Dr Dan Goyal 💙 Profile picture
Sep 10 14 tweets 3 min read Twitter logo Read on Twitter
1. Money

In October 2022 the Scottish Govt allocated £528m specifically for Health & Social Care and specifically to be spent for winter preparation

This is equivalent to over £5b in England.
Meanwhile, the U.K. govt committed to £200m (the equivalent of £20m in Scotland) for Social Care only. No additional winter fund for the NHS.
Scotland provided more to recruit paramedics and ambulance staff (£40m) than the U.K. govt did to the entire NHS in England.

Plus
▪️£120m (England equivalent £1.2b) to enhance care homes

▪️£144m (equiv. £1.4b) to expand care at home.
This was on top of £200m just to increase the hourly rate of adult care workers in Scotland

▪️£8m to recruit nurses from overseas for the winter

▪️130 additional doctor training posts

▪️overtime allowance for final year GP trainees to work out of hours
▪️£50m just for urgent care…that is the equivalent of £500m for more A&E and acute medical staff in England just for the winter months!!! These are the folks that treat heart attacks, strokes, sepsis, broken bones,…
Meanwhile the U.K. govt are putting £15b into diagnostic centres (many private) and only deal with uncomplicated simple conditions, not sepsis, strokes, heart attacks !

And £250m for 900 beds by April 2024!

That’s it.
But perhaps one of the most impactful things the Scottish govt did was to reduce the harm caused by 13 yrs of Tory austerity by focusing on the cost of living crisis:

▪️£3b to support people hit hardest…that is equivalent to £30bn in England.
▪️a rent freeze over the winter until March 2023

▪️a no eviction law over the winter - people could not be evicted if they couldn’t afford rent

▪️extra support to disabled children, vulnerable, free school meals

This stuff keeps people alive and out of hospital!!
Also an extra £124m to provide hospital care at home and prevent hospital admissions. Imagine getting an extra £1.2b in England to expand hospital at home!!!
2. Priorities
The key is not just how much money is invested but where it is invested.

Look at U.K. govt, investing in expanding private care - which during winter makes even less sense.

Scotland invested in urgent care, ambulances, expanding care at home, actually doing…
Something substantial to recruit and retain staff, and actually giving the NHS money to pay overtime to existing staff so we can actually take on more activity.

These are the actions of a govt trying to save the NHS and patients versus trying to enhance private care.
Don’t get me wrong, Scotland are not doing well. We are not a national healthcare system to aspire to. Austerity has hit us hard and we are still a decade behind leading healthcare countries…

But we did enough last winter so that so many people didn’t need to die unnecessarily
The U.K. govt know this. All of this. Sunak, Hunt, Barclay all know that their refusal to fund the NHS properly through the winter will lead to people dying or suffering disability due to delayed treatment. They know this.

For me this truly despicable!
And the kicker!!!…

It’s not they aren’t spending our money and not spending tons of it…it’s just they’re spending it on themselves and their donors and not on this very real and very devastating winter crisis

It’s their choice to do so. But our choice whether we support them!

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More from @danielgoyal

Sep 10
We are heading for another winter of needless deaths…

But there is still time to save thousands of lives

Last year Scotland had no non-Covid excess deaths, whereas England & Wales had over 500/week.

Here’s how Scotland saved thousands…

🧵
1. Money

In October 2022 the Scottish Govt allocated £528m specifically for Health & Social Care and specifically to be spent for winter preparation

This is equivalent to over £5b in England.
Yet again the Twitter gremlins strikes and kills my thread. Remember when Twitter actually worked!
Read 4 tweets
Sep 1
As the reality of Covid hit they realised the death of younger people would turn the strategy into a failure. The optics were bad. They didn’t care about older people dying and sadly some of the public didn’t either. But young deaths would be a disaster, politically.
It culminated in Cummings seeking advice from Prof Gower - a mathematician. Gower wrote clearly that the govt’s current strategy of herd immunity would be a disaster. ‘You would need at least ten times the number of ICU beds’.

theguardian.com/world/2021/may…
Nightingales were principally set up so the govt could continue it’s herd immunity strategy without getting bad press.

But why then not simply expand NHS capacity? Why set up an entirely new and temporary facility?
Read 16 tweets
Sep 1
Most people are aware of the main reason Nightingales were a calamity - there were no people to staff them - , but Nightingale hospitals were bizarre for other reasons

Well, bizarre when you assume the govt is acting in the interests of the public’s health…
1/n
Field hospitals during Covid were a normal response by many countries. They were indeed the WHO recommendations.

Most countries used hotels or youth hostels or army barracks…

But no country (other than U.K.) set up ICU field hospitals!
2/n
The advice (and common sense) was to set up field hospitals for basic (Level 1) care. That is, a place where oxygen can be given and patients monitored.

It makes sense. Actual hospitals are the best place to run ICU/HDU services. Not makeshift exhibition centres.
3/n
Read 12 tweets
Aug 27
For all that’s going on with the NHS you would be forgiven for thinking ‘where the hell is the NHS CEO’’

Or ‘what exactly is the role of the NHS CEO?’

Ironically, the post was designed to allow NHS executives to speak out against govt policy…

So why are they so complicit
🧵
Primarily because the government of the day chooses the CEO of the NHS.

Much like choosing the Chairperson of the BBC, they are rubber stamped by a select committee but it’s the PM and Health Secretary who decide who goes forward.
You may recall Simon Stevens, a former executive to a US private healthcare company was appointed as CEO to NHS in 2014

You will be forgiven for not knowing who he is, for despite being NHS CEO during the worst national health emergency since the war he didn’t say much!
Read 15 tweets
Aug 16
Yesterday’s announcement by this Govt about winter beds was really devious and dishonest.

The message they were sending to the public was ‘we are investing in the NHS to prepare for Winter’

The reality was quite the opposite…
1/7
Their goal is to push the NHS deeper into a spiral of failure and boost the private sector. But the public won’t stand for it. So they need to look like they are strengthening the NHS without actually strengthening it in anyway.
So they announce “£250m for 5000 extra beds for winter”!

On the face of it, great! We need more capacity to handle winter. We need more like 20k but 5k is better than nothing.

But it isn’t more capacity. It’s just more beds. Actual beds…

And only 900.

And only by April 2024
Read 8 tweets
Aug 15
The change to cancer targets is a big deal!

The issue is the 28-day to diagnosis versus the 2-week wait target.

That is, if your GP suspects cancer, from the point of referral, 75% of patients should be diagnosed or given the all clear in 28 days
🧵
Currently, if your GP suspects cancer and refers for a test or specialist appointment 80% should have received their test or appointment within 2 weeks.

Currently less than 60% do. In 2010 it was 90%.
There are some advantages to the 28-day target, mainly in regards to the focus being on diagnosis versus receiving “just” a test or an appointment.

But (and it is a big but) many diagnoses are reached within the two week wait already.
Read 15 tweets

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