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  • Memorial of Health & Social Care Workers taken by COVID-19 Moving and interactive a digital tribute and memorial by Nursing Notes to the dedicated members of our health and social care family who gave their lives during the fight against Coronavirus (SARS-CoV-2 / COVID-19).
    NursingNotes is committed to planting a new tree in a protected forest for every single health and social care worker who loses their lives because of the COVID-19 pandemic.

  • Private hospitals profit from NHS waiting lists as people without insurance pay out Guardian September 18 with a possibly exaggerated view of a real threat to the NHS:
    “People on modest incomes, and even those claiming benefits are turning to private providers for knee or hip replacements, cataract removal or even expensive cancer treatment.
    “This week, a survey of 4,000 adults commissioned by charity Engage Britain showed more than a fifth had gone private because they could not get the treatment they needed. While support for the NHS remains high, a quarter said the wait for treatment for themselves or a loved one had had a serious impact on their mental health.
    “Roughly 13% of the UK population has some kind of health insurance, mostly through their employers. The rest are faced with a stark choice – wait months and even years for badly needed treatment, or dig into savings to jump the queue."

  • Asylum seeker given £100,000 hospital bill after suffering stroke Guardian September 18 with another grim example of Johnson government racist policies undermining the core principles of the NHS and levying extortionate charges:
    “Simba Mujakachi, a personal trainer, was just 29 years old in June 2019 when he suffered a catastrophic stroke that left him comatose. When he awoke, he was paralysed on his left side and unable to talk or eat.
    “His stroke could have been prevented by relatively inexpensive medication for a blood clotting condition that, as a refused asylum seeker, he was not entitled to on the NHS.
    “Now Mujakachi, who has lived in the UK since he was a child, owes nearly £100,000 for the emergency treatment that saved his life, a staggering sum which he does not know how he will ever repay.
    “No one can pay £100,000, who has got that? I’m looking at the bill and I’m thinking, that’s a house,” he said.”

  • Brain health and its social determinants Lancet Sept 18 editorial underscores the importance of social determinants in understanding mental health
    "Opinions about the relative importance of the biological and sociological causes of mental ill health have moved wildly from one extreme to another over the past 50 years. So, when Vivian Pender, the newly elected President of the American Psychiatric Association (APA), pronounced in July that “we need to be more aware of the broader context in which that illness occurred and how that context has shaped the health outcome”, cynics could be forgiven for thinking it just another swing of the pendulum. However, perhaps this time Pender—and many others, for she is not alone—has got it right.
    "Much evidence has been published supporting Pender's call for social determinants to be considered as key in understanding and treating mental illness. The Lancet Commission on global mental health and sustainable development stated that research consistently shows a strong association between social disadvantage and poor mental health.
    "At the individual level, the Commission reported that poverty, childhood adversity, and violence are key risk factors for mental disorders. The COVID-19 pandemic has further focused attention on the importance of social determinants in causing both mental and physical illness.
    "That Pender has felt the need to create a taskforce to examine this issue, reporting to the APA's annual meeting in May, 2022, probably reflects the strength with which many US psychiatrists are wedded to the biomedical model of mental ill health and the utility of pharmacotherapy. Reaching for the prescription pad is certainly easier than fixing a patient's economic and social circumstances. But current treatments, including medication and talking therapy, have their limitations."

  • More patients should expect their operations to be cancelled, warns top doctor Independent report September 15:
    “Dr Fiona Donald, new president of the Royal College of Anaesthetists, told The Independent the workforce gaps among anaesthetists, the largest group of hospital specialist doctors, had deteriorated since the pandemic with one in three reporting mental health problems following their experiences during the Covid crisis.
    “In her first interview, Dr Donald, a consultant anaesthetist at Southmead Hospital in Bristol, said she was very worried about the demand on hospitals during winter, adding that doctors were being asked to do extra work that was “beyond reasonable.”
    “She said she feared it was “inevitable” there would be more cancellations of operations in the coming months as the NHS comes under extra pressure – with the shortage of doctors placing a limit on how many surgeries could be done.”

  • Hospital admits patient care is being compromised as cancer operations delayed September 14 report from The Independent:
    “Cancer operations at one of England’s largest hospital trusts are being delayed as bosses admit patient care on wards is being compromised.
    “Nottingham University Hospitals Trust has been forced to convert one of its few remaining wards for cancer surgery patients into an emergency medical ward to cope with an influx of patients.
    “The Independent understands the trust’s A&E department is regularly overcrowded with 40 or more patients waiting for a bed at the start of most days.
    “The trust, which is set to begin filming on a new series of 24 Hours in A&E this week, said staff were going “above and beyond on a daily basis”.
    “It is one of a number of NHS trusts hit hard by rising demand for NHS services and increasing numbers of coronavirus patients. The East Midlands trust had more than 140 Covid-19 patients on its wards on Monday.”

  • NHS trusts ‘wrongly charging’ vulnerable migrant women for maternity care Shocking Sept 17 report from the Independent on the racist policies imposed by government and NHS management:
    “NHS trusts are wrongly charging deeply vulnerable migrant women for their maternity care, new research has found.
    “Maternity Action, who carried out the study, said “terrified women” are ringing their helpline saying they are too scared to attend antenatal appointments in case they are charged for their healthcare.
    “The organisation discovered many NHS Trusts are “routinely ignoring or misinterpreting” the law on requesting payment from overseas women for maternity care, despite the fact the government's own policy stipulates the most vulnerable women should not be charged.
    “Rules specify overseas women from outside the European Union who are expecting a baby must be charged for NHS care – with debt from maternity care affecting future immigration applications. Charges start at around £7,000 but potentially double if there are complications with the pregnancy.”

  • Bad managers ‘never get fired’ in the NHS, complain doctors Yet another appalling badly informed Torygraph article, Sept 17, attacking the NHS and its management – despite never criticising the huge fat cat packages trousered by bosses of private companies – or indeed low-talent right wing journalists.
    “Ten years ago, NHS super-managers with six-figure salaries, expense accounts and hefty pensions were a rare breed in the country’s hospital boardrooms and local commissioning groups.
    “Not any more. While nurses have seen their pay fall in real terms over the past decade during an era of austerity, the ranks of these richly rewarded health bosses have swelled dramatically.
    “In September 2010, there were 985 hospital directors and healthcare managers in England earning more than £110,000, according to NHS Digital, the health information centre that tracks the numbers of “very senior managers” for salary reviews. But by September 2020 there were 2,788. It means their numbers have almost tripled in a decade.”

  • NHS unions express fury as health minister admits £2.8bn of PPE unfit for purpose Morning Star Sept 17:
    “NHS unions and campaigners reacted with fury today to a government admission that £2.8 billion of personal protective equipment (PPE) is not fit for purpose.
    “Health minister Lord Bethell revealed that nearly two billion items of PPE are unusable and lying in warehouses labelled “do not supply” — more than 6 per cent of the volume purchased.
    “The government admitted in July that it was in dispute with a number of companies over 40 contracts for £1.2bn worth of PPE that was either substandard or simply undelivered — including a million masks found to be below the FFP3 standard used in intensive care.
    “Unite union national officer for health Colenzo Jarrett-Thorpe said that the latest revelation was “a searing indictment of the secretive fast-track fashion (in which) many of the PPE contracts were awarded to ‘friends’ of the Tory Establishment, something we have suspected for a long time.”

  • EU, Switzerland, UK continue opposition, amid support for TRIPS waiver Shocking Sept 15 Third World News report on British government, EU and Switzerland blocking steps to increase production and distribution of Covid vaccine
    “Amid the groundswell of international support for the TRIPS waiver at the WTO coupled with more countries, including Malaysia, joining as co-sponsors of the waiver, three members – the European Union led by Germany, Switzerland, and the United Kingdom – seem determined to undermine an expeditious decision on the temporary waiver for combating the COVID-19 pandemic, said people familiar with the development.
    “The intransigent positions adopted by these three members against the waiver appears more like an attempt to protect the monopolies and massive profits of Big Pharma over the enormous loss of lives globally due to the ravaging COVID-19 pandemic and the denial of vaccines to the global South, said people familiar with the discussions.
    “The much-delayed temporary TRIPS waiver seeks to suspend certain provisions in the TRIPS Agreement relating to copyrights, industrial designs, patents, and protection of undisclosed information for ramping-up the production of diagnostics, therapeutics, and vaccines across countries on an expeditious basis.
    “The EU, Switzerland and the United Kingdom escalated their opposition to the waiver on “ideological” grounds that could create a permanent state of “vaccine apartheid” as well as loss of millions of lives due to Covid-19, said people, who asked not to be quoted.”

  • Canada: Alberta healthcare system on verge of collapse as Covid cases and anti-vax sentiments rise Guardian report September 15 on the consequences of rejecting any restrictions to limit the spread of Covid:
    “A surge in coronavirus cases has pushed the healthcare system in the Canadian province of Alberta to the verge of collapse, as healthcare workers struggle against mounting exhaustion and a growing anti-vaccine movement in the region.
    “The province warned this week that its ICU capacity was strained, with more people requiring intensive care than any other point during the pandemic – nearly all of them unvaccinated.
    “It’s not easy to go to work every day and watch people in their 30s die,” an ICU nurse in Edmonton told the Guardian. “Having to help a family say goodbye and then going through the actions that are required at the end of someone’s life, is worse than anyone can imagine.”
    “Alberta has long boasted of its loose coronavirus restrictions – including advertising the previous months as the “best summer ever” as it rolled back those few restrictions. It has also been the site of North America’s highest caseloads.”

  • NHS app storing facial verification data via contract with firm linked to Tory donors Guardian report September 15:
    “The NHS app is collecting and storing facial verification data from citizens in England in a process which has fuelled concerns about transparency and accountability.
    “The data collection is taking place under a contract with a company linked to Tory donors called iProov, awarded by NHS Digital in 2019, which has yet to be published on the government website.
    “Privacy campaigners say the opacity of the relationship between London-based iProov and the government raises questions about how securely the information is held, with one saying they were “deeply concerned” about the secrecy surrounding the use of data.
    “An NHS spokesperson confirmed law enforcement bodies were able to request data, but that a special panel reviewed such requests, taking into account the health service’s duty of confidence.”

  • ‘Severe pressures’ driving two-month waits for urgent scans HSJ report Sept 15 on the growing delays of an under-funded NHS:
    “An internal update at Shrewsbury and Telford Hospital Trust, labelled “September turnaround times” and seen by HSJ, suggested the current response time for the most urgent “two-week” CT scans is nine weeks.
    “The waiting times then rise to 15 weeks for scans which are still urgent but do not need a two-week response, and more than six months for routine scans. For routine scans the document adds: “Currently unable to appoint due to capacity available”.
    “… Diagnostics data that is published by NHS England shows the proportion of all cases waiting more than six weeks, regardless of their urgency. The latest data from July showed 27 per cent of cases waiting for a CT scan at SaTH breached this standard, against the national average of 16 per cent. This meant it was among the 30 worst trusts on this measure.”

  • Essex: Children harmed by mental health service failings BBC News September 15 report on a troubles trust where parents and relatives have been campaigning for action for years:
    “Young people cared for by an NHS mental health service "came to harm" because of its failings, inspectors said.
    “The care provided by Essex Partnership University NHS Foundation Trust (EPUT) has been rated "inadequate" by the Care Quality Commission (CQC).
    “It has now been stopped from admitting new patients after inspectors found "serious concerns" in the children and adolescent mental health services.
    “EPUT said it had increased staffing levels and had been coaching staff.
    “The inspection was prompted by a serious incident and concerning information received about safety and quality, the CQC said.”

  • Child Covid rates in Greater Manchester spiked by 56 per cent after first week back at school Grim report from Manchester Evening News Sept 14:
    “The reopening of schools has brought a large spike in the number of pupils infected with Covid.
    “Infection rates among children aged 10-14 are now higher than in any other age group. Figures for the week ending September 8 show that rates have risen by more than 50 per cent in all-but three areas of Greater Manchester.
    Rochdale has had the largest percentage increase, of 128pc, followed by Bolton at 87pc.
    “But Tameside has the highest infection rate among 10 to 14-year-olds, at 859 cases per 100,000, followed by Stockport with 780.3 cases per 100,000.”

  • The NHS is broken – GPs know it and the patients are suffering the consequences Another (Sept 14) instalment of the Daily Torygraph hate campaign against the NHS in general and GPs in particular – in which not one word is said about the decade of under-funding and endless broken promises of Tory ministers. Fortunately behind a paywall:
    “…the starkest gap between how we want the NHS to be and how it actually is comes in general practice. It is in this aspect of the nation’s health provision, found a recent poll for The Patients Association, that most Britons have struggled to access care.
    “Before the pandemic, a quarter said they found it hard to see a GP. By April this year, that had risen by half to 36 per cent – worse than for any other NHS service. And now, a survey conducted over the summer reveals, it has jumped again, with 52 per cent finding it hard to get a GP appointment.
    “GPs are the front door to the NHS,” notes The Patients Association, “and patients are increasingly perceiving that that door is closed to them.”
    “The impact is very real. Some 56 per cent of patients admit to putting off appointments, and more than half also expect their health to suffer as a result of changes to provision during the pandemic. The toll may already be emerging. For the last 18 months the number of so-called “excess deaths” in private homes has remained stubbornly above the five-year average.”

  • The Long-Term Safety Argument over COVID-19 Vaccines Boston Review article September 14 takes on the “safety” argume t employed by anti-vaxxers:
    “Vaccine hesitancy remains a very serious and costly obstacle for many countries, with the United States very much in the spotlight. While some hesitancy is rooted in longer trends, much of it appears to be driven by coordinated disinformation campaigns specific to this pandemic.
    “Despite highly impressive safety profiles, strong efficacy, and continually encouraging data showing real-world vaccine effectiveness, numerous spurious and scientifically illiterate arguments to avoid the jab are reaching millions of people each day.
    “These efforts have taken a variety of forms. Staunch anti-vaxxers sow doubt more by fearmongering than by reasoned argument. Others present more specific concerns.
    “Some have expressed concern at emergency use authorization rather than full approval by the U.S. Food and Drug Administration. This point is now moot, given that Pfizer/BioNTech won full approval in late August. (Moderna has submitted its own application for full approval and will almost surely win it soon.)
    “Perhaps the most stubborn challenge, however, is the contention that we lack “long-term” safety data for the vaccines. Assertions have been made on widely viewed broadcast media that the recent FDA approval has been rushed.
    “The mRNA shots seem to attract the lion’s share of this particular scare, due to the claim that these are “new” technologies. Given their novelty, the worry goes, we need more data before we can make a more informed decision about how they might impact us in the long run.”

  • ‘The virus is painfully real’: vaccine hesitant people are dying – and their loved ones want the world to listen Guardian report September 14:
    “In the UK and other developed nations such as France and the US, Covid-19 has become a pandemic of the unvaccinated.
    “Last month, Prof Chris Whitty, England’s chief medical officer, tweeted that: “The majority of our hospitalised Covid patients are unvaccinated and regret delaying [their vaccines].”
    “About 60% of all hospitalisations due to Covid in the UK are of unvaccinated people. An Office for National Statistics report published on Monday says that in the first six months of 2021, Covid was involved in 37.4% of deaths in unvaccinated people – and just 0.8% of deaths in fully vaccinated people.
    “While 80% of the UK adult population is fully vaccinated (and 89% have received a first dose, indicating they will go on to be fully vaccinated), vaccine uptake rates have been tapering off in virtually all regions of the UK.”

  • NHS leaders ‘set for fight’ amid signs mental health will miss out on new funding HSJ article Sept 14:
    “Last week, the government announced an additional £15bn for NHS England over the next three years, with a clear aim to increase elective activity in acute hospitals by 30 per cent on pre-pandemic levels. Other priorities were described as putting services on a sustainable footing, and focusing on prevention.
    “But there were no new commitments specified for mental health services, despite an acknowledgement of “unprecedented demands placed on staff and the public as a whole”.
    “In recent years there has been a firm commitment to reaching “parity of esteem” for mental health services, meaning the sector has generally received a fair share of any spending increases, and a growing proportion of the overall budget.
    “But well-placed sources told HSJ there are currently no additional increases planned for mental health over the three years from 2022-23.”

  • Multinational care companies are the real winners from Johnson’s new tax Excellent Sept 14 Guardian Opinion column by Allyson Pollock dissecting the dysfunctional social care system and the profits milked out of it:
    “Social services for community and long-stay care in the UK are among the most privatised and fragmented in the western world – even more so than in the US.
    “Local authorities in England commission most of their care services from private providers, of which there are 14,800 registered organisations providing care across 25,800 locations.
    “This situation arose as local authorities, facing budget shortages and central government-imposed regulatory and financial incentives, sold off their care homes and turned to outsourcing. Scotland and the other devolved administrations face similar structural issues.
    “According to a study by the Competition and Markets Authority carried out in 2016 and updated in 2018, the care homes industry alone was worth around £15.9bn a year in the UK with 5,500 different providers operating 11,300 care homes for older people.
    “In 2020, there were more than 456,000 care home beds in England, with local authorities and the NHS combined having closed and sold off an equivalent number during the preceding decades. For-profit providers, many of them large multinational chains, own 83% of care home beds with a further 13% provided by the voluntary sector.
    “At the same time, government funding for local authority adult social care in England fell by 55% in 2019-20 compared with 2010-11, resulting in a 29% real-terms reduction in local government spending power. By 2019-20, local authority net spending on care was £16.5bn, 4% lower in real terms than in 2010-11.”

  • UK near top of ‘league table of shame’ for delivering just 7pc of Covid jabs promised to poor countries Boris Johnson’s former employers the Daily Telegraph Sept 14 pointing out the broken promises by the government they normally refuse to criticise:
    “The UK has delivered less than seven per cent of the vaccines it has promised to developing countries, coming near the bottom in what critics are calling a “league table of shame”.
    “Data compiled by Our World in Data, a research hub based at the University of Oxford, show the world's major economies have promised to donate many more doses of vaccine to poor countries than they have delivered.
    “The data looks at donations to Covax, the initiative to share vaccines globally, and finds that of the 554 million doses promised by the world's richest nations, only 90.8 million, or 16 per cent, have been delivered.
    “The UK is the second biggest pledger of vaccines after the United States, promising 80 million doses to Covax. But is towards the bottom of the league table when it comes to delivery. So far it has only delivered 5.1 million doses, just 6.38 per cent of what it has promised.”

  • Anti-Vaxxers Are Now Gargling Iodine to Prevent Covid-19 Rolling Stone Sept 13 uncovers more idiocy from anti-vaxxers:
    “As if attempting to one-up last week’s stupidity with regards to ivermectin, anti-vaxxers on Facebook and Twitter are advocating for a new and unproven Covid-19 treatment: Betadine, an antiseptic used to treat cuts and scrapes.
    “Povidone iodine, often sold under the brand-name Betadine, is an iodine-based treatment largely for topical use that kills bacteria.
    “It’s a “commonly used cleanser in the ER and OR,” says Kenneth Weinberg, an emergency room physician in New York City. “If you’re in the ER and someone has a wound to sew it up, you use it to clean with.”
    “When told that anti-vaxxers had taken to gargling with Betadine, Weinberg said, “Fuck me! Of course they are.”

  • Early CT scans deliver huge fall in lung cancer deaths, study shows Guardian Sept 12:
    “Low-dose computerised tomography (CT) scans can detect tumours in people’s lungs early and cut deaths by 16%, according to the UK Lung Cancer Screening Trial (UKLS).
    “The findings have prompted renewed calls from lung cancer experts for the government to bring in routine screening across the UK of all those who are at risk because of their smoking history. They say that early detection means patients can have potentially curative surgery or radiotherapy.
    “‘Lung cancer early detection and surgical intervention saves lives,’ said Professor John Field of Liverpool University, an author of the trial. …
    “About 47,000 Britons a year are diagnosed with lung cancer, and 35,000 die of the disease. It kills more men than prostate cancer and more women than breast cancer. Only a quarter of lung cancers are found when they are at stages one or two – when treatment may keep someone alive.”

  • ‘Only a fraction’ of long Covid sufferers able to access NHS support clinics Independent report, Sept 12:
    “Hundreds of thousands of people suffering from long Covid in England may be struggling to access NHS clinics dedicated to treating the condition, figures suggest, with patients waiting up to six months for an appointment following a GP referral.
    “Between 5 July and 1 August just 5,737 referrals were made to the support centres, which were established by the NHS at the beginning of the year to offer a range of treatments and rehabilitative services to those with long-lasting Covid symptoms.
    “But data from the Office for National Statistics show that an estimated 970,000 people are experiencing long Covid in the UK – more than a third of whom have suffered from the condition for over a year.
    “This means “only a fraction” of the number of people thought to have the condition are being seen by the clinics, said one member of the NHS Long Covid Taskforce, who asked to remain anonymous.”

  • Covid hospitalisations moving in ‘alarming’ direction, experts and NHS officials say Independent report Sept 11:
    “Covid-19 hospitalisations are increasing at an “alarming” rate, experts have warned, putting increased pressure on the NHS as it struggles to cope with a spike in demand for emergency care and the largest waiting list on record.
    “Figures show that the number of people in hospital with Covid-19 has increased by more than 1,000 within the last 11 days, jumping from 7,091 to 8,098 – a 14 per cent rise. In the previous 11 days, from 19 August to 29 August, the number of Covid patients increased by 590, or 9 per cent.
    “Covid bed occupancy levels are now at their highest levels since 10 March, according to government data, after daily admissions passed the 1,000 mark this week.
    “And analysis suggests that the UK could be forced back into another lockdown by mid-November if the number of daily admissions continues on its current trajectory.”

  • Should Meirion Thomas be subject to disciplinary action for expressing his offensive views? Useful 2015 blog illustrating the dodgy political track record of the surgeon who has just knocked out a Telegraph hate piece attacking GPs:
    “Meirion Thomas is a consultant surgeon who works at the Royal Marsden Hospital. He also has a sideline publishing controversial opinions in publications such as the Spectator and the Daily Mail.
    “He has published articles (e.g. here and here) in the Spectator on the subject of immigration that would, no doubt, delight the National Front and UKIP.
    “He has published in the Daily Mail, expressing:
    • “views on female doctors that even the Daily Mail described as "provocative"; and which many considered offensive - see the Royal College of General Practitioner's response here; and
    • “another which many felt was extremely inaccurate and offensive to general practitioners - see a response in GP magazine Pulse here."

  • If the GPs went on strike, would anybody notice? Rant by a right wing surgeon against GPs in, of course, the Torygraph Sept 11:
    “Most of the complaints of the GPs themselves, however, do not pass muster. Dr Samira Anane, workforce policy lead of the BMA GP Committee, recently seemed to suggest that GPs were cutting their hours to avoid burnout because of the stresses and pressures of the job.
    “But in my 33 years as a hospital consultant surgeon I didn’t see this happen once, even in cardiac, brain or cancer doctors who take life and death decisions daily. Why should GPs be so badly affected given that they work at the opposite end of the medical complexity spectrum?
    “The wider problem with all the new money that the Government is committing to the NHS is that it comes without any reform, and I predict that the bureaucrats that the health service seems to be hiring, charged in part with spending the £36 billion wisely, will never have worked at the bedside. I know from experience that the natural instinct of hospital managers when faced with a problem is to appoint more managers.”

  • Covid crisis as hospitals axe operations and move to highest alert level Mirror Sept 11 report on a situation in Derbyshire that is increasingly affecting the whole of England:
    “A county's healthcare system under 'severe pressure' has moved to its highest alert level and begun cancelling some operations.
    “NHS and care services across Derbyshire and Staffordshire sounded the alarm after seeing a huge surge in patients in recent days.
    “Health bosses in the region said there had been a 'significant increase' in sick patients and that in a single day the A&E departments saw 1,038 patients. The numbers were seen at Chesterfield Royal, Royal Derby Hospital and Queen's Hospital, Burton on Monday.
    “It has now prompted some hospitals to reportedly move to 'Opel 4' - which signifies a hospital is 'unable to deliver comprehensive care.'”

  • Betsi Cadwaladr health board cancels some surgery amid Covid rise BBC News Sept 11 on the worsening crisis in Welsh hospitals:
    “A Welsh health board has cancelled some surgical operations due to a rise in Covid-19 cases in hospitals.
    “Betsi Cadwaladr health board, which covers north Wales, said the decision was not taken lightly but was necessary to "safely care for patients".
    “And the health board has also decided to significantly restrict hospital visits as it battles outbreaks at four of its hospitals.
    “First Minister Mark Drakeford has said cases are "likely to get worse".
    “It comes after Hywel Dda health board suspended some planned orthopaedic surgery, and Cwm Taf Morgannwg health board banned most hospital visiting.”

  • Chart of the week: How much of the health and care levy will social care receive and what is this intended to do? Useful Nuffield Trust diagram (Sept 10) on the breakdown of the £30bn allocated to England over 3 years, showing how little goes to social care, and how little of that to address the workforce crisis:
    "What we do know is that £500 million of the £5.4 billion is meant to go towards the professional development of care staff. But critics have questioned whether this will be enough for the 1.52 million strong social care workforce, given the known low pay and working conditions they experience. To put this in perspective, the NHS Pay Review Body reports the government has estimated a cost of £1.2 billion to bring the lowest paid care workers in line with their NHS counterparts."

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