :

“denationalisation should not be attempted by frontal attack but by preparation for return to the private sector by stealth. We should first pass legislation to destroy the public sector monopolies. We might also need to take power to sell assets. Secondly, we should fragment the industries as far as possible and set up the units as separate profit centres” (source). 

Ridley here has given a very concise summary of the subsequent history of the NHS.


Here is a step by step record of the privatisation process:

1. In 1987, the Thatcher Government introduced the “Internal Market” in the NHS, by creating a division between purchasers of care services and providers of care services. This immediately increased additional complexity and inefficiency into the NHS, with huge amounts of administrative work needed to calculate (or estimate) the costs of everything from brain surgery to hip replacements to visiting your GP. This administrative work has imposed a serious cost burden on the NHS. In the US, around 30% of the healthcare cost is absorbed by administration.

2. Foundation Trusts were introduced by a Labour Government, which breaks the NHS down into smaller chunks which are more capable of being sold off. This was attempted in the case of Hinchingbrooke Hospital, but the experiment failed.

3. GPs have been re-organised first into fund holders, and later into consortia, amalgamating practices into larger units which are capable of being marketed. 

4. Integrated Care Systems were introduced in 2017, and are closely analogous to the US Accountable Care Organisations model. Their aim is to reduce spending. If a private partner in the ICS manages to reduce spending, it is allowed to keep the savings. This is a clear incentive to cut corners.

5. Sir Simon Stevens, CEO of NHS England, has introduced Sustainability and Transformation plans which aim to reduce NHS beds (the UK has among the lowest ratio of beds to population in the developed world), save £5 billion a year in NHS spending, and reduce the number of A&E departments in the UK from 144 to 50. Sir Simon was involved in opposition to Obamacare when he was CEO of a US healthcare corporation.

6. In the negotiations of a post-Brexit trade deal, US corporations are very keen to reduce the ability of the NHS to control drug prices. Their plans could increase the cost of drugs to the NHS by a massive £27 billion.

7. Hospitals are increasingly renting space and facilities to private health care organisations. For instance, Guy’s hospital has rented space to the Hospital Corporation of America.

8. Increasing numbers of private centres are being set up to do things like hip replacement surgery, which are simple and relatively predictable. If anything goes wrong subsequently, the NHS is expected to put things right, not the private corporation who did the operation.

The Conservative defence of privatisation

In response to accusations that they are privatising the NHS, Conservatives will say that GPs, pharmacists, dentists and opticians have always been independent sub-contractors. This is quite true, but the difference is that this arrangement was, prior to the 1980s, static, but since then, the changes that Conservatives (and to a lesser extent, Labour and LibDems) are creating is causing the private agencies’ role in the NHS to be steadily expanding. 

Tories argue that privatised medicine will be more efficient than the NHS. The opposite is true. Private provision is far more expensive because of all the accountancy: the bills and invoices applied to every item, right down to the cost of a disposable cardboard bedpan. In the US, administration costs amount to about 40% of total healthcare costs; in the UK before privatisation those costs were 6%. 

It is quite clear that medical insurance is all based on risk assessment. Insurance companies will screen off high-risk patients, leaving them to fend for themselves.

Conservatives also argue that it does not matter who owns the bricks and mortar of the place where treatment takes place, so long as the treatment is delivered. This begs the question of how the treatment is paid for, whether out of general taxation or out of the patient’s ability to pay.  

Conservatives also argue that health care costs are rising unsustainably. This is true, and is due to a number of factors, including changes in the numbers, age, and lifestyle of the population, and changes in medical technology. Rising costs of health care is a universal problem in the modern world, and the NHS is placed in the middle the range in international comparisons regarding cost. 

The answer to this problem of rising healthcare costs is to address demand management by improving the health of the people, and increasing their understanding of self-management of their health. In my 1996 book Bills of Health I calculated that about 20% of the NHS clinical budget was devoted to treating problems caused by unemployment, inequality, sub-standard housing, and pollution. 


In conclusion, there is no reasonable doubt that for the last 40 years of its 73 year history, the NHS has been subject to an insidious series of changes that will facilitate the eventual privatisation and  Americanisation of a much-valued British institution. More evidence on the privatisation can be found on the Keep Our NHS Public website here.

The fundamental reason for Government to exist is to protect the well-being of the population of the country, and ready availability of health care is an integral part of well-being. Any country where a human is denied vital healthcare because they do not have the means to pay for it a country that is simply lacking in civilisation and humanity. The process of NHS privatisation must be stopped and reversed.

This change can only be brought about by grassroots action by the British people. 


Campaigning to save the NHS

We must bring pressure not just on our MPs but also on Parliamentary candidates of all parties, demanding a clear and unambiguous commitment from them that they will work to stop and reverse the privatisation of the NHS. 

We can start by writing a letter, or rather, opening a conversation. The first response from the politician will nearly always be a bland, non-specific set of words. We must go for a long, serial correspondence, in which the MPs’ (or candidates’) responses are defined and refined until they have made a clear commitment will help save the NHS. 

This will be a long process. It will take time and effort and cooperation in local letter writing groups, and we will have to send MP responses to expert groups like Keep Our NHS Public to get their help in answering detailed points. 

This is what it takes to prevent the destruction of our much loved and much valued National Health Service.

Here is a model letter to get you started

Saturday, January 16, 2021

Zoom Meeting on the Melbourne Isolation Hood to stop spread of Covid in Hospital

 



You are invited to a  Zoom meeting on the Melbourne Isolation Hood
Time: Jan 28, 2021 09:00 London time

The Isolation Hood is designed to cut the risk that Covid-19 patients in hospital spreading the infection to fellow patients or to Nurses, Doctors and other front-line health care workers.
It does this by capturing all droplets and aerosols breathed out by the patient and drawing them through a High Efficiency Particulate Air (HEPA), where the virus is trapped and inactivated.

The Isolation Hood (also known as the McMonty Medihood) is in production in Melbourne, Australia, and 80 units are in use in six Australian cities, all within ICUs and wards.

It has been welcomed by front line health care workers, who feel more secure when the Hood is in use.

One unit has been kindly donated free of charge to the NHS by the manufacturers, Evan Evans of Melbourne, and is being installed in the renal unit of a hospital in the South West, since if patients on renal dialysis contract Covid-19 they are at risk, on account of being on immune suppressant medication.

The speaker at the Zoom meeting will be Dr Forbes McGain, a consultant anaesthetist, who developed the Medihood in collaboration with Prof Jason Monty, Professor of Engineering at the University of Melbourne. He will speak for 30 minutes, leaving plenty of time for questions.

Links

Medihood website https://medihood.com.au/

Aerosol generation relative to respiratory interventions and the effectiveness of a personal ventilation hood McGain F et al, Critical Care and Resuscitation


To Join the Zoom Meeting:
https://us02web.zoom.us/j/88053702729?pwd=c29Bb3o0bjkyMEdNYW9rdFU4VkUzdz09

Meeting ID: 880 5370 2729
Passcode: 13EuQi
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Dial by your location
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Meeting ID: 880 5370 2729
Passcode: 051523
Find your local number: https://us02web.zoom.us/u/khBTUREs5

Friday, January 01, 2021

We Can Cut the Number of Hospital Acquired Covid Infections


The virus that causes Covid-19 is spread mainly by inhaling droplets from infected people who are within two metres or less, and by aerosols of virus particles, which may persist in air for 30 minutes or more.

10-20% of hospitalised  Covid-19 cases caught the virus in hospital.

This situation can be improved with some pretty basic technology.  

The transmission risk from Covid-19 cases

People in hospitals who are known to be infected with Covid-19 are putting out droplets containing the Sars-CoV-2 in large amounts when they cough, speak and breathe , especially in the first week since symptoms began.

People with Covid who are receiving oxygen delivered via mask or cannula will be continually exhaling droplets into the hospital environment. The air in their vicinity and in their room will contain a considerable quantity of virus, both as droplets and as aerosols.

Bed coverings and the floor within a couple of metres will be hosting significant amounts of virus. This virus will feed back onto the patient, continually re-infecting them every time they breathe in, or when they touch their face after letting their hands rest on their sheets. The floors can be cleansed at frequent intervals, but the bed linen presents an infection risk to anyone who handles it.


The health and safety of health care workers needs to be protected

The air in the vicinity of the patient poses a health and safety risk to anyone who enters the room or indeed breathes air in the vicinity of the room. PPE is used to reduce this risk, but PPE does not present an impenetrable shield, and 649 healthcare workers (including 36 doctors) have died from Covid-19 contracted while giving care.

The simplest way to capture expired air is by means of a hood positioned over the head. Air will be withdrawn from the hood through a tube positioned above the head at a rate greater than 6 litres/minute, which is the volume of air that is exhaled by a human at rest. The material of the hood will be of transparent plastic that can be sterilised. This hood will produce an upward flow of air across the face, and all expired air will be safely collected.

I produced Figure 1 below with the help of a professional artist friend, (thanks Stephan Marjoram). It shows one configuration of an air management hood. In this embodiment, the hood is open, and the body of exhaled breath is managed by the flow of air. This was my concept, and is very similar to the NIOSH hood (below) but I have abandoned development in favour of the market-ready Medihood.

Figure 1