NHS & Private Medicine: Best Health Care & Porsche

Do we judge how good a doctor is by the car he drives? I remember medical school friends preferred to seek advice from Ferrari driving surgeons than from Rover driving psychiatrists.

My friend was amazed that I gave up Private Health Care when my wife retired.

“I know you worked for the NHS but there is no guarantee, is there?”

Well, in life you do have to believe in something. The truth is simpler in that after five years from her retirement, the co-payment is 90%.

He worked for one of the major utility companies and had the top-notch coverage.

“The laser treatment for my cataract was amazing and the surgeon drives a Porsche 911.”

Porsche official Website

He was very happy with the results.

“He has to be good, he drives a Porsche.”

Then he started feeling dizzy and having some strange noise problems in one of his ears.

“I saw a wonderful ENT specialist within a week at the same private hospital whereas I would have to wait much longer in the NHS.”

What could one say! We are losing the funny game.

What does he drive?

A Carrera.

Another Porsche.

We are OK then.

Or are we.

He was not any better. And after eight months of fortnightly appointments, the Carrera doctor suggested a mastoidectomy.

Perhaps you should get a second opinion from an NHS consultant. Perhaps see a neurologist.

“I could not believe you said that, his two children are doctors. And he has private health care!” I was told off by my wife.

He took my advice though and he got an appointment within two weeks at one of the famous neurological units at a teaching hospital.

To cut the long story short, he has DAVF.

I asked my ENT colleague if it was difficult to diagnose DAVF.

“Not these days!”

He had a range of treatments and is now much better.

All in the NHS hospital.

“I don’t know what car he drives, but he is good. One of the procedures took 6 hours.”

Best health care.

I always knew: Porsche or otherwise.

Related:

Best Health Care: France & The NHS

Anorexia Nervosa: Chirac & Faustian Pact

Related:

Enemy Of The People: NHS, Internal Market & Safety Net

First Emperor, Animal Farm & Allyson Pollock

NHS: Changes Or A Conspiracy Against The Public Interest

UnitedHealth & Big Profits: AMA & BMA

RBS, Lord Ashcroft, Priory & The NHS Reform

NHS & The Ruling Class: Disappointed! Dismayed! Disgusted!

As I listened to the Ring Cycle (Solti), I am reminded of the genius of Wagner who warned us about the Ruling Class years ago.      

Soon they will start selling off the famous hospitals.

The NHS (England) as we know it will soon disappear. 

Wagner’s opera will always be there: The Ring: Child Psychiatry & Human Behaviour

So will Finland's forest!

© 2012 Am Ang Zhang

                                                                                                                                                                                                                                                                                                      A culture of corruption pervades the links between government and business,

 fuelled by and fuelling privatisation. 

These relationships are  – a conspiracy against the public interest.

Adam Smith

Allyson Pollock:CQC

We now know that England's healthcare regulator, the Care Quality Commission, tried to cover up an investigation into a hospital trust where babies were dying. This appalling tale has been spun to be about the "rotten culture" at the heart of the NHS. The true story of the Morecambe Bay cover-up, however – just like Mid Staffs, where hundreds of patients died – is one of market failure.

Two questions in particular have not been properly addressed. Why would the CQC be complicit in the cover-up of poor performance? And why was the University Hospitals of Morecambe Bay NHS foundation trust so desperate not to expose the failings at its Furness hospital? The answer to both questions lies with the new market system that brought the CQC into being, a system introduced by New Labour and implemented by the Tories.

.....The CQC is has a legal imperative to get the market up and running by developing the systems to register more than 22,000 health and social care providers. The real story of the CQC scandal is that market-led changes are creating deficits and poor quality of care, which managers must seek to conceal in order to survive. Central to the government's NHS reforms is the concept of a well-regulated market. Behind the CQC controversy is an assumption that if a commercially run hospital is failing it has simply not been well enough regulated. But experience from the US shows that effective regulation of large healthcare corporations is impossible: we cannot afford it, or get the data necessary to carry it out. That is why the NHS had direct management in the first place.

Remember East Coast Rail:

There is no end, it seems, to the fiasco of rail privatisation. For the second time in three years, the holder of the coveted east coast franchise has walked away from a contract it can no longer afford. Not only that, but it turns out that National Express – whose chief executive, Richard Bowker, has decamped to the Gulf in a hurry – has protected itself from the vast bulk of the £1.4bn it owes the government by insulating its subsidiary, Fred Goodwin style, as a "special purpose vehicle".

But far from slinking off into the corporate undergrowth, National Express is now threatening to sue the government if it also takes over the company's two other profitable franchises. Once again, we are in the world of the Metronet consortium, whose collapse finally discredited Gordon Brown's disastrous public-private partnership for the London underground: where instead of transferring risk to the private sector, the government ends up subsidising private profit and picking up the bill when the music stops.

For all its rise in passenger numbers, Britain's rail system remains hobbled by the folly of privatisation: overcrowded, unreliable, fragmented and exorbitantly expensive. But far from putting it out of its misery to create a reintegrated publicly owned railway at zero cost, the transport secretary, Lord Adonis, was yesterday insisting the east coast line would be up for tender again as soon as he could manage it.

Now NHS:

As we are ourselves experiencing the worst from our ruling class over the NHS and its so called reform, Wagner’s opera is an uncomfortable reminder that we should never have trusted the ruling class.

Even before the new Bill was passed, changes were in place in the NHS that made it impossible to go back. Now it looks as though the changes were much worse than first thought. Doctor leaders were hoping that there is still decency in our ruling class. 

Well, unfortunately many of us will be disappointed, dismayed and disgusted.

Please do not get me wrong, it is not a simple privatisation. We are not really following the US. They regulate insurers where we do not. If we were required to get insurance Obama Style it might have been better. No, basically even if you get the top insurance there will be conditions that will be left to your friendly NHS hospitals. Just check your policy if you do not believe me. 

No it is under the guise of COMPETITION.

It is allowing Any Qualified Provider (privateer if you must know) to cream off. But it is not as simple as that. Recent PIP private clinics not only refused to remove the implants but went into administration to avoid paying compensation. There is as yet not legislation to guarantee NHS patients. Even travellers seem better protected.

In health care, DEATH is irreversible.

The NHS has been by and large highly efficient as it has avoided the pitfall of internal market system until recent years.

The crazy bonus system, internal market and Pavlovian style reward system skewed the efficient NHS to breaking point.

A once fairly integrated health care system where many doctors and nurses contributed free extra hours became a scandal ridden system where OOH fight not to see patients and not let A & E see them either. Or else OOH are run by so few doctors that patients suffered or died.

But it could be worse as the new AQPs do not seem to be liable:

The Guardian:

Family sues out-of-hours GP provider and nurse over death liability

The family of a young woman is suing the country's biggest out-of-hours GP provider and one of its nurses, whose failures meant her fatal condition was not diagnosed, because neither will accept liability in a test case over legal responsibility in a privatised NHS.

Clare Secker, 19, died of bronchopneumonia in December 2008 after a nurse working for the privately-run telephone service told her parents to give her paracetamol and fluids.

Earlier this year the nurse admitted through her lawyers that she had been "in breach of her duty by failing to arrange for [Secker] to be seen by a doctor". If the young mother, who died when her son Tyler was less than a year old, had been prescribed antibiotics she would have recovered fully.

Despite this neither the firm, which was part of the Harmoni out-of-hours service until it was bought by Care UK in November 2012, nor the nurse has offered compensation to the family.

The nurse claims she does not need to pay out as her employment contract specifically states that the company had insurance in place "to indemnify … for any claim arising from any wrongful act committed by … any employee while carrying out their contractual obligations". But Harmoni says its insurance excludes responsibility for negligence by nurses.

With the Health and Social Care Act 2012 leading to more NHS contracts going to private providers, lawyers are concerned that the fragmented system will lead to a loss of accountability.

"It cannot be right that patients no longer know who is actually providing their care, or for those who are harmed to have the additional stress of providers trying to dodge responsibility by pointing to a clause in a contract or insurance policy. Until something disastrous happens we, the public, think we are still within the safety net of the NHS and increasingly that's just not the case. There is little transparency or protection, it seems to me."

Hospitals now fight other hospitals and the failed ones will be handed over to privateers. Some of these have the highest mortality rates. I am surprised that they are not sold  off for just a single pound.

The more failed hospitals, the better for the government. Once they washed their hands off, it is not their problem. If the privately run hospital failed, they change CEO, change ownership and continue. 

The GMC has been quiet about them as they have with the Breast Implant ones and many other plastic surgery private hospitals. 

Yet, right now the NHS picked up the mess of the PIP implants. The private companies pocketed the money. Lots of money.                                                                                                   

Lesson from Sweden:

• Randeep Ramesh in Stockholm
• The Guardian, Tuesday 18 December 2012 09.57 EST

Perhaps most damaging for private investors drawn by the potential profits to be made from the state has been the probing of their affairs by tax inspectors. The industry has been under scrutiny since 2007, when a spate of high-profile deals, including the buyout of Capio, led to investigations into financiers.

The charge is that private equity firms siphon profits out of the state's coffers while avoiding their fair share of taxes. Berglund, of Capio, says: "It is always thrown about that we are not paying taxes but it is not true."

Swedish tax authorities are, however, taking some companies to court because pay in private equity groups is often linked to the profits made on deals and has been incorrectly taxed, it is said, for years at rates lower than that required for income in Sweden.

Earlier this month one of Capio's owners, a private equity firm called Nordic Capital, lost a court case against the Swedish tax agency, leaving it with a bill of 672m Swedish krona (£63m). The authorities, it is reported, will also slap a tax bill collectively of 2.6bn krona on another 34 individuals.

"There has been a strong reaction in Sweden. These people have been paying themselves enormous sums of money," says Dahlgren. "It should be a worry for every health system where you have competition and private firms arriving."                            

If they are not RULING, where are they?

Virginia Bottomley: Secretary of State for Health 1992-95   now with BUPA. Cousin  of  Jeremy Hunt.

The Slog

So there’s Jeremy newly installed as Health Secretary after just seven short years as an MP. This is a summary of his meteoric rise:

He made a fortune at the taxpayers’ expense as monopoly supplier to a notorious quango where, by happy coincidence, his cousin sat on the Board. He became MP for SW Surrey where, by happy coincidence, his cousin had been MP previously. He became Minister in charge of Media & Culture where, by happy coincidence, he wound up steering his pals at Newscorp in the right direction. And he became Health Secretary partly because, by happy coincidence, his cousin is a lobbyist for the private health sector.

The Guardian

“Interestingly, former health ministers have done particularly well. The ex-health secretary Patricia Hewitt earns more than £100,000 as a consultant for Alliance Boots and Cinven, a private equity group that bought 25 private hospitals from Bupa. After leaving the department, her predecessor, Alan Milburn, worked for Bridgepoint Capital, which successfully bid for NHS contracts, and now boasts a striking portfolio of jobs with private health companies.”

Alan Milburn

Following his resignation as Secretary of State for Health (to spend more time with his family, his partner is a hospital doctor), Milburn took a post for £30,000 a year as an advisor to Bridgepoint Capital, a venture capital firm heavily involved in financing private health care firms moving into the NHS, including Alliance Medical, Match Group, Medica and the Robinia Care Group. He has been Member of Advisory Board of Pepsico since April 2007. Wikipedia

 Alan Milburn now also holds a place on the board of PepsiCo as an advisor.        Wikipedia

Patricia Hewitt

In January 2008, it was announced that Hewitt had been appointed "special consultant" to the world's largest chemists, Alliance Boots. Such an appointment was controversial given Hewitt's former role as Health Minister, resulting in objections to her appointment by members of a Parliamentary committee. Hewitt will also become the "special adviser" to private equity company Cinven, which paid £1.4 billion for Bupa's UK hospitals.

In March 2008, it was announced that Hewitt will join the BT Group board as a non-executive director.[40] She joined the group on 24 March 2008. In July 2009, Patricia Hewitt joined the UK India Business Council as its Chair.

In May 2009 The Daily Telegraph reported that Hewitt claimed £920 in legal fees when she moved out of a flat in her constituency, stayed in hotels and then rented another flat inLeicester. Claimed for furniture including £194 for blinds delivered to her London home. In June 2009 Hewitt announced that she will be stepping down from the House of Commons. She said she was leaving the Commons for personal reasons as she wanted to spend more time with her family.   Wikipedia

 

Ex-NHS: Patricia Hewitt: now with Cinven (Bupa Hospitals)

Simon Stevens: now with UnitedHealth

Shadow Elite: They are everywhere! Come fly with me!

Hello Summer: Singapore!

© Am Ang Zhang 2013

Singapore Health Care: The Future Now!

Singapore: NO! NOT FREE!

Singapore’s health delivery is not free at any point. This has the singular advantage of preventing the over-utilisation of any of its healthcare services. As England struggled to stem the flow of new EU citizens from coming to use (or abuse) our NHS, Singapore’s system simply see to it that it would not happen. Yet there is a safeguard in public health for what is known as a catastrophic situation which happened during the SARS outbreak.

Singaporeans are considerably healthier than Americans, yet pay, per person, about one-fifth of what Americans pay for their healthcare.

So in Singapore private clinics are responsible for 80% of primary care but public hospitals cover 80% of hospital care!

 

Singapore has some of the best public hospitals in the Far East if not the world so much so that even those with private insurance often chose to have their operations in a public hospital but staying in a more private room if their insurance covers it. Public hospitals of this level of excellence become the natural competitor for the private market and helps to keep overall cost down without the need of draconian legislation. Such good public hospitals also provide some of the best training grounds for future generations of top class doctors.

 

Singapore together with Iceland has one of the lowest Infant Mortality rates in the world, a third the figure of the USA.

Anorexia & Bulimia: Early Abuse & Perverse Disturbance!

In years of Child Psychiatric work, the saddest thing about abuse is the perverse disturbance that seem to affect many victims. The number of children that were physically abused and yet found themselves married to abusive partners is well known, often repeatedly.

The sadder picture is that of sex abuse!

©2008 Am Ang Zhang

Chris

      That Chris’ mother should have been the patient was obvious from the first time I met her. She indeed saw a psychiatrist before moving from Dorset. She had been hospitalised for Anorexia Nervosa.

      She was cured. She got married. Then she had Chris.

      If she did not tell me, I never would have guessed she had Anorexia Nervosa.

      At first I did not even know how I knew.

      “She was a very good looking woman,” my secretary told me one day, “she hasn’t got a bad figure either.”

      Doctors are not supposed to notice these things and if they do they have to keep it to themselves.

      That was the discordance. She had a good figure. Many recovered anorectics cannot maintain a nice balanced figure and I am quite sure it is to do with the various hormonal upsets from the extreme dieting, a sort of gonadotrophin stimulating hormone problem.

      She did have fertility treatment in order to have Chris. She would feed me with information now and again.  Perhaps that had something to do with it.

      Chris was difficult, but no more than the average single parent child. His father had long since disappeared.

      Was Chris’ behaviour one of the reasons she consulted me?

      She was one of those mothers with lots of questions, and I am one of those psychiatrists who wanted parents to find their own answers.

      In psychiatry knowing the answer is no guarantee to a cure. In fact it is the same in many branches of medicine as we still have so many incurable diseases. Parents do want to have the answer and of course in the commercial world there are now doctors that cater for that desire. A nice label, be it ADHD, ME, Autism or Asperger.  As long as there is a technical sounding name people are happy. If you can have a specific drug, so much the better.  If not you may get special education, benefits or both.

      As long as it has nothing to do with “upbringing”.

      But upbringing could be trans-generational.  What happens to one generation can have an impact on the next generation.

      Many parents want to look at the here and now and a quick fix answer.

      One day mother told me, “I am bulimic!”

      Then she took out some capsules and said that she could not have those as she could not have an orgasm.  She had been seeing an adult psychiatrist but came to me for the problems she found too embarrassing to discuss with her own psychiatrist.

      She had a new boy friend who was much older than she was and he was a pilot.

      She wanted me to see him to explain about the side effect of her medication.

      “I am taking 60 mg.” she told me.

      I did wonder, as the 20 mg dosage might have been less problematic.

      I declined the request and she was rather disappointed. She accepted my reasoning – I did not initiate the treatment.

      Three weeks later she told me she broke up with him.

      Then she told me she normally could not have an orgasm unless she imagined she was having sex with an older man. She then thought it might work with having an older boyfriend.

      As I listened mother decided to tell me more.

      She had been abused by her father from about the age of twelve and the awful thing for her was that she actually enjoyed the sexual side of things. It was an abuse she found hard to come to terms with. She could not hate her father because when she came out of hospital after her Anorexia, she had no breasts to speak of. Her father paid for implants, twice.

      When Chris’s father left he bought a house for them.

      He paid for her private treatment for Bulimia.

      Worst of all, she had to imagine her father whenever she made love to have any chance of an orgasm.

      No. She had never told anyone else before.

                                                   From The Cockroach Catcher 

You may also want to read about  Amanda.

Hamlet: Forgiveness

Other Posts:Anorexia Nervosa: Olanzapine (Zyprexa)-Veganism
Anorexia Nervosa: Bach
Anorexia Nervosa: What If!
A Brief History of Time: Anorexia Nervosa

The Book: The Cockroach Catcher, 

 A Chapter on Anorexia Nervosa,  

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