Alternative plan for NHS reform

This below is a response to Lansley's plans for dismantling the NHS. It was drawn up by Dr Tim bland, and has developed supporters through email lists. Tim is trying to get it into the letters columns of papers, without success so far. I believe this is because it is information-dense, and the media cannot cope with information. They deal with impressions.




Alternative Agenda for Healthcare Reform

4.1.2011

Letter for publication in The Guardian



Sir, Following Polly Toynbee’s comment article on the NHS published on page 29 on 4.1.2011 we are a doctors’campaign group who would like to keep the pressure up on the Government with an alternative agenda for NHS Reform. Healthcare does need reforming, but not in the destructive way the Government is signalling; so what should the government do? Unfortunately Labour is not offering a constructive alternative at the present time.



1 Put the White paper on hold and have a time of national consultation with all stakeholders. The new Secretary of State is moving “too far, too fast” with a level of reform that carries a huge risk of major failure. We need a national rethink on the way forward for the next 50 years, not the next five.



2 The coalition government needs to realise that this White Paper risks bringing about the end of the NHS as we know it by causing complete chaos followed by fragmentation and piecemeal privatisation. We should not put responsibility for running the whole NHS onto GPs, as is proposed by Mr Lansley.



3 We believe that the Government does want to retain our state-run healthcare system i.e. NHS, but that it is missing a golden opportunity to introduce changes that place more onus on individual responsibility for health and associated costs. The only way to save the NHS is to reform it. However, Mr Lansley is increasing patient expectation when he should be increasing patient responsibility.



4 A new contract would need to be established between the State and the Population for the continuation of a universally applicable, state-run, healthcare system. This would involve the Population accepting a reduced scope of NHS services, the State committing itself to long-term healthcare provision and all parties recognising that the NHS’s performance is crucial to the success of the greater project for national debt reduction.



5 Be true to the sensible, Conservative manifesto commitment to have no more major, reorganisational change in the NHS. Keep most existing structures in place and bring about rational, consensus-based, incremental change. This will be far less expensive and leave doctors free to focus on efficiency savings instead of being diverted to major reorganisational change.



6 Have a full, informed debate on the expensive, 20 year, experiment of the purchaser/ provider split, which began in 1990 with Kenneth Clarke and Margaret Thatcher. A decision needs to be made now on whether to keep it or get rid of it.



7 Abandon blind faith in the ideology that the free market will be an effective agent for “saving” the healthcare system. This blind faith is a pre-2008 idea, utterly discredited since the Banking Crisis broke upon us. This supreme faith in the free market needs to be downgraded onto a par with the many other healthcare ideologies in the intellectual market.



8 Focus on doing something urgently about the state of our hospital sector. Consultants should be given back power from managers and also the accountability that always used to go with the crucial link between each patient and their named consultant. Restore the traditional “firm system” of consultant-led teams; this could only be done by finding some way of reducing the drastic effect that the EWTD is having on our healthcare system; this would enable restoration of continuity of care in hospitals and proper training for the next generation of doctors, especially future surgeons. Do something about the national scandal of PFI costs that are bleeding the NHS dry. Get rid of the plethora of centrally driven targets.



9 Don’t force any change upon GPs that compromises their vital advocacy role on behalf of their patients or diverts their attention from patient care. Each patient has to know that his GP’s sole consideration is the patient’s best interest.



10 Make sure that the U.K retains its high level of medical training, medical research and public health, which are some of its greatest strengths.



We believe these ideas could be developed into a pragmatic, centrist philosophy for sustainable state-run healthcare that could command widespread support for many years to come. We want to bring this alternative agenda for NHS Reform to a wider, national and parliamentary audience



The NHS Twenty Ten Group of U.K. Doctors

Dr Tim Bland, GP, Chairman

Mr Wael Ismael, general surgeon

Dr Raj Patel, haematologist

Dr John O’Moore, GP

Dr Raj de Silva, neurologist

Dr Mohsen Khorshid, dermatologist

Mr Bhik Kotecha, ENT surgeon

Mr A Sivaraman, spinal surgeon

Dr Pushpa Chopra, GP

Mr Jag Chawla, ophthalmologist

Dr Ashok Kumar, GP locum

Dr Chaman Sajjanhar, GP retired

Mr Bhabu Chopra, ENT surgeon

Dr John Lee, GP

Dr Abdul Jabbar, GP

Dr S Subramaniam, GP

Mr Chitta Chowdhury, ENT surgeon

Dr Mani Subramanian, GP

Dr Badi Beheshti, GP

Mr Krishna Vemulapalli, orthopaedic surgeon

Dr Sridevi Vemulapalli, GP locum

Dr Maryline Punungwe, GP locum

Dr Pamela Punungwe, GP registrar

Dr Richard Lawson, GP locum



Dr T. C. Bland

NHS GP

Chairman of The NHS Twenty Ten Group of U.K. Doctors

Wife who retracted rape claim: Explained

There are many news reports on the case of the wife who falsely retracted an allegation that her husband had raped her, and was sent to prison.

The Guardian gives them the names Sarah and Ray.

In essence Ray was abusive and a control freak over many years of marriage. After he had raped her, Sarach called the police, and Ray was arrested and sent down. Out on bail, he manipulated Sarah, first into dropping her charges against him, and then into retracting her rape allegation against him. She phoned the police and said she had made it up. The Crown Prosecution Service then did her for perverting the course of justice, and she went down until the sensible Judge Judge (sic) released her.

As a psychiatrist and GP I have seen many of these cases. 
There is usually a manipulative male* who insists on controlling all actions of his partner. She is unable to talk to friends, especially male, but also female. She has difficulty in going out of her partner's sight. Violence and rape is common. She is miserable, and begins to think about leaving; and this is where the difficulty begins.

Say an alert GP or Social Worker notice what is going on, and offer to help. She says she needs help, but then a strange on-off pattern kicks in. She wants help, but keeps going back to him - irrationally, and to the total frustration of anyone who is trying to help her.

The Battered Woman Syndrome has been written up by Lenore Walker, a psychologist. She frames it in terms of PTSD.

I offer a simpler framework: the woman's will has been taken over by the male. He exerts control over her actions, through very extensive manipulation.

For instance, when she tries to get away, he will convince her that he is going to kill her, or her children, and/or himself. He is able to convince her time and again that he is sorry, and that he will change. So the woman, powerfully driven by misery and pain to seek to leave him, is drawn back, equally powerfully, by his manipulations.

If this state of affairs were more clearly recognised by psychiatrists, medics, SWs, police, CPS and judges, we would all be that much better off.

I ought to write to the Royal College of Psychiatrists. Maybe I will.

In the meantime, girls, if he seems to be a control freak - RUN!


*gender roles can of course be reversed

Take a Measure of Corpse, or a Cup of Blood

Corpse medicine was widely practiced in Europe until well into the eighteenth century; yes, it was!. Doctors were in the habit of using all sorts of substances from recently-dead bodies, anything from blood to fat, treated and dried before use, as well as powders from ground-up Egyptian mummies. It was a tradition inherited from Classical and Arab texts, and recommended by such enlightened figures as Francis Bacon, the philosopher, and John Donne, the poet.

But the usage did not stop with the dried and the desiccated, oh no. Renaissance thinkers believed that corpse medicine was the best way if imbibing the spiritual life-force of another; and there was no better way of doing this than drinking fresh blood. In the late seventeenth century Edward Taylor, a puritan minister, wrote that “…human blood, drunk warm and new is held good for the falling sickness.” Drinking hot blood was still being recommended as a treatment for epilepsy by English physicians in the mid-eighteenth century. They were all vampires then. :))