CentreRight

When will the music stop?...

These are extraordinary times! The revolving door at Westminster has been spinning so fast, there hasn't been time to even start spreading rumours. Apart from Flint at health, as suggested by Benedict Brogan that is. Luckily that was proved to be false (I have the Nation's health and well-being at heart), but not before (I am sure) they had started having kittens at the Department of Health. I remember one civil servant rolling her eyes at the memory of the time when Caroline was there and they had to repeat briefings in two syllable words. It was not her forte. (I've just read her letter to Gordon; must have been a joke rumour :)

I wondered too about Shaun Woodward, who sat loyally beside Gordon at PMQs this week, nodding, smiling in all the right places. He'll be really cross, as will Hoon, who has never hidden his high flying ambitions. But in beefing up roles for Mandelson and Balls and getting rid of DIUS, one interesting question is how will Cameron now use David Willetts' skills now? ......The best news however is in the Council Elections and that my childhood county of Derbyshire has gone blue! Yeah! Fabulous news! Now, back to the net to see what MORE has happened in the last few minutes... 

We still need a Zacchaeus moment

This has to be one of the saddest weeks of my 9 years involvement in British politics.
Distressed for the honourable MPs who have always kept their expenses within the spirit of the regulations and are now smeared either by false allegations or by association with their greedy colleagues.
Despairing at the damage done by the Chancellor of ALL people who flips his homes 4 times to avoid paying tax!!! Is he so cocooned that he doesn't understand that this is carte blanche for all those considering other forms of tax evasion?
Outraged for the sense of betrayal felt by the Conservative Party at large, that is made up of wonderful, ordinary people who for no personal gain give time, money and energy to further the freedom and democracy that they care so passionately about. 
Miserable that our precious democracy is jeopardised by the deepening apathy and disengagement that this scandal has engendered amongst the electorate.
I previously called for radical, immediate action - a Zacchaeus moment - in British politics. There is no more time to lose. As well as previous suggestions I would add another. The MP's main home in the constituency or in London should be bought, owned and maintained by an arms-length organisation that is wholly owned by the State so the asset remains with the taxpayer. Just as vicarages up and down the country are established in the parish for successive incumbents and owned by the Church of England [roughly - I'll spare you the details], a house from which the MP serves his or her community should be made available. This wouldn't stop those with the means to buy their own place or live out of two homes, but it would put an end to the practice and perception of profiteering from home allowances.
Some will say that this will deter good people from entering politics. I would say that the first time I heard David Cameron speak he talked of service and sacrifice. Now, with depression on one side and scandal on another, more than ever we need to rebuild the reputation of the British politician - and this has to be demonstrably based on the virtues of frugality, integrity and good stewardship.

The importance of history in a diagnosis

Following my 'flu forecast on Thursday in which I raised the socio-economic angle to the pandemic, yesterday in the NYT the significance of Mexican culture is highlighted further. Dr Andrew Paxman, an expert in all things Mexican [I can say that as his sister] clarifies as well that it is the loss of wages posed by a day spent queuing in hospital that is one significant deterrent for people seeking help. Culturally he also says that Mexicans are 'stoical' about illness and fond of self-medicating as far as possible, a point also made in the NYT article. Going to the doctor or hospital is the last resort, when all else has failed. And tragically as we have seen, it has been too late in many cases already.

While there are still many unanswered questions about the virus, which the evidence shows is highly contagious, it is right that the government takes precautions. But in order to maintain a realistic perspective we need to be aware of the history and cultural circumstances of the deaths now being found to be caused by swine 'flu [or H1N1 influenza A as WHO now call it]. Maybe it's people of working age who have died because they were the ones who didn't want to take a day off work? With a reported 20% rise in 'sickies' in the UK in the past few days already, and a freely available NHS, that is never going to happen here! Tomorrow my cousin returns from 2 weeks in Mexico with a group of fellow doctors; I wonder if they will find themselves on extended leave...

Flu forecast?

The current evidence backs up Ryan Air boss Michael O'Leary's assertion in today's Times that swine 'flu is only a real threat to slum dwellers. Speaking to my brother yesterday, a professor of Mexican studies, he too pointed out that it was poor Mexicans who can't afford the doctor's fees who have died.

I don't want to diminish the global significance of a new, rapidly transmitted virus - especially one like 'flu that could mutate and get worse over time. But will the unfolding tragedy really be that there is another new form of disease, like diarrhoea, like pneumonia, that is entirely treatable and which is an inconvenience to the rich in the west, but a death sentence for the poor? If so, what are we going to do about it?

Not Immune – immediate government action required

If we are lucky, this new swine H1N1 strain of 'flu will fizzle out and we will merely be sending heartfelt condolences to the people of Mexico. However we can't simply wait for that 'if' to materialise and the government needs to show leadership today including:

• Acting to reassure the nation that they have systems in place to cope with an influenza pandemic, even though swine ‘flu that is being spread out from Mexico by global travellers has so far proved less virulent in the countries to which it has spread.
• Willing to be honest: there is no way of containing a virus like this even if borders are closed. So clear information and instructions should be immediately issued to all international arrivals at our airports and ports.
• Publicising our position re stockpiles of the two ‘flu drugs that seem to be effective against it – Tamiflu and Relenza. The risks and benefits should be clearly publicised by the independent Health Protection Agency to avoid scaremongering by the anti-jabs brigade.
• Reviewing all the literature around the 1976 outbreak of the same H1N1 virus [though we are probably dealing with a different strain] which caused major alarm in the USA but which never developed into the feared pandemic. Why – was it just luck or did certain measures make all the difference?
• Considering how we can support our less-developed Commonwealth partners if they should need our help.
  

A pandemic is not inevitable, neither is panic. We're not immune but we can be prepared - time will tell if this is something this government was ready for.

BBC Indian Election Train

Having been either away or submerged in family illness, I'm just venturing forth again with a few questions.  Firstly, am intrigued to know what CR readers think of their money being spent on a BBC Indian Election Train? I know we paid for a bus to follow the US elections, but that was about the next leader of the world's greatest super power. India is a developing nation, granted has a significant geo-strategic position and I'm a fan of the World Service, but is this train a good use of our licence fee?

We need a Zacchaeus Watershed in British Politics

If MPs were subject to the European Working Time directive limit that is coming in for junior doctors of 48 hours, half of all parliamentary activity would grind to a halt. The majority of MPs work long and hard hours representing, scrutinising, legislating and campaigning on behalf of their constituents. The majority have gone into politics wanting to improve the quality of life for those they represent. And most of them earn less than the average salary of a mere director of an NHS  Trust.

The headlines of fraud, failure and foolishness must grieve the many honourable MPs who are all tarred with the same brush. But today we face an unprecedented situation: seismic national economic meltdown combined with extensive individual fiscal suspicion. Whilst politicians are always towards the bottom of trustability league tables, unfolding revelations of individual greed are grating against a backdrop of developing personal hardship and the public are left feeing angry and betrayed.

Brown’s current position is untenable.  To do nothing (yet) and allow the Standards watchdog to follow up the trail of successive media exposés is allowing a crisis of trust to deepen. Sleaze will continue to flow and the damage will be to local confidence, national democracy and international reputation.

Or Brown could change his mind and authorise an immediate investigation into the expenses of all 646 UK MPs. An expensive exercise that will exonerate some, condemn others but satisfy no one as no resignations will accompany the findings. In any other walk of life there would already have been legal proceedings and firings. But whether through ignorance, weakness or their own deliberate fault the rules on expenses have been abused and what is right and appropriate has got lost in the muddy waters of allowance guidelines.

But there is another option which I call the Zacchaeus opportunity.

Still waiting for IT to deliver better health

The hospital I am sitting in has had had multi-millions spent on it in the past 10 years. There are shiny new wards and smart new beds, flat screen tv for my daughter to watch and impressive portable technology that can scan, monitor and measure [but not weigh - that one is broken] at the flick of a switch.

So can someone tell me why it took 3 hours for notes to follow her from A&E to the ward which meant tests were delayed until the next day; why the Consultant couldn't access previous blood test results processed by the in-house lab; and why I've had to fill in her details 4 times?  Ok, so I know the answer. IT. Lack of. It's just so incredible that we are still relying on paper records and the IT records that are in place are either partial or inaccessible to different departments all or some of the time.

Not only would electronic records improve efficiency all round, they are an essential component of affordable healthcare in the developing world. This is one of the key recommendations of the Rockefeller Foundation's ehealth 'Call to Action'. But while they focus on international development, we need to make rapid progress here because IT is one of the answers to the squeeze that will come on public sector spending in the years ahead. I could plug 2020health's Transformational IT Seminar on May 19th at the Royal College of Medicine with our emphasis on patient-controlled electronic records, or our international speakers including one coming from a Spanish paperless hospital. But I'll do that another time. Right now I just want the test results to come through, even on paper.

Fundamental questions need to be answered

The front pages quite rightly today detail the desperate case of Mid Staffordshire NHS Foundation Trust. The Guardian lists some of the failings.

I doubt there is a clinician alive in the NHS today who has not seen how targets have distorted clinical priorities. Are we shocked by this story? No. Because we have seen these distortions for years and have we complained? Yes. And what has been the outcome? Put-downs by managers who have been put in the invidious position of enforce or be punished by this Labour Government. Clinical need and quality of care have been trumped by clockwatching and fear.

Reviews have been launched into quality of care and A&E but there are fundamental procedural questions to be answered.

1. Why on earth didn't Monitor, the independent regulator of foundation trusts know that the HealthCare Commission had serious concerns about the Trust?
2. Why is there no red alert system when there is a rising number of deaths?
3. And why are the Trust's minutes so inadequate? 

I might have an answer to the last one - because the Trust I used to work in had a chairman who edited the minutes for anything she didn't want to be recorded including for meetings where she wasn't present.

If this can happen, then records of complaints from staff, clinicians and family can all be altered / changed / lost too can't they? Most people whether managers or clinicians or ancillary staff go into the NHS to care and to serve. What has happened to us when external pressures drive out this noble aim and integrity is thrown out with the hospital waste?

Kids, money and alcohol

News of a minimum price for alcohol broke last week and it's still the subject of many column inches today although timesonline is now reporting that Gordon Brown has rejected the idea. The Conservative's ideas of targeted rises on both loss-leader promotions and high-alcohol drinks is laudable, but it's not enough in isolation.

And Simon Carr in the Independent illustrates perfectly a significant part of the problem - parental disengagement. I don't know how old his children are, but he expects everyone else to keep them occupied and out of trouble and unashamedly dismisses his own 'guzzling' with the fact that 'role models don't always work'. No they don't always, but often they do. And this includes not just how we drink in the home but how we handle our money. The fact that one in ten admissions to hospital for alcohol abuse is for a minor with no personal income should be shocking us here. Let me ask the obvious - where do most teens get their money from? Answer, their parents. How many parents are teaching their kids how use this money sensibly? Anecdotally I would say the minority. I know many who seem to 'demand supply' their kids with cash. So isn't this ready supply part of the problem?

Teaching your teenagers how to budget on an 'allowance' seems to be out of fashion big time, but it is a crucial parental role. My daughter has had her monthly allowance since she was 12 - she has to cover her phone, pet supplies, stationary, travel, gifts and other specified items. When the money runs out, no more is forthcoming until the 1st of the next month. Hard lessons are learned - but that's the point - they are learned. And where did I get my model from? From my parents.

You can't legislate for this but it is part of the bigger picture of the need for Government to raise the status of parenting. And not only do more confident, more involved parents who nurture and teach their children good habits save the NHS Public and Mental Health budget millions, but they are an investment for the future of civil society.

Knowledge, size and incentives, not chocolate

A Scottish family doctor will today call for a tax on chocolate at a medical conference north of the border. Without getting distracted by the cultural anomaly of a Scot asking to pay more, isn't this a gimmicky suggestion instead of answers to three far more fundamental questions?

One is that many people have no idea of the nutritional value of food and there is a dearth of knowledge about what constitutes a balanced diet. One of my patients once proudly told me about all the fruit she ate, but that was in between her main meals and on top of rich puddings! There's been talk of more 'food technology' in schools to educate kids - but how many of the new school builds have allowed for this.....?  And isn't it the parents who supply the fizzipops and crisps that they eat for breakfast as they walk to school?

Two is that we don't realise how many calories there are in the portions we have - and this is where he does have a point about chocolate, but check out pizza and wine and pies too - are we going to tax all of these [more?]. Surely it's about size of portion as there has been an American drift in the sizes of portions that we eat and a concurrent reduction in the distances we walk. Maybe there is too much public transport?

And thirdly, there has to be an incentive to eat less. It used to partly be the shame at being obese, being thought of as being greedy. Can we regain a sense of shame in a society that embraces relativism? What other incentives are there?

The Scottish doctor's suggestion is really a plea for help; chocolate tax isn't the answer but we have to come up with others.

Public Health confidence booster

Everyone who reads these words has benefitted from the top two Public Health measures of all time: clean water and vaccination. While clean water is still de riguer, vaccine conspiracy theorists continue to threaten the health of the nation with spurious stories that simply reflect the need to blame something for poorly understood diseases. Yet the truth remains - millions of lives are saved every year through immunisation.

In 2020health's new report out today Not Immune: UK vaccination policy in a changing world we make the case for strengthening the role of the vaccine decision making body in the UK, the JCVI (Joint Committee on Vaccination and Immunisation). Although the high profile that Andrew Lansley, shadow health secretary, has given to Public Health is superb, we disagree with the Conservative Party's suggestion that vaccine decisions should be moved to NICE [which assesses medicines and medical devices]. The complexity of decision making about vaccines, the fact that the JCVI covers the whole of the UK [whereas NICE just covers England and Wales] and the controversy surrounding some of NICE's decisions would, we felt, jeopardize the UK's successful immunisation programme.

However there is considerable room for improvement in the way the JCVI works regarding horizon scanning, speed, transparency, industry relations and cost-effective analysis. One of the most important changes would be to make the JCVI meetings public. Openness in health and science policy making, as well as the involvement of patient groups could only boost confidence in the decision making process. They shouldn't be immune from public scrutiny and we should for ever be grateful to Jenner and his milkmaids.

Cyberbullying truths

The Mail today claims that facebook and twitter 'fuel' cyberbullying. While cyberbullying is a serious problem and sad reality [apart from when Guido does it!], I would argue that these sites do not fuel it. Yes they offer the cowardly bully a medium through which they can torment, but to accuse them of promoting it is simply to shoot the messenger.

The much more serious point here is that 50% of mental health problems begin in children under the age of 14 years and that will certainly rise if we don't take responsibility for protecting children while using this great software. There have already been tragic cases of suicide after experiences of cyberbullying. I would suggest there are three significant contributors to this neglect of responsibility.

Firstly many [most?] parents don't or don't know how to set security & privacy settings for their children's computers, mobiles or social networking sites [which have an age limit of 13 years anyway]. The recent cybersurvey undertaken by Mr Manning at his school revealed a scandalous level of neglect by parents in this domain, both in the unlimited terms of access and time [more on that another post - and there is another clue to obesity in there too]. Whether through ignorance, weakness or deliberate some of this is another consequence of the undermining of parenting by Labour.

Secondly, children are not taught how to be safe online when they use IT - surely this should a basic priority for teachers in the primary school PHSE curriculum. And lastly kids themselves need to behave responsibly, although a large part of this is having the emotional intelligence to be able to block unwanted calls and 'friends', and that often depends on whether their parents have bothered to instil it.

Picking up the pieces is unsustainable - psychiatry colleagues are currently being told to find cuts in their mental health service provisions. We need to start somewhere, so how about a high profile campaign led by the likes of the Sun, Mirror and Mail with cut-out 20 things to make your home pc safe along with a school-centred awareness campaign that kid's mental wellbeing is at stake paid for by the software/networking companies. What a great chance to demonstrate their CSR! Now, who's ready to get this one going?

Military Mental Health

Lance Corporal Johnson Beharry has been brave again, highlighting the disgraceful inadequacies in the help available for veterans with post traumatic stress disorder [PTSD]. [It's worth looking at the comments on the impact of PTSD posted in the Independent online to get a glimpse of what families suffer]. Although he is still a serving soldier, he was talking about ex-service personnel, and it seems that nothing has substantially changed since the early 2008 publication of the Seventh Report of the Commons Select Defence Committee in which one psychiatrist was particularly critical of the lack of proactive provision of mental healthcare for veterans, saying that the NHS "hardly deals with them at all"

The Chief Executive of the charity Combat Stress also said at the time: "A veteran who has undergone a traumatic experience in battle could find himself referred to a PTSD support group with people who had been in car accidents or had suffered traumatic childbirths". It beggars belief that anyone could think this appropriate.

  He also reported a 27% increase in referrals for help in the previous year - now standing at 53% over 3 years.

Meanwhile the Government think that their six 2 year community mental health pilots for veterans are adequate. But hang on, the Tories launched a successful pilot in 1996 in Yorkshire - it proved a success - and is now a mainstream service. What's to pilot? That's no commitment, that's a cop out.

We need a military health service in the UK that communicates the deep appreciation and respect that most of us have for our veterans. The price paid by our forces in the daily sacrifices of duty should be credited to them in the specialised care they receive when their losses later extend to their mental health.

Wise men are keeping Osborne company

I'm just coming to the end of a fabulous week in the USA and vote Washington DC the most friendly city I have ever been to. London would be transformed if we could be as polite and helpful and spontaneous as our Washingtonian cousins. Now in New York I got the Wall Street Journal this morning and came across the full page spread advert paid for by the Cato Institute which has over 260 economists including Nobel laureates [though not Jed Bartlett] disagreeing with Obama's quote from Jan 9th when he said that "economists from across the political spectrum agree" on the need for massive government spending.

It's worth reproducing their succinct argument here:

"Notwithstanding reports that all economists are now Keynesians and that we all support a big increase in the burden of government, we the undersigned do not believe that more government spending is a way to improve economic performance. More government spending by Hoover and Roosevelt did not pull the United States economy out of the Great Depression in the 1930's. More government spending did not solve Japan's 'lost decade' in the 1990s. As such, it is a triumph of hope over experience to believe that more government spending will help the US today. To improve the economy, policymakers should focus on reforms that remove the impediments to work, saving, investment and production. Lower tax rates and a reduction in the burden of government are the best ways of using fiscal policy to boost growth."

So Cameron-Osborne are not so lonely now, but the grim reality is that they will have to become salvage experts between now and the next election.

How to raise the status of parenting?

The Children's Society 'The Good Childhood Inquiry' to be published on Wednesday was previewed in the weekend papers, and we are told, will contain 'controversial' findings. 'Controversial' implies the findings might not be true or valid, when what they probably mean is 1) the findings are true and therefore exclusive [all truth excludes] but 2) they apply them universally, which, as I have recently been reminded, makes too many presumptions and ignores individual circumstances. Being a working mother has not meant I have neglected kids or have left my husband through my economic independence.

But the overall theme - the 'excessive individualism' of adults today is totally valid and key to changing this as I have said before, is how the Tory Party raises the status of being a parent, which is the most important job I will ever do. I hope that they will adopt some of the really positive suggestions made by this report such as civic ceremonies for the public acceptance of parental responsibilities [booked at the Registrars office?!] and free parenting classes and 'normalise' family support access [more here]. NuLab in all their PC glory have contributed massively to this mess by withdrawing funding from many organisations that supported families and marriage in the late 90's.

Churchill said of Asquith 'His children are his best memorial, and their lives recount and revive his (great) qualities.' Imagine that becoming the maxim for all parents in this country... anyhow, must go, have just committed myself to a snowball fight which, bearing in mind the bowling ability of my 10 year old, demonstrates total commitment!

Chaos theory denies grandparents adoption rights

We may not have all the facts, but if the headlines in the Daily Mail are true, the grandparents aged 46 and 59 who have been told they are too old to adopt their grandchildren are victims of the most ludicrous and detrimental application of social services regulations [please tell me it's not the law!]. The list of common sense objections to this decision should be too obvious to state.... many natural mothers have babies in their 40's [Cherie Blair at 45]....the grandmother's diabetes is chronic condition handled by thousands of mothers alongside child-rearing....housing children with extended family should be the priority....the children need security and the vast majority of gay couples split within 6 years [a fact not a prejudice] ....grandparents across the UK are routinely involved in grandchild care.... etc etc etc

Having had a heroin-addict mother [according to the 6am BBC news but not yet on website] these children will already have had a hugely traumatic start to their lives. All the evidence points to the grandparents wanting the best for their grandchildren, their being the best source of love and continuity yet having been persuaded by the authorities that they weren't good enough. Chaos theory seems to have taken over Edinburgh Social Services.

Google goes Pollock

Turned on my browser this morning to find a bunch of scribble instead of the Google logo on my home page. Obviously someone at the search engine likes Jackson Pollock who was born this day in 1912 - but after logo changes for the Queen and Chinese New Year, is this now going to be a daily feature and if so, can we nominate changes? If so mine are WC Fields [a bat for the L?] for tomorrow and FDR for the 30th [head and shoulders for the G?]!

Evidence shows Bush was right, Obama is wrong and Britain is poorer.

I think we can all agree that our taxes should be spent on what works.

Figures from the Medical Research Council this week show that the evidence, political will and the money are all now pointing in the same direction - to induced pluripotent cells and adult stem cells (over 80 successful therapeutic applications so far) as revealing the most potential for healing. Prior to this, evidence was not allowed to get in the way of political will as the money went to hyped-up hybrids and human embryos (no applications so far).

David Jones in the Guardian today says 'The grandiose claims for cures from animal-human hybrids were never credible and now they can be seen to be empty promises. It can no longer be pretended that this avenue of research is "necessary".

And how long before we stop wasting money on tumorgenic human embryonic stem cells? It cost us 10 key scientists last year as they moved from the UK to France where adult stem cell research is better supported. So not only have we wasted money but we have lost vital talent. Bush was right not to give federal funds to this research - Obama's promise to reverse this in the light of hard facts is a triumph of liberalism over evidence.

Kidney Beans

A man wants his kidney back as part of a divorce settlement. This reinforces the principle that, contrary to Cato Institute philosphy and both legal Iranian and illegal black-market practice, organ donation should always remain a gift. Put a price on a body part and we lose the essence of our humanity as we are reduced to mere biological merchandise. Will this man be also claiming for the right to half his children's body parts too, or just wanting beans for his kidney?

Obama's GOATs

As Obama continues to assert that 'science is top of his agenda', team watchers are speculating on his choice for Surgeon General, the US equivalent of our Chief Medical Officer (only they have few constitutional powers). Dr Sanjay Gupta is a handsome 39 year old neurosurgeon and anchor with CNN who is being assumed as the next SG.

Despite the few powers, the influence of the post was demonstrated most brilliantly by Dr C. Everett Koop. When he arrived in Washington he was advised to 'keep your head down and your mouth shut'. He did the exact opposite for the next 10 years, presiding over the greatest decline in smoking, campaigning for immunization, transforming the public's understanding of Aids through mass distribution of information booklets and criticising the politicization of the abortion debate. As an evangelical Christian he was pilloried by the conservative right for compromising on his beliefs over Aids. While promoting condoms for anyone having sex outside of marriage his personal belief remained that sex should only be for marriage. He said 'I am the Surgeon General, not the Chaplain General'. It was his integrity and passion to improve the health of the nation that won him admirers from all quarters - a work that he is still doing aged 92.

The big beasts that the new SG will have to tackle are obesity, dementia, addictions and ironically another sexual disease epidemic. With two doctors at the helm of the National Science and Technology Council, expect to see a high profile given to health technologies. A good start though would be insisting on all clinical trials having to be registered [this applies to the UK too]. While many negative results go unrecorded and unpublished, Governments will not have all the information they needed for decision making. Taken as a dig at the outgoing administration Obama said his elevation of science was about 'protecting free and open enquiry..ensuring the facts and evidence are never twisted or obscured by politics or ideology'. However the reality is that we will need scientists and industry to be transparent about all their findings if we are to have evidence that can be trusted.

Zimbabwe must remain in the spotlight

Having family in Zimbabwe meant that our conversations over Christmas included Mugabe and Cholera alongside Mandelson and 'flu. Although the numbers are provisional, it is thought that over 1600 people have already died from this ruthless diarrhoea causing bacterium vibrio cholerae with over 30,000 people effected. Areas with the worst sanitation and least health resources are worst hit and the numbers are still rising with nearly 1000 new cases reported on New Year's day.

Cholera is no stranger to Zimbabwe where there have been annual outbreaks for decades. However the current epidemic is far worse than the last in 1992. There is little surprise in this as the country's infrastructure, including the crucial water supply and sanitation, has crumbled since then as many provincial Councils have been undermined by Mugabe's henchmen. The internal chaos and lack of professionals also precludes even considering the distribution of the oral vaccine to prevent the infection.

My relations say hope is in short supply, but there are two things we can do. Firstly ensure we keep Zimbabwe in the media spotlight. Cholera, refugees and other fall-out should mean that Zimbabwe's future is a key issue in the April elections in neighbouring South Africa. Likewise support for the countries who have already spoken out against Mugabe - Zambia, Botswana and Tanzania - should be publicised. Secondly we can all support the charities working to fight the cholera outbreak and famine [Red Cross, Unicef, Zane]. When a fiver feeds a child for a month in Africa, how can we ignore such value for money and redeeming return on our Pounds in these thrifty times?

Reasons for getting rid of Labour: Ten on Health

It's PBR day today and as we await details of the BBB [Brown borrowing binge], it's timely to remind ourselves of how Labour have squandered the NHS - the people, our money and it's reputation. The NHS is now on a life support machine and here are some of the reasons why:

1. Wasted Investment - a Naive assumption that money alone will raise standards. Cumulatively hundreds of billions extra have been spent on the NHS since 1997 but we still can't access the latest medicine or innovative technology; most hospitals are understaffed; delays in diagnosis means poorer prognosis; community nurses are becoming a rare breed; transaction costs are ludicrously high and simple business paradigms are not applied. Labour have been appalling stewards of the public purse.

2. NHS IT fiasco - Labour thought it was about IT when it should have been about improving care. Mind boggling belief that the Centre should control supply of IT through firms with no products to hospitals with existing systems while ignoring the workforce. At a predicted total cost that rivals the Olympics, the NHS IT Programme has so far cost us at least £2Bn [there is dispute over actual spend to date] and delivered precious little other than increased costs and decreased efficiency, now being counted in million pound deficits by hospitals such as the Royal Free.

3. Consultation Shams - insulting charades that purport to draw on frontline expertise. What is the point of spending millions on round Britain 'consultations' with hand picked audiences who simply endorse and consolidate the proposals? Result - the most disillusioned workforce [clinicians and managers] in the history of the NHS.

4. Healthcare Acquired Infections [HAIs] - death by neglect. The knowledge of HAIs has been growing particularly since the 1990s when the incidence of MRSA exploded. Hospital responses have varied but there is no doubt that the ability to deal with HAIs has beens significantly hampered by the huge burden of innumerable, centrally imposed mandatory targets...

New hope for bikers

Something for investors (yes, really!) to consider over the weekend. A fantastic development that will be loved by Cameron, Boris, me and all other bikers out there. Wired Magazine reports a new gadget for cyclists for turning red traffic lights to green. Just needs a bit more development to get it to manufacture and it may need some UK tweaks being of US origin, but your market is here!

Another child tragedy that WAS preventable

There are some chilling statistics in the tragic death of Baby P as reported extensively in the Guardian today. Despite 50 injuries and 60 contacts with health and social care staff Baby P 'did not pass the threshold to be taken into Care' despite police advice that he should.

There are two questions that leap out from this. Firstly, how high is this threshold? The outcome would suggest catastrophically too high. Another family I know well had their social worker suspended for suspected misconduct for over 6 months, during which time the 4 children on the At Risk register had no contact at all from the social services. And when things were particularly bad, I was told Care was not an option as there was no spare capacity in our borough [not dissimilar to Haringey] for children who's 'lives were not thought to be at stake'. However in this case, for the Social Services to believe that the repeated accidents and bruising suffered by Baby P were normal and not life-threatening, and not a result of neglect or abuse is surely criminally negligent. They had been advised by both the police and at least one medic not to allow the child back to his birth mother.

And secondly sixty contacts tells us processes are in place but obviously no one person with the experience, confidence and authority to provide the protection that this child so desperately needed. Whoever did take the decision to allow the child back to his mother after his bruise-free month in the care of a friend should not only be sacked but prosecuted.

But there is a bigger picture that includes us all here. Surely the downgrading of the status of parenting and the commodification of children have contributed to a demeaning of their humanity and left them ever more vulnerable? And when we've promoted anyone having a child anyway they chose, what are the chances that the child's welfare will be a priority to the parents when a secure start never was? We need mature and radical responses that include raising the status of parenting, funding the expansion of organisations like the Bristol Community Family Trust that support family life and review the inadequate training received by UK social workers.