Britain, Government, Health

GP surgeries and out-of-hours primary care…

OUT-OF-HOURS CARE

The crisis facing out-of-hours primary care services is largely down to the health policy pursued by the last Labour government. Whilst it is a bit rich for Andy Burnham, the shadow health secretary, to accuse the present Government of ‘an epic U-turn’ for announcing a financial package intended to encourage GP surgeries to stay open in the evenings and at weekends – in reversing the mess the Government inherited from Labour – Mr Burnham has a case if we put hypocrisy aside. As the implications of the new contract began to take hold, the last government offered something very similar to what is being offered to GPs now – but funding was withdrawn by the Coalition when they came to office on the basis that there was no demand for the services. Now, though, an additional £50 million is being earmarked for doctors’ surgeries that want to remain open during unsociable hours or those GPs that wish to embrace new, hi-tech consultation methods.

Surely, the time has come to repair the huge damage caused by Labour’s poorly-judged contract with GPs in 2004. The contract removed responsibility for out-of-hours care from GPs, the majority of who opted out of providing it. The consequences are well-documented: demand has been pushed on to hospital A&E services with the resultant pressures making many A&E units unable to cope with a winter crisis. Worse still, has been the non-emergency telephone advice service which has been found seriously wanting with patients left frustrated in their efforts to make appointments at times convenient to them rather than to the practitioners.

The current Health Secretary, Jeremy Hunt, says he wants GPs to ‘rediscover family doctoring’, an ambition no-doubt that will be shared by most people. Innovative ideas such as wider use of email and Skype are good ones that could help to restore an element of personal contact with surgeries when people need it most.

Who would doubt that it is in the interests of GPs that they play their part in bringing about a more modern, proactive and flexible service for their patients?

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Britain, Economic, Environment, Government, Politics, Society, United Nations, United States

Climate change and the need for a global price on carbon…

CLIMATE CHANGE

The recent findings of the United Nations Intergovernmental Panel on Climate Change (IPCC) are alarmingly clear. The environment is incontestably warming – evidenced through the fact that each of the past three decades has been successfully warmer than any since 1850 – and it is now beyond reasonable doubt that human activities are the cause.

The IPCC report, the fifth of its kind, whilst not containing much that is absolutely new, does offer a higher degree of certainty than the previous report delivered in 2007. It is now as sure that human beings are causing climate change (a probability of 95 per cent) as of cigarettes causing cancer. This is not the judgement of politicians or those campaigners with vested interests, but the consensus of thousands of scientists from all over the world. With scientists having considered all the available evidence, one can only hope that it will banish the scepticism of the ignorant.

The effects of the alterations in the Earth’s environment are already being felt, and not just in extreme weather patterns. The polar ice sheets are thinning, sea levels are rising and the oceans are increasingly acidic. But of concern is what is still to come. The likelihood that rising temperatures will stay below the 2°C threshold, above which changes become catastrophic, looks far less achievable.  Quantifying this is not difficult if we consider that we have already burned through 54 per cent of the ‘carbon budget’ calculated to equate to a spike of 2°C.

Without radical action, the inference implied is that the outlook is bleak. Yet, the politics of long-term, counter-factual disaster-avoidance are no easier now than they were in the past. Last week, The International Development Secretary made all the right noises, commenting that Britain must play its part, only to be countered by the Chancellor who judges the green agenda an unaffordable luxury in times of public austerity. Ed Miliband, talks of a good game, too, with his pledge of carbon-free electricity by 2030. However, his promise to freeze energy bills raises serious questions about where the investment will come from and has already spooked potential investors.

In America, John Kerry, U.S. Secretary of State, responded to the IPCC in stirring terms… ‘This is yet another wake-up call: those who deny the science or choose excuses over action are playing with fire.’ But while Mr Kerry went on to affirm that the U.S. is ‘deeply committed to leading on climate change’ Congress is in the midst of yet another budget fight, upon which Republicans are demanding that any new borrowing is conditional on the weakening of carbon-emission regulations.

The sceptics are certainly right when they say that the cost of mitigating climate change is high. But it is also unavoidable, and the longer we delay the greater the bill will be – both in terms of money and human lives. We must then, throw, all we have at the problem, from the incremental (such as better insulation for our houses) to the fundamental (re-thinking how industry and transport, for example, uses energy). And then there is the thorny diplomatic issues over who should pay – the rich countries that did the historical polluting, or emerging economies from the developing world that are now industrialising in double-quick time.

Ultimately, though, the solution lies with the market. Europe’s ground-breaking carbon trading scheme has floundered, and with its price being meaninglessly low it could be easy to write it off. In America, President Obama’s hopes for national cap-and-trade were dashed by the Senate, leaving only a smattering of regional initiatives. The Australian Prime Minister wants to repeal his predecessor’s ‘carbon tax’. Despite the teething problems, however, a global price on carbon is vital and must be a priority. With China and South Korea now putting together their own schemes, there is at least some progress being made in dealing with the climate change threat.

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