🧵THREAD about public/healthcare funding

1/

🗣️ "We must not resort to infighting...instead of placing the focus of our rage where it deserves to be placed – at the feet of those who have been managing the NHS in recent years."
2/

It's not only mismanagement. It's consistent underfunding.

When you look at the govt's own figures, it looks like public spending is increasing: gov.uk/government/sta…

Note the y-axis is £ billions but not accounting for inflation (nothing about real terms).
3/

When you look in detail it looks like health spending is increasing and social care is constant.

Note the y-axis is £ billions but now IS accounting for inflation.
4/

But when you look at public spending as a proportion of GDP public spending is actually decreasing: ifs.org.uk/election/2019/…

From around 46 % to < 40% in the modern day.

Note the y-axis is shrunken and does not start at 0 %.

@TheIFS @PJTheEconomist @HelenMiller_IFS
5/

And then look at health spending as a fraction of GDP. It has gone down over the last decade: nhsconfed.org/-/media/Confed…

@NHSE_Danny @NHSConfed

@AnitaCTHF @HealthFdn

@PJTheEconomist @TheIFS
6/

Similarly social care spending has fallen too: nhsconfed.org/-/media/Confed…
7/

However perhaps other sectors of public spending have had cuts but is this in real terms: nhsconfed.org/-/media/Confed…

Note the axis is in £ billions.

How much is this as a fraction of GDP?
8/

Maybe there is room for improvement - our spending on the 'nanny state' is pretty small compared to other country with far better health outcomes.

Yes - I'm citing Scandinavia unashamedly.
9/

Yes funding for new hospitals is welcome: gov.uk/government/new…

But why just secondary care?

What about investment in the causes of worsening health inequality?
10/

When you read the @MichaelMarmot's @TheMarmotReview you find the cuts to public spending were associated with stalling life expectancy and increased health inequality:
11/

In conclusion

1⃣ Look at % GDP spending over real terms

2⃣ Let's not just focus on healthcare spending, but it's important.

3⃣ We must urgently focus on the causes of poor health

Read this from @sandrogalea: publichealthpost.org/the-publics-he…

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More from @DipeshGopal

4 Jan
1/

🧵 THREAD about probably one of the BEST discussions about social value of work, economic wealth and fairness in a while.

40 mins with @amolrajan, @PJTheEconomist @elerianm @KGerlich777 Louise Casey

@davidgraeber 🗣️ "The more your job helps others, the less you get paid"
2/

Reminded me of @euan_lawson for @BJGPjournal quoting Michael Sandel on meritocracy: bjgp.org/content/70/701…

🗣️ "In an unequal society, those who land on top want to believe their success is morally justified. In a meritocratic society, this means the winners must believe...
3/

🗣️ "...they have earned their success through their own talent and hard work.… at a time when racism and sexism are out of favor (discredited though not eliminated), credentialism is the last acceptable prejudice."
Read 10 tweets
28 Nov 20
2/

Editors' note: Dr @HDambhaMiller (Editor in Chief), Dr Umar Chaudhry (@StGeorgesUni), Dr Peter Adams (@uwicave_hill)

They explain how they will be taking on diversity/inclusion by looking at:

outreach / mentoring students
diversity at submission

bjgpopen.org/content/early/…
3a/

Our group work looks at how race and racism affects the working life of a GP: bjgpopen.org/content/early/…

When it comes to issues of race / racism, is it comfortable to ignore them?

@v_silverwood @EbMulla @olamide_dada @salmanWaqar
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THREAD on @RoySocMed ONP51: Health inequalities: what can healthcare professionals do?"

1/

Dr Chad Hockey talks about how the original game of monopoly which originally had wealth distribution that is no longer part of the game

bbc.com/worklife/artic…
2/

🗣️ "The poverty of our century is unlike that of any other. It is not...the result of natural scarcity, but of a set of priorities imposed upon the rest of the world by the rich. Consequently, the modern poor are not pitied … but written off as trash.” John Berger
3/

Healthcare provision is based on the fact that we all have the same healthcare needs but this is not the case.
Read 15 tweets
19 Nov 20
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From @Hludders

🔴 What are the late GI effects of radiotherapy❓

#RTLateeffects Image
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⚫️ How could I recognise the late effects of radiotherapy to the bowel❓

Evidence base and the screening tool: sciencedirect.com/science/articl…

#RTLateeffects Image
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🟠 How could I manage the GI symptoms of pelvic radiation disease❓

macmillan.org.uk/_images/practi…

#RTLateeffects Image
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13 Sep 20
1/

🧵

THREAD about why race is in the @NICEComms hypertension (blood pressure) guidelines and why it should go: nice.org.uk/guidance/ng136

@MedCrisis and I read #AngelaSaini's book "Superior" and were horrified at the inclusion of race without clear scientific basis:

#FOAMed
2/

The @NICEComms specifically implies that Black people are inherently different (assumption: biological/genetic) compared to White people.

Why? @DoctorMayJay

Suggestions: Black people are inherent salt retainers due to salt deficiency, etc: ncbi.nlm.nih.gov/pmc/articles/P…
3a/

This article from @American_Heart is a long reach arguing that there are inherent genetic differences between Black people and White people citing small genetic studies: ahajournals.org/doi/full/10.11…
Read 14 tweets
3 Sep 20
Thank you to the @bmj_latest for hosting the
#BMJCovid

@PaulGarnerWoof: #LongCovid was way long than the 2 weeks

blogs.bmj.com/bmj/2020/06/23…
@Dr2NisreenAlwan - "why aren't we measuring #LongCovid?"

#LongCovid - often has a wide range of symptoms: body ache, chest pressure, tiredness, rash. The symptoms do not completely go - relapsing and remitting. #BMJCovid

Read her article here: blogs.bmj.com/bmj/2020/07/28…
@trishgreenhalgh - "you do not necessarily need a positive test to have #LongCovid"

Let's not get too caught up with this - we weren't testing at the beginning of the pandemic. #BMJCovid

How do we manage #LongCovid. Great patient resources here: bmj.com/content/370/bm…
Read 14 tweets

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