Cowper's Cut 231: A new Dad's Army

I'm old enough to remember "Brexit means Brexit, and we're going to make a success of it". It now appears that unchecked immigration is suddenly OK again - at least when it comes to massively belatedly pretending to try to do something about the longstanding health and social care workforce crisis.

Yep, I missed the memo too. We learn from this Times piece that "as concern mounts in government about the state of the NHS and social care, ministers are looking at bringing in foreign staff “on a mass scale”.

"Steve Barclay, the health secretary, wants an overseas hiring spree in which NHS managers may also be sent to countries such as India and the Philippines to recruit thousands of nurses.

"He also wants to make it easier for regulators to check overseas qualifications so that staff can get to work more quickly".

The piece goes on to note that "although Brexit cut a key source of labour for a sector in which rates average £9 an hour, care staff have been placed on a shortage occupation list and now need only to earn more than £20,480".

One must have a heart of stone not to laugh. See also: reaping what you sow.

The Fictional Forty ride again

Imagine my surprise to learn that the majority of the fictional 40 'new hospitals' will not be built by the next General Election.

Sky News' thorough assembly of the available evidence, underlined with their FOIs to the fictional forty, tells 'Cut' readers nothing they don't already know - but it does represent a significant news organisation adding further awareness of this massive lie into the public realm.

Cutting training places for doctors

We live in remarkable times, when a shortage of doctors is matched with reductions in the training places available for doctors. The Sunday Times notes that "would-be medical students face a particularly difficult challenge to secure a place as the government has capped the number it helps to fund at 7,500, with strict quotas for each medical school. They can recruit up to 7.5 per cent of their intake from overseas students, who can be charged up to £45,000 a year.

"About 85 per cent of British students who applied to medical school were rejected, despite the shortage of GPs and hospital doctors."

Thanks to the on-costs of our dear old chums The Treasury Munchkins' chronic fiscal short-termism, NHS and care workforce planning is deeply broken.

Leadership schmeadership

As regards health policy, the Conservative And Unionist Party's leadership contest this week skipped from constipation to diarrhoea without missing a beat.

The Guardian helpfully disinterred a Spectator article written by Liz 'Surgical' Truss in 2009, when she was deputy director of Reform. In this Budget commentary, Truss proposed cutting doctors' pay, writing that “no department can be a no go area. This means the NHS, accounting for a sixth of government expenditure, cannot be put on a pedestal.

"Doctors’ pay which has risen inexorably needs to be restrained. Superfluous bodies such as Strategic Health Authorities, and health campaigns exhorting the public to stop ‘vegging out’, should be abandoned.”

Her Spectator article is here. Curiously, the Reform report in question, 'Back To Black' (yeah, you can almost hear Amy Winehouse cackling) has been taken down.

A new Dad's Army

To whom other than The Old Currant Bun could La Surgical unveil her NHS restoration plans?

Well, exactly. "A NEW “Dad’s Army” of retired ­doctors, nurses and medical staff should be called up to tackle the NHS crisis, Liz Truss has said. "She spoke out amid stories of pensioners being forced to wait up to 40 hours for ambulances after falls.

"Ms Truss said: “It’s about making sure we have a culture where we’re encouraging people to work in the NHS. During Covid, we successfully brought people back from retirement to help out. And what I’m interested in is how can we do that now we’re facing these critical issues in the NHS?

"“Because [there are] lots of fantastic people who have worked in the health service who could help.”

She said she’d make tackling NHS waiting times a “key priority”. And Brits must be able to get a GP and dentist appointment, she pledged. She also vowed to “fix the issues in social care” to ease pressure on hospitals."

Yes, I'm reassured too.

Still, perhaps we should be glad that La Surgical has abandoned any pretence at going through a reality-based phase. My observation from a few weeks back that she is the ‘Continuity Johnson’ candidate continues to age quite gracefully.

Team Surgical also briefed the Telegraph that The Dear Leaderene plans to review the perverse incentives created by the pensions taper tax and annual allowance, and that the NHS backlog will be one of her 'top three' priorities.

The Brand or The Taxman

If (as polling has always suggested) La Surgical wins, The Times political team suggests she will offer health to her defeated rival Rishi 'The Brand' Sunak, with tax-hesitant Nadhim Zahawi in reserve.

What a choice: The Brand or The Taxman. Still, there's always Nadine Dorries.

The oncoming winter

That noted source of health expertise, erstwhile newspaper and Boris Johnson fanzine the Telegraph has again sought to blame the parlous state of the NHS on lockdowns.

Ahem. It's worth re-watching ths clip of CMO Prof Chris Whitty schooling Tory MP Dean Russell, who tried this nonsense last year. Likewise, reading actuary John Roberts' analysis:

Winter is coming

The old tunes are still the oldest, and the one about 'x units of time to save the NHS' is back: the T0ny Blair Institute has published this sensible piece on what is required to get the NHS into a state where the coming winter pressures, almost certainly exacerbated by Covid and flu, are survivable for users and system alike.

'Three Months To Save The NHS' is published into an environment in which NHS England's winter plan (covered last week) has been poorly received in much of the service. It is a context well described in Shaun Lintern's and Tom Calver's analysis of rising deaths in emergency care for the Sunday Times.

Things are desperately bad. If I were working in the service right now, I'd be keeping copious notes about the ongoing patient safety crisis - and if I were in a clinical profession, I'd be very tempted to start wearing a camera to record what's going on. It still feels as if people do not yet believe just how bad things are.

Yet. Right up to the point when they or theirs need emergency care, I guess. We still haven't yet had 2022's Robert Winston moment.

Moderna love

La Surgical's plans for GPs to issue households with 'energy credit notes' could have a fascinating impact on the need for primary care to deliver the autumn vaccination campaigns. There is not only another round of Covid19 boosters, but also the flu jabs.

Still, it's a good thing that primary care has been stunningly quiet and under-worked for years now. It should make all of this just a breeze to deliver.

The Alan comeback

The forthcoming Tortoise interview should have Alan fans rapt. The New Statesman has this interview with former SpAd to The People's Partridge, Richard Sloggett of the FutureHealth consultancy.

Required and recommended reading

The Johnson whose opinion is worth hearing, IFS boss Paul Johnson, wrote this very good column on political 'cakeism'.

A very good FT piece on the medical possibilities of gene editing.

The Government bowed to the inevitable, and confirmed that they accept the committee's recommendations that victims of the infected blood scandal should receive interim payments of £100,000.

The Sunday Times has the complainant's side of the story in the NHS Blood And Transplant scandal, and this fascinating interview with neurosurgeon and author Henry Marsh, who is dealing with advanced prostate cancer.

Fair-minded FT profile of Randox