Christmas Lottery

 Politicians hate variation in healthcare. Anything that hints of a postcode lottery inevitably means bad press. Labour’s 1998 White Paper – ‘A First Class Service’ – opened with a very bold promise. ‘All patients in the National Health Service are entitled to high quality care. This should not depend on the geographic accident of where they happen to live. The Government is determined that all patients should receive a first class service. The unacceptable variations that have grown up in recent years must end.’ Thirteen years later, the NHS Atlas of Variation has found that disparities in treatment and funding across the service are as wide as ever.

There will always be some variation in the NHS. By random chance alone, some services do better than others and at any point in time, half of all doctors/ nurses/ managers will be below average. What the NHS needs to do is to ensure all services reach defined standards of quality and – given the money that has poured into the NHS – what’s most unacceptable is that this has yet to happen.

There has been a longstanding time lottery in the NHS – if you’re fortunate enough

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The NHS Gagging Wars

Several Private Eye readers have pointed out that NHS whistleblowers can only be gagged by their employers if they consent to it, and that a true whistleblower would forgo any pay-off to get their story in the public domain (Eye last). The Government argues that – under protection offered by the Public Interest Disclosure Act (PIDA) – all such gags are legally void and that whistleblowers who are persecuted for speaking up may gain unlimited damages at an employment tribunal. So what’s the problem?

Alas, the NHS at its Stalinist, bullying best uses public money and a host of dirty psychological tricks to destroy whistleblowers long before they make it to an employment tribunal (see Shoot the Messenger,  Eye 1292). And those who refuse to be gagged find any compensation swallowed up by legal fees. Consultant surgeon Ramon Niekrash was suspended from Queen Elizabeth Hospital, Woolwich for 10 weeks after raising concerns about the impact of closing a urology ward was having on patient care. The tribunal found in his favour but left him a  £160,000 legal bill.

The NHS is a monopoly employer and any employee who goes public with safety

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British Medical Journal  Published 30 November 2011

Phil Hammond, general practitioner, broadcaster, and journalist hamm82@msn.com

The UK at last follows other countries in providing the Gardasil vaccine

Health campaigning, like much of public health, can be a slow, repetitive business. The media will break a big story once and then tend to lose interest unless a fresh scandal surfaces. But to change culture, opinion, or behaviour the same message may have to be drip fed over many years. And if the story doesn’t lend itself to a cute front page photo the chance of success is remote. Genital warts will never make the headlines in the Daily Mail or indeed any other newspaper—which makes the government’s decision to switch to a multipurpose vaccine against human papillomavirus all the more remarkable.1

 The Lancet kicked off the campaign in October 2006, with an editorial titled “Should HPV vaccines be mandatory for all adolescents?”2 It argued that Gardasil, which protects against HPV types 6, 11, 16, and 18, could dramatically reduce not just the incidence of cervical cancer but unpleasant conditions such as genital warts, anal cancer, and other malignancies affecting both sexes. It concluded, “EU member states should lead by making the

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Click below to download Shoot the Messenger – How NHS whistleblowers are silenced and sacked – by Phil Hammond and Andrew Bousfield, which appeared in Private Eye Issue 1292 (8 July -22 July 2011).  Back orders are available by calling Private Eye Subs on 01795 414870. Updates to stories are available at www.medicalharm.org

Shoot the Mesenger

(Not) Warts and All

British Medical Journal  2008  

Phil Hammond

General practitioner, writer, and broadcaster

‘You’d be mad not to protect your daughter against genital warts if you can afford to.’ So advised Peter Greenhouse, a sexual health consultant inBristol, when I asked him which human papilloma virus (HPV) vaccine I should choose for my daughter. The NHS vaccination programme may have opted for the bivalent vaccine (Cervarix) to concentrate resources on preventing cervical cancer, but every doctor I’ve spoken to has chosen the quadrivalent vaccine (Gardasil) for their own daughters (and the odd off-licence son).

Genital warts genital warts are common (100,000 new cases inEnglandeach year) and they’re on the increase, particularly amongst the young (60% of warts in women occur in the 16-24 year old age group). They don’t kill you, but they can kill your sex life and in some people they can be recurrent and extensive. Health minister Dawn Primarolo claims warts are ‘preventable’ but meticulous condom usage only cuts HPV transmission by 50%. A far safer option is to vaccinate.

The NHS Choices (sic) website promotes Cervarix but doesn’t return a single hit for Gardasil. Having chosen one vaccine for

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