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“You Are Watching the Power of Music Changing Brain Chemistry”

Published by Anonymous (not verified) on Fri, 27/05/2022 - 6:00pm in

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Health, aging, Health, Music

This story originally appeared in Rotary magazine, the official publication of Rotary International, a service organization with 1.4 million members around the world. For more information, visit Rotary.org.

Carol Rosenstein was watching her husband, Irwin, slip away inch by inch. At one time he had been a brilliant lawyer, a lover of Broadway musicals, a world traveler. But after his diagnosis of Parkinson’s disease in 2006, he developed dementia, and slowly everything changed. His gait flattened to a shuffle. The sparkle in his eyes turned into a blank stare. His mood soured. Worsening matters, the medications he took caused hallucinations and extreme agitation. As communication grew more challenging, Carol felt the distance between them growing.

Irwin and Carol Rosenstein

Then, in 2014, something happened. Irwin, who had been a gifted pianist since childhood, sat down at the piano and began to play.  As his fingers floated through American classics like “Fly Me to the Moon,” “What a Wonderful World,” and “Try to Remember,” Carol saw his posture straighten. The sparkle returned to his eyes. The husband she once knew came back, bit by bit, if only briefly. “I could see this human being resurrect and start to reconnect with his environment,” she says, “just like I had given him a dose of medication.” 

Mystified, she called his neurologist and asked what was happening. “He said, ‘Carol, you are watching the power of music, changing brain chemistry.’” 

That statement would go on to change not only their lives but the lives of countless others.

Music, it turns out, is medicine for the mind.

While it’s tempting to search for a woo-woo reason why music resonates with us so deeply, it’s not necessary. For people like Concetta Tomaino, the effects can be explained by science and logic — even if there’s still a lot to learn. “I think I went past that magical, mysterious piece a long time ago,” she laughs. Tomaino is one of the pioneers in this area; she has been researching how music affects all aspects of neurologic function for more than 40 years. To her, the impact of music on the mind and body demonstrates how much of our makeup as human beings is based on rhythm, resonance, and perception, all of which connect us in a fundamental way to who we are. “Everything in the world is a vibration of some kind,” she says. “Music is an extension of who we are, and that’s why it helps us reach people who seem to be disconnected because of illness or a traumatic brain injury.”

oliver sacksOliver Sacks in 2009. Credit: Steve Jurvetson / Flickr

Tomaino spent decades as a music therapist, pursuing evidence-based research around music and the brain before volumes of such literature existed. In 1980, she began working at Beth Abraham Hospital (now Beth Abraham Center) in the Bronx, New York, where she first met the consulting neurologist Oliver Sacks. By then Sacks had already written Awakenings, an autobiographical book (and later a movie) about a group of encephalitis lethargica patients frozen in trancelike states, whom he “awakened” using a new drug, along with music.

Like Tomaino, Sacks was extremely interested in understanding more about the potential impact of music on patients. In 1995, the two co-founded the Institute for Music and Neurologic Function, where Tomaino remains the executive director, to better understand the ways that music helps people with neurological problems to move better and remember more.

Sacks, a legend who wrote many books on his patients’ neurological experiences, including Musicophilia, which delves into the effects of music, passed away in 2015. His words on the topic remain as evocative and poetic today as when he spoke them in 1991 before the U.S. Senate’s Special Committee on Aging: “Though the nervous system is sometimes compared to a computer, I think it is much more like an orchestra or a symphony. I think we are musical through and through, from the lowest levels of rhythm in our nerve cells to the highest levels. There is a vast range of neurological disorders in which this inner music is impaired, and all of these can be transformed by the healing power of music.”

“Though the nervous system is sometimes compared to a computer, I think it is much more like an orchestra or a symphony.”

Music has a way of worming into the brain, whether it’s jingles you can’t forget or songs that really resonate. They’re tied to strong, emotional moments and experiences in your own autobiography. And they’re not just stored in one area of the brain. Rather, Tomaino says they’re ingrained in the more fundamental mechanisms of brain processing. In other words, the music that we love actually becomes a part of who we are. 

Because of that, when we hear those old, meaningful tunes even a half-century later, they stimulate multiple areas and networks of the brain — including areas that are relatively unharmed by a disease like dementia — and those long-ago memories resurface. That’s why a person with memory impairment may not recall their daughter’s name but may remember all the lyrics to her favorite lullaby. “It’s pulling from emotions, it’s pulling from feelings, it’s pulling from interpersonal associations, it’s pulling from a date or time or period of one’s life — historical things,” Tomaino says. Music serves as a clue, coaxing the brain to fill in the blanks. 

After her call with the neurologist, Carol Rosenstein began to wonder: If music could help her husband return to himself, even briefly, what could it do for others? She grabbed her Rolodex, told Irwin’s story to her friends in L.A., and invited other “like-minded” people to a night of making music together at a studio space in a private school.

About 30 people showed up. While most of them made small talk, Irwin and three other men, all of whom had neurological conditions, made a beeline for different instruments. A man with Parkinson’s sat at the drums. Another, with Alzheimer’s, settled in at the piano. A third, who no longer spoke, pulled a harmonica out of the breast pocket of his jacket. Irwin gravitated toward the saxophone, an instrument he had played in his college marching band. They didn’t converse, and they didn’t need to. As they started to play, music became their shared language.

“These four strangers became like soulmates in a sandbox,” Carol recalls. “Instead of buckets, shovels, and spades, they had musical instruments, and this was their second childhood. They found each other, they used the music, they bonded.”

Credit: Music Mends Minds

Since its humble beginnings in 2014, Music Mends Minds has expanded with more than 20 bands around the globe.

Carol was so eager to keep the quartet’s energy going that she formed a band, called The 5th Dementia, and launched a nonprofit called Music Mends Minds. The band’s “core four” grew to more than two dozen members and met regularly at Brentwood Presbyterian Church. Local and then national media got wind of it, and, in 2015, a story about The 5th Dementia aired on PBS NewsHour. 

Since its humble beginnings in 2014, Music Mends Minds has expanded with more than 20 bands around the globe. (Most of the bands are now meeting virtually because of the pandemic, and are led by a music therapist.) In 2018, CNN named Carol one of its CNN Heroes. 

A band student participates in The 5th Dementia flagship band’s intergenerational platform. Credit: Music Mends Minds

Carol Rosenstein saw more and more scenes that reinforced the power of music: people who couldn’t remember their own names crooning Frank Sinatra; men and women who barely talked, playing instruments; older adults pushing aside their walkers to dance. She also learned more about the science behind it, thanks to such academics as Michael Thaut, a professor of music and neuroscience at the University of Toronto who is now on the advisory board of Music Mends Minds. Thaut has been researching how music affects the brains of people with Alzheimer’s in hopes of pinpointing ways to improve their lives. He says that scientists aren’t sure what causes Alzheimer’s, which is the most common type of dementia, and that while medications may treat some symptoms, there is no cure.

When a person has Alzheimer’s, the proteins in their brain don’t function normally, and that leads to the death of brain cells. A person in the early stages of Alzheimer’s may forget words or repeat questions. In the end stages, they may experience delusions and forget how to do even the most basic tasks, like eating or walking. According to the U.S. Centers for Disease Control and Prevention, as many as 5.8 million Americans have Alzheimer’s. By 2060, that number is expected to nearly triple. 

In a study published in the Journal of Alzheimer’s Disease in 2021, Thaut and other researchers set out to see what happens in the brain when a person with mild cognitive impairment or early Alzheimer’s disease listens to their favorite playlist for an hour every day for three weeks. At the beginning and end of the study, the 14 participants had brain scans and took neuropsychological tests that involved memory exercises.

“When you drive these networks on a regular basis, you exercise those networks, and then the connectivity within these networks becomes stronger again.”

To Thaut’s surprise, at the end of the trial the participants showed a small but statistically significant improvement in memory — something that is extremely unusual in people with Alzheimer’s or any type of dementia. Close examination of the brain scans revealed visible changes. Most notably, Thaut saw that measurable new connections had formed between different regions of the brain — highways, if you will, that actually changed brain plasticity and also improved function in relaying information. Thaut says the research shows that while music is in no way a cure for Alzheimer’s, it can provide a “cognitive boost.” 

But not all music has the same impact. In another study published in 2020, Thaut and his colleagues compared brain activation when study participants listened to two different types of music: music that dated back at least 25 years, and music that was new to them. What they found was that the different types of music activated different parts of the brain. With new music, brain activity appears limited to mostly auditory processing, but not deep processing. Familiar music, however, stimulated more regions more significantly in a way that is deeply encoded in the brain. Those regions are associated with emotion, cognition, and autobiographical memory, and are minimally affected by early-stage Alzheimer’s. “This is one of the reasons, possibly, that some musical memories are preserved, because they’re encoded in such widely distributed regions,” Thaut says. “So the chance that some of the regions associated with music-based memories are preserved is just higher.”

While the “why” of it all isn’t yet fully known, Thaut says that mood and memory are closely connected, and networks of memories can become connected to mood “nodes.” He describes it as a kind of classical conditioning: You hear a certain song that was important in your past and you automatically think of a certain time or event connected to the music. When you listen to that music more frequently, it’s like a cognitive workout for the brain. “When you drive these networks on a regular basis,” Thaut says, “you exercise those networks, and then the connectivity within these networks becomes stronger again.” 

He was like a corpse under his blankets. Then his arms would start to come out of the covers, his knees would start to lift, and before you knew it, he was dancing with me.

When those who live with and care for people with diseases such as Alzheimer’s and Parkinson’s seek out music and musical groups to help their loved ones, they often find the experience benefits them, too. And there’s research to support that. 

For decades, Mary Mittelman, an epidemiologist who works at New York University as a researcher in the department of psychiatry, has been developing and studying social and psychological methods to help people with cognitive impairment and their family members. In 2011, curious about the impact of music, she started her own chorus, called The Unforgettables, to investigate what rehearsing and performing in a concert could do for participants. The initial chorus consisted of 22 people — 11 had memory impairment and 11 were their family caregivers. Mittelman’s published findings documented improvements in quality of life and communication not just for those with memory impairment but also for caregivers, who reported improved social support and self-esteem thanks to the chorus.

Anecdotes shared by the choral conductors stand out in Mittelman’s report. They saw couples holding hands and looking into each other’s eyes, “as though they were first dating.” They would joke around. Song lyrics would bring back memories and spark conversations. Beyond those observations, Mittelman remembers watching transformations among participants: Some would arrive grunting, agitated. They would leave speaking in full sentences, calm.

Irwin Rosenstein passed away in January 2021, 15 years after his diagnosis and seven years after rediscovering music. In those final days, Carol recalls, he could no longer speak and could not leave his bed or a wheelchair. His smile was a memory. He would look at his wife with a gaze that she refers to as the “Parkinson’s stare.” 

Unless, that is, there was music. 

All the way until the end, Carol made rhythm a part of their lives. As Irwin lay in bed, she would pick up two little egg-shaped shakers and play music and dance in front of him. “He was like a corpse under his blankets. Then his arms would start to come out of the covers, his knees would start to lift, and before you knew it, he was dancing with me,” she says, smiling through her tears. “That’s how we said goodbye, because his brain was so connected to the rhythm of the music when everything else was gone.”

Music could bring Irwin back to the moment, back to himself. It also brought him back to Carol. “It is painful to watch your beloved slip away inch by inch,” she says. “And if it weren’t for the music, I wouldn’t be sitting here today. As a caregiver and first responder, I can tell you, I would have never survived the journey.”

The post “You Are Watching the Power of Music Changing Brain Chemistry” appeared first on Reasons to be Cheerful.

The Ignored Long COVID Crisis

Published by Anonymous (not verified) on Thu, 26/05/2022 - 6:45pm in

The Bank of England has warned of COVID-related labour shortages in Britain, but why aren’t we taking its long-term effects more seriously? Sasha Baker investigates

It was September 2020. Lisa had been unable to work due to Long COVID for the entire summer. She was attempting to return to her job as an executive assistant but it was making her symptoms worse. She could often feel her heart racing. One day she collapsed on the kitchen floor, struggling to breathe.

“I was there for about an hour before I could get the strength to even find my phone and make a call,” she said. She was taken to hospital in an ambulance but returned home that evening without a clinical explanation for the day’s events.

The 40-year-old from London had always been career-driven – but now she could think of little but her health. “I went to bed for about a six-week period thinking I was going to die every night,” she told Byline Times.

Even the smallest tasks were insurmountable. One morning, a flat tyre meant that Lisa had to walk her youngest son to school. It was a short walk – scarcely a kilometre – but the nine-year-old raced ahead as she struggled to keep up. “He kept turning round and saying, 'mummy, I’m so sorry you have to walk’,” she recalled.

Quitting her job seemed to be the only option. A few months later, feeling slightly better, Lisa took a civil service role below her skill level. It meant a £10,000 pay cut but she found the job easy and it would ensure financial security if she needed to take time off. As it turned out, she was signed off for most of the following five months.

There are an estimated 1.8 million people in the UK living with Long COVID and the number is rising rapidly. The Bank of England warned last week that the condition is contributing to labour shortages, with an estimated 320,000 chronically ill people dropping out of the workforce before retirement age.

Some – known as ‘long-haulers’ – have been unwell since the early days of the Coronavirus pandemic with little to no respite from the debilitating exhaustion, brain fog, chronic pain and trouble breathing associated with the condition. Many are unable to work.

Throughout the crisis, the advice to people with COVID-19 has been to return to normal activities as soon as they are feeling better – but many Long COVID sufferers blame returning to work too quickly for the severity of their illness.

Dr Asad Khan, 46, is a respiratory consultant for the NHS in Manchester who went back to work for three days after a bout of acute COVID-19, which is when his Long COVID symptoms started.

Dr Khan has been unable to practice for the past 18 months because of severe illness. He used to love cycling and swimming but now says that he “can barely go to the corner shop”.

Dr Deepti Gurdasani, an epidemiologist and senior lecturer at Queen Mary, University of London, has been raising the alarm about Long COVID throughout the pandemic. According to her research, and the published research of other groups, “consistently what you find is that being able to rest when you have persistent [COVID] symptoms correlates with recovery”. She has also noted that the illness is occupational, with those in health, social care and teaching most likely to be unwell.

Long COVID patients also struggle to access disability benefits.

Dr Khan has applied for personal independence payments (PIP), a non-means-tested benefit to help disabled people with the extra costs of managing their condition, but was initially denied. He has asked the Department for Work and Pensions (DWP) to reconsider his case, but the process involves writing a “long, complicated letter, which with fatigue and cognitive issues is not easy.” While he is waiting to hear, he is relying on money from his parents.

The DWP has recorded only 1,600 PIP decisions relating to people with Long COVID, with half of that number being awarded payments. Figures for decisions before March 2021 are not recorded as COVID-related and some without a formal diagnosis may also not be counted.

The Government also does not collect figures on the number of people with Long COVID claiming Universal Credit.

Herd Immunity

Workplaces vary in how they treat people with Long COVID.

NHS workers are meant to be protected because COVID-related sickness absences are not subject to usual policies, but these are not applied consistently. 

Emma, 44, is a clinical coder for the NHS in Bristol, but has not been able to work since the start of the pandemic. “I haven’t been hit financially but I did really have to fight to get my illness recognised as COVID-related,” she said.

COVID tests were not yet in widespread circulation when she fell ill so there was no way to confirm her diagnosis. Her employer moved to dismiss her because of her illness.

“When they were talking about sacking me I’d only been off for like three months,” said Emma. “I’d had no referrals. I had no idea what was going on.”

She has been allowed to continue on full pay, though she worries that the NHS will one day stop paying COVID-19 long-haulers.

For those in the private sector, there are no such protections.

Sy, 44, is a former call-centre worker and DJ from Leeds who has experienced debilitating Long COVID symptoms for two years. He has been claiming Universal Credit for most of that time, after no longer being to claim statutory sick pay.

“My workplace actually tried to take me down the road to a disciplinary for not being at work” he said. He appealed the decision and won in May 2021 but when his workplace tried again that August, he “didn’t have anything left to give” and had to accept the disciplinary procedures.

For some, claiming benefits is simply not an option.

Wil, 23, is a Dutch student in Bristol who has been struggling to juggle her degree with the 10 hours of work she is legally allowed to undertake each week, while managing her Long COVID symptoms. “My student loan just covers my rent and my tuition so if I didn’t work I wouldn’t be able to eat,” she said.

For most of this year, Wil worked 10 hours a week in a pizzeria, which used up practically all of her energy. “My attendance was below 30% in the first semester because I just couldn’t bring myself to walk 15 minutes to campus,” she said.

She has learned to manage her energy well enough to complete her degree, spending an hour or two in the morning and evening writing her dissertation with a long nap in the middle of the day. Now she is about to graduate, Wil is ineligible for benefits, having not contributed enough national insurance in her three years as a student in the UK.

She is moving in with her partner, which will help with rent, but she is struggling to find full-time work that won’t worsen her illness. Anything physically demanding is out of the question but there are other considerations.

“I also can’t really do an office job because screens and reading aggravate my symptoms,” said Wil, whose Long COVID is currently manifesting as a months-long migraine. She needs to find ways to work, but without significant accommodations from future employers that will be a challenge.

The extent of the impact of Long COVID on the economy is still to be seen, but the country has not adapted to meet the needs of those suffering from the illness or taken steps to prevent hundreds of thousands more from becoming disabled.

According to Dr Gurdasani, the Government’s approach to the pandemic has made the spread of Long COVID inevitable.

“There’s never been a focus on reducing transmission, which is what’s needed to prevent Long COVID, and I suspect that’s very political,” she said. “I think the reasons for ignoring Long COVID and minimising it have been because doing so normalises the Government’s strategy.”

This article was produced by the Byline Intelligence Team – a collaborative investigative project formed by Byline Times with The Citizens. If you would like to find out more about the Intelligence Team and how to fund its work, click on the button below.

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Could Whistleblowing Become Big Business?

Published by Anonymous (not verified) on Wed, 25/05/2022 - 8:22pm in

While some campaigners want to bring in a US 'bounty' system for whistleblowing, others warn this could create a tiered system that leaves vulnerable people in the cold. Sian Norris reports

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As pictures emerge of Boris wielding a glass of booze, and junior Whitehall staff speak to the BBC about a party culture in Number 10, whistleblowers are more important than ever. Without them, the scandal of Partygate may never have emerged.

But a new Bill to protect whistleblowers has been criticised by some campaigners for potentially opening the door to a US-style corporatisation of whistleblowing.

The bill, which was introduced to the House by Mary Robinson, a Conservative MP and Chair of the Whistleblowing APPG, recommended the UK sets up an independent, US-style Office of the Whistleblower, “to make whistleblowing work properly and safely for everyone”. The bill was not, in the end, taken forward.

Concerns have been raised that the office would be expected to “report back to the Government”, something which campaigners say would undermine independence and sink whistleblowers who want to shine a light on public services and Government misbehaviour. 

WhistleBlowersUK, which provides the secretariat for the APPG, told Byline Times that the “independent Office of the Whistleblower will only report trends and serious concerns directly to the Government – not individual cases”. 

Campaigners also believe the new bill could be a trojan horse for money-making firms seeking to ape a US ‘bounty’ style approach to whistleblowing.

A report from the APPG, and published in the run-up to the bill, states “the issue of financial incentivisation has been discussed with experts in the UK and abroad who concluded that it was time for the UK to introduce some form of reward scheme” for those who blow the whistle on bad behaviour.

The report continued: “after careful consideration by the APPG it concluded that this should be a matter for the Office of the Whistleblower to decide”. It committed to carrying out further research on whether financial rewards for whistleblowing should be introduced. WhistleblowersUK told Byline Times it “stands by its commitment that all whistleblowers should be properly recognised and compensated where appropriate”. 

The APPG’s secretariat was at one point sponsored by Constantine Cannon – a US-based law firm which opened a London office in 2017 and, according to a report in the New York Times, “has long sought to persuade the British authorities to offer rewards to whistle-blowers”.

“I’ve never met a genuine whistleblower who is pro-bounty,” said Eileen Chubb, who set up the whistleblower’s charity Compassion In Care. “It will make millions for the compliance industry and for the legal industry. People will get rich off such a policy – except the most vulnerable whistleblowers”.

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Financial Rewards

In the US, whistleblowing is big business thanks to the Dodd-Frank Act, with those who report bad behaviour receiving financial rewards – as do their lawyers. Individuals who blew the whistle on the banking firm JP & Morgan received a massive $30 million remuneration for their actions.  

“Most whistleblowers don’t speak up because they want money,” explained Dr Minh Alexander, a former NHS doctor who now campaigns for better protections for whistleblowers. “They are motivated by acting in the public interest”.

Those who support financial rewards for whistleblowers argue that it helps to ensure those who expose wrongdoing are better protected. The penalties suffered by whistleblowers has, in part, led to a worrying decline in people coming forward to report their employers – while reports of harassment of whistleblowers has increased.

But critics have raised multiple issues with the bounty system – particularly when it comes to blowing the whistle on the public sector. The first is that financial rewards for whistleblowing risk contradicting the Nolan principles of selflessness, neutrality and the need for public servants to avoid any conflict of interest or actions motivated by personal gain. Bounties could therefore undermine public trust in whistleblowers. 

Further, following various scandals in health and social care, one of the contractual obligations on NHS staff is to raise concerns if they see them in the workplace. It therefore creates a potential conflict of interest if staff are receiving an additional financial reward for fulfilling part of their job description.

“The question that we think that the public are asking is why are whistleblowers across any sector, especially the NHS, being subjected to unacceptable retaliation which encompasses, victimisation, penalties, harassment, bullying and being silenced for fulfilling their contractual obligations” a spokesperson from Whistleblowers UK told Byline Times. “The Bill will address retaliation and incentivise positive responses to whistleblowers across every sector”.

The bounty model is accused of making it harder for whistleblowers who want to expose wrongdoing in the public sector, where there is little hope of big financial returns. Those blowing the whistle on issues that won’t provide a financial benefit to lawyers and governments “won’t get as much attention as they are not as profitable,” said Chubb. 

“We have been contacted by whistleblowers in the US who are raising issues about abuse and a whole variety of issues,” Chubb told Byline Times. “But unless they are exposing something that will save the government money, such as tax evasion or financial fraud, they don’t want to know. So you end up with a two-tiered system where a few hundred people get big rewards and the majority are ignored”. 

“The way the bounty system works,” Dr Alexander explains, “is that a disclosure has to net monies above a certain ceiling in order for the whistleblower and its legal representative to qualify for a cut of the monies retrieved. But if your case is not about money – say you are in the social care sector and it’s about abuse – you aren’t going to hit that threshold and the law firms won’t retrieve the money and so they won't be interested in representing you”. 

As such, the bounty system risks making it harder for whistleblowers in the public sector to get the support they need to hold power to account. 

Financial Ties

The secretariat for the APPG on Whistleblowing is the not-for-profit WhistleblowersUK, which argues that “actions that benefit society should be encouraged and recognised by way of financial compensation, and other forms of recognition, separate from that awarded by the tribunals”. It added that “the amount can be determined by the Office of the Whistleblower”, should the office be created by the bill.  

In 2018/19, the APPG was sponsored by US law firm Constantine Cannon LLP, which declared that it paid WhistleblowersUK between £13,501 and £15,000 to provide the secretariat. WhistleBlowersUK told Byline Times: “We comply fully with the rules set out by the Parliamentary Commissioner for standards”. 

Constantine Cannon set up its London office to represent the increasing number of whistleblowers living outside the US but who can use the US whistleblower reward programmes. In practice, this means UK citizens blowing the whistle on US organisations; alerting the US Government to fraud schemes that cross international borders; or that occur on foreign soil have ripple effects which then reverberate in the US. 

Since 2019, Constantine Cannon has not been listed on the APPG register as providing sponsorship. WhistleblowersUK provides an in kind benefit to the APPG of between £21,001 - £22,000. A part-time employee of the organisation also works part-time for Mary Robinson.  

The CEO of WhistleblowersUK, Georgina Halford-Hall, is listed in Liberal Democrat Peer Baroness Kramer’s register of members’ staff interests as holding a remunerated position. 

“I have been overwhelmed by the positive and enthusiastic response to the Whistleblowing Bill, which extends comprehensive and inclusive protection to every citizen who is, or is, perceived to be a whistleblower, or is in anyway related to a whistleblower,” Mary Robinson told Byline Times.

“The Whistleblowing Bill seeks to set up an Office of the Whistleblower, which will champion whistleblowers and whistleblowing. It will be one central hub that sets and monitors standards, and has far reaching powers to investigate allegations and apply meaningful sanctions and penalties to those who fail to comply with the new obligations and award compensation including uncapped damages to whistleblowers who suffer harm and loss. This Bill has been designed to be fair to every citizen and incentivise positive behaviour”.

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Government Ignored High-Level Monkeypox Warnings as UK Health Security Agency Ranked Threat ‘Very Low’

Published by Anonymous (not verified) on Tue, 24/05/2022 - 10:23pm in

TJ Coles explores how the Government has reacted to months of alerts about the growing Monkeypox threat

In recent days, the World Health Organisation has warned that 80 cases of Monkeypox – a viral disease first discovered 60 years ago – was present in 11, non-endemic countries; meaning countries with populations who have no immunity to the virus.

At the time of writing, the most recent statement from the UK Health Security Agency (UKHSA) puts the number of infected UK residents at 20.

Health and Social Care Secretary Sajid Javid recently confirmed that the Government has procured more doses of Smallpox vaccines in an effort to prepare against further Monkeypox spread.

But documents seen by Byline Times show that international health and security experts had anticipated an outbreak of the virus last November – even predicting the month (May) in which the virus was likely to spread.

Despite this, the UKHSA just last month rated the threat of Monkeypox as “very low”. 

The UKHSA – launched in April 2021 – got off to a bumpy start, with professional papers decrying the agency’s lack of structural clarity and clear chain of responsibility.

More recently, as it underestimated the Monkeypox threat, industry publications noted that the UKHSA announced plans to cut 40% of its workforce – some 800 staff. Department of Health and Social Care (DHSC) officer, Jawad Raza, tweeted: “Staff morale is indeed very low and this process isn’t being handled well, experienced staff are now looking to move elsewhere.”

According to the US Centers for Disease Control and Prevention (CDC), Monkeypox belongs to the Orthopoxvirus genus of the Poxviridae family, which includes variola virus; the same that causes Smallpox. It was first discovered in 1958 in caged, lab animals, which are often a reservoir for diseases.

The first human cases were reported in 1970 in what is now the Democratic Republic of Congo. Since then, the virus has spread to neighbouring African countries and is endemic. Human travel and animal importation have, historically, been two factors that have spread the virus to the West, which lacks immunisation.

Generally less severe than Smallpox but apparently deadlier than COVID-19, according to the CDC, symptoms can last up to one month and include rashes, swollen lymph nodes, fever, headache, and exhaustion.

Animal-to-human transmission can occur from bites and scratches, while human-to-human transmission can result from close contact with infected persons via the respiratory tract, mucous membranes, and open skin. 

The Nuclear Threat Initiative is a think tank that deals with the eponymous issue of biological events, as well as disarmament and proliferation studies for biological and chemical weapons and agents. Its members include former US Secretary of Energy Ernest Moniz, the media giant Ted Turner, and former US Food and Drug Administration commissioner Margaret Hamburg. Britain’s own former Foreign Secretary Malcolm Rifkind is also on the board of directors.

In a speculative exercise by the Nuclear Threat Initiative, a Monkeypox outbreak begins on 15 May 2022 in a fictional country, infecting more than 1,400 people and killing four. There were “no international warnings or advisories”. By the following January, 1.3 million are dead as the virus becomes vaccine-resistant. The Monkeypox “was caused by a terrorist attack using a pathogen engineered in a laboratory with inadequate biosafety and biosecurity provisions and weak oversight”. Three billion are infected and 270 million die.

The fictional disaster highlighted the need for better detection systems, closure of national preparedness gaps, and more financing for biosecurity.

Institutional Inaction

Despite the high-profile nature of the organisations involved in planning and publishing the report, the Government appears to have taken no action beyond existing, under-funded monitoring programmes.

As it stands, just 19 results are returned when typing “Monkeypox” into the gov.uk website. The earliest mention of it is from September 2018, when Public Health England (PHE) identified and isolated three individuals diagnosed with the virus. Also in that year, Porton Down research laboratories reported their apparent success in developing at least one Monkeypox vaccine candidate and three therapeutics. What is not confirmed, however, is how much money the Government spent perfecting the vaccine to obtain a license or if the vaccine is already licensed.

In January 2019, PHE also listed Monkeypox as present in the UK, spread by rats, along with dozens of other zoonotic diseases. After SARS-CoV-2 struck, PHE later reported its new infectious disease strategy to tackle, among other things, Monkeypox.

But within a year, then Health and Social Care Secretary Matt Hancock announced plans to scrap PHE and merge it into a new body called National Institute for Health Protection. The Government’s November 2020 policy paper, ‘UK Pandemic Preparedness’, merely lists Monkeypox in the context of the Government boasting about previous success stories.

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A March 2021 statement on the new UK Health Security Agency doesn’t mention the body’s role in detecting and combating Monkeypox, but rather that the director, Dr Jenny Harries, has prior experience tackling the virus.

Back in 2008, New Labour’s UK National Security Strategy (NSS) warned of an inevitable pandemic. It said “the highest risk is an influenza-type pandemic, like the outbreak in 1918 which killed 228,000 people in the UK and an estimated 20-40 million worldwide".

It added that “experts agree that there is a high probability of a pandemic occurring – and that, as the SARS (severe acute respiratory syndrome) outbreak [in 2003] showed, the speed at which it could spread has increased with globalisation”.

The NSS concluded that “a pandemic could cause fatalities in the UK in the range 50,000 to 750,000, although both the timing and the impact are impossible to predict exactly”.

Instead of taking the warnings seriously, successive Conservative governments have undermined public health organisations.

The Health and Social Care Act 2012 further fragmented and privatised the NHS. In 2013, the British Medical Association (BMA) provided evidence to the House of Commons that “the fragmented nature of the new health system will require that each organisation... [is] aware of the plans in place to deal with potential outbreaks of ill health, such as pandemic flu or legionnaires disease”.

The BMA warned that “the Health and Social Care Act 2012 is not clear on these lines of responsibility. As such, it is possible that different areas of the country will develop different ways of dealing with outbreaks”.

It concluded that this will be "problematic for those organisations that have a national role and who will therefore have to tailor their responses to local plans. This could lead to inefficiency, duplication of effort and ultimately put lives at risk”.

This is exactly what happened when COVID-19 struck – and it could yet happen again.

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Asylum Seekers Held in Hotels Struggling With Food-Related Poor Health, Report Finds

Published by Anonymous (not verified) on Thu, 19/05/2022 - 7:28pm in

The Independent Chief Inspector of Borders and Immigration raises concerns about housing people seeking asylum in temporary accommodation

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A report into hotel accommodation for people seeking asylum found residents suffering from poor nutrition and diet, leading to new presentations of type 2 diabetes in young patients, poorly controlled type 1 and type 2 diabetes resulting in hospital admissions for diabetic ketoacidosis. 

It added that children are missing development milestones because of problems with nutrition. and are failing to thrive. 

Third sector organisations told inspectors that people seeking asylum and housed in hotels were also demonstrating obesity and raised BMI, pre-diabetes and poor mental wellbeing, iron deficiency anaemia, B12 and Folate deficiencies, Vitamin D deficiencies.

The health challenges undermine the Home Secretary Priti Patel’s claim that people seeking asylum risk dangerous journeys across the Channel because they want to stay in hotels.

The report was compiled by the Independent Chief Inspector of Borders and Immigration (ICIBI). The inspectorate’s future is under threat after Patel instigated an independent review into the quango, as part of a push to slim down the number of public bodies.

The Chief Inspector looked at hotel accommodation for people seeking asylum between May 2021 and November 2021. It found that by November, a total of 21,500 people were housed in 181 hotels, double the number than in May. The contracts for those providing accommodation had a combined value of £4.5 billion over 10 years. People in hotel accommodation receive food and essentials, as well as an £8 weekly allowance.

Due to widespread understanding that long-term hotel accommodation for people seeking asylum is not ideal, the Home Office had set a target to end hotel accommodation by May 2021. The inspector explained that “we found little credible evidence that the target to end the use of hotels as asylum accommodation by May 2021 would be met; 12 months later nobody believes the revised target of March 2022 is achievable”. 

It added that “a clear understanding of the situation which allows the creation of an effective strategy is an essential first step to tackling the huge challenges the Home Office faces”. 

"All families should have access to the food and housing needed to live healthy and secure lives," Interim Director of Joint Council for the Welfare of Immigrants Paola Uccellari told Byline Times. "Yet this Government continues to house people in unsuitable hotels for months and months, where poor, innutritious meals are putting children’s health at risk. What we’re seeing is heart-breaking - children being driven into hospital because this Government has denied them a healthy diet".

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Faulty Towers

While the inspector’s report acknowledges it is difficult to provide food in hotel accommodation that everyone would enjoy, interviews with third-sector organisations supporting residents raise the alarm on the health impact of a poor diet.

One response to the inspector explained how the hotel food was often “high in carbohydrates and low in vitamin content”. This led to people presenting with health conditions directly relating to poor nutrition, including type 2 diabetes, constipation and various vitamin deficiencies. People already living with diabetes were struggling to control their condition. 

The inspector also found that food was not always appropriate for children and babies, including food that was “overly spicy” and “unsuitable for children”. As such, they were “failing to thrive” and missing developmental milestones. Families were turning to food banks to ensure their children had enough to eat.

Other issues raised were the lack of culturally appropriate food, a lack of choice, and the disempowerment of not being able to cook for oneself. The report did note, however, that “menus that were on display at the sites appeared to be well balanced and showed that food options were rotated to create variety”. 85% of properties offered specialist meals, and 81% showed that different dietary needs were considered.   

Alongside the physical health impacts, inspectors were informed that people housed in hotels often struggled with the emotional impact of living in limbo – waiting to be moved from temporary accommodation to ‘dispersed accommodation’ such as a flat or a house. 

People housed in hotels told inspectors that the biggest challenge was “never knowing how long they will be in” the accommodation; that they are “worried” about how long they will be expected to stay before moving to a home; and that living in hotels is “not normal life”. 

This view was echoed by the accommodation providers, with one staff member telling the inspector that hotels are “not suitable for more than three months, especially for families”. 

While the pandemic had an impact on length of stay, even after restrictions were lifted the pace of moving people out of hotel accommodation and into flats or houses “continued to be slow”. One provider told the inspectors that “the problem isn’t with the place the people are in, it’s that we have to use hotels and it takes longer than it should to move them on”. 

Other issues raised in the report related to a lack of training for hotel staff, a lack of data sharing, and an unclear process when it came to setting up new sites for housing people seeking asylum. 

One stakeholder told the inspector: “Typically, no meetings between the Home Office and its contractors and local authorities were held to determine whether the health, wellbeing and social care needs of the households could be met at the locations in question before bookings of hotel rooms were made and placement of asylum seeker families undertaken”.

"It’s clear that Priti Patel’s asylum policy is failing families," said Uccellari. What we need are fair and fast asylum processes that allow people to live as part of our communities, get support, and move on with their lives".

In a statement published by the Home Office following the report’s publication, it accepted all the recommendations made by the ICIBI. A spokesperson told Byline Times: “The Chief Inspector positively concludes that asylum accommodation providers are delivering in line with contractual requirements. Work is already underway to address the report’s recommendations and reduce the use of hotels which are costing the taxpayer almost £5million a day. This includes creating a fairer asylum dispersal system and setting up reception centres as part of the New Plan for Immigration”. 

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Your Money and Your Life: Private Equity Blasts Ethical Boundaries of American Medicine

Published by Anonymous (not verified) on Thu, 19/05/2022 - 4:29am in

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Health

In a harrowing new book, scholar Laura Katz Olson pulls back the curtain on a shadowy Wall Street threat that is taking over health care companies – and preying on human lives.

Newsflash: Private equity firms– the most rapacious entities ever spawned by Wall Street -- want your body.

They’re already in your urinary tract and your fallopian tubes. In your dentist’s chair and your dermatologist’s office. Unbeknownst to you, these financiers track you from cradle to grave, lining their pockets through everything from fertility treatments to hospice care, all the while decimating the quality of services you receive and jacking up prices.

Kids, the elderly, and the poor are especially tasty targets in their break-neck hunt for profits. They’re even coming for your pets.

In her harrowing new book, Ethically Challenged: Private Equity Storms US Health Care, political scientist Laura Katz Olson documents how private equity firms are reshaping health care in the U.S., circling in to buy dentist offices, mental health facilities, autism treatment centers, rehab facilities, physician staffing services, and myriad other providers, forcing them into bare-bones, bottom-lined focused “care”.

Once upon a time, it was stores like Toys ‘R Us that learned what happens when billionaire-run PE firms fix companies in their sights. Now, the harm they do is about more than bankruptcies and lost jobs. It’s a matter of life and death.

In a nutshell, PE seeks to invest or acquire equity ownership in companies and flip them fast for a higher price. They’ll get that higher price by any means necessary – chopping staff, cutting corners, and loading the company with debt along the way. The idea is to buy, squeeze, dump, repeat. Private equity is now a major player in the health care sector, with investments accelerated in recent years at a mind-blowing pace ($100 billion in capital invested in 2018 alone).

So how do these motives and operations line up with health care? Let’s see … how would you like to send your loved one to a rehab facility where successful treatment would be considered a failure because they want the patient to come back?

As Olson documents, that’s how perverse things get. She notes that in order to gin up business, PE firms taking over rehab centers will resort to a tactic known as “body brokering” – having companies pay intermediaries to lure patients in by trolling on social media, hanging out at 12-step meetings, and spinning fancy marketing campaigns. If the (often unscientific) treatments don’t work, score one for private equity! Owners aren’t liable for ineffective treatments, Olson points out, “so when patients relapse they can charge them another round.” Meanwhile, they abuse eligibility for federal payments, soaking up taxpayer funds meant to fight human tragedies like the opioid scourge.

Some of the worst players in this frightening game of human health roulette have likely already set up shop in your town. Bain Capital (hi, Mitt Romney!) swoops in on renal care, home health care, substance abuse, emergency medical transport, and hospitals. The Carlyle Group goes for dentistry, home health care, hospice, and eating disorders. KKR, one of the biggest players in the health care industry, targets physician staffing, emergency medical transport, dentistry, home health care, substance abuse, autism disorders, health information, and hospitals.

As usual, it all goes back to the 1980s, when financialization took hold of the American economy. Olson observes that private equity has been growing ever since, boosted by lax regulation and preferential tax treatment. Politicians and regulators grease the wheels of the gravy train in hopes of hopping aboard the minute they leave office. Private equity often gushes campaign contributions, and both parties enjoy the largesse. Never mind that PE bilks taxpayers through Medicare and Medicaid, making medical bills more burdensome and patients sicker.

“PE firms take over businesses using other people’s money; plunder what they can, and spit out the remains,” writes Olson. And sadly, it’s public pensions that feed the hungry beast. She notes that pension funds, along with endowments and wealthy individuals, finance the largest percentage of PE deals. This means that workers are invested in the very business model that wrecks their jobs – and now, their health.

“Private equity’s business model is neoliberalism on steroids,” declares Olson. It’s the profit motive over everything – most assuredly over human life. And there’s hardly a whiff of accountability: “private equity lives in a darkly curtained world, protected from external scrutiny,” she writes.

It's like the black hole of capitalism, into which every positive human value vanishes into oblivion.

This is real. This is happening. And as Olson warns, it’s just getting started.

The Institute for New Economic Thinking (INET) has focused on the alarming trend of private equity buying health care providers and taking them private through research by Eileen Appelbaum and Rosemary Batt, and detailed the encroachment of private equity into emergency rooms in a series of articles over the pandemic. INET’s Thomas Ferguson and colleagues Paul Jorgensen and Jie Chen have also focused attention on private equity’s political contributions. Now, Laura Katz Olson shares her perspective with INET on how we got to this dangerous place and what we can do to get out of it.

Lynn Parramore: We all remember Mitt Romney telling us during his presidential campaign that private equity firms like Bain Capital are good for society, saving failing companies and creating jobs. What didn’t Mitt tell us? How is the public perception skewed?

Laura Katz Olson: There are a few private equity firms that specialize in buying distressed firms -- sometimes they buy businesses decimated by other PE firms just to milk what’s left. But in reality, most of them buy up flourishing companies. The results usually aren’t very good for society.

LP: How do they make money buying well-functioning companies?

LKO: The first way is to put high debt on the company and have the company pay it off. PE firms generally aren’t putting in more than 2% in equity themselves. Maybe 28% or so comes from their limited partners, like public pension funds. When the PE firm sells the company, the debt has been paid off by the company but the PE firm gets 20% of the money, having put very little in.

The second way is to charge the company all kinds of enormous fees – transaction fees, monitoring fees, annual management fees, consulting fees, advisory fees, servicing fees. The PE firms siphon a great deal of money in fees both from the company and from their limited partners, like the pensions.

The third way, becoming more popular recently, is to take special dividends called “dividend recaps.” The company has to take on even more debt to pay these dividend recaps. The PE firms share a little bit of the money with limited partners but they pocket most of it. And it’s a lot of money – PE took in $58 billion this way in 2021.

Just think about all this debt and all this money going into the PE firm’s pockets! The company is stuck paying off the debt, so it has to increase the cash flow any way it can. It all makes me think of that old medical practice of bloodletting. PE just drains the company and weakens it, at times driving it into bankruptcy.

Private equity firms used to take huge conglomerates and tear them apart to sell off the parts because the parts were worth far more than the whole. Today what they do is the opposite – they take a small piece that’s well-functioning, like a flourishing dental practice, and they add more and more dental practices to it -- consolidating. They’re especially interested in niches that are not consolidated. After they consolidate for three or four years, they sell it in a secondary LBO [leveraged buyout], and after that, they’re selling it to a third, on and on.

LP: It seems like a neat trick to extract so much money from a company and at the same time build its market worth for resale. How do they manage it?

LKO: Consolidating is one of the main ways they do it now. Instead of the parts being worth more than the whole, the sum is worth more than the parts. They put all this debt on the company and then squeeze it. When you’re talking about services like home care or hospice care, it’s the front-line staff that will get squeezed. They cut the workforce, so you have fewer workers per patient. You lower the qualifications for the staff so you can get cheaper labor. You have fewer physicians because they’re expensive. You have less training and supervision. You overbook – you get a kind of production line going. For products, you use cheaper materials. You skimp on medical supplies, etc.

In the case of dermatology, we’ve seen unnecessary treatments being pushed, as well as untrained people who may not know, for example, how to spot cancer. Dentistry has had an especially egregious history -- and some companies known for abuses, like the chain Aspen Dental, are still around. It’s incredible.

LP: Private equity firms like to claim that they are maximizing efficiency and controlling costs, but it looks like what they’re really doing is pushing shoddy services and products at higher prices.

LKO: That’s right.

LP: What happens to patients when they get into the hands of a health care provider under pressure from private equity? What else can go wrong beyond getting poorly trained staff?

LKO: Well, you have to worry about getting lured into procedures you don’t need. I’ve heard of dental offices where children were put in straight jackets and teeth were pulled that didn’t need to be pulled. Elderly people have been given unnecessary dental work. I’m particularly offended by what goes on in hospice care. You have people dying and Medicare is paying for them to have a dignified, quiet death. Instead, they are neglected as these PE firms are profiteering. Children with autism are being harmed, too. Autism is an easy target for profiteering because there’s a shortage of practitioners and you’re free to do whatever treatment you want and call it standard treatment. There’s so much that goes wrong. These are just a few examples.

LP: As you’re pointing out, children and the elderly are especially vulnerable to the harm done by the intrusion of private equity into medicine. How are the poor affected?

LKO: If you go through all of these areas of health care, Medicaid is paying a significant percentage. The poor are very vulnerable. Minorities are also vulnerable.

LP: And the taxpayers?

LKO: Taxpayers get hit hard by the Medicare and Medicaid costs. Medicaid is the second-largest item on every state budget and around the fifth largest item on the federal budget. Medicare, for example, is the major payer for hospice services.

LP: How is this allowed to go on? Why isn’t anybody in government doing anything about it?

LKO: I would have to argue – I’m trying to think how to put it – this is not a partisan issue. The Democrats and the Republicans both take advantage of it. They go back and forth between private equity and top government positions, like secretaries of defense and secretaries of state. It’s so lucrative. Even presidents. George H.W. Bush was involved—he went to a private equity firm.

LP: We’re talking about big money here, as you say. In your book, you mention that the heads of the six main listed PE firms are among the topmost earners in the U.S. right now.

LKO. It's very big money. A significant percentage of our billionaires now come from private equity. They make far more money than investment bankers.

LP: Let’s talk about how this money is working its way through the political system. What most concerns you?

LKO: You have the lobbying and the campaign donations, of course. But the larger issue in my view is the revolving door. If government officials come down hard on private equity, that would preclude them from joining the PE firms when they leave the Biden administration, for example. It just keeps anybody from being interested in this, with a few exceptions like Elizabeth Warren. Such a lack of interest!

One thing that has to be looked at is how the public pension funds are invested in private equity. That is steadily increasing, and it means that PE is getting more and more money. They are now going to appeal to retail so that the general public can put in money. And the more money they get, the more they have to spend, and the more health care facilities and practices they buy.

LP: So this problem is metastasizing as we speak, to use a term from medicine.

LKO: Yes. That’s a good word.

LP: How does a regular person know if private equity has gotten involved in their health care? Are there any telltale signs?

LKO: You have to ask. It’s difficult to know. Many of these chains have separate names for each of their businesses so they are hard to identify. Often I’ve noticed that the facilities have nice, shiny nice buildings, like the rehab centers, for example. They’re gorgeous.

LP: Let’s talk about this involvement of private equity in rehab and mental health facilities. It seems that PE contributes to the distress in our society – and then turns right around and profits from that distress. How are patients faring in these facilities?

LKO: Not very well. Look at the rehab facilities – one thing they tend to have in common is that people who have alcohol or drug problems usually have other issues, too. But the facilities taken over by PE tend not to have other kinds of specialists. They focus on one thing and don’t look at the co-existing issues. The staff tends to be less trained. It’s all the things we’ve talked about. They use techniques and treatments without scientific backing. One of the techniques is using horses. Look, horses are wonderful. I love horses. But there’s no proof that horse therapy can treat drug or alcohol abuse!

LP: Sounds like there’s not much oversight on the efficacy of treatments.

LKO: It’s a problem with private equity in general. They tend to pick areas that have very little oversight.

LP: Private equity is even getting into pet care, as I understand it.

LKO: I haven’t studied it specifically, but I belong to groups and I see things coming in about pet facilities that are very concerning. PetSmart, for example, is reported to have some serious issues. Animals are reportedly being killed and abused.

LP: Is there any case that you’ve seen in which private equity makes medicine better?

LKO: No, I haven’t. Private equity argues that one of the best things they do is make more services available in scarce markets. Well, certainly they do make more services available, as in the case of autism services. But is it better to have more low-quality services than none at all? Experts will tell you that low-quality autism services are pretty damaging to the child.

LP: Does private equity belong in medicine at all? Should it be banned?

LKO: This is something I didn’t put in my book, but the conclusion I have come to is yes, we have to ban it. We really need to prohibit, I think, the corporate practice of medicine, period. If you look at the private equity playbook, its only goal is to make outsized profits – they can’t make ordinary profits. If they make ordinary, respectable profits, their investors will go somewhere else because of the risk.

Private equity doesn’t care whether the product is Roto-Rooter or hospice. That’s one of the major differences between PE and a regular company, which may care about the community, the reputation of the company, and the quality of the product. They want to keep their customers. They care about the future. But private equity doesn’t work like that. Because private equity often aims to sell a company after four or five months, they don’t care about the future. They don’t care about the product at all. Private equity is antithetical to our health care system.

So yes, we need to ban private equity from health care. But given that it’s not going to happen, I would say that we need to prohibit the corporate practice of medicine – anybody can make a case for that. You can eliminate their tax advantages. You can limit the debt imposed on companies, especially in the health sector. You could easily control consolidation and monopolies in the health sector. You could use specific anti-trust laws. I would definitely forbid investment by retail customers such as their 401(k)s. I would forbid non-disclosure and non-disparagement agreements, which make it so difficult to obtain information. I had such a hard time interviewing people. When I could get people to talk to me – and that was really hard -- they were extraordinarily careful. I would also prohibit “stealth branding” – where the PE firm buys a chain, like a dental chain, but gives each office its own name, like Marilyn’s Happy Dental Care. It’s very deceptive.

LP: It’s interesting that PE players and firms don’t tend to be household names. They’ve really managed to fly under the radar. Can you mention a few that came up a lot in your research? Folks to look out for?

LKO: Bain Capital, the PE company that Mitt Romney still profits from, is one. The Carlyle Group has really been involved in recruiting high-ranking people from the government – one of its co-founders, David Rubenstein, served as Deputy Assistant to the President for Domestic Policy during the Carter administration. George H.W. Bush became a senior member of its Asia advisory, and so on. KKR, of course, is one of the biggest. They control a lot in health care.

I’m concerned that as PE gets more and more money – with these pension funds, and especially if they get their hands into the 401(k)s – they’re just going to keep buying up anything and everything. And it’s not just health care. More and more of these firms are appearing and getting into more and more industries. As young people, or even older people involved in the well-established financial firms, realize how much money is involved, they just start a PE firm. Look at Jared Kushner [Affinity Partners]. It’s a very worrisome situation.

If I were the Minister for Health

Published by Anonymous (not verified) on Wed, 18/05/2022 - 4:57am in

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Health, Politics

I would progressively wind back and eliminate the $14b pa taxpayer subsidy for Private Health Insurance and use that very large sum to fund the inclusion of dental care within Medicare and increase the funding to the states for expanded specialist services in outpatient clinics at public hospitals. The inequity and inefficiency of Private Health Continue reading »

New Report Challenges Media Mockery of NHS Translation Services

Published by Anonymous (not verified) on Tue, 17/05/2022 - 11:41pm in

Public spending on translation and interpreter services was reviled by the anti-migrant media. But new figures show the real extent of spending and need, reports Sian Norris

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Spend on translation and interpretation makes up an average of 0.057% of an NHS Trust’s total expenses, Byline Times and the Byline Intelligence Team can exclusively reveal, challenging a media narrative which has previously accused the NHS of wasting money on translation services.

A new report, published by Inbox Translation and shared with this paper, found that total NHS spending on translation and interpreting services for Trusts and Health Boards in the UK was £65,962,418 in 2019/2020 – this included British Sign Language, braille and Welsh language materials.

The report authors understand there was a 20.1% drop in spending in 2020/21, based on a small set of sample data. This may be linked to the pandemic.

The Inbox Translation report was designed to put right misconceptions about translation and interpretation services in the NHS, updating data released a decade ago in the 20/20 Health Report. 

That first report was greeted with shock and horror by a British media that criticised “ridiculous” sums of money being spent on “helping immigrants who can’t speak English”.

The new report’s authors sought to challenge the media narrative that expressed outrage at money being spent on making healthcare accessible to people for whom English is not their first language. It did this by breaking down the spend on interpreters, braille and British Sign Language interpreters, and written translated materials. 

Of the money spent, they found the vast majority went on interpretation services, which made up 84.8% of the total spend. 13% of spending went on British Sign Language interpreters. In contrast, only 2.2% of the total was spent on translated materials. 

Despite this low percentage, the 20/20 Health Report had recommended that Trusts could save money on translation services by using Google Translate instead of professional services. However, this new data reveals that such a move would fail to make savings, seeing as written translations only make up a small fraction of money spent to make medical services accessible. 

This article was produced by the Byline Intelligence Team – a collaborative investigative project formed by Byline Times with The Citizens. If you would like to find out more about the Intelligence Team and how to fund its work, click on the button below.

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Challenging the Media

The 2012 report failed to separate out spending on interpreters and translated materials, leading to problems with understanding exactly what was being spent on what when it came to making healthcare accessible. Instead, the right-wing press complained that a “staggering £59,000 a day” was spent on translations across the public sector – rather than recognising that much of this money was likely used to pay interpreters.

Outraged media reports claimed money was being wasted on translating written materials for patients for whom English is not a first language. 

The Daily Express called it “ridiculous” to spend “£100 million on translators for 128 languages in six years”; while the Daily Mail referred to “shock figures”. The £100 million referred to translation spends from police, hospitals and councils. The paper led with the message: “how you pay £100 million a year to aid immigrants who can’t speak English”. 

“This is despite repeated Government attempts to save money and improve social cohesion by making new arrivals take English tests, and by telling councils not to waste money on translating leaflets”. The Government cut ESOL services – designed to teach English to migrant people – by 60% between 2010-16, reducing funding from £203 million to £90 million

The Daily Mail continued: “critics said that, at a time when budgets are being slashed by the Government, key public services can ill afford to spend millions of pounds to help immigrants who have not learned English”.

The narrative suggested that migrant people who struggled with English should somehow be penalised by the public sector.

“There were three main reasons for doing this research: lack of recent, reliable data on the topic, biased reporting from the media – which always use words like shocking, wasteful, staggering when talking about the amounts spent on translation and interpreting – and personal interest in the area of medical translation and interpreting, though all the work we do is for private companies or individuals,” said Alina Cincan, who authored the report. 

Fair and Inclusive

Despite press accusations that spending money on translation and interpretation services is “ridiculous”, ensuring people have access to healthcare is a human rights issue.

Translations and interpreters help to create fair and accessible public services so that everyone can get the information and treatment they need when they are sick. 

Research published in the Oman Medical Health Journal into language barriers and healthcare found that “language barriers are responsible for reducing the satisfaction of medical providers and patients, as well as the quality of healthcare delivery and patient safety”. This causes health disparities in patient outcomes.

Little wonder then that 2015 data from the Office for National Statistics found that poor levels of English led to poor health – only two-thirds (65%) of people who could not speak English well or at all were in good health, compared with nearly nine in 10 (88%) who could speak English very well or well. The researchers suggested this “may be due to lower proficiency in English making it difficult for people to access suitable healthcare, which may have a longer term impact on health”.

As such, making healthcare accessible to non-English speakers is vital to ensuring equity in health outcomes, no matter what someone’s first language is. 

“A person's health should never be put at risk by asking someone untrained to interpret,” Cincan said. “Family and friends may not understand or know the correct terminology, and they also may be tempted to gloss over or even omit some unpleasant details in order not to cause upset. Having professionals handle this is, plain and simple, vital, nothing more and nothing less. When people's lives are at stake, no risk is worth taking”.

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The erosion of Medicare

Published by Anonymous (not verified) on Mon, 16/05/2022 - 4:52am in

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Health, Politics

Large out-of-pocket costs for specialist consultations driven by inadequate indexations are undermining Medicare. When Medicare was introduced in 1984 – replicating the key features of Medibank as it operated in 1975-76 – the policy intention was clear: access to health services by Australians should not be restricted by capacity to pay. As Dr Neal Blewett Continue reading »

When is the Conservative poverty handbook being published?

Published by Anonymous (not verified) on Sun, 15/05/2022 - 6:48pm in

The Tory MP Lee Anderson has recently opined that producing a meal for 30p a head is perfectly possible. Though clearly not for him. He supports a government who spent £37 billion to manage test and trace but somehow that wasn’t enough to make it work. So having continued to support that government in relentless... Read more

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