Bham PCT Merger Is Ruled As Against Patient Choice

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Yep its some GP out on the edges in Birmingham as the NHS empire reshapes.

It seems some slick movements by the South Bham PCT and others in B'ham contravenes the Patient Choice agenda quite seriously according to the Co-operation and Competition Panel take a look below . Mind you in mental health "choice" is highly likely to be stitched up with 3rd Sectorisation and the cheap as chips volunteering-economy ..

What will the difference between slavery in the future and volunteering ? Volunteering is done without chains and whips, but god knows how all these volunteers will be supported when the welfare state and benefits are unlikely to support their needs in an economy of illusions. Yet this development with other parts of health is interesting - who knows maybe in time the new Charity-State in mental health provision will be honest and become businesses. We advise that you stop being suckers though and just stop doing the lottery. Save your money for your locality not the newly re-adjusting middle classes .

SEE THE DOCUMENT ABOUT BHAM PCT'S

Extract below from the Co-operation and Competition Panel

" EXECUTIVE SUMMARY Feb 2011

1. The Cooperation and Competition Panel (CCP) has reviewed the proposed merger of the community services provider arms of South Birmingham PCT, Birmingham East and North PCT and Heart of Birmingham PCT. Our advice to the Department of Health is that the merger as currently constituted is not consistent with Principles 9 and 10 of the Principles and Rules for Cooperation and Competition (Principles and Rules).

2. The CCP concluded that the merger between the three PCT provider arms in Birmingham will reduce patient choice and competition and thus give rise to material costs to patients and taxpayers in relation to the provision of: District nursing and Health visiting services across the three PCTs in Birmingham; and Universal children’s services in Birmingham East and North PCT and South Birmingham PCT.

3. The CCP also concluded that the vertical integration of the acute elective dental services provided by the provider arm of South Birmingham PCT with the community dental services provided by the provider arm of Heart of Birmingham PCT, a provider of community services that holds gate-keeping responsibilities equivalent to those of a GP, is likely to undermine the GP gatekeeper function and hence give rise to costs to patients.

4. Together with this report, the CCP is publishing for consultation with interested stakeholders an invitation to comment on suitable remedies to address the adverse effect on patient and taxpayers identified in this report. Comments on this notice should be provided by 4 March 2011 and we plan to publish our remedies recommendations in March 2011. "

AND BELOW FROM HEALTH SERVICE JOURNAL March 10th 2011

"The Cooperation and Competition Panel has ruled outright against a merger between two trusts for the first time.

Norfolk and Waveney Mental Health Foundation Trust had wanted to merge with Suffolk Mental Health Partnership Trust.

The move would also have allowed Suffolk to achieve foundation status as part of the merged organisation.

But the panel said the merger would result in the removal of “close competition” for contracts from three primary care trusts, due to the lack of other credible competitors within the area.

Any benefits accruing from the merger were too small to outweigh the adverse effect from the reduced competition, the panel said."

Mental Health CBT 117 Trial Study Shows Only 18% Effectiveness

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Save Coggy Now He's Only 18% Resolved

He's one of the 1.8 in 10

Oh dear, no sooner some of the Improvement to Access for Psychological Therapies (IAPT) Cognitive Behaviour Therapy national roll out almost gets underway, er, here and there, but not via your GP Surgery according to a GP study, so it also gets hammered by strong implication by a study published in the

British Journal Of Psychiatry.

The study done by Professor Pim Cuijpers and others were trying to answer a question :

"It is not clear whether the effects of cognitive–behavioural therapy and other psychotherapies have been overestimated because of publication bias."

The study reviewed 117 trials against 175 comparisons and discovered a considerable overestimation of effectiveness of the therapies on depression .

Jeremy Laurence (Independent Health Editor) probed it well in his March 23rd report :

"Does Cognitive Behaviour Therapy Work And Should The NHS Provide More Of It For Depression"

He states :

"But how effective is it?

Less so than its supporters think. Although approved by Nice, a review of 175 trials in the British Journal of Psychiatry published this month concluded that the effects had been exaggerated. Two-thirds of people (67 per cent) improved with therapy, which sounds impressive. However, 40 per cent improved without therapy. So the treatment delivered an extra 27 percentage-point "effect".

How has this been exaggerated?

By "publication bias". Publication bias occurs when publishers of medical journals choose to accept trials that show positive results and reject those that show zero or negative results. This skews the published literature to show a larger effect of the treatment than is true in reality. Pim Cuijpers from Vrije University, Amsterdam, who led the review, said that when publication bias is taken into account, it reduces the effect of CBT by "about one-third, to 18 per cent".

We at UserWatch note the British Journal of Psychiatry abstract of the study did seem to use interchangeable terms : "cognitive behaviour therapy , psychotherapy , psychological therapies" rather too much because it is State prescribed CBT that has been very promoted over the last few years and appears to be taught very stricturedly behind the scenes and is under the spotlight . Never mind the study is free in one year's time after yer cogs have only been 18% oiled .....

We thought some time ago that CBT will give useful deeper empathic therapies - genuinely trying to help people's damaged emotional lives, a really bad name by being lumped together as "psychotherapy" but then that's part of a bigger problem which might have been moving towards clearer resolution if patients had real choices and they as a genuine market drove quality over time .

We also note the social engineering tendency of the Guardian and BBC have hardly touched the efficacy of deeper therapy appropriate for people's life damages. And the need for greater supply of it to support people into better emotionally realistic navigation of themselves. What's wrong with hearing out people's pain , hurt, into witness ?

But then who needs cultures of depth of feeling and thought, other than those of the established status quo of State control and almost subtle social engineering colonial leanings ?

Try asking the 500 Afro Caribbeans who were wrongly diagnosed with onset psychosis and whose backgrounds of parental poor attachments and cultures of instability created their pain and behavior .. Strange isn't it how a large study with 500 Afro Caribbeans gets buried because basically it blows the myth of bio-medical standpoints into the winds of the social streets and their felt and experienced effects .. Yeahhhh lets ignore depth .... Its dangerous for class interests..

Mind you the Guardian did report the study, that's something ...

Dec 9th 2009 Guardian

"The worrying figures emerged from a large study carried out by psychiatrists and epidemiologists at the social psychiatry unit of the Institute of Psychiatry at the Maudsley hospital in south London. Named Aesop (Aetiology and Ethnicity in Schizophrenia and other Psychoses), the study involved 500 patients with mental health problems from various ethnic groups, comparing them with a control group of 350 healthy subjects.

The researchers ruled out genetic issues as the cause, and the previously held suspicions that psychiatrists were more inclined to diagnose schizophrenia when dealing with black males in particular. They concluded instead that the root causes lay in a whole range of social factors that lead to severe social isolation – people living alone, unemployment, and the vexed issue of separation from parents due to family breakdowns in the African Caribbean community amounting to a kind of "sensory deprivation" "

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