Charging for the NHS puts everyone’s health at risk

The Tories are going for increasingly tabloid friendly policies that will sound like a good idea to Daily Mail readers, but ultimately achieve nothing, other than pour more fuel on the fire of xenophobia. Take their recent announcement that foreigners will have to pay for NHS services up front.

Certainly no doubt the NHS is chronically underfunded and over stretched. Nine out of ten UK hospitals is overcrowded at the moment and the country now has the shortest GP appointment times in the world.

So how much could this save the NHS? Well foreigners using the NHS fall into two categories. The first group are what we’d refer to as “health tourism”, where someone enters the UK for the expressed purpose of taking advantage of NHS services. This costs the UK between £110 – £280 million. The second represent more “normal” use of the NHS, where say a Spanish tourist breaks his leg and has to go to A&E. These costs amount to £1.8 billion per year. However it should be noted that probably only about £500 million is actually recoverable or chargeable.

The bulk of those being treated in this 2nd category are from European countries (or Australia) where the UK had reciprocal health care agreements with those nations (e.g. if a British pensioner or tourist needs treatment in Spain they get treated). Individuals nominally resident in the UK (e.g. students or those in employment) are generally exempt from NHS charges. Of course these conditions may not hold post brexit.

Note that the patient in this second group may not have much choice that they get treated in an NHS hospital. An American tourist who collapses in the street, a passenger who is taken ill on a transatlantic flight. So recovering costs from these people “up front” would likely be impossible.

Adding it all together, the NHS can recover (or avoid spending) between £610 – £780 million per year. That sounds like a lot, until you realise that the current NHS budget is about £120 billion, out of the £145 billion the UK spends on healthcare. So at most 0.65% of the NHS budget, or probably more realistically 0.3% of the UK’s total health spending. Even the infamous NHS funding gap of £30 billion, cannot be plugged by such charges, meeting barely 3-4% of this deficit.

The simple fact is that charging foreigners for NHS services will not solve anything. Yes it is unethical for someone to get on a plane and go to the UK intentionally to use NHS services, but its hardly a crippling burden and this represent a tiny fraction of those using the NHS. Trying to recover healthcare costs from them would be a drop in the ocean compared to the money spent treating UK residents.

And one has to consider the consequences to such up front costs. The government is talking about putting sick people in need of treatment out on the curb, or perhaps detaining those who are given emergency treatment and putting them in the equivalent of a debtors prison. We are talking about going against every principle the NHS was founded on, sinking the UK to Dickensian levels. Yes the Tories are going to turn the clock back post-brexit to the 19th century.

 And what’s the bet that the Tories will float off the unit responsible for this treatment and sell it in the private sector? Remember, many in the Tory party want to privatise the NHS (and they’ve been quietly privatising bits of the NHS), so one does have to worry if this is merely the first step on a slippery slope.

And worse, what happens, as I considered in a prior post, if a foreigner comes down with some sort of new virus or infection. Stopping any pandemic requires swift action, you need to get that person to a hospital as early as possible. Outbreaks have been avoided where healthcare could be given swiftly to the patient zero and a cordon put up around those inadvertently exposed to the virus. However, in other cases, where such action wasn’t taken (generally because the patient zero didn’t get treated swiftly enough), the virus has spread around the world with frightening speed. Consider that the bulk of the deaths related to the SARS outbreak of 2002, can be attributed to a single sneeze in a lift lobby.

So this policy will not help plug the NHS funding gap, it will be a drop in the ocean. Refusing treatment is not only morally bankrupt but puts the health of everyone in the country at risk. And it is being done purely to the benefit of the Daily Mail reading UKIP types.

Why UKIP is seriously bad for you’re health

Among the more controversial comments from last week’s political debate was Farage’s comments regarding HIV and his suggestion that we should “treat British people first” and that it would be “unchristian” to do otherwise. Of course he offered no evidence to back up his claim (same as his previous attempts to claim 80% of pickpockets were Romanian, again no evidence given to support this), so I think we can dismiss it as more ramblings of a one balled racist loon.

However I would argue that what this comment does is to betray a dangerous flaw in both his, and the Tory party’s, policy of denying NHS treatment to non-nationals. For disease and viruses do not respect economic nor political boundaries. Such a policy therefore puts many UK citizens at grave risk and threatens to undermine the UK’s entire healthcare policy, which has stark implications for us all.

Let me illustrate my point by us imagining the following scenario. We have a woman, who works in London as a short order cook, whom we’ll call Eve. She’s recently arrived to the UK and therefore does not qualify for NHS treatment (or at least she’s unsure and reluctant to go to a hospital and be presented with a bill). She could be from Eastern Europe or beyond or perhaps even a British born person (or the spouse of a brit) whose given up their citizenship while living abroad and is one of many who fall through the cracks in the UK’s immigration system.

Either way, she starts to feel ill. But as she’s on a low wage and her boss doesn’t give sick pay (which is illegal but still goes on). So she continues working, potentially infecting others in work or on the commute. When she gets sufficiently ill that she thinks of going to a hospital, one of her friends text’s her a link to a Daily Mail article, which convinces her not to go, besides she’s starting to feel better again. Unfortunately, this apparent improvement, is merely because the virus has entered its final more critical stage. Within 24 hrs she starts to get very ill and ends up collapsing in a convulsing fit in the middle of a packed London tube train.

What Eve did not realise is that she was in fact patient zero in a new viral pandemic. It could be a new more deadly variant of pandemic flu, or some other form of respiratory infection, perhaps a form of Ebola or HIV that’s developed the capability for airborne transmission, or it could just be a new virus that’s managed to jump the species barrier. It sort of doesn’t matter. Either way, the point is, we have a new viral infection and thanks to the policies of the Tories and UKIP it would potentially be now out in the open and spreading rapidly.

Should you think the scenario I’m painting sounds a little far fetched, well you see that’s the scary thing – it isn’t! New viruses do pop up all the time, some are pretty harmless, others have killed millions. And one common start point for such events, as portrayed in the scarily scientifically accurate film Contagion, is when animals are slaughtered and in the handling of raw meat, as this presents an opportunity for a virus to jump species and start infecting humans.

For example, while we don’t know where exactly the 1918 “Spainsh flu” pandemic started (called so because wartime censorship stopped media outside of Spain from reporting it), but its likely it started off in the US. Indeed some even go so far as to pin point one cook’s assistant Albert Gitchell in Fort Riley, Kansas as the likely patient zero. It should be noted that on this base the Army kept and slaughtered pigs, and kitchen staff such as Gitchell would have contact with the animals (both before and after slaughter), and we now know that the virus in question was a variant of H1N1, a form of swine flu.

So suffice to say that anyone involved in the handling of raw meat or the slaughter of animals is a very likely candidate for patient zero in the case of any new infection. And the bad news is that lots of those involved in these industries, but in the UK, the EU and in the US, tend to be migrant workers. People who both Farage and Cameron are on record of wanting to strip of their access to medical care.

And incidentally, many HIV or Hepatitis victims got sick from things such as blood transfusions so infection isn’t their fault and I fail to understand why they should be punished for it.

So denying anyone treatment creates a major weakness in our healthcare system, for in the event of a new pandemic the first few days are crucial in determining whether a ring fence can be thrown up and the infection contained. Its a bit like defending against an amphibious assault, the first 72 hours can determine whether the invader will be held at the beach and then thrown back into the sea, or whether they’ll be able to push deep inland and break out of their landing zone. Furthermore while a few dozen men can defend a beach against attack, if the enemy breaks in land you’re going to need alot more troops, at least a 1:1 forces ratio to stop them. Similarly with medicine a handful of doctors and nurses can contain an outbreak in its earliest stages, but if it breaks out into the general population its very possible the healthcare system will be overwhelmed by the number of patients.

Previous epidemics have been stopped thanks to good detective work and swift action by healthcare workers. For example, the Nigerian outbreak of Ebola, the 2003 SARS outbreak, which was a very close run thing, as was MERS in 2012. However crucially in many of these outbreaks, the virus had a relatively slow rate of infection and the initial patients arrived in hospitals alive and concious and thus were able to pass on key nuggets of information to doctors, allowing them to diagnose what was wrong (difficult when a doctor is faced with a virus he’s never seen nor heard of) and so that the patients movements can be traced and those who they’d had contact with can be identified and isolated.

In our scenario, our patient now arrives in a London hospital, unconscious and unresponsive. There is a very strong chance of miss-diagnosis. And in any event doctors will be focused on just keeping her alive, not having time to worry about the root cause of the problem (particularly as they don’t know who she is or what she does for a living, so no alarm bells have been set off). Consequently its very likely that the first the NHS will realise what they are facing is when hundreds of people across London and the south east descend on hospitals reporting similar symptoms.

And again if that sounds far fetched, that’s the scary thing – its not! Its believed that the bulk of the victims of SARS, which infected over 8,000 and killed nearly 800 people can be traced to a single sneeze in a hotel lift lobby. And again this is despite the fact that the individual in question, was a doctor who was already on his way to hospital as he guessed he needed treatment.

So in all likelihood in our scenario by the time the NHS wakes up to the crisis, its too late, the virus is out, its not going to be possible to contain it. It will sweep the country and the globe infecting millions and causing all manner of economic chaos, which would make any amount of money spent on “NHS tourism” seem like a rounding error.

Worse still, the fatality rate of many viruses depends on the level of care a patient receives. This is why Ebola has a fatality rate varying from 25% (with good treatment) to 90% (with poor or non existent medical care). But health care workers often make up the brunt of early casualties in any pandemic (with SARS a large proportion of its victims were health care workers). This means that as the numbers of staff drops and the number of patients rises, the fatality rate starts to climb.

Consider that a repeat of the 1918 pandemic would result in 25% of the UK population being infected, with 10% of those being sufficiently ill that they’d require intensive care treatment….but we’ve only hospital beds for less than 1% of those infected! This is why estimates for the death rate of such an outbreak vary from the high tens of thousands, to just shy of half a million perhaps 1 in 12 people in the country!

An if Farage or Cameron thinks they are safe from this hiding behind their private medical insurance, think again. The last think any private hospital wants is a deadly virus running around their place of business bumping off paying punters. They don’t have the resources to cope with such a thing and they’ll be sending anyone with such symptoms down to the nearest NHS hospital, or more than likely some sort of improvised field hospital in a school gym somewhere. And keep in mind that people in the same age groups as many of those inclined to vote Tory or UKIP are likely to make up a disproportionate number of those dying from any new pandemic.

And should you think the scenario I paint seem bleak, lets repeat the exercise in the US. While Obamacare has ensured most Americans now do have access to healthcare, there are some who are falling through the cracks….and there will be even more of those if the Republicans have their way. And again those who aren’t receiving coverage are the most likely to be infected first should a new virus emerge. But as viruses don’t respect economic boundaries, all it takes is one sneeze over a few cheese burgers in the back of a fast food joint and suddenly many middle class Americans are getting more than they bargained for with that happy meal.

And how would the US private healthcare system cope with a new pandemic?…probably very badly if the evidence from Ebola in the US is anything to go by, where a host of amateurish screw ups nearly led to disaster. And naturally the panic in America (Americans not exactly known for calm and rational reaction to a crisis, again look at the US media reaction to Ebola) will be all that greater.

I’ve long assumed that the US private healthcare system will last up until the next major pandemic. Because after tens of millions of Americans submit simultaneous claims in the order of tens of thousands each, at the same time hospitals are reeling from the billions in losses from patients whom they treated who weren’t covered (they are legally required to stabilise any patient who comes in) and the insurance industry is facing a few million simultaneous life insurance pay outs. Its possible that the whole US insurance industry could well be driven to bankruptcy, likely prompting a bailout of the US healthcare system by the US government that will make the 2007 bank bailout seem small. And result in de-facto state funded universal healthcare in America in all but name (perhaps they’ll called it “Freedom Care” or “Patriot Care”) ;D

So given these facts should we pay for these HIV treatments, something that would cost (at worst) about 0.18% of the annual NHS budget? Well of course we should! Any amount spend on treating non-residences healthcare is going to pale in comparison to the incalculable costs if a pandemic were to be allowed to get started.

Like I said at the beginning disease, cancer and other health problems do not respect economic or geopolitical boundaries. I always view healthcare as being like insurance, you don’t want to pay it, but you know you’re screwed if the worst happens without it. So literally trying to save a few pennies that amounts to a rounding error (in the grand scheme of things) would be madness, immoral and definitely “unchristian”.

Across the pond

A couple of stories from across the pond in America have caught my eye recently, the sort that may have been overlooked by the media over here…

US Cadbury ban
Ex-pats and other fans of UK made Cadbury’s chocolate products are currently stockpiling large quantities of their favourites, as a ban on the British made stuff is about to come into effect to prevent “brand confusion”…or perhaps because the leading US firm Hershey doesn’t want to face up to any competition.

You may enquire, don’t we have a free trade agreement with the US? How can they just ban stuff like this? Well because there are loopholes in such trade agreements covering issues such as health regulations, corporate branding and environmental legislation. And suffice to say, there ain’t a lot a lawyer needs to drive a bus thro such rules.

If you think they’re being a bit hard on Cadbury, try buying Haggis in the US or Marmite and Irn Bru! It is literally easier to buy crack cocaine in parts of the US, given the consequences of US government regulations. Yes, to the yanks an AR-15 or uzi can be safely handled by a 11 year old, but letting people eat offal or drink a can of ginger is just downright reckless endangerment. :??:

Americans like to pride themselves on being the land of free enterprise and small government, however the reality is that they are nothing of the sort. Many of the same Tea party type who wave their “get big government off my back” placards will be the first to start whinging if foreign or out of state competition threatens their jobs. Congressmen in Washington therefore come under enormous pressure, both from well funded lobby groups for one industry or another, as well as from their constituents, to try and protect jobs within their state and free markets be damned.

Good examples include the US steel industry, the debacle over the KC-X tanker aircraft (where a European aircraft beat a US designed one to the contract, prompting congress to restart the competition & re-write the rules to make sure the “right” aircraft won), generous farm subsidies (which makes it almost impossible for other food producers in Africa or South America to compete on grain prices) as well as the Medicare budget (a massive free subsidy to big pharma) as well as numerous subsidies to the US fossil fuels and nuclear industry.

And if you think that Congress is bad, the individual US states are even worse. Take for example, the recent banning of sales of electric cars from Tesla Motors in several US states. In part this was due to the pathological hatred of many Republicans for anything green, but mostly it was done to protect vested interests in the established auto industry, as well as jobs in local auto dealers from an upstart company like Tesla.

These policies are so engrained in the US political system it can lead to all sorts of laughable absurdities. Such as arch-climate denier Rick Perry talking up the success of Texas wind farms in reducing America’s carbon footprint (Texas has more wind farms now than any other US state). The rest of the GOP seems to develop selective deafness whenever this comes up. Same as the Democrats will ignore one of their own from a coal mining state voting against the president on any climate change issue. As its assumed that he will do whatever needed to protect local jobs, regardless of the implications for party politics….or the polar bears!

I’m reminded of the situation in Nigeria, whereby corruption is so endemic within the country, its simply assumed that any politician who wins office will “share the cake”, i.e. reward his friends and family with cosy jobs and kick backs. A politician who actually tried to tackle the country’s corruption would likely be in for a very short stint in power and likely be ostracised by his community afterwards.

Anyway, I bring this matter up as it does represent one of the dangers with UKIP and the Tory proposals for leaving the EU. Crucial to such a move would be securing a free trade agreement with both the EU and most of the rest of the world (as existing treaties with other trading blocs would have to be renegotiated). And much like the SNP seemed to assume they were entitled by right to sharing Sterling, there is no guarantee whatsoever that UKIP will get what they want here.

But as events in the US show, even if they get a free trade agreement with the EU, it will be all too tempting in many situations for politicians, either side of the channel, with jobs in their district under threat, to try and find loopholes in any such trade agreements allowing them to restrict the sale of UK goods (or visa versa).

As one libertarian blogger points out (hardly the sort of person we can accuse of pro-EU basis) if a company ships its goods across the channel and the French ceases them (for a perfectly legal custom’s inspection….which they are then very slow to complete), what is he supposed to do in a Brexit situation? Well at the moment he could go directly to the EU or failing that his MEP…hoping and praying that MEP isn’t a member of UKIP, as they aren’t terribly active in their jobs. With the UK outside of the EU, it has to be raised with the department of Trade, who talk to Foreign affairs, who would then talk to the EU (possibly via the WTO), who would then pass it down the food chain the other side. And knowing how governments work that means it would be six months to year before anything gets done (in the best of circumstances), by which stage most SME’s will have run out of operating capital and gone bust, rendering the whole argument moot.

So anyone in UKIP deluded enough to think that leaving the EU won’t have a negative economic impact (for some crazy reason some seem to think it will have a positive impact!) is living in cloud cuckoo land.

Climate liabilities
Its becoming increasingly difficult for climate change deniers to counter the weight of evidence in support of anthropogenic climate change. Increasingly deniers are forced into relying on crack pot conspiracy theories that often accuse scientists of being part of some giant global conspiracy. When its pointed out to them that such claims are libellous, they promptly retreat behind the bastion of free speech, that they are usually very quick to deny their critics, on issues such as gun control for example.

However, a court in Canada has now ruled that no, this isn’t a free speech issue, such comments are libellous and has awarded a cash settlement to a climate scientist who had been accused by a tabloid of having “a warmist agenda”. This case does have much wider implications, notably as a much larger and more significant case is looming between Micheal Mann and the Republican CEI and National Review.

It is perhaps worth reflecting on the fact that what shut the tobacco lobby up wasn’t government legislation, but a constant barrage of expensive litigation. Could we be seeing the start of the same for the fossil fuel lobby?

US Measles epidemic
There’s a measles epidemic ongoing in the US. While infection rates are low so far (as in “only” a few thousand) but one of the problems with this disease is its highly contagious nature and hence its ability to spread like wildfire. This is having all sorts of implications, with health advice to avoid bringing kids to parks, public areas or daycare centres.

And just so we’re clear, measles is not a harmless disease. While many of those reading this blog, who got measles before vaccines were widely available, may not have suffered serious ill effects. Keep in mind that globally, measles kills tens of thousands per year. So the advice would be, vaccinate you’re kids and get vaccinated yourself if you’re not sure you’ve had it.

Who do we have to blame for this? Well, all of these tinfoil hat wearing anti-vaccine types…who seem to have a habit of also being climate change deniers as well as believing in other crack pot conspiracies (MH17, 9/11 was a setup, Kennedy, etc.). Are they willing to admit their error? well no, of course not!

Ultimately one could argue the real disease here isn’t measles, but a condition called Republican Mental Lock-in Syndrome :crazy:. Whereby, those on the right can’t admit that they are wrong about anything, ever. Even when confronted with overwhelming evidence to the contrary, they will instead perform acts of extreme mental gymnastics to concoct all sorts of outlandish conspiracy theories to satisfy their ego.

Scary Nukes
An ongoing story that’s some elements of the US media have been ignoring is the state of America’s nuclear weapons. Crippled by funding and obsolete and maintenance hungry equipment, questions are being raised as to the safety and reliability surrounding America’s nuclear arsenal. Some stories talk of blast proof doors propped open with a crow bar (as the mechanism has failed), of missile units with only one set of tools (so they can only do maintenance on one missile at a time….they have to Fed Ex the tool kit around and hope it doesn’t get lost in the post when a war starts!). Oh, and apparently the computers that arm the missile rely on floppy disks….and I mean the really big old floppies! 88|

To make matters worse, morale within the US nuclear weapons program is very low. :zz: Largely because if you want to kill your career as a US officer, the surest way to do so, is to go on Armageddon watch. While you’re fellow officers are getting that all important front line experience, or learning new skills (useful in their future career outside the military), you’re stuck in a bunker underneath hicksville, playing solitaire while surrounded by equipment that should have become museum exhibits many decades ago. Indeed one has to question whether its such a good idea to put clinically depressed officers in charge of the nukes? |-|

Either way, so long as country’s like the US choose to have nuclear weapons, they have an obligation to maintain these weapons in a safe and secure manner. And personally I’d question the point of spending hundreds of billions on a weapon system you don’t plan on ever using. And if the US, or other superpowers, are unable to maintain their stockpiles then they have invalidated their right retain them.

Ebola: A tale of health care systems

One could argue that many of the victims of Ebola in Africa are as much victims of poverty, due to the poor nature of health care in Africa. This is threatening to wipe out an entire generation of young doctors and nurses in West Africa. Hence why Western assistance vital, both to contain the virus and stop a global pandemic, but also to prevent any more serious long term damage to already impoverished states.

That said the health authorities in Nigeria and Senegal both deserve quite a bit of credit for their quick thinking and clever detective work, which help halt the outbreak in both countries. In both these nations initial cases were quickly investigated and a ring fence thrown around anyone potentially exposed. Both are on the verge of being declared disease free.

Of course one has to contrasts this with the events in Texas. If you believe the horror stories about US health care they will tell you about paramedics who are more skilled in finding credit cards and checking health insurance than actually treating patients. The tales coming out of the US reveal something of a farce. We hear stories about poorly trained and equipped health care workers, of a person running a fever and prior exposure to Ebola being allowed to board a commercial flight.

In many respects you do have to wonder how well the US health care system would cope with a serious disease outbreak. For as our libertarian tea party types would likely discover, disease does not respect economic boundaries. Indeed we have the irony of ex-US presidential candidate Rich Perry, blaming Obama and the federal government for being too slow. I mean surely Obama should have spent the last few years doing something about America’s chronic health care problems…oh wait he did only it was Republicans like Perry who tried to stop him!

As events in Africa have shown, once a virus takes root, it’s very difficult to stop. Perhaps they might want to think about then when next denouncing Obamacare.

Ebola’s only briefly appeared in any UK patients, generally those flown home for treatment. But it is perhaps topical to bring it up given the release last week of a report on the future funding of the NHS. These suggest that the chronic underfunding of the NHS in recent years now needs at least an extra £8 billion a year by 2020 to set right.

Clearly this means that something is going to have to give. Either cuts in other areas of the sort one doubt even the Tories would be happy with, or taxes going up. But I suppose it boils down to the question of what sort of health care system do you want. While Ebola might be a fairly minor risk to the UK at the moment, there are plenty of other things that are a more serious long term risk (pandemic flu, heart disease, cancer, etc.) and having a robust health care system is therefore essential.

Other News of the Week

The Dictator’s Daughter in trouble
Last week I made mention of Gulnara Karimova, the daughter of Karimov, the Uzbek dictator, aka “the dictator’s daughter” or according to wikileaks diplomatic cables “the most hated person in the country”. Anyway, the BBC revealed a letter from her, allegedly smuggled out of prison, that suggests a spectacular fall from grace.

Gulnara, never shy of publicity, has been noticeably absent the last few weeks. Her twitter feed went dead a few weeks ago. She also made the unprecedented move of openly criticising her father a few weeks back. Anyone else who’s remotely thought of doing that has been killed or arrested. All this suggests a feud going on, possibly even a power struggle between dictator and his charismatic daughter.

Now while one cannot help but be sympathetic to her plight, they are probably more than a few who will conclude that what goes around comes around. Gulnara cannot feign ignorance as to the crimes of her father, not least because she’s been intimately involved in more than a few of them! Evidence suggests that she has been directly involved ibn racketeering, bribery and general acting like a spoiled despotic bimbo.

Indeed, what may well have triggered this whole sequence of events was her implication in a massive bribery scandal in Sweden and in Switzerland, one which involved hundreds of millions of pounds (possibly the biggest ever in Sweden). Its possible that the excesses of his daughter simply became too much for the despot.

Or equally its possible that she tried to move against him (rumours suggest he’s not well and might be dying). Indeed the BBC have a series on right now about the Plantagenet kings. One unfortunate trend for the Plantagenet’s was how king after king, no sooner had he the crown on his head, but his own relatives, often his own sons and wife, were plotting his overthrow, often helped out by the king of France. Such is the way of any despotic government, which is why we need to do everything possible to topple such regimes.

Farage v’s Clegg on Europe
Speaking of authoritarian, right wing nut jobs, I missed the whole Farage v’s Clegg debate. But that wasn’t so bad, for as I predicted would happen a few weeks back, the debate was ruined by Farage repeating the old nazi trick of telling big lies often enough such that people start to believe they are true :no:.

According to Farage, 29 million Romanians and Bulgarians (or was it 500 million!) are about to descend on us (btw that’s more than the entire population of both countries!), 120% of the UK population are now immigrants, 98.7% of whom are only here to claim benefits, steal our jobs, commit crimes, butcher horsemeat, spread diseases and commit terrorism in what little free time this busy schedule allows :)).

It is no use “debating” something with someone who is going to rattle off a load of bullshit. We see the same thing when scientists try to debate creationists or climate change deniers. The only situation where a debate with Farage would be acceptable would be if we had a moderator able to act as fact checker and call out Farage’s porkies and half backed myths as he goes along. Otherwise its like wrestling a pig, you both get dirty and the pig seems to enjoy it ;D.

TB in moggie’s
Of course the tabloids soon had another thing to obsess over other that the EU debate, the fact that TB might have spread to cats, possibly from Badgers and then to humans. I would note the risk of infection is pretty low, but then again when have you known the tabloids to let a few “facts” get in the way of a good story!

I would argue that this shows the faults in the government’s policy on Badgers. That a policy of vaccination of badgers and cattle is better than culling. As you can never be sure to get all the badgers and inevitably disrupting an eco-system by killing badgers in the area can have all sorts of consequences…such as badgers from neighbouring areas moving in and spreading new diseases too that area. Now while this is unlikely to have been the trigger for this outbreak, a future TB outbreak could easily be triggered by such a sequence of events.

In short humans meddling with nature rarely has the consequences we intended. And if you don’t believe me about that, go ask the Australians about toads and rabbits.

NHS budget’s under pressure
One of the big Tory lies promises was that NHS spending would be safe under them. Well we’ve seen yet more evidence that this simply isn’t so. A report suggests that many NHS trusts are now in deficit. I suspect this may have something to do with the Tories ridiculous policy of allowing doctors (hardly the best people to put in charge of a budget, that’s why we have accountants for!) greater control over budgets, apparently so that we the health care users get more “choice”.

Ya, that’s the one thing I wanted in an NHS hospital, more “choice”. That way if injured I could choose not to be taken to the nearest A&E but maybe remain in agony a few minutes longer to go to a different one down the road. Or how about a choice between a lime green X-ray machine and a blue one? ;D

As if to compound matters, there are also reports of councils, who have come under severe budgetary pressure from the government, dipping into NHS funds to pay for certain services. Again, given the enormous pressure council budgets are under, this is hardly a huge surprise. In fact it’s a bit like waving a chuck of raw meat in the face of a lion and acting surprised when he bites.

Of course the danger is that the Tories will merely use the failure of any NHS trust as an excuse to try and privatise it.

When elf n’ safety Jobsworth’s kill

I’m all for the benefits of Elf n’ Safety but the problem often is Jobsworth‘s, more interested in protecting their career or engaging in work avoidance strategies. By for example, sticking rigidly to the letter of the law even well past the point where they’ve perverted its original intend while ignoring the most basic common sense. E.g. when once I was in a climbing club some jobsworth in the Student’s Union refused two climbers access to ropes and other equipment on grounds of “Health and Safety”. Consequently they went out and did the route they’d planned without any safety equipment (and without telling me where they were going either!) :no:.

Hence I often refer to such individuals by the acronym SAPS, as in Save Ass Policy Schemes.

And tragically we have a fatal example of SAPS doing the rounds in Ireland. Emma Sloan, who suffered from a nut allergy was at a pre-christmas dinner when she accidentally ate something which contained nuts. She went into shock and began having trouble breathing.

Unfortunately, she didn’t have her critical life-saving medication handy so her parents dragged her to a pharmacy (Hamilton Long chemists on O’Connell street, if you want to avoid the place in future) to get medication, where upon Mr Jobsworth in the chemists refused to sell the medication without a prescription even with the poor teenager literally convulsing on the street outside. Unfortunately she died minutes later.

Indeed the Pharmaceutical Society of Ireland has now stepped in and pointed out that the law allows for exceptions to be made to selling without a prescription in situations that are clearly an emergency (i.e. someone is rolling around on the ground with breathing problems). After all this is why you need a degree to stand behind a chemists counter rather than the five minutes training to do the same job in a corner shop.

While I hate to judge before all the facts are in, but if these allegations are true then the store staff responsible should be charged with manslaughter if not murder. Indeed maybe making an example of them this would send a message out to other Jobsworth’s of the consequences of their actions.

We told you so

As I’ve mentioned in the past the Tories are ideologically committed to privatising the NHS, after all persist the thought of the plebs getting decent health care! Of course outright privatisation is likely to be opposed. The lib dems certainly won’t support it and I suspect focus groups where they’ve floated the idea likely resulted in the Troy drone who asked the public would have had need for NHS services afterwards (to remove clipboard and pen from certain orifices :)) ).

So the Tory plan has been to act more subtlety. Firstly they have cut the NHS budget in real terms (while on paper its up, when you factor in inflation, an ageing and growing population, etc. effectively its being cut). Secondly they have sought to carve away chucks of the NHS services and privatise them.

One of those services was the NHS 111 non-emergency help number. Their plan was to have private companies bid for these contracts and run these services locally on a for profit basis. However, this has largely been thwarted by the fact that the bulk of services are being run by local ambulance trusts. Furthermore the largest provider, NHS Direct, is now looking to pull out of running contracts across a third of the country.

A large chuck of the problem for NHS Direct has been that more calls are coming in to their centre’s than they’ve been expecting and its taking longer to process them. Projections from NHS direct’s own accounts suggest they are loosing money on every single call they receive and are looking at a deficit of £26 million over this financial year.

And if anything we can credit NHS direct for at least putting their hand up and saying that they cannot cope. For as many reports indicate the 111 service is beset with flaws and problems. Channel 4 just broadcast a Dispatches programme that used undercover reporters and showed how many of these 111 service providers are struggling to cope, in particular those covered by the private sector. Indeed it is not an exaggeration to say that lives are being put in danger.

Inevitably, the problems highlighted here mirror exactly what has happened any time the government has privatised a public service. Chaos has reigned, service quality has nosedived and costs have soared. If this is what a privatised NHS looks like, you can count me out. And anyone even thinking of voting Tory next election, all I can say is don’t plan on getting sick…ever!

Aborted Debate

Personally, I’m of the view that as I’m a bloke and I’ll never give birth (well I hope not anyway, otherwise something pretty odd will be going on :>>), my opinions on abortion don’t really count as this is a debate that the women need to have (sorry if that sounds awfully sexist)…but considering current events…Tory bible thumper Nadine Dorries is trying to get the abortion laws changed so that providers of abortions services such as the charities Marie Stopes or the British Pregnancy Advisory Service (BPAS) will be unable to supply the compulsory counselling that must be offered before an abortion is provided. Her argument is that these services have a “vested interest” in pressuring women into an abortion, given that they also supply them.

Sounds okay, until you realise that both are charities, how can you argue that they therefore have any financial gain to make by “pressuring” people into abortions? All Mrs Dorries demonstrates by this statement is her own bigoted religious views that anyone who supplies abortions is a baby killer who only does it purely to further their gay/liberal/socialist agenda, not to mention score some browning points with their buddy Beelzebub. And even if we were to take Mrs Dorries and her bible waving allies seriously, all that the Marie Stopes would have to do to get around these changes, would be to spin themselves off into two separate independent entities, one supplying abortion advice and the other the abortions. In short all you would do is create a bit more red tape and a slower less efficient abortion service (aren’t Tory’s supposed to be against red tape for these very reasons?).

Furthermore I would argue that the even if we were to let the religious brigade have they’re way here what will be the outcome? Take Ireland, it has very strict abortion legislation with one only being legal in the country if the life of the mother is in danger. The result is total hypocrisy. Women who can’t come up with a convincing “life in danger” excuse just go abroad to the UK (one of the reasons why abortions are so high in the UK is people coming in from Ireland or other former British colonies for this expressed purpose) or Europe and get an abortion there (which with Ryanair these days is not entirely expensive). In essence we’ve merely exported our abortion debate and dumped it onto some other state because Irish politicans are too spineless to take on the bible thumpers, although the wanning power of the Catholic church post the paedophile priest scandals might change that.

Even if the “pro-life” lot in the UK or US were to have they’re way, this too is the likely outcome. Women would just go to Canada or Holland and get abortions there. The only women whom you’d be preventing from having an abortion would be the lazy ones or those who couldn’t afford to travel. And of course that’s just the legal abortions, no doubt some back alley abortion clinics would soon be springing up to do the job for women unwilling to travel. Indeed in both the US and UK the hypocrisy would be even starker. Certain US states would never sign up to a ban on abortion (a democrat in NY once told me they’d sooner cede from the Union that accept that) and so it would merely be a case of crossing state lines, or going to Scotland in the case of the UK.

Again my position is, I’m in favour of a women’s right to choose, but I don’t think men should be getting involved in this debate, especially 70 year old German virgins living in the Vatican. But even if you oppose abortions, banning them or wrapping them up in more red tape does more harm than good. It just exports the problem or increases the chances of women resorting to back alley alternatives. The whole reason why we brought in abortion laws in many countries was to ensure that it was done within a proper legal frame work that balanced a women’s right to choose with health & safety and morality. The “pro-lifers” proposed to scrap this frame work and replace it with a bible. And how is that working out for you guys? In the US the religious lot tried out a system of Abstinence Only sex education under Bush, which resulted in a dramatic rise in teenage pregnancies and STD’s. So what’s the bet the same thing will happen again here with abortion?

But there’s little point in me going on. The core of this anti-abortion movement is a group of religious extremist who will ignore all logic and pesky little “facts”. They’re sole reason for opposing abortion or stem cells or gay marriage is just so they can score a few browning points with the guy upstairs, because if you read Ezekiel 25.17 backwards he seems to say he’s against these things. The social problems that such new rules will create, the fact that they will make worse the very moral questions they were supposed to put right, matters little to such people. They won’t be the ones picking up the pieces afterwards. The fact that they are increasing the power of the state at the expense of personal freedom is also ignored, even thought most conservatives think that “big government” should get off peoples backs…yet they advocate a government so big and so intrusive that it literally comes into a citizens bedroom and tells you what to do and also tells you when you’re going to have to start a family, and who you can marry. Even communist Russia was more liberal than that!

Fortunately, as I write this, the abortion bill has been killed off 368 votes to 118. Cameron voted against it, as he had previously made clear he would. Diane Abbott described it as “an attempt to import American sensationalism into abortion issues“. Couldn’t have put it better myself. Part of the reason why the religous right talk about abortion or bash the gays so much state side is because if they didn’t, they’d have to talk about something else. And what did Jesus devote the bulk of the bible too? Well talking about the poor, charity and good will, how the rich and the greedy will have trouble getting into heaven, turning the other cheek, loving thy neighbour and other “commie crap” like that ;D! And we all know how keen Perry, Bachmann and Palin are on such topics!

Still it is worrying that 118 MP’s did vote for this, can we have their names such that sensible folk know not to vote for them again?

The war on Drugs….that we’ve lost!

For the last few decades global governments have been fighting a global “war on drugs”. Started by Nixon in 1971, hundreds of billions have been since been spend globally on police, military and intelligence action against the drug lords and pushers. Tens of millions have been arrested and imprisoned, some states have taken extremely draconian measures, Singapore for example imposes the death penalty for just 15g of cannabis. American operations, such as Plan Colombia have involved mass spraying of herbicides over vast areas of rainforest with little thought to the health consequences.

And the end results of all of this? – drug use globally has actually increased! Profits for the drug lords are up and crime caused by drugs has also gone up! As this report by the Global Commission on Drugs policy makes clear (see a Beeb news article on it here) the war on drugs has failed. Between 1998 and 2008, opiate use has gone up by 35%, cannabis by 8.5% and cocaine (and its derivates) by 27%. And this is just a globally average figure, indeed it seems the more a government pushes against drugs, the worse it gets.

Countries like the US have seen drug use soar while the level of drug use has stabilised in other countries with more relaxed drug laws. It seems the harder governments try to enforce the argue laws the worse things get. Indeed economists would point out that there is good reason for this. By going to drastic levels to intercept drug shipments this reduces the amount of drugs on the street, which pushes up the price, which stimulates more people to go into the drugs business, which eventually leads to an increased supply, a glut and more drugs on the street at lower prices. Unless the government can intercept a vast proportion of all drug shipments (they currently catch about 10-30% but would need to intercept 75%+ to have any significant financial impact) then all they are doing is “stimulating” the illegal drugs trade through the principles of Market capitalism. It is of course ironic how so many of the right-wing supporters of tough drug policy, who are also fans of free-market theory, can ignore such a massive glaring contradiction.

And if all of this weren’t bad enough, we’ve also seen crimes related to drug use soar, see here and here, drug related deaths have gone up and the profits going into the coffers of the drug lords has soared. It is conservatively estimated that globally the illicit drugs trade makes 1% of global GDP at around $320 Billion!…if the illegal drug’s industry was a company it would vie with Exxon & Wal-mart for the title of world’s largest corporation. If it were a country, it would be the 30th largest economy in the world, on par with countries such as Iran, Thailand and Denmark. And in all probability, the real figures are much higher than this. Much of that money gets ploughed into various illegal enterprises from bribery and corruption of public officials, market trading and money laundering as well as other crimes such as prostitution, people trafficking, racketeering and even terrorism. Worst of all, nearly all of that drugs money is not only untaxed, but we (taxpayers) are having to pay tens of billions per year on drug enforcement. I mean seriously, we’d be as well off going down to the local drug lord and paying him a few million to reduce his imports of drugs, or at least not increase them by as much, or maybe even just buying his entire stock off of him, for all the good that it would do!

I’m reminded of that Press secretary for the Iraqi government, declaring that there are no Americans in Baghdad (while we could hear them fighting into the city behind him!) and that in fact the Americans were committing suicide at the gates of the city. That’s about what any announcement you hear from any current government as regards “progress” on the war on drugs amounts too. The progress is, that we’re not only loosing, we’ve arguably already lost.

I’m NOT a hippy!
I would just say before going any further that I’m not a hippy. The problem when you start critiquing the current drug enforcement regime is that everybody leaps to the conclusion that you’re some sort of dope smoking hippy who just wants the establishment and all the other squares to back off and leave you in peace to poof away on some stonkin BC bud while chillin to some groovy tunes.

I’ll admit to trying pot once (and I mean one puff) many years ago (if not decades now), but that’s it. I am not a user of drugs. Quite honestly, I’ve no idea what all the fuss is about. I don’t smoke and never have, and I’m not planning on taking it up. Alcohol (I am Irish) is my only vice (I’m drinking a glass of wine right now!). But I recognise that quite a large number of people do take drugs (see an example here for the UK) and clearly prohibition isn’t deterring them. My concern is squarely a prospective of minimising harm, as well as the cost to society, i.e. is it financially responsible for governments to continue throwing good money after bad enforcing drug laws that are clearly unenforceable? Are such laws actually doing more harm than good?

The lesson of history – just don’t call it prohibition!
One think you will note about the anti-drug puritans is the use of language from them. Calling it a “war on drugs” or “narcotics control” or words to that effect…I seem to remember there being a word in the English language to describe the banning of a substance under government control…what could that word be?…oh yes! prohibition!

Of course, this is the one word you will never hear any anti-drug puritans use, as prohibition has certain “negative connotations”. In the 1920’s several nations engaged in the prohibition of alcohol and other intoxicating liquors, most noticeably the United States from 1921 to 1932. The consequences of this? Crime levels went up, the cost to society of alcohol went up and while there is still some dispute as to whether alcohol use itself went up (the bootleggers didn’t exactly keep accurate records!) it is generally considered probable that consumption of hard liquors did increase dramatically. And of course, all of the money made by prohibition went straight into the pockets of criminals, notably the Italian mafia, who used it to found a massive criminal dynasty that persists to this day.

Interesting aside – Ironically, the Irish mafia was prior to 1920, the dominant criminal force in many American cities, but they failed to anticipate the financial consequences of prohibition, and act swiftly to capitalise on it (the head of one NY Irish mafia gang being imprisoned the night it came in after nearly killing a barman who refused to sell him a drink!). They were thus left constantly playing catch up with the Italians.

But either way, why is anyone surprised that we tried exactly the same thing again, with our current “war on drugs”, just on a much larger and grander scale….and subsequently failed on a much larger and grander scale! He who ignores the lessons of history is doomed to repeat them!

Drug classifications…..a serving suggestion from governments?
A telling example of the chaotic mess that is the current drug laws is the classification of drugs. This is supposed to give police a means of prioritising drugs relative to the harm that they actually do (see more info here from the Beeb). However, independent research by Dr Nutt (who probably would be taken more seriously if it wasn’t for his name!), paints a different picture. He originally worked for the UK government but got fired after he made the mistake of trying to bring sanity to the UK’s drug enforcement. He has published a list of 20 of most commonly available drugs, relative to the harm they cause to the individual and to society as a whole. As you can see by clicking the link this puts legal drugs such as Alcohol at the top (worst) and Class-A drugs such as Ecstasy and Mushrooms at the bottom. I would note that while Dr Nutt’s research is controversial (i.e. mainstream science doesn’t fully accept his conclusions) it has been subject to peer review and publication in a reputable source, see a graph from lancet here and the full report here while I have yet to see any similar peer review journal accept anything justifying the government’s position.

But what, you may ask, about all those teenagers who took Ectasy and died? Why I read about another one in the Sun the other day…and how many of the hundreds of teenagers who suffered alcohol poisoning per year or the tens of thousands of alcohol and tobacco related deaths do the tabloids report? None perhaps? Or how about the many people who die each year after taking legally acquired prescription drugs for medical reasons, most famously the untimely death in 2009 of the actress Brittany Murphy. Aside from celebrities, I’m betting not one other death as a consequence of legal pharmaceuticals ever makes tabloid headlines. I would also note that the bulk of Ecstasy related deaths are usually a consequence of either the combination of alcohol, lack of water, dehydration and the physical exhaustion of rave events, rather than the pills themselves. Blaming ecstasy and ecstasy alone for such deaths is to take liberties with the truth. There is also the issue of taking dodgy ecstasy pills which have not been made to any sort of quality control protocol and often have very different effects (i.e. some can be ridiculously strong but take ages for you to feel any “buzz” others are milder but you feel it straight away, obviously if you get the two extremes mixed up its easy to have an overdose).

Either way, its clear that the UK, and most other countries, drug classification policy is set by scary tabloid headlines (the children, the children, dear god will somebody please think of the children!) and polticans desire to seem like they’re doing something, rather than scientific facts. It’s the modern day equivalent of mob rule or a witch hunt. And of course the problem here is that the young’uns who are taking the drugs know it’s all a farce. They probably know more about the relative harm or an effect of drugs than any government scientist does. So seeing how the drug classifications are completely bonkers, they ignore the drug laws altogether, rendering government “drug classifications” as little more than a form of serving suggestion! (If you’ve tried E’s why not try something else from our Class-A range!)

Decriminalisation?
Of course, the prohibition mob usual come in at this point and say, ya, but you see, drugs like ecstasy are made in backstreet labs that’s the problem, at least alcohol is made and sold in proper licensed establishments. Well perhaps that’s the solution! We part-decriminalise the softer drugs such as Ecstasy and LSD. While they would still technically be illegal, people would be allowed to consume them in designated and licensed establishments. The drugs themselves would be supplied by the existing pharmaceuticals industry (who believe me would jump at the chance of taking a bite out of that $300 Billion pie!) subject to strict government control. At these licensed clubs strict rules on consumption could be enforced (e.g limits on alcohol use, or indeed even a total ban on it, a requirement that say before taking an E you had to drink a proscribed amount of water in front of the bar man, age limits and checks, etc.).

The critics would say, oh! it would never work! The ravers would never put up with such rules and the clubs won’t enforce them. Won’t they? The security at many clubs or music festivals these days is quite intensive, I mean some of them put you through metal detectors and finger print clubbers. I know many people who have to take their passports to clubs if they want to be sure of getting in. So I would suggest that many users of such drugs would, up to a point, put up with some measures if it means getting Mr John Q law off they’re backs. The club owners will of course bend over backwards to comply, as the amount of money you could make selling drugs legally is considerable (practically a license to print money!).

In short, such a policy as I’ve outlined above would drastically cut the health problems associated with certain softer drugs, as compared to the current, unregulated free for all being done in back alleys. This would inevitably reduce deaths, save lives and limit (or maybe even eliminate) the harm caused by such drugs to society. Yes, our current policy with some drugs is probably endangering lives, not saving them! More importantly, the profits would go to legitimate businesses that would also pay the state tax on their profits….as compared to us paying cops to chase down criminals who pocket the cash and divert it into other criminal enterprises.

The slippery slope
Of course, the criticism you then hear at this point from the puritans is, ah! yes but you see it’s a slippery slope. The kids start off on ecstasy, then they do hash, and next thing you know their smoking crack while injecting heroin! My response to that is, where’s your evidence? Can someone point me in the direction of one peer reviewed journal paper that proves this “slippery slope” is anything other than the figment of certain conservative politician’s imaginations? Again, its case of policy set by tabloid headlines and not scientific facts.

And even if we were to take this “slippery slope” argument seriously, what’s the first rung on the drugs ladder? Alcohol and tobacco! So surely if this “slippery slope” is so real and so dangerous, and I mean dangerous enough that we’re prepared to maintain the current status quo of banning softer drugs like ecstasy, while ignoring the fact I’ve outlined above that this policy is probably endangering lives rather than saving them. If this slippery slope is so bad, then clearly we need to kick away the first two steps on the ladder – i.e. a total ban on cigarettes and alcohol….but of course that would be silly! As I pointed out earlier we tried that and it didn’t work!…..and what makes anyone think it might miraculously work for other narcotics?

Full legalisation?
Some critics of drug laws would move for full legalisation. This would have the advantage of bringing all drug use, as I outlined above, back inside a legal framework. It would ensure the drugs themselves came from licensed producers, and was consumed in as safe a manner as possible, with any profits going into legal enterprises which would ultimately be taxed. In the case of the USA, which currently spends about $47 Billion a year fighting drugs, Uncle Sam could be looking at taking in that amount each year as its cut from such legal drugs use. That money could then be used to more effectively deal with the problems of drug use.

More importantly we’d be depriving the criminals of a huge source of funding. This would limit the amount of money they had available to spend on other criminal activities areas and restore the momentum to the law enforcement agencies. Also many drug related crimes (i.e. burglaries by addicts) would be reduced.

Of course the critics say that by legalising all drugs, even nasty ones like Heroin, Crack, meth and Cocaine (which Dr Nutt rated 1st, 2nd 3rd and 5th respectively in terms of harm to the user, the lancet report here lists heroin and cocaine as easily the worst from a dependence and harm point of view) would be disastrous. We have enough problems with alcohol abuse already, if you allowed people to openly and legally smoke crack cocaine the results would be chaos. And they may have a point here; we simply don’t know what the consequences of such a policy would be, largely because there is a vacuum of reliable data. It could be bad, or it could be no worse than what we see at present.

But there is a issue of deep rooted social problems to consider here. The one question I never hear asked about “binge drinking” by politicians is why people do it? Clearly if some people’s lives are so stressful or problematic that they feel the need to anesthetise themselves every weekend with a vast quantity of alcohol this is indicative of some serious underlining social problems within western society (reminds me, I need another glass of wine!). The danger is that if harder drugs became available, then many people would resort to using them instead, again in dangerously large quantities, indeed some already do (Jasus! that wine went fast! hic!). But, this is a social problem, not a drug problem. Drugs, or alcohol, are merely a symptom of a more deep rooted issue, not the end cause. We could discuss the causes of this till the cows come home, high unemployment and disenfranchising of some elements of society, pressures to succeed at work, etc. Another day’s post! but clearly a social issue. But its a lot easier for a politician to make a speech bashing binge drinkers or E using ravers than it is to actually try and solve big social issues, not helped when its often their policy’s that have caused these problems in the first place!

Treatment not punishment?
But jokes aside, its possible that full legalisation of harder drugs would be going too far too quickly. One alternative, as pioneered by several European countries such as Portugal, is to treat use of drugs such as heroin as a “illness” not a crime. Addicts can acquire and take the drugs in proscribed quantities within the confines of special treatment centres. This again reduces the harm caused, and gets the addicts out of the pocket of the drug pushers, as well as tackling street crime associated with drug addiction. It also makes rehabilitation and eventual breaking of the addiction cycle easier to achieve. Again, I struggle to see how the current status quo can be considered a better alternative.

The drug laws don’t work! They just make it worse!
The bottom line is, our current drug laws are doing more harm than good. Whether you’re an anti-drugs puritan or a dope smoking hippy, you have to conclude that the current status quo in the “war on drugs” is unacceptable, we’re loosing and the longer this goes on the deeper a hole we’ll dig ourselves into. What we need is a sensible holistic drugs policies, based on scientific facts not what the tabloid hacks say. And the core of that policy would be reducing the harm caused by said drugs as well as getting the profits from it out of the hands of criminals. If ultimately that does mean some form of legalisation, then its better than the current alternative, for there is little point in continuing to call it a “war” on drugs, as the word “war” implies that both sides have some chance of winning…and we haven’t a hope!