Baby George and Pulmonary Atresia

George Peter Sams

George Peter Sams was born at 10:22 am on the 10^th October 2014 at St Thomas’ hospital, London. He has had the most amazing support from the medical staff there and is currently under care in the Intensive care ward. For those of you who don’t know my son (my third child) has Pulmonary Atresia, a rare heart defect that ultimately leaves half of his heart, the half that pumps de-oxygenated blood to the lungs to bring back vital Oxygen for the rest of the body, non functioning. We had the option to terminate early on but…

On Monday he goes in to have his first of three operations . This one is to put a plastic pipe or shunt into the closing hole in-between the ventricles that keeps the heart as a two (rather than 4) chambered pump giving him the shot at life. More will follow and his is not an easy road. He will have limited tolerance to exercise, complications to diet, digestion, renal function etc caused by the future ops and above him the spectre of early death on the operating table, or if his weak half a heart should give out. All the while we have agreed to give him this shot.

It just seems so bitterly unfair that this little bundle of innocence has already been given this massive handicap that could and probably will kill him eventually and we his parents have to make choices as to how long he gets to live or try and guess at what may or may not happen. I keep wishing our roles were reversed but to no avail.

Every hour I panic and worry that we’ve done the right thing, that he is going to be alright and that he has the best shot at life as he possibly can. I’m terrified of leaving the hospital on Monday unless I’m not there and…

I’m not a religious man, far from it, but for the first time in a log while I have offered up a silent prayer to my ancestors (especially my Grandparents) to watch over him and to take care of him. His fate is in the hands of the Doctors and in nature and all manner of things. If there is a higher reason or force controlling everything then I hope that George is dealt a better hand.

A good friend of mine said to me this weekend that I was tough, and I could get through the heart ache, pain and stress to come. The truth is – I’m not tough, I’ll get through this because I have to but in reality I’m terrified. I'm maintaining a steely façade and the "I'm good with this" stance to cover up the little boy inside who just wants to curl up into a ball and beg this to stop. This past year hasn't been the best for me or my family and more bad things are being pushed below the surface with the other repressed feelings. It is so repressed that the other day I started sobbing uncontrollably when I read that a German Cruiser sank with all hands a century ago! I mean really?

The raft I cling to is that he was a good weight, a healthy colour and alert and focused so should be strong enough to fight through the surgery and make a full recovery. He is one of us and my forebears were hardy and resilient. So should he be. He WILL be ok!

This whole blog post probably doesn't make sense. It is more an attempt to get my thoughts and feelings onto paper and definitely not a cry for help.

NHS reshaping, privitisation and hypochondria

I was very interested to read in today's Metro, that suggestions have been made to cut cost in the NHS by copying ideas from poorer nations like India or Ghana such as people sending picture texts of injuries to Doctors/Nurses for a response, Mexican telephone calls to a nurse with symptoms and cutting about 30 non necessary surgical procedures that are of no medical (or cosmetic) benefit.

The point is the NHS is spending, on average £2,264 PA per person in the UK and the NHS is looking at a £30bn shortfall!

Take the NHS back to brass tacks. It was to provide medical assistance for free to all funded by National Insurance payments.

I agree that non-essential surgery and cosmetic surgeries should be carried out on the NHS. Why should someone get their breasts augmented or their nose reshaped for free unless it was because of an accident?
A child gets mauled by a dog and their face is a mess - yep, give them the surgery. You're 24 and you don't like your nose - sorry I think you should pay for it.

I've had some issues with Medway's NHS and the way it is run and dealt with my family members. It is not a slight against the hard working nursing or casualty staff, they have always been excellent and deserve more than they get in pay and praise. However there are issues more towards the top.

One of my big problems is GP appointments. You always have to wait almost a week and when you get to them they are always running late or brimming with people with sniffles. The same is true when you go to casualty. My brother-in-law was struck on the head with a brick and had to wait three hours in Casualty, in the mean time you have people waiting there because - and I swear to god this is true - a woman had paint in her hair.

My wife, who was unwell called the NHS direct service and was advised to get to Casualty immediately and within the hour only to be gently referred to the MEDOC for a Middle Ear infection brought on by Gastritis. When I have been in casualty I've often thought what a massive waste of time this has all been and wonder how ill or injured some of the people sat calmly reading the paper really are.

People of my Grandfather's generation used to self medicate and diagnose. I know I do still and won't waste a doctor's time unless I think it is serious enough to warrant it. I've been to the Doctors, for my self, once (and the resulting referral to the hospital) since I was 18! People seem all to ready to call up the Doctors or wander around to casualty and waste everyone's time because they ate a dodgy Kebab last night or they've got a bruised shin and they think it is broken...

I would indeed welcome a service that could cut down waiting time at the first line of medical attention, a screen if you will for non-essential cases. After all a battlefield surgeon doesn't have time to help a soldier with a stubbed toe when they are under fire and neither should an A&E doctor.

What erked me even more about this was they wheeled out Andy Burnham, Labour's shadow Health secretary, who said;

This will send a shiver down many a spine. It confirms the suspicion many people have that David Cameron is softening up the NHS for privatisation.

Really?

It really does seem that every time serious, constructive change and slimming down to make the service more effective  Labour come out with the cry of Privitisation. It is an absolute crock.

First the NHS should always be free at point of use. However it needs to be functional for everyone and for necessary medical needs.

I want to be able to go into casualty with a wound and be seen quickly not sit wait a few hours killing time because someone has flu or bruised their shin or got paint in their hair. I agree with Monitor's chairman David Bennett.

While there are things the sector can do - like be more efficient in its procurement or introducing new ways of working - what is needed is a step change.

Governments have failed the NHS & Residents of Medway

NHS is in trouble but Politicians haven't been listening

Yesterday was a sad day for our Democracy and the House of Commons.

The Secretary for Health Jeremy Hunt made announcements relating to the Keogh commission report and on going problems with the Nation's hospitals, especially dealing with unnecessary deaths.

Twitter exploded with comments about what was being said in Parliament and most party members and supporters that I follow were horrified by the level of partisan tweets and comments in Parliament. Tories going after Andy Burnham, Labour blaming the Coalition for deep cuts and mismanagements. Both sides of the house sat sneering at each other and shouting like the crowd at a Roma vs. Lazio game - Not the seat of power of a First World country and people who should know a lot better.

Even on a Local level the various Party politicos have started winding up the noise about the incompetence of the others - Andy Burnham this and Tory cuts that. The Labour PPC for Chatham & Aylesford has released a press statement on the subject and their various Twitter feeds have been releasing stats showing what has come into being since 2010. The Tories and some Libdems have been passing around a petition to get Andy Burnham to accept responsibility and resign... It needs to stop.

The NHS has had problems for a long time. Medway Hospital has had issues for at least a decade. Back in March I wrote about my family's problems with Medway hospital back in 2007.I also referenced problems that Rehman Chishti highlighted in 2008. It is irresponsible for the Labour Party to say this has all been since May 2010. However the Coalition needs to take ownership of the cuts and recognise that they have also had a massive impact and they need to be reexamined.

However lets look at the NHS Chief Executive at Medway Hospital who administers the cuts. Instead of keeping care and staff levels up efficiency savings were made and then a stupid amount of money was spent on a motivational speaker for the staff!

Then there is the merger with Darant Valley which has been beset with problems for Medway. Who was given a voice for this concerns? Only NHS trust members - not the staff or the residents who use the service. Even the elected representitve of Gillingham South ward, Lib dem Geoff Juby, was ignored by the Chief executive.

Of course there is also the Local NHS hospitals. Medway is the only local hospital with a 24 hour A&E where as the others can close at a certain time or redirect cases up to Medway. This obviously throws the already stretched triage and Emergency staff to unacceptable levels with priorities being thrown all over the place. When I took my infant son up with a suspected case of Meningitis we had to be hurriedly discharged (after thankfully pronouncing him all clear!) as they had an emergency case literally outside the curtain that desperately needed the space.

It also means that Medway has a catchment area of One Million people in North Kent covering Sheppey to Dartford and can include Maidstone and Canterbury on a rough day. This is a horrendous amount of space and people for one A&E and hospital to cover.

A culture of target meeting and figures started to develop in the 90s and now hospitals are stuck trying to meet Government targets and not treating the sick as human beings rather than Statistics. Party Politics has been using the lives and deaths of the sick and elderly for years as a way of measuring the success of policy and to beat the other party over the head at PMQs.

This HAS to stop.

Many politicos sit and wonder why the public are fed up with Politics and don't vote and it is because of incidents like this that push people too far. If Politicians, and I use this as a broad stroke - I know there are exceptions, could stop acting like Children and trying to constantly get votes and score points and actually sort this problem out. People's lives genuinely depend on it and too many have been lost already.

What needs to happen is for the three main parties to get together and work out what is the best for everyone and stop acting like children. Medway Council need to look at things, the Department for Health need to look at Medway Maritime management, priorities and staffing. Most importantly of all Politicians of all ilks and creeds need to listen to the residents, of the horror stories that will hit the Press this Friday and of people's general disgruntlement and actually do something about it rather than play the blame game which is a game that frankly, we all lose at.

Medway hospital; mergers, mortality and management

I remember my 27th birthday very clearly.

I was at Medway hospital with my Mum, sister, grandfather and my 90 year old grandmother who was suffering from dementia and had suffered a fall and had a nasty leg wound. After a long wait in triage she was moved on trolley to a staging area for another few hours. As time went by mum became most distraught and asked the only nearby nurse for assistance, namely the wound dressed and water for a dehydrated patient who had no idea what was happening.

"I'm doing my paperwork" she was told.

After half an hour my Mum spoke loudly and with a huff and a puff the nurse finally complied.

It boils down to a 90 year old dementia sufferer was left on a trolley with an untreated open wound with out water because paperwork is more important than care.

Medway's Liberal Democrats have worked hard with the hospital on many issues. We have also opposed the joint merger with Darant Valley because of fears that it was being done purely for financial reasons and that patient care would suffer immensely. Medway maritime has a large catchment area, covering much of North Kent and even Sheppey with approximately 1 million people.

Many of our ward constituents have voiced concerns over the merger as Daren't valley is difficult to get too by public transport, as well as expensive. Embarrassingly it is easier and cheaper to come up to London!

Unfortunately, the constituents have had very little voice during consultation as the regular meetings and forums were only available for the Trust's members. It seems that, even though problems have been identified and raised to the Hospital Board they had become fixed on pushing this through solely for the money and ignoring valid concerns of patients, users and patient groups as well as their elected local representitives.

However, the merger has been put on hold due to Medway's high levels of mortality. On Thursday Chatham & Aylesford MP Tracey Crouch raised concerns in Westminster;

The Medway Maritime hospital is under investigation for higher than expected hospital standardised mortality rates, and there is currently a specific outlier alert on septicaemia. Worrying, this is not the first time this has happened. Discrepancies in coding were highlighted way back in 2008 with the discovery that 8% of deaths were being recorded as end-of-life care when the proportion should have been 37% ... A clear manipulation and distortion.

I, like Tracey presumably, am not accusing Medway of repeated malpractice but clearly there are issues that need addressing. I would sincerely hope that there will be maximum transparency and not just to the Trust's members.

I'd like to tell another story.

About a decade ago a nurse was struck off for failing in patient care. On a night shift an understaffed ward (1 nurse, an auxiliary and an agency) forced the nurse, with no training or real supervisory training to take charge of the shift. In the middle of the night she heard a noise that could have been a slap but was unsure. Having seen the agency with a confused elderly patient moments before she presumed it had been an altercation. With no one senior about and with no evidence of wrong doing as well as dealing with a whole ward to deal with she thought she'd report it to a superior first thing in the
Morning. She was suspended and taken to tribunal for failure to act straight away despite all the problems.

She was sacked.

A more legally savvy relative tried to appeal the case and dig up information on the processes involved and was met with an sir of hostility that ended with the threat of legal action for harassment.

As I understand it there has been quite a history of bullying at Medway hospital, indeed Rehman Chishti has been up there three times for this reason yet it is still continuing, however it was Tracey (not Rehman) who bought it up in Parliament again;

A culture of bullying and its suppression within the NHS has been mentioned. The latest staff survey at the Medway Maritime hospital shows that there is still a perception that bullying is widespread.

Then of course there was the motivational speaker issue that made the national press (here) with up to a hundred jobs being lost but £140k available for a motivational speaker...

Something is not right up at the Maritime hospital. Although I can report that every time I have been there the nursing and medical staff have been fantastic and this is in no way a slight at hard working individuals on little pay, there is something questioning the management and its practises and would encourage greater transparity for patient groups and families and where there is liability the right course of action is taken.

NHS must remain in Public domain

About ten years ago documentary maker Morgan Spurlock (of Supersize me fame) made a documentary about living on the Minimum wage in the US. At one point he was injured and went to the local ER, where as he was unable to afford health insurance he had to pay $90 for filling out paperwork and sitting in the waiting room without treatment.

This is illustrative of what could occur here should the NHS start to be broken up.

As a case study let's take an average family and look at their NHS usage.

I was brought up to believe you weren't sick until you were bed ridden. I've very rarely been to the doctors and maintain a self medicated existence usually involving aspirin/ibuprofen or Lambs Navy rum. My health insurance would be quite good. The same is true for my wife who soldiers on through the same illnesses as me and apart from two trips to the maternity wing she has been fairly healthy.

Of course there are the attached services like weighing, health visitors (a service I would much rather do away with considering the hassle we have had from a non-mandatory service), etc etc that would be an added cost or drain on your premium.

Now we reach the kids.

My little girl Sophie has had problem's with walking, we thought it was a muscular problem and she has been attending psyiotherapy for the last two months, with a total of about 15 appointments. She has also been referred to the paediatrician who has seen her twice, she's been fitted with her third pair of Peadro boots to help her walking, a set of splints to help align her feet and is to be given a pair of special tights that have plates etc to help keep the legs where they are supposed to be and using the right muscles.

The latest news has been that she may have Cerebral Palsy or a type of hereditary Spastic Parapalgia (Though I keep getting the wrong condition - it was something like that), which can get worse over time and could in some extreme cases lead to paralysis. I'm hoping that this was just to prepare us for the worse but... Anyway, that aside, the fact is that Soph has more follow up appointments and an MRI scan.

If it turns out to be the second option - again I think it is a version of this I can't remember the exact term and keep getting it wrong but it is something like that - it is something my mother-in-law has (She's had similarly large amount of tests, medication and psyio for it) and developed in her late forties, my wife could similarly develop it.

My followers on Twitter will also be aware of the deteriation of my Grandfather's mental health with a possibility of dementia as well. Well that's been moved forward and he has undergone tests for a possible blood clot in his leg, referrals and we are looking at the possibility of being put into full time care.

Oliver, my son, has been pretty good but had a nasty recurring vomiting bug which saw him have several doctors appointments. Then about three weeks ago we saw a rash on his leg that wouldn't fade once rubbed. Immediately fearing meningitis we rushed to Casualty where he was examined and given a clean bill of health. Going back to the Morgan Spurlock example, that could have cost us quite heavily and how many people will think twice before seeking medical assistance? How many cases could turn out fatal?

A few years ago my wife found a lump on my back and I had it checked and was given the all clear. Her father had a lump, didn't go to the doctors until it was too late and he died when she was nine. Not going to the doctors could be fatal.

My concern is that certain medical care could become unaffordable for the working poor and only those who can afford treatments can have them. Whilst this is good for population figures it is bad for the majority who may not be able to afford things. An MRI can be exceptionally vital, the line between life and death but if you're not covered by insurance and you can't afford it you aren't having it. I'm going to be honest, had it been privatised I wouldn't be able to afford to pay for my daughter's treatments be it by premium or on the day. How many parents are in the same boat? You'd try and move Heaven and Earth to find the money but sometimes it just isn't there. Could you sit back and do nothing knowing you couldn't afford to do anything? It would be soul destroying...

The NHS has to remain a free service for all, with the option of using private providers if you so wish in certain services. What needs to happen is a streamlining of the NHS management, get rid of the middle managers and quangos that are there to solely make sure figures and would be targets are met - pay the nurses what they deserve and pump the rest of the money into improving services rather than them being forced to keep asking Government for it. Any move to fully privatise the NHS MUST be opposed.

Dementia care capped - amazing news

Excellent news came out of Libdem HQ and Westminster last week;

Yesterday the Coalition Government announced an historic reform to the way we pay for long-term care. This package of measures will end unlimited care costs and provide more help for those who are less well-off.

There are two key reforms:

· A cap of £75,000 on the amount that anyone will have to pay for care
· A massive increase in the means test threshold from £23,250 to £123,000. This means that more people with modest wealth will get help from the state with the costs of care. Anyone with assets below this level will get help paying for care.

The current system is a lottery. If you develop cancer, the NHS will pay for your treatment. But if you develop dementia, and need help with washing, dressing and going to the bathroom, you have to pay for your care. One in ten people are hit with catastrophic costs of more than £100,000.

At a time when public finances are so tight, finding the right solution was a huge challenge. But the plan we have set out is fairer, simpler and more sustainable than the current system.

The Liberal Democrats in Government fought hard for this historic achievement. The Labour Government failed to do anything to reform an unfair system during their 13 years in office. Alongside other steps, such as extra protection for people who develop care needs as a child or during their working life, these reforms will help provide dignity and security for all of us in later life.

Those of you who follow me on Twitter will know that around Christmas my Grandfather had a serious episode. He was taken home by the Police on Boxing day after being in an exceptionally confused state in Asda. The following day I went to visit and found the gas fire pouring out methane and filling the house as he'd simply forgotten to light it. he had even forgotten how to drink a cup of tea!

Although he seems to have recovered he is still suffering from getting severely muddled. To preserve his dignity I won't go any further, needless to say we, as a family are going to need to look at care options and there I'm not going to lie - cost is a consideration.

We are better off than most as Grandad, a trained engineer made a bucket load of cash in the 1950s restructuring Ghana for independence and retired as a consultant for the waterboard. However many are not so fortunate and in this case my Mum may give up work to be his full time carer, a position that many can't do. Then of course there is the possibility that we might have to resort to a residential care home if my Mum, who is 60 this year, can't cope. With Medway council selling on the specialist Nelson's court we could be facing an astronomical bill well beyond our meagre incomes.

News that the Government are capping fees is a relief for my family and countless others, the priority has to be the elderly relative rather than stressing about money. In the past how many families have suffered in silence or sub standard care due to shortage of funds?

This is really welcome news.

Jeremy Hunt; rewarding failure.

Deep in the ruins of GHQ in fortress Stalingrad General Paulus mused over the situation. His army was dead, dying, captured or starving. He held in his hand a memo from Berlin that effectively promoted him to Generalfeldmarschall, no German army had ever been defeated in the field, nor had a GFM surrendered nor were they expected to. The implication for failure was clear.

After the failure of July plot General von Treskow walked out into a minefield.

Generals Clinton and Burgoyne never held a significant command after failing in the Americas.

Asquith and Chamberlain slipped into obscurity after their respective administrations failed to cope with war in Europe.

My meandering point is that failure should not be rewarded and in many cases punished. Yet somehow this reshuffle has failed to address this.

I take the point that George Osborne being kept could be a good thing as the policies do receive mixed reviews - though personally I think Cable, Lawes and Alexander would be a dream team in the treasury.

My big issue is Jeremy Hunt's promotion to Health minister. Ok Lanesly had to go, that's very understandable. In fact many commentators have been expecting it for sometime.

What I don't understand is that Hunt failed in an epic way - truly it was the proverbial cock-up. His appointment to oversee the BSKYB bid was predicted, on the twitter-sphere, to give Murdoch the bid before he'd got the job.

The Leveson enquiry has shown a lot of discrepancies in the process including many questionable actions by Mr Hunt. Whether guilty or not, the public consider it a dirty deal.

Further to that questions were asked in parliament about the conduct of Mr Hunt, questions that were not satisfactorily answered.

I can understand David Cameron standing by his minister at the time, it's the right thing to do after all you're a team but he should, like Lanesly, been sidelined at this reshuffle.

Fair enough his work on the Olympics and Jubilee are worthy of praise but he was a cog in a monstrously large machine and cannot take all of the credit. Indeed his failure and the accusations of corruption far over over shadow anything else.

To promote him to the Health portfolio is just sheer madness. The Conservatives are always open to attack over the NHS and it is easy for the opposition to frighten the populous with talk of privatisation whenever there is any well meaning reform and with Jeremy Hunt's track record there will be a lot more worried people and serious scrutiny of his offices.

I'm sure David Cameron has his reasons but they had better be good ones. May be I'm being judgemental. After all Churchill failed on many occasions before his premiership resulting in the General strike and Galllipoli massacre. Yet he went on to win the Second World War. Some how though I don't think Jeremy Hunt is in the same category as Churchill.

Assisted dying.

My Grandmother Sams died when I was four from throat Cancer, my Grandfather was at her side and took care of her through her illness but would never talk about it, except that he had lost the love of his life.

However when I was at school and there was a debate on assisted dying and Euthanasia he did say in conversation that the hardest thing in life is to watch someone you care deeply about suffer in agony and slowly. He said that, if a dog was dying from an illness or hideous injury the humane thing to do is to put them to sleep but when it comes to humans there is a different barrier.

Euthanasia is an ugly word. It brings to mind images of Nazi mandatory euthanasia, the programs to purge the human race of mentally and physically ill people under the guise of "Humanity."

It doesn't have to be like that.

What I say isn't applicable to those with mentally disability or suffering from the depression, mostly those with terminal or life debilitating diseases. I'm not being discriminatory, its just I know that that is a particular can of worms that leads to a heated debate and I'm not the person to start it. My sister worked as an NHS psychologist and has dealt with suicidal people and those with depression and said it is a tricky area. She said all you can do is offer as much help and support as you can but if someone is determined enough to take their own life they will, a fact confirmed by my Grandfather who, as a Policeman, had witnessed more than a few suicides in his time.
Or indeed, when I was a student, a man on Winchester station was arguing with his son then calmly walked down the platform and into the path of the express as it thundered through.
As I say, the main thrust of my argument is for those who are physically sick or debilitated and want to die.

As a Liberal, I believe in the rights of Man and as much freedom from the state as can be gained responsibly. Ultimately you have the rights to do what you want within the structure of law and as long as your actions do not infringe on other people's lives or rights. If someone is dying or living life in agony and wants to die, to end it I honestly believe that they should be allowed to. Medicine can only do so much to alleviate pain and to offer quality of life and should the patient feel that their quality of life is such that they cannot carry on then why not?

I know it is slightly different but assisted dying has happened at war for many years. Soldiers, to badly wounded to move have been left with pistols to finish the job, or been helped out by a comrade. RAF pilots would often carry revolvers in case they were trapped in a burning fighter heading towards the ground and this was at a time that Suicide was considered "self Murder" and illegal. Everyone just looked the other way.

Yes Suicide is a selfish act. It ends your suffering but leaves others in pain and having to deal with the emotional loss of a loved one but that loss must be weighed against the pain and suffering of the individual and surely it is better to remember someone as they were rather than what they became?
I always remember my Grandfather sat in his chair with a glass of Sicilian Red or German White, a sausage sandwich at his side and his smile - not as the whithered shell that lay in the Chapel of Remembrance at Medway Maritime - I refuse to. I only had to see him for five minutes like that so I was able to suppress the memory but someone who sees their partner deteriorate over months or even years doesn't have that luxury.

What if they find a cure?

Yes, I remember the scene in Star Trek V (the Final Frontier) when Dr McCoy helped his father to die and then a month or so later they found a cure and he could have recovered.
Life doesn't always pan out like that and with every decision you make you have to use the available information.

Our choices, our freedoms are restricted by many things including Law, money, time, others... We try to navigate life to get and do what we want in cooperation with others but ultimately the only thing we have power over is if we want Life to end. Why can't someone who makes that choice but physically can't carry it out be assisted?

Nick Clegg and Baroness Williams' letter on NHS reform

Dear Chris,

As you know, the Liberal Democrats fought for significant changes to the Government's original Health & Social Care Bill. We've succeeded in making a real difference. Thanks to those efforts, and if we are able to win amendments on competition and Foundation Trusts, the bill now going before the House of Lords should be allowed to be completed.

Today we have written to all of our colleagues in the Commons and Lords. You can read the letter here (see below.)

Later this week the House of Lords will debate Liberal Democrat amendments to ensure we rule out any threat of a US-style market in the NHS.

If these amendments pass we are confident that competition and diversity in the NHS will always be done in the interests of patients, not profits.

Next month we will return to where this process all began a year ago when we meet at our party's Spring Conference.  If we secure these necessary changes Conference can be reassured that it has finished the job it started last March and the Bill should be allowed to proceed.

With your support we can build a stronger and better NHS ready to put patients at the centre, working with local communities, and responding to the financial challenges of an ageing population.
Best wishes,

Nick Clegg MP
Leader of the Liberal Democrats and Deputy Prime Minister

Baroness Shirley Williams of Crosby

Dear Colleague,

The Health Bill currently in the House of Lords is now undoubtedly a better Bill because of the Liberal Democrats. A number of people deserve credit for improving this Bill. Firstly, and most important, are our Party members who made it clear at our conference in Sheffield in March last year that we would not accept a Bill that puts profits before patients. We secured a “pause” in the legislation, which led to a number of substantial changes to the Bill, for instance that competition could only be on quality and not on price. Since the “pause”, there have been further changes, which owe a great deal to the hard work of our Health Minister, Paul Burstow and our parliamentary health committee led by co-chairs, John Pugh and John Alderdice. Second, our Liberal Democrat peers in the House of Lords, led superbly by Judith Jolly, have done an outstanding job scrutinising the Bill line by line.

With the help of the House of Lords Constitution Committee, several eminent Conservative peers, Labour’s Lords team led by Baroness Thornton and Lord Hunt, and a determined group of cross-benchers, many members of the medical professions, an all-party consensus has now ensured that the Secretary of State will remain responsible and accountable for a comprehensive health service financed by taxpayers, accessible to all and free at the point of need.

This should guarantee the future of the NHS, one of Britain’s greatest social achievements. In addition, led by Phil Willis and others, arrangements have been put in place to make the UK a world leader in medical research, to raise the status and protect the independence of the Public Health service, and to ensure that all profits from the treatment of private patients in Foundation Trust hospitals must benefit the NHS.

The Bill has now undergone more than 200 hours of scrutiny and had more than 1,000 amendments made to it, amendments that have put patients and the people who know them best at the very heart of the legislation. This is not the Bill that we debated as a party last March. Crucially, some elements of Labour’s 2006 Health Act, which opened up the possibility of a US-style market in the NHS, have been radically changed, such as the gold plated contracts for the private sector, which allowed a Labour Government to pay private providers a total of £250million for operations that weren’t even performed. We can also take pride in the fact that it was the Liberal Democrats who changed this Bill to ensure that no government will once again be able to favour the private sector over the public sector like the last Labour government.

The Bill also now has in place safeguards to stop private providers “cherry picking” profitable, easy cases from the NHS, and we have made sure that private providers can only offer their services where patients say they want them. We are also clear that no one should be allowed to spend public money without telling us how they are going to use it. That is why we have insisted that decisions about patient services and taxpayers’ money must be made in an open, transparent and accountable way.

We now have a Bill that delivers on the issues that Liberal Democrats have campaigned on for years. For the first time, there will be real democratic accountability in the NHS through new Health and Wellbeing Boards that will give councils a real role in shaping local health services. Public health will finally be returned to its rightful place in local government. Integration between health and social care will become the norm rather than the exception.

However, given how precious the NHS is, we want to rule out beyond doubt any threat of a US-style market in the NHS. That is why we want to see changes made to this Bill that have been put forward by our Liberal Democrat team in the House of Lords to make sure that the NHS can never be treated like the gas, electricity, or water industry. First, we propose removing the reviews by the Competition Commission from the Bill to make sure that the NHS is never treated like a private industry. Second, we want to keep the independent regulator of Foundation Trusts, Monitor, to make sure hospitals always serve NHS patients first and foremost. Third, we will introduce measures to protect the NHS from any threat of takeover from US -style healthcare providers by insulating the NHS from the full force of competition law. We will also insist that anyone involved with a commissioning group is required to declare their own financial interests so that the integrity of the clinical commissioning groups is maintained. Finally, we will put in place additional safeguards to the private income cap to make sure that Foundation Trusts cannot focus on private profits before patients. These changes are needed, not just because of this Bill, but also to plug the holes left by Labour’s 2006 Health Act that allowed private providers to make profits at the NHS’ and taxpayers' expense. It was that Act that started the process of the marketisation of the NHS by allowing private providers to be paid on average 11% more than the NHS. These changes will ensure that competition and diversity in the NHS will always be done in the interests of patients and not profits.

Next month we will return to where this process all began a year ago when we meet at our party’s Spring conference. Once these final changes have been agreed, we believe conference can be reassured that it has finished the job it started last March and the Bill should be allowed to proceed. We believe these changes will appeal to those in the House of Lords and the House of Commons who share our commitment to the NHS, and believe it can now embark on the reforms that matter: putting patients at the centre, working with local communities, and responding to the financial challenges of an ageing population.

That will demand a united effort not only from the NHS but from all of us who cherish it. Then the essential work will begin to ensure that the necessary changes are introduced as smoothly as possible in full collaboration with everyone who works in the NHS. The real test will be to demonstrate tangible benefits to patients. After all, in the end, it is the interests of patients, which should count most of all.

Best wishes


Nick Clegg
Baroness Shirley Williams

News From Gillingham South's Councillors

Councillor Juby, Leader of the Libdem group

Well, another batch of Focus' for me to deliver in the new year arrived last week and here is a review of what Councillors Geoff Juby and Shelia Kearney have done for you... the lucky people of Gillingham South!

Well lets get the more mundane, less interesting but necessary stuff done first!

Road re-surfacing in Canterbury Street, Balmoral Road and Duncan Road all of which needed serious attention. Rubbish clearance from Lock Street and Canterbury street and an alley way cleared between Balmoral Road and Franklin Road.

A Salt bin has been approved and placed by us at Windmill Road's junction with Canterbury Street after resident's complained that last year Medway Council didn't salt some roads and paths.

Two benches have been provided in Rookery fields Park from the Ward improvement funds. Sadly I must report that I've noticed they've been heavily graffittied by the School Kids who've gone past in the past few weeks but a bench is a bench still!



The Bridge as it was



I can also report a success story too. After 13 years of campaigning the Railway bridge outside Gillingham Station's footpath has been widened! Before the Station's refit the path could fit two people abreast which was problematic for wheel chair users, buggies and prams or at the traffic lights if there were a lot of people waiting to cross.

Now, with a bit of road re-direction and change it is now around four people across and is much easier for the people of Gillingham who are trying to get into the town.

As for Parking, which is another on going problem in Gillingham and in fact most of Medway.
Medway Council are only going to do reviews if they can be funded externally due to the budget cuts due to the Budget cuts and lack of money and, sadly, none of the developments being undertaken in Gillingham currently warrant a Section 106 which would mean they have to pay for the review.
Geoff and Shelia have pushed that the parking fine revenue earned should be used to pay for a review. Why not cure the problem with the benefits?

The Conservatives have refused.

Another interesting thing is the "Better for Less" streamlining of the telephone services to the Council. The aim was to cut down the number of operators and lines for residents to call however Geoff and Shelia have said that there have been many complaints from residents saying that they have found it very difficult to get through to the person or department they need and that problems are taking weeks rather than hours to solve. Is this another policy rushed through with out proper thought and implementation by the council?

The promise was that Customer's would come first still but it looks like a rocky start!

If YOU have had trouble getting through and are a resident of Gillingham South, please contact Geoff or Shelia and they will continue to up the pressure to make sure the system will work.

Finally, and I will be writing about this properly in the New year, the proposed merger of Medway Maritime and Darent Valley Hospital Dartford. As I've said in the past we as a group are worried about the merger, especially for the secrecy that seems to have overtaken the proceedings. The Consultation meetings are pretty much being held behind closed doors unless you are a member of LINK(?)

The big concerns are the sharing of certain services. Front line services are being kept at each hospital but specialist things are being shared out but Darent is dificult to get to by Public transport, (in fact it is easier to get to London hospitals!) especially as Medway Maritime covers the Isle of Sheppey also which is a fair old stretch to Darent!

Well, that's the news so far from Gillingham South. If you are a resident or have met with the issues I've mentioned feel free to email me or Geoff and Shelia on the above links or you can attend one of the Ward Surgeries held on the Second Monday of the month at St Mark's Church or the Third Saturday at Salem Church, Nelson road (opposite the Bus depot).

Councillor Geoff on the NHS.

Councillor Geoff Juby

In Friday 7th October's Medway Kent Messenger local Liberal Democrat councillor and stalwart Councillor Geoff Juby wrote a small piece on the NHS and Medway. (page 22 if you have it.) 

Geoff exposes some facts that I'm sure members of the community will not know, including me!

There does seem to be a major discrepancy between the NHS reform and services and the role of the public. As Geoff says, the NHS is one of the Government services that touches all of our lives and is the support for "Cradle to grave." yet who gets to say how it is run?
Lib Dem party members at the Sheffield voted to stall changes and for the Government to listen at the Spring conference but you must
a.) Be a Liberal Democrat member.
b.) Be in Sheffield for the conference.

Anyone else must lobby their MP and Andrew Lansley and hope they get the results they need!!!

Geoff argues that the Medway NHS trust now holds its meetings behind closed door now, where as before they were open to the Public. Why has this move been made? Surely the people should be allowed to hear what the local NHS trust is planning. I'm sure it is probably quite deathly dull to most people but it means that all decissions and the decission makers can be held accountable to the Public. Behind closed doors everyone is blind to what is happening. The only scrutiny of the meetings, according to Geoff is a;

farce as it consists of dozens of long reports which simply have the end 'Recoomendation - that the report be noted.'

Geoff also rubbished the chairman of Medways NHS trust's claim that Dartford being cheaper to access than London.

At least most of the London hospitals, which are mostly easily reached by public transport, have proven track records for certain conditions - why on Earth should patients want tot struggle to get to Darenth Valley hospital and probably have to pay double in taxi fares than they would have paid for a cheap day return on the train.

This is referencing Medway trust's proposed merger with Dartford, something which hasn't been highly publicised and I don't know if the public at large have much knowledge of it or how it will affect their services.

The Lib Dem group is struggling, in all kinds of ways so it is good that as the third largest party in Medway (just!) we are still able to publish a voice. Geoff raises some important points, I just hope that someone notices, which is one of the reasons I've written this too!

Fat tax on unhealthy food. Is this fair?

mmmm Whopper.... *drool*

Obesity is a major problem in Britain. Hell I'll admit it I could do with losing a stone... maybe two to look really trim, and I do enjoy good meals and don't get that much exercise as I travel by train and spend my working day sat down watching screens all day.

Individual studies have found that Obesity and heart disease, mostly caused by unhealthy living is one of the top killers in this country, even more so than Cancer. It is a major drain on our economy and on the NHS and something should be done.

Que the new proposals to levy a duty on high calorie food. This, like the duty on beer and tobacco products will raise money for the Treasury which can be put back into the NHS to help fund treatments and re-education on correct eating. Also with the raised costs it may put people off ordering a Whooper meal and perhaps eating something more healthy which again is a good thing right?

Well that's the merits dealt with, lets talk about the cons.

I like MacDonald's, Burger King and KFC. I like food that's not good for me. I don't eat it all the time but when I've got up for work at 4.30 am and caught a train so I can be in London for 6.30 why not have a McMuffin meal to make me feel better about myself? I have OJ with it...

Some people do eat to excess but why should we all have to suffer? Its not fair as its the casual munchers that suffer. Why should Government tell me what I can and can't eat? Will Chocolate be next?!

I don't smoke so that particular vice has gone and I already can't afford a beer anymore and I didn't even drink to excess anyway!!! If the Government take away my Zinger tower meals I will be most distraught.

Let people live the way they want to. Let them have the freedom to eat what they want to. If they want to fill their faces with greasy crap and face the consequences let them.

I know this is a weak argument in the face of sorting out Obesity and off setting the cost of health care but lets face it, it is a case of the Paternal Government taking you by the hand and saying.

"Now son, do you really want a Big Mac? Have some salad... Go on. There's a good boy."

As a closing statement I must say;

I could eat healthily and get hit by a bus tomorrow. I could eat KFC, Sausages, MacDonalds, Red meat and live to the grand age of 100. You never know, shouldn't life be about enjoyment? (Not controlled fun.)

Harman damages any future Lib-Lab coalitions.

 Now I've never been a fan of Harriet Harman, but I have kept my thoughts to myself until the "rodentgate." As a redhead, I found her comments about Danny Alexander exceptionally offensive and  and ill thought out and now I barely hide my contempt so apologies if this is a bit slanted however her comments today are also as ill thought out.

With the future of British politics looking a little shaky and a general consensus that Coalitions and hung parliaments might become more regular the third largest party hold the key to a safe majority and at the moment that's the Lib Dems. It would make sense that, if you were to criticise the Lib Dems and their part in the Coalition you should not attack the core values such as Individual Liberty right?

Cue Harriet Harman... In her speech today she began by attacking the Conservatives and their policies and taking the moral high ground by pointing out the Tories like people with money and saying that for them Downton Abby was a "Fly on the wall documentary." - Very constructive.

Then she moved to those who do the "Dirty work" of the Coalition - The Lib Dems. It's their fault that local communities cannot have CCTV and that the DNA databases were destroyed!

Well yes, it is. Its as if she still doesn't get it. The DNA database was wrong, the government compiling of personal information of anyone's, including the Innocent, is an invasion of personal liberty. Its my DNA, my private information, why the hell should the Government have that information if I don't want them to. When I apply for a Passport I supply information in return for a document that will allow me to travel but my DNA?

As for CCTV, it is not necessarily a crime prevention as images can be grainy or be pointing in completely the wrong direction. It also means that free citizens are having their movements monitored by authorities, other than the Police. Why should everyone's movements be monitored for the sake of a possibility of a wrong doing? Should the innocent suffer with the guilty?

Anyway, if you agree or disagree, the point is Liberals don't and fought damn hard to get rid of Labour's oppressive measures and now Harriet is lamenting their loss?

Then she moved on to attack the Lib Dem theory that we act as a brake to the Conservative led Coalition. Ok, we're not perfect, Tuition fees was something that couldn't be avoided and the new system of repayment is a lot fairer and protects students who cannot get top paying jobs from paying back on smaller wages. Lets face it, and be honest, how many students have come out of Uni and ended up earning £30,000 straight of the bat? How many have earned around £20k or less and ended up paying back loan?

She also levels the NHS - something our activists voted to delay and get the parliamentary party to listen and think again, Police cuts - which are not government led but done by local Chief Constables, VAT - which we can't have that much of an impact over. What she has forgotten is that if we weren't in Government at all then things would be different, we've got around 70% of our manifesto through to the benefit of people everywhere and some of these would not have been passed by the Conservatives alone such as lifting people out of Income tax, Voting referendum, I could go on.

I'm not saying we're perfect in government and I have got plenty of problems with the Coalition but with power and Government we will make mistakes and errors of judgement, as Labour did when it first came into power in 1924 i.e the Zinoviev letter... However it is a learning curve. Needless to say, she has damaged prospects of the parties working together in the future if New New Labour drum into their party a dislike for the Lib Dems or even spend the next four years telling the electorate how awful we are and then have to go back on themselves if they ever need a Coalition.

Yes the Lib Dems were evil but now... they're urm, they're really nice evil?

The last thing, and this made me raise an eyebrow, was that according to Harriet;

As we look to the year ahead, as more people suffer from the Tories, as fewer people trust the Lib Dems, the political map is changing and Labour's activists are mobilising.

Changing? Anyone would think Labour weren't in for 13 years and that the Coalition is a result of a yearning for change. It sounds like she is believing her own hype and it made me think of Hitler telling Feldmarschall Von Griem of the thousands of Luftwaffe jets now available and the Wehrmacht mobilising to throw the Allies out of Germany in April 1945.

PMQs: Nadine Dorries Question.

I've done something that rarely happens. I have left PMQs halfway through to sit and write, and write cross. (arguably I've written some of my best work cross!)

Prime Minister's Questions is an open forum for the Prime minister to be questioned about policy and direct issues to do with constituencies and since is televisation, and I agree with Charles Kennedy on this one, that it has become more of an open circus with people making media statements and trying to get noticed.

Any way today, and I should I have since this coming considering my previous post; ( http://gingerliberal.blogspot.com/2011/09/covert-whipping-and-nadine-dorries.html) Nadine Dorries asked the Prime minister;

"Considering that the Liberal Democrats make up only 8% of parliament why do they have such a large impact on Government policy? When will the Prime Minister tell the Deputy Prime Minister who is boss?"

Or words to that affect.

Firstly, a quick stats check... There may only be 50 Lib Dem MPs but 25% of the vote across the country was for the Liberal Democrats, so we are pretty unrepresented.

Secondly, the issue of abortion is being discussed by the whole house this afternoon and it isn't just the Lib Dems who oppose her amendment, in fact large groups across the country are against it, we are merely voicing their concerns which is what you are supposed to do in the House.

As for the Lib Dem influence on the Coalition? Maybe we do have a large influence, however there is a lot of common ground between our two parties and so a lot of the Government policy is naturally agreed upon and tweaked where necessary by both sides. We've had to sign off on things that we've not agreed on, Tuition Fees for example or Trident... The coalition is a partnership and we both have to make sacrifices - That's how it works!

I know, as I said in the previously mentioned post, that Ms Dorries thinks that Nick Clegg has influenced the Prime Minister and the letter that was sent to all MPs but this is not the case. She is frustrated that her amendment is not getting support and is looking for someone to blame. 

Both parties are in this Coalition together, and lets not forget why we are doing this, for "Real change" to the country and to sort out the massive deficit that has befallen the nation.

Will we always agree? No!

Do we negotiate and talk before finding a common ground that we can agree on like adults? Yes.

If Ms Dorries has a problem with the way the Government is being run, she should talk to her party leader, Mr Cameron and voice her concerns properly, not on national television in front of the whole house like that. It makes valid concerns that some Conservatives have about the government look like spoilt children.

We do not throw our toys out of the pram at PMQs just because we think the other kids are deciding what games are played. It's school yard and infantile and not the kind of grown up politics that this nation needs.

NHS reform; Nick draws the battle lines.

As the NHS reform proposals make their way into parliament this week after prolonged a “listening exercise” sparked by the Lib Dem spring conference, concerns reach boiling point.

Dr Evan Harris has said the reforms were “Poor in all aspects.”

Andrew George MP, Lib Dem member of the parliamentary Health committee has already vowed to vote against it as it is “driven more by private profit than by concern about patient care.”

Baroness Shirley Williams has indicated that there will be opposition in the Lords and that the “battle was far from over”

Against these pillars of Liberalism Nick could only muster;

“Let me be clear: There is nothing, nothing, nothing, nothing – in any of this Government’s plans which in any way threatens the basic principles of the NHS.”

Andrew Lansley has also promised that the bill seeks to improve and maintain the comprehensive service;  “The NHS is not going to be broken, it is not going to be privatised…”

The Evening Standard has predicted a back bench revolt and indeed another grilling for the entrenched Deputy Prime Minister by angered grass roots party members at this Autumn’s Conference- Well those who passed the stringent security checks!

Whatever happens though Nick has vowed :-

“The package will not now be reopened – About that I am clear.”