"The NHS will last as long as there are folk left with the faith to fight for it"
Aneurin Bevan

Monday, 22 July 2013

Rotten Egg Hunt

I've already written about how I think Jeremy Hunt visiting hospitals is a gimmick, and I've politely suggested how he can do some actual good, rather use his time as a minister for self-promotion. Now the Guardian Professional (which, I have to stress, is not the society pages, it is a separate part of their website that appears to be used for puff pieces for PR companies) have an article which describes jeremy Hunt as a "good egg". In response I added this comment:
22 July 2013 10:42am
This hagiography is embarrassing: it made me cringe. Are you talking about the same Hunt as me?
"As a long-term NHS customer, he does seem to think like a patient." 
Well, that shows the problem immediately none of us are customers of the NHS. I am a long-term patient, I have had type 1 diabetes for 40 years and I have used the service regularly. I can tell you terrible stories of the NHS during the Thatcher/Major years. I can also tell you how immensely the NHS improved in the early years of this century. I can tell you as a real long term condition patient what the NHS is like. Lansley's reforms are tearing the NHS apart and hapless, clueless Hunt is unaware, and does not care.
Hunt's visits to hospitals are a gimmick. You are wrong: every minister has done them. They like their picture to be taken with smiling patients: Hunt is no different to any of the other Health secretaries.
If he really wanted to know what the NHS is like, he would attend all the patient meetings, like I do (do you? I have never seen any evidence that you do). Hunt should go to his local GP's Patient Participation Group - and if his GP does not have one, he should start it. He should go to his CCG Patient Reference Group, he should attend the FT governors meetings of the FTs in his area. These are all patient-run groups. It is in these meetings that he will know about the pressures in the NHS, about poor care that patients get. And more importantly, he will be able to find out what patients want.
You're obsessed with urgent care and returning it to GPs? Good. Now tell me how Hunt has improved this? Earlier this year a co-op of GPs in Hackney tried to tender to take over the OOH service that was being delivered badly by Harmoni. They were told that they could not be commissioned because there had not been a full competitive tender. Hunt was the secretary of state that brought in the Section 75 regulations on procurement, and he is the man who is stopping GPs from taking over OOH services.
I attend my local CCG commissioning meetings, for a year patients have been improving quality in our local services. Last week we were told that money is so tight that all commissioning has to be on cost alone, and that as patients we will soon be consulted on rationing treatments. Hunt did that. Twice during the meeting the Drs there stopped us and said that what we were suggesting would contravene Section 75 regulations: patients could not commission the services they wanted. Hunt did that.
"He gets down to the nitty gritty of prescribing the exact amount of medication for a diabetic patient." 
Huh? Was Hunt legally responsible? If that patient had been given the wrong dose, would he have been prosecuted? What a silly, obsequious statement to make.
You want to know about diabetes? I will tell you. Diabetes treatment is in a shambles, there are not enough Diabetic Specialist Nurses (you know, those people who give continuity of care?). At my GP there has been no GP with a specialist interest in diabetes since the previous one retired 5 years ago. The DSN told me at the beginning of the year that because of cuts in staff I would be seen once a year not twice as I have been throughout the last decade.
Then there is the issue that in this month's Balance magazine (Diabetes UK's magazine) I read that the needles I use are being withdrawn. I asked my pharmacist about this and she told me that it was because the needles are not popular and hence the drug company was not selling enough of them: the withdrawn is because of profit. Yet for clinical reasons I need these needles. Why isn't Hunt standing up to the drug company and saying to them "bugger your profits, we want patient choice, so you should provide the full range of needles or you'll not be allowed to sell any"?
The same thing happened to me a decade ago over my insulin. I had three month notice (via Balance, the weasly drug companies couldn't even be bothered to contact me) that the drug that was keeping me alive was being withdrawn. Why? Because the drug company wanted me to use their alternative which cost three times more (and which I had used, and it made me ill). Where was the NHS then? Why didn't the NHS protect my supply of insulin, and use its huge might to force the drug company to continue to supply the insulin I need? Hunt is not aware of this: he does not care, the debacle over my needles shows that he does not care. Incidentally, the drug company withdrew the insulin for humans, but (even though it is human insulin) it is available for treating diabetic dogs.
"I have anecdotal evidence from my contemporaries, that this happens."
Err, anecdote is not evidence.
Sorry, but this is a terrible article and the only excuse I can give the Guardian for printing it is that this is the Guardian Professional where contributors pay to publish puff pieces.
OK so I was ranting, but I think I was justified. Then four hours later there was a reply to my comment:
Gladiatrix > richardblogger 22 July 2013 3:11pm 
You don't actually know if Jeremy Hunt does attend the types of meetings which you have suggested. For all you know he may well do. 
I am sorry about the problems with the withdrawal of the needles which you use but see no evidence that you have actually raised this with your MP, with the select committee or with the SoS himself although you are blaming him for it. Given the nature of his role there is every chance that Jeremy Hunt hasn't been told about this, in which case you should bring it to his attention. 
The s.75 regulations were Andrew Lansley's idea not Jeremy Hunt's. 
Again, with regard to your preferred type of insulin if Jeremy Hunt doesn't know about this, because he wasn't responsible for the health system at the time it is unreasonable to blame him for it. The person who should have stopped it was either the then SoS or the CE of the NHS. Did you contact either of them?
I read this two hours later. I typed a reply, but by the time I posted it comments had closed and my reply was rejected.

The Guardian had closed comments after only eight hours. Why? Why were comments only enabled for such a short time? Anyway, here is my reply to Gladiatrix:
And you don't actually know if Hunt is doing anything useful when he visits hospitals. I contend he isn't. He does not have the training, and since he's not an employee then I doubt if he's actually covered by negligence insurance. He's a spare part, and worse, if Dave called Hunt on his mobile phone, Hunt would be back in London at a shot: no employee (nor volunteer) can do that. I could easily find out if he has ever attended a patient meeting as a patient, do you want to put money on his attendance?
As to the needles, it has just been sprung on me this month and I am told they will be withdrawn within three months. (Think about it FFS, this is what keeps me alive it is serious.) Contacting my MP (who is a junior minister) will be pointless. I know this because I've contacted him before, about the so-called "listening exercise". As a patient I was not invited to any of them in my area (I suspect that no patients were, I've asked around and no patients were aware of them). I wrote to my MP asking if he could help me get to one and he delayed and then replied after the exercise had finished to say that they had finished! Now you may think that is conspiracy - preventing an outspoken and informed patient from attending a so-called "listening" meeting - but I put it down to incompetence and contempt for the electorate: this government really doesn't care about the population. 
Why doesn't Hunt know about how patients have no choice about the medical devices they use? According to the article writer (and presumably also, you) he knows exactly what is best for patients. Well I think he doesn't care. OK, so here's another diabetic rant, something Hunt is doing nothing about. There are 4 or 5 manufacturers of insulin, all delivered through an insulin pen. However, the "cartridges" are all different: you cannot use a competing insulin in another company's pen. I take a large dose and only one pen will deliver that dose (ahem, that pen is likely to be withdrawn too, so another rant is due when that happens) so it means that I can only use one insulin. Where's the choice? If Hunt really knew patients' concerns he would be campaigning right now to get the drug manufacturers to standardise on insulin cartridges. There is no reason that they shouldn't standardise. Why isn't he? It's because he is a amateur, he's just a rent-a-suit minister, one day Culture Secretary, the next, Health Secretary, and the day after, back on the back-benches as a hapless nobody. He has no passion for the NHS and no ability as a patient activist.
"The s.75 regulations were Andrew Lansley's idea not Jeremy Hunt's."
Rubbish. The regulations (not the section) were published, and then changed, in April this year. Hunt became the Secretary of State in September 2012. They are Hunt's regulations. (Of course, if you want to be pedantic the actual regulations are signed by Lord Howe, but Hunt is the boss.) Are you seriously saying that Hunt is a puppet delivering what the Leader of the House tells him to? Hmm that would agree with what I'm saying about Hunt being an amateur, temporary, pointless minister.
Anyway, its lovely to see that you are blaming me for the failure of the system. The system can be improved by putting patients in control - and getting rid of the straitjacket of the procurement regulations would be a start - but all you want to do is blame patients. 
I have tousled with "Dick Vinegar" before, I find that he is opinionated without providing much evidence behind those opinions (hence my comment about "anecdotes" above).

I encounter his undying belief that technology will solve everything throughout the NHS. However, when I hear it from an NHS manager I can at least excuse them that they know nothing and are echoing what they have been told to say. This is not the case with "Dick Vinegar" who appears to have the ear of politicians. (I wonder if he has written any code? I tend to find that the people who believe that technology will solve everything - for example Tim Kelsey - have never written any code themselves.)

Dick Vinegar

This is the nom de plume of Richard Sarson who says he is a member of the "Parliamentary IT Committee". Richard Sarson was the Editor of the PITCOM website from 1995. PITCOM was disbanded at the end of the last Parliament and was replaced with the Parliamentary and ICT Forum (PICTFOR) in 2011. I cannot find any trace of Richard Sarson on the PICTFOR website.

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