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Editors' Blog

June 2008 - Posts

  • Darzi delays the bad news

    Just when we thought that we would finally get the full story on Darzi’s vision of the new NHS, the moment has been snatched away from us.

    We were building up towards a climax at 3.30 this afternoon, when the DoH press conference had been arranged to give us all the details.

    But then we find that, apart from a few titbits in the workforce report, this afternoon will all be about secondary care. I didn’t even know that Darzi had been looking at hospital services – mind you, 70 per cent of the public has never even heard of the Darzi review.

    So the full facts of the primary care review will be delivered on Thursday, which means that there must be some huge, news-agenda-dominating event due to happen that day, to totally obliterate all mention of polyclinics (are they or aren’t they, will they or won’t they?) from the national media. An invasion of Zimbabwe would certainly go down well with the DoH spin doctors.

    Of course, Alan Johnson was popping up all over the place at the weekend to push his points home, following a beautifully timed appearance by Lord Darzi on Desert Island Discs.

    So now it seems that we will get the ‘good’ news from the review today, and the media will be so bored with the story by Thursday that they will not even bother turning up to the press conference.

    Either way, we’ll bring you the news here, from 10am on 3 July (it’s an ‘on the record, off-camera’ briefing).

     

  • Revealed: the contents of the Darzi review

    We had Darzi Island Discs on Sunday but what will Monday's publication of the Darzi review bring? 

    Here at HCR we've been rubbing our crystal ball and predict: 

    1 An emphasis on practice-based commissioning freedoms for entrepreneurial GPs

    2 Nursing to become an all-graduate profession, 

    3 The ability for NHS staff who opt out of the NHS to form social enterprises to provide care to retain their NHS pensions

    4 An MPIG phase out negotiated by the GPC, 

    5 An NHS constitution spelling out what patients can expect from the NHS and, undoubtedly, what the NHS requires of patients,

    and, finally, call me cynical, but 6 The best bits to be leaked all over the Sundays despite the 3.30pm Monday embargo. My money's on The Observer for the most Labour-friendly spin. 

    For those of you unaware of how the media works, you might be surprised to learn that the briefings about the review's contents began today. 

    We're having our ‘fireside chat' tomorrow, so we're not breaking any embargos with the gaze into the crystal ball above. 

    And Darzi? 

    Well, no doubt the DoH regarded the Desert Island Discs appearance a triumph because it showed the health minister in a more human context than is normal at a time (11.15am Sunday) when voters might be feeling a bit more favourably disposed towards him. 

    But have you actually heard The Logical Song? What's that all about?

    neil.durham@haymarket.com

  • Why is Britain teetering on the verge of becoming the abortion capital of the world?

    So why is the abortion rate in England and Wales rising year after year to the point that Britain will soon become the abortion capital of the world? 

    This is just one of the issues being discussed at today's Future of Abortion conference in central London. 

    Latest figures from the DoH have revealed that 193,700 abortions were carried out in 2007. A 2.5 per cent increase in the numbers seen in 2006. While the under-16 abortion rate has increased from 4.4 per 1,000 in 2007 to 3.9 per 1,000 in 2006. 

    An article in the Independent last week suggests that experts are ‘baffled' by the rising trend. 

    But I have yet to see any experts wandering around the conference hall scratching their heads and looking perplexed. 

    In fact the answer, according to Ann Furedi, chief executive of the British Pregnancy Advisory Service (BPAS), is very simple. 

    ‘People who do not want to have children are having sex.' 

    People in England want to have good, exciting, risky sex, be it in the back of a car or in the stationery cupboard at work, although this sort of thing does not go on at BPAS, stressed Ms Furedi. 

    So it appears that the best way to reduce abortion rates is to educate people so that they stop having risky sex and use contraception. 

    It is welcome news then that the DoH has announced that it will spend £20 million a year for the next three years working with PCTs to develop health services in further education settings to help educate young people. 

    The DoH also plans to test out the feasibility of offering women who attend abortion clinics long-acting reversible contraceptives in bid to reduce the number of abortions. 

    It seems the experts aren't so baffled after all. 

    sanjay.tanday@haymarket.com

  • Could Amy’s emphysema be a wake-up call for other young smokers?

    The news that ‘troubled singer' Amy Winehouse is said to be suffering from early stage emphysema is a shock, given that she is only 24 years old.

    Crack cocaine and cigarettes are reported to have caused permanent damage, ‘leaving her with 70 per cent lung capacity', clearly disastrous for someone who earns a living through singing.

    As Amy's father has explained: ‘She's got emphysema. It's in its early stages, but had it gone on for another month, they painted a very vivid picture of her sitting there like an old person with a mask on her face struggling to breathe.'

    ‘A month' is not a very long time - not 20 or 30 years, not some unspecified point at the end of a singing career, or a lifetime. It suggests that Amy Winehouse is unlikely to have much of a singing career, nor even a life, should she continue to abuse her body with drugs and cigarettes. 

    With any luck, this frightening diagnosis might serve as a wake-up call, not only to her but to the hordes of smokers who are left unmoved by the smoking ban (though reports in the tabloids that Ms Winehouse was seen smoking a cigarette hours after leaving her doctor, do not bode particularly well).

    Generally speaking, there is nothing so persuasive, in terms of changing your lifestyle, as someone you know - or a celebrity you feel you know - being ill because of similar habits. By contrast, expensive anti-smoking government campaigns are often seen as preachy, the annoying interventions of the ‘nanny state'. 

    Ok, it is probable that smoking crack cocaine has accelerated Amy Winehouse's lung disease. However, it is cigarettes that are the main cause of emphysema in the general population.

    Many young smokers are numb to the scary messages printed on cigarette packets; quite prepared to stand outside a bar on a cold, wet January evening; and anaesthetised to the best efforts of their local health professionals to encourage them into local smoking cessation clinics.

    They associate smoking with lung cancer - with potentially unpleasant but far-off symptoms, to be experienced in old age (‘Well, you've got to die of something,' they parrot. ‘You could get run over by a bus tomorrow') and may know nothing about emphysema, which ages lungs prematurely, causing irreversible damage.

    Many won't have heard of it at all and even fewer are probably aware of the umbrella term for respiratory diseases, ‘COPD' which is one of the fastest-growing diseases in the UK. In fact, WHO statistics predict that COPD will be the fourth leading cause of death by 2030; it already affects up to one in 20 Britons, killing 30,000 people in the UK each year.

    Health professionals are only too aware of its prevalence: community nurses regularly visit patients with severe COPD, for whom carrying out simple tasks and daily activities has become increasingly burdensome. Breathing difficulties, unpleasant in themselves, can also leave sufferers easily exhausted and with muscle-wasting and weight-loss, leading to complications such as heart failure. Patients often become depressed and isolated, unable to work, exercise or socialise.

    I can personally remember a conversation with a nurse who commented that it is the ‘lucky' smokers who die quickly of lung cancer; the unlucky ones get emphysema, an often-torturous condition which blights their daily lives.

    Though nobody would wish such a future on Amy Winehouse, one hopes that her prognosis might highlight the reality of respiratory conditions like emphysema and encourage her to listen to the advice of her doctors and loved ones. Meanwhile, it may serve to bring home the issues for her many fans, encouraging at least a few to give up smoking once and for all.

     

  • Hidden meanings in Darzi's Desert Island Discs

    Anyone who managed to sit through Lord Darzi’s Desert Island Discs yesterday would have heard him build a virtual polyclinic of selections that would have made any patient-choice advocate proud.

    Indeed many of the tracks he chose were from collections such as ‘Now That’s What I Call Music 8’, thus weaving an even greater level of complexity in to the range of choice available. And of course his eight favourites contained a huge number of hidden meanings and covert messages to be picked over by journalists.

    His first track was a hymn from Now That’s What I Call Armenian Music, on the Celestial Harmonies label. This was clearly a clarion call to end the divisions in the NHS (caused by his policy review) and later there was a plea to Gordon Brown and colleagues in his choice of ‘Don’t Give Up’, by Peter Gabriel and Kate Bush.

    ‘Another Brick In The Wall’ was either a reference to the building of new clinics or the way Lord Darzi thinks patients are treated in primary care. Though how it ended up on ‘A Collection of Great Dance Songs’ is anybody’s guess.

    ‘The Logical Song’ by Supertramp was just an awful burst of high-pitched nonsense, in which I can’t even begin to contemplate a potential hidden meaning for fear that the tune could be become lodged in my brain for the rest of the day (as did 'Total Eclipse of the Heart' when I was watching Big Brother last week).

    Lord Darzi’s favourite piece of music was the excellent 'Seven Seconds' by Youssou N’Dour and Neneh Cherry, and also a reminder of his ideal target time for a patient to be seen by a failed medical student in a polyclinic offering instant access keyhole surgery.

    He said he would take a copy of Yes, Minister to read on the desert island (he likes the sound of that), and his luxury item was a ‘pencil and paper’, presumably to map out a brave new health system for the island.

    But I think the real insight into how Lord Darzi sees his mission in government was in his choice of 'Jerusalem', suitably taken from the Chariots of Fire soundtrack. Is it he, with his scalpel of burning gold, who will not sleep until polyclinics are builded next door to dark satanic individual practices?

    Maybe I’m just seeing things. Either way, I think it’s great that, during a time of such huge and controversial changes in the NHS, the BBC should allow Lord Darzi and Alan Johnson to present their personal sides to the public within a matter of months of each other, and just a few weeks before Darzi’s review is published.
     

  • An NHS trust has lost my data - it was only a matter of time

    It's hard to have faith in pretty much any organisation's ability to protect confidential data at the moment. National and local newspapers are stuffed virtually every day with stories about people's details being lost. NHS information, child benefit information, bank information, government secrets - all of the above seems to go missing on a regular basis.

    I had been wondering how long it would take until I read about my own data being lost, when a letter turned up this week from the chief executive of St George's Healthcare NHS Trust. ‘It is with regret,' the letter began, ‘that I write to inform you that the hospital was recently the victim of a theft that may affect your child's confidentiality.' So I've joined the club.

    Despite what sound like Terminator-proof defences - ‘secure offices that were accessible only by a swipe card and key-locked door, within locked cabinets' - some ingenious chancer had stolen six laptops, one or all of which apparently had my four-year-old son's name, hospital number, date of birth and postcode on them.

    The letter bleats about it being trust policy to keep this sort of data on central servers only. Er, apart from on this occasion, when there was a problem with the network drive so ‘data was being stored temporarily on the laptops while the problem was resolved'.

    Should I be worried? Well, probably not. The data on the laptop was password protected and probably of no interest to whoever nicked it. They'll likely be wiped clean and sold on e-bay or at a car boot sale sometime soon. Alternatively, my four-year-old son may already have the credit rating of an inveterate gambler, with thousands of maxed-out credit cards to his name, but I doubt it.

    But the laptop theft highlights the main problem with our IT systems in black and white. People. We are the biggest argument against national records of any sort - at some point, particularly in an NHS with a million-plus employees, someone is going to lose data by failing to follow procedure. It may not be a malicious move, just one of expediency as was the case at St George's.

    Whatever the circumstances, the more people like me who receive letters about their data being lost, the more will opt out of national databases such as the NHS Summary Care Record. If protecting people's data isn't an incentive for the government to get its house in order, the billions it's spending to set up IT systems people increasingly want no part of should be.
  • Is this goodbye to an NHS free at the point of delivery?

    My cat called Jules has just been diagnosed with feline hyperthyroidism.

    The vet's given me three treatment choices: daily pills she can't stomach (£30 a month), going under the knife with all the risks that entails (several hundreds of pounds) or a radiation dose normally reserved for humans (£1,000 plus).

    Poor Jules is uninsured and there's no NHS for pets, so I have to base my decision on my pet's condition and my ability to pay. There I was thinking: 'Well, at least with the good old NHS I'm not debating funding the care of a sick elderly relative' and up pops health secretary Alan Johnson with his review of co-payments.

    For the uninitiated, this would give NHS patients the ability to pay privately for unfunded treatment.

    Now there are two sides to every story and this reminded me of a friend who insists on flying business and muttering: 'There must be a way I can pay extra to get quicker service' even while queueing for the free bar in the lounge.

    Co-payments were one of the hot topics of debate at last night's BMJ summer lecture in London by Professor Chris Ham, a former DoH adviser and professor of health policy and management at the University of Birmingham. The other was Darzi 'to tempt entrepreneurial GPs with PBC freedoms to integrate care' .

    Professor Ham described co-payments as 'a straw in the wind signifying bigger change in the NHS'. He added that the UK relied on taxation for a far bigger proportion of healthcare funding than other countries (87 per cent compared with an average 72 per cent) and now was the time for 'a broader debate' about where extra funding could come from.

    What do you think? Can taxpayers take more of a hit? Is it right to top-up care with co-payments or expand private insurance?

    BMA chairman Dr Hamish Meldrum asked whether introduction of co-payments or expansion of private insurance was likely to do much to tackle inequalities of care.

    Others felt that if the NHS hadn't perfected care 'free at the point of delivery' in 60 years perhaps now was the time to change.

    So is this: 'Happy 60th birthday NHS and goodbye to care free at the point of delivery?'

    I predict much heart-searching and future debate. 

    And Jules? She has a vet appointment Saturday but I've a feeling the recommendation will be for a  Flash Gordon-style radiation zap that will cost the earth and result in a three-week stay in a lead-lined cage in a cattery. I don't know whether her other half (called Judge, of course) could bear to be apart from her for that long.

    neil.durham@haymarket.com

     

     

     

  • Long live GPSIs

    In South Africa the hunt may still be on for a few hospital escapees with drug-resistant TB who, two days ago, broke out of hospital in Port Elizabeth after one of their number - a patient with untreatable XDR-TB - was allowed out on a shopping trip.

    Security guards refused another 19 TB patients' cries of ‘Me too' only to be overpowered.  While some rushed off to the shops, others wanted freedom - in spite of the pool tables, soccer and netball kit, etc - that had been brought in to deter breakouts. Of the group, 12 patients returned to the hospital and three went home to their families. Four remained at large and a search by a team clad in protection gear was to get underway.

    In the London area I live in, most patients going to the local hospital would be delighted to get suited up in protective clothing first. And a lot more than ping-pong balls or online poker free at the point of delivery is probably needed to keep the walking wounded inside it for any length of time. Mention its name and locals starting talking about MRSA and C difficile. We dread being run over in case its A & E is the nearest.

    The hospital's reputation for poor hygiene long predates the Healthcare Commission's inspection regime - and, yes, the trust does languish on the list announced on 16 July of NHS facilities to get nine months to clean up their act or else.

    So if you ask my neighbours and I about visiting a GPSI in a local surgery rather than going to outpatients at (to be on the safe side, a more distant) hospital, guess which we choose. Treatment by GPSIs is convenient and skilled, and waiting lists are short. The more GPSIs the merrier, is what we say.

  • Can shocking TV ads really tackle binge drinking?

    'You wouldn't start a night like this, so why end it that way?' This is the tagline of the new anti-binge drinking campaign launched by the government this week.

    The £4m campaign includes a series of hard-hitting TV adverts which reverse the sequence of a night out gone wrong, showing graphic scenes involving young people deliberately injuring themselves while getting ready for a night out.

    One of them shows a young man smashing a door in his face, urinating on his shoes  and pouring food down his shirt before going out.

    Aimed at shocking teenagers and raising awareness of the dangers of binge drinking, the adverts will be aired throughout the summer on British TV.

    The Home Office campaign also includes a range of radio, print and online adverts designed to change behaviour among 18 to 25 year olds.

    This latest government campaign come on the heels of a similar TV campaign recently launched by Diageo - aka the world's biggest beer, wine and spirits company. You might have seen one of the adverts dubbed "A night to remember? Or one to forget?", in particular one featuring a woman whose night takes a turn for the worse after one too many drinks.

    The question is: does this kind of approach have a positive impact? I always find such shocking TV adverts quite effective in the way they make viewers think twice before behaving like the people featuring in them.

    It seems that the approach behind these adverts is the more dramatic the images, the more efficient the message. With binge drinking costing £20bn a year to the government, this latest campaign will hopefully make people more aware of the dangers of excessive drinking...

  • Should the way NHS pay deals are negotiated change?

    At the end of next month, nurses employed by the NHS are likely to see their 2008/9 pay increase of 2.75 per cent in their salary slips - but not everyone is happy.

    The three-year pay deal for NHS staff has clearly polarised the unions and, despite the fact that the two biggest unions voted in favour of the deal, the NHS faces possible strikes after Unite voted to ballot on industrial action.

    The three-year deal, offering 2.75 per cent in 2008/9, 2.4 per cent in 2009/10 and 2.25 per cent in 2010/11, was negotiated by Unison and the RCN, so perhaps it is unsurprising that these two unions backed the deal. But it is the extent of the support (and clear rejection in the other unions) that's interesting.

    Over 90 per cent of RCN members supported the deal, while over 90 per cent of members from Unite and the Royal College of Midwives (RCM) rejected it. Unison came somewhere in the middle with 65 per cent accepting it.

    The main reason Unison support was lower was probably because the union didn't recommend the deal during its ballot. A heated debate at the organisation's health conference earlier this year ensured ballot papers went out without any recommendation on whether the pay offer was a good or bad option.

    So there is clear discord, and this does beg the question - can two unions negotiate a deal that meets the needs of every employee in the NHS? Members of Unite, the RCM and the GMB (who also rejected the deal) would undoubtedly say no.

    The deal is definitely good for some. The RCN claims some of its lowest paid members - newly qualified nurses on band 5 and healthcare assistants - stand to gain between 14 and 16 per cent over the three years. If this was the case for everyone, I'm sure all the other unions would have thrown their weight behind the plans.

    The fact the smaller unions have voted so overwhelmingly against the pay offer suggests that their interests have not been properly represented in these negotiations and surely that must be addressed in the future.

    And future negotiations could be sooner than we think. With inflation running at the highest level for years it seems likely that unions will be making use of that clause to re-evaluate the deal in years two and three. In fact, as Independent Nurse revealed last month, negotiations could be restarted as early as Christmas - maybe this time the smaller unions could sit in on discussions?

  • Ministers desperate as battle with GPs turns personal

    There must be a growing sense of desperation at the DoH. Alan Johnson and Ben Bradshaw may just be starting to feel that they have pushed a step too far with their plans to bulldoze general practice.

    The dynamic duo were no doubt buoyed by their ‘success’ in bullying the GPC to accept extended hours. As chairman Dr Laurence Buckman said yesterday, that was a case of asking GPs: ‘do you want to be hung or shot?’ They should have been more careful.

    The profession has since hit back with the support of 1.2 million patients, and Labour must feel that it can do nothing right.

    Indeed, Mr Bradshaw’s outrageous accusation that GPs have lied to patients about polyclinics is another move that can only be described as ‘wrong’. Wrong in terms of the facts, and wrong in an ethical sense. Yes, those boys must really be desperate.

    Yesterday, GP representatives backed votes of no confidence in the health secretary and Lord Darzi. They defied Dr Buckman’s pleas for caution.He said that ministers were just doing their jobs. ‘We don’t do personal’, said Dr Buckman.

    But the floor was not convinced. As Dr Eric Rose said: ‘When someone bullies me in to accepting a policy that could bankrupt the practice that I have spent ten years of my life building up – that’s personal.’

    And all this came before Mr Bradshaw accused GPs of ‘false claims’ and ‘blatant inaccuracies’. So, is there any GP in the country now who does not think this battle is personal?

  • Buckman nobbled by style police but retains the rough edges

    It was one of those awful moments.

    A colleague mentioned that she was disappointed with the conservative choice of tie by GPC chairman Dr Laurence Buckman minutes before his maiden speech as chairman at today's LMCs conference in London.

    The irrepressible Dr Buckman was, of course, standing immediately behind her in the press office and heard every word.

    And, as she acknowledged his presence, he chirupped: 'The style police have got to me.'

    In tie terms, Dr Buckman is usually renowned for his love of the colourful and garish - more Homer Simpson than Paul Smith.

    And this year it wasn't just the tie that was more conservative. The BMA's Support Your Surgery campaign and the 1.2 million patient signatures it has generated in just three weeks has gone down a storm in some sections of the media. It made the splash in today's Daily Telegraph and is heavily-featured in the Daily Mail.

    And any doubts that anyone may have had about Dr Buckman's ability to speak for LMC representatives should have been dispelled by this morning's rousing speech. The LMCs chairman was not the only one to notice that its two standing ovations were quite likely unprecedented.

    This was my eighth LMCs conference and I can't ever recall that. I can remember being impressed by the headmasterly qualities of Dr John Chisholm and the understated charm and cool of Dr Hamish Meldrum. But what of Dr Buckman?

    Well, he may have been nobbled by the style police in tie terms but his style retains its rather honest and endearing rough edges despite the efforts of those around him to 'moderate' him.

    Notable turns of phrase this morning included: 'I got slagged off on the floor of the House for being the 'worst trade unionist since Arthur Scargill'. I don't even have his hairstyle' and even the frankly rather odd 'come on peeps' at one point.

    But, most importantly, I guess Dr Buckman succeeded in accurately reflecting exactly how LMCs representatives are feeling right now.

    There was sustained applause throughout his speech and genuine chord touching for sentiments such as: 'The NHS should be putting money into GP premises and staff rather than PFIs for the benefit of private shareholders' and 'The NHS depends on the goodwill of its workers. The government was very unwise to throw it away as they won't get it back easily'.

    He may not have endorsed GP's Valuing General Practice campaign by name but 'value' was the 19th word in his speech and it was repeated twice as he pointed out government's current under-appreciation of the profession.

    What the DoH obeservers at the back of the conference made of it is anyone's guess. But they can't have failed to be impressed by Dr Buckman's support and leadership.

    The conclusion to the speech was particularly energising: 'So, what's it to be government: peace and construction or a never-ending fight to protect the NHS? I'm game for either.'

    What Number 10 will make of the more conservative Dr Buckman remains to be seen.  

     

  • Fat chance of reducing obesity

    For every measure taken to combat obesity, it seems that another is invented to capitalise on human beings' essential laziness. No sooner has the government decided to fund free admission to public swimming pools for the over sixties, possibly extending this to all by 2012, than some bright spark comes up with a marvellous labour-saving idea: the motorised ice cream cone has arrived!

    For those of you who might have missed this important announcement, the new must-have gadget is designed to reduce the amount of effort required to eat an ice cream. Instead of turning the cone manually, this battery-operated device enables users to position their tongue adjacent to the ice cream and press a button so that the cone rotates in an anticlockwise direction, no licking required.

    Thank goodness somebody sorted that out.

    Of course, the impact of this invention is hardly likely to bring the NHS to its knees, but the principle remains the same: we live increasingly sedentary lives in an ‘obesogenic' environment, in which people are ‘too lazy to fend off death', according to the British Heart Foundation.

    Last year, it was reported that one person dies every 15 minutes because of inactivity and that only four out of ten Brits would do more exercise, even if their lives depended on it. So surely people should be busy coming up with strategies and inventions that encourage activity, not slovenliness?

    Instead, for every inroad made (think former London Mayor Ken Livingstone's £500m cycling campaign) there's a new scheme to sabotage it (think home delivery services for grocery shopping).Which is a bit of a disaster, given that obesity has been blamed for everything from bankrupting our health service to aggravating global warming.

    Innovative long-term solutions are being mooted, for example, the ‘vertical workstation treadmill' enabling people to ‘walk while they work'. Perhaps more realistically, urban planners are hoping to turn towns into outdoor gyms so that people exercise without noticing: NICE recently issued guidelines on how transport and planning policies can combat obesity by designing well-lit, accessible staircases and wider footpaths.

    However, in the meantime, perhaps it's no bad thing that - according to the Tories - patients will soon have to travel ‘three times further' to polyclinics than they currently have to, to see their GP. While most of us are not likely to invest in motorised ice cream cones, we could still probably do with a brisk walk, after all. 

  • Can GPs cope with appointment targets?

    With the Government already struggling to impose its polyclinics plans, a report about the state of the NHS released this week by the Liberal Democrats is definitely not helping.

    The survey of 200 surgeries found that a third failed to meet the Government target to offer patients appointments within 48 hours. And in almost 25 per cent of cases, patients even had to wait up to a week to see their GP.

    Despite all the frenzy around the extended hours issue, only 12 per cent of GPs were able to offer an appointment at 7pm on a weekday, and only 10 per cent on a weekend, the Lib Dem survey revealed.

    According to media reports, Liberal Democrat leader Nick Clegg is expected to give a speech today to the King's Fund - the think-tank that has just published a damning report on polyclinics - in which he will accuse the government of failing to address a "yawning gap" in healthcare between the richest and poorest areas of the country.

    Clegg will also propose the introduction of a new system where patients who didn't receive treatment within a set time would be sent elsewhere, either within the NHS or privately, with costs covered by the NHS. According to a report in The Times, he will also recommend the implementation of a 'patient premium' which is expected to encourage GPs to work in deprived areas.

    In a few weeks, Lord Darzi will unveil his final report on the NHS "Next Stage Review" in which he is expected to recommend the implementation of his controversial polyclinics.

    And so the battle continues. Watch this space for more in the Polyclinics drama.

  • Darzi centres or Polly clinics?

    Polly Toynebee is one of those influential media people who can turn the tide of an election campaign with a few carefully chosen phrases.
    Many Guardian readers will still remember her exhortation at the 2005 General Election to ‘put a clothes peg on your nose and vote Labour’.

    She’s obviously got used to the smell because her most recent column reads as if it’s been written by a DoH press officer.
    It even comes complete with traditional inaccuracies such as GPs having ‘life-long contracts that can't be removed, with a guaranteed income.’

    The title tells you all you need to know…‘Don't be fooled: this doctors' protest is all about profits, not patients’.
    Unfortunately, Polly seems to have been sucked in to the government’s ‘new reality’ machine.

    If the reality of a situation is something they don’t like, they create a ‘new reality’ by constantly re-stating their own more palatable version until it is widely accepted as the truth.

    One of the biggest criticisms of the Darzi plans is that polyclinics are a solution for London that’s being inappropriately forced upon the rest of the country.

    The original plan was for every PCT to set up one polyclinic. But Polly is now telling us that there are 152 new clinics planned for London only, and everyone else can do whatever they like. The fact that 152 is also the number of PCTs across the country, gives a hint as to the previous reality.

    So should we still be calling these buildings Darzi centres, or would Polly clinics be more appropriate in the new reality?
     

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