Just Remind Me How The Tories Will be Worse?

Later, a healthcare professional working for the private healthcare company which carries out these assessments, wrote in indicating that there was a target that the inspection team were expected to meet. Under the username rightthewrong, he wrote:

“I probably am going to get fired tommorrow for coming on this forum, but I don’t care. I have been doing these “assessments” for some time now. It’ s rubbish, draconian to say the least and it is designed to get people off the sick benefit. It is designed so that 75% of the people who apply for ESA, come hell or high water, ‘fail’ it.”

Well Duh

NHS walk-in centres near railway stations are not popular with commuters and are a waste of money, say University of Sheffield researchers.

…a study has found they are seeing as few as 30 patients a day and cost twice as much as other GP surgeries.

While they are paid for by the NHS, they are actually run by private health firms.

The Department of Health-funded evaluation found that the clinics were seeing between 33 and 101 patients a day, despite having capacity for 150 to 180 patients.

Four of the centres were in a poor location away from the beaten track, the study – reported in the British Journal of General Practice – concluded.

It was estimated that the price per attendance at the clinics was £33 compared with an estimated £13 for walk-in centres provided by the NHS.

At some centres, the cost per patient was as high as £62.

Study leader Dr Alicia O’Cathain said the results showed that walk-in centres should be provided by the NHS, rather than private companies.

And she added that they needed to be placed near where people work, rather than at train stations. “One of the problems was location, so one for example was near the train station but wasn’t on the commuter track and there were very few people who went through that way. At the start and end of the day people are in a rush, but the way that people use walk-in centres is to go in their lunchtime.”

Obama Fail

Healthcare

Hip Op & You Don’t Stop

Once again it is hip arthroplasty time! If I look back it was January ’08 when mi madre had her left hip done and as is often the case it soon became apparent the pain was not just from that naughty joint, the right needed doing too, so factor in enough recovery from first op and schedules and here we are about to embark on it again. This time it is to sunny Ysbyty Gwynedd we go for our socialised medicine. Despite occasional horror stories about the hospital (thanks internal market and outsourcing!) the surgeon seems good and me and my sister and assembled nieces will be on hand to keep things kopasetic (the theatre is ‘ring fenced’ against infection they trumpet, but then you think, erm, surely all theatres are/ should be?!?! They’re not likely to say ‘yeah the St. MRSA suite is smeared in shit, blood and pus but hey whadya gonna do? Clean it?! We’ve got management consultants to pay you know.’). Anyways, things like this require a leap of faith in society, you cannot be everything and do it all yourself (thus libertarian’s juvenile narcissism breaks down) we pay tax into a common pot, we have medical staff trained, we have hospitals, time to see if people still care enough about other people to do a good job despite the best efforts of the atomising ‘free market’ and its political & corporate shills.

Swine Flu Silver Lining

It could be worse, you could be in a backwards nation with no comprehensive health service-

The fatality rate also appears to be low. In the UK, only three people – all with significant underlying health problems – have died out of 7,447 confirmed cases. Health experts believe more people have caught swine flu but shown no symptoms. In the United States, the official figures show 27,725 Americans have contracted H1N1, with 127 deaths.

Hmm roughly what, almost a thousand percent higher fatality rate for corporate profits first system? (money- a pretty comon motive for murder I guess).

PsychoSocialism

At last a good article in the ‘meejah’on the privatising and removing of entitlement bill (also known in newspeak as the Welfare Reform Bill), HarpyMarx makes good points too and states the most pressing simple solution- ditch the bill. It is Toryism being inflicted by a nominally Labour Government. I have experience of the system as it treats us differently sane types and one subject that is avoided is the role of the PCA system in increasing stressors on suicidal people, consequently the DWP have directly played a major contributory part in suicides that could have been avoided. This is known but ignored in order to cut benefits and follow orthodox neoliberal ideology towards moving public money into private hands. As such I consider it a form of corporate manslaughter by our government and the associated corporations it contracts.

Atos Origin employ doctors to run the software tests (which cannot be peer reviewed for medical efficacy because the DWP & Atos claim ‘commercial confidentiality’) which are then adjudicated by non doctors. As such an interesting appearance of medical professionalism is presented by this, the claimant sees a doctor -albeit just clicking a mouse on a PC questionnaire- not the office based adjudicator. I think the medical profession have to ask some hard questions as to the ethics of playing a role in the current and proposed systems. However given the role of medical professionals in torture, I won’t hold my breath (no water boarding pun intended).

Harpy’s mention of Michael Moore’s Sicko is very apt, as it showed the process of corporate executives receiving bonuses and career advancement in return for denying treatment to clients that lead to the clients death but to increased profit for the corporation. The private sector’s advance into the NHS is spearheaded by the privatising of welfare and particularly its medical aspects. Just as America wakes up to the horrors of healthcare for profit (and the ruling class fight desperately to avoid a democratically majority desired national healthcare system) we are about to fall fully into the nightmare, piloted -as ever- on the least powerful, most ignored and misunderstood minorities in society. We should be saying- “I’m as mad as hell, and I’m not going to take this anymore!” (this time, pun intended).

Welfare reform will contribute to the growing problem of mental illness. The DWP is taking on the role of a therapeutic agent, claiming work will make people better against the advice of their doctors.

Welfare reforms to date are failing the needs of people with mental illness. Claimants who have “symptoms without diseases”, or mental health conditions, and who cannot demonstrate that their illness has an “objective medical pathology” will be most at risk of being denied benefits or forced to undertake inappropriate work activity.

Personal Capability Assessment claims have been assessed by Atos Origin employees with no medical training. Computerised evaluations coupled with clearance time targets have led to significant statistical error. Fifty per cent of appeals against the refusal of claims found in favour of the claimant (pdf). In 80% of these cases the problem was poor assessment of mental health problems.

DWP research shows (pdf) that Pathways to Work pilots have done little to help people with mental illness find work. Further DWP research shows that one of the main barriers to attending work-focused interviews is mental ill health (pdf). The same report also reveals that sanctions have a negative impact on people’s mental health, both for those who are already mentally ill and for others who develop anxiety or depression.

Welsh Fucking Water! (Well United Utilities)

And now… some light ranty relief:-

Here in sunny, ok rainy at present North Wales you get used to the fact that Welsh Water, the privatised water providing monopoly is incapable of providing clean fucking drinking water on a reliable basis! And here we go again-

About 70,000 households and businesses in two north Wales counties are being advised to boil their drinking water after bacteria were found in supplies. Customers in areas of Flintshire and Denbighshire supplied by the Alwen treatment works are affected.

Now this doesn’t affect me…yet, but for all those tired of this bullshit year in year out I ask- Is drinking water somehow beyond our scientific abilities? I’m sure I’ve heard of other places where amazingly you can drink the water and not get ill, ooh it must be like some futuristic dreamscape! Has the concept of potable water become an impossible riddle to even the greatest of minds?

No, it is just an impossibility to the neoliberal mind. Now enjoy the hilarious farce that is Welsh Water’s post privatisation history (thanks Conservatives!)-

Welsh Water Authority was privatised by stock market flotation in 1989, along with the other nine regional water authorities, which provided the company with a substantial cash surplus for some years, which it used to diversify in a wide range of sectors including leisure (Hotels, Fishing etc.).

Yeah that’s what I want from a water provider, a good range of hotels and a keen interest in angling. Oh no, what I meant was the other thing, what I like in a water provider is clean fucking drinking water! (I may have already mentioned that -clean fucking drinking water- but y’know repetition might make it sink in, in between the suits looking at new car brochures and second home buying).

It renamed itself Hyder in 1996 after taking over a local electricity company (SWALEC) and becoming a water and electricity multi-utility.

What could possibly go wrong, water and electricity mix so well!

However, in 1999/2000, following the windfall tax on utility profits and the 1999 Ofwat price review, Hyder got into financial difficulties which led to its breakup following a takeover battle.

Who could of foreseen their huge profits might get taxed and their business practices were so criminal Ofwat would force a change? They’re not mind readers…Oh these things took some years to happen and there were months of warning, erm…maybe they were otherwise engaged on what colour the hotels should be painted or which celebrity to advertise their fishing business, was Noel Edmonds busy, did Roger Daltrey turn them down?

Western Power Distribution purchased Hyder on 15 September 2000 with a view to acquiring its electricity distribution business, and rapidly sold off Hyder’s other assets. Welsh Water was sold by WPD to Glas Cymru for £1,

A pound? That explains it, they found a babbling tramp in a Cardiff street and swapped the company for a half can of special brew. Wait they didn’t? So what can explain it? Neoliberal MBA managerialism that couldn’t organise a piss up in a brewery? Financiers who make money with every transaction regardless of the consequences to those who actually use the service? Like that could ever go wrong, CDO’s all round!

along with £1.85 billion of Hyder debt. Under the terms of its licence Glas Cymru may not operate in sectors other than water.

Imagine, a water providing monopoly actually dedicated to providing water and not using its monopoly (which makes it an industry manifestly unsuitable for privatisation even free market theoreticians could figure that out… or not apparently). But as it’s a monopoly, how about we own it (y’know, like we did), so it runs at cost and no one exploits the need for the most essential substance for life on planet Earth- water.

Dŵr Cymru / Welsh Water (Dŵr Cymru means Welsh Water in Welsh) is owned by Glas Cymru, a company limited by guarantee. Most of Welsh Water’s activities are outsourced to other companies.

So really Welsh Water is a contracting body which passes on the work and …the responsibility?

KWS Wales operate waste water in the south and United Utilities operate clean water for the whole of Wales and waste water in the north.

Hey here’s an idea, keep the two separate! There you can have that for free, you see maybe your consultants haven’t told you this but sewage and drinking water…not the same thing, m’kay? But what was that again?

clean water for the whole of Wales.

Whoa there- United Utilities operate clean water for the whole of Wales– they do? Can we have some of this clean water? Where can you get it? Because it certainly doesn’t come out of the fucking taps!

Those Filthy Communists At Oxfam & Their Evil ‘Facts’

Government-provided healthcare is weak in many countries, but it is more effective to improve public health than to turn to private care, the report states. Evidence shows that making the public health sector work “is the only proven route to achieving universal and equitable healthcare”.

A growing number of international donors are promoting an expansion of private-sector health-care delivery to fulfil this goal. The private sector can play a role in health care. But this paper shows there is an urgent need to reassess the arguments used in favour of scaling-up private-sector provision in poor countries. The evidence shows that prioritising this approach is extremely unlikely to deliver health for poor people. Governments and rich country donors must strengthen state capacities to regulate and focus on the rapid expansion of free publicly provided health care, a proven way to save millions of lives worldwide.

For over two decades, the World Bank advocated a solution based on investment and growth of the private health-care sector. Decrying the failure of public health services in poor countries, failure in which the Bank’s enforced public sector spending cuts and widescale restructuring have played a significant role, the argument was that the private sector could do a better job. Although in recent years the World Bank has acknowledged the key role of the government in health care, this is largely as a regulator and ‘steward’ rather than as a provider of services.

Despite the poor performance of private sector-led solutions, there has been a noticeable increase in efforts in recent months by a number of donors and influential organisations, to encourage and fund an expansion of health care by the private sector. The idea is that those who can afford it should buy their own health care in the private sector and governments should contract private providers to serve those who can’t. The approach is promoted not only as a matter of ‘common sense’ but as essential to reverse the lack of progress in health care and to save the lives of poor people.

This paper examines the arguments made in favour of increased private for-profit provision of health services as a means of scaling-up to achieve health care for all. It finds the evidence in favour of private-sector solutions is weak. On the contrary, there is considerable and increasing evidence that there are serious failings inherent in private provision which make it a very risky and costly path to take. All too often these risks are not taken into account.

At the same time, a growing body of international research reaffirms that despite their serious problems in many countries, publicly financed and delivered services continue to dominate in higher performing, more equitable health systems.

[Link to full paper] And indeed support the poor benighted Americans and their struggle to replace their third world health care- Thursday, February 12, Is National Call In Day for Single Payer Healthcare

Back In The W-NHS!

Today was emergency scrambling around back and forth to Salford (6hrs) and 4 hours in casualty (on 3hrs sleep for almost all of us in one way or another) with sis and niece number one who had sustained a complex knee & leg injury while ‘cheerleading’ at ‘university’ (young people’s slang for doing crack while bear bating I’ll wager! Apparently the ‘flyer’ landed with rather more force than anticipated. Someone tell the Daily Mail to ban this filth!). Go figure.

Anyway two lots of docs in Manchester and Bangor, two lots of X-rays and a trauma conference tomorrow and the cost for this expertise…zero, well, funded by direct taxation, so slightly progressively funded single payer universal healthcare. Don’t let them take it away and my US chums do not let Obama rat you out to the corporatists on this. Viva NHS!

PS. Of course the Patslide invented by Pat Slide the famous Irish medical innovator, honest.

Publication Bias Galore!

Recent studies reveal some of how drug company money has compromised the objectivity of drug research. Psychological Medicine in November 2006 reported that drug studies funded by pharmaceutical companies show positive results for psychiatric drugs 78 percent of the time, while drug studies without pharmaceutical company funding show favorable results only 48 percent of the time. This was discovered after examining 301 articles that were published between 1992 and 2002 in the American Journal of Psychiatry, Archives of General Psychiatry, Journal of Clinical Psychiatry, and Journal of Clinical Psychopharmacology.

Also reported by Psychological Medicine was that the percentage of studies sponsored by drug companies increased from 25% in 1992 to 57% in 2002. Currently, it is increasingly rare for a drug study not to be funded by the drug’s manufacturer.

Why are so many doctors unaware of just how poorly antidepressants have actually fared in studies? The New England Journal of Medicine (January 17, 2008) reviewed both published and unpublished antidepressant studies registered with the FDA between 1987 and 2004 on twelve antidepressants, and it reported that most studies with negative results were never published in journals. While 94 percent of antidepressant studies published in journals show antidepressants to be more effective than placebos, only 51 percent of all registered studies were determined by the FDA to show antidepressants superior to placebos.

Follow the money-

• Dr. Frederick Goodwin $1.3 million from drug companies between 2000 and 2007
• Dr. Joseph Biederman & Dr. Timothy E. Wilens $1.6 million in consulting fees from drug makers from 2000 to 2007
• Dr. Charles Nemeroff of Emory University $2.8 million from drug companies between 2000 to 2007
• President-elect of the APA [American Psychiatric Association], Alan Schatzberg of Stanford University, had $4.8 million stock holdings in a drug development company and that the APA itself was heavily dependent on drug-company financing

World Aids Day

Oops, I am reminded it is/was World’s Aids Day. Religious fools still insist on abstinence programs and even fund false information against condom use as being effective. And as the bailouts show money for research into treatment could easily be found if the political will could be formed (if you like- a disease that affected elite wealth got immediate action one that kills people…nah, no biggie). So a ways to go yet, there is always struggle, so be good to one another, have fun & stay safe peeps.

Getting Sicko

Certainly the situation of people losing NHS care if they bought drugs outside of the NHS was not ideal, but…this sets off all kinds of warning signals, especially as change in US healthcare would have insurers looking for new markets as well as our own corporate predators. Capital never rests and the NHS has been a prime target since Thatcher let loose, then along comes a crisis and new profit centres are needed, wheel in the next victim.

Insurance bosses believe there is a lucrative market opening up to sell policies to NHS patients after the decision to lift the top-ups ban. Leading firms including Standard Life, AXA PPP and Bupa are looking into the implications of this week’s decision.

One firm said it could be bigger than the private medical insurance market, while analysts predicted the top-up ruling could mark a “pivotal point”. But union Unison said such developments could endanger the values of the NHS.

Health Secretary Alan Johnson announced plans on Tuesday that would mean patients would no longer lose their right to NHS care if they decided to pay privately for drugs not available on the health service.

William Laing, of Laing and Buisson, the top market analysts for the private health sector, said: “I would expect to see action in this area. It could be that the announcement is a pivotal point.”

But the manoeuvring of the insurance sector has been met by dismay from Unison, which represents a range of NHS staff, including nurses. A spokeswoman said: “Once people start taking out insurance en masse we risk losing the very essence of the NHS – a health service which is free and equal for everybody.

“It is a very slippery slope and is why we have always warned top-ups could lead to a two-tier system.”

The Duplicate Study Scam

The (sometimes annoying) Ben Goldacre on naughty big pharma-

So the ClinPsyc blog (clinpsyc.blogspot.com) has spotted that the drug company Lilly has published identical data on duloxetine – a newish antidepressant drug – twice over, in two entirely separate scientific papers.

The first article is from the January 2008 edition of the Journal of Clinical Psychiatry, a study which concludes that the “switch to duloxetine was associated with significant improvements in both emotional and painful physical symptoms of depression”. The second concluded the same thing.

ClinPsyc went through both papers and checked all the numbers in the data tables, finding that they were essentially identical. A few different subscales were reported in each paper, and the emphasis in the second is more on pain than depression, but other than that, this is identical data.

There are several reasons why this is interesting. Firstly, duplicate publication distorts a reader’s impression of how much evidence is out there. If you think there are two trials showing that something works, then obviously that’s much more impressive than if there’s just one. “Of course I prescribe it,” you can hear the doctors say. “I’ve seen two trials showing that it works.”

Read the rest at the grauniad. I took duloxetine briefly, I had such an adverse reaction I had to stop, which is of course just personal anecdotal testimony, it might work for some, but I’d rather gargle cold diarrhoea myself.

Beckley Report- Cannabis ‘Considerably’ Less Harmful Than Alcohol & Tobacco

Full report here. The Independent does a big Q&A thing, the Grauniad summarises–

This week, the respected Beckley Foundation has published the report of its global cannabis commission, compiled by an international team of acknowledged experts on the issue, and its findings make intriguing reading.

The thrust of the report, presented in the House of Lords yesterday, is that there is urgent need for a debate to move beyond the stalemate we have now reached. As the report suggests, although cannabis can have a negative impact on health, including mental health, in terms of relative harm, it is considerably less damaging than alcohol or tobacco. While there have only been two deaths worldwide attributed to cannabis, alcohol and tobacco together are responsible for an estimated 150,000 deaths per annum in the UK alone.

Yet more than half the arrests for drugs worldwide are for minor cannabis offences and, suggests the commission, the damage done by the criminalising these minor offenders, drawing them into the criminal world and using the time and resources of the justice system to do so, appears to far outweigh the medical and societal damage.

The lead author of the report, Professor Robin Room, spelled out the potential areas for discussion and the options for regulation of the drug. He was not advocating legalisation but merely asking for politicians to engage with the actual research that exists. For instance, the lowering of cannabis from a class B to a class C drug in the UK did not have the effect of increasing its use, despite the parroted claims that it would “send the wrong message”. In fact, the opposite happened, which makes the government’s current plans to reverse the reclassification even more baffling.

There is ample evidence that regulation and education work for drugs: in 1950, 80% of men smoked tobacco, now the figure is around 30%, thanks to a mixture of information, taxation and restriction. But neither the government nor the Conservative party dare to discuss the issue and only the Liberal Democrats and the Greens will address what is one of the most important issues facing us. Instead, we follow the bellicose call from across the Atlantic for a “war on drugs” as misdirected and misinformed as the “war on terror”.

Picking Your Brains- Basal Cell Carcinoma

Due to a mishandled treatment of an actinic keratosis my mother now has a Basal Cell Carcinoma. It’s not a terribly serious diagnosis but the carcinoma is on the tip of her nose thus treatment needs to take into account the cosmetic results. So far the consultant wants to do the typical slice and graft but does this take into consideration how the nose will look? There has been no option of photodynamic therapy and I am suspicious this is simply because they do not do it (maybe it’s just not suitable but maybe its new fangledness is less cheap and old school than slicing bits off). Her concern for her appearance to be considered sympathetically and factored into the treatment seems reasonable regardless of age or the off handed male demeanour of consultants. So does anyone have knowledge and/or experience of this and what treatment would best leave a nose that doesn’t result in people desperately trying not to look…but their eyes are inevitably drawn to it.