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

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/

Several of these people Bob Redfield, Brett Giroir, Alex Azar were led by craven ambition, Jerome Adams by cowardice, but I do think Deb Birx and Tony tried as institutionalists, insiders to make a difference. 5/
@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 1/ The 🏴󠁧󠁢󠁥󠁮󠁧󠁿 government decided pediatric gender care in England would be a monopoly contract (a Labour minister, in 2008), despite all other NHS patients officially being entitled to a choice of providers, & second opinions on diagnoses & treatment, & gave it to GIDS, which has…

@janethooton_ @ErinInTheMorn @fifi_EY 2/…always advocated that trans minors & their families must have no alternative source of care, & subsequent Tory ministers have personally put their signature on renewals of it, and even personally rejected proposals for improvement that have been put forward by NHS England…

@janethooton_ @ErinInTheMorn @fifi_EY 3/…as a result of wider & public consultation. They & their civil servants listen only to GIDS on trans minors - it was GIDS advised against <18s being allowed #GenderRecognition in 2004, & since, on the basis that no one under 18 can be certain of their gender identity, just…

@janethooton_ @ErinInTheMorn @fifi_EY 4/…as many other staff at their trust wrote⬇️ to the press in 2002 (when the first instigator of this case, psychoanalyst Susan Evans was on staff too) that no trans people should be allowed that recognition but needed

@janethooton_ @ErinInTheMorn @fifi_EY 5/…to "cure" us instead. Yet GIDS proved incapable of defending its super-conservative protocol in court - no doubt because GIDS has always expected challenges to be from patients seeking care more like that elsewhere, arrogantly ignoring that services in countries where the…
On 18.12.2020, computer engineer @FitTuber shared @YouTube video titled "10 Safe & Useful Ayurvedic Tablets to Replace Allopathic Pills (Instant Relief)". The drugs he promoted were by @baidyanathgroup, not sure if it was paid promotion. I bought them:
https://t.co/w6Sh2pMvJf


10 drugs, details, batch numbers R given in pic👇. All by @baidyanathgroup exept 1 by https://t.co/tg46sBhJr2
We did GCMSMS, ICP-OES and FTIR analyses on these samples. Here are my 10 safer modern medicine alternatives 2 @FitTuber's untested, potentially harmful #Ayurvedic drugs


Kanthsudharak Vati by Unjha Pharma
@FitTuber: 4 sorethroat, cold, cough
Analysis: Lead 0.54 mg/kg, Cadmium 0.4 mg/kg, Thallium 0.71 mg/kg and industrial phenols.
Low values, but not ideal.

Safe alternative: Levocetrizine & non-sedative cough syrup Levodropropizine


Baidyanath Rajbati
@Fittuber: for bloating, gas
Analysis:
Mercury 1.2 mg/kg
Arsenic 2.25 mg/kg
Male anabolic hormone - hydroxy testosterone+
Curcumin
Talc powder

Safer alternative: activated charcoal+simethicone (non-absorbed, no side effects) or short course esomeprazole.


Baidyanath Bilwadi Choorna
@Fittuber - 4 diarrhoea
Analysis
Thallium 3.68 mg/kg
[fun fact: 10-15 mg/kg is lethal dose for humans. Death can occur at lower dosages] https://t.co/9ozOKROhCK
Fenretinide - synthetic anti-cancer drug
Liver toxic chromium phosph.

Safer: Racecadotril

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THE MEANING, SIGNIFICANCE AND HISTORY OF SWASTIK

The Swastik is a geometrical figure and an ancient religious icon. Swastik has been Sanatan Dharma’s symbol of auspiciousness – mangalya since time immemorial.


The name swastika comes from Sanskrit (Devanagari: स्वस्तिक, pronounced: swastik) &denotes “conducive to wellbeing or auspicious”.
The word Swastik has a definite etymological origin in Sanskrit. It is derived from the roots su – meaning “well or auspicious” & as meaning “being”.


"सु अस्ति येन तत स्वस्तिकं"
Swastik is de symbol through which everything auspicios occurs

Scholars believe word’s origin in Vedas,known as Swasti mantra;

"🕉स्वस्ति ना इन्द्रो वृधश्रवाहा
स्वस्ति ना पूषा विश्ववेदाहा
स्वस्तिनास्तरक्ष्यो अरिश्तनेमिही
स्वस्तिनो बृहस्पतिर्दधातु"


It translates to," O famed Indra, redeem us. O Pusha, the beholder of all knowledge, redeem us. Redeem us O Garudji, of limitless speed and O Bruhaspati, redeem us".

SWASTIK’s COSMIC ORIGIN

The Swastika represents the living creation in the whole Cosmos.


Hindu astronomers divide the ecliptic circle of cosmos in 27 divisions called
https://t.co/sLeuV1R2eQ this manner a cross forms in 4 directions in the celestial sky. At centre of this cross is Dhruva(Polestar). In a line from Dhruva, the stars known as Saptarishi can be observed.