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!
Lawrence van Rijn - Law Lord to be 