More Privates on Parade

The NHS has always had an awkward relationship with doctors who also practice privately. Unlike schools, where teachers choose state or private, consultants can serve two masters simultaneously thanks to the ‘stuff their mouths with gold’ compromise agreed by health secretary Nye Bevan in 1948, to try to win around the 85% of doctors who had voted against joining the NHS in a BMA plebiscite just 5 months before the new service was due to launch. Bevan – and the consultants – preferred option was to have NHS pay beds which allowed doctors to stay ‘on site’ and not bugger off to Harley Street leaving their junior staff to fly by the seat of their pants. And it also gave private patients the benefits of NHS facilities and emergency care if their treatment went badly awry.

In the event, the creation of the NHS and the provision of universal healthcare made private practice much less popular, with fewer than 100,000 people having private medical insurance in 1950. In the sixties, it made a comeback as a company perk for rewarding workers who couldn’t be paid in cash and by 1974, 2.3 million people were covered

[…..] Read More

Whistleblowers Seldom Win

Do NHS whistleblowers have any meaningful legal protection if they take safety concerns to the media? In 2012, Edwin Jesudason –a highly regarded consultant paediatric surgeon and researcher – went to the media because he believed Alder Hey Children’s Hospital (AHCH) failed to address serious concerns about harm and risk to children, and the smearing of the mental health of a fellow surgeon-whistleblower, Mr Ahmed (Eyes passim). Jesudason hoped he would be protected by the Public Interest Disclosure Act (1998), which was introduced to protect whistleblowers after the appalling treatment of anaesthetist Steve Bolsin, who became unemployable in the NHS after exposing the Bristol heart scandal, and saving dozens of babies from brain damage and death (Eyes passim).

In July 2012, Jesudason won a temporary high court injunction with costs against AHCH, which was seeking his “no fault” dismissal after certain surgical colleagues refused to work with him. However, in trying to make the injunction permanent and to improve whistleblowing protection for other NHS staff, Jesudason lost at a second high court hearing after his union, the BMA, withdrew their legal support for him. The BMA often represents doctors on both sides in whistleblowing disputes, hardly an

[…..] Read More

Fat Kids, Fat Profits

In 1946, poor children in the UK were on average 2kg lighter than rich children at the age of 11. Today, they are 2 kg heavier, according to an analysis in The Lancet Public Health. Then and now, poorer people struggle to eat sufficient nutritious food. But now they eat an excess of cheap, sugary, salty highly-processed crap, triggering an obesity epidemic that has become the commonest cause of preventable disease and premature death, and is bringing every health service to its knees. Nearly a third of UK children aged two to 15 are overweight or obese and younger generations are becoming obese at earlier ages and staying obese for longer. So who’s to blame?

The strategy for the last 40 years has been ‘to encourage individuals to make healthy choices’ whilst giving them the wrong information and allowing the food industry to run riot. But simply blaming the food industry is too simplistic. Egged on by the pharmaceutical industry, doctors have for decades focused on the aggressive lowering of low-density lipoprotein cholesterol to reduce heart disease risk by cutting out saturated fats in the diet and prescribing statins. This in turn encouraged the food

[…..] Read More

Safety First?

The 2018 World Patient Safety, Science and Technology Summit at the ‘stunning’ 8 Northumberland Avenue in London ‘was organized with the support of the Secretary of State for Health and Social Care, the Rt. Hon. Jeremy Hunt MP’. Prices were $1000 for hospitals, healthcare organizations and committed partners that have made a formal pledge of allegiance to the Patient Safety Movement Foundation (PSMF). For ‘first time’ attendees who were ready to commit it was also $1000. For medical technology, medical product and pharmaceutical companies that have not formally affiliated with the PSMF, the price rose to $5000. The highlight of the conference is the PSMF Humanitarian Award which each year goes to the ‘patient safety leader who has made significant progress in eliminating preventable patient deaths so that we can reach our shared goal of zero by 2020.’ Step forward Jeremy Hunt, without whose support the conference would not have been possible.

Given the large number of preventable patient deaths and widespread avoidable suffering in the NHS due to insufficient capacity, unsafe staffing levels and widespread cancellations of routine care, this would seem a bold choice. True, MD would far rather have a health secretary who is

[…..] Read More

Shoot the Junior Doctor

The government’s 2015 manifesto commitment that the NHS ‘will offer you the safest and most compassionate care in the world’ has looked terminal since the winter crisis (Eyes passim) but may now have been killed off forever after the striking off by the GMC of Dr Hadiza Bawa-Garba. Health secretary Jeremy Hunt has questioned the GMC over the decision, but he too must act urgently to legislate for mandatory safe staffing and skill mix, time-limited shifts and compulsory breaks for acute and emergency NHS care – even if routine care has to be postponed as a result. A plane would be grounded without the right staff to fly it and a safe number of passengers on board. But every day in the NHS patients die because of staffing gaps and a lack of beds to cope with the demand.

Hunt talks a lot about ‘zero avoidable harm’ in the NHS and – just last week – ‘zero in-patient suicides’ but his track record on the essential safe staffing to support this is poor. The NHS provides widespread exceptional care but its recurrent weakness is that it has had, for decades, far fewer staff and beds

[…..] Read More