The Risk Register

What do we hate more – secrets or lies? It seems to me that The Department of Health are hiding away the Risk Register for the Health and Social Care Bill whilst feeding us a load of lies about how safe and equitable this Bill is going to be. Even the stuff we’re allowed to see (impact assessments) are hidden away on the government website.

The government argues that releasing the Risk Register would carry “significant implications” for all departments of government. And that the risks laid out in the register are the “worse-case scenario” for all government departments. Their arguments based on the fact that these speculations may be wrongly interpreted in the public eye and may give the wrong impression. Huh?

Does that not paint the whole picture? For something as sensitive as this, SURELY MPs and the members of the House of Lords should have access to ALL the risks before they debate it in Parliament?

Many of us wrote to our MPs last year asking them to put pressure on Andrew Lansley to release the Risk Register. The Department of Health issued a standard response deflecting attention at least until the New Year. The exact words being:

“It is expected that the Appeals Tribunal will consider this case in the new year.” *

Well. We are not going to let them forget their promise to reconsider releasing the Risk Register in 2012. Now is the time for us to kindly remind our MPs of the response the letter included, and ask them to get back in touch with Andrew Lansley. The more pressure we put on, the more likely it is that the Risk Register will be released. This will allow knowledgeable and fair debate in the House of Commons and the House of Lords.

What can you do next?

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Standing in the way of control

Who would have thought that I’d begin a blog championing the words of Beth Ditto. Regardless of my view on their musical talent (I’m kidding, long live the Gossip) there is something to be said about choosing “Standing in the way of control” as the title of their debut single;

“Nobody in the States was that surprised or shocked by what Bush did, but it made everyone I know feel helpless and cheated. I wrote the chorus to try to encourage people not to give up. It’s a scary time for civil rights, but I really believe the only way to survive is to stick together and keep fighting.” (Ditto)

And here we are still fighting, and man look where that fight has brought us. As far as I’m aware, there has never been mass civil disobedience to protect the NHS, which is what makes this Sunday’s Block the Bill so interesting. It’s definitely something I’ve thought (ok, dreamed and longed for) in my years of health campaigning – but as with all decisions on direct action it’s about the right time and the right place.

Now, it’s been a tiring year for NHS campaigners, and I’m beginning to agree with Ditto – politicians have a way of making you feel helpless an cheated. It appears that no number of letters to the editor, internet craze rap songs, impromptu performances outside the Department of Health or UK wide petitions have done enough to halt this colossal bulldozer. Yes, the democratic process is still to be played out, and I’m not one to question the democratic process *cough* but ………. I’m going to.

The farce of the listening exercise did very little to calm the nerves of policy analysts, and, well, anyone really. The pervasive influence of the private sector still exists and the professional bodies with the knowledge to truly speak out on these issues continues to be ignored.

I’m not saying it has been wholly worthless. 363 changes were made to the H&SC Bill in the Commons, the majority of which (you might be surprised to hear) were proposed by the government. Look closer at what these were however, and you’ll see that they were the same one-word replacement made 200-and-something times throughout the Bill. Not so impressive now, is it? Luckily there was always a sense that the Lords were the place where we could have the most impact, and with outspoken peers such as Dame Shirley Williams we can feel a little more assured that debate will be rigorous and challenging.

Is that enough? Campaigning groups have set up some excellent tools to lobby peers over the past few weeks, with the hope that public discontent will be heard through the legitimate democratic process. The problem I have with this process is that a nicely worded letter to Lord Owen (who just happens to be on our side anyway) makes me feel like I’ve done something, but it doesn’t make me feel I’ve done everything. 

I feel, and have felt for a long time, a deep passion towards the NHS. Not because I have strong feelings for hand sanitiser and those flappy plastic doors that catch your bag when you walk through them, but because I love our health service. I truly love that Britain developed a health system based on equal access to good quality care for all. I cherish the fact, that despite where you live, how much you earn, what your health status is and where you came from, you have the right to get better. It feels to me, that a long poetic description of my over-emotional attachment to a network of hospitals isn’t going to fly too well with Lord Owen, regardless of his shared support. And that’s the problem with the NHS and our democratic process. I feel constrained by the words I write on paper, they don’t express me, and they don’t express the way I value a publicly funded health system, and the intrinsic value of health.

If Lansley insists on passing these reforms then there is one thing I know I can do that does express how I feel. And whilst 400 health professionals signing on to an open letter is of relative power and influence; 1000+ people standing in the way of control just feels like so much more. Block the Bill isn’t just about direct action for the sake of direct action. Block the Bill is a way for us to express our ourselves outside of the “political process” we’ve been made to feel is the only way. If you’re a citizen of this country and you value the NHS, then do something that makes you feel like you’re making an impact, and not  just something that you have been told will.

Opinions expressed in this blog are of my own and not that of Big Society NHS

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Live Health and Social Care Bill

Ok folks, here we go – live blogging from H&SC Bill in its third reading

Ok – got to run out (sorry!) will be back tomorrow, but if you are actually tuned in, think you should follow @HPIAndyCowper on twitter for more great commentary

16.36 OSAL fumbles over his own response to 38 Degrees legal advice on duty of Secretary of State to provide a comprehensive healthcare service. He has no duty to provide in his eyes. Oh wait. Apparently he does and he’s just delegated it. I’m not sure he knows himself.

16.32 Charming. 38 Degrees described as poxy!

16.27 OSAL (Our Saviour and Liberator) details role of Monitor. Little unclear to the differing roles of Monitor and Office of Fair Trading ….. however still not explicit that “collaboration” is given equal weight as “competition”.

16.24 Oh Lansley’s here. Where did he sneak in from?

16.21 720 amendments made by government all list changing GP consortia to Commissioning Consortia – that’s why there are 720 of them. There’s one amendment for each mention of the term Consortia. Titillating

16.13 Whilst that’s going on, interesting to see  LibDem rebel Andrew George & semi-rebel John Pugh in huddle with Simon Hughes & Alistair Carmichael

16.08 Right, appears my computer is too old to be doing “live” blogging but as an update, they’re voting now on timetabling motion for Bill – results in a couple of minutes

15.58: Shadow Health Secretary Liz Kendall . Always a bit cringe listening to Labour defend NHS against privitisation but let’s see what else she’s got. 420 pages and 300 clauses in this Bill apparently

15.50: Simon Burns is up. It appears that the Bill has been the longest under scrutiny than any other Healthcare Bill in history. Does this mean he thinks it’s been well scrutinised? Or there’s so much to scrutiny to be had.

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Healthcare is (not) a game


Keep yourself entertained while we wait for Parliament to begin proceedings at 2.30pm – ace bumper NHS reforms comic by

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Are we too romantic about our health system?

After a long summer of being distracted by …. festivals, sunshine, parklife, picnics …..we jumped back into action last weekend with not one, but TWO Letters to the Editor in Saturday Guardian and Sunday Tory….(sorry) Telegraph. Win.

And now as if the summer of love had never happened, we’re at the eve of the third reading – the point in a Bills transition through Parliament where MPs vote on whether it is ready to enter the House of Lords. To celebrate (I use that term ironically) this exciting (irony again) evening, I ventured to my local town hall to watch a screening of “The Return of Fear” a new 40 minute documentary on the Health & Social Care Bill.


Ahead of the film’s screening, Larry Sanders, (Oxford East councillor and passionate NHS campaigner) opened the meeting with some choice words on *bastard* private healthcare providers and *incompetent* politicians. His fervor was followed closely by film producer Anne-Marie Sweeney who gave an equally fruity description of our decision makers. These guys were emotionally pumped campaigners, dedicated to the NHS with unadulterated affection.

I wondered in the seconds before the film started whether with all this NHS campaigning we’ve got a bit dewy-eyed over our healthcare service. Long-standing health activists can be heard using words you’d use to express love for the family pet. Even I, someone who has been campaigning on healthcare since I started university, was feeling a bit uncomfortable by it all. And we hadn’t even passed the titles screens.

But then the film rolled on, and I found myself enveloped in its stories. First up, the mother of young boy suffering from Duchenne muscular dystrophy. Second, residents of an old people’s home facing closure.

I was beginning to warm up.

But it was when the final story began unfolding, of King George A&E in Ilford, that I really got going. Not only did King George give me my first memories of being in hospital (yes, this is where I confess that I am an Essex gal), but it struck a cord right in my limbic system about my family, my childhood and my first real motivations of wanting to become a doctor. The film beautifully demonstrates the community groups fighting to keep it open. Mothers and daughters, union workers, mid-wives, and the local Sikh community handing out cups of chaah on a damp wintery morning. This was what we love about the NHS. That no matter who you are, where you’re from, how much you earn, or how ill you have become – you have the right to get help, and you are given the chance to get better. As the film puts it, “the NHS is the most civilised thing our society has”.

And that’s when I realised: It’s all very well having the Big Society NHS’s slick satire with Lansley offering us endless charactertures of himself (watch closely at around 15mins in and our Lansley tosser banner makes an appearance), but real NHS campaigns are born out of real people – real lives, real illnesses, real families and real heartache,

As Larry put it as he ended the meeting, the politicians aren’t the point. Politicians come last in all discussions about the NHS. It’s the situation we face that keeps us going.

Sure, private wealth, unearthed emails, under-the-table deal making and slimy politicians make a good headline. But if you got caught up in the NHS campaigning through the media and are feeling a bit of corruption fatigue, take 40 minutes to watch this video and remind yourself what the NHS does for us all.

Are we too romantic about our health system?

No. Afterall, it’s the most civilised thing our society has

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Our last chance to save the NHS?

BigSocietyNHS has been busily scurrying round the last week or so in an attempt to thwart the Health and Social Care Bill in parliament.  The Bill shall have its 3rd reading on the 6th and 7th of September; should it pass this stage, our last remaining hope is in the Lords throwing it out.  With recent polls suggesting merely one third of the general public supports the reforms, can there be any reason the bill passes to become law?  Read on for what you can do to stop this bill in its tracks and keep our health service in public hands.

So what can you still do?

1. Read our letters

BigSocietyNHS published two letters this weekend with friends and colleagues across the UK in the Guardian and Sunday Telegraph:

2. Adopt a Lord
Trade Unions and Labour have teamed up to mobilise lobbying of the Lords.  Enter your details and get given a Member of the House of Lords all to yourself.  Tell them what you think; it may be up to the Lords to decide the future of the NHS should Parliament accept the Bill this week.
3. Contact your  MP
It isn’t too late to contact your MP about the reforms.  Better yet, why not give them a call before the Bill is heard tomorrow?  Find your MP’s details at the link below.  Remember, you may be able to contact two politicians if you are a student in a different city from home.
4. Take part in the BMA’s NHS Reform Social Media Day
Several groups are hoping to create a ‘social media storm’ around the reforms in Parliament this week.  The more attention the bill receives the more lobbying and press coverage it may achieve.  Visit the link below to get started!
If you or your colleagues has any ideas get in touch.  And make sure to visit the groups below for more ideas!
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Adopting Baroness Elizabeth Smith

It’s been a little while since we’ve posted, I hope you haven’t missed us too much. Big Society NHS members have been a little distracted by studying for finals, moving across the country to start new jobs and such, but never fear like David Cameron hot footing it to Downing Street from Cornwall – we’re back and ready for action.

So where are we now? There are many steps to be taken between the devastating law being proposed and it becoming an Act of Parliament as this handy graphic from the Government’s website shows.
The Health and Social Care Bill has passed the first and second readings, and also the ‘committee stage’. It is scheduled to hit the ‘report stage’ on the 6th of September and it is likely that it won’t be long until it reaches the House of Lords. As such many groups feel that the Lords are where we should focus our campaigning efforts as there is significant opportunity for amendments to be made. As such, the Trade Union Congress – the TUC which includes UNITE, UNISON and many other unions of health workers, although not the BMA – has started a campaign which we think provides a real way of making a difference. See their website here.

Much like the successful UKYCC’s ‘Adopt an MP’ campaign, the TUC suggest that you adopt a Peer, in order that you can lobby that one person and hopefully build some kind of relationship and rapport with them. As Peers don’t have constituents, we often don’t think of contacting them, but they can have a real impact on the content and success of proposed legislation.

It takes just a few minutes to adopt your very own peer, you simply fill in your email here and the TUC will randomly assign you a peer and email you their details. I did this last night and was assigned Baroness Elizabeth Smith, widow of the late Labour leader John Smith. I have written her a letter today outlining my criticisms of the proposed Health and Social Care Bill and imploring her to protect our NHS. I popped it in my postbox this morning and will let you know when I have a reply.

There are over 700 peers in our bounteous House of Lords, so we need as many people as possible to get on board with this campaign and adopt a Peer – it’s much easier than adopting a baby, or even a puppy, a few clicks and you’re ready to go! So adopt a Peer today.

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The NHS this week

Well tornados may still be devastating America but we have our own whirlwind of activity on this side of the Atlantic as the NHS listening exercise draws to a close.

Big Society NHS’ new website just keeps on growing. If you want to add your name to the graphic click here.

38 Degrees

On Wednesday they managed to get an advert promoting their petition into The Guardian, Daily Mail, Daily Mirror, Metro and the Daily Express.

At the time of writing they had nearly 420,000 signatures. There is still time to make your voice heard; sign their petition here.


40 charities have this week said that the proposed changes must be revised in order to protect the most vulnerable patients.

The National Council for Voluntary Organisations said this week that “The voluntary sector is a valuable source of expertise in helping to design health services that meet the needs of local people.

They have also said that it is vital that GP consortia work with the local voluntary sector to best involve and cater for the needs of patients.


As previously mentioned by Big Society NHS, the private healthcare group, Circle, is one of the big players in the reforms.

They have recently been commissioned to take over the financial side of Hinchingbrooke hospital in Cambridgeshire to help relieve its struggling finances.

However, they have no experience in running a district hospital. Their preferred income comes from routine operations at a privately run hospital competing for NHS patients. How and if they succeed could pave the direction for future hospital take-overs.

Nick Clegg

After his earth-shattering defeat with the AV vote and at local elections earlier this month Mr Clegg has been looking for a popularity bandwagon onto which to jump. Fortunately, or unfortunately depending on how things go, for us he chose the NHS.

He has announced that the Bill will go back to the committee stage and could take another six months before legislation is made. He said it would be “wrong to bounce the Bill through parliament”.

However in true Tory style they have announced some red lines over which they say they are refusing to budge; 3 of which handily contradict what Clegg said in his speech.

  1. The Government should do nothing that stands in the way of private providers or charities supplying care”.

Mr Clegg said there would be “no sudden, top-down opening up of all NHS services to any qualified provider”

  1. “Statutory responsibility must transfer from the top-down bureaucracy to GP consortia by April 2013″.

Mr Clegg said there should be “no arbitrary deadline”

  1. The requirement for all GPs to take on these new responsibilities, right across England “there must be no two-tier NHS”.

Mr Clegg said the change from PCTs to GP consortia should be introduced in a “planned, phased way”.

Other news

If there are large scale amendments to the Bill, it is likely that Andrew Lansley may quit the cabinet as he becomes isolated from his opinions on the NHS.

Marches have taken place in Leeds and Sheffield over cuts to the NHS budget.

The King’s Fund has presented a paper detailing the reforms it believes are necessary to provide more integrated patient care.

Royal College of Paediatrics and Child Health has warned that the reforms may undermine child protection, as there is little stress on the importance of integration between health, social care and other public services such as policing and schools.

With Steve Fields to start writing his report in the next few days, it won’t be long before our Big Society finds out the consequences of the listening exercise.

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NHS Listening Exercise – New website launched!

A blog from the Big Society NHS Listening Exercise; check out our new web visualisation –

We are a group of people who proudly fond of the NHS, and we are worried that the coalition government isn’t listening.

Despite the recently announced ‘listening exercise‘, it seems that the

valid concerns of patients, doctors, nurses, patients, health systems experts and others are still being ignored by Andrew Lansley, who has suggested that the only problem is his being misunderstood.

As active members of the “Big Society” we want to help make it really clear what people think of what the Government proposes with this bill, which has been described as “the biggest reorganisation in the history of the NHS“.

Drawing inspiration from work such as … we’ve created a similar visualisation to show who supports or opposes the government’s reforms.

This is up and ready for your contribution at

What we need from YOU:

1.)   Help us to crowd source what others (including organisations) think:

Help us to add unions, MPs, peers, think tanks, high profile persons, etc. who have publicly stated a position on the reforms.  This will be invaluable in contributing to public understanding of who is for and who is against the reforms.

Ask yourself; does X organisation support the NHS reforms proposed by the coalition government?

Click HERE to add your voice. (PS: please try to copy a link to something that shows us why you concluded what you did. Thanks!)

2.)    Please add yourself; tell us what you think, by answering the simple question: 

“Do you support the NHS reforms proposed by the coalition government?”

 Click HERE to add your voice. (actually the same form!)

 Thankyou for your help; we can’t do it alone!

The Big Society NHS Listening Exercise team

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A Big Society NHS Royal Wedding Special

A Royal Wedding as beautiful as this may have temporarily covered up the NHS for a week, but we’ve lifted the veil and uncovered the face of our beloved healthservice.

The World’s media spent all of last week waiting for this dress:

Waiting for this moment:

And thousands of people travelled into London to watch the action unfold first hand.

But whilst all of this was being anticipated, reviewed and repeated endlessly on TV channels across the World, something else must have happened?

Well, thats start with some World news.

Over 500 people have been killed in Syria during anti-government protests, resulting in the Syrian ambassador’s wedding invitation to be withdrawn.

Further human rights violations have been occurring in Libya.

And Alabama has been raised to the ground following massive tornado storms where over 300 people have been killed.

So, has our NHS survived this memorable week where all other British things have been celebrated? And how has the government been dealing with the strains of their coalition as it nears their 1st anniversary?

The variations that already exist within the NHS through different areas of the UK is set to become wider if the planned reforms go ahead. Whilst the rest of the nations are shunning privatisation and competition, England are embracing it. As finances are stretched the improvement in quality, with better value for money is seen to be important, but no-one is sure as to which NHS will come out on top.

The Public Accounts Committee says that making £20bn worth of savings whilst pushing through radical reforms will damage front line services. These are amongst other concerns that the Department of Health has not yet developed a high quality risk management protocol for either the commissioning or providing bodies detailed in the reforms.

It was during a debate about the NHS reforms that David Cameron told Ms Eagle, a Labour MP, to “Calm down, dear“. Not only sexist but patronising too. But offence was caused, which could explain why come Friday, 2 days after the event, at the wedding he was looking like this…

And obviously wasn’t feeling that this was the time to tell his wife that she was not adhering to the wedding dress code(coats and hats) before they left the house.

Tensions were also high at the ceremony, with Nick Clegg and his wife looking very weary and seeming as though there could be a political spat at any moment.

Dr Howard Stoate, a former Labour MP, has also this week accused David Cameron of using the NHS as a political football, and that if changes were to be made then the health service should just be allowed to get on with it.

Monitor this week have announced that efficiency savings are more likely to be in the region of 6-7% per annum, rather than the previously quoted 4%. These are not a part of the larger scale of public sector cuts, but are part of savings that all trusts will have to make in order for them to balance the books so that they can become Foundation Trusts, an idea bred out of the reforms process.

But perhaps the Royal Wedding covering some of this news up in a lace-trimmed veil isn’t such a bad thing. It may have united the nation to enjoy the good times, even in times of hardship, and to come together to support something that we all enjoy. So we should all come together in the same fashion to support our NHS as we know it now, and not how David Cameron believes it should be.

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