NHS pay gap widens as chiefs earn more than bliar

Chief executives at some of the biggest National Health Service trusts are paid more than most Whitehall permanent secretaries, with the most highly paid earning more than the prime minister or cabinet secretary.
Their latest rise comes as top pay in the NHS is becoming much more like that in the private sector, according to Income Data Services, the pay specialists, with a widening gap between the pay of senior executives and other employees.
Pay for the chief executives who run hospital trusts rose between 7% and 7.5% in 2003- according to Income Data Services. This is over twice the 3.2% average that the rest of the NHS staff received.
This reflects a continuing trend, with the total remuneration of NHS chief execs rising by 70% over the past decade while the earnings of nurses rose by only 50%.
For the first time the pay of an NHS chief has gone through the £200,000 barrier with Derek Smith the CEO of Hammersmith Hospital's NHS trust receiving between £210,000 and £215,000 last year.

Pioneering hospital could be mothballed for lack of patients

A HOSPITAL set up three years ago as a blueprint for cutting NHS waiting times is facing closure after failing to attract patients and running into multimillion- pound debt.
Documents seen by The Times show that Ravenscourt Park Hospital, a specialist centre for hip and knee operations in West London, is expected to incur losses of £37 million by 2010 because of high running costs and lack of demand.
Ministers have championed treatment centres such as Ravenscourt Park as a cost- effective means of driving down waiting times and giving patients more choice over where they are treated.
Doctors’ leaders said that the hospital’s problems were symptomatic of fundamental flaws in the policy: wasting money and destabilising existing hospitals.
Ravenscourt Park, which cost £14 million to set up, has had to close one ward for lack of patients, with only 40 of its 116 beds required at present. Minutes from recent meetings of the clinical board show that it faces a £12 million deficit this financial year, with annual debts of at least £5 million expected over the next five years. Senior staff describe the situation as bleak.
Last month the Government hailed Ravenscourt Park and its 28 other treatment centres as vital to the future of the NHS. A further 17 NHS-run centres and more than a dozen in the private sector are due to open by the end of this year. A Department of Health report described the centres, which are designed to carry out elective work such as orthopaedic and general day-care surgery on an extra 200,000 patients a year, as “spearheading the NHS drive to modernise and improve patient care ”.
Recent meetings of the Ravenscourt Park board paint a different picture. Minutes of one meeting last April said that a proposal “to ‘mothball’ Ravenscourt Park Hospital at a cost of £4 million annually should be looked at in the context of funding projections”.
The hospital was in an even worse state by December’s meeting. Unable to perform treatments for trusts at competitive rates, it has been rejected by five out of seven local trusts, putting it in a perilous financial situation. It is estimated that the hospital must carry out almost double its current 6,000 operations a year to remain viable. An emergency plan has been drafted to bring in short-term work from Buckinghamshire. The problem comes amid growing concern about the way in which NHS reforms are being implemented. Although waiting lists are being reduced, it is feared that excessive costs could spell ruin for the NHS.
The country’s first treatment centre, opened in 1999 at the Central Middlesex Hospital, in Park Royal, North London, has also plunged into debt. Hailed as the “embodiment of the NHS” by Tony Blair, it is now running at half capacity.
John Reid, the Health Secretary, said that he accepted that there were “bubbles in the system”, but said that these would disappear from 2008, when patients were allowed to choose treatment anywhere in the country. “We may have extra capacity sitting [at the moment],” Mr Reid said. “However, once we get to complete patient choice, the plan is that if you have a very good hospital, people will get to it. It is inevitable that it takes time to transform the system.”
Derek Smith, chief executive of Hammersmith Hospitals NHS Trust, which manages Ravenscourt Park, was unavailable for comment. James Johnson, chairman of the British Medical Association, said the hospital’s crisis was symptomatic of “very serious problems” with reforms. “These are not just teething troubles. It seems to be an intrinsic problem, which is why it is so worrying.”

TREATMENT CENTRES STRUGGLE
# Treatment centres should cater for an extra 200,000 patients a year
# At Ravenscourt Park Hospital, West London, just 40 of 116 beds are needed, with losses projected to reach £12 million by April and £37 million by 2010
# ACAD (ambulatory care and diagnostic) clinic at Central Middlesex Hospital, North London, is running at half its capacity. Weekend work has stopped and more than 20 staff have been relocated. It has lost more than £3.5 million in potential revenue
# Southampton General Hospital is expected to lose 50 per cent of elective work to independent treatment centres over the next five years
# NHS services in Birmingham are expected to lose many patients to independent treatment centres, which have been earmarked for at least £39 million of elective operations

First published by Times Online 14/2/5

NHS facing serious surgeons shortage

Thousands of extra surgeons are going to be needed over the next few years to meet demand, a report warns. The Royal College of Surgeons (RCS) said there would be a 2,760 shortfall by 2010 because of early retirement and new working practices.
The figure amounts to 50% of the current number of surgeons and takes into account surgeons who will graduate from training in the coming years. The study said action was needed now as it takes 10 years to train a surgeon.
The RCS said the government has been relying on short-term measures such as international recruitment. But it said there was a need for more long-term plan, adding: "The bedrock of UK surgery remains the high standards and lifelong commitment of UK-trained consultants."
The report raised concerns that as many as 4,000 surgeons could take early retirement by 2007 as they had reached their maximum achievable pension entitlement. The shortage of surgeons in England and Wales is critical.
More surgeons will also be needed as the effect of the 56-hour working week demanded by the European working time directive kicks in.
RCS president Hugh Phillips said the government needed to act straight away if the demand for 6m operations a year was to be met in the years to come.
"In 2001 we said we did not have sufficient numbers of consultants. "Since then there has been expansion but now even more are required because of new technologies, new treatment opportunities and the increased demands of training and education."
And he added the extra training places must be funded as patient safety was paramount.
Dr Alan Russell, deputy chairman of the British Medical Association consultants committee, said if the government did not act it could harm a key election promise.
"The shortage of surgeons in England and Wales is critical. It is extremely difficult to see how the government can meet its proposed 'patient journey' waiting list target of no more than 18 weeks if the NHS does not have enough surgeons to carry out operations. The BMA totally supports the call for increased government funding for more surgical posts."
The government said it had increased the numbers of consultants, which includes surgeons and all types of other specialists, by nearly 5,000 from 2000 to 2003.
However, the government missed its target of increasing consultants by 7,500 by 2004.
A Department of Health spokeswoman said the government was looking to increase the number of surgeons.
"It is something we are working towards. We know we have more work to do here.
"But the vacancy rate has done down and the number of medical student places has increased."
http://news.bbc.co.uk/1/hi/health/4265559.stm

UK tops Euro league for costs of heart disease

The UK is shouldering the brunt of economic burden from coronary heart disease, according to new pan-European statistics from the British Heart Foundation and the European Heart Network.
The figures show the UK spends more money on healthcare for the disease per capita than any other country in the EU. The total is £3.4 billion (€5.2 billion) a year - almost a quarter of the EU’s entire spending on CHD.
This spend reflects the huge advances in treatment for heart disease in the UK, meaning it no longer means a quick death - 2.7 million people in the UK are now living with heart disease and require ongoing care.
On top of the healthcare costs, the illness prevents many patients from working and the country loses almost £877 million annually as a result. This represents more than a third of the EU total for lost productivity.
The figures out today also show that informal care for CHD, provided by the unpaid friends and family who’s full-time jobs are looking after heart patients, costs £1.14 billion every year in lost economic productivity, and much more than that in reduced quality of life. Only Germany, with a far larger population than the UK, loses more money.

http://www.bhf.org.uk/news/index.asp?secID=16&secondlevel=241&thirdlevel=1515&artID=6935

Labour lies on mixed sex wards revealed

The photograph that exposes Labour's broken promises on mixed hospital wards. This is the photograph that exposes the Labour Government's broken promises to eliminate degrading mixed-sex hospital wards.

Lil le-Beau in a mixed-sex ward with husband Terence and an elderly male patient
Lil le-Beau, 57, is one of hundreds of patients who are being forced every day to endure the indignity of sharing their ward with the opposite sex at a time when they are sick and at their most vulnerable.
The promise to eliminate mixed "Nightingale" wards – occupied by up to 30 male and female patients – was first made by Tony Blair during the 1997 election campaign. Then, in 2001, it was pledged that all 366 mixed-sex "Nightingale" wards would be ended by April last year. It was another missed target.
Earlier this year, the Department of Health claimed that 98 per cent of wards were single-sex. Today, The Telegraph reveals that this figure cannot be trusted, as NHS trusts, confronted with our photographic evidence, admitted last week to not officially registering the existence of wards such as the one shown here, at Oldchurch Hospital in Romford, Essex.
Mrs le-Beau and her husband, Terence, 57, a roofer from Dagenham, Essex, feel humiliated and outraged at the conditions she has been subjected to since she was admitted on Friday for treatment to her swollen legs.
She has an elderly man lying in a bed opposite her, another two beds to her left and a third next to him. In all, ward C6 contains about 10 women and 10 men, randomly placed.
"The state of the wards here is awful," Mr le-Beau said yesterday. "The staff work very hard and are wonderful people, but the conditions they have to work under are just not acceptable. It's disgusting.
"My wife should not have to be exposed like that. It has got to be degrading for women to be mixed with men. It's not right and we are very upset. In this day and age there should not be any mixed wards, but this hospital is full of them.
"There is no decency or privacy. On Friday night a man in the ward was urinating openly into one of those containers. My wife said, 'Look what he's doing. What do I do?' I said, 'Turn away. That's all you can do.' "
Opposite Mrs le-Beau, a frail elderly woman, clearly distressed and in great pain, continually moved around in her bed, causing her gown to ride up.
With barely two feet separating the beds, and the nurses overworked, the woman lay, partially clothed, in view of the male patients until Mr le-Beau could advise staff to cover the patient with blankets to preserve her dignity.
The Telegraph spoke to several visitors at the hospital, who confirmed that there were at least three mixed-sex open wards, with up to two dozen patients in each.
The Government has repeatedly failed to eliminate these wards, despite committing over £120 million towards a modernisation programme. Targets to end the Victorian-era wards, where long halls with men and women lay exposed in beds only inches apart, have been pushed back no fewer than three times.
Patients up and down the country repeatedly have to endure the humiliation of rooms often shared with partially clothed and ill members of the opposite sex.
The conditions at Oldchurch Hospital were among the worst discovered during The Telegraph's two-week investigation into the prevalence and standards of mixed wards across the country.
The situation was similar at Brighton General Hospital, which has five mixed dormitory-style wards dating back to the early 1900s. The overpowering smell of faeces and urine permeates some of the wards, where only the width of a chair separates the beds.
Steve Clark, a financial consultant, whose grandmother died at the age of 86 in one of Brighton General's mixed wards on Tuesday, was incensed at the conditions she was subjected to.
"There is no privacy," he said. "The men walk through the wards all the time and, a few days before my nan passed away, a man got into her bed thinking she was his wife. The nurse had to pull him off. That's not right.
"Men would walk around who had trouble keeping their hospital trousers fastened. It is not their fault, they are infirm, but with all the taxes we pay this should not happen.
"The conditions of the wards are awful. If they smell like that, they can't be clean. It makes me so mad to think that my nan had to die in those conditions."
In Bristol, Jeanette Daw, 39, was recently admitted to the Royal Infirmary with suspected liver inflammation. To her horror, she was given a bed in a mixed ward. Ms Daw, a mother-of-three from Knowle, said: "I couldn't believe it. There is one man in the bed next to mine and one opposite. I feel really intimidated by it. I have to get undressed there and the doctors examined me with just a curtain separating me from the men.
"It's bad enough that I am in hospital without having to cope with this. It's really undignified," said Ms Daw. Her mother died last year, aged 66, on a mixed ward at the same hospital. "I can't believe I am in the same situation now,'' she says.
The practice of mixing genders is not confined to old hospitals with outdated facilities. King George Hospital in Ilford, which was built in 1993, has several mixed wards. Although its wards are smaller, with six patients to a room, our reporters discovered at least four wards where women and men lay side by side.
A spokesman from Barking Havering and Redbridge Hospitals NHS Trust, which includes Oldchurch and King George hospitals, said: "Strictly speaking, we do not have any mixed wards, but the reality is different. Where we put people in with the opposite sex, we try as much as we can to relocate them, but this is often difficult."
A spokesman for Brighton and Sussex University Hospitals NHS Trust, which covers Brighton General Hospital said: "Obviously we have to apologise to anyone who have been upset by being put in a mixed ward. We are working towards eliminating mixed wards, but there are no firm target dates."

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2005/02/13/nhosp113.xml&sSheet=/news/2005/02/13/ixnewstop.html