BRITISH UNIONS ATTACK LIMITED NHS PRIVATIZATION

Hospitals and GPs' surgeries could be hit by widespread disruption in the first national strike in the NHS for 18 years after workers who buy and distribute vital supplies voted to walk out. The proposed strike by workers in NHS Logistics could delay operations and treatment if hospitals run out of key supplies such as syringes, hand-cleansing gel, latex gloves, disposable bedpans and hand towels, according to Unison, the public service union. NHS Logistics handles 51,000 products, including vaccines, but not general drugs, and delivers supplies to hospitals.

The action will hit hospitals and GPs' surgeries across England in the first national action since midwives went on strike. The strike - which was backed by three to one in the ballot - is in protest at the Government's plans to outsource the logistics work to DHL, the parcels group, in one of the biggest privatisations of health service work. NHS Logistics, which has 1,400 employees, serves 600 hospitals in England and nearly 9,000 GPs' surgeries. Dave Prentis, the general secretary of Unison, said: "These are not troublemakers, not hardliners, but workers who care deeply about the NHS. "NHS Logistics is an award-winning service and it makes no sense to sell it off."

Unison will decide on Friday whether it will mount one lengthy strike or a series of one-day strikes. Its action could come before the Labour Party conference in two weeks' time. Nigel Edwards, the director of policy at the NHS Confederation, which represents more than 90 per cent of NHS organisations, said: "Many hospitals do not hold large volumes of the medical supplies provided by NHS Logistics. Therefore those trusts that use NHS Logistics - which is not all of them - will now be looking at contingency arrangements to ensure they have adequate medical supplies. "We hope that NHS Logistics will be working with individual trusts to make sure that contingency arrangements can be put in place so that patient care is not adversely affected. We would also hope that strike action does not place patient care in jeopardy."

Unison is taking the Government to court to seek a judicial review of the way the contract was awarded after its value was suddenly changed from 700 million pounds to 1.6 billion. A spokesman for the Department of Health said: "The NHS uses about 500,000 different products such as catering supplies, office equipment and medical supplies, but only around 51,000 of these products are provided by NHS Logistics. The majority of hospitals have their own local supply and delivery arrangements."

The announcement of the strike ballot came as health unions and medical associations began a joint campaign to fight the Government's reforms and further involvement of the private sector in the NHS. Stephen Campion, the general secretary of the Association of Hospital Consultants and Specialists, told a meeting of campaign leaders that the Government's relationships with the health unions was "one of the most divisive and fragmented relationships since those bad old days of the 1980s". Mr Prentis told the TUC's annual conference that despite Labour's large investment in the NHS since it came to power, this year it was "in crisis, threatened as never before".

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When is the stupidity of vastly overworked public hospital doctors going to stop?

It is bad for the patients and bad for the young doctors

On Saturday March 11, as the city [Melbourne] preened itself for the Commonwealth Games, a young man, loved for his warmth and generosity, walked for the last time into The Alfred hospital, where he was a trainee surgeon. Chanh Thaow had come a long way since his Hobart childhood. The pride of his parents, leading members of Tasmania's Hmong community, Chanh had clocked up 14 years of training. To achieve his dream of being a surgeon, he needed only to pass one more exam. His teachers believe he would have passed the test, had he lived to take it. But on that day in March, Chanh walked to the registrars' room and closed the door. He then intravenously administered to himself a lethal dose of anaesthetic drugs - enough to end his life. He was 32.

In an interview with The Age, Chanh's father, Vue Thaow, has spoken for the first time of his concerns that his son was overworked and alienated by the surgical culture at The Alfred. Mr Thaow said his son was told to stop recording his level of tiredness during marathon shifts.

Chanh's death, which is being investigated by the State Coroner, is the second suicide of a young doctor in the past nine months. On December 16, Lachlan McIntyre, 29, an intensive care registrar at St Vincent's, died of an injected drug cocktail in his North Melbourne bedroom. He was found with a suicide note nearby.

These young men were struggling with private demons and no one will ever know what tipped them over. Their deaths shocked Melbourne's medical fraternity and sparked a wave of introspection and questioning about support for young doctors and the culture of overworking trainees. A working party of doctors from across the medical colleges, headed by North Carlton GP Raymond Martyres, has requested a meeting with the coroner investigating Chanh's suicide to raise concerns about the treatment and emotional health of young doctors. The coroner's workplace unit is also aware of the details of the death. "These unexpected suicides have focused our attention," the head of the Victorian Doctors Health Program, Dr Naham (Jack) Warhaft, told The Age. "They are particularly tragic because they are usually the really good ones. They are competent clinically, they are high achievers." Dr Warhaft has called on the medical profession to openly discuss and address the problem of "unexpected suicides". The doctors involved asked for no help and felt an "acute hopelessness", but had no outward signs of depression.

The call comes as the Australian Medical Association prepares to release its "safe hours" survey of trainees working in hospitals, nine years after its first campaign to stamp out shabby treatment of young doctors. The results, to be released next month, are still being analysed, but AMA president Mukesh Haikerwal told The Age there had been only minor improvement since the last survey in 2001, which found many young doctors were working long shifts. (Studies have shown the performance of doctors after more than 18 hours awake is the same as having a blood-alcohol reading of more than .05). Dr Haikerwal said the survey had found that long and unsafe shifts were still too common. "If hospitals think they can get away with it, they will try," he said.

There are no official figures on how many trainee doctors commit suicide, although it is estimated to be at least one or two each year in Victoria. Doctors are twice as likely to commit suicide as the rest of the population, and female doctors are five times more likely than the average person.

Mr Thaow said his son's death came "out of the blue", but Chanh had been exhausted. "My son told me it was an environment where you would have to go on a 24 or 36-hour shift and never say that you were tired." Chanh told his father that "snobbish and selfish" senior surgeons pressured young doctors so they felt they could not speak up about their concerns. "No matter how hard he had to work, he would have to bear it and then do the same thing to the people who followed him."

The Alfred hospital refused to allow its senior medical staff to be interviewed for this report and would not say whether it had investigated Chanh's death. Instead, it issued a short statement that declared the health of young doctors a "priority" and detailed a mentoring scheme and career support for trainees. Spokeswoman Tracey Ellis refused to answer questions about average working hours for surgical trainees and the surgical culture. If the coroner decides to hold an inquest on Chanh's death, The Alfred will probably be called on to justify its roster system for young doctors.

Dr Warhaft said some hospitals supported their young doctors, but there was still "a long way to go for all of us". The profession needed to work on its emotional intelligence and provide a more supportive environment - particularly when doctors were under personal stress - where admissions of despair and suicidal thoughts were better accepted. "There are extraordinary pressures on young doctors," Dr Warhaft said. "They are trying to make huge advances in their career, they have their clinical load, their studies, often a new relationship and a few young kids, and they are working perhaps up to a 100-hour week."

Dr Deborah Amott, chairwoman of the Royal Australasian College of Surgeons' trainees' association, said that although working hours for some young doctors were improving, the culture had to change. "There is this awful culture around medicine which involves the complete bastardisation of junior staff. There is this hyper-masculine, balls-to-the-wall culture in surgery of cure at all costs - both to the patient and doctors. It is quite a struggle to turn that around."

Professor John Collins, the dean of education at the college of surgeons, denied there was a general problem with the culture of senior surgeons, but said some hospitals were more demanding than others. "It is a huge thing for a major international college to lose one of its trainees," he said. "We try to do everything we can to prevent this." As part of the college's accreditation of training hospitals, trainees could reveal confidentially any concerns, he said. The college had recently reprimanded a Victorian hospital for unsafe working practices for young doctors, but he would not say which one.

After Chanh's death, the college is looking to strengthen the criteria around safe and healthy working conditions it requires of hospitals to keep their accreditation as training institutions. "We are committed to the safety and wellbeing of these young people, but at the end of the day we have no power over the hospitals," he said. "All we can ask for is some evidence that the rosters and work schedules take the AMA's code of practice on safe hours into account."

Professor Collins often hosted Chanh and his study group at his Carlton home as they prepared for exams. He remembers him as an old-fashioned gentleman, loyal and considerate of the young doctors behind him, and someone who always arrived at the door with a gift, chocolates or soft drinks in hand. "It was a sombre occasion at the (Alfred) debrief," said Professor Collins, who said he was devastated by Chanh's death. "Watching the young doctors and their reactions to this - I mean, they loved him."

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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