Archive for March, 2012

Health and Social Care Bill : Risk Register leak

The Health and Social Care Bill has trundled its way through the House of Commons, the House of Lords, where it was subject to about a thousand amendments, and back through the House of Commons. It will have become law once it receives Royal Assent. The Bill may already be approved by the Queen, in which case it becomes an Act of Parliament i.e. Law.

This has been one of the most controversial pieces of legislation that has passed through parliament. Although it refers only to English Law there may be ramifications for the healthcare in other UK countries.

Many believe the law was intentionally long and unintelligible and few understood its full implications. There is a widely held view that it heralds the end of the NHS in England and is designed in such a way that the government abdicates much of the responsibility for the healthcare of the citizens in England, and that the NHS over the next few years will move fast forward into the private sector with some care funded through taxation and some rationed and paid by the patient directly or through separate insurance cover. There is a worry that the private sector will cherry-pick the most profitable and easy to treat conditions.

Another controversy was that the government refused to publish a document indicating the risks associated with Bill. This is known as a Risk Register and it is normal practice for these assessments not to be published. However, because of the perceived risk to the health of the nation the coalition government was told to publish it but refused to do so. Recently what was alleged to be an early copy of the Risk Register was leaked to at least two individuals and last night Twitter was chirping away about the contents.

This alleged Risk Register is currently located here :


Note the red and orange warnings.

And note the government-speak gobbledygook in the “Mitigation Actions” column.

No doubt the government will respond (if it chooses to respond at all) by saying this is an old document and the thousand amendments have solved the problem.

There are many who do not agree with that view.

Here are two of these people :

The Professional Case for Withdrawing The Health and Social Care Bill from Daniel Saul on Vimeo.

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A bad migraine is pretty horrible and can be very incapacitating. Unfortunately it is a common condition although there is marked variation in both intensity and frequency.

I suffered from migraines as a teenager and always had the feeling that they were precipitated by working in fluorescent light but never really went to the bother of proving this to myself. Fortunately for me, though, the visual aura was the worst part of it and the headache that followed was always tolerable. Fortunately too, they disappeared completely in my twenties, never to return.



Stages of migraine

There are five distinct stages to a migraine, although not everyone goes through all the stages:

1. ‘Prodromal’ (pre-headache) stage. Some people experience changes in mood, energy levels, behaviour and appetite, and sometimes aches and pains several hours or days before an attack.

2. Aura. Some people experience a sensation, or aura, just before their migraine starts. Symptoms of aura include flashes of light or blind spots, difficulty focusing, and seeing things as if you are looking through a broken mirror. This stage normally lasts around 15 minutes to an hour.

3. Headache stage. This is usually a pulsating or throbbing pain on one side of the head. You usually have nausea or vomiting, and extreme sensitivity to bright light and loud sounds, with a strong desire to lie down in a darkened room. This stage lasts for four to 72 hours.

4. Resolution stage. Most attacks gradually fade away. Some people find the headache stops suddenly after they have been sick. Sleep often relieves the symptoms.

5. ‘Postdromal’ or recovery phase. There may be a stage of exhaustion and weakness afterwards.


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It could be said there are certain things in life that are so unthinkable that they are better left unsaid, until someone else decides to broadcast their thoughts on the matter and as a consequence it becomes a concern  that needs to be fully addressed

Some unthinkable thoughts regarding infanticide have been inserted into a respected journal of bioethics. The paper is called “After-birth abortion : why should the baby live?” The authors are Alberto Giubilini and Francesca Minerva.

In it they argue that abortion is not different ethically from infanticide and therefore infanticide should be subject to the same rules that allow abortion.

There was a cyber-uproar regarding this and the two bioethicists involved felt threatened by some of the things that were being said.

The blogosphere’s response was vicious.

However, here is a a debate on the matter that does not carry death threats for the authors of the article or for the editor who permitted it to be published.


“The paper raises two distinct questions. The first is not in fact whether the authors have a point: it is the more general question of whether the paper, undoubtedly deeply repugnant to many in its content, should have been published in the first place. The argument is that, by sowing what Dr No once called Malicious Seeds of Mischievous Doubt, ivory tower academics introduce ideas into society that will then grow in to abhorrent practical applications; and that therefore the ideas should never be aired in the first place.

But Dr No, as he said in Malicious Seeds, has no truck with the suppression of ideas. Debate is always better than silence, however potentially or actually repugnant the idea, and so he applauds the courage of the JME in publishing the paper, and so forcing the debate into the open. In return, it is beholden on those who object to the ideas to advance not fire-crackers and death threats, but sound argument that exposes the flaw in the philosopher’s reasoning, and so ensure the mistaken idea is dealt a blow that is as legitimate as it is fatal.”

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