Shortage of key IT skills in public sector

Public sector information technology projects and their suppliers are grappling with a shortage of key skills on which their successful delivery depends, Richard Granger, director of the National Health Service's £6.2bn IT programme has warned.
He said the IT industry had lost between 100,000 and 250,000 jobs since 2000 so there was now "real difficulty" in getting core software written and assembling "the high quality teams needed to deliver complex programmes".
Mr Granger told the Healthcare Computing conference in Harrogate that the shortage stemmed from the huge expansion of the business in the late 1990s needed to deal with the millennium bug.
That brought forward the replacement of older IT systems that subsequently produced a slowing in spending compounded when the dotcom bubble burst. The job losses meant "succession planning", in which junior staff moved up to become team leaders and project managers "has fallen apart in our industry and that is causing real problems with major programmes," he said.
The issue had not been helped by the revival in demand for IT projects in the private sector, which had come on top of a big expansion in public sector programmes, he said.
He had discussed the issue with the chief executives of the big NHS suppliers and with the trade association Intellect, adding: "There are massive demands for resources that just aren't in the market. That bodes ill for the medium term."
He said that 10 years ago all the software for big public sector programmes was written in the UK. The NHS project, however, was having to use programmers in the US and in India to develop core software.
And while the staff were high quality, and in the case of India low cost, that still led to difficulties with time zones and different cultures, which mattered when programming for health.

http://news.ft.com/cms/s/ed413da0-9c08-11d9-815d-00000e2511c8.html

Current ID card legislation must be abandoned- LSE urges

The current identity card bill proposals are 'too complex, technically unsafe, overly prescriptive and lack a foundation of public trust and confidence', according to a new report published by academics from the London School of Economics and Political Science.
The report, The Identity Project: an assessment of the UK Identity Cards Bill- which labour claims is essential for the NHS reforms- and its implications, is a major is a root and branch analysis of the Identity Cards Bill. It involved more than 100 academics and outside experts in the fields of law, technology, information systems, government policy, business, economics and security and is the most comprehensive analysis yet produced during the two-year gestation of the proposals.
While the report supports the concept of a national identity system for the UK, it recommends that the current legislation should be replaced with a different model. The consequences of the current proposals might include 'failure of systems, unforeseen financial costs, increased security threats and unacceptable imposition on citizens.'
Professor Ian Angell, head of LSE's Department of Information Systems and a member of the report's advisory group, commented: 'This is rigorous and balanced research that has highlighted substantial flaws in the Home Office identity card proposals. The report has proposed a more sensible model for a national identity scheme. The government should seriously consider this alternative.'
Another member of the report's advisory group, Professor Patrick Dunleavy of LSE's Government Department, said: 'The report very clearly shows that an identity card must be a real benefit to the citizen rather than being a costly imposition. We have an opportunity right now to develop an identity system that people genuinely want to use in their day-to day-lives. It has to be secure and it has to be user-friendly.'
The report was initiated and hosted by the Department of Information Systems of LSE and has involved senior academics from ten centres and departments across the School.
The authors say: 'The success of a national identity system depends on a sensitive, cautious and cooperative approach involving all key stakeholder groups including an independent and rolling risk assessment and a regular review of management practices. We are not confident that these conditions have been satisfied in the development of the Identity Cards Bill. The risk of failure in the current proposals is therefore magnified to the point where the scheme should be regarded as a potential danger to the public interest and to the legal rights of individuals.'
The report goes on to warn that, rather than increasing UK security, the Bill may create greater security dangers than before. 'The proposed system unnecessarily introduces, at a national level, a new tier of technological and organisational infrastructure that will carry associated risks of failure. A fully integrated national system of this complexity and importance will be technologically precarious and could itself become a target for attacks by terrorists or others.'
It is arguable, say the report's authors, that the legislation may contravene the European Convention on Human Rights, the right of free movement for EU citizens, the Disability Discrimination Act and the Data Protection Act. And they warn that the overall cost of a national identity scheme may be well in excess of government projections.

http://www.lse.ac.uk/collections/pressAndInformationOffice/newsAndEvents/archives/2005/IDReport.htm

Syphilis crisis continues as sex diseases rise

Senior MPs warn of a crisis in sexual diseases among the young with the prospect of a 50% rise in cases within the next three years. A report by the House of Commons Health Select Commitee reveals that the number of people attending clinics for diseases ranging from chlamydia to gonorrhoea has more than doubled in 10 years.
Government plans to tackle ‘Health Tourism’ may have serious effects on public heath and the fight against HIV. The concludes that failed asylum seekers and illegal immigrants with HIV should receive free treatment to reduce the likelihood of onward transmission of HIV.
Under new Government rules, individuals who are in the UK without proper authority, including failed asylum seekers, visa overstayers and illegal immigrants, are no longer able to access free treatment on the NHS.
Treatment for certain infectious diseases is free of charge on public health grounds – but while this includes treatment for TB and sexually transmitted infections, it does not include treatment for HIV.
The reports concludes that if free treatment is not available, people may be deterred from taking an HIV test, and will remain in the community undiagnosed and infectious. Evidence also suggests that HIV treatment can in fact significantly lower an individual’s infectiousness, reducing the potential for onward transmission.
Committee Chairman David Hinchliffe said “The Committee does not underestimate the difficulties the Government faces in combating ‘health tourism’, and it’s vital that the UK does not become a magnet for HIV positive individuals seeking to emigrate to this country to access our health care. However, we have seen no evidence that this is happening. The Government has no estimates of the numbers of people likely to be involved in health tourism, or of what they might be costing the NHS.
Evidence actually suggests that HIV positive migrants do not access NHS services until their disease is very advanced, sometimes years after their arrival in the UK.
The public health issue is a real concern – the Health Protection Agency, the Government’s own public health advisory body, said that if these individuals are not treated, and they remain sexually active in this country, then ‘transmission is bound to go up’.”
The report also notes that rates of sexually transmitted infections have continued to rise, as have waiting times for sexual health clinics. In fact, according to one of the Committee’s witnesses, there is a “continuing crisis in sexual health”.
To reduce the risk of onward transmission of sexually transmitted infections, the Government is aiming for all patients to be seen within 48 hours of requesting an appointment. However, the latest figures indicate that only 38% of people get an appointment within 48 hours, and over a quarter have to wait more than two weeks.
Commenting, David Hinchliffe said, “Rates of sexually transmitted infections are still rising, and sexual health services are more overstretched than ever. The Government has announced extra investment and new targets around sexual health, which we welcome, but they will need to monitor the situation closely over the coming years to ensure the extra investment actually reaches clinics to enable them to deliver better services.”
"It is particularly important that sexual health services are able to meet the extra demand that will be generated by the Government’s planned health education campaign. “Educating young people about relationships and sexual health is one of the most powerful tools we have to promote better sexual health. However, young people are still being taught about sex and relationships by teachers who lack both competence and confidence in this area.”
The Health Committee recommends:
* Government’s sexual health education campaign should not begin until it is certain that sexual health services will be able to meet increased demand
* Government should conduct a financial audit to ensure that extra sexual health funding actually reaches sexual health clinics
* Chlamydia screening should focus on men as well as women
* The Government should give GPs better incentives to provide sexual health services. A dedicated sexual health training programme should also be established for those working in primary care
* By 2007, all sex and relationships education in schools should be taught by a specialist teacher rather than a form tutor.
* Sex and relationships education should be a statutory and assessed part of the national curriculum in schools.
* All HIV+ people regardless of their eligibility status should receive free treatment to reduce the likelihood of onward transmission of HIV

The report's title is ‘New Developments in HIV/AIDS and Sexual Health Policy and is published as their third report of Session 2004-05 (HC 252).

http://www.parliament.uk/parliamentary_committees/health_committee/050318.cfm

MRSA kills 2 day old baby

A baby of just two days has died after becoming infected with the MRSA superbug. Luke Day, who died in Ipswich Hospital aged 36 hours, is believed to be the youngest ever victim of the virus.
His parents, 17-year-old Glynis Day and 24-year-old Kevin Fenton, said he was first thought to have septicaemia. But a post-mortem revealed he died from septicaemia caused by MRSA (methicillin-resistant staphylococcus sureus)
Luke's grandmother Kathy Day has quit her job as a family support worker at the hospital in disgust. She said: "We've got to make sure this terrible tragedy never happens again."
Luke was born an apparently healthy 7lb 7oz child.
His mother Glynis said: "He had no symptoms or anything. As far as they were concerned Luke was just a normal healthy baby. There was no warning at all."
When the family went to sign Luke's death certificate they were shocked to find it did not mention MRSA. They refused to sign the certificate until it had been changed.
Mrs Day said: "A baby has died from MRSA in an NHS hospital. People need to know.
"Something must be done in eradicating this terrible superbug. We do not want other families to go through the pain we have suffered over the last few weeks."
A hospital spokeswoman said staff were doing all they could to get to the bottom of Luke's death.
She said tests on the ward, maternity facilities, staff and family members had found no trace of MRSA.
The bug is resistant to methicillin and many other types of antibiotic.

http://www.sky.com/skynews/article/0,,30100-13314803,00.html

This raises two further worries:
1) The hospital is clearly not in control of the situation as they can not find the source of the MRSA infection,
2) The attempt to mis- describe the reason for death on the death certificate once again questions how far one can trust Tony's statistics.

Revealed: where the extra NHS cash is really spent

Tony Bliar has failed to transform the National Health Service despite the biggest government spending spree in the 60-year history of the welfare state, according to an independent audit.
The “unprecedented” injection of more than £30 billion of taxpayers’ money into the service has achieved “significant” benefits, says the study, but has yet to translate into clear gains in the nation’s health. “There has been significant improvement in most areas the government has focused policies on,” concludes an analysis published this weekend by the King’s Fund, an independent health research group. “However, the NHS as a whole has not yet been transformed.”
The report, commissioned by The Sunday Times, states that “important problems” remain and that “there is as yet no firm evidence to show that Labour’s reforms have produced a marked difference in health outcomes”.
The findings come as public spending emerges as a key election battleground between Labour and the Conservatives. Blair has accused the Tories of planning to cut spending by £35 billion; the Tories argue that they will maintain spending increases but at a more prudent rate than Labour.
Since Blair declared that he would “save” the health service, spending on the NHS in England has jumped from £34 billion in 1997-98 to £69 billion this year.
The soaring budget has reduced waiting times and increased the number of doctors and nurses, say the authors; most patients now get to see their GP promptly and are treated within four hours if they attend an accident and emergency department.
“Overall the results of the audit undertaken by the King’s Fund are positive,” said Niall Dickson, its chief executive. “Is the NHS service better than it was in 1997? The answer is yes — but so it should be since the budget has more than doubled.”
By 2008 Britain will be devoting 9% of its gross domestic product to health, a level comparable with other European nations. Yet standards of care remain better in other leading European Union countries. The King’s Fund believes that many improvements are still feeding through the NHS but gives warning that flaws remain.
The audit’s findings include:
# The bulk of new funding for the NHS is being eaten up by pay increases for staff and other “cost pressures”.
# The funding increase left for new hospital services in 2004- 05 was only 2.4% despite an overall increase of 12%.
# Figures for new doctors and nurses are overstated because more NHS staff are working part-time.
# Waiting lists are coming down but some waits for diagnostic tests for cancer and other diseases are increasing.
# MRSA infections are still a “significant problem” for the NHS.

http://www.timesonline.co.uk/newspaper/0,,176-1533370,00.html