Features

Sickness in the health service

The Mid Staffs scandal shows that we cannot continue to turn a blind eye to NHS failings

9 February 2013

9:00 AM

9 February 2013

9:00 AM

A former editor of this magazine, Nigel Lawson, once described the NHS as ‘the closest thing the English have to a religion, with those who practise in it regarding themselves as a priesthood’. He meant to imply that blind faith tends to take over from observation. But there are other likenesses: bickering cardinals, grandiose PFI cathedrals that suck money from the pockets of believers — and now, finally exposed after being covered up for years, a shocking scandal of abuse.

Hospital managers like to commission paintings of the premises to hang in their corridors. In the case of Mid Staffordshire Hospitals Trust, William Hogarth would have been a suitable choice of artist. If the scenes of ‘routine neglect’ exposed by Robert Francis’s report were described in a charity campaign for a developing country, it would have tens of thousands of concerned Britons stuffing tenners into envelopes.

It is now clear that this was not a unique tragedy, but an egregious example of a systemic problem: what happens when the NHS goes wrong. As Francis reveals, poor care was bred into the system, with managers and medical staff responsible for it allowed to take up jobs elsewhere in the NHS. His central recommendation — that medical staff be put under a ‘duty of candour’ to report poor care — may open a very large Pandora’s box. According to a survey by the Nursing Times, one in four nurses believes their NHS hospital is ‘at risk’ of suffering a similar scandal to Mid Staffordshire. One in eight say hospitals are already experiencing a similar collapse in the standard of care.

Even the Conservative ministers who answer every challenge to the NHS by saying that more cash than ever before is being poured into its coffers should by now realise that this is not a question of money, but of organisation. The Francis report shows that the failure to take a clear-eyed view of the NHS and confront its failings has a human cost. Any dispassionate assessment would show that even when it is not showing callous bureaucratic negligence, the NHS performs remarkably poorly for a national treasure which is supposedly the envy of the world.

British health spending more than doubled under Labour, yet still our cancer survival rates are mediocre. To take one example, the five-year survival rate for colo-rectal cancer in the UK is 53 per cent for men and 54 per cent for women, compared with an OECD average of 59 per cent and 62 per cent respectively. Hospital-acquired infections have fallen since they peaked five years ago, but remain scandalously high. The latest figures, for 2011, show that a staggering 2,200 NHS patients died after acquiring superbugs in hospital. Patients are twice as likely to acquire such fatal infections in the NHS as they are in private clinics.

The Mid Staffs scandal is all the more shocking because it is so at odds with the NHS that we hear about at political conferences. In this NHS no bedpan ever went unemptied, no patient ever went unfed, no one — unlike the 800 at Mid Staffordshire — ever died unnecessarily. This NHS is staffed entirely by selfless Florence Nightingale types who devote their lives to healing the sick: nurses who, in the words of David Cameron’s 2006 speech, ‘do everything to make you comfortable’ and doctors ‘who desperately want to get to the truth’.

Of course, many NHS staff are indeed dedicated and good at their jobs. But probably no higher a proportion than car mechanics, cleaners, and other occupations whom we rely upon but who rarely get showered with praise from politicians. As Lord Lawson said, working for the NHS is seen as a higher calling. The self-imposed censorship which prevents political leaders from ever doing anything other than praising doctors and nurses has a serious consequence, as it leaves ministers shorn of the ability to speak objectively about NHS failures.

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Like any other trade union, the ‘Royal Colleges’ of doctors and nurses fight to preserve their comfortable little empires — and deploy the added leverage of public emotion. Any kind of involvement of the independent providers in the NHS is denounced as the precursor to fully privatised US-style insurance-based healthcare system.

There is unquestionably in Britain a (justified) fear of such a system, which is hugely expensive and tends to have a very poor outcome for those who, either through poverty or self-employment, have fallen through the insurance net. But surely what attaches the public to the NHS is the principle that it is free at the point of delivery — not that it is run as one state-owned monolith. The trick of the British Medical Association and other professional bodies is to try to confuse the two things, making out that you must either have a fully state-run, state-owned NHS or a fully privatised healthcare system.

The goal of health reformers, including many in the NHS, is to advocate a third way: having an NHS which pays for the medical services, but having a network of clinics and physicians providing the services in independent clinics. That the patient, rather than being told where to go, is given the power to choose — and can go to the hospital with the best reputation. Given that the NHS has more employees than Estonia has people, such reforms were always going to be a British answer to perestroika — fiercely resisted by those who like the status quo. The severity of internal NHS opposition is that market-based reforms are doomed to be compromised.

If David Cameron’s Health and Social Care Act didn’t start off as one of the ‘pointless reorganisations’ he denounced in opposition, it has certainly ended up that way. After trying to force the greater part of the NHS budget into the hands of reluctant GPs, we have ended up with a system whereby the money will be handled by Clinical Commissioning Groups chaired by GPs but staffed by pretty much the same people who ran the Primary Care Trusts that preceded them. Whatever they are supposed to achieve, it won’t make any difference to agonised patients trying with great frustration to make an appointment at their local surgery. Several generations of ‘market’ reforms for the NHS have done pitifully little to offer patients a choice of GP.

While Cameron was bogged down in his legislation, the most promising development in the NHS happened almost by accident, without new legislation. Hinchingbrooke Hospital in Huntingdon was handed over to be run by the private-sector provider Circle Healthcare.

While health unions protested — Karen Jennings, head of health at Unison, called it a ‘very serious and worrying development’ — public disapproval was muted for the simple reason that the alternative was closure. The hospital had run up £39 million in debt, while simultaneously sliding to the bottom of patient satisfaction surveys.

The deal with Circle Healthcare was a last desperate throw of the dice. Yet the results have been remarkable. Within six months of its takeover in February last year, Hinchingbrooke had climbed from the bottom to the very top of the 46 NHS trusts in the Midlands and East Anglia in A&E waiting times and patient satisfaction surveys. Even satisfaction with the food had improved to 94 per cent — and since April 2011, it has only found two cases of MRSA. It is still an NHS hospital, but no longer part of the largest bureaucracy in the free world.

The Hinchingbrooke secret was to trust doctors, not bureaucrats. It ditched the corporate management culture which so bugs medical staff elsewhere in the NHS. A tier of managers was removed and clinical staff were put at the heart of running the hospital. They were made a majority on the board, and the hospital’s operations divided into 12 clinically led units. Nurses talked about being better valued and being taken seriously when they made suggestions. The Hinchingbrooke experience shows that excessive management has been the biggest ailment afflicting the NHS.

Hinchingbrooke Hospital is not yet out of the woods. As of last November, Circle was making slower progress on the financial front than it had hoped: it was by then £4.1 million in the red rather than the £1.9 million which it had budgeted to be by that stage. And as expectations have risen, patient satisfaction has fallen. The experiment may yet fail. But even if it does, at least some innovation will have been injected into the running of an NHS hospital.

As well as providing ideas for how to run a hospital, the Hinchingbrooke experiment provides a political model for successful NHS reform. If you announce wholesale upheaval, and then appoint civil servants to design a system which will govern the entire NHS — subsuming the good as well as the bad — you are inviting doctors’ and nurses’ groups to line up against you. How much better to pick out parts of the NHS which have obviously failed and to concentrate reform on those, when staff and patients can see that there is no alternative other than failure. There is every chance that, as in the Hinchingbrooke case, the results might overcome the prejudice of NHS bureaucrats hostile to the notion of independent management.

This is the approach which has worked so well in education. Academies began as replacements for failing schools which were facing closure. Not every academy has proved successful, but because a sufficiently large number have, better-performing schools, too, are choosing the freedom of life outside local authority control. Parents who still have an ideological commitment to the idea of councils running schools can find one if they want to, but there is now greater diversity. We see schools approaching education in a variety of ways, which can be tested against each other. At no point has this ‘creeping privatisation’, as left-wing critics put it, put under any kind of threat the principle of school education that is free at the point of delivery.

Ultimately, it would be better for everyone if the ideological battle for the British health service could be carried out in a similarly competitive marketplace of ideas. If public sector managers are running something well, let them carry on. But where they have failed — and there are plenty of examples — let the NHS hospitals be put under independent control. Over time, the NHS may naturally evolve into the sort of service which Cameron would not have dared even to try to legislate for: a buyer of services from a variety of public and private providers, with patients themselves, not GPs, being the ultimate commissioners of services.

As for now, how about handing Stafford Hospital to an independent provider, as Hinchingbrooke was? Yes, reform brings its risks. But the brutal lesson of Mid Staffs is that leaving the NHS alone does not mean that patients won’t be killed. ‘The suffering undergone by the patients and those close to them in Stafford demands that the lessons to be learned are not considered for a day or two, and then forgotten,’ Mr Francis said when presenting his report. He says, in terms, that the extent of failure uncovered in the NHS system ‘suggests that a fundamental culture change is needed’, and this does not mean yet another bureaucratic reorganisation. Good luck to anyone minded to set up a ‘save Stafford hospital from privatisation’ protest group.  It is clear that the principle of a monolithic NHS run from Whitehall is not one worth trying to save.


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Show comments
  • wycombewanderer

    I wonder if polly Toynbee is penning next weeks guardian article condemning the chief executive, a former communist and common purpose supporter?

    • ReefKnot

      Looking on the Guardian website ( Ipad version ) they are not reporting anything at all. Everything is still honky- dory in NHS land.

      • Knives_and_Faux

        The comment sorting on their site is like the Internet in 1994, dreadful to attempt to read through.

      • fitz fitzgerald

        The Guardian knew of dire NHS patient problems for years … yet kept silent & supportive of the Royal (? ) College of Nursing (? ) – a labour union .

  • Eddie

    Best to bear in mind that England, Wales and Scotland have different health services now.
    They are thus different – and in my experience, the one in Wales is – (in general ward care, not in terms of its superb heart and other units) – falling behind that in England, with patients given less (ie no) choice, patients unable to see success/failure rates for individual hospital departments (which the English can do via the excellent Dr Foster website) and the complaints process rigged to stop patients finding out what has happened. Ann Clywd show be applauded for her efforts. Things need to change.
    First to change should be the sheer arrogance of the nursing unions which promote the utter lie that ‘there is no such thing as a bad nurse’. There is such a thing – and plenty of nurses should be sacked if they can’t do their job with professionalism and compassion. My experience is that some nurses are great, but many are not and need retraining or the sack. They are not all angels – some are lazy, rude and incompetent, and see doing dirty jobs as below them. And for this, they earnh more than the average national salary, aged 21.
    The protectionist unions are a disgrace: we need more whistleblowers to expose any instance of poor patient care, and the complaints process needs to be made much better – having been through it, and bearing the scars on my back, I have nothing but contempt for the liars and back-scratchers who have no fear of such a toothless tiger. They all cover their own backs, always, and we do not even have the right to know which surgeons have the most failed operations – and if they hurt or kill people by error and incompetence, they get no punishment and do not even have to explain their performance. We assess and monitor bus drivers more. Why?

    • oakwoodbank

      I agree that the complaints process needs to be made much better. Both NHS and Social Services compaints system are incestuous and lessons are only learned when someone dies as a result of poor care. The funding of all complaints departments and recruitment to them, should be administered centrally. The Comminity Health Councils in Wales should have their independence returned and they should be reinstated in England.

      • Eddie

        Yes, and sadly Wales seems to be lagging behind England now.
        Dr Foster (the website) does not include Wales.
        Most new developments and rights announced the by the government only apply to England, not Wales.
        There seems to be some incestuous, back-scratching unionist attitude in wales, which says, more or less, ‘you should be greatful for what you’re given and shut up’. It’s lesft wing ideology, it seems, but wonderfully countered by the superb Labour and leftie MP Anne Clywedd.
        This is really not a left or right or whatever political thing at all, of course.
        But Wales is behind England, which is awful – though I do have to say that the heart department (and other specialist departments) here are the best in the UK. The wards are not, though, and nor are the nurses, doctors and general operations.
        And what annoysw me most is being kept in the dark! The attitude seems to be: ‘you the patient have no right to know anything and should be grateful thet we are bothering to treat you’.
        As I have said to more than one nurse: ‘what if it were YOUR mother?’

      • http://twitter.com/JunkkMale Peter Martin

        ‘the complaints process needs to be made much better’

        Across the board, with true accountability.

        http://www.dailymail.co.uk/news/article-2276026/Gloria-Foster-Council-left-81-year-old-widow-starve-death-home-warned-police-needed-urgent-care.html#axzz2KPmwF7Ak

        Otherwise one set of box-tickers can point at another set and whoever falls between the cracks of their creation… well… who learns from history if they don’t have to?

  • http://www.facebook.com/sue.jarvis.7399 Sue Jarvis

    At one point you say Hitchingham had climbed to top of patient satisfaction surveys but now that satisfaction has fallen and it’s four times overspent ?

  • http://twitter.com/stephenmedlock Stephen Medlock

    One can see why Labour appointed Nicholson but why is the coalition defending him via Francis? He must go . .

    • fubar_saunders

      Because Common Purpose have got their tentacles in Cameron as well. There is no rational explanation why the spineless tw*t wont do anything about them.

  • JabbaTheCat

    Seen elsewhere…

    “Death rates per 100,000 per year

    Gun violence (Jamaica) – 47
    Gun violence (US) – 10.2
    Gun violence (UK) – 0.25
    Car accidents (Egypt) – 42
    Car accidents (UK) – 3.59
    Suicide (Europe) – 3.5
    N(ational) H(omicide) S(ervice) Staffs – 160 (a minimum estimate assuming Stafford hospital is one of 4 in the county – these are excess deaths)

    Living in Staffordshire you are almost 4 times as likely to be murdered by the NHS as a Jamaican is likely to be shot in Jamaica.

    Logically, this makes the case for bringing back guns and making Staffordshire an NHS free zone, and making the UK a ZaNuLab-free zone, as this happened under a ZaNuLab government and a ZaNuLab MP in Stafford.”

  • http://www.facebook.com/el.capitan.1253 El Capitan

    Florence Nightingale wrote on the same subject one hundred and sixty-three years ago in her “Notes on Nursing: What it is and what it is not”:

    To leave the patient’s untasted food by his side . . . is simply to prevent him taking any food at all. Let the food come at the right time and be taken away, eaten or uneaten, at the right time.

    Blogged about (not by me) here:

    http://www.puritangift.com/en/blog/2013/02/08/the-francis-report-on-mid-staffs-hospital-is-a-half-eaten-dried-out-meal-sitting-beside-a-semi-conscious-patient/

  • Marcus

    Ross, don’t write the NHS is the ‘envy of the world’ in quotation marks. It
    really is you know.

    It costs less (in terms of % GDP) and also has worse outcomes than most
    other Western health services.

    Yet the U.K. population think it’s is so great that other countries envy us.

    Internationally most politicians are genuinely envious of this national confidence
    trick, particularly when our ostensibly ‘free press’ is prepared to play along
    so enthusiastically.

  • Corbus

    Nurses aren’t paid particularly good wages. And the profession has slumped in popularity among nationals. It wouldn’t be unfair to say that for the last 10-15 years the NHS has sought to fill its nurse banks with overseas recruitment drives and private nursing agencies (this has dropped off as a result of the extortionate rates charged). Who wants to be a nurse when you could catch a lucky break on a talent show? And if that fails then the nursing isn’t going to be forever, surely? When it dawns that it is, maybe there’s resentment. I mean the health service only gets bad press – so who really wants to work in public healthcare? The point I am making is that service is riven by dissatisfaction at the chalk face, where it interacts directly with patients. In the last few years I have read countless news reports of cruelty to ‘clients’. Is it worse now than in Victorian Britain (to use a hackneyed comparison)? Shouldn’t we be doing so much better in this modern, technology assisted era of ours? Perhaps attitudes towards hospitals haven’t changed that much. My grandfather was deeply suspicious of hospitals, seeing them as graveyards. But I suspect that was his relatively poor education at work, shaking a fist at modern, fandangled post war institutions. When I took my son in for an adenoid operation (a gruesomely bloody and rotten procedure) it did pass through my mind that he may be subjected to other risks – MRSA, Difficlie (it was doing the rounds at that time…literally), or maybe the worst thing of all, that he wouldn’t be cared for when he was in pain or scared. Yes, it was the last that bothered me most because I have absorbed the idea (unfairly perhaps) that our healthcare establishments are peopled by carers who have become desensitised, broken down by the national malfunction of their industry, or maybe simply couldn’t perform to their best ability because of language issues – yes, this is a problem. On more than one occasion I had some difficulty explaining something to what I later discovered was a Portuguese nurse – friendly, and I read on her face, well-meaning, but nonetheless in a position of responsibility with possible comprehension problems. I’ve said too much. I think we all agree that there is an endemic problem in the NHS, as there is in our education system, like the purpose of our modern society in general. I wouldn’t want to be the one to solve it. But Jeremy Hunt could be – I hope.

  • Corbus

    Nurses aren’t paid particularly good wages. And the profession has
    slumped in popularity among nationals. It wouldn’t be unfair to say that
    for the last 10-15 years the NHS has sought to fill its nurse banks
    with overseas recruitment drives and private nursing agencies (this has
    dropped off as a result of the extortionate rates charged). Who wants to
    be a nurse when you could catch a lucky break on a talent show? And if
    that fails then the nursing isn’t going to be forever, surely? When it
    dawns that it is, maybe there’s resentment. I mean the health service
    only gets bad press – so who really wants to work in public healthcare?
    The point I am making is that service is riven by dissatisfaction at the
    chalk face, where it interacts directly with patients. In the last few
    years I have read countless news reports of cruelty to ‘clients’. Is it
    worse now than in Victorian Britain (to use a hackneyed comparison)?
    Shouldn’t we be doing so much better in this modern, technology assisted
    era of ours? Perhaps attitudes towards hospitals haven’t changed that
    much. My grandfather was deeply suspicious of hospitals, seeing them as
    graveyards. But I suspect that was his relatively poor education at
    work, shaking a fist at modern, fandangled post war institutions. When I
    took my son in for an adenoid operation (a gruesomely bloody and scary procedure) it did pass through my mind that he may be subjected to
    other risks – MRSA, Difficlie (it was doing the rounds at that
    time…literally), or maybe the worst thing of all, that he wouldn’t be
    cared for when he was in pain or scared. Yes, it was the last that
    bothered me most because I have absorbed the idea (unfairly perhaps)
    that our healthcare establishments are peopled by carers who have become
    desensitised, broken down by the national malfunction of their
    industry, or maybe simply couldn’t perform to their best ability because
    of language issues – yes, this is a problem. On more than one occasion I
    had some difficulty explaining something to what I later discovered was
    a Portuguese nurse – friendly, and I read on her face, well-meaning,
    but nonetheless in a position of responsibility with possible
    comprehension problems. I’ve said too much. I think we all agree that
    there is an endemic problem in the NHS, as there is in our education
    system, like the purpose of our modern society in general. I wouldn’t
    want to be the one to solve it. But Jeremy Hunt could be – I hope.

  • http://twitter.com/btt1943 Boon Tee Tan

    Britain Is Completely Dysfunctional, says Daily Telegraph;
    Britain’s Vaunted Health Service a Shambles, says The Spectator;
    UK horsemeat scandal deepens, says BBC news; and many more, all on the same
    day.

    Little wonder, the once mighty colonialist is on the decline, irreversible decline.
    Only British could save Britain now.
    (vzc1943, mtd1943)

  • justejudexultionis

    This crisis is the direct outcome of years of Thatcherite ‘free market’ meddling in what should be a not-for-profit service.

    • Ridcully

      What on earth does “free-market meddling” have to do with a basic lack of compassion?
      I have been a nurse for just over 25 years and right now I just feel sick.

      • Despicable Dan the Bongo Man

        I’m sorry, but the English always vote tory and that’s what you get.

      • Despicable Dan the Bongo Man

        You’re sick? Fubar spunky boy is really sick!

    • Despicable Dan the Bongo Man

      Tell that to Fubar above; he loves a Tory. He lurvs Thatcher -and anyone who disagrees is jealous. Yes jealous! Thats his whole philosophy, the poor fool. And all the time his tory pals are taking him to the cleaners; and he blames socialists for that. What a misery goat he is.

      • Ridcully

        He said nothing of the sort; you’ve just twisted his words.

        • Despicable Dan the Bongo Man

          Wrong.

          I look under his words and see his selfish nasty heart. He is a Tory and you defend him. You too are a Tory.

          • Ridcully

            Do you have any debate to offer that can’t be distilled down into “Yah- Boo!”

          • Despicable Dan the Bongo Man

            Bah – yoo.

          • Ridcully

            Thank you for answering my question.
            Have a nice life.

          • Despicable Dan the Bongo Man

            Dont be riddycullus. Do you really wish me a nice life or are you twofaced?

  • pimpmypost

    You Tories have done so much damage to this country over the years. You should hang your rotten heads in shame.

    Before

    we

    cut

    them

    off.

    • fubar_saunders

      Yawn. And you f**king lefties have done soooooo much for us as well havent you? F**k off back under your stone and stay there. Dont you dare come back out, you f**kers have done enough damage to last a f**king lifetime.

      • Despicable Dan the Bongo Man

        I LOVE to see an angry Tory. There’s a good chance of a heart attack!. Then lets see them run to private health care.

        MORE please!

        • fubar_saunders

          I’d gladly go private Dan, if it meant I could stop paying any tax towards the bottomless pit of the National Homicide Service.

          Much better chance of survival that way compared to staying in a system thats designed more around the unionised pocket lining pricks who work in it rather than the service its meant to give to the public. If it were up to me, I’d privatise the whole of the f**king National Homicide Service in a f**king blink of an eye and chuck every single one of the f**kers on the dole where they f**king belong.

          Y’see thats the thing with you lot. Its all about those who work in it, isnt it? Its got f**k all to do with public service any more. You dont give a f**k what happens to the public, so long as they cough up. Thats why we’ve been having surveys recently where even those who work in the NHS wouldnt want to be treated in the same f**king hospitals that they work in!!! But, they expect us to fall for this “NHS, pride of the world” bullsh*t and to just suck it up?? Hahahah!! In yer f**kin dreams, comrade!!

          The funny thing about PimpMyPost is that he’s probably about 15, born in Surrey to Tory stockbroker parents who dropped him on his head as a child and now he figures they dont love him enough and he resents it. Most of you gobshite lefties are teenage, spotty, sub educated monosyllablic unemployables like Owen Jones anyway.

          PmP??? He couldnt cut the f**king wrapper off a f**king sweet packet. Just another fifteen year old keyboard warrior who has seen f**k all of life yet.

          Oh and by the way, I’m not a tory. But then again, you lot are too thick to figure that out, arent you? You figure that anyone who isnt one of you has to be a tory. No knee left unjerked and all that.

          And you’d know about it if I was angry. Man, I went past angry years ago. Now I just laugh at your lot. Although I do understand that its not meant to be funny to mock the afflicted.

          • Despicable Dan the Bongo Man

            What a result!

            You “went past angry’ did you? LOL!

            Best was your prediction about who I was etc. If ever someone was a cretin, it was you! More please.

            You are like Thatcher who thought there was no such thing as society. I’d love to apply that to you, pinhead. Meaning you are on your own for any service or facility that society offers. You, chump, would be dead in a week. And you wouldnt get buried. But I’d headbutt your corpse. lol.

            You can mock the afflicted if you want – please respond by mocking. I lurv it when you get angry. Mwah!

            Keep going – you have nothing to lose but your sanity. And you will.

          • fubar_saunders

            Grow the f*ck up “Dan”.

            You think anyone gives a shit about what you think, just another lonely teenage keyboard warrior?

            You’re not only probably not old enough to remember Thatch (most of you sad lefties cant, you’re too young, I grew up during her time, in a one horse industrial town that died on its arse with no prospects for any f**ker. I remember what it was really like). But because you’re so devoid of any f**king ideas of your own, you have to keep on dragging this old corpse of a corn-doll from its grave in an attempt to scare the shit out of the politically thick who follow you and your running dog “mates”. And you got the “no society” quote wrong as well. For a change. All you schoolboy revolutionaries do. You c*nts arent even capable of getting that right.

            Put your dick away and get on with the rest of your life you sad f*ck.

          • Despicable Dan the Bongo Man

            This, fubar, is a joy. I love spunky impassioned posts especially when they are full of pent up anger. I like people who lose the rag-it’s honest. And thats a rare quality.

            Your problem is you are angry but dont know how to put your anger into action. So you splurge it on to me. I dont mind at all. Feel free. You know nothing of me or you wouldnt even dream of trying to get me going. I’ve reread your post and can see just how much effort you’ve put into trying to stick the knife, to make a wounding comment. But fubar, spunky baby, you’re up against it with me! lol.

            *I dont care if no-one cares about my post. DILLIGAF?

            *I am not a teenager.
            *I remember Thatcher (who the English loved – your people)
            *I am not a schoolboy revo unfortunately. You didnt get that right.
            *You are a hopeless amateur in winding people up, believe me.
            *You are verbally incontinent.
            *You are a one-handed adulterer.

            xx!

            I want you to post more to me. I like it. And I want you to tell me what you are doing to help society. I dont mean your usual ‘solitary pursuits for gentlemen’; I mean something more than that. Not spluttering on the internet – I’m telling you to sh*it or get off the pot; stop ranting and DO something you wally. Or shut up.

          • fubar_saunders

            oh you’re a sweaty. That explains everything.

            what am I doing to help society, Daniel?

            Exactly the same that it is doing for me and has ever done for me, Danny boy… Jack Shit.

          • Despicable Dan the Bongo Man

            Sweaty Sock to Whingeing Pom….that explains everything – to Mr Angry.

            Society did a lot for you bruvver, and I arsk you to stop voting Tory, you kaant. Innit?

            You are so bitter and angry it’s a crime to get you going – you are in deep sh*t as it is.

            I want you to become a socialist, bruvver, so stop being a tory individualist. Get your sorry head out of your sorry ar**hole. If you wont do that then suffer in your solitary confinement. Chump.

            lol!

          • fubar_saunders

            Haha, Danny, Danny, thats the thing with you “socialists”… you just cannot walk past that lowest of the low hanging fruit that says “everyone who doesnt think like me is a tory”. You’re just completely incapable of doing it, brother. Haha. I’ve never voted Tory in my life. I might have been a natural tory voter, but, funny though a twisted old “socialist” like you might find it hard to believe, I’ve never actually left a voting booth after having endorsed the conservative candidate. Never. And that is the Gods honest truth. Suck it up baby!

            I’m bitter….. yes about people like you, who think socialism is the answer. Its been proven around the world that it isnt. Socialism isnt good for the people, only for the small dicked inadequates who practise it or evangalise about it. They only do it for their own interests, not for those of the workers or the masses… After all, nothing is EVER too good for the reprasentatives of the people, right?

            Its NEVER been about making the lives of the poor any better. Its always been about bringing down those rich bastards, isnt it?

            Thats all it ever has been and ever will be about. Dont ever pretend that its about the poor. Once the poor have been seperated from their vote, they cease to be of relevance. You dont give a shit about the poor any more than the tories do -in fact, its probably more accurate to say you HATE the poor more than the tories do – at least they’re useful to the tories, even if its just as cheap labour – but at least the tories dont make up some big song and dance bullshit in the first place about how they’re “the party of the many not the few” and then forget about them and import the rest of the world’s dregs to do their jobs and leave them in a noose on dumbed down benefits for the rest of their days. Your lot have never given the remotest of fucks for the poor, NEVER. They’re just too thick to see it. Thats why your whole education system is about making them even thicker, making them less likely to ask questions, less likely to upset the order of things, its why your health service is more about the people who work in it than the service its meant to give to its patients – thats how it kills TWELVE THOUSAND of them every year, and nobody says shit!

            And dont start me on the champagne socialists, the very worst kind of self loathing middle class dropped on their heads attention seeking inaedquate hypocrites. These bastards should all without exception be double tapped in public and their entrails posted around the railings of the offices of the Grauniad, pour encourager les autres. I would gladly hang them by their scrawny, self loathing, self important, self appointed elite necks with piano wire from a lamp post in a heartbeat.

            Be a socialist, Danny boy? I’d rather be dead than go through my whole life being consumed by the vinegary veined jealousy that tells me that I’ve never stood a chance of being in control of my own destiny, because someone who’se birth circumstances were different to mine somehow stole all my life chances. I’ve never heard such complete and utter camelshit in all my life.

            And how you can live with yourself, how you can sleep at night, when you tell people more vulnerable than you, poorer than you thicker than you, that your system is the answer when you know, deep down in your heart, in the very fibre of your being that it was never about them at all, it was all about how you just cant live with anyone having anything more than you, no matter what the circumstances….

            Sorry Dan, I much prefer the view from up my own arse than ever to resort to the fundamental, naked, penis-envied, unashamed, flagrant dishonesty of ever being a “socialist”. I’d rather be dead. At least its got integrity up there, it never pretends to be anything else. You might like to try that view. You might actually find it refreshing.

            Cant say the same for your lot I’m afraid!!!!!

          • Despicable Dan the Bongo Man

            Fubar baby – thats a better response. Its like freeing constipation for you isnt it? Aah – that’s better!

            I note how you have kind word for tories. I knew you were one. It’s all that ‘faak society’ and ‘rugged individualist’ and ‘poor me’ which alerted me to your tory heart. Even if I know it and you dont. Be in denial if you like. DILLIGAF? “You might have been a natural tory” you say. Oh I know fubar baby, I know. Re-education will be your lot. Or 50 grams of lead placed wisely. At velocity.

            You use all the fascist criticisms of socialism ie jealousy etc. And so I know your dirty little secret. But not as dirty as your solitary fumblings. Oh no!

            There’s a worrying fixation on genitalia in your text. Can you explain? I can read you like a book, fumbly fubar.

            Again I see the effort you’ve made here, with your little tongue sticking out of the side of your mouth as you tickle the qwerty, straining (oh yes) to flatten the opposition. You’ve made a big mistake…..lol.

          • fubar_saunders

            Daniel old man, you might not have anything better to do. I have.

            You wanna indulge in a willy waving contest, on you go. I’m sure someone will indulge you.

            There are far more important people in my life than you. Ones that have something interesting to say

            Bye

          • Despicable Dan the Bongo Man

            More obsession with genitalia. Arrested development? Say 12 years old?

            I’m glad you know important people – even tho’ you hate society; thats hero worship you know, a Tory trait. I’ve got your number.

            You “wanna” indulge do you? Are you teenage twat, cap reversed, to talk like that? You could have called me ‘dude’, eh? ‘Awesome’ eh?

            Bye bye snafu, get out of my life you bitter, twisted sociopath Tory .

          • Despicable Dan the Bongo Man

            Soapy Saunders is saying a bit less here. Medication kicked in maybe?

            “Oh Danny Boy, the pipes, the pipes are ca-a-lling.
            From glen to glen and down the mountainside”….

  • Bob T

    Obama has refused to recognize the UK’s example of the futility of Government run health care. Brace yourself USA for ObamaScare!

  • Tom M

    Yes well fine. So why is no-one out on the streets about this? This is a national disgrace. This is way way beyond the realms of ” news worthy commentary” or “lessons will have to be learnt”. One worthy MP on Question Time the other night had the temerity to suggest that “we need a proper investigation into what has happened here”. In case he reads this the tax payer has just spent £13m on an inquiry. How many do you need Mr Baker?

    First principle of government: Protect the people. If this had happened in the private sector the H&S would have descended like tons of bricks and prosecutions would have followed. I demand to be protected.

    Having listened to the hand wringing for weeks now (this article is in this category) is anyone going to start heads rolling? There are people today employed in the NHS that are clearly guilty of manslaughter on an industrial scale. Why are they still in post? What confidence does anybody have going into hospital knowing that these people are still there?

    A government minister recently lost his job because he was supposed to have sworn at a policeman. Am I missing something here? Where’s the comparison? What has happened to my country if this is treated as just another tea cup storm that will pass over?

  • http://twitter.com/Bruciebabe Bruce Everiss

    Why are labour silent on this?
    Why are the BBC under reporting such a huge story?
    Thousands killed by a state institution.

    • fubar_saunders

      because the BBC are so far up Labour’s arse….. not to mention the shared umbilicus of Common Purpose. The same sets of progressive scumbags who know far better than we do as to what we need. W*nkers…..

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