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Readers' letters

Letters to Health Service Journal's editor.

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Parliament, policy, politician, government

Readers’ letters – 20 October 2015Subscription

20 October, 2015

Response to the new medical innovation bill

Dave West

The 'GP Forward View' avoids some awkward realities of reformSubscription

21 April, 2016

Today’s national strategy for general practice had to fulfil two separate purposes. In doing so, it has omitted some uncomfortable but important realities, writes Dave West

  • Trust blames 'bad behaviour' of neighbouring providers for staff shortage

    4 May, 2016 9:46 pm

    The fundamental problem is that we need to have a radical re-think on how we provide the service. When the EWTD was introduced in 1998 we rightly said we could not continue to provide the service in the same way (dependent on trainees / "junior" doctors) with fewer hours. We were given a 10 year derogation to change the system. We did nothing - we continued to try and run it exactly the same but with "gaps" in the rotas to make them compliant. And now we are surprised that there are not enough locums to fill the gaps. We need to develop an extended team with non- medical staff (the Americans have had Physicians' Assistants for years). Another issue is that we have too many acute sites resulting in too many acute rotas to be covered. We need to concentrate the acute work in to fewer sites with Consultants providing more of the care - not depending on "middle grade" medics.

  • North East trust tops sickness absence table for third year

    4 May, 2016 7:53 pm

    They're just better at recording it than everywhere else !

  • NHS Improvement to check waiting lists of 60 trusts

    4 May, 2016 7:03 pm

    Why stop at 60? Might as well do the lot...

  • Judge criticises NHS England for 'totally irrational' drug decision

    4 May, 2016 6:59 pm

    Firstly, I do hope that the child finally gets the drug and she benefits from it. However, let us not use this as an opportunity to shoot down the NHS. We need to be careful what we wish for. Yes, we can get access to all drugs for any potential condition , as soon as they hit the market- just like they do in the US . But that kind of pro-market healthcare system comes at a cost- not just the £s but cost of equitable access. The divide between access to care between rich and average American families is wide and deep. We need to decide whether we want a decent three course meal or a free for all buffet full of cheap pasta and luncheon meat. This is not a failure of NHS England, this is a failure of our healthcare funding system. If we want to do something constructive , its high time we start supporting a move to means tested subsidy for drugs instead of a free for all and a co-payment and insurance based healthcare funcing system. Our politicians hold their votebank too dearly to take this bold step. Lets us encourage them to take a chance on England and lead the much needed change in the national policy. Vineta B

  • Trusts told to prepare for indefinite strike action

    4 May, 2016 5:42 pm

    the terms of reference at the start of negotiations confirmed the pay envelope stayed the same so it was about how to get the best fit of more pay to the hardest working. It was not about more pay. The problem was Mr Hunt claiming that the election promise of 7DS depends upon a new junior contract which was and remains a nonsense. 7DS requires more doctors and other healthcare staff and is undeliverable while trying to make huge cuts. If Mr Hunt would admit that these two issues have become confused there might be a solution. BMA is not opposing 7DS as long as the staffing and resources are right and the patients can be safely discharged in to social care at weekends. There are many gaps on junior rotas now and these will rise unless there is a better balance between workload and total NHS resources. There is a world shortage of doctors; the NHS needs to provide reasonable conditions to retain and attract doctors and other staff. Spending up to the European average on health would be a start. Good leaders lead, bad leaders dictate.

  • Colchester told to partner with local trust or face failure regime

    4 May, 2016 4:17 pm

    I note that Mike Richards and Jim Mackey are pressing the Colchester-Ipswich merger. Nick Hulme current CEO of Ipswich was previously CEO of Croydon Health Services NHS Trust July 2009 – February 2012, which was severely criticised by an Employment Tribunal for whistleblower victimisation in the case of Dr Kevin Beatt. The ET concluded that Dr Beatt had been subjected to detriment for whistleblowing, which included unfair dismissal. The ET’s uploaded judgment can be found here: https://www.dropbox.com/home?preview=Beatt+v+Croydon+NHS+Judgement+2014-10-27-185143.pdf Please see the following paragraphs of the ET judgment, which are of particular relevance: Para 9, page 3 Para 16, page 4 Para 3, page 9 Para 394, page 166 Para 406, page 171 Paras 413 & 415, page 173 Para 417, page 174 Para 49, page 196 Para 56, page 200 Dr Beatt made an FPPR referral to CQC about these events, but the CQC panel chaired by Mike Richards rejected his referral. As the Croydon Guardian reported, CQC did not examine all relevant evidence in making this decision: “Dr Beatt said he had not been asked to provide any documents” NHS TDA was asked to review governance and safety issues arising from the ET judgment against Croydon. The referral letter to NHSTDA is uploaded here: http://twitdoc.com/view.asp?id=267730&sid=5QKY&ext=PDF&lcl=NHSTDA-To-Bob-Alexander-re-investigations-ref-ET-findings-22-08-2015.pdf&usr=alexander_minh NHS TDA consulted only the trust and declined to accept evidence offered by Dr Beatt, which contradicted assurance submitted by the trust. The final letter from NHSTDA is uploaded here: http://twitdoc.com/view.asp?id=267731&sid=5QKZ&ext=PDF&lcl=Final-NHSTDA-response-2016-03-31-Letter-to-Dr-M-Alexander.pdf&usr=alexander_minh So, taking all these events into account, what message do people think is coming from the top?

  • Private providers make case for bigger role in STPs

    4 May, 2016 2:58 pm

    Does he mean more contracts should go to the private sector ?. The NHS doesn't need the so called independent or private sector their involvement is at best a distraction and a waste of resources that could be devoted to improving the service. End the involvement of the market in the NHS now , the NHS doesn't exist as an opportunity for the private sector to make money by slashing staff terms and conditions to the bone and offering zero hours contracts.

  • Teaching trust loses second chief executive in two weeks

    4 May, 2016 2:33 pm

    It is under the leadership of Mr Scott that the Divisional structure was implemented whole heartedly after his arrival in 2011. The only thing this caused is division. Staff who used to work together now work in silos that are so strong nothing can break them. Clincial staff feel distanced from management (Junior doctors dispute 'alienated staff at all levels' at teaching hospital HSJ. 28 APRIL, 2016 by BEN CLOVER), poor morale (as per recent NHS Staff Survey) and an over-riding sense that the senior team (clinical and non-clinical) have dragged St Georges Hospital reputation through the mud and have let down both the staff and the population they serve. It is a very sad, unnecessary, situation. Burn-out is starting to be seen more and more with the consequences of this becoming all the more real. I hope that in the coming year a different, stable, senior team can be installed to allow St George's to flourish in the way that it should.

  • Revealed: The capital projects deferred in 'undignified scramble'

    4 May, 2016 1:34 pm

    On one hand the Bootham Park report points to a serious lack of strategic investment and urges NHS Trusts to "get a grip". On the other hand NHS England has presided over the obliteration of the business case process to what is now an entirely opaque mechanism. Spending capital is procedurally constrained and so gets transferred to support revenue. It's an interesting time to try and plan infrastructure - which needs a 30 year forward view. There is little appreciation of how damaging it is when things break or how much of a revenue burden obsolete infrastructure costs. A shame that we have broken the system of relating capital to revenue at a time when the running cost of the NHS are hugely problematic and the cost of capital is at a 100 year low point.

  • STP lead’s trust will miss savings targets

    4 May, 2016 10:16 am

    So here's an example of STP vs. the real, current, world we live in. NHSI and NHSE need to support these Trusts to keep delivering and, at the same time, build a STP that will deliver sustainability in time. This sustainability will NOT happen overnight, and it's about time that those with oversight of the health and care economies acknowledge this. Cannot seem to post this under my name HSJ - happens quite a lot. Jean Eksteen

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