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NHS - The Perfect Storm

A number of changes are being driven through the NHS which could be considered like the "Perfect Storm".

One most talked about the PbR or Payment by Activity. This has been accompanied by the removal or moreso phasing out of the purchaser protection adjustment. The DH was well aware of what hospitals faced difficulties, but nothing was done until too late.

The financial impact of the new consultants contract was not properly costed by the Department of Health and Agenda for Change also has a substantial impact on costs.

There is a sensible attempt to move care into primary care from secondary care, but this is being done at the same time as everything else and in a relatively insensitive manner in terms of handling staff who could be redeployed rather than made redundant.

The Costs of PFI are excessive and concealed by the use of optimism bias.

There is a bit of good news

The introduction of strong market participants in Foundation Trusts before Commissioning was fully established was the wrong way around whatever one's view about Foundation Trusts.

There is a bit of good news in that the government's pressure to move to 15% of commissioning from the private sector has disappeared off the agenda. Eastern Birmingham spends between 1 and 2% at the moment on specialist services where required. Such as Forensic Mental Health and services for people with Learning Difficulties. The 15% figure is managed through the Local Delivery Plan and the Strategic Health Authorities.

The nature of the first wave ISTC contracts such as the one in Burton where an amount of "activity" payment is guaranteed and, therefore, hhospitals such as Good Hope in Birmingham are likely to have reductions in Activity to move it to Burton. This will hit the new NE Birmingham PCT. Second wave contracts are more sensible, however.

In the mean time PCT budgets have been top sliced by SHA. In Birmingham it is about 2.6%.

The real problem lies in the reorganisation fo the PCTS. The PCTS have an aggregate commissioning budget of 64.309 billion. To put people into job uncertainty causes planning difficulties.

Meltdown occured with PbR in the Czech republic as hospitals found ways of getting extra money from the system.

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Statement by John Hemming
I am pleased that the Police have now made it clear that there has been a concerted effort to promote false criminal allegations against me and that the allegations had no substance whatsoever.
I would like to thank Emily Cox, my children, Ayaz Iqbal (my Solicitor), my local lib dem team and many others who supported me through this dreadful experience. There are many worse things that happen to people, but this was a really bad experience.
It is bad enough to have false allegations made about yourself to the police, but to have a concerted campaign involving your political opponents and many others in public creates an environment in which it is reasonable to be concerned about ill founded vigilante attacks on your family and yourself. Luckily there was a more substantial lobby to the contrary as well, which included many people who were themselves real survivors of abuse, which has helped.
I am normally someone who helps other people fight injustice. …

R v SUSSEX JUSTICES ex p McCARTHY [1924] 1 KB 256

I have only just found this one which I think is accurately reported below (but if it is not please give me an accurate report).

KING’S BENCH DIVISION

R v SUSSEX JUSTICES ex p McCARTHY [1924] 1 KB 256

November 9 1923

Editor’s comments in bold.

Here, the magistrates’ clerk retired with the bench when they were considering a charge of dangerous driving. The clerk belonged to a firm of solicitors acting in civil proceedings for the other party to the accident. It was entirely irrelevant that there had been no evidence of actual influence brought to bear on the magistrates, and the conviction was duly quashed.

LORD HEWART CJ:
It is clear that the deputy clerk was a member of the firm of solicitors engaged in the conduct of proceedings for damages against the applicant in respect of the same collision as that which gave rise to the charge that the justices were considering. It is said, and, no doubt, truly, that when that gentleman retired in the usual way with the justices, taking with him the…

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