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Peter Reynolds

The life and times of Peter Reynolds

Posts Tagged ‘health service

Snooper’s Charter. This Is Why Americans Keep Their Guns.

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 “You can have my guns when you take them from my cold, dead hands.”

“You can have my guns when you take them from my cold, dead hands.”

Nick Clegg has caved in again.  Norman Baker sat next to the most monstrous woman in British politics as she sneaked her snide subversion of our freedom through parliament. These people are ‘Liberal Democrats’?

It is all decided.  There is nothing we can do.  Parliament adjourns in less than a fortnight.  There’s little your MP could do for you anyway, even if he or she had the balls to stand up against this railroading of fundamental changes to our rights.  The leadership of the main parties have conspired to pervert our democracy to their own ends. In America they would be put on trial for treason.  This is why Americans keep their guns. It is some protection against an overbearing state.

Meanwhile, in London, Boris Johnson’s water cannons have arrived. Julian Assange is still holed up in the Ecuador embassy. Edward Snowden, the great American hero is running for his life in Russia.

Bring the Guillotines To Parliament Square!

Bring the Guillotines To Parliament Square!

At least America has a constitution. British democracy is a sick joke. We have no control over our government.  Elections are meaningless.  Politicians are a self-serving, incestuous elite, part of the tripartite oligarchy with the Fleet Street Mafia and the bankers.  We are the servants of the state.  We can’t even determine the issues that the media and parliament consider.  Their agenda and priorities are imposed on us.  We can’t enact local medicinal cannabis laws as 23 states have in the US, where the people have instructed the government what to do.  We can’t define the debate on education, the health service or foreign policy.  We must just do what we’re told.

We let these people take our guns away from us – and we were foolish to do so.  After the water cannons, what comes next?

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Back To The Future Of The NHS

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I have grave concerns about the government’s NHS reforms.  I feel like it’s Groundhog  Day.

I was deeply involved in the last major health service reforms back in the 1990s.  I am hearing exactly the same ideas, phrases and promises as we heard then.  Haven’t we done this all before?

When the “internal market” was introduced and the first NHS Trusts were “founded”, the idea of  marketing was introduced to the NHS for the first time.  I saw the opportunity, organised a conference at the QEII conference centre and built a nice business, thank you very much, for several years as an expert in the field.    I was an advisor to several health authorities and a number of the new NHS trusts.  I undertook marketing and communications audits, ran training courses and I made something of a specialty of designing, writing and producing annual reports.   I learned a lot and I felt I contributed a lot.  Why is it all being done again?

Marketing is a perfect description of the way the health service should work.  It is the management process responsible for anticipating, identifying and satisfying customer needs efficiently.  The 1990s NHS model was that  “purchasers”, health authorities and GP fundholders, would buy services from “providers”, hospitals and community health services.  “Purchasing” was later renamed “commissioning” to reflect how complex the task is. It’s about understanding what services are required and making complex choices as well as actually contracting for them.

Strategic Health Authorities (SHAs) were always a redundant tier of bureaucracy in my view.  District Health Authorities (DHAs) were to be the principal commissioners but the plan was that GP fundholders would eventually take over most of it with DHAs becoming centres of expertise rather than administration.  Then there was a rather messy fudge between GPs and community health services and we ended up with Primary Care Trusts (PCTs).

There is a huge amount of expertise required in commissioning.  The complexity of the tasks involved – understanding, assessing, testing, planning, choosing, contracting and much more, is enormous.  GPs will have to buy in that expertise which will build a bureaucracy which we will call – what?  We will have gone round in a circle.

One of the biggest mistakes made about the NHS is the endless stream of attacks on managers.  Almost all the problems that the NHS has and that people complain about are management problems.  NHS managers have a hugely demanding and thankless task for which they are regularly pilloried and censured.  They are, actually, crucial to an effective NHS, just as much as the clinicians.

So now we are to have “Foundation Trusts” and GP commissioning.  It is the same thing, yet again, under a slightly different name.  The NHS is not broken. It is, in fact, greatly improved.  It doesn’t need fixing.

We do not need more reform.  We need some adjustments.  There have been great achievements on waiting times.   Now, we need to shift the emphasis towards outcomes.  We need targets on quality rather than quantity.  It’s a tweak rather than a revolution.

The Drugs Debate

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It won’t go away will it?  It seems like at least once a month now some new high profile figure comes out against prohibition.  The latest, Sir Ian Gilmore, outgoing president of the Royal College of Physicians, is hot on the heels of  Nicholas Green QC, chairman of the Bar Council in July and three eminent co-authors in The Lancet in May.  The National Audit Office and the Public Accounts Committee have also criticised government for failing to implement an evidence-based drugs policy and instead giving more weight to opinion.

Meanwhile the Humpty Dumpties at the Home Office keep on building their big walls, refusing to listen, refusing to think, refusing to care.  Their response is no, no, no, out of the question, no and no again.  In fact, I don’t think the ministers even think about it at all.   They just replay the same old no, no and no again as written by some civil servant, probably in the days of the golf ball typewriter.  Remember those?

It won’t go away though.  I first submitted a report to the Home Affairs Committee on the cannabis laws in 1978.  It was called “An Unaffordable Prejudice”.  I’ve been giving them the facts and the evidence ever since and so have hundreds of other individuals and organisations.  I’m in direct correspondence with the Home Office at the moment.  I’ve received one three page response and replied with four.  That’s how long it takes to get a dialogue going with our “responsive” government.   I started in May, immediately after my new MP was elected, and it takes a good three months to get anywhere – or perhaps I mean nowhere.  Still, I expect it was worse in the USSR.

It won’t go away.   Aside from the Home Office the only people in favour of our current drugs policy are the drug dealers and the Taliban.  They certainly don’t want things to change.

The Home Office can’t even get its story straight.  Today its latest pearls are: “Drugs such as heroin, cocaine and cannabis are extremely harmful and can cause misery to communities across the country.”  This is nothing short of crass stupidity and irresponsible misinformation.  Lumping in cannabis with heroin and cocaine is simply ridiculous.  Describing cannabis as “extremely harmful” is in direct contradiction to every one of the Home Office’s own scientific experts.  These are the people who are supposed to be protecting our children, the vulnerable and the uneducated.   They should be ashamed of themselves.

When Proposition 19 passes on 2nd November (see here), the world will sit up and take notice.   Even Humpty Dumpty will have to engage his brain then because when 37 million Californians get the right to enjoy God’s herb without interference, well it ain’t gonna stop there.  If for no other reason than that our avaricious politicians will soon put aside their “principles” when they realise the oodles of cash and brownie points they’re missing out on.  California reckons it will create up to 110,000 new jobs, £1.4 billion in new tax revenue and a saving of $200 million in law enforcement costs.  When Humpty Dumpty takes off his blindfold of prejudice, ignorance and propaganda he’ll soon be gagging for the cash.

There are a million quotes from world leaders, politicians, doctors, scientists and “experts” of all sorts stating how ridiculous and self-defeating current drugs policy is.    It never seems to make any difference though.  David Cameron and Nick Clegg have both called for change many times but once they get into power what happens?  However, just to get right up the nose of Humpty Dumpty (that’s right, snort it up there), here’s what one very, very senior civil servant said just two years ago:

“I think what was truly depressing about my time in UKADCU was that the overwhelming majority of professionals I met, including those from the police, the health service, the government and voluntary sectors held the same view: the illegality of drugs causes far more problems for society and the individual than it solves. Yet publicly, all those intelligent, knowledgeable people were forced to repeat the nonsensical mantra that the government would be ‘tough on drugs’, even though they all knew the government’s policy was actually causing harm.”

Julian Critchley, Director, Cabinet Office UK Anti-Drug Coordination Unit. 13-08-08

It won’t go away.  Just Say No has become Just Say Now and the slimy dissembling oiks who insist on running our lives (and ruining many) will soon be in retreat.  It won’t go away.