Labour must put patients above dogma 30 September 2019 As the Conservatives finalised their plans to bury the most egregious parts of the NHS reforms they forced through in 2012, Labour set out its healthcare policies. The Tories look set to play it safe on the NHS in the general election, adopting proposals from NHS England to drastically reduce the role of competition, sort out the legal mess around its structures and make it easier for hospitals, GPs and community services to work together. Labour, meanwhile, is gunning for drug companies and service contractors. Speaking in the wake of drug company Vertex putting a list price of £104,000 per patient per year on the cystic fibrosis treatment Orkambi, Jeremy Corbyn promised compulsory licensing would secure generic versions of expensive patented medicines while a state-owned drug company would manufacture generics. A pharmaceutical company charging extortionate prices is a familiar story, but usually a pincer movement by regulator Nice and NHS England secures access to innovative treatments at manageable prices. The fact that Donald Trump has railed against national healthcare systems “freeloading” on American drug companies is a measure of the NHS’s success. Read the full article at Guardian Society __________________________________________________ Cheap fags are last gasp of health policy 13 September 2019 In a government gearing up for an election, where every statement is supposed to be choreographed as part of a finely tuned grid of speeches and events, it takes a particular stupidity for the chancellor, Sajid Javid, to extol the virtues of cheap cigarettes and booze just as the health and social care secretary, Matt Hancock, was heading for Public Health England’s annual conference. Having alighted upon what he regards as unequivocally good news about leaving the EU without a deal, Javid announced on Tuesday that people travelling to Europe will be able to buy alcohol and cigarettes without paying UK excise duty. Javid added chirpily that this decision “will help holidaymakers’ cash go that little bit further”, apparently oblivious to the way the pound has tanked against the euro since the referendum. It left Hancock struggling to defend the government’s commitment to end smoking by 2030 in his speech to the public health conference on Wednesday. Stocking up on whisky on your way out of the country may be an understandable reaction to the government’s inability to get your usual medication into it. Read the full article at Guardian Society __________________________________________________ Brexit frenzy wrecks financial stability 30 August 2019 As the constitutional battle intensifies, public services are becoming collateral damage. The Brexit frenzy, combined with preparations for a general election, has torpedoed the chances of any semblance of financial stability returning to government spending. The chancellor, Sajid Javid, will present a one-year public spending round on 4 September instead of planning for the usual three-year review. This will give departments short-term funding once the current spending plans come to an end in March 2020. In political terms, it will position the Conservatives for a general election and allow officials to concentrate on leaving the EU. There will be some pre-election largesse – some real, some sleight of hand – delivering the cash to honour pledges already made by the prime minister on policing, schools and the NHS. But austerity will be far from over, in terms of both the funding provided and the enduring damage caused by previous cuts. Housing, prisons, culture, and legal aid can expect little respite. The atrophying of the justice system, from funding the courts to the treatment of prisoners, is a scandal pushed to the margins of public policy. Read the full article at Guardian Society __________________________________________________ Diva doctor culture put patients at risk 16 August 2019 Toxic subcultures are thriving in the medical profession, often putting patients at risk. Everyone who works in the NHS has met these people, but dealing with the problem is a huge management challenge. A senior manager recently described to me the struggle in his trust to stop surgeons bullying anaesthetists and admin staff. He got to the point of having to spell out that he would personally walk someone off the site, no matter how senior, if it happened again. This experience is borne out by General Medical Council research which laid bare five distinct problematic groups of healthcare professionals. Ironically, the study aimed to understand how doctors approach the task of building good workplace cultures that deliver high-quality care. It reveals the signs of poor culture, such as cynical staff, blaming and shaming, a defensive attitude to performance data and a lack of mutual support. Other flags include a focus on the technical side of medicine while ignoring patients’ experiences, professional battles taking precedence over patient needs and lax implementation of protocols such as surgical checklists. Stress and burnout are also often endemic in teams with a poor working culture. Read the full article at Guardian Society __________________________________________________ Priti Patel will not defeat knife crime 2 August 2019 Priti Patel is being hailed as the “hardest line home secretary for years”. Her fan club expects a tough, criminal justice-led approach that will reclaim the Conservatives’ reputation as the party of law and order. If so, she will be the wrong home secretary to tackle the surge in youth violence. The hard right are looking forward to a return to the tried-and- failed approach of searching, arresting and imprisoning our way out of trouble, but the evidence points to the need for prevention and early intervention by a range of state agencies. In the year to March 2019, police forces in England and Wales recorded more than 47,000 offences involving knives, up 8% on the previous year and the highest total since records began. In the year to March 2018, 285 people in England and Wales were stabbed to death. The number of juvenile offenders convicted or cautioned for knife offences has increased by 48% in four years.Figures from eight of the largest police forces reveal that stop and search has more than doubled in two years. In the first nine weeks of 2019, 10 teenagers were stabbed to death. Against this blood-soaked backdrop, the cross-party home affairs select committee has published its report on serious youth violence. Read the full article at Guardian Society __________________________________________________ Threat of Johnson’s fantasy economics 19 July 2019 In his campaign for the Conservative leadership, Boris Johnson has pledged more bobbies on the beat, a budget boost for schools and his team hinted at public sector pay rises. But his warm words about public services are underpinned by fantasy economics. His most eye-catching public service commitment has been to reverse his party’s cuts to policing by finding £1.1bn to hire 20,000 more police officers. Johnson sees his record on cutting crime as London mayor as one of his most impressive achievements, although it is less persuasive when compared with long-term national trends. But this pitch to restore the Tories’ battered reputation as the party of law and order misses the point that cutting crime requires substantial and sustained investment in technology, as well as addressing weaknesses in the regional structure of police forces. Some of those promised officers should be traded for better kit and stronger organisation. The cost of his promise on policing is dwarfed by his commitment to boost the budget for English schools by £4.6bn, with the aim of returning school spending per pupil to its 2015 peak. Read the full article at Guardian Society __________________________________________________ Self-reliance on the road to Wigan cheer 5 July 2019 Wigan council has achieved a remarkable feat. Despite cuts of £140m, it has maintained, even improved, its services, and transformed its relationship with residents. But there has been a cost: more than 1,000 of its staff have lost their jobs – roughly a fifth of the workforce. Under relentless pressure to do more with less, all councils have had to make cuts. Many also bandy the word transformation around, but few achieve it. A study of Wigan by the King’s Fund makes clear this council is an exception. The bedrock of Wigan’s approach is a new relationship with both its staff and local people. It has rejected the paternalism that bedevils many public services in favour of working with individuals, families and communities to nurture their strengths and build independence and self-reliance. This is known locally as the Wigan Deal. Key to its success has been farsighted financial planning. While many councils in the early years of austerity became fixated on what they had to cut, Wigan looked at evidence from across the country to decide what it could do differently. Read the full article at Guardian Society __________________________________________________