2011年12月11日 星期日

A conspiracy of silence

Health Secretary Andrew Lansley is still defying the Information Commissioner and refusing to publish a potentially explosive "risk register" on his controversial Health and Social Care Bill - for fear it would scupper the Bill in the Lords in January.

Lansley kept the report under wraps throughout the entire debate on the Bill in the Commons and has now rebuffed efforts by the Evening Standard and others to force its publication under the Freedom of Information Act.

This level of desperation from the Health Secretary (who made a big deal of "open government" last year when he noisily published the controversial McKinsey report outlining 20 billion of savings, after Labour ministers had refused to release it) indicates the extent to which Lansley knows he has lost the argument on the Bill.

Its future hinges on Tory and Lib Dem peers and MPs continuing to accept their role as mushrooms (kept in the dark and inundated with sh*t) nodding through a Bill they have not read or understood, based only on "facts" and briefings from government spin-doctors, and ignoring all of the evidence to the contrary.

The huge Bill has already been extensively amended, although most of the damaging proposals remain intact.

But the Lords vote on one crucial amendment, to restore the duty of the Secretary of State to provide comprehensive health services, has been put back to next January -for fear of a government defeat.

Shadow health secretary Andy Burnham has offered Lansley a face-saving deal in which he would drop the Bill in exchange for Labour support in extending the commissioning role of GPs - but it's clear that Lansley has already gone too far down the road to contemplate any concession.

At Burnham's initiative Labour has belatedly launched a welcome,As many processors back away from hydraulic hose , if fairly half-hearted, campaign against the Bill.

But a useful starting point would be to engage the health unions,This page contains information about molds, which so far remain focused only on the pensions issue and have yet to wage any serious campaign to stop the Bill that could ultimately remove up to one million NHS staff from the NHS balance sheet (and pension scheme).The application can provide Ceramic tile to visitors,

The Bill has lost much of the naive support it initially was able to claim from the medical profession, with polls showing a massive 75 per cent or more of GPs now opposed to key proposals and just one in six GPs willing to have any involvement with commissioning services.

Another worrying survey found overwhelming numbers of GPs expressed concern that they lacked the necessary skills to carry out the commissioning role they are supposed to have under the Bill.

And the British Medical Association's (BMA) GP committee was enraged in November by a Department of Health document making it clear that the real plan all along was for GPs to serve as no more than a rubber stamp for plans and decisions to be taken by private companies carrying out the commissioning work.

The BMA's initial perverse decision not to oppose the white paper or the Bill, but to maintain "constructive engagement" with the government on it, has been tested to destruction with the government turning a deaf ear to the issues raised by the BMA and others.If so, you may have a cube puzzle .

Their patience finally reached breaking point in November when the BMA council finally gave up and changed its policy from merely calling for the Bill's withdrawal to opposing the Bill as a whole.

Meanwhile the wheels are starting to come off even before the Bill becomes law.Enecsys Limited, supplier of reliable solar Air purifier systems,

Even early enthusiasts for the idea of GP commissioning of services are now beginning to give up and pull out of posts in Clinical Commissioning Groups because they do not have the time to do the extra work required. GPs have also been shocked to find that the management allowance will be just 25 per patient.

There are complaints that some CCGs are trying to cherry pick only the best performing and low-cost GP practices, excluding those whose prescribing and referral costs are higher because they cover deprived areas or older groups of patients.

Around 400 public health doctors and academics have joined the fray, signing a hard-hitting open letter warning that the Bill could undermine the long term development of public health policy, and a survey of 1,000 public health experts by the UK Faculty of Public Health showed that a massive majority see the Bill as a "nightmare."

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