NHS "standing on burning platform" of outdated acute care model

The health service “stands on a burning platform” of an outdated model of acute care that is no longer able to deliver the services needed for modern patients, according to England’s top hospital inspector.

Prof Sir Mike Richards, the Care Quality Commission’s chief inspector of hospitals, said safety remains a “real concern” in the NHS, with wide variations of quality between hospitals and even between services within the same hospitals.

Remarking on the first round of inspections of England’s 136 acute non-specialist trusts and 18 specialist trusts, carried out between 2014-16, he said inspectors had uncovered pockets of “very poor care” in otherwise good hospitals.

“The scale of the challenge that hospitals are now facing is unprecedented,” Richards said. “Rising demand coupled with economic pressures are creating difficult-to-manage situations that are putting patient care at risk.

“During winter 2016-17, hospitals have faced ever-increasing demand for urgent and emergency services and the continuing challenges of delays in discharging patients to community and social care services.”

Richards’s comments come just a month after the British Red Cross said the NHS was facing a humanitarian crisis as hospitals and ambulance services struggled to keep pace with rising demand. In December, 50 of England’s 152 acute hospital trusts were forced to declare an alert because they could not cope.

According to the CQC’s state of hospitals report, published on Thursday, 81% of the 136 non-specialist trusts were deemed to be inadequate or to require improvement for safety, while 11% of hospital trusts were given the lowest rating for safety. None received a rating of outstanding in this area.

Urgent and emergency services and medical care had more ratings of inadequate and requires improvement than good or outstanding, which the report said reflected the fact many A&E services were struggling to cope with increasing numbers of patients.

The CQC introduced an inspection programme in 2013 after the public inquiry into the care scandal at Mid Staffordshire NHS foundation trust. Despite misgivings, its report applauded staff for their caring attitudes to patients, with no hospital trust given the lowest rating for providing a caring atmosphere for patients.

Opponents of healthcare privatisation and the government’s austerity agenda said the deficiencies highlighted by the CQC showed the impact of deep cuts to NHS services. “This should surprise no one and anger us all,” said Alan Taman, campaign manager for Keep Our NHS Public and Doctors for the NHS.

“How many years of cuts, cloaked in the coy term ‘efficiency savings’ did the government think it would take to put lives at serious risk? And how many lives will be taken before the truth is faced?” Taman said plans to close more hospitals and further slash staff would push more patients into costly private healthcare.

“The NHS is about fairness, about removing fear, about all of us giving the best to those that need it the most,” he said. “The fact that it has been deliberately run down and crippled like this is unfair, unjust and increasingly unsafe. The callous indifference of this government to heed an equally lengthening queue of informed, alarmed and angry people and blame anyone but themselves is the height of irresponsibility.

“People should join us in London this Saturday 4 March, to let this government know: we shall not let you destroy our NHS without a fight.”

A Department of Health spokesperson said: “As the report shows, hard-working NHS staff continue to make improvements for patients at a time of significant pressure, and we want to continue that throughout the country.”

NHS "standing on burning platform" of outdated acute care model

Tax Break For Burning Your Belly Fat?

Almost 7.5 million people have feasted on 6 Ways to Burn Your Belly Fat Fast, which is good since the author says fat in your midsection is a particularly bad sign. The six ways seem simple and not very expensive, but I’m betting some of those millions are looking for tax deductions for whatever expenses they do incur. That, it turns out, can hinge on doctor’s orders, exactly what the doctor orders, and for what condition.

If possible, get written advice from your doctor prescribing your particular treatment regimen. Keep proof that you followed the prescribed regimen, and that you incurred the expenses. A lot also depends on how good your records are and how high your expenses are compared with your income.

What qualifies as a medical expense for tax purposes? It’s surprisingly broad. In fact, swimming pools, vacations, medical marijuana, spa visits and patio awnings, all might qualify. An expense for the diagnosis, cure, mitigation, treatment or prevention of disease qualifies. In contrast, an expense merely beneficial to general health doesn’t. See IRS Publication 502.

(Photo credit: kennethkonica)

False teeth, prescription eyeglasses, contact lenses, laser eye surgery, hearing aids, crutches, wheelchairs, and guide dogs for the blind or deaf are deductible medical expenses. You can’t deduct funeral or burial expenses, health club dues, over-the-counter medicines, toothpaste, toiletries, or cosmetics. No-no’s also include most cosmetic surgery, dancing or swimming lessons.

Costs of special foods and beverages qualify if prescribed by a doctor to alleviate or treat a specific illness, if they are in addition to the taxpayer’s normal diet, and if they are not part of the patient’s nutritional needs. See Revenue Ruling 55-261. If it’s special food you’re claiming, you’ll need a statement from your doctor.

Plus, the food can’t substitute for something else you would consume. Prescribed low calorie foods don’t qualify. They are substitutes for the food you would normally consume to satisfy nutritional requirements.

For more line drawing, consider Revenue Ruling 79-151, where the IRS said a weight-loss program to improve general health or appearance didn’t qualify. But in Revenue Ruling 2002-19, the IRS said you can deduct a weight-loss program treating for a specific disease diagnosed by a physician. If you’re diagnosed as obese that’s sufficient.

Even for costs that qualify, there’s a very high threshold. Medical expenses are deductible only to the extent they exceed 10% of your adjusted gross income. That is up (starting with 2013) from the previous 7.5% threshold. If you or your spouse is 65 or over, you are exempt from the 7.5% to 10% threshold increase until 2017. See IRS Topic 502 – Medical and Dental Expenses.

If your adjusted gross income is $ 100,000, the first $ 10,000 of medical expenses are on you. But if you exceed it, you have fairly wide latitude as to what qualifies. It must be for the medical care of the taxpayer, spouse or dependent.

Some of the line-drawing seems downright bizarre. For example, the IRS ruled that a mother with a double-mastectomy could not deduct the cost of her baby’s formula as a medical expense. See Private Letter Ruling 200941003. Although the baby’s need for formula was clear, it satisfied the child’s normal food needs and that meant no deduction.

In Halby v. Commissioner, a 78 year old lawyer wrote off therapeutic treatments by prostitutes. He didn’t even have a doctor’s note but he deducted their “professional” fees. With no medical diagnosis and a self-prescribed treatment that was illegal, the Tax Court said no. The New York State Tax Appeals Board did too. See Matter of Halby, Nos. 821494/821810. No wonder people hate lawyers.

You can reach me at Wood@WoodLLP.com. This discussion is not intended as legal advice, and cannot be relied upon for any purpose without the services of a qualified professional.

Tax Break For Burning Your Belly Fat?

Tax Break For Burning Your Belly Body fat?

Almost 7.5 million people have feasted on 6 Ways to Burn Your Belly Fat Fast, which is good since the author says fat in your midsection is a particularly bad sign. The six ways seem simple and not very expensive, but I’m betting some of those millions are looking for tax deductions for whatever expenses they do incur. That, it turns out, can hinge on doctor’s orders, exactly what the doctor orders, and for what condition.

If possible, get written advice from your doctor prescribing your particular treatment regimen. Keep proof that you followed the prescribed regimen, and that you incurred the expenses. A lot also depends on how good your records are and how high your expenses are compared with your income.

What qualifies as a medical expense for tax purposes? It’s surprisingly broad. In fact, swimming pools, vacations, medical marijuana, spa visits and patio awnings, all might qualify. An expense for the diagnosis, cure, mitigation, treatment or prevention of disease qualifies. In contrast, an expense merely beneficial to general health doesn’t. See IRS Publication 502.

(Photo credit: kennethkonica)

False teeth, prescription eyeglasses, contact lenses, laser eye surgery, hearing aids, crutches, wheelchairs, and guide dogs for the blind or deaf are deductible medical expenses. You can’t deduct funeral or burial expenses, health club dues, over-the-counter medicines, toothpaste, toiletries, or cosmetics. No-no’s also include most cosmetic surgery, dancing or swimming lessons.

Costs of special foods and beverages qualify if prescribed by a doctor to alleviate or treat a specific illness, if they are in addition to the taxpayer’s normal diet, and if they are not part of the patient’s nutritional needs. See Revenue Ruling 55-261. If it’s special food you’re claiming, you’ll need a statement from your doctor.

Plus, the food can’t substitute for something else you would consume. Prescribed low calorie foods don’t qualify. They are substitutes for the food you would normally consume to satisfy nutritional requirements.

For more line drawing, consider Revenue Ruling 79-151, where the IRS said a weight-loss program to improve general health or appearance didn’t qualify. But in Revenue Ruling 2002-19, the IRS said you can deduct a weight-loss program treating for a specific disease diagnosed by a physician. If you’re diagnosed as obese that’s sufficient.

Even for costs that qualify, there’s a very high threshold. Medical expenses are deductible only to the extent they exceed 10% of your adjusted gross income. That is up (starting with 2013) from the previous 7.5% threshold. If you or your spouse is 65 or over, you are exempt from the 7.5% to 10% threshold increase until 2017. See IRS Topic 502 – Medical and Dental Expenses.

If your adjusted gross income is $ 100,000, the first $ 10,000 of medical expenses are on you. But if you exceed it, you have fairly wide latitude as to what qualifies. It must be for the medical care of the taxpayer, spouse or dependent.

Some of the line-drawing seems downright bizarre. For example, the IRS ruled that a mother with a double-mastectomy could not deduct the cost of her baby’s formula as a medical expense. See Private Letter Ruling 200941003. Although the baby’s need for formula was clear, it satisfied the child’s normal food needs and that meant no deduction.

In Halby v. Commissioner, a 78 year old lawyer wrote off therapeutic treatments by prostitutes. He didn’t even have a doctor’s note but he deducted their “professional” fees. With no medical diagnosis and a self-prescribed treatment that was illegal, the Tax Court said no. The New York State Tax Appeals Board did too. See Matter of Halby, Nos. 821494/821810. No wonder people hate lawyers.

You can reach me at Wood@WoodLLP.com. This discussion is not intended as legal advice, and cannot be relied upon for any purpose without the services of a qualified professional.

Tax Break For Burning Your Belly Body fat?