Category Archives: Government policy

National Health: Who Cares?

The Great Yorkshire Conversation, Part 3

Saturday 26 September, 2020, 2pm – 5pm on Zoom


Discussing a comprehensive strategy for restoring our universal health system

Key issues

  • Restoring the whole Health System
  • Driving out Privatisation

The coronavirus pandemic has exposed the failings of a health service hamstrung by damaging government policies and unnecessary austerity. Our conference will provide a platform to explore the power of socialism to deliver the highest quality healthcare to all, free at the point of need, publicly financed.

The way to do this is to address the service as a whole system from the Upstream (Public Health, including Care Homes) to Final Delivery (Primary and Acute Care).

It is axiomatic, therefore, that bolstering public health services has a positive impact on societal inequalities and the vulnerable in our society. This will reduce the demand on primary and acute care and reduce costs while improving quality. The rationale for privatisation will disappear and we will bring services back in-house.

Our main speaker will be Prof. Allyson Pollock (Professor of Public Health, Newcastle University; Hon. President of the SHA). A recent BMJ editorial by Prof. Pollock discusses “COVID-19: Why we need a national health and social care service” (read online).

Conference Outline

  1. Welcome and introduction
  2. Speaker (Prof. Allyson Pollock)
  3. Q&A
  4. Discussion groups
  5. Feedback
  6. Forward to YSHA Conference 2021

General Practice and Primary Care Networks (members’ meeting)

YSHA meeting 11th May 2019

at Mill Hill Chapel, Leeds

The meeting focused on the themes introduced in talks by Dr Jack Czauderna (Doctors In Unite) and Dr John Puntis (KONP co-chair): 

Jack: General practice cannot to be just a set of tasks carried out in relentlessly driven isolation. It must return to its role as family practice, committed to understanding local communities and the families that live in them, and supporting them in pursuing their own health

John: Primary Care Networks (PCNs) and a Charter for Primary Care

Summary of the practical issues raised:

  • GPs are no longer family doctors, so we miss the notion of community. We need get back to Primary Care Teams. However, we are so used to being in a command and control environment that many GPs will not have the skills needed for a participatory culture. They will need to be helped to design a management system conducive to collaboration and to develop engagement policies and skills.
  • PCNs are an overkill. Structural changes, e.g. compartmentalisation of function and role are not conducive to collaboration. It is not something you can “harness” – a classic top down policy that politicians use to disguise their control pathology. We need to provide a collaborative model that that really works, as opposed to strangling people’s efforts to cooperate.
  • The vision needs to include real shared values embedded in policies, e.g. we will really understand the patients’ needs before applying a solution and will engage the patient and their family/community in the process. Then like the GPs we may need to train the staff in these engagement skills, using a set of behavioural skills that have been shown empirically to work. The vision may also wish to include a profit-sharing policy without profiteering, e.g. ask staff how any surplus could be distributed – externally as well as internally.
  • Only then look at the legal structure the PCN might need, e.g. a Community Interest Company (CIC). 

The meeting had a very engaging and informed discussion on economics and, in particular, Modern Monetary Theory, which could dramatically change the SHA and politicians’ stance on funding.

The Conservative Government’s Misery Business

John Carlisle, Chair, YSHA

18 July 2018

The government has for eight years now been successfully building national factories which produces millions of sick, depressed and hopeless people. The recently retired CEO and Chairman, George Osborne and David Cameron, can sit back with great satisfaction at the success of their enterprise: The Austerity Brexit Company.

They have brilliantly cornered the market in misery. The cunning strategy is threefold:

  1. Broaden the customer base by policies that punish those in greatest need and those who have vocations to alleviate suffering, e.g. carers, nurses, doctors, and create anxiety, uncertainty and fear, especially as regards employment, by insisting on a Brexit that is unworkable. The latter is a brilliant marketing ploy, of which Richard Branson himself must be envious.
  2. Enact legislation and policies that supports private enterprise in the public realm (NHS, public transport, etc.) and take money from municipalities to give the Treasury, and social care.
  3. Employ as directors of the great departments of state the “children of Douglas Haig”, who will carry out any neoliberal strategy they have devised, no matter what the cost to the people. In a really fair monarchy Grayling, Duncan Smith and, the recently retired Jeremy Hunt would have been awarded knighthoods for the successful obliteration of the wellbeing of both the employees in these departments and their “customers”.

Jeremy Hunt, who comes from a military background, would doubtless be proud to be associated with Field Marshal Haig on this day, as we commemorate the centenary of the turning of the tide of World War I. To quote B.H. Liddell-Hart, a distinguished military historian who had been wounded on the Western Front, from his diary: He [Haig] was a man of supreme egoism and utter lack of scruple—who, to his overweening ambition, sacrificed hundreds of thousands of men. A man who betrayed even his most devoted assistants as well as the Government which he served. A man who gained his ends by trickery of a kind that was not merely immoral but criminal.

To examine the parallels just look at the nurses, who, like the Tommies in the war, are the backbone of the NHS, and whose ratio to patients is the main determinant of good patient care.

NURSES (with grateful acknowledgement to NHS FOR SALE?)

The NHS is spending almost £1.5bn a year on agency nurses while its own staff are leaving in droves, a new report suggests.

The vast outlay on temp workers would be enough to pay the wages of 66,000 full-time positions for a year, according to the study by The Open University.

The RCN branded the situation dangerous, but ministers said steps were being taken to recruit more nurses. Hunt was warned in mid-2017 of the coming crisis: NHS faces staff crisis as student nurse applications plummet after Tories scrapped their grants (The Mirror: 13th July 2017).

The number applying to be student nurses has dropped from 65,620 to 53,010 – a fall of 12,610 on last year. The fall comes after the Government axed student bursaries for trainee nurses and midwives.

Stressed nurses are leaving the NHS in increasing numbers after 160,000 quit in five years. Long hours and poor pay have been blamed for the numbers leaving increasing by a fifth.

An unprecedented NHS staffing crisis has left at least 40,000 unfilled nursing posts in England alone and wards having to close due to dangerous understaffing. Data released by Government shows 33,530 quit the profession in the year up to September 2017.

This is a 17% increase on the 28,547 who quit in 2012/13 after year-on-year increases for the last four years. In total 159,134 nurses have quit the NHS in the last five years.

The number of nurses and health visitors across the NHS in England has dropped by over 400 people. Sector leaders feel this decline reflects how frontline nursing has become an “easy target for cuts”.

At a time when the government is actively trying to boost workforce numbers to tackle high rates of vacancies across the country, the latest figures from NHS Digital show that the opposite has been happening. Since 2016, the nursing and health visitor workforce has shrunk to 284,000 FTE, a drop of 435 people.

There was also a decrease of 0.2% across the nursing workforce within GP practices, with 27 less staff working in the NHS now than in 2016

Janet Davies, chief executive and general secretary of the Royal College of Nursing, argued the latest statistics are a worrying sign that the number of nurses continues to slide – and they have also come just a day after a major survey revealed public satisfaction with the NHS is dwindling due to staffing worries. This must be a major achievement for the Sickness Business. Well done!

Almost two thirds of healthcare assistants (HCAs) are performing roles usually undertaken by nurses, such as giving patients drugs and dressing their wounds, in the latest illustration of the NHS’s staffing crisis. The apparently growing trend of assistants acting as “nurse substitutes” has sparked concern that patients may receive inferior or potentially unsafe care because they do not have the same skills.

Of the 376,000 assistants in the NHS in England, 74% are taking on extra tasks, according to findings by the union Unison.

This is the equivalent of Haig’s attrition rate exactly 100 years ago. In Churchill’s chilling phrase, “driving to the shambles by stern laws the remaining manhood of the nation. Lads of 18 and 19, elderly men up to 45, the last surviving brother, the only son of his mother (and she a widow), the father, the sole support of the family, the weak, the consumptive, the thrice wounded—all must now prepare themselves for the scythe.”

We have had our warning for years. Now let us turn on the government and turn the tide of their war against the public sector.