Conservative Government Ignores Flu Advice From Doctors

Health Secretary Andrew Lansley
In U-Turn

What is our Tory led Government doing to help protect us during the latest H1N1 "swine-flu" outbreak?

Before the Labour government left office they had organised an advertising campaign advising people, especially those at risk, to take up the seasonal flu vaccine, the Conservatives, scrapped the planned campaign, branding it as "too costly, and unnecessary".

Last night in an humiliating climbdown Health Secretary Andrew Lansley was forced to resurrect the effective "Catch it, Bin it, Kill it" advertising/information campaign that the previous Labour Government had previously run with excellent effect.

Perhaps if prime minister David Cameron, and Andrew Lansley, had not been too busy  cutting, slashing, burning budgets, and axing front-line NHS jobs, they would not have taken their eye off of the ball, and they would have realised the and heeded the numerous warnings that have been issued by doctors, and health pressure groups, as it stands, they have ignored all these warnings. Geoff Martin chair of the pressure group "Health Emergency" said; the Tory Government "have scrapped the publicity to save a few pounds but placed peoples lives at risk".
In another report the Health Protection Agency said the number of flu victims in intensive care has doubled in a week to 738. Twelve more people have died since last week, on top of the 27 victims who have died from the flu virus since October 2010.
To add to the chaos this Conservative Government are causing in the NHS, the British Medical Association (BMA) has warned that if the Government insist on rushing through these radical reforms in the NHS, it will be tested to its limit in 2011.

The Government have known since October what the country could be facing, but they have ignored all warnings and it is simply unacceptable.

On the 21st December 2010 an NHS Central Alert by  the Interim Chief Medical Officer, Dame Sally Davies was sent out to clinicians and other health care professions about the use of  SEASONAL INFLUENZA: PRESCRIPTION OF ANTIVIRALS (2010/11).

"This letter contains information about the prescription of antivirals (oseltamivir and zanamivir) to meet clinical circumstances arising during the current seasonal influenza outbreak. Antiviral treatments for influenza are currently only available from GPs for NHS patients who are in a designated "at clinical risk" category. The most recent surveillance data indicate that higher than normal numbers of patients, who are not in one of the "at clinical risk" groups, are becoming seriously ill with flu – requiring hospitalisation. "
 (redacted)

"Regulations currently say that prescribers should not order oseltamivir and zanamivir for patients who are not in the target risk groups. However, the Chief Medical Officer has recommended that the current restrictions -see the Annex to this letter – should be amended to allow general practitioners (and other prescribers) to exercise their clinical discretion so that any patient who their GP feels is at serious risk of developing complications from influenza may receive these treatments on the NHS. "Full text Of Letter Here

That letter was date 21st December, it is now 31st December, noteably the CMO did not copy in Andrew Lansley, I pressume, at least one would hope she is keeping him informed privately?
Why has it taken Andrew Lansley a further 10 days to act?

Urgent Report from the Health Protection Agency: TUESDAY 14th DECEMBER

H1N1 influenza – Report of an HPA-led teleconference 10 December 2010

"The number of cases of H1N1 is increasing. Worryingly, there is a disconnect between the number of cases in the general population (13/1000 incidence, below the threshold to declare a pandemic which is 30/1000) and the impact on ICU of the severely ill. The numbers are increasing especially in the North-West and in the Midlands.

"There have been 12 flu deaths in the UK not including Scotland, 10 of which were confirmed H1N1. (Swine flu)

They ranged in age from 1 – 51 years old; none had had vaccinations. Four had cerebral palsy, one asthma, one alcoholic liver disease, one asthma, one was obese.
"Several pregnant patients have presented needing intensive care. Ten of the 14 nationally available extracorporeal membrane oxygenation (ECMO) beds are occupied by ‘flu patients, three of whom are or were pregnant.
"Although surge funding has been agreed for additional ECMO beds (at Papworth, the Brompton, Aberdeen, Leicester, Wythenshawe) this funding has not been released as yet, and the ECMO units are struggling to maintain their elective surgery as well as deal with pandemic cases.

(redacted)

"There was a plea for a national statement from the DH (Department of Health) about the issue".
I will be chasing the issues of the surge funding and a national DH statement later today.

UPDATE 1 Call made to DH at 11.10 am asking about these issues. At 17.51, the following statement was received
(redacted)
No answer there to my question about whether the agreed funding has yet been released.

UPDATE 2
At 16.45, the following CAS Alert was sent out by DH:
Central Alerting System: Treatment Guidelines For Patients With Influenza 2010/2011
CASMSG00000001609690
Cascade codes: #GP#, #ACCIDENTEMERGENCY#, #COMMUNITYPHARMACISTS#Category: Non urgent (cascade within 48 hours)
Issue date: 14-Dec-2010
Reference: CEM/CMO/2010/18
From: Chief Medical Officer - Department of Health
(Redacted - See below)

Dear Colleague

Treatment guidelines for patients with influenza 2010/2011.

Professor David Salisbury wrote last week on the use of antivirals for individuals suspected to have influenza, particularly in the context of primary care

The purpose of this letter is to update you on appropriate guidelines for treatment in secondary care and other settings.
Over the last few days, we have been alerted by the Health Protection Agency (HPA) and other sources that the incidence of severe illness due to influenza infection requiring access to critical care services has increased. At the 7th of December 2010, sixteen confirmed cases in 18-35 year olds are in hospital (all due to H1N1 infection), with a number of probable cases currently under investigation. Many, but not all, of those cases have underlying conditions including pregnancy. Eleven of twelve cases currently receiving ECMO treatment are confirmed or probable swine flu (H1N1) cases. Since the beginning of September, eleven deaths associated with influenza infection have been reported in the UK. Ten cases are associated with A(H1N1) 2009 infection and one with influenza B. Ages ranged from four to 51 years including four cases under 10 years.
Based on the reports from colleagues treating such patients about the similarities of the clinical presentations to last year’s A (H1N1) 2009 cases, I recommend that last year's Clinical Management Guidelines should be followed for patients admitted to hospital with symptoms suggestive of H1N1(2009) influenza.

(Redacted) Read Full Letter Text Here:

Yours sincerely,
PROFESSOR DAME SALLY C DAVIES
Chief Medical Officer (Interim)

Below Follows a Letter In Full Letter From  Professor D M SALISBURY  Director of Immunisation

Dear Colleague

Influenza Season 2010/11 – Use of Antivirals

During the 2009/2010 H1N1 pandemic, oseltamivir (Tamiflu) or zanamivir (Relenza) were recommended for the treatment of all clinically diagnosed cases of influenza. Prophylaxis with oseltamivir and zanamivir was recommended for people who had been in recent close contact with a clinically diagnosed case of influenza and who were either pregnant or had a serious underlying medical condition. Once influenza activity dropped to below baseline levels during 2010, the pandemic-specific recommendations for the use of these antivirals ceased and the NICE guidance on the use of antivirals was reinstated.
The H1N1 (2009) virus is now regarded as one of the group of seasonal influenza viruses in general circulation and therefore the NICE recommendations on the use of antivirals for treatment and prophylaxis will apply during the 2010/11 influenza season.

The Current Position

The purpose of this letter is to inform you that the most recent surveillance data from the Health Protection Agency indicate that there is now a substantial likelihood that people presenting with an influenza-like illness are infected with influenza virus. Oseltamivir continues to be recommended, along with zanamivir, for the prophylaxis and treatment of influenza.  For clinicians treating hospitalised patients with suspected influenza, rapid laboratory confirmation with subtype identification is advised to support patient management.
From 1 November 2010, the relevant regulations have been updated so that the list of people 'at clinical risk' from seasonal flu and eligible to receive antivirals prescribed by General Practitioners has been extended to include pregnant women. General Practitioners will wish to note the information on use in pregnancy in the Summary of Product Characteristics of both antivirals. In line with the National Institute of Clinical Excellence (NICE) guidance, the use of antiviral drugs for the prevention or treatment of influenza is now recommended.
Antivirals should therefore be used when:

• A person with a flu-like illness is in an ‘at-risk’ group and they can start treatment within 48 hours (or within 36 hours for zanamivir treatment in children) of the onset of symptoms as per licensed indications and
• the national surveillance schemes indicate that influenza virus A or B is circulating (as the first part of this letter confirms)

During localised outbreaks of influenza-like illness (outside the periods when national surveillance indicates that influenza virus is circulating in the community), oseltamivir and zanamivir may be offered for the treatment of influenza in ‘at-risk’ people who live in long-term residential or nursing homes. However, these treatments should be offered only if there is a high level of certainty that the causative agent in a localised outbreak is influenza (usually based on virological evidence of influenza infection in the initial case).

The full NICE guidance on the use of antivirals can be accessed at: I would also like to take this opportunity to highlight the importance of GP practices achieving high uptake of the seasonal flu vaccine among their patients in at-risk groups, pregnant women and healthcare workers.

Yours sincerely
Professor D M SALISBURY CB FRCP FRCPCH FFPH Director of Immunisation

You can see from the dates I have found when researching that Andrew Lansley the health secretary has been in receipt of information about the escalating H1N1 virus (swine flu). Of course he would have known for many months that swine flu was going to be a problem this year because it was included in the seasonal flu vaccine.
This year the flu vaccine has been a poor uptake, attributed to two things. 1) The Tory government cancelled the planned information campaign in the press and on TV, reminding people, especially those in the at risk groups to take up their vaccine and 2) because the swine flu strain was included in this years jab. This is why the Labour government wanted to inform people so they could make informed choices to have the vaccine.

In December 2010 former RCGP chair, Professor Steve Field criticised the DH  for its "ill-advised" decision to cut back on the £180,000 it spent last year (2009 under Labour government) on a public awareness campaign.

In response, the DH said "it had no plans to bow to the criticism and launch a marketing drive - and that instead GPs should ring patients individually to invite them into clinics over Christmas, as it was "vital that those at greatest risk are vaccinated as soon as possible".

This was on the 23rd December 2010, the government knew we had a problem, yet still did nothing, it took them 10 MORE days to act!Obviously it is vital and if so, then why are they leaving it to GPs? All that should be done - yes, but equally Andrew Lansley and the Department of Health KNEW many months about swine flu, so a concerted and organised advertising campaign was urgently needed and they CANCELLED it, saying it was too costly and unnecessary!
In every previous pandemic the major problem has been in the second winter season. So why is it that the Government decided to do nothing at all this year, and then expect  GPs to clean up the mess and chaos they have caused with their belligerent penny pinching?

Questions must be asked of Andrew Lansley - URGENTLY. The House of Commons  should be brought back early and Andrew Lansley should make a statement.

Norfolk Hospital Goes On "Black Alert" Due To Swine Flu Virus

Footnote:

I make every effort to check my facts when reporting and like to give as much background information as possible. The 'Central Alerting System' mentioned at the top of this report  brings together CMO's Public Health Link (PHL) and the Safety Alert Broadcast System (SABS). It enables alerts and urgent patient safety specific guidance to be accessed at any time.

In this instance italics are used to denote quotes and information from other sources, wherever possible I have enclosed links to those sources. Look out for the highlighted links.

Please feel free to copy this where you feel it may help, please always do me the courtesy of providing a link back to here - Many Thanks

Tories GP Consortia-Too Far-Too Much and Too Rushed

Cuts are Ideologically Driven

In another hasty bid to cover up a 'bad news' story, the Government's commissioning tsar Dame Barbara Hakin, has said that the Government is set to announce details of "many more" GP consortia pathfinders as early as January 2011, which could go live as early as February, March or April.

NHS managers have been accused by commissioners of setting misleading criteria for selecting consortia for the pathfinder programme, the accusations came after many of their bids were turned down in favour of less stable and less financially secure applicants.

If this is the case, then the public has a right to demand answers from the Government, Health Secretary Andrew Lansley, and the Government's commissioning tsar Dame Barbara Hakin.

Hakin has said that she thinks too much has been made about the criteria for the selection of the first pathfinders and in any case, those pathfinders were apparently selected to be part of a 'learning network'. At the same time she announced that she expects to see many more pathfinders being announced in January, who will then start to go live in February, March or April.

Dame Barbara says she acknowledges the BMA's concerns about key concepts of the white paper, especially the "any willing provider policy", but just like this Tory government is sticking her head in the sand and totally ignoring growing concerns in all areas, that too much, is being done too soon, and without proper consultation.
The Government has turned its back on the preferred provider policy it inherited and has replaced it with the "any willing provider" models instead. This completely undone what the previous health secretary, Andy Burnham, announced when he moved to make the NHS the ‘preferred provider’.
Under any willing provider, several approved providers can offer a service to patients at the same time but have no guarantee of numbers they will treat.

In a nutshell GP Commissioners will be able to advertise on a service specific basis for willing providers of services as they are to be procured. These will of course mainly be in the private sector and will turn GPs into accountants and sales people. *When will they have time to do any doctoring*?
Proper answers must be given about the what criteria was used to select the original 52 pathfinders and why that particular criteria was used.

Legitimate dissent and opposition to the Government's plans for the radical reform of the health service, reform which has never been seen before in its 62 year history, is being stifled, concerns glossed over with a wave of the hand.

Growing concerns over patient safety, patient care, and staffing levels and staff pay and conditions must be answered and satisfactory reassurances and detailed explanations given.

While in opposition the prime minister, David Cameron, repeatedly promised that there would be no top down reorganisation of the NHS, and that the NHS was "safe in his hands", this was a blatant lie. Cameron looked the nation in the eyes and lied to their faces about his plans for the NHS.
Plans like this for the NHS could not possible have been drawn up in the six weeks between Cameron and the Tories assuming office producing the coalition paper, and Andrew Lansley announcing them in his white paper.

If Cameron had spoken of the Tory plans for the NHS both before and during his election campaign, it is very doubtful he would have won the number of seats his party secured at the 2010 general election.

More, Nick Clegg and negotiators of the coalition agreement, David Laws, Danny Alexander, Vince Cable and Chris Huhne categorically *MUST* have been aware of the Tory plans for the NHS when they agreed the coalition agreement, which makes them liars  and deceivers too.

Conservative government plans are not concerned about patient care, and safety, their concerns are twofold, saving as much money as possible for George Osborne's "mega rich people's awards" war chest, while they pave the way for the wholesale sell off of the NHS.

The Conservatives, David Cameron, George Osborne, "Nick Clegg" and Andrew Lansley are actually presiding over the greatest con in the political history of this country, privatising the NHS under the noses of the people without them realising (until it is too late) what is happening.

Dame Barbara's and Andrew Lansley's insistence that their plans have been overwhelmingly received as "positive" are just more fabrication and lies, how can we have trust and confidence in Dame Barbara, the Conservative Government, and health secretary Andrew Lansley, when we read about BMA chiefs who launched a double-pronged attack on the Government's plans last week, with BMA chair Dr Hamish Meldrum accusing health secretary Andrew Lansley of 'charging forward' with his plans? And GPC chair Dr Laurence Buckman, warning GPs had been left 'extremely disappointed' by the Government's failure to listen to their concerns? The Government is trying to sweep this dissent under the carpet.

If such doctors are saying this in public, what on earth are they saying in private? Surely we, the public, have a right to know? These are the very people that are supposed to be entrusted with our welfare and our safety. If the likes of Dr Hamish Meldrum and Dr Laurence Buckman know things the public do not, it is their absolute duty to speak out now, loud and clear in an unambiguous fashion. The public should not be left in any doubt about what they are saying. These doctors first line of duty is not to the "Lord of the Flies" type Government, their duty is to us, the general public.
 This is *OUR* NHS, it does not belong to Cameron, Osborne, Clegg, Lansley and Hakin and these people were *NOT* given a mandate to carry out such radical reforms, especially at a time when the Government is carrying out other radical reforms in welfare, education, and the police, not to mention the unprecedented risk and gamble this inexperienced government is taking with the British economy.

This is not only an appalling abuse of power by the shambolic Conservative government, it is an appalling break of trust, wrapped up in wall to wall bare faced lies.

Doctors, Dame Barbara, and others in the know about the true extent of the Conservative Government's plans for the health service, cannot and must not, stay quiet about the Government's obvious haste to introduce the Tory competition agenda and private healthcare companies into the NHS and reassurances are beginning to sound false and hollow. it is not rocket science to understand that the Government's competition agenda would  prevent "constructive co-operation between GPs and hospital doctors".  What are we going to have in the NHS, bidding wars etc? While we all stand helplessly around watching while patient care, treatment and safety is heavily compromised? Have some forgotten what happened when hospital cleaning was put out to tender? The lowest bids winning and the result was filthy hospitals, filthy wards, filthy departments and the resurgence of MRSA and C Diff etc which at that time had all but been eradicated from hospitals?  This is yet another example of an ill-thought out policy, short term gains to save money at the expense of long term failure in treatment and patient and staff confidence and satisfaction rates.

Dame Barbara is falling for the "psycho-babble clap trap of the Tory "Cost Cutters", patients may want "choice", but ask them to place choice in a list of clean, modern and efficiently run hospitals, offering excellent standard of care uniformly across the UK and  good available GP services with good practice and see where it falls. Why would someone "choose" to travel to the other side of the country for something they should be able to find in their own locality?

Dame Barbara appears to be condoning the introduction of some sort of "Big Society" into the provision of health care, this is taking the "voluntary/involuntary groups" just a little too far! Yes of course all clinical professionals and GPs should be working together, where is there argument against that? Where has there ever been argument against that? What we have now is a government and a government tsar insistent on introducing psycho-babble and buzz-words and calling it "patient pathway".
However, what is really c becoming apparent with each passing day is that this government is not really interested in improving patient care, patient choices or whatever, all it is interested in is saving money while they get rid of the NHS by selling it off to the private sector, and Dame Barbara and this government can go on about choices and improving the service all they like, in the end when healthcare is in the hands of the private sector, choices and treatment will be badly eroded for the majority of ordinary people who will be unable to purchase expensive healthcare.

How much choice will a non paying patient who needs an MRI scan have, against a private patient who has been allowed to opt out of paying contributions and has purchased expensive health cover? Who will get the scan first? Who will nurse the private patients in NHS Trust hospitals?

Choice for the ordinary person in the end will be severely restricted. This is not just some empty threat, as a direct result of the Tory government and Andrew Lansley removing targets in the NHS, waiting times and lists have already risen sharply, and they have been flippantly explained away by Lansley as a "seasonal rise".
Lansley has also already removed the cap that NHS trusts have which restrict the number of private patients they treat, this will see a rise in the number of private patients treated and further erosion of choice treatment for NHS patients.

On this blog I have persistently tried to bring to people's attention about one of the biggest dangers that I see facing Lansley's "consortia".

GPs will be given a budget, that budget will be finite as the government is abolishing SHAs and PCTs, there will be nowhere to turn to if the money runs out. So which Consortia is going to want on their lists thousands of disabled, chronically sick and elderly people? These groups are notoriously expensive to treat, I have said we will be creating groups of health vagrants, drifting from one emergency treatment consortia to another as they will be unable to secure permanent healthcare, carrying with them all the obvious risks having no permanent health care would create.
Equally the opposite has been mentioned by GPC chair Dr Laurence Buckman, who has warned that failing GP practices could have to form a ‘consortium for the unwanted’ because the health white paper makes no provision for practices expelled from other consortia.

This radical reform of the NHS is going too fast, too far and  trying to cover too much ground, for the health and safety of every single person in this country, this insane initiative must be stopped. these changes are not about improvig the NHS, they are about the ideological needs of the Conservative party who see this as their chance to rid central government of the "millstone" they have always thought of the NHS.

NHS Direct Vs NHS 111?

Once again we discover the Tory led government are being profoundly devious. They have stopped calling NHS Direct; NHS Direct, instead they now refer to it as "Urgent Care Phone Line" (NHS 111). Few could argue with giving this service such an easy number to remember I can go along with that. However, it is not this we object to, it is this government getting rid of NHS Direct by stealth and hoping that no one will notice what they have done, that we object to

When the story first broke that the government were thinking of axing NHS Direct, they managed to halt the bad news coverage by insisting that they were only piloting the NHS 111 Urgent Care phone line to see if it is a viable prospect, there is four regions taking part in this pilot scheme: County Durham and Darlington, Nottingham City, Lincolnshire and Luton.

Now the Government has suddenly announced it will rapidly expand the number of areas piloting the new 111 non-emergency telephone line, ahead of GP consortia taking control of the service.

I do not remember Andrew Lansley stating this when news that the government were *THINKING* of disbanding NHS Direct first broke.

The Department of Health wants to expand the NHS 111 service in England prior to universal coverage by 2013. Now the government has announced that GPs will be charged with buying in replacement services for the soon to be scrapped NHS Direct helpline, with private firms to compete with NHS bodies to offer a competing versions of the new 111 number across England.

How is this all going to work? How is the NHS going to work? How are patients and NHS staff going to know who does what and who is responsible for who and what and which service and when?

As they themselves have demonstrated, this Tory led government cannot even get one simple policy right, they seem utterly incapable of seeing something through without causing drastic problems. This can be seen in policies such as Child Benefit; Education; Sport; Transport/snow;  Flu Vaccine; Etc. So given their level of inexperience and incompetence, how will this government oversee the health service most radical reforms that have never been attempted anywhere else in the world?

What is going on in the Health Service is not so much top down reform, as it is a dismantling of every single nut and bolt that holds the NHS together, taking it all apart and then jumbling it all up without having a blue-print , or the first clue on how to re assemble it.

 People are rightly worried about all the talk of slashing spending, and cutting the number of qualified nurses that are available to take calls in the NHS Direct 0845 46 47 service, so worried that petitions were set up which collected thousands of signatures and thousands also emailed our MPs and sent a strong signal that we want to support NHS Direct service as it stands today.

Now we learn that the Department of Health, plans for its new NHS 111 service, to be available nationwide from 2013. But there are still concerns about the qualified medical professionals being replaced by quickly-trained telephone operators. Now we learn from the Health Secretary that this is not just a pilot scheme, they are going ahead with disbanding NHS Direct and making it reapply along with private companies for a part of running the service.

  

Three of the main concerns were:

1) That there would be a reduction in the number of trained nurses taking calls from the public
2) That this would not produce the required savings the government were after making, as it would increase the number of people sent to Accident & Emergency Departments and
3) Also increase the number of calls to the 999 ambulance service.

On 19 October 2010 the Chair of the Health Committee, Stephen Dorrell, wrote to the Secretary of State for Health, Andrew Lansley, to ask him about his plans for NHS Direct. Here is the text of the letter:

“In late August and early September there were a number of stories in the news media reporting that the Department of Health was to close NHS Direct and to replace it with a new helpline, NHS 111.
In view of the considerable interest this has stimulated both inside and outside Parliament, the Committee would be extremely grateful if you could set out the government’s position on this issue, and in particular:

• How NHS 111 differs from the NHS Direct Helpline
• Whether the online and other services NHS Direct currently operates will continue in their present form
• Whether NHS Direct is included in the QIPP programme of efficiency savings and if so what targets it is seeking to achieve
• What estimate the department has made of the cost savings to the NHS from patients contacting NHS Direct as a first port of call (the NHS Direct Annual Review 2010 says “Our research identifies that we recommend to around 49% of all our callers that they should go to a less urgent and lower cost point of care than they would have gone to if they had not sought our advice.”)
• Whether it is the intention to staff NHS 111 in a broadly similar way to NHS Direct when it is rolled out across the country (that is, NHS Direct has around 3,400 staff of whom 1,400 are nurses – is that what NHS 111 will look like?)
• How long the pilots of NHS 111 will run for, and when the assessment of those pilots will be made available
• What criteria the pilots will be assessed against
• Whether a cost benefit analysis of the change to NHS 111 has been carried out, and what were its conclusions

As this is a matter of considerable interest I would be grateful if you could reply to us by 8 November.”

Here is Andrew Lansley's reply to Stephen Dorrell MP, chair of the House of Commons health committee,

                                                                                            Department of Health
                                                                                            4 November 2010

Dear Stephen

Thank you for your letter of 19 October 2010, in your role as Chairman of the Health Select Committee, about the new NHS 111 service, and the future of NHS Direct. I am happy to be able to set out the government’s position on both these issues.

The White Paper, “Equality and Excellence: Liberating the NHS” set the Coalition Government’s commitment to developing an integrated approach to the delivery of 24/7 urgent emergency care:

“develop a coherent 24/7 urgent care service in every area of England that makes sense to patients when they have to make choices about their care…we will make care more accessible by introducing, informed by evaluation, a single telephone number for every kind of urgent and social care and by using technology to help people communicate with their clinicians”

This commitment makes it clear that the new NHS 111 service will make it easier for patients to access the services they need at the right time. However, we have only recently launched the first NHS 111 pilots in the North East of England and so it is still a little early to say exactly how NHS 111 will look when it’s rolled out nationally. We need robust data before taking important decisions about the wider roll-out of the service and we have commissioned a full evaluation which is designed to provide this.

I have provided answers to each of your questions in turn:

How NHS 111 differs from the NHS Direct Helpline

NHS 111 is a free to call service, available through the easy to remember three-digit number. It will provide a more comprehensive service by providing consistent clinical assessment of patient needs and using a comprehensive directory of service to ensure they are sign-posted to a service which is best able to suit these needs, taking into account their location, the time of day, and the capacity of local services. It will also deliver an improved telephone experience, by booking appointments in the appropriate service and eliminating call-backs, wherever possible.

Whether the online and other services NHS Direct currently operates will continue in their present form:

In launching the first NHS 111 pilot, I announced plans to phase out the NHS Direct number - 845 4647 – so that, by 2013 we have two numbers for people to call: 999 for an emergency, 111 for non emergencies. This will have two advantages: first 111 is an easier memorable number than 0845 4647, which, independent studies show is not recognised by a significant proportion of the population; and second, 111 will be free of charge. When 111 is rolled out nationally, it will replace the NHS Direct 0845 4647 telephone number. Until then NHS Direct will provide its current service. While its telephone number will no longer exists in the long term, we do expect an ongoing role for NHS Direct alongside other providers, in delivering the NHS 111 service in line with an  any other willing provider approach.

The health information content from the NHS Direct website moved to the NHS Choices website in November 2008, creating single NHS online health information website. NHS Direct continues to create online content, such as interactive self assessment tools, and these are available via both websites.

The Department of Health’s recent consultation document, “Liberating the NHS: An Information Revolution” discusses transforming the way information is accessed, collected, analysed and used by the NHS and patients. This consultation notes the need for a “channel strategy” to provide a coherent view of the nationally-managed information channels needed to support access to information. The role of information sources such as NHS Choices and NHS Direct’s website, alongside NHS 111 will be considered as part of this strategy. Further information will be made available following conclusion of the consultation.

Whether NHS Direct is included in the QIPP programme of efficiency savings and if so what targets it is seeking to achieve

NHS Direct is not included in the QIPP programme of efficiency savings. However, the National QIPP Urgent and Emergency Care workstream, led by Sir John Oldham, outlines plans for revisions to the urgent and emergency care system to eradicate overlap and duplication and to make it easier for patients to navigate. The future roles of NHS 111 and NHS Direct are key considerations of this programme.

However, efficiency gains are already being made. Over the last two years operating costs for NHS Direct’s 0845 4647 service have reduced significantly with a drop in the contract value, from £136.5 million in 2009/10 to £123.3 million in 2010/11. Through its commissioner, we continue to expect further savings in future years.

What estimate the department has made of the cost savings to the NHS from patients contacting NHS Direct as a first port of call (the NHS Direct Annual Review 2010 says “Our research identifies that we recommend to around 49% of all our callers that they should go to a less urgent and lower cost point of care than they would have gone to if they had not sought our advice.”)

The department has not made any estimate of the cost savings to the wider NHS from patients contacting NHS Direct, although I am aware of  NHS Direct own research in this area. NHS Direct undoubtedly offers value to the NHS by helping patients find the most appropriate place to seek care; however, I believe that NHS 111 will be more widely used. Especially by patients who would default to 999, because the number is more memorable, and it’s free to call. The independent NHS 111 evaluation is accessing the exact impact of the new service on the rest of the NHS.

It is well established that creating a more integrated urgent care system can result in significant savings. For instance, Commissioning Support for London has estimated that introducing a single point of access into urgent care could realise savings of up to £13m a year, in London alone, through reductions in A&E attendances and ambulance despatches.

Whether it is the intention to staff NHS 111 in a broadly similar way to NHS Direct when it is rolled out across the country (that is, NHS Direct has around 3,400 staff of whom 1,400 are nurses – is that what NHS 111 will look like?)

The most appropriate staff mix for NHS 111 call handling must be evidence based and reflect the needs of commissioners, which is exactly why we are piloting the service. There will not necessarily be a “one size fits all” approach to staffing NHS 111 – commissioners will be free to determine what is best for patients.

In the current NHS 111 site in County Durham and Darlington, 38 per cent of staff are trained nurses, compared to 48 per cent in NHS Direct 0845 4647 service. This assessment system requires a smaller proportion of nurses to call handlers and is based on clinical evidence supported by many of the major royal colleges including RCGP and the BMA. However, if any caller to any NHS 111 site needs to speak to a nurse, they will speak to a nurse. Likewise if the caller needs to see a doctor, then the service will arrange for them to see a doctor.

It is also worth noting that the same assessment system in the North east pilot site is used in parts of the 999 ambulance service, where call handlers are not clinically trained, yet the service has been shown to be safe by the Emergency Call Prioritisation Advisory Group (ECPAG).

How long the pilots of NHS 111 will run for, and when the assessment of those pilots will be made available

To assure we understand and assess the full impact of the service the pilots will run  for a period of 12 months and the evaluation will be available in November 2011. The Department has commissioned the University of Sheffield to conduct an independent, academic, evaluation of the service, and baseline population surveys of the pilots sites, and comparative control sites, have already been completed. The evaluations will assess the success of the service itself, as well as look at the impact of the introduction of the service on the wider health economy.

We will also expand the range of current pilots underway and produce a minimum dataset to ensure accurate and consistent information about these pilots is collected, and made available to GP consortia so that hey can make informed decisions about how NHS 111 should be commissioned and delivered in their area. We will accelerate the publication of this data so that it is available during 2011. Each of the pilots will be compliant with the NHS 111 specification, but will be free to decide which operating system and clinical content they use.

We will also ask the Care Quality Commission (CQC) to clinically assure future providers of NHS 111, and ensure they meet the national service specification.

What criteria the pilots will be assessed against

The pilots will be evaluated against five benefits. They are:

• Improving public access to non-emergency healthcare services;
• Increasing the efficiency of the NHS by ensuring that people are able to quickly and easily access the healthcare services they need;
• Increasing public satisfaction and confidence in the NHS;
• Enabling the commissioning of more effective and productive healthcare services that are designed to meet peoples’ needs; and
• Increasing the efficiency of the 999 emergency ambulance service by reducing non-emergency calls to 999.

We will also be looking to assess the impact that the NHS 111 pilots have on the wider health economy, as we hope patients will feel able to call 111 when they do not know where to seek help. This will enable commissioners to make informed decisions about how NHS 111 is delivered, and how the service fits into their local urgent care systems.

Whether a cost benefit analysis of the change to NHS 111 has been carried out, and what were its conclusions

The Department published an Impact Assessment for the pilot phase of NHS 111 on 18 December 2009, which is attached at Annex B. It concluded that:

“There are many uncertainties in the costing, cost savings and potential benefits of 3DN [three-digit number] including the uncertainty around volume of calls a 3DN would receive. However the possible efficiencies that could be gained, the opportunities to lever integration across urgent care services and to benefit patients by providing a simple point of access lead us to point to considerable gains that could be made.”

We are continually updating the cost benefit analysis work and the final, evidence based conclusions will be published in external evaluation.

It is important to note that while it is essential that NHS 111 is delivered in the most cost effective way, the primary reasons for its introduction is to improve access to NHS services for patients, to end confusion about where to go for urgent health needs, and to support a more integrated and effective urgent care service.

I hope this response is helpful.

Yours Ever

Andrew Lansley  CBE

Mr Lansley confirmed for the first time that GP consortia will have responsibility for commissioning the new service, including the ‘appropriate skill mix’ of the call handlers used by their chosen provider.
NHS Direct, local ambulance services and out-of-hours provider Harmoni have already thrown their hats into the ring to provide 111 services.

Pilots of the service have begun, with the first run by a local ambulance service in County Durham and Darlington, having a workforce comprised of 38% trained nurses, compared to 48% on NHS Direct’s 0845 line.

The Government’s decision to scrap the NHS Direct telephone hotline which cost the NHS £123m this year - has been welcomed by the majority of GPs.

But there have been claims from NHS Direct insiders that early results of the trial have seen a big increase in the number of patients sent to hospital, with one claiming the rate had shot up from 3% to 11%.

There are a number of questions NHS 111 throws up, to me this looks like it is going to be far more than the old NHS Direct 0845 4647 service.

The government talks about putting people in touch with the services they need.

Observations:

• Who is going to make the decision as to what service is required? Medically trained or non medically trained?
• Exactly what services can callers to NHS 111 be expected to be put through to?
• If this is going to be controlled by GP Consortia, then who has control for a region?
• Will people call NHS 111 and then be put through to their area?
• How many GP Consortia will there be in the entire country?
• Will there be closures of medical centers and individual GP practices?
• Will there be extra funding for GP Consortia to run NHS 111 or will it come out of the existing £80 billion budget?
• Will this initiative affect the number of receptionists attached to GP led medical centers?
• Is there expected to be an axing of staff? ie receptionists who at present book appointments etc?
• You say there will be a "consistent clinical assessment of patient needs and using a comprehensive directory of service to ensure they are sign-posted to a service which is best able to suit these needs, taking into account their location, the time of day" who is to carry out such assessments, or are staff going to be relying on a sign post list and if so, how likely is it that non medically trained staff will miss something very important and vital to the patient's well being? Why should time of day and location matter to the person presenting with a set of urgent medical problems?
• So basically what Lansley is saying is that NHS Direct can apply to run the new service alongside " any other willing provider approach"? Meaning they can compete for the contract alongside private companies?
• By QIPP I am assuming that Lansley is referring to "Quality, Innovation, Productivity and Prevention". Efficiency targets were identified by the previous Labour administration, identified and acted upon and good efficiency savings of around £13m and increasing, being made, then why is Andrew Lansley pushing for still more efficiency savings, at the the same time as trying to what appears to be carry out a vast expansion of the NHS Direct programme, leading it into NHS 111 with expanded services? Is Lansley hoping to achieve this by NOT employing adequately trained physicians and nurses?
• Is Sir John Oldham holding a revision of urgent and emergency care system to eradicate overlap and duplication? If so then why is the NHS 111 being carried out and piloted before the outcome of the revisions is fully known? If this is to be rolled out nationally, then errors in the system will be rolled out nationally too!
• I have grave doubts that patients would defer to NHS 111, when they know the chances are they will speak to an unqualified telephone operator working from a sign post list of symptoms to check off against symptoms a caller is presenting with. Confidence is a big thing in medicine, if it is not there, then this will lead to increasing number of people turning up at their local Accident & Emergency Departments and more people calling the 999 emergency service. In fact I have inside information from the areas the pilot schemes are running in, that attendance to Accident & Emergency departments in those regions has increased by something like 3%, from 8% to 11%, since NHS Direct has given way to NHS 111. It is also reported in the same regions that calls to 999 have also increased.
• It does not automatically follow that every caller who needs to speak to a trained nurse or doctor gets to speak to them. This depends on the operator taking the call and this is the crux of the matter, if these operators are not medically trained how will they know when to refer a call to a qualified member of staff, some people will fall through the net, this is very worrying. No amount of check lists with sign posts are going to be able to replace medical experience.
• On one hand the Health Secretary is saying they piloting the scheme to discover all about it, yet on the other he says he is increasing the number of pilot schemes operating in other regions, why is he doing this before he knows how the pilots are operating in the four regions? I suspect, that he has already decided that NHS Direct is going and that his replacement NHS 111 is coming in, complete with all the changes, regardless of how many problems the system picks up!

Throughout Lansley's reply to Stephen Dorrell, it is plain that the only thing that is driving change in NHS Direct is money. It is all about efficiency savings and NOT about increasing patient care, patient satisfaction and making the service a better service for its callers. It is being driven by savings and it appears that Health Secretary, Andrew Lansley, is just trying to pile as many services onto NHS 111 as is possible and not increasing the budget, but DECREASING it.

If you look at this one initiative, NHS Direct/NHS111 is but one very small part of the NHS, yet to change it involves, studies, pilots, commissions and a compete dismantling and reassembling of the service. There must be reports and the linkage of patient care must literally cover conception to the grave. The previous NHS Direct service 0845 4647 was working perfectly well, it had a place, it had a purpose and it was saving the NHS millions in reducing the number of people turning up at A & E's and calling 999 emergency service, it took many years to get it to this stage and in the latter years it was beginning to save itself money in efficiency savings. It appears to me that the Tory government want to continue this service but they want to reduce its funding yet increase its workload.
I am also worried at a cursory look at the figures it seems that this new scheme could very well end up costing far more than it saves and if it doesn't, then the number of extra services being load upon it will suffer and inevitably, so will patient care.
I am very concerned that this is the doorway to creeping privatisation by stealth, it seems to me that at every possible juncture, the use of private health care providers is going to be considered. The Consortia scheme itself is going to turn GPs into accountants and GP practices into private businesses.
The idea of having 111 to access the service is excellent, but so far this is the only plus I can give this new scheme, which is turning out to be a private wolf in sheep's clothing.

I remain concerned that the government can make all these radical reforms at a time when the country as well as the world is in recession and will be going through severe austerity over the coming years. We are talking about a government, that can hardly bring out one simple policy without making horrendous blunders, it took the education Secretary SIX attempts at his policy right and he still did not manage it. Since then we have had several fiasco's and above that why would the government want to carry out such radical forms in the NHS, at the same time they are carrying radical reforms out in the economy, education and welfare, with unemployment set to increase sharply over the next 2 years?

What is the rush? The NHS is working extremely well, it can make efficiency savings without dismantling and disbanding it and totally disrupting the day to day running of it. In fact NHS Direct with its efficiency savings of £13m per year under the Labour government, is a case in point! Why are the Conservatives in such an unseemly rush to fix something that is no longer the broken third world service it was after the last 19 years of Conservative governments?

David Cameron-Prime Minister & Media Whore!

The Country Is grinding To a Halt
And The Prime Minister
Thinks It's Funny!

Amazing! During the past month, we have seen mass demonstrations on the streets of all our towns and cities, we have seen rioting on the streets of our capital London.

Nick Clegg was wheeled out to face the media over swingeing 25% cuts to local authority funding.

Snow and freezing conditions brought the country to a virtual stand-still.

There has been a doubling of those suffering with swine flu being admitted to hospital and ITU's, under fives can no longer have the the flu jab free.

The NHS is beginning to buckle under the strain of the flu virus.

Cameron and Andrew Lansley were told of this several times BEFORE it got to this stage and the Tory led government were asked to run the advertising campaign to inform people about the flu vaccine, but they refused and now it looks like we are going to have an pandemic on our hands, as cases are being reported all over the country, which will be made worse with people visiting each other over the holidays.
The country is grinding to a halt because of the arrogance and sheer incompetence of this Tory led Government, we are descending into chaos, mess and mayhem - fast

And where is our Prime Minister David Cameron? 

Nowhere to be seen, except once he was "papped" running around Hyde Park with his extremely expensive celebrity personal trainer, and his police bodyguard, Cameron was looking flushed, flustered, and out of breath. Apart from this and his compulsory visit to PMQ in the House before it broke up for the Christmas holidays - complete silence.

It appears that every time we have a major problem in this country our Conservative prime minister suddenly realises he has to be somewhere else, or he is holed up in his office hiding.

However to be fair, today, he did manage to get himself  on Sky News (where else?) In front of the camera for considerable time, in order to be interviewed. Great, what was the most pressing and urgent issue serious enough for him to take a break from his family Christmas? Was the country facing yet another crisis?

None of that, Cameron was speaking about the - cricket!

Good old Dave, there he was basking in the reflected glory of the England cricket team, getting on down and really getting into it all, associating himself with good news. You have to hand it to our prime minister, he really knows how to do this.

David Cameron mentioned he was up all night this week watching the cricket on Sky, nice of him to mention that, because I love cricket, I love watching our national side playing anyone, at anything, and I would really have loved to watch the Test Match series, but I could not - why? Because I cannot afford Sky, because our "illustrious" prime minister David Cameron's mate, News Corporation and bidder to take over 100% of BSkyB, Rupert Murdoch, has stopped me, and thousands like me from watching the cricket and even some of England's football matches and he is now in the process of getting his hands on all of BSkyB aided and abetted by another of David Cameron's mates, the Conservative Culture, media and Sport Secretary, Jeremy Hunt!

Hey but that has not stopped "call me Dave" from diving in front of Sky News cameras and associating himself with the good news that England have won the Ashes and will be bringing them back, what is the betting that when they come back, good old Dave will be hosting a champagne reception for them at Downing Street? Associating himself with more good news.

The prime minister of Britain, David Cameron, is nothing but a 2 bit media whore.

Give credit where it is due, when Labour PM Gordon Brown's government was hit by Foot & Mouth, Bird Flu, Floods, swine Flu, Icelandic volcano, etc etc, he was straight out, reassuring the country that all that could be done, was being done. eg in the case of the swine flu outbreak, Brown ensured there was vaccine and Tamiflu available for every single person in the country and emergency measures were put in place with our NHS, just in case, in the case of the volcano, Brown got people home via our Royal navy.

But then call brown all the names under the "Sun", he was gruff, grumpy, looked miserable and all the rest of it, but he genuinely cared for the people of this country and he would have walked over hot coals for us all to ensure we were OK, what does David Cameron do? Nothing, he hides and slinks back off to his privileged life in his millionaire homes and lives it up at the cost of the taxpayer but what else do you expect from a media whore?

The NHS - Progress and Privatisation

The truth is that the NHS must progress, it must never be scared of progress. If we are scared of progress then we will just have a repeat of the way the NHS was allowed to decline under successive Conservative governments from 1979 to 1997. Sometimes tough decisions have to be taken yes, but I do not believe that we need to privatise the NHS to do this. Our NHS performance was improving year upon year until the Tories got back into government, already it has slipped into decline and is showing symptoms of the very same internal pressures introduced by the Tories, that nearly killed the NHS back when they were in power.

Of course there will always be things we like, and things we do not like, and change is sometimes hard to accept but is necessary on the path to keeping our NHS modern, vibrant and best serving the people, this is not unique, it is not Labour government all good for NHS, or Tory Government all bad for NHS, it is never as simple or straight forward as that, but it does have to be said, in all honesty out of the two governments, the Labour party have always run the NHS well and efficiently, and for the greater good and "free at the point of need". To the Conservatives the NHS has always been seen as something they would rather do without, to the Tories the NHS is simply money first, not the health and welfare of our people.

If we value the NHS and want it to continue, then as a nation we can never afford to behave like dinosaurs, we have to view change with an open mind and not just condemn it out of hand before it is thoroughly considered. Just because the NHS serves the people it cannot be allowed to become a bottomless pit to which we throw billions of pounds and it never be accounted for, or bothered about, this does not serve the interests of the people. Equally as a country, we have to stop attacking NHS managers and administrators, the vast majority of which are needed to keep the service and hospitals running efficiently. NHS managers are not faceless people, they are human beings with families and the vast majority strive to give the public the best possible service with the least problems at the time they need it the most. Speaking as a healthcare professional who has provided care at the sharp and messy end, I have had my fair share of moans and groans at NHS managers, but do appreciate their input, because without it, nurses and doctors would be even more bogged down in administration tasks and would not be out in the various wards and departments caring for people.

When Margaret Thatcher introduced non medical managers into the NHS, I was appalled, and identified many of the problems that indeed came to fruition. I was never in favour of top managers who did not have medical backgrounds then, and all these years later, I am still not in favour of this. Managers responsible for taking and making decisions on patient care, in my opinion, should always be medically trained, not until someone has worked delivering actual patient care in the many points of delivering patient care, are they in a position to properly understand the concerns and worries of patients, doctors and nurses. This is not to say that all managers and NHS staff need to be medical professionals, just those that make and take the important decisions over what patient care and services we are to offer and how they are to be administered.

Please do not misunderstand me, I have never been against a certain scale of so-called "privatisation",  I don't much care for it but recognise that if  handled correctly, and used correctly, it can be beneficial, ideally, no private companies save for suppliers would be allowed in the NHS, but we do not have this luxury or the money for this, so we have to be rational. People should be under no illusion that private companies have always been a part of the NHS, it is impossible to run it without, so market forces will always be there. Money is a factor in the NHS and we do have to cut out cloth accordingly. During Labour's 13 year tenure of being in charge of the NHS, we saw an NHS service not fit for "third World" consumption in 1997, dragged up by its boot strings and turned into one of the best health care systems in the world by 2010. Make no mistake, when Labour took over in 1997 the NHS was in a parlous state, it had just gone through years of terminal decline and chronic underinvestment under successive Tory governments, the problems were so immense that solving them took 13 years, and Labour had still not completed their revamp and total overhaul of our NHS when they lost the election in 2010. There were, and still are many areas in need of modernisation and attention, but from where the NHS was in 1997 to where it is now in 2010, the service is unrecognisable and patient satisfaction with the service has rocketed. However, Labour were not complacent and there were still many tragedies that just should not have happened, still the cost of human misery that tore into the soul of NHS carers, administrators and Labour government alike, which is why the Labour government's intent and resolve to improving the NHS for all never let up.  When the Labour government took over the NHS it faced many obstacles some not so apparent, there were ethical as well as financial pressures in solving the severe shortage of nurses and doctors, thanks to the years of the Tories cutting nurse and doctor training places. The staff shortages caused by the Tory governments took many years to recover from and now the same shortages will occur yet again, if the Tory government insists on carrying out its plan to decrease the number of nurse and doctor training places yet again. Remember it takes 6 years to train a doctor to GP level and GPs are at the heart if this government's plans for the NHS, if in six years we suffer a shortage of them, where does this leave their plans for the NHS? In total chaos before they start, this Tory led government seem totally incapable of thinking things through in the long term, they are unable to foresee that their actions are going to cause future pressures, strains and utter mayhem in our health service.

In 1997 the NHS was totally fragmented, it was as if a metaphorical sledge hammer had been taken to the infrastructure and smashed it to smithereens, it had to be put back together, but the problems were so serious it was hard to know where to start. By the end of their tenure, the Labour government will be the first to admit that they made mistakes, that they did not do everything they wanted to do and that to some extent there were still places in the country where the NHS was not running as well and were totally inadequate, not to admit this puts lives at risk, so we have a duty to identify and correct this as soon as it is known Overall though, what the three Labour governments managed to achieve in the NHS was nothing short of an actual miracle and it should never be forgotten, that if it were not for the Labour party, our country would have lost our NHS years ago.

Under the Tories and Thatcher we saw the loss of cottage hospitals, the closure of accident services, the closure of wards in every single hospital in the country, the number of ITU/HDU beds and SCABU cots fell alarmingly and seriously ill patients and babies were often ferried half way across the country to vacant beds or cots to receive the care they needed. At one point in the Tory NHS we saw ambulances pulling up in hospital car parks and were unable to take their patients into the A&E departments because the departments were full to bursting, some patients had to be treated in the ambulance in the car park. Patients on trolleys waiting for beds was the norm. Medical supplies were in short supply and pressures on other services were at breaking point. During this mayhem the then Tory government decided in their infinite wisdom to put the all important hospital cleaning out to tender and private contractors became responsible for keeping our hospitals clean - it was at this point that we saw a rapid increase in the so-called hospital "superbugs" like MRSA and C-Diff etc, as contracts were awarded to the lowest bidders, irrespective of if they could actually carry out a proper and efficient service for their money. The charge of the Tories then was exactly as it is now, "they know the price of everything and the value of nothing" and this causes unnecessary problems and even deaths in a service like the NHS.

By the time Labour left office in 2010 they had managed to pull off a minor miracle, they had (it has to be said) with the help of the private sector provided over 120 brand new state of the art hospitals, which we as a country can be very proud of, incidentally the Tory government has now halted all hospital building programmes. The labour government also had every A&E department in the country which needed it refurbished and upgraded as well as building extra wards or departments onto existing hospitals.
Labour introduced targets, a lot of healthcare professionals were against the introduction of targets, but they did help and they did do what they said on the can.

• Hospital appointments to see a doctor increased
• Outpatient clinic waiting times fell
• Accident Service waiting times fell
• Waiting lists for operations and other procedures fell
• Patients suspected of having cancer fast tracked and their treatment waiting times fell.

Since coming to office this Tory government have scrapped internal targets and already in all the above areas waiting times are already increasing at an alarming rate.

Different government's will have different ways of running the NHS and different approaches, this is to be expected and it need not alarm people, however, the difference between a Labour government and a Conservative government running the NHS in present times has never been so stark. The Labour government ensured the NHS was funded adequately and the incoming prime minister, David Cameron, promised us faithfully that the "NHS was safe in his hands", but it turns out that it is anything but safe in his or Tory hands and now the NHS faces the same kind of cuts that almost ruined it before and turned it into a third world service the last time the Tories were in control of it. It not only faces cuts, but it is doubtful the NHS will survive as we know it today, it is in the throes of being "completely" privatised by stealth, we are losing our NHS.

Make no mistake the Conservatives are going to privatise the NHS and they always had plans to do this BEFORE the election, they did not tell us because they knew, if they did, then people would not vote for them, and now the British healthcare system is moving towards "Americanisation". Very soon we will be forced to buy expensive health insurance for our families and if we cannot afford that then we will be treated in "poor hospitals". All the new modern hospitals the Labour government had built in partnership with the private sector, will be sold off to "friends of the Tory party", these so-called friends usually turn out to be very large financial backers of the Tories, donating millions of pounds to Tory coffers and the companies they run like Healthcare UK and Care UK, stand to win lucrative contracts worth millions from NHS privatisation. Within a few years, people who do not have expensive health cover, will not  be able to be treated in the hospitals their taxes help pay for, if they have not got the ability to pay or buy expensive health cover then they will be turned away from accident and emergency departments and ferried miles to the nearest designated hospital for the poor.
                                          
We will see the privatisation of our ambulance service, and different companies will run them, patients will be asked at scene of their accident if they have health cover, if they have not then some ambulances will not even take them, they will just eave people there unaided, this is the policy in America and this is what this government are trying to introduce here.

This Conservative government threat to our NHS is real and it is coming to us, we already know that the Conservatives have promised American politicians that they will govern as more "pro-American". We have already seen the start of the decay set to hit our NHS.  Rupert Murdoch's Fox News in the US, gave copious amounts of  airtime over to Conservative MEP Daniel Hannan, who is a close friend of David Cameron's,  Hannan used all that airtime to lie and completely trash our wonderful and efficient NHS to the American people. Hannan told so many lies, that even David Cameron when in opposition, was forced to intervene and deny what he was saying, but now David Cameron himself has been found to be lying about NHS funding, Cameron had alleged that funding would increase in real terms, it is not, because it is not keeping abreast of inflation, which is beginning to rise significantly.

If people do not stand up now, rise and fight this creeping Tory privatisation cancer in our NHS, then we are going to lose it and once the NHS is lost, we will NEVER, not ever again be able to afford to take it back under state control. This maybe OK if you are rich and affluent like the millionaires we have in this government, people like Cameron, George Osborne, Nick Clegg, Vince Cable, Danny Alexander, people like this will always be able to purchase the best health cover for them and their families, the best treatments, the best medications etc but for the great majority of people this will be just totally impossible, we are now entering a phase where many of our citizens will have no health care cover and will be vulnerable, is this what the Tories call progress?

Under this Tory government we are very likely to see every single NHS Trust hospital sold off to the private sector, as the Tories seek to completely rid government of the NHS, it is a well known fact that the Tories having previously described the NHS as a "millstone around their necks", want to rid central government of the NHS entirely.

Remember Cameron saying the NHS was safe with the Conservatives? Do you still believe the liar? Recently David Cameron has been caught out in a NHS funding lie. John Healy Challenges Tories To Explain NHS Broken Promise On Funding



" When Andrew Lansley took over as health secretary, the NHS was performing well, with satisfaction ratings that most companies would be proud of. The experts advised them to keep the NHS stable, maintain high standards and keep staff motivated to work harder with less money.
So Lansley published a plan to do the opposite. He is forcing GPs to buy all the services and drugs for their patients and wants to strip out the backbone of the NHS: strategic health authorities (SHAs) and primary care trusts (PCTs). He wants to put patients in charge and trust people power and open competition to keep standards high. The plan relies on the SHAs and PCTs transferring their roles to GPs, and coping with less money by making massive efficiency savings.

Unfortunately, they are not doing either task very well. Lansley's first act was to tell them they were not very good and would be abolished. As a result, they are disintegrating as staff desert a fleet of sinking ships. Senior NHS managers are alarmed by the uncertainty spreading across the service. The resulting hysteria is leading to botched budget cuts as treatments are restricted and increasing numbers of frontline staff are told they are losing their jobs."

Read More:  The NHS is NOT Safe in Tory Hands

David Cameron and the Tories promised us NO top down reorganisation of the NHS, they have broken this promise too, what the Health Secretary Andrew Lansley is proposing, is the biggest shake up to performed on our NHS, which quite frankly has never been tried anywhere else in the world, by Lansley's own admission, this is set to cause major disruption in the system and there is absolutely no precedent for it and absolutely no guarantee that it will work. Thousands of lives could be placed in danger and all this is to be completed by 2013? All this major upheaval at a time when Cameron and chancellor George Osborne are taking a huge, massive gamble with the economy and peoples livelihoods and our children;s futures? Why now? The NHS is working very well, it needs changes, every big organisation does, but what it does not need is this incredible risk taking with all of our lives!

The Tories are taking everything we hold dear in this country and destroying it. Bit by bit, they are destroying the British way of life and they are ripping up the very fabric of our society.

If you value the NHS, rise up and do not allow this "Conservative" led government to destroy everything we hold dear.
Fight, Fight, Fight back!

Andrew Lansley - Stupid Is As Stupid Does!

Stupid Is, As Stupid Does
Health Secretary
Andrew Lansley

How can we have faith in the Health Secretary Andrew Lansley to oversee the biggest upheaval of any health service undertaken anywhere in the world, when he cannot even get the call to inform people of the flu jab uptake right?

The Department of Health and Andrew Lansley were warned back in early November that uptake for the seasonal flu-jab was being shunned because people were worried about the swine-flu component being included. They were asked then to run an advertising campaign to help inform people but they refused!

They were again asked by GP leaders run a renewed marketing campaign to help fight off a looming flu crisis. This plea was refused, and instead, GPs were told to phone up their at risk patients to try and persuade them to be vaccinated.

The Department of Health has been advised that its decision to cut back on the £180.000 it spent in 2010 on public awareness is ill advised and last week the Department of Health ignored a plea from the GPC to immediately step up their publicity to try and avert a big flu outbreak this winter.

The fact that in 2009/10 the swine flu and general flu outbreak was contained was because the then Labour government took all the necessary steps to avert it.

In response to these urgent requests the Department of Health said it had no plans to bow to the criticism and launch a marketing drive and that instead GPs should ring patients individually to invite them into clinics over Christmas, as it was "vital that those at greatest risk are vaccinated as soon as possible".

A DH spokesperson said: ‘In 2009/10 the DH spent £177,573 advertising seasonal flu vaccinations. This year there is no central campaign, but most PCTs already run localised activity with their GPs to ensure that eligible patients are called up for their annual vaccination.'


I would like the very stupid, very ignorant Andrew Lansely to contact me gracie.samuels@hushmail.com and explain why in his appalling ignorance and arrogance, he thinks he knows better than health care professionals. He may also like to explain to the nation, how when he shows such appalling ignorance and arrogance, he thinks he is a fit person to oversee the privatisation or the British NHS?

If this is what it is like now, what the hell is it going to be like when this ludicrous, unnecessary venture in the NHS gets under way.

Do people have to die before the people of this country wake up and see what this TORY government is doing to our country?

Please Visit here for information.

Department of Health

Members of the public are being urged to check whether they should have the flu jab this winter.

This winter, the H1N1 strain of the flu virus is one of three strains of flu that the seasonal flu jab protects against. H1N1 is the same strain of flu behind last year's swine flu pandemic. The other two strains of flu this year's jab protects against are H3N2 and B.
H1N1 is no different from other strains of flu as regards the principles of creating a vaccine to protect against it. Its inclusion in this year’s seasonal flu jab poses no additional risk. It is included simply because it is one of the major flu strains circulating in Britain this winter.
It is recommended people have a flu jab if they:

• are 65 or over
• are pregnant (see below)
• have a serious medical condition
• live in a residential or nursing home
• are the main carer for an elderly or disabled person whose welfare may be at risk if they fall ill
• are a healthcare or social care professional directly involved in patient care
• work with poultry

This year (2010/2011), it is recommended that pregnant women not in the high-risk groups who have not previously been vaccinated against H1N1 flu have the seasonal flu jab.
If they are the parent of a child (over six months) with a long-term condition, they should speak with their GP about the flu jab. A child's condition may get worse if they catch flu.
If someone is the carer of an elderly or disabled person, they should make sure sure they have had their flu jab.