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Exclusive: NHSE leak reveals GP ‘work to rule’ could cost £570m in four months
The NHS England slide seen by HSJ calculates that, based on a 30 per cent reduction in GP activity from August to November, the cost of work diverted to other services would be £569m.
The British Medical Association GP Committee announced last week that GP partners had voted overwhelmingly to scale down work that goes “above and beyond” their contract, in an unprecedented move.
This could include a range of “work to rule”-style actions, including: capping daily appointments; stopping “rationing referrals, investigations and admissions”; and stopping using “e-referral advice & guidance”.
The figures lay bare the potentially profound impact service reductions could inflict if GP partners take a robust approach. The financial cost to the service follows an estimated £1.7bn bill for strike costs, mostly for action by junior doctors and consultants, in 2023-24.
NHSE was given extra money to cover some of those costs, although the service was also forced to cut back activity and development plans.
Under a 30 per cent reduction in GP activity from August to November, the £569m costs over the four months comes from several sources. These include an extra 1.2m A&E attendances (£319m); 492,000 elective referrals (£104m); 736,000 urgent care centres attendances (£67m); 1.8m more pharmacy visits (£27m) and 1.8m more calls to NHS 111 (£21m).
The NHSE slide also calculates the impact of scenarios of a 10 per cent or 30 per cent reduction for a single month, August. These projections suggest a 10 per cent in-month reduction would cost around £37m, while a 30 per cent reduction would cost £103m with 43,000 or 86,000 additional elective referrals respectively.
The BMA GP Committee has not said how long the action is planned for, and there is no legal end-point, but it has been holding talks with the health and social care secretary Wes Streeting, to talk about pay and other concerns.
In its statement announcing the GP collective action, BMA GPC chair Katie Bramall-Stainer said the “funding crisis in general practice” meant practices “are struggling to keep the lights on, can’t afford to hire much-needed GPs and other staff, and some have even closed for good”.
She said: “This will not be a ‘big bang’. It will be a slow burn. It’s likely that impact may not be felt for some time. We hope this will give the new government time to consider our proposed solutions including fixing our contract once and for all.”
Source: The HSJ, 6 August 2024
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US imposes sanctions on Paraguayan cigarette producer for allegedly enriching the former president
The Biden administration on Tuesday imposed sanctions on a Paraguayan tobacco company for allegedly enriching the country's controversial former president, a cigarette tycoon sanctioned last year by the White House for corruption.
The U.S. Treasury Department said it was targeting cigarette producer Tabacalera del Este over its links to Horacio Cartes, one of the Paraguay’s richest men who served as president from 2013 to 2018 and still wields significant political power in the country. Paraguay's current president, Santiago Peña, is a political protégé of Cartes who also hails from the dominant conservative Colorado party.
At the time, the Treasury also designated four companies controlled by Cartes that spanned the Paraguayan economy's main sectors, including cattle ranching, tobacco and consumer goods.
Cartes has dismissed the corruption allegations as politically motivated. There was no immediate response from the Tabacalera del Este tobacco company. The phone numbers on the company website were disconnected.
Cartes says he no longer owns nor is actively involved in the management of Tabacalera del Este, a company that has roused competitors' suspicions that smuggling was occurring given its massive volume of cigarette sales.
Nonetheless, the Treasury Department on Tuesday accused Tabacalera del Este of funnelling millions of dollars to Cartes “pursuant to a sales agreement.” The department's Office of Foreign Assets Control last year identified Cartes as owning a 50% or greater interest in the company, directly or indirectly.
Source: ABC News, 6 August 2024
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Opinion: The Australian government is under pressure to ban gambling ads. History shows half-measures don’t work
Writing for The Conversation, Associate Professor at the School of Public Health and Preventive Medicine, Monash University, Charles Livingstone, addresses the mounting pressure on the Australian Government to implement a total ban on gambling advertisements. This pressure comes as reports circulate that the Australian Government will not fully implement the recommendations of last year’s gambling inquiry, partially banning advertisements rather than phasing them out altogether over three years as recommended.
Professor Livingstone highlights the growing concern among the public and advocacy groups regarding the pervasive nature of gambling advertisements and their potential impact on vulnerable populations, including young people and those struggling with gambling addiction.
Livingstone outlines how partial regulatory efforts, such as restrictions on the timing and content of ads, have proven insufficient in curbing the influence of other harmful commodities like tobacco in the past. Livingston argues that these measures often fail to address the core issues, allowing companies to find loopholes and continue targeting at-risk individuals.
Livingstone concludes that a comprehensive ban on gambling advertisements is necessary to tackle the problem effectively. Livingstone draws parallels with successful public health campaigns against tobacco advertising, suggesting that a similar approach could mitigate the harms associated with gambling. Livingstone maintains that by eliminating gambling promotion altogether, the government could reduce the normalization of gambling and protect vulnerable populations from the marketing tactics of gambling companies.
Source: The Conversation, 6 August 2024
See also: Parliament of Australia - You win some, you lose more: Online gambling and its impacts on those experiencing gambling harm
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