Saturday, 14 February 2015

Obese could lose benefits if they refuse treatment - PM

Obese could lose benefits if they refuse treatment - PM

Overweight man eating fast foodThere is no requirement for people with treatable health problems to get help under the current system

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People who cannot work because they are obese or have alcohol or drug problems could have their sickness benefits cut if they refuse treatment, the PM says.
David Cameron has launched a review of the current system, which he says fails to encourage people with long-term, treatable issues to get medical help.
Some 100,000 people with such conditions claim Employment and Support Allowance (ESA), the government says.
Labour said the policy would do nothing to help people to get off benefits.
Campaigners said it was "naive" to think overweight people did not want to change their lives.
There is currently no requirement for people with alcohol, drug or weight-related health problems to undertake treatment.
'A life of work'
Mr Cameron has asked Prof Dame Carol Black, an adviser to the Department of Health, to look at whether it would be appropriate to withhold benefits from those who are unwilling to accept help.
Announcing the proposal, he said: "Some [people] have drug or alcohol problems, but refuse treatment.
"In other cases people have problems with their weight that could be addressed - but instead a life on benefits rather than work becomes the choice.
"It is not fair to ask hardworking taxpayers to fund the benefits of people who refuse to accept the support and treatment that could help them get back to a life of work."
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Analysis
Bottles of alcohol
By political correspondent Alex Forsyth
David Cameron sees the wide-ranging welfare reforms introduced in this Parliament as part of a "moral mission".
He has said they give new hope to people who have been written off by helping them back to work.
He also knows taxpayers who fund the welfare state like policies which ensure benefits only go to those who need them.
So despite criticism of what some see as an increasingly punitive benefits regime, the Conservatives are floating a new suggestion - possible sanctions for those claimants who refuse help to overcome treatable conditions.
On the same day, during a speech in Wales, Labour's leader will pledge to continue his attack on tax avoidance.
So David Cameron runs the risk of being seen as someone wanting to crack down on some of society's most vulnerable, while Ed Miliband targets the wealthiest.
The truth is both party leaders are trying to persuade "hard-working families" that they're on their side.
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Similar proposals have been considered by the government before.
In 2010 and 2012 the Conservatives considered plans to remove or cut benefits for drug and alcohol addicts who refused treatment.
At the time the plans were met with concern by charities, who said there was no evidence benefit sanctions would help addicts engage with treatment.
Disabilities Minister Mark Harper said people who were overweight or had alcohol or drug problems needed treatment to get back to work
Dame Carol welcomed Saturday's announcement, saying: "These people, in addition to their long-term conditions and lifestyle issues, suffer the great disadvantage of not being engaged in the world of work, such an important feature of society."
And Minister for Disabled People Mark Harper told the BBC the right interventions could be "very successful".
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Case study
Terry Hogan, 45, from Ashton-under-Lyne, has been on incapacity benefit - before it became ESA - since 1992 and is also on a weight-management course.
He suffers from fibromyalgia, osteoarthritis, type-2 diabetes, depression, lymphoedema, cellulitis, and Klinefelter's Syndrome.
He said his illnesses had caused him to become more sedentary, which in turn led to him putting on weight.
"When I was well enough I did voluntary work," he told the BBC.
"In 2012 I became incapacitated to the point where everything I do leaves me tired and in pain.
"I don't think this review is helpful. If you're overweight on sickness benefits, forcing someone to lose weight and cutting benefits won't help the individual. There may be underlying causes to weight gain.
"I still walk on crutches, am in a lot of pain all of the time, and take a lot of painkillers. I do want to lose weight but it's not that simple."
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Susannah Gilbert, from obesity support group Big Matters, said the policy "wouldn't be feasible".
She said: "I think it's naive to think that people don't want to change their life. Many of them have tried every diet under the sun and they still have a weight problem, so to think they don't want to have help isn't true."
Not helping
Labour's shadow minister for disabled people, Kate Green MP, said the announcement did "nothing to help people off benefits and into work", adding: "David Cameron's government has stripped back funding for drug support programmes and their Work Programme has helped just 7% of people back to work, so it is clear the Tory plan isn't working."
The UK Independence Party also said it was "another example of the way that this government bullies those it has decided are beyond the pale".
Deputy chairman Suzanne Evans said: "The government obviously doesn't care about those with weight or addiction problems, it is just ideologically driven by its contempt for those on benefits and its need to get the benefits bill down at all costs."
ESA was introduced in 2008 to replace incapacity benefit and income support, paid because of an illness or disability.
It requires claimants to undertake a work capability assessment to see how much their illness or disability affects their ability to work.
Once a claim is accepted, those receiving ESA get up to £108.15 a week.
Some 60% of the 2.5 million people claiming ESA have been doing so for more than five years, government figures show.

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NHS 'to get whistleblower guardians'

NHS 'to get whistleblower guardians'

A nurse and another member of hospital staff pushing a trolley bed in a hospital

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NHS trusts will have to appoint a guardian to help whistleblowers in England, ministers have confirmed.
The measure was called for by Sir Robert Francis after he warned staff too often faced "bullying and being isolated" when they tried to speak out.
Sir Robert, who led the public inquiry into the Stafford Hospital scandal, also said a new national officer should be appointed to help the guardians.
The government immediately accepted all his recommendations.
Health Secretary Jeremy Hunt said: "If we don't get the culture right we will never deliver the ambitions we have for the NHS."
He said he agreed with the proposals in principle, but would now consult on how best to implement them.
And he added legislation to ensure whistleblowers were not discriminated against when they went for other jobs would also be introduced.
Sir Robert's Freedom to Speak Up Review took evidence from over 600 people about their experiences, while another 19,000 responded to an online survey.
It said there were lots of examples of organisations supporting whistleblowers.
But it also said too many were put off speaking up because they "fear victimisation", while others do not raise concerns because they feel they will not be listened too.
The review heard stories of staff that have faced isolation, bullying and counter-allegations.
In some extreme cases when staff had been brave enough to speak up their lives had been ruined, it said.
Robert FrancisA "significant proportion" of health workers are afraid to speak out, Sir Robert Francis said
Sir Robert told the BBC: "I've heard some frankly shocking stories about [staff] whose health has suffered, and in rare cases who've felt suicidal as a result of their perception of them being ignored or worse."
He said raising concerns should be "welcomed and celebrated".
His review called for:
  • A "Freedom to Speak Up Guardian" to be appointed in every NHS trust to support staff, particularly junior members.
  • A national independent officer to help guardians when cases are going wrong.
  • A new support scheme to help NHS staff who have found themselves out of a job as a result of raising concerns.
  • Processes established at all trusts to make sure concerns are heard and investigated properly.
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Analysis
By Hugh Pym, BBC Health Editor
Perhaps the most eye-catching remark by Sir Robert Francis this morning is that two years, almost to the day, since his final report on the Mid Staffordshire scandal there is still a "serious problem in the NHS" relating to whistleblowers.
Sir Robert says that even after the drive for transparency following Mid Staffs there are still too many staff who are afraid and who had told his review they had seen colleagues suffer.
He proposes there should be "guardians" appointed at hospitals to support whistleblowers, but if the trusts pay their salaries will they be truly independent?
Sir Robert does not feel he can offer an amnesty for whistleblowers currently in dispute with employers - the legal process, in his view, must be left to take its course though he urges employers involved in cases to "reflect" on his report.
Sir Robert pointed out that the key change needed related to cultural rather than regulatory reform.
Few would disagree that culture change needs more than a report from an eminent QC.
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The recommendations have been made despite a growing focus on patient safety since Sir Robert published his public inquiry in 2013 into the Stafford Hospital scandal.
One of the main findings of that report was that people within the NHS knew about the poor levels of care at the hospital, but did not raise the alarm.
Since then a number of initiatives have been launched to improve safety.
Jeremy Hunt: "The message must go out today that we are calling time on bullying, intimidation and victimisation which has no place in our NHS"
In 2012 NHS Employers launched its "Speaking Up Charter" asking trusts to commit to helping staff raise concerns.
And last year the government unveiled its "Sign Up to Safety Campaign" - a three-year plan to halve avoidable harm through greater transparency, collaboration with other trusts and support for staff.
But Sir Robert said the NHS had still not got it right.
He argued: "There is a serious issue within the NHS. It's not just about whistleblowing, it is fundamentally a patient safety issue.
"The NHS is blessed with staff who want to do the best for their patients. They want to be able to raise their concerns free of fear that they may be badly treated when they do so and confident that effective action will be taken.
"Unfortunately I heard shocking accounts from distressed NHS staff who did not have this experience when they spoke up."
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Case study
Nurse with patients
Staff who gave evidence to the review complained of being labelled a "snitch" and being "punished" if they raised concerns.
One nurse described what happened to her after she complained during a team meeting about the care being provided at her trust.
She was later called into an office by two managers and shouted at until she was reduced to tears.
She then described being criticised at every opportunity thereafter and at her next appraisal the comments from managers were critical. Her mental health was also questioned.
She said, to her knowledge, the concerns she raised were never looked into and she did not pursue it for fear it would damage her career.
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'Persecution'
Dr Raj Mattu, a cardiologist who was suspended then sacked after raising concerns about patient safety in 2001, said it was frustrating and depressing that there had been "very few biting changes" to protect whistleblowers.
He said there was still "persecution of whistleblowers on a grand scale" in the NHS.
Dr Kim Holt: "I don't want any whistleblower to suffer like I did"
Asked why this was the case, he said medical staff were in their jobs because they wanted to help patients but many senior staff were there for a "career in management".
"What then happens is the interests of the trusts and the NHS conflict from time to time with those of the patient and many of us who are whistleblowers feel compelled under moral obligation to speak up," he said.
He called for independent assessment of whistleblowers' claims, and "real protections" for those raising concerns.
Dr Mark Porter, of the British Medical Association, said: "The freedom to raise concerns without fear of reprisal is vitally important for patient safety.
"We need to put an end to the climate of fear that has built up in the NHS over a number of years, and everyone in the NHS - especially those in managerial and leadership positions - must lead by example to make this a reality."

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NHS

Friday, 23 January 2015

Treatment of whistleblowers a stain on NHS, say MPs

Treatment of whistleblowers a stain on NHS, say MPs

Nurse with patients

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The failure to protect whistleblowers remains a "stain" on the reputation of the NHS in England, MPs have said.
The Health Select Committee says the treatment of staff who raise concerns has undermined trust in the system.
And whistleblowers who are vindicated should receive an apology and "practical redress", its report adds.
The MPs also say the complaints system for patients is complex and confusing and there should be a "single gateway" covering health and social care.
The report says despite numerous inquiries and reports highlighting failings in complaint-handling and whistleblowing, serious shortcomings remain.
It emphasises the importance of ensuring health and care workers feel supported in raising professional concerns.
"The treatment of whistleblowers is a stain on the reputation of the NHS and has led to unwarranted, inexcusable pain for the courageous individuals affected," it says.
Open culture
The report acknowledges there have been some attempts to create an open culture, where staff are encouraged to raise concerns, and there is a proper response.
But it concludes these initiatives are "far from common", and warns other potential whistleblowers may be deterred from coming forward.
"This has undermined trust in the system's ability to treat whistleblowers with fairness. This lack of confidence about the consequences of raising concerns has implications for patient safety."
The MPs are calling for a programme to identify whistleblowers whose actions are proven to have been vindicated. They say they should receive an apology and "practical redress", which could mean financial recompense, or - in some cases - getting their job back.

Start Quote

Patients and staff do not complain for financial redress but because they seek an acknowledgement and explanation, a timely apology if appropriate and for the NHS to reduce the chance of avoidable harm to others”
Dr Sarah WollastonChairwoman, Health Select Committee
'Breakdown of trust'
They also highlight continued failings in the way the NHS responds to patients' complaints. They say despite some progress, the current system remains "variable".
Too many individual cases are "mishandled", they say, sometimes leading to a "complete breakdown of trust" between patients and the NHS, and a failure to improve patient safety.
They argue the current "overly complex" system should be simplified by establishing a single complaints gateway covering health and social care. They suggest this could be modelled on the Complaints Wales service run by the Public Services Ombudsman for Wales.
Alongside this they say there is a "strong case" for the creation of a single health and social care ombudsman for England.
Health Secretary Jeremy Hunt has welcomed the report.
"We want to make the NHS the safest healthcare system in the world and we know that listening to patients and staff is absolutely vital to improve care.
"That's why we've made hospitals legally obliged to apologise to patients when mistakes do happen, introduced complaints handling as a crucial element of tougher hospital inspections and have asked Sir Robert Francis to produce an independent report on how to create a more open NHS culture," he said.
'Gold dust'
Katherine Murphy from the Patients Association said the NHS must demonstrate it is prepared to listen.
"Complaints are like gold dust - they should be welcomed, they are telling you something is not right."
Peter Walsh from the charity Action against Medical Accidents, said he valued the MPs' recommendations, but warned that progress had been too slow.
"This is just the latest in a long line of reports and we now demand action to improve what has been a failing system."
The former NHS whistleblower Dr Kim Holt, founder of the charity Patients First, said the report was a first step in making much-needed changes.
"I am really pleased that a suggestion has been made that historic whistleblower cases are looked at and practical ways found of providing redress for them. That is a really amazing step forward, but the system needs an overhaul.
"We no longer want to see people on long-term suspensions, sick leave or dismissed for speaking up. The link between bullying and raising concerns is a close one and our key issue to be addressed is the one of bullying, which creates fear and desperation."

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