Nhs

The Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust carries out some of the most complex and contentious clinical work in the NHS. It deals with children and young people who are experiencing discomfort over their gender identity, but is it raising patient safety concerns? Some of the children it sees go on to change their legal gender. Some receive physical treatment in the form of puberty-blocking medications. Some go on to have further treatments including cross-sex hormones and surgery. The service, which is heavily over-subscribed, is a divisive one. A number say it offers vital, even life-changing care to children in great distress and need, others are less positive.

When the media have gone large on the conclusions of an overpoweringly tedious report, one of the biggest favours a columnist can do for a readership is to read the source. Friends, you owe me. I will expect flowers and chocolate. For I have located Public Health England’s ‘Beyond the Data: Understanding the impact of Covid-19 on BAME communities’ and ploughed through the whole bloody thing. This is the report that produced headlines like the Guardian’s ‘Historical racism may be behind England’s higher BAME Covid-19 rate’. Channel 4 News hit the same black-and-brown-patients-are-dying-of-racism note, which conveniently chimes with the current hair-shirtery of Black Lives Matter. A bit too conveniently, I thought, which is why I tortured myself.

Hong Kong’s future Sir: So we have a moral duty to protect the people of Hong Kong and guide them back to the golden world which existed before 1997 under British rule (‘Let them come’, 6 June)? Come off it. It is true that the hope behind the 1984 Joint Declaration was for HK to move gradually to stronger democratic forms, although under the direct authority of the government of the PRC, as it had been with the UK. What has destabilised Hong Kong and alarmed Beijing is digital grass-roots empowerment — the same thing that half the world’s governments are facing. In Hong Kong it appears in a particularly virulent form. The Chinese have their own way of trying to police it.

Covid deaths Has Covid-19 evolved to become less deadly?— Global infections reached a new peak on 29 May, with 125,473. The daily average for the past seven days is 108,965, 36% higher than in the week beginning 14 April.— However, deaths peaked at 8,429 on 17 April. The daily total for the past seven days is 3,902, 43% lower than in the week beginning 14 April.Source: Worldometers Quiet hospitals How did NHS activity change in the last quarter of 2019/20 compared with a year earlier?Hospital admissions -9.6% Elective admissions -9.7%GP referrals -13.9% Other referrals -8.

I’m embarrassed every Thursday. I don’t mean to sound ungrateful. The outpouring of love for NHS workers at 8 p.m. each week has been touching. Who wouldn’t want to be clapped and cheered? But quietly among ourselves, many of us in the health service have increasingly felt it’s misplaced. I’ve come to dread it. It makes me wince. The fact is that the NHS is currently letting down thousands upon thousands of patients. When the dust has settled, I fear that we will be responsible for the death or morbidity of countless people. Since the pandemic hit, entire NHS services have completely stopped. I fear that this will have catastrophic consequences for the health of the nation.

The speed with which ‘model’ Nightingale hospitals have been designed and erected across the UK reminds one of the experts in this sort of thing: the Romans. Legionary fortresses provide a good example. All were designed on roughly the same pattern, and all had a hospital (valetudinarium). The fortress built at Inchtuthil in Scotland offers a typical illustration. Picture a quadrangle about 100 yards by 65 yards, surrounded on all four sides by a ring of ‘wards’, outside that ring a corridor, and outside that an outer ring of ‘wards’. The central corridor provides free movement round the whole block and access to both the inner and outer ring.

As we begin to learn best practice in the fight against Covid-19, it is notable that the handful of countries that have reduced the number of new cases to zero have used diagnostic testing and contact tracing on a large scale and have recommended the use of face masks. After two frantic months, the UK has just about got a handle on testing, but its embryonic contact tracing app has the hallmarks of every government IT fiasco, and there are barely has enough face masks for health workers, let alone the general public. No country can prepare perfectly for a new viral pandemic, but Britain’s public health system has fallen conspicuously short. Why?

Technology can save the world — from South Korea to Singapore to, um, the Isle of Wight. Oh yes. Britain is catching up at super-fibre-optic-lightning speed with the superpowers of tech in its fight against Covid-19. We’ve developed a snazzy ‘track and trace’ app, that's already been trialled at an RAF base in Yorkshire, and the government now intends to roll it out in a pilot scheme on the lovely Isle of Wight and the Scottish Isles, Health Secretary Matt Hancock will announce on Monday. Sod the threats to privacy and liberty — let’s get people-monitoring done! One small problem — the internet on the Isle of Wight doesn’t really work. Mobile telephone reception is notoriously rubbish; so too is broadband. It's a common gripe down here.

As the NHS was preparing for the Covid onslaught, thousands of hospital patients were discharged to care homes in an attempt to free up beds. This worked: about 40,000 NHS beds are now unoccupied, four times the normal amount for this time of year. Attendance at A&E has halved. Almost half of all intensive care beds with mechanical ventilators lie unused. This is before the seven pop-up Nightingale hospitals, most of which are also empty, are factored in. The NHS was effectively protected in this crisis. Care homes were not. While those in hospital were being given the care one would expect from one of the world’s best-resourced health services, most care home residents who fell sick with symptoms of Covid-19 were not even being tested for the disease.