MRSA death rates double in only 4 years

The number of deaths in which the superbug MRSA has been cited as a cause has doubled in four years, official statistics show. The Office for National Statistics said in 2003 MRSA was mentioned on 955 death certificates - up from 487 in 1999.
FAQ: MRSA Facts
Mortality rates were highest among older people with more men than women dying.
MRSA was involved in two out of 1,000 deaths in hospitals and three out of 1,000 deaths in NHS nursing homes, compared to an overall figure of one out of 1,000 deaths for the years 1999 to 2002.
But laboratory reporting of MRSA cases only increased by 7% in the last year compared to a 19% rise in deaths.
Tony Field, chairman of patient group MRSA Support, said the figures were worrying. "This again illustrates the MRSA rate is on the increase and the authorities still haven't got to grips with it. However, I think these figures underestimate the scale of the problem."
"MRSA host on other causes of death. A cancer patient may get MRSA and die but cancer will be cited as the cause of death, but MRSA would have played a contributing role.
"I would expect the true figure to be much more than 955."
And Karen Jennings, of the health care union Unison, added: "That is far too many tragedies. There is a solution to it. We need a proper strategy to make cleaning central to policy development."
She said the contracting out of cleaning services has meant the quality of service has decreased.
The government has launched a drive to combat the superbug and last year Health Secretary John Reid ordered hospitals to slash rates of MRSA bloodstream infection by half by March 2008.
But Conservative Party leader Michael Howard blamed the government's "obsession with targets. It is a fact that doctors and nurses are prevented from closing wards they know to be infected with the super bug because of Tony Blair's targets. No other country has seen the super bug infection take over its hospitals in the same way as we have in Britain."
And Liberal Democrats health spokesman Paul Burstow added the figures were "only the tip of the iceberg".
"A clearer picture is beginning to emerge of the uphill task we face in tackling MRSA in our hospitals."
Chief Nursing Officer Chris Beasley said fighting the superbug was a top priority and part of the increase was because of better reporting. She added: "By improving reporting of MRSA like this it will help us identify avoidable factors and learn useful lessons."

http://news.bbc.co.uk/1/hi/health/4293765.stm

Hospitals are getting dirtier claims patients

Hospital patients say they are waiting less time for emergency treatment and outpatient appointments, according to two major surveys of patient opinion published today by the independent Healthcare Commission.
However, the findings also suggest that further improvements are needed. In particular, patients want greater information from clinicians on treatment and higher standards of cleanliness in hospitals.
The Healthcare Commission has carried out two surveys in which 140,000 patients gave their perception of local outpatient clinics and emergency departments.
The surveys, representing one of the biggest national tests of patient attitudes, will be closely watched as they provide an indicator of whether patients believe that services are really improving. Findings from these patient surveys will be used by the Healthcare Commission in future inspections and in the formulation of the trust’s star ratings in 2005. Where there are areas for concern, the Commission will review the issue in detail with the individual trust.
The key findings are as follows:
Patients are broadly positive about their experience, but areas for improvement indicated by patients included:
* 45% of patients rated the emergency department as ‘very clean’, a four percent decrease from 2003
* 53% of outpatients rated the outpatients department as ‘very clean’, a 6% decrease from 2003
* Patient involvement was found to be a key issue for patients visiting both emergency and outpatients departments:
- 20% of outpatients felt they were not getting the right amount of information for them to be fully involved in their care
- particularly concerning was the finding that only 49% of patients leaving A&E were given any information regarding possible side effects of new medication
- A new question was added to the 2004 outpatients survey, regarding patient choice and 70% of patients reported that they were not given a choice of appointment times. However, out of these only 23% expressed a desire to have that choice.
Anna Walker, chief executive of the Healthcare Commission said: “This survey is very encouraging, and it is particularly good to see patients are beginning to experience a reduction in waiting times. People who are sceptical of the NHS should take note of what patients are actually saying, as it is clear how much they value the services on offer.”
“There is much to celebrate but patients still, and rightly so, expect further improvement in their health service. Patients are sending a very clear message that they want more involvement in decisions on their treatment and that current standards of cleanliness are still not good enough. That must improve.”

http://www.healthcarecommission.org.uk/NewsAndEvents/PressReleases/PressReleaseDetail/fs/en?CONTENT_ID=4014870&chk=/UqDJJ

Independent Treatment Centres not the solution for the NHS, warns BMA leader

Speaking at the conference of Honorary Secretaries of BMA Divisions in Edinburgh today (Friday 18 February 2005), Dr Sam Everington, Deputy Chairman of the BMA (UK) warned that the Westminster Government’s continuing push for private sector involvement in the provision of NHS services could spread to the other countries of the UK.

He said:
“We face a fundamental shift in the balance between public and private provision. At present this is only a vision for England, but the other countries of the United Kingdom cannot fail to be affected by the wind of change blowing through the English Health System. How odd that we should be defending an integrated NHS against a government that created it in the beginning.”
Commenting on the increasing reliance on Independent Treatment Centres, Dr Everington added:
“They are a wonderful idea on paper. Patients get more choice and quicker treatment, NHS capacity is freed and the government meets its targets. Everyone wins.
“But they are forcing NHS hospitals to compete with the private sector and in a market, as we know, there are winners and losers. NHS trusts will lose money. The natural consequences are for units to close. Some local hospitals will then become increasingly unsustainable.
“Patients get sick around the clock, seven days a week and hospitals must be fully resourced and staffed to cope with all their needs. At 3am in the morning patients go to NHS hospitals because they provide both emergency and integrated care. It is therefore misleading for John Reid to claim that treatment centres provide services faster than NHS hospitals, when for a large number of patients; they provide no service at all.
“Is this more choice for patients – when often the first choice for patients is to be seen at their local hospital?”

http://www.bma.org.uk/ap.nsf/Content/PR-Independent+Treatment+Centres+not+the+solution+for+the+NHS%2C+warns+BMA+leader+-+18+Feb+2005

Increased immigration application charges will deter doctors coming to the UK, says BMA

In response to the recent announcement that fees for immigration applications will increase by at least 200% on April 1st 2005 - BMA Chairman, Mr James Johnson in a letter to Home Secretary Charles Clarke said:
“Doctors often change jobs frequently and the proposal to make them pay £500 for each renewal application perhaps two to three times a year is unreasonable and the BMA would urge the government to reconsider this decision.”
He added:
“The NHS relies heavily on the skills of international medical graduates with an estimated three out ten doctors working in the UK having gained their qualifications abroad. The UK is still desperately short of doctors and until the day comes when NHS is self sufficient in doctors, we can not risk excessive charges for immigration applications discouraging doctors from migrating to the UK.”
Dr Edwin Borman Chairman of the BMA’s International committee said:
“Thousands of overseas doctors in the UK are frustrated at the introduction and subsequent increase in the charges for immigration applications. I would not be surprised if doctors think twice about coming to the UK and instead migrate to other countries in need of their skills. It is time to stop using overseas doctors a political football and adopt sensible immigration policies that take into account Britain’s need for skilled healthcare professionals.”

http://www.bma.org.uk/ap.nsf/Content/PR-Increased+immigration+application+charges+will+deter+doctors+coming+to+the+UK%2C+says+BMA+-+18+Feb+2005

PFI Lenders hold on to PFI funds

Senior lenders on Jarvis's former private finance initiative construction projects are understood to be withholding cash needed to complete work on schools and hospitals because they want to satisfy themselves that they are getting value for money.
It has emerged that the banks controlling the money will not release it until they have carried out their own audits, threatening further delays to projects including new acute facilities at the Whittington hospital in London and work on primary schools in Richmond upon Thames. Jarvis's apparent success in quitting its PFI obligations without jeopardising the 14 projects involved was hailed by proponents of PFIs as evidence that, even when the private sector runs into difficulties, the partnership model still works.
News of the latest hitch, however, may bolster critics who have warned that PFIs were vulnerable to financial problems suffered by the private consortiums responsible for delivering them.
Jarvis and investors in its former special purpose vehicles (SPVs) - set up to run the PFI contracts - raised more than £100m to get the outstanding work completed on all 14 contracts.
That sum is now being kept in trust accounts to ensure that Jarvis and its creditors cannot touch it.
But its release and use requires consent from two current SPV stakeholders and the senior creditors that lend money to the projects. The investors that now own the SPVs - Barclays Private Equity, the Secondary Market Infrastructure Fund and Halifax Bank of Scotland - have had technical teams assess how long the work will take to finish. They have also selected a series of subcontractors. But the project lenders, which are understood to include Barclays Bank, SociétéGéné rale, Bank of Ireland, NIB Capital, AXA, Nationwide and Helaba bank, are not satisfied and want to carry out their own assessments with their own technical consultants.
One person close to the deal said: "The banks are suffering from a lack of reality. They control the money going out of the door but delays and empty sites cost money. The delays in releasing the cash only mean that more money will eventually be needed to complete the projects. I estimate that every week of delay across all the projects costs about £500,000."
Nationwide said: "The funding will be released when appropriate. This is normal process." AXA said: "Our unlisted financial activities are confidential." SG Corporate and Investment banking said: "We are the agent bank on one of the projects. We act as a co-ordinator but we cannot comment further. We are not holding up the paperwork."
The Bank of Ireland, Barclays Bank and NIB Capital declined to comment.
http://news.ft.com/cms/s/2605e12e-821c-11d9-9e19-00000e2511c8.html

BBC- Panorama: What has labour done for the NHS?

Professor John Appleby, Chief Economist at the King's Fund, was asked by Panorama to analyse the government's spending plans for the National Health Service (NHS). His analysis reveals that the price the NHS pays hospitals for treatment will have risen by around 17% in the three years from 2003 to 2005 - assuming hospitals are able to make the efficiency gains the Department of Health has asked of them.
And it suggests that there's a lot less for managers to spend, on new and existing services, than the 7.4% real terms annual increase the government talks about: specifically he calculates it to be an increase of 5% last year, 2.4% this year and 2.2% next financial year.
According to Prof Appleby much of the spending has been ear-marked for rises in basic pay, health service price inflation and changes to working practices, including the costs of new contracts for consultants and family doctors, and implementing guidance on better quality care and drugs from the National Institute for Clinical Excellence (NICE).
Last year, higher pay and the new employment contracts which some NHS organisations say are costing more than expected accounted for a third of the cash rise. Professor Appleby told Panorama: When you add all these sort of cost pressures together, that reduces the amounts of money left over to spend on reducing waiting times quite considerably.
"NHS spending in England has gone up quite considerably over the last 5-6 years by about 10% in cash terms each year. If we take account of inflation generally in the economy then that reduces the rise; so the real rise every year has been something of the order of 7 to 7.5% each year."
"The NHS has its own experience of inflation. It buys doctors, it buys nurses and so on, and their pay and prices go up differently to the general economy. So if you look at that, then the rise has not been so great - it's between, say, 5 and 6 percent in real terms each year."
"But if we look at the last few years, one of the things we have to take account of are cost pressures on the NHS: So what does the NHS have to spend its money on? Things like pay, increases in pay, increases in prices of goods and services that the NHS buys, pension contributions the NHS has to make have gone up, payments for clinical negligence."
"When you add all these sort of cost pressures together, that actually reduces the amounts of money left over to spend on reducing waiting times quite considerably. Analysis from the Department of Health seems to suggest that this year, for example, the money spare for the NHS is only around 2 to 3% - 2.5% maybe."
"Now that's considerably different from the 10% extra cash the NHS was given and different from the real rise that ministers talk about of around 7.5 %."
The data is only available now because it's been produced by the Department of Health, as part of setting a new national tariff for treatment the NHS provides- so called Payment by Results, which is being extended to all NHS trusts in 2005-2006.
http://news.bbc.co.uk/1/hi/programmes/panorama/4278479.stm

Five more hospitals have 'hidden' mixed-sex wards

An investigation by The Telegraph has discovered that five more hospitals have mixed-sex wards despite claiming that they do not, increasing the pressure on the Government to end the degrading practice.
Last week this newspaper published details of four similar hospitals with mixed wards, and exposed Labour's failure to honour its pledge to eliminate them. In the past seven days our investigation has uncovered a further five hospitals treating patients in mixed wards despite officially claiming to only have single-sex accommodation.
Labour first promised to close all mixed wards in 1997 and again in 2001 but so far three separate deadlines have been missed. The Government has claimed that mixed wards persist in older buildings awaiting refurbishment. Yet one of the five uncovered this week is Addenbrooke's Hospital in Cambridge, which is one of the country's newest.
Andrew Lansley, the Shadow Health Secretary and MP for South Cambridgeshire, which includes Addenbrooke's Hospital, said: "The target culture Labour have imposed on the NHS has meant that managers are obsessed with waiting times to the exclusion of patients' privacy and dignity."
Brighton and Sussex University Hospital NHS Trust, which covers the Royal Sussex County Hospital, said it had no "official" mixed-sex wards. When confronted with our evidence, however, it admitted that it put men in beds next to women because of waiting list pressures.
Desmond Turner, the Labour MP for Brighton Kemptown, said: "Patients should quite rightly be upset. The hospital does not have these wards as a policy but at the moment it clearly does happen."
The three other hospitals discovered to have mixed wards were the Queen Elizabeth II, in Welwyn Garden City, Hertfordshire; the Princess Alexandra Hospital, Harlow, Essex and the Darrent Valley Hospital, Dartford, Kent.
A Department of Health spokesman said: "In the National Health Service 99 per cent of hospitals provide single-sex accommodation.
In emergencies hospitals cannot turn patients away because they cannot guarantee them a bed alongside other patients of the same gender."

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2005/02/20/nward20.xml&sSheet=/portal/2005/02/20/ixportaltop.html