Assisted Dying

We’re all going to die, but sadly not all quickly or with dignity. The provision of good palliative care in the UK remains patchy but even with the best that palliative care has to offer, some deaths remain very protracted and distressing. As Professor Ray Tallis puts it: ‘Unbearable suffering, prolonged by medical care, and inflicted on a dying patient who wishes to die, is unequivocally a bad thing.’ MD would willingly assist such deaths were it legal to do so, but the High Court has repeatedly made it clear that any change in the laws would have to come from Parliament, and it seems unlikely that politicians will ever enact the overwhelming will of the people to have the right to exit with dignity. And so the pointless suffering continues.

One of the strongest arguments against assisted dying is whether it could be legally and practically introduced in an understaffed NHS that struggles with assisted living. If we can’t give many patients decent humane lives, what chance decent humane deaths? To counter the concern that assisted dying would become the ‘go to’ option, we would need to offer everyone excellent palliative care first, and there is

[…..] Read More

It’s still not safe to speak up in parts of the NHS – and the staff know it

The risks to the NHS of Brexit are well known. The promised extra £350 million a week to fund the service was never likely to materialise, but a staffing crisis may well do. There are currently 24000 unfilled nursing posts in England alone. The failure of government to guarantee a right of remain for the 140,000 EU nationals working in the NHS and social care system has bred further insecurity. In one survey, 42% of European health staff working here said they are now thinking of leaving the UK. Many have protested about being used as bargaining chips and almost 5,500 have left since the Brexit vote according to NHS Digital, a 25% increase on the 2015 figures. Coming in, only 96 European nurses registered to work in the UK in December, compared to 1,304 last July. Vital EU research funding streams could just disappear, as could EU collaboration on infectious disease control, licensing and regulation of medicines and public health initiatives. These risks are very real and present, yet the government’s latest mandate to NHS England made not a single mention

[…..] Read More

Virgin to sue the NHS

Following MD’s revelation that Virgin Care was cutting up rough after losing the £82 million Surrey children’s services tender (Eye last), the Health Service Journal has discovered Richard Branson’s business empire is suing NHS England, Surrey County Council and the county’s six clinical commissioning groups after commissioners awarded the three-year contract to Surrey Healthy Children and Families Services Limited Liability Partnership.
A Virgin Care spokesman told the HSJ the company had concerns about “serious flaws in the procurement process which has led to an outcome that we strongly feel is not in the best interests of the children and families we support, or our valued colleagues.” A Virgin Care whistle-blower was less convinced the company deserved to retain the contract it had held for 5 years. ‘A lot was promised by Virgin when they won the contract, but very little materialised. We all got nice phones and new computers, but the recruitment needed into developmental paediatrics didn’t happen. There was lots of branding and leadership courses, but I don’t think the care of children with special educational needs, or the support for their families, improved. For example, a key receptionist was not replaced and

[…..] Read More

Virgin Territory

According to Chief Inspector of Hospitals Prof Mike Richards, the NHS stands on a ‘burning platform’ with 11% of trusts rated inadequate by the CQC and 70% requiring improvement. Understaffing and overcrowding put patients and staff at risk every day. Meanwhile, private providers lead by Virgin Care are busy ‘conquering the community care space’ says HealthInvestor magazine. ‘A market worth around £10 billion has suddenly become a private affair…’ Virgin has already hoovered up over 400 health, social care and local authority services’ contracts, worth over £1 billion. It’s ‘quite the portfolio’ according to HealthInvestor, and other companies are lining up to conquer what’s left. ‘The chance to drink in a £9 billion pool in tantalising…’

There’s a clear underfunding and privatizing trend in NHS and Local Authority services. Between April 2013 and April 2016, 45% of the community health services that were put up for tender went to non-NHS providers. Private operators now run GP and out of hours services, walk-in centres and minor injury units, district nursing, diabetes, musculoskeletal, audiology, dermatology, physiotherapy, podiatry, rheumatology, mental health and other chronic disease services, urgent care, phlebotomy, anti-coagulation, sexual health, wheelchair services, prison healthcare, community hospitals, neuro-rehabilitation, frail and

[…..] Read More

Who wants to be Leader?

Health secretary Jeremy Hunt believes, rightly for once, that the NHS can only survive if more clinical staff become leaders. Yet most clinical staff don’t want to be lead by Jeremy Hunt or implement dangerous £22 billion austerity cuts, departmental closures and the private outsourcing policy of the government. Leading an organization where patients and staff are routinely harmed by the effects of unnecessary underfunding is a thankless task. The BBC’s week long exposure of the NHS crisis introduced us to the concept of ‘corridor nurse’ in scenes reminiscent of the nineties. Back in July, a Surrey woman died after being denied entrance to 3 hospitals and NHS England was warned of worse to come. Now many ambulance trusts aren’t able to fulfil their emergency response times, and staff are in tears in short-staffed departments that can’t cope with the demand. The service has always been glued together by goodwill but under Hunt, the goodwill has gone and staff are walking.

Under Hunt’s command, the number of junior doctors progressing directly into specialty training has fallen from 71.6% in 2011 to 50.4% in 2016, its lowest ever level (Eye last). This is sad,

[…..] Read More