Oops we shouldn't have closed the NHS Walk-In Centres

After Andrew Lansley's campaign to close the NHS Walk-In Centres we now see David Cameron promising a scheme where people will get out-of-hours access to GP Surgeries. One of the features of the Nurse led NHS Walk-In Centres was they were available from 0700 to 2200 364 days a year, however the GPs (mostly private practitioners) thought the funding of this service was a waste of money and led Lansley by the nose into closing down or reducing the hours of the WICs.

No more holidays in Spain?

Given Spain's obstruction of the people of Gibraltar I would be of the opinion that Spain is not a place for any British person to spend a holiday. I was fascinated to see the Spanish Director General of Foreign Affairs declaration that Gibraltar's action of placing concrete block to form a reef disrupted fishing in a special conservation area.

I say "Vote with your wallet" and stay away from Spain.

Spain still has colonies on Moroccan land namely Ceuta and  Melilla and Peñón de Vélez de la Gomera just across the Straits of Gibraltar. When they return the land to Morocco, maybe just maybe Spain can talk to Britain about Gibraltar.

Spain has constructed many artificial reefs to protect habitat against illegal fishing! The picture below is an extract from an International Maritime Organisation report.

Country life

Long time no post: I've moved to Derbyshire away from the City. Though at the moment I commute to London (2 hour trip eachway).I now get to see the countryside and the seasons from the train window.

This morning before I set off to the station, at 5:30 am, I spent 5 minutes watching a Peregrine Falcon being mobbed by 3 crows high in the air above my house. No contest really.

Mis-sold Swaps to cost UK banks billions

Over the past decade banks have been boosting their profits by selling Interest Rate Swap deal to SME businesses. The idea was that for a fee the business would be protected from interest rate increases on their bank loans. It is similar, but not the same as insurance. The flip side is that if the interest rate goes down the business has to pay the difference via the bank to the other party in the interest rate swap. 

Back in the 1990s there was a big fuss about IRS deal wrongly sold to Local Authorities. Much activity was focussed on unwinding the deals and paying compensation to the local authorities.  There is no way that the banks didn't know that IRS deals can be very bad news for SME organisations, but the banks gave in to greed again.

They fully deserve a big compensation bill.

Proposed closure of an A&E in south London

The NHS is proposing to close Lewisham A&E. Here's what the local doctors say in a petition to David Cameron:

We, doctors in Lewisham, have grave concerns about the proposal to downgrade emergency medical and surgical services at Lewisham Hospital made by the Trust Special Administrator (TSA) for South London Healthcare NHS Trust. Lewisham Hospital is not part of that trust. It is a solvent, successful organisation that delivers high-quality care to its patients. Yet the TSA has taken the extraordinary view that Lewisham’s Accident and Emergency Department should close to admissions, leading to closure of acute services including full maternity services, and that most of the hospital site be sold.  

Emergency services are vital for the population of Lewisham, which contains some of the most deprived wards in England.  Lewisham Hospital’s new £12 million A&E department opened as recently as April 2012 in response to the need for expanded services. The TSA’s report asserts that the need for emergency care would be reduced by 30% simply by providing more care in the community. However, there is simply no clinical evidence to back this up. In any case Lewisham Hospital has already been innovative in working with social services to provide more care at home and avoid admissions in patients with chronic illness. Our intensive care unit has excellent standardised mortality rates. Our new birthing centre has high maternal satisfaction and provides high-quality care to a community with a high proportion of ‘high risk’ births, which would be jeopardised if maternity services are lost or downgraded. Lewisham Hospital features in the top 40 hospitals in the CHKS rankings. It its acute services are lost, they could not be provided by others without risking patients' safety and quality of care. 

The TSA’s review fails the “four tests” that you and the Secretary of State for Health have recently laid down in Parliament. It does not have the backing of GPs. It does not have public support, as the demonstrations, public meetings and the petition have shown. It is not based on sound clinical evidence (detailed responses from groups of clinicians, including GPs, are at http://www.savelewishamhospital.com/). Even the report itself acknowledges that it will not improve patient choice. 

Your government's response to this report has an importance beyond Lewisham. The report is an attempted regional reconfiguration, tacked onto the statutory regime for an unsustainable provider, which is being used here for the first time ever. The report was drawn up to statutory timescales that are much too short for a considered reconfiguration, with the result that the clinical consultation is desultory and the clinical evidence is of poor quality. If this report is accepted as it stands, it will create a dangerous precedent for the rest of England. Furthermore, the TSA has produced a report which perversely recommends that a solvent and successful organisation be punished to save a separate, unsustainable provider. We doubt that this is a signal that you will want to send to the NHS and the public.     

We urge you and the Secretary of State for Health to reject the recommendation that Lewisham Hospital lose its A&E and acute services.

Here's another view.

Here's the outcome.of the decision.



Update 31st July 2013

So far the Courts agree with us, the plan has been overruled. It is a dumb and not legal decision to leap over the fence to beggar a performing NHS Trust to fund another failing NHS Trust in an adjacent area.

Benefit inequality

Picked up from the Internet:

The British Government provides the following financial assistance:-


BRITISH OLD AGED PENSIONER
(bearing in mind they worked hard and paid their Income Tax and
National Insurance contributions to the British Government all their
working life)

Weekly allowance: £106.00?   

IMMIGRANTS/REFUGEES LIVING IN BRITAIN
(No Income Tax and National Insurance contribution whatsoever)

Weekly allowance: £250.00


BRITISH OLD AGED PENSIONER
Weekly Spouse Allowance: £25.00?   


ILLEGAL  IMMIGRANTS/REFUGEES LIVING IN BRITAIN
Weekly Spouse Allowance: £225.00


BRITISH OLD AGED PENSIONER
Additional Weekly Hardship Allowance:£0.00? 

   ILLEGAL  IMMIGRANTS/REFUGEES LIVING IN BRITAIN
Additional Weekly Hardship Allowance:£100.00


A  British old age pensioner is no less hard up than an illegal
immigrant/refugee yet receives nothing

BRITISH OLD AGED PENSIONER
TOTAL YEARLY BENEFIT £6,000?   

ILLEGAL IMMIGRANTS/REFUGEES LIVING IN BRITAIN
TOTAL YEARLY BENEFIT: £29,900

 The average pensioner has paid taxes and contributed to the
growth of this country for the last 40 to 60 years.

Peterborough Hospital PFI

The Private Finance Initiative (PFI) uses the equivalent of a full operational lease used by many governmental authorities in the UK. Financiers form a company borrow the money to (re)build a new hospital. The PFI company then leases back the building to the local Hospital Trust, but there's a kicker. As part of the deal the PFI company also gains exclusive rights to provide services such as facilities management within the hospital. It is a very very expensive method of financing the hospital (re)build.  In recent year Governments liked this method of financing because it does not show up on the capital borrowing total for public finances, it is in effect a future operating cost. These contracts go on for 30 - 50 years. 

It would be much cheaper for the public purse if the Government was honest and just borrowed the money up front and built the hospital using their own managers. In the news today is yet another report of a Hospital Trust struggling to pick up the bill for a PFI. Peterborough and Stamford hospital Trust have been criticised by the National Audit Office for poor financial control and mounting debt.

Much of the unplanned cost comes from the provision of services not included in the original contract. Minor changes such as moving a phone or installing an extra shelve must be be purchased via the PFI company. As there is no competition these costs are greatly inflated by the PFI company.

The consequences of the "overspend" caused by the PFI is that hospital staff including nurses are made redundant. Clinical services are cut back.   Peterborough Hospital PFI was agreed in 2007, it is a very nasty financial legacy left by the Labour Party Government at the time. I've seen estimates of £800 Million required to rescue the hospital finances.