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

More from Health

Some thoughts on this: Firstly, it might be personal preference, but I am not keen on this kind of campaign as I feel like it trivialises cancer. Sometimes the serious message gets lost because people are sharing pics of cats or whatever and the important context is gone.


More importantly, the statistic being used in the campaign is misleading. It says 57% of women put off cervical screening if they can't get waxed. But on further investigation, that's not accurate.

The page here goes on to say "57% of women who regularly have their pubic hair professionally removed would put off attending their cervical screening appointment if they hadn’t been able to visit a beauty salon."

So the 57% represents a concern not across the whole population of women, but only those who regularly get waxed. So how big of an issue is this across the whole population? And what else is stopping people getting smears?

I think campaigns for cancer screening are really tricky because there is so much nuance that often doesn't fit into a catchy headline or hashtag. It's certainly not easy and is part of a bigger conversation.

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Tip from the Monkey
Pangolins, September 2019 and PLA are the key to this mystery
Stay Tuned!


1. Yang


2. A jacobin capuchin dangling a flagellin pangolin on a javelin while playing a mandolin and strangling a mannequin on a paladin's palanquin, said Saladin
More to come tomorrow!


3. Yigang Tong
https://t.co/CYtqYorhzH
Archived: https://t.co/ncz5ruwE2W


4. YT Interview
Some bats & pangolins carry viruses related with SARS-CoV-2, found in SE Asia and in Yunnan, & the pangolins carrying SARS-CoV-2 related viruses were smuggled from SE Asia, so there is a possibility that SARS-CoV-2 were coming from
The UN just voted to condemn Israel 9 times, and the rest of the world 0.

View the resolutions and voting results here:

The resolution titled "The occupied Syrian Golan," which condemns Israel for "repressive measures" against Syrian citizens in the Golan Heights, was adopted by a vote of 151 - 2 - 14.

Israel and the U.S. voted 'No'
https://t.co/HoO7oz0dwr


The resolution titled "Israeli practices affecting the human rights of the Palestinian people..." was adopted by a vote of 153 - 6 - 9.

Australia, Canada, Israel, Marshall Islands, Micronesia, and the U.S. voted 'No' https://t.co/1Ntpi7Vqab


The resolution titled "Israeli settlements in the Occupied Palestinian Territory, including East Jerusalem, and the occupied Syrian Golan" was adopted by a vote of 153 – 5 – 10.

Canada, Israel, Marshall Islands, Micronesia, and the U.S. voted 'No'
https://t.co/REumYgyRuF


The resolution titled "Applicability of the Geneva Convention... to the
Occupied Palestinian Territory..." was adopted by a vote of 154 - 5 - 8.

Canada, Israel, Marshall Islands, Micronesia, and the U.S. voted 'No'
https://t.co/xDAeS9K1kW