NHS royal commission should assess long-term future, says Lord Saatchi

A royal commission should be set up to examine the long-term future of the National Health Service, a senior Tory peer has said.

Former Conservative chairman Lord Saatchi said a commission could take the issue out of politics and “detoxify” any changes that needed to be made.

His recommendation comes before the publication of a report that is expected to show the parlous state of English NHS finances.

In a paper for the Centre for Policy Studies thinktank, Lord Saatchi said: “There is a wide range of perspectives on the current performance of the NHS, and varied confidence in its long-term future, from the pessimistic view that the system is in crisis, to the optimistic position that its only threats are meddling politicians. A royal commission offers significant benefits regardless of the position taken.

“A royal commission is an opportunity to help reverse a deterioration in some clinical outcomes, to identify and eliminate barriers to equal access, and to ensure that trusts are adequately funded to cope with current demand pressures. The solutions it arrives at could help to avert the kind of distress seen throughout the system over the 2016-17 winter.”

Saatchi said the advantages of a commission, rather than any other sort of inquiry, included “the ability to secure the bipartisan support needed to embed lasting changes, to detoxify reforms that otherwise may be too politically dangerous to pursue, and to deploy its unique investigatory power to establish what reforms are needed to ensure that we have a world-class, 21st century, health system”.

“A commission’s investigatory powers and capacity to provide evidenced-based review, free from the constraints of the immediate political cycle, allow it to craft solutions that command the support of practitioners and politicians alike. When set up properly, its recommendations carry a unique legitimacy that could be essential to securing a lasting, bipartisan settlement on the NHS.

As the NHS approaches its 70th birthday he said it “would be reckless not to seek a full body check-up – the first in decades”.

On Monday, NHS Improvement’s figures for the third quarter of 2016-17 will be published.

NHS Improvement’s chief executive, Jim Mackey, has acknowledged that trusts would miss the £580m deficit “control target” and forecasters have predicted the combined hole in their finances could reach nearly £1bn by the end of the year.

Responses to the King’s Fund thinktank’s latest survey of NHS finance directors, carried out in late January and early February, made for “uncomfortable reading”, its director of policy, Richard Murray, said.

“They suggests that the forecast net deficit has risen by about 30% since the autumn, when NHS Improvement’s quarter two report showed a net deficit for the year of £669m. Simply applying one number to the other would give a 2016-17 net provider deficit somewhere between the £820m to £920m mark.”

Murray suggested it was a “big ask” to expect trusts to recover ground over the remainder of the year, given the scale of the winter crisis.

NHS royal commission should assess long-term future, says Lord Saatchi

Vaccination skeptic Robert F Kennedy Jr to chair vaccine safety commission

Donald Trump has asked Robert F Kennedy Jr, a prominent skeptic regarding the use of vaccines, to chair a commission on vaccination safety.

“President-elect Trump has some doubts about the current vaccine policies and he has questions about it,” said Kennedy, speaking with reporters after a meeting with the president-elect at Trump Tower on Tuesday.

“His opinion doesn’t matter but the science does matter, and we ought to be reading the science and we ought to be debating the science,” said Kennedy, the son of the late attorney general Robert Kennedy and nephew of late president John F Kennedy.

Childhood vaccines have been falsely linked to autism in recent years, despite multiple scientific studies proving that incorrect.

During a 2015 Republican debate, Trump claimed that a child of some employees of his had become autistic after getting vaccinated.

“People that work for me, just the other day, two years old, beautiful child went to have the vaccine and came back and a week later, got a tremendous fever, got very, very sick, now is autistic,” Trump said in September 2015.

According to Kennedy, an environmental activist, radio host and attorney who has written for the Guardian, Trump has created a commission “on vaccine safety and scientific integrity” and asked him to chair it.

“Everybody ought to be able to be assured that the vaccines that we have – he’s very pro-vaccine, as am I – but they’re as safe as they possibly can be,” Kennedy added.

Although Kennedy calls himself “pro-vaccine”, he has pushed hard against the use of thimerosal, a preservative used in vaccines made from mercury, launching a group called the World Mercury Project, backed by anti-vaxxers. He advocates that parents should choose whether their children are vaccinated.

In 2014, he edited a book titled Thimerosal: Let the Science Speak: The Evidence Supporting the Immediate Removal of Mercury – a Known Neurotoxin – from Vaccines.

In 2015, he said Congress was stalling on investigating links between autism and the mumps, measles, and rubella (MMR) vaccine because it was scared of Big Pharma, a trillion-dollar industry and the biggest employer of lobbyists.

When questioned what his father and uncle – leading lights in the 1960s Democratic party – would make of Trump as president, Kennedy said on Tuesday that Trump “can be any kind of president he wants to be”.

“He probably comes into office less encumbered by ideology or obligations than anybody that has been in political office or won the presidency,” Kennedy said.

The Guardian has contacted the Trump transition team to ask them to confirm the commission has been set up and to give further details.

Vaccination skeptic Robert F Kennedy Jr to chair vaccine safety commission

Indigenous suicide is a humanitarian crisis. We need a royal commission | Dameyon Bonson

The right of self-determination of all people is a fundamental principle in international law, yet within the prevention of suicide for Indigenous Australians, that has been obstructed. Until now.

Recently it was announced that Black Rainbow will become the first peak Indigenous LGBTI body. You want to know why this is important? Let me tell you.

5.2% of Indigenous Australian lives are lost to suicide but as yet, there is no Indigenous organisation driving policy to combat this devastating problem. I estimate that there are between 10,000 to 15,000 same sex attracted Indigenous Australians. Same sex attracted people in Australia are up to 14 times more likely to die by suicide. So as Indigenous same sex attracted Australians, we rank at the highest of the highs in terms of suicide rates.

Related: Indigenous suicide rates in Kimberley seven times higher than other Australians

Our indigeniety is not the cause of these suicides. From my lived and from my professional experience, I can tell you the drivers of suicide for Indigenous people are many, and they are multi-factorial, multi-faceted and multi-layered. Therefore, our suicides cannot be viewed or treated just within the scope of a pathogenic paradigm, or in other words, we cannot medicalise the suicide and thus the person too. As this approach continues, and if we let it continue, Indigenous people will continue to be seen as the bearer of the problem and not the holder of the solution. We need to be more about franchise than empowerment – or at very least invest in both.

As an Indigenous Australian gay male I know that when it comes to the suicide of gender and sexuality diverse people (LGBQTI), our solutions are not pathologised. Efforts instead are made to combat what we call the drivers of suicide ideation and elevated risk of psychological distress. These drivers are bigotry and hatred. It is not our diverse genders and sexualities that cause us distress – it’s the homophobia, transphobia and the social exclusion.

The same goes for us, as Indigenous Australians. It is not our indigeniety that causes us distress. It is the drivers of racism, whiteness and social exclusion. Over many years, I have witnessed the whiteness in suicide prevention and its imagined white supremacist ideology that excludes Indigenous Australians. This year I experienced heterosexism. Heartbreakingly, this was from within my own mob. Heterosexism works on the assumption all people are straight (heterosexual) – because the majority of people are straight, the needs of us whom are diverse in sexuality and gender can unintentionally be viewed as secondary.

But I want to give you an example of whiteness in this space. Suicide Prevention Australia (SPA) and its subsidiary, the National Coalition of Suicide Prevention (NCSP) both proclaim to be national representatives, ie for all Australians. But did you know that there is not one Indigenous Australian as part of the executive or leadership of either of them?

There are 30 organisational members of the NCSP, and not one is an Indigenous peak body or representative. That both SPA and the NCSP are cognisant of this exclusion but have done nothing about it is a classic example of systemic racism.

Recently I was told that “SPA doesn’t have representatives of ‘other’ high risk groups either”. Indigenous Australians are first peoples of this country – we are not we are not an “other”. Conflating our plight against colonialism with the plights of all marginalised/high risk groups cloaks the specific needs of Indigenous people and the humanitarian crisis of Indigenous suicide. As stated earlier, 5.2% of Indigenous Australian lives are lost to suicide. We are not another high risk group. We are the highest risk group in the country; 12th highest in the world.

With our new status, Black Rainbow will be able to provide expert advice at the intersection of racism and homophobia and how they affect our lives. We’ll advocate for a more inclusive suicide prevention space. But most importantly, we will seek out solutions to the high rates of Indigenous suicides, using a method not of pathogenesis. This current pathogenic approach is not doing our mob any favours: hetero, homo or trans.

Black Rainbow will take formation in the coming months and soon we will be inviting peak Indigenous organisations to form our own coalition for the prevention of Indigenous suicide.

Related: Health service calls for royal commission into Indigenous suicide rates

If my years on the frontline preventing suicide and tic-tacking 35,000km plus across the remote north west, have taught me anything, it is that self-determination is an essential factor in the fight against suicide.

I hope that together the peak bodies of Aboriginal and Torres Strait Islander health can unify and collaborate to address the core drivers of these suicides. Of course, non-Indigenous peak bodies are more than welcome to join, but their function and role will be as advisory members. We may or may not match the cost of having to join the NCSP, because as Indigenous people we know that capitalism is not the friend of the impoverished.

I am laying down the new rules of engagement in Indigenous suicide prevention and they begin with: “Nevermore, will something proclaim to be for us, without us. That stops today”.

Bring on the Royal Commission into Aboriginal and Torres Strait Islander suicides.

Dameyon Bonson is a human rights award winner and founder of Black Rainbow.

Indigenous suicide is a humanitarian crisis. We need a royal commission | Dameyon Bonson

NHS charges could shell out for free elderly care - commission

But the Commission, set up last yr by the King’s Fund, the overall health feel-tank, warns that doing so could price billions of lbs added which would have to come from taxpayers, patients or both.

“To do any of this implies we have to look these hard options squarely in the eye” the commission’s very first report warns.

“To move in the instructions we argue for will demand some combination of greater taxation, expenses for overall health care, or cuts in other places of public investing.”

Taxpayers presently commit about £120 billion a 12 months on well being and social care in England but offering better accessibility to care could substantially increase the bill total.

The commission, chaired by Kate Barker, the economist and former member of the Bank of England’s Monetary Policy Committee, sets out a series of possible situations to increase additional funding and will make company recommendations in a later on report due in September.

One particular suggestion is introducing fees for individuals to go to GPs and A&ampE ranging from a flat £5 fee to as much as £25, with exemptions for some. It is estimated that a £10 fee for a GP consultations would increase about £3 billion a year – enough to fund a significant growth in social care.

It also calculates that charging £10-a-time for hospital appointments could reap another £800 million, whilst a £50 charge for hospital treatments could raise one more £900 million.

The further charges could, it suggests, be deferred throughout people’s lifetimes and reclaimed from their estate after their death in the exact same way that care charges will be when the Government’s reform package deal comes into impact.

Meanwhile limiting free of charge prescriptions to poorer pensioners could also net about £1.five billion, the examine calculates.

Other options set out contain introducing means tests to rewards this kind of as the winter fuel allowance or attendance allowance – which the report calculates could each and every increase in between £1.four billion and £1.5 billion – and limiting free bus passes for pensioners.

Alternatively it suggests new approaches of raising taxes this kind of as imposing VAT on personal overall health care or making these even now functioning soon after the age of 65 pay National Insurance coverage.

The commission argues: “The contrast among a health support totally free at the level of use, and a social care services that is signifies examined, and publicly funded only for individuals with hefty requirements outcomes in a lottery – the sort of ailment you have will determine the fiscal help you get to cope with its results.

“The outcome of this lottery is that there is no equity – related demands do not receive equal treatment.”

Caroline Abrahams, charity director of Age United kingdom said: “This essential new report rightly highlights the relevance of a more joined up strategy among the NHS and social care and the barriers in the way, of which the continual underfunding of social care is one particular of the best.

“Since funding is failing to maintain speed with expanding demand social care is more and more limited to these with the best wants, producing daily life a misery for several older individuals and their households and intensifying pressure on the NHS. “This can make no moral or useful sense.

“Integration of well being and care is the correct approach but it can’t take place till the social care funding gap is filled, and politicians in each get together need to recognise this and commit to action as an urgent priority.”

NHS charges could shell out for free elderly care - commission