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Cowper's Cut 209: Vaccine and not herd

Health But Social Care Secretary Sajid 'The Saj' Javid recovered from his triumphant speech last week by giving media interviews telling the country (in terms) to suck up the increase in Covid19 infections that became apparent last week, and has done increasingly the same this week.
Cowper's Cut 209: Vaccine and not herd

Health But Social Care Secretary Sajid 'The Saj' Javid recovered from his triumphant speech last week by giving media interviews telling the country (in terms) to suck up the increase in Covid19 infections that became apparent last week, and has done increasingly the same this week.

(If you need some The Saj-related workout by a good hard cringe, by the way, this week he delivered to his party faithful what was intended to be a William Hague impersonation. The Saj's version sounds more like a constipated Dalek from Lancashire.)

'Nothing to see here' appears to be The Saj's mantra. By happy coincidence, new data from the Office for National Statistics shows that Covid infections are roaring away merrily across all age groups, whether or not The People's Government wants to believe in it. The Zoe data does the same, and the official dashboard shows hospital admissions rocketing (although mechanical ventilation rates remain mercifully low).

What could conceivably go wrong?

Perhaps some nice fantasy economics, like the NHS (which has an underlying deficit of about £5 billion a year) making 2.2% (£4.75 billion worth) in increased efficiency savings according to the Chancellor.

Mr Sunak is apparently abandoning his previous plan for 1.1% efficiency savings, which was merely unreasonably stupid. This step up from 'unreasonably stupid' to 'massively, visibly-from-space stupid' will be a bracing one.

Clearly, only fantasy economic thinking can save us now.

It doesn't make one optimistic that the Chancellor's Spring Statement on Wednesday will address how inflation is going to have a huge impact on the health and care system, and on its staff. The Chancellor's Draghi Moment - "whatever it needs, whatever it costs" - seems a very long time ago.

The Institute for Fiscal Studies' projections are quite something, both on the planned tax rises and on the coherence between 'levelling up' and the Government's spending plans for the public sector.

Through to the real world, and what Alice found there
The Public Accounts Committee issued a damning report on the state of NHS services in England. “For the next few years it is likely that waiting time performance for cancer and elective care will remain poor and the waiting list for elective care will continue to grow,” it said, adding that “DHSC has overseen a long-term decline in elective and critical cancer care that is dragging our National Health Service and the heroic staff down”.


This report notes that the system has not managed to hit the target of treating 92% of people awaiting non-urgent care within 18 weeks since February 2016, and has not met the eight key targets for cancer care since 2014.

It doubts that any of the extra £8bn for NHS England for 2022-5; the recent “elective recovery plan”; or the pledge that hospitals will increase by 30% the number of operations they perform by 2025 will have any meaningful impact on the backlog: “we on PAC are now extremely concerned that there is no real plan to turn a large cash injection, for elective care and capital costs of dangerously crumbling facilities, into better outcomes for people waiting for life-saving or quality of life improving treatment”.

It says that the DHSC and NHS England “have not set out in meaningful detail what the money will be spent on”.

It is hard to disagree with the report's conclusions that "the Department needs to be better at communicating with NHS staff and patients about what the NHS will be able to deliver in the coming years and it urgently needs to improve its record of holding NHSE&I to account, given the additional £8 billion of revenue funding for elective recovery and £5.9 billion of capital funding. The Government has told the NHS to deliver 30% more elective care activity by 2024–25 than it was delivering before the pandemic. We urge NHSE&I and the Department to be clear about what this will mean for patient waiting times and how performance may differ across the country".

Jeremy Hunt's Health Select Committee this week excoriated the DHBSC's failure to respond on its childrens' and young people's  mental health report and recommendations within the usual and not-at-all-difficult-if-you're-a-serious-organisation period of three months.

Oh, and new analysis by the Improvement Analytics Unit (IAU) (a partnership between the Health Foundation and NHS England) finds that only 10% of patient care requests made to GP practices indicate a preference for a face-to-face consultation.

Over to them: "the analysis examined data from 146 GP practices in England using the askmyGP online consultation system between 1 March 2019 and 30 September 2021, including over 7.5 million patient-initiated requests for care. Using this system allowed analysts to follow patients’ journeys from the initial point of contact through to delivery of their care.

"This information was examined alongside data captured on patient characteristics, clinical needs and preferences. Only a minority of patient requests for care stated a preference for a face-to-face consultation – falling from 30% of requests before the pandemic to less than 4% at the start of the pandemic. And while requests for face-to-face consultations did increase after that, they only accounted for 10% of requests by the end of the study period in September 2021".

It's an 'oooops' for the Daily Mail campaign, then.

Getting the Bill
The Health But Care Bill finished its Lords report stage this week, and goes for its Third Reading in The Other Place on Wednesday.

As commented previously, the next real action comes at the 'ping-pong' stage, which threatens the legislation not being passed in this session of Parliament. As the BBC's Mark D'Arcy points out, healthland is Not Alone.

Coronamillions and Cronyvirus update
Civil Service World have another excellent feature interviewing Crown Commercial Service chief executive Simon Tse about their role in the background during the pandemic and its procurements. The most striking line? "Regulations are a matter for the Cabinet Office, not CCS, so Tse opts not to talk about what he calls the “probity side” of PPE procurement."

Ahem. This should come to the attention of the public inquiry.

Health procurement expert Rob Knott noted some interesting corporate changes at Excalibur Healthcare, a winner of a £160 million Covid contract and provider of 2,700 ventilators at £50,000 a piece.

Over to Rob: "Despite all of that new income and profits (wealth), the company registered a charge? Sir Chris Evans then resigned (this month) to be replaced by Shafia Zahoor, the ‘accountant’. And the company has changed its name to International Medical Supplies Limited … and so …

"The last time this happened - its name changed to PZT and made Zahoor a Director - they closed the company, and then opened a new one in the name of the old company (Excalibur Healthcare Services Limited). And its accounts are overdue after extending its accounting period …"

The Alan comeback
Everybody's favourite People's Partridge was hard at it again this week.

No, not podcasting about how he fell in lurve, or City AM shilling for Crypto: Alan was writing about how much he looks forward to the public inquiry. He  claims it as "fact that last month the UK became the first major country to move from pandemic to endemic".

Alan prays in aid the recent Lancet study of international excess deaths during the pandemic as showing that perceptions that the UK managed Covid19 unusually poorly were incorrect.

The Lancet study appears to have attracted some critical attention for its interpretation of the data, such as this from Times science correspondent Tom Whipple.

Alan was also doing some more shilling for crypto this week (his brother, as noted last week, is a Crypto Bro.)

Recommended and required reading
The Guardian has a piece on the opening of the Cleveland Clinic's London hospital.

Isabel Hardman's monthly health policy column for the i is clear-eyed on the political risks of the failure to tackle the NHS backlog.

Lovely bit of shade by Imperial about the Telegraph's consistent fact-free trash-talking for their epidemiology over Covid19 - this is the 16th correction that the erstwhile newspaper has had to make in this area.

Future Health, a bijou think-tank-ette run by Alan's former SpAd Richard Sloggett, published a new study on adult vaccination rates and health inequalities this week.

Author and doctor Rachel Clarke points out a particularly egregious piece of lying by the Government.

The Cass Review's interim findings should be widely read. Both Great Ormond Street Hospital's cancellation of a proposed conference and an un-named hospital alleged to have denied that a woman patient was raped because the attacker was transgender scarcely give us confidence that the NHS has a logical or sensible position on the trans agenda, either corporately or individually.