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999 Call for the NHS

A grassroots NHS campaign. Not affiliated to any of the political parties.

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By Jenny Shepherd, Mar 7 2019 06:09PM


999 Call for the NHS is urging everyone to write to their MP to support NHS EDM #2013 which is an Early Day Motion called a “Prayer” Motion. It’s the only type of motion that can annul and stop secondary legislation.


This is urgent because the Department of Health has “quietly” introduced secondary legislation, in the form of a Statutory Instrument, to make major changes to NHS regulations that will damage the way in which GP/Primary Care and Commissioning works - and of course it will not benefit patients or staff.


We are asking MPs to use parliamentary procedure to call this legislation into question and annul the Statutory Instrument


Please visit our Prayer Motion page to find a LETTER TO MY MP template and more information. This is urgent we have until March 24th to get this annulled. It can be done.



Secondary legislation? What the Duck is all that about then?


In the light of raised eyebrows and lots of questions since we launched the Prayer Motion campaign - this blog post explains what secondary legislation is, when it was created and how it has been used and abused since it was introduced in the Statutory Instruments Act 1946.


The Parliament UK website says that:


Secondary legislation is law created by ministers (or other bodies) under powers given to them by an Act of Parliament - the Statutory Instruments Act 1946. It  is used to fill in the details of Acts (primary legislation). These details provide practical measures that enable the  law to be enforced and operate in daily life. 


Most secondary legislation is created, 'made and laid' as a Statutory Instrument.


Statutory Instruments (SI) were intended as a device to allow Ministers to make minor updates and amend existing Bills without bothering the House of Commons (or indeed any part of parliament) - allowing ministers to deal with localised and/or minor issues and changes to law without time-wasting debates in the Commons.


That’s the theory. The practice seems to be a bit different.





THE BIG CONCERN


The theory sounds like common sense, sort of... Until you notice the sharp upward trend in the use of Statutory Instruments through the Thatcher Years, into New Labour and the last ten years of this thing we call ‘Austerity’ government.


The red lines in the table below show a huge disparity between the number of actual ACTS (Primary Legislation passed in the Commons & Lords) and the number of Statutory Instruments.






By and large, because of the way they are made (the Negative Procedure), Statutory Instruments are only seen by ministerial committees. This means there is NO opposition oversight of or input into these legislative changes. In the case of this Statutory Instrument - it is not even required to have even nominal scrutiny by the cross-party-house Joint Committee of Statutory Instruments (Select Committee).


What’s the point of having Parliamentary opposition if it can’t oppose? To use the Mainstream Media’s classic line “where's the balance?” One party state, anyone?



Latest figures on the number of SI’s passing through unseen? The House of Commons Background Paper on Statutory Instruments (2016) says:


In the region of 3,500 SIs are made each year. Many SIs are not subject to any parliamentary procedure, and simply become law on the date stated. Whether they are subject to parliamentary procedure, and if so which one, is determined by the parent Act.


On top of this,look at the size of these Statutory Instruments. Given the number of pages, can they really contain only minor amendments and non-vital pieces of policy making?





According to Bracknell: “Statutory Instruments vary enormously in their scope from substantial pieces of legislation to considerable numbers of orders temporarily restricting traffic on particular local roads.”

The full easy-to-read Bracknell report is here: https://vdocuments.site/acts-and-statutory-instruments.html


So we have to ask - are Statutory Instruments now a way of changing Acts and regulations without Parliamentary debate and proper scrutiny?


If so much paperwork filled with items, appendices and addendums is passing through the corridors of parliament unseen by most MPs and Lords, is it any wonder that we are crying out “Democracy? What Democracy?”


This concern applies with a vengeance to Statutory Instrument 2019 No.248 The Amendments Relating to the Provision of Integrated Care Regulations 2019. It contains pages and pages of guff.


You can see for yourself - and pay special attention to PART 9 & 10.



It's a good job there is an Explanatory Memorandum to SI 2019#248 - be warned it’s uncomfortable reading but at least it’s in an English most MPs and members of the public can understand - if they were given the chance to read it of course.






If you haven't already please help make this happen. Don't be confused by Parliamentary Procedure.


Write to your MP from our Prayer Motion Page


Many thanks.












By Jenny Shepherd, 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. Now...shoes 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.


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