400 doctors & specialists sign opposing NHS bill


12:01 am - October 4th 2011

by Sunny Hundal    


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In an open letter to all members of the House of Lords, more than 400 public health doctors and specialists from all over the UK have called for the government’s Health and Social Care Bill to be rejected.

The letter, to be published in today’s Daily Telegraph (below), includes signatories from across the whole spectrum of public health practice, including over 40 Directors of Public Health and over 100 leading public health academics.

The letter states that “the Health and Social Care Bill will erode the NHS’s ethical and cooperative foundations” and “will not deliver efficiency, quality, fairness or choice”.

They also draw attention to the likelihood of the Bill undermining the country’s overall public health capabilities.

Professor Martin McKee CBE, from the London School of Hygiene and Tropical Medicine, said:

This letter demonstrates the widespread recognition within the public health community that this Bill is bad for the NHS and harmful to the overall health of the population.

There is no research evidence that reforms clearly intended to promote commercial competition will improve quality and safety of care. On the contrary, they are likely to lead to higher administrative costs, greater inequity and an erosion of medical ethics and professionalism.

Dr Paul Edmondson-Jones, Director of Public Health in Portsmouth, said:

As public health professionals, we have a duty to promote evidence, effectiveness and equity in health and social care. The Bill, as it stands, is not supported by any such evidence and will simply fragment our system. Evidence from other countries suggests that the proposals are more likely to create more inefficiency and greater cost and more importantly, increase our vulnerability to infectious disease outbreaks and a bigger health divide.

The organisers of the letter now intend to encourage further discussion between public health professionals with other segments of the health professions including the Royal College of General
Practitioners.
From a press release

TEXT OF THE FULL LETTER
Dear Honourable Members of the House of Lords,

As public health doctors and specialists from within the NHS, academia and elsewhere, we write to express our concerns about the Health and Social Care Bill.

The Bill will do irreparable harm to the NHS, to individual patients and to society as a whole.

It ushers in a significantly heightened degree of commercialisation and marketisation that will fragment patient care; aggravate risks to individual patient safety; erode medical ethics and trust within the health system; widen health inequalities; waste much money on attempts to regulate and manage competition; and undermine the ability of the health system to respond effectively and efficiently to communicable disease outbreaks and other public health emergencies.

While we welcome the emphasis placed on establishing a closer working relationship between public health and local government, the proposed reforms as a whole will disrupt, fragment and weaken the country’s public health capabilities.

The government claims that the reforms have the backing of the health professions. They do not. Neither do they have the general support of the public.

It is our professional judgement that the Health and Social Care Bill will erode the NHS’s ethical and cooperative foundations and that it will not deliver efficiency, quality, fairness or choice.

We therefore request that you reject passage of the Health and Social Care Bill.

—————–

The full list of signatories will be on the Telegraph website

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About the author
Sunny Hundal is editor of LC. Also: on Twitter, at Pickled Politics and Guardian CIF.
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Reader comments


1. So Much For Subtlety

The letter, to be published in today’s Daily Telegraph (below), includes signatories from across the whole spectrum of public health practice, including over 40 Directors of Public Health and over 100 leading public health academics.

But that is the problem isn’t it? The opinions of the producers – the people who live off the system – are not really what we want to hear. We want to hear the voices of the consumers – the public that uses and pays for the NHS. Except we cannot really know what they think until we have experienced both systems. Although we know by most sane measures America does better than us and by any measure at all, France does too. What we can do is insist that NHS policy is responsive to the consumer and not to the producers. Which means we need to ignore these people. Worse than that really. We need to make sure we don’t do what they want. The NHS should be about us, not them.

2. Leon Wolfson

The opinions of the people sworn to protect lives. The professionals in the field.

Of course people don’t need to go without basic healthcare to understand that it’s a good thing to have. You’re the one who wants the NHS to have to farm off vast portions of it’s budget to private “producers”. And of course you want it to be all about the private “producer’s”, whose side you’re paid to take.

And you still need that MPD treatment I see.

3. Leon Wolfson

Right, ignore the professionals. Ignore the people sworn to protect life. All so you can syphon the NHS’s funds for your paid buddie’s private healthcare companies, so we can end up with people experiencing the American system of “no non-emergency healthcare for YOU, you’re poor!”

4. Leon Wolfson

(Apologies to the editors, I got a 404 when I posted the first rant)

1
But isn’t this new bill about the opinion of certain MPs, and, unless, they have first hand experience of the NHS, who should we believe, I would say those with the expertise. And this is the norm, if we want advice about house building we consult an architect and a builder, if we want advice about our teeth we consult a dentist, all of these professionals are also producers.

Well done Sunny! You’ve found a letter from 400 doctors who don’t like the government. Now try and find us one from the other few hundred thousand.

The NHS, much like public sector pensions HAS to be reformed as it simply is going to run out of cash if left as it is. It’s hardly surprising those on the producer side of the fence are going to defend it as long as possible,

I mean, it is hardly in the NHS interests to be erxposed to the scrutiny of competition, is it?

7. the a&e charge nurse

Oh, I do love the ‘producer interest’ logic – a near blanket invalidation of the views of workers in any given sector.

We get the same infantile drooling when it comes to other groups,
Teachers mustn’t talk about education.
The police mustn’t talk about law enforcement.
Soldiers mustn’t talk about military activity.
And of course journalists mustn’t talk about the press.

If these foolish workers do insist on commenting on their respective fields, we can easily dismiss views under the “producer interest”cliche – yes,this line of thinking certainly works for me.

After all, once you join the NHS nobody ever gets, sick, relatives never die, and nobody is ever allowed to have a baby again.

8. Flowerpower

“Public Health doctors”……..mmm

Aren’t they the ones who think you can fight disease with leaflets and ‘awareness campaigns’ instead of drugs or surgery?

Kinda “advertising meets homeopathy”. Jeez…..

@1

By the sane measures of money and life expectancy, the USA does not do as well (as the UK).

The cost of health care in the US is almost twice the percentage of GDP, and outcomes overall are less good.

As for Tyler and Flowerpower – the usual meatheads peddling the usual drivel.

10. Leon Wolfson

@8 – Guess what? Their techniques, when implemented. reduced infectious disease issues in European cities by over 90%. Vaccines and medical techniques picked up the other 9% (you can’t /eliminate/ them…), but allowing our cities to become open sewers again would overwhelm those programs.

But thanks for calling for that.

11. the a&e charge nurse

[8] This approach was seen to full effect when Dr Gawande was in India to witness the monumental effort to vaccinate four million children in just three days.
It was the first case of polio in over two years, which kicked off when a family travelled down from the north. The scale of the response was barely imaginable. Every child within a 50,000 mile radius had to receive the vaccine. “On the one level” Dr Gawande says “You think solving the polio problem is about just making sure people get an injection. How hard can that be? So we’ve invested all of our effort in the early part of the last century in discovering the solution – but not in thinking about how do you actually deploy it”. Seeing the vaccination programme take off was like watching an army get into gear, Dr Gawande remembers. “You think it is impossible. They had to go door-to-door.” The teams used the knowledge of local physicians who had studied the area to assess logistical challenges – such as making sure ice could be transported with the vaccines to keep them at the correct temperature.
http://news.bbc.co.uk/1/hi/health/8493922.stm

Yeah, so just like homeopathy, or advertising?

The simple fact is they can’t be trusted with the NHS, they never could, they should just F##k Off.

13. So Much For Subtlety

5. jojo

But isn’t this new bill about the opinion of certain MPs, and, unless, they have first hand experience of the NHS, who should we believe, I would say those with the expertise.

I assume most MPs have been sick at some point. They will have relatives who have used the NHS. That gives them the right sort of experience, no?

And this is the norm, if we want advice about house building we consult an architect and a builder, if we want advice about our teeth we consult a dentist, all of these professionals are also producers.

Yeah but they don’t usually have a government monopoly which we are forced to pay for. There is competition in most of those markets. So we can shop around and hence they are forced to give us what we want. Look how badly architecture turned out when it did have a government monopoly – I refer you to the housing estates of Islington or Glasgow for instance.

7. the a&e charge nurse

Oh, I do love the ‘producer interest’ logic – a near blanket invalidation of the views of workers in any given sector.

Indeed. And rightly.

We get the same infantile drooling when it comes to other groups, Teachers mustn’t talk about education.

Alas education has been captured by the Education Unions and so is a massive cluster-f**k of incompetence, failure, waste and politically correctness. Education proves exactly why we should be careful listening to the producers and not the consumers.

The police mustn’t talk about law enforcement.

Is this the first time that LC has ever defended the views of the police on law enforcement? I think it might be you know. Sure, let’s listen to the police tell us about law enforcement. I mean their views on Blair Peach and that guy who got “pushed” at that demo in London were so interesting. When it comes to civil liberties and things like being verballed, why listen to civil liberties groups? Let’s just ask the police what they think shall we?

Come on. As perhaps the strongest supporter of law and order here, if not in Britain, even I recognise the police have some issues here. Just as I don’t think prison guards should be making penal policy. Although it would be better than the creepy thugopholes who do make penal policy.

14. So Much For Subtlety

11. the a&e charge nurse

This approach was seen to full effect when Dr Gawande was in India to witness the monumental effort to vaccinate four million children in just three days.
…. Yeah, so just like homeopathy, or advertising?

When was the last time Britain had a major vaccination campaign against a major killer? I suspect the last time anyone involved in public health contributed to vaccination was when someone suggested that vaccination caused autism. A typical public health approach.

There is no denying that public health campaigns were once useful. In the same way the Howard Society was did good things. It has been a long time since they have done so in Britain. Perhaps Doll and smoking was the last actual contribution they made to British health. Since then they have been lying to us about the dangers of drink and cholesterol. They have been trying to bully us into some semi-Seventh-Day-Adventist quasi-vegetarian diet. And otherwise just wasting our time. This would not matter if it did not mean that doctors were moving from the useful – discovering new drugs which has largely stopped – to the counter-productive – finding spurious correlations and demanding change.

We would be better off without any academics in public health. They know it too. But rather than give up their power and pensions, they are going to man the barricades and demand we continue to pay them. Great.

15. Leon Wolfson

@13 – I’ve been shot at. According to you, I’m now an instant expert on firearms.

And “law and order” is that what you call totalitarianism and sadism? I see. You’d be right at home in North Korea’s elite…

13
I find it laughable that you think that being ‘sick’ makes one an expert in understanding the machinations of one of the largest organizations in Europe. I suppose you believe that after buying an house, you become an expert in architecture. I can see why you have some rather strange ideas about education.
I would also be interested in how shopping-around for something we know nothing about is somehow useful, I mean, how do we know that we have found the right treatment, we can’t rely on those professional with the knowledge, can we?
Regardless of the method of funding, a visit to any doctor in the UK should be about clinical outcomes. This is not the case in the US, where the rich can buy, via their doctors, any licensed drug available, regardless of clinical guidance eg. Micheal Jackson.
The NHS isn’t perfect but much of your criticism would be valid if you were talking about private practice.

17. So Much For Subtlety

16. jojo

I find it laughable that you think that being ‘sick’ makes one an expert in understanding the machinations of one of the largest organizations in Europe.

I find it laughable that you think anyone would believe you got that out of anything I said. Not that I didn’t, as you must know I didn’t, but that you would think anyone on your side is so stupid as to believe I did.

how do we know that we have found the right treatment, we can’t rely on those professional with the knowledge, can we?

Treatment is another issue. And even there we are careful not to allow doctors’ financial interests to get in the way of treatment. Thus we buy drugs from a pharmacist, not from our surgeon (OK, not as much as we used to but still, the point remains). Why should we listen to people whose job depends on the NHS spending like a drunken sailor?

Regardless of the method of funding, a visit to any doctor in the UK should be about clinical outcomes. This is not the case in the US, where the rich can buy, via their doctors, any licensed drug available, regardless of clinical guidance eg. Micheal Jackson.

It *is* the case in the US. It is not here. It is no more the case that the rich can get whatever drug they want than anyone in Britain can get whatever drug they want with a little shopping around and perhaps some intimidation of the doctor. Both are partially true but not really.

The NHS isn’t perfect but much of your criticism would be valid if you were talking about private practice.

Why is someone’s living less vital to them just because their cash comes from the Treasury?

18. the a&e charge nurse

[14]” When was the last time Britain had a major vaccination campaign against a major killer” – err, last year during the swine flu outbreak.

Perhaps you have never heard of drug resistant TB, or new strains of hiv that are becoming harder to treat?

If the UK was subject to attack by chemical weapons such as sarin, or anthrax which group of doctors should manage public risk.

Maybe we can keep just one public health doctor in a special bottle (rather like the remaining smallbox virus) then break it open when the next outbreak of avian flu arrives – after all it is hardly going to need any expertise or cumulative experience?

19. So Much For Subtlety

18. the a&e charge nurse

err, last year during the swine flu outbreak.

Sorry but would that be the flu outbreak we were forced to spend billions on useless vaccines for which never actually materialised? That flu outbreak?

Thus the problem with modern public health – a non-issue that was beaten into a mass panic greatly enriching a small number of vaccination manufacturers. With whom leading members of the WHO may or may not have had close financial interests.

Perhaps you have never heard of drug resistant TB, or new strains of hiv that are becoming harder to treat?

HIV seems close to a break through. But public health has been useless in this. In fact the medical profession has largely behaved shamefully in the HIV epidemic – lying, twisting facts, holding up sensible prevention programmes and so on. Not that any of this is relevant as the public health approach has not worked particularly well. Nor has it with drug resistant TB. Or at all in that case. So are you just throwing stuff out in the hope some of it works?

If the UK was subject to attack by chemical weapons such as sarin, or anthrax which group of doctors should manage public risk.

Don’t forget to ask what happens if we are attacked by little green men from Mars.

Maybe we can keep just one public health doctor in a special bottle (rather like the remaining smallbox virus) then break it open when the next outbreak of avian flu arrives – after all it is hardly going to need any expertise or cumulative experience?

Sure. Why not? As long as they stick to their area of expertise. Which is medicine one would think. Not technical issues of how we choose to fund the NHS. Or to take the first name from this article, Martin McKee CBE, from the London School of Hygiene and Tropical Medicine, pretty much anything he teaches:

Teaching

I established and now contribute to a course on issues in public health, taught in the autumn term. This course seeks to show that public health can actually be exciting and stimulating. It is intended for people who want to make the world a better, and fairer place to live in. It uses problem based learning and is based on real life issues, such as gun control, discrimination, and challenging vested interests. It is not for those who see public health as a way to a quiet life! I also contribute to a course on health systems, in the summer term, that draws extensively on our work in the European Observatory.

Make the world better and fairer? So not medicine then, but political activism? Gun control? Not a medical issue but a political one. Discrimination? Likewise not a medical issue but a political one. Challenging vested interests? Just what he is afraid of it seems. Being a massive vested interest himself.

It is all just warmed up socialism passing itself off as science. He must have cried all night when Foot lost. He should have his funding cut and his post abolished. This is not what the NHS should be about.

20. the a&e charge nurse

[19] “Sorry but would that be the flu outbreak we were forced to spend billions on useless vaccines for which never actually materialised” – ahh, the unmistakable smugness of life viewed through the retrospectoscope.

In April 2009 Mexico City was virtually shut down as a novel virus claimed over a hundred lives in the first month – the virus then made it’s way to the UK.

A novel virus, an apparently significant infection to death ratio – what would you have done as resident H1N1 expert?
Or are you just the sort of armchair critic who, as well as deciding what does or does not constitute a public health threat, is also rather fond of telling football managers how they should be running their teams?

19
Aren’t vaccines preventative medicine and the whole purpose is to ensure that each individual getitng that vaccine, prevents a public outbreak (many individuals getting the disease)
I remember Richard Littlebrain, whoops Littlejohn, stating something similar about the money spent on advertisizing to prevent a spread of the HIV virus, when it didn’t materialize, he did a ‘you coulnd’t make it up’.
Clearly you feel the same way about the predicted flue outbreak and that the best outcome, when spending millions on preventative medicines, is that there is a huge outbreak.
Really, you couldn’t make it up.

22. the a&e charge nurse

[19] “Don’t forget to ask what happens if we are attacked by little green men from Mars” – oh dear, somebody that has never heard of sarin, ricin, anthrax or polonimum
http://www.semp.us/_images/biots/Biot171PhotoA.jpg

Still even if there was an attack we mustn’t involve public health doctors – what do they know, eh?

23. So Much For Subtlety

20. the a&e charge nurse

ahh, the unmistakable smugness of life viewed through the retrospectoscope.

Well no. To even define this as a pandemic, the WHO had to seriously dumb down its definition. This was a manufactured panic and that was apparent even at the time. The WHO, of course, suffering from a crisis of relevancy if it does not find things to scare its funders over.

In April 2009 Mexico City was virtually shut down as a novel virus claimed over a hundred lives in the first month – the virus then made it’s way to the UK.

Yeah. You see that little over reaction there? Not a good argument for you is it?

A novel virus, an apparently significant infection to death ratio – what would you have done as resident H1N1 expert?

I would have stuck with the old WHO definition and not got so worked up about it.

What, in fact, a large number of people with expertise in the area, but no ties to vaccine manufacturers, in fact said.

21. steveb

I remember Richard Littlebrain, whoops Littlejohn, stating something similar about the money spent on advertisizing to prevent a spread of the HIV virus, when it didn’t materialize, he did a ‘you coulnd’t make it up’.

I have a tiger-repelling rock. For just £19.99 I am happy to sell it to you and I guarantee you will have no tigers wandering through your back yard. Deal?

The problem with doing something is that you have to show something needs to be done. We can sacrifice a virgin to the Great Sky God and then claim that deterred the flu epidemic because, after all, we don’t know what the outcome would have been if we didn’t. Doesn’t mean the sacrifice worked does it?

With HIV there has been a strong and powerful lobby that has recognised that most people don’t give a damn if drug users and homosexuals get AIDS. Sad but true. So they lie, or at least exaggerate. They claim that HIV is a threat to heterosexual couples. Despite there being no evidence of this. Which means that these campaigns target everyone, not high risk groups. Don’t want to stigmatise Gays after all. Lo and behold, the epidemic never happens. Does that mean that the campaign worked? Or just that there was next to no risk for heterosexuals in the first place? Elizabeth Pisani not only wrote a very good book on her work on HIV, she freely admits to this sort of thing.

Clearly you feel the same way about the predicted flue outbreak and that the best outcome, when spending millions on preventative medicines, is that there is a huge outbreak.

The best outcome is a one-to-one correspondence between spending and risk. We don’t spend when we don’t need to – as we have been doing – and we do spend when we do need to. By and large the public health experts have let us down by always going for the over-reaction. Look at their colleagues who were responsible for foot-and-mouth.

22. the a&e charge nurse

[oh dear, somebody that has never heard of sarin, ricin, anthrax or polonimum M

I see. You are advancing this as a serious argument? What prey tell could any expert in public health do about a terrorist attack involving sarin?

Still even if there was an attack we mustn’t involve public health doctors – what do they know, eh?

Very little about sarin I expect.

24. Leon Wolfson

@23 – “They claim that HIV is a threat to heterosexual couples. Despite there being no evidence of this. ”

What a surprise, also complete denial of HIV as a virus, able to affect anyone exposed to it. Science is too good for you, isn’t it… ignoring the wider risks leads to Africa’s situation where it starts spreading widely in the population.

Of course, they’re “only” Africans to you, not Humans.

“What prey tell could any expert in public health do about a terrorist attack involving sarin?”

You don’t have a clue about emergency management either I see, as well as a complete denial of the role of public health, which is a VERY wide discipline.

More typical calls to dismantle the “unnecessary” social infrastructure, as usual. Record Broken Is.

25. So Much For Subtlety

24. Leon Wolfson

What a surprise, also complete denial of HIV as a virus, able to affect anyone exposed to it. Science is too good for you, isn’t it… ignoring the wider risks leads to Africa’s situation where it starts spreading widely in the population.

Leon, your garbage is not worth dealing with. This is only just an exception as it is talking about important issues. Which you, obviously, do not have a clue about. Of course HIV is a virus. And it is able to infect anyone exposed to it. But the important question is the one that, of course, you are unable to formulate on your own – what is the risk of being exposed to it? The chances of acquiring HIV from normal vaginal intercourse is something on the order of 10 per 10,000 for women and 5 per 10,000 for men. That is, if you are doing it with an infected partner. A man would have to have unprotected sex with a HIV positive woman once a week for almost *forty*years* to reach that 1 in 2000 number.

In other words, the chances of heterosexual men getting HIV is negligible as long as they are not IV drug users.

We have no idea what the African situation is. We have no firm figures. What we know is that the figures we have are wrong. It may be co-infection – if a man has herpes for instance, the chances of getting infected go up. It may be some unusual forms of heterosexual intercourse (such as the insertion of dirt to make the woman “dry” and hence, supposedly, more pleasurable for the man). It is certainly a high level of hospital infections through using dirty needles. All we do know is that the Africans who come to Britain are at high risk – mobile, away from their villages, and usually young. In Britain they are properly tested. Their infection rate is something like 4%. In other words, Africa’s real infection rate is probably lower than that.

You don’t have a clue about emergency management either I see, as well as a complete denial of the role of public health, which is a VERY wide discipline.

It is a wide discipline. Which mostly involves sitting in offices looking at statistics. As such it is useless for dealing with terrorist attacks. Emergency medicine would be useful. But public medicine is not. I note you inability to understand even the basics of what we are talking about.

26. Leon Wolfson

@25 – So why did you explicitly deny it? Oh right, you didn’t take the time to even read wikipedia before you posted your screed from the cheat-sheet, got it.

“We have no idea what the African situation is. We have no firm figures.”

Yes, we do. We’ve had them for a long time. You are using pseudo-science to wave idiotic statements around. Under 4%? Denial! Plain denial! It’s spitting in the faces of people infected…there are half a dozen countries with 15%+ infection rates, and about 35 million infections worldwide!

Science and rationality are alien to you. You’re here simply to disrupt discussion, shill.

And right, there’s no need for PLANNING. The rich people will be able to get out of emergency areas, everyone else can just die. That you think emergency management is an office job shows your contempt for modern society.

27. So Much For Subtlety

26. Leon Wolfson

So why did you explicitly deny it? Oh right, you didn’t take the time to even read wikipedia before you posted your screed from the cheat-sheet, got it.

Leon, your habitual practice of lying and making shit up is beyond boring. I did not deny it. Get a grip boyo.

Yes, we do. We’ve had them for a long time. You are using pseudo-science to wave idiotic statements around. Under 4%? Denial! Plain denial! It’s spitting in the faces of people infected…there are half a dozen countries with 15%+ infection rates, and about 35 million infections worldwide!

No we do not. We have no idea. African figures are based on projections of small groups. Usually pregnant women – who self report. Even then we can have little confidence that the tests are done in a proper manner or in an environment that rules out cross-contamination. I know you know nothing about anything, but try to find out what medical care is like in Africa. In a continent where providing even something as basic as refrigeration for vaccines is a struggle, we can’t do reliable HIV tests. End of story.

Just 4% of African immigrants to Britain have HIV – even though they are in a higher risk category. If you can explain why the figure is so low I would like to hear it. Actually I wouldn’t because you are not worth wasting my time on.

So many countries with merely 15% infection rates? Come on, people usually claim double that at least. If this was true it would have reduced Africa’s growth rates by now. But their populations, in so far as we can tell and we can’t really even tell that, are growing away. No sign of large scale deaths. Decades after HIV was supposed to be so rife.

And right, there’s no need for PLANNING. The rich people will be able to get out of emergency areas, everyone else can just die. That you think emergency management is an office job shows your contempt for modern society.

How do you plan for a sarin attack on the Underground? But by all means, plan away. Not a public health issue. An emergency health one. Again you make stuff up with no shame at all. Pathetic.

28. the a&e charge nurse

[23] “What prey tell could any expert in public health do about a terrorist attack involving sarin?” – dear, oh dear, oh dear.

23
In 2010,42% of HIV diagnoses was caused by hetrosexual sex and 38.5% sex between men. Unfortunately, quite a few people share your misconception, how did that ad go, ah yes, ‘Ignorance Kills’. And whoever sold you your tiger repellent saw you coming, you have very little chance of being attacked by such a beast, you must have purchased it in an unregulated market.
One group of people who took the HIV ads seriously were female prostitutes, and still we hear of silly men offering them extra money to have sex without a condom.
As far as public health is concerned, the vaccines we give in the UK have been tested and proved to be effective, ie the person who has been vaccinated does not acquire the disease. We cannot guarantee that they would or would not have come into contact with the infection, however, an outbreak of swine flue or polio or diptheria, in a population, could be a disaster. All preventative measures, whether it is in medicine or other activities, are based on the worst outcome, in that way all eventualities are addressed.

30. So Much For Subtlety

28. the a&e charge nurse

dear, oh dear, oh dear.

So we are in agreement – basically nothing.

29. steveb

In 2010,42% of HIV diagnoses was caused by hetrosexual sex and 38.5% sex between men. Unfortunately, quite a few people share your misconception, how did that ad go, ah yes, ‘Ignorance Kills’.

That is unusual verging on the dishonest – 42% of new infections reported not being Gay. That is true. On the other hand, 80% of them acquired the disease in Africa. Just one fifth, or 8% of the total, reported acquiring the infection in the UK. Given that the number of women with HIV is growing, it is likely that many of these are women. Who may have acquired it “heterosexually” but not through normal vaginal intercourse – passive anal intercourse greatly increases your risks even if you are a woman. Or, of course, they are on the “down low” and are lying to themselves and their families. It is a trust system of reporting after all. Or they have a co-infection. Or they are prostitutes who are having sex with a lot more than 2000 people in 40 years.

We cannot guarantee that they would or would not have come into contact with the infection, however, an outbreak of swine flue or polio or diptheria, in a population, could be a disaster. All preventative measures, whether it is in medicine or other activities, are based on the worst outcome, in that way all eventualities are addressed.

Sorry but no they are not. They are based on reasonable worst outcomes. The worst outcome is that just as the epidemic broke out, the Earth was hit by a giant meteor or something. Take HIV for instance. We never panicked and assumed the worse case – that no one would listen to safe sex messages for instance. Why should we have accepted a dumbed down version of pandemic and then let the WHO hustle us into wasting hundreds of millions on vaccines we did not need?

31. Gimmehendrix

I kinda agree in some respects with ‘So Much for Subtlety’. Many of the actions of Doctors can be seen as self seeking. If you want an opinion about some disease treatment for example and ask 100 doctors you will get a 100 different answers. They are largely an unregulated and arogant group who in my opinion act under the mistique of life givers. There is consequently a lot of undue deference awarded to them.
But all of this is precisely why the tory reforms should not go through. Unfortunately ,as in most individual actions and consequence there is a wider view. The idea of NICE for example is to get value for money and undoubtedly overides perceived individual need in favour of the common good. For this reason I applaude the letter sent to Lords. Out of any medical service the public health aspect needs to be strengthend in my opinion. Consider obesity.alcohol abuse and smoking as key financial disablers of the NHS in future years. This is quite apart from the human consequence. So to with infectious disease such as H1N1
which is predicted to become highly infectious in the next few years. Only a strong public health service will have the capacity to organise a response.
Unfortunately. whenever capitalism has interfaced with medicine patients have always come off worse. It is not enough for little groups of doctors to organise little groups of patients. Common standards and responses need to be determined by a unitary organisation focused on the common good.

32. So Much For Subtlety

31. Gimmehendrix

The idea of NICE for example is to get value for money and undoubtedly overides perceived individual need in favour of the common good.

Yeeaahhh. There’s something not quite right with that isn’t there?

Consider obesity.alcohol abuse and smoking as key financial disablers of the NHS in future years. This is quite apart from the human consequence.

In future years. How do you know it will ever arrive? They public health experts lied to us about alcohol for years. A reasonable amount of alcohol is actually good for you. How do you know alcoholism is going to impose any costs on us? Obesity is aesthetically displeasing, but is it a health problem? I notice that as we get fatter, we live longer. Co-incidence? Let’s wait to see if it becomes a health problem. Smoking is on the decline, but that decline will result in more people living longer and costing more. That is true.

So to with infectious disease such as H1N1 which is predicted to become highly infectious in the next few years. Only a strong public health service will have the capacity to organise a response.

So I would hope twenty years ago we drew up a plan. We hardly need so many crypto-Fascists telling us what to eat.

Unfortunately. whenever capitalism has interfaced with medicine patients have always come off worse.

Sure. That is why people live so much longer under Socialism – whether of the Soviet, African, Arab or Nehru versions.

30
Your argument is based on speculation, there is absolutely no way of knowing 100% the root of any disease, the point is prevention and/or treatment, generally speaking prevention is less costly and certainly emotionally preferable. You see, anyone of your family could acquire HIV, from any encounter eg with a dentist, like most infections, it has no value judgemments.
32
The NHS is a socialist concept albeit operating in a capitalist system, which is why it is most vulnerable to greedy, private, self-seeking individuals. Its sheer size allows the majority to access modern technology and drugs. In many ways this assists the private sector, as newly licensed drugs are very expensive because of the research and develpment costs, consequently the bulk buying of NHS brings the costs down very quickly.
And this is one problem that few who believe in private medicine overlook, it wouldn’t just carry-on as is under the management of financial interests, there are major costs such as training. As it is, medical staff can go into private practice but I doubt if the taxpayer would want to finance this if every medic who trains is lost to profit making schemes.

34. Leon Wolfson

@32 – “So I would hope twenty years ago we drew up a plan. We hardly need so many crypto-Fascists telling us what to eat.”

Here-here. Stop telling the poor to tighten their buckles and eat *less*, as you crush their wages, you crypto-Fascist.

And oh, look, in the Socalist Nordic countries, people live longer and with far less stress. No, gotta crush the working class and ensure they’re panicked! Cattle, after all.


Reactions: Twitter, blogs
  1. Plymouth Buzz

    400 doctors can't be wrong about the Tory health chaos. Please rwad and RT http://t.co/IqUMEDlf /via @sunny_hundal

  2. Sian

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  3. David Heathcote

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  4. Shane McKee

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  5. Steven Lambert

    & I agree with the petitioners > RT @aboutpower: RT @libcon 400 doctors & specialists sign letter opposing NHS bill http://t.co/xqm2emFs

  6. Bern O'Donoghue

    "[NHS] Bill will erode…ethical and cooperative foundations” and “not deliver efficiency, quality, fairness or choice" http://t.co/yj76yyqc

  7. Andy Watt

    Here it is! Highly damning letter from 400 doctors and specialists calls on Lords to kill NHS bill http://t.co/yj76yyqc

  8. Jessica Pigg

    "[NHS] Bill will erode…ethical and cooperative foundations” and “not deliver efficiency, quality, fairness or choice" http://t.co/yj76yyqc

  9. Pone77

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  10. smc

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  11. Liberal Conspiracy

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  12. Steve Smith

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  13. Owen Blacker

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  14. Maanas Jain

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  18. Levin Wheller

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  22. sue

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    Highly damning letter from 400 doctors and specialists http://t.co/M07ejA4A #cpc11

  23. Cryton Chikoko

    400 doctors & specialists sign opposing NHS bill | Liberal Conspiracy http://t.co/QQP87u69 via @libcon

  24. Lee Chalmers

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  25. Liz Todd

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  27. Robert Newman

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  28. House Of Twits

    RT @sunny_hundal Highly damning letter from 400 doctors and specialists calls on the Lords to reject the NHS bill http://t.co/2A5VCLCF

  29. Robert Frost

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  31. Amanda Ramsay

    RT @sunny_hundal Highly damning letter from 400 doctors and specialists calls on the Lords to reject the NHS bill http://t.co/2A5VCLCF

  32. Amanda Ramsay

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  35. Dave Ludlam

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  38. Tara B

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  39. Charlie Owen

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  40. Howard Dartnall

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  42. Lee Curran

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  43. Lee Curran

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  45. sue turner

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  46. sue turner

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  47. w.m o'mara

    400 doctors & specialists sign opposing NHS bill | Liberal Conspiracy http://t.co/00QOJr0A via @libcon #NHS

  48. w.m o'mara

    400 doctors & specialists sign opposing NHS bill | Liberal Conspiracy http://t.co/00QOJr0A via @libcon #NHS

  49. w.m o'mara

    400 doctors & specialists sign opposing NHS bill | Liberal Conspiracy http://t.co/00QOJr0A via @libcon #NHS

  50. Alex Braithwaite

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  51. Alex Braithwaite

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  52. Alex Braithwaite

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  53. Clara Boxall

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  54. Clara Boxall

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  56. Sarah Shoraka

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  57. Sarah Shoraka

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  58. Sarah Shoraka

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  59. Jake Mountain

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  60. Jake Mountain

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  61. Jen Th

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  62. Chris Wills

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  63. Mark McCormack

    Very critical letter from 400 doctors and specialists calls on Lords to reject the NHS bill http://t.co/3gX7FZ0i

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    RT @sunny_hundal Highly damning letter from 400 doctors and specialists calls on the Lords to reject the NHS bill http://t.co/2A5VCLCF

  65. Fiona McMahon

    Here it is! Highly damning letter from 400 doctors and specialists calls on Lords to kill NHS bill http://t.co/yj76yyqc

  66. James Maddison

    400 doctors & specialists sign opposing NHS bill | Liberal Conspiracy http://ow.ly/6MASu

  67. michelle howlett

    Pl read this: from 400 docs & specialists. Go to Westminster on 9th Oct & Block the Bridge, Block the Bill. http://t.co/gdOXPWn9 via @libcon

  68. Lanie Ingram

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  69. malcolm

    "[NHS] Bill will erode…ethical and cooperative foundations” and “not deliver efficiency, quality, fairness or choice" http://t.co/yj76yyqc

  70. malcolm

    Dear Honourable Members of the House of Lords, The Bill will do irreparable harm to the NHS … #SaveOurNHS #NHSreform http://t.co/EdezJ0dP

  71. Paul Wood

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  72. dexys42

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  73. Geoff Birch

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  74. JulietteHarkin

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  75. brian hocknull

    Pl read this: from 400 docs & specialists. Go to Westminster on 9th Oct & Block the Bridge, Block the Bill. http://t.co/gdOXPWn9 via @libcon

  76. James Maddison

    #Cameron's "NHS moment" same as Clegg's "student fees moment".Slippery tongue doesn't disguise his lies on #NHS pledges.http://t.co/Hlowzf0F

  77. Dave M

    Anyone asked Andrew Lansley which medical professionals still back his NHS Bill, after today's letter? http://t.co/yj76yyqc

  78. DPWF

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  79. James McCullough

    Highly damning letter from 400 doctors and specialists calls on the Lords to reject the NHS bill http://t.co/yj76yyqc

  80. Alastair Sutherland

    Anyone asked Andrew Lansley which medical professionals still back his NHS Bill, after today's letter? http://t.co/yj76yyqc

  81. Kat Friel

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  82. Paul

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  83. Tamworth Talks

    Anyone asked Andrew Lansley which medical professionals still back his NHS Bill, after today's letter? http://t.co/yj76yyqc

  84. Paul Hufton

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  85. CLARE SAMBROOK

    400 doctors & specialists sign letter opposing NHS bill http://t.co/3gX7FZ0i

  86. Peter Underwood

    Anyone asked Andrew Lansley which medical professionals still back his NHS Bill, after today's letter? http://t.co/yj76yyqc

  87. Matt Zarb-Cousin

    @jamesjohnson252 @Rosiecosy OK, we'll have a debate on your terms. Reform for the better you say? 400 doctors disagree http://t.co/rlL9fMm4





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