BC HEALTH
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New NHS reforms announced today. Seems to be a story of two parts, plus a missing character. Quick thoughts (1/):

 Part 1 of the story is a set of technical fixes wanted by NHS leaders to encourage collaboration in the health system. The direction here makes sense—and fits with what the NHS has been doing for ages. Competition is (mostly) out; collaboration is in: good (2/)
And the need for legal changes to tidy the mess left by Lansley’s 2012 Act has long been recognized. But... (3/)
The benefits of integration are often way overstated, and the risk of reorganizations underplayed. In its first 30 years, the NHS’s structure was relatively stable. But over the past 30, the NHS in England has been on an almost constant treadmill of reform and reorganization (4/)
Overall, evidence suggests that previous reorganizations have delivered little measurable benefit. They can also distract and disrupt, depending on how they’re done. The list of other things for the NHS to be doing during and after the pandemic is very long. So be cautious (5/)
(Plus there’s still quite a lot of detail left to be filled out about how ICSs will actually work in practice) (6/)
Part 2 of the story is a set of political changes proposed by government to increase ministerial control over the day-to-day workings of the NHS in England. The rationale here isn’t very clear (7/)
Jeremy Hunt—the last health sec—claimed he never felt he ‘lacked a power to give direction’ to the NHS when he needed to under the 2012 Act. But Matt Hancock must feel less powerful (8/)
The leaked white paper seemed to claim that the pandemic illustrated the need for these changes. But evidence that stronger ministerial control would have boosted the NHS’s pandemic performance is hard to find (9/)
The missing character—as ever—is a comprehensive plan for reforming adult social care in England. Sure, this bill is mostly about the NHS. And a plan for social care is promised (you guessed it…) later... (10/)
But we’ve been hearing that for an awfully long time now. Continued government inaction on social care amounts to choosing to prolong major public policy failure (11/)
Some more analysis with context, nuance, better word choice, etc here:

https://t.co/GChxwuvEF4
https://t.co/0tYunQaWkz
https://t.co/bMB9vvZm8t

(12/12) @HealthFdn
@nedwards_1 @HPIAndyCowper @mancunianmedic @so_says_sally @Davewwest @ADMBriggs @TimGardnerTHF etc - hopefully feels sensible

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THIS IS A CATCHY & ATTENTION-GRABBING TITLE

Today, the Province will likely announce what zone of the reopening framework we'll shift into as of Tuesday. Whatever is announced, though, doesn't change what we need to do. Why?

Kindly read these 14 tweets & we'll tell you. (1/14)

Fun fact: COVID-19 does not follow us on Twitter. COVID doesn't know, or particularly care, if we're in the Red or Orange zone.

The behaviours of the virus do not depend on the current ‘zone’ of public health restrictions. And, to be perfectly candid, neither should ours. (2/14)

Once upon a time we used to say #WeAreInThisTogether in our messaging. Here's the thing: we are, but we aren't. Not everyone is experiencing this pandemic the same.

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I think @SamAdlerBell in his quest to be the contrarian on Fauci gets several things wrong here. 1/


First, the failure last year actually was driven by the White House, the #Trump inner circle. Watch what's happening now, the US' scientific and public health infrastructure is creaking back to life. 2/

I think Sam underestimates the decimation of many of our health agencies over the past four years and the establishment of ideological control over them during the pandemic. 3/

I also am puzzled why Tony gets the blame for not speaking up, etc. Robert Redfield, Brett Giroir, Deb Birx, Jerome Adams, Alex Azar all could have done the same. 4/

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NortherlyRose \U0001f308 \U0001f499
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#Thread

Living with meltdowns.

A personal, very late diagnosed, autistic perspective.

#autism
#AllAutistics
#ActuallyAutistic

1/

Before my autism diagnosis I had occasional emotional outbursts. These generally happened at home after a sustained period of pressure at school or at work.

When I discovered I was autistic I realised that these were actually what people call meltdowns.

2/

Getting intensely upset was a bit of a family thing. Sudden shouting and throwing of things, with resumption of peace and calm afterwards, wasn’t that unusual.

In fact we had a kind of mantra that it was much better to express our emotions than to keep them bottled up.

3/

It was hard to gauge my own emotions against other people’s but by any measure I felt things incredibly intensely.

As a child the injustice of being told off for something that wasn’t my fault burned into me. I sobbed until the tears stang my face and I could hardly breathe.

4/

But suppressing emotion was necessary for me to survive in the outside world. That’s partly what led to uncontrolled outbursts of feelings at home.

I melted down because there was no justice and I’d been misunderstood. I wasn’t using emotion as some kind of bargaining tool.

5/
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While #Tulane school of medicine is rightfully being exposed for its contemporary racism towards faculty, staff, students (and patients) due to the racist firing of Dr. Princess Dennar, it’s important to call out the deeply anti-Black history of this school, specifically... 1/

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cw: medical racism

Tulane’s school of medicine rose to national prominence for its collection of human “specimens” in their anatomy museum “rivaled only by Harvard”. How did it acquire these “specimens” you might ask?

The collection was “curated” by a Dr. Edward Souchon... 3/

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A tale of valor, deception and decimation.

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This decisive battle was fought between the Vijayanagara empire and the Deccan sultanates resulting in a rout of Vijayanagara and ending the last major medieval era Hindu kingdom in south India.(1)

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