Photography: London Zone 1
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Junior doctors are warning us
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This article first appeared in the New Statesman on January 15 2016 Junior doctors aren’t just going on strike. They’re trying to warn us There’s a bigger story than just pay and conditions, warns Benedict Cooper. By Benedict Cooper On a bitterly cold afternoon in Nottingham’s Old Market Square, a group of junior doctors stood shivering together, banners in hand, pleading with the people hurrying by in thick winter coats and scarves to listen to their reasons for why they and colleagues throughout England are on strike. A few stopped, tapping their feet in the chill air; some even signed their petition. On the surface it’s about pay. But there’s something more serious going on – a lesson we ignore at our peril. Doctors are deeply concerned about safety on the wards. Why do they feel they have to take to the streets to tell people, rather than going through the official channels? Because that’s a dangerous game as well. Take the case of Dr Chris Day. When Day qualified in 2009, the idea that he was destined to cross swords with the Secretary of State for Health would have seemed ludicrous. Now he is embroiled in a dispute with the highest levels that has implications for the future of the controversial, and often misunderstood practice of ‘whistleblowing’. It all started one night back in January 2014. Day was working through the night on ICU at Queen Elizabeth Hospital, part of Lewisham & Greenwich NHS Trust. When two locum doctors […]

The refugee crisis/medical angle
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With winter fast approaching the refugee crisis could become a medical disaster This article first appeared on OpenDemocracy As temperatures drop in eastern Europe, western attitudes to refugees cool. The Paris attacks have hardened many hearts, yet still the migrants arrive, at medical camps and aid agencies. When ISIS arrived in Mosul, Fatima knew that her son, a policeman, was in mortal danger. With his children they fled to Erbil, the capital of Iraqi Kurdistan, a safer place for now but with little future to offer a displaced family. So Fatima set off on her own, on a tortuous journey in search of a better life for the family. She flew to Istanbul, then made her way to the Turkish coast, straight into the hands of people smugglers. When the boat she was on reached the Isle of Lesbos there was no beach to land on so she and the other passengers were slung overboard to swim to shore. If it wasn’t for two younger men supporting her as they swam Fatima, in her mid 60s and overweight, says she would surely have drowned. “I had nothing to lose when I left Iraq”, said Fatima, as she waited anxiously for the ambulance to arrive to take her to hospital. “I am old. I took the risk so that my family can live”. … While arriving in Europe, into the arms of volunteer doctors, is a moment of salvation in the eyes of those who have survived that far, what they […]

The attack on Kunduz Trauma Centre
Open Democracy

This article was first published on OpenDemocracy in November OUT OF THE DARKNESS of the Afghan night, in the skies over the Kunduz Trauma Centre, the faint drone of propellers could be heard. Then, the bombing began. The intensive care unit (ICU), where the most critically ill adults and children silently lay, kept  alive only by ventilators, was first to be hit. For the next hour the American AC-130 gunship circled its target, unleashing “concentrated volleys” of rockets on the medical centre. As staff escaped the building and fled, they were cut down by machine gun fire from above. What they saw in that terrible hour on October 3, and in the grim aftermath, was enough to test the most conflict-hardened medic. Patients burning to death in their beds in ICU; two killed while lying on the operating table; the decapitated body of a colleague; the charred remains of children lying in the blood and the dust. Frantic efforts to temper the chaos followed: a desk in the undamaged administrative building was converted into an operating theatre to perform emergency operations on staff and patients left dismembered, with open chest wounds, ruptured abdominal blood vessels and severe shock. While the sun came up, the hell continued. As the wounded were rushed out to ambulances dispatched by the Ministry of Public Health to take them to hospital, fresh clashes erupted outside the compound leaving one ambulance riddled with bullet holes as it took patients away. _ What isn’t up for question […]

Debunking the government’s NHS conference spin

It was David Cameron’s birthday last week. The big day was actually Friday, but the gifts began pouring in much sooner. An hour of conference-talk was enough to convince seemingly most of the political commentariat that the Conservatives are now the true guardians of left wing politics. Including the Blairite right, that is pursuing vengeance on the new leadership with such venom that it happily cheers Tory spin over anything Labour now says or does. Exactly how a party which is working away at, say, the Trade Union Bill – a legislative two fingers up to everything the Left stands for – can possibly be described as left-wing, I don’t know. Birthday treat perhaps. But if you want to see just how well David did last week, you need to look no further than the speech by his Secretary of State for Health. The fact that Jeremy Hunt could stand up and with a straight face say that the Conservatives want to be “the party of the NHS” is one thing; that so much of the press believed him and, more importantly, didn’t check that statement against the reality, is something else. I wonder if it occurred to him that there are currently 13 trusts in special measures, and 33 without chief executives, when he said “there is no greater privilege in government than being responsible for our NHS”. Even if the Department of Health didn’t lean on Monitor to delay a hideous set of financial figures until after the […]

The law students who took on the DWP
NS_CMYK

First published in the New Statesman, September 30th 2015 Law students had to help a man in debilitating pain fight being declared “fit to work” Disabled claimants are increasingly vulnerable, with justice more difficult to access, and the need to be reassessed after being declared “fit to work”, By Benedict Cooper The first Paul Crane knew of having his benefits cut off was when his landlord called up to ask where the rent was. It was the start of a harrowing time. After ten years of receiving support for debilitating pains – caused when gamma knife radiosurgery to repair a haemorrhage on his brain stem caused radiation damage to surrounding tissue – he had suddenly been declared “fit to work”. Paul’s life has never been the same since the operation, which repaired the haemorrhage but left parts of his brain and spinal cord permanently damaged. Every day he is haunted by stimuli – light, noise, crowded places – anything that sets off his “excitable nerves” will leave him in agony with migraines, cause numbness and dizziness, or leave part of his face sagging. Even sneezing or tiredness can cause a traumatic flare up. He says: “Tiredness causes pain and pain causes tiredness. I don’t socialise much, I’ve let people down too many times. I go fishing, which is my only relaxation but even that sometimes is too much”. Over a decade of suffering and being prescribed a cornucopia of drugs – none of which have fully worked – Paul has learnt to live with the pain. But a new regime at […]

Hunt thinks junior doctors lack “professionalism…
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…and a sense of vocation”? Is he kidding? If Jeremy Hunt isn’t trying to rile the medical profession, he’s got a funny way of going about it. With tensions high and strike action on the cards, saying that contract reforms, the very source of the strain, will bring back “professionalism and a sense of vocation” to a career that attracts some of the most talented and dedicated people around is either a whole new level of crass or it’s designed to inflame. And inflame it has: on Saturday the BMA’s Junior Doctor Committee voted to ballot its members over strike action (or some other form of protest), which could happen within a few weeks. There could, and hopefully will be some agreement before then, but if NHS Employers are going to keep cancelling meetings with the BMA as they did Monday evening – possibly to avoid protests that were set to take place outside – it’s not looking too good. Ostensibly the reforms are about working towards a ‘7-day NHS’ service – nothing wrong with that. But let’s call this what it is: a way to pay doctors less and reduce the overall bill, plain and simple. Speaking in July at the Department of Health-sponsored procurement conference, P4H, which bills itself as the “largest event bringing buyers and sellers of the NHS together”, John Warrington, deputy director for policy and research in the procurement, investment and commercial division at the DH, said: “All the work that Lord Carter has done […]

Addenbrooke’s hospital is just the canary in the coal mine as far as the NHS is concerned
NS_CMYK

First published in the New Statesman A toxic cocktail of under-pressure local authorities and low staffing has the NHS on the brink. By Benedict Cooper Among the grim litany of charges laid out in the Francis Report into the Mid Staffordshire scandal, time and again short staffing came up. “It should have been clear,” the report said, “from the history and the nature of the deficiencies being reported, particularly in relation to staffing, that a dangerous situation had been allowed by the Trust leadership to develop and that urgent action and intervention were required”. It went on: “The complaints heard at both the first inquiry and this one testified not only to inadequate staffing levels, but poor leadership, recruitment and training”. Two and a half years later, have the lessons of that dark episode been learned? Today’s Independent would suggest not. It reports that out of 89 acute hospitals inspected between 2014 and 2015, three quarters raised concerns over staffing levels. Yesterday Addenbrooke’s Hospital in Cambridgeshire became the latest acute hospital to be branded “inadequate” by the Care Quality Commission (CQC) and the trust that runs it placed into special measures. “Inspectors found a significant shortage of staff in a number of areas including critical care services,” the CQC said in a statement. “This often resulted in staff being moved across different services, with gaps back-filled by bank or agency staff. After the long recess, it’s always a good time to reflect. Just as Parliament broke Jeremy Hunt was facing […]

Why didn’t Cameron give Dan Hodges a peerage?

“It’s not the professional Labourphobia and ceaseless smearing of the Left that bothers me. It’s the total unwillingness to hold the Conservatives to account”. Andrew Lansley got one, and his Health and Social Care Act has been one of the most catastrophic pieces of legislation in modern politics. It’s been condemned by the medical profession, activists, campaigners, even Conservative MPs, and given the Tories multiple headaches. If it wasn’t for such an indifferent electorate, it might have been much worse. So surely Dan Hodges, who has done more to distract the public from such sins and help the Tories back into power than almost anyone, should have been kicked something? To be a successful journalist you need a USP. It’s not enough to write well, have good ideas, even know the right people. You have to stand out, find that unique angle that nobody else has got. In the cynical arena of British political writing, there’s plenty of tribalism; plenty of exploitation of facts and words to paint your own team in a better light and more importantly, smear the other lot whenever possible. Every now and then there’s another category; the angry defector who switches over and gleefully pans his former comrades. But Dan has found even more of a specialism, a truly surreal position – as the Kevin Pieterson of political commentary. The former union man and Labour Party member-turned-ex-member-turned-member-again’s columns in the Telegraph receive rapturous applause from Conservatives and conservatives. And why wouldn’t they? I bet they […]

The Spokesman
BertrandRussell

An article I co-wrote with Zenn Athar for the Nottingham We Deserve campaigning newsletter was reproduced in The Spokesman, the publication founded by Bertrand Russell. The article is below.   The city has been on the front line of some of the most radical and, many argue, damaging reforms to the NHS since its creation. The Nottingham We Deserve investigates. by Benedict Cooper and Zenn Athar When five of the UK’s leading dermatologists quit the QMC in December, Nottingham was thrust into the middle of a gathering storm of political debate. To many their departure was the latest symbol of a health service breaking down, and a workforce under increasing pressure.The doctors wouldn’t be drawn on the issue, but sources quoted deep discomfort about a big decision that had quietly happened away from the public’s eye: the unit was to be run by Circle, a private company. Unite head of health Rachael Maskell says the case in Nottingham was a key moment for many campaigning against the growing influence of private healthcare companies like Circle in the service. “It showed the strength of feeling people have towards the NHS,” she says. “It’s not just an ideological step they took, it’s also a clinical point of view. The consultants were willing to forfeit their careers to protect care in Nottingham”. So why the strength of feeling? And what made the doctors quit? As activists in Nottingham and further afield know, the QMC case is just the tip of the iceberg. Everywhere […]

There is no closure – just grief
NS_CMYK

New Statesman, August 28th 2015 The headlines about “parity of esteem” between mental and physical health remain just that, warns Benedict Cooper. I don’t need to look very far to find the little black marks on this government’s mental health record. Just down the road, in fact. A short bus journey away from my flat in Nottingham is the Queens Medical Centre, once the largest hospital in Europe, now an embattled giant. Not only has the QMC’s formerly world-renowned dermatology service been reduced to a nub since private provider Circle took over – but that’s for another day – it has lost two whole mental health wards in the past year. Add this to the closure of two more wards on the other side of town at the City Hospital, the closure of the Enright Close rehabilitation centre in Newark, plus two more centres proposed for closure in the imminent future, and you’re left with a city already with half as many inpatient mental health beds as it had a year ago and some very concerned citizens. Not that Nottingham is alone – anything but. Over 2,100 mental health beds had been closed in England between April 2011 and last summer. Everywhere you go there are wards being shuttered; patients are being forced to travel hundreds of miles to get treatment in wards often well over-capacity, incidents of violence against mental health workers is increasing, police officers are becoming de facto frontline mental health crisis teams, and cuts to community […]

‘The triumph of Corbynism is the death rattle of New Labour’
Labour leadership contender Jeremy Corbyn, address delegates at the annual conference of the GMB union in Dublin.

This piece appeared in the New Statesman on August 18th 2015 Perhaps the ultimate tribute to Tony Blair is that his trademark brand of politics, the mastery of style-over-content, is alive and well in the Labour Party. For a while it wasn’t the third way: it was the only way. The ease with which New Labour swaggered onto the top table of the party, and then into Downing Street, was testament to its ability to beguile the left and the right with the same conjuring trick.  How have we come from that dazzling show to this crude spectacle of tearing our own insides out in public? All of Labour’s gory details and contradictions lie on the slab. The uncomfortable truth that this is an organism of incommensurable anatomical parts sharing a blood stream is there for all to see. I’ve been gripped by politics since my mid-teens, coincidentally, perhaps, just at the point that New Labour was at its zenith circa 1997.What I understand now, that I didn’t then, is that Blairism tried to thwart the core of the Labour Party that cares more about issues than power. Now, I understand where he and others are coming from when they talk about unelectability; I understand that you have to be in power, or at least a sizeable opposition, to make anything happen, and to do that you need broad appeal. Not that it matters, but this is not a ‘Why I’m supporting Candidate X.’ piece. What I’m certainly not shying […]

The right wing does the NHS
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I realise that Douglas Murray, associate director of the Henry Jackson Society and polemic Spectator columnist, may have ideological even political reasons to bemoan the “perils of a socialised [healthcare] system”. That’s hardly going to come as a shock. What is surprising is that such an elevated journalist as he is willing to let so many innacuracies stand in this careless denigration of the health service. But it’s a useful exercise – it proves that certain stripes within the right have set out to manipulate the truth about the NHS for ideological means. And why they’re wrong. (Incidentally my own writing on medical politics appears mainily on the New Statesman). Murray believes that “George Osborne refuses to seek savings in [the NHS] budget and promised an unbudgeted further £9 billion”. Perhaps he is not aware of the fact that the Simon Stevens’ plan to which he (presumably) refers, and to which the government is committed, also calls for £22bn worth of cuts as a quid-pro-quo? Much of the NHS has already been cut, drastically in fact. Not least Public Health -a fact, surely, he should be happy about. After all, most of his piece is taken up by a loathing for the role of the state in tying to educate the public about the perils of obesity, smoking and other killers, which he considers paternalistic sermonising. Murray says that the NHS is the “only untouchable force in the state”. Perhaps he is not aware of the implications of the Health and Social […]

#weneedtotalkaboutjeremy
NS_CMYK

New Statesman, July 28th 2015 We need to talk about Jeremy: why doctors are so angry with Jeremy Hunt [1] Jeremy Hunt is at the centre with another row with the medical profession. What’s going on? by Benedict Cooper [2] Published 28 July, 2015 – 09:35 First, do no harm. Photo: Getty Images The long summer break can’t have come too soon for Jeremy Hunt. In the last 10 days alone, two separate waves of vitriol from the medical profession have come crashing down on him, and as he scarpers off to sun himself he must be wondering what type of mood he’ll be coming back to. First there was the #Iminworkjeremy [3] campaign, a fierce rebuttal of Hunt’s attack on the BMA [4] over consultants’ supposed unwillingness to work seven days. This must have seemed like a breeze though, compared with the last week’s bruising.  Cue #weneedtotalkaboutjeremy [5], an even angrier backlash sparked by the government’s response to a petition which has gathered more than 200,000 signatures (and rising), calling for a debate of no confidence in the Secretary of State. The reply was meant to silence the mob – it’s had the opposite effect, and been branded as “manipulative and misleading” by Dr Hamed Khan [6] who I know speaks for many doctors out there. The whole saga has yet further uncovered a bitter divide, a growing rift between the Secretary of State for Health and the medical profession. Yes, the government’s response to the no-confidence petition made […]

Nursing in crisis
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This piece appeared in PRN Magazine in July 2015 Nursing in crisis: The disappearing numbers   A pay-freeze, a row over safe staffing and new rules to kick thousands of nurses out of the country: it’s been a stormy summer in medical politics. Benedict Cooper reports. You’d be forgiven for thinking that the government has it in for the nursing profession. In the last two months alone, a string of policies have put pressure on a workforce already in strife, and laid some shaky stones to step over next.First NHS England asks NICE to halt an investigation into safe staffing – to the approval of the Department of Health but the dismay of safe staffing campaigners. Then the Home Office chips in with tough new rules to deport non-EU migrants earning less than £35,000 a year, which the RCN says could lead to the loss of 7,000 nurses. And, finally, to round off a torrid month, in his budget the Chancellor delivers the news that the pay freeze on all public sector workers is to continue – for four more years. “Getting tough on migrants might play out well with the public, but anyone who has worked in an NHS hospital knows how crucial these workers are for the service.” Take any one of these decisions in isolation, and you will find nurses reeling as a result. Take them all together, and it begins to feel like a concerted effort. Getting tough on migrants might play out well with the […]

The quiet exodus of GPs
NS_CMYK

This article appeared in the New Statesman in July 2015 George Osborne quietly slipped into his budget some news that the medical staff perhaps dreaded, perhaps didn’t even imagine was possible: the public sector pay freeze will continue. For another four years. I’ll just let that sink in. For months, doctors and nurses have been begging the public and the government to take notice: pressure on the wards is building to dangerous levels. Medical staff are overworked, under-appreciated and underpaid, and now there’s this insult to injury – a further slap in the face from a Chancellor unwilling to reward their graft with a share of the recovery, for which they have already sacrificed so much. It’s so far from justice, such a total misdirection of priorities, it’s taken this long to process. The Conservatives are on such a high at the moment that judgement seems to be on hold. Back in April at the health election debate, Jeremy Hunt barely managed to defend the Health and Social Care Act, on which the Conservative government’s entire health record will be judged. But last week he unveiled a policy that could only have made it into the X-rated version of the Health and Social Care Act. And his explanation for why printing the cost of a prescription, with the words ‘Funded by the taxpayer’ on the box would help patients and not just leave them guilt-ridden as well as sick, was so unconvincingly delivered on Question Time that I doubt it would […]

Greece: a word from the wise

From Will Hutton’s Them and Us (2010); Chapter 6 ‘Blind Capital’ “The new credit default swap (CDS) was meant to insure the holder of a security against default, but in fact it did little more than provide the means to speculate on the price of bonds, rather as currency options could be used to speculate on currencies. Again, there was no insurable interest: the CDS was not an insurable premium but a gambling chip. Buy a CDS in a bank or country debt, and as soon as there was concern about the credit-worthiness of the loan the price of the CDS would rise. Hedge funds buying CDSs in incredible volume would be key destabalisers during the banking crisis – the trigger for both Bear Stearns’ and Lehman’s demise – and later triggers of the sovereign debt crisis in Europe. It was massive buying of CDSs on Greek government debt in April 2010 that forced the massive EU and IMF bail-out.”  

The time bomb at the heart of the NHS
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This article appeared in the New Statesman on July 1st 2015 Staffing: the time bomb at the heart of the NHS There’s an unnerving continuity at the Department of Health: a maddeningly consistent split between two realities. First there’s what’s going on in the wards, in the hearts and minds of the profession. Then there is what ministers like Jeremy Hunt and Ben Gummer say at the despatch box. The DoH must be aware, for example, that on Tuesday the Royal College of Nurses (RCN) voted 99.4 per cent in favour of a motion to lobby to reinstate the investigation by the National Institute for Clinical Excellence (NICE) into staffing levels, scrapped by Simon Stevens earlier this month. It was one of the urgent recommendations of the Francis Report after Mid-Staffordshire: someone needs to look into safe staffing levels, now. Not long later, NICE got on the case. Results had started to come in, guidance was being formulated. Jeremy Hunt, Ben Gummer and others must know that the RCN, safe staffing campaigners and other experts were incensed by the decision to halt this investigation, announced by Stevens without warning in a speech to the NHS Confederation in Liverpool. But in case they missed it, the full wording of the RCN motion was pretty unequivocal: “That this meeting of RCN Congress deplores the decision to halt the current work by NICE on safe staffing and calls for RCN Council to lobby for the reversal of this decision that puts patients at […]