Andy Cowper Profile
Andy Cowper

@HPIAndyCowper

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Editor, Health Policy Insight / Cowper’s Cut. “Invaluable, insightful, funny: excellent value for money. Subscribe!" @NicholasTimmins

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@HPIAndyCowper
Andy Cowper
5 years
British media went to shit first. British politics followed.
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@HPIAndyCowper
Andy Cowper
2 years
"This is a milder variant", the PM claims, a few minutes after CMO Chris Whitty said the hospitalisation data shows clearly that this is not a mild disease.
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@HPIAndyCowper
Andy Cowper
3 years
Why did Matt Hancock's older sister give him 15% of her company, which has won £300,000 worthy of NHS contracts?
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@HPIAndyCowper
Andy Cowper
2 years
If there’s a less smart choice of person for The People’s Partridge to have tried to patronise than @jessphillips , I’m failing to think who she/he might be.
@itvpeston
Peston
2 years
“What an absolute load of rubbish... Did anyone else’s friends get contracts?” Watch @JessPhillips and @MattHancock disagree over the handling of PPE contracts during the pandemic. #Peston
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@HPIAndyCowper
Andy Cowper
8 months
John Glen, deputy to @Jeremy_Hunt , wants to know “why doctors and nurses say they spend up to half their time not with patients, but on admin”. The Lansley reforms cut NHS management by 40% in 2012. That work still needed doing, so now it’s clinicians doing it. Happy to help.
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@HPIAndyCowper
Andy Cowper
4 years
Nightingale hospitals do not have staff. Just worth mentioning this.
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@HPIAndyCowper
Andy Cowper
1 year
This is a hell of an anecdote from Pat Cullen: "ministers coming into the room saying to me that they're shocked that nursing staff may be the main breadwinner in the family. Because they believe that it's a second salary that we don't depend on."
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@HPIAndyCowper
Andy Cowper
1 year
This would be an official departmental Twitter account doing blatant politics about an industrial dispute, then.
@DHSCgovuk
Department of Health and Social Care
1 year
The BMA has demanded a 35% pay rise for junior doctors. Here's their current average pay rates at different levels.
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@HPIAndyCowper
Andy Cowper
2 years
The problem with the Johnson administration is the lying culture, not the underlying culture.
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@HPIAndyCowper
Andy Cowper
5 months
It’s objectively hilarious that the Boris Johnson Fanzine can’t find one single serving NHS consultant willing to go on the record criticising the junior doctors’ strikes.
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@HPIAndyCowper
Andy Cowper
10 months
One must have a heart of stone not to laugh.
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@HPIAndyCowper
Andy Cowper
1 year
Junior doctors are what we might call Schrödinger's Trainees, to borrow Mike Reynolds' line: too unimportant to pay fairly, but too important to strike.
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@HPIAndyCowper
Andy Cowper
4 years
The Nightingale Hospitals are delightful fictions. They don’t have workforces.
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@HPIAndyCowper
Andy Cowper
3 years
“As they say, you have to set yourself on fire to keep others warm. A lot of the NHS are setting themselves on fire to keep everyone else warm,”
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@HPIAndyCowper
Andy Cowper
4 months
Good thread. What should have been an uncontroversial win-win to improve medics’ working lives has been grotesquely mis-handled. The parties involved in implementing this will be forced back to the drawing board.
@AliJaneMoore
Alison Moore
4 months
It’s becoming obvious that everyone has been sold a pup with physician’s associate roles. Docs thought they were getting a helper, someone to remove some of the burden of admin and chasing for junior docs and who could also do some routine tasks (but under supervision and 1/n
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@HPIAndyCowper
Andy Cowper
2 years
Well, that was £37 billion well spent. Not even a ‘notify me when back in stock’ option. Lack of the most basic contingency planning. Profound incompetence.
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@HPIAndyCowper
Andy Cowper
1 year
This is a result for @DanNeidle , who was courageous and ceaseless in calling Mr Zahawi out for obviously lying about his tax evasion.
@PippaCrerar
Pippa Crerar
1 year
💥Former chancellor Nadhim Zahawi has agreed to pay several million in tax after scrutiny of his family’s tax affairs.
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@HPIAndyCowper
Andy Cowper
4 years
This really is the Sinclair C5 of UK Governments, isn’t it?
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@HPIAndyCowper
Andy Cowper
4 years
We have not protected the NHS: we created surge ICU-ish capacity with lower staffing ratios which was not overwhelmed.
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@HPIAndyCowper
Andy Cowper
1 year
There are not going to be 40 new hospitals by 2030. This is an obvious untruth. To keep trying with it begs the question of whether the Secretary Of State is a fool, a knave, or both.
@SteveBarclay
Steve Barclay
1 year
Today I confirmed our manifesto commitment to build 40 hospitals by 2030. My statement 👇🏻
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@HPIAndyCowper
Andy Cowper
4 years
There are not going to be 40 new hospitals. This is a blatant lie.
@MattHancock
Matt Hancock
4 years
🏨40 new hospitals 👨‍⚕️👩‍⚕️6000 more GPs 💷 Record NHS funding I’m so excited to unveil our other plans for this county - make sure you tune in for the #ConservativeManifesto
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@HPIAndyCowper
Andy Cowper
4 years
@Tachyon100 For the sake of God = ‘for God’s sake’. So it’s 100% ‘for fuck’s sake’.
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@HPIAndyCowper
Andy Cowper
4 months
This is staggering. Even for those who know it, and have been chronicling it, it’s still staggering.
@Channel4News
Channel 4 News
4 months
How has England’s NHS fared under Conservative governments? @C4Ciaran and @FactCheck have been crunching the numbers.
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@HPIAndyCowper
Andy Cowper
1 year
There has been much weeping and rending of garments about this strike among NHS system leaders, on the grounds of the risk of harm to patients.
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@HPIAndyCowper
Andy Cowper
10 months
Powerful. The Government did realise that in taking on the consultants, they were taking on some of the most articulate, dedicated and educated people in the country. Didn’t they?
@lucygoss
lucy gossage
10 months
I’m an oncologist and I love my job. But I’m striking because I know first-hand that the NHS is failing our patients with cancer and I’m striking because I know first-hand that the NHS is failing its workforce. #ConsultantsStrike
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@HPIAndyCowper
Andy Cowper
3 years
If Test And Trace were a nation, it would have the 83rd largest economy in the world.
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@HPIAndyCowper
Andy Cowper
7 years
Read this by @sarahkendzior , who consistently and correctly called Trump's ascent
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@HPIAndyCowper
Andy Cowper
2 years
“Sunak is promising an emergency package to force down NHS waiting lists through tougher targets led by a “backlogs task force”.” This proposed solution is based on utterly un-serious analysis of the problem.
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@HPIAndyCowper
Andy Cowper
4 years
The anarchic dismantling of lockdown smacks of contempt for the health and care staff who went through the Covid19 front-line these past few months - some of whom, of course, didn’t survive.
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@HPIAndyCowper
Andy Cowper
1 year
So where were these system leaders during the many maternity scandals of recent years? Or when young people needed access to adequate mental health services?
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@HPIAndyCowper
Andy Cowper
8 months
To attract and retain more teachers, there will be special tax-free bonuses up to £30,000, Mr Sunak says. That will calm the NHS pay strikes down nicely.
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@HPIAndyCowper
Andy Cowper
1 year
The ‘A&E crisis causing 500 deaths a week’ number cannot be definitively proved in real time - other than by @NHSEngland . As @ChrisHopsonNHS knows. So here you go, Chris. You always asked for honesty and transparency when you were @NHSProviders CE: publish this data. Every week.
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@HPIAndyCowper
Andy Cowper
3 years
The Nightingales weren't hospitals. They were a PR/last resort insurance hybrid: surge capacity, built in conference centres and sports stadia, for people who weren't critically ill. And they didn't have staff.
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@HPIAndyCowper
Andy Cowper
4 years
I know that most of you know, but it's worth emphasising that all this Tiers Of A Clown bullshit does not matter one bit if they do not fix Test And Trace.
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@HPIAndyCowper
Andy Cowper
5 years
On the new NHS buildings money announcement, worth keeping a few points in mind:
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@HPIAndyCowper
Andy Cowper
6 years
This was the future once
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@HPIAndyCowper
Andy Cowper
3 years
A National Insurance rise to pay for social care? The very tax that retired people don’t pay? This fuckery is getting baroque.
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@HPIAndyCowper
Andy Cowper
4 years
Pfizer are at the Hancock speech; the press are not.
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@HPIAndyCowper
Andy Cowper
1 year
Your periodic reminder that the UK’s successful vaccines procurement was mainly thanks to @katebingham2 , and its delivery mainly thanks to @NHSEngland
@adampayne26
Adam Payne
1 year
Rishi Sunak’s letter to Nadhim Zahawi telling him he’s sacked for breaching the ministerial code
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@HPIAndyCowper
Andy Cowper
1 year
Or during the collapse of ambulance/ A&E services at the end of last year? Oh, and how about the latest sitrep data showing that 13,000 beds are taken up by patients who no longer need to be in hospital every day last week, and more than 19 out of 20 adult beds being occupied?
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@HPIAndyCowper
Andy Cowper
8 months
The Lansley reforms cut NHS management by 40% in 2012. Of course clinicians spent more time doing that work afterwards. @Jeremy_Hunt , along with all Conservative MPs, voted for the Lansley reforms at every stage.
@Steven_Swinford
Steven Swinford
8 months
Hunt says it is ‘outrageous’ that doctors and nurses spend third of their time doing admin He’s has asked all Cab ministers to come back to him with how much time front line public sector workers are spending on paperwork He says Treasury will invest in AI & tech to ease burden
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@HPIAndyCowper
Andy Cowper
6 years
This is how to respond to tabloid nonsense: calm, factual and right. The NHS overall needs to get way, way better at doing this.
@StGeorgesTrust
St George's NHS FT
6 years
Our response to Mail on Sunday story today about 10 St George’s doctors currently on study leave in France
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@HPIAndyCowper
Andy Cowper
6 years
"We choose the future". Except when it comes to the NHS, which is slipping back into the long waiting times of the past that cost tens of billions to fix.
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@HPIAndyCowper
Andy Cowper
1 year
But yes, of course if harm or deaths happen during this week's industrial action, it'll be the very first time there has ever been a risk to patients using NHS services in recorded history. Of course it will.
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@HPIAndyCowper
Andy Cowper
4 years
McKinsey banks £560,000 consulting on “vision, purpose and narrative” for new test and trace body > Baroness Harding and McKinseys: the gift that keeps on giving
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@HPIAndyCowper
Andy Cowper
5 years
This is still quite wonderful, from ⁦ @TheEconomist
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@HPIAndyCowper
Andy Cowper
3 months
If you take out 45% of management resource, then that work doesn’t simply stop being needed. It just starts getting done by clinicians. And that is what’s happened.
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@HPIAndyCowper
Andy Cowper
11 months
That attempt to recruit your way out of a retention crisis has not worked so far, and may well continue not to work. Your most experienced staff are your most valuable staff.
@BBCPolitics
BBC Politics
11 months
“It will represent… the largest expansion in training and workforce in NHS history” PM Rishi Sunak says his NHS workforce plan, to be announced later this week, will ensure the NHS has the right number of doctors and nurses #BBCLauraK
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@HPIAndyCowper
Andy Cowper
3 years
MASSIVE FUCKING LIE ALERT: "the backlog is a result of the pandemic", Alan asserts. No it isn't. Work of @kingsfund @NuffieldTrust @HealthFdn has tracked its growth over many years.
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@HPIAndyCowper
Andy Cowper
3 years
Health Minister Nadine Dorries tells nurses their husbands' pay/furlough makes the 1% pay offer OK
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@HPIAndyCowper
Andy Cowper
3 months
“We need to restart the programme of public sector reform from before the pandemic”, Chancellor @Jeremy_Hunt tells the Kuenssberg Show. He intimates that cutting bureaucracy can free up lots of clinicians’ time. Ahem.
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@HPIAndyCowper
Andy Cowper
1 year
Your regular reminder that the NHS backlog was not down to Covid. It was 4.4 million in January 2020 before the pandemic (), and now stands at just over 7.2 million: it’s been rising by about 100,000 a month
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@HPIAndyCowper
Andy Cowper
3 years
Nope. Not a single question asked about the rate of supply of the vaccines, which is the rate-determining step. Sigh.
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@HPIAndyCowper
Andy Cowper
7 years
Anyone who thinks NHS managers do easy jobs should be watching 'Hospital' on BBC2 right now. Brilliant, honest and highly real television.
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@HPIAndyCowper
Andy Cowper
2 years
A “backlogs task force” and tougher targets are Mr Sunak’s solution What an absolute arsehole.
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@HPIAndyCowper
Andy Cowper
2 months
From what I’ve seen of yesterday’s EGM, this is wholly justified. If I were the RCP’s leadership, I’d be fairly concerned today. It also took a bit of moral courage to do this, which is always good to see. Nice one, Rachel.
@doctor_oxford
Dr Rachel Clarke
2 months
I was deeply honoured to be invited to be a keynote speaker at this year's @RCPhysicians annual conference. But after last night's #RCPEGM I can no longer, in all conscience, give my speech. I feel duty bound to share in public my reasons why.
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@HPIAndyCowper
Andy Cowper
3 years
Utter, utter bollocks from the PM there about people staying in hospital beds because they were scared of paying for residential care. IN reality, the residential care beds that would accept high-acuity patients were not there.
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@HPIAndyCowper
Andy Cowper
2 years
The real issue facing @Jeremy_Hunt is how little the austerity decade has left to cut. Local government funding cuts effectively destroyed social care, which is a huge part of the problem facing the NHS getting frail older people (the bulk of its regular users) out of hospitals.
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@HPIAndyCowper
Andy Cowper
2 years
Why do so many staff leave the NHS? It's a mystery.
@SyncopeJohn
John Davison
2 years
After 29 years work for the NHS, 23 for 1 Trust, 17 as a consultant, it’s been humbling to feel so valued and appreciated.
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@HPIAndyCowper
Andy Cowper
3 years
Your regular public service announcement that there are no 40 new hospitals coming
@MattHancock
Matt Hancock
3 years
Great move by @robertjenrick . This will help us drive delivery of our commitment to build 40 new hospitals over the next 10 years 🏥
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@HPIAndyCowper
Andy Cowper
11 months
It does not cost taxpayers £500,000 to train a doctor. The Right Honourable Nadine Dorries MP (pro tem) is quite simply lying and making shit up here:
@NadineDorries
Rt Hon Nadine Dorries
11 months
My ⁦ @DailyMailUK ⁩ column today. We tax payers pay half a million £ to train a doctor and when they are qualified, almost half of them from some medical schools head to Australia or NZ. Time to impose pay back!
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@HPIAndyCowper
Andy Cowper
1 year
I wonder when the bulk of NHS leaders and politicians will realise that the mental feudalism that sort-of worked on NHS staff in the past no longer flies.
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@HPIAndyCowper
Andy Cowper
5 months
Doctors still in their formal university training - ‘doctors in training’. Then ‘doctors’. Then for those who go on to it, ‘consultants’. ‘Junior’ is utterly anachronistic.
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@HPIAndyCowper
Andy Cowper
3 years
“Bring in the military to review NHS management!” “Ah. Are they notoriously good at outcome measurement, resource allocation, procurement, and suchlike?” “…”
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@HPIAndyCowper
Andy Cowper
2 years
The dregs having a go at @bootstrapcook ought to be ashamed of themselves (but won't). Jack Monroe shouldn't be ashamed of anything.
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@HPIAndyCowper
Andy Cowper
1 year
At some point, the penny will drop more widely that system leaders and the Government need the co-operation and good-will of the current junior doctors. We’re not there yet, but some people are remarkably slow learners.
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@HPIAndyCowper
Andy Cowper
4 years
I'd been meaning to give the benefit of the doubt to Ms Kuenssberg's epically poor-quality piece from earlier today , but this is an evident pattern of behaviour. Her work should embarrass both herself and the BBC.
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@HPIAndyCowper
Andy Cowper
2 years
PM lying again re vaccination. It was not “our freedom from the rules of the EU”. UKI procured and started delivering the vaccines while still in the EU. We left the EU 31.12.2020. …
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@HPIAndyCowper
Andy Cowper
4 years
This is an extremely helpful timeline of @devisridhar being basically correct about everything to do with managing Covid19 right. Share it widely: store it for those who will 100% claim that 'it was all very difficult and no-one was psychic'.
@raging_steel
raging_steel
4 years
1/n THREAD: #SARSCov2 insights from @devisridhar . Initial objective was to collate a timeline for myself, then I thought it may be useful to others too. I intended to capture one item for each month, but some months were so packed the thread grew 🙃 Brief summary at end.
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@HPIAndyCowper
Andy Cowper
3 years
Genuinely surprising to see the @FT fall for the Government's 'blame Public Health England' strategy, terming PHE 'discredited'. That'll be the same PHE that was line-managed by @DHSCgovuk , just as the new UK Health Security Agency will be.
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@HPIAndyCowper
Andy Cowper
2 years
It is a sign of daunting ignorance of a) reality and b) public policy for any senior politician to propose that the NHS backlog has resulted from insufficient tough targets and the absence of a backlogs task force, and that these things will fix it.
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@HPIAndyCowper
Andy Cowper
5 years
@MattHancock Extra £20bn for the NHS is of course not coming on stream in 2019. Not on stream until 2023-24, just in case you feel like not lying/misleading.
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@HPIAndyCowper
Andy Cowper
6 years
Patients are charged. It’s called income tax. The BMA are an utter embarrassment.
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@HPIAndyCowper
Andy Cowper
4 years
So that's what hope sounds like.
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@HPIAndyCowper
Andy Cowper
1 year
I know it's a shock, but the Boris Johnson Fanzine is talking bullshit about the NHS again "no other country in the world has replicated the British system" Apart from Italy, Spain, Portugal and arguably the Scandinavian countries
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@HPIAndyCowper
Andy Cowper
2 years
There is A Big Old Lot Of Bollocks being talked about the Health Bill going back to the Commons tomorrow.
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@HPIAndyCowper
Andy Cowper
3 years
@lewis_goodall @mattfrei The Nightingale 'hospitals' were astute political fictions to reassure the general public. They had no staff to deal with patients (any hospitals who sent Nightingales patients had to send staff with them). They were theatre.
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@HPIAndyCowper
Andy Cowper
3 years
(Metaphorical) white smoke emerging from Skipton House. The new NHS Pope (CEO of @NHSEngland ) has been chosen, I’m told. Announcement planned for the middle of next week.
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@HPIAndyCowper
Andy Cowper
2 years
Imagine if someone who knew a lot about this stuff had consistently pointed out that the ‘40 new hospitals’ claim was complete bollocks since pretty much the start.
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@HPIAndyCowper
Andy Cowper
4 years
Well, this isn't embarrassing at all
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@HPIAndyCowper
Andy Cowper
4 years
If Public Health England were indeed not succeeding in its work, the responsibility ultimately sits with the Secretary Of State into whom it reports and to whom it is accountable. One Matt Hancock, oddly enough.
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@HPIAndyCowper
Andy Cowper
11 months
No, I’ve just double-checked. The Prime Minister of the United Kingdom and the leader of the Conservative And Unionist Party said this out loud, in the real world.
@AdamBienkov
Adam Bienkov
11 months
Rishi Sunak tells an IKEA worker, whose family is struggling to get treatment on the NHS, that he has a "really, really good plan" to solve the problem, which involves "being a bit clever about how we do things."
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@HPIAndyCowper
Andy Cowper
2 years
It is embarrassing and pathetic that a candidate to be the next leader of a major party and PM does not know this.
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@HPIAndyCowper
Andy Cowper
3 months
Yep, the Government actually do want the entire NHS taking industrial action.
@pulsetoday
PulseToday
3 months
BREAKING: NHS England will increase funding for general practice to 2% as part of what it calls 'final arrangements' for the 2024/25 GP contract
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@HPIAndyCowper
Andy Cowper
2 years
Ooops. Very stupid politics to attack NHS managers.
@wesstreeting
Wes Streeting MP
2 years
Under the Conservatives, eye-watering sums of taxpayers’ money are paid out to managers and consultants. That means less investment in the frontline staff who our NHS relies on.   Meanwhile many NHS workers barely earn enough to get by.
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Andy Cowper
7 years
How can the NHS sort its bullying culture? Easy. Sack the bullies, and say why. And lose a few employment tribunals. Utterly worthwhile.
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@HPIAndyCowper
Andy Cowper
3 years
The ‘data, not dates’ thing lasted as long as I thought it would.
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@HPIAndyCowper
Andy Cowper
4 years
Mr Starmer makes a big, smart call. SAGE report recommendations ignored by the Government gave him the ammunition. If there's to be a 2-3 week lockdown, Test And Trace must be re-plumbed to move its resources under leadership of DPHs in the first 3 days after that decision's made
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@HPIAndyCowper
Andy Cowper
4 months
The reason ‘Mr Bates vs The Post Office’ resonates so strongly is that so many of us have experienced arrogant, unaccountable and inhumane behaviour from Government, public sector or pseudo-public sector bodies, who rely on legal threats when their wrongdoing becomes apparent.
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@HPIAndyCowper
Andy Cowper
2 years
“The health secretary is formulating the reorganisation to give well-run hospitals more freedom, as well as forcing failing trusts to improve.” Genius. You could call them ‘Foundation Trusts’, and the improvement body the ‘Trust Development Authority’.
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@HPIAndyCowper
Andy Cowper
10 months
This is an untruth. The Government missed both its 24-month and 18-month RTT waiting time targets before the strikes were a serious factor. Nor is Covid19 a major factor: the backlog was 4.4 million in January 2020 before Covid hit, and rises by an average of 100,000 a month.
@RishiSunak
Rishi Sunak
10 months
First, I gave a quick update on my five priorities. Whilst we’re on track to achieve most of them, waiting lists are not yet falling because of the strikes in our NHS. I hope those still striking will accept the independent pay offer and get back to doing what they love.
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@HPIAndyCowper
Andy Cowper
2 years
Just a few hours to go until DHBSC and NHS staff can use Oxford commas all they like again.
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@HPIAndyCowper
Andy Cowper
2 years
'Mr Shit, may I introduce Miss Fan?'
@ShaunLintern
Shaun Lintern
2 years
BREAKING: A very serious situation at hospitals across Lincolnshire tonight as @ULHT_News declares a 'critical incident' over "extreme and unprecedented" staff shortages. It says it is "unable to maintain safe staffing levels" leading to "compromised care" across its sites:
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@HPIAndyCowper
Andy Cowper
7 years
Really hope the NHS management-bashing community watching #Hospital on BBC2 now. This is what these people do: take life or death decisions
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@HPIAndyCowper
Andy Cowper
7 years
I have rarely seen Jeremy Hunt this flustered. That is a man under a lot of pressure
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@HPIAndyCowper
Andy Cowper
2 years
This is a shame, as @mancunianmedic would have been an excellent President, but it's typically straight-up of him to do this.
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