Category Archives: Health
Frequently reported differences in health outcomes are generally ascribed to factors beyond the control of the health service, such as unhealthy lifestyles or poor living conditions. However, research has disclosed that there is a difference in the level of service received by poorer communities.
Though the NHS’s funding formula is designed to provide more money to the neediest areas, an FT article reported last week that – according to data analysed by the Nuffield Trust for the Financial Times – some poorer communities being “left behind” when accessing GP services.
Sarah Neville, Global Pharmaceuticals Editor, summarising the data, reports that rich and poor people in England receive different standards of care from the UK’s universal free health service.
Despite the higher burden of ill health in lower socio-economic groups, there are markedly fewer GPs per head in poorer areas of England than in richer areas
There was an average of 1,869 patients on GP lists for each doctor in the most affluent clinical commissioning groups, compared with 2,125 in the most deprived, according to Nuffield researchers. One in seven people in the poorest areas was unable to get a GP appointment, compared with one in 10 in the richest areas.
As GPs act as the crucial “gatekeeper” to other health services, a delay in seeing a doctor can lead to delays in securing other appropriate treatment. Emergency admissions were nearly 30% higher in the most deprived fifth of CCGs, compared with the least deprived fifth, which could point to delays in securing — or seeking — the right treatment. (See references to Sandwell here)
Nigel Edwards, chief executive of the Nuffield Trust, said that the new analysis showed there were “concerning discrepancies between the standards of care rich and poor receive from some NHS services”.
NHS England, “more medical treatment isn’t by itself the only answer”:
“ (T)he NHS long-term plan will be setting out new action to tackle inequalities including in access to primary care. But with the root cause of ill health lying in factors such as diet, smoking and exercise, income security, housing, air pollution and social connection, more medical treatment isn’t by itself the only answer.”
Ms Neville concludes that the findings raise questions about how well the 70-year-old National Health Service is meeting its founding principles of equity. They increase pressure on the NHS to outline plans to reduce health inequalities when it publishes its long-awaited spending plan next month.
A year ago, Colin Hines and Jonathon Porritt challenged the “permanent propping up of whole sectors of our economy as a direct result of our failure to train people properly here in the UK”.
They called for the training of enough IT experts, doctors, nurses and carers from our own population to “prevent the shameful theft of such vital staff from the poorer countries which originally paid for their education”.
Mass migration from developing countries deprives those places of the young, enterprising, dynamic citizens they desperately need at home
Dependence on the free movement of peoples as practised in the UK is the opposite of internationalism, since it implies that we will continue to employ workers from other countries in agriculture and service industries and steal doctors, nurses, IT experts etc from poorer countries, rather than train enough of our own.
Many individuals who migrate have experienced multiple stresses that can impact their mental well-being
Professor Dinesh Bhugrah is an authority on the stresses of migration. Years of research have revealed that the rates of mental illness are increased in some migrant groups. Stresses include the loss of the familiar, including language (especially colloquial and dialect), attitudes, values, loss of cultural norms, religious customs, social structures and support networks.
Porritt and Hines advocate – like former Chancellor Merkel – a redoubling of our commitments to improve people’s economic and social prospects in their own countries, tackling the root causes of why people feel they have no choice but to leave family, friends and communities in the first place.
They advocate the replacement of the so-called free market with an emphasis on rebuilding local economies . . . dramatically lessening the need for people to emigrate in the first case. Hines gives a route to localization in his classic: Localization: a global manifesto, pages 63-67.
The seven basic steps to be introduced, over a suitable transition period are:
- Reintroduction of protective safeguards for domestic economies (tariffs, quotas etc);
- a site-here-to-sell-here policy for manufacturing and services domestically or regionally;
- localising money so that the majority stays within its place of origin;
- enforcing a local competition policy to eliminate monopolies from the more protected economies;
- introduction of resource taxes to increase environmental improvements and help fund the transition to Protect the Local, Globally;
- increased democratic involvement both politically and economically to ensure the effectiveness and equity of the movement to more diverse local economies;
- reorientation of the end goals of aid and trade rules so that they contribute to the rebuilding of local economies and local control, particularly through the global transfer of relevant information and technology.
Since that book was written, a gifted group of people set out the Green New Deal which – though aimed initially at transforming the British economy – is valid for all countries and most urgently needed in the poorest countries from which people feel impelled to emigrate.
Funded by fairer taxes, savings, government expenditure and if necessary green quantitative easing, it addresses the need to develop ‘green energy’ and ‘energy-proofing’ buildings, creating new jobs, a reliable energy supply and slowing down the rate of climate change.
Senator Bernie Sanders and Alexandria Ocasio-Cortez, the youngest person ever to be elected in Congress, now advocate a Green New Deal in the US.
Professor John Roberts, in one of the newsletters posted on http://www.jrmundialist.org/ says: “Increasingly my thoughts return to the overwhelming need for all of us to think (and then act) as world citizens, conscious of a primary loyalty not to our local nationalism but to the human race (however confused and divided) as a whole”.
Jonathon Porritt quotes Alistair Sawday: “I remembered that the skills and the policies to reverse the damage are there; it is a matter of will – and of all of us waking up.
António Guterres, Secretary-General of the United Nations, which has developed urges all to work to “…Narrow the gaps. Bridge the divides. Rebuild trust by bringing people together around common goals. Unity is our path. Our future depends on it.” –
Jeremy Corbyn addressed the General Assembly at the United Nations Geneva headquarters last year. He concluded:
“The world’s economy can and must deliver for the common good and the majority of its people. . . But let us be clear: the long-term answer is genuine international cooperation based on human rights, which confronts the root causes of conflict, persecution and inequality . . . The world demands the UN Security Council responds, becomes more representative and plays the role it was set up to on peace and security. We can live in a more peaceful world. The desire to help create a better life for all burns within us. Governments, civil society, social movements and international organisations can all help realise that goal. We need to redouble our efforts to create a global rules based system that applies to all and works for the many, not the few.
“With solidarity, calm leadership and cooperation we can build a new social and economic system with human rights and justice at its core, deliver climate justice and a better way to live together on this planet, recognise the humanity of refugees and offer them a place of safety. Work for peace, security and understanding. The survival of our common humanity requires nothing less”.
As the FT’s Simon Kuper recently reported, air pollution is said to contribute to more than 9,000 premature deaths in London each year and its harmful nitrogen dioxide levels are nearly as bad as those in Beijing and New Delhi – and much worse than in other developed cities such as New York or Madrid.
Nitrogen dioxide, which inflames lungs and is linked to shorter life expectancy, has become a major problem. The capital missed binding EU limits on air quality that came into force in 2010, largely due to diesel vehicles — which, it later emerged, emitted higher levels of pollutants in the real world than in tests. Congestion, which has pushed average traffic speed down to 8mph, compounds the problem. Add in the City of London’s narrow streets and tall buildings, and two of the capital’s five hotspots for excessive nitrogen levels lie within it.
The mayor of London is making headway
The impact of the City’s plans will be even greater if they bolster commitments by Sadiq Khan, London’s mayor, to prioritise fighting air pollution throughout the capital and force the government to take action across the country.
- From this year, all new single-decker buses will be zero emission.
- New taxis must be hybrid or electric.
- Next year, an ultra-low emission zone will come into force in central London, expanding outwards in 2021.
The borough of Westminster has proposed turning Oxford Street, the UK’s busiest shopping location, into a zero-emissions zone by 2022 and a parliamentary committee has called for a UK-wide ban on new petrol and diesel cars to be brought forward eight years, to 2032.
The FT reports ‘lessons elsewhere’. Singapore has had an automated electronic road pricing scheme since 1988 and is moving to a satellite-based scheme in 2020 and advocates a move to cycling rates such as those In Amsterdam or Copenhagen.
Take a carrot-and-stick approach? The FT editorial board thinks that governments should both help and oblige people to change their behaviour
It cites Germany’s carrot-and-stick approach. A court ruling this week banned older diesel cars from driving in certain parts of Berlin – after the government had offered car owners generous bonuses for trading in older diesel cars.
The FT believes that The British government has not provided enough fiscal incentives to businesses and individuals who bought diesel vehicles in the mistaken belief that they were greener.
The Centre for London think-tank has proposed offering cash or mobility credits — which can be used to pay for public or shared transport — for scrapping diesel cars, as well as smarter distance-based car charges, and higher vehicle excise duties on the most polluting cars. The FT’s truism:
“Despite efforts to address it in London and other big cities, air pollution will remain dangerously high unless more people change behaviour. The City of London’s bold moves are worthwhile — but need to be happening not in a bubble, but right across the world’s major cities”.
At last, the case of people whose health has been seriously damaged caused by infected blood bought by a government agency is coming to the fore. But the plight of farmers, whose health suffered because government compelled them to use organophosphate sheep dips, is yet to be addressed – many affected veterans and farmers have died after long suffering.
OP-affected Richard Bruce writes: Dr Davis and Dr Ahmed wrote some informative papers on the subject. One may be read here: https://psychcentral.com/lib/what-is-functional-magnetic-resonance-imaging-fmri/
Allowed to sink into obscurity
In 1996 Defence minister Nicholas Soames confirmed that many of the soldiers returning from the Gulf War reporting fatigue, memory loss, weakness, joint and muscle pain and depression – a condition now known as Gulf War Syndrome, had been exposed to some sort of organophosphate pesticide.
From the archives:
1999: the US Government accepted that their veterans’ illnesses were mostly due to service in the Gulf. Of their 700,000-plus troops deployed there, 88% became eligible for benefits through their equivalent of the Veterans Agency and 45% had by then sought medical care. The US Government also accepted the extremely serious consequences of using organophosphates.
2000-2001: the UK government funded more research into the effects of organophosphate exposure and poisoning. The results of some studies provided support for the poisoning hypothesis but the research was delayed by the FMD outbreak and only completed in 2007.
2004: A study published in the British Medical Journal: ‘Overcoming apathy in research on organophosphate poisoning’, concluded that high rates of pesticide poisoning in developing countries and increasing risk of nerve gas attacks in the West mean effective antidotes for organophosphates should be a worldwide priority.
2008: the American government concluded an intensive study into the cause of “Gulf War Syndrome” Their $400,000 study found that OPs had causal responsibility for the harm inflicted. This finding was reported to the British Government by the Chief of Defence Staff [RAF].
Conflicts of interest: those campaigning for a ban on organophosphate pesticides have to face opposition from the agro-chemical industry, whose representatives sit on expert committees advising governments on pesticide safety.
As the Countess of Mar explained: There seems to be a nucleus of about 25 individuals who advise on a number of committees. The scientific community is very close-knit and because the numbers of individuals in specialties is small, they will all know one another. They are dependent upon one another for support, guidance, praise and recognition. If they wish to succeed, they must run with the prevailing ethos of their group, department or specialism Hansard 24 Jun 1997: Columns 1555-9
The Scotsman reported the findings of the 2004 independent inquiry into illnesses suffered by veterans of the first Gulf War which was headed by the former law lord Lord Lloyd of Berwick, called on the Ministry of Defence finally to recognise the existence of a “Gulf War syndrome”. It said that it was clear the cocktail of health problems suffered by an estimated 6,000 veterans were a direct result of their service in the 1991 conflict and urged the MoD to establish a special fund to make one-off compensation payments to those affected.
Is the long and inhumane delay due to the fact that the establishment of a link between Gulf War Syndrome and organophosphate poisoning would cost the MoD vast sums in compensation?
Keep Our NHS Public Birmingham (KONP) says, “It looks like we’ve won our campaign for a publicly-funded (non-PFI) Midland Metropolitan Hospital in Smethwick/West Birmingham!”
The construction of the Midland Metropolitan Hospital in Smethwick collapsed after Carillion crashed spectacularly in Jan 2018 leaving the hospital half built. Then the bankers behind the ‘private finance initiative’ pulled the plug on the deal.
KONP Birmingham immediately organised a protest outside the hospital site demanding that the Treasury, health ministers and the Government should fully fund the hospital and run it properly under government and NHS control! Supporters included Birmingham TUC (BTUC), Unite the Union West Midlands, Unite the Community Birmingham, West Midlands Pensioners Convention and Birmingham Against the Cuts.
A month later, the Sandwell and West Birmingham Hospitals Trust Board voted to tell the Government that the only viable option for the completion was direct government funding, a full vindication of the KONP Birmingham campaign argument.
The Government and Hospital Trust has now reached an agreement to finish construction work with the Government providing funding for the remainder of the building work at Midland Metropolitan Hospital – which will see the new hospital built by 2022.
Birmingham Against The Cuts (BATC) says: “We believe that the Midland Met fiasco is a final nail in the coffin of successive governments’ love affair with PFI /2”
BATC gives a very cautious welcome for a publicly funded Midland Met Hospital in Smethwick/West B’ham (no PFI!) and expresses its continuing concerns:
Firstly, there is a delay in starting completion until early summer 2019, partly because the half built hospital was rotting away without any protection for 6 months and an additional £20m worth of work will have to be done from this September.
Additionally, the Hospital’s Trust Board Chief Executive has been dropping in phrases to his announcements such as “making cost improvement programmes above national norms”, “limited reconfigurations”, etc, which reflect the concern in Dr John Lister’s 2016 review (right) of the privately financed hospital published by KONPB and BTUC when the Midland Met was first mooted.
The Times reports that incineration has grown from 5.5 million tonnes in 2012/13 to over 10 million in 2016/17 according to government data and since 2010 21 incinerators have been built, almost doubling the number in use, with another 18 under construction.
Cross-party MPs warning of an escalating “incinerator boom” releasing harmful particulates, harmful to public health.
UK Without Incineration Network (UKWIN), has launched its report with cross-party support from John Grogan MP (Lab), Philip Davies MP (Con), and Lord Tyler (Lib Dem). They called on the Government to introduce an incineration tax.
The research revealed that harmful particles released by incinerators in England last year were equivalent to the emissions of more than a quarter-of-a-million 40-tonne lorries travelling 75,000 miles per year. This exceeds pollution reporting thresholds for particulates, but the report claimed that “due to a loophole” the public is not informed of the emissions.
Despite public resistance, the average incineration rate in the country is rising: about 38%, up from 30% two years earlier.
According to latest figures from the Department for Environment, Food and Rural Affairs, about 342,872 tonnes of rubbish, 69% of all waste, ended up in specialist Energy-from-Waste (EfW) power plants as fuel to generate heat and electricity in 2016-2017.
Many communities have resisted incineration with all the means they had and, for many years, Gloucestershire residents did so, in a saga worth recording in full – see one instance.
Following the disclosure of the full contract and Information Tribunal ruling, Community R4C, a not for profit Community Benefit Society, commissioned two consultants not associated with CR4C, and drew on contributions from other independent experts, to provide evidence on the incinerator contract between GCC and UBB. Main findings:
Construction has started, despite this ongoing investigation by the Competition and Markets Authority into the contract held between the county council and Urbaser Balfour Beattie.
Shlomo Dowen, national coordinator of United Kingdom Without Incineration Network (UKWIN), goes to the heart of the matter: “Many councils are locked into long-term waste contracts that encourage the incineration of recyclable and compostable material.”
An online search supports the observation that some councils have already broken free of waste contracts: on the first page of results Ealing, Lancashire CC/Blackpool, Sheffield, Peterborough were named.
Libby Forrest, policy and parliamentary affairs officer at Environmental Services Association, reckons the increase of waste incineration should be celebrated. She said: “Energy from Waste has increased because we are successfully moving away from landfill, which is more damaging to the environment. Energy from Waste saves 200kg of CO₂ per tonne of waste diverted from landfill, and generates low-carbon power far more efficiently than landfill, contributing to renewable energy targets and energy security”.
Jenny Jones (House of Lords) said: “There is a logic to generating energy from the waste that we cannot recycle or reuse, but it is meant to be the last resort option. What we have created instead is a market-driven system of incinerators which constantly need to be fed.”