nhs

What do the Tories want, blood?

Sent this evening. Let’s see how long the government’s mouthpiece in my constituency my MP takes to reply and how she squirms around this one.

Dear Esther McVey,

Please can you confirm the following:

1) That the government, of which you are a member, is seeking to privatise Plasma Resources UK and turn a not-for-profit part of the NHS into a profit centre for shareholders of (often foreign-owned) companies

2) That you personally support this policy as MP for Wirral West

3) That the sale is being run by Lazards, who are a major donor to the Conservative Party and are owned by major donors to the Conservative Party

4) That you personally support Lazards being paid taxpayers’ funds in this way

5) That there will be a publicity campaign to tell blood and plasma donors, who are making donations free and in their own time, that a profit, largely from taxpayers’ money, will be made from their donations

6) That you personally want such a publicity campaign to take place?

I look forward to hearing from you, directly, as soon as possible.

Yours sincerely, etc

 

[Reference]

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Of fraud and fraudsters

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Photograph by ell brown on Flickr. Creative Commons licence

If you, like me, have something incurable but treatable that, without treatment, would leave you unable to work, the NHS in England is grudgingly willing to let you have your prescriptions for free.

They don’t make it easy for you to find this out. You need to either wade through dozens of forms and leaflets offering you ways of paying in advance or in instalments, or, as happened to me, pay for prescriptions that were keeping me alive for about a year until my GP casually asked if anyone had told me I could be having them for free.

For five years the NHS has been pumping an increasing number of pills in to me (mostly to counteract the side-effects of the previous set of pills, as far as I can tell) and it hasn’t cost me a penny. Which is good, because otherwise it would be costing me over £40 a month just to stay alive. There have been times recently when I simply didn’t have £40 for such non-essential luxuries as medicines to stay alive, so I’m grateful to Dr Botherway for mentioning the existence of the card in the first place.

These cards last 5 years. I’ve just reached that milestone and have been through the tortuous process of applying for a renewal – go to your GP, get a form, pick between the two types of hypoparathyroidism mentioned without really knowing which one you have, sign the form, return it to the GP, get him to sign it and post it, wait for anything up to 3 generations for the new card to come back from Newcastle… the usual experience when dealing with any bureaucracy that hates its customers (that is to say: all of them).

So I was very pleased to see an NHS envelope on my doorstep this morning. That was quick. Oddly large, bulging envelope… can’t feel the card in it. Hmmm. Have they changed formats? Are they bombarding me with leaflets to get me to eat less meat… again?

Oh, if only. I opened the envelope and was confronted with two Penalty Charge Notices, for £88 each. Two badly (impenetrably) written covering letters. Two photocopies of the back of two prescriptions. Two identical two page forms asking for information they hadn’t got (like my NI number and my NHS number… now that’s worrying). And one envelope designed to take one very large cheque.

There was no “please explain how…” or “our records don’t appear to show…” or any other attempt to communicate. Just the awfully written letter telling me that they had made rigorous checks of my February 2012 prescriptions and had discovered that I was defrauding the NHS of vital funds and must pay up immediately. This was annoying on several levels, as I’m sure you can imagine.

First, the letter is clearly actionable as it accuses me, baselessly, of fraud against an organisation that I’m loudly proud of and have attempted to defend – our NHS. That’s defamation.

Second, I have to prove to them my innocence of these baseless charges. They don’t make that easy, either, providing little or no space to write information like “I’m holding the fucking exemption card in my damn hand NOW, you berks” or the like. I also have to go out, get two photocopies made of my card and return it within 7 days… in a second class prepaid envelope. The clock on this started ticking when they posted the Penalty Charge Letter second class on Wednesday. The post around here is so slow, it won’t get to them in time.

Third, the prescriptions themselves don’t have a place to write the number of the card. No, really. You tick a box, but you don’t provide proof. You can show the card to the pharmacist, but about 2 years ago they were told not to ask for it any more and when you do show it they show no interest whatsoever. One of the prescriptions has the number scrawled on it. The other is stamped “evidence not seen”. So the evidence was seen, just very reluctantly.

Fourth, I now have a permanent record, as far as I can tell, sat on a file somewhere in the NHS saying that I’m a fraudster. One day I might go crawling to the NHS for some help, you know, dying or something trivial and a doctor ro administrator or receptionist will pick up the file, see “DEFRAUDED NHS PHARMACY FEBRUARY 2012” on it and let me slip to the back of the queue (this type of thing does happen: seven years ago a homophobic doctor kept pushing down the queue for investigations and operations because she felt I’d brought the symptoms of bowel cancer on myself with all the poky bum sex I wasn’t having because I had the symptoms of bowel cancer).

Fifth, it would be really helpful if the NHS didn’t spring nasty surprises like this on people who are on medication for disorders that are made worse by stress. I’d’ve hoped that was obvious.

Sixth, the cost of all of this. A letter to me, saying “Our records show you ticked this box but we can’t match it to your card. Please write the number of the card here:” sent second class with a return envelope would cost comfortably under a pound and would offend nobody. An A5 envelope with 10 sheets of paper, 2 staples, a return envelope, a covering letter, photocopies and the whole swirling back room admin of trying, albeit not very hard, to match the prescription with the card plus going to a higher officer for permission to fine me, opening a file, maintaining it and all the rest can’t come in much under £20, if not a whole lot more.

Sure, they’d make that up if I was indeed a fraudster. But they won’t this time. Or, judging by this performance, most of the time. Instead this is just money that has washed down the drain (along with the billions in sweeteners to the private companies the Tories are selling the NHS to).

As ever, it remains true that our NHS could use a great deal of reform. But not this insane Tory/Liberal privatisation nonsense. Not the constant rearranging of the boardroom chairs and the merry-go-round of managers, managing directors, commissioners and all that shit. What our NHS needs is the simple application of common sense in all the things it does, from prescriptions to prognoses, from gynaecology to geriatrics.

Sadly, however, when was the last time you saw any politician with even a tiny grain of common sense?

We wake up, we go out, smoke a fag, put it out

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I’m a smoker.

I have been since my early teens. Smoking and me were made for each other. I love the taste. I love the smell. I love the sophistication that I feel with a fag between my fingers. Each cigarette is something I look forward to, enjoy lighting, enjoy drawing the fumes into my asthmatic lungs and enjoy stubbing out at the end. Smoking and me were made for each other. When I’m not smoking a cigarette, something is missing from my hand.

I’m an anti-smoker.

I don’t like other people’s smoke. As much as I would really enjoy a ciggy with a pint, I’d rather not share my pint with other people’s smoke. I love a cigarette between courses of food but don’t want someone smoking during my meal. A very long train journey is a nightmare for me without the gaspers. I’d rather not share a carriage with a single person puffing on a fag – let alone sit in a (now long forgotten) smoking carriage.

Perhaps that lets me make the following comment about current government policy on cigarettes.

Cigarettes are expensive. This is A Good Thing. The cost deters people from starting and makes the insane cost of nicotine replacement therapy seem reasonable. (Yes, a full weekly course of NRT costs less than a week of cigs, but smokers discount the cost of the daily packet as if it was background voices and inflate the cost of NRT because it seems so upfront).

The latest wheeze (ho ho) is to put cigarettes out of sight. You go to buy them and they’re not there. The shop assistant unlocks a door, fishes them out and sells them to you blind.

I have my preferred brand – Silk Cut Silver, if you must know. It’s low tar and low nicotine. Of course this is worse than not smoking at all, and I agree it it’s probably no better than smoking Capstan Full Strength. But as I queue at the kiosk, if they don’t have my brand, what do I do? Write off the queue time or buy something else? I’m human. I’ll buy something else. And it’ll be stronger. So for the next 24-48 hours, I’ll be smoking something that tastes stronger, has higher tar and has higher nicotine. That’ll help when the day comes to give up.

But the worst part of this stupid idea is that it makes the price of fags completely discountable. Yes, us smokers will choose by price to a degree, despite what I said above. But if prices continue to rise above inflation, the motivation for stopping increases. Poorer smokers – and I’ve been a poor smoker, even whilst in the arms of the welfare state – will buy a packet of 10 and eke them out when the price gets too much. Eventually, they’ll turn to their GP and ask to be enrolled on the humiliation-and-hectoring course the NHS does free to help you quit (that would *so* not work for me – the words “who the fuck do you think you’re talking to?” would bubble up uncontrollably).

What has happened here is that the price of cigarettes has now been hidden. Not the packets, not the subtle advertising, not the craving – just the price. As the cupboard doors appear over the fags, so the connection between price and the cost of smoking disappear. Already WHSmith do this – their railway station outlets put a £1 premium on the cost of 20 fags. The shop assistants usually warn you. “They’re £8.10 here and there’s a real shop down the street”. When they don’t warn you, you’re faced with paying £8.10 there and then. And you do, because you’ve queued and because you’re gasping and because you don’t want to shop elsewhere and you don’t want to annoy the shoppie… So you pay.

And so it will be when all the cigarettes are covered up. The supermarket hegemony will jack the prices because you can’t see them. The local shops will undercut them, but only by a few pence. The NHS’s major weapon against smoking, the control of the price, will be broken and the rewards will be taken by the large retailers and the tobacco companies who are about to get a cigarette-based bonanza of cash.

And the losers? Well, the slow but steady rise in the cost of fags has benefited the NHS via the Treasury for 30 or more years. It has also pealed off the more casual smoker who choses to give up on Budget Day. The forthcoming free-for-all in prices will benefit neither. Smokers will be quickly immunised to the prices. But the retailers and the tobacco companies will be minting it.

The only loser will be the NHS. But then we’re under a Liberal-Conservative government of the rich, by the rich, for the rich, that believes that the NHS is for losers only anyway. So it hardly matters.

 

Tear down this Bill, Mr Lansley

The government’s epetitions website is meant to be a place that we subjects can blow off a little steam without actually bothering our lords and masters.

That, however, isn’t to say it isn’t useful for those of us who want to take back parliament from the vested interests that are now running the show. When 100,000 people sign a petition, MPs have to look into having a debate about it – getting our voice into parliament, something many MPs (my own, Fester McVague, in particular) feel they were elected to prevent.

So here’s a petition that can make a difference, even if the result is only to bolster the ineffective opposition parties and shake the smug, self-satisfied consciences of the Liberal Democrat MPs who have let power go to their heads and their hearts.

If you’re a British resident, visit the Drop the NHS Reforms Bill epetition now – at the time of writing, it’s agonisingly close to the 100,000 signatures needed to force a debate, most of which were gained today.

Whatever you vote, and I don’t presume to know what goes on between you and a (secret) ballot box, if you’re British you have reason to be grateful for our NHS. Yeah, it’s not perfect, but it’s ours and it’s run by people who are doing it for love not money, for people regardless of what they can or should be asked to pay. And it is ours, not the government’s, not big business’s, not Lansley’s, not anyone’s. The NHS is ours and we need to stop it being privatised by stealth.

On being a Whoer

He's back… and it's about time. The new series of Doctor Who starts tonight and I am unreasonably excited, as I have been for nearly every new series since about 1981.

My earliest memory of watching Doctor Who is accidentally stumbling upon Warriors' Gate in 1981. I must've come in part way through an episode part way through the adventure, but I was instantly and irredeemably hooked. Then, a couple of months later, the Doctor fell from Jodrell Bank and turned into a completely different person. From that moment, I ceased to be hooked and became obsessed.

I think this works the same for all fans of Doctor Who. They enjoy the series until their first regeneration, at which point they become addicted to it. I remained addicted all through Peter Davison's tenure, despite the BBC moving the series to somewhere harder to find in the schedules. I even gave up a club I went to on Monday evenings with my best friend of the time in favour of watching the show.

I stuck with the series through Colin Baker's time, although by this point the series was beginning to flag, even for me. No fault of Colin Baker – a fine actor to this day – but the series was clearly unloved by the BBC and needed a rest and a change of production management. In the BBC of the day, only the pause was possible, and the series disappeared in 1985 for a year and a half, but sadly returned with a smaller budget and the same tired executives in place. I stuck with it.

The Doctor regenerated again, and Sylvester McCoy, a truly great Doctor, appeared. The series was freshened up and really started to catch fire again. So the BBC cancelled it.

Seven years passed and I moved on to other interests – Star Trek: The Next Generation launched and I got obsessed with that instead. The BBC tried again with a one-off backdoor pilot for a new Doctor Who, made in Canada, but it relied on (a) money from Fox that wasn't forthcoming and (b) intimate knowledge of the show's backstory mixed with the ability to ignore the places where they had changed that same story. So that wasn't going to work.

Time passes, and in 2004 the BBC announced that the show was coming back. It didn't sound hopeful: it was to be made in south Wales, of all places, written by a guy best known for comedy and children's TV, and starring a teenypop girly singer known as "Billie". Still, I'll watch it, I thought, if only for the nostalgia.

In the run-up to it going out for the first time, I had actually started to get excited, even while doubting that it could be as good as I remembered (if you go back and watch episodes of stuff you enjoyed as a kid, it is often surprisingly dull). On Saturday 26 March 2005 I popped to my doctor to have a blood test, with plans to nip to Sainsbury's to buy booze and snackfood to consume in front of the TV that night.

At 7pm on that Saturday, I was lying in a hospital bed, having 4 pints of blood put into me. Something had gone terribly wrong. I hurriedly paid for the terrible Patientline service to get BBC-1. I was foiled: during the title sequence, the junior doctor arrived, and having heard me say how I'd been waiting for this moment for 9 years, announced that this was the only time she had available to perform some tests. These tests involved looking up bum, which made watching TV difficult, and it would've been nice if she'd bothered to close the curtain around the bed, but when you're ill, the NHS makes you better in return for your dignity. (I later learnt that the hospital had decided that, since I was bleeding to death internally and would ultimately need a large, murderously-inclined part of my bowel removing, it was obviously my own fault because I was a filthy queer – hence the, er, less-than-caring attitude of the staff. Once I was well, I had to take action against them. I won)

Still, I watched the rest of the series as my life ebbed away. The new series was brilliant. Wales is a great place to make television, it turns out, with some of the most talented production crews in the entire world – that shouldn't surprise a Welshman like me, but there we are. Russell T Davies, that comedy and children's writer, had also written Queer as Folk, the series that directly brought about a change in society's attitudes to homosexuality and relaunched serial drama as a television phenomena. The series was more than safe in his hands: it was in perfect hands. And Billie, teenybopper, was actually Billie Piper, award-winning actress of real talent.

Time passed, I was cured, and I kept watching as the 'new' Doctor, Christopher Eccleston, regenerated into the newer David Tennant (I cried), then through Tennant's years in the role, falling deeply in love with his Doctor. And then he regenerated (I cried for days and still do if I see the regeneration scene) and Matt Smith took over, after – correcting the injustices of the past – a decent break that built expectations and a change in production management that kept the format fresh (and brought another comedy/children's writer to the helm, the equally brilliant Steven Moffat).

Tonight is the second series of Matt Smith's Doctor Who. I'm not in love with the 11th Doctor in the sexually-perverted way I was with the 10th (although I'm nursing a crush that could squash him) but I'm just as excited as I was in 2005, and in 1981. That is effectively forever??in television terms, which shows the true power of a format invented back in 1963 by Sydney Newman and Verity Lambert. For the ball-and-chain, who saw the first ever episode go out the day after JFK was assassinated and was also instantly hooked, the excitement is no different, even almost 50 years later.

So tonight, I'm buying the booze, he's buying the Chinese takeaway and we're sitting down in front of BBC One HD at 6pm.

I have no blood tests planned.

Andrew Lansley, dangerous idiot

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When the Tories came to power (yeah, whatever), the party faithful and the new MPs were the most right-wing they had been in their entire history. They've liberalised their views on some social issues (they're now pro-gay, they say, although they still hate single mothers and other social deviants) but economically, they're neo-conservatives in the George W Bush/Tea Party stylee.

Unlike the neo-cons in the US, they know that the British people are basically centrist, so they have done a good job of hiding the breadth of their plans for selling public services to their friends in big business. We Brits don't tend to like that type of thing.

With the NHS, the Tory plan seems to have tested well in focus groups before the election. In broad terms, it does indeed sound good. Instead of remote boards and faceless managers deciding everything, the job will be handed to your friendly, cheerful, local GP to do. And, if he won't do it, well, don't worry, other groups (private businesses, but we won't say that loudly) can do it. All's well.

Except it isn't. This is a radical switch in power from those with a lot of knowledge to those with none. By making hospitals dance to the GPs' tune, the experts – specialists, consultants, nurses – in given diseases will have to do what the GP – general, jack-of-all-trades – wants them to do. And I've just experienced this.

I've been having tests at a local hospital. They're all negative. Yesterday, I saw the specialist and she was downright hostile. Why, she demanded, was I wanting all of these pointless tests? What was I trying to prove? Well, nothing. I didn't want any of the tests. My GP wanted me to have them. I really don't have the medical knowledge to decide whether the GP is seeking pointless tests or not.

She pushed further into my notes and wondered if they were incomplete. Did I know what the results were for such-and-such a test? Did I know what level something-or-other was at? No, I didn't, because I'd never had those tests. My GP had seized upon one symptom and was having the hospital probe that symptom over and over again; what he wasn't doing was attempting to find a root cause for all the symptoms. He hadn't stopped and looked at the whole body, he'd skipped to the likeliest outcome based on one symptom and passed me on to the hospital, rather than paying for the actually-needed other tests.

The specialist at the hospital will now be writing him a stern letter, reminding him to do his job fully first in future.

And here's the rub: when Andrew Lansley's "reforms" to the NHS go through, the specialist will never again be able to write such a letter. The power will move from her, with her a-lot-about-a-little knowledge, to the GP, with his a-little-about-a-lot way of working. The hospital will have to keep performing the pointless tests on one symptom until the GP is satisfied. The patient – me – gets a worse deal than ever, being poked and prodded and taking time off work for tests that aren't needed. The GP gets to make expensive financial decisions in the 4-minute slot allocated to each patient every day along with the medical decisions that we'd rather he made in that tiny time. The specialist doesn't get to specialise; the generalist has to do the impossible and get more specialised about more and more generalities.

This is all bad. Give me a remote, faceless bureaucracy any day.