The same thing happened when Lord Winston made a fuss about the dreadful treatment that his elderly mother received in hospital. Only then did the government stop denying that there was anything wrong.

Street-Porter published extracts last week of the diary of Patricia Balsom, her dying sister. They were horrifying. Among the miseries she endured was lying neglected in a mixed ward, where she was woken more than once to see a naked male patient masturbating opposite her bed. Her shocking stories prompted a flood of others.

The late Eileen Fahey, for instance, dying of cancer, was put onto a mixed geriatric ward where confused people wandered about without supervision. One man with dementia regularly masturbated at the nurses’ station and tried to get into women patients’ beds; he was a threat to them all but staff took no notice, according to her daughter Maureen. Other patients have to give answers to intimate questions in the hearing of other patients. One deaf old man was repeatedly asked when he last had an erection, until tears ran down his cheeks.

A former midwife described eloquently on Radio 4 the indignities of being in a 24-bed mixed-sex ward, stripped of all dignity and intimidated. Bedlam was the word she used, and it applies even more accurately to the secure psychiatric mixed ward in London endured by Susan Craig last year, after a breakdown. She suffered regular sexual harassment, with mentally ill men groping her and exposing themselves. The nurses disbelieved her and told her husband she was “flaunting herself”.

If so (I don’t believe them), their job was to protect a patient from her own folly. Instead they chose, in modern cant, to blame the victim.

Sexual harassment is only a small part of the problem. Many people, both men and women, feel their modesty is violated by such closeness to random members of the opposite sex, even when they are not threatened.

Patients lie naked, half washed and forgotten, their sick and ageing flesh exposed to everyone, while nurses rush elsewhere. It is commonplace to have to walk to filthy mixed lavatories with gowns wide open at the back. At a time of sickness and anxiety many people are profoundly embarrassed to be surrounded by a clutter of bed pans, colostomy bags, nakedness, cries of pain and sweat, blood and tears — their own and other people’s.

All this is much worse, for many, when they are surrounded by members of the opposite sex; shame and anxiety are not the best bedfellows of hope and healing.

Much has been written about the rape of modesty and the death of shame. However, it is still true in this weary country that most men and women prefer to perform private bodily functions alone if possible, and among their own sex only, if not. That’s why we have separate public lavatories and separate changing rooms in shops and clubs and pubs. That’s why people put up towels on the beach. That’s why women give birth in female wards, not in mixed wards or not — I hope — so far.

Admittedly there are some who believe that mixed wards are not a problem, but our prime minister is not one. “Is it really beyond the collective wits of the government and health administrators to deal with the problem?” he demanded in 1996, flying high on vectors of dizzying youthful indignation as leader of the opposition. “It’s not just a question of money,” he went on. “It’s a question of political will.” Well, he said it and he promised to end mixed-sex wards by 2002.

What we have come to expect of new Labour promises, following failure, changing the goalposts, more failure and exposure, is denial. Sure enough Patricia Hewitt, the health secretary, was sent onto the Today programme in denial mode last week.

Although the Healthcare Commission watchdog found that on average 22% of patients have to stay in mixed-sex wards, rising to 60% in some hospitals, Hewitt’s officials at the Department of Health say the government has achieved its target of abolishing mixed-sex wards, with 99% of trusts providing single-sex accommodation.

It is not difficult to spot the problem with that claim. It is not the same as saying 99% of patients get single-sex accommodation; it may be “provided” for very few. There has been the usual goalpost shifting: hospitals can claim they are providing single-sex accommodation by putting screens between beds in mixed-sex wards. Brilliant.

Hewitt admits there was a problem of perception; she even admitted that there was a “clear gap” between patients’ experiences and figures provided by hospital trusts to the Department of Health. One does tend to have a problem of perception, I find, if one is being misled.

My feeling is that mixed-sex wards are not the worst of NHS hospitals’ problems, although they demonstrate them. They demonstrate the incompetence and deviousness of hospital management in general, and they also show something worse.

In all the stories I’ve come across what stands out is the ignorance, incompetence, laziness and heartlessness of all too many nurses, who are allowed to neglect and insult their patients without supervision and without sanction — in single-sex wards just as much as mixed.

Bliar did not just promise to abolish mixed-sex wards, he also promised to save the entire NHS. He believes in divine judgment; I wonder how he will answer.

This posting was aided by:
http://www.timesonline.co.uk/article/0,,2088-2472127,00.html
http://www.timesonline.co.uk/article/0,,2088-2472127_2,00.html

Health Direct first covered the broken promises of closing mixed sex wards nearly two years ago on February 13, 2005 in Labour lies on mixed sex wards revealed The promise to eliminate mixed “Nightingale” wards – occupied by up to 30 male and female patients – was first made by Tony Blair during the 1997 election campaign. Then, in 2001, it was pledged that all 366 mixed-sex “Nightingale” wards would be ended by April last year (2004) . It was another missed target.

Earlier this year (2005) , the Department of Health claimed that 98 per cent of wards were single-sex. The Telegraph discovered that this figure cannot be trusted, as NHS trusts, confronted with our photographic evidence, admitted last week to not officially registering the existence of wards such as the one shown here, at Oldchurch Hospital in Romford, Essex.

And again a week later Health Direct reported Feb 21, 2005 when Five more hospitals have ‘hidden’ mixed-sex wards when an investigation by The Telegraph 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 we 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.

Greg Clark, a member of the House of Commons Public Accounts Committee, said the June report was “the most gushing” of all NAO reports he had read. Another member of the Public Accounts Committee, Richard Bacon, said the NAO’s report on the NPfIT was not up to the organisation’s usual high standards.

This new inquiry announced yesterday, the terms of reference for which will be announced shortly, is expected to involve the committee’s members questioning ministers and officials at a series of hearings.

MPs on the committee can take in evidence from trust executives who are concerned about the lack of progress in the delivery of core patient systems for hospitals, and from GPs about whether centralised electronic health records will be secure.

The committee in October rejected an inquiry partly because some members believed the programme was too complicated to be investigated by non-expert MPs.

Its change of heart comes after Computer Weekly provided some committee members with new evidence – including a confidential briefing paper on the NPfIT from directors of informatics at a large NHS trust. The paper expressed profound concerns about some aspects of the NPfIT.

Computer Weekly has also learned that strong support for an inquiry came from Dr Richard Taylor, a former hospital consultant and the only independent MP in the House of Commons.

Taylor told Computer Weekly that he was originally not in favour of an inquiry, but changed his mind after an informal briefing by BT, one of the main suppliers to the NPfIT.

He said BT’s briefing had been so unremittingly positive about the programme that he found it lacked credibility, and this made him wonder whether the programme was as successful as the supplier claimed.

It is seven months since 23 academics, wrote an open letter to the committee calling on its members to ask the government to commission an independent audit into the national programme.

Martyn Thomas, one of the 23 academics who wrote the open letter to the health committee, said, “Speaking on behalf of the 23, we welcome the news that the Health Committee intends to hold an inquiry early in the new year. We intend to submit evidence to the inquiry further supporting our call for a full, independent and open review of the NPfIT.”

Todays posting was taken from:
http://www.computerweekly.com/Articles/2006/11/28/220206/mps-will-hold-inquiry-into-12bn-nhs-it-plan.htm

Even on education, the public has become more sceptical. In May last year, at the time of the general election, more people believed services would get better than worse in all areas except the environment.

The public’s view of the NHS is, by a tiny margin, not quite as bad as in September, its lowest point since the poll began.

On September 18, 06 Health Direct reported on the previous MORI poll: Tories have best health and education policies, say voters. And continued-

The public has become so disillusioned with the government’s ability to deliver improvements in key public services that the Conservatives are now seen as having the best policies for education and health for the first time since Labour won power in 1997, according to polling by Ipsos MORI. The research company’s quarterly tracking index, which is eagerly watched by the government, shows the public disagrees by two to one (59 per cent compared with 31 per cent) that Labour’s policies will improve the state of public services overall.

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.

In September, 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.”

http://www.healthdirect.co.uk/2006/09/tories-have-best-health-and-education.html

Mori continues today:

“But it comes as, for the first time in polling history, the Conservatives are seen as having better policies for the NHS than Labour,” said Ben Page, managing director of Ipsos Mori public affairs.

With the NHS struggling to balance its books and hospitals shedding staff andfacing locally contentious reconfigurations, “that is really disillusionment rather than people being positive about what the Conservatives are offering,” he said.

Just one person in 100 believes the NHS will get better over the next few years, against 13 who believe it will get much worse.

The quarterly tracking poll is monitored closely by Downing Street’s delivery unit. Government may find some comfort in its finding that Labour supporters still believe by a net margin of47 percentage points that the government will succeed in improving public services.

If the public is highly sceptical over the government’s performance on public services, it is not much warmer over the economy. Only39 per cent agree the government’s policies will improve the economy in the long run, while 51 per cent disagree.

Ipsos Mori interviewed 980 adults by phone between November 17 and 18.

Today’s posting is taken from:
http://www.ft.com/cms/s/e62c94a6-7dbb-11db-9fa2-0000779e2340.html

Dr Richard Vautrey, a member of the association’s GPs’ committee, said: “We are concerned about additional questions being asked about opening hours, because we had agreed with the Department of Health how this questionnaire would work and it was changed at the last minute.

“We reluctantly consented to having some part of practice income dependent on a patient questionnaire about access provided it was based on fair, unbiased questions which we agreed,” he said.

“Progress towards such an agreement was made until the Government imposed additional questions in the survey which were not agreed.”

He pointed out that Saturday and evening surgeries were not part of their contract and that no extra money had been allocated to provide surgeries outside normal hours.

“The GP committee believes the imposition of these questions will raise patient expectations unfairly,” he said.

“The questions ask patients if they are satisfied with arrangements for early morning, evening and weekend surgeries at a time when the Government is not prepared to provide GP practices with the resources to open at these times.”

Dr Meldrum said the Patient Experience Survey was “totally discredited by the addition of these questions”. “GPs will continue to consult their patients about their views on the services they provide because we value their opinions and want to try to arrange our surgeries to meet their needs,” he said.

“But using a survey containing leading questions, putting words in patients’ mouths, and falsely raising expectations, is not the way to do it.”

The survey will also ask about telephone access to the surgery and the ability to book appointments in advance.

Last year Tony Bliar was caught out on BBC’s Question Time when a member of the audience, Diana Church, told him she had been unable to make an appointment for her son for two weeks ahead.

It emerged that GP’s who were required to provide appointments within 48 hours had stopped accepting advance bookings in some practices.

Today’s Health Direct blog was compiled from:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2006/11/27/ngps27.xml
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2006/11/26/nhs126.xml

The figures come from the department’s annual expenditure memorandum to the Commons health committee and show that of the extra spending last year, 56 per cent went on staff.

However, of that 47 per cent – almost £2.6bn – went on higher pay and a mere 9 per cent on extra staff.

The huge increase came as the first effects were felt of the new contracts for consultants and family doctors – which cost much more than expected – and the big pay restructuring deal “agenda for change” for most other NHS staff – which also cost more than anticipated.

This is the first time that the department has broken down the extra costs of pay between the amount devoted to pay rises and the amount spent on recruiting extra staff whose numbers have increased by 268,000 since 1999.

In recent earlier years, according to the chief executive’s annual reports, between 30 and 40 per cent of the extra spending has gone on staff.

The memorandum also discloses that the redundancy costs from shrinking 28 health authorities down to 10 strategic ones and reducing the 303 primary care trusts to 150 are expected to amount to about £325m, depending on the number and age of staff who leave.

The department said earlier this month that changes to age-discrimination legislation could add £70m to that figure.

Ministers have said that the smaller number of health authorities and primary care trusts will eventually save £250m a year, but the redundancy costs coincide with the NHS having to work hard to balance its books this year.

A small surplus that was projected three months into the financial year has become a projected deficit of £94m on the six-month figures, although Patricia Hewitt, health secretary, has said that she is confident that the NHS as a whole will break even this year.

Andrew Lansley, the Conservative health spokesman, said the cost of external consultants and the size of the redundancy bill “reflects Labour’s mismanagement of the NHS. It is clear that a lot of the additional growth money this year will be lost”.

More information at:
http://www.ft.com/cms/s/fd79cafe-7aa8-11db-8838-0000779e2340.html

Who’s Been Sleeping in my Bed? The incidence and impact of bed over-occupancy in the mental health acute sector highlights the distress and detrimental effects seen in patients who are asked to take leave or move wards to vacate a bed.

Senior MHAC policy analyst Mat Kinton, author of the report, said: ‘There has been much on the development of community services as an alternative to admitting patients to hospital, but we have found that some community services are very much embryonic.

‘In some areas authorities have cut beds in the hope that the new community outreach projects will take up the slack and that has not universally happened yet. It will eventually, in two or three years -but there is a danger of clipping it too far as it’s easy to make cuts when feeling the financial pinch.’

Although Mr Kinton could not say whether bed over-occupancy had worsened over the years, he highlighted one instance in which a patient was kept waiting for nearly a month.

He said: ‘I think there were some surprises in the effects on patient care such as a patient sitting in Manchester for 28 days awaiting a bed. I have worked for the MHAC for about 12 years and that has never happened before – where a patient has had to wait for so long.’

The report focused on 15 wards in which two instances of over-occupancy had been recorded.

Of the 17 patients interviewed, two had been asked to go home on leave authorised by their doctor under section 17 of the act, and 11 had been asked to move ward for bed management purposes while four patients could not be admitted to their local acute facility due to bed pressures.

The responses revealed a lack of notice and choice in the experience, and bed management had been unsettling, with five patients informed on the day of their move and seven reporting no advance warning.

The report also said the possibility of losing a room or bed made patients reluctant to leave and staff believed that bed transfers could compromise relationships with patients.

The commission plans to follow up this report by going into the identified hospitals once or twice a year to put pressure on them to address the problem.

It will also report back to the DoH on hospitals that in its view are not managing the beds safely and appropriately.

Further news on:
http://www.hsj.co.uk/healthservicejournal/pages/n1/p12/061116

Coming only a week after the most damning 400 page report (16 Nov 06) Scandal of Labour’s blunders that led to murder by mental patient when the needs of dangerous psychiatric patients are being put before the safety of the general public, this further report on mental health provision is very worrying.

The highly critical report into how a psychiatric patient at a south London hospital escaped and attacked Denis Finnegan as he cycled through Richmond Park revealled how a catalogue of systemic errors led to his death.

Chaired by Robert Robinson, a mental health lawyer, the report is said to be one of the most damning in the past decade. Over 400 pages it details a catalogue of preventable errors at Springfield Hospital which led to Mr Finnegan’s murder. It concludes that a special medium secure facility in the hospital, the Shaftesbury Unit, must be closed pending an external audit.

Asked by a Tory member of the health select committee, Mike Penning, if it was fair that people in her Labour constituency of Leicester West received £1,300 per head in NHS spending, compared with £960 in his Hemel Hempstead seat, she replied: “I am satisfied that funding allocations are fair. I believe that reflects the very real differences in health areas, in the prevalence of disease between our two constituencies.

She added: “It seems to me absolutely right and fair that those with greater health needs get better funding than patients with better health and less health needs, who get less funding.”

Her comments follow claims of political interference by Labour in the running of the NHS, and revelations that Miss Hewitt asked officials to draw up “heat maps” to ensure hospital closures did not hit the Labour vote in its marginal seats.

Mr Penning said Miss Hewitt had given “the most complacent, arrogant and patronising evidence I have ever heard.” He added: “She gets nearly £400 per head more than I do for the NHS because my constituents aren’t as sick. It is the most ridiculous thing I have ever heard.”

Todays story was taken from:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2006/11/22/nhealth122.xml

Credit where credit is due. Health Direct applauds the Health Secretary for publically admitting that she and the Labour govt are rigging the health cuts away from Labour voting areas.

On the other hand the brazen policy that will condem many to early deaths and discomfort is disgraceful. Please see also our stories below:

NHS cuts twice as likely in Tory and Lib Dem voting areas
Tue 24 Oct 06- Following Health Direct’s lead on Sept 25, 2006 NHS closures rigged away from Labour voting constituencies and the Times last week: Oct 16 Hospitals in Tory seats are ‘targeted for closure’ the Sunday Telegraph has now come to the same conclusion: that hospitals in Conservative and Liberal Democrat constituencies are more than twice as likely to suffer from NHS cuts as hospitals in Labour voting seats.

The survey reveals that four out of five doctors think the confidentiality of their patients’ medical records will be at risk if the government proceeds with plans to load them on to the new database.

More than 60% of family doctors in England also said they feared records would be vulnerable to hackers and unauthorised access by public officials from outside the NHS and social care.

Ministers have committed a large slice of the NHS’s £12bn IT upgrade to developing the Spine. They acted on the assumption that doctors would provide the information without asking their patients’ permission first.

The new system has been constructed to upload information from GPs’ computer systems automatically, without giving patients a say. But the poll found 51% of GPs are unwilling to allow this uploading without getting each patient’s specific consent. Only 13% say they are willing to proceed without consent and the rest are unsure or lack enough information to comment.

The poll was conducted by Medix, a healthcare online research organisation that has been used previously by the government to test medical opinion. It found most doctors think a national electronic record will bring clinical benefits for patients. About 51% of GPs and 65% of hospital doctors said it would enable doctors and nurses “to make better decisions by having easy access to a complete up-to-date record of clinical information”. But the doctors were not convinced about the security of the records.

They saw a big threat to patient confidentiality, with 79% of GPs and 55% of hospital doctors disagreeing with the claim of Richard Granger, the NHS IT chief, that the new system will be more secure than current arrangements.

Asked to identify the three most important concerns about confidentiality, 62% of GPs and 56% of hospital doctors said they were worried about “outsiders hacking into the system”; 62% of GPs and 51% of hospital doctors similarly feared “access by public officials outside health or social care”. Other big fears included “bribery or blackmail of people with access to the records” and concern about “clinicians not adhering to the rules”.

Nearly half the doctors who saw clinical benefits from a national record thought the confidentiality risks worth taking. But only 11% of GPs and 18% of hospital doctors were prepared to upload details without the patient’s consent.

The British Medical Association said: “We share the concerns of the GPs responding to the poll. We are worried patients are not going to have all the information they need to know what is going on with their records. That is why we are in favour of a system that seeks their explicit consent.”

Connecting for Health, the agency responsible for the NHS’s £12bn IT investment, said the poll showed most doctors recognised the benefits to patients of the national programme for IT and agreed that introducing electronic care records would help clinicians make better decisions.

A spokesman said: “The law constrains how a national database must operate, but it does not prevent the creation of such a database, nor does it prevent the merger of existing databases for efficiency and safety reasons, as is being done to create the central summary clinical record. The Department of Health believes that this will be of great benefit to a great majority of people, improving healthcare and preventing unnecessary deaths.”

Ministers are preparing a public information campaign to persuade patients of the medical benefits of a national electronic patient record. About 50 NHS primary care trusts have volunteered to trial the electronic record by uploading a summary of key medical information about patients, but excluding sensitive medical histories. Ministers have shortlisted six PCTs for the trials.

Local information campaigns will tell patients they can deny NHS staff access to their medical details, but doing so may damage their chances of getting the best treatment. However, once the record is stored on the Spine, there will be no way of deleting it.

Medix said the sample of 1,026 GPs, consultants and other doctors was fully representative of the profession. The survey was commissioned by the Guardian and four magazines and websites with an interest in NHS IT. It was conducted online this month, about a week after a Guardian inquiry found a lack of safeguards against access to medical records on the Spine.

For more information on this:
http://society.guardian.co.uk/health/story/0,,1953212,00.html

The reluctance of Doctors to have nothing to do with Labour’s white IT elephant should surprise no- one. On March 28, 2006 Health Direct noted that Doctors opt to have private operations out of NHS when hospital consultants were spurning the National Health Service by paying for medical insurance so they can be treated privately if they become ill. A survey of 500 consultants, commissioned by Bupa, the health insurer, found that 41% of senior hospital doctors have invested in private health cover. The primiary reason given was lack of person privacy.

Earlier this month Health Direct warned of the massive invasion of personal privacy- November 03, 06 Warning over privacy of 50m patient files in NHS IT project when millions of personal medical records are to be uploaded regardless of patients’ wishes to a central national database from where information can be made available to police and security services, the Guardian has learned.

Details of mental illnesses, abortions, pregnancy, HIV status, drug-taking, or alcoholism may also be included, and there are no laws to prevent DNA profiles being added. The uploading is planned under Whitehall’s bedevilled £12bn scheme to computerise the health service.

As we went on to suggest- What can patients do?

Ross Anderson, professor of security engineering at Cambridge University, believes that patients do have legal rights over their medical records: “Write and insist that you are not put on the NHS data spine,” Prof Anderson says. “If enough people boycott having centralised NHS records, with a bit of luck the service will be abandoned.”

If you are concerned, you should discuss it with your GP. You can put a block on your own data by writing to:

The Secretary of State for Health
Richmond House
79 Whitehall Terrace
London SW1A 2NS

And send the same letter to your GP.

It should say:

Dear Sir/ Madam

I require you not to begin processing my sensitive personal data to the proposed NHS Summary Care Record on the Spine. It is likely to cause me substantial unwarranted distress because:

1. No ‘sealed envelopes’ yet exist to limit access
2. No online patient system yet exists to correct errors
3. Data uploaded may include genetic, psychological or sexual information
4. It is intended to make my data available to social workers, researchers and commercial firms
5. My consent will not be asked before beginning processing
6. Adequate criminal penalties against abuse do not yet exist
7. Police and other agencies can gain access to a potentially unlimited range of information about me. There is abundant evidence that computer databases – including police, vehicle licensing and banking computers – are routinely penetrated by private investigators on behalf of clients, including media organisations
8. 250,000 smart cards have been issued granting access to the Spine
9. The department threatens to withhold appropriate medical care to objectors
10. Doctors say there is no necessity to design the Spine in this way

For these reasons, among others, I strongly fear that I am in danger of having false or damaging health information fall into the wrong hands. My privacy is being unnecessarily violated.

Yours faithfully

Health Direct suggests that you write NOW- before this disgraceful plan gathers momentum.

The total liabilities of publicsector pensions now exceed £960bn – compared to around £800bn for all private-sector schemes, most of which are funded by assets, such as equities and bonds. However, public-sector schemes will have to be funded by future tax receipts.

Many companies have already raised retirement ages or poured money into their funds. Only last week British Airways announced plans to put an extra £300m into its scheme.

David Frost, the director-general of the British Chambers of Commerce, said: “The huge cost of public-sector pensions is one of the biggest issues facing this country and the government is doing nothing to address it. It is totally unfair that the burden of pension reform is being left to the private sector.”

Frost called for the Government to look again urgently at raising retirement age of state workers from 60 to 65.

The total size of the NHS’s scheme liabilities has risen sharply due to a big recruitment drive in the public sector, pay rises and longer life expectancy.

Using previous accounts, leading actuary Watson Wyatt has calculated that the total liability grew from £128bn to £156bn in the 12 months to March. Stephen Yeo, senior consultant at Watson Wyatt, criticised the way in which the Government reports its pension liabilities. “Public-sector pension liabilities have ballooned in recent years with only token attempts to control them,” Yeo said.

“The very least we should expect is that the liabilities be reported in a prompt and accessible manner. But it seems that the figures for the largest scheme will be late and released in a manner designed to minimise their impact.”

The late filing of the NHS pension accounts raises more questions about the Government’s financial management. Last week, the National Audit Office refused to sign off the Department for Work & Pensions’ accounts. The Home Office’s accounts for 2004-05 were filed late and had to be re-written after the NAO identified “material omissions, mis-statements. . . numerous errors and internal inconsistencies”.

The NAO told The Sunday Telegraph last week that the Home Office has also failed to file its 2005-06 resource accounts, which were due at the beginning of July. The same is also true of HM Revenue & Customs’ prosecution office.

http://www.telegraph.co.uk/money/main.jhtml?xml=/money/2006/11/19/cnnhs19.xml

Earlier this year (Feb 27) Health Direct warned that the unfunded black hole in NHS pensions schemes grows to £26.8 billion. Experts said the increase showed that the public sector pensions bill was growing at an alarming rate and they questioned why the Government’s policy is not to set aside money now, but to pay the bill from future taxes. By failing to make provision now the final bill will spiral.

The black hole in public sector pensions is almost four times larger than originally estimated, Whitehall accounts show. This follows a change in the way the Government works out the cost of its retirement schemes. Government documents show that since last year the amount of annual provision needed for public sector pensions has risen from £24.2 billion to £81 billion. For the NHS the Treasury figures disclosed that the provision for the NHS pension scheme this year is some £26.8 billion, rather than the £7.8 billion in the previous year’s figures.

They want NICE to withdraw the recommendations and postpone issuing its final guidance, which is due on 22 November.

Eisai and Pfizer, who produce donepezil (also known as Aricept) are also asking the institute to disclose a “fully transparent working version of the calculations used in the cost effectiveness model for independent evaluation and comment”.

They would like NICE to develop a new guidance using “both a more accurate cost effectiveness model and data”.

Dr Paul Hooper, managing director of Eisai Limited, said: “We are deeply concerned about the way that NICE’s decision on treatment recommendations for early Alzheimer’s disease was reached.

“A judicial review is now the only option remaining to us to ensure that NICE reconsiders how it arrived at such flawed conclusions.”

If the judicial review goes ahead it would be the first time a NICE decision has been contested at this level.

NICE, whose guidelines cover England and Wales, has 14 days to formally respond to Eisai’s written proposals, after which Eisai may apply to the High Court for permission to proceed to judicial review.

Campaigners have repeatedly argued patients in the early stages of Alzheimer’s should also have access to the £2.50-per-day drugs.

Neil Hunt, chief executive of the Alzheimer’s Society, said: “It’s great news that NICE will be challenged in court. NICE holds the fate of thousands of people’s lives in its hands and it is only right that it is brought to account.”

The society is co-ordinating a number of protest marches across the country calling for doctors to have greater flexibility in prescribing Alzheimer’s treatments.

Last month, NICE rejected their appeal saying studies showed the drugs “did not make enough of a difference.”

More on this story can be found at:
http://news.bbc.co.uk/1/hi/health/6154668.stm

Health Direct has seen that time after time NICE (the National Institute for Curbing Expenditure) restricts small priced drugs because many thousands of voters would hope to use the drugs.

On 11 Oct 06 Health Direct carried this origional ruling in – National Institute for Curbing Expenditure (NICE) blights thousands of Alzheimer sufferer when NICE was renamed by NHS doctors as the National Institute for Curbing Expenditure after it’s latest edict to ban the funding of Alzheimers drugs costing only £2.50 a day- which will effect hunderds of thousands of sufferers. “This blatant cost-cutting will rob people of priceless time” said Neil Hunt of the Alzheimer’s Society.

Neil Hunt, chief executive of the Alzheimer’s Society, added: “This blatant cost-cutting will rob people of priceless time early in the disease and later clinicians will have no choice but to use dangerous sedatives that increase the risk of heart disease and stroke.”

He said there had been “fundamental flaws” in NICE’s appraisal process, and called on the government to step in.

Jonathan Ellis, senior policy manager at the charity, added: “It cannot be right to allow the health of thousands of older people to deteriorate on the altar of cost.

“On the one hand, the government says it is committed to improving care for older people, while on the other NICE is blocking access to treatment which would help them retain their independence and dignity. This is botched policy making at its worst.”

Chaired by Robert Robinson, a mental health lawyer, the report is said to be one of the most damning in the past decade. Over 400 pages it details a catalogue of preventable errors at Springfield Hospital which led to Mr Finnegan’s murder. It concludes that a special medium secure facility in the hospital, the Shaftesbury Unit, must be closed pending an external audit.

A mental health insider said: “This report contains relentless criticism of the systems in place to look after violent patients. It will send shockwaves through the whole of the mental health system and should be adopted nationally as a guide to what to do and not to do with this group of patients.”

Springfield Hospital, run by South West London and St George’s Mental Health NHS Trust, was seen as a centre of excellence. However in the last decade several psychiatric patients under the care of the hospital have committed murders.

Mr Finnegan was killed by John Barrett in September 2004. Barrett had previously stabbed three people in the outpatients department of St George’s Hospital in 2002. As a result, he became a “restricted patient” which means that the Home Office had ultimate responsibility for monitoring him in the community.

He was admitted to the Shaftesbury Unit the day before he murdered Mr Finnegan. He was given an hour’s ground leave but absconded. He is now in Broadmoor hospital. Mr Finnegan was stabbed several times in the back and chest before Barrett walked away. As Mr Finnegan bled to death from three stab wounds he asked Barrett: “What have I done?” Later Barrett said: “With all my heart, nobody should deserve that. I am glad to have been caught.”

At his Old Bailey trial in March last year, Barrett pleaded guilty to manslaughter on the grounds of diminished responsibility. He was jailed for life with a recommendation that he serve at least eight years.

The inquiry report calls for the Shaftesbury Unit to be closed for examination by an external team. It says the panel has doubts about the managerial abilities of this part of the forensic service and that this has “serious implications for the safe delivery of patient care”. It also finds that many of the regular reports which psychiatrists must submit to the Home Office so that a risk assessment of the patient staying in the community can be carried out were never submitted.

The Home Office admitted to The Guardian this year that there was a problem with monitoring violent offenders with mental health problems after release. A spokesman at the time said: “It is an ongoing battle to get the reports.”

The inquiry report also finds that the delicate balance between the therapeutic needs of patients and the safety of the community had swung too far towards patients, putting people in the community at risk in this case. John Finnegan, brother of Denis Finnegan who has received the report, said: “It’s a great relief to me that this report is robust and isn’t a whitewash.

“When people have been negligent it needs to be broadcast far and wide in the NHS. The lack of monitoring of patients like John Barrett is a major issue. I hope that this report will be used nationally to highlight what’s gone wrong and to prevent it from happening again.”

Michael Howlett, of the mental health charity the Zito Trust, said: “My understanding is that the death of Denis Finnegan was very preventable and that serious questions are now being asked of the forensic services at Springfield Hospital which require a national response.”

Previous Springfield patients who have carried out murders include Joseph Cann, an aggressive patient who was left alone with psychiatric nurse Eshan Chattun in June 2003. He bludgeoned Mr Chattun to death. In February Matthew Carter was kicked and stamped to death by Springfield patient Sean Perry, a schizophrenic who was released from the hospital into the community but relapsed and stopped taking his medication.

This posting is from:
http://society.guardian.co.uk/socialcare/news/0,,1948788,00.html

Nearly two years ago (Feb 28 2005) Health Direct carried a report on this tragic case: Review of Mental Health Bill after knife killing when John Reid, the then Secretary of State for Health, ordered a review of proposed changes to the law covering mental patients after the case of John Barrett, the paranoid schizophrenic who released himself from care and stabbed a banker to death in a London park.

Since then virtually nothing has improved.

Changes to the then draft Mental Health Bill were considered to give doctors greater powers to detain patients such as Barrett who volunteer for treatment for mental illness and then discharge themselves.

But as our posting pointed out, a fundamental overhaul was needed.

The case goes to the heart of the problems encountered by the Government with its Mental Health Bill, which ran into enormous opposition from mental health groups when it was unveiled in 2002. The Bill tried to close a loophole in the law which the former home secretary Jack Straw believed had led to the release of Michael Stone before he killed Lin Russell and her daughter Megan in a hammer attack in Kent in 1996.

Stone was left free to commit the murder because his severe personality disorder was considered untreatable. It was estimated there were more than 600 similar, dangerous cases in Britain and the first draft of the Bill proposed new powers to detain such people.

But the proposals were watered down after an outcry from mental health professionals, charities and patients and since ditched.

Mr Reid had ordered his officials to review the national implications for care in the community. This report today is the “urgent” result.

The Denis Finnegan Trust- Denis Rides Out
The Denis Finnegan Trust was set up and published the book Denis Rides Out as they believe with your help we can make a Difference. His family and friends do not want his death to be in vain.

“We must address failing government Care in the Community policy, an issue that was first raised back in 1994 by the Zito family after the tragic loss of Jonathan in similar harrowing circumstances. What have the Government learned in ten years? How many more lives need to be lost? The impact is immeasurable.”
http://www.finneganstrust.com

A brief look at his friends’ website shows that the world is a sadder place without Mr Finnegan. One such example reads:
“From New York
It was Ronald Regan that said “There are no Russians in East Germany”. He was of course always more than half a degree off plumb. Now though he would probably be right, the Russians are on the move leaving the mother country now they can all get passports.

I was on the plane waiting to set off for New York and I saw two coming towards me. She was hangover white with cigarette smoke hair. She was a true super model of the tundra. She looked a bit like a plate of unruly mixed grill with bits and pieces of meat sticking out everywhere.

I didn’t know then but found out later that in fact she was more of a mixed up grill. She let loose during the flight that she had a fear of sponges. Well, I think it was sponges. It was difficult to
work out exactly what she was saying most of the time.

Her husband had that type of big potbelly where the trousers dip under the overhang to emerge a couple of miles later on the other side. He was obviously storing up for the possibility that life would not always be as fat as it now was, fearing that sooner or later it could be back to hunting down the last cabbage in the village or eating your frozen neighbour.”

The book appears to be great value at £7 including postage and packaging, with all profits going to childrens’ charities. http://www.finneganstrust.com

Three out of four were resolved locally by the hospital or community service within the target time of 20 days. This is the same proportion as the previous year, but 10% higher than when records began in 1997-1998.

However, 21,755 complaints were not resolved within the target time, and nearly 2,000 had not been resolved at all by the time the data was collected.

In 2005/06, there were just over 36,000 complaints about aspects of clinical care.

Just under 11,500 complaints were about delays and cancellations of outpatient appointments. And nearly 11,500 were about the attitude of NHS staff. The number of complaints about family health services, such as GPs and dentists, has remained level at around 43,000 for the past three years.

The highest number of complaints were recorded in London (19,338), followed by the North West (12,560).

The North East region recorded the fewest number of complaints (3,940).

Three individual trusts recorded more than 1,000 complaints. They were:
* Leeds Teaching Hospitals NHS Trust
* University Hospitals of Leicester NHS Trust
* Barking, Havering and Redbridge Hospitals NHS Trust.

More news on the latest NHS complaints can be found at:
http://news.bbc.co.uk/1/hi/health/6150390.stm

Health Direct has been chronicling the inablity of the NHS and healthcare Commission for quite a while: Feb 04, 2005 NHS complaints soar- backlog hits 4,000 we noted that the NHS complaints backlog had hit 4,000 and the health watchdog has hired a consultancy firm to help ease a backlog of nearly 4,000 patient complaints.

The Healthcare Commission has been forced into the move – just six months into the job – as there had been a huge surge in grievances. Only 525 of 4,500 complaints have been solved but the commission said it was confident the backlog would be tackled.

And on May 17, 2005 in Healthcare Commission deluged with complaints Health Direct noted that one in five complaints received by the Healthcare Commission have been waiting more than half a year to be resolved under a deluge of cases. Latest figures released by the commission show that 19 per cent of complaints have not been closed within its own six-month deadline. A further 25 per cent have been with the commission for five or six months.

She told HSJ: ‘There is a bullying aspect to Connecting for Health.’ Local staff felt unable to voice their concerns, she added. ‘We are not allowed to put out anything that is not spin, but the only real progress that is being made is with existing systems.’

Ms Foad told the audience of managers and IT contractors that CFH was disrupting the work of GPs and PCTs at a time when trusts were already under huge pressure due to mergers and redundancies.

Barnsley PCT chief executive Ailsa Claire said the project was focusing on the wrong issues.

‘The largest users of our services are elderly people who need integrated health and social care records but that is very far down the agenda.’ NHS modernisation aimed to provide patient-centred care, she believes, but CfH did not follow that ethos. ‘These systems are designed to be efficient for businesses to talk to each other, not for clients to control their own care,’ she said.

Cash-strapped PCTs were unable to provide the investment needed locally. ‘My PCT spends 2 per cent on IT. What we should be [spending] is about 4 per cent but that is very difficult,’ Ms Claire added.

Ms Foad said cuts in PCT budgets ordered by the Department of Health had made it difficult to respond to the increased demands of CfH initiatives: ‘My engineers are now tied up with choose and book issues so they are taken away from supporting GP systems. I have no money to pay them overtime.’

Computer scientist Professor Colin Tully warned that there was a lack of scrutiny of the programme, meaning mistakes would go unnoticed: ‘This affects everyone in the country and 1 million NHS workers. We cannot just impose a solution on all our citizens and NHS staff.’

Professor Tully, of Middlesex University, is one of a group of eminent computer scientists who have demanded a public inquiry into CfH. He said the group would shortly issue a response to health minister Lord Warner’s rejection of its demand.

The full story can be read at:
http://www.hsj.co.uk/healthservicejournal/pages/n1/9/061109

Every time that Health Direct covers the Connected for Health fiasco we are constantly amazed at the debacle that is developing. We quote newspapers and other origional content providers to prove that we couldn’t make this up ourselves.

On Nov 02, 2006 in NHS and suppliers struggle with basics on CfH patient record system
Mr Bacon, a member of the Commons Public Accounts Committee, said: “At a time when hard-pressed NHS trusts are having to make painful choices in order to reduce deficits, they are being forced to pay money they don’t have and release staff they can’t spare for something they don’t want and doesn’t work.”

The committee recommended that the government “should not introduce systems which are not fully tested and without enough suitable staff being available and properly trained to use the system”.

These surpluses will be used to “cancel out” the deficits run up by other trusts, an accounting exercise to help strategic health authorities balance the books in their area.

The warning came as a new Department of Health report revealed the number of trusts forecasting a deficit has risen by nearly 50 per cent in the past three months.

Despite record funding for the health service, there has also been a “significant deterioration” in the overall finances of trusts in five of England’s 10 strategic health authorities.

Emergency “turnaround” teams have now been sent into 143 trusts facing the worst problems. The situation is so bad that a total of 210 trusts are not even able to balance their books month-by-month.

The findings are a big blow for Patricia Hewitt, the Health Secretary, who promised the Commons in June that NHS finances would be back in balance by the end of this current financial year. Her pledge came after trusts ran up a £1.3 billion deficit last year.

Her optimism was boosted by figures published three months ago that predicted the NHS as a whole would end the year £18 million in the black, once the deficits in some trusts are balanced against surpluses in others.

But the latest figures, which cover the first half of the financial year, are now forecasting that the NHS will end up £94 million in the red.

However, these figures disguise the huge crisis in front-line services because they include surpluses of more than £0.5 billion run up by strategic health authorities, as well as a £350 million national contingency fund.

If these figures are stripped away, the NHS trusts which run hospitals and GP clinics across England will end the year £1.18 billion in the red. Three months ago ministers were predicting this figure would only be £883 million.

The number of trusts now forecasting they will end the year in deficit has risen from 120 to 175 over the past three months. Ministers hope recent cuts in the price of generic drugs may help to ease the pressure. But they admit that the introduction of age discrimination laws could add £70 million to the health service’s bill for redundancies.

Miss Hewitt is still determined to balance the books by the end of the year and a senior official said yesterday that the best-performing trusts would have to make sacrifices to balance the deficits run up by other hospitals in their region.

This will involve well-managed hospitals being told they cannot spend all of their budgets this year or being forced to cut some services in order to deliver a surplus that will help their strategic health authority balance the books.

In some cases, officials admitted that trusts might even have to go into deficit to deliver the surpluses required.

Despite the bleak outlook, David Nicholson, the NHS chief executive, said he believed the health service was on track to break even this year.

Opposition politicians have voiced alarm at the worsening situation. Stephen O’Brien, the shadow health minister, said: “Despite all their warm words and promises, not to mention extra millions spent on turnaround consultants, Labour are failing to solve the NHS cash crisis.”

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2006/11/10/nhospital10.xml

The fact that the NHS continues to lurch from one financial crisis to another shouldn’t be a surprise to anyone who read Health Direct’s posting on 30 Oct 06- PbR Payment by Results are fundamentally flawed says coding chief when we pointed out that the current system of Payment by Results (PbR) is ‘fundamentally flawed and unacceptable’.

The head of the Professional Association of Clinical Coders Managing director Sue Eve-Jones told a conference that the NHS was ‘doing the best we can with a fundamentally flawed and unacceptable system’.

In June 2006, she was appointed to the Privy Council, and she was sworn in on 19 July 2006- the same date as her colleague lying Lord Warner.

Rosie Winterton was educated at Doncaster Grammar School and then read for a BA in History at the University of Hull. Winterton first worked as John Prescott’s Constituency Personal Assistant from 1980 until 1986, and then Parliamentary Officers, first for Southwark Council for two years until 1988 and then for a further two for the Royal College of Nursing until 1990.

After working for four years in the private sector, as MD of Connect Public Affairs, Ms Winterton returned to politics to assist John Prescott in 1994, as the Head of Office for the then-deputy Party Leader until 1997.

Ms Winterton became an MP in the 1997 election, serving the safe Labour seat of Doncaster Central constituency with a vote share exceeding 50% in each general election since then. She entered government in 2001, serving as a Parliamentary Under-Secretary of State in the Lord Chancellor’s Department.

Winterton can be contacted at:
Office address: Department of Health, Richmond House, 79 Whitehall, London SW1A 2NL
Office phone:
020 7219 0925
Office fax:
020 7219 4581
Office e-mail:
wintertonr@parliament.uk
Constituency address:
Guildhall Advice Centre, Old Guildhall Yard, Doncaster, South Yorkshire, DN1 1QW

The above information is courtesy of:
http://en.wikipedia.org/wiki/Rosie_Winterton
http://news.bbc.co.uk/1/shared/mpdb/html/194.stm

Seeing as the duff information was provided to Ms Winterton by the NHS Information Centre, here is a bit more news on this organisation:

The Information Centre for health and social care (The IC) was created in April 2005 out of the former NHS Information Authority and the Department of Health Statistics Unit.

The really sad bit follows on their website at:
http://www.ic.nhs.uk/aboutus/

“Information is our business, and information used effectively in the field of health and social care has a lasting impact on all of our lives. How it is used has never been more important, particularly where it matters most.”

Their website continues:
“Quite simply, we are putting information at the heart of decision making. By doing so, we enable informed decisions to be made across the many services and agencies we serve.

In this complex health and social care environment, information and monitoring are vital for local services to run effectively, while enabling national policies to be set.

Sound information gathered effectively also underpins regulation, quality assurance, health research, education and training.

Frontline health and social care services need information and knowledge to work efficiently. Our information is practical, timely and to the point.

We will make a difference in health and social care, and we are continually striving to help improve those services so critical to all of our lives.”

Health Direct then wonders- if our lives depend on the The Information Centre, to quote Private Frazer in Dad’s Army- “Doomed- we’re all doomed!”.

In a written ministerial statement, the Department of Health apologised for the error and said steps had been taken to ensure it did not happen again.

Misleading answer
It said the figure was provided by the NHS Information Centre, which had formally apologised and accepted full responsibility for providing an incorrect response.

The statement said: “The attempt was intended to be helpful, but ended up being misleading because it is not possible from the existing data sets to say with any precision how many tattoos are removed by the NHS each year.”

“How can we give any credence to any answer about costs and statistics in the National Health Service when such things are allowed to go on unchecked?” Lord Tebbit.

It added that “clinical advice is that it is likely to be a far smaller number than the figure given”.

Tattoo removal on the NHS is sometimes allowed for psychological reasons – criticised by some MPs and doctors who say money is being spent on trivial surgery while staff are laid off and patients denied potentially life-saving drugs.

Millions spent
Ms Winterton’s original answer given on 18 October prompted the Sunday Times to report: “NHS blows millions on removing tattoos”.

Its estimates put the cost of removing 187,063 tattoos under anaesthetic at at least £37m, but some consultants said it could run to £300m.

But Lord Tebbit said it was extraordinary the wrong figure had been given in the Commons, and had only been corrected once it was queried in the Lords.

“How can we give any credence to any answer about costs and statistics in the National Health Service when such things are allowed to go on unchecked until there is a further question in this House?” he said.

More news on this story can be found at:
http://news.bbc.co.uk/1/hi/uk_politics/6125022.stm

Health Direct carried this story on Thu 27 Oct 06- NHS blows millions on removing 187,000 tattoos that the National Health Service spent tens of millions of pounds removing nearly 200,000 tattoos last year, according to figures released by the Department of Health last week. Rosie Winterton, the health minister, said in a Commons written answer that doctors had carried out the procedure, involving either skin grafts or lasers, on 187,063 tattoos.

We had our doubts about the sheer scale of the numbers involved, but as the health department employs 142 press and public relation officers (Aug 31, 06- Spending on spin trebles under Bliar’s Labour govt) we made the erroneous assumption that someone at the department knew what they were talking about.

However coming hard on the heels of another health minister Lord Warner caught lying to the House of Lords Tue 7 Nov 06- Labour’s lying Lord- Baron Warner health minister- a brief biographical overview of his “achievements” by Health Direct and Mon 6 Nov 06- Labour’s Health Minister admits lying- Lord Warner lies to Parliament we now have the situation where the health minister in the Commons has not a clue about what she is talking about either.

And the Great Liar claims that he wonders why voters don’t trust labour politicians.

David Nicholson, the new chief Executive of the NHS has said that sixty hospitals are likely to face significant changes to the way that their services are delivered. In many cases these hospitals will lose their Accident and Emergency departments.

Hell-times-three for staff selling changes

“From Halifax, Huddersfield and Hell, good Lord preserve us”, ran the old Yorkshire saying when the woollen industry blanketed the towns with greasy smog and the sparrows were said to wake up coughing, writes Nicholas Timmins.

Those days may be long gone but for the NHS managers and clinicians supporting the reorganisation proposals, some of the public meetings fell easily into the third of those designations.

“These meetings were horrendous, not once but three times” claimed Linda Riordan, Halifax’s Labour MP. ” For the executives and the doctors it was awful. They were shouted at and abused. They were accused of only doing this to keep their jobs, or to get a bonus, or lining their own pockets at the expense of patients.”

Health Direct has a question for Ms Riordan. In the real business world there is a saying- KISS- Keep It Simple Stupid. If the NHS closures and cutbacks are so simple and aren’t based on labour’s underfunding- why can’t the practitioners explain the need for closures to the voters?

OTHER KEY NHS CLOSURE BATTLEGROUNDS

SURREY AND SUSSEX
Proposals expected shortly. Five full ‘blue light’ accident and emergency departments in Surrey may be reduced to two, with hospitals in Crawley and Redhill and in Worthing and Chichester, among others, likely to see changes. A campaign to ‘save’ the Royal Surrey Hospital in Guildford has spurred 7,000 people to join a march even before the proposals are published

EAST OF ENGLAND
19 hospitals across Bedfordshire, Hertfordshire, Essex and the rest of East Anglia are under review. It is suggested that the number of full-blown casualty departments may halve

NORTH-EAST
Changes to services in Stockton and Hartlepool currently with independent reconfiguration panel

NORTH-WEST
Closure of full accident and emergency services in Rochdale, Burnley and Kendal proposed. Significant changes in Warrington, Manchester and Trafford

LONDON
Plans still being drawn up. Changes likely to be extensive.

The above was based on an article in today’s FT:
http://www.ft.com/cms/s/b67654d2-6ece-11db-b5c4-0000779e2340.html

Before entering the House of Lords he was Director of Social Services for Kent County Council between 1985 and 1991. In the mid 1990s he was Senior Policy Adviser to Jack Straw when he was the Home Secretary. He has also held the Chair of the Youth Justice Board, National Council for Voluntary Organisations and the London Region Sports Board.

His posts under Labour include:
* Minister of State (Reform), Department of Health (23 May 2006 to 3 Aug 2006)
* Minister of State (NHS Delivery), Department of Health (9 Jan 2006 to 23 May 2006)
* Minister of State, Department of Health (11 May 2005 to 9 Jan 2006)
* Parliamentary Under-Secretary, Department of Health (13 Jun 2003 to 11 May 2005)

Other Lord Warnerisms where is was economical with the truth include:

On waiting times- “Almost everyone in England can now see a GP within 48 hours”. Lord Warner put the figure at 99.98 per cent.

Strangely a YouGov poll for The Daily Telegraph suggested that almost half of patients cannot get an appointment to see a family doctor within two days, despite the fact that this is supposed to be a key Government achievement. August 22, 2005 Fantasy of the 48 hour wait to see a GP
when Labour ministers were accused of living in “a fantasy world” after new evidence contradicted Government claims that almost everyone can see a GP within 48 hours.

The survey of nearly 2,500 adults also indicated that there is little public support for Tony Blair’s idea that patients should be given a choice of hospital.

On Labour’s red tape costs- Lord Warner, the health minister, said foundation trusts would not be charged administration fees for labour’s red tape surveys “because it has always been clear that foundation trusts are part of the NHS”.

December 01, 2004 Private hospitals face 60% rise in inspection costs when private hospitals and treatment centres, including those that treat National Health Service patients, are to be charged the full cost of their inspection and regulation as part of the government’s efficiency drive.

“If everyone is working to the same NHS tariff, then everyone should face the same regulatory costs,” said the forum. Without that the competition would not be fair, it said. Where the full cost of inspection had been introduced in Wales, the few private facilities there had seen a 60 per cent jump in the cost, the forum said. The department estimated fees in England covered only 40 per cent of the cost of inspections.

On the balkanisation of the NHS- Lord Warner accepted that a procurement notice mighty have given a “false impression”. As a result, he said, the advertisement had been withdrawn because of “drafting errors”. However, the department was unable to spell those out yesterday.

July 01, 2006 NHS reform falters as Labour ministers pull advert- when the sense that the Labour government is losing its grip on plans to reform the National Health Service gathered momentum yesterday as ministers pulled a procurement notice inviting the private sector to bid to purchase NHS services in the face of all-out opposition from unions. Patricia Hewitt, the health secretary, and Lord Warner, minister for NHS reform, said there had been “drafting errors” in the advertisement.

On the trebling of the cost of the NHS’s new IT system: “The national contracts remained on budget, he said. But they essentially covered the infrastructure and applications and not the additional local spending needed to train staff, buy computer screens, assimilate existing systems and convert data and other costs.”

Much like buying a new car- without the steering wheel and controls. And about as useful.
May 31, 2006- Health service faces up to costly IT operations when the National Health Service is likely to spend close to £20bn over the next decade on its ambitious programme to create an electronic record for every patient in England, Lord Warner, the health minister in charge of the programme, has said yesterday.

http://en.wikipedia.org/wiki/Norman_Warner%2C_Baron_Warner
http://www.publications.parliament.uk/pa/ld199798/minutes/981012/ldminute.htm
http://www.theyworkforyou.com/peer/lord_warner

He has now confirmed that the Department of Health spent thousands of pounds of taxpayers’ money on two executive coaching companies, Praesta and ER Consultants. Two months ago, in a written parliamentary answer, he denied that the department had held any contracts with the two companies.

Warner blamed the mistake on “human error” and claimed that some of the payments were made after he answered the question.

But opposition politicians said they were losing faith in the government’s honesty.

Lord Oakeshott of Seagrove Bay, the Liberal Democrat peer who highlighted the use of life coaches in Whitehall, said: “This is a disgrace. How difficult can it be to check whether you are employing life coaches or not? We are on a slippery slope for parliamentary scrutiny.”

Warner was questioned about the health department’s use of life coaching companies in September, after The Sunday Times revealed that a string of government departments were employing psychologists to help senior staff cope with the pressures of government.

The personal coaches are paid an estimated £250 an hour to act as “critical friends” to ministers and senior mandarins, using techniques such as role play to boost their confidence.

In a written answer on September 14, Warner denied his department had held any contracts with ER Consultants or Praesta in any of the past three financial years.

However, in a letter to Oakeshott last week, copied to the Speaker of the House of Lords for the record, Warner said: “I regret that the answer I gave . . . was inaccurate . . . This was caused by human error when extracting data from the department’s accounting system and was not a
deliberate attempt to provide misleading information.”

Publishing misleading or false answers to written parliamentary questions is a breach of government rules and is regarded as a grave offence at Westminster.

Warner wrote: “Please be assured that I do not underestimate the seriousness of the situation and I am deeply sorry for the confusion caused.”

The health department now admits it paid £22,530 to ER Consultants in September this year, and £45,237 to Praesta last year.

However, Whitehall’s overall spending on life coaches is much higher. Written answers about the use of life coaches in other government departments suggest the two payments are just a small part of the total.

Bridget Prentice, a minister in the department for constitutional affairs, admitted that her department had a £220,000 contract with Praesta for “coaching programmes and leadership” training.

Alan Duncan, the shadow trade secretary, said: “Good for Lord Warner having the decency to come clean, but what is really disturbing is that the initial answer was totally untrue.

“Many of us have lost faith in the government’s trustworthiness when it comes to written answers.”

http://www.timesonline.co.uk/newspaper/0,,176-2438146,00.html

Health Direct- in common with the Shadow Trade Secretary gave up several months ago quoting Lord Warner’s ridiculous comments. The twilight world that the Health Minister lives in bears no relation to the real world when he opens his mouth.

Time was when a government minister who was caught lying to Parliament either resigned or was sacked. But since “purer than pure” bliar came to power the honourable course of action went out of fashion.

After two years of confusion and delays, the system will start coming into effect in stages early next year.

Though the government says the database will revolutionise management of the NHS, civil liberties critics are calling it “data rape” and are urging Britons to boycott it. The British Medical Association also has reservations. “We believe that the government should get the explicit permission of patients before transferring their information on to the central database,” a spokeswoman said yesterday.

And a Guardian inquiry has found a lack of safeguards against access to the records once they are on the Spine, the computer designed to collect details automatically from doctors and hospitals. The NHS initiative is the world’s biggest civilian IT project. In the scheme, each person’s cradle-to-grave medical records no longer remain in the confidential custody of their GP practice. Instead, up to 50m medical summaries will be loaded on the Spine.

The health department’s IT agency has made it clear that the public will not be able to object to information being loaded on to the database: “Patients will have data uploaded … Patients do not have the right to say the information cannot be held.”

Once the data is uploaded, the onus is on patients to speak out if they do not want their records seen by other people. If they do object, an on-screen “flag” will be added to their records. But any objection can be overridden “in the public interest”.

Harry Cayton, a key ministerial adviser, warned last month of “considerable pressure to obtain access to [the] data from … police and immigration services”, but he is confident that these demands can be resisted by his department.

Another concern is the number of people who can view the data. The health department has issued 250,000 pin-coded smart cards to NHS staff. These will grant varied access from more than 30,000 terminals – greater access for medical staff, and less for receptionists. Health managers, council social workers, private medical firms, ambulance staff, and commercial researchers will also be able to see varying levels of information. Officials say the data will be shared only on a need-to-know basis. But Guardian inquiries show a lack of safeguards.

Although data protection laws supposedly ban unnecessary build-ups of computer information, patients will get no right to choose whether their history is put on the Spine. Once uploading has taken place, a government PR blitz will follow. This will be said to bring about “implied consent” to allow others view the data. Those objecting will be told that their medical care could suffer.

The government claims that computerised “sealed envelopes” will allow patients selectively to protect sensitive parts of their uploaded history from being widely accessed. But no such software is yet in existence. It is being promised for an unspecified date. Some doctors say “sealed envelopes” may be too complex to be workable.

The design also allows NHS staff to “break the seal” under some circumstances. Police will be able to seek data, including on grounds of national security. Government agencies can get at records, according to the health department, if “the interests of the general public are thought to be of greater importance than your confidentiality”. Examples given of such cases include “serious crime and national security”.

The department’s guidelines say: “The definition of serious crime is not entirely clear … Serious harm to the security of the state or to public order, and crimes that involve substantial financial gain or loss will … generally fall within this category.” The health department says confidentiality can already be breached in such cases.

At present, police have to persuade a GP, who knows the patient, to divulge limited facts, or insist on a court order.

Under the new system, data may be disclosed centrally and anonymously, at the touch of a button. Health department privacy advisers say they do not wish to allow police to have clinical information. But they are prepared to disclose patients’ addresses.

Another safeguard initially promised was that all patients would be able to check their records on the internet for mistakes. But a system involving the issue of smart cards to patients has not yet been tried out.

Current criminal penalties are so weak they have failed to stop tabloid journalists and private detectives raiding such data on an industrial scale, according to a recent special report by Richard Thomas, the information commissioner.

Sir John Bourn’s National Audit Office also wrote a recent report warning of significant concerns among NHS staff “that the confidentiality of patient information may be at risk”. But officials persuaded the NAO to delete the warnings in the published version.

The original draft said: “Patient confidentiality remains a controversial issue among critics … both as regards the adequacy of the planned safeguards to protect information, and whether patients should have a right to opt out of having their information recorded”.

More information on how weak Labour’s contorl over our personal health information can be found at:
http://society.guardian.co.uk/health/news/0,,1936403,00.html
http://society.guardian.co.uk/health/news/0,,1936192,00.html

What can patients do?

Ross Anderson, professor of security engineering at Cambridge University, believes that patients do have legal rights over their medical records: “Write and insist that you are not put on the NHS data spine,” Prof Anderson says. “If enough people boycott having centralised NHS records, with a bit of luck the service will be abandoned.”

If you are concerned, you should discuss it with your GP. You can put a block on your own data by writing to:

The Secretary of State for Health
Richmond House
79 Whitehall Terrace
London SW1A 2NS

And send the same letter to your GP.

It should say:

Dear Sir/ Madam

I require you not to begin processing my sensitive personal data to the proposed NHS Summary Care Record on the Spine. It is likely to cause me substantial unwarranted distress because:

1. No ‘sealed envelopes’ yet exist to limit access

2. No online patient system yet exists to correct errors

3. Data uploaded may include genetic, psychological or sexual information

4. It is intended to make my data available to social workers, researchers and commercial firms

5. My consent will not be asked before beginning processing

6. Adequate criminal penalties against abuse do not yet exist

7. Police and other agencies can gain access to a potentially unlimited range of information about me. There is abundant evidence that computer databases – including police, vehicle licensing and banking computers – are routinely penetrated by private investigators on behalf of clients, including media organisations

8. 250,000 smart cards have been issued granting access to the Spine

9. The department threatens to withhold appropriate medical care to objectors

10. Doctors say there is no necessity to design the Spine in this way

For these reasons, among others, I strongly fear that I am in danger of having false or damaging health information fall into the wrong hands. My privacy is being unnecessarily violated.

Yours faithfully

Health Direct suggests that you write NOW- before this disgraceful plan gathers momentum.

Some NHS trusts have put off taking patient administration systems to wait for new versions of the software, while others are demanding more customisation of the system than suppliers originally envisaged.

Figures released by Connecting for Health, the NHS IT programme, show that of 87 planned deployments of patient administration and other systems between the end of June and the end of October, only 56 have taken place.

They include smaller systems, such as picture archiving to replace x-ray film with digital images. But installations of the basic building blocks for the electronic record – new patient administration systems – continue to run late. Of 43 patient administration systems that the IT programme said should be in place by the end of November, only about 19 have been installed.

Earlier this year one of the leading suppliers said privately that installing the systems should be “like shelling peas” once the first few had gone in.

But comments by suppliers and Connecting for Health on the reasons for the continued delays point to a host of problems.

These include the failure of some trusts to put aside enough money and resources for staff training; the reluctance of some staff to follow procedures with the new systems; extended testing periods when old systems are found to have duplicate records for many patients; and complications when other hospital systems have to be plugged into new ones.

CSC in the north-west put its deployments on hold after a data centre crash in July. It has installed just two out of seven patient administration systems that were meant to be operational, with two more due in December. Southport and Ormskirk has put off installation of its system until beyond next April because of “financial pressures”, says Connecting for Health.

In the south, Fujitsu has installed just three out of 14 patient administration systems, with no firm date set for eight of the remainder to go live. Its explanations in-clude “resource constraints” in some trusts, “software errors” during testing, and the requirement for “trust specific” configurations.

http://www.ft.com/cms/s/507eae5c-694e-11db-b4c2-0000779e2340.html

On Mon 4 Sep 06 Health Direct warned of a New setback for NHS IT computer project as NPfIT “sleepwalks to disaster” when the troubled multi-billion-pound NHS computer system suffered a fresh blow last night when it emerged that two-thirds of the hospital trusts due to have installed an electronic patient administration system for booking appointments with consultants by the end of October will not meet the deadline.

That the NHS’s IT project will end in tears was obvious to anyone with a modicum of IT implementation knowledge when on Thu 8 Jun Health Direct reported that Trusts pay to end NPfIT staff supply contracts in red tape chaos that National Health Service trusts are having to buy themselves out of a commitment to supply staff to companies building the NPfIT electronic patient record system. Trusts in the south are paying Fujitsu £19m after the service found it could not provide 50 NHS employees to help with the programme.

Mr Bacon, a member of the Commons Public Accounts Committee, said: “At a time when hard-pressed NHS trusts are having to make painful choices in order to reduce deficits, they are being forced to pay money they don’t have and release staff they can’t spare for something they don’t want and doesn’t work.”

Separately the FT also noted yesterday (1st Nov 06) that :MPs attack department that ‘left people hanging on phone’ when almost half of the telephone calls made by the public seeking advice on pensions, welfare benefits and jobs went unanswered after the government closed local offices in an attempt to cut costs and make services more efficient, MPs reported yesterday.

Edward Leigh, chairman of the public accounts committee that scrutinises the effectiveness of public spending, said that people “left hanging on the phone would, no doubt, have met with derisive laughter the claim by the Department for Work and Pensions that it was modernising the delivery of welfare benefits”.

Mr Leigh said local offices, which many people used to visit, had closed but “the telephone service provided has often been unresponsive, over-complicated and unreliable . . . and, stop me if you heard this before, the underlying IT system is complex and unreliable”.

The committee recommended that the government “should not introduce systems which are not fully tested and without enough suitable staff being available and properly trained to use the system”.

The full sorry story on another Labour IT incompetence project is at:
http://www.ft.com/cms/s/0ac16fd4-6a17-11db-952e-0000779e2340.html

A series of speakers, including Unison general secretary Dave Prentis, have been lined up to address the rally.

They agree with Health Direct that 20,000 posts are being cut – although the government says only 900 staff will actually be made redundant with the other cuts being made through natural wastage and voluntary redundancy.

Campaigners will also criticise the government’s reform programme which they say risks “fragmenting” the health service.

Over recent years, the government has increasingly relied on private involvement through independent sector treatment centres, which carry out minor surgery, and PFI schemes, which use private money to build new hospitals.

Some of the NHS’s major acute hospitals are also coming under threat as local health bosses carry out reviews of services to make the health service more efficient.

A spokeswoman for NHS Together, which includes the British Medical Association, Royal College of Nursing and Unison, said: “NHS staff are proud of the real improvements in the health service in recent years but we are increasingly worried that progress is now under threat.

“Staff morale is at an all time low. We support changes that improve patient care but there is too much top down change that has not won the support or involvement of the staff who have to implement it.”

Steve Sweeney, a psychiatric nurse from Cambridge, who will be joining the protest, said his area was facing cuts to mental health, inpatient care and rehabilitation wards.

“I’m going to London because what’s happening here is happening throughout the country. The government is diverting money to private companies, who are leeching off the NHS. It’s important for people to stand up and show the government that they can’t do this without a fight.”

The protest comes as a YouGov poll of 2,000 people showed more than half believed the NHS had got worse in the last decade.

Details of the NHS protest is being carried by the BBC and Sky News at:
http://news.bbc.co.uk/1/hi/health/6103290.stm
http://news.sky.com/skynews/article/0,,30000-13549925,00.html

Labour politicians can’t run away from the consequencies of their actions. The public can see with thier own eyes the empty wards and hosiptals that have closed due to Labour’s underfunding.

Only last week (Wed 25 Oct 06) Health Direct reported that Support for the Labour party is at lowest level since Thatcher’s last election victory when support for Labour has dropped to its lowest level in almost 20 years with the Conservatives opening up a potentially election-winning 10-point lead, according to a Guardian/ICM poll published today. Labour has the backing of only 29% of voters, equal to its lowest-ever level of support in a Guardian/ICM poll – recorded in May 1987, a month before Margaret Thatcher won a third term.

Only 14% of voters think the money invested in the NHS since 1997 has been well spent, against 72% who agree that “a lot” has been used badly. Even 58% of Labour voters think the extra money has been misspent. As a result only 25% of voters think that the NHS has improved since Labour came to power in 1997, against 30% who think it has got worse and 39% who think Labour has made little difference. When one reads yesterday’s blog is it any surprise that Labour gets the bird?