Wednesday, June 4, 2014

NHS & The Elite: Specialist & Community Hospitals!

In Health Care, death is irreversible.

The Elite

Zebra in fact belongs to the same family as the horse (Genus Equus) but unlike the horse has never been domesticated. It is believed that the stripes in a herd is protective as many animals merge together and thus appeared larger.     

©2012 Am Ang Zhang


There is now a new plot on the horizon: Persuade people that they only need community hospitals near them to be run by Primary Care and they may not even be doctors.

 

This way the punters might be tricked into not going to Hospital A&Es but Urgent Care Centres at these locals.

 

Really.

 

Punters would not be punters if they are that stupid.

 

No matter; as we will close A&Es and even their hospitals.

 

Why?

 

It is the one big drain on NHS spending and it cannot be controlled. We can pay GPs if they do not refer but self referrals to A&E is now the norm.

 

A reprint:

NHS Reform: Democracy is for the Elite! So is Health Care!

Is it really that difficult to grasp! Our democracy is for the ELITE. Why pretend? So is Health Care!


Most people in well paid jobs (including those at the GMC) have health insurance. GPs have traditionally been gatekeepers and asked for specialist help when needed. If we are honest about private insurance it is not about Primary Care, that most of us have quick access to; it is about Specialist Care, from IVF to Caesarian Section ( and there are no Nurse Specialists doing that yet), from Appendectomy to Colonic Cancer treatment (and Bare Foot doctors in the Mao era cannot do the latter either), from keyhole knee work for Cricketers to full hip-replacements, from Stents to Heart Transplants, from Anorexia Nervosa to Schizophrenia, from Trigeminal Neuralgia to Multifocal Glioma, from prostate cancer to kidney transplant and I could go on and on.China realised in 1986 you need well trained Specialists to do those. We do not seem to learn from the mistakes of others.

When there are not enough specialists to go round in any country money is used to ration care.


So we are going to but in a peculiar manner as the NHS used to be state run and free. Reform is needed!!! Enter GP commissioning. If it is your GP doing the rationing it is no longer the State's problem.
Some very clever people indeed are working for the government. 


Is it Conspiracy or Cockup? You decide.

But strangely they thought there is still money to be made.

The current concern for the NHS Reform is perhaps too focused on privatisation.

The main aim by some very clever people in government is that somehow there must be a way to limit health spending.

The first obvious way is to find someone that could do it without the blame coming back to the politicians who needs to worry about the next election or next job.

GP Commissioning was thought to be the answer as the blame would now be on the GPs.


Integration of Health Care
Integration of Health Care now carries a new meaning: integrated as long as it is all within the remit of Primary Care and not between Primary and Secondary Care. Yet there is only so much that Primary Care can do unless they started employing their own consultants and running there specialist hospitals. That is one way of saving money.

The other way is to refer to Any Qualified Provider, the new NHS speak for Private Providers. Better still if these are owned by the same organisations that own some of the GP practices. Believe me, it is already happening and it will spread.

How could this be done? Simple, NHS Foundation Hospitals will not stand a chance if they have to continue with the expensive and unprofitable conditions or expensive dialysis and Intensive Care that many private insurers will not touch. In the new world order, they will fail and be closed or be bought by private companies. We have the regulator called Monitor that will see to it.

Again it will not be the politician’s fault: just bad management.

The new structure of HSCB is perfectly geared towards failing FT Hospitals. Some will survive through high levels of private work for those from wealthy countries. There is only a limited number of specialists to go round in England and in fact in most countries.

Which means that there will be a long waiting list for NHS patients!!!

Rationing by any other name.

It really does not need a genius to work out that Foundation Hospitals if they fail will be bought up by private firms.

 

So there are not enough Consultants and shortage creates demand and you can name your price. Consultants do not really want to waste time in consortia arguing about the price of hips or knees. 

 

Privateers

A big portion of the NHS money will now be spent in the counting houses of the new Commissioning Offices. Gradually more and more of that money will be re-distributed to Privateers.

 

Those who could afford to will now get their own Health Insurance and when the Insurers refuse to cover some conditions you may have to return to the NHS. But who knows, it might just be too late then as those hospitals may no longer be there

So do you really think that hospitals are not necessary, or not necessary for the average citizen of England. Soon they will be sold and it will be costly to buy them back.

What about medical training? If these hospitals are sold, who pays?

And watch out, someone, your parent, your spouse, your child and even your MP may need a Hospital Consultant one day. 

Do we still have those: yes we do!  See here>>>>
In London alone these are specialist hospitals that are famous the world over:
The Maudsley Hospital

Then there is Papworth. Need I say more!!!
I know that when you visit them nowadays, these places seem to be full of: non locals. Or could it be that these are now the new locals, I doubt as you can sometimes see the lovely foreign plated cars parked outside them. If I am wrong, I do apologise.
The truth is that medical tourists come not for the GP services we provide, they come for the cutting edge medical procedures and in England, it is also about value for money.
So, opening up many of these rather precious hospitals for up to 49% private will mean a severe reduction in actual medical times available to NHS patients.

That is why: the pretending is over. No, at the end of the day it will not be the medical care you can get from your GP or Noctors, it will be well trained specialists with up to date complex procedures that you or one of your relatives may need!

Tuesday, June 3, 2014

Multiple Sclerosis: Never say never!

There is suddenly a great interest in one of my earliest posts: 


Multiple Sclerosis, Iguanas and Wrong Foot


In the summer of 2005 I read a rather compelling story in Hospital Doctor. The headline was: “Ignoring the Evidence: Diagnosis of his wife’s progressive multiple sclerosis would not have taken so long had doctors taken a proper history, says Dr David Wheldon.”


It was an extremely well written article. It had to be, as Dr Wheldon’s hobby is poetry writing. He is a microbiologist by profession.
His wife is an accomplished painter and a violin restorer and dealer. As early as 2000, she noticed that she was dragging her right foot on a walking holiday in the Auvergne. She was referred to an orthopaedic surgeon. “Congenital spinal stenosis,” he confidently diagnosed. She got worse. In 2003 she was referred to a neurologist but during the months when she was made to wait for an MRI (why was it not done immediately?) she deteriorated rapidly and was soon unable to walk unaided and had a multitude of other neurological symptoms.
“Progressive multiple sclerosis,” proclaimed the neurologist. "No treatment is available. Just let the disease evolve."
Dr Wheldon at this point commented that a proper history would have allowed for the diagnosis to be made earlier, as his wife had had two transient episodes of weakness of an arm and dimmed vision in one eye.
There was no time to waste and having been given a “no hope” verdict, Dr Wheldon thought that alternatives had to be found. How often have we found patients seeking alternative treatment and sometimes very very alternative treatments once they were told what was thought to be the “truth”? Luckily I learned early on in my medical training that one should “never say never” (as mentioned in the chapter “Miracles” in my book.)
He found the Vanderbilt University work on Chlamydia pneumoniae. The rest, so to speak, was history. His wife was put on two antichlamydial agents and later metronidazole. After some typical reactions his wife started to recover. Eighteen months later, she was able to paint and walk a mile or so.
Some may argue that the recovery had nothing to do with the treatment, but was just one of those rare spontaneous recoveries. I am aware that this is only an isolated case, but there is ongoing research in this area.

Iguana iguana, Costa Rica

So what is the iguana doing in today’s blog? Many iguanas kept as pets are wild, truly wild caught and they carry various bacteria including Chlamydia pneumoniae, which also infect and cause diseases in Koalas, snakes, chameleons, frogs, and green turtles.
According to National Geographic, one of my favourite reads,
“Green, or common, iguanas are also among the most popular reptile pets in the United States, despite being quite difficult to care for properly. In fact, most captive iguanas die within the first year, and many are either turned loose by their owners or given to reptile rescue groups.”
Perhaps we should leave them to stay in the wild.
Dr Zhang should have checked if Tommy, his Wrong Foot patient, kept an iguana. His mother was diagnosed with multiple sclerosis.

Chlamydia pneumoniae site: CPNHELP.ORG


Other Posts on Multiple Sclerosis:
Multiple Sclerosis Treatment – an Update

Links

“Multiple Sclerosis:  A Curable Infectious Disease?”, July 7, 2010, http://perfecthealthdiet.com/?p=157.
“Is Multiple Sclerosis an Autoimmune Disease?”, July 5, 2010, http://perfecthealthdiet.com/?p=151.
“Eleven Steps for Overcoming Alzheimer’s and Other Chronic Infectious Diseases,” July 1, 2010,http://perfecthealthdiet.com/?p=134.
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9 comments:

Sarah Longlands said...
Dear Dr Zhang,

My name is Sarah Longlands, the wife of Dr Wheldon, mentioned above. I found your blog by accident when looking up "David Wheldon" on Google, something I do from time to time to see who is linking to both our web sites.

I thought I would give you a small update:nearly three years on again since the publication of "Ignoring the Evidence" I am still going strong, not having had an adverse MS event since starting treatment in August 2003. When I started I couldn't even hold a paintbrush but now I have worked through watercolours to acrylics and have now moved back to my favourite medium of oil paints and of no mean size. My progressive multiple sclerosis was so aggressive, I really shouldn't be here now, but I am.

I have not seen my neurologist since being given the diagnosis. David has, since they work in the same hospital, but although at one point the man showed some interest, this soon passed and the man has never looked at my subsequent improved scans. In fact, he once ran out of the radiologists room exclaiming "I can't look at this!" He is obviously very good at saying "Never."

There are always going to be people willing to put my recovery down to "spontaneous recovery" but I think it very odd that this should have happened within a few hours of downing my first ever doxycycline, after having my first multiple sclerosis relapse twenty years previously, age 24. Then and for many years it was untroubling, with few, easily resolved relapses. Over the years I had been able to forget about it, so I readily accepted the diagnosis of the orthopaedic surgeon. I have since discovered that David married me thinking I might well have MS, because of my clumsiness although by that time I has already decided that it couldn't possibly be the case.

Since starting to recover, David has seen many patients abandoned by the neurological establishment and has written two papers with Charles Stratton of Vanderbilt University about chlamydia pneumoniae and multiple sclerosis. I started writing on http://www.thisisms.com, where a psychologist named Jim Kepner, a sufferer of another disease caused by chlamydia pneumoniae, saw me and started to treat himself. Two and a half years ago this led to him starting a wonderful site: http://www.cpnhelp.org where people from all over the world suffering from any of the many diseases in which CPn is implicated can come together for freely given help and reassurance.

Very best wishes,

Sarah Longlands. 12th April, 2008
Am Ang Zhang said...
Many thanks Sarah for taking the time to make the comment. All the best.

Dr Am Ang Zhang
Anonymous said...
Copied from CPNhelp because I thought you might not see it there:

"Hello again Dr Zhang! I hope you enjoyed your hols, but it was only a tiny flurry really, like the small snowfall we had the other Sunday morning which was gone before most people knew it had been there.

I totally agree with you about the state controls, first set in place in our country when the fat man in hush puppies was health minister, I had only recently both got my MA and acquired MSi and chlamydia pneumoniae was not even realised to be a serious pathogen. I'm glad we have original thinkers over at Vanderbilt and I am so glad I am married to one here, who discovered what they were doing and thought that it was better to get on with treating me rather than waiting for endless double blind trials that would never happen, antibioticsi not being profitable things.......Sarah




An Itinerary in Light and Shadow by a real "Painter of Light"...........Completed Stratton/Wheldon regime for aggressive secondary progressive MS in June 2007, after four years, three of which intermittent. Still slowly improving and no exacerbation since starting. EDSS was 7, now 2, less on a good day."
Anonymous said...
that is the case too, the antibiotics on the protocol used to treat are long off patent & sport the least amount of side effects from the abx themselves. The pharma companies have no interest.

but wow, they now have something they can make money on! a drug for Fibromyalgia pain (packed with a plethora of side effects)!
Gill said...
Hi, I have been recently diagnosed with MS and was also told there was nothing that could be done. My options appeared to be nil or joining the MS Society for group hugs and "learning how to live with my disease". Not a chance I was putting up with that so I started to scour the web and talk to friends recently diagnosed.

I thank my lucky stars that one friend pointed me straight to David Wheldon's site and having met with him, I'm about to start on the protocol. With the help of the pioneering stalwarts on the CPn Help forum mentioned above, David Wheldon, and the inspirational Sarah, I fully intend to see this through. If it's possible to cure it then I'll have a darn good try.

My GP and Neurologist have refused to have anything to do with the Protocol which I find exceedingly strange. I always thought the medical profession were tasked with making patients well by whatever means, it seems however that unless the drug companies are waving some new miracle drug at them, they're not open to looking at old medication used in a new way.

Having read your blog though, I'm going to spend the afternoon scouring the house in case I have a recalcitrant Iguana hiding in a dark corner. Or maybe I'll round up the frogs in the pond and force them to take a Chlamydia Pneumoniae test. :-)
Am Ang Zhang said...
Hello all, back from Hols and the blog engine has restarted.
Am Ang Zhang said...
Sarah's letter is now posted here.

The Cockroach Catcher

Sunday, June 1, 2014

Circles's Hinchingbrooke: Smart Hospital

I have stated this before about the future of the NHS:



“There are two futures, 
the future of desire and the future of fate, 
and man's reason 
has never learnt to separate them.”


 J. D. Bernal, Professor of Physics, Birkbeck College, London, FRS ( 1901—1971)

Lets enjoy the sunset.

©2004 Am Ang Zhang

Looks like not many noticed that Hinchingbrooke is not a FULL hospital. Very smart and I am sure it will work if it is not doing the money losing part.


Some smart people dreaming up some smart solutions: NHS for loss making future and PRIVATE for the profit making future!!! 



1) Hinchingbrooke hospital is a modern purpose-built district general hospital, which opened in 1983.

2) Hinchingbrooke hospital serves people in Huntingdonshire and surrounding areas; approximately 160,000 people.

3) Hinchingbrooke Health Care NHS Trust provides a wide range of outpatient, daycase and inpatient services, a 24 hour accident and emergency department and maternity services.

4) Cambridgeshire Community Services provides services on the hospital site including 25 children’s beds and 12 special care baby unit cots*.
5) There are also two wards for patients with mental health needs, run by Cambridgeshire & Peterborough NHS Foundation Trust*, and Addenbrookes runs adialysis unit from this site*

*The services marked with an asterix will not become part of the operating franchise agreement detailed on the East of England website.  Or>>>Hinchingbrooke Next Steps


Ian Greener: Why Ali Parsa is wrong about healthcare (and the NHS).

Healthcare is not unsustainable, and the near public monopoly on it has made it fantastically affordable in the UK. As I’ve said many times in this blog, the entry of providers of others types means we have to keep comprehensive providers open (as Circle have benefited from at Hinchingbrooke), meaning that those providers cannot fail, while at the same time pretending we are introducing competition. There is no real failure if particular providers cannot fail. If there is no competition. 

Circle Posts:




To say the Circle is the John Lewis of Health Care is indeed a blatant insult to that much loved high street store. John Lewis had no Cayman connection and Circle is not fully 100% employee co-owned. But Circle is really a ...




NHS & Circle: Smart People & Hinchingbrooke. I have always maintained that Andrew Lansley is very smart & I might be right: some very smart moves from the listening exercise to the House of Lords. But could he face his ...



Circle will have the power to hire and fire staff, and change operating procedures as long as the hospital meets NHS standards. The move opens the way for other financially failing hospitals to be run by private firms. Around ...


Dr Julian Neal, a Circle GP partner and a member of the company's primary care development team, says: 'We're about providing practices with the opportunity if they wish, to develop new services which are certainly not just ...
Circle's CEO, ex-Goldman Sachs banker Ali Parsadoust set out his view that the NHS is “an unsustainable industry” that costs too much to run. “In his view, Britain has world class retailers, telecoms and financial services firms, ...
We saw Circle's Ali Parsadoust in an altruistic posture proclaiming that Circle is the only one that can save the NHS. Then we saw the unholy gaming by one Hospital on one PCT/GP practice. Or did they? I have always ...
The financial strength of Circle Health, one of the UK's most prominent private health providers, will come under close scrutiny as its parent company prepares to float this week. ……Parent firm Circle Holdings' expected ...


Circle: - Currently largest partnership of clinical doctors in the UK. Says services could include telehealth, enhanced diabetic services, urological services, day case surgery, endoscopy, community-based ENT or ophthalmic ...