Welcome to the Court of Jesters.

From time to time we will release our very private Minutes of what is going on with our rivals.

For you must BEWARE the CARNIVAL OF CLOWNS and the CIRCUS OF FOOLS who everyday distract us with their jolly japes and deceptions.

We shall identify their tricks, buffoonery and tom-foolery, so DON’T LET YOURSELF BE FOOLED.

They will cheat you of what is rightfully yours as soon as look at you.

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As through this world I've wandered
I've seen lots of funny men;
Some will rob you with a six-gun,
And some with a fountain pen.

Woody Guthrie 

Jesterminutes  2 (part 1) highlights NHS and Health Care along with

Regular Features and New Contributions  - now in sonata form - 2 parts to follow

• Jolly Troughing Weather/Whose nose is it anyway? – the Jesters monitor the Westminster gravy train
• Through the Looking Glass – Alice helps us to understand the Westminster world where, as Humpty Dumpty explains  “ (everything) means just what I choose it to mean - neither more nor less"
• Julian Brays – ‘The pronouncements, philosophies and battle cries’ of Julian Brazier MP for Canterbury
• Celebrity Book at Bedtime – Ministers prepare the next generation of voters
• The Interment of NHS – a reworking of the classics as tribute to Mike Gove’s thumbs down to American Literature and thumbs up to Shakespeare
• Great Minds Think in 140 Characters – Great Tweets from the past
• You Do the Maths (including Poverty/Inequality Watch – Jester  few numbers to crunch on
• Jester Poet/Poetic Jester
• The End is Nye  - Past heroes – past wisdoms  ‘ gone but never forgotten’
• The End is Nigh, Nye  - Killing off 65 years of NHS

NHS on a ‘cliff-edge’

The founding of an NHS in 1948 is recognised as a crowning achievement for that small but determined group of reformers, who had struggled for a more inclusive, egalitarian and compassionate society.  More than any other institution it is emblematic of a caring, inclusive, humanitarian society.  For successive generations it has provided a touchstone of who we are and how we wish to live together.  At the 2012 London Olympics, we chose to show-case the NHS in order that the world would understand our culture and our values.

 When it was launched by the then Minister of Health, Aneurin Bevan, on July 5 1948, it was based on three core principles:

·         that it meet the needs of everyone

·         that it be free at the point of delivery

·         that it be based on clinical need, not ability to pay

Ask Healthcare practitioners and they will tell you that these three principles have guided the development of the NHS over more than 60 years and remain at its core today. They will also say that the NHS is under threat as never before from a Government, which is driven and doctrinaire in its determination to create a healthcare market and privatise provision of healthcare services

Unsafe in Tory Hands

Once the Health Service was established, no Tory, whether in government or opposition, has dared openly to challenge the NHS. Whilst Tory rhetoric was supportive of a NHS, the truth is that with the exception of a few ‘One Nation’ Tories there has never been any real enthusiasm for a universal system of healthcare. It is easy to forget that in 1946 the Tories opposed the NHS lock stock, and barrel on the basis that it would undermine the freedom and independence of the medical profession – a bellwether of Tory future Health policy where they have always put private interest ahead of public good. During the intervening 65 years the Conservatives’ appetite for a universal healthcare system has been meagre while their appetite for the marketing of public services has steadily increased and is now gargantuan.

Healthcare market – a flawed concept

The Tories constantly repeat the mantra that the ‘NHS is safe in our hands’. It is a promise that looks increasingly empty as the current Government forges recklessly ahead with privatisation... The USA healthcare system stands as a stark warning to us that privatisation works for the rich but is disastrous for the poor.  Here are 6 reasons why the notion of a market in health is generally flawed, and for those at the sharp end ‘fatally’ flawed:

• Ethics –It is just plain wrong for the rich to make money out of individual illness or injury; markets  produce both winners and losers –    ‘Losers’ , unable to access services they need can end up paying with their lives
• Profit – Healthcare companies will always privilege shareholder returns over Service Users’ needs
• Cherry Picking – the Private Sector has no interest in parts of the market that cannot guarantee return on investment. Large areas of healthcare provision will be unattractive to companies and the risk of those areas of medicine being neglected is high
• Instability/unpredictability – Healthcare providers will move out when profits drop putting services at risk. e.g. the withdrawal of NHS Direct from  111 Telephone  Advice Service
• Unaccountability – In practice it is difficult and costly for the State to put in place structures and regulatory processes which are effective in guaranteeing standards and quality in provision
• Hidden Costs  – there are significant costs to maintaining an internal market e.g.
• Cross-tendering
• Mediation and resolution of financial disputes
• Escalating cost of medical insurance –US market shows that there is an ever-growing insurance premium to be paid in order to cover defaulters or those who are unable to pay
• “The hyper-transactional financial system turns out to be highly unstable, imposing vast systemic costs;”      Will Hutton - Observer 22.6.2014

Cracks to Chasms

This Coalition Government would have us believe that those, who question privatization or point out deterioration in healthcare services are alarmists or left-wing proselytisers. Yet they must know they are in trouble when one of their own, Sarah Wollaston, Tory MP for Totnes, and member of the Health Select Committee launched a scathing attack on plans for reform, saying that they risk changing the NHS "beyond recognition".  Dr. Wollaston said that proposals to hand a £80billion health service budget to GPs to administer would result in the NHS going "belly-up, not top-down".

The Government relies on the empty rhetoric of the present Health Secretary, Jeremy Hunt, to divert attention away from what is happening on the ground. Reports by Nuffield Foundation and King’s Fund (and others), however, give us a true picture.  They highlight:

• Provision on a ‘cliff edge’ with hospitals planning to cut emergency and elective work in order to balance the books
• The Health Service’s inability to close the income-expenditure gap at a local level by ‘efficiency savings ‘  alone.  
• The stark reality that the NHS faces ‘significant cuts to services’ unless extra cash is ploughed in – without new money there will inevitably be a financial crisis that will damage patients in 2015/16”
• Longer waiting times especially in A&E.
• District Nurses  ( cornerstones of community care system) under threat through’ lack of investment and soaring patient demand’
• That a stark divide in access to doctors exists with people living in the most deprived communities facing the longest waiting times (Royal College of GPs  research)
• Seriously ill patients suffering from illnesses like cancer and HIV endure  ‘significant delays’ in receiving drugs because of private contractor Healthcare at Home’s failure to deliver on time
• Rapidly falling user satisfaction levels
• Higher levels of ‘avoidable mortality’ than in other countries

• Growing Health Inequalities  - 22% of people in Bradford report not being able to make an appointment with GP whereas figure in Bath and North East Somerset was 5%
• The fact that “patients in hospitals located in competitive markets (are) more likely to die after an admission following a heart attack"

• The fact that only 40% of Trusts are confident of financial balance in 2014/15 and  only 16% believe it possible to balance the books in 2015/16
• The need for more money for transformational change and short-term support
• That the implementation of the Better Care Fund  will throw the NHS into financial crisis in 2015/16
• BCF pools £3.8 billion for local authorities and clinical commissioning groups to spend jointly on social services and community services. Most of the money comes from the NHS. None of it is ‘new’

Dr.  Mark Porter at the British Medical Association in June 2014 expressed the view that “a combination of rising patient demand, staff shortages and falling funding is undermining the very foundations of the NHS.”

Locally, Dr. Martin Garsed, specialist in palliative care in Canterbury, has gone on record as saying

“Hospitals are in freefall. Primary care is disjointed. The Out-of-Hours service is bordering on incompetence.”

Earlier this month a Canterbury GP expressed the view that the ‘NHS is being readied for privatization through neglect’.

On the eve of the 1997 election, Tony Blair famously told voters they had 24 hours to save the NHS.  2014 is not the time to copy Blairite histrionics but it is the time for action. Act now and vote the Tories out or we will be left with an NHS, which we hardly recognise.  As Dr. McCoy from Star Trek might have said,

“Yes, Jim (Kirk) it is the NHS; but not as we know it.”

Sing-a long with the Bullenden Boys – (Whose nose is in the trough?)

To the tune of the Eton Boating Song

The Cameroon leads the way:

Jolly Troughing weather

Jolly Financial wheeze

Fly like a feather 

And apply the jolly squeeze

All in this together

Your future on your knees

All in this together 

Your future's down on your knees

Boris picks up the melody:

Cronies - why pay your taxes?

Just keep the loot off-shore

Jersey, Cayman, Bermuda

Avoidance’s not breaking the law

(Cos’ we’re) all in this together

Our future’s the Antilles

All in this together

Your future’s down on your knees

Jezza joins the medley:

Health Care’s ripe for snouting

Contracts drawn, ready to go

It’s all over bar the shouting

Shaft quietly, and no-one will know

All in this together

There’s money in replacement knees

All in this together

We do what we fcuking please