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nhsManagers.net

10th April 2025

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News and comment from

Roy Lilley



Get on and do it...

_____________

The tumbleweed blew down the deserted street.


In the baking sun of high-noon, the three men stood, facing each other.


Each with their weapon of choice.


A Colt .45, single-action revolver… drawn, cocked ready. 


The others… a Smith and Wesson Model 3, and a Remington 75.  


The three, guns pointing at each other.


The saloon-bar door swung and creaked as the last passerby took cover.


It was a Mexican stand-off.  


Who would blink first? Who would squeeze the trigger? Would the three fall, together?


There would only be one winner… the thin, pale face of the undertaker could just be made-out, standing in the shadows, peering through the window…


… too nervous to pull back the curtain and have a proper look at the history being made in his small town but certain, in the next few minutes he would be the richer by a coffin, or two. 


Right now, history is being made in one of our not-so-small towns. A city, in fact. 


A city where there’s a Mexican stand-off. Just as dramatic. No tumbleweed rolling down the streets. Here, there are rats running down the streets.


The bin strike in Birmingham, the stand-off between, the Labour government, a Labour council and a Labour funding trades union. 


Each, refusing to back down. Each, powerless to resolve the dispute.


A tension, that exposes deep fractures within the Labour movement and raises questions about priorities, power dynamics, and political accountability. 


Birmingham, Labour council and Keir Starmer’s national Labour are not aligned.


The Council issued a Section 114 notice in 2023 because of a £760 million equal pay liability… and is bankrupt.


Legally, it cannot agree to pay-deals or make financial commitments that worsen its budget. 


Unite, under its leader Sharon Graham, has a militant and independent stance, often publicly criticising Labour politicians who don't defend workers’ interests.


She’s fighting for the retention of Waste and Recycling Collection Officers. The ending of which led to an £8,000 pay cut for 170 workers.  


Brum is broke. Even if they wanted to reverse it, they can’t... unless they are bailed out.


Charmer, who promised nation before politics, is stuck: 


  • Can’t be seen taking sides. Not to do so makes him appear impotent and weak. 
  • Pressuring the union risks alienating a core financial backer. 
  • If he pressures the council to pay, it would be financially irresponsible… possibly ultra-vires.


Labour should be able to sort this out. They run the council, they run the country, and they’re deeply connected to the union.


In practice, the council is broke, the union is militant, and the national party is cautious, hence…


… the Mexican Stand-off.


Meanwhile, rubbish piles up in the streets. The public health risk exacerbates. 


Public health professionals should be raging about the risks to families and kids, but they're employed by the council. You can hear the saloon-doors swinging as the dive for cover.


Lansley's idea of moving PH people into local authorities has backfired. They are gagged and in fear of their jobs.


Charmer has no money and he won’t waste political capital by stepping in.


What’s the answer? 


Speak to the man on the Clapham omnibus, or in this case the woman on the Number 50 bus in Brum. 


They’ll say; sort it out... bring in the army. The public's health is more important than political posturing.


Possible? Yes, under the Military Aid to the Civil Authorities Act.


If:


  • There is a significant threat to public health or safety… yes.
  • All civilian options have been exhausted… yes.
  • The request is made by local authorities and approved by central government…


Does it meet the criteria for a request? You be the judge.  


There’s accumulated rubbish which will lead to a serious health emergency, a disease outbreak or widespread infestation that local services cannot handle.


This is an obvious public health crisis, even if the Brum public health people can't say so and Labour is impotent.


Vermin are chasing off terrified workers, and are attacking property, it will be children next. Already an outraged public are setting fire to piles of festering rubbish and how long before undertakers become unexpectedly busy.


No other local or regional resources can resolve the problem… this is too big for private contractors. This is a Mexican stand-off. Labour are stuck and the public are at risk.


The threshold is met. The families of Birmingham are plunging into a rat infested hell-hole.


Ignore Labour's blushes.


Birmingham Council should request help through the Department for Levelling Up, Housing and Communities, and the Ministry of Defence should decide.


Best they get on and do it.

NEW - FREE - PODCAST

Former BBC Health Editor, GMC chief Executive and Confed boss,

Niall Dickson

and

Roy Lilley

In conversation with

Paul Johnson

Director of the Institute for Fiscal Studies.

'What is the truth behind NHS funding'

Want to contact Roy Lilley?

Please use this e-address

roy.lilley@nhsmanagers.net 

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News and Other Stuff

---

>> Bristol hospital staff 'already stretched to the limit' - ahead of job cuts

>> Chris Hopson to help with “integration” with DHSC for next three months - and then he's out-a-there. Off into the wide blue yonder of something or other. Good luck.

>> Streeting decides not to intervene - over eight service reconfigurations.

>> Planning the healthcare workforce - how many GPs do we need? interesting model in Cuba.

>> Sam Jones, former Trust ChX - set to be the next perm=sec at DH+.

>> HMG and the Wellcome Trust will invest up to £600 million - to create a new health data research service.

>> Social care must stay ‘distinct’ from NHS, says Streeting - so why bother with the inquiry, now we know what they've been told to conclude.

This is a £-walled story in the Telegraph and I can't find another source. It looks like a good idea but I suspect Royal Mail's real worry is losing revenues as a more efficient NHS will make greater use of text and email for the majority of patients. Many NHS Trusts still use older Patient Administration Systems that are integrated with traditional mail workflows. There isn’t a specific law requiring letters, but under the NHS Constitution and Equality Act 2010, the NHS must ensure fair access and reasonable adjustments for different needs. It's easier to send letters to everyone than to figure out who has special needs.

Richard Meddings, former chair of NHSE, in reflective mood, following his standing down.

This is a long read but an absolute cuppa-builder's!

Not only from the insight into his time and his preoccupations but also for the cornucopia of facts and figures that are not easily found in the public domain. Must read!

Well, not quite if you read this article in Pulse, who have had a look at the ARRS reimbursement claims. The figure are nothing like the DH+ claims.

Leading UK Charity invests in Canadian trial of drug treatment for ME/CFS and Long Covid


The ME Association, a leading UK charity for people with ME/CFS and Long Covid, has announced investment in a clinical trial in Canada to test the potential benefits of low-dose naltrexone. Results from the trial should help to clarify whether LDN can affect the underlying disease processes in ME/CFS and Long Covid and improve symptoms.

European Health Digest for April

Roger Steer's usual comprehensive round-up. Not to be missed.


'...it is a warning against ‘Wilful Blindness’ or the evasion of uncomfortable truths; of the need to confront taboos even if you might be uncomfortable with it, and of not falling for ‘Hollow Men’ who purport to tell a simplistic story as though obedience to the line described exempted the listener from the duty of discernment and critical thinking.'

⬇️ For more news, scroll down








This is what I'm hearing, unless you know different. In which case, tell me, in confidence.

__________


>> I'm hearing - The Royal Society for Public Health (RSPH) will today, announce that it will be offering free mental health training to all sitting Members of Parliament.

>> I'm hearing - economists are forecasting the NHS and care services will face £1.2bn pressure from disability benefits cuts.

>> I'm hearing - Last week saw the funding deal for pharmacies arrive. Apparently there was no funding allocation for this month’s NICs hike. What does this mean for the sector now?

>> I'm hearing - Nick Williams, who was the prime minister's main infrastructure advisor, and Tom Webb, a senior advisor on health and public services, have both left

Downing Street.

More news


>> Braintree Community Hospital’s £1.3m procedure room - set to open this summer.

>> NHS Trust surpasses 1,000 robotic-assisted surgery procedures - in under two years.

>> Trust racially discriminated doctor sacked for gross misconduct - judge rules United Lincolnshire Hospitals Trust to pay more than £256k.

>> Training scheme was to boost professional accreditation of local procurement and logistics and materials management staff - in doubt.

>> More than 100,000 baby loss certificates have now been issued to parents - who have lost a pregnancy, allowing them to formally recognise their loss.

>> The U.S. measles outbreak - shows no signs of slowing

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