Sunday, 14 November 2010
Thursday, 11 November 2010
Monday, 8 November 2010
Friday, 5 November 2010
Monday, 1 November 2010
Friday, 29 October 2010
Theses another power related problem here.
Thursday, 28 October 2010
Tuesday, 26 October 2010
Saturday, 2 October 2010
Sunday, 26 September 2010
Q109 Chair: Secretary of State, thank you very much to you and your colleagues for the time that you spent with us. I understand that you would like to say something briefly on fire control just in finish.
Eric Pickles: I just thought I would quickly bring the Committee up to date with the contract. As you know, this Committee has expressed some concerns and worries about the contract. Indeed the Fire Minister met with Mr Gallois who is EADSs European board member with the responsibility for fire control. He apologised for the delays and stressed the organisation’s commitment to fire control. He promised to commit resources as necessary. He confirmed that EADS cannot meet the June delivery milestone which we activated and offered a further alternative suggestion as to how EADS might deliver the schedule if the fire service were willing to accept a system of reduced functionality.
I am really telling the Committee that I am very concerned about this. I do not think that EADS are treating this at all with the degree of seriousness that I would expect. As you will recall our team went to locate at Newport with EADS and they include expert secondees from the fire and rescue service. That team now, including some 15 uniform secondees, is currently located in portakabins on EADS car park, having been moved out of the main building and denied direct access to their counterparts in EADS.
We are worried that they seemed to be forming a pattern that they are employing lobbyists to try and get us to change our mind to accept a different and a smaller contract than the initial contract, for something that we did not want. Mr Betts, I really wanted to put on to the public record that this Government has no intention of rolling over and having our tummy tickled on this. We expect them to deliver their contract.
If I could just crave you indulgence I have to tell you this, there are two things. When they came before this committee they promised that they would pay compensation damages for any delay. They have now withdrawn that offer but have kindly agreed that the extra time that they are spending in order to rectify the mistakes on the contract that they have made they will not actually bill us. This is a rare thing because the last time they appeared before you they sent the Department a bill for £12,000 to cover their costs. I have to say, my predecessor and the previous Government refused to pay that and we will not be paying that £12,000.
If I could just go a little further and say, one of the things that that we are worried about is that they have produced a tool kit for the fire service to record their assets. There is a problem with it in that it does not recognise fire engines. By and large I think it is a good idea for assets to be able to recognise fire engines. This is a practical problem in so far that we need to be able to route fire engines, fire units, where there are low bridges we do not want them to go through it and find that they are missing their ladders. There is a particular problem; it has to be said, for you Mr Betts and me if I had been living in Keighley, because the only town that the system recognises within the whole of Yorkshire is Wakefield. That in itself is slightly worrying, but when you consider that the only place that the system currently recognises in London in Southwark. But kind of understand the problems that we are up against.
There is good news that the mobilising kit that they delivered to local fire stations which randomly turned itself off has now been fixed. Unfortunately the latest version has a tendency to overheat and is a fire hazard. The on board computers of fire engines currently have out of date maps and are not able to change the route easily. You and I could wonder down Victoria Street and go into a large retailer and get ourselves something for £180 that would do precisely that. I have given you these examples, admittedly slightly light-hearted but are a mess. The substantive message I think I need to give this Committee, and we have shared with the Chairman the detailed documentation, we are doing to have to come to a decision pretty soon. Our message is that a big European company like EADS should not mess us around anymore. We expect them to come to the negotiating table and fix what they have so far not fixed.
Q110 Chair: Is there actually a contract in place now? A firmly agreed contract with them.
Monday, 20 September 2010
Friday, 10 September 2010
Monday, 6 September 2010
Your easy access NHS Walk-In Centres and out of hours Primary Care Centres are actively being dismantled by the UK Coalition Government. They will be history in a year or so.
Back in the 1990’s the Dept of Health renegotiated the funding contracts with the General Practitioners. These independent contractors, who do not have contracts of employment with the NHS, were suddenly earning a lot more money for less hours and no longer provided out of hours coverage.
The responsibility for out of hours coverage fell on the Primary Care Trusts, who had to suddenly contract Doctors to provide out of hours coverage, where the GP’s had previously covered. Another increase in the health funding bills. In many cases the newly recruited out-of-hours doctors also for a GP Practice – Ho Hum more money for the new Volvo SUV.
The public were finding that the GP Surgeries were only available during the working day and even then it could be many days before they could get an appointment to see a GP. Sickness and injury does not wait for the limited GP availability hours, so the public took the only course open to them and went to the local accident and emergency department of the local hospital. Many of these attendances could easily have been dealt with by a skilled general practice nurse of a GP. As a consequence waiting times extended at the A&E and the price tab for handling these minor ailments skyrocketed.
The Government of the day reacted by setting up Walk-In Centres (and NHS Direct) in clinics around the country. There the patient could walk through the door with no prior appointment 364 days a year from 7 am to 10 pm and be seen by a skilled medical practitioner reasonably promptly. Often the medical practitioner would be a skilled and highly trained Nurse Practitioner with many years’ experience and medical post graduate degrees. Any serious case would be referred to medical specialists or A&E departments. Many of the people who attend the Walk-In Centres went because they could not get an appointment with their GP or had indeed been sent there by the GP Surgery staff. The consultation cost at a Walk-In Centre worked out at approximately £25 per session. A similar consultation at a GP surgery would cost the public purse around £40. Someone attending the A&E department would be a minimum of £110 per consultation even for a simple sore throat.
The Walk-In Centres are normally nurse-led. That means a senior nurse usually with 20 years or more experience would manage the service, even employing Doctors to act in a GP mode where necessary. The independent GP’s contractors around the country hate this loss of power, status, (and potential income) to the nurse led services. The senior nurses are required to follow formal medical protocols in respect of treatment, to keep detailed computer records of the reasons for their diagnosis of any patient. They have long training before they are allowed to prescribe medicines. The quality of treatment is at least as good as you would find at the GP Surgery. Many of the independent GP contractors hold positions of power in the governing committees in the local NHS Primary Care Trusts and use this power to thwart to central Dept of Health push for Walk-In and Urgent Primary Care centres.
With the proposed dismantling of Primary Care Trusts by the Conservatives/Lid-Dem Coalition we will see the closure of nurse led Walk-In Centres. They will be hived off to be run by GP Practices or attached to Hospital Trust A & E Departments. Neither the GP’s nor the A&E Departments have a sparkling record when it comes to cost efficient services. The well trained nurses will be frittered away and replaced by GP’s who are paid at least three times the cost of the nurses they replace. It is GP’s who have the ear of the Health Minister and are making sure that the “aberration” of nurse led Walk-In Centres are wiped from the services available to the public.
If you think this doesn’t happen, take a look at the case of the SE London Walk-In Centre based in New Cross. A building was fitted out as a Walk-In Centre Clinic with consultation rooms and an admin area. Almost £1,000,000 was spent on the development and set up. There used to be team of about 12 nurses providing coverage 364 days a year from 07:00 to 22:00. Now the clinic building has been handed over to an independent GP contract practice. The Walk-In centre nurses have been moved out and have a room or two working for another GP Practice. Only three nurses remain.