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The Department of Health is watching you!

By Guest
February 25th, 2013 at 9:00 am | Comments Off on The Department of Health is watching you! | Posted in health

Last week a number of bloggers focussed on the dishonest, authoritarian nature of the DoH. This is not news to those who have researched the ethically dubious behaviour of a government department that is the only one that admits to paying third parties to lobby government. The department’s track record on public health interventions in particular is justifiable only in the eyes of those whose narrow focus allows them to take the extremist position that “the end justifies the means” and therefore excuses behaviours that are otherwise unacceptable.

I and many others have previously highlighted the lack of objectivity that is a feature of DoH “consultations” and the fundamentally flawed approach that has seen the DoH directly funding social “scientists” to provide “evidence” to support public health policies such as smoking bans and minimum alcohol pricing. To any objective observer the processes and people involved in producing this policy based evidence undermine the credibility of the policies and of the DoH itself.

I have no reason to have confidence in the DoH and ample reason to be concerned about its agenda so I was rather alarmed to find out just how much control it has over GP practices. I recently attended my practice for a routine appointment and was surprised to find out that I had to answer a question about my smoking habits in order to check in using the automated system.  I don’t smoke but as far as I am concerned, that together with my other lifestyle choices is information that I am prepared to share with my GP but do not necessarily wish to share with others.

The Orwellian and in my view unethical nature of this approach to information gathering prompted me to find out why a practice that has served my family well for decades has become increasingly impersonal and public health obsessed.  I was alarmed to discover that the DoH is effectively paying GPs to ascertain the smoking status of everyone over 15 and that this is not the only way in which the relationship between patients and doctors is being depersonalised and centrally controlled.

The mechanism underlying this policy is called the Quality and Outcomes Framework (QoF). The QoF financially incentivises doctors to not only to gather lifestyle information but to treat patients based not on what might be best for a specific patient in a specific GPs experience but on what DoH /NICE centralists deem best practice. This potentially undermines the important GP/patient relationship and represents a major bureaucratic overhead.

The QoF is supposed to be voluntary but is in the Leninist tradition of the DoH is “voluntary” only if GPs can afford to forgo the state funding associated with it. In reality 98-99 % of practices participate as according to one well-placed source it is “almost unsustainable” for practices to opt out of providing this service.

The QoF was introduced by the previous government in 2004. Despite claiming that it wants to empower GPs and reduce paperwork, the current government has done nothing to mitigate either its centralist nature or its bureaucratic content. Each revision seems to be more demanding than the last and some GPs are of the opinion that some of the latest additions make it “unworkable and impractical”

The lifestyle information gathering aspects of QoF are alarming from a liberal perspective and are also likely to have negative consequences for doctor patient relations thanks to the intrusive and repetitive nature of the questioning involved. The government cannot claim to be unaware of this and other issues relating to QoF as medical organisations including the BMA claim to have raised it on more than one occasion.

In 2013 the QoF section on smoking has been changed from being a semi-reasonable attempt to ascertain the smoking status and offer quit services to people with problems such as emphysema, to a blanket demand for practices to catalogue the smoking habits of everyone over 15 years of age.

Alcohol consumption is likely to follow the same path and NICE /DoH have already decided on QoF targets for screening a subset of patients. As the subset includes anyone with high blood pressure it will be quite large, so scaling it up to all patients won’t be a problem at some future review.

The manner in which this information is being gathered, the people who see it and the way in which it is used by the DoH are all further cause for concern. It is one thing to share information with a GP who is bound by doctor patient confidentiality but another thing entirely to supply that information in a format that might be viewed by many other people who are not. Data is supposed to be “anonymised” before practices forward it to the DoH but some professionals are concerned that this may not always be the case in light of increasing government demands for general access to health records.

It is not difficult to imagine a near future scenario in which the DoH thinks it knows the lifestyle choices of the majority of us at an individual level and really is watching us. It is already watching our GPs rather too closely for comfort.

It would appear that whatever government is nominally representing us, it is powerful entrenched bureaucrats with centralist inclinations who dictate the health agenda. Perhaps we might be better off diverting resources to front line services rather than ring fencing DoH funding?

By Chris Oakley. Chris’ previous posts on Liberal Vision include: Minimum pricing – policy based evidenceAlcohol is Old News – Minimum Pricing for Digestives is the “Next Logical Step” , Soviet Style Alcohol Suppression Campaign Called for By Public Health Activists , Alcohol Taxation: The truth, the whole truth and nothing but the truth Lies, damn lies, statistics &…

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Lord Rennard: Good news, but MORE questions

By Angela Harbutt
February 24th, 2013 at 9:27 pm | 3 Comments | Posted in Uncategorized

Good news from the Party today that the investigation will NOW be “independently chaired”. Why such an obvious decision was not easily made at the outset is concerning. From what I can gather, they seem to have taken this decision without any conversation with the women concerned [but will happily be stand corrected]. But it is good to hear that our concerns (and others) were listened to. Special mention here goes to Stephen Tall , who piled in behind us on Friday. No news yet on who the “independent Chair” is to be or how they will be appointed.

Questions: Following suggestions that the person at the end of the “whistle-blower” hotline appears to be too intimately connected to the party, on too many levels. I assume that the hotline will now likewise be put in the hands of someone out side of the party. And quickly.

This isn’t to suggest any aspersions about the fair-mindedness of either Tim Farron (who was originally slated to head up the inquiry) or Kate Parminter (who manages the rather under-advertised hotline), but surely these things properly need to be placed under the command of those who don’t have a long history at the senior levels of the party?

Finally, it has to be asked, for the umpteenth time, who exactly is managing the party PR machine? Had the party line on Friday not been so hapless, some of the weekend’s newspaper speculation, and embarrassing statements from Cable and Browne could probably have been avoided.

Added to that, the statement made by Nick Clegg this evening, and the press office follow up,  seem to leave more questions than answers. Nick’s tone of indignation was utterly inappropriate. And he is already having to issue clarifications about the difference between his knowledge and his office’s. This is exactly the sort of running commentary that he said, rather optimistically, he wished to avoid. He is unlikely to be able to do so over the coming days.

Update: We are delighted that the party has announced that a new independent whistleblower group will deal with complaints: Telephone number 020 7404 6609

It has also announced that it has appointed Alistair Webster QC to lead the formal internal investigation under the Party’s disciplinary rules into the specific allegations made about the conduct of Lord Rennard.

Finally the party has said that it will also be announcing an independent Chair for the investigation into party procedures and to thoroughly examine how allegations made in the past have been handled.

 

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Lord Rennard : What next ?

By Angela Harbutt
February 22nd, 2013 at 1:37 pm | 4 Comments | Posted in Uncategorized

News broke last night that Lord Rennard is being investigated for sexual impropriety.

Lib Dem Voice can hardly bring itself to mention the words, referring to it rather obliquely as “Party launches investigation over C4 News allegations“. You would not know the allegation was even about Lord Rennard, had they not put up a statement from Lord Rennard’s solicitors. Likewise the rest of the blogs seem unusually quiet on the issue. Shock? Fear? Denial?

The Channel 4 investigative report is admittedly, truly shocking. Put simply, the programme states that women who worked for the Liberal Democrats have told the programme that Lord Rennard abused his position for years by inappropriately touching and propositioning them – and that leading Lib Dem MPs and peers who knew – failed to take any meaningful action. Lord Rennard has responded through a solicitor saying he has no recollection of any inappropriate behaviour and is unaware of any complaint about his conduct ever being made against him.

It is too early to get into the specifics of the allegations made about Lord Rennard. This may well end up being a police or legal matter. It is worth stating that those appearing in the Channel 4 programme all came across as highly rational women with no particular axe to grind. There was no payment involved and the motivation for them speaking up was said to be the concern that, having quit as Chief Executive, Lord Rennard was being re-integrated into the party.

The women should be applauded for their actions. It was a terribly brave thing to do. Who knows how many other women may feel emboldened to come forward as a result of their willingness to put themselves in the firing line. Who knows what this may eventually uncover.

There are three things that the party needs to do. It has not had much time, and thus far gone some way to addressing them, though there are as many questions as answers raised by the Party statement made to date. And some things that feel, well, just wrong. Let me go through them:

1. We need full investigation into claims made against Lord Rennard.

The party has stated that an internal investigation into the specific allegations raised by Channel 4 has begun under the Party’s disciplinary procedures.

The allegations made in the programme are individually serious and collectively devastating. An investigation must happen. But the suggestion is to conduct an internal investigation. Is it really appropriate given the allegations made? Have the women concerned been asked how they would like to see this conducted? After all, one of the women was quite clear that she had already tried the internal complaint route. Would she be happy treading the same path again?

Surely, and mindful that I have not spoken to the women either, wouldn’t it be better if this job was conducted by an independent arms-length body or individual. People, perhaps still active in the party, may feel more comfortable coming forward, if the investigators they have to speak to are NOT their colleagues, bosses, or leading members of the party.

We also do not know where this investigation may take us, who may come forward, and what they might say. Though we all hope it is not the case, supposing other members of the party are accused of harassment or bullying? At what point does an internal investigation into internal issues become an impossible mess?

All in all, we do need an investigation, but I urge the party to consider consulting with the women first this time, and probably putting this investigation into hands of a third party, giving them full reign to investigate where they will with impunity. That is surely the only way to be sure of the best outcome for everyone.

2. We need a full investigation into the actions of Paul Burstow, Jo Swinson and Ros Scott

The party says there are a number of questions that have been raised and that the review will ensure it properly addresses all of them.

I assume this refers to the fact that at least one of the women, Alison Smith, states that she took her complaint to not one but two parliamentarians.

The first person she says she took her complaint to, “within a week” was Paul Burstow, the then Chief Whip. She says he listened to her complaint and did nothing. Paul has to be allowed to have his say of course. But this has to be investigated, and if true, he must face serious sanctions. It really is that simple isn’t it?

Alison Smith then says she took her complaint to a second member of Parliament, Jo Swinson, the then spokeswomen for the party for “women and equality” [She is also the MP who put down a motion in parliament for “unwanted touching and harassment“]. According to Alison Smith, Swinson did at least agree to investigate her complaint and, indeed appears to have done so. But again says nothing happened.

Again Jo must be given the opportunity to answer the claims made. But if she was indeed “aware of a number of cases”, and let the matter get swept under the table then she too should face serious sanctions.  Certainly she would have to cease to pronounce on women’s issues forthwith.

Finally we must ask what the party president knew. In a statement she gave to Channel 4 News, Baroness Scott refused to comment on why Lord Rennard resigned. Why? It was ill health wasn’t it?

According to Alison Smith, Ros Scott told her that Chris Rennard had been forced to stand down because of these allegations. Ros Scott did say to Channel 4 that she was “aware that there were issues about his behaviour” She says that she received no formal complaint; but says that as a result of the allegations she instigated a review of the party’s whistle-blower procedures. This is puzzling. She was sufficiently concerned about allegations she had heard to instigate a better protocol for whistle-blowing, but appears to be insufficiently concerned about the lives of the young women to investigate, or demand to be told who had investigated the situation, and what the outcome was.

There may be others.

We cannot stand on platforms espousing equality, women’s rights and commitments to tackling sex discrimination in the workplace whilst turning a blind eye to what may be happening within our own ranks. That would be hypocrisy. If the cries of help from women have been ignored, then anyone who ignored them, failed to take action, or stood by and allowed nothing to happen, must all face the music. .

3. Getting it all out

The party is urging anyone to contact the Chief Executive or the Lib Dem confidential whistle-blower procedure if they have issues they wish to raise as a result of Channel 4’s report.

That is welcome but insufficient. We cannot sit back and “hope” that word gets around that that an investigation is underway. If we are serious about this we need a letter written to every Liberal Democrat member, informing of the investigation and asking anyone with information to come forward. We need a specific name to contact (not “the Chief Executive”) a hotline telephone number, and a confidential email address people can write to. Every member of staff should be encouraged to come forward, if they have anything meaningful to report, using the “confidential whistle blower procedure” (whatever that is).

As well as putting this investigation into the hands of an arm’s-length third party, we should also ask the party to a commitment to reporting back its findings. I do not mean the specifics of the allegations against Lord Rennard. But at the very least we should expect a report detailing the findings of the broader investigation, conclusions and outcomes. To date there has been no mention of what the outcomes may look like. This must be addressed.

It is fair to say that collectively we are in shock. But we must get over that. If we are to move on from this we have to get to the truth, and be seen to get the truth. If that means asking questions about how the party is to conduct this investigation, and demanding more of it, if we find it wanting, so be it.  Mostly we must ensure that the women in this are given every opportunity to have their say in how this process is conducted.

Update: Earlier this evening  I received an email from Alex Folkes , a leading Lib Dem photographer for many years , asking that I immediately take down the photo of Lord Rennard because it was “unauthorised and uncredited”

Alex Folkes is in Georgia so I gather he was unable to contact me by telephone.

Following an email exchange with him, I am delighted to confirm he is now content for the image to appear on our website.

Liberal Vision is pleased to confirm that Mr Folkes is the copyright owner of this image and we are grateful to him for allowing us use of it.

 

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