Opinion: The blame game.
The mismanagement of the NHS by unelected Theresa May's Tory government continues.
This time the target of abuse is over worked GPs.
But as the Tories scapegoat GPs never forget blame lies with the Tory government elected in 2010 and Mrs May's current unelected government.
In response to claims by some A and E patients that they attend a hospital emergency department as they are often unable to get a timely appointment with their General Practitioner the Tory government is pushing ahead with its plan for a seven-day a week appointment service and has issued a threat.
In order to force the issue through "Some GPs in England have been warned they could lose extra funding if they fail to meet a commitment to keep their surgeries open for longer."
Some are already feeling the financial pinch.
Some may be pished to close and what then? Will a private GP service pick up the slack?
"The government wants surgeries to open between 08:00 and 20:00, seven days a week, unless they can prove the demand is not there" reports BBC News Saturday.
That has obvious implications both good and bad.
Previously the government has compared the NHS to supermarkets that offer a seven-day a week service but come on.
It is not a one-size fits all affair.
A few years ago NHS trusts where forced to jump through hoops to get foundation trust status. Locally hospitals spent time, money and effort establishing so-called "business groups."
The obvious Tory desire to privatise the NHS is there if you take a good look.
Having worked for a GP practice and then in NHS hospitals from about 1997 until retirement there is always work to do to improve the service but that is true of any large organisation.
Moving the goalposts, moving them again and then again, undermines the service, hits the morale of staff, leads to staff moving on and ultimately millions of pounds later invariably means you are back to square one but in many ways in a worse position.
The Tory government and political hopeful party UKip would prefer a privatised health care system.
The Liberal Democrats may be talking the talk with regards to the current NHS crisis but never forget they sat alongside an NHS slashing Tory government in coalition for five years. They could have quit and forced an election but they preferred to hang on to their time in office.
In doing so they lost all credibility especially when it comes to the NHS.
Only a Labour government will commit to the NHS as a cradle to grave healthcare service.
But if we sit back and allow an unelected PM to drag her heels until the next scheduled General Election in 2010 it may be too late.
Boundary changes look set to reduce the number of Labour MPs. Other factors including BRexit will impact on an election.
But while the electorate remain blinkered the NHS is being made unfit for purpose ahead of privatisation.
It is how Tory governments work.
Remember public transport, water, Royal Mail and energy privatisation all sold to you on a promise of more competition and better value for money? What whopping lies were told? A few people got that bit richer out of previous privatisation and the big loser was the general public.
The NHS is as a crossroads and it will never be safe in Tory hands.
If you do not believe that you are deluded.
Full BBC News story:
You cannot trust UKip on the NHS
Jeremy Hunt you are mishandling and have mishandled the NHS and in particular the imposition of new junior doctor working contracts.
This is not the first ministerial job that you have screwed up but your political career survives.
Could that be because you were one of those who supported Cameron in his bid to lead the Tory party?
This is what this retired NHS employee thinks:
On the back of Jeremy Hunt's announcement Thursday that he will impose new working contracts on junior doctors after failing to reach an agreement the fallout continues.
#dimposition was trending on Twitter Thursday as tweeters in England took to social media to express their anger.
Junior doctors in NHS England that means not in Scotland, Wales or Ireland will have new non-agreed working contracts forced on them in August unless Hunt is forced into a U Turn.
The Tory tactic of public letters that appear to show support from people linked to the debate are falling flat Friday.
In April 2015, days ahead of the UK General Election, #lettergate blew wide open. As we reported it was a case of "Business leaders dodgy Tory letter more mind games."
The Tories won the General Election but with a majority of just 12 seats.
But that letter included people who later distanced themselves saying they had not been asked but rather just included by Tory campaigners.
Seems this may have happened again.
Friday the Guardian reports "Health chief: letter backing 'whatever is necessary' on contracts was not agreed -NHS trust chiefs distance themselves from letter supporting plans to impose new contracts on junior doctors."
Is that down to misinterpretation of 'whatever is necessary' or something sleazier?
Either way Jeremy Hunt’s claim that he has the backing of 20 NHS bosses to impose new contracts on junior doctors quickly unravelled overnight; at least half said they had never agreed to support forcing the deal.
Health Minister Hunt joined a Tory Shadow Cabinet originally as Shadow Secretary of State for Culture, Media and Sport.
He made a pig's ear of that role and was moved on to Culture.
After a second pig's ear he was rewarded with the role of Health Minister.
The only qualification Hunt has to oversee healthcare in the UK appears to be that he co-authored a book calling for NHS to be replaced with private insurance.
How come Ministers need no qualifications? What next for Hunt - Chancellor?
That fits with the way he is handling NHS England while pretending that he is simply trying to fulfil a Tory manifesto pledge for a seven-day NHS.
The NHS of course is already a 24/7 NHS each and every day and night of the year.
Currently some services are limited at the weekend a bit like in parliament-Ministers only attend willy nilly during the week and it is closed weekends.
If and when parliament are recalled during vacations due to a national crisis the taxpayer foots the bill and it is a costly one.
If parliament wants a seven day working week that is a one pay fits all then they should lead by example but moreover they should reward staff.
Junior doctors already work far too many hours; they may get some sleep on a long night shift but if they are working on a busy hospital ward or department they may be run ragged covering more than ward across a huge site.
They already work weekends, nights, bank-holidays and more but on a shift basis; as these same doctors have to fit in lectures, study, training and more that is understandable. They also rack up debt as they undergo extensive training which lasts for years.
The conclusion has to be Mr Hunt that the new junior doctor working contracts, with the promise or is that threat of further changes in the working contracts of other staff, is only about cutting the service to the bone.
In allegedly trying to make a 24/7 NHS you are in fact wrecking the service - either so that it will be ripe, ready and cheap for your buddies when they come on the scene to privatise or undermine it completely in the minds of voters.
But either way you will fail.
The NHS has its problems but remains much loved and the pride of Britain and long may that continue.
Op-Ed: Bed blocking is making British headline news again but what lies behind that derogatory term?
Where to start?
If you are an NHS hospital patient classed as medically fit but not able to return home you may be called a bed-blocker. It could be that you need adaptations to your home prior discharge or that you need a place in a care home, either temporarily or permanently, but whatever the reason your status as patient changes to bed-blocker.
With NHS beds and services stretched bed-blockers can hit admissions; the dominio effect comes into play and the service begins to crumble.
Because perhaps after care is not readily available the whole system is under threat; remember 'for want of a nail the shoe was lost, for want of a shoe the horse was lost, for want of a horse a battle was lost?'
The British government claims an increase in beds being blocked is down to our increasingly aged population, people living longer, and other reasons but shies away from some home truths.
Here in my Yorkshire city the closure of an old hospital that provided sometimes long-term care helped start the rot.
Losing so many beds was always going to have a knock on effect.
Plans to improve care in the community soon failed.
Old wards at other hospitals across the city closed although to be fair new buildings such as dedicated cancer, cardiology and ophthalmology centres should have eased the situation.
But when you live in a city with a vast range of social and economic problems you can hardly compete or compare with a rural hospital located in a wealthy rural area of the country.
The NHS has to roll with the punches that often come from central government.
When you work for the NHS you soon realise that work for this health service provider long enough and you will see changes come around and around. In the end you will be back at square one but it will have been a costly game.
The cost comes in funding and in personal hardship to patients.
Bed blocking is a fact of the 21st century NHS.
Chief executives of various trusts across the country receive huge pay deals but tend to shuffle off in a few years with a hefty pay off tucked under their belt. Some then go on to take another job in the NHS and on it goes.
With a Tory government that wants to privatise the NHS, full stop, negatives such as bed blocking are widely publicised.
However the reasons for people staying in hospital after being classed medically fit are complex.
A great deal of time and money is spent working out who is fit and good to go although maybe not quite able to.
In some areas half-way home care centres are being established but look carefully at who owns and runs such centres and the warning signs are there.
Cuts in social care budgets and support workers mean some patients will invariably be stuck on a hospital ward waiting for discharge. That has a negative effect on the patient and their loved ones.
The only way to address bed blocking is:
Bed blocking news reporting tends to be ageist but it is not just older citizens that find themselves caught in an NHS trap.
Outbreaks of the winter vomiting bug close wards and prevent patient discharge to care homes. Young people also suffer strokes, heart atacks, brain injury and other illnesses which can require long-term aftercare.
And when you are stuck on a ward waiting for discharge your physical and mental well-being may suffer.
But when you are called a bed-blocker you may feel you have no identity, are just a waste of space and a drain on resources. That has to be wrong.
[A report by Labour peer Lord Carter highlights the problems of bed blocking while saying million of pounds can be saved by 2020 with a rethink of working practices. Me I wonder what Lord Carter was paid to undertake that study and justwhich decade NHS staff and patients will be taken back to on this never ending merry-go-round of change]
The Tories along with Lib Dem coalition partners helped draw up new working contracts for junior doctors; the government describes "the current arrangements as "outdated" and "unfair", pointing out they were introduced in the 1990s." Talks on the new contracts stalled in 2012 and have been going nowhere.
The doctors looked set to take a pay cut as reclassifying unsocial hours came into force; 'normal hours' will be reclassified as being from "7am to 10pm, Monday to Saturday. Extra payments for unsociable working will be earned only outside of these times, rather than the current arrangements of 7am to 7pm Monday to Friday."
Working hours of 48 hours a week will remain and Hunt is promising the top limit of 91 hours will reduce to 72.
But can junior doctors trust the Tories? According to the Daily Mirror "Doctors threatening to strike say it's 'spin' and there are plenty of reasons it's nowhere near 11% . For some people it'll actually be a cut."
The government is trying to slowly but surely erase any positives accredited to former Labour governments; they were responsible for many previous N.H.S. pay and working hour improvements.
The doctors are not about to take new contracts lying down and "the junior doctors committee of the British Medical Association (BMA) is preparing to ballot its members about potential walkouts." With the government threatening to impose the new contracts on junior doctors in 2016 if agreement could not be reached battle lines were drawn.
But it seems the government has had a change of heart; offering an additional 10% pay rise on top of the restricted 1% or less for other N.H.S. staff could do the trick but what about those other staff members? How will they feel when they receive 1% or less knowing junior doctors are getting a whopping 11%?
The problem is all staff who work for the N.H.S. except for some managers, are essential to the best care of patients.
But some of the lower grade staff earn paltry wages and yes some are also on zero hours contracts.
There was a time when junior doctors worked crippling shifts that must have endangered patient and their own, health and safety; that was improved and under a previous Labour government when 'Agenda for Change' was implemented to correct an imbalance between private sector and public sector health care workers pay.
Working for the N.H.S. for around 13 years pre-retirement this writer experienced the good the bad and the ugly. Staff would say work here long enough and you will see any changes come around at least twice and that was a fact.
A succession of well paid 'project managers' appeared in an endless stream; in some cases it was difficult to know exactly what they did. Many may have only been on temporary contracts but were paid exceptionally well, often had already worked for the N.H.S. and retired and usually were handed another post without a problem when the role ended.
Can Hunt afford to give junior doctors 11%? Will it be a no strings attached offer? Will the government abide by any promises it makes?
Will Hunt have to rob Peter to pay Paul?
All N.H.S. staff deserve a decent working contract but can that be achieved under a Tory government that is hoping to privatise the service?
Sources and more information at:
BMA refuses to re-enter contract talks
Today "The government has announced measures to clamp down on "rip-off" staffing agencies used by the NHS to plug gaps in nursing and doctor rotas."
The plan is to set a maximum hourly rate of pay. The government will also try to stop financially struggling NHS trusts from overspending to temporarily fill staffing gaps.
Sounds a plan on the surface but there is a great deal to consider.
Temp agencies have overheads and not all are ripping the NHS off. If an hourly rate cap is put in place will some agencies simply drop NHS contracts? There is nothing to say they have to supply temps permanently to the NHS.
As NHS contracts fixed or casual come under attack expect staffing issues inside the NHS to deepen.
Agencies that rely on the NHS to keep their business afloat may go to the wall. How many agencies are run by bosses with links to government we wonder? Will these numbers increase as the cap begins to bite? That is quite possible if you know or can anticipate the government's next moves.
When an hourly rate cap is put in place how will it be monitored? Is that going to increase bureaucracy in the NHS and introduce another tier of costly management?
How many agencies will simply reduce the fee paid to their temp rather than take a financial hit themselves? Employers of temps via agencies pay a fee which is made up of money for the worker and a fee for the agency. Shifting the pay to fee ratio may leave the temp out of pocket.
New temps may settle for less money but if you have been paid a particular rate of pay to cover nursing shifts on a temporary basis will you accept a drop in pay?
Agency nursing staff has been one of many thorns in the side of the NHS for some time.
There are situations when temps on wards are getting paid more than the permanent staff and this can cause resentment.
However a temp may work regularly or infrequently and miss out on perks. It is the usual case of 'swings and roundabouts'.
But when BBC News reports "NHS foundation trusts in England spent nearly £2bn last year on agency staff - more than twice the planned amount" you know something has to give. "Health Secretary Jeremy Hunt said the cost of agency and contract staff across the entire NHS in England last year was £3.3bn and staff costs had spiralled out of control. On one occasion, an agency nurse cost the NHS £2,200 for a 12-hour shift, and a doctor £3,700 for a 30-hour shift."
Expensive management consultants rip the NHS off big time. Created jobs under the vague term of 'project manager' pay over the odds to a favoured few.
But in the end if temps do not plug nursing gaps on NHS hospital wards who will suffer the most? The patient’s first and foremost but of course other staff suffer along the way.
Will the Tory government care if the NHS fails?
Why would they when most of them can easily afford private healthcare. They may use the NHS but in times of dire need they have other alternatives. The majority of the electorate do not.
NHS spending: how temporary staff keep the health service going
Fast forward to 2015 and some citizens call their GP or an ambulance for trivial or non-existent health emergencies straining the NHS to the extreme.
And if you have a real health emergency it is also very different in 2015
Luckily it is two years since we experienced a health emergency at night and put in a call to our GP. My husband was flat out and an emergency call was necessary.
I was put through to an out-of-hours service that initially asked that we go to a night surgery across the city. We have no transport but even without those issues the patient was not fit to travel even in a taxi.
The responder understood but it would take time to get a GP to our home with no guarantees as to when.
A decision was made to contact an ambulance and husband was taken to hospital and admitted for three days; in the end it was not a serious matter but he did need treatment.
Back to the past
The issue of night visits is not new. In 1972 when my mum suffered a life-changing and ultimately life-taking stroke she was let down by her GP. He failed to visit in time resulting in a night-call-out but a locum attended. The locum did his best but without mum's medical history and notes it was deadly.
But that was an exception rather than a rule.
Out of hours service 2015
A mixture of heavy patient demand and a commercial out of hour’s service is potentially lethal.
It adds pressure on hospitals and the ambulance service as desperate people bypass what they see as a failing service.
Most GP practises in the UK now use outside contractors to cover out-of-hours services; about half of the companies used are not-for-profit with around a quarter commercial private contractors.
New technology adds an extra dimension to healthcare and the access of patients notes in 2015 but a 'family doctor' with your best interests at heart remains hard to beat.
Patient satisfaction with private companies providing out of hours care is poor and although researchers say the reasons are not clear we could all form an opinion on that one and the following statement from the Mail Online report which says "NHS providers scored highest on timeliness, patient confidence in doctors, and overall care experience."