Tag Archives: NHS

April 4, 2016 · 21:21

Working for a new boss

This morning starts off with an entirely different wave of events. Brexit is turning out to the two teams misrepresenting issues as much as possible, many of these representations are about scaremongering. The NHS is going on and on and on and other views are given. In both cases I agree with some parts, I disagree with loads of it (from my point of view with decent evidence). Yet all this we would have overlooked almost half a dozen articles. The story is only the smallest part of it. What is massively interesting that there is for a chosen few a job available! It is not glamorous, you will be frowned upon, but consider a job that will get you a 7 figure income (after a while), a decent house, possible tropical views a few times a year. In this day and age? Who would not accept that? Perhaps the single ideological man or woman, but that leaves a few million people, all ready to accept a position with the glamorous firm of Mossack Fonseca, a panama based law firm, with services on a global scale. Clients like Russian President Vladimir Putin (allegedly). They operate in tax havens including Switzerland, Cyprus and the British Virgin Islands, and in the British crown dependencies Guernsey, Jersey and the Isle of Man. I would love a nice job on Guernsey, a nice house, retirement at some point. I am a Trade Marks attorney, one that would love to get an additional degree in finance if that gives me a good job with Mossack Fonseca, is that not what you saw?

The first article ‘What are the Panama Papers? A guide to the biggest leak in history‘ (at http://www.theguardian.com/news/2016/apr/03/what-you-need-to-know-about-the-panama-papers), assisting the rich and famous store their wealth in tax havens. You see, this is all legal, this is not FIFA screwing its soccer fans over breaking ethical boundaries. This is all thankful to a multitude of short-sighted politicians (or really clever ones depending on your point of view) who enabled options in their tax homes. The article ‘used lawfully to anonymously hold property and bank accounts, these companies were registered in a range of tax havens and this map shows the most popular locations among its clients. The British Virgin Islands held more than 100,000 companies‘, so you would not be breaking the law. You just have to accept that some people pay (a lot) less taxation. After 30 year I have clearly seen and learned that living morally correct will get you a one bedroom apartment in the suburbs, a place you will not be able to pay off before you die. So as morality is not a legal requirement, as all this work is perfectly legal, why not?

This is all coming to light because of a leak, someone (as stated by the Guardian) got a hold of 2.6 terabytes of data. The quote is literally “There are 11.5m documents and 2.6 terabytes of information drawn from Mossack Fonseca’s internal database“, which implies that the facts were discovered through criminal activities. This means that Mossack Fonseca might have a case against those perpetrators. Another interesting quote is “Using offshore structures is entirely legal. There are many legitimate reasons for doing so“, so why not become a service provider here?

On the other side there is the quote “In a speech last year in Singapore, David Cameron said “the corrupt, criminals and money launderers” take advantage of anonymous company structures. The government is trying to do something about this. It wants to set up a central register that will reveal the beneficial owners of offshore companies“, which is equally valid. Mossack Fonseca stated: “it complies with anti-money-laundering laws and carries out thorough due diligence on all its clients. It says it regrets any misuse of its services and tries actively to prevent it. The firm says it cannot be blamed for failings by intermediaries, who include banks, law firms and accountants“, this gives us another side too. When we consider banks we can consider Barclays (Libor 2012), Marcus Agius, former chairman of Barclays, resigned from his position over it. He’s sitting pretty being amongst others on the board of the BBC. Now, there is no evidence that he was directly involved, but it happened under his nose (so to speak), with a few exceptions most got out with their bonus intact and this was a legal transgression, so why would anyone not want to work for Mossack Fonseca, who is not breaking any laws?

When we consider law firms we should consider the news form the Independent in 2013 where we see: “The Serious Organised Crime Agency (Soca) knew six years ago that law firms, telecoms giants and insurance were hiring private investigators to break the law and further their commercial interests, the report reveals, yet the agency did next to nothing to disrupt the unlawful trade” (at http://www.independent.co.uk/news/uk/crime/the-other-hacking-scandal-suppressed-report-reveals-that-law-firms-telecoms-giants-and-insurance-8669148.html) and when we see the word ‘accountant’ I think Tesco and Pricewaterhouse Coopers. For example the quote I used “Tesco paid PwC £10.4m in the last financial year – plus another £3.6m for other consultancy work“ (at https://lawlordtobe.com/2014/09/30/thriving-team-tesco/) in the article ‘Thriving Team Tesco?‘, where again the case of wrongdoing should be regarded as more likely than not, so why would we not consider perfectly legal work at Mossack Fonseca?

Let’s not forget that the governments on a global scale are enabling this to get some tax revenue. Consider that the British Virgin Islands have 100,000 companies, without them, how much taxation would have been collected? It is a mere case of need and availability.

For example, a fictive person goes to His Excellency John Duncan and states: “Sir, if you offer us a favourable tax option, the option would be open to bring industry and taxable revenue in access of $1,000,000,000. Would you be willing to consider a low taxation plan?” to this the governor would respond “My dear man, we have no profit tax and no corporation tax!”

So how long until the big boys move a few billion to a place like that?

We seem to find time to worry about ethical issues, when the installed governments in Europe have yet to show a mere accountable bone in their bodies for overspending trillions. We seem to be ignoring the obvious. Even if this was illegal, how many banker have gone to prison from 2004 onwards? This is not illegal, this is a mere application of true globalisation. In addition, consider that offshore companies and offshore trusts are in most cases taken out of the view of taxation to begin with, so why not employ this option?

You see, the part that is in the middle of all this is not answered, it is skated around. No one seems to care on HOW the information was gotten at. The quote “2.6 terabytes of information drawn from Mossack Fonseca’s internal database” implies hacking. This does not mean that it could not have been facilitated by internal sources. Such an amount of data does not just easily download, so either someone got access and mirrored a drive, which implies that the server was accessible, what is more likely (read: speculation), is that this is one of the first cloud hacks. To have such a large environment, so global gives the option that data was in the cloud and someone was able to access it. This morning IT Pro had the following quote (at http://www.itpro.co.uk/data-leakage/26293/panama-papers-leaked-through-server-hack-1). “it had opened an investigation after discovering that “unfortunately” it had suffered “an attack on its email server” and that it is taking “all necessary measures to prevent this from happening again“, which could be the case. My issue here is that from a server, getting access to that much data should either be noticed (bandwidth), or it was internal (read: facilitated). When we consider the e-mail data overall, there is nothing that raises flags. Oh yes, there is! That much data with a truckload of attachments gives food for thought. Even as we consider no criminal acts have been undertaken, one would try to secure that much data. Perhaps this was done, but how was so much data gained?

In my view, encrypted UNIX servers would have required massive amounts of time to access and a good IT team always keeps one eye on their servers. Fortune quoted “Mossack Fonseca is calling the 11.5 million leaked documents a “limited” breach” (at http://fortune.com/2016/04/04/panama-papers-law-firm/), which is also likely, yet in all that if that was limited, yet fortune gives us one quote the Guardian would be unlikely to state “It appears that you have had unauthorized access to proprietary documents and information taken from our company and have presented and interpreted them out of context“, now that part will be close to impossible to prove, because the Guardian clearly stated “Using offshore structures is entirely legal”

No matter how this plays out, it seems to me that politicians on a global scale will start playing their ‘hypocrisy card’. Which is another laughing matter altogether. I cannot predict how this will officially play out, but they do have a website at http://www.mossfon.com/ and they are also in Trade Marks, so I should see what my options are. For you the reader, especially those with a degree in wealth management. I suggest you send your resume to:

The MF Group
54th Street, Marbella
Panama, Rep. of Panama

You could also go to web page: http://www.mossfon.com/about_service/careers/, if you want to post your resume online!

Let’s not forget, these people have not broken any laws (at present).

Have a fun day and dream of a life without debt in a place you could never have afforded in any other legal way.

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Filed under Finance, IT, Law, Media, Politics

Tagged as Barclays, BBC, Brexit, British Virgin Islands, IT Pro, John Duncan, LIBOR, Marcus Agius, Mossack Fonseca, NHS, offshore companies, offshore trusts, President Vladimir Putin, Pricewaterhouse Coopers, Serious Organised Crime Agency, Soca, Tax havens, Tesco, the Guardian, The Independent

April 3, 2016 · 14:10

The Medic and the Medici

There are several issues exploding, yes, they are literally exploding in the faces of people all around us, especially in the UK. The first event is ‘Leaked Brexit email claims David Cameron has ‘starved’ NHS‘ (at http://www.theguardian.com/politics/2016/apr/01/senior-tories-brexit-vote-leave-attacks-david-cameron-letter-nhs-staff).

This article gives us the following quotes: “David Cameron and Jeremy Hunt must accept responsibility for this – they have starved the NHS of necessary funding for too long.” The claim is more than outlandish, it is for all intent and purposes a clear fabrication. So who is Cleo Watson? What evidence has she produced? These two elements are important. Apart from her short time with the Vote Leave campaign, she is an unknown. This letter is also a clear visible act where both Michael Gove and Boris Johnson need to question their support for this group. Michael Gove gave his reasons clearly and well written in the Independent. Boris Johnson has his business and governing mental experience regarding the link between the UK and the European Union. I am on the fence, yet to some extent I am leaning more and more heavily towards Brexit. Yet I want to do this on the facts that matter, people need to vote based on actual facts. Cleo Watson is just making a joke everyone needs to ignore. This we see when we take the following facts into account:

#1. 2011, NHS pulls the plug on its £11bn IT system, a system abandoned after 9 years of spending and no result.

#2. 2013, The NHS says it has lost millions of pounds in the last year because of the number of patients failing to turn up for appointments.

#3. 2015, The NHS saw the worst performance by A&E departments since records began in 2010, with only 91.4% of patients being seen within the four hour target time.

#4. 2016, Nurse staffing levels, missed vital signs observations and mortality in hospital wards: modelling the consequences and costs of variations in nurse staffing and skill mix.

Now, this is not about laying blame with the NHS, yet serious questions need to be asked. You see, only the arms industry has at times the luxury to blow away 11 billion and not feel the consequences. It’s pretty much the operation expenses of the Patriot Missile system in the US. Oh wait, the UK cannot afford that system, so it selected the Aster which gives more bang for the buck (50 missiles more bang for the buck). It had issues after that in both quality and availability. In addition, a study to be completed in 2017 is costing the NHS half a million.

There are other issues that play, they are all with the NHS; the issue is that these things just happen. Any machine has cogs that aren’t pulling their weight, they are there in case something else goes wrong, or they are in support, or even just idle because the system requires them to be. The response in the Guardian was also direct: “A senior source at the Department of Health hit back by claiming the government had provided an additional £10bn for the NHS and said that “every Conservative MP stood on a manifesto to deliver this package”. They added: “So we expect every Conservative MP to have absolutely nothing to do with this letter”“, which for the moment might sound very correct, but within all this a serious question remains. How could any project go this far out of bounds? In a time when the NHS is not smothered to death, but only a step away from drowning in costs and costings, we must demand a firm hold on expenses. Yet, this goes a lot deeper than just expenses, you see in all this, especially in regards to the squandered £11bn, questions must be asked of the political side, did they interfere, was there interference at all and how did that explode costs? That is an equally important question in this race for comprehension.

So as we see one part nullified from Vote Leave. We are not done, not by a longshot. You see, these matters are tried again and again. This becomes more outspoken when we see ‘Female doctors may be forced to quit over new contract, experts say‘ (at http://www.theguardian.com/society/2016/apr/01/female-doctors-new-contract-medical-royal-colleges). Now, let’s be fair. There was always a small chance that this was the Guardian entering its own April fool’s day article of the year. Yet that part can be ignored when we read: “The MWF is worried that will force female doctors who are mothers to try and find childcare at those times. The new contract could breach junior doctors’ right to a family life under the Human Rights Act“. In addition there is “Dr Roshana Mehdian, one of the leaders of the junior doctors’ campaign against the contract, criticised the DH for saying that women should make “informal childcare arrangements” if they are affected by having to work more antisocial hours“. When we look against “This is ludicrous in the 21st century when childcare costs are spiralling and access to out-of-hours childcare is limited. This discriminates against women, single parents and working couples“, we must ask ourselves ‘Are these doctors on drugs and please can we get some of them?’

You see, there is no denying that the MD’s in this world work really ungodly hours. I do not think it is fair, yet the current system does not have that much margin to work with. In addition, a personal view is that any woman who now goes into medicine, who also wants to be a mother needs to realise that she can do one or the other, not both. Those in the medical and legal industry tend to work an easy 50-60 hours a week. Unless those women have chosen to marry a househusband, that option is gone! All this bickering and especially Dr Roshana Mehdian who not unjustly stated “This is ludicrous” is forgetting that in the old days the man worked, the woman stayed at home. Now, if we accept (and I do), that someone has to be with the kids (to some extent), in an age where a man and a woman can make the same fortune, she must also realise that if she is making the fortune, she needs to realise that Mr Mehdian might be expected to be at home to raise the kids. In a bad analogy I would rephrase this into, you can’t be a hooker and expect to be given the options of a virgin. One excludes the other. And in an age of spiralling childcare costs, the cost of living went up for all. This is not about fairness, this is about reality and realism. Because only labour seems to feed the public the idea that all can have a job, free education is a given and childcare is priced under the tax deduction act, those who believe will not have a life, not have a family and they will not have any money left.

The article calls for another two quotes that have relevance and importance. The first is “The DH analysis, published on Thursday, has intensified the long-running dispute between the profession and ministers over the contract. There is particular unease about its statement that “while there are features of the new contract that impact disproportionately on women, of which some we expect to be advantageous and others disadvantageous, we do not consider that this would amount to indirect discrimination as the impacts can be comfortably justified”“, the second is: “This contract is a huge step forward for achieving fairness for all trainee doctors”, a spokeswoman said. “For the first time, junior doctors will be paid and rewarded solely on the basis of their own hard work and achievement. That is ultimately what employers and the BMA they want and everyone deserves: a level playing field.”

You see, these might seem like two sides of the same coin, but I reckon they are not and this is a lot more of an issue that some might realise. You see, the Guardian and the Independent are both on the same side when we see “the measures would discriminate against single women“, I disagree! From my point of view, being a single parent and in law or medicine is massively stupid and selfish. It is clearly given at the beginning of your career, already in University for some that the immense amount of hours made will equally mean that being a parent (in any other way than the old way is the real story that will not be a reality). I reckon that any person becoming a parent whilst working 50+ hours a week is a bad parent and should not be allowed to be a parent. You can’t have it all and for the most, most of the population knows this to be a truth. Is it possible down the track? That remains to be seen, there is a clarity that unless the economy does not drastically improve the family life for many will be a mere concept that will never become a reality to many couples. Nourishing any act in that direction is self-delusional.

Is it fair?

Of course it is not, but the current economy is not about fairness, in all fairness the previous administrations should not have pushed this government with a 14 hundred billion pound debt, but that happened and until now, no serious acts have been performed to rein in spending and to reign in debt, which is part of all this as well. The full contract can be found at http://www.nhsemployers.org/case-studies-and-resources/2016/03/junior-doctors-terms-and-conditions-of-service. I am not going to bore you with the contract as such, because some of the elements discussed require a person much more versed in contracts than I am. Yet, I feel that it is imperative to mention: “The work schedule for a doctor on a general practice training programme working in a general practice setting should reflect the 2012 COGPED guidance or any successor document on the session split during the average 40-hour week that comprise a minimum full-time contract. Any additional hours of work above 40 must be included in the doctor’s work schedule and linked through to the curriculum, as per those for doctors in hospital settings“, which we see on page 28. This part has a reference to “The doctor’s actual total ‘new contract’ pay at appointment to the first post and subsequently at appointment to each new post under these TCS will be calculated as per the provisions of Schedule 2 of these TCS” I cannot state whether this is fair or unfair. Yet there is one given, there is no mention of gender here. I have seen how Emma Watson gave her speech at the UN (I am completely in support of this), yet when we see equality, for me it means on all fronts. This also implies that you do not get to have a career and be a mother. You see, in that same view, nearly every man worked every day (and sometimes nights) and did not get to be a father, they merely became the provider of the family. We have to accept that, because the rent and the food must be paid for, in that same light women will have to face that too. So, they do not get to complain that as a single mother there are debilitations. So is this what the Department of Health claims to be, a ‘level playing field’, or is there another side? You see, Dr Roshana Mehdian did not convince me of her side with: ‘when childcare costs are spiralling and access to out-of-hours childcare is limited’, in that same light, it took two to tango, so why is the child not with the father? If there is true gender equality that question is fair and valid. Of course, reality tends to be not in equal measure and we would accept that, but in all this when we see the pressures in the medical profession, it makes sense that having an equal weight responsibility means that in the medical and legal profession, having a child will impact your value on that market, merely because your head was not in the game, for 15 hours it was with your own bundle of joy. That premise is valid, it will make massive sense for some to start a family, but in equal measure it means that it will either cost you a family or a career. We have come to the stage that both is no longer an option, especially as a single parent. From my personal viewpoint, raising a child is a career all in itself. Now answer the following question honestly: “How can you have two careers and do right by both?”

An answer not easily given, because it is not an easy question!

What is a matter of concern is that the political parties (on both isles) have taken certain stances, both are debatable and both have had little options and the shortage that was strangled upon these parties is equally a problem. By trying to maintain a medical elite in the UK, the balance shifted. You see, when we consider the Social structure within the United Kingdom as it was, where the upper class included the barristers, judges, dentists and doctors, yet were also in the middle class. We see a shift after WW2, so those who were in the high field tried to keep themselves and their family in that higher echelon, therefor rejecting fiercely a foreign infusion of highly needed talented workforce. After WW2 this became a shift towards a services-dominated economy with additional mass immigration. The medical profession, due to unrealistic standards saw their workforce diminish over the last 10 years giving us the issues we see nowadays. Consider the following response “I wrote my exam on 12 Dec 2015 and got my result 24 Dec 2015. I promptly went online and started the application and 2 days later I got the Pearson Vue testing reference number and booked and paid $280 for the computer based Test of Competency. I could have sat this next week but I chose to sit it on 2 Feb to give myself more time to practise as I can’t afford to fail. So far the process has been really smooth and quick“, another voice was a lot less positive, but there could have been a clear issue of timing involved. Overall the issue remains that by making a transfer of knowledge so hard, especially as some applicants have degrees in Commonwealth nations, it seems to me that some players are trying to dampen the influx of foreign talent, which is just my personal view in all this.

This path could have been smoothened out by the politicians a long time ago, but it seems that schooling and re-schooling nurses does not sound as sexy as a new innovative IT system (which didn’t work anyway). Last I get to that list of 4. The first one is old news now, but 11 billion is a lot to lose and it has to come from somewhere. The second one is one that can be dealt with. If the patient misses two appointments, they can either pay a penalty fee for not cancelling in time. Cancelling an appointment is just a phone call away. If you forgot it, there is a fair assumption that there was not a pressing medical need (I know the ice of that statement is very thin). In all this we must realise that doctors work ungodly hours, so steering clear from giving them additional pressures seems to be a given first. A task at which, as I personally see it, Jeremy Hunt failed miserably at present. The third in my list is the one I would give A&E a pass for. My reasoning is that the skewed scale that A&E works with has not been properly adjusted for growth in patients and stagnating staff numbers. We get these numbers from http://www.parliament.uk/briefing-papers/sn06964.pdf, where we can see in the introduction and the summary that the title ‘Accident and Emergency Statistics‘ is ever so slightly misleading. I wonder what Carl Baker had in mind with this paper and what purpose it serves. It seems to ‘focus’ on the +4 hour people way too much. The one summary number that does matter is ‘There were 4.0 million emergency admissions to hospital via A&E in 2014/15 – up 4.8% on the previous year’, which only paints a partial picture. You see, ‘Chart 2: Annual A&E attendance, England, 2004-2015‘ seems to tell the story, but other ways could have been more explicit to deal with the issue. Over a period of 10 years, the attendance of the minor injury units nearly doubled. Yes it doubled! The major injury unit also rose, but not by a large part, although, from just over 13 million to close to 15 million is still a growth that is not to be ignored. This report ‘writes it off’ as a mere 10%, which still amounts to 1.4 million additions. Yet in all this staffing levels are not addressed at all, leaving this ‘work’ with some uneasy questions. What I like the most is the disclaimer at the end. “This information is provided to Members of Parliament in support of their parliamentary duties. It is a general briefing only and should not be relied on as a substitute for specific advice. The House of Commons or the author(s) shall not be liable for any errors or omissions, or for any loss or damage of any kind arising from its use, and may remove, vary or amend any information at any time without prior notice”

So how does staffing levels in answer to 4 hour waiting times not assist? From this I must question what the Rt Hon Jeremy Hunt MP had in mind with this writing? From my point of view, a bad paper does not make the NHS look bad, it makes the Secretary of State for Health look bad not less good than he should look, especially as he should be fighting for the plight of the members of the Department of health, a side I have yet to see at present. He has been called a lot worse by many, it seems unproductive to go that way. What is matter of urgency is the fact that the Prime minister needs to ascertain if Mr Hunt is the right person in the right place and if not, he needs to get someone there that will take the side of the doctors and fast, because at present they do have the power to let it all collapse, and woe be onto the administration that is governing when that happens.

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Filed under Finance, Law, Media, Politics

Tagged as Boris Johnson, Carl Baker, Cleo Watson, COGPED, David Cameron, Department of Health, Dr Roshana Mehdian, Emma Watson, Jeremy Hunt, Michael Gove, NHS, UK

March 27, 2016 · 23:00

The excuse from a failed politician

The NHS has been in the news more than once as it is an important issue. It is today’s article in the Guardian that is a much bigger issue than most people will realise. Let’s take a look at the issue. The title ‘NHS would be put under threat by Brexit, says Jeremy Hunt‘ (at http://www.theguardian.com/politics/2016/mar/26/nhs-under-threat-from-brexit) is only the beginning.

To show you part of this we need to look at this part by part. The first part is shown at the very beginning “The National Health Service will face budget cuts, falling standards and an exodus of overseas doctors and nurses if the UK leaves the European Union, health secretary Jeremy Hunt has said“, which gets my initial response ‘Let me play the worlds tiniest violin for you Jeremy! Why don’t you consider an alternative job like in a taxi or perhaps become a barber, it’s just a suggestion!‘

Is my response to harsh? In this light, which should always be considered, we need to state the following:

The NHS will always face budget cuts, Brexit is not a factor in that reality. Remember that the NHS works off the UK national budget, which is under pressure to say the least, the EU donation not being the smallest expense in all this.
Failing standards if Brexit happens. This might be the most ludicrous reasoning. Ludicrous because standards are either being met or not and at present from several sources they are not being met, the EU seems to be setting unrealistic high requirements in some cases, requirements that many nations are failing, it should be about British standards, they should be the highest and they should be met, EU be damned (and all that).
An exodus of overseas doctors and nurses when Brexit happens. This could have been an issue, but it was clearly stated in my blog ‘The News shows its limit of English‘ (at https://lawlordtobe.com/2015/06/22/the-news-shows-its-limit-of-english/), where I showed how both Sky News and the Guardian were basically fucking up and creating unneeded panic. That article called ‘New immigration rules will cost the NHS millions, warns nursing union‘ showed the lack of investigation by both news sources as the UK government had published clearly in section 79E ‘is expected to demonstrate that he is being paid either at or above the appropriate rate for the job, as stated in the Codes of Practice in Appendix J‘, the nurses are clearly mentioned and the expected income as set out in the charter.

As I see it, I had to explain that to the press in my article on June 22^nd 2015, so why would Jeremy Hunt state option C? In his defence, some people might be nervous if the UK leaves the EEC, yet a British passport is one of the most revered ones on the planet. So any non-EU medical employee would do a lot to gain that status and the UK government has done its share of keeping these highly qualified people interested in staying in the UK. So tell me, why is Jeremy giving us part C?

He actually gives us a decent answer through “Hunt argues that, with the NHS budget already under huge pressure, funding levels can only be maintained if the British economy remains strong“, it is only partially an acceptable answer as the NHS has been a mess for almost half a decade now, so these issues had been known, even if Brexit is an additional element, the danger of Brexit had been a fact for at least 6 months, that is, the chance of it becoming a reality, so the consequences of diminished economy has been an element for almost a decade. Even as the UK had been fortunate, the dangers of a receding economy have been a danger for the larger extent and when we realise that other EU nations have not been this fortunate, we should see that part in the light of ‘Jeremy hunt has had an economic advantage until now’. Not being ready for that risk is clearly a failing of health secretary Jeremy Hunt (as I personally see it).

After that he then kicks in his own windows when we read “He cites a series of economic surveys, including from the CBI as evidence of the adverse impact of an exit on the UK economy“, the CBI survey, which was an absolute joke, as shown in ‘Is the truth out there?‘ (At https://lawlordtobe.com/2016/03/21/is-the-truth-out-there/), it makes for a decent read and shows how the CBI survey could be seen as another chapter from one of the most famous books in statistics called ‘How to Lie with Statistics‘ by Darrell Huff, a 1954 publications that shows us never to ignore the classics.

The quote: “Hunt suggests that progress the government is making in employing 11,000 extra doctors and 12,000 more nurses will be threatened and warns of the “damage caused by losing some of the 100,000 skilled EU workers who work in our health and social care system”. Some could leave because of uncertainties over visas and residence permits, he suggests“, which again I consider to be a load of (the word starts with a ‘B’ and ends with ‘locks’). There shouldn’t be any uncertainties on visas or residency permits and offering that even as a suggestion makes (again, in my personal opinion), Jeremy Hunt unqualified for his present position. It is his job to create calm and take stress away, not to introduce additional stresses to an area where he already failed, in addition to these points I am raising, personally, as a conservative. I believe that there are questions on Brexit and to be against Brexit might be the party line, but there are too many questions regarding the European Community, there are conservatives who seem to support Brexit. For one there is Lord Chancellor Secretary of State for Justice Michael Gove, who gave his reasons at http://www.independent.co.uk/news/uk/politics/eu-referendum-michael-goves-full-statement-on-why-he-is-backing-brexit-a6886221.html, that part is not up for discussion. The only quote in all this is “The EU is an institution rooted in the past and is proving incapable of reforming to meet the big technological, demographic and economic challenges of our time“, which applies to the NHS because it is facing both technological and economic challenges already. The Labour party bungled the option to get part of the technological solution implemented that could have helped the NHS (perhaps you remember the loss of roughly £11.2 billion in NHS IT restructuring).

My issue in all this is that (again, as I personally see it) Jeremy Hunt is not much of a visionary, which means that as expected, he will follow the party line as any governing body needs to adhere to. Yet in all this, scaremongering is the wrong approach. We need to be the enlightened party, the leaders that give rise to inspiration by properly informing the people. The growing problem for the Conservatives is that like Michael Gove, more will see that the EU has stopped being a solution. Many will not be as eloquent as Michael was in his essay, as printed by the Independent. This does not matter if we are united in finding a solution. My big worry is that scaremongering is a dangerous tactic. It is also the wrong one to make for the reason that enlightening the audience creates trust, needlessly scaring them will only drive part of our party towards UKIP (or Labour), a choice that is a lot more dangerous! To govern one must be elected and the view given at present is not that encouraging.

Stephen Dorrell, the former health secretary and ex-chairman of the Commons health select committee gave us this “EU research programmes and single market legislation have greatly strengthened European cooperation in this area with substantial benefits for both healthcare and employment in the UK. It is a simple fact that Brexit would put all this at risk“, which we might see (initially), as a fair enough statement. Yet in my view, the information could be regarded as incomplete (read: speculative view). You see, when we consider Stephen Dorrell, Healthcare and Public Sector Senior Adviser to KPMG in the UK (at https://home.kpmg.com/uk/en/home/contacts/d/stephen-dorrell.html), we need to consider what KPMG could lose, apart from the NHS £1 Billion revenue solution, as one might phrase it. When we re-consider the info the Guardian gave, which is correct in the view that NHS funds will find cutbacks, KPMG has a clear danger that it will reflect on their 10 figure deal, all in pounds and a lot less on medical staff. This gives an additional weight to the view that Stephen Dorrell did not give all the information, because there is a lot more, not on the hands of Stephen Dorrell or in the hands of him mind you, but in the hands of his friends (read: associates), possibly with KPMG who are realising that Brexit will impact their juicy pharmaceutical profits, with a growing chance that India could move more and more into the UK pouch of generic medication and the expenditure cutback solutions they bring. Now, reader be warned, there is a fair bit of speculation here (the part about India), that speculation is partially because I think there are long term solutions here for the Commonwealth at large, partially because it seems to me that I (and the public at large) have had enough of fat cats (especially pharmaceuticals) avoiding taxation to the degree they have whilst selling overpriced solutions, that are being re-patented again and again.

The list of misinformation appears to be growing and I am trying to offer resistance, because my party should be better than that! After all, we aren’t the Labour party!

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February 20, 2016 · 12:25

Omphalos and its syndrome

This syndrome comes from the references of Delphi and the ‘navel of the world’, which is what Delphi was regarded as. Nowadays, we see Omphalos syndrome as the misguided belief that a place of geopolitical power and currency is the most important place in the world.

I believe that to be no longer correct, I believe that it has been ‘converted’ into something slightly more generic. I believe that it should be seen as ‘the misguided believe that its choice of management and achievement of profit are the most important in the world’. Let’s take a look at a few examples.

A is for Apple

‘Apple apologises over Error 53 and issues fix for bricked iPhones’ (at http://www.theguardian.com/technology/2016/feb/19/error-53-apple-issues-fix-bricked-iphones) shows the first example. The entire error53 mess is a direct example. It goes on to the core that we now see “Apple has released a fix for users affected by “Error 53”, a software issue that rendered useless iPhones that had had their home buttons replaced by third parties“, The initial response “At the time Apple said that Error 53 was a security feature to protect customers” reads like a joke. The mere alternative that was open was that any non-Apple certified method meant the wiping of data would have been enough. It took me 5 minutes to come up with that solution. A mere auto wipe of all data. No we have to read quotes like “Apple has apologised for Error 53 and said customers who paid for an out-of-warranty replacement for their phone should contact AppleCare about reimbursement” as well as “Solving Error 53 does not re-enable Touch ID, as a third-party replacement of the home button could potentially allow unauthorised access to a locked phone by modifying the fingerprint sensor“. It would have been the simplest of solutions to go through the re-enabling system again. All these simple solutions, all because apple wanted to enforce the repairs of their phones to what they consider to be THEIR allowed service repair shops. An application of greed, to maximise profits, not the openness of what was once the Apple OS X through a Unix open source system, but the mere stranglehold of a greed driven corporation. It was brought to light by several articles in the Guardian and an initial customer service based solution comes “after widespread publicity and the Californian tech giant being served with a class action lawsuit over in the US and attention from a competition watchdog in Australia“, I wonder how many IOS people will start considering Android now.

E is for Eisai

This event is taking us back a fair bit, around 2000 Eisai came with its Alzheimer’s drug Aricept (donepezil). The fact that profits grow by 100% might not be the biggest thing on the planet. Yes when the LA Times (at http://articles.latimes.com/2012/mar/22/health/la-he-aricept-fda-20120323) reported “FDA officials should not have allowed it, the authors said, because the clinical studies Eisai offered in support of its application did not meet standards the agency itself had laid out“, in addition we see “it failed to yield the improvements that the FDA had set as a condition of approval“, in all this a clear investigation did not take place. It is still allowed, mainly because it is FDA approved. We see in other sources the claims like “Further, the higher dose was not superior on either of the pre-specified secondary outcome measures, which, as the FDA medical reviewer pointed out, argues that the cognitive difference was not meaningful“, which we get from the FDA Center for Drug Evauation and Research. Application number 022568: medical review. Aricept 23 mg tablets. (at www.accessdata.fda.gov/drugsatfda_docs/nda/2010/022568Orig1s000MedR.pdf), when we consider the source http://www.nhs.uk/news/2015/10October/Pages/Cheap-Alzheimers-drug-may-help-keep-people-out-of-care-homes.aspx, where we get the quote “a year’s worth of donepezil costs around £21 a year, compared with a year’s worth of care home costs – estimated to be between £30,732 and £34,424 a year. If the results of the study were replicated at a population level, this could save the NHS a considerable sum of money“.

This is where we see another version of Omphalos syndrome, “the misguided believe that my version of cost cutting is the best in the world“, at this point, we should investigate the players and consider whether a case for criminal endangerment exists. The fact that sources have shown ‘evidence’ as per 2007 gives rise to a failed system, not just the NHS, but the leeway for pharmaceuticals as, from the given reports failed to yield the improvements that the FDA had set as a condition of approval, making the question why on earth was it approved at all and why are certain diseases used for marketing a cash cow, more important why is the NHS not loudly and outspoken dealing with this? Especially as www.NHS.UK is involved in promoting articles in favour of Aricept (donepezil).

I is for Insight Enterprises

This is a side that rests with Omphalos, yet in all this it is in equal measure a situation we must accept. Insight Enterprises did nothing wrong, it made a choice, it’s governing body stated ‘this is the best path, this is the golden solution’, we must accept that any governing body, being it corporate or governmental will be ‘smitten’ with Omphalos Syndrome. So as Microsoft changed the partner program in 2014, Insight Enterprises saw the filling of its corporate coffers trickle down to zero. (at http://www.crn.com/news/channel-programs/300079674/insight-enterprises-absorbs-another-hit-after-microsoft-partner-program-changes.htm). We can debate the mess Insight Enterprises received, the near simple answer is that Microsoft had to change programs, any large corporations will do that. Any program they offer and device tends to be ‘fluidic’ over time. Yet when we see the quote “The changes also affected Microsoft’s Licensing Solution Providers, like Tempe, Ariz.-based Insight, which are the only partners Microsoft allows to sell licensing agreements to large corporations“, which is now showing another side. Does this make Microsoft narcissistically selfish or just plain sociopathic? You see all narcissists are selfish, but not all selfish corporations are narcissistically in nature (which is proven as greed we put the greedy in front of a mirrors), yet in all this, is this a sociopathic side in Microsoft? Well, that is a debate for another day as the entire Omphalos topic would soon get too murky.

O is for Omphalos

As shown in the last example, we tend to see Omphalos in a bad light. Which is not all correct either. On the other side we can take Bill Gates and his Omphalosian approach to IT. This got us DOS and later Windows. On the far side of the scale of limiting, there is the view of the truly visionary, but that view needs a start. Here the Omphalos syndrome works in another way. As I see it, we can accuse Bill Gates, Steve Jobs and Larry Ellison on that list. Yet, we only did that AFTER they became successful, the not so successful are usually never heard of again.

In this world today, the foundation of ‘the most important place in the world’ is less and less applicable, it becomes a world of solutions, an amalgamation of aggregated values (the European Economic Community being a nice example). Yet the foundation of how to go about it was done in a very Omphalosian way. Especially when we consider the past blogs on how only self-proclaimed departures were the option. Which is exactly where Brexit is now. As Brexit gains momentum we see that the Omphalosian solution was the most dangerous here, it took one of the smallest nations (Greece) to push their non-accountability for the entire EEC to be in turmoil, with now a decent chance of collapsing the EEC as well as the Euro as a coin. Even as the United Kingdom is not on the Euro, France is and a Brexit will soon push for an additional Frexit. In that regard, the Financial Times quoted Florian Philippot who stated “the idea of challenging greater EU integration had become “taboo” in Europe. “The more we talk about it, the more people will vote against it,” he said” (at http://www.ft.com/cms/s/0/58f9cc98-ce51-11e5-92a1-c5e23ef99c77.html#axzz40fDAW3BL). This is yet another side of Omphalos, actually two sides. The foundation of Omphalos is based on one view, if that view does not evolve or alters as time goes by, that view becomes less and less actual. The view becomes an act of obstruction at best and debilitating at worst.

In the second part, we have forever seen the Omphalos syndrome in its power core on the scope of government (read: Communistic), in that view we forgot that it is corporations with their view on the ‘only’ solution that is now impacting the lives of people in several (read: many) nations. In that same view we see that the old approach to currency is no longer the same. Most values are too dependent on independent views of static organisations and their push for changed industrialisations. How come that the value of a coin is now directly impacted by places like Dow Jones index, Nasdaq, Standards and Poor, the IMF, the ECB and so on? Governments allowed themselves to be directly be valued from what is perceived to be an ‘independent’ side. This is the other part that drives Brexit and other plans to no longer be part of anything. There is a near global consensus that these sources can no longer be trusted. That their view is to some extent ‘Greed Incarnate’.

As I see it, there is no true independence anymore. When we read that Eagle Capital Management Invests $293000 and that J. W. Burns & Company Has $533000 invested in in SPDR Dow Jones Industrial Average ETF (DIA). When the index itself is invested on, the expectations of improved value must be met, where does that leave us?

U is for You!

Even when we see the old and the new versions of the Omphalos syndrome, we need to realise that what once seen as short-sighted and limited is now not so limiting. It remains (as I personally see it) as short-sighted as it ever was (only in the rarest of occasions is it visionary), but now, the impact is no longer limited to one government, now its short-sighted impact is nearly global. It hits parties in many nations and it does not stop there. You see in a governmental approach it is ‘set’ to be what is best for its citizens and in case of the EEC it is what a group of nations see. Now consider the application from corporations that impacts governments on a global scale, offices of standards that impact the dangers to lives on a global scale as it does not enforce its own given values. How can we be aligned to a limiting view that could cost us our lives and our choice of living?

So as you consider ‘the misguided believe that its choice of management and achievement of profit are the most important in the world’ also strongly consider what it will cost you, not now, but down the track.

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February 17, 2016 · 20:56

Behind the smiling numbers

An interesting story got to see the internet light by Nicholas Watt (at http://www.theguardian.com/society/2016/feb/16/income-tax-must-rise-3p-to-stop-nhs-staggering-from-year-to-year). The title ‘Income tax must rise 3p to stop NHS ‘staggering from year to year’‘, which implies initially that the NHS needs £1.95m, which might be OK. Yet the truth is far from that, the text gives us that Lord Kerslake stated “Income tax will have to increase by at least 3p in the pound…. “, which is another story entirely (and first evidence that members of the House of Lords are gifted with a decent sense of humour).

His lordship is quite correct when he states: “big questions needed to be asked to ensure that spending kept up with medical advances, an ageing population and the need to invest in hospitals“, yet these are mere facts that should have been asked almost a decade ago, there was a clear and near immediate danger to the health of the NHS. The logic we see after that becomes an issue (read: worry, concern, and both are debatable) “Health spending needs to rise at least in line with GDP. Arguably, we may need to go faster if we want to match European funding. You might argue there is a discount there because we have a more efficient system. But it’s got to be at least GDP-linked otherwise I don’t think we’ll get there“. So let’s take a look. First the Dutch version (at http://www.rijksbegroting.nl/2015/voorbereiding/begroting,kst199401_25.html) gives us two issues should we be willing to ignore language barrier. The BZK gets €71.3b, which is divided in €7.5b called budget financed expenditure and €63.8b from premium financed expenditures. So for argument sake, let’s take the total and divide that on a population of 17 million, this now implies that there is almost €4200 per person (remember that this is a terribly rough estimate).

Now for Belgium we get the VBO with €23.85b. Now we all know that Belgium is a much smaller nation (not that much smaller than the Netherlands in size) and with 11.5 million calling the Belgium nation their homestead we now see that they end up with €2075 per person (Rounded upwards). Perhaps his Lordship could give a slightly more detailed explanation for the remark “Health spending needs to rise at least in line with GDP. Arguably, we may need to go faster if we want to match European funding“. Considering that the Netherlands and Belgium are next to one another and their budgets per person are apart by a mere 49.404%.

This gets me to the core of the proclaimed matter, can anyone explain why we are linking healthcare to GDP? Perhaps, and this is merely a lose speculation, some people in the House of Lords had the time to read a paper by Santiago Lago Peñas (added at the end) called ‘On the relationship between GDP and Health Care expenditure; A new perspective‘, now that might be a good thing, there is nothing wrong with Spain taking the lead in matters (especially if it is a good idea). Santiago Lago Peñas as well as David Cantarero Prieto and Carla Blázquez Fernández have written an interesting paper.

First let’s take a look at part of the abstract, which states “Econometric results show that the long-run multiplier is close to unity, that health expenditure is more sensitive to per capita income cyclical movements than to trend movements, and that those countries with a higher share of private health expenditure fit faster and following a different pattern“. Now, I am not going to take a deep dive into this one (it is after all an abstract), but it gave me a few ideas on where to dig.

Next are a few quotes: “Attention is paid to several usually neglected dimensions of this link. With this aim, four different specifications are presented, with the logarithm of per capital total health care expenditure as the dependent variable in all cases” this doesn’t seem to be more than just a quote, but it will have impact down the track.

It is part 2 called previous evidence that is a first issue. When we accept the initial statement “the debate on this link has moved on whether the income elasticity of health expenditure is greater or less than 1 (Bac and Le Pen, 2002). An income elasticity less than 1 classified health expenditure and income inelastic, therefore, as a “necessary” good. On the other hand, if the elasticity is higher than 1, health will be classified as a “luxury” good“, which will do for now. You see, my issue is when we see the part that follows:

The seminal paper by Newhouse (1977)
An earlier study by Kleiman (1974) for a different set of countries
Leu (1986) using cross-sectional data for 19 OECD countries in 1974
Parkin et al. (1987) using similar methods and data from 1980
Brown (1987) using a sample of 20 OECD countries

Here we have the first issue. You see, this is not regarding the methodology, it is about the data, methods of data collection, usage of weights (if done), these numbers regarded in contrast towards those temporary populations in reflection to the whole. Health expenditure is one part, but based against which healthy part. Now consider the initial reflection I had on the Netherlands and Belgium. They have very different norms in respect to mental health care. Now consider the statements ‘19 OECD countries in 1974‘ and ‘20 OECD countries in 1987‘ I will again make a clear speculative declaration that the mental health norms are not equal, especially when considering economic differences, which gives my first thought, how useful is the paper on a whole (I am not attacking it) and how applicable this would be (read: could be) in reflection towards the whole.

You only need to scan for ‘psychology, psychiatry and mental health’ to see that the paper does not take this into consideration. As we know that the EEC nations have had their own approach to mental health in the past, is not a statement that they did anything wrong, but if this is the first element that does not align, what else will not align (there are a few). One that shines directly behind the ‘previous evidence‘. You see in my head the question comes to mind when I see “The econometric analysis relies on annual data for 31 OECD countries from 1970 to 2009 gathered from the OECD Health Data Set 2011“, so is this aggregated data or raw data. if it is aggregated data the foundation might not align giving an unbalanced and invalid view (in my personal opinion), if it is raw data, what ground line data (the full population) is added so that the individual record compares towards the national whole, if that is missing how can any calculation be truly reflective of what was, especially taking into account the data is reflective over different time zones with very different social pressures. In that case I wonder if I can get a similar result by calculating Z-scores and run a Crosstabs in IBM Statistics #JustSaying!

Now we get back to the article which comes with the image of a smiling Lord Kerslake. Does this paper validate or invalidate the idea? No it does not, but it leads to questions, serious ones.

The quote “John Appleby, the chief economist at the King’s Fund, has estimated that NHS spending is due to fall from 7.3% of GDP to 6.6% in 2020-21. If health spending were to keep pace with economic growth, Appleby estimates an extra £16bn would have to be found every year by 2020-21 to take the NHS budget to £158bn. This works out at 3p on all rates of income tax, according to the IFS” is next!

The term ‘NHS spending is due to fall‘ reads like an event Baron Munchausen could have come up with (the character from Raspe’s book in 1785, not the syndrome). Of course the prediction is 5 years away, which makes it speculative. Now we know that John Appleby is more than the Chief economist for The King’s fund. He is also a Visiting Professor at the Department of Economics at City University and he has a whole range of publications to his name, so why am I opposed?

Well, part of this starts with his own article ‘Social care: a future we don’t yet know‘ (at http://www.kingsfund.org.uk/blog/2015/11/social-care-future), the two quotes that get the foreground are “In our submission to the Spending Review we called for social care to be protected from further cuts and for the money previously agreed for the postponed Care Act funding reforms to be retained and invested in social care. But non-protected departments have been asked by HM Treasury to model cuts of 25 and 40 per cent – so further cuts seem inevitable“, as well as “What would happen if the spending cuts applied to social care over the past five years continue over the next five? Spending on social care for people of all ages as a share of GDP has already begun to fall. It was roughly 1.2 per cent in 2009 but if cuts continue at the same rate it will have halved by the end of this parliament to barely more than a half of one per cent of GDP“. Now there is nothing wrong with any of the texts, John Appleby is not where he is because he is silly, he is very (read: extremely) clued in. I am stating that the environment has changed, it has changed drastically from 2011 onwards and in addition; the changes the UK faces over the next three years will take some of these prediction to town in not so nice a manner.

You will now ask why, which is the question you should ask!

We get part of this from the London School of Economics and Political science (at http://cep.lse.ac.uk/pubs/download/special/cepsp26.pdf), the initial answer is given on page 13. Where we see “To summarise, treatments for the “common mental disorders” of depression and anxiety can be self-financing within the NHS. By spending more, we save even more. This is different from much of NHS expenditure. At the same time we relieve one of the main sources of suffering in our community“, in addition page 15 gives us “According to the 2007 survey, which covered a random sample of households, only 24% of people with depression and anxiety disorders were in any form of treatment“. This now gives us the first part in all this. The overall costs are not in league of the budgets because there is a missing foundations of equality on what falls ‘within’ the NHS. There is no option for the NHS other than to evolve into something ‘more’ complete. The UK is about to get 20,000 refugees from war torn Syria (over several years), the initial approved £1b seems to be nothing more than a drop of water on a hot plate, the ‘why’ will be clear shortly.

The UK has seen a massive rise in mental health issues in the last year alone. Depression and anxiety mainly due to economic events (cost of living) is now a serious concern, especially as the pressures of the economy are likely to continue a few more years. Consider my article two days ago (at https://lawlordtobe.com/2016/02/15/is-there-a-doctor-on-this-budget/) called ‘Is there a doctor on this budget?‘ where we saw the link to ‘Health Care for Undocumented Migrants: European Approaches‘. The graph shown on page 3 is the charm. If we consider the cube, we see that on the X-axis we see subcategories of undocumented migrants, yet the same expenditure would apply to refugees (or the population for that matter). Now consider the Y-axis which is about the type of services and the Z-axis are the funding arrangements. Now this can be treated like a glass with liquid. If we increase the base (X or Y) the funding arrangements go down, it is the simplest of physics, a bigger glass requires more fluid to fill, so we have a population with more health care needs, mental health care in this case and the types of services is not just against depression or anxiety, it will require the coverage of war trauma and shell shock. This will impact refugees of all ages. So the glass gets bigger and bigger and more and more funding will be required to keep funding arrangements on an equal level, this is merely the application of logic.

This is why I opposed John Appleby’s approach, it shows little application of a changing population, merely a greying one (which is a form of change), but it does not hold water against the massive change the UK has faced since 2013 and will face until 2019. This is why I am not in agreement with the statements of John Appleby. Now we get back to Lord Kerslake. You see, the paper I mentioned is an example. It might not even be the foundation of Lord Kerslake’s approach. Yet a multitude of papers clearly show that there seems to be no real no equality in the setting of healthcare (read: cost of health care). It seems to be wearing a different hat in nearly every European nation, it would already be a great leap forward if they all had the same colour, which does not seem to be the case either.

Now we get the quote that wakes us all up “Appleby estimates that NHS spending would have to increase by 30% or £43bn a year to take NHS total spending to the EU-15 average by 2020-21. The IFS estimates that this would involve an 8p increase on all rates of income tax“, which is one side of the option. How about the other side? When we see that AstraZeneca has been able to avoid corporation tax on a massive scale, which dwarves when we compare it to the mergers Pfizer and Allergan have achieved. Is it perhaps possible that his lordship looks at another solution like closing that tax abyss? Might I suggest an idea where any corporation involved in tax avoidance gets its medication ‘grey’ listed? Which means that any drug that could be begotten in a generic form from a place like India will be selected as a first solution? It could even result in India starting businesses in the UK (with the economic benefits that those places will give). It would also send a clear signal that if corporations would like to avoid taxation, which in legal correct way is just fine, but at that point other distributors of pharmaceuticals will be found. I reckon that between that announcement and the offer of reduced medications (read: less costs for the NHS) from pharmaceutical firms would be forthcoming within 24 hours of making the announcement.

Yet, this was not about the costing, it was about the increase and setting against the GDP. The fact that health spending and economic spending are on par reads more like an option for deferred payments to big pharma and medical supplier than anything else. In case of doctors it would mean that their incomes would go through the roof (which might be a deserved reality), but it is one that the coffers under the care of George Osborne cannot afford.

There is wisdom in his lordship stating that “a royal commission should be established to build a national consensus on NHS funding“, which sounds a lot more ‘reliable’ (read: acceptable) than the Labour party giving way by letting a banker (Sir Derek Wanless) set the NHS spending levels. It is of course desirable to go with the people and keep the directly funded NHS free at the point of use, yet that comes with a price tag that is no longer realistic in this day and age of deficit, in addition harder times are coming for a while longer, making the price tag we already have a non-linear shifting one. Yet I feel adamant to speak that mental health must be fully accepted as part of the NHS (for all people, anywhere in the UK), which slides the scales of budget by a lot. A reality many papers (as I expect it to be) did not take into account. Raising income taxation as implied could equally be an issue as that could potentially drive depression and suicide statistics overnight (the latter would lower rents but that seems just too harsh a solution).

What is a given is that Lord Kerslake is the catalyst that is making us ask several serious questions.

I am however not entirely convinced that his lordship took the best path in getting these issues out into the open.

On the relationship between GDP and Health Care expenditure; A new perspective

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February 15, 2016 · 21:33

Is there a doctor on this budget?

The title ‘Is this doctor (and Ukip candidate) right that EU migrants will destroy the NHS?‘ seems inflammatory to say the least, but the reality is actually a lot less appealing. Even when we see today’s article: ‘NHS vows to transform mental health services with extra £1bn a year‘ (at http://www.theguardian.com/society/2016/feb/15/nhs-vows-to-transform-mental-health-services-with-extra-1bn-a-year), the quote “People facing mental health crises will be able to get community care 24 hours a day, seven days a week as part of the biggest transformation of NHS mental health services in England for a generation, to be unveiled on Monday“, that quote now reflects back to the initial NHL article. There we see that Professor Angus Dalgleish is giving us another view: “He says the NHS is on its knees and “could collapse completely” because of immigrants from the EU that we are legally obliged to treat“, so even as the Guardian is hiding behind the identity ‘Pass notes‘, there are issues. The first is the unintelligent trivialisation by ‘Pass notes‘. The quote “Eighteen British hospitals made £42m from people coming here for treatment on 2010” is just too ridiculous to be considered valid. I am not stating that it is a lie, but consider that the NHS budget is set to be around £115b for 2015/2016, that £42m amounts to roughly 0.000365%, so how insignificant is that trivialisation? Especially when we consider that many papers (including the Guardian) reported the NHS to be £1.6b in deficit, so there is an issue already.

Now we get the next step.

From several sources we see that refugees are coming. That is not an accusation, or negativism, it is merely factual that over the next 5 years 20.000 refugees will arrive. Now consider that these people come from actual devastated locations, on a horrendous trip that has lasted years (including their stay in refugee centres) to get to the UK, if only 75% needs mental health care, the UK should be thanking their lucky stars. So that £1bn will not last too long, especially considering the current population is in dire need of mental health in one form or another. So as ‘Pass notes‘ complains the quote “But I expect doctors to be liberal! By which I mean intelligent! By which I mean liberal! We expect much. And sometimes we are disappointed“, which is just the Guardian showing that its own values are not set on intelligence. The NHS itself states: “However, if you are now living in an EEA member state and pay into a state healthcare scheme then you are entitled to apply to that member state for an EHIC. Under EC law, this entitles you free of charge to ‘all medically necessary treatment’ here, which provides a greater coverage than that mentioned above since it includes routine treatment for chronic conditions such as diabetes“, which gives way to the claim that Professor Dalgleish is making. In addition the National Health Service Act 2006, section 83 states that “all reasonable requirements to provide or secure necessary primary medical services for all patients, irrespective of their immigration status, within their areas” must be met, this is a legal duty for the primary care trust as reported by the Primary Care Commission (at https://www.pcc-cic.org.uk/sites/default/files/articles/attachments/pcc_briefing_-_illegal_immigrantsv6.pdf), which now implies that Professor Dalgleish has indeed reported an issue that the Guardian casually trivialises. Yet, we must also ask, what if the Guardian is correct? Well, section 83 of the National Health Service Act 2006, literally states at s83(1) “Each Primary Care Trust must, to the extent that it considers necessary to meet all reasonable requirements, exercise its powers so as to provide primary medical services within its area, or secure their provision within its area“, which bakes the cake on one side. The issue is however not done, it is about to get a lot ‘worse’, because s83(2)(b) gives us: “A Primary Care Trust may (in addition to any other power conferred on it) make such arrangements for their provision (whether within or outside its area) as it considers appropriate, and may in particular make contractual arrangements with any person“, which now gets us two elements:

Make contractual arrangements with any person, which also implies that it could be a contract set at £0.00.
Arrangements for their provision (whether within or outside its area), which now implies that the Primary medical services can transfer a refugee or illegal immigrant to psychological care and/or specialised mental health clinics.

So ‘Pass notes‘ is not reflecting on the dangers that Professor Dalgleish was trying to illuminate. More important, these issues have been known for some time. Issues on these elements have been illuminated in plenty of publications going back to 2012. There is even more information at http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2012/Dec/1650_Gray_hlt_care_undocumented_migrants_intl_brief.pdf, yet overall they tend to give the same reflection, especially when you look at page 3, where the cubic impression titled ‘Exhibit 1. Three Dimensions of Health Care Coverage Policy for Undocumented Migrants‘, gives rise to the massive growth of costs that could be associated with migrant health care (not to mention due to incoming refugees).

So how much valid weight can be given to the statements of Professor Dalgleish? I personally believe that the weight of his statements should be weight on a debatable high level (evidence to follow at the near end). The issue is not just regarding the costing the immigrants and refugees bring, the fact that the Euro systems is wreaking havoc all over the world is an equal concern. I cannot state for certain what will be the best path, what is a given is that trivialisation was never an option.

When we add ‘Jeremy Hunt on the NHS: ‘I think this decade needs to see the quality revolution’‘ (at http://www.theguardian.com/politics/2016/feb/15/jeremy-hunt-on-the-nhs-i-think-this-decade-needs-to-see-the-quality-revolution) to the fold, the plot thickens. You see, quality revolution sounds fair and essential, it is in fact at resent likely the least important part. There is a massive shortage of medical professionals, there is a lack of funds and that lack can be sized into the billions. This implies that quality, though nice is nothing compared towards the lack of resources. Which gets us to the Junior Doctor contracts. You see the quote “none of the 152 foundation trust hospitals in England will be obliged to force their junior doctors to accept the deal and can instead offer them better terms“, which gets us back to that massive deficit and more important, what additional pressures will be added onto it?

That is a part which has been known for a while, I voiced it at least 2 years ago and the current investigation that the BBC gave visibility to in January 2016 (at http://www.bbc.com/news/uk-scotland-scotland-politics-35361908) is still centre in all the issues that will come. You see, without a proper IT system, the NHS will have less and less options to streamline any solution, with that I mean larger operational matters for streamlining. Even as Tavish Scott (Lib Dem Scotland) asked on who got figuratively axed, we got the answer: “The chair of the board is no longer there, the chief executive is no longer there and the chief finance officer“, a very unsatisfactory answer. When we consider “he was not informed of a ‘fundamental flaw’ in the system being delivered for 22 months, adding “other, more junior staff were aware of omissions” in the contract, “but they didn’t tell me”“, we see a systematic shortening of another matter. The fact that junior staff were aware, implies that the documentation was an issue from day 1, in addition, no clear QA protocol was in place. No drilldown teams, from Junior to board member line was in play and overall the system was beyond merely defective. Consider the simple quote: “Mr Turner, who signed the 1,000-page contract for the IT system in March 2012, said he felt “very let down” by a senior colleague, saying they “didn’t advise me at all”“, can anyone explain to me, how such a document does not come with an excerpt chapter by chapter (by members of the NHS) underwriting per chapter how the contract impacts the NHS, the system and their services? A mere SWOT analyses (Strengths, Weaknesses, Opportunities and Threats) would have made all the difference before signing. A waste of £40-£50 million is more than just a few doctors, the lack of such a solution will give additional worry to the claims Professor Dalgleish made. In light of refugees, illegal immigrants and costings, the lack of oversight will soon pressure resources down further.

This all gives a clear view that a doctor is required to take the pulse of the budget. It is billions in deficit and the drain will only increase. The fact that most parties have not given clear light to several sides is only a first reason why Ukip is gaining momentum. That view goes a little further when we consider “Committee convener Paul Martin said there must have been issues with management if staff did not feel able to come forward“, Scottish Labour has more than just a point, the issue becomes why junior members were not asked directly. Someone had to make an inventory, which means that the step was skipped, or intentionally overlooked. That now gives way to the fact that axing three members is not nearly enough. There is, what could be regarded as an institutional failure within the NHS. Considering that the NHS 24 is only one of several systems that are not on par, or even worse, then never got properly managed is proof further still that the NHS cannot handle too many pressure points at present.

What was wrong from Professor Dalgleish is that ‘EU migrants’ are only one of several straws, each currently heavy enough to separately break the camel’s back (read: NHS), which might be a case that the professor was trying to make, but ‘Pass notes‘ was too busy writing lame non-jokes, whilst the editor of the Guardian remained absent in this matter, which is why its readers are left in the dark (and in the near future untreated too). It was interesting to see that Rochdale Online did give more information through the statement by Louise Bours, UKIP health spokesman and North West MEP.

Here you must ask yourself the question: “Is this all just a storm in a teacup?” Especially as the larger papers ignored the ‘Dalgleish matter’. I myself expect that the statement from Dalgleish is out of context and incomplete. This failing as other elements that are driving the NHS over the cliffs were ignored could have been an option to illuminate why Ukip might not be the answer, yet as we see these levels of trivialisation, people are wondering the why; mainly because no clear explanation is coming forward they start to listen to Ukip more and more. Which is EXACTLY why I wrote the initial view with supporting documentation of a more academic level. So it is not a storm in a teacup, as we can clearly see that the NHS could be seen as close to ‘terminal’, but the factors here are a lot more than just the EU-migrants, what is a given is that unless certain things change, the EU-migrants could be breaking the NHS back, but that is equally a given for a few more factors that are currently in play.

Should any of these elements drive you crazy, then you will be equally out of luck as the BBC reported that finding a mental health spot has become pretty impossible, in that element alone, the £1b might be a great help, but there is a decent chance it will not be enough, because it is not just the beds that are unavailable, services are an equal worry, services that require staff and the refugee pressure will only add to that shortage (which is not the fault of these refugees mind you).

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Tagged as BBC, Jeremy Hunt, John Turner, Lib Dem Scotland, Louise Bours, National Health Service Act 2006, NHS, Paul Martin, PCC, Primary Care Commission, Professor Dalgleish, Rochdale Online, Scottish Labour, SWOT analyses, Tavish Scott, the Guardian, UK, UKIP

December 6, 2015 · 23:18

Let it (or them) die!

Harsh words that are befitting a slightly harsher world than we bargained for. Yesterday I had one of those ridiculous epiphany. In my view I saw some news regarding ICE and how it is so addictive and how it is costing healthcare 500 million. There is news all over the place in both the UK and Australia regarding the abuse of both drugs and alcohol. We seem to go out of our way to reward and support stupid people. Now when it comes to simple things like consumer protection it is one thing. A person can be misinformed and a person can be misled, for this we have consumer protection to give them additional protection. I have no issue with that, when a consumer loses out on a misrepresented or misled purchase, there should be protection. For the most, many shops will exchange and usually even refund. Yet at some point in this day and age, we need to make changes, we need to adjust. It is not by choice, it is out of necessity. You see, choices were made and politicians will need to be held to account. We need to show to all around us that going soft on corporations and going too soft on the people at large can no longer be supported. You see, it is the price you pay for making a choice.

What if we change the law? As per January 1^st 2017 certain medical options fall away from adults. You see, from that date, what if we stop paying for treatment of drugs and alcohol abuse. A person can only get treatment if they pay fully and pay upfront. Without that, there will be no treatment and the drugs and drunk tanks are reintroduced. You see, as stated, we no longer have an option. How can we accept that our governments push us deeper and deeper into debt, unable to keep a proper balance whilst at the same time give more and more breaks for corporations to skim from the top and become more and more non tax accountable! Until we get the law properly to properly adjust certain parts in taxation, accountability and prosecution we no longer have an option. We stop to support certain acts of stupidity. If they die? Let them!

I see images of thousands of refugees, genuinely wanting a future for them and their family, not an extremist thought in sight, just to start a life and create a future for their children. How can we stop these people and keep on supporting junkies? At 7.35 billion mankind is not going extinct any day soon, so why bother with outrageous forms of support for someone so stupid to make such mistakes again and again. In my cruel view, let them die! Let the first 100 be a clear sign to people that drugs kill, there is no next, there is no after again and again. I truly believe that it will push the use of drugs down, when more and more people are confronted that someone they directly know, who had died from drug or alcohol abuse, these elements will soon diminish to a much lower amount. It will never go away, but it will go down to such an extent that people will seriously consider not taking drugs. You see, the drugs pusher will always come with the ‘once will not hurt‘, ‘once is fine, we all do it!‘ He/she lies to you! I and many of my friends never took drugs. And let’s look at the additional benefits this solution will bring. Hospital costs go down, healthcare support goes up, less pressure on support systems and as these people relishing freedom of choice die, their places open up to you me and the refugee. All those who want a real life, a new life or a better life.

This is about more than just booze and drugs. On January 23^rd 2015 I wrote ‘The danger topic‘ (at https://lawlordtobe.com/2015/01/23/the-danger-topic/), here we see the issue I raised almost a year ago. We see “At The Bruegal Institute in Brussels is not the only think-tank to believe the estimated €250bn cost of a Grexit, while covered by the bailout funds, would cripple the Eurozone and delay recovery for a decade we now see that the ECB is about to spend 1.1 trillion for bonds. When we see “The Frankfurt-based bank will use electronically created money to buy the bonds of Eurozone governments – quantitative easing – to try to boost confidence, push up inflation and drive down the value of the single currency, helping to increase exports and kick-start growth”“, yes the Italian Draghi had an idea to kick-start the economy. Now we see ‘ECB Day: markets tumble as Draghi disappoints investors‘ (at http://www.theguardian.com/business/live/2015/dec/03/ecb-stimulus-qe-negative-rates-mario-draghi-live#block-566070ebe4b073bf0735b3be). “But they may have a point. As Draghi pointed out – the Eurozone economy is growing, credit conditions are improving. QE is working, and they’ll keep doing it. Why bring out a bigger punchbowl?” and “The wave of selling rippled from Frankfurt and Paris to Madrid and Milan, as traders expressed disappointment that the ECB hadn’t expanded its QE programme, or hit the banks with tougher negative interest rates“. This is the problem for us. You see, investors expected more, they always expect more, which is why it would not work. In addition, their push could result in more spending and less and less control on that spending. I foresaw it almost a year ago, but as people ignored me and listened to these good weather forecasters on how the economy would grow, are now confronted with more and more bad news management. How the economy grew between 0.3% and 0.4%, so when we look at http://ec.europa.eu/economy_finance/eu/forecasts/2015_winter_forecast_en.htm, and we see a forecast that is written like “Growth this year is forecast to rise to 1.7% for the EU as a whole and to 1.3% for the euro area. In 2016, economic activity should grow by 2.1% and 1.9% respectively“, that 0.3% does not come close, and still these governments are living the gravy train, spending more and more and leaving the invoice for a next government who will borrow even more to deal with invoiced that cannot be dealt with. So how about taking away certain support. How about letting the people see in the street how the future is warped because the symbiotic relationship between nations and large corporations are no longer correctly honoured. Letting the system collapse is one option, letting the people die, so that those nurses can focus on nursing to true health, NHS systems on a global scale will have less and less costs and we can actually move forward.

We can no longer afford to be nice. If you doubt that, thank consider the title ‘Investors got ECB odds wrong but Draghi could pay hefty price‘ (at http://www.theguardian.com/business/nils-pratley-on-finance/2015/dec/03/investors-got-ecb-odds-wrong-but-draghi-could-pay-hefty-price), when we read “It’s hard to know who is most to blame: Mario Draghi, for leading investors up the garden path; or investors, for believing that the European Central Bank president’s talk of doing “what we must” equated to a firm promise of a bigger dose of quantitative easing“, in what way ‘bigger dose‘? We can’t even take care of the current dose and the investors want more and more and more. So, we need to think differently. When we get rid of a surplus population, more jobs, more rental places, less costs, which means lower debt options. The investors will go ‘Baahhhhh, humbug!‘, but only because greed is eternal and they require that extra cash.

When we start hitting governments a dollar for dollar (or pound for pound) option, the game will change and we will see additional false promises on how the economy will get sooo much better in 2017. I say, well, when those tax dollars come in, we can consider paying for certain treatments, only when those dollars (or pounds) are actually COLLECTED.

You know, I can already predict the answer, it will be some accounting stunt that allows for ‘spare change‘. If PriceWaterhouse Coopers comes with that option, you should ask how that worked out for Tesco, both them and the press will remains massively silent on either matter. So, we must change the game, as the players have changed the format of the game. We can’t change the players, but we can limit their actions, hence dropping services.

How inhumane is it? In equal measure I ask, how inhumane is it to leave a multi trillion debt to our children? Is Greece not a clear example, they will never escape the debt that previous governments left them, they will go through life blaming those not responsible, whilst not prosecuting those responsible, what kind of a future is that? At http://www.ibtimes.co.uk/greece-debt-crisis-athens-narrowly-passes-2016-austerity-budget-1532011 we see the title ‘Greece debt crisis: Athens narrowly passes 2016 austerity budget‘, you might think that this is good news, but so far all additional debts have been used to pay bills and pay for interest, Greece is not moving forward, which means that 5.7 billion in spending cuts is required, with one third of that as cuts towards the pensions, so the 10,000 not so poor Greeks are leaving, whilst leaving the rest to pay for an invoice no one in Greece can afford, it is not that far a thought that 2016/2017 will be the years when Greek youth, man and women will marry out of Greece so that they can have a future, reducing the future of Greece even further. Public debt will grow the coming year by another 8% towards 188% whilst unemployment will remain at 25%, so how is that any future? Statistica reported that the advantage of marrying a foreigner received 42% of the women and 33% of the men stating that ‘better education and social stability of the children‘ was received, only 2% for both gender relied on same religion, which could be a massive blow to Orthodox Greece. Whether this comes to pass is not possible to predict, but as options diminish, other solutions will be sought by those hardest hit, so is my leap of not caring for a collection of idiots that cannot accept responsibility such a massive leap? The Sydney Morning Herald reported in June (at http://www.smh.com.au/nsw/newtown-gets-busy-as-kings-cross-empties-20150619-ghseco.html): “According to NSW Bureau of Crime Statistics and Research numbers analysed by Fairfax Media, in the 10 months from April 2013 to Jan 2014 there were 86 instances of alcohol-related attacks in Newtown. From February 2014 to the end of November there were 102 attacks, an increase of 18 per cent. From January to March 2015 there were 34 assaults, compared to 27 in the same period the previous year“, so will the drunk tank be a solution? That remains to be seen, but I feel certain that the first hospital invoice to be paid upfront will definitely have an impact. As people get to pay $300 for alcohol treatment it will not go to bars, if they cannot pay, the drunk tank will be the route to take. How long until someone figures out that this lifestyle gets them killed? How about changing the lifestyle of binge drinking that has absolutely no positive impact other than a fake instilment of Ego?

We have tried all these soft labour solutions and none, I repeat none have worked. It is time that we employ different solutions.

I will be the first one to admit that it is as inhumane as it gets, but people are for the most massively stupid, especially when they are in groups, so as such less intelligent solutions must be considered. Perhaps it will work, perhaps not, but can we truly ignore the option? The cost for alcohol related abuse was $14.352b in 2010 (Australia, at http://www.aic.gov.au/publications/current%20series/tandi/441-460/tandi454.html), yet, can an alternative be found? Yes, there is one other solution, how about on June 30^th all Australian residents receive an additional tax invoice of $625. If over 80% pays it, we keep to the old system, if not we will try my option, dollar for dollar. If you are unwilling to pay one way, you get to pay another way. I reckon it will not take more than 3 months until 90% plus suddenly decides to pay that additional bill.

I prefer to let the debt die, not the people, but we are running out of options and those who should truly inform us are hiding behind experts who will treat us to carefully phrased denials, how is that leading to a solution? Yes, in this blog I phrased more questions than answers. I am pretty intelligent, yet a solution cannot be given until we make massive changes to the society we currently live in so that our children and our grandchildren will have any future. When you realise that we are getting to a point that it is proven, that making the life of a person negotiable is a lot less impossible than we ever thought, that will be the point that a push for massive legislative change is more likely than not to succeed, it is the one push big business cannot counter, some things can truly push a shadow over greed, we only have to be willing to push enough people into that shadow.

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Tagged as ATO, Australia, debt, ECB, Fairfax Media, Frankfurt, Greece, IBTimes, ICE, lawlordtobe, Madrid, Mario Draghi, Milan, NHS, NSW, NSW Bureau of Crime Statistics and Research, Orthodox Greece, Paris, Pricewaterhouse Coopers, SMH, Sydney Morning Herald, The Bruegal Institute, the Guardian, UK

October 5, 2015 · 11:25

How to cure economic sickness

The Guardian is bringing me grim news today. As a British conservative and as an Australian Liberal the news presented does not look good, it is slightly beyond critical. It also reminds me of a small gag I heard in the Netherlands 3 decades ago. The one-liner was: “Due to a death, this cemetery will remain closed for the next few days” (source Fons Jansen), yes it seems like a laughing matter, but the Grimness behind it is less amusing and more dread based than we realise. The news ‘Ministers ‘are hiding details of £2bn NHS cash crisis’‘ (at http://www.theguardian.com/society/2015/oct/03/ministers-hiding-details-nhs-cash-crisis) is at the centre of all this. As a conservative my response (with all due respect) to Prime Minister David Cameron is ‘Sir, are you barking mad?‘ I will direct this at the Prime Minister because he is ‘our’ leader, the man in charge. If there is even the slightest hint that he was not aware than a massive reshuffle will be needed within the next 48 hours.

You see, I have forever opposed hiding bad news. Managing bad news will always bite the parties involved in the end. When the implied deficit amounts to 0.5% of all collected taxations in 2014, we have a massive problem which must be addressed and it needs to be addressed sooner rather than later. You see, no matter how trivial this 0.5% might seem. The coffers are down well over a trillion pounds, which requires 100% of all collected taxations for three years to address. Now that act is not realistic, but that show you the massive damage the United Kingdom faces. Economies are slowing down, partially due to Asia, partially due to acts that America is about to do and as such the American economy will soon take another tumble. As I see it, Thanksgiving and Christmas might hide the events, but the end of January through March, especially when the US Department of Defence will make 40,000 people redundant, that economy will shift over the following 4 months. In all this, the UK can no longer afford to hide bad news of this nature. The Commonwealth in general needs to realise that as the US seems to enable greed based corporations, we as members of the Commonwealth will have to stick together. This is no longer about national pride and ego. Our collective politicians are more likely to walk away with opportunities that will guarantee the well-being of their families for more than two generations, whilst in all this the people will end up getting saddled with a debt that will stop them from moving forward in any decent future for decades to come. None of us agreed to such imbalance.

The quote “Heidi Alexander, the shadow health secretary, said on Saturday: “This appears to be a cynical attempt to suppress bad news ahead of the Tory party conference. It makes a mockery of Tory claims to be committed to transparency in the NHS, and leaves Jeremy Hunt with very serious questions to answer. These figures must now be published in full as a matter of urgency”” gives weight to this. Part of me is also very cautious on her statement, let’s not forget that it was Labour that squandered 11 billion from the NHS and they have not been forthcoming at all, so let’s realise that this still remains an issue of the Pot calling the Kettle black.

The next part is set over two quotes. The first is “Professor Chris Ham, chief executive of the King’s Fund think tank, recently said that the NHS’s fast-ballooning deficit was leading to “panic” at the health department and “denial” at the Treasury. The service’s overspend was so large that it needed an emergency injection of £1bn in the comprehensive spending review to keep functioning, added Ham“, the second quote is “Without extra funding, he argued, the NHS would end up unable to cope, “most likely during the winter when many hospitals run out of money … With NHS hospitals unable to go bankrupt…, the Treasury will be forced to intervene or accept a rapid decline in performance.”“. The issue is in more than one part. In the first we must question how the NHS ended up short by 2 billion. We have heard all the wild accusations in the papers, but what news there has any reliability? No matter how little of it is true, Jeremy Hunt has an official problem, because if he has kept facts away from the public than he has no right being in his position, if he is falling on his sword for the party, we have an even larger issue. Because the conservative members feel that they should be told the facts, good or bad. We cannot fix when things remain hidden. We within the Commonwealth will become puppets to those operating the machines. It is a fake freedom which does do no one any good.

Yet the NHS has issues on several levels. One level was discussed in my blog article called ‘In Greed we trust‘ (at https://lawlordtobe.com/2015/09/22/in-greed-we-trust/). Here we looked at Turing Pharmaceuticals AG and the little caper they pulled on Daraprim. They weren’t the only ones. The Financial Post (at http://business.financialpost.com/investing/global-investor/valeant-pharmaceuticals-international-inc-shares-plummet-as-525-hike-in-drug-price-draws-fire) gave us “Valeant Pharmaceuticals International Inc. shares fell as much as 20 per cent after Democrats in the U.S. House asked to subpoena the company for documents relating to drug price increases, the latest move by politicians seeking to curb price hikes on acquired drugs“. When we see places like Turing Pharmaceuticals ‘hiding’ behind places like PrWeb and PrNewsWire, you better believe you are facing marketing from the bottom of the barrel. Yet in all this serious demands from the government looking into these companies who bought up niche medications and driving up prices by hundreds of percentage points is a matter this government (as well as the previous one) did not have to content with and as such the NHS will receive even more pressure. This is exactly why I have pushed for close to two years towards a stronger Commonwealth coalition. India with its Generic pharmaceuticals that will become one of the pillars of salvation for the NHS. This needs to happen now, before the Australian government (as well as the previous one) does something irreversibly stupid like signing the TPP. We must recognise here that it was not Australian Labor or the Australian Liberals asking the questions that had to be asked, it was New Zealand that put up a fight against the TPP issues. So have we been watching a media event by Martin Shkreli and Turing Pharmaceuticals?

Because we all need to realise clearly that once the TPP is signed, the signing government will have placed a knife on the throats of nearly 21.7% of the population of Australia, whilst that group will be left with no medical alternative!

That part reflects on the NHS!

When we consider some information from the ABPI (at http://www.abpi.org.uk/our-work/library/industry/Documents/OHE%20ABPI%20Medicines%20Bill%20Forecast.pdf), we must also acknowledge that they, the Association of the British Pharmaceutical Industry, represents commercial enterprises, a branch not to favoured, or flavoured towards generic medication. They are given, as I personally see it (read: speculate) the inside track from ‘friends’ on how far they must lower the price to remain seated. It is a form of let’s say branded exploitation that can no longer be afforded. Now, we must be clear that there is nothing illegal on branded exploitation, but we have to acknowledge that the NHS can no longer afford to play that game (a 2 billion deficit is ample proof of that).

Within the ABPI we see plenty of information, now consider this one quote from one of their presentations: “Loss of exclusivity of some major brands is projected to yield £3.4bn cumulative savings to the NHS between 2012 and 2015 with £5.4bn cumulative lost revenue to industry“. Do you think this is about the savings to the NHS, or the revenue lost to industry? If you think that this is about ‘savings to the NHS‘ than you, the respectful reader, will be slightly too naive than is good for you! I cannot fault the ABPI, because it is doing what it needs to do, represent its industry, we all forgot that they are not living in a symbiotic relationship with the government as they provide THEIR solutions to the NHS. The people the ABPI is representing, is a commercial group. They want to get the most out of whatever they can. Culling their needs by having stronger ties with Generic brands, even Indian ones is essential. They might cry about their low prices, but the reality is different. These players claiming the high costs are hoping you forget about news from 2001 (and many other years) where we saw “The UK government is introducing tax incentives aimed at persuading British-based pharmaceutical companies to boost their research into diseases affecting the world’s poor, such as AIDS, tuberculosis and malaria“, so they get the tax breaks for research, they have the inside tracks on ‘maximising’ product pricing solutions, yet overall they still complain. Which in light when we consider the ABPI document showing a 15% growth in spending on medication to be another issue. This is was a projection over 4 years (up to 2015), yet the facts remain, the NHS needs another solution and we agree that generic medication will not be as strong, however a medication that needs to be taken 10% longer might be preferable to medication that is 30% more expensive. Clarity is what matters here and for the implied accusation that Jeremy Hunt was keeping people in the dark should be offensive to all of us. There is one more side to all this, which is shown in that same presentation. The Office of Health Economics (OHE) is stating with their key message 6 that: “By 2015, new branded medicines launched between 2012 and 2015 will account for less than 2% of the total medicines bill. This underlies the issue in the UK of slow uptake of innovative new medicines“. From an analyst side I want to offer this thought to you. the quote ‘new branded medicines’ implies not that they are new medication, but new versions of existing medications, which means that rebranded and possibly marketed solutions is now implied to be below 2%, yet whatever deal is in place, it could also imply that this 2% is also a group that for now cannot be replaced by generic mediation. This is a speculation on my side, yet these kinds of presentations are never about ‘informing’ the people, it is about awareness on which questions to ask and what solutions to push for. Both tend to be expensive exercises for any NHS.

Yet medication is only one side, it is the one side we can clearly fight for with the possible reward of direct savings, but other sides need to be considered too. This we see in the comment article in the Guardian called ‘This junior doctor contract puts patients in danger‘ (at http://www.theguardian.com/commentisfree/2015/oct/04/junior-doctor-contract-patients-danger). Can anyone explain to me how the stupidity of “The contract that the Department of Health is threatening to impose on junior doctors once again raises the prospect of 90-hour weeks being written into rotas“? I went to University with some of these upcoming doctors, the pressure on them is just beyond harsh. How can a 90-hour contract be allowed? apart from that being a step just one hair fraction away from being regarded as slave labour, the pressures on these people will result in a certain harm to them self, an implied certain harm to their patients and a long term harm to the NHS as a whole. Because this will fall over within 2 years after which there will be no doctors left, there will be nearly no nurses left and the UK gets to rely on the medical care we can import from Siberia and Africa, how would that end well?

As a final year student in Intellectual Property law I call upon my peers to aid the NHS, give aid to them by creating strong patents for Generic medication, for patents that lessen the stranglehold on prolonged exclusive medication. In 2008 in the Financial Times, Yusuf Hamied, stated: “I am not against patents, but India cannot afford them. I am against monopolies”, he is correct! In addition, now 7 years later the UK and many other nations cannot afford them either. That part has been ignored on many governmental levels all over the Commonwealth. The response the article gives: “he is a “pirate”, an opportunist who has exploited others’ intellectual property to swell his own profits. In the process, they say, he is undermining investment in future medicines, including the next generation of HIV therapies“, this fake response is flame baked with emotion, the reference to ‘the next generation of HIV therapies‘ does that. You see they had a patent, they had exclusivity for 20 years, but the people in that house became lazy and greedy and now they do not want to give it up. They try to revamp the drug to the tiniest part (they will call it an innovative new drug) and then they reshape it with a patent for 20 more years of exclusivity. They are now learning that this is not always successful. As a Patent Attorney (if I make it to the end) I would want to work on the patents of Generic medications, lowering the barricades to NHS on a global level, which is one of the reasons I oppose the TPP. Governments (including the UK) have squandered the position they had by prolonging a solution that never worked and voila, here we have the trillion pound deficit!

OK, I admit it is not a completely accurate statement and as such the issues are more complex, but we must fight the wars we can win and the NHS war could be won, however if Mr not so bright, I am hiding the numbers Jeremy Hunt MP is indeed hiding the numbers, any NHS solution will come too late, which puts 68 million in peril.

I feel that I am on the right track. Some will question my view towards Generic Medication Patents. When I consider my duties as stated in the Code of Conduct for Patent and Trade Marks Attorneys 2013, I see section 11 that a registered attorney must act as a patent attorney or a trade marks attorney in the following:

In accordance with the law; and
In the best interests of the registered attorney’s client; and
In the public interest; and
In the interests of the registered attorney’s profession as a whole.

The first two would carry for certain, the latter two are the debate. I believe that Generic Medication and protecting these is in the public interest on a global scale, I never believed that ‘reworking’ a patent, unless it is truly a new substance was in the public interest. You see exclusivity is a right given to the actual innovator, not giving in perpetuity, which only propagates exploitation, the last part is that the profession as a whole relies not on the cash of the rich client. It relies on driving true innovation, when we start repackaging the same solution with a new delivery method (which costs less than $15 dollars to make), the price hike from $20 to $175 is not just a tough pill to swallow it is a dangerous escalation in our greying population. The fact that Patent Laws as well as Patent Regulations have not been properly updated (even though this example is specifically for the US, not the UK) should give warning to other parts that needs to be overhauled.

This all hits back to the NHS. The Independent showed a few sides which reflects mighty badly on Jeremy Hunt. You see the quote: “it was his intention that no one should lose out financially” might sound nice and perhaps the change to a schedule where doctors work 7 days a week might not be an avoidable part, yet in all this the 90 hour a week part is still one of the deadliest issues. That person might not feel a financial ‘pinch’, but I guarantee you that these hours will drive most doctors bonkers within 2 years. How can the NHS survive when by 2018 23% of the medical GP’s are in a sanatorium? Did Mr Hunt add that risk to his spreadsheet?

So how will this end? Well, for Jeremy Hun MP not all that good I reckon (speculation on my side), but we have to wait to see all the facts to place judgment on this. In all this, as I see it, I started with the title: ‘How to cure economic sickness‘.

The answer in my case is by changing direction, by changing it massively. There is now more than half a decade of data and Business Intelligence that the US only considers the US and there they falter and fail as they refuse to deal with Greed. They hide behind more and more emotional stories (especially when there are school shootings), even there the US legislative branch is failing its people. The Commonwealth cannot afford these steps. We the Commonwealth must unite as never before. We the people of the Commonwealth must also realise that to make this work we must be willing to make large changes if needed. I always lived a global live, so if I am required to move to the UK, Canada or perhaps even India, than I will! In this day and age, holding onto your one little hill (especially those with tertiary educations) we must consider a global (read a complete Commonwealth field). The UK must start to realise this too, because they have squandered too much funds on solutions that never worked. Australia is moving into that direction as well as Canada, they just move in that direction more politely than the other players.

And finally my message to David Cameron. David, your Conservative party can be the solution, we all can be part of that solution, yet in all this we must know how bad things are and the playbook you currently use needs to change, the US can no longer be seen as a potential ‘solution’, they burned that bridge by themselves. Our Commonwealth can grow towards the empire it was, we have the skills, we have the innovators, we have the drive and (most of us) the loyalty to the crown, yet in all this, not enough drive towards a Commonwealth Union has been made. The SNP is partially evidence of that. They now realise that their oil revenue is not making it work, they need to realise that together we are stronger. Yes, perhaps that will be as an independent Scotland, but then it should still be a Commonwealth Nation, we must propel on all sides to show both the US and China that the UK is the 5th largest economy, yet as a United Commonwealth we can surpass China and become the second largest economy! The next 12 years will be about the innovators that propel ideas in many fields. We will see a growth in Trade Marks, in Patents and in Business solutions and all this will be resulting in new avenues of growth, yet as a single nation the UK can no longer compete to the extent it needs to. The costs are too high, the NHS is the first and clearest piece of evidence.

So economic sickness can be cured, it needs the right medication and this can be administered by acquiring the right medication, the current providers have shown that they are not up to the task!

I leave it to the honourable David Cameron to set the right course!

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Tagged as ABPI, Australia, Canada, China, Conservative, Daraprim, David Cameron, Financial Times, Heidi Alexander, Jeremy Hunt, King’s Fund think tank, Liberals, Martin Shkreli, New Zealand, NHS, Office of health economics, OHE, Patent Laws as well as Patent Regulations, Professor Chris Ham, the Guardian, TPP, Trans Pacific Partnership, Turing Pharmaceuticals, UK, United Commonwealth, Valeant Pharmaceuticals International Inc, Yusuf Hamied

September 27, 2015 · 00:26

What news is news?

There are several pieces, not just in the Guardian, the BBC, the Independent or the Times. They all tell us that they have news, but do they have any actual news? The Guardian shows us a tech article (in the Tech section) called: ‘the node pole: inside Facebook’s Swedish hub near the Arctic Circle‘, all innocent news, one could surmise that it is just a space filler. Or was it done to give extra view to the article ‘Facebook is making more and more money from you. Should you be paid for it?‘, or perhaps to give extra light to ‘Facebook case may force European firms to change data storage practices‘, which I gave my views on in my previous blog. You decide!

In the business section we see VW to get some centre stage, which makes perfect sense and that is just the Guardian. The independent also has a go at Facebook, but now has a go at its users, well, actually it is not the Independent, but the employee tribunal. Now the article shows all kind of signs of bullying, which is never OK and in that regard Rachael Roberts has a real case, but in light of the events, Mrs Bird does not seem to be a friend of Mrs Roberts, so why is the act of unfriending on Facebook the killer? Yet it is the quote “But employment lawyer Josh Bornstein told ABC news the unfriending incident was found to be workplace bullying in the context of several other issues“, which baffles me, if they are not friends, one or the other could unfriend the other party, that part seems clear cut to me, not bullying. So out of the 18 allegations of bullying in total, the unfriending in Facebook took the cake? It does not add up to me!

In addition we see two whole articles on Facebook being down and oh yes, the new iPhone is for sale! Let’s not forget the fact that the iPhone now allows for sextracking. So, parents buy your boy or girl on of these bad boys so you can find new ways on how you are about to become a grandparent! Really? You need to keep scores on your phone now? Didn’t Ashley Maddison teach you anything regarding sex that is on the internet, everyone will know soon thereafter?

Finally they also gave visibility to ‘Hospital apologises for removing RAF sergeant from A&E because uniform could ‘upset’ patients‘, which is a can of worms in its own right. In that light I expect the NHS to move all drug and binge drink casualties to their basement as not to invoke bad thoughts from the Presbyterian community. How insane was the idea to move a wounded RAF sergeant in the first place!

All these events, some are actually news, but no one seems to have any balls. No one is looking at Pricewaterhouse Coopers. Which of course ties in nicely with the words of the Dalai Lama ‘Dalai Lama on Britain’s policy towards China: ‘Where is morality?’’, the answer might not be such a high moral one, it goes a little like “Who is willing to suck the smallest extremity for the good of one’s career?”

To some extent we can accept that the SFO is silent, only to the smallest extent. You see Tesco is dealing with a write-off of £6.4bn, which of course is massive. We have seen all the news on how some former Tesco entities are getting grilled (as they should) but the press on many levels in many nations keep on rehashing the old news and no one is digging into PwC. No one is digging there. Does that not sound awfully weird? Yet here is the kicker, we see more and more messages like ‘Multinational tax avoiders targeted’, with quotes like “while the American Chamber of Commerce in Australia warned about throwing up new hurdles in what is already a high-cost economy. The chamber’s board includes representatives from ConocoPhillips, GE, Boeing, PwC and Exxon Mobile“, yes it seems it is never a good time to go after tax avoiders (not to mention the impact it has on the bonus benefits for those working in that part of the financial branch).

Before you whisk this away as mere banter (which you are of course allowed to do), take a look at this article that is a little over a week old. It is from the Wall Street Journal, which I do not look into too often. The article (at http://blogs.wsj.com/cio/2015/09/15/the-morning-download-identity-theft-key-to-attack-on-cisco-routers/) called ‘The Morning Download: Identity Theft Key to Attack on Cisco Routers‘, starts with: “Good morning. The international attacks on Cisco Systems Inc. routers, disclosed earlier today by security firm FireEye Inc.’s Mandiant unit, began with the theft of legitimate network credentials. Securing and managing the identity of network users continues to be a massive challenge for CIOs and CISOs and ultimately, the CEO and the board. The attacks have been named ‘SYNful’ because of how the malicious software moves across routers using their syndication functions “Cisco said SYNful did not take advantage of any vulnerability in its own software. Instead it stole valid network administration credentials from organizations targeted in the attacks or by gaining physical access to their routers,” Reuters reports today. Mandiant said in a blog post that it had found 14 instances of router implants, which replace Cisco’s operating system”

Now, to complement that statement, I will add the following. On June 5^th (more than 3 months before the WSJ article), I wrote ‘In reference to the router‘ (at https://lawlordtobe.com/2015/06/05/in-reference-to-the-router/) , here I stated: “Soon thereafter no more firewall, no more routers, just the bliss of cloud servers and data, so much data!“, which reflected on the article I wrote on February 8^th (more than 7 months before the WSJ), there I wrote “I think that ‘hackers’ have created a new level (as I mentioned before). I think that Cisco IOS was invisibly patched“, (at https://lawlordtobe.com/2015/02/08/the-next-cyber-wave/). I was literally accused by some to be insane, there was no way that this would EVER happen. Now we see in the Wall Street Journal: “Mandiant said in a blog post that it had found 14 instances of router implants, which replace Cisco’s operating system“, interesting how I am now proven correct. Are the members of the Baboon family (usually found in the FBI) reconsidering their North-Korean option? Let’s face it, this took top level skills, we can (as I pointed out in the past) find those boffins in the US, UK, FR, the FSB and Chinese Intelligence, however in North Korea not that much!

The Reuters article shows a lot more (at http://www.reuters.com/article/2015/09/16/us-cybersecurity-routers-cisco-systems-idUSKCN0RF0N420150916), however, they are just rehashing something I stated for almost a year, the quote ““That feat is only able to be obtained by a handful of nation-state actors,” DeWalt said, while declining to name which countries he suspected might be behind the Cisco router attacks” adds to my view that I was correct all along (finally another ‘I told you so!’ opportunity). The only difference is, is that DeWalt includes Israel, I have no real quality data on the Israeli cyber capabilities, so I am willing to give him that one. Finally we should consider the quote “Infected hardware devices include Cisco routers 1841, 2811 and 3825“, which is fair enough, yet in my article I offer the option that the CF unit found in nearly EVERY router could also open doors, so the danger could in theory go far beyond those three routers.

I also stated that my thoughts were based on sound speculation. You might wonder what sound speculation is. Basically, it means that even as I might not have them skills to program, I do understand that my solution is viable, the fact that routers are getting programmed with a new OS is clear evidence of that. In addition, it also gives weight to two infestation systems I speculated on as well as the weakness that those believing in the cloud are not realising at present. I was willing to look beyond the veil, a side everyone ignored. Yet when a router can be reprogrammed to the extent it was, also clearly means that data in motion is no longer safe, which means that pretty much any cloud data can be gotten too, the user only has to access the file to make that happen.

I even had a thought on dealing with the Iranian glow in the dark power plants when the time is there, just by thinking out of the box. It does involve a Piranha valve (which actually already exists in name, but mine is so much cooler). None of this is newsworthy, speculative opinion one might state. Yet in my speculation, I have shown solutions to be real in several occasions and in addition to that I also clearly outlined long before the press decided to show the minimalistic amount of balls (read testicles), that a look into Pricewaterhouse Coopers was adamant. It seems that apart from a December 2014 message from the SFO (rehashed by nearly all papers) not much happened, apart from that news, the press at large stayed clear of mentioning PwC and Tesco in one sentence. Is that not utterly weird?

Of course the luggage of someone’s mum in Tenerife (shipping at £122) gets front seat exposure, yet, the issue on £6.4bn getting lost due to assistance (better stated too weak opposition) by Pricewaterhouse Coopers seems too trivial to keep pressure on. Way to go Consumer Champions, Money! I actually mean that! They did do a good job and they have done so in the past, yet I fear that a letter by Dave Lewis on how his firm lost £6.4bn as the keeper of his books was not prudent, or is that tenacious enough to ring that bell very loudly when things looked too odd. Will Consumer Champions find that money? Will they write “Pricewaterhouse Coopers must accept responsibility for the signing off on books as the “accountant”?” Consumer Champions might not get this done, which is fair enough. It should not be on their plate, but the parties this should be very visible on are also not doing anything as far as we can tell, they remain silent, they remain this silent after 9 months.

Yet in all this there is one part both the Guardian and the Independent are getting right. It is the news on the NHS, there are massive problems and knowing them all is essential in finding a solution. In this matter the press has played a good role. In my view exposing former and current politicians a little more on the political game they play, so that we all understand that a proper solution is needed and taking the politicians out of that equation might not be the worst idea, the end result stays the same, the NHS is now too close on the edge of collapse to be acceptable, yet where lies the solution? Although I understand the issue the Independent shows, I partially disagree. The headline ‘New NHS junior doctor contract would discriminate against women, senior medics warn‘ is not incorrect (at http://www.independent.co.uk/life-style/health-and-families/health-news/new-nhs-junior-doctor-contract-would-discriminate-against-women-senior-medics-warn-10516885.html), yet in all fairness, the quote “Under the new contract, trainees who decide to work part-time would see their pay increase more slowly than their colleagues” is a can of worms! Why would my co-worker doing 32 hours get the same raise as myself working 60 hours? (Remember, I am not a doctor). A choice was made! Yet, there is a level of fairness here too. Which means that to tackle it should be done in another way. Even as there is a shortage, the burnout of physicians is a known issue and making a maximum of 40 hours a week a mandatory status could be close to the only solution. Perhaps we have been too indulged, perhaps some options should only be there during the week. Perhaps the change to healthcare is essential (like hiring 40% more staff), but we also accept that at current not one government remains to afford that change (well perhaps Easter Island where there are less than 10 doctors). In the end the system has been ignored for too long. Too many politicians are on the ‘let’s get the computers up and running‘ whilst they know that staff will remains a problem for a long time.

That is news! That is what matters, but too many papers and too many news broadcasts are about the emotions and not the actual news that matters. That might be an incorrect view and a very biased view. It might be that some news is more important than other news parts, I will instantly agree, yet in all that the complete silence from pretty much all the papers regarding Tesco and some involved book keeping parties remains a mystery to me, how is that part not news? We will see more events that will not get the proper light in newspapers, both in paper as well as online, I’ll let you decide how that measurement applies to an involved party to events that started a £6.4bn downgrade.

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Tagged as ABC, Ashley Maddison, Boeing, China, Chinese Intelligence, Cisco Routers, Cisco Systems Inc, ConocoPhillips, Dalai Lama, Dave DeWalt, Exxon Mobile, Facebook, FBI, FireEye Inc, FR, GE, Iran, Josh Bornstein, Mandiant, NHS, North-Korea, Piranha valve, Pricewaterhouse Coopers, PwC, reuters, SYNful, Tesco, the FSB, the Guardian, The Independent, The Morning Download, UK, US, Wall Street Journal, WSJ

September 22, 2015 · 22:11

In Greed we trust

In greed we trust, all others are expected to die! That is the basic setting which is now ruling the internet and it all started when the CEO of Turing Pharmaceuticals AG bought the rights to generic drug Daraprim and he subsequently raised the price by 5500%. This now creates two parts. They are:

How is this legal?
How to prevent such dangerous situations?

The initial part is not found. You see, when we look at the definition of Financial Exploitation, we get: “Financial exploitation occurs when a person misuses or takes the assets of a vulnerable adult for his/her own personal benefit. This frequently occurs without the explicit knowledge or consent of a senior or disabled adult, depriving him/her of vital financial resources for his/her personal needs” (source: National Adult Protective Services Association (NAPSA)). Most forms of protection against exploitation is against what people own. One of the most famous cases in Australia is Commercial Bank of Australia v Amadio (1983) 151 CLR 447; [1983] HCA 14. Yet, the law regarding exploitation of something that is not owned is not clear, in certain places we see that in the Generics and Biosimilars Initiative Journal (GaBI Journal). 2012;1(3-4):146-9. The title of the PPRI conference reports gives us this with ‘The potential of generics policies: more room for exploitation’. The tactic is quite sound, if the price of normal medication cannot be lowered, than raising the price of generics is a sound strategy from the view of the greedy. The paper also gives us “Mr Richard Bergstrom, President of the European Federation of Pharmaceutical Industries and Associations stated that ‘once patents expire, prices should fall to a low, but sustainable, level’. In this panel discussion but also throughout the conference there appeared to be a common understanding that generics competition works well”. This was a view stated almost 3 years ago, which is true. However, the solutions that are addressed to a 2% or even 1% market does not seem to have too many alternatives, this is where the solutions like Daraprim and Cycloserine seem to come into play. The older small solutions that have no equal because the need is too small, now a massive option for larger profits.

When we look at Bloomberg on August 6^th, we get: “Allergan Plc’s Actavis unit got a subpoena from the U.S. Justice Department seeking information on the marketing and prices of its generic drugs, becoming the biggest company yet to draw scrutiny in the government’s widening antitrust probe of the industry. The June 25 subpoena also sought information about communications with competitors regarding the products, Allergan said Thursday in a filing. While the company didn’t supply further information and didn’t specify the competitors, rivals including Lannett Co., Endo International Plc, Par Pharmaceutical Holdings Inc. and Impax Laboratories Inc. have made similar disclosures in the past several months“, as well as “Some 10 percent of generic drugs doubled in price between July 2013 and June 2014, and half of all generic drugs rose in price, according to an analysis earlier this year of Centres for Medicare and Medicaid data cited by Senator Bernie Sanders, an independent from Vermont who’s running for president, and Representative Elijah Cummings, a Democrat from Maryland”

So as we see these events, why did Martin Shkreli make this move? An entrepreneur of his achievements does not play around. What is his game?

The ‘defence’ we see from the other side is “Shkreli said: “We need to turn a profit on the drug.” He defended the decision by telling Bloomberg News that newer versions of the drug needed to be developed and his was the first company “to really focus on this product” for decades and that such research was extremely expensive“. This goes against the statement he later makes, which was “He also promised that: “If you cannot afford the drug we will give it away for free.” Shkreli also said the drug was currently under priced” (source: http://www.theguardian.com/business/2015/sep/21/entrepreneur-defends-raise-price-daraprim-drug).

Now we have an issue with all this. Is this about the medication, or is this a first step to bleed dry health systems?

For this we must show one additional quote. It is “Shkreli’s start-up company, Turing Pharmaceuticals, acquired Daraprim in August. The drug was first developed in the 1940s and is used to treat toxoplasmosis, an infection that is not common but is particularly dangerous and can be fatal“. The question in my mind is how this existing drug is any form of treatment against the complications of AIDS? A drug that is over 60 years old, which is suddenly the foundation towards a cure? What are we not seeing? Well, that part is shown by CNBC (at http://www.cnbc.com/2015/09/21/drug-prices-big-price-increase-for-daraprim-rescinded.html). Here we see that this is the second act. The first one was “Cycloserine was acquired last month by Rodelis Therapeutics, which promptly raised the price to $10,800 for 30 capsules, from $500. But the company agreed to return the drug to its former owner, a non-profit organization affiliated with Purdue University, the organization said on Monday“, after which the price ‘stabilised’ at twice the original price. So is this about a changing approach to the increase of generic medication by 100%-300% in the end? In addition, the other CNBC quote is “However, outrage over a gigantic price increase for another drug spread into the political sphere on Monday, causing biotechnology stocks to fall broadly as investors worried about possible government action to control pharmaceutical prices. The Nasdaq Biotechnology Index fell more than 4 percent“, now this is all starting to make sense. A hedge funds manager playing the market and playing the waves of market exploitation. This is not unheard of, more important, for the most, we could argue that no illegal acts were undertaken. The Guardian stated “It is not uncommon for companies to use inventive interpretations of government regulations and loopholes in the law to corner the market for certain drugs, especially ones that were developed a long time ago and have only a limited market“, which is true, but when we considered the additional event that the Guardian ignored, give us cause for concern. I am not stating that the Guardian is trying to misinform its readers, their conclusion on one case is sound. Yet, when we see the addition that came from CNBC regarding Rodelis Therapeutics, we see another side. Here we see a side of market exploitation and Market manipulation, as far as I can tell at present in a very legal way. That we see from “Mr. Hasler said the new price was needed to stem losses”. Really? So is this about feigned losses, or is this one of many steps where drugs that treat smaller populations to grow 100%-300% in price to assure a market niche that most NHS systems (US, EEC and Commonwealth nations) are unable to fight. In this way on an international level the respected NHS versions will be placed under additional pressure. As I see it, Martin Shkreli has started Turing Pharmaceuticals AG to dig into this very profitable branch. In addition, for something this expensive, how come those rights transferred for only 55 million?

It seems to me that parts in all this remains unstated. Why?

Now in this part I am not having a go at journalists as in the past. For one, this is an evolving story, in the second part there are a few sides to all this. For one, I am speculating in what the game is here (speculating is not now, nor should it ever be regarded as factual). In addition there are sides that have not played yet. One of these sides is the law. As I personally see it, certain entrepreneurs, wealthy or not are now trying to corner the 2% treatment solutions, perhaps even the one percent group. Consider how this affects the UK. Let’s use the UK statistics. When we consider 240 million patients a year. If 2.4 million people require a drug and if that price suddenly goes up from $500 to $1000 (the Cycloserine example). This is only in the UK. Which gives them an additional 1.2 billion and this is only ONE nation, now consider the effect on the EEC as well as the US and the other Commonwealth nations, now the money becomes really handsome. Even at 0.1% it is a massive influx of money and for now all very legal. I have full faith that the law will be adjusted, yet we will see that it will be adjusted too late and some of these fast moving rascals will have made a massive additional amount of money, which is not an illegal act by the way.

This whilst I am still slaving over my issues of Infringement. That and a massive student loan will not propel me whilst some dubious hedge funds individual walks away with billions. A clever mind is half the battle!

So as this event escalates, the UK will have a new problem, because as is, the prospect stated ‘Planned NHS expenditure for 2015/16 is £116.574bn‘ is possible off by no less than 10%, the generic pharma side is only one side. I wonder what happens when these ‘entrepreneurs’ acquire the service contracts of hospitals at large, what happens when the MRI contracts are sold off to third parties? What happens when those prices go up? This is a path that Stadium Group CEO Charlie Peppiatt seems to be walking towards in a very successful way. As one third of the planet goes into ‘one foot in the grave mode’ that population will require a massive amount of support in medical terms (until they move towards their respective casket or urn). There is one side that is an issue for the other players. As I see it Martin Shkreli might be the most visible one but as I see it not the brightest (massively richer than me though), in one bash he has given visibility to a move that many wanted to keep under wraps, because out of sight, out of mind and that would have resulted in profits (loads of it). The visibility forced on the eyes of many might now result in NHS safety valves that could stop the forced squandering of funds. I wonder if my view is correct and more important will proper steps be taken sooner rather than later.

I’ll let you decide.

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Tagged as Allergan, bloomberg, Charlie Peppiatt, CNBC, Commercial Bank of Australia v Amadio, Commonwealth, Cycloserine, Daraprim, EEC, Endo International Plc, Generics and Biosimilars Initiative Journal, Impax Laboratories Inc, Martin Shkreli, NAPSA, Nasdaq Biotechnology Index, National Adult Protective Services Association, NHS, Par Pharmaceutical Holdings Inc, President of the European Federation of Pharmaceutical Industries and Associations, Purdue University, Representative Elijah Cummings, Richard Bergstrom, Rodelis Therapeutics, Senator Bernie Sanders, Stadium Group, the Guardian, Turing Pharmaceuticals, US

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