Radio DJs are suppliers of banal chatter, not health advice on partying | David Mitchell

Sometimes it’s the little things that get to you. Viruses, obviously. Bacteria. Tiny, tiny flakes of asbestos. Or, to be less literal, the inconsequential things. An inconsequential thing that got to me last week was a report of some Northumbria University research saying that Radio 2 DJs’ repeated references to alcohol were making their listeners hit the bottle.

That’s how it was spun by the tabloid reporting it. But I suppose that was just its way of dragging the story closer to one of the small collection of things it likes to always say: “Women who aspire to do anything deserve the misery they inevitably suffer”; “Decent people are no longer safe in their own homes”; “The BBC is evil”; “Everything gives you cancer”. “This one’s a three!” someone must’ve shouted across the newsroom.

I’m sure the details of the study are more nuanced. The researchers analysed four radio stations aimed at listeners who were middle-aged or older – three commercial ones and Radio 2 – to find out the frequency and nature of the booze-mentioning. And what do you think they found out? You’re right, it’s that.

They are blaming Simon Mayo for ‘normalising’ drunkenness. I’m pretty sure it’s been normal since Dionysus

Yes, obviously the DJs mentioned booze loads and repeatedly implied that it was fine and nice. As Northumbria’s associate professor of public health and wellbeing put it: “Alcohol consumption is often portrayed as the norm without negative consequences, and just 5% of references on all stations were about sensible drinking.” That’s a lot more discussion of sensible drinking than I would’ve expected.

This is a bit of a soft target, you might think. Leave the guys at Northumbria University alone. If they can get funding for counting the number of times Steve Wright mentions Lambrusco, maybe I should wish them luck. But I don’t. Because it’s another case of people scrutinising how other people talk and vetting them for inadvertent divergences from an approved value system. A mild case, perhaps – these guys aren’t no-platforming Peter Tatchell – but they are blaming Simon Mayo for “normalising” drunkenness. I’m pretty sure it’s been normal since Dionysus. The study will probably be ignored but, in these inane times, you just can’t be completely sure.

So it might be worth saying something obvious: DJs on the radio have to talk like human beings – the specific human beings they happen to be. That’s the premise of this form of entertainment: natural chat interspersed with music. It’s not high culture but it passes the time in heavy traffic.

But it won’t work if the people at the microphone, desperately trying to keep the energy up, also have to reflect some externally imposed consensus of how life should be lived. That’s Thought for the Day, which is scripted in advance and lasts under three minutes. Any longer than that and it really would drive listeners to drink…

DJ 1: And Chris from Reading has tweeted to say he’s “just kicking back and chilling with a couple of beers”. Nice one, Chris, but do remember that’s at least four of your recommended maximum of 14 weekly units right there. So do maybe stick at two.

DJ 2: Depending on how much you’ve been drinking the rest of the week, Chris. Are these really your first? Or has it been two every night? Maybe it’s time for a break. I’d hate to think you can’t kick back and chill without the soporific effect of beer. I wouldn’t want to normalise that.

DJ 1: But it’s good that you’re talking about it. Perhaps this is the first step towards a better understanding of your problem.

DJ 2: Yes indeed. And keep those tweets, texts and emails coming in. The weekend starts here…

JINGLE: It’s Friiiiidaaaaaaaaaaaaay! The weekend starts here!

DJ 1: Julie from Norwich has asked for a shout-out to everyone who works with her…

DJ 2: Hi guys!

DJ 1: And says they’re partying already.

DJ 2: Nice one!

DJ 1: She says they’re “already popping the prosecco around the photocopier”.

DJ 2: Ooh. Now, erm, should we be normalising that? I assumed she meant dancing, games, cake…

DJ 1: Not to underplay the obesity crisis.

DJ 2: Of course not – we’re sitting on a diabetes timebomb. Nevertheless, cake is OK occasionally, at a party.

DJ 1: Mary Berry is stick thin.

DJ 2: Exactly. And it certainly doesn’t lead to the sort of partying that results in poor life choices. You know, money problems, problems in the home…

Illustration by David Foldvari.

DJ 1: Neil, I was really hoping we could get through one drivetime without you mentioning domestic violence.

DJ 2: It happens, Tim!

DJ 1: I know.

DJ 2: Do you want me to say it doesn’t happen?!

DJ 1: No, because that would involve mentioning it again.

DJ 2: It’s a terrible world out there.

DJ 1: Yeah, but… you know… Friday!!

DJ 2: Yeah.

DJ 1: Good. So, take it easy on the prosecco, girls. It’s got a higher ABV than you’d think, but nevertheless have a great one.

DJ 2: Just not the sort of great one you look back on with bitterness in a couple of decades when you get cirrhosis of the liver!

DJ 1: We should get that turned into a jingle. Here’s one from Andy in Luton: “At the end of a long week working for a faceless corporation, I intend to make myself feel briefly better by consuming more alcohol than is medically wise, something as ingrained in western European culture as that weird thing that makes the women’s necks all long is with whoever does that…”

DJ 2: That should have gone through Compliance.

DJ 1: “…but I really miss the days when your show used to make that feel normal and positive and like it was how I’d want to live my life. I’m not fulfilled and I like a drink. It’s essential that society has a way to make people like me continue to acquiesce in our existences, and media references to ‘having it large’, ‘chilling’ and ‘having a massive one’ may be a crucial part of what makes that happen. After all, I’ve long since realised I’m never going to stop drinking and follow my dream of becoming a sculptor and it would only harm the economy if I tried. Cheers.”

DJ 2: I’m quite surprised you read all of that out.

DJ 1: It’s for balance. And here’s one from the regulars at the Crown in North… actually let’s go to a song.

DJ 2: I expect the lyrics somehow reinforce the patriarchy.

DJ 1: Here’s hoping.

Radio DJs are suppliers of banal chatter, not health advice on partying | David Mitchell

NHS drug suppliers investigated over prices

The competition watchdog has launched an investigation into drug companies accused of charging the NHS excessive prices.

If the companies are found by the the Competition and Markets Authority to have broken the law, they could face fines of up to 10% of their turnover.

The CMA said: “The investigation relates to suspected unfair pricing by way of charging excessive prices in the supply of certain pharmaceutical products, including to the National Health Service.”

The health secretary, Jeremy Hunt, called in the CMA in June after an investigation by the Times suggested companies were exploiting a loophole in NHS rules to raise prices of medicines.

The newspaper alleged that companies faced limited competition on long-established, off-patent drugs, bought from large pharmaceutical firms. It was also claimed that the prices of 32 drugs had risen by more than 1,000% in the past five years.

Concordia International said it was one of the companies being investigated. A spokesman said: “We are working co-operatively to better understand the CMA’s position and we will continue to work constructively to resolve the matter.

“Although Concordia has also had past discussions with the CMA regarding the supply of certain of its products in the UK, this is the first interaction with the CMA regarding the company’s pricing.”

NHS drug suppliers investigated over prices

Why do social care suppliers get less help than their NHS counterparts?

Integrated well being and care services have been the objective of central policies and local discussion for some time, and moves to devolve well being budgets to regions such as Manchester and Cornwall are providing integration nevertheless more impetus. At the Health Foundation, we’ve been considering about approaches to enhancing top quality in the health and social care worlds, and how they may be bridged for integrated care.

The variations among the two sectors are stark. Social care is offered by 1000′s of special, typically modest private and third sector organisations. NHS companies are primarily state run, huge organisations, holding a great deal of sway with local commissioners. NHS providers are usually witnessed as too huge to fail – social care suppliers can and do go out of enterprise. The NHS average wage is £29,754, whilst most homecare providers struggle to spend a lot more than minimum wage.

Related: Integration is not a remedy-all for health and care – seem at Northern Ireland

These differences are also evident in the strategy taken to supporting top quality improvement. In well being, there is an implicit assumption that central government has ultimate obligation for top quality. This is encapsulated in former health minister Aneurin Bevan’s phrase “if a hospital bedpan is dropped in a hospital corridor in Tredegar, the reverberations should echo around Whitehall”. Several well being secretaries have repeated this phrase when just lately asked about their role.

Despite various attempts to get rid of the formal accountability of the secretary of state, the national, political and quasi-religious standing of the NHS means that when well being providers are failing, governments act.

The Overall health Basis has argued that there is also tiny help for NHS suppliers, and national action has centered also significantly on levers such as payment programs and overall performance management. Even so, the national stance has constantly been that responsibility for supplier transformation goes beyond providers themselves – encompassing their commissioners, and requiring regional or nationwide assistance programmes.

In social care, the story is distinct. The reverberations of bedpans once reached town halls, but now they struggle to be heard by even the most perceptive councillors. For numerous reasons, the purchaser-supplier split genuinely transformed how social care is delivered, accelerated by the want to offer the choice and manage for men and women employing companies. This continues in the Care Act’s industry shaping duties, albeit with a duty to have regard to “the importance of fostering steady improvement” in a varied care market.

As much more care is currently being delivered by the voluntary and personal sector, improvement help in social care has been more and more observed as the duty of providers themselves. It is largely provided via good practice advice provided by organisations this kind of as the Social Care Institute for Excellence, Think Regional Act Individual and Skills for Care – the most latest illustration becoming the joint web site Care Improvement Performs, mapping sources towards regulatory requirements. Direct support is normally only accessible on an individual consultancy basis.

In which the delivery of statutory functions (this kind of as evaluation, care preparing, evaluation and safeguarding) has remained largely the operate of the local authorities themselves, peer overview has played a considerable part, and is viewed positively by these concerned.

So in health there is recognition that improvement takes help beyond the boundaries of providers, and in social care much significantly less so. Why is this? A massive contributor could be ownership a feeling that we must assistance publicly owned organisations to improve (hospitals) but privately owned organisations (care residences) should sort themselves out. This probably explains why support for basic practice in well being is a considerably overlooked area. However, the concept that sources to help adjust will be feeding into income looks laughable in the recent financial climate.

Relevant: The Manchester experiment is not the way to integration

Scale also has a function to play. Well being has a strong nationwide and regional part, whereas social care focuses quite considerably on the marketplace inside of a council. And a third issue could be knowing of outcomes. A lot more transparency in efficiency in overall health may indicate a lot more interest is paid to it. In social care, there has been really small data to judge high quality of care on right up until just lately.

The Five Year Forward View, devolution to city regions and the implementation of the Care Act drastically changed the wellness and care landscape, and demand joined up pondering about how to improve top quality. Where will the reverberations be heard from integrated provision, multi-speciality suppliers and neighborhood government run hospitals?

Health and social care can understand from every other. The focus on peer support and learning in social care could usefully be picked up by well being, such as support for commissioners. And in social care, a lot more support for providers could let them headspace to appear beyond the day to day, and regional coordination could facilitate understanding and spread of innovation. Some elements are currently being explored, for instance via the lately announced pilot of peer testimonials for Much better Care Fund pursuits. It is critical that the supportive stance of peer assessment is carried by way of to implementation.

Past mechanisms for improvement, the task of bringing collectively very different cultures must not be underestimated. Help for the two people foremost adjust and individuals delivering care will make achievement a lot much more probably. If we are severe about integration, we need to confront and examine our cultural assumptions about improvement at a nationwide and neighborhood degree, and consider the ideal from wellness and care’s diverse approaches to supporting improvement.

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  Felicity Dormon is senior policy fellow at the Overall health Foundation and Patrick Hall is practice growth manager (policy) at the Social Care Institute for Excellence.
  
  

Why do social care suppliers get less help than their NHS counterparts?

NHS suppliers encounter mounting financial and staffing pressures

NHS suppliers are feeling the heat as fiscal pressures proceed to expand. Photograph: Alamy

NHS foundation trusts (FT) and NHS trusts are facing the broadest range of issues for much more than a generation such as dealing with an ever tighter price range and swiftly rising demand. With NHS England warning of an “even more tough” financial year than 2013-14, how did NHS providers finish final year and what shape are they in to deliver the modifications required to make the NHS clinically and financially sustainable?

The last fortnight has noticed the publication of yr end reviews from Check for NHS Foundation Trusts and the Trust Advancement Authority for NHS Trusts. They recognize 4 trends: “extremely considerable fiscal pressure”, a quick, largely unfunded, growth in employees numbers, very good operational performance with some increasing considerations, and a pessimistic outlook.

Quite considerable financial pressure

The reviews display that the fiscal position of NHS providers is deteriorating quickly. In 2012/13, the 249 NHS providers produced an aggregate surplus of £591m. In 2013/14 they planned a surplus of £183m. In reality, at year end, the sector had an overall deficit of £108m. The £700m descent into deficit in a single 12 months is a quite massive, rapid, damaging, alter.

The quantity of trusts in deficit is growing rapidly with the place of acute hospitals specifically worrying – of 145 acute trusts, 41% (59) had been in deficit at 12 months finish. We know that a lot of of these are effectively run suppliers that haven’t been in deficit for a prolonged time, if at all. Despite the very best efforts of their management teams they are getting driven into deficit by growing demand and the unprecedented squeeze on costs paid by commissioners.

This is regardless of the two FTs and trusts continuing to supply important monetary financial savings – for example, £1.2bn or three% of controllable working costs in 2013/14 in the FT sector. The actuality even though is that after three many years of the Nicholson Challenge “the much more standard inner value-reduction efforts … hav[e been] all but exhausted”.

This economic deterioration isn’t just limited to a handful of trusts creating larger deficits – it is affecting almost all trusts.

Improved staffing numbers

Considerably of this monetary pressure is triggered by a speedy unplanned boost in personnel numbers. In the FT sector, for example, these went up by more than 24,000 – a 4% boost on 2012/13 – with 15,000 of these unplanned.

Higher numbers of the appropriate personnel are, of program, good news for patient care and it’s right that NHS suppliers respond to the Keogh and Francis critiques, and the new CQC inspection regime. But this service improvement comes at a expense and this improve is a huge, largely unfunded, extra monetary strain on trusts.

The FT sector information also demonstrates the consequence of this kind of a quick, massive, enhance when there is much more demand than long term provide. Trusts have to use several more agency and contract staff than planned, which carries its very own dangers. FTs alone invested £1.4bn on such employees in 2013/14, compared to the strategy of £523m.

Excellent operational efficiency but growing elective access considerations

Overall, “the sector has usually carried out nicely in preserving important operational standards”. The mixed efforts of local community, psychological overall health, ambulance and acute trusts and FTs in delivering the A&ampE standard is “a considerable achievement at a time of great stress for which fantastic credit is due to personnel”. There is, nevertheless, developing pressure on elective accessibility with “a system-broad decline in waiting time efficiency” in the last quarter.

Pessimistic outlook

NHS suppliers are facing a quintuple whammy so “plans submitted by trusts for 2014/15 show that the general [financial] place is very likely to deteriorate even more”, with an additional set of new pressures due in 2015/16. The 5 sources of strain are:

• A continuing squeeze on income by means of additional tariff efficiencies in 2014/15
• Continuing demand growth
• Pressures to preserve and invest service top quality – for instance personnel increases
• Squeezed specialist commissioning contracts, as NHS England seeks to decrease overspends in this price range
• The impact of the Far better Care Fund, which decreases NHS funding in 2015/16 by £1.9bn.

To date, patients largely haven’t felt the stress on finances hit their companies, as suppliers have absorbed the influence by cutting surpluses and going into deficit. This is unsustainable and several providers are now worrying about how to keep the quality of patient care large as assets are squeezed. If we are to stay away from the sector falling even more into deficit at the finish of 2014/15 we urgently require a funding and payment strategy that greater matches the actuality of what companies are becoming asked to deliver.

Chris Hopson is chief executive of the Basis Trust Network

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NHS suppliers encounter mounting financial and staffing pressures

Wisconsin abortion suppliers challenge law on admitting privileges

Abortion companies in Wisconsin tried Tuesday to persuade a federal judge that a state law requiring them to have hospital admitting privileges was pointless and damaging to girls seeking the process.

Planned Parenthood and Affiliated Medical Solutions contend the law will force AMS’s Milwaukee clinic to near simply because companies there lack such admitting privileges. State attorneys counter that the law supplies continuity of care if issues come up.

Wisconsin is a single of a handful of states in which abortion opponents just lately got laws passed requiring medical professionals to have hospital admitting privileges. Abortion clinics in Alabama have filed a lawsuit similar to the one particular in Wisconsin.

Planned Parenthood and AMS filed their lawsuit in Wisconsin on 5July, the identical day Republican governor Scott Walker signed the Republican-backed legislation.

The organizations initially argued that the law would place an undue burden on females looking for abortions by forcing a Planned Parenthood clinic in Appleton and an AMS clinic in Milwaukee to close. Suppliers at the Planned Parenthood clinic have because obtained admitting privileges, but individuals at the AMS clinic have not.

Closure of the AMS facility would effectively finish abortions following 19 weeks in Wisconsin because no other facility offers them later than that, the clinics have explained.

AMS clinic director Wendie Ashlock testified in a bench trial Tuesday that between 2010 and 2012 about 60 of the clinic’s roughly 7,000 sufferers suffered issues and 3 were transferred to hospitals in 2012 and 2013. Planned Parenthood of Wisconsin healthcare director Kathy King testified that problems are uncommon and emergency room physicians can deal with the sufferers.

State attorneys counter that the law promotes a more thorough evaluation of abortion providers’ competency, assures continuity of care if a lady develops issues requiring a hospital visit and prevents providers from abandoning their patients. They also argue that there’s no longer a cause for the Appleton clinic to close and AMS’ providers haven’t attempted hard enough to get admitting privileges.

Along with Wisconsin and Alabama, Louisiana, Mississippi and Texas require abortion suppliers to have admitting privileges. Wisconsin’s law has not yet been enforced since a federal judge put it on hold although the lawsuit was pending.

Wisconsin abortion suppliers challenge law on admitting privileges

Amid Obamacare Rollout, Hospice Suppliers Launch 2014 Schooling Campaign

In an work to boost awareness about hospice and palliative care, the sector is launching a very first-ever nationwide training and marketing campaign this 12 months.

The Nationwide Hospice and Palliative Care Organization  (NHPCO) is launching a very first-ever marketing and advertising and educational campaign about hospice and palliative care. (NHPCO photograph)

The yearlong blitz by the Nationwide Hospice and Palliative Care Organization, which organizers say will be a “multi-million-dollar” effort, will start this month with a grassroots campaign to get stories from hospice patients and their families. This kind of stories will then grow to be portion of a multi-media campaign to educate Americans about hospice and palliative care and spur a “national conversation on the worth of hospice and palliative care.”

It’s the forty^th anniversary of hospice in the U.S. The 1st hospice was started out in Connecticut in 1964 and coverage of this kind of solutions started two decades later on below the Medicare health insurance coverage program for the elderly and disabled.

But most Americans really don’t realize what hospice offers unless they have had a personal experience, analysts and providers say.

“What we are striving to do is begin a national conversation on palliative and hospice care earlier,” mentioned Anita Brikman, NHPCO’s senior vice president of strategic communications explained in an interview with Forbes. “By documenting and sharing real-existence stories in an trustworthy, emotionally candid way, we hope to motivate families to contemplate or look for out a hospice or palliative care provider three to 6 months just before the end of life, not in the ultimate days.”

The hospice market has a monetary stake in the campaign’s success, notably as far more Americans get medical care coverage this yr below the Affordable Care Act and a population of child boomers ages. For example, more and a lot more healthcare care companies are incorporating end-of-daily life care into accountable care organizations (ACOs), which are contracting with Medicare, Medicaid and personal insurers to obtain greater outcomes.

A lot more than five.3 million Medicare beneficiaries will be acquiring care from these ACOs, according to an announcement final month by the Centers for Medicare &amp Medicaid Services, which runs the Medicare system.

The government-led program performs with Medicare contracting with medical doctors and hospitals through an ACO which, in flip, pushes large quality, less pricey care rather than today’s payment technique that typically prospects to extreme care by having to pay for every single treatment method or method that isn’t usually greater. The providers in an ACO are responsible for managing the care of the well being program enrollees and are financially rewarded if the enrollees, or sufferers, remain out of the far more pricey hospital.

ACOs are contracting with private insurers like Aetna Aetna (AET), Cigna Cigna (CI), Humana Humana (HUM), UnitedHealth Group UnitedHealth Group (UNH) and Blue Cross and Blue Shield ideas.

The hospice business sees its service in maintaining with the ambitions of the well being law and this kind of trends in healthcare care reimbursement that emphasize lower costs and high quality like ACOs and the patient-centered health-related house. Hospice, they say, is significantly less high-priced and what the patient desires as opposed to inpatient hospital care.

Hospice is usually considered health-related care supplied in a patient’s residence for these dealing with sickness near the end of their lives. Such care can also be supplied in a center, hospital, nursing residence or other long-term care facility.

“Never prior to has the significance that hospice plays in our healthcare system been clearer,” Donald Schumacher, president and chief executive officer of National Hospice and Palliative Care Organization stated in a statement to Forbes. “As a lot more and more infant boomers are dealing with the end of their lives, the timely and suitable referral decreases household burden and supplies the patient the possibility to say excellent bye with peace, comfort and dignity.”

However the association’s personal data shows the number of patients served by hospice has jumped 25 percent to far more than 1.five million in the final five years from 2008, health-related care suppliers say the sufferers or their households usually don’t recognize hospice was an choice significantly later on in a patient’s “life-limiting” illness.

“People want to be, as much as achievable, at home . . . pain free and surrounding by family and buddies,” Brikman said.

Amid Obamacare Rollout, Hospice Suppliers Launch 2014 Schooling Campaign