Sir Richard Branson’s health firm, Virgin Care, has won a £700m contract to deliver 200 types of NHS and social care services to more than 200,000 people in Bath and north-east Somerset.
The contract, which was approved on Thursday, has sparked new fears about private health firms expanding their role in the provision of publicly funded health services.
Virgin Care has been handed the contract by both Bath and North East Somerset NHS clinical commissioning group and Conservative-led Bath and North East Somerset council. It is worth £70m a year for seven years and the contract includes an option to extend it by another three years at the same price.
It means that from 1 April Virgin Care will become the prime provider of a wide range of care for adults and children. That will include everything from services for those with diabetes, dementia or who have suffered a stroke, as well as people with mental health conditions. It will also cover care of children with learning disabilities and frail, elderly people who are undergoing rehabilitation to enable them to go back to living at home safely after an operation.
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NHS campaigners warned that the history of previous privatisations of NHS services in other parts of England may mean the quality of care patients receive drops once Virgin takes over.
“This is obviously part of a big push by Virgin to dominate the supply of community health across England. The experience so far from NHS outsourcing is that companies struggle to deliver the level of service that patients need and make a profit,” said Paul Evans, co-ordinator of the NHS Support Federation, which monitors NHS contracts being awarded to firms such as Virgin.
“In too many instances outsourced healthcare has resulted in care being compromised to cuts costs. Patients need secure services that they can trust and rely on,” Evans added.
The collapse of the £725m UnitingCare contract in Cambridgeshire meant Virgin’s newly acquired contract would be the most lucrative ongoing deal for providing NHS care, he said.
Eleanor Jackson, a Labour member of Bath and North East Somerset council, told the Mirror she was “horrified” by the decision. “Make no mistake about it, what has happened here is the beginning of the privatisation of the NHS in this country. Woe betide you getting ill in this area if you are old, disabled or have learning difficulties in the next seven years. It is just a horrifying decision,” she said.
There are concerns that handing the work to Virgin Care will take important income away from the many local NHS, voluntary, charitable and housing bodies that currently provide some of the services. They include the Royal United hospitals Bath NHS foundation trust, Great Western hospitals NHS foundation trust and the Avon and Wiltshire mental health partnership NHS trust. Charities affected include Age UK’s Bath branch and the Alzheimer’s Society.
Virgin will also run the urgent care facility at Paulton community hospital, which is 12 miles from Bath, and subcontract a number of other services to other providers, including the provision of dementia and end of life care and a “hospital from home” service for recently discharged patients.
“I am pleased that we can now start the process of transferring services. Following extensive consultation with local people and a very rigorous procurement process, the CCG board is assured that Virgin Care is the right organisation to deliver the personalised and preventative care that local people have asked for,” said Dr Ian Orpen, the clinical chair of Bath and North East Somerset clinical commissioning group.
“We will be working closely with the council and our new partners, Virgin Care, over the coming months to ensure that services and staff are transferred across safely on 1 April 2017 and to minimise disruption to the care and support that people currently receive.”
Cancer is a devastating disease with roots in genetics, diet, environmental surroundings and sometimes what some see as random chaos. But another villain may also be at the helm when it comes to spreading cancer: the very ones who claim to be preventing it. Chemotherapy is a harsh treatment designed to kill both good and bad cancer cells. Extremely high cancer return percentages have led many to believe that the chemotherapy treatments spawn more cancer. Women with breast cancer commonly die from brain tumors. Were they predisposed through genetics or is chemotherapy tainted? That might be rhetorical.
The idea and concept behind chemotherapy are somewhat astounding. In all the years that it has been around, how have we had nothing else in the way of evolution? The only way to treat cancer is by destroying all our cells? Natural, holistic therapies have long been buried by large pharmaceutical companies with an interest in cancer revenue. When all things are considered, we can see why there hasn’t been much in the way of evolution.
Well, in some ways, there has been evolution. Jimmy Carter cured advanced melanoma using what is termed as, immunotherapy. With immunotherapy, the immune system is boosted in order to fight the cancer cells which wreak havoc all throughout our body and organs. Carter curing his cancer this was was, of course, a big deal. But then again, it really wasn’t. Why wasn’t it? Because publicity for logical cancer cures just don’t exist. And secondly, it has actually been around for years.
Before we get into all of that, however, let’s allow our gut instincts a moment to do its own work: Think and conclude. My intuition tells me that fighting cancer by powering up the immune system makes all the sense in the world. I’m not a doctor, but I am sure that strengthening an army with more weapons helps them defeat an enemy invader. And that’s what cancer is – an enemy invader. The current accepted, and costly method, of chemotherapy, destroys the body. It beats down the immune system, which is why patients on chemo are assigned immune boosting drugs. Does it make sense to decimate our immune system when fighting a disease? A radical might think chemo is just keeping cancer treatments in business. A radical, I said, with a smile.
In 1890, a doctor named William Coley was the first to deploy immunotherapy (a good 135 years before Jimmy Carter ever found his melanoma cure in it). Coley would try to solve a woman’s cancer first with amputation. But that failed attempt led him down a more logical, more reasonable alternative path. This was many years before chemo or radiation, so Coley had no alliances working against his seeking a greater good. The patient he performed an amputation on led him down a road to find a better solution. A more logical and practical way to cure what ails us. And so he did. An article on today’s NPR details the life, the tragedy, the events which shaped Coley’s exploration into a new frontier. And it is a mind-blowingly outstanding read.
So in the winter of 1891, William Coley the surgeon became William Coley the detective. He headed for the tenements of the Lower East Side of Manhattan where the German immigrant community lived. He knocked on door after door asking for a man named Fred Stein who had a distinctive scar across his neck. After several weeks of searching, Coley found him alive and cancer-free.
So why did Stein’s cancer go away and stay away after he got a bacterial infection? Coley speculated that the strep infection had reversed the cancer. and wondered what would happen if he tried to reproduce the effect by deliberately injecting cancer patients with bacteria.
Coley connecting the immune system’s boost mode, if you will, to a cure for cancer, is groundbreaking, but also subjugated, material. With the exception of Carter, we rarely hear anything relating a boosted, more powerful immune system to curing cancer. We live in a society which has led us to believe that chemotherapy is the only option. In fact, we often call it a cure, even though the logic of the numbers doesn’t really add up.
It was in 1884 that a migrant house-painter in New York with a recurrent, aggressive cancer behind his ear — a four-inch ‘ugly, ominous bunch of grapes’ — underwent a fourth surgery to attempt to save his life, but the cancer was so large and invasive that the wound could not even be closed after the procedure. Left with an open crater in his neck and a virtual death sentence, the unfortunate man developed a raging skin infection that itself might have ended his life precipitously in those days before antibiotics. Instead, he survived the infection and a second one, and — to the astonishment of his surgeons — the cancerous ulcer healed and the malignancy disappeared.
This strange occurrence might have been relegated to some forgotten file of medical miracles had it not been noticed by a young surgeon devastated by the death several years later of one of his own patients with a similar cancer. Searching the “literature” of that time, William S Coley was struck by the juxtaposition of infection and cancer cure in the immigrant. He began a lifelong quest for a bacterial substance he believed would cure what was thought to be incurable. While he never learned that it wasn’t the organisms but the substances the body produced to fight them that had demolished the house-painter’s sarcoma, his work — and that of a phalanx of brilliant investigators since then — has pushed the boundaries of scientific knowledge of the human immune system to a level of complexity extraordinary enough to challenge even the most scientifically sophisticated. It is to his very great credit that Stephen S. Hall, in his book, A Commotion in the Blood — Life, Death, And The Immune System, has been able to construct a clear, engaging, carefully documented chronicle of the investigations and discoveries that have begun to delineate the science underpinning such miracles, and to do so even-handedly and with great empathy for the scientists, patients and doctors involved.
As recently as the early 1970s, standard medical texts contained almost nothing about Coley or others who utilized ingenuity and innovation to try to attack cancer immunologically in the face of a paucity of scientific information about the human immune system; those same texts contained little about the genetic or molecular biology of immunity. But the potential and the perils of delving into the body’s immune regulators to find those that could be stimulated to search out and destroy cancer exploded into international consciousness in 1975, when Fortune Magazine proclaimed a “Cancer Breakthrough” on its cover and reported that NIH scientist Dr Steven A Rosenberg’s work with two such immune substances had produced results “unheard of in cancer drugs.” (They were interleukin-2 and LAK cells; the former stimulates growth and development of one important group of the body’s infection-fighting cells, and was accidentally discovered during a search for a virus that might cause leukaemia; the latter are cells fished out of a pool of mouse lymphocytes that were found to kill cancer in the test tube).
In the last 20 years, new genetics corporations have emerged, sunk into bankruptcy, and been supplanted by others as first the promise, and later the profound problems, of using interleukin-2, tumour necrosis factor, interferon and other substances wrestled from the body’s immune armamentarium rocked the medical community and jolted research machines into high gear. Reputations and fortunes have been risked and sometimes lost in pursuit of a cure for cancer. Tantalizing fragments of the immune puzzle have been pieced together, and there have been impressive cures of some advanced melanomas, sarcomas and other cancers. But the financial costs have been mind-boggling, and an even more painful price has been paid in adverse effects of the immune modulators themselves on cancer patients — debilitation, long stays in intensive care units, sometimes death.
Stephen Hall, has scrupulously documented the gains and the price. He has searched the archives, interviewed scores of scientists, sat with people who have survived their cancers and talked with those who have subsequently died. He opens windows for readers into the laboratories where this highly exacting, tedious work is done and notes the fits and quirks of the sometimes haphazard process of discovery. He makes it possible to begin to grasp the order and timing of the immunologic discoveries of the last two decades and helps to make sense of what even medical professionals have found to be an overwhelming accumulation of information — and he does so with cleverness and patience and clarity. While the efficacy of immune regulators as cancer fighters remains problematic, impressive spin-offs have contributed substantially to human welfare. Substances have been identified and produced, such as the interferon used to treat hepatitis B and C and multiple sclerosis; erythropoietin (a stimulator of red blood cell development), which treats some previously untreatable anaemias; and stimulating factors that promote the growth of new white blood cells to help fight infection in people whose white blood cells have been destroyed. Stephen Hall’s book is fascinating and, in a sense, compelling.
On behalf of courageous people with cancer who have put their lives and well-being on the line to contribute to this research, and for physicians and scientists who have struggled to develop the technology to sustain their creative imaginings, the rest of us ought to read it and understand how difficult the task has been and how profound the challenges are that remain.
The documentary about Big Sugar, from it’s early days with ties to slavery to modern times with it’s detrimental effects on the everglades and political ties. This is both part 1 and part 2. Written & Directed by: Brian McKenna, and produced by: Galafilm in 2005.
Raising Cane – A History of Big Sugar In South Florida
6,000 years ago, the Everglades were created when a receding ocean revealed a bare limestone plain that covered south Florida. Fed by heavy rainfall, subtropical plants made their home on the low nutrient soil. Rain falling across central Florida made its way to Lake Okeechobee, which frequently overflowed its southern boundaries, creating a slow moving ‘river of grass’ that once covered most of present-day Dade and Broward counties as well as the southern part of the state. As this ‘river’ slowly made its way towards Florida Bay, impurities were flushed from the water and Florida’s aquifers (large, underground limestone caves filled with fresh water) were replenished. Plants and animals thrived in this very unique ecosystem for thousands of years. Then the white man came…
The saga that is the tale of Florida’s sugar industry and its effect on the local environment is one of greed and power, of farmers and politically savvy wealthy foreigners, of bribes and Huge cattails clog the Everglade’s shady deals, all wrapped in the southern pride of the tiny town of Clewiston. It reads like the script to a Hollywood movie with no one, Democrat or Republican, being spared from ensnarement in the decade’s long legacy of abuse. Its rippling effects reach residents of both coasts, from Ft. Myers to Jensen Beach, but is primary victims remain the non-human residents of Lake Okeechobee and the long-suffering Everglades.
Of the four primary sugar-producing states, Florida is number one, accounting for half of all sugarcane acreage and generating between $1.3 and $1.6 billion in total income and over 18,000 full-time jobs. The two primary players, US Sugar and Florida Crystals, each control around 40% of Florida’s industry. But it was not always this way.
In 1920 the US government, pushed by Florida lawmakers, began ‘reclaiming’ the Everglades by dredging and building canals that drained the swamp just south of the lake. This caused Florida’s coastal population to explode and brought former General Motors magnate Charles Stewart Mott, an investor who founded U.S. Sugar in 1931. But sugar cane simply does not grow well in Florida’s climate, even after drainage and massive applications of fertilizers like phosphorus and nitrogen. As one scientist puts it “Paying lavish subsidies to produce sugar in Florida makes as much sense as creating a federal subsidy program to grow bananas in Massachusetts”. But pay the federal government does, beginning with the Sugar Act of 1934, subsidies to the tune of $180 million a year which costs the American consumer some $1.4 billion a year in higher costs for the sweet stuff.
Even with government help, however, Florida’s sugar industry remained tiny until 1959 and the Cuban Revolution. Almost overnight, all Cuban sugar was embargoed and U.S trade officials made up for the loss by offering more incentives. The Army Corps of Engineers drained even more of the Everglades, more cane was planted, and sugar began to take over south Florida, complete with politicians and the town of Clewiston wrapped around its sweet little finger. The Cuban Revolution also brought the Fanjuls.
Alfonso Fanjul was heir to the Gomez-Mena sugar empire in Cuba when Castro took power. Forced to flee, they arrived in Fl orida just as the Corps were draining more land. He and his fellow exiles bought a farm on existing land and began to expand. Today, his sons, Alfy and Pepe are the largest sugar growers in the state, with 180,000 acres. But there’s more. Even with the expansion of Florida’s sugar industry, the country still needed more sugar. The U.S. government, to protect domestic growers, assigns quotas to sugar-producing nations, the largest of which goes to the Dominican Republic. In a move that would make any hard driven capitalist proud, in 1985 the Fanjuls bought up a rival’s holdings there, allowing them to produce sugar on the cheap and making them the largest exporter of Dominican sugar. All of this after complaining about cheap labor being exploited by foreign markets.
Today, the Fanjuls are political masterminds, pouring money into both the Democrats’ and Republicans’ pockets, flying officials around in company jets, even hosting fundraisers for both parties at their posh Dominican resort, Casa de Campo. All this while snubbing everyone else, especially the press and their own workers. Their strategy is so outrageous that they have been targets for everyone from 60 Minutes to Hollywood, who presented them as villains in the 1996 movie, Striptease (based on a book of the same name by Miami born author, Carl Hiassen). But, as based on their some $500 million fortune and rank among the richest Americans (which, technically, they aren’t) it is a strategy that works.
US Sugar – their biggest rivals – meanwhile, take a different approach, virtually wrapping themselves in the American flag with their ‘down-home farmer’ image. They invite the media to every major event and woo them with sticky sweet southern hospitality. Nowhere on earth is this more evident than the town of Clewiston, a village of 6,348 residents on a narrow crescent of drained swampland within sight of Lake Okeechobee’s southern levee. In this deeply religious town, one will find monuments to Florida’s sugar history such as Sugarland Highway, Sugar Industry Appreciation Week, the Sugar Festival, the ‘Miss Sugar’ Beauty Pageant, the Taste of Sugar Country Dessert Contest and, so the black section of town can join the fun, a ‘Miss Brown Sugar’ contest.
All of this farming and fertilizing and draining were having disastrous effects on both Lake Okeechobee and the Everglades, however. The huge system of pumps, dikes and levees that the Army Corps of Engineers used to create the Everglades Agricultural Area (EAA) keeps what was once the northern part of the Everglades dry for farming. Below it, to serve as a water source for the 5 million people living on Florida’s southeast coast, lays the million-acre reservoirs known as Water Conservation Areas (the once middle part of the swamp) which is bordered by a massive north-south levee to keep the coast swamp-free. The only part of the Everglades allowed to remain natural was the southern part, created in 1947 as the Everglades National Park. In the wet summer months, excess water that would have flooded Lake Okeechobee and the EAA is drained away, some to the Water Conservation Areas (still a swamp) where it floods and drowns the wildlife there. The rest is pumped into canals connected to both the Caloosahatchee and St. Lucie rivers, sending several hundred billion gallons a year of phosphorous laden fresh water to the saltwater estuaries at the mouths of both rivers. This pollution wrecks havoc with the delicate ecosystems there, causing massive algae blooms that kill fish, oysters, crabs and tourism. Meanwhile, the Everglades National Park receives virtually no water except what is dumped there, the polluted runoff from the farms.
For many years, the sugar industry was allowed to dump its excess water wherever it wanted, either by reverse-pumping into Lake Okeechobee or allowing it to runoff into the Everglades. This water is laden with as much as 500 parts per billion of phosphorous which, when mixed into the historically low-nutrient water of the Everglades, causes native plants to die off and cattails (which love phosphorous) to grow so thickly that wading birds have no place to land and nothing to eat. In a process known as ‘eutrophication’, these plants also suck all the oxygen out of the water, killing fish. In Lake O, which is 730 square miles in size but only nine feet deep, as much as three feet of muck now covers the bottom causing one Corps official to declare it a ‘chocolate mess’. A microbiologist from Florida International University claims that a maximum of 10 parts per billion of phosphorous is a natural level.
This went on unchecked until 1988 when a young U.S. Attorney named Dexter Lehtinen, fresh from indicting Manuel Noriega, sued Florida to force it to stop big sugar from polluting the Everglades. The sugar industry responded with both guns blazing. The devil was indeed loose in south Florida.
After failing both to get the suit dismissed and discredit Lehtinen’s star expert, big sugar poured millions of dollars into the 1992 presidential campaigns. The Fanjul brothers, traditionally Republicans, split allegiances with Pepe vice-chairing the Bush-Quayle Finance Committee and Alfy hosting a $120,000 fund-raiser and serving as co-chairman for Bill Clinton’s Florida campaign. When Clinton got elected, Alfy Fanjul met with Clinton’s new interior secretary, Bruce Babbitt, and persuaded him to turn the Everglades lawsuit mess back over to the state. Now big sugar began an all-out blitzkrieg on Florida, complete with an all-star lobbying team and big money media campaign to convince voters the phosphorous problem was overblown along with thinly veiled threats that the EAA would be sold to developers if sugar was forced out.
Viola! The Everglades Forever Act, a cleanup bill so slanted in favor of big sugar (who pretty much wrote it) that leading state environmentalists refused to have their names associated with it, was signed into law by Governor Lawton Chiles in 1994. This law capped industry cleanup costs at $320 million and saddled taxpayers with the rest (some $700 million). It also set the cleanup deadline at 2003, at which point state officials, not federal scientists, would determine the allowable phosphorous level. “The Clinton Administration delivers” crowed a jubilant Alfy Fanjul. Other plans attempting to undo some of what has been done have met with similar fates.
In 1995, Republican candidates Richard Luger and Bob Dole, looking to get Florida back for the 1996 election, proposed a grower’s tax to help fund Everglades cleanup. To big sugar’s dismay, the Clinton Administration joined in, sending Al Gore to Florida promising a ‘polluter’s tax’ and, horror of horrors, to convert 100,000 acres of sugar farms back into swamp (to restore water flow from Lake Okeechobee). This led to the infamous phone call made to President Clinton on February 19, 1996 – interrupting an emotional meeting with Monica Lewinsky – in which Alfy Fanjul yelled at a sitting President. Though the White House promptly dropped the plan, thanks to a group called Save Our Everglades the tax appeared on the state ballot in 1996. This group had $13 million in funds which they used to campaign on the common sense notion that a heavily subsidized industry could afford a penny a pound tax to help fix the mess they had created.
With an astonishing $23 million in PAC money, big sugar again went to war, unleashing a $5.2 million media blitz calling the initiative ‘radical environmental extremism’ that would cost taxpayers money and jobs. They brought in Jesse Jackson to convince voters the tax was a ‘showdown between alligators and people’. They gave ‘informational tours’ to seniors, complete with a free lunch and bus ride to the cane fields. But the coup de grace was when they resorted to just plain lying, telling voters this would raise their property taxes (the tax applied only to sugar growers within the EAA). In what a Fort Lauderdale Sun Sentinel editorial called “a triumph of disinformation” the tax was defeated by a landslide.
There was also the Farm Bill of 1995 that should have, by all accounts, finally put an end to the sugar subsidy. A newly Republican Congress decided to target farm subsidies, which they considered ‘corporate welfare’. Public opinion about big sugar had swayed to anger over the environment. In May of 1995, Republican Dan Miller (from a non-sugar district in Florida) and Democrat Schumer from New York persuaded forty-seven Democrats and seventy-one Republicans to sponsor a phase-out of the sugar program and then added it to the Farm Bill. Big Sugar responded with $2 million and the usual P.R. blitz, complete with bogus reports about the price spikes of 1974 and 1980 and a deluge of scripted calls to lawmakers claiming the ‘voters’ support of the program, even professing support from churches.
Now that God had entered the picture, Congress freaked. Republican House Agricultural Chair Pat Roberts dropped the Miller-Schumer bill from the Farm Bill and forced a separate vote, which lost by five votes. Voting against the bill were its own co-sponsors. A quote from Republican Senator Larry Craig of Idaho (who received $59,602 from sugar that year) sums it up, “I ain’t no Johnny Cochran, but I can defend the sugar program”.
Big sugar attempted to extract revenge, too: when Miller returned home, he found his office picketed by growers and heard that sugar was offering $500,000 in campaign funding to anyone who would challenge him (he was reelected anyway).
Still, it isn’t all bad. The Everglades Forever Act has enjoyed some success, with phosphorus levels now down to the low 20s in some areas. The feds have joined in too, creating the Comprehensive Everglades Restoration Plan (CERP), involving multiple state and federal agencies in what is probably the ‘most complex and expensive environmental restoration program in U.S. history’. But CERP is not without controversy, either. The plan involves storing fresh water in reservoirs that will then be released into the Everglades in an attempt to mimic natural flow and the conversion of 50,000 acres of farmland. However, the reservoirs are to be blasted out of the limestone (which no one knows will work) and scientists claim that the project won’t help the park so much as boost water supplies for existing developments. In 2006, they reported that the Everglades were still ‘starved for water’. Also, President and Governor Bush gave this project to the very entity that destroyed the Everglades in the first place, The Army Corps of Engineers.
CERP has other issues, too. Federal governments’ commitment relies on the state to hold up its end of the bargain by adhering to the terms of the settled lawsuit (Everglades Forever) and clean up the pollution. While progress has been made, phosphorus levels still remain high further north in the Everglades and even the lows are not as low as was promised. So in 2003, despite opposition from both parties, Governor Bush signed a bill pushing the deadline back to 2013. Once again, sugar prevailed, and this on an agreement that they wrote themselves. The feds are not impressed and are threatening to pull out of CERP.
Receptionists quizzing patients about why they need to see their GP could be putting some sick people off visiting their surgery, a survey suggests.
Of almost 2,000 adults questioned for Cancer Research UK, four in 10 said they disliked having to discuss their ills with office staff in order to get an appointment.
Many were worried about making a fuss.
Experts say patients must be forceful and not take no for an answer if they have symptoms that need investigating.
The government says it is funding training to help receptionists learn how to be sensitive to patients’ needs.
Receptionists are the first point of contact in primary care and it is their job to decide which patients should see the GP and how urgently.
They do a vital job, but feedback from patients reveals some can be off-putting.
In the survey, the top three barriers to seeing a GP were:
- difficulty getting an appointment with a particular doctor (41.8%)
- difficulty getting an appointment at a convenient time (41.5%)
- dislike of having to speak to the GP receptionist about symptoms (39.5%)
Around a third of the patients interviewed were also concerned that they might be negatively viewed as the type of person who makes a fuss, the Journal of Public Health – which published the survey results – said.
Lead researcher Dr Jodie Moffat urged people with symptoms to “grab the bull by the horns” and seek help rather than suffer in silence.
“Don’t let yourself be put off. Make that appointment,” she said.
“Be forceful. I know that’s easier said than done. But it’s clear that a new sign or symptom, or something that has stayed or got worse over time, needs to be checked out by a GP.”
Worrying symptoms that need a medical opinion include bleeding, a persistent cough, a change in bowel habit and unexplained lumps or swellings.
‘Onus’ On Receptionists
Dr Moffat said: “If you find it hard, ask a friend or a relative to make an appointment for you. Or go online. Lots of GP surgeries now take online bookings.”
Prof Elizabeth Stokoe, from Loughborough University, recently carried out a study that listened in to the conversations of patients and GP receptionists.
She found patients often had to drive the conversation to get answers.
“The onus should be on the receptionist to provide all the information, but often it is the patient who has to push to get it.
“If they don’t push then they get no service at all or they desperately scrabble to get their voice heard.”
Dr Maureen Baker, chairwoman of the Royal College of GPs, said doctors understood that their patients would prefer to speak directly to them about their health, especially when it is something sensitive or embarrassing – but it is not always possible.
The Health-Care Survivor’s Comment
If I am ever faced with what I consider to be unnecessary questions, in this context, I have a very simple, and effective reply:
It’s about my health… I think my doctor is best qualified to help me. Thank you very much.
‘Words cannot express how miserable I was today and have been on so many occasions in the past. If anyone asked me advice on pursuing a career in nursing I would strongly advise against it. It is by far the worst decision I have ever made’
A student nurse’s post exposing the brutal realities of the nursing profession has gone viral, after they described being “soul destroyed” by exhausting work on low pay.
The nurse, who lives in Ireland and is a single parent, submitted their experience to the Facebook page ‘Support for Nurses, Midwives and Frontline Staff in Ireland’. They describe how they feel “on the brink of giving up” in the brutally honest insight to life for nurses.
The post has since gone viral, garnering more than 7,000 likes and prompting expressions of sympathy and support from around the world.
In a particularly poignant moment, they describe their struggle to hide their tears from their daughter after a difficult day at work: “I am crying now even writing this. So many times she has to see me in this state. I have just had enough.”
The nurse explains: “Words cannot express how miserable I was today and have been on so many occasions in the past. If anyone asked me advice on pursuing a career in nursing I would strongly advise against it. It is by far the worst decision I have ever made…I can barely feed my daughter and I cannot pay my car tax/ insurance, my electricity, I often stay freezing cold in the winter because I can’t afford to put the heating on.”
The full post says: “Today, yet again like so many other times, I have broken down crying wondering why the hell I bothered pursuing a degree in nursing. I am a fourth year Mental Health nurse student on my last supernumerary placement.
This morning I woke up ill, with a sore throat, blocked sinuses, a headache and to top it off I have vertigo. I contemplated phoning in sick but thought the day hospital are already short of staff and over worked. They need me.
Off I drove, rushing to try get my daughter to school (I am a lone parent) in a car I can’t afford, wondering how I am going to pay for petrol as I am already nearly out, AGAIN. Also worrying about how I am going to pay for food for the rest of the week as I only have €25 and need to buy petrol.
When I got into work I received a phone call from the only other nurse due in that day to tell me she was sick with a fever. I had only been placed in the day hospital 3 days previous and was told that day I would be left with full responsibility of approximately 20+ patients suffering from various mental health issues.
Some are acutely ill. I had very minimal knowledge and how to manage the place, in fact nearly no knowledge and I feel that amount of responsibility should not be left with a student who has never been in a day hospital.
I was to call all the clients to let them know their groups had been cancelled due to staff shortage. I find this to be so unfair to the clients as the care given to them in the day hospital is extremely important in aiding their recovery. The great work the nurses do here is so important to these people.
I never got to breakfast, have a proper lunch or wee as much as I needed to. I managed to stuff a few crackers (they’re all I can ever afford) in my mouth between phone calls which consisted mainly of trying to support people who wanted to self-harm, people who were in distress, people who needed adequate support and care from more than one student nurse who couldn’t cope with running a day hospital on her own sick, tired, hungry and needing the loo. I felt faint at one stage.
Words cannot express how miserable I was today and have been on so many occasions in the past. If anyone asked me advice on pursuing a career in nursing I would strongly advise against it. It is by far the worst decision I ever made. The HSE is shockingly understaffed and over worked.
It really hurts to know that bus drivers spend 4-6 weeks training and get paid more than a nurse after doing a gruelling 4 year degree. We are so unbelievably undervalued and we find it difficult to strike in numbers because people may actually die if we do strike as we are so short of staff. Who the hell else is going to look after the dying patients if we strike????
I did not get paid a penny for the work I did today as I am not even in my internship. Zilch. Even when I finally qualify I get paid buttons for the work I do, just like all the other nurses when they qualify.
I can barely feed my daughter and I cannot pay my car tax/insurance, my electricity, I often stay freezing cold in the winter because I can’t afford to put the heating on. I don’t buy myself any clothes, my socks are full of holes (no joke), I have a non-existent social life because I simply can’t afford to go anywhere (no exaggeration).
I am due to pay €270 for my daughter’s school books and I don’t bloody have it! I don’t get proper sleep every night because I am so anxious about money and work and so pissed off about my not so promising career choice.
I am depressed, run down and so bloody angry right now. I cried the whole way home in the car today that I could barely see the road. My daughter shouldn’t have had to comfort me when I walked in the door from work crying my eyes out, it should be me comforting her in times of need. She made me tea and wrote on the cup with chalk “It will be okay, I love you”. I am crying now even writing this. So many times she has had to see me in this state. I have just had enough.
Greenpeace UK is asking people to Sign The Petition, asking the government to start investing in renewables, instead of wasting billions on Hinkle
UK Government: Don’t Waste Billions Of £s On Nuclear Power
Update, September 2016: The government has now approved Hinkley. But you can still sign the petition and we’ll keep you posted on how we can work together to stop the nuclear plant from being built.
Government plans to build a new nuclear power station at Hinkley Point in Somerset are shaping up to be a disaster. Hinkley’s already 8 years overdue. And by the time it’s finished it’ll be the most expensive object on earth.
After the Brexit vote, Prime Minister Theresa May has announced a fresh review of Hinkley — meaning the whole project could be on the rocks.
Let’s seize this moment to pile the pressure on Theresa May and the new Chancellor Philip Hammond. A huge petition could be enough to convince them to abandon Hinkley and back cheaper, cleaner renewable power instead.
The petition is addressed to Prime Minister Theresa May and Chancellor Philip Hammond. It asks that they:
Don’t waste billions of pounds building Hinkley Point nuclear plant. Please invest government spending in renewable energy instead.
With thanks to Greenpeace UK | Visit the Greenpeace UK website, for more information.
The Health-Care Survivor’s Comment
I invite you to consider this important issue, with care, and then to join me in support of this campaign, with many thanks.
The number of medical school places will increase by 25% from 2018 under plans to make England “self-sufficient” in training doctors.
The government’s plan will see an expansion in training places from 6,000 to 7,500 a year.
Ministers believe increasing the number of home-grown doctors will be essential given the ageing population.
There is also concern it will become more difficult to recruit doctors trained abroad in the future.
About a quarter of the medical workforce is trained outside the UK, but the impact of Brexit and a global shortage of doctors could make it harder to recruit so many in the future.
Prime Minister Theresa May told the BBC: “We want to see the NHS able to recruit doctors from this country. We want to see more British doctors in the NHS.”
The increase also comes after the government has spent a year at loggerheads with junior doctors over the pressures being placed on them to fill rota gaps.
Doctor Workforce In Numbers
Doctors Working In NHS
- 25% are foreign
- 9% due to retire in next five years
- 2% more needed each year to keep up with demand
- 7-10% of posts are vacant
Source: BBC, Civitas, NHS, DoH, GMC
Life On The Frontline
Dr Daniel Bunce, 27, is in his third year of being a junior doctor after completing his medical degree. He is now working in a hospital in the south west in intensive care.
He says he got into medicine because he wanted to “care for people and make a difference”.
“It’s been difficult. There is so much pressure, particularly during winter. We just don’t have the time to spend with patients that we need to provide the care we want to because we are rushing around just trying to keep up.
“I’m now working in intensive care so the staff to patient ratios is much better than it was when I was on medical wards. But the workload is making people I work with think about whether this is something they want to do for the rest of their career.
“The increase in medical school places is a good move, but we will have to see what impact it has in hospitals in the long-term.”
Medical degrees take five years to complete, so it will be 2024 before the impact of these extra places is felt.
But Mr Hunt told the Conservative Party conference in Birmingham on Tuesday: “We need to prepare the NHS for the future, which means doing something we have never done properly before – training enough doctors.
“Currently a quarter of our doctors come from overseas. They do a fantastic job and we have been clear that we want EU nationals who are already here to stay post-Brexit.
“But is it right to import doctors from poorer countries that need them while turning away bright home graduates desperate to study medicine?”
Mr Hunt said the steps would mean that by the end of the next Parliament the health service in England would be “self-sufficient” when it comes to training doctors.
Scientists from Case Western Reserve University have identified a species of fungus that may play a key role in the development of Crohn’s disease, in a study published in the journal mBio.
“We already know that bacteria, in addition to genetic and dietary factors, play a major role in causing Crohn’s disease,” lead author Mahmoud Ghannoum said. “Essentially, patients with Crohn’s have abnormal immune responses to these bacteria, which inhabit the intestines of all people. While most researchers focus their investigations on these bacteria, few have examined the role of fungi, which are also present in everyone’s intestines.”
The study strengthens the evidence that a healthy microbiome – the billions of microorganisms that live naturally in and on the human body, particularly in the gut – plays a key role in regulating immune health and preventing inflammatory bowel disease (IBD).
‘Striking’ Differences In Microbiome
Crohn’s disease is one of the two major types of IBD, along with ulcerative colitis. IBD is characterized by inflammation of the gut producing sporadic flare-ups of intense pain, bloating, gas, cramps and alternating constipation and diarrhea.
The exact causes of IBD and its flare-ups remain poorly understood, although research suggests that there may be an autoimmune component to the disease. Crohn’s in particular also seems to have a heavily genetic component, with 20 percent of sufferers having a close relative who also has IBD.
In the new study, the researchers took fecal samples from 20 people with Crohn’s disease, 28 of their close relatives who did not have the disease, and 21 unrelated people without Crohn’s or any family history of it. They found that in people with Crohn’s disease, the bacteria E. coli and Serratia marcescens were interacting with the fungus Candida tropicalis to produce a biofilm in the gut. This film, in turn, triggered the inflammation characteristic of Crohn’s disease.
The researchers further found that relatives of Crohn’s patients had a relatively similar gut microbiome, but that the three microbial species were found in their guts in much smaller concentrations. The people with no family history of Crohn’s, however, had a completely different microbiome composition.
“Among hundreds of bacterial and fungal species inhabiting the intestines, it is telling that the three we identified were so highly correlated in Crohn’s patients,” Ghannoum said.
While he called the differences between Crohn’s families and non-Crohn’s families “striking,” he cautioned against assuming the difference to be genetic, or assuming that the microbes are the only factor causing Crohn’s.
“For example, we know that family members also share diet and environment to significant degrees,” he said.
Vitamin D for a healthy microbiome
Another known factor contributing to the risk and severity of Crohn’s disease is low blood levels of immune-regulating nutrients, particularly vitamin D.
Low levels of vitamin D have been strongly linked to risk of a variety of autoimmune diseases, and in some cases vitamin therapy has even shown promise as a natural cure.
Preliminary research supports the potential of vitamin D to play all these roles in Crohn’s disease. For instance, a study published in the Indian Journal of Medical Research in 2009 found that people with Crohn’s disease had significantly lower levels of vitamin D than healthy controls, and that the people with the lowest levels also had the most severe form of the disease.
The Abolition Of The NHS In England
15 March, 2016
On Friday, the cross party NHS Bill returned to the Commons for its second reading. The Bill was filibustered by the Conservatives, and following only 17 minutes of debate, it was adjourned. The second reading is unlikely to continue.
Most people are probably unaware of what’s happening. But increasingly the market is invading. Virgin now has over 300 NHS contracts, and an active litigation department. They have successfully prevented commissioners in Hull from allowing local GPs to run primary care services, and are facing a legal challenge from the local trust in Kent to their £128 million contract because of concerns about patient and staff safety. Meanwhile Monitor the regulator has now issued 114 private provider licences. The amount spent by local commissioners and trusts on non-NHS providers went up from £6.6 billion in 2009 to £10 billion in 2014. Industry analysts estimate the community services market to be worth £10bn-to £20bn annually. Trade unions have described “a surge in privatisation“.
Nick Clegg said in 2010 that “breaking up the NHS is exactly what you do need to do“. It’s a painful irony that this is one of the more successful things the coalition government achieved. Its 2012 Health and Social Care Act, piloted by Andrew Lansley, abolished the duties of the Secretary of State to provide and secure services in accordance with the Act, and to provide listed health services throughout England. The latter was replaced by a duty on over 200 new clinical commissioning groups to make contracts for those services for persons for whom each CCG is responsible and establishing the NHS Commissioning Board (NHS England). NHS trusts were prospectively abolished, with the intention of them all becoming NHS foundation trusts which can now receive 49% of their income from outside the NHS. “Public health” functions were created as two legal categories split between the Secretary of State and local authorities, and carved out of the NHS. Virtually compulsory contractual tendering for providing NHS services was introduced and Monitor’s role as an economic regulator was extended with functions aimed at preventing anti-competitive practices.
But the rot didn’t begin with Lansley’s Act. Ken Clarke started it in 1990 with his great split. He ended direct management of services by health authorities and created “purchasers” and “providers”, turning hospitals into ‘NHS trusts’ with borrowing powers, and their own finance, human resources and PR departments. New Labour built on that by scaling up the exorbitantly expensive Private Finance Initiative, so that for one hospital built we may be paying for two. Alan Milburn paved the way for foundation trusts, and now runs a very profitable private healthcare consultancy, while Lansley advises Bain & Company, which helps healthcare companies with their strategy.
Politicians pushing laws from which they then benefit corrode the political process, and these laws have wasted billions of pounds, year on year. The purchaser-provider split was introduced to open up the market in health services. Providers compete for patients and service income. Lawyers, accountants and management consultants are needed to administer – and challenge – the market, and they can’t do their jobs without pulling clinicians away from theirs. Quantifying the costs of a market bureaucracy is fraught with difficulty, but the costs of a market bureaucracy are significantly more than the costs of a public bureaucracy. The House of Commons Select Committee in 2010 was “appalled” that the four most senior civil servants in the Department of Health could not tell them the cost of the market.The usually-cited figures for NHS administrative costs are about 5% before the 1980s, and 14% by 2005 – whilst in the US in 2009, about 30% was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Professor Paton puts the extra cost of the NHS market at about £5 billion.
This sickening state of affairs need not continue, but it will unless Parliament passes a law to stop it. The NHS Bill aims to do this, by restoring the duty to provide and returning the NHS in England to full public ownership, as in Scotland and Wales, based on bottom-up proposals developed by current commissioners, trusts and local authorities with patients, voluntary organisations, trade unionists and academics.
The most common criticism of the Bill from those who can’t see the wood for the trees is that the last thing the NHS needs is another top-down major reorganisation. Nobody wants unnecessary disruption, but massive and expensive fragmentation and disorganisation is currently underway and this is appreciated by many who work in the NHS – hence support for the Bill from Unite and the BMA.
Over 62,000 people have signed a petition urging MPs to turn up in the Commons on Friday and to support the Bill. We wait to see whether they are worthy of our trust.
Professor Allyson Pollock and Peter Roderick
This article also appeared in Huffington Post UK
This talk was given at a local TEDx event, produced independently of the TED Conferences. The 1948 Act establishing the NHS gave the Secretary of State for Health the duty to provide universal health care.
The Health and Social Care Act 2012 removes this duty and introduces a market. Allyson Pollock describes why we need to worry.
Professor Allyson Pollock is Professor of Public Health Research & Policy at Queen Mary, University of London. She is one of the UK’s leading medical intellectuals, and undertakes research and teaching intended to assist the realisation of the principles of social justice and public health, with a particular emphasis on health systems research, trade, and pharmaceuticals.
She trained in medicine in Scotland and became a consultant in public health. Among her previous roles she has been director of the Centre for International Public Health Policy at the University of Edinburgh and director of research & development at UCL Hospitals NHS Trust. She is the author of NHS plc and co-author of The New NHS: a guide.
The Health-Care Survivor’s Comment
If you care about the NHS, and the principal of providing health care as a genuine ‘service’, free at the point of use, and available on the basis of need, then this talk, and well referenced article, by Professor Allyson Pollock, should be terrifying, and sobering in equal measure, and it should spur every one of us into action. We must defend what is left of our NHS, and fight to force our government to re-instate those of its founding principals, which have already been destroyed.