It's not train tickets & rules - it's the economy stupid(s)!

Those who truly know me will be aware that I don't nail my colours to any one party or the other. I believe most politicians are at heart good people who want to change things for the better - that's why people become politicians.

But I do feel sometimes, for whatever reason, some politicians take the wrong path. Ted Hughes would have called it the road less travelled - but the problem with the road less travelled is there's nobody else there to tell you you're headed in the wrong direction.

Today we learn that Britain is out of recession and growth is higher than expected.

We have also learnt that 1,400 British jobs have been lost at Ford.

These are both issues that should surely be at the forefront of all our minds?

I'm not particularly defending the Prime Minister over alleged rule breaking by hinting at GDP figures a day before publication. Indeed it's perfectly in order for Labour or anyone else to hark back to the Emergency Budget of 2010 when castle in the air type growth figures were being lorded and elimination of the deficit was boasted.

Today's news is a far cry from that - but surely it's more important to discuss GDP - than trying to create over words the Prime Minister used which could have appeared to be hinting to today's news, breaking all the rules of advanced sight of the stats - but by the same toke, could easily have been totally unrelated.

That's politics baby!

My own judgement is that there is NO WAY on this earth that anyone will EVER prove that the PM hinted towards today's GDP fires - even though I think he probably was doing just that.

But it's besides the point. The man of the Clapham Omnibus (the average man or woman on the street) wouldn't give a yak's eye whether David Cameron hinted at today's result or not.

And it's ironic that the people creating (I'm not thinking specifically of any party, or politician here even) are the same people who would brand (with or without justification) the PM as out of touch. Double standards me thinks.

And frankly, notwithstanding the fact that it made a good story last week, surely which ticket the Chancellor had on a train to London - when he actually paid the upgrade, and there is no suggestion he tried to criminally evade paying should take a back seat to GDP today?

Who is this a dig at? No one really... it's the system we live in. Journalists (and I am one) are doing the job as expected by editors, viewers, listeners and readers - and as journalists, we have a duty to report what politicians and public figures are saying - but speaking to people who live in the real world - people on trains, on busses, in cafe's and shops just perceive tickets, Andre Mitchell and POSSIBLE and very technical rule breaches as out of touch.

Three words today - no actually, four:

Economy, economy, bloody economy!

A pro free speechers take (and concerns) about the campaign to repeal S5 Public Order Act

My take on the Section 5, Public Order Act campaign

I would like to thank Paul Waugh ( @paulwaugh on twitter), the Lobby Chairman for tweeting this video of Rowan Atkinson's speech to Parliament on repealing Section 5 of the Public Order Act http://polho.me/SfD6B6 

This is a personal rather than professional comment on Section 5 POA - and I speak as someone who is in favour of free speech… but also as someone who believes that free speech can cross a line and become "disorderly conduct" as the American offence goes.

Section 5 of the Public Order Act 1986 outlaws "insulting or threatening words, actions or behaviour" that would be likely to cause "alarm, harassment or distress" to "a person of reasonable firmness" - i.e. theoretically at least, it wouldn't be considered an offence to say the word yellow if an unreasonable person took offence to it.

This campaign, headed by the real David Davis, the Prime Minister who nearly was - seeks to remove the word "insulting" - and I for one find it hard to argue against that - so long as some consideration given to insulting behaviour becoming threatening.

The best example I can give where I think this proposed campaign falls down, backed by the lovely former Assistance Commissioner Lord Dear (and genuinely lovely man) springs straight in to my mind. This weekend gone, a group of youths shouted at me, while I was safely navigating with a white stick, "watch out for the bin you blind prick" and laughed at me. Last night, 48 hours after this unhappy experience, judging from the voice and language, one of the same youths shouted at me - from about 4 feet away, "you're going to crash you blind prick" in a loud voice. I can say without any doubt that there was no bin on the first occasion, and that there was no risk of my "crashing" in to anything - and so the intention was to harass me. This situation, under a revised POA could be regarded as merely "insulting" and therefore not an offence - but the reality is that even me, a very confident, loud mouthed journalist found these situation - particularly the second one quite alarming and upsetting.

In a free society, someone should have the freedom to offend and even upset - but my worry would be that the yob I keep encountering in Stevenage in Hertfordshire would commit no offence if the real David Davis is successful.

If you've watched the video, the excellent Rowan Atkinson talks of some silly cases where people have been arrested - in one case, for calling a police horse "gay" - and a preacher arrested for displaying bible passages… yet again it seems that common sense has been lacking - but it is important to remember that Section 5 is now used often instead of drunk and disorderly - simply because the current culture discourages D&D arrests in many areas.

The US supreme Court, bound by the first amendment to the United States Constitution Ruled that free speech does not permit someone to run in to a crowded movie theatre and shout "fire" - and so even the country many pro free speeches would look to for support backs the notion of some kind of reasonable cut off.

The major hurdle I foresee to any change to the Public Order Act is that if the word "insulting" is removed from the Legislation - other primary Legislation would be required to cover eventualities where for example disabled people were being abused in the street… where they have genuine reason to feel intimidated - and believe me people do (for instance, 180,000 blind and partially sighed people in the UK NEVER leave their home alone) and where society would be letting down the most vulnerable by acting first and thinking later.

I don't foresee, as a free speech supporter that this Act will change any time soon… and if it does, I certainly don't see it being repealed. But perhaps this is my Michael Fish moment.

Dr Mark O’Flynn, Medical Director for Clinicenta:

Patient care

“Since Clinicenta started providing clinical services at Lister Surgicentre in September 2011 there have been nearly 60,000 patient attendances. The patients attending have reported a continuing increase in satisfaction levels and we have received very high levels of positive feedback about the care and service provided by our team. Since April there has been a dramatic reduction in the number of complaints from 130 per month to 20. We are working hard to do even better.

“We also now have one of the best lengths of stay records for knee and hip replacements in the East of England and beyond. The length of stay for patients has been brought down from on average 8 nights, when we inherited the service, to just 4, through the use of a new Enhanced Recovery Programme. Replacing a patient’s hip or knee is a major operation and does carry the risk of complications, which is explained to patients before surgery. It is premature to comment on cases in which there have been complications until the investigation is completed.

“We acknowledge that some administration issues have come to light following the opening of the Lister Surgicentre. We are working hard to rectify these issues and are making significant headway. We have also been assiduously contacting patients to ensure that the relevant follow up appointments have been scheduled. We have previously publically apologised to any patients that have been inconvenienced – an apology that I can offer again.

“In the early months of operation people were having difficulty making contact with the Surgicentre by telephone. We have now made changes and patients are now easily able to get in touch with the necessary departments in the Surgicentre.

“We are pleased that our focus on improving data security has paid off with Lloyds Register Quality Assurance Auditors recommending Clinicenta for ISO 27001:2005 Certification, Information Security. This is the highest standard of accreditation available to ensure that the information held on patients is accurate, accessible only to those authorised to access it and appropriately available when it is needed. This is a tremendous endorsement to have received after just one year in post at Lister Surgicentre and shows that our administration procedures are recognised as being of a very high standard.”


Stephen McPartland’s comments

“It is disappointing that Mr McPartland has sought to take a Surgicentre success and to distort this to suggest that the management are suggesting that everything is running OK. At no time have we made such claims. We have made improvements to the service since February and this has been acknowledged by both NHS Hertfordshire and the Care Quality Commission. These improvements are continuing.

“We have met with Mr McPartland on several occasions, including with a number of his fellow Hertfordshire MPs. Many of the issues they raised have now been addressed.

“It is pleasing that Mr McPartland recognises the quality of care provided by the clinical staff. What he fails to realise is that many of the support staff are also from the NHS. His logic in drawing conclusions about the management of the service is, at best, flawed.



Waiting times

“With regards waiting times for Ophthalmology services: following discussion with the PCT in August, a decision was taken to place a temporary diversion of new ophthalmology outpatient referrals at Lister Surgicentre. This measure was put in place in order to allow us to time to complete our current work on boosting capacity and cutting waiting times for our patients.

“Thanks to the efforts of our Surgicentre staff, our work on capacity and waiting times is already accelerating. New ophthalmology outpatient status will now be reviewed regularly and we hope to resume accepting new outpatients this month.

“Unfortunately, what Stephen McPartland fails to grasp is that this temporary diversion of referrals does not represent that the 1,300 GPs’ loss of faith in Surgicentre or have concerns about the quality of care – a sentiment echoed following our discussions with the GPs who refer patients to Surgicentre – instead, it has been put in place simply to reduce current waiting times.”

“The waiting times for surgical procedures have reduced and continue to reduce. We are confident that by working with the East & North Hertfordshire Trust, which jointly manages the patient pathway, we can further reduce waiting times.


Care Quality Commission (CQC)

“We can confirm that we have had a number of visits from the Care Quality Commission. Their comments and observations have been helpful and we have addressed areas in which they raised concerns. Currently we are awaiting a final report from the CQC visit to ophthalmology.

“We work closely with the CQC to ensure that we continue to improve our administration procedures and meet their standards, as does every medical centre in the UK.

“In the meantime, Lister Surgicentre’s excellent team of staff continues to provide exceptionally high levels of patient care in all areas, using some of the most hi-tech and advanced equipment available in the county. The Surgicentre remains an asset to the local community and we at Clinicenta are determined that this remains the case.”


Patient feedback

Here are three patient quotes, out of hundreds that we now collect:

§ “I could not ask for more. I had first class treatment from the start to when I left.” – David

§ “Both doctors and nurses were there to ensure I was comfortable and understood what was happening. The receptionists were very helpful too. Appointments were on time, at my initial visit I did not have to wait very long for treatment. This eye unit is an excellent facility and I appreciate it being here and at the hard work of the staff.” - Sue

§ “I felt cared for and everything was explained to me, was treated as an individual. I am sad at the adverse publicity in the media today especially after the excellent treatment I received.” – Jean



- Posted using BlogPress from my iPhone

Location:NHS Investigation: Surgicentre response in fu

NHS INVESTIGATION: How a major government contractor’s PPP threatens patients health

By Sean Dilley and Siobhan Meade

Public-private partnerships are not a new concept – neither is the competence of one political party or the other, in government to manage the NHS and protect the best interests of patients – but we’ve become aware of one such set-up that needs urgent attention.

It was given the green light under Labour in 2003, and opened under the current government in November 2011 as an innovative new way to cut patient waiting times and improve service delivery -.

Private and Public sector working hand in hand - backed fully by the reds and the blues.

But with two deaths currently under investigation in it's first year, and a big thumbs down from the local Primary Care Trust and Care Quality Commission, the Stevenage Surgicentre's future is very much in question.

The East and North Hertfordshire NHS website describes the operation, run by a company called Clinicenta (a subsidiary of major government contractor Carillion finance) as, providing "specialist orthopaedic care, including hip and knee joint replacement and shoulder joint surgery, day case and short stay general surgery and gynaecology, head and neck and ophthalmology (eye) treatment"

Carillion Finance, who won the contract to build the new GCHQ building boast “an outstanding record” on their website, “Carillion has won 58 PPP (Public, Private Partnership) Projects contracts in the UK and Canada for hospitals, schools, prisons, military accommodation roads and railways”

But put simply, Surgicentre’s function here is to carry out very low risk elective surgery and clinical check-ups. "deaths should simply be extraordinary if everyone's doing what they should be" said one doctor - though she acknowledged both cases are currently under investigation. It's far too early to point fingers in these cases in the opinion of these writers..

But it's way too late too be addressing the undisputed failures in administration and management as evidenced by the number of cases from referral to treatment that are simply not being dealt with within the 18 weeks required by law.

Losing patient files also seems to be an issue. One local resident, a friend of mine told us  how his adult son has had a knee operation there recently. "No complaints with the doctors on the day" he said, "but every time my son calls to book the follow-up appointments they told him he'd need, they just can't find any record of him - what if a life-threatening infection were missed through this sloppiness?" he asked.

What indeed?

Such are the concerns of local people that Surgicentre's operating company "Clinicenta" have been hauled before Ministers at the Department of Health earlier this year to explain themselves. Assurances were given to those present - including local MP's Stephen McPartland (Stevenage) and Grant Shapps (Welwyn Hatfield) that improvements would be made - but here's what the Care Quality Commission told me in a statement on Friday afternoon (5th October, 7 months after they were served a non-compliance notice.

The Care Quality Commission (CQC) is aware of two post-operative deaths following treatment at the Lister Surgicentre. We are liaising closely with the PCT while they investigate these deaths, and await information regarding cause of death..

An unannounced inspection of the Lister Surgicentre by CQC in February found serious concerns around the identification and management of risk. Inspectors also found that the waiting times were being breached, with no evidence that people waiting for treatment were being appropriately prioritised.

At this point, CQC issued a warning notice demanding improvements and publicised our concerns about this service on our website and via the media.

Clinicenta Ltd, the company who run services at Lister Surgicentre, provided an action plan detailing how they would make the necessary improvements. CQC made a follow-up inspection in April, but were not satisfied that the all required improvements had been made. We then worked extensively with the PCT and SHA to consider all the available information we jointly hold on this service.

Another unannounced inspection of the Lister Surgicentre will be taking place shortly; following this, we will consider what enforcement action might be appropriate. Our enforcement powers can include suspending or cancelling registration.

This new information about post-operative deaths may inform any action we take, but this is not something we can consider until we are assured that we have all the relevant information on these cases.

"CQC inspected the other service run by Clinicenta Limited, the Clinicenta Ophthalmology Outpatient Clinic, in August. A full report of our inspectors' findings will be published on our website shortly."

And it's not only the Care Quality Commission who has concerns. The Primary Care trust has written to GP's warning them that the Lister Surgicentre is not up to scratch - telling us in a statement. again just this Friday:

"We are concerned that Clinicenta are unable to provide us with the necessary assurance about waiting times for outpatient and routine surgical procedures. In order to minimise the time that patients wait for an appointment, as an interim measure, we have asked GPs to refer new patients into ophthalmology services at alternative local providers. We will closely monitor the situation over the coming weeks and will continue to work closely with Clinicenta to gain the assurance we need about the timely treatment of our patients.

It should be noted however that NHS Hertfordshire do not appear to have any concerns about the quality of treatment by Surgicentre Ophthalmologists - instead they seem to be as upset as the medical staff and patients we have spoken with because the law of the land is being broken by failing to meet referrals within 18 weeks. Their statement continued,

"We have taken this step as a temporary measure and want to reassure patients that we are not concerned about the quality of services at the Surgicentre, but we have a duty to reduce the current long waiting times and to minimise inconvenience to patients. The measures being taken affect routine, or elective, patients. Those requiring follow up appointments, urgent treatment and diabetic retinopathy will continue to be seen by Clinicenta.’

And why wouldn't they be? Clinicenta staff is in fact made up of NHS consultants, doctors and nurses on secondment to Surgicentre. The effects of privatisation could only be in the management of staff and administrations - areas coincidentally that the Surgicentre hasn't won any awards from the PCT, CQC or even medical doctors and patients in the Hertfordshire area.

Stevenage MP Stephen McPartland told us he's been to see the Chief Executive at the Care Quality Commission to demand action and to ask why, when "the Local Medical Council", a group of clinicians and physicians are advising colleagues not to refer patients to the Surgicenter, the CQC are not taking dramatic action and suspending Clinicenta's licence to operate.

Speaking with us earlier this evening, Stephen McPartland said,

"I'm shocked ClinicentaCarrillion are trying to claim everything is ok at the Surgicentre when it clearly is not. The staff are doing a great job, but they are being failed by the way in which the contract is being managed. The Primary Care Trust have made it clear they do not want doctors to refer new patients to the Opthamology Service and the Care Quality Commission has serious concerns about the facility.

"I have met with the Chief Executive of the Care Quality Commission this week to discuss my concerns regarding the management of the ClinicentaCarrillion-owned Surgicentre.

"I explained they have lost the faith of the local medical professionals and the local community. They are not up to the job and the quality of care available to my constituents is just not good enough. I asked the Care Quality Commission to take action and seriously consider removing their licence to provide healthcare in the UK."

Strong words from the Stevenage MP, but the question must be asked, if the CQC remove their licence to operate tomorrow, who runs the ship on Tuesday? Such dramatic action would also have a knock on affect on other services provided in partnership with the NHS - but surely it's now time to ask why such standards, which the professionals tell us fall below what is expected, has apparently been allowed to continue for so long.

Why, this long after the Surgicentre being slapped with a non compliance notice by the CQC do we not know what actions need to be taken by what point in time to protect patients, and given that two deaths are currently under investigation - without prejudice to those investigations, how can we be sure that an organisation who have been slammed by NHS Hertfordshire for failing to identify and manage risks, are not now failing to identify and manage ongoing risks to patients?

We can draw a solid conclusion from our conversations with the PCT and the Care Quality Commission as well as less formal discussions with the local MP, Stephen McPartland, and discussions with patients and medical staff that operational frontline service delivery is top notch - but given all the other serious criticisms by the experts - why shouldn't the CQC suspend this license and why shouldn't that have happened yesterday?

We submit that private sector partners to the public sector should be held as accountable as those not in the pay of profit chasing shareholders - and we find it hard to disagree with Stephen McPartland's point that any hospital Chief Executive would have been canned a long time before now. How, when the axe of unemployment is being swung on the public sector can the senior management team at Clinicenta be bending down to pick up a paper clip so often?

The public may well ask whether there could be any link between the government’s other contracts with Carillion and the iron underpants they appear to be wearing.

 

IMPORTANT NOTE: This story came to us late on Thursday afternoon and it took us until late on Friday to gather comments from the CQC, NHS Hertfordshire, and Stephen McPartland MP and to have much needed conversations with patients and two local doctors who have asked not to be identified. We put in a call at 17:10 on Friday afternoon, but were told by the Surgicentre Switchboard that they did not have any press office contact details because "we are an outside company" and "you'll have to phone back on Monday. We are approaching day two of the Conservative Party Conference - and so in the public interests, we are publishing what we were able to gather and will publish, in full, any reply Clinacenta, or their parent company Carillion wish to make. The authors do not in any way suggest lives are at risk, or that Carillion is in any way responsible for any reticence (or otherwise) the government / Doha may have in dealings with a subsidiary company of a major government contractor.