Saturday 1 November 2014

TTIP the best short film around that explains it simply &Helen Mercer letter in Guardian.

a 4 minutes cartoon film on TTIP

A suitable case for tweeting?  

 Lewisham People before Profit  activist Helen Mercer letter in the Guardian

Simon Stevens, PFI and the need for realism about NHS funding

NHS new chief executive
Chief executive of NHS England, Simon Stevens (centre), talking to staff at at Shotley Bridge Hospital in County Durham. Photograph: Owen Humphreys/PA
Perhaps Simon Stevens should rethink his defence of private finance initiative contracts in the NHS (The NHS is on life support. Can this plan revive it?, 24 October). Last year it required a massive public campaign to prevent the illegal downgrading or closure of A&E and maternity services at Lewisham hospital which was proposed in response to the problems in an adjacent hospital suffering crippling PFI payments. Lewisham hospital is now part of a new NHS trust and is once again threatened by extortionate PFI payments.
Our research shows the trust could save up to £18m a year by challenging the PFI profiteers. In the last financial year, the PFI companies’ accounts list a profit of £7.49m from service contracts and £1.82m for directors’ remuneration and “administrative costs”. The annual interest repayments were approximately £18m. The average interest charges on PFI contracts is 8% per annum, but borrowing through government – the standard before PFIs were forced on public authorities – is half that, reducing the trust’s charges to £9m. These unjustified costs totalling £18m represent a 46% reduction in the trust’s current annual PFI “unitary payment” of £39m.
By 2020-21, the annual costs of the 118 NHS PFIs will be £2.14bn; saving 46% of that would release about £1bn a year. And that is before considering profits on the service subcontracts, that PFIs were never value for money and skewed the very form of the tender. Time to stop PFI contracts draining precious public money from the NHS into the pockets of fatcats.
Helen Mercer
Drop the NHS Debt
• Stevens’s plans have many useful elements: care at home, new relationships to match medical developments, action to discourage unhealthy behaviour all seem wonderful. However, Stevens evaded the questions on the Today programme when asked about the large quantity of new contracts going to private providers. Polly Toynbee says that his document does not refer to competition. He does not need to mention competition in a document. He can just let it take hold while underplaying its significance.
On 23 October I followed up reading the report with sitting in a meeting run by our local commissioning group. The same fantasy opened the meeting. Under pressure, the commissioners had to admit to being clueless about the debts that are rapidly building up. This needs some realism about money that none of the three major parties have shown.
Geoff Barr
Exeter Keep Our NHS Public
• We are told Stevens has “big plans” for the NHS, including “big improvements in mental health services”. One such improvement will be to “introduce standards for getting access to mental health in the same way that has been present for hip replacements and cataracts”. In this connection it is interesting to note that South-West London and St George’s mental health NHS trust has recently made the majority of its senior and experienced therapists working in child and adolescent mental health redundant. At least one NHS trust is not on board with Mr Stevens’s agenda.
David Benton
Department of neuroscience, physiology and pharmacology, UCL
• MPs are right to be cautious about healthcare measures that do not have a strong evidence base (Patients not warned about risks of cancer screening, 29 October), and clear risk benefit ratios. We also support the science and technology committee’s call for more information for patients before screening. However, with over 2 million people living with undiagnosed chronic obstructive pulmonary disease (COPD) in the UK, and late diagnosis one of the key reasons why UK lung cancer survival lags so far behind Europe and the US, it is vital that the potential benefits of screening and the health check are not dismissed altogether.
Early research indicates that screening for lung cancer could be extremely effective in diagnosing patients earlier. Introducing questions on breathlessness and lung function assessments like spirometry into the health check could also help tackle the burden of COPD and lung disease. Some of the reporting around the committee’s recommendations risks throwing the baby out with the bathwater when it comes to screening. For people with lung disease, which kills 120,000 people a year in the UK but is not yet routinely screened for, this could prove a fatal mistake.
Dr Penny Woods
Chief executive, British Lung Foundation
• In 1983 the NHS spent 5% of its income on management while the US spent nearly 27%. After 30 years of “reforms” and “improvements”, the NHS now spends around 15% on management and the US over 30%. This is insane. Reduce spending on management to 10%. Make it a legal duty not to exceed that and the financial problems disappear.
Philip Clayton
• So, Lord Steel and Lady Williams were “very troubled” by the proposals to curb judicial review rights (Report, 28 October). It’s a pity neither of them felt even slightly troubled by the NHS reforms. I hope it’s not a question of the fees charged by the legal profession?
Helen Hughes
Ludlow, Shropshire

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