Health, housing and adult social services National politics

The NHS is going to the dogs, again – or maybe not



Local Labour types were keen to jump on the dumb reporting of the latest numbers coming out of the NHS on cancelled elective operations. Cancelled operations are always unwelcome but the NHS cancels a tiny fraction of its operations.

The headline in the Guardian was “Hospitals cancelling largest number of operations for 10 years”. Even the Telegraph had “Surge in cancelled NHS operations”.

I wondered what the long term picture was. The NHS keep stats going back to 1996/7. The Q4 figures (January to March) are always worst because it is the worst bit of winter and the time in the financial year when all the money is running out.

Q4 cancelled elective operations

This chart give the Q4 numbers for the last 19 years. Yes, cancellations are the worst for 10 years at around 20K. But, they were around 20K in 8 out of 13 Labour years. The worst year in this series was 2000/01 when it almost hit 25,000.

The average Q4 figure in 13 years under Labour was just under 19,000. The average figure for the five Coalition years was fractionally more than 18,000. We are doing more operations under a harsher financial climate but actually cancelling fewer operations.

Call me cynical but what really stunned me about this chart was how there is peak followed by a fall every election year (ringed in yellow). Surely the NHS bureaucracy doesn’t contrive a mini NHS crisis every winter before an election does it?

Ealing and Northfield Health, housing and adult social services

After five years of screaming blue murder over Labour’s own Nicholson Challenge Burnham offers us a “clinical review”

You might think that after five years of complaining about local NHS changes the local Labour types would expect some real meat from Shadow Secretary of State for Health Andy Burnham when he came to Ealing on the eve of a general election and talked about changes to our local health system.

Labour NHS event 2nd May

On Saturday night (yes, this really is how Labour types spend their Saturday nights) Andy Burnham addressed a Labour NHS rally in Acton. You can see a photo here tweeted by Labour MP Andy Slaughter showing a nurse in uniform (not very appropriate), comedienne Jo Brand, “Dr” Rupa Huq, Andy Burnham and GP, BMA official and Labour zealot Clare “fear of annihilation” Gerada.


According to Slaughter Burnham said:

I am minded not to proceed with those changes (to west London A&Es). Will demand full clinical review.

Whoah! Strong language!

I am minded …

He doesn’t say: “I will roll back closures of Central Middlesex and Hammersmith A&Es.”
He doesn’t say: “I will keep the current A&Es as they are.”
He doesn’t say: “I will keep Ealing maternity services open.”

No, he says: “I am minded not to proceed with those changes.” But he would not, in law, be able to make any changes without proper process and evidence.

His call for a “full clinical review” is his real offer and is just silly. The Shaping a Healthier Future (SaHF) programme was produced by clinicians and reviewed by a body (with clinical skills) called the Independent Reconfiguration Panel which reviewed it and passed it. The SaHF programme was never very attractive to Ealing residents and the only actor in this drama who has ever given us any respite is Conservative Secretary of State Jeremy Hunt who had representations from our MP Angie Bray and demanded that Ealing and Charing Cross A&Es stayed put.

Now after five years of Labour screaming blue murder Burnham promises us a review. Now we know from Burnham’s own mouth to his own people what his offer is. A review.

The most likely outcome from Burnham’s “full clinical review” is that it will find that SaHF is sound and let it roll on.

Labour has spent five years belly aching about the consequences of Burnham’s own £20 billion Nicholson Challenge and Burnham now promises a review. Talk about weak.

Health, housing and adult social services

I am afraid that Harry Leslie Smith is an unreliable historical witness

Today the Labour party has used 91 year old Harry Leslie Smith in its party political broadcast. He is two years younger than my Dad so I do know something of the world he grew up in, albeit second hand. Smith’s story about his sister is heart wrenching but I think he is an unreliable historical witness who is peddling a distorted view of the pre-war world. It was a time of great social change and medical innovation. It is only a shame that these changes did not come to fruition in time to help his sister.

There were four hospitals in Barnsley when he was a boy. In particular there was the Mount Vernon Sanatorium which was acquired by Wakefield and Barnsley Councils in 1915 to be used for tuberculosis patients. So rather than there being “no social health care” there was a local authority run TB sanatorium in Barnsley. I don’t know if his sister went there or to St. Helen hospital which was originally built in 1880 as a purpose-built hospital and adjoined the workhouse. St. Helen provided for the poor, destitute and elderly. St. Helen is now the site of Barnsley Hospital.

It is a terrible shame that he lost his sister so young but TB was incurable until penicillin was widely used (at the end of World War II by the US military and more widely thereafter). Without penicillin the NHS would not have saved his sister either.

The NHS is a wonderful institution but we should get our history right.

Health, housing and adult social services

Sahota’s numbers betray him

Local GP Onkar Sahota is playing his full part in Labour’s efforts to keep the NHS at the centre of its political campaigning in the run-up to the next general election. He “retweeted” this tonight – for non-tweeters that means he highlighted something he found of interest that he had found to his “followers” – his audience.

In retweeting this graphic from Labour Left he is in danger of undermining his own case quite badly. In spite of all Labour’s mendacious talks of Tory cuts the graphic confirms that under the Coalition government NHS spending has been protected in real terms. As much as Labour complains that the Tories do not prioritise the NHS the evidence is that they have. Labour made no such promise in the run up to the 2010 election. The Tories promised increased NHS spending and they have delivered. It is there in the right hand column of Sahota’s chart.

His chart say that NHS spending increased in real terms by 4% a year until 2011. I don’t doubt it. That means NHS spending increased by a factor of 12 in real terms between 1948 and 2011. In other words it has got 12 times bigger. The modern NHS is a very different one to that which was founded after the war. It now consumes 10% of GDP. NHS spending more than doubled under Labour in real terms in the 1997-2010 period.

For me the main take away from the graph is that when our economy is feeling its greatest stress in the post-war period asking a service that has enjoyed real terms growth of 6.5% per annum for 13 years to make do with slightly more isn’t the most unreasonable demand. This will involve some big changes but it is not unreasonable.

As a muli-millionaire GP maybe Sahota has some clues as to how the NHS can manage within its protected budget. If he has, he is not rushing to share. It still boggles my mind quite how venal Sahota is.

Health, housing and adult social services Uncategorized

Onkar Sahota will get an early visit from CQC

20141118_231254Today the Daily Mail went over the top with its front page. The CQC’s risk based approach to doing assessments of GP’s surgeries seems sound and it is good they are being transparent and publishing the whole thing. The Daily Mail should have covered it more objectively.

I wasn’t impressed when I heard chairman of the BMA’s GP committee, Chaand Nagpaul, complaining on the BBC Today programme this morning that the data should have been kept secret. In the public services we have too many highly paid people keeping data out of sight. Believe me after 8 years of being a local councillor I have seen it too often. Nagpaul’s Twitter account is headed with the phrase “The NHS is a revered public service not a shopping mall.”

Reverence isn’t very 21st century. Transparency is.

The whole thing did make me ask though – how is Onkar Sahota’s business doing? Sahota is the sole shareholder of Healthcare 360 Limited which owns three GP’s practices. Privatisation isn’t a dirty word for Dr Sahota. One of Onkar Sahota’s practices is going to get a visit soon having been rated 1 (ie highest risk). None of the three practices got the lowest rating (6).

Greenford Avenue Family Health Practice

Rated 1 (most risky)

Potentially not identifying enough Chronic Obstructive Pulmonary Disease, not doing enough flu jabs, not nagging smokers enough and a poor result in their patient survey.

Somerset Family Practice

Rated 3 (risky)

Potentially not identifying enough Chronic Obstructive Pulmonary at a level that CQC consider to be an “elevated risk”. Only 29% of patients reporting that it is easy to get through to the surgery on the phone.

Hanwell Health Centre

Rated 5

Potentially not identifying enough Chronic Obstructive Pulmonary Disease and dementia.

Health, housing and adult social services

Labour’s union funded campaign denies its own NHS record

Labour NHS Campaign

Today Ealing’s Labour campaigners were bolstered by a group of young people who came out to talk about the NHS in Acton. They were taking part in a union funded campaign that essentially insists that the NHS must be run for the benefit of its staff and cannot change to meet the needs of the people who use it and pay for it.

The union paid for posters talk about “selling off our NHS, piece by piece”. First off you might ask where is it sensible to draw the line? Should we have NHS coal dug in NHS mines used to fire NHS steel furnaces to make steel to be rolled in NHS rolling mills and transported in NHS lorries to NHS scalpel factories? Most people don’t care how their health service is provided they just want to keep the cross-party post-war consensus that health services should be provided free at the point of use.

No doubt the unions would like to see the 35 year Private Finance Initiative (the clue is in the name) at nearby West Middlesex Hospital undone. The deal was done in January 2001. You can read all about it in a National Audit Office report. Of course it wasn’t done by David Cameron it was done by Labour’s own Alan Milburn when he was Secretary of State for Health when some of these young people were tiny children. The last Labour government went further than any other government, including the current one, in introducing privatisation into the NHS.

Did the Labour party explain to these fresh faced youngsters that the stringency that the NHS is operating under was already locked in in 2010 and written down on page 4:3 of Labour’s manifesto to give Labour cover to proceed? The so-called Nicholson Challenge was kicked off in 2009 by Andy Burnham when he was Health Secretary.

Labour Manifesto Nicholson Challenge - close up

Labour think if they keep denying their own record on the NHS they can fool voters as well as these young people.

Health, housing and adult social services

Typically Dr Sahota is only telling half of the story

Local GP and Labour politician Onkar Sahota has been writing on the LabourList blog. Typically Dr Sahota is only telling half of the story.

North West London’s Shaping a Healthier Future programme is merely the local roll out of Labour’s £20 billion Nicholson Challenge. Nicholson was kicked off in 2009 by Andy Burnham and aimed to take £20 billion of savings out of existing services to ensure that new services could be provided and new demand met in a post 2008 world. To give itself cover to proceed with this programme Labour included it on page 4:3 of their 2010 manifesto. Go and look. The Coalition had little choice but to continue with it.

Labour Manifesto Nicholson Challenge - close up

Shaping a Healthier Future follows from both Nicholson and Labour’s own Darzi Review. The programme would have happened in the same way if Labour had won in 2010 as the same decision makers would have been working to the same constraints. The reason Ealing hospital is under threat is because the West Middlesex is subject to a 35 year PFI deal signed under a Labour government. 35 years! Sahota fails to mention this key point. He wants to pay for a brand new PFI hospital and keep a tired old building going at the same time but refuses to say where the money will come from.

As Sahota rightly points out only two A&Es have closed not the four originally proposed. That is because Tory Secretary of State Jeremy Hunt demanded that they stay open. The only actor that has mitigated the North West London programme in any way is Jeremy Hunt. Not the courts. Not the Independent Reconfiguration Panel. And Labour refuses to make any promises of mitigation whatsoever.

We are all angry that London North West Hospitals trust has messed up its change programme failing to open its brand new A&E at Northwick Park in time for the closure programme. This is bureaucratic failure not government direction.

Sahota still refers to himself as a GP in spite of sullenly failing to be objective about health issues since he was elected. Poor show.

Health, housing and adult social services

Does Sahota believe a word of it?

This morning local Labour assembly member for Ealing and Hillingdon, Onkar Sahota, retweeted this five point manifesto from a campaign group called People’s Vote for the NHS.

I am not sure who People’s Vote for the NHS are beyond an anonymous Facebook account that seems to be related to the NHS “Jarrow” march in August/September this year.

The core of these people are hard left unionist and SWP types who have no interest whatsoever in making sure that the 10% of GDP we spend on health in this country gets the best results for the most people. They do want to bring down the Coalition and make sure that the Conservatives do not get into power. They do want to make sure that the Labour party protects vested interests and ignores patient outcomes as in Stafford.

What is Labour’s policy and how does it compare with this pledge list?


Labour will make a show of tweaking the NHS reforms but will do nothing substantial to change the purchaser/provider split that sits at the centre of them and which are entirely uncontroversial to all but a few on the extreme left who believe that the NHS can be directed by central control. Privatisation under the Coalition has been going on at a slower pace than it did under Labour but Andrew Burnham thinks this a good line so he will limit privatisation even if it means worse outcomes for patients. The TTIP bit seems to be Labour party policy even if the whole issue has been misunderstood and is probably a red herring. Sahota probably can endorse this first pledge but after this it gets hard.


Labour was vague about this before the last election and it will remain vague. They didn’t make any firm promise to protect health spending in 2010 unlike the Conservatives who have delivered on this pledge. Labour did though put the £20 billion Nicholson Challenge on page 4:3 of their manifesto and it was built into the NHS’s planning before the election. More recently Labour seems to be offering £2.5 billion from a mansion tax which will not appear for at least 2 years. The £2.5 billion has to pay for a new social care service which will be a huge undertaking. It represents only just over 2% of total NHS spending and cannot plausibly go anywhere near covering wage pressure, a so-called GP “crisis”, a so-called A&E “crisis”, undoing Nicholson and cover social care.

Labour will not end the funding freeze. All they are promising is a very tiny amount of money to do something new. The Tories have promised to protect health spending which Labour still has not done unequivocally. Perhaps Sahota can tell us how much the NHS will get and when?


Sahota cannot possibly agree to this proposal. It is totally unaffordable nonsense and flies in the face of previous Labour health policy as laid down in the Darzi Review and the Nicholson Challenge. The only way that the NHS is going to have half a chance of meeting new demand within financial constraints is if there are massive changes to services. Sahota needs to spell out what he would do differently and how it would be paid for. He won’t because he hasn’t got the first idea.


The rule of law and respect for commercial contracts are two of the main underpinnings of our economy. These contracts cannot be unmade without very expensively compensating the PFI operators, most of whom were given contracts by the Labour government. For instance, the reason that Ealing Hospital is losing out and that West Middlesex isn’t is that the Labour government signed a 35 year, yes 35 year, deal on it. Does Sahota, who has spent a whole career being a private supplier to the NHS, really think that that the NHS should rip up its PFI contracts breaking both UK and EU law? Or does he think they should be bought out? Where will the money come from? Is Sahota serious? Perhaps he can explain?


Labour is making no promises on pay and the most likely outcome is that there will have to be years of pay restraint in the NHS unless it can revolutionise its productivity. Perhaps Sahota can spell out how he thinks NHS pay will change under a Labour government?

It is strange to see an ostensibly mainstream Labour politician like Sahota endorsing this left-wing agenda which is miles away from official Labour party policy. Either he is totally off piste and naive or he doesn’t mind what lies he tells to get Labour back into power. Given that he is a very rich and successful doctor which one do you think is true?

Health, housing and adult social services

GPs want their cake and eat it

Dr-Maureen-Baker_cdp-20131009123916836Today sees the start of the Royal College of GP’s annual conference and is marked by a media blitz by their chairman Maureen Baker. Again and again Baker overstates her case.

Baker is seeking a 37.5% increase in resources for GPs. Sure we would all like someone to wave a magic wand and push a lot more cash at us. It is an outrageous demand.

The latest piece of evidence Baker is using is a bogus piece of research that suggests over 500 GPs practices will close as their doctors are over 60.

In making her case Baker undoes herself. Her own press release says: “the average retirement age of GPs is 59”. Wait a minute. Why are GPs retiring so early? Has she no self-awareness? Do the GPs really think they can opt out of working life, after such a long and expensive education largely paid for by the state, after such a short working life?

One of the things that really confuses me about the NHS is that GPs manage to remain as private contractors but also enjoy a state provided defined benefit pension scheme. I can only imagine that this pension is way too generous if doctors are checking out so early. In the interests of public debate and seeing that Baker raised the issue perhaps the RCGP could publish details of the GP’s pension scheme?

Of course local multi-millionaire GP Onkar Sahota is backing Baker’s campaign. If so few medical students want to go into general practice maybe Baker should send Sahota to medical schools to explain to young doctors how they too can make their fortunes out of being private operators within the NHS.

Ealing and Northfield Health, housing and adult social services

15,500 take the trouble to respond to NHS NWL consultation

According to the Evening Standard this morning 15,500 responded to the NHS North West London’s “Shaping a Healthier Future” consultation.

Local Conservatives spent the summer encouraging residents to respond to the consultation as we were acutely aware that this was probably the most effective way of influencing the NHS decision makers.

We delivered leaflets explaining the consultation to households and had a large team at the rally on Ealing Common on September 15th to physically hand out the consultation packs and explain to people how they might respond. It is gratifying therefore to see that such a lot of people took the trouble to respond. It is almost 1% of the population of the area and probably represents 3-4% of households. Wow!