Archive for category Health

David Cameron is standing at the (Southern) cross roads

Let’s say there are two tribes. One goes to great lengths to ensure that no-one goes hungry, no-one goes homeless and the sick and the elderly are looked after in a caring, compassionate and unconditional manner. The second tribe is quite the opposite; everything is about survival and competition. The tallest get the best fruits, the strongest kill the meatiest animals and build the best homes and those who don’t measure up are effectively cut loose.

On the face of it, a private investment deal that went from a valuation of £1bn in 2006 to £18m today would attract little sympathy. Some rich group, that presumably doesn’t know what it’s doing, that belongs to the latter tribe in the above paragraph and that has deep pockets backed by Qatari investors is it? Well, yes and no.

The situation I am referring to is Southern Cross Healthcare, a UK company that has had a dizzying fall from grace but runs a huge number of care homes, including some 100 in Scotland, so any financial implosion would have unthinkable consequences for the tens of thousands of elderly residents that are now at the mercy of open markets. This is more than a case of schadenfreude at the rich getting poorer, much more.

Southern Cross is, to use a well worn phrase, too big to fail. Many of these care homes have no obvious new owner and many of the areas involved have no alternative provision. The residents can surely only stay in the buildings they currently live in but a liquidated company will surely want to sell off its assets to meet its debts.

Figures quoted in The Guardian suggest around ~£240m is required to prop up the Group to pay rent for another year which is surely better value for money for the Government compared to the tens of billions pumped into banks, much of which has continued to puff up over-inflated salaries in the financial sector.

This issue epitomises the mistrust and distaste that many either side of the border reserve for the Conservatives, reckless private financing of a very public concern. The same could be said for the railways (30% more expensive in the UK because of privatisation). And, worryingly, the issues surrounding this company could easily apply to the NHS in future (south of the border) if private involvement is allowed to infiltrate the Health Service. It is good to know that nurses, doctors, the Greens, Labour and even the Lib Dems are wise to the complicated risks at hand but Britain stands at a crossroads and a public NHS and a country that still competently looks after its weakest is at risk.

I know which tribe that I believe the Conservatives are regrettably closer to and I know which road I believe they are trying to take the country down. The fate of Southern Cross is Cameron’s first test and 31,000 elderly residents await his Government’s next move.

This is one issue where a Government going tribal is acceptable, it just depends which tribe it picks.

The Scottish Government’s first 100 days

For some reason, a reason that has always bewildered me, Governments are often judged on the delivery of their promises within their first 100 days.

In 2007, the SNP was able to rhyme off a dizzying list of achievements in its first 100 days, wrongfooting its opponents who no longer taunted ‘the biggest thing they’ve ever run is Falkirk Council’. I don’t think we’ll hear that barb’s ilk again either.

It is perhaps unfair to throw down a short-term gauntlet to the new majority Government when Scotland’s problems are largely structural, are partly out of the Government’s hands and require more than a quick-win -> moving away from PFI, increasing education standards, increasing health and well-being and powering the renewables revolution, for example.

So, if the SNP is to be conscious of delivering a 100 days that will stand up to the Scottish media’s scrutiny, what might they contain?

For me, a key debate and a winning vote on minimum pricing, even at a stage of the Bill before finalisation, would be more than enough. What a way for the SNP to put a marker down that this term will see more progress thanks to insufficient opposition to the most sensible of policies. Pats on the back from numerous stakeholders from the BMA to the police would be sufficient to tick that 100 day box.

The only non-political opposition that I have seen recently is from the Scotch Whisky Association, odd you would think given whisky is largely a premium product so its pricing would be largely unaffected by minimum pricing. My suspicion is that some of the members of SWA also sell deep-discounted alcohol away from the whisky line and a clever use of that respectable-sounding umbrella organisation is being made. Either way, they are in the minority, politically as well as from a civic perspective.

But what else could these 100 days bring? Or is it only 93 now? Well, feel free to make some suggestions because despite a plethora of manifestoes and a long election campaign, I am somewhat stumped.

Not that it ‘really’ matters of course. As JFK put it:

“All this will not be finished in the first hundred days. Nor will it be finished in the first thousand days, nor in the life of this administration, nor even perhaps in our lifetime on this planet. But let us begin.”

The United Kingdom – ’til death do us part

As the death toll from the flu virus rises still higher, a quite remarkable situation has arisen where Scotland has spare flu vaccines available, is perfectly open to supplying south of the border but parts of the rest of the UK are using old stocks that do not cover every strain of the virus. Local shortfalls exist while GPs scour Continental Europe for any spare vaccines that already exist in Scotland.

In difficult times, the human mind can find a survival instinct that allows it to find the necessary solutions quicker in order to overcome problems. For some reason, that same instinct seems to be lacking from the current UK Government as the simplest solution here would be to take Scotland’s spares and quickly deliver them to where the need is the greatest, wherever that may be across the entire UK.

One can only hope that it was not the consideration of the SNP being seen to be helping out the Conservative/Lib Dem coalition that led to the Scottish Government’s spare vaccines being rebuffed. Alternative reasons are thin on the ground though and, once again, Cameron’s party’s ‘respect’ agenda for Scotland can only be called into question.

As I’ve said before, I’m not overly fussed about independence as there’s no reason why two neighbouring countries can’t operate just as effectively with each other irrespective of where the border is drawn. Of course the flip side of that is that we should act as one country when we are one country so the apparent difficulty to do just that is what is so concerning here; that we can’t even distribute a life-saving vaccine as efficiently as possible.

‘Stronger together, weaker apart’ is the constant refrain from each of the unionist parties regarding the constitutional arrangement of the UK. But if London won’t even tap Scotland for a few spare flu vaccines when parts of England are in desperate need of them, can we really take that argument seriously?

Scotland’s Next Big Idea? – No more private healthcare

This post is largely borne out of Doug Daniel’s open challenge (in a comment in a previous post) to find what Scotland’s next big idea could be.

The problem with big ideas is someone needs to come up with the ideas in the first place. What big ideas could the debate be focussing on? That’s the question. LIT is sure to feature, but what else could the parties be focussing on?

Doug is right to point to LIT (as well as renationalising rail, increased powers for Holyrood and independence) as potential big ideas for the coming election campaign but there is an element of raking over hot coals with each of these, to a varying degree. There must be areas for discussion out there that have barely made the light of day and are waiting to be explored (and if you are reading that as an open invite for a Guest Post then you have read it correctly – send any to (subject to quality control, of course)).

After a short racking of my own humble little brain, the best new idea that I can think of is as follows – an unashamedly 100% public health service.

The NHS is a tremendous institution with foreigners often visibly taken aback by the pride with which Scots and Brits defend it. While the current situation involves healthcare being free at the point of use and many who can afford it opting for private cover, what if the rules were changed such that it was not permissible to obtain private healthcare except for services that the NHS do not provide (I’m thinking plastic surgery or bespoke prosthetic limb provision)

I mean no more BUPA in Scotland and no private medical insurance. It would be a colossal change and a massive statement to make to the wider world about how a country could, and perhaps should, look after itself.

The advantages would be:

– a more consistent level of NHS services across the entire nation. There is a risk that, with the current situation, the more affluent areas of Scotland have poorer NHS options available as greater numbers are covered privately and there is insufficient funding for those that do require free cover. All parts of the country using one service will ensure an even spread of resources and an equitable level of service.
– Many of Scotland’s best doctors are lured into working for private institutions by the larger pay and bonuses available. That is not to take away from the expertise that the NHS currently has available but pooling all of our medical talent under one roof would ensure better access for specific needs for all Scots and less pressure on the remuneration of public sector doctors and health staff.

Many (of the many) detractors will say that if they can afford to jump the queue then they should be allowed to do so. Many will say that such a move will cost lives. Both are convincing arguments but if a continued public/private split of health cover contributes to a two-tier country and a widening of the gap between rich and poor then is this policy proposal justified nonetheless?

Nicola Sturgeon once celebrated a privately-run hospital “coming home” to the NHS. Could the Health Minister, or a parliamentary colleague from any of the parties, take this a few steps further and argue for private healthcare in its entirety being brought under NHS control?

There are no doubt considerable legal concerns with this move and Scotland would probably need more flexible fiscal powers in order to fund it more appropriately but, well, it certainly ticks the big idea box and that is perhaps what Scotland is crying out for.

Refreshingly radical or dogma gone barking mad?

Minimum Pricing – Down in One

Hague drinks the first of manySo for all the talk of 40p, 45p or 50p levels of pricing, of a £2bn scourge on our economy, of the legality of trying to fix our nation’s illness and of political posturing that has not always shown our Parliament in its best light, the radical change that our politicians have agreed on to win the hitherto one-sided battle against alcohol is to ban irresponsible drink promotions at off licenses and introduce a social responsibility fee. It really doesn’t go far enough I’m afraid.

Someone, somewhere has failed, but trying to look at the position as objectively as possible, I disagree with The Scotsman’s view that it is the SNP who has suffered “a blow” here today. Nicola Sturgeon can hold her head high and be confident that she is on the right side of the argument. The Scottish Government after all had the BMA, doctors, the police, nurses, community groups and whole lot more on their side. Sadly Labour, the Lib Dems and the Tories were not amongst that number. The Greens, to their little-heralded credit, looked at the SNP’s policies, largely agreed with them and have been onboard ever since.

So who loses here, aside from the many who will continue to drink themselves into an early grave?

Well, the Conservatives cannot really be blamed for having a firmly held belief and principle that is diametrically opposite to that proposed by the Scottish Government. Their typical supporters and more libertarian followers will not be moved by seeing minimum pricing voted down.

For the Lib Dems and Labour it is a different story. There should have been enough common ground with the SNP for a deal to have been reached and Gray and Scott should really have been persuaded by the views of the BMA, doctors and the police, not to mention their colleagues in London in some instances.

Focussing on caffeinated drinks may have some merit but it is inviting judgement over the motives of the decision to prioritise this particular angle. Was it because this is where Scotland’s greatest threat is regarding alcohol or was it just a convenient way to avoid facing up to the persuasive arguments for backing the radical option of minimum pricing?

On May 6th we will find out to what extent Scottish political parties get rewarded for saying a largely uninterrupted ‘No’ for four years and preventing much about anything getting done. Alcohol is holding Scotland back, so too are too many of our politicians.