23rd February 2016

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Prof Sir Mike (Deep-Diver) Richards - CQC
In conversation with Roy Lilley - King's Fund March 1st, 5.30pm
Sold Out  HERE

No reason to forget this year
News and Comment from Roy Lilley
The in-out- hokey-cokey has got me miffed.  The culmination, the up-shot will be on the 23rd June... my birthday.  

No one asked me if I minded; would it inconvenience me, would it distract media coverage, would it make it more difficult to hire a venue or a celebrity to sing for me.
Reluctantly, I have to concede; there will be one or two people more interested in the future of the nation than the fact that Lilley has struggled through another year.
What does Brexit mean for the NHS?  Who knows?  We can only have a stab at the answer and wait for the big brain-boxes to have a row with each other.  In general, I thought this was balanced?
Let's try a dip into three headings; people, products and privatisation. 
Start with people.  Do you have relatives leading the Sangria life on the Costas?  Will they and the 2 million, probably +65's like them, head back to the Albion and bust the NHS?
Probably not.  The Vienna Convention on the Law of Treaties 1969 would come into play. It contains articles that are based on 'acquired rights', which individuals build up over time and hold, despite any changes in future treaties enacted by their nation.
However, if you do want to cash-in your chips and head for a life of crevettes and chips, it might be a bit more difficult.
Patients?  Under some circumstances, where patients can demonstrate 'undue delay' in getting treatment here, they can pop across the Channel, get fixed up and give the CCG the bill.  It looks to me that neat trick ends as EU directive 2011/24/EU goes out the window.
What happens if you are in your budgie-smugglers and fall out of a pedalo?  As of now you will receive the treatment that a citizen of that country, would expect.  You need a card, once an E111, now EHIC.  It will also cover you for pre-existing conditions and routine maternity care. And, vice-versa.
I guess that goes by the board and we will have to head for the insurance companies.  Nice little earner...
Staff?  This is all tangled up with 'free movement'.  A clinician (subject to registration and language), a cleaner or a porter can move here, get a job.  No need for a work permit.  They can stay for as long as they have a job and beyond and have the same working conditions and social and tax advantages as the rest of us (with the exceptions outlined in the proposed Cameron deal).
Given the pressures on the workforce, this might be serious, at least until we can grow our own.  If the EU working time directive goes down the toilet; expect a row with the junior doctors over another contract... yawn.
Products, kit and caboodle?  Selling our kit to 'them' will depend on trade agreements and I have no idea how long they will take to negotiate.  The other way around; the reverse applies. Does that mean shortages of patented, copyrighted, esoteric bits and pieces?  Dunno.  I'd think about a Plan B. 
Pharma?  They like being in the UK.  Time zones, safety, language, ease of access to academic trials, NICE approval, convenience of travel and entrée across EU and US markets are all factors.  The NHS is a very small market for them but our health service carries a considerable cachette.  Will they move?  
Privatisation?  By and large the EU has kept out of meddling with the NHS. In 2006 Labour opened the NHS to marketization; once the lid is off the tin...
The EU has become more aggressive on market access.  They fined Dutch GPs, €7m, for improving access to poorly doctored areas without going out to tender... which leads us to TTIP.  

The DH claim the NHS is exempt, many disagree.  If we move out of the EU, TTIP won't go away; it is a global trade deal, not a European one, aimed at regulatory convergence.  Furthermore it might be that TTIP is a 'mixed agreement' needing both EU and national parliament sign-off.
It's a mixed bag, a lot to think about... you'll have to be the judge.
But, I've given you fair warning, so you've no reason to forget my birthday this year!
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In conversatin with Roy Lilley
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14th April
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Health Chat
Prof Sir Mike Richards
Chief Inspector of Hospitals 
1st March 2016
King's Fund 5.30pm
A few tickets left
This is what I'm hearing;
if you know different,
tell me here
>>  I'm hearing - NHS Professionals is up for sale and Cumberledge is interested.
>>  I'm hearing - under the new contract GPs will have to submit evening and weekend access data.
Need inspiration, a good idea or solve a problem
Dr Rodney 
The biggest single year rise in deaths for almost 50 years.
Did you know that?
This is very significant, methinks...
Can you believe it?