Category Archives: Health
We don’t think enough about local government, one of whose jobs it is to mend potholes. When in our own lives our nearside front tyre is shredded, the pothole, Parris believes, represents “a momentary twitching-back of one tiny corner of a great curtain, behind which lie, no, not potholes, but a million anxious human stories, caused in part by cuts in public spending”.
He adds that accidents due to potholes are usually relatively trivial compared with cuts which for others may have meant:
- the loss of social care in dementia,
- no Sure Start centre for a child,
- the closure of a small local hospital
- or the end of a vital local bus service.
Potholes are a parable for others that matter even more. Unfilled potholes put lives at risk and have become a symbol of the damage done to every walk of life by spending cuts.
All the pressures on those who run government, local and central, are to worry about the short-term. it is usually possible to leave issues like road maintenance, decaying school buildings, rotting prisons, social care for the elderly, Britain’s military preparedness or a cash-strapped health service, to tread water for years or even decades. “They’ll get by,” say fiscal hawks, and in the short-term they’re often right.
- Nobody’s likely to invade us;
- the NHS is used to squeezing slightly more out of not enough;
- cutting pre-school provision is hardly the Slaughter of the Innocents;
- the elderly won’t all get dementia at once;
- there’s little public sympathy for prisoners;
- teachers can place a bucket under the hole in the roof
- and road users can dodge potholes.
Parris continues: “But beneath the surface problems build up. The old get older, and more numerous. Potholes start breaking cyclists’ necks. Care homes start going under. The Crown Prosecution Service begins to flounder. We run out of social housing. Prisoners riot. And is there really no link between things like pre-schooling, sports and leisure centres and local outreach work, and the discouragement of knife crime?”
“When New Labour was elected in 1997 we Tories groaned as it tipper-trucked money into the NHS, school building and other public services. Thirteen years later when Labour left office the undersupply was monetary, the red ink all too visible”.
Parris asks: “Must we forever oscillate like this?
One answer: Green & Labour Party leaders would meet these needs and avoid red ink by redirecting the money raised by quantitative easing.
The rational case against metro mayors ably set out by Richard Hatcher, George Morran and Steve Beauchampé, has been shattered for the writer by the media-feeding chaotic, emotion-led, vicious, counterproductive squabbling in the Labour & Conservative ranks.
Still, evidently, a tribal people, we appear to need the ‘high-profile leadership’ extolled by Andrew Carter, chief executive of the Centre for Cities , largest funders Gatsby Charitable Foundation (Lord Sainsbury) and Catapult network, established by Innovate UK, a government agency. (see report cover right)
As yet, the announcements made by the West Midlands metro mayor Andy Street, respected even by most opponents of the post, with a business record seen as a guarantee of efficiency, are provoking little dissension.
Dan Jarvis, who is expected to win the Sheffield election becoming Britain’s seventh metro mayor, intends to continue to sit in the House of Commons to work for a better devolution deal and speak for the whole county. (map, regions in 2017)
His desire to stay in parliament while serving as a mayor is thought, by the author of FT View, to reflect a recognition that the real authority and power of these positions is limited:
- The six mayors have no say on how taxes are raised and spent.
- Outside Greater Manchester, the mayors have little control over health policy.
- Major spending decisions on transport policy are still taken by central government.
Days after taking office in Greater Manchester, Andy Burnham’s announcement of a new fund to tackle the region’s homelessness problem was backed by ‘a chunk’ of his own mayoral salary.
Andrew Carter points out that England’s mayors are highly constrained in their control over local tax revenue and how it is spent, compared with their counterparts in other countries.
FT View describes this extra layer of government as yet merely creating cheerleaders, adding:
“Voices alone will not be enough to shift economic and political power to the regions. England’s mayors need more control. If the government is serious about devolution, the mayors need the powers to match that ambition”.
Could well-endowed, unsuborned metro mayors out-perform successive corporate-bound national governments?
On 1 April 2018 the government will introduce the first Accountable Care Organisations (ACOs), which are to act as partnership bodies incorporating hospitals, community services and councils into the NHS in England.
The Health Service Journal reports that ACOs organisation, a corporate joint venture with GPs, will bring together most of a local area’s NHS services under a single budget, run directly by one big organisation – the ACO. which are to act as partnership bodies incorporating hospitals, community services and councils
Government intends to pass laws allowing ACOs to be set up (see above) without an automatic vote in Parliament.
A BBC website reports that campaigners has been given permission to challenge a government health policy in the High Court. They will pursue a judicial review against Health Secretary Jeremy Hunt and NHS England over plans to create ACOs. Campaigners say it risks privatisation, but this is denied by ministers. The group bringing the case to court says an act of Parliament would be needed for the changes.
The DHSS said the claims would be resisted and it is irresponsible scaremongering to say ACOs were supporting privatisation. A spokesman said: “The NHS will remain a taxpayer-funded system free at the point of use; ACOs are simply about making care more joined-up between different health and care organisations. “Our consultation on changes to support ACOs is entirely appropriate and lawful”.
Dr Kailash Chand, an honorary Vice President of the British Medical Association, claimed ACOs could be a “Trojan horse for privatisation” adding:
“At worst, they are the end game for the NHS.”
The British Medical Association union warned: “Combining multiple services into one contract risks the potential for non-NHS providers taking over the provision of care for entire health economies.”
And the Commons Health Committee chair Dr Sarah Wollaston (Conservative) said: “There is a great deal of anxiety out there that this is going to be a mechanism for privatising the NHS.”
Much ado about an OP nerve-agent: but hundreds of British farmers were poisoned – compelled by government to use OP dips
Senior ministers have been told that the nerve agent used to poison Sergei and Yulia Skripal in in Salisbury, on Sunday 4 March 2018 near Porton Down, has been identified by Porton Down experts as the organophosphate Novichock. Porton Down’s research focus has successively been known as Chemical Warfare, Chemical Defence, Chemical & Biological Defence and now Defence Science and Technology. Areas of concern are outlined here. Early British collaboration with American chemical warfare research (aka ‘field studies’) is acknowledged here.
In 2015 the Guardian reported that a cross-party MPs called for an inquiry into the compulsory use of dangerous chemicals called organophosphates (OPs), used to protect livestock from parasites. The Farmers Weekly reported that the Sheep Dip Sufferers Support Group repeated this call in 2016
The problem was first identified by Dr Goran Jamal, a Kurdish-born neurologist working in Glasgow, who later gave evidence of OP-related Gulf War Syndrome. Read Booker’s compelling account in Scared to Death: From BSE to Global Warming: Why Scares are Costing Us the Earth, or extracts from it here.
In his autobiography, BBC Countryfile presenter Adam Henson wrote: “the authorities realized that they were poisoning a lot of farmers”. In Countryfile Magazine (9.6.17) he wrote (snapshot of page, above right)
BBC Countryfile Magazine made the following points below:
- OPs were originally created as a nerve gas and were developed during the Second World War. In 1951 Lord Zuckerman, who would go on to become the government’s chief scientist, warned of the dangers of allowing farmers to use OPs. Zuckerman raised concerns that farmers could absorb the poison through skin or inhalation. Read the legal noticepublished by Minister of Agriculture and Fishery regarding the harmful effects of Ops in 1951. Read a report published by Tim Farron, MP, stating that Government knew about the harmful effects of OPs.
- Zuckerman called for farmers to be given detailed instructions for the use of OPs and for the substance to be labelled as deadly poison, although neither suggestion would be adopted until the 1980s.
- Dipping sheep became compulsory in the late 1970s, and the use of OPs specifically was mandated by the British government until 1992. Read abstract at Small Ruminant Research.
- In 1981 an advice leaflet was produced by the Health and Safety Executive (HSE) that warned against the dangers of using OPs, citing that the chemicals could be absorbed through the skin. A report from the HSE in 1990showed growing concerns over the use of the chemicals.
- UCL’s Dr Sarah MacKenzie Ross reviewed existing scientific evidence in 2013 and found that 13 out of 16 studies showed evidence of neurological problems following long-term, low-level exposure to Ops. Long-term health issues linked to OP poisoning also include multiple sclerosis and memory issues. (Ed; we add her work in Neurotoxicology and Teratology, Volume 32, Issue 4, 2010, abstract here.)
- In April 2014 MPs called for a ‘Hillsborough-style’ inquiry into the sheep-dip poisoning, with Shadow health secretary Andy Burnham called it a “major scandal”. Source: Agri Wales.
A saga of missing medical records
In the Telegraph, Booker pointed out that the health of thousands of farmers and their families had been destroyed by using highly toxic organo-phosphate (OP) chemicals to dip their sheep, as a protection against parasites. When the Health and Safety Executive (HSE) commissioned its own internal study into this disaster, its findings in 1991 were so devastating that they had to be ruthlessly suppressed. The survey, later released under a freedom of information request, said:
“Repeated absorption of small doses [can] have a cumulative effect and can result in progressive inhibition of nervous system cholinesterase.”
The Manchester Evening News published an early photograph of Littleborough farmer, the late Brenda Sutcliff with her husband Harold. She and three family members became ill after using a government-recommended sheep dip. No active, healthy old age for her – but her persistent campaigning was recognised and celebrated by many (below left).
Details of a sheep dipping survey were released by the Health and Safety Executive following a Freedom of Information Request by the Sheep Dip Sufferers Group. The HSE survey examined sheep dipping facilities and practices on a representative sample of 696 farmers across 16 different regions of Britain. See also: Minister pledges to re-examine OP sheep dip files
But in the same month as this report was published internally – May 1991 – the farming minister at the time, John Gummer, was demanding that local authorities clamp down on farmers who refused to use the chemical.
The report found 160 occasions where some form of ill-health occurred after dipping. It also criticised manufacturers for providing inadequate protective clothing and unclear instructions to farmers on how to use the chemicals: “If with all the resources available to them, a major chemical company proves unable to select appropriate protective equipment, what hope is there for an end-user?” Booker commented that ministers were only too aware that the government had forced the farmers to use these chemicals, which its own Veterinary Medicines Directorate had licensed as safe to use and ends:
“Although in 1992, the government quietly dropped the compulsory use of OPs for dipping, without explanation, a succession of Tory and Labour ministers refused to accept publicly that repeated exposure to them could cause irreparable damage – because, it seemed, any public admission that they were as dangerous as the HSE had found them to be might trigger off a major scandal resulting in tens of millions of pounds of compensation claims”.
A more high-profile victim (see illness), former sheep farmer Margaret Mar (right), a life peer in the House of Lords, has spent three decades campaigning in Westminster on the issue.
She said: “I know from private discussions with an advisor at the Department of Health that officials knew about the risks, but couldn’t publicly criticise OPs because they were a government-recommended dip at that time”.
An campaign by the Sheep Dip Sufferers’ Support Group, co-ordinated by Tom Rigby, organic dairy farmer and chair of NFU’s Organic Forum, has an exceptionally accurate and informative website, with a balanced approach, useful links and well-documented interviews and reports with the political establishment – recording reasonable interaction with MPs like Andy Burnham, George Eustice and Paul Tyler.
They deserve the last word:
“We are a group of volunteers campaigning for better diagnosis and treatment for all those affected by organophosphates used in agriculture. We have no membership subscription or outside funding and rely mostly on the collective experience of those who have been bravely battling against the devastating effects of these chemicals for decades.
“We hope 2018 will be the year when the farming community comes to realise the impact these insecticides have had on those involved in disease control and that they finally start to get the help and support they urgently need”.
Over 2400 of the people who were given contaminated blood have died and MP Diana Johnson (below, left) asked for an urgent Commons debate last year.
She had to get six leaders of opposition parties — including the DUP — to sign a letter to Ms May asking for an inquiry before Theresa May finally succumbed to pressure and announced a public inquiry into this 1970s and 80s scandal.
Last year it was recalled here that British haemophiliacs and other victims’ lives were blighted in the 1970s and 1980s by cheap imported US blood products, harvested from inmates and drug addicts. More than 5,000 were infected and went on unknowingly to infect family and friends. It is estimated that over 2.400 have died since then.
At a 1997 independent inquiry into the scandal, Lord Archer of Sandwell said: “By the mid 1970s it was known in medical and government circles that blood products carried a danger of infection… and that commercially manufactured products from the USA were particularly suspect… but the products continued to be imported and used, often with tragic consequences.”
It was decided that victims should die to avoid going over budget
Ministers believe the reforms (cutbacks) are necessary because more people are now considered likely to develop serious health issues – and be entitled to higher payouts – pushing the programme as much as £123m over budget.
In April, as he left the Commons, the former health secretary Andy Burnham declared there had been a “criminal cover-up on an industrial scale in the NHS” over contaminated blood and called for a Hillsborough-style inquiry.
Meanwhile the contaminated die apace as this inquiry gets under way, 30 years too late.
Work capability assessments, introduced under the last Labour government, were first carried out by Atos, which had a £100 million a year contract in 2012 – and later earned much more. The firm made a £42million profit in 2010 and paid its chief executive Keith Wilman £800,000, a 22% pay rise on the previous year. Since then other providers, including Capita and Maximus, have also been making these assessments. For several years there has been evidence from a wide range of sources that they are not being carried out efficiently. A few examples follow:
Doctors backed a motion at the annual BMA conference in 2012 stating that Atos’s assessments were “inadequate” and “have little regard to the nature or complexity of the needs of long-term sick and disabled persons.
In their evidence to the Fifth Independent Review of the Work Capability Assessment (2014), the BMA repeated its 2012 call for government to end it “with immediate effect and replace it with a rigorous and safe system that does not cause avoidable harm to the weakest and most vulnerable in our society”.
2015: An academic paper, published in the BMJ’s Journal of Epidemiology and Community Health in which examined 149 English council areas, found that nearly 600 suicides in England may be associated with the government’s “fit-for-work” tests.
Oxford and Liverpool researchers looked at three years’ data and also found the Work Capability Assessments could be linked to a rise in mental health problems. The BBC reported in 2015 that the study found the areas with most WCAs showed the sharpest increases.
2016: The UN Committee on the Rights of Persons with Disabilities found that UK welfare reforms have led to “grave and systematic violations” of disabled people’s rights.
Changes to benefits “disproportionately affected” disabled people, the UN Committee on the Rights of Persons with Disabilities (CRPD) found. The 2016 investigation was launched after receiving evidence from disability organisations about an “alleged adverse impact” of government reforms on disabled people. UN committee members visited London, Manchester, Birmingham, Cardiff, Edinburgh and Belfast in October 2015 to identify any gaps in human rights protection for disabled people. As part of its inquiry, the CRPD also looked at a range of recent welfare reforms and legislation including the Welfare Reform Act 2012, Care Act 2014, and Welfare Reform and Work Act 2016.
The BBC reported the UN inquiry’s conclusion that changes made to housing benefits and criteria for parts of the Personal Independence Payment, combined with a narrowing of social care criteria and the closure of the Independent Living Fund, “hindered disabled people’s right to live independently and be included in the community”.
Work and Pensions Secretary Damian Green rejected the UN report’s findings, but it has now been announced that after a high court ruling on 2017 regulations, introducing criteria which discriminated against those with impaired mental health, decisions on personal independence payments will be reviewed.
2017: Directors and other officers of the Department of Work and Pensions receive new year’s honours for services to ‘welfare reform’, as a reader draws attention to an undated article in the Dorset Eye, by Douglas James, listing 82 people who have died or committed suicide soon after dealings with agencies such as ATOS and the government’s Department of Work and Pensions. A search was made for news of the first five on the Dorset Eye list and links to fuller accounts were added. Most of the people were aged 30-40.
2018: Private Eye 1462 reported in January that despite long-drawn-out resistance from the DWP, Atos and Capita, the Information Commissioner’s Office has now ruled that the DWP must reveal monthly reports These include details of complaints against assessors, the length of time taken by t-assessments and how many fail – i.e. are overturned on appeal.
In December the Commons Work & Pensions Select Committee report revealed that:
- it had heard disturbing evidence,
- accounts of medical assessments range from frustrating to gruelling,
- there were remarkably high, if slowly improving, levels of unacceptable reports,
- not one doctor had been involved in the assessments and
- Capita’s own auditing found that at points in the contract almost 60% of its reports were “unacceptable”.
MP Tom Brake speaks out:
“Many constituents are in despair when they contact me after an inaccurate report. Reports of face-to-face assessments need to be unbiased, fair and above all accurate. It was important to flag up these discrepancies directly with ATOS. The Government need to ensure that assessments are recorded to prevent alarming inaccuracies. I will continue to put pressure on the Government to reform the current system. At the moment too many people have lost faith in the system.”
Last resort: after many disastrous years – like Windscale nuclear reactor station – in June Atos Healthcare announced changes to its name – but not its practice.