Crisis, what NHS crisis? Theresa May must stop this denial | Jan Filochowski

A few months into my first job in the NHS, some 38 years ago, I watched Prime Minister Jim Callaghan being interviewed, on his return to the UK after an international mid-winter summit in the Caribbean, about the strikes in public services that have come to be known as the winter of discontent. I and pretty well everyone working in the NHS, and most of the population, knew there was a crisis. Callaghan’s dismissive comment were famously reported as “Crisis, what crisis?” They didn’t go down well, he didn’t act, and he went on to lose the impending election.

Today, can it really be that our current prime minister is the only one who doesn’t realise there is an NHS crisis?

The comment by the British Red Cross chief executive that there is a “humanitarian crisis” upped the ante, but at prime minister’s questions Theresa May said he was crying wolf. However, the fact is that, humanitarian or not, crisis means crisis, and if she carries on with her current denial – and inaction – the NHS will soon cease to be able to cope.

There have been three further NHS crises since 1979: in 1987-8, as the NHS ran out of money and failed to cope with the winter pressures it faced; in the early 90s, when the sickest patients were left waiting on trolleys in corridors for days; and in 2006, when the NHS overspent across the board because it couldn’t do the limitless amount the Blair government expected of it. Each crisis began to be sorted only when the government of the day finally accepted there was problem, and that ministers had to play a leading part in solving it. And so will this one.

Theresa May and Jeremy Corbyn clash over NHS at first PMQs of 2017

My own experience taking on and turning round three different “failing” hospitals taught me that failure occurs when those responsible for poor performance can’t or won’t face up to the reality and instead present it as merely “challenging”. This government describes a service that is being financed as requested, struggling to meet surprising “record” demand but “mainly” coping reasonably, as (it thinks) NHS England confirms, and which would cope well if the resources diverted to thoughtless people who aren’t very ill were used to support the truly needy.

The reality is starkly different. Senior NHS staff know it but keep quiet because they risk being sacked if they speak out. Demand is rising steadily, in line with long-term predictions, at up to 5% a year, so there is no justification for any surprise. On the other hand, waits are rising up to 20 times as fast, which should be cause for alarm. NHS England’s most recent quarterly figures for major A&Es show an increase in attendances of under 5% and an increase of over 70% in waits of more than four hour in a year. Astonishingly, that the numbers waiting more than four hours increased by more than the number of patients, so fewer patients were seen within four hours than a year previously. If these rates of decline continue, the NHS will simply keel over.

Jeremy Hunt: up to 30% of people using A&E departments do not need emergency care

What capacity exists is increasingly silting up as patients are unable to move from one part of their care to the next because there is no room. Because they are stuck where they don’t need to be, they prevent the next (sicker) group of patients from getting the care they need promptly, a classic downward spiral. To make matters worse, capacity is actually being reduced in social care and the NHS – the result of a financial settlement for this parliament with minimal growth and an assumed £22bn of savings. As his Commons appearance last week revealed, the NHS England chief, Simon Stevens, now realises the settlement was insufficient from the outset.

The capacity shortfall has little to do with the “thoughtless 30%” so excoriated by Jeremy Hunt for turning up unnecessarily at A&E. May’s suggestion, making already overwhelmed GPs work longer hours, completely misses the point, and suggests she does too. It would obviously help a bit if some of the 30% didn’t turn up unnecessarily, but it wouldn’t create capacity where it is currently lacking. The real problems relate to blockages in treating those who are really ill and in immediate need of treatment, and those who need further support in their own home or a care home, to make their discharge from hospital possible. These are the problems May must turn her mind to.

The best report on the NHS in the last 30 years, chaired by Sir Roy Griffiths, memorably said: “If Florence Nightingale were carrying her lamp through the corridors of the NHS today she would almost certainly be searching for the people in charge.” Yet today, three decades on, no one is in charge of the NHS. So much time is spent buck-passing and cost-shifting for problems that require concerted action.

In the meantime, ballooning wait times prejudice safety everywhere, on occasion with disastrous and fatal consequences. This is what “mainly” coping really means. And as the delays increase, so will these consequences.

Crisis, what NHS crisis? Theresa May must stop this denial | Jan Filochowski

Theresa May accused of being in denial over NHS financial woes

Theresa May was in denial about the extent of the NHS’s financial problems and should accept that its sums “just do not add up”, the government spending watchdog has claimed.

Meg Hillier, the chair of the Commons public accounts committee, wrote in a letter to the prime minister on Thursday that growing evidence disproved her insistence that the NHS was getting enough money.

Hillier, the MP for Hackney South and Shoreditch, also accused NHS bosses, including its chief executive, Simon Stevens, of not telling May the truth about how grim the health service’s finances were.

Meg Hillier. Photograph: Jonathan Goldberg/Rex

Hillier is the second select committee chair this week to dispute the accuracy of May’s assertions that the NHS in England would receive £10bn extra funding by 2020-21 and that it was getting all the money it said it needed.

Earlier this week, the government rebutted the health select committee’s detailed critique of government statements about NHS funding, the accuracy of which is increasingly being challenged.

“In nine reports and multiple hearings we have had on the NHS this calendar year, concerns about the sustainability of the budget were very clear,” Hillier wrote.

“As you are aware, concerns have also been raised by the chair of the health select committee, Dr Sarah Wollaston MP, in her letter to the chancellor of the exchequer on 26 October. I was dismayed that the official government response was to deny there was any issue. This flies in the face of the evidence that our committees and the National Audit Office have uncovered.”

Hillier added that growing demand for patient care and a reliance on expensive agency staff, due to budget restrictions stopping trusts hiring permanent workers, were behind the NHS’s financial problems, rather than overspending by hospitals.

The Guardian revealed last month that, at their first meeting on 8 September, May told Stevens that the service would get no extra money in the autumn statement and that it should focus on becoming more efficient.

In an apparent reference to that meeting, Hillier said: “Too often NHS personnel raising concerns find themselves pariahs in the system. There is a long list of formal whistleblowers who have never worked in the NHS again as a result of their willingness to raise their concerns. I fear that this lack of willingness to talk truth to those in charge extends right up to No 10.”

In an annex to the letter, summarising evidence the committee has heard this year about how lack of money is affecting various NHS services, Hillier told May: “Taken as a whole, the current situation and the current budget just do not add up.”

May is under fire for saying the government is giving the NHS £10bn extra, allegedly £2bn more than it requested. However, Stevens has dismissed the £10bn figure and also warned that underfunding may force NHS bosses to ration care and close some hospital units.

Downing Street did not respond immediately to Hillier’s letter. But on Monday a government spokesman responding to the health select committee’s letter to Philip Hammond said: “The government has backed the NHS’s own plan for the future with a £10bn real-terms increase in its annual funding by 2020-21, helping to ease the pressure on hospitals, GPs and mental health services. It is wrong to suggest otherwise.”

Theresa May accused of being in denial over NHS financial woes

"I was in detox denial - till I attempted it"

DAY one

Pre-retreat guidance is to reduce back on caffeine, alcohol, bread, and snack food items the week before departure ‘’in purchase to acquire maximum benefit from the programme whilst you are away’’. I read through this essential information for the 1st time at 30,000ft en route to Spain while sipping my second gin and tonic of the flight.

At Malaga we’re greeted by our host, Mel Brown, a nutritionist who, judging by her trim physique and radiant skin is a focused practitioner of what she preaches. There are other suspiciously toned looking men and women, possessed of small suitcases and a vitality entirely lacking in the group of females (myself included) burdened with also considerably luggage that was now assembling around Mel. Turns out these are the personalized trainers (PTs) accountable for the week’s fitness regime.

Some 90 minutes later we arrive at the Hotel Monasterio de San Martin, near the village of Gaucin in Cadiz province. It is a discrete compound with white-washed walls draped in bougainvillea and surrounded by orange, lemon and olive groves and little else. In the somnolent heat of late afternoon, it is utterly peaceful – and we have it to ourselves.

I have the first of a zillion cups of herbal tea that I’ll drink over the next week as I work my way by means of the in depth variety in search of one particular that tastes of something… anything at all.

Dinner is served at a communal table on the terrace more than-searching the lush gardens. We are 17 in complete, 15 women and 2 guys, ranging in age from early twenties to mid-sixties and most are lone travellers. Meals – starter, principal program but no dessert – is remarkably delicious considering the restrictions.

And, rather excitingly, there is as much water as a single can drink. Mel introduces the in:Spa crew comprising 3 private trainers, a yoga instructor, a nutritionist, a massage therapist and a chef. She talks us by way of the week ahead and assures us this isn’t a boot camp. Attendance at the different pursuits is not compulsory. Later I discover the grounds and learn a massive pool and fitness pavilion. In bed by 9pm which is a initial in a decade or much more.

DAY two

My everyday existence is dominated by schedules – by conferences, meetings, appointments. So the last factor I want away from function is the want to adhere to 1, but I discover it is quite much a characteristic of the retreat.

There is a group schedule of routines and an person schedule created up of two PT sessions, two massages and a consultation with a nutritionist. I truly feel exhausted just studying it. It may not be boot camp but give a stressed out girl a routine and what decision does she have but to adhere to it?

So at 8am I’m discovering just how inflexible my body is in a yoga class, taken by former ballet dancer Isaac Mullins (www.isaacmullins.com) whose very own posture and economy of motion exude a calmness that all agree we aspire to, nonetheless unrealistic that may be. My inability to sit cross-legged (dodgy hip) seems to startle him at initial but he finds an alternative position for me with a number of props.

At breakfast we’re encouraged to combine protein (eggs) with a vast array of fruit, seeds and grains (multi-grain crackers are a excellent substitute for bread – see recipe beneath) in various varieties from the buffet. And, yes, drink water, although a little glass of orange juice is available but not encouraged (sugar alert!). My kidneys might be celebrating but I would destroy for a cup of Yorkshire Gold.

The day unfolds: a cross-training class that aims to challenge most muscle groups by means of a demanding circuit that leaves us exhausted a dance class with Mal Coombes (www.movtime.co.united kingdom), yet another dancer and musicals veteran turned personal trainer to the stars (Boy George, no significantly less). He’s a guy in perpetual movement and his danceFITT lessons, with booming 80s soundtrack are, along with the yoga, the most well-known of the week.

Throw in a massage and a lecture on the evils of dwarf wheat (the modern type of wheat which is less nutrient-rich and tougher to digest than the standard crop), then it’s time to wind down with restorative yoga ahead of dinner. Attendance is generally great at all lessons, no one particular skiving off just but.

There is plenty of rest time created in, to chill in your room or by the pool. I have the hint of a headache which I get to imply detoxing is under way. Hurrah!

Bed by 9pm.

DAY 3

Our very first hike, a 7am start and by 9am we’re making good progress up a prolonged, winding hill, dripping with sweat and breathing tough, in the Los Alcornocales All-natural Park. It is property to the biggest cork oak forest in Spain, and the largest oleander bushes and thistles I’ve ever witnessed.

Walking solo and taking in the views of mountains, valleys and plains is a delight, but so as well is falling into conversation with fellow detoxers, affording as it does a glimpse of the trials and tribulations of other lives.

One lady booked the retreat following her husband, whom she had nursed, was offered the all clear from cancer one more had just broken up with her partner following two years. A bride-to-be wished to kick commence a healthier life style with a view to commencing a loved ones, even though a person who had gained bodyweight following injury had incapacitated her was desperate to shift some lbs.

Indeed, most were keen to get rid of weight or at least start off the approach, but all were clear that their common well-being was the focus. ‘’I needed to do something for me,’’ a single lady explained.

We are urged to sip water continuously as very good hydration is crucial to hold detox signs and symptoms at bay. I’m feeling Okay, boosted by a high power ‘date ball’ (see under) and an apple when we cease for a break. But for a fleeting second my vision blurs, objects about me consider on a shimmering visual appeal. I blame it on the intensity of the sun and carry on.

Back at the hotel lunch is served but abruptly, and despite getting hungry, I can’t bear the sight or smell of foods, as appetising as it seems. I disappear to my space exactly where, more than the following hour I begin to truly feel sicker than I can ever bear in mind. My head is in a vice, increasing tighter by the minute, I come to feel nauseous and the light creeping around the drawn curtains hurts my eyes.

I’m scorching and cold by flip and are not able to settle. At some point, convinced I have meningitis, I seek help.

“What is it you truly feel like,” Mel asks perceptively. “Is there something your entire body would like?” “Glucose,” I gasp, “glucose.” Till that moment I didn’t know it. But the realisation – and the supply of a date with honey – triggers my flight to the flower bed to throw up.

The caffeine-free diktat is relaxed and a cup of sweet tea produced and, joy of joys, a sugary biscuit. Mel (melaniebrownnutrition.com) confesses to contraband for emergencies. Within minutes – literally minutes – the headache and nausea are receding. But I’m confined to bed for the rest of the day and I dine on a sachet of Dioralyte. Miss boxing and yoga. Bed by 8pm.

DAY 4

Following my histrionics of the day just before, I’m now on unique measures: created to sip scorching water and salt with breakfast to lessen extreme dehydration, followed by more Dioralyte. No 1 else has suffered anything much more than a headache.

Nutritionist Tanya Borowski (www.nutritionalvalues.co.uk) concludes that a mixture of dehydration, exertion on the hike, the change in diet regime, and a sudden tension response had triggered my glucose crash. There is no mobile signal at the hotel but while hiking my telephone had picked up a number of texts telling me of a drama back house about which I could do very little. As an explanation it made sense.

Anyway, I’m feeling fine now, even more energised if I’m honest: out at 8am on a 5K walk/run with PT Kate Taylor who specialises in strength coaching for females (www.ambitionfitness.com), then X-instruction, and one more PT session (boxing) with Stan Blair, an expat operates at Sotogrande (www.slicfitness.com).

The day concludes with 1 more fitness class and restorative yoga. I prefer the latter to the much more demanding morning sessions which I’ve started to skip.

Early to bed once more. A single of the advantages of no alcohol is that lingering on the terrace right after dinner with a glass of water or an herbal tea does not have the very same allure as when a carafe of wine is concerned.

DAY 5

An additional 7am start and another, difficult ‘’fat-busting’’ hike. ‘’Nothing works much better than hills if you want to shed excess weight,’’ Stan Blair tells us. This time there are no dire consequences for me.

Studying the rest of the group I notice a marked distinction, the two in visual appeal and mood. A few days publicity to UV rays helps of program and sun-kissed is often a greater seem than pale and pasty. But every person appears much less tense and their bodies sleeker as they move a lot more freely. Pounds have definitely shifted which would seem virtually miraculous in this kind of a brief room of time. My very own abdomen is flatter than I can remember and clothes undoubtedly looser.

Every person agrees that they really feel less bloated – that universal complaint of womankind – and that soon after preliminary gut disturbances (constipation or diarrhoea) which can consequence from a change in diet regime and withdrawal of specified meals, digestive methods are calmer.

Mentally, as well, there is the relief that comes with freedom from every day responsibilities of household and perform. Right here you are responsible just for yourself, and the only decisions to be made are whether or not or not to attend a class or settle on a lounger with a guide by the pool.

The lack of mobile signals and erratic Wi-Fi that meant email entry is difficult had been a supply of anxiety for all of us utilized to far more or less 24/seven communication. I think about my mobile a component of my anatomy. But, as the days pass, it is such a relief not to have a purpose to preserve checking it. I even neglect about it after or twice.

DAY 6

Original hunger pangs of the initial couple of days have now subsided. I locate myself totally satisfied consuming meals of protein (chicken, turkey, fish or eggs) and plentiful greens and salads 3 instances a day. Wholesome carbs are obtainable but we’re recommended to go simple if 1 of our goals is excess weight reduction. Snacking is gently frowned upon even though nuts and seeds and numerous fruit/veg drinks are available late each afternoon for people who want a tiny some thing. Sugar cravings have disappeared.

Miranda Martin (mirandamartin.co.uk), the in:spa chef, is a marvel who tends to make healthful consuming a joy. Her cookery demonstration midweek showcases recipes that hectic people may possibly really contemplate. Her raspberry muffins (see below), are worthy of a specific mention in dispatches.

Have an additional fantastic massage, tailored to my distinct aches and pains from in:spa therapist Jo Nighy.

And early to bed yet again. If only this could turn into a habit…

DAY seven

The third and last – and most demanding – hike of all sees us scrambling, practically on hands and knees at times, up a steep, rocky path. It is a mercifully short ascent and the views from the best worth it – down to the Costa del Sol and to the proper along the coast to the Rock of Gibraltar. Then on down by way of a pine-forested valley to the town of Juzcar, well-known for painting its conventional white buildings blue in 2011 to mark the premiere of the Smurfs movie. (They’re now white once again). Bars and cafes are open but no one tends to make a break for it in search of an espresso, although some speak longingly of ice-cream.

As a group we’re transformed. Everybody is commenting on it and complimenting each other: much less tired and tense, definitely slimmer, generally a lot more relaxed, laughing and smiling a lot more readily. There is no question that feel great factor amongst us has taken root.

Do I feel in the benefits of detox now? I undoubtedly feel there is no harm in providing your body a break from its every single day stresses, fuelling it with easier but high-good quality foods, and creating hydration a priority.

Getting it moving is bound to increase mood, boosting endorphin release and blood-flow. Most of us are sleep deprived and a week of early nights was for me at least transformative.

Just before this retreat I did not believe that a week could make such a variation to so numerous men and women. I do now. Translating some of that encounter back in the genuine world is hard but 5 weeks on I’m following a largely gluten-free of charge diet regime, have lower back dramatically on dairy goods and workout is when a lot more part of my daily routine.

Final proof of the positive aspects of the retreat came back at Malaga airport when news of a 12 hour delay to our flight was greeted with smiling equanimity – even though most of us then headed for the bar. We felt we’d earned it!

Spa Spy (Liz Hunt) was a guest of in:spa, which provides 7-night health, fitness and detox retreats in Andalusia, the South of France and Marrakech. A seven-night in:spa retreat in Andalusia costs from £1,895 pp and is primarily based on two sharing on an all-inclusive basis. Value contains all group actions, 1 x nutrition consultation, one x private education session, two x massages and personal airport transfers. Price tag excludes flights, despite the fact that in:spa is in a position to advise on flights at the time of booking.

http://www.inspa-retreats.com/locations/personal-residence-in-andalusia/1/all/summary/

Following retreat in Andalusia is Aug 14-21 (£500pp saving on this retreat) South of France July 31-Aug seven Sept 14-20 Marrakech Oct sixteen-23 and Nov 12-19 Dec 28-Jan four 2015.

RECIPES

Healthful Berry Muffins

(Makes 2, so double up as suitable)

two tblsp cooked quinoa and 2 tblsp of polenta

one tblsp soaked chai seeds

one tblsp sunflower oil

one egg

A drizzle great high quality maple syrup

1 tblsp berries – fresh or frozen

Mix all the “wet” components together. Then combine into the dry elements and spoon into a non-stick muffin tray

Cook for 25 mins at 180 degrees

Power Snack Balls

Mix collectively 1 cup every single of: Almonds, pumpkin and sunflower seeds

Include up to two tblsp of 1 or combo of: hemp powder, raw cacoa, flaxseed and gogi berries, maca powder, lacuma

Bind with two cups chopped and pitted dates (majhol best)

To make them bind exactly- use rice syrup, whizzing right up until you see combine clumping collectively. Roll in cocoa, coconut

Crackers (a great option to bread)

Place in a measuring jug one hundred ml every of four varieties of seeds – pumpkin, sesame, sunflower and chia a grated carrot and some fennel seeds 300ml gluten cost-free flour

Include pinch of salt and baking powder.

Include flavouring: carrot, seaweed, rosemary and sea salt, sun-blushed tomatoes, chopped olives, herbs

Combine with approx. 200ml water, right up until reach a cookie dough consistency but not also wet.

Divide into 3 and put 1 on a baking tray, cover with baking sheet and roll

Bake at one hundred degrees for 1 hr.

"I was in detox denial - till I attempted it"

Bristol Children"s Hospital "still in denial" about deaths, say parents

Sir Bruce, the medical director of the NHS, announced the inquiry following an emotional three-hour meeting on Friday with seven households whose children both died or were left significantly ill following treatment method in Bristol.

Yesterday, Faye Valentine, the mom of 7-12 months-old Luke Jenkins who died just days soon after he was moved out of intensive care following heart surgical treatment at BCH said: “We are extremely glad to see Sir Bruce Keogh take action and recognise our considerations.”

Mrs Valentine, 28, from Cardiff additional: “Sir Ian Kennedy carried out the preceding review at Bristol when numerous kids died and suffered for the duration of the 1990′s and his findings and recommendations did not appear to be carried out so we hope with his expertise and the cooperation of Sir Bruce’s staff, the families involved and the hospital that we can all attain our aim of creating confident Bristol children’s hospital is protected for potential patients.

“We are anxious that the hospital have been in denial, particularly the management as there are some superb staff that do work there, but every person is getting allow down. We just hope that now the spotlight has been positioned further on them that they will stand up and realise they require to carry out action programs and suggestions that could come out of this evaluation.”

Another bereaved mother or father, Steve Turner whose four-yr-previous son Sean died in the course of the after-care at the children’s hospital following corrective heart surgical procedure in March 2012, tweeted: Unfortunately Bristol Children’s Hospital’s culture has slipped back the incorrect way. Let’s hope Ian Kennedy can pull it up by its boots.”

Last year it emerged around 10 households have been believed to be taking legal action towards the trust, such as 7 whose kids died right after getting handled at the hospital.

Previously some had named for a public inquiry into what they claimed to be “chronically reduced specifications”.

A spokesman for University Hospitals Bristol NHS Foundation Trust explained it welcomed the review.

A spokesperson mentioned: “The Believe in remains troubled that households whose kids we have cared for carry on to have worries about the care provided regardless of our attempts to respond to these troubles. We hope that the meeting this week will support to resolve the families’ exceptional considerations or highlight techniques in which the Believe in can react additional and we welcome the possibility to contemplate suggestions from the meeting.

“We have learnt considerably from the experiences of the households meeting these days and have produced numerous modifications in locations the place shortcomings had been highlighted, particularly in how staff talk with parents.”

Bristol Children"s Hospital "still in denial" about deaths, say parents

Bristol Children"s Hospital "still in denial" about deaths, say parents

Sir Bruce, the medical director of the NHS, announced the inquiry following an emotional three-hour meeting on Friday with 7 families whose children either died or have been left significantly unwell following therapy in Bristol.

Yesterday, Faye Valentine, the mother of 7-12 months-outdated Luke Jenkins who died just days right after he was moved out of intensive care following heart surgical treatment at BCH mentioned: “We are extremely glad to see Sir Bruce Keogh consider action and recognise our issues.”

Mrs Valentine, 28, from Cardiff extra: “Sir Ian Kennedy carried out the prior evaluation at Bristol when several young children died and suffered for the duration of the 1990′s and his findings and recommendations did not seem to be carried out so we hope with his information and the cooperation of Sir Bruce’s group, the families involved and the hospital that we can all achieve our aim of producing confident Bristol children’s hospital is protected for future sufferers.

“We are worried that the hospital have been in denial, specifically the management as there are some exceptional personnel that do work there, but absolutely everyone is being let down. We just hope that now the spotlight has been positioned further on them that they will stand up and realise they need to carry out action programs and recommendations that may come out of this review.”

Another bereaved mother or father, Steve Turner whose four-year-old son Sean died during the following-care at the children’s hospital following corrective heart surgical treatment in March 2012, tweeted: However Bristol Children’s Hospital’s culture has slipped back the wrong way. Let’s hope Ian Kennedy can pull it up by its boots.”

Final yr it emerged around 10 families have been believed to be taking legal action against the believe in, including seven whose kids died following currently being handled at the hospital.

Previously some had known as for a public inquiry into what they claimed to be “chronically low requirements”.

A spokesman for University Hospitals Bristol NHS Foundation Believe in mentioned it welcomed the assessment.

A spokesperson stated: “The Trust remains troubled that families whose youngsters we have cared for continue to have concerns about the care provided regardless of our attempts to reply to these issues. We hope that the meeting this week will aid to resolve the families’ excellent issues or highlight methods in which the Believe in can reply further and we welcome the opportunity to take into account feedback from the meeting.

“We have learnt a lot from the experiences of the families meeting right now and have created a lot of changes in places in which shortcomings have been highlighted, specifically in how workers communicate with dad and mom.”

Bristol Children"s Hospital "still in denial" about deaths, say parents