To improve mental health, start with benefits system | Sarah Chapman

Two-thirds of British adults have experienced mental health problems at some point in their lives, according to the Mental Health Foundation. For people forced to use a food bank like ours, the figures are even higher.

It’s no wonder. The NHS says depression can be caused by “an upsetting or stressful life event, such as bereavement, divorce, illness, redundancy and job or money worries”. People who use food banks face many of these – often at the same time.

A blister from new work boots leads to an ulcer; you’re struggling to walk round the building site and the foreman lays you off with no warning and no sick pay. It takes weeks to access sickness benefits. Your marriage breaks down and you’re suddenly homeless. This is just one story, of a man in his 60s facing an onslaught most of us would struggle to withstand.

Our research highlights that poor mental health is both a cause and a consequence of poverty. Of 20 food bank users we interviewed during one week, 18 said they had experienced poor mental health – stress, anxiety and depression – in the last 12 months. Six said they had considered or attempted suicide in the past year.

Philip*, for instance, had just left hospital when he came to us, after being sectioned six weeks earlier when he attempted to take his own life. Sue*, a grandmother in her 50s, told us, “I’ve had suicidal thoughts. Sometimes I do feel it is the answer. I constantly think of different ways, you know – that can take up a whole evening”.

This is the reality of food banks across the country. Research with referrers to our food bank (such as GPs, mental health services, schools and children’s centres) highlights the same issue; nine out of 10 cite seeing poorer mental health as a direct consequence of poverty.

Time and time again, research [pdf] shows that poverty exacerbates mental health issues by increasing feelings of humiliation, fear, distrust, isolation, insecurity and powerlessness.

Insecurity when you lose your low-paid temporary job or you don’t get the hours you need in a zero-hours contract; when your benefits are due to change as a child turns five, or your Disability Living Allowance needs replacing with Personal Independence Payment; when your private landlord calls time and you join the queue at the council, desperate to be accepted on to the housing list.

Humiliation when your benefits are sanctioned for missing one appointment and “you can’t complain because they’ve got control of you by the money”, as one lady told us after being referred to our food bank by the job centre that sanctioned her. “They can do what they want with you, unless you say please and thank you, and beg.”

Policies that create appalling situations that damage people’s health make me more angry than I can say

Isolation when your “one offer” of temporary accommodation is miles away in another borough, where you don’t know anyone but you’ll still need to get your children back to primary school every day (and you’ll receive no financial help for the extra travel costs).

Fear and distrust when you are called for a medical assessment and the report bears little relation to the interview you had, and even less relation to the expert testimony of your GP, hospital consultant or support worker. Your benefit stops.

We listen to these stories every day at the food bank, keeping how we feel to ourselves as we nod, hand out tissues and make more tea. The short-sightedness of policies that worsen – sometimes even create – appalling situations that damage people’s health makes me more angry than I can say.

You try it. “The job centre told him he needed to do his job in a wheelchair,” says Asha*, mum of three, about her husband, a supermarket delivery driver whose back problems mean he can’t walk properly. “His job? It doesn’t make sense. But to even get to work, he needs to get out of his depression first. Last week he took an overdose.”

“It’s like a nightmare,” she continues. “The system makes it worse and in the end they just leave you with your problems. Any small change and you can lose everything. When it will stop?”

If politicians are serious about tackling poor mental health, our social security system needs to be strong – and for those lining up at our door every day to put food on the table for their kids, it just isn’t.

We should be a country in which people are treated with humanity, fairness, respect and compassion. We need a safety net that is more responsive to unexpected changes in circumstances and health, and less quick to penalise people for whom, at one particular moment in time, life has become an unbearable struggle. That would mean a benefits system which actually boosts people’s chances of improving their life prospects. Until then, we’ll have to keep training our volunteers in mental health issues, because we’re not just handing out food – we’re a source of solace.

* Some names have been changed

Sarah Chapman is a trustee at Wandsworth food bank

Talk to us on Twitter via @Gdnvoluntary and join our community for your free fortnightly Guardian Voluntary Sector newsletter, with analysis and opinion sent direct to you on the first and third Thursday of the month.

To improve mental health, start with benefits system | Sarah Chapman

How we can start a social care revolution in seven easy steps | Katie Johnson

The government’s commitment to provide an additional £2bn for social care in the spring budget was presented as a solution to help ease pressure on the NHS and councils over the next three years. While the measure has addressed the immediate funding crisis, there is concern that this is no more than a short-term fix. The announcement risks masking the true scale of the challenges ahead and the radical surgery required to reform social care.

In all likelihood, the extra money will be used by local authority and NHS commissioners to block purchase places in residential care homes. This is not the answer.

Spending money in this way will do little to tackle the fundamental problem: we are admitting too many older people to hospital, keeping them there for too long and failing to give them the care they need in their own homes.

While cheaper than a hospital bed, a place in a residential care home is still more expensive and, crucially, less effective than care and support in the community.

There needs to be a transformation in the way that social care is commissioned and provided, to improve the quality of care, but also to make services financially sustainable, without the need to raid other budgets for extra funding.

A strategy for reform would have seven key elements:

1. Champion independent living

We need to engineer a dramatic shift away from residential care towards the kind of support elderly people actually want and need. That means better support for people to live independently in their own homes, with a skilled, professional workforce to provide the advice and assistance they need. We need to invest in a model of care that involves greater collaboration between the person being supported and those providing support.

2. Support families and carers

There needs to be stronger provision of advice and assistance for families and other carers, and more effective liaison with voluntary and community organisations that are skilled in providing support to older people. This means creating partnerships that can empower volunteers and deliver more professionalised community care.

3. Shift the funding focus to community-based care

Local authorities need to switch their focus away from expensive residential provision to support family, carer and community-based services. This funding shift is necessary if we are to create a fundamentally new system that offers holistic care in the home and keeps older people, wherever possible, out of hospital and residential care.

4. Incentivise local authorities

Local authorities should be incentivised to purchase individually tailored packages of care. Why are we so afraid of asking people, and their relatives and carers, what they really want and need? Many councils want to do this, but their options are limited by what the market can provide or by a lack of imagination. They should be rewarded when they invest in transforming the way providers think about services.

5. Prevention rather than cure

Transforming the social care system, rather than simply shoring it up, would address the problem of delayed discharges from hospital, but also reduce the flow of older people into hospital in the first place. It would prioritise prevention, rather than waiting for problems to arise and then attempting an inadequate cure. The best local authorities are already using their resources creatively, such as looking at predictive analytics to anticipate demand.

6. A better alternative to ‘integration’

There is plenty of talk about the need for an integrated health and social care system, or even a “National Care Service”. There is a much simpler solution. NHS providers and local government need to co-operate better to find the right kind of care for elderly people.

Liaison between hospitals and local authorities will never be truly effective if it is just one more item on the to-do list of hard-pressed nurses and social care workers. It requires dedicated resources – well qualified people whose full-time job it is to ensure that the hand-offs between hospital and community care are speedy, efficient and driven by the individual needs of the patient. Creating these vital liaison roles should be only the first step in a programme to transform the skills and role of the social care workforce.

7. Pool resources

Just as the NHS and local authorities should look to share resources, there is a key role to be played by combined authorities and other city and county partnerships. They should be encouraged to pool their money to fund the transformation of social care.

The budget has already seen one U-turn. It is not too late to redirect the £2bn and make a real difference to health and social care in the UK.

Katie Johnston is director at KPMG

Join the Social Care Network to read more pieces like this. Follow us on Twitter (@GdnSocialCare) and like us on Facebook to keep up with the latest social care news and views.

How we can start a social care revolution in seven easy steps | Katie Johnson

Organic Breakfast Ideas That Will Help Give Your Day A Good Start

There’s nothing healthier than starting your day with an organic breakfast.

Bread, cereal, fruits, yogurt, eggs, and pancake mix are just some of the many delectable morning meal ingredients available as organics. If you’re new to an organic lifestyle, you’ll be surprised how you can still enjoy your favorite breakfast dishes. You’ll realize that going organic isn’t as hard. It may even inspire you to create your own selection of deliciously healthy, satisfying morning meals.

Here are some organic breakfast ideas that will help give your day a good start:

1. Organic Flourless Peanut Butter Jelly Pancakes

This one is a classic favorite, easy to prepare breakfast not just for you, but for the whole family. For sweet and pancake cravings at the start of your day, here’s a pleasantly delightful pancake recipe. It doesn’t only taste great, but it’s packed with protein. It’s an awesome grain-free and gluten-free breakfast.

Here’s what you’ll need:

1. 4 pieces of Organic Eggs


2. A cup of Peanut, Almond, or any Nut Butter (Organic)


3. 1/4 cup of Organic Greek Yogurt


4. A tablespoon of Vanilla Extract


5. 2-3 Tablespoons of Organic Jam (Strawberry, Blueberry, Raspberry, Apricot, or any jam that you prefer)


6. Agave or Maple Syrup (Organic)


7. Coconut Oil

Here’s how to prepare:

1. Mix the first 5 ingredients in a bowl, and blend them with a whisk.


2. Heat your frying pan/skillet to 350F.


3. When the frying pan is hot, pour a small amount of coconut oil.


4. Pour the pancake batter mix into the frying pan and cook till both sides are golden brown.


5. If you prefer, add some agave/maple syrup or more jam on your pancake.


6. Enjoy!

2. Organic Avocado Pineapple Sandwich Toast

This sandwich toast offers a good balance of protein and vitamins. This recipe is made even more delicious with honey mustard as a supplement.

You’ll only need:

1. 2 Slices of Toasted Organic Wheat or Oat Bread


2. Avocado


3. Fresh Pineapple Slices


4. Spring Mix


5. Organic Honey Mustard

How to prepare:

1. Just combine the ingredients to make a sandwich. So simple, so fast.

3. Green Organic Smoothie

Green smoothies will surely give your day a good start. It offers a healthy and nutritious blend that’s easy on your stomach and will also energize you for the day.  You may want to swap some of the ingredients according to your preference.

Here’s what you’ll need:

1. Banana


2. Spinach


3. Organic Greek Yogurt


4. 1/2 Orange


5. Almond Milk or just Water

How to prepare:

1. Simply mix them all in your blender until it’s creamy. That’s just about it.

These super quick organic breakfast ideas are perfect for those who love eating healthy and getting fit. You can never go wrong with going organic. Organic foods or ingredients are now easily found in every grocery store.

Author bio: The article on organic breakfast ideas has been written by Ignacio D. Pena who is a very active blogger and loves to write in the Food niche.

Organic Breakfast Ideas That Will Help Give Your Day A Good Start

THIS Will Happen When You Start Drinking Golden Milk Every Night (How it’s made)

THIS Will Happen When You Start Drinking Golden Milk Every Night (How it’s made)

10 Best Superfoods To Kick Start Your Day

10 Best Superfoods To Kick Start Your Day

Life expectancy in Syria fell by six years at start of civil war

Life expectancy in Syria fell by six years in the first three years of the civil war, according to a study showing that the health of populations in many countries that experienced uprisings or conflict during the Arab spring has suffered serious effects.

Between 2010 and 2013, average life expectancy dropped by approximately three months in Yemen, Tunisia and Egypt, according to research published in the Lancet global healthjournal. Libya experienced a steep drop in life expectancy after the 2011 uprising that deposed Muammar Gaddafi, but it rose after the initial conflict ended.

Worst affected was Syria, where men and women were expected to live to 75 and 80 respectively in 2010, but 69 and 75 by 2013. Infant deaths in the country rose by 9.1% over the same period, in stark contrast to the average 6% yearly decline in the decade to 2010, according to the study.

Ali Mokdad, professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington, Seattle, who led the research, said the situation was likely to have worsened since.

“The sad part is that we stop at 2013 and we know that the war has been raging in Syria [since], and there’s a war in Yemen and war in Libya right now as well,” he said. “People are dying from killing and bombing, but they’re also dying because they’re unable to get their blood pressure medicine, not able to get to hospital. Kids are not eating properly, getting anaemia – we need to stop this madness.”

The study authors warn that hard-won gains that have led to life expectancy in the eastern Mediterranean region as a whole increasing from 65 in 1990 to 71 in 2013 are under threat. In the same period, life expectancy in Libya, Syria and Yemen rose steadily by about three months per year.

Mokdad said the situation had been aggravated by a brain drain of doctors, who were often among the first to leave when conflict broke out even though their skills would be vital during war and beyond.

The report, funded by the Bill and Melinda Gates Foundation, warns that on top of the direct threat posed by conflict, millions of people in countries where uprisings took place in 2010 are faced with dire water shortages and poor sanitation, which can lead to outbreaks of disease. Frequent attacks on vaccination teams have slowed immunisation campaigns, and polio has again become a major concern – especially in refugee camps – at a time when the region was close to eradicating it.

Mokdad said: “We need a road map for building health infrastructure in these countries. All we do in immunisation is based on electricity for the fridges to keep medicines in, everything is based on roads, everything is based on safety, so drivers can deliver. All countries need to come together to fix this.”

Just under two years ago, the UN estimated that the death toll in Syria from the conflict was 250,000. But in February, the Syrian Centre for Policy Research said 470,000 people had died – about 400,000 directly owing to violence and 70,000 because of a lack of adequate health services.

Life expectancy in Syria fell by six years at start of civil war

British smokers urged to start vaping by well being officials

Britain’s eight million smokers have been urged to start off ‘vaping’ soon after a government-backed report identified that the electronic gadgets are 20 times much less dangerous than traditional cigarettes.

So far no electronic cigarette has been licensed by the Medicines and Healthcare merchandise Regulatory Company (MHRA) or the National Institute for Overall health and Care Excellence (Nice).

But a new report launched these days by Public Well being England, Kings College London and Queen Mary London, discovered e-cigarettes carry just 5 per cent of the risk of tobacco and must be broadly adopted by smokers.

If each smoker in Britain switched to vaping, all around 75,000 lives a year could be saved, they estimate. The authorities known as for e-cigarettes to be prescribed on the NHS as soon as regulated.

Nagy Memes Szabolcz and Georgia Samuels at Vapefest, Shrewsbury

Nevertheless several scientific studies have identified that the flavours employed in e-cigarettes may result in respiratory issues and damage the immune technique while analysis published on Tuesday by the University of Southern California advised they could encourage youngsters to take up smoking.

“E-cigarettes are not completely threat totally free but when compared to smoking , evidence displays they carry just a fraction of the harm,” mentioned Professor Kevin Fenton, Director of Well being and Well-getting, at PHE.

“We’re encouraging smokers to look at e-cigarettes as a way to help them to lessen publicity to harm from smoking.

“At the moment there are no licensed goods that can be utilized for medicinal purposes and that’s why we are extremely supportive of the MRHA seeking at the pathway for making certain that there are safe and regulated e-cigarettes that can be promoted for health care purposes.

“Smoking continues to result in the biggest numbers of preventable deaths every single 12 months. Our ambition remains to see the 1st smoke free of charge generation by 2025.”

“Concerns do remain as to the prolonged-phrase well being impact of e-cigarettes…”

Penny Woods, Chief Executive of the British Lung Basis

British smokers urged to start vaping by well being officials

Assisted dying: this Bill has so numerous flaws I will not know the place to start off

The Residence of Lords is debating, on Friday, a question the answer to which has an effect on every man or woman in the land – must we permit medical professionals to aid and abet the suicides of some of their patients? Because this is what Lord Falconer’s Private Member’s Bill quantities to.

Lord Falconer seems to be below the misapprehension that his Bill has the backing of the Supreme Court. The Court has surely known as for Parliament to take into account whether or not the law must be altered. But, insofar as it has ventured into the dangerous territory of how it may possibly be altered, its pondering seems to be far eliminated from what Lord Falconer’s Bill is proposing.

In his judgment 3 weeks in the past the President of the Court speculated – no a lot more than that – that the balance among providing some individuals the selection of assisted suicide and guarding other people from harm as a result may perhaps be accomplished if (and allow us quote him verbatim) “no support could be given to a particular person who wishes to die except if and right up until a Judge of the Substantial Court has been content that his wish to do so was voluntary, clear, settled and informed”.

My own examination of Lord Falconer’s Bill demonstrates it to be deeply flawed. Its so-known as safeguards are feeble: they are similar to placing up a discover not to go close to the edge of a cliff but not placing a railing there to stop men and women falling above. It defines terminal illness in this kind of a way as to carry huge numbers of people with chronic illnesses and disabilities within its ambit. It has no compliance system. I could go on and on. But, given that the Supreme Court has known as on Parliament to deal with this query and as Lord Falconer’s Bill is on the table, we need to give it our complete consideration.

In this procedure I hope the House of Lords will devote rather significantly less time focusing on philosophical rules, like autonomy, and far more on the challenging practicalities of life that numerous of us face in our every day lives. It is all very effectively for a minority of sturdy-willed and self-assured individuals to assert that they want for themselves what they call (incorrectly, as it presently exists) a “proper to die”. I am far more concerned with the plight of the underdog – of significantly ill and disabled folks who are struggling to cope with existence amid poor social care, inadequate housing and loneliness (that growing ailment of our society) and who do not want to die – but who could all as well easily locate themselves drawn into ending their lives out of depression or despair.

Choice is a wonderful issue but it has to be true choice, and many folks just do not have that. As peers we are used to taking decisions for ourselves, we know how the law operates and we are normally capable to look after our personal interests with no difficulty. But we must remember nowadays that many people’s encounter of lifestyle, specifically the sick and the disabled, is much less about undertaking and far more about becoming completed to. These are the men and women who want our help and safety.

Patronising, some might say. But as legislators we have a duty to ensure that any laws we make do not expose other men and women to harm. That is what leads to me to fret about the notion of supplying help with suicide inside the NHS.

Baroness Grey-Thompson is a crossbench peer

Assisted dying: this Bill has so numerous flaws I will not know the place to start off

Personal school pupils have head start off in sports activities, says Ofsted video

Ofsted chief Sir Michael Wilshaw says too a lot of pupils are getting denied the chance to get part in aggressive sport by state schools who treat it as an “optional extra”. He says the current report shows a link among carrying out properly on the taking part in fields and in the classroom. The schooling watchdog, Ofsted, has called on state colleges to urgently increase the good quality of competitive sport they offer you

Personal school pupils have head start off in sports activities, says Ofsted video

An Entrepreneur"s Prescription For Repairing Healthcare: Start Innovating!

Jonathan Bush is CEO and Co-Founder of athenahealth, Inc., a cloud-primarily based overall health technological innovation and services business. In his lately published book entitled “In which does it Hurt?: An Entrepreneur’s Guide to Repairing Well being Care” he shares his basic belief in the want for techniques-altering innovations in health care. Ashoka approached Jonathan to draw him out on his vision and driving principles. 

What do you see as the largest shift in business practices we are witnessing nowadays?

There has been a massive shift in how organization functions, since the World wide web allows people anyplace to entry info and products. And for people who are marketing an details item, it allows instantaneous accessibility to a worldwide market, which helps make it possible to design and style and sell customized merchandise like by no means just before. We are also moving towards an economy in which repetition of “business as usual” virtually often guarantees failure. Sadly, these revolutions have not nevertheless reached the overall health care business.

Why not?

Nicely, for one particular, since we really do not motivate innovation adequate between these who could be creating better solutions. The doctors and caregivers who know how to create and deliver health worth, as well typically, do not think in terms of goods and managing items. In overall health care, there is a lengthy tradition of a bureaucratic company model that does not nurture or encourage the creation of items based on people’s requirements. I feel there has to be a shift towards considering about how to deliver providers in a format and at a price level that will encourage men and women to get engaged, and more importantly to store in well being care. But, in buy for that to occur, we require to make sense of the piece elements. Correct now, all of the data is spread in a million places, and it is unattainable to assemble it in a way that makes sense.

It is also challenging for caregivers to layout and package merchandise that can compete for the overall health care dollar, due to the fact the method is amazingly price insensitive and inefficient, eating up a ton of sources with no always delivering worth to the buyer.

banksy – peaceful hearts medical doctor – three (Photograph credit score: Eva Blue)

Is this different in the US than in other countries?

Absolutely. In India, for example, given that the formal program is significantly weaker, there is an army of characters making substantial change—and fortunes—by contemplating differently, and by solution-managing care. In the U.S., there are pockets in which innovative entrepreneurs are undertaking just this: they are creating certain products outside the formal technique that men and women need to have and want. This is what Aravind is carrying out for eye care. In the U.S., we have a regulatory atmosphere that will get in the way of well being care entrepreneurship at a broad scale. This has to alter.  Health care deserves significantly far more innovation. And as far as timing, it is the ideal time to get in—the water’s great with every ache and inefficiency of the industry is an possibility. We need the crazy and brave ones to disrupt the standing quo, and create new methods of performing factors and value everywhere. You just want to look about and see all the people who are unable to get what they want at a value they can afford, and then, develop a enterprise to serve them better.

What keeps you up at night?

The imagined that men and women can not store for health care companies in an informed manner.

For me, the remedy is clear: it is the creation of a overall health care Net. A net-primarily based cloud that is safe  and dependable so folks can entrust their data to a system that will allow item development and broad information curation and entry. It occurred to us, at athenahealth, that it demands to be feasible for folks to package deal up health care and marketplace it in various methods. Medical doctors need to be in a position to go on the Internet and say, “I do hips for half as significantly funds as any supplier in the nation, and here are the statistics that show that my achievement rate is just as excellent, if not far better.” It has not historically been possible to repackage the hip as a product, value it differently, and market it. And it is not just hips. It’s colon care and pregnancy, and so on. People really do not get to shop for health care! The thought of the overall health care Web is the connective tissue in between the different actors and companies.

This implies a rather radical shift: away from seeing men and women as “the sick,” who need to be provided a service, and toward seeing them as customers who are trying to handle their own health and wellness. What are the main problems of this transition?

The biggest challenge is that well being care is an incredibly complicated data merchandise. All of this data demands to be assembled and transported simply by people who aren’t element of the same business—stock brokers do it all the time, for example. Imagine if investors had to figure out how to valuate companies all on their own! That is the reality for overall health care, and it’s reckless.

The main care supplier requirements to be enabled as a broker, who assists the consumer search at his/her wellness as a portfolio to be managed and locate the goods and service levels they require. Iora Health is undertaking just this: the wellness coach turns into an advisor, assisting you to find what you need to have. We need far more medical doctors, and non-medical pros as well, to start taking part in this role.

How will this impact the delivery of healthcare and the healthcare expertise?

An Entrepreneur"s Prescription For Repairing Healthcare: Start Innovating!

Drug users start injecting "legal highs"

“Bearing in mind the significant potential impact of new patterns of injection being recognized, the shut monitoring of synthetic cathinones use in Europe is obviously an crucial public health priority,” it explained.

“While most cathinone use requires both snorting the medication as a powder or oral use, a latest worrying phenomenon has emerged of synthetic cathinones becoming injected by some groups of drug users

“On the complete, reviews propose that injecting cathinone end users are primarily injectors of other drugs … who, for a assortment of causes, switch to cathinone injection or contain cathinones in their drug-making use of repertoire.

“In addition, there are reviews of long-term abstinent ex-opiate end users who have started to inject cathinones and constrained reviews of younger individuals starting their injecting job with cathinones.”

The yearly report stated there had been reviews of mephedrone injection in Britain.

“These included each experienced users of other drugs switching to mephedrone, and novice users who have by no means injected other medicines before,” it warned.

“Mephedrone customers had been reportedly younger than other groups of large-risk drug end users observed by drug solutions.”

It additional there was “increasing concern” about a new trend in the gay local community to inject the drugs at “chem sex” parties, in a practice know as “slamming”.

“Parties can final from around eight hrs up to three days with the participants usually engaging in risky sexual practices this kind of as not utilizing condoms and sharing a number of partners,” it explained.

“To date in Europe, this new practice has largely been documented between limited sub-groups of gay guys in London and a small quantity of French cities nonetheless, the likely exists, in this very mobile population, for it to grow to be much more widespread.”

Elsewhere in its European Drug Report 2013, the agency stated common mortality charge due to overdose of all drugs in Britain was 38.3 per million population, much more than twice the average for Europe at 17 per million.

Nonetheless drug deaths in this country are in decline, with the complete falling from two,569 in 2008 to two,250 in 2011.

“Most overdoses occur between men and women who have consumed several substances, and attributing causality is usually problematic,” the report mentioned.

“With the continuing release of new psychoactive substances on the drug industry, there is concern that new or obscure substances that have contributed to deaths could escape detection.”

The Residence Office launched a review of legal highs last yr to appear at how laws can be improved.

The Government banned two groups of psychoactive substances in December, the NBOMe and Benzofuran compounds.

Drug users start injecting "legal highs"

Tony Abbott now admits $one.8bn in hospital cuts will start from July

Tony Abbott has conceded the government is cutting a hospitals funding agreement with quick impact, contrary to his weekend declare that the cuts did not get result for many years.

On Sunday Abbott stated: “We’re not talking about following week or subsequent month or even subsequent yr we are talking about adjustments in three years’ time”.

But Abbott now agrees the nationwide partnership agreement on public hospitals, which begins on 1 July, has been lower. Spending budget paperwork say it has been cut by $ 1.8bn in excess of the up coming four years.

The prime minister says the reductions should be blamed on Labor simply because the former government had previously revised the agreement.

“There was a nationwide partnerships agreement which the Labor get together hadn’t funded on [hospital] beds and we have decided not to renew it, but this is a Labor minimize, it is not a Coalition lower,” Abbott advised the ABC.

But the price range document is clear that cash has been cut by this government, stating: “The government will conserve $ 1.8bn over 4 many years from 2014-15 by ceasing the funding ensures underneath the nationwide health reform agreement 2011 and revising commonwealth hospital funding arrangements from July 2017.”

The determination cuts $ 217m from hospitals in 2014-15, $ 260m in 2015-16 and $ 133m in 2016-17 just before the big cuts get started in 2017-18, when the commonwealth ceases its contribution to the growth in hospital expenses due to the ageing population and greater therapy costs. From that time commonwealth investing increases only in line with inflation and population growth.

State premiers say the cuts eliminate funding necessary for 1,200 hospital beds and they have no capability to fill the gap.

Abbott was flying to Rockhampton on Monday morning with the Queensland premier, Campbell Newman – 1 of the most outspoken critics of the cuts – to attend the funeral of Graeme Acton, a prominent Queensland grazier.

Later on in the day Abbott returned to his earlier argument – that hospital funding is still increasing 12 months on yr.

“For the following three many years hospital funding increases … and then in the fourth yr commonwealth funding will boost by 6%, so we are not cutting funding, we are growing funding … all we are not undertaking is not agreeing to the pie-in-the-sky funding promised by Labor,” Abbott said.

The budget paperwork reveal virtually $ 3bn worth of funding agreements with state governments in the well being portfolio alone that have been lower, deferred or abandoned – with the cuts starting up this 12 months or up coming year.

These cuts are on leading of the $ 80bn in lengthy-term funding reduce out of wellness and education, and on top of savings from the new $ 7 Medicare co-payment (which could force folks to look for help in state-run emergency departments instead of seeing a basic practitioner) the extra $ 5 co-payment for medicines the pausing of indexation for medical advantage routine charges and other price range savings. As well, numerous partnership agreements have been axed in other portfolios.

• The national overall health reform agreement, signed by all states and the commonwealth in 2011. (This cuts $ one.8bn from public hospital funding, beginning this 12 months. Income to be put into the health care study future fund.)

• The dental flexible grants program. (Cuts quantity to $ 229m, starting this year. This program was to aid dentists set up in outer metropolitan and rural locations. Money goes to the Health care Study Long term Fund.)

• Grownup public dental services. (Cuts equal $ 390m, commencing this year, by deferring a nationwide partnership agreement signed with the states, which was supposed to help clear the 400,000-robust waiting lists for public dental care. Income goes to the Health-related Analysis Future Fund.)

• Strengthening public hospital companies. (Cuts of $ 201m, starting up next yr, from cash that was supposed to aid the states reduce waiting instances at public hospitals. Funds goes to the Healthcare Study Long term Fund.)

• National partnership on preventive well being. (Cuts of $ 367m, starting up this year, from agreement that was supposed to fund preventive overall health schooling applications, this kind of as anti-smoking campaigns. The government is also conserving $ 6m by abolishing the nationwide preventive well being company. Money from each goes to the Health-related Analysis Long term Fund.)

The spending budget also ends federal contributions to a range of pensioner concession schemes. Abbott mentioned: “We made the choice in a very challenging budget that if the states needed to continue those concessions they could do it themselves.”

As two polls showed a dramatic slump in his very own and his government’s standing right after the budget, Abbott repeated that, despite his pre-election pledges not to lower education and overall health and not to modify pensions, voters had been “on notice” about the cuts unveiled in final Tuesday.

South Australian premier Jay Weatherill stated the price range eliminated funding for 150 hospital beds in his state from July.

The premiers have demanded an emergency Coag meeting. The prime minister’s spokeswoman says there is unlikely to be a meeting before the up coming scheduled gathering in September. She says the prime minister has spoken to most of the premiers by telephone. Weatherill mentioned the prime minister had not spoken to him.

Tony Abbott now admits $one.8bn in hospital cuts will start from July

Legalising euthanasia would be only the start of our experiment

Now, I have no religious “big picture” to instruct me that self-destruction is a universal sin, but the religious have a level about the necessity of such a picture, or map we require 1 to navigate the ethical ocean in which we swim. As it happens, I fairly like the Christian map – I just cannot get into its cartographer – and since the law is based on it, I’m fine that it puts “life” as north and “death” as south, and declares: head north.

Yet all maps have their limits of scale. In the smallest of pictures, the most intimate settings, they can never describe in ample detail the reality of the bodily planet they attempt to capture. In such spots, we have no massive photographs to guidebook us, no external principles – absolutely nothing but ourselves, each and every other, our love.

A single such place is within the area where patient X is assisted to die by his loved 1 call her Y. Of program, given that I’m at present blessed with health, I do not know what I would do if I located myself in such a situation. But I feel I would look for release. Let’s not mince words: I believe I would want to die. And, of program, I would not like my loved a single to suffer the legal consequences, had been he to assist me attain that end result. Actual men and women in this predicament exist: it is inhuman not to want to support them.

But what about other Xs, other Ys? It is not unreasonable, in a nation the place the scandal of elderly “care” seeps into our consciousness like a weeping wound, to propose that plenty of Xs may wind up dead at the hands of Ys who located themselves succumbing to the lure of selfishness. I really do not think the double-doctor lock would conserve every single X from undesired extinction, not following (say) 50 many years had passed.

Mercy killings have constantly took place – they often will. And the individual who dies asks a great deal of his killer, on whose mercy he throws himself. But he asks it of the rest of us, also: he also asks his killer to area herself at our mercy. She must inquire for our pity and our really like. We either accept that duty of judgment, or flip a blind eye, and outsource our concern to legislation. We need to trust, in other words, in our capability to inform the distinction.

Legalising euthanasia would be only the start of our experiment

A new yr should herald a new start for the NHS | @guardianletters

‘We should strike the right balance between recognising the extraordinary achievements that NHS personnel deliver each day and the need for improvement’ – Chris Hopson et al. Photograph: Christopher Thomond for the Guardian

This week, at a single of the most pressured occasions of the yr, hundreds of thousands of committed NHS personnel all through the nation will be supplying high-high quality healthcare to hundreds of thousands of sufferers – something that typically acquired lost amid final year’s headlines. As we move into 2014 can we, as organisations representing the NHS frontline, get in touch with for a new page to be turned as we begin a new year? The failures in patient care need to be addressed, and element of carrying out this implies, in the words of Professor Don Berwick’s review of patient security, leaving “worry, blame, recrimination and demoralisation” behind, and going forward with power and optimism.

Undoubtedly, there are problems to face in making sure we have the substantial-quality service that every person in the NHS wants to offer you, which includes growing demand on services and the need to do more with tighter budgets. But we need to reach a more measured see of how the NHS is carrying out. We have to strike the correct stability between recognising the extraordinary achievements that NHS workers provide every day and the need for improvement highlighted by the Francis report. Rather than searching back to the failures of the previous, we now need to have to dedicate our time and energy to meeting the quite real problems we encounter to secure a sustainable NHS for the long term.
Chris Hopson Chief executive, Basis Believe in Network, Dr Mark Porter Chair of council, BMA, Dr Clifford Mann President, College of Emergency Medicine, Matt Tee CEO, NHS Confederation, Phil Gray Chief executive, Chartered Society of Physiotherapy, Dr Maureen Baker Chair, Royal School of Standard Practitioners, Professor Cathy Warwick Chief executive, Royal College of Midwives, Dr Peter Carter Chief executive and basic secretary, Royal School of Nursing, Richard Thompson President, Royal University of Doctors, Professor Sue Bailey President, Royal University of Psychiatrists

• It is really worth contrasting the government’s most recent miserly and cruel rationing of NHS services (Tourists and migrants to be charged to use NHS emergency providers, thirty December), with Cuba’s technique to well being requirements – a nation with a GDP per capita of 15% of the UK’s. At residence, Cuba has presented extended-term care for 18,000 victims of the Chernobyl catastrophe and has presented eye surgical procedure, at no price, for hundreds of 1000′s of Latin Americans. A recent review by Professor John M Kirk reported that Cuba has much more health care personnel serving abroad than the G8 nations combined. As of April 2012, there were 38,868 Cuban health care professionals doing work in 66 nations, of whom 15,047 had been physicians.

Cuba’s health-related internationalism programme rarely will get reported, although it did when the country supplied one,500 health-related specialists to the US to assistance the catastrophe relief hard work following Hurricane Katrina – which George W Bush rejected. When Bevan founded the NHS he said it would be based mostly on the principles that it would meet the wants of everyone, be free at the level of delivery and be based on clinical want, not ability to pay out. Comparing that with the imply-spirited utterings of David Cameron and Jeremy Hunt, he sounds like Fidel Castro.
Martin Quinn
Tavistock, Devon

• Your post on expenses for antenatal care and childbirth (Report, 28 December) mentioned that the well being of migrant ladies and their youngsters had been being put at risk, but failed to give information of the guidelines or how to contest fees getting manufactured by NHS trusts misapplying rules. It appeared that all immigrant females were becoming charged – although a moment’s imagined would have raised queries about EU nationals. On checking, it emerges that asylum seekers and ladies who have overstayed visas can be charged. Nonetheless, if they cannot spend, then providers are even now offered – something that the article did say. So it would be useful to lessen be concerned for females with legitimate visas, refugee standing or waiting to hear about asylum claims, if it had been manufactured clear that they will not be charged.
Diana Bruce
Derby

• The final time NHS staff were ordered to refuse to treat foreign sufferers with no charge was for the duration of Thatcher’s leadership. Shortly after, I was known as to see a distressed girl who’d brought her sick child to our hospital’s children’s ward. Ahead of I arrived, an enthusiastic administrator had informed her that even though she was entitled to treatment as the daughter of a US serviceman stationed in the United kingdom, her child had no such right. She had presently been provided the identical data at the military hospital, which is why she had come to us. By the time I attended she had left, her little one unexamined and untreated.

I felt deeply ashamed on behalf of my department and my hospital that we had been the expression of our politicians’ parsimony. I am appalled that my successors could be forced into adopting the identical business strategy to individuals needing help.
Dr Harvey Marcovitch
Balscote, Oxfordshire

A new yr should herald a new start for the NHS | @guardianletters