Developments in the NHS
1. Developments in the NHS, doctors’ hours, research and primary care trusts (PCTs), TLC, and voluntary and charity work look to be ominous in the competence and confidence the public should expect from a reputable service for the wellbeing our civil service and politicians must provide for the needy. The coalition government’s rather gungo approach to an ailing population left to “look after yourselves,” especially when there are occasional examples of undue nannying, and the words come ill from toffs with dissolute backgrounds and generous support from the health-services for help in their predicaments. The recent argument in which the PM bullied the Health Minister contemptuously into withdrawals of her remarks on school milks and the dumping of the running of services on the doctors already overburdened with the practice of well-trained care don’t bid well for appropriate attention according to general need.
2. More than 100 specialists in tackling problems such as obesity, alcohol abuse and smoking are being sacked by the DoH in a move that has alarmed senior doctors. “The cost-cutting move has raised doubts about health secretary Andrew Lansley’s commitment to improve public health,” states The Guardian on Saturday, 11September 2010. Some of these people have already gone, others are leaving this month and the departures will continue until next April. At least 30 work at the DoH’s headquarters in London; the others are regional coordinators across England, trying to reduce teenage pregnancies, boost rates of breastfeeding and improve schoolchildren’s diets. VEGA is, like many other charities, seeing the signs of more or intensified devolution on organisations of dubious and some with competitive competence.
3. Dr Lindsey Davies, president of the Faculty of Public Health, which represents specialists in the NHS and local government, has criticized “shortsighted” action and “feared it would make difficult problems even harder to tackle and increase the burden on the NHS.” The Faculty knew of 70 to 80 regional specialists whose jobs are disappearing and “the majority of these individuals are highly experienced in the development and delivery of vital public health programmes such as tobacco cessation, teenage pregnancy and alcohol misuse. It is shortsighted of the government to lose this expertise, particularly when they appear to be so committed to public health.”
4. At departmental headquarters 4 of the 10 tobaccos’ control team have seen their posts go because funding has been ended. Other lost jobs cover alcohol, physical activity, obesity, nutrition, breastfeeding, child-centred public health and health inequalities. In the West Midlands posts are being lost in tobacco control, alcohol, food and nutrition, infant feeding, healthy schools and the “You’re welcome programme” for 11 – to 19 year olds. Dr John Middleton, the director of public health in Sandwell, regretted “the loss would affect health improvement drives in the region.” For example, the tobacco control network helped ensure the implementation of the public smoking ban in 2007 and worked with HM Revenue and Customs to tackle cigarette smuggling. “Networks of this nature take a long time to be established and to be successful. Taking them out leaves a big hole in our response to major public health problems,” he said.
5. Sir Richard Thompson, the president of the Royal College of Physicians, criticized the job losses. “It is not the time to be reducing the public health workforce. We should be strengthening our capacity to address the growing health problems due to alcohol and obesity.”
6. A DoH spokeswomen confirmed the job losses saying, “Some of these were temporary programmes that were coming to an end anyway. We are reshaping and improving public health strategies.” She did not explain if the losses would spoil the chances in these public health strategies. Will some of the beneficiaries of training in the UK return to their homelands, many of which are developing rapidly and are seeking reinforcement in their efforts by skills and experience in a population that, in all fairness, should be persuaded to deal with problems back home. Let us just acknowledge the work of doctors, nurses and other professionals who must trace their origins to countries where services are developing, if not – unfortunately – to their own peoples but to practices such as elective surgery to affluent patients whose needs are much less but whose wealth and self-interest are much greater.
7. Correspondingly, other agencies with less skill and commitment but more cash will move in and the poor – who need the services more – will be priced out. In VEGA’s experience many – or even nearly all – of these NGOs and charity organizations are not gloriously independent, but struck in ruts at the limits of jobsworths, who ignore experience and advice that might be drawn from pensioners not lured by world cruises and property dealings underwritten by the purchase of a second home or hobby farm from the proceeds from the sale of an empty nest as the “sprogs” take up jobs and look for homes of their own. Many of these are in the food-service industry, which is disproportionately engaged in junk foods or products unfit for purpose while the threat of rationing and price rises hang over the immediate future for the eating trends in a Recession. VEGA, with its campaigning for “hearty” breakfasts must be the only NGO to set on the conference tables of organizations such as the Food Standards Agency and Sustain examples of developed muesli -type breakfast meals, some designed specially for children, as real nutritional health-food rather than an indigestible heap of bumf telling of meetings, minutes and reports that “they” at some government agency should foist on the public.
8. Many food policies based on “what the consumer wants/demands” and on “strictly scientific evidence” are shams to cover matters most consumers would not be able to ask about, let alone conduct a scientific debate about; nor is it likely that they scrutinize information on labels and understand it, but it is likely that the scientists will get away with don’t know indecisive answers, without volunteering to the confused consumer what the expert scientist is eating at home with his family and it is likely that the said omniscient has a grant from the government to prove or confirm facts that the government can refer questioners to for substantiation and assertion or to fend off enquiries from the media. Ultimately farmers, manufacturers and retailers concoct verisimilitudinous claims for what they can produce most easily and cheaply, having done research that surpasses anything that trading standards officers and government agencies can match on monitor. The press likewise publishes information from press releases with little effort at assessing it. The BSE inquiry illustrated many of these factors at play or suppressed.
9. VEGA is at present beavering and badgering in many mysteries in matters of farming, food, health, the land and the many corollaries in matters of the environment and animal welfare that arise from them and they coalesce, diverge and become specialized. For the moment we foresee at the imminent British Science Week eagerly awaited results and comment on vitamin D, obesity, fish oils, eating plans, agriculture and agronomy, and the results of surgery or diet (or both in combination) for dealing with the factors in thyroid dysfunction and gout in the manifold symptoms of syndrome X. The succession of cruelties in our treatments, rearing, handling of animals domestic, wild, feral and reared for our greed and pleasure attract the lagging interests of the law and the succession of punishments exacted by the Courts. We note that our suggestions of penalties in kWhr generated on a treadmill have at last headline attention as “green” punishments for bad behaviour in the Bullingdon Club reckonings that at least errant MPs might pay and repay.