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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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Prescription Spend on Heart Disease Increases by Half a Billion in Four Years

Published by Anonymous (not verified) on Tue, 10/05/2022 - 9:05pm in

The amount spent on prescriptions for atrial fibrillation conditions has increased by 129.6% since 2016

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The NHS spend on drugs used to treat some cardiovascular illnesses has risen by nearly half a billion pounds since 2016. 

The increase follows an update in the National Institute for Clinical Excellence for Atrial Fibrillation Diagnosis and Management (NICE AF) in 2014 which recommended healthcare workers use a wider range of novel oral anticoagulants to treat heart disease. 

Data from the British National Formulary, which offers information and advice on medical prescriptions and treatments, and analysed by the Byline Intelligence Team, has revealed that the spend on anticoagulants and protamine treatments for cardiovascular disease increased to more than £742 million in 2020 from £299 million in 2016 – or by 129.6%.

Already, the 2016 figures represented an increase from £84 million in 2014, when the NICE AF guidelines were updated. 

Pre-2014, the NICE AF guidance encouraged doctors to prescribe warfarin for atrial fibrillation conditions. The guidance then switched to recommending healthcare professionals use alternatives to warfarin when treating cardiovascular disorders. NICE AF pointed to a range of novel oral anticoagulants (NOACs) such as apixaban, dabigatran etexilate and rivaroxaban as suitable options. 

Patients experiencing cardiovascular issues who take warfarin require regular monitoring, which can of course put pressure on primary care services. In contrast, the NOACs recommended in the updated NICE guidance do not require patients to have regular monitoring. It was also suggested that the updated list of drugs could be a better option for patients who struggled with dosage control.

The increase in spending on prescriptions for medicines treating cardiovascular disease is, in part, down to greater awareness of protecting patients living with atrial fibrillation. However, the NOACs listed in the guidance can cost up to three times the amount of warfarin, which also accounts for the rise in spend. 

Since the switch, the pharmaceutical companies manufacturing the new drugs have seen a significant uptick in their profits. Bayer, one of the main producers of rivaroxaban, declared a loss of £54 million in 2016. However, by 2019 its fortunes had turned around, with a profit of £60 million. In 2020 it declared a profit of £33 million.

Deaths from heart disease have decreased significantly in the past decade, although they still cause a quarter of all deaths in the UK.

At the start of the century, heart disease accounted for 503 deaths in every 100,000. By 2014, when the NICE AF guidance changed, it had nearly halved to 263 per 100,000. Since the guidance changed, death rates have remained relatively static: in 2020 heart disease made up 259 of every 100,000 deaths. 

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Although anticoagulant and protamine prescriptions saw the biggest price rises, other drug treatments have also seen above-inflation cost rises since 2016 – including treatments for hypertension and heart failure, which had risen by 39.59%. 

Antisecretory drug and mucosal protectants used to treat the gastro-intestinal system have increased in cost by 39.07% since 2016 to £180 million in 2020. Antisecretory drugs treat gastroesophageal reflux disease, which affects around five in 1,000 people in the UK. The costs of drugs used to treat diabetes increased by 12.09% between 2016 and 2020 – again, an above inflation rise.

The largest drop in NHS spending on prescriptions was for epilepsy, which went down by 46.54% between 2016-20, despite the number of people with a known diagnosis increasing over the past 14 years. 402,000 people with a known diagnosis of epilepsy in the UK in 2008/09, today it is over 600,000. Death rates have remained fairly stable: in 2014, 747 people died from causes related to epilepsy – a number that dropped to 743 in 2019. 

Pressures on Prescription Budgets 

Already in 2016, alarm bells were ringing that the rising spend on atrial fibrillation treatment was putting pressure on GP budgets.

GP Online reported how the move to prescribe NOACs as the first choice for patients diagnosed in hospitals was putting pressure on GPs’ prescribing budgets once the patient moved back into primary care.

Each GP practice is set a prescription budget by the clinical commissioning group (CCG) it sits under. CCGs are set to be replaced by new integrated care boards (ICBs), following the passing of the Health and Social Care Act last month. These boards will take over all commissioning responsibilities from the CCGs, including setting GP budgets. 

ICBs have faced criticism from NHS campaigners who have expressed concern that representatives from private healthcare interests can be invited to join the board and influence commissioning and budget decisions. 

The Byline Intelligence Team’s analysis comes at a time when GP surgeries and primary care services are already feeling the pressure when it comes to budgets. 

A £550 million cut to councils' public health grants between 2015/16 and 2019/20 left local authorities and GP practices struggling to meet demand and in 2019 it was reported that GP services were facing large funding deficits due to real-term cuts to NHS spending since 2010.

In 2020, the British Medical Association raised how GP services had endured a decade of under-investment and called for 11% of the NHS budget to be allocated to GPs – an additional £3.6 billion. In 2017, GPs received 8.1% of the NHS budget, excluding the reimbursement of drugs. This was a decrease from in 2005/06, when they received 9.6%. The Chancellor failed to pledge additional funding for GP services in his 2022 Spring Budget.

Additional reporting by Iain Overton

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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Further detail on the Crown Courts crisis

Published by Anonymous (not verified) on Tue, 12/04/2022 - 12:56am in

..Is contained in this good piece from the Secret Barrister, who picks up on the description by Justice Secretary, Dominic Raab, of the decision by the Criminal Bar association to suspend their goodwill in one area of work, as an “unnecessary and irresponsible strike”! As the article points out the government response to the courts... Read more

The NHS is failing and the only people to blame are the Tories

Published by Anonymous (not verified) on Mon, 11/04/2022 - 5:36pm in

The Guardian reports an interview with Dr Katherine Henderson, the president of the Royal College of Emergency Medicine this morning.

As she has noted, pressure in the NHS is now so severe that it is breaking its “basic agreement” with the public to treat the sickest in a timely way.

She also noted that the:

urgent and emergency care was in a “deeper crisis than ever before”, and for the first time in its history the NHS could no longer stick to its “contract” with the nation to promptly reach seriously ill patients who dial 999.

Her explanation was:

“The true barrier to tackling this crisis is political unwillingness,” Henderson said. “The current situation is breaking the workforce and breaking our hearts.”

Hospitals are facing record demand from patients coming forward after two years of the pandemic, while struggling to discharge patients because of the crisis in social care.

As a result, Henderson said, doctors are struggling to find any space for patients arriving at A&E. That is causing record delays in ambulances handing over patients, which is leading to waits of up to 22 hours for 999 callers.

At the same time, as reported in the Sunday Times yesterday, moves are being made to end the separation of patients with Covid from other patients within hospital. As one hospital consultant, who is utterly committed to it, noted as a result, this makes the H in NHS stand for Harm.

None of this, in my opinion, is the fault of an NHS employee. It is, instead, wholly the government's fault.

First, it has been utterly negligent on Covid. The Covid pandemic is not over. Covid is not endemic. More than 350 people dies of Covid in one day last week. Around one in 12 people in the country have it. The illness is serious with potential long term impacts for many that are massive. And some people are getting it successively, within weeks of bouts. Despite this the government has turned its back on this issue, pretending it does not exist, when the impact is enormous, as indicated by everything from failed flights onwards. Irresponsibility on this scale cannot be made up.

Second, it has deliberately under-resourced the NHS, knowing that there is excess demand for healthcare now and knowing that there is a need for staff morale to be raised.

Third, it is under-resourcing social care still and has no real plan to change that, in which case bed-blocking will continue and that is now causing crisis conditions in many hospitals.

Fourth, it has no plan of any sort to remedy this because all it wants to do is balance its budget, which is the last thing it needs to do and which is wholly unnecessary.

In other words, the whole NHS crisis is government manufactured, deliberately.

What is required to solve it?

First, it's the capacity to care.

Second, there has to be the willingness to use the power of government to redirect resources in society.

Third, there has to be the willingness to fund this, which does require new money creation.

Fourth, there has too to be the need to create the social conditions in which people can flourish, which requires redistribution of income and wealth.

Fifth, there must be the willingness to explain this, and get buy in.

Sixth, there is a need for commitment, which is wholly absent.

These are desperate times. There is no guarantee the NHS will survive this. And that is all down to choice by Tory governments.

The needs of people must prevail over myths of a duty to balance the books

Published by Anonymous (not verified) on Mon, 11/04/2022 - 1:39am in

Chancellor Rishi SunakImage by HM Treasury on Flickr. Creative Commons 2.0 license

“Any intelligent fool can make things bigger, more complex, and more violent. It takes a touch of genius — and a lot of courage to move in the opposite direction.”
E.F. Schumacher

 

Illusionists with their smoke and mirrors and monetary make-believe rule the roost. After the Chancellor spent big, doing only what a sovereign currency-issuing government can do to stop an economy from collapsing, the message now being promoted by that same Chancellor is that fiscal discipline must take precedence; that getting the public finances under control is vital to the future health of the economy, but noting at the same time, that his £30bn ‘fiscal headroom’ could be threatened by energy market volatility. Sunak, still in household budget mode, has also been clear that he is not prepared to sacrifice his fiscal target of keeping debt falling, supposedly to protect future generations from excessive tax burdens.

The nonsense keeps coming. Here we have it yet again. Sunak claiming that he’s got a difficult job divvying up scarce monetary resources when nothing could be further from the truth. Or suggesting that too much spending now will burden future taxpayers.  All this is artifice and trickery and represents self-imposed and unnecessary targets for the public finances, not monetary reality.

The reality is that it is only real resources, not monetary ones, that give life to and sustain an economy.  From people to the physical resources employed in providing the things that keep society functioning. That is what must be managed for the public purpose. And the only burden that will be faced by future generations will be the one caused by insufficient government spending today to ensure a productive and sustainable future tomorrow.

Others, like Boris Johnson, alluding to the household budget narrative of how government spends, said this week that he had no problem with raising National Insurance contributions to help fund the NHS. The banker from the Department of Health, backing up his leader, suggested similarly that this increase was both right and a fair way to fund it.

In the light of the Chancellor raising the NI threshold, after the rise had been sold to the public as being necessary to fund the NHS and social care, it reveals a simple truth. It demonstrates the nonsensical position that taxes (of any sort) fund spending. Since, according to the prevailing myths about how government spends, the Chancellor will now have to find the funds to make up the shortfall arising from raising the NI threshold, and begs the logical question, where will the money come from to plug the gap? The Guardian suggests that it will come from general taxation, and yet again, we have the media, unsurprisingly, pushing a defunct model of government spending.

The government will, instead, as it did for the banking crisis in 2008, and the pandemic, create it out of nothing, as it always does. Because, quite simply, taxes do not fund government spending. But of course, it is not in the interests of the powerful for the general public to know that – they might in Oliver Twist style, revolt and ask for more.

This tax will do nothing to fund the NHS or social care, or any of the other things being claimed for taxes as a whole. Furthermore, it is a regressive tax which, regardless of the threshold rise, will do nothing to help the low paid, as inflationary pressures bite and the cost of living rises, taking as it does, more from the poorest than from the wealthiest.

The government, Johnson said this week, has to do ‘difficult things, … take big decisions.’  Gosh!  Really? So, when pressed about the cost-of-living crisis he agreed that people would have to choose ‘cheaper food, old clothes and no heating.’   It seems that hurting the poorest, sickest, and most vulnerable in our society, whilst at the same time driving the economy further into the ground and affecting everyone, is the price we must pay for the government’s economic mismanagement.

What government chooses to impose further harm on those who have suffered the consequences of government policies over a decade by suggesting again that there is no alternative to austerity? What responsible government chooses book balancing over national economic well-being at a time of economic uncertainty? This is a government with its currency-issuing powers shifting avoidable pain onto a nation already burdened and facing worse to come. As Michael Marmot noted this week ‘Poverty is literally a matter of life and death for those on the margins, and the government has so far failed to step in.

And yet, the illusion of truth continues to keep the public blindfolded and compliant to the message that fiscal discipline trumps human well-being. When there is an alternative.

As a result of insufficient government support, recession, which will affect individuals and businesses alike, cannot be far behind. These are not the actions of a government that has the interests of its citizens at the forefront of its mind, or a functioning economy. Without sufficient spending support, the economy will shrink. As people have less in their pockets to spend, businesses will stop investing and reduce their inventories, unemployment will rise and living standards will continue to fall. It becomes a vicious circle. Many think tanks, even while they promote the household budget model of the state finances, acknowledge that the Chancellor’s actions or lack of them will cause further harm to the poorest.

Clearly, Government ministers have also been on the orthodox economics induction course. Sajid Javid, the Secretary for Health, fresh from his 101 class said this week:

“When we spend money on public services, whether it’s NHS or anything else, for that matter, the money can only come from two sources. You raise it directly for people today, that’s through taxes, or you borrow it, which essentially you are asking the next generation to pay for it.’

For forty years, Margaret Thatcher’s dictums have guided the spending policies of both the right and left of the political spectrum. Whilst the right wing pushes its fiscal discipline message (with jam tomorrow, maybe, possibly, let’s see), the left wing embraces a false narrative by talking incessantly about raising revenue to pay for its programmes from taxing the rich, or most recently imposing windfall taxes on the fossil fuel corporations that have exploited the current economic instability to increase profits and CEO pay. Whilst it was shocking to learn last month that the CEO of Shell took home a monstrous £6.1 million pay package, it doesn’t change the fact that such ‘windfall’ taxes would not fund anything, let alone provide better public services or a fairer distribution of wealth. Indeed, taxation has quite a different purpose.

And yet as corporations price gouge and rake in higher profits, as reported in the MMT Lens two weeks ago, the Resolution Foundation forecast that the fall in real incomes would push a further 1.3 million people in the UK into absolute poverty, including 500,000 children, bringing the total to 12.5 million. When we talk about the cost-of-living crisis, it fails to convey what this means to some of the poorest and most vulnerable who are having to choose between heating and eating, a situation which, in fact, preceded the pandemic and is evidenced by the huge growth in food banks. Austerity has a lot to answer for. It is the difference between a good life without want and living in fear of it.

The blame lies with a government that has not only had an empathy bypass but also plays the blame game by dividing workers into the deserving and undeserving. But worse still, it has deliberately chosen this path, when it has the fiscal tools to avoid it. Currently, we have a prime minister who thinks that there is no alternative to more suffering. Whatever happened to the concept of ‘levelling up?’ And this is before we factor into the picture the effects of climate change on the poorest, who without action, will pick up the real bill, whilst the rich continue to live off the fat of the land, while it lasts, at any rate.

While the human suffering continues by government choice, the climate crisis seems to have been displaced on the front pages by the war in Ukraine and the associated consequences related to rising prices and shortages of oil, gas, food, and other vital resources. But it hasn’t gone away. It is the elephant still stalking the room.

As the IPCC (the Intergovernmental Panel on Climate Change) published its third and final report this week which draws on the work of thousands of scientists, the Cabinet Minister Jacob Rees Mogg suggested that the government wanted to extract, ‘every last drop of oil and gas from the North Sea,’ saying that ‘2050 is a long way off’. He said that the profits of the fossil fuel companies had to be protected from the prospect of windfall taxes, so that they could invest in further North Sea drilling for oil and gas. So much for COP26 and any hope that we can avoid the worst effects of climate change. The political priorities are clear.

Antonio Guterres, the UN secretary-general said this week, Nations and corporations are not just turning a blind eye to planetary disaster but adding fuel to the flames,’ and added that ‘it is a file of shame, cataloguing the empty pledges that put us firmly on track towards an unliveable world.

We are in the last chance saloon, and yet, western style, neoliberal oriented governments, that put markets and profit above people and the planet, are fixated with economic development, and uncontrolled growth at whatever cost, not to mention ramping up the war machine with public money, to keep the distorted economic system going, and the profits rolling in.

Remind us from where the money is coming for that dead-end exercise? When Rishi Sunak cuts spending on public and social infrastructure or fails to support the economy with adequate spending to match the economic conditions, or indeed allocate sufficient funding for climate action, all predicated on the lie of monetary scarcity and paying back debt, there seems to be an endless porridge pot for arms and killing people. When so much is at stake shouldn’t the public be demanding answers at the gates of Parliament? Monetary reality is displayed in those choices.

The fancy rhetoric of COP26 has been short-lived, and the promises watered down or swept away if indeed it was ever intended to fulfil them. The corporate body, which includes the damaging fossil fuel industry, dictates its terms using its huge wealth, power and influence, and governments around the world cosily comply as politicians stand to gain through the revolving door.

As the former astrophysicist and climate scientist Peter Kalmus noted in a Guardian Op-Ed piece this week:

‘Earth breakdown is much worse than most people realise … The science indicates that as fossil fuels continue to heat our planet, everything we love is at risk. For me, one of the most horrific aspects of all this is the juxtaposition of present day and near-future climate disasters with the ‘business as usual’ occurring all around me.  It’s […] surreal.  If everyone could see what I see coming, society would switch into climate emergency mode and end fossil fuels in just a few years.’

 

Kalmus joined over 1000 other scientists protesting around the world about the lack of urgent action and was arrested for locking himself onto an entrance of JP Morgan Chase in Los Angeles. They warned that the IPPC’s report language had been ‘watered down at the behest of governments unwilling to rapidly phase out fossil fuels.’

If we are to act at all, it cannot be piecemeal. It cannot be left to individuals, communities, or businesses to do their bit, however committed, without an overarching strategy in place. It must start with government serving its citizens as the planner, legislator, and currency issuer, to address the climate crisis and deliver a just green transition. Everything that comes next stems from that. This government has so far abdicated its responsibilities.

Based on current conditions, it is depressing to realise that we might be waiting forever for that, or that what is delivered is a greenwashed world, based on the same toxic and unjust economic model. But never let it be said it was not possible to change the very basis upon which our society operates and where the power lies.

As David Graeber, co-author of the Dawn of Civilisation, and Five Thousand Years of Debt, wrote  just before he died:

“… the crisis we just experienced was waking from a dream, a confrontation with the actual reality of human life, which is that we are a collection of fragile beings taking care of one another, and that those who do the lion’s share of this care work that keeps us alive are overtaxed, underpaid, and daily humiliated, and that a very large proportion of the population don’t do anything at all but spin fantasies, extract rents, and generally get in the way of those who are making, fixing, moving, and transporting things, or tending to the needs of other living beings. It is imperative that we not slip back into a reality where all this makes some sort of inexplicable sense, the way senseless things so often do in dreams.”

 The pandemic opened our eyes to a different way of thinking and doing things.  We cannot turn our backs on it, facing as we are the next great crisis, climate change, which, coupled with the human dimension of already existing gruelling poverty and inequality can only get worse if we carry on as we are. We must grasp the moment and push for concrete action, not half-hearted promises that are designed to go nowhere. Understanding how governments really spend offers us the framework for that change.

 

 

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The post The needs of people must prevail over myths of a duty to balance the books appeared first on The Gower Initiative for Modern Money Studies.

Crises? What crises? Government still looks the other way

Published by Anonymous (not verified) on Sun, 10/04/2022 - 8:55pm in

More worrying news from our justice system and our hospital system. First the Criminal Bar Association is commencing action on Monday towards a measure of non co-operation with the court service, particularly when asked to accept cases at short notice: Government has failed to recognise the crisis in the court service despite delays of two... Read more

Covid conclusions – such as they are

Published by Anonymous (not verified) on Sat, 09/04/2022 - 6:48am in

This will, I think be controversial – as it should be – and is indeed for me. The video is made by a retired doctor, whose previous job was to train A&E nurses – and his teaching ability shows, for sure, in the video. The video is about 20 minutes and suggests that the vaccines... Read more

NHS Staff Face £50 a Month COVID Tests Simply to go to Work

Published by Anonymous (not verified) on Tue, 29/03/2022 - 7:00pm in

The end of free lateral flow tests will cost NHS staff extra cash each month – while councils warn that they need more funding to manage COVID-19 outbreaks and the poorest risk not being able to test at all

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NHS staff face monthly testing bills of up to £50 from 1 April, when the Government stops providing free lateral flow tests (LFTs) to the public, the NHS Confederation has warned.

While care home residents and staff, hospital patients and other vulnerable groups will be entitled to free tests, NHS frontline workers are not included on the list of those eligible.

As a result, nurses, doctors and other key healthcare workers may have to purchase their own LFTs to ensure they are safe to work – or risk infecting vulnerable patients. 

NHS England has said that its staff will be expected to report their test and trace results twice a week. 

This could mean staff having to pay £50 per month simply to go to work safely, at a time when the cost of living crisis and a below-inflation pay rise for nurses is squeezing staff incomes. On average, a nurse earns £33,000 per annum, although the starting salary is closer to £18,000.

Back in February, the NHS was promised specific details on testing protocol for staff. But, with days to go before the end of free testing, this still hasn’t materialised. 

Outside of the NHS, parents have also raised concerns about the affordability of testing school-age children once free testing ends.

One mother on Twitter shared how her child's school was asking families to test twice a week. For a family of four with two school-age children, this would mean having to replace a box of LFTs once a week, at the cost of £6. 

When some of the poorest families are struggling to make ends meet, this puts pressure on households on low incomes to do, what the Prime Minister Boris Johnson has called, “the right thing”. 

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Poorest at Risk

The end of free testing comes days after Chancellor Rishi Sunak’s Spring Statement, which has highlighted the impact of the ongoing cost of living crisis.

The failure to increase benefits in line with rising inflation has been much criticised by poverty charities, which have warned the poorest families will be hit hardest by Sunak’s policy announcements. 

Research from the Joseph Rowntree Foundation found that a further 600,000 households would be pulled into poverty by the announced changes. 

While Sunak raised the threshold for paying National Insurance, he had little to say to those who don’t or can’t work.

Tax giveaways disproportionately benefited the better off – with households in poverty set to lose £446 on average, compared to £288 for middle-income households.

According to the Resolution Foundation, seven in eight workers will be paying more income tax and National Insurance by 2024/25, with only earners on £49,100-£50,300 set to pay less income tax.

With so many families struggling to cover the most basic costs, and parents saying that they are going hungry in order to keep their children fed, the decision to charge for testing risks creating a tiered health system – those who can afford to test and isolate will, while those who can’t spare the £6 or more a week will be forced to risk their health and others. 

Public Health Forgotten

Beyond testing, local councils and public health leaders have raised the alarm that there was no mention in the Spring Statement about extending local outbreak management funding, as Coronavirus cases continue to rise. 

The Local Government Association – which represents councils in England and Wales –has warned that without a funding extension, councils will not have the capacity to tackle rising rates of community transmission, as well as combat the threat of future COVID-19 variants, due to a loss of relevant expertise.

Throughout the pandemic, the Government has provided £400 million in funding to local authorities to help them reduce the spread of Coronavirus and support public health in the community. The funding is set to end in the next week – along with free testing for the public – and the Government has not committed to a replacement. 

Thanks to the success of the vaccination programme, which has reduced the number of hospitalisations and deaths from the virus, any replacement funding would not need to be at the same levels as during the early phases of the pandemic. 

However, case rates of Coronavirus have soared over recent weeks, with 102,670 new cases recorded on 23 March, the second anniversary of the first lockdown. 

Councils are therefore hoping for support so that they can continue to tackle outbreaks in at-risk settings such as care homes, in an attempt to reduce hospitalisation rates.

Councillor David Fothergill, chair of the Local Government Association's wellbeing board, said: “There will need to be a continuing role for councils and their public health teams as we move to a new phase of this pandemic. Although this won’t require the same level of funding as the Government has provided so far, they will need ongoing funding support.

"With time running out, it is vitally important that the Government extends part of the Contain Outbreak Management Fund. This will allow councils to respond to new variants, tackle outbreaks in at-risk settings and recruit and retain vital public health staff."

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OBR Forecast Reveals Pressures on NHS Waiting Lists – and Casts Doubt on Chancellor’s Cash Promises

Published by Anonymous (not verified) on Fri, 25/03/2022 - 11:34pm in

Published in the minutes following the Chancellor's Spring Statement, the Office for Budget Responsibility's fiscal forecast raises alarm over post-pandemic health pressures

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The £13 billion a year for the NHS announced in the Chancellor's Autumn Budget last year comes at a time of “extraordinary pressure” for the health service, the Office for Budget Responsibility (OBR) has said.

In its Economic and Fiscal Outlook, published following Rishi Sunak’s Spring Statement this week, the OBR states that, while pandemic pressures have “eased somewhat”, the increase in funding promised by the Government “arrives at a time where several indicators point to intense pressures across the health service”.

The outlook was published on 23 March 2022, two years after the start of the first lockdown when people across England were told to stay at home and protect the NHS. 

The pressures on the NHS are most visible with increased waiting times, including an 100-fold increase on patients having to wait for more than a year for non-urgent care.

In 2019, of the 4.2 million people waiting for non-urgent care, only 0.1% had to wait longer than 52 weeks. As of December 2021, the waiting list had grown to 6.1 million with 5.1% waiting longer than a year.

At the same time, 31% patients in need of non-urgent care are waiting for 18-52 weeks, an increase from 13.2% in 2019. 

This has been exacerbated by staffing pressures, with vacancies in the NHS rising since the start of the pandemic to 22,900 in July 2021. Vacancies were at 15,900 in January 2019.

Even more concerning is that the numbers of people waiting for non-urgent, ‘elective’ care could be higher than estimated.

New referrals for non-urgent care dropped off at the start of the pandemic – in early 2020 there were just under 1.8 million referrals for non-urgent care, a number that reached a low of 500,000 in the first lockdown. The pre-pandemic average was around 1.5 million. 

As a result, there are fears that around 10 million people who might have otherwise come forward for treatment have yet to do so, risking a health crisis down the line. 

The Missing Millions

The Institute for Fiscal Studies (IFS) has modelled various scenarios on the impact of waiting lists should those patients come forward for treatment in the coming months. It found that, if as few as 30% approached the NHS for treatment, waiting lists would continue to increase until June 2023, when they peak at 7.4 million before returning to current levels in September 2024. 

Should 50% of patients come forward, waiting lists would reach 8.7 million in October 2023, and if 80% of those ‘missing’ patients refer themselves for non-urgent care, lists would hit 10.8 million in December and never return to pre-December 2021 levels. 

From an economic perspective, the OBR said in its outlook that “to the extent that such pressures – or indeed broader pressures from pay and inflation – were accommodated in higher budget allocations, that would represent a risk to our forecasts”. 

However, policy risks from NHS spending "could well still remain to the upside”.

Analysis by the IFS found that, between the 1982 Autumn Statement and the 2015 Spending Review, there have only been two occasions when health spending has risen by less than was originally planned.

The resource spending plans for the NHS set out in the Autumn Budget were, according to the OBR, consistent with average real annual growth of 3.8% in the NHS between 2021-22 and 2024-25, broadly in line with this historical average. 

The OBR explained that revisions to its GDP deflator forecast since October mean that the real growth rate consistent with its latest forecast is 3.3%.

"Despite the £13 billion increase to NHS funding at the 2021 Spending Review, policy risks from NHS spending could well still remain to the upside," the forecast concluded.

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The NHS is not safe with the Tories. Not only do they want to undermine it, they’re also succeeding in doing so. 

Published by Anonymous (not verified) on Wed, 16/03/2022 - 6:22pm in

The House of Commons Public Accounts Committee has published a new report this morning that is damning of Tory NHS management. Remember that this is a cross-party committee that only publishes with unanimous support from its members, and it has said:

The Department has overseen years of decline in the NHS’s cancer and elective care waiting time performance and, even before the pandemic, did not increase capacity sufficiently to meet growing demand. The NHS has not met the 18-week maximum waiting time standard for elective care since February 2016 nor, in totality, the eight key standards for cancer care since 2014. As demand for services rose faster than supply in the years before the pandemic, performance against waiting times standards declined but the Department neither adjusted these standards to realistic levels nor sought to hold NHSE&I to account adequately.

This is not, then, a Covid issue. This is a long term systemic issue of Tory mismanagement of the NHS. That is the core message that runs through all that the Committee has to say.

Worse, they note that the mismanagement continues:

At our evidence session the Department and NHSE&I appeared unwilling to make measurable commitments about what new funding for elective recovery would achieve in terms of additional NHS capacity and reduced patient waiting times. NHSE&I will receive an additional £8 billion for elective care recovery and £5.9 billion for capital between 2022–23 and 202425. Government expects that this additional funding will enable elective care activity to be 30% higher than pre-pandemic levels. However, the Department and NHSE&I have not set out in meaningful detail what the money will be spent on.

Instead what we got from Sajid Javid was his recent speech on his vision for the NHS. This was our Ayn Rand in its tone. As I noted:

If Javid wanted to set up the NHS to fail this is the speech he would have delivered.

As Health Policy Insight also noted (behind a paywall):

The Saj announced NHS modernisation that is in effect The Patient's Charter (1991: PM - John Major), Choose And Book (2005; PM - Tony Blair) and Personal Health Budgets (2008: PM - Gordon Brown).

All those policies failed. So too will Javid, as the committee has noted, in the process also noting the failures of Hancock and Hunt.

The NHS is not safe with the Tories. Not only do they want to undermine it, but they are also doing so.

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