Owen Paterson is not fit for purpose

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It’s probably no exaggeration to say the NHS saved my life last week.

I had been having some odd pains for about a month which eventually turned out to be a kidney stone. This is unimaginably painful unless you have had one (and now I realise many people have.) The stone wasn’t playing ball (sorry) and got stuck, blocking the flow of urine from one kidney, causing a kidney infection that was rapidly turning into sepsis. I had an operation to bypass the stone and was pumped full of antibiotics. I have been in and out of our local hospital quite a few times over the past 10 days and have nothing but praise for our overworked nurses, doctors and support staff. I am now back at home.

No, the NHS is not perfect, by any means.

The number of times I saw hospital staff (and GPs) struggling with IT systems which seemed to go on the blink all too often, was surprising. I also saw doctors having to make difficult decisions about who to keep in (taking up precious beds) and who to send home. The collapse in social care services makes it much more difficult to send home patients who are well enough, if they have home support. The 111 phone services were always stretched, and the ambulance which eventually arrived to take me into A and E turned out to be a paramedic car, in the front seat of which I sat (dosed on morphine) to be transported.

But everyone I encountered was kind, helpful and did all they could to make me better.

This experience is still rather fresh in my mind – I’m still on extra strength antibiotics, am probably still fighting off some nasty bugs;  have some new plumbing (a uretal stent) and I still have the stone, to be dealt with at a later date. I’m unable to do anything else for quite a while, other than sit in front of a computer; and waddle to the loo all too often.

And then I noticed our old friend Owen Paterson, former Secretary of State against the Environment, has published a report today, under the banner of his secretively funded “think tank” UK 2020.

The report, “The UK health system – an international comparison of health outcomes” was written by Kristian Niemietz of the corporate libertarian think-tank the Institute of Eeconomic Affairs (the IEA), about which I have written many times. Niemietz may be a clever person, but he is not a health economist or any kind of health academic. The paper is not peer-reviewed and I have no idea whether the approach, comparing something called amenable mortality, across different countries, has any basis in science or statistical validity.

But the IEA have been regularly promoting the idea that NHS should be broken up and sold off. This unbiased piece, for example from Dr Niemietz – “Those who oppose NHS privatisation are really opposed to patient choice” gives a flavour of the position they take.

Niemitz is evidently working on a project of some considerable scope for the IEA, funded in part by the John Templeton Foundation. Templeton are well known for supporting projects which link christianity and science, though in this case the Templeton Foundation may well be continuing a very long standing mutual friendship that started with the founders of both organisations – Antony Fisher and John Templeton, both members of the right-libertarian Mont Pelerin Society.

I find it useful to check how many times a report author cites their own (non peer-reviewed) papers. For this UK2020 report, Niemietz self refers to no less than five other IEA-published papers he wrote himself. By comparison Niemietz neglects to reference a key paper from the Office for National Statistics in 2010 which concluded that

“there is insufficient evidence on how much of the decline in amenable mortality can be attributed to the healthcare system.” (Kamarudeen 2010 )

Niemitz was “borrowed” by UKIP2020 from the IEA to write the report, apparently. Conveniently, both thinktanks operate out of exactly the same building, 55 Tufton Street – along with a whole load of other right wing “free market” libertarian outfits – as described in this excellent infographic from earlier this year.

Let’s assume (just for arguments sake) that what the report says is true – that the NHS is not as good at achieving preventable deaths from cancer, stroke, heart disease etc as other countries’ healthcare systems. The report makes no attempt to investigate why this might be.

  • Could it be that the NHS is being starved of resources by a Government hell bent on breaking it up and selling it off to their mates?
  • Could it be that the NHS staff morale is sinking like a stone (sorry) because the Health Secretary is attacking them and forcing them to sign contracts they know will threaten patient health?
  • Could it be that the fake NHS internal market created by this Government has only created lots of jobs for managers, who actually make it more difficult for health care professionals to do their jobs and help people get better?
  • Could it be that the creeping privatisation of services within the NHS is actually making the whole organisation work less effectively.

It could be all or none of these things, but the report isn’t interested in the whys and wherefores, it’s mission is to rubbish the NHS, in comparison with other countries.

The report claims that it has no interest in identifying what sort of solutions would help improve the NHS. Fortunately for us Owen Paterson has about as much ability to stay on message as Donald Trump on crystal meth.

Paterson, writing on the Conservative Home website this morning boldly announced that

“it’s time to face up to the grim truth – the NHS isn’t fit for purpose.”

Now one might think that Paterson was only interested in helping develop a new national health system that was the envy of the world, for purely altruistic reasons. Until that is, I point out to you that the report was sponsored by Randox Laboratories.

Randox is a private healthcare company, based in Northern Ireland, where Paterson was shadow secretary of state for a while. Here’s Paterson being vigorously lobbied by Randox back in 2011 – when Randox called for “red tape” strangling innovation to be removed.

Paterson obviously got on well with Randox founder and owner Peter Fitzgerald as they both love horses. Perhaps that’s why Randox made Paterson their President in 2015, for which he now receives over £4000 a month for around 8 hours work. And he’s a regular guest (all expenses paid) at the Randox international Polo festival.

Randox are also the new sponsor of the Grand National and now provide healthcare to the Jockey Club.

Randox also supply 1 in 10 of the world’s cholesterol checks. Randox have recently opened a load of new clinics where you can go and pay for lots of medical tests.

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As to whether you need them or not is another matter. After all, as Dr Niemietz says, patient choice is the most important thing, right? well actually, no – funnily enough the experts ie the doctors and other healthcare professionals in the NHS have spent years training and are paid to make those difficult decisions, obviously in consultation with the patients.

With that in mind, today a group of Royal Colleges published “choosing wisely” which identified a range of unnecessary medical procedures and tests. One of those identified is the Prostate cancer PSA test.

As the Royal College of Pathologists puts it:

Unless a patient is at risk of prostate cancer because of race or family history, PSA-based screening does not lead to a longer life.

But Randox have developed a really clever new cheap Prostate PSA test, which simply must be used – it says so in the Daily Mail so it must be true.

It turns out that the NHS is wasting money doing lots of procedures and tests which are pointless at best, and in some cases (including diagnostic testing) may actually do more harm than good.

And politicians like Owen Paterson, who are supposed to be acting in the public interest, appear to be promoting private healthcare, for their own personal gain.

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