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999 Call for the NHS

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By 999 Call for the NHS, Jan 11 2019 10:59PM

Today was my Diabetic half-yearly checkup. A good thing. Blood pressure, weight, draw a bit of blood. I love my diabetic nurse (let’s call her Susan) because she listens, she asks questions about my life, we swap notes on current NHS politics, she is an expert in drawing blood out of my always reluctant hard-to-find veins.

I wonder how Susan is? I’ve not seen her for over a year and a half. I miss her. And I don’t know who I will be seeing today as i pull open the GP Surgery door.

My heart sinks as I tap the digital screen on the wall just inside the GP Surgery door. (Another new software I notice). Receptionists are far too busy doing important stuff to say “good morning” or smile. I know because I can hear them laughing behind the shutters on their windows.

The login screen tells me I am the next patient with (not real name) Julia HCA. How many people here today actually know what an HCA is I wonder? The Nurse’s Room is still next to the waiting room. I know this because the door still has the room plaque “Surgery Nurse” on it - in a nice understated NHS blue.

But beneath it now sits a much larger piece of white plastic with a rather heavy clumsy black font displaying HEALTH CARE ASSISTANT. Being an artistic spirit my heart aches at the complete lack of care and aesthetic sensitivity thats gone into the creation of this overbearing plastic functional sign.

It’s ugly.

My heart sinks further when the door opens and I recognise Julia HCA. My first encounter with Julia HCA was the last time I saw lovely Diabetic Nurse Susan.

That appointment I returned home with four large wads of cotton wool - stuck to both arms, back of both hands (large bruises later) where the needle had been swivelled, twisted and jabbed in an attempt to extract my life-source. On that occasion. after four arduous attempts, Julia HCA had accepted defeat and called Diabetic Nurse Susan away from her very important paper-work (in the next room) to draw my blood.

One sharp, a prick so small I didn’t feel it at all, a smile and a line of friendly genuine chat - two tubes of blood were filled easily. Perhaps my relief at seeing Diabetic Nurse Susan was a factor? I miss Diabetic Nurse Susan.

Anyway... Julia HCA tells me to take a seat by the bed. The chair that is facing away from her. I turn my head so I can see Julia HCA - the other human in the room. Julia HCA is busy reading her screen and tapping her keyboard. She tells me she is going to measure my blood pressure, weigh me and take some blood. Because that is what the screen tells her presumably. When Julia HCA finally looks up I’ve already rolled up my shirt sleeve and placed my arm on the bed.

Without looking at me Julia HCA slips the cuff of the Blood Pressure machine onto my arm. She says firmly “Don’t talk or move while the machine is working.”

She turns away to the counter and gets busy opening the requisite needle pack, card tray and plastic tubes that drawing blood will require.

I don’t move or talk. I’m feeling the pressure. I stare at the PAID FOOT CARE leaflet stuck to the wall...

The blood pressure machine stops whirring and the cuff begins to deflate. Julia HCA scribbles on her pad. She does not offer a comment on her scribbling. I ask what the figures mean. It’s a little over the target. I refrain from suggesting why that might be.

And so the fun bit. Drawing the blood. Today is better. Julia HCA has had 18months more practice. Today only takes three “small prick” attempts and a weary “oh come on” sigh before finally stabbing a vein (in frustration?) and rich dark red fluid flowing forth. I experience a combination of deep relief she does not need to stab me again, gratitude that she has improved, and disappointment that I will not get to see Diabetic Nurse Susan.

So just two large cotton balls taped to my arms this visit. off, pockets emptied and I stand on the scales. Julia HCA tells me my weight in kilos which i have also read from the digital window. Julia HCA goes to the computer. Silence is broken with a “oh 2016 is the last time we weighed you...”.

We both agree that’s bullshit - my words not hers. But Julia HCA cannot tell me how much I have lost since my last visit because its not on the screen. I’m disappointed but resist voicing my internal “for fucks sake”.

Shoes on in silence. Slipping jacket on I thank Julia HCA. Nothing much more to say. Completing her computer screen box-ticking Julia says “Goodbye, see you in 6 months time”. I leave. I realise that throughout this entire clinical process Julia HCA and I have not made eye contact. Not once.

The questions begin as I walk home. (I’m lucky not needing to travel far). Where is Diabetic Nurse Susan? If Julia HCA is replacing her with her skills as the conduit twixt me and computer screen database what is Diabetic Nurse Susan doing? Is she next door doing very important computer work? Is she being a “Martini Nurse” - out and about putting ‘right care in the right place at the right time’ into the community? Or perhaps she’s at a Clinical Commissioning Group or Sustainability & Transformation Partnership meeting offering her valuable clinical expertise towards integrated accounts packages?

This is my experience of the modern NHS GP surgery. I don’t doubt there are good people in them still. But this experience has been faceless with no sense of a relationship, connection or purpose between me and the care professionals - those who once were praised and rewarded for their personal human interaction skills but now are forced to fit the machine of the “health economy” which is one more American idealogical phrase that has crept into our NHS. Scary article warning: PwC New Health Economy in an age of Disruption

Disruption is about right. My relationship with Diabetic Nurse Susan has been disrupted. Ended probably. I have no personal connection now between my sense of looking after myself (Preventative Care - what the NHS claims healthcare is all about) and a healthcare professional who actually gives a shit. Doctors have been warning about the dangers of destroying the doctor/patient relationship since 2012 - the Year of NHS Disruption

Disrupting patients and staff, denying proper human interaction and replacing it with a computer screen or an app only creates an apathy in me that gives rise to me being a patient who doesn't really give a shit either.

Can’t blame Julia HCA. She must know she’s cheaper and not respected in the scheme of things.

Can’t blame my Diabetic Nurse Susan. She’s off somewhere no doubt trying to be integrated and keep her job afloat.

Blame the GP surgery? They’re struggling to find staff on limited funds, under yet more pressure from NHS England to join the new, ultimately faceless, Super Hubs which are supposed to cover 30-50,000 population areas. Even though there is little evidence to prove they will lead to better healthcare.

I can definitely blame NHS England and NHS Improvement along with numerous other business busybodies like the Kings Fund, Nuffield Trust and Health Foundation who with their research studies are “wreckless driving” this inhuman new model of care that will produce better financial outcomes for company shareholders but will not produce better healthcare for patients - not here or anywhere.

It’s been a busy week with new job and campaign admin. I have yet to catch up with all the fuss and nonsense of the new NHS Long Term Plan. Part of me feels there is no point in reading the f**king thing. More of the same as the last bastard 5 Year Forward View plan that has laid the foundations for this “new model of care” we are seeing not so much evolve but explode (disruption don’t forget) inside our NHS.

Why are we allowing Simon Stevens, Chris Ham and others to adopt the Accountable Care Organisation healthcare model following the American model of care when it is universally recognised as being just a bit crap (utter shite) and "based on faulty assumptions, poor economics, and junk science"

This is just one reason why 999 Call for the NHS are continuing our fight in the courts. We have to keep fighting for a healthcare system that is human based, focused and managed. Not a corporate money making machine where patients and doctors are just faceless cogs in the economic machine.


By 999 Call for the NHS, Apr 22 2016 09:26AM

Investigating is Tricky
Investigating is Tricky

We began NHS Detectives as a bit of a joke late in 2015. In a way it was something creative and "fun" to relieve the relentless onslaught of awful news we were being bombarded with from NHS England, NHS Confederation, NHS Employers, NHS QUEST, NHS Providers - the list just goes on and on. That's not even close to the daily news we recieve from local hospital campaign groups who are fighting desperately to keep their services in place.

Our work to "Connect.Organise.Inspire" has been arduous but it's working. Campaign groups are now in touch with one another and we have encouraged this from the very start. We always dreamed that people would fight locally because that is vital - but they would understand that their local situation was a duplication of exactly what was happening across the country. A&E's downgraded, Maternity Wards moved due to safety, Paediatrics the same... all part of the national pattern of wilful destruction of the NHS by Simon Stevens' Five Year Forward View. A rather glamorous "caring sharing" sounding document that set out a plan to rescue and "transform" the NHS that was fast becoming unsustainable and suffering a crisis of monumental proportions.

Simon Stevens, former Blair advisor, former President (9years) of Global Strategy with American private-for-profit health corporation United Health, Simon Stevens who lobbied in Washington DC to pressure the TransAtlantic Trade & Investment Partnership... Simon Stevens the boss, CEO of NHS England as of 2014... Simon Stevens became our first case. THe case is now open again and the NHS Detectives are re-examining the evidence. Simon Stevens is not the saviour of a broken NHS. He is the designer of the coffin.

Next came an exercise in mapping the private companies (THE MAP). Twitterers and FB'rs sent in info and we began to build a map. It's a bit rough round the edges. It became a huge task. (If anyone is interested in helping to continue building let us know.) But even after only one week of building it began to provide a fearful picture of just how far we have let our NHS be eaten into by private companies - not just in providing services, that is not the real problem. The real deathknoll for our public NHS is the strategic position many of these companies have squeezed themsleves into. They are now advisors, support, managers, planning and strategy formulators working quite happily with Simon Stevens' 5YFV (catchy title).

It works just like breaking up a company - too big to take over all at once, break it up into pieces then take over each of those little bits. THEN - here comes the clever bit.... tell us all what's needed is "joined up care" , "integrated care" that the division between all the NHS Trusts, Foundation Trusts, the Providers, the Commissioners is in need of cleaner, safer, smoother process and it can be fixed by making it more connected, more integrated - sort of the way it used to be twenty five years ago only this time with the private companies inside the fabric, inside the net we always thought was there for our safety.

Clever. Break it up. Move in. Take over. Stick it back together with few new Acute Care models thrown in, close or downgrade the hospitals and services that you dont want as they won't make any money, drag charities in to do the "face" damage (no one likes to criticise a charity), and force communities to be more resilient. Clever.

All the while campaigners struggle with the mindboggling question. Are these corporate business types evil people who have nothing in their heads but the right hand column of the accountsl spreadsheet? Or are they misguided in their belief that they are doing the right thing to help our nation stay healthy? Stupid? Evil? That's the question.

Stupid or duplicitous?
Stupid or duplicitous?

The more you investigate the more that question grows and the overriding feeling that there must be an awful lot of confused, mentally conflicted individuals who, even now whilst you are reading this, are sitting in meetings sitting politiely listening to a speaker rabbiting on about Improvement, Care, Quality, Future Health and Transformation, Sustainability. The evil process of privatisation we fight is complex, multi-faceted and in places subtle and ethereal. It's imbued in designer graphics, photographs of arthritic pensioners, mainstream media stories of NHS Staff unable to cope, pamphlets, patients groups, and good people doing good things... Like the Health Foundation who can criticise a charity who want better health?

We call it the 4Point Click. 1 - Go to a site. 2 - About Us. 3 - Governance 4 - Board/NonExec and there these evil twisted mentally conflicted individuals sit, usually smiling at you in a way that is chilling. Give it a go. Follow the link below. Try the 4 point click. Let us know what you start to dig up.

Your Mission if you wish to accept it... CLUE - McKinsey

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