Campaigners said the findings were concerning, and even NHS admitted that there is room for improvement. The vast majority of people with mental health problems are treated out of hospital by community mental health specialists, including GPs, nurses, counsellors and social workers.

The Healthcare Commission, which analysed performance data and patient surveys, found while the majority of local mental health teams had out-of-hours services in their plan, just 49% of people with problems had the phone number of someone they could contact after office hours.

And 59% of the partnerships, known as local implementation teams (LITs), scored poorly when it came to providing access to crisis accommodation out-of-hours. The Healthcare Commission rated 9% of LITs as excellent, 45% as good, 43% as fair and 3% as weak.

It also found a greater need for access to talking therapies – such as counselling, cognitive behavioural therapy or psychoanalysis.

National guidelines say all people with schizophrenia or suspected schizophrenia should be offered appropriate talking therapies. The review found that only half of people questioned had such access and in 20% of LIT areas the figure was “significantly lower”.

It also said the management of medicines for patients with schizophrenia needed to improve – with 84% of LITs deemed fair or weak. The watchdog said 89% of services had not adequately recorded side effects or how well patients had responded to drugs.

Healthcare Commission chief executive Anna Walker said: “The majority of people who suffer from mental illness receive their treatment in their own community, not in hospital.

“They want to remain in the community and this helps them get better. But for care in the community to work for the mentally ill, more access is needed to talking therapies and out-of-hours crisis care. Mental health crises don’t keep office hours and the service must be flexible enough to tackle this.”

Professor Louis Appleby, the national director of mental health, said there were about 1,700 more clinical psychologists, and nearly 1,000 more primary care therapists working in the NHS in recent years.

“But in a way these new therapies – cognitive therapy is the main one – are a victim of their success. There’s growing research evidence that they can be used for a whole range of conditions, so of course the demand and the need is much greater, and it’s far outstripping what we can provide at the moment.”

Even Nigel Edwards, of the NHS Confederation, which represents health trusts, was quoted as saying that “Mental health has often been a Cinderella service in the NHS, yet one in four of us will experience a mental health problem every year.”

Mental health charities have expressed their concern at the commission’s findings.

Paul Farmer, chief executive of Mind, said: “We’re concerned about the large number of people who don’t have access to basic treatments, like cognitive behavioural therapy, which is simply not available in many areas of the country.”

Majorie Wallace of Sane said “This report shows that the community care policy still fails thousands of mentally ill people and their families. It is disturbing that this strong indictment of out-of-hours community care should come at the very time that mental health budgets are being slashed.”

The full sorry story can be found at: http://news.bbc.co.uk/1/hi/health/5389864.stm

Accenture yesterday remained circumspect about its reasons for leaving the NHS’s National Programme for IT (NPfIT) after almost three years’ work.

Under the terms of its exit agreement, Accenture must repay £63m of the £173m it has been paid for work delivered on its two contracts. The settlement is a fraction of damages the NHS promised to extract in the event of a major contractor leaving the project. Accenture faced a maximum liability on the two contracts of close to £1bn.

At the beginning of April, Accenture made a £240m provision against future losses on its work on the NPfIT. This came on top of a £75m loss on the two contracts last year.

Accenture was the only lead contractor to have made write-downs or provisions on NPfIT work despite the NHS’s own figures showing the US firm has made more progress on the programme than its peers. The figures show Accenture has been responsible for 80% of regional contractor system deployments so far and made progress in many more of the work areas defined under the NPfIT than the other lead contractors, CSC, BT and Fujitsu.

Richard Granger, director general for NHS IT, yesterday insisted the replacement of Accenture would not cause a loss of momentum, nor would it cost the taxpayer a penny. “The settlement is good value for money for the taxpayer when compared with what has been delivered,” he said.

CSC now has contracts across three regions with iSoft to install the financially stretched software firm’s Lorenzo package. CSC and iSoft are responsible for deploying IT systems for 620,000 NHS staff looking after a population almost 30m. In February, CSC and Accenture produced a damning joint report on Lorenzo. It found iSoft had “no believable plan for releases”.

There followed a series of legal letters making clear both US consultancy firms felt they had grounds for claims against iSoft. Accenture publicly made clear it blamed the London-listed software firm for missed NPfIT deadlines – delays which cost the US firm dear. Last month, iSoft announced it had resolved all legal disputes with CSC. CSC now has rights to take managerial control should Lorenzo delivery fall behind an agreed schedule.

Accenture yesterday agreed to drop its potential legal claims against iSoft as part of its exit deal with the NHS. The move will be welcomed by iSoft which remains at full stretch financially after posting a £344m pre-tax loss last month. It emerged this month that iSoft had received payments directly from the Department of Health of £82m for up-front work on IT system maintenance which it had not yet carried out. A cash injection of £58m was critical in helping iSoft meet City expectations last year.

Health Direct reminds Richard Granger of the old adage- stop digging if your neck is approaching the waterline.

The NPfIT project was fatally over- ambitious in it’s concept and is evolving into an expensive white elephant as it developments. On 20 Mar 06 Health Direct warned that the NPfIT NHS plan is evolving but one-size-fits-all is a fundamental flaw, says hospital chief when Sir Jonathan Michael, a top NHS executive, spoke at a healthcare symposium at London’s City University and pointed to a fundamental flaw in the NHS’s IT-driven modernisation. The flaw Michael sees in the National Programme for IT (NPfIT) is its centralised, standardised approach at a time when the health service is decentralising.

The policy of giving the Bank of England the power to set interest rates, free from political interference, has been an undoubted success. So now Mr Brown wants to extend that model to the public services, with the NHS most commonly named as the first to be reformed in this way. An “independent board” will be established to administer the service, with the role of politicians restricted to setting overall goals and strategy.

Apparently the Conservatives are sufficiently enthusiastic about the idea to claim that Mr Brown has stolen it from them. The day will come when the Tories will pretend that they had nothing whatsoever to do with it.

The problem with policy ideas is that you either discover that someone has done them already or that it was such a flawed notion that no one would want to do it. Well, congratulations to Mr Brown.

The NHS is not like the Bank of England. The Bank is setting the price of money. The NHS has an output not far off that of Portugal. It handles something like 10 per cent of our national income. It still employs over half a million people. It is a very different animal.

There are two ways of holding such a body to account. The first is through voice — the right to protest to a political representative who depends on your vote. The alternative is exit — the right to take your custom elsewhere, with the seller dependent on your patronage in order to thrive.

Mr Brown plans to remove both these forms of accountability. When he describes the new board as independent, you just have to ask: independent of what, exactly? And the answer, it turns out, is independent of you and me.

Sir Peter Lachmann, former president of the Royal College of Pathologists, felt moved to write to the Times saying that Mr Brown’s new policy was “probably the best news the NHS has had in the past 30 years”. This endorsement from a lickspittle is hardly surprising. The senior management of the service is bound to conclude that the interference of meddling politicians is nothing but a nuisance. They want to run their NHS with our money and without us pesky voters sticking our nose in the whole time.

The Chancellor is arguing that the closure of a local hospital ought to be decided by health service managers without the right of politicians to prevent it. If he isn’t saying this, he is saying nothing. But is it really acceptable that such sensitive decisions be made only by a group of unelected people, accountable only to each other and without appeal to the local electorate?

The model that Mr Brown intends to apply to the NHS is not really the Bank of England at all. It is, well, the model that the Tories tried to apply to the NHS in the mid-1980s.

In 1985 Norman Fowler, then the Health Secretary, appointed Victor Page as the chief executive of the NHS with the idea of relinquishing political control of administrative matters. It was perhaps with this experience in mind that another former Health Secretary yesterday said that he thought Mr Brown’s plan was “bonkers”. Political pressure from voters and the media ensured that it didn’t last five minutes. And neither will Mr Brown’s plan.

The Chancellor has set his face against such a Blairite (actually Tory) solution. But his third way between two forms of accountability is to provide no accountability of all. His NHS board idea was intended to reinforce his image as a man of substance instead it will show him up again as Bonkers.

Health Direct points out that the way that Labour have created the NHS closures process mean that a 3 month “consultation process” is a legal requirement before any cutbacks should actually take place. However after that three month timescale has finished, they will close the hospitals anyway.

(Please also see July 18, 2006 Anger over ‘legality’ of NHS cuts a Cornish district council boss questioned the legality of an NHS trust’s plans to cut health services after the proposals for the closure of St Michael’s Hospital were leaked to the media.)

The Trafford Healthcare NHS Trust which admitted in court it closed the wards without public consultation, is to hold four public meetings next month on the issue of inpatient beds in Altrincham.

Mrs Morris, 65, who quit her job to bring a judicial review against the trust, said: “There are no winners today – only losers. They will just go through the motions.”

Mrs Morris, who was represented by a counsel who did not receive a fee, said she had risked financial ruin, as she could have lost the case and been ordered to pay the trust’s costs. But she was awarded her costs which were less than £1,000.

Mr Justice Hodge said: “I do not accept that the need to close the wards at Altrincham General Hospital was so urgent that it was right that no public consultation should take place.” However he refused to order the wards’ reopening because the trust had accepted it was right to hold a consultation “very shortly.”

“It is a possibility that, having conducted a proper consultation, the trust reaches a conclusion which the claimant will not welcome, that it would be wrong to reopen the wards.

“It cannot be right for this court in its discretion to order the reopening of the wards on the basis that there will be a public consultation which might legitimately then decide to close them again.”

The full story can be found here:
http://news.bbc.co.uk/1/hi/england/manchester/5370376.stm

On 15 Sep 06 Health Direct noted that Labour targets NHS hospital cuts away from marginal constituencies as Labour may be trying to target hospital cutbacks in areas where rival parties have seats when Hazel Bears met Patricia Hewitt to discuss NHS cutbacks and clousres.

And to cut down on pesky costly midwifery services, all routine IVF treatment will also be stopped in Gloucestershire. Oh and ambulance transfers may become chargeable.

Protestors have campaigned heavily against the cuts since the proposals were made in May. More than 30,000 people took part in a rally in Cheltenham in July and a petition was sent to Westminster.

A nurse from Cheltenham’s maternity unit said: “I’m disappointed to lose the consultant-led unit but glad to retain a midwife-led unit but I feel it’s a bit of an after thought.”

The full disgraceful story of NHS political cutbacks can be read at:
http://news.bbc.co.uk/1/hi/england/gloucestershire/5368790.stm

There were fears the 24-hour walkout may leave hospitals and GPs short of equipment, but the government said disruption was being kept to a minimum.

A Department of Health spokeswoman said: “Contingency plans are in place and are working well. There are no reports of any problems.”

Reports from the distribution centres in Derbyshire, Cheshire, West Yorkshire, Kent and Suffolk suggested the strike was being “solidly” supported, according to the workers’ union Unison.

Unison also said other health workers, including nurses, and fire-fighters had visited some of the picket lines to show solidarity with the strikers.

The head of health at Unison, Karen Jennings, said: “What we’re very clearly trying to say to the government is let’s go back to partnership, let’s go back to talking, let’s get a consensus around what the NHS should be like. The rest of the staff in the NHS will be watching what’s happening to NHS Logistics.”

A second strike is due on 26 September during the labour party conference with more action to follow.

But their walkout looks to be in vain after Unison scrapped plans for a judicial review to reverse the deal after being told it had little chance of succeeding.

NHS Logistics supplies about 50,000 lines of products, including bedpans, latex gloves, syringes, bandages, medical equipment and food.

But from the start of October it will be run by DHL in a deal the government says will help save £1bn over 10 years.

The most recent major health service strike was when midwives were involved in a pay dispute in 1988.

http://news.bbc.co.uk/1/hi/health/5366096.stm

Health Direct salutes the NHS strikers- at least someone is trying to stand up for patients.

But the exercise, which the ONS yesterday noted had posed “significant measurement challenges”, because of the “complexity and variety of PFI schemes”, has raised almost as many questions as it has answered.

For example, PFI hospitals in Scotland were included in the figures but most of those in England and Wales were not, an anomaly that yesterday had opposition parties united in calling for government statisticians to be made independent.

Vince Cable, Liberal Democrat Treasury spokesman, said: “Hospital PFIs have given PFI a bad name because many projects were undertaken for the wrong reason as a way of hiding government debt.

“This debt will have to be paid. Many financially hard-pressed hospitals will be stuck with the burden for many years to come.”

The controversy over accounting for PFI projects is not confined to opposition politicians. Jean Shaoul, professor of Public Accountability at Manchester Business School, said the reason why so many hospitals were off-balance sheet was because government accountants had assumed risk had been transferred to the private sector.

“That is a dubious assumption and I am not comfortable with the way PFI is accounted for in national statistics because when things go wrong, ultimately the public sector picks up the tab,” she said.

Another anomaly, alluded to by the ONS, is that some projects, especially hospitals, are often neither on the government’s nor the private sector’s books. Yet others, notably roads, are included in the accounts of both.

The total capital value of PFI projects signed by March 2006 was £48bn and the Treasury has said that £23bn of this is on its books. The balance is off-balance sheet because of a judgment that the risk is in the hands of the private sector.

Of the £23bn of on-balance sheet PFI, £16bn relates to funding for the London Underground, only a small proportion of which has been spent. In addition, the government has already paid the private sector money to cover some finance lease liabilities, which is why the ONS estimate of £4.95bn looks relatively small.

But as the Institute for Fiscal Studies noted, this figure will keep changing. As projects come into operation, the amount added to net debt will be increased.

Christine Frayne, senior research economist at the think-tank, said: “However, the upwards adjustment will also be reduced by payments made by the public sector to the private sector that cover part of the finance lease liability and which are already included in public sector debt. Therefore it is not straightforward to judge how today’s improvements to the measurement of debt will change debt going forwards.”

John Hawksworth, of PwC, the professional services firm, said: “We don’t know if the numbers will rise quite quickly or whether they will be relatively stable.” On balance, however, he said the changes were an improvement. “It’s not the end of the debate but it is a step forward in what has been a murky area.”

http://www.ft.com/cms/s/bfee2c56-490d-11db-a996-0000779e2340.html

Health Direct applauds the Office for National Statistics for it’s decision to add the £4.95bn to public debts statistics, but we note that £25 billion appears to subject to further interpretation.

This £25 billion figure equates to roughly a third of the NHS’s entire annual budget.

As such the call for independence for the ONS will only grow when bliar so blatantly spins it’s figures- as we witnessed at the TUC’s conference when he incorrectly anounced that unemployement had fallen when in fact the number had actually increased.

In a speech in London to the Institute of Public Policy Research, the think-tank, the health secretary risked the wrath of trades unionists and Labour left-wingers by declaring that the government would set no curbs on the extent of private sector provision of NHS care.

“We don’t need to set arbitrary targets or limits for one provider or another” – whether the private or voluntary sector, or direct NHS-owned provision, she said.

Instead, the answer to the question “where will the NHS be in five, 10 or 15 years” would come “not from Whitehall but from the choices of patients, the decisions of local commissioners and the creativity of hospital and community staff”.

If independent providers “can help the NHS provide even better care and value for money for patients, we should use them. If they can’t, we shouldn’t”.

But the decision to use the private sector would increasingly become a local one, she said. Under questioning, she said: “We are not planning any new central procurements.” She “saw no need” for a third wave of independent treatment centres.

Invitations to tender are already out for the private sector to supply under-doctored areas, and to support or supply the commissioning of care.

Beyond that there could, she indicated, be situations where the centre could help with contract expertise and frameworks for negotiations on which primary care trusts and others could call.

“But in future I think the share [of NHS care] that a particular provider will get will depend on local needs and the decisions of patients and commissioners.”

The declaration that the government would set no limit to independent sector involvement in the health service angered the health unions.

James Johnson, the chairman of council for the British Medical Association, said the doctors’ organisation was “very concerned about the potential open-door policy to the private sector”.

Ms Hewitt, however, stressed that the NHS would not become “only” a commissioner, or a “kind of glorified insurance system buying services from the private sector”. It would always remain a provider of care “because of the quality and commitment of its staff, in and outside hospitals”.

The majority of hospitals and community services would remain publicly owned but their ownership would change to foundation trust status, owned not by the government but by the public and run by their staff.

http://www.ft.com/cms/s/5a2d74c2-4844-11db-a42e-0000779e2340.html

Health Direct wonders whether the labour government’s Secretary of State Patricia Hewitt is losing her marbles.

On the one hand we have here her saying under questioning yesterday “We are not planning any new central procurements.”

Then on the other, within the past fortnight we have the outsourcing of the NHS logistics £22 billion contract (5 Sep 06- DHL signs £22 billion NHS supply deal) and the ongoing NpfIT £20 billion white elephant to connect up the NHS. (20 Mar 06 -NPfIT NHS plan is evolving but one-size-fits-all is a fundamental flaw says hospital chief.)

One can’t use the excuse of Hewitt brazenly being economical with the truth so the only other possibility is that her centralised micro managing is losing it’s joined up thinking.

Connecting for Health said that with the system operating 24 hours a day seven days a week, these amounted to “very small service interruptions”. A significant number of those affecting digital picture systems were also due to local issues, not the central system, and items that the programme classifies as “major incidents” could be limited to a patient administration system running slow.

Richard Bacon, a member of the Commons public accounts committee, said the figures were evidence that the programme needed to be rethought.

http://www.ft.com/cms/s/ebb00780-477b-11db-83df-0000779e2340.html

Computer Weekely also reported that NHS IT staff “demoralised and undervalued” according to new research from their representative body.

Despite the government investing more in NHS IT than ever before, few IT professionals in the service feel they have benefited from the investment, says Assist, which represents NHS professionals in health informatics, including IT staff.

Its research found that vacancy rates range from 12% for information managers to 4% for senior managers and clinical informatics staff. Staff retention is being affected by low morale – informatics staff feel embattled, overworked and undervalued.

Andrew Haw, chairman of Assist, said, “With tough competition for informatics specialists from all sectors of the economy, the Assist survey highlights the need for urgent action across the NHS on health informatics workforce planning, recruitment and retention, and the establishment of health informatics as a formal profession.”

The research, involving 11 NHS organisations, found the application of Agenda for Change, the new NHS pay scale, had been inconsistent. Assist said there was a case for a recruitment and retention prima.

http://www.computerweekly.com/Articles/2006/09/15/218507/NHS+IT+staff+%e2%80%98demoralised+and+undervalued%e2%80%99.htm

On June 17, 2006 Health Direct NAO warns on NHS IT systems two years late and £20bn cost climbs noted that the NAO has three key worries for the future strategy of the NPfIT project:

• Ensuring that the IT suppliers continue to deliver systems that meet the needs of the NHS,
• Ensuring that NHS organisations can and do fully play their part in implementing the Programme’s systems.
• Winning the support of NHS staff and the public in making the best use of the systems to improve services.

Scepticism about the state of the National Health Service is rocketing.

Sixteen months ago, just after the general election, far more people believed the NHS would get better over the next few years than believed that it would get worse.

This month, after a battery of headlines about NHS deficits, job cuts, and the potential closures and changes at scores of hospitals, half the country believes the service will get worse over the next few years. A mere one in six, 18 per cent, believes it will get better – in spite of the billions of pounds that are still being poured into health spending.

It is by far the worst finding for labour since the tracking index was launched in 2002.

Most remarkably, despite the fact that the party yet has little formal policy in place, the Conservatives are now seen to have the best policies for health and education by those voters who see such issues as “very important” in how they will vote – the first time that has happened since Labour took power in 1997.

“Labour’s standing on public services is not quite in free fall,” Sir Robert Worcester, founder of MORI said. “But the public is clearly disenchanted with Labour’s ability to improve public services after nine years in office. Its figures are down and continuing to fall.”

The finding that the Conservatives were ahead, even if only marginally, on two traditionally strong Labour areas – health and education – pointed to an “anyone but Labour” effect, Sir Robert said.

Health looks to be the most serious area for Labour, rated as the second most important issue likely to shape people’s votes at the next general election.

Among those who describe health as an important issue for their vote, 25 per cent now believe the Conservatives to have the best policy, against 21 per cent for Labour – a 9 per cent swing since the last election. On education, the lead is a mere 2 percentage points, 28 to 26, but still an 8.5 per cent swing since the past election.

Back in 1997 the Labour party had a 38 percentage point lead on health and 23 percentage points on education.

Labour is still seen by a wide margin as the best party on the economy, unemployment and public transport, although it lags behind in traditional Conservative areas such as crime and asylum, and now, marginally in health and education.

The Ipsos MORI Delivery Index was conducted between September 8 and September 10 among 957 adults aged over 18 by telephone. Data were weighted to reflect the electorate. Ipsos MORI abides by the rules of the British Polling Council.

http://www.ft.com/cms/s/0212cc12-46b2-11db-ac52-0000779e2340.html

Coming only days after Health Direct helped publicise Labour’s targeting NHS cutbacks and closures away from Labour voting constituencies Labour targets NHS hospital cuts away from marginal constituencies 15 Sep 06- it is remarkable that even without any discernable health policies the Conservatives are seen as better than 9 years of Labour’s NHS incompetence.

Downing Street denied changes were politically motivated, insisting they were what was best for local people. Tony Bliar’s official spokesman said: “The restructuring is based on an analysis of what services are needed at a local level.”

The claims follow news an Accident and Emergency unit in a key marginal constituency is to be axed in favour of an “urgent care centre” dealing with less serious casualties. The provisional decision to scrap Rochdale Infirmary’s A&E; unit was taken by a joint committee of Primary Care Trusts in the area.

Rochdale Labour Party has been hoping to oust Liberal Democrat MP Paul Rowen at the next election. He snatched the seat from Labour in 2005 with a majority of only 442 votes.

The Rochdale decision is the first since NHS chief executive David Nicholson unveiled plans to concentrate key NHS services at fewer hospitals – a plan which could include around 60 such “reconfigurations”.

Labour Party chairman Hazel Blears met Health Secretary Patricia Hewitt on 3 July to talk about hospital closures and other matters, leaked emails seen by the BBC reveal.

The emails also refer to “heat maps” – Whitehall jargon for maps showing areas where public concern about hospital closures is running high. But officials deny press reports “heat maps” show areas where Labour could lose seats.

‘Sham’ consultations

Andrew Lansley, for the Tories, said he had not seen the minutes of Ms Blears’ meeting with health ministers but added “I can see what is happening and it really makes me angry”.

“There are difficult decisions to be made in the NHS and they are the responsibility of Labour because the financial mismanagement of the unprecedented resources going into the NHS has badly let down NHS staff, and the patients and the public.

“And those difficult decisions should be openly arrived at,” he told BBC Radio 4′s Today programme.

He said he did not think Mr Nicholson and staff at strategic health authorities, which make the decisions about local services, were “complicit” in politically motivated health closures.

But he added: “I think ministers are telling officials what to do and officials, unfortunately when ministers tell them things just go off and do it.”

He said the NHS should be more independent and called for an end to “sham” consultations in which the public were not given the full facts. And he urged Labour to stop using the NHS as a “political football”.

Steve Webb, for the Liberal Democrats, said: “No one doubts that there must be change in the health service, but people will be outraged to find out this is being planned around the jobs of Labour MPs. The NHS is owned by all of us. It is not a plaything of the Labour party.”

Health Minister Rosie Winterton insisted decisions were being made with patients in mind and there had been no political pressure on the “reconfiguration” of local health services.

“Very often when we’re talking about these reconfigurations it is about saying what is the best way of delivering care,” she told the Today programme.

She said in areas like cancer specialisms it can be effective to have experts who deal with a particular type in one place.

Hazel Blears had met health ministers and officials, added Miss Winterton, but had been “quite properly” looking at the “political dimensions” of health policy, such as whether manifesto commitments were being delivered.

http://news.bbc.co.uk/1/hi/uk_politics/5348246.stm

Health Direct has long questioned the targeting of NHS closures in non- labour voting constituencies. We are now starting to get proof of their vicious deviousness.

On 12 May 06- Voters turn against Labour’s NHS cutbacks and closures in local elections we wrote that local opposition to NHS reorganisations provided the catalyst for single-issue party candidates standing in last week’s local elections. GP Dr Jacqueline Gunsell was elected to Kirklees council on the Save Huddersfield Health Campaign ticket. She was one of three candidates standing in protest at plans to move services from their local hospital in Halifax.

Fifty of the clinics surveyed said they either had no sperm or insufficient supplies. Many reported waiting times of at least six months for couples needing donor sperm, and some were having to turn patients away.

The secretary of the British Fertility Society, Dr Allan Pacey, said: “We are certainly in a crisis at the moment – most clinics are finding it difficult to get enough sperm to treat their patients.

“And in the few cases that patients are receiving treatment, they’re not necessarily getting the choice they once had and are having to accept treatment with the only donor that’s available. This is a consequence of the law change and the manner in which it was implemented.”

“We made the point that centres needed help and some resources in order to receive donors following the law change – but sadly they’ve been left to their own devices, and now we have a tremendous crisis on our hands.”

And the BBC survey shows that doctors who are still recruiting have been using some imaginative methods – such as targeting workers in the emergency services.

Charities representing donor-conceived people say the change in the law has been a vital measure to bring openness into the lives of adults who were created in this way.

They fought hard to get these rights which, they say, simply put donor-conceived people on a par with those who were adopted and feel a need to contact their biological parents.

Olivia Montuschi, of the Donor Conception Network, said it was more complex than simply saying removing anonymity had led to the shortage of donors, and was also influenced by a change in the type of men thought to be suitable to be donors.

“It is also because many clinics, opposed to the ending of anonymity and unable to believe that the government would actually do it, panicked donors by saying that the law could possibly be retrospective or that donor conceived people would make huge demands on them.

http://news.bbc.co.uk/1/hi/health/5341982.stm

On April 28, 2005 Health Direct noted that the NHS IVF fertility system is in chaos- when plans to reform fertility treatment available on the NHS have resulted in a chaotic system with vast differences in the level of treatment on offer.

Health Secretary John Reid set a deadline of 1 April last year for all eligible women to get one free cycle of IVF treatment. But analysis of the system by a Parliamentary group and fertility watchdogs found:
# Women in some areas have to wait up to two years for treatment.
# Some areas which previously offered several cycles of IVF are reducing their provision to one.
# Wide discrepancies between the criteria to qualify for treatment.

The shake-up was seen as a step towards implementing guidelines issued by the National Institute for Clinical Excellence recommending that women should eventually receive three free cycles to give them the best chance of conceiving.

In London some areas were providing up to three free treatments while in other places women were not entitled to any. Now most Primary Care Trusts, which pay for treatment for patients, are promising to provide one free treatment while others are continuing to offer more.

But critics say the guidelines are in danger of becoming irrelevant because of the long waiting times in some areas. Some women are in danger of waiting so long that they will breach the upper age limit of 39 by the time they reach the front of the queue.

Delegates at the TUC Congress cheered when Dave Prentis, Unison’s general secretary, announced the result of the postal ballot that set the stage for the first strikes to take place before or during the Labour Party conference in Manchester in a fortnight.

Senior Unison officers will meet on Friday to decide what form the strikes should take. Officials suggested an initial series of one-day strikes would be staged as the first part of a “rolling” programme of industrial action.

The announcement came as all the main health unions representing doctors, nurses, midwives, physiotherapists and anciliary workers joined forces in a campaign aimed at forcing ministers to rethink plans to extend private sector involvement. They will stage a series of demonstrations, culminating in a lobby of Parliament next spring.

Before the last election, ministers said the private sector would provide no more than 15 per cent of services in the NHS. They have since admitted that involvement may expand well beyond that.

Tony Bliar, who today addresses the TUC for the last time as Labour leader, will face hostile questions on the expanding role of private companies in the NHS when he answers questions.

Unison said prolonged strikes would mean hospitals quickly running out of bulky equipment such as bedpans which were hard to stockpile.

Other equipment such as hand gel, latex gloves and food, including breakfast cereals, drinks and tinned vegetables would run short.

Mr Prentis said the decision to award the 10-year contract would turn the clock back 20 years as DHL tried to provide more cost-effective services. “Hospitals will need huge storage areas to cope with bulk buying,” he said. “Wards can order one packet of cornflakes if that’s what they want.

“Under DHL they will have to order packs of 14 boxes and hospitals will have to find space to store them and busy nurses and ward staff will have to unpack and stack them.”

Under rules laid down to protect former public service workers after privatisation, the 1,400 workers will be protected although the unions fear that in the long run their pay and conditions may not match those still in the NHS.

Paul Harper, Unison’s branch secretary at the Maidstone depot, Kent, said: “We deliver direct to hospital wards and operating theatres so getting it wrong could be a matter of life and death. This is not a service the Government should be gambling with by handing it over to a parcel delivery company.”

Unison is also seeking a judicial review against the DHL contract.

If the strikes go ahead it will be the biggest bout of national industrial action in the health service since midwives struck over pay in 1988.

A Health Department spokesman played down the effects of strike action. “The NHS uses 500,000 different products but only around 51,000 are provided by NHS Logistics. Most hospitals have their own local supply and delivery arrangements. We have put detailed contingency plans in place to ensure minimum disruption.”

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2006/09/12/nstrike12.xml

Health Direct notes that the labour givt can ill afford a NHS strike as it will directly impinge on it’s cleanliness targets- in particular it’s promise to halve MRSA:

On April 09, 2005- we questioned Why politics and MRSA don’t mix- MRSA is having a detrimental effect on the UK health economy and our ability to adequately treat hospital-acquired infections. But the desire to combat it with adequately financed and resourced strategies doesn’t exist and the transmissible strains that are driving the epidemic go largely unchecked. The Department of Health wants to reduce the MRSA blood infection rate by 50 per cent by 2008.

But the Department of Health said the figure should be seen in the context of the annual £70bn NHS budget. NHS trusts are able to employ external consultants for advice on how to run their services and staff.

The government has also enlisted companies like KPMG and Price Waterhouse Coopers to act as “turnaround teams” for some failing trusts.

In their report, the Tories said trusts’ spending on management consultants was increasing, and that the use of consultants was a “reliable yardstick” for job losses and debts. The report added that a total of £93.8 million was spent in 2004/05 on external consultants, rising to £117.9 million in 2005/06.

The projected spend for 2006/07 is £171.6 million.

The figures were calculated using the data returned from trusts, and projections for the remainder.

Mr Shapps said several trusts refused to respond to his request, adding they had an even worse track record than some in the report.

He added: “I think it’s extremely dubious as to how much effect these consultants are having, other than sacking lots of staff. The government needed to look at whether taxpayers were getting value for money when jobs and services were being cut and wards closed.”

The report said 10 of the worst trusts had millions of Pounds of debt, yet had a projected spend each of between £1.9 million and £3.6 million on consultants for 2006/07.

Brighton and Sussex University Hospitals NHS Trust owes more than £6 million and is cutting 325 jobs, but has a projected consultants spend of £3.6 million, it added.

Maidstone and Tunbridge Wells NHS Trust has a debt of more than £16 million and 300 job cuts but a projected spend of £3.5 million.

And United Lincolnshire Hospitals NHS Trust owes more than £11 million, and is cutting 320 job cuts but has a projected spend of £2.7 million on consultants for 2006/07, the report said.

Dr Paul Miller, chairman of the British Medical Association’s (BMA) consultants’ committee, said he would not be surprised if trusts’ total spend was even higher.

He added: “The NHS is wasting hundreds of millions of pounds on management consultants who don’t have the answers. I would like the secretary of state to stop the NHS wasting all this money on management consultants – it takes money away from patient care.”

Dr Miller, who has an MBA, continued: “The NHS needs good management and good managers but that involves people who know the trust, the staff, the locality and the services it provides – not just people parachuted in from outside with no health experience.”

A spokeswoman for the Department of Health said it not comment on the figures in the report because there were no details of what kind of services were included in the costs, and said the total spend on management consultants was not collated.

She denied that there was a link between deficits and the use of management consultants and said independent evaluation had found “no common cause” for deficits.

http://news.bbc.co.uk/1/hi/health/5337602.stm

Health Direct agrees with Dr Paul Miller, chairman of the British Medical Association’s (BMA) consultants’ committee, when he said that he would not be surprised if trusts’ total spend was even higher.

On Tue 8 Aug 06 Health Direct noted in Public sector consultants to cost £20bn under Labour’s stewardship that the bill for management consultancy within government is set to top £20bn over the lifetime of three parliaments, according to a former consultant who has carried out an extensive survey of public spending on external advice- David Craig, formerly of Capgemini, the consulting company.

Children with MRSA in their blood require emergency hospital treatment to prevent blood poisoning and toxic shock, which can quickly lead to organ failure and death. Premature babies receiving intravenous treatment are at particular risk because MRSA is able to enter their bloodstream through the tiny open wound required to administer drugs or fluids.

Preliminary results from the Health Protection Agency study, which will be unveiled at the organisation’s annual conference tomorrow, show that more than three-quarters of the 147 youngsters affected since the research began last year were less than a year old. Of those, four out of 10 were under the age of one month.

Dr Alan Johnson, a researcher and microbiologist, said: “We have provisionally seen 147 cases of MRSA bacteraemia in children reported to us. This is very much an interim picture because we are still getting questionnaires from paediatricians.”

He suggested that enhanced surveillance explained much of the rise, but said that the study had been extended for another year.

However, Dr Mark Enright, reader in microbiology at Imperial College London, said: “If you are getting nearly 150 bloodstream infections in children, that is an awful lot and it means things are getting out of control.”

He added that, because bloodstream infections usually account for about 20 per cent of all MRSA cases, it was possible that as many as 750 children each year are contracting the superbug.

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2006/09/10/nhs10.xml

Health Direct questions the accuracy of the Health Protection Agency’s figures as on October 24, 2005 Newborn babies at 90% of hospitals are carrying MRSA superbug we noted that babies fall sick as doctors ignore superbug hygiene- newborn babies at 90% of hospitals are carrying the superbug MRSA, according to a study which found that doctors and nurses are ignoring basic hygiene measures to combat the spread of infection.

Fewer than half of doctors and 63% of nurses always wash their hands with antiseptic gels between patients, says the report. In some parts of the country only a third of hospitals have cleaners at night.

On Tuesday, the Government confirmed that DHL would take over £22bn worth of buying and distribution for about 600 hospitals. Shares in Deutsche Post, DHL’s parent, rose on news that the 10-year contract was worth up to £1.6bn a year.

Union leaders said it was the biggest “privatisation” of NHS services to date. Some 1,700 staff working for two NHS divisions, Logistics, and Purchasing and Supply, will be transferred to a new company from October 1.

Dave Prentis, general secretary of Unison, said: “Our members are proud to work for the NHS and feel betrayed by a Government that is handing them over to DHL, like one of the packages they deliver. The Government’s decision to privatise it is driven by pure dogma.”

The GMB, as well as representing NHS workers, is also the main union at DHL.

Sharon Holder, GMB national officer, said members in the NHS and DHL would “seek common ground” to oppose the deal. She said: “It is part of the creeping, ill-thought out privatisation of health services.”

http://www.telegraph.co.uk/money/main.jhtml?xml=/money/2006/09/06/cnhs06.xml

As Health Direct noted on Tuesday, September 05, 2006 DHL signs £22 billion NHS supply deal this DHL outsource deal is the biggest yet bar Network Rail in the history of Labour’s incompetence.

The NAO’s value for money reports on IT projects are usually one-offs. So its decision to produce two reports on the NPfIT is an unusual step.

Since the publication of the NAO’s report on the National Programme, several developments have worried IT managers and some executives on the boards of NHS trusts across England:
* A loss of £382m at iSoft, the main software supplier to the programme. The company is also the subject of an investigation by the Financial Services Authority.
* The crash of a datacentre which interrupted NPfIT services in some cases for several days. Some IT managers and executives on boards of NHS trusts are now unsure whether they want to rely on national services for critical clinical systems such as medical records and e-prescriptions.
* Persistent suggestions that Accenture, the NPfIT’s supplier in the east of England, might have withdrawn from supplying most major hospitals. Accenture, which operates between the borders of Scotland and the edge of London, has declined to comment.
* Independent surveys by Nursix and Ipsos Mori which indicate that support for the way the programme is being implemented may be waning among some groups of NHS staff.

Clark said that in the light of recent events the published NAO report “raises more questions than it answers”. He added his committee would hold a new hearing on the NPfIT, based on a new NAO report. He expected the hearing to occur next year.

In its June report the NAO said it “may return to carry out a further examination at a later date should this appear necessary”. But last week its spokesman told Computer Weekly that the NAO had decided to publish a new report, though no date has been set.

http://www.computerweekly.com/Feeds/RSS/Articles/2006/09/05/218205/Audit+Office+pledges+new+report+on+NHS+.htm

Why a new report is needed- on August 21, 2006 in Labour conceals NHS criticism by NAO of NPfIT we found that Labour faces allegations of trying to undermine the independence of the National Audit Office after it successfully toned down the findings of an inquiry into the £12 billion NHS computer system. Documents released last week show how key passages in the NAO report were changed after interventions by Department of Health officials. These included removing warnings about the difficulties of creating computerised records for every patient in the country.

The NAO’s report, published in June, was replete with praise for Connecting for Health, the agency running the National Programme for IT in the NHS.

But its tone was in marked contrast to two draft reports seen by Health Direct. The drafts had been through a six-month “clearance” process which allowed Connecting for Health to refuse to sign off a report if it disagreed with its factual content.

The final report omitted some of the most serious criticisms of the programme. It did not mention the effect on NHS trusts of software delays.

While so-called health tourism is on the rise, many EU members have argued that medical services fall outside the scope of the single market.

But the European Court of Justice has found that they do not. In a ruling in May on the case of British woman Yvonne Watts, who went to France to avoid a year-long wait for a hip operation, the court said patients facing “undue delay” should be entitled to be treated in other countries and paid for by their national health systems.

Mr Kyprianou said: “The internal market applies to health services. People can shop around.”

Opening the market could provide lucrative opportunities for private providers to lure clients from across Europe.

The move would have big budget implications for countries such as the UK, which effectively rations healthcare by limiting capacity and having long waiting lists. EU health spending rose from an average 7 per cent of gross domestic product to 7.7 per cent between 2000 and 2003.

Today, Mr Kyprianou will launch a debate, requested by member states, in the European Commission that will lead to proposals within months for how the market should function.

“We need to give people information. For example, if you want a hip replacement, where do you go, which country? There must be a better way to help the citizen make a choice,” he said. “On the other hand, can a receiving country turn down a patient?”

About 1 per cent of operations across the EU involve people from other countries. Defining “undue delay” will be one thorny issue. “I am not going to produce a list of time limits,” Mr Kyprianou said. There is also the question of liability if an operation goes wrong and who should pay for follow-up treatment when the patient returns home.

Patients could only travel for treatment that would be available in their own country and at the same price. They would have to meet extra costs themselves.

Jim Murray, director of BEUC, a European consumer lobby group, welcomed the debate. “Patients need much more clarification of their rights,” he said.

Although José Manuel Barroso, the liberal president of the European Commission, wants to go further, many members insisted on health being excluded from a recentl EU directive to liberalise trade in services.

http://www.ft.com/cms/s/2d44219c-3c7b-11db-9c97-0000779e2340.html

Health Direct warned back on May 16, 2006 NHS told to fund treatment abroad in landmark court ruling that the case of Yvonne Watts, 75, of Bedford, who paid £3,900 for a hip operation in France when the European Court of Justice ruled that the case, which centres on the definition of “undue delay”, could have a significant impact on the NHS. It will allow any patient facing an unacceptable delay who has the funds to pay for an operation upfront to seek treatment abroad and recoup the costs from the NHS.

UK patients who are forced to wait longer than they should for NHS treatment are entitled to reclaim the cost of being treated in Europe, a court has ruled. The European Court of Justice said the NHS must refund costs if patients waited longer than clinicians advised, even if waiting time targets were met. The case, which centres on the definition of “undue delay”, could have a significant impact on the whole NHS.

The court ruling also meant that Labour’s much vaunted promise of a maximium 18 week delay to NHS treatment is a valuable as Neville Chamberlain’s paper.

It is the company’s biggest UK deal. The drive to outsource the work of NHS Logistics – already a winner of repeated supply chain awards – has been attacked by health service unions.

Unison is already balloting about 1,000 of its members over strike action. The result is due to be announced next Monday, the first day of the Trades Union Congress’s annual conference. The deal will increase friction over the “privatisation” of the NHS between the union and the government ahead of the Labour party conference.

The move to outsource purchasing of everything from beds and bandages to medical devices and office supplies has also alarmed suppliers to the NHS, who fear a price squeeze.

The Association of British Healthcare Industries argues the government risks creating a near-monopoly purchaser for the NHS that it says will damage small companies and stifle innovation.

According to DHL and Department of Health sources, the deal is expected to generate savings of about £1bn, or about 5 per cent of turnover, for the NHS over the lifetime of the contract. John Allan, DHL’s chief executive, said the company was being paid on the basis of the savings it would generate and the volume of business it achieved.

According to DHL, the existing in-house arrangement currently provides about 45 per cent of the NHS’s non-pharmaceutical supply needs, with the remaining NHS organisations acting alone or in consortia. There will be no requirement on NHS organisations to use the new business, to be known as NHS Supply Chain, but John Pattullo, DHL’s chief operating officer, said the aim was to grow its share of the market “significantly” – up to perhaps 70 to 80 per cent.

“We will have to convince NHS trusts and hospitals that we have something to offer,” he said. DHL will use Novation, the biggest US medical supplies company, as a subcontractor.

Mr Pattullo attempted to calm fears that DHL/Novation would seek to cut the 500,000 separate lines that the NHS now uses and cut their price, at the expense of quality and innovation.

There would be moves to simplify the range of items on offer, he said. But the company would set up a dozen product councils, involving clinicians and buying experts, to seek out new and innovative products.

“People with new ideas will be able to offer them to an organisation that already has about 45 per cent of the market and that’s not a bad starting point,” he said.

Staff transferred will retain a defined benefit pension equivalent to the generous NHS one, the company said. It estimated that 1,000 new jobs could be created over the decade as the business expands. But Unison said: “This is taking an award-winning not-for-profit business that shares the savings it makes with the NHS and handing it over to a profit-making one.”

The deal, however, represents “world-class best practice”, according to Allan Waller, president of the Chartered Institute of Logistics, who was brought in by the NHS commercial directorate, which negotiated the deal, to assess the contract.

DHL already has a small outsourced contract with NHS Logistics and acts for healthcare suppliers in other countries.

http://www.ft.com/cms/s/46c05e98-3c7a-11db-9c97-0000779e2340.html

Health Direct notes that this outsourcing of NHS supplies is by far the biggest privatisation project within the NHS. On July 01, 2006 NHS reform falters as Labour ministers pull advert we warned about the pace of NHS privatisation.

Additionally Health Direct notes that John Allan, DHL’s chief executive, said the company “was being paid on the basis of the savings it would generate and the volume of business it achieved.”

It’s worrying that nothing was mentioned about patients’ security when this is a growing area of concern: June 23, 2006 Trusts criticised for outsourcing patient records to cut costs when the Unison union says it has evidence of an incorrect incident report which led to a patient being given the wrong treatment, and has examples of other typing errors in the private transcription services which could lead to life and death decisions.

The delay has raised concern that the project – already two years behind schedule – may be continuing to overrun. The government believes it will cost £12.4bn but critics fear more delays could mean costs spiralling to more than £18bn.

Of the 22 NHS acute trusts supposed to be receiving the new patient administration system by the end of October only seven believe they will now hit the target, according to a survey by E-Health Insider, a specialist online magazine for health professionals. The system is crucial to the entire project as it is the foundation on which all other aspects of the IT system are built.

The revelation of the difficulties undermines the credibility of claims made by Connecting for Health, the government body overseeing the project.

In June it told MPs on the influential Commons Public Accounts Committee that 22 trusts would get replacement systems by the end of next month.

Two committee members, Richard Bacon, the Conservative MP for South Norfolk, and John Pugh, Liberal Democrat MP for Southport, have taken the unprecedented decision of warning that the NHS is in danger of ‘sleepwalking to disaster’ and wasting billions of pounds on the project unless it is dramatically scaled back.

The upgrade of NHS computers, the largest IT project in the world, has been dogged by controversy and criticised for over-centralisation. Its largest software supplier, iSoft, is under investigation by the Financial Services Authority for possible accounting irregularities.

http://observer.guardian.co.uk/politics/story/0,,1863823,00.html

Health Direct applauds Richard Bacon and John Pugh as at last some politicians are starting to realise the extent of the folly of the NPfIT project. With the wheels coming off the project on an almost weekly basis, it could be an interesting September.

“This year has seen vitally needed healthcare professionals losing their jobs. Doctors report on their cancelled clinics, empty operating theatres and patient referrals diverted to referral management centres where patients are often redirected. The BMA is dismayed by the incoherence of current government policies and the damage they cause to the NHS and the delivery of patient care.

“Healthcare should be free at the point of delivery, ethically rationed by clinical priority without discriminatory values, equitably resourced and funded out of general taxation. These fundamental values cannot be maintained if the NHS is broken up and tendered to commercial corporations which are accountable to shareholders rather than to patients.”

Mr Johnson believes that only by engaging with doctors will the NHS work for patients.

He says: “Doctors have repeatedly demonstrated their ability to foster innovation and the NHS is a proven mechanism that can deliver, and has delivered, reform. Any NHS reform must be based on the values of co-operation, strategic planning and equity and should deliver integrated care. It is also important that the NHS creates an environment in which teaching, training and research can flourish.

“Policies are too often developed without the involvement of NHS staff and patients. I believe that if doctors and other healthcare staff are allowed to get involved in every aspect of managing, running and shaping the NHS, we can make the NHS work well for patients and for the staff within it.“

http://www.bma.org.uk/ap.nsf/Content/PR-Involve+doctors+in+health+policy+or+risk+damaging+the+NHS%2C+BMA+warns+-+31+Aug+2006

Health Direct notes that the BMA used to be fairly bipatisan, but in recent months they have started to put the boot into the labour govt’s fragmentation and closure with growing forcefullness.

Basically calling the new labour reforms as having a lack of clear vision- ie rubbish, it implies that those currently at the top ought to stand aside now.

Please see also: June 29, 2006- Doctors toughen position against Labour’s NHS reforms- the British Medical Association moved towards near total opposition to market-like reforms to the National Health Service yesterday. It called for no further involvement of the private sector, a potential end to the split between purchasers and providers and to the private finance initiative.