One in 20 people over 65 and one in five people over 80 has a form of dementia. Around two thirds of those affected have Alzheimer’s disease.

There is no cure for dementia, and those with the condition need increasing care as the disease progresses.

‘Piecemeal’

The researchers’ investigations reveal caring for one person with late-onset dementia costs an average of £25,472 per year. Currently, the bulk of this cost is met by people with dementia and their families. Two thirds of these people live at home – either alone or with friends or relatives.

They said there were “marked variations” in the levels of provision and spending across the UK, and that care and support is “delivered piecemeal and in an inefficient fashion.”

“Dementia is one of the main causes of disability later in life ahead of cancer, cardiovascular disease and stroke, yet funding for dementia research is significantly lower than these other conditions.

“Even delaying the onset of dementia by five years would halve the number of related deaths, saving nearly 30,000 lives annually.”

‘Intolerable strain’

Neil Hunt, chief executive of the Alzheimer’s Society, added: “With every second ticking by, dementia costs the UK £539. We can’t afford to ignore the true cost of dementia to society as a whole.

“We must tackle this huge challenge head on.”

“We need to invest in dementia services, research, support and training and use what money is being spent more effectively. Planning now will save lives and money in the future.”

He added: “This new research shows that the government is failing to support people with dementia and their carers.

“Dementia will place an intolerable strain on our health and social care system unless the right services and support are in place.”

Older people’s tsar Professor Ian Philp, who is currently preparing new guidance for local health and social care bodies on early intervention and support for people with dementia, said: “This is a significant report that highlights the key issues around dementia and its economic impact.”

From:
http://news.bbc.co.uk/1/hi/health/6389977.stm

Health Direct notes that Alzheimer sufferers and their carers lives are currently bearing the brunt of the NHS cash shortages.

On 11 Oct 06- in National Institute for Curbing Expenditure (NICE) blights thousands of Alzheimer sufferers we posted that NICE has been 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.

The backlash against this ruling by the National Institute for Curbing Expenditure led to our posting on 17 Nov 06- Drugs watchdog faces legal review- NICE’s approach is irrational and flawed.

A decision by the Labour government’s drugs watchdog to restrict the use by the NHS of Alzheimer’s medication is to be challenged in court. Two drug companies plan to apply for a judicial review of the way the National Institute for Health and Clinical Excellence reached its conclusion. NICE ruled NHS patients with newly diagnosed, mild Alzheimer’s disease should not be prescribed the drugs.

The hospital PFI programme is being cut back from an original £12bn of additional schemes to something closer to £7bn-£9bn, according to the health department, as hospitals adjust to the uncertainty of a system that pays them for each patient they treat, in contrast to block contracts.

Yesterday’s announcements in part reflects that. The value of the seven schemes given the go-ahead is being reduced by about 15 per cent, or by £248m on their original £1.63bn value.

But although the go-aheads – for schemes at various stages of procurement – has now been given the first stage of the review was meant to be completed by late last year.

And a reappraisal of 23 other schemes with a capital value of about £5.5bn, including some individual projects worth £500m and more, is unlikely to be completed before the autumn, the health department said – the better part of two years since the review of PFI projects was launched.

“The delays and uncertainties are frustrating,” Adrian Bull, managing director of Carillion Health, a PFI provider, said.

“It is right that there should be a review because the biggest thing that bedevils PFI projects is when there are changes to a scheme part-way through. So we want them to come to market absolutely clear about what it is they want, so that the procurement can be efficient.

“But having said that, the uncertainty and the stop-go nature of the pipeline makes it extremely difficult for organisations that have to plan to commit considerable and significant resources to these projects.”

To date, only a few PFI projects – the £1bn Paddington campus scheme, Whipps Cross and Essex Rivers – have been withdrawn. Three of yesterday’s approvals – Peterborough, a rebuild in North Bristol, and a smaller project in the north-east, went through unchanged.

Two more have undergone relatively minor revision. But the Maidstone deal has been cut back from a £269m scheme to £218m, while one in Mid-Essex is down from £199m to £143m.

The announcement came as health ministers stressed the scale of the National Health Service building programme since 1997, which has seen 116 new hospitals opened or approved, along with 188 primary care facilities, at a total cost of £10.6bn.

Unison, the health service union, protested that taxpayers will be “paying over the odds” for the new facilities for years to come because they have been built through the PFI.

From:
http://www.ft.com/cms/s/6c27d924-c607-11db-b460-000b5df10621.html

With the announcements above, the scandal of more PFI waste in the NHS sadly continues. On 22 Jan 07 in Health Direct’s blog: PFI firms make £23bn profits from NHS we posted that the private sector will make £23bn in profits and interest over the next 30 years by building NHS hospitals, campaigners have calculated.

Under the private finance initiative, a company builds a hospital and then gets “rent” from the NHS for a set term. A report by the Keep Our NHS Public claims the Labour government is carrying out “patchwork privatisation” of the NHS.

And it’s all sadly to form from the chancellor- in Brother Brown can’t cure this paralysed NHS, so he plans to privatise it (16 Jan 07) we wrote about how the former Granada boss Sir Gerry Robinson recently spent six months trying to reform Rotherham general hospital. The result was shown in three hours of fly on the wall television on BBC2 last week.

It was rightly put after the watershed: as politics it was certificate 18. At the end of each day Robinson could be seen slumped in the back of his car, his face buried in his hands. A tycoon sobbing in a limousine is the perfect icon of Labour’s health service.

The consultant plastic and reconstructive surgeon, who specialises in skin cancer and breast reconstruction, said he and his colleagues are being prohibited from operating in non-urgent cases unless the patient has been waiting for a minimum of 20 weeks.

This is because the hospital would not get paid – even if the patient and staff were ready for the operation.

Mr Jaffe said the Prime Minister’s pledge to have patients waiting no longer than 18 weeks between referral and treatment would be “impossible” unless more money was made available to primary care trusts.

He rubbished the Government’s vision of 24-hour surgery, saying that after normal working hours only a skeleton staff was available.

“We are trying to do what the Prime Minister wants us to do but we cannot do it properly because there is no money,” he said.

“Waiting lists will only go up if, as is the case, doctors cannot perform operations unless the patient has been waiting for more than 20 weeks. It’s absurd.”

Mr Jaffe, who works at the University Hospital of North Staffordshire NHS Trust, said the 20-week ruling was a “global issue” within the NHS and not just a problem at UHNS. He claimed that he was unable to fill his evening lists because of the 20-week constraint, and that patients were having to wait longer to be seen than necessary.

He said: “Doctors across the country are talking about the same thing and it’s happening everywhere.

“It’s not the hospitals – these rules are being put in place by the PCTs to take them over the April 1 threshold, when the new financial year begins and they get their money from the Labour Government.

At the moment they have no money so cannot pay the hospitals. How that tallies with getting maximum waiting times down to seven weeks, which is another target, I do not know.

“The way things stand, waiting lists will grow, not shorten, if operations have to be put back because of a lack of money. It’s clearly a ridiculous way of doing business.”

His candid remarks come on the same day that radiotherapists reveal how other cancer patients are having to wait months beyond their recommended dates for treatment that can prevent the disease returning.

Channel 4′s Dispatches programme, to be shown tonight, found that the waiting gap between operations to remove cancerous growths and radiotherapy treatment is at least three months in Kent, breaching the Royal College of Radiologists’ guidelines.

Three patients have seen the disease return during the long gap between their operation and radiotherapy.

The programme found that five UK radiotherapy units have an average wait of 28 days, which means that many patients are waiting longer. In two centres, more than three-quarters of patients were not treated within 28 days.

Mr Jaffe said Government proposals to increase operating hours into the night were “laudable”. But he added: “We would need more doctors, more nurses, more staff. More, in fact, of all the people they keep making redundant.

They are getting rid of people yet trying to impose regulations on us that mean we need more people. Nurses are qualifying yet no trusts are employing them because they have no money.”

A spokesman for the UHNS trust said that waiting times at the hospital had dropped from 26 weeks to 20 weeks in the last year, and he added that Mr Jaffe’s comments only covered routine surgery, not emergency surgery.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/02/26/nops26.xml

Health Direct questioned last week (Feb 20) how Bliar intends to achieve his latest spin NHS target without providing any more money.

Health Direct posted : Barking Bliar’s latest drive to cut waiting times for NHS operations
when Tony Bliar stepped up the drive to define his legacy by declaring that he wanted to see “the framework” in place to ensure that by the end of 2008 no one waits more than 18 weeks for an operation after seeing the GP.

The target- originally announced two and a half years ago implies an average wait of eight to nine weeks. How he intends to achieve this breakthrough without providing any extra money was not explained.

James Johnson, chairman of council of the British Medical Association, said there were two “stumbling blocks” to using operating theatres more intensively. One was how to staff them.

But the other was that “many parts of the NHS are broke. If primary care trusts have run out of money, they clearly cannot buy a lot more operations. This and the lack of staff have already prevented extended working from happening in many parts of the NHS.”

Deaths involving Clostridium difficile rose by 69% to 3,800 from 2004-05, the Office for National Statistics said. In the same period, MRSA mentions on certificates increased by 39% to 1,629. In total there were 5429 superbug deaths in 2005.

The ONS figures also showed that between 2001 and 2005 MRSA was mentioned on one in every 500 death certificates in England and Wales. For C. difficile it was one in every 250.

The BBC reported yesterday that :

The head of health at Unison, Karen Jennings, said: “These shocking figures show that MRSA and C difficile have a deadly grip on our NHS. Dirt is not cheap.

“We need to wage war on these superbugs and cleaning and cleaners should be on the front line as an integral part of the infection control team.

“No one wants to be treated in a dirty hospital but sadly the culture of cleaning was sold off at the same time as compulsory competitive tendering was brought in.

“It’s time for hospitals to set safe minimum staffing levels for their cleaning services – patients and staff deserve nothing less.”

A spokeswoman for the Patients Association said: “Our worry is that these figures will continue to rise as other priorities take precedence “The government promised to make infection control one of its top priorities. Yet its own announcement to further reduce waiting times by ’round the clock operations’ will inevitably harm these efforts,” she said.

From:
http://news.bbc.co.uk/1/hi/health/6385323.stm

On 27 Oct 06- Health Direct posted : MRSA kills twice as many people as drunk drivers in the UK when Sir John Oldham, a GP and head of the Improvement Foundation, which advises primary care trusts, warned that one in five clinical staff failed to wash their hands, despite evidence that doing so cuts the incidence of hospital-acquired infections such as MRSA, which costs the NHS £1bn a year. Figures for 2004 show MRSA killed 1,623 patients in England and Wales. Some 580 people were killed in drink-driving incidents in Britain.

Earlier this year (11 Jan 07) Health Direct also wrote that NHS hospitals may never achieve MRSA superbug targets when the NHS was not on track to meet its MRSA target and perhaps never will, a leaked government memo says.

In November 2004, then health secretary John “not fit for purpose” Reid pledged MRSA rates would be halved by April 2008. But the memo, sent to ministers by a Department of Health official, said it would only be cut by a third by then. It also reportedly recommended ways to handle the news in the media. Dr Mark Enright, from Imperial College, said the target was “unrealistic”.

The official roads deaths figures can be found on the National Statistics Office’s website at:
http://www.statistics.gov.uk/cci/nugget.asp?id=1208
In 2005, 671 pedestrians were killed in road accidents in Great Britain, this was 21 per cent of all deaths from road accidents, the lowest total for over 40 years.

The total number of deaths in road accidents fell slightly by 1 per cent to 3,201 in 2005 from 3,221 in 2004. However, the number of fatalities has remained fairly constant over the last ten years.

The health secretary has said she will take personal responsibility for the NHS achieving financial balance this year. Yesterday the health department published figures suggesting that by the end of next month there will be a £13m surplus in England on a £75bn turnover.

35 per cent of organisations – 2 percentage points up on last year – are forecasting a gross deficit that almost exactly matches last year’s £1.3bn.

Those deficits are off-set by surpluses elsewhere and a £450m contingency reserve. But strategic health authorities are also holding back more than £1.1bn top-sliced from the budgets of primary care trusts.

A minority of NHS organisations remain in deep financial trouble. Around 30, or 8 per cent, are forecasting deficits of more than 5 per cent of turnover, with some projecting 10 per cent. In one or two cases, the deficit will be 30 per cent or more.

But the underlying performance of the whole system, including foundation trusts, shows it is running at a small in-year surplus after allowing for a £450m reserve created for this year, and once the £700m of previous overspends dealt with this year, are knocked off.

David Nicholson, the NHS chief executive, said the figures showed the health service would be “on a sound financial footing” for next year.

Some £700m will go back into the budget, on top of an increase of about £7bn in cash spending, with some of the top-sliced money being returned to primary care trusts.

The improvement, however, has come at a price. Around a quarter of primary care trusts are setting minimum waiting times for patients or otherwise slowing treatment, at least until the start of the new financial year.

Hundreds of millions of pounds have been taken from training and other budgets. Some organisations are pushing orders for supplies and planned developments into April and beyond – the start of the new financial year.

Mr Nicholson acknowledged that patients had been affected. But he said the service was still treating more people, and training cuts would be restored next year.

However, Andrew Lansley, the Conservative health spokesman, said “the surplus they have generated is a sham”. More organisations were saddled with worse deficits than last year, he said, adding that “Patricia Hewitt’s skin is being saved only by savage cuts to centrally held budgets”.

The NHS Confederation argued that half the overspend was in just 6 per cent of organisations. It urged the health department to end the “double whammy” caused by a set of accounting rules it said were being applied inappropriately to some hospitals, causing them to enter an inescapable spiral of debt.

From:
http://www.ft.com/cms/s/3f56e594-c151-11db-bf18-000b5df10621.html

The delusions of the Alice in Wonderland were reported by Health Direct blog on Feb09, 07 when in Bed closures are a healthy sign for the NHS, says Patricia Hewitt

Patricia Hewitt, the Health Secretary, was criticised for claiming bed closures were a sign of “success” as new figures showed NHS trusts will end the year more than £1 billion in the red.

The scale of the health service’s financial crisis emerged as Miss Hewitt delivered a presentation to the Cabinet on NHS “reconfiguration” — plans which will lead to the closure of dozens of maternity units, casualty departments and community hospitals.

Andrew Lansley, the shadow health secretary, said Miss Hewitt’s remarks would be greeted with incredulity at a time when many trusts were struggling to cope with huge deficits.

“The Health Secretary is living on a fantasy planet, far removed from the reality of the front line cuts that are having a daily adverse impact on NHS staff and patients,” he said.

“Despite this year’s savage job losses, bed cuts and service closures, the NHS organisations providing front-line care are no less in the red than they were last year.”

The Patients Association said it did not see bed closures as a sign of success.
As Health Direct wrote on 3 Jan 07- in NHS hospitals told to delay operations to ease health service’s debt underfunding.

Health Direct warned that the New Year has only just begun but it is clear that the next three months are not a good time to become ill as the NHS can not cope with Labour’s underfunding of the health services as patients in some parts of the National Health Service are for the first time facing minimum waits to be seen and treated as managers attempt to balance their books. Suffolk, Hertfordshire, North Yorkshire and Kingston are all imposing various forms of minimum wait, with some primary care trust chiefs saying their organisations may follow suit as the NHS battles to recover from last year’s £536m plus overspend.

The new smoke-free rules come into force in England on July 1, when people will be banned from smoking in workplaces or enclosed public areas.

However, there might be confusion about the application of the rules. A home owner is allowed to smoke at home but not if a work colleague arrives to discuss a business plan. Similarly, home owners can smoke if friends are invited, but not if caterers are there to help with the food and drink.

Officers will be able to sit among drinkers undercover and photograph and film people. A Government-funded course is expected to train 1,200 council employees in the next few months, with more to follow later.

Ian Gray, the policy officer for the Chartered Institute of Environmental Health and chief trainer for the Government course, said: ” I am sure that there will be some occasions when action has to be taken and I am sure the officers will not shy away from that.

“These officers do not have to identify themselves when they go into premises and they can film and photograph people to gather evidence although this may not be appropriate in many cases.”

In Nottingham, about 30 officers will patrol the city, including new staff and environmental health officers.

In Liverpool, there will be a core team of about 20 to 25 staff, although about 200 staff are expected to patrol the city in the first few days of the ban. Liverpool City Council official Andy Hull told the BBC: “We want to make our presence felt, and while we will probably just issue warnings on the first day, we won’t be afraid of making an example of people or businesses.”

Simon Clark, director of the smokers’ group Forest, said: “The idea of getting public officials to snoop on people is distasteful.” A spokesman for the British Beer and Pub Association said the plan was “elaborate”.

News of the increased number of smoking snoopers comes after The Daily Telegraph revealed that there were just three uniformed police officers on the streets in some towns at night.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/02/16/nsmoke16.xml

Given that Labour have massacred pension savings in the UK with their maladministration and stealth taxes, it is somewhat ironic that they now want people to live longer- but in diminished circumstances.

Health Direct points out that people only describe bliar as being “middle of the road” because on every subject his policies are both from the extreme right and the extreme left of the spectrum.

For example, in the NHS we have the stalinist centralist targets and dictats and at the same time we have post code lotteries where spending powers have been devolved down to unelected quangoes.

It would mean that over the course of a decade “what was the biggest problem in the National Health Service – that people had to wait months and months, often in pain and sometimes even dying for want of their operations” would have been “transformed”, the prime minister said.

Some hospitals are considering keeping operating theatres open in the evenings and at weekends. But the NHS Confederation, which represents health authorities and trusts, said many hospitals would have “to completely redesign how patients flow through the system” to achieve the goal.

Nigel Edwards, the confederation’s director of policy, also warned of the challenge that lay ahead as the increase in NHS spending slowed: to create the facilities to deal with the current backlog of cases without then leaving the NHS with higher costs or excess capacity once that had been done.

James Johnson, chairman of council of the British Medical Association, said there were two “stumbling blocks” to using operating theatres more intensively. One was how to staff them.

But the other was that “many parts of the NHS are broke. If primary care trusts have run out of money, they clearly cannot buy a lot more operations. This and the lack of staff have already prevented extended working from happening in many parts of the NHS.”

Bliar’s latest spin comes as news that some primary care trusts are delaying operations into the next financial year, or putting a minimum wait on treatment, while, according to suppliers, some parts of the NHS are paying bills late or cutting orders for supplies until the financial year ends in March.

While the NHS overall may achieve financial balance, a large number of hospitals and primary care trusts will be saddled both with overspends this year and years of accumulated debt.

The figures emerged as a doctors.net poll of more than 3,000 doctors for The Times showed that almost three-quarters believe that the extra money for the NHS has not been spent well. Some 28 per cent believe David Cameron would protect the NHS more effectively than would Gordon Brown, who is favoured by just 15 per cent. (Please see yesterday’s Health Direct posting- Disillusioned doctors say Labour decade of reform has failed the NHS)

From:
http://www.ft.com/cms/s/19ec376e-c089-11db-995a-000b5df10621.html

How Bliar intends to achieve his latest spin NHS target without providing any more money has not been explained.

Especially from an organisation that is desperately indulging in every trick in the financial book
to massage the cash flow figures.

On 14 Feb 07 in NHS paying bills late in struggle to balance books, say suppliers, Health Direct posted: The National Health Service is delaying paying bills and cutting orders for supplies as it tries to balance its books, according to the trade associations whose members supply the service with everything from scanners to diagnostic tests.

Ray Hodgkinson, director-general of the British Healthcare Trades Association, said that while the picture was highly variable “some of our members are having real trouble getting money out of NHS trusts”.

Faith in Labour’s ability to put it right is rock bottom. Nearly twice as many doctors would trust the NHS with David Cameron, the Opposition Leader, than with Gordon Brown, though a larger number trust neither of them.

The poll, carried out by doctors.net.uk, Britain’s busiest medical website, shows a profession disillusioned with central control, angered by the growth of bureaucracy, and deeply sceptical of initiatives such as the £20 billion IT system. Even more worrying for Labour, more than two fifths of the 3,092 doctors who responded are young, having graduated since 2000.

More than half of respondents (56 per cent) said that there had been no improvement in the NHS since 2002, when the Government increased funding. Only 27 per cent thought there had been.

Almost three quarters (72 per cent) did not believe that the extra money had been well spent, while 11 per cent said that it had. Similar views were held on the quality of care: 72 per cent said that there had been no improvement; 15 per cent said that there had been.

In a surprisingly strong rejection of the Government’s belief that taxation is the only way to pay for the NHS, 79 per cent of respondents doubted that the highest standards expected of the NHS could be sustained through taxation alone after 2008, when the huge annual increases in funding will drop off.

Neil Bacon, who launched doctors.net in 1999, was not surprised by the results of the survey. “Doctors support the NHS, but they have a great deal of concern that the underlying problems are not being addressed,” he said.

Mark Porter, deputy chairman of the British Medical Association’s consultants’ committee, said: “The results of this survey are disturbing and give a snapshot view of how demoralised and frustrated some doctors are feeling.

“It is of major concern that a majority of respondents to this survey are saying that they do not believe the NHS has improved since 2002 and that they do not think the increase in NHS expenditure has been well spent. It is also worrying that so many of them say they plan to retire early.

“The survey also reveals a deep anxiety among doctors about what will happen after 2008, when the rate of increased funding is due to end.

“It is tragic that the Labour Government has used so much of the increased expenditure on wasteful initiatives like independent sector treatment centres and PFI. The private sector has certainly done well out of the increased funding.”

Andrew Haldenby, of the think-tank Reform, which wants funding of the NHS to be opened up, said that he was heartened by the degree of support doctors had shown for the idea. “The real issue is whether the tax model can work. This poll requires all the politicians to rethink their positions,” he said. “This poll suggests very strongly that at least part of the medical community has been taking notice, and it is particularly interesting that so many younger doctors have contributed.”

From:
http://www.timesonline.co.uk/tol/news/uk/health/article1403738.ece

It’s not just doctors- who see the waste from the inside, who know that labour is wasting our tax payers money on the NHS. On 25 Jan 07 Health Direct posted: Bliar effect is hurting Labour a new ICM poll confirms when declining public trust in Tony Bliar is dragging down wider public support for Labour, according to a Guardian/ICM poll published this week. It shows that the Conservatives have secured a lead in policy areas that once helped Mr Blair win three commanding general election like the NHS.

And it said clinics could sometimes only meet targets by changing the way they booked appointments. The report’s stark warning echoes one issued last year by the Independent Advisory Group on Sexual Health and HIV (IAG).

That group said a substantial proportion of the £300m set aside for sexual health was being diverted by primary care trusts (PCTs) to pay off debts.

The new survey of sexual health chiefs reinforced the view that cash allocated in the 2004 Choosing Health White Paper was being held back by PCTs or Strategic Health Authorities.

Overall, 59% of respondents said either all or part of the Choosing Health money had been diverted away from sexual health services. The report said: “The diversion of this money will affect delivery of services in key areas of sexual health.

“We ask the Government to take urgent action to ringfence future sexual health funding and enable PCTs to spend allocated money on the services for which it was intended.”

Dr Gill Morgan, chief executive of the NHS Confederation, which represents 90% of PCTs, said: “Sexual health services are one of many important priorities for primary care trusts.”

From:
http://news.sky.com/skynews/article/0,,30100-1251689,00.html

On Fri 4 Aug 2006 Health Direct posted: Sexual health (STI) funds are being used to cut trust debts when millions of pounds intended for improving sexual health services are being diverted to pay off debts, a government advisory group said yesterday. The Independent Advisory Group on Sexual Health and HIV said that a substantial part of the £300 million set aside had been absorbed by primary care trusts (PCTs).

And what is the result of labour’s postcode lottery- Wed 5 Jul 06- Sexually Transmitted Infections (STI)s increases again in 2005- New figures released today by the Health Protection Agency show that the number of sexually transmitted infections (STIs) and other conditions diagnosed in genitourinary medicine (GUM) clinics in the UK increased by 3% between 2004 and 2005.

Chlamydia remains the most commonly diagnosed STI, with 109,832 new cases in 2005, a 5% increase on the previous year. The highest rates of infection and highest increases in diagnoses were seen for both sexes in the 16 to 24 age group.

He has recently studied the recent outbreak of Clostridium difficile at the Queen’s Medical Centre in Nottingham, which resulted in nine deaths and led to the area’s coroner, Dr Nigel Chapman, drawing attention to the scale of the problem.

Professor Grundmann studied computer models of infection rates in the Nottingham hospital’s intensive care unit and found during the winter period when bed occupancy rates increased so too did the transmission rates for MRSA.

MRSA
“With this model I went to the chief executive at the Queen’s Medical Centre and showed him that by closing two beds in intensive care we could always be on top of any outbreak. We would effectively stop all hospital transmissions.

“But with waiting list targets this couldn’t happen and so what we see are outbreaks which are difficult to bring under control.

“There is a direct conflict between the government’s desire to bring down waiting times in hospitals and their wish to tackle the spread of hospital acquired infections.”

It is thought that approximately 5,000 people a year die from a hospital acquired infection – a figure the government says has to be seen in the context of the 12m people treated every year by the NHS.

About 3% of healthy adults carry C. difficile and it is impossible for hospitals to keep it out, according to Dr Richard Slack, the consultant in communicable diseases for the East Midlands Health Protection Agency.

“The job therefore is to limit the spread of it. But with more than 50,000 cases in 2005 and the numbers rising all the time it was clear that the problem was getting worse rather than better.

“The other thing is that we’re getting reports from colleagues up and down the country who are seeing an increasing number of patients who require major surgery, and some patients who are dying, of C. difficile.”

Control

Managers at the Queen’s Medical Centre will not say how long it took to bring the outbreak of C. Difficile under control, or how many patients were infected.

But the Nottingham Coroner, Dr Nigel Chapman, said he had seen a sharp rise in deaths from C. difficile to investigate.

Where he would normally expect to see two cases a year he has had nine deaths from the Queen’s Medical Centre over a four-week period.

From:
http://news.bbc.co.uk/1/hi/health/6348163.stm

The scandal of thousands of preventable deaths every year in NHS hospitals through patients contracting MRSA, C Difficile and other superbugs is not going to improve until the govt is prepared to finally address the issue.

It means more money to reduce bed occupancy rates, thorough cleaning of the beds between use and constant hygiene on wards including the automatic washing of hands by staff between contact with every patient.

On Thu 11 Jan 07- Health Direct posted: NHS hospitals may never achieve MRSA superbug targets as the NHS is not on track to meet its MRSA target and perhaps never will, a leaked government memo says. In November 2004, then health secretary John Reid pledged MRSA rates would be halved by April 2008. But the memo, sent to ministers by a Department of Health official, said it would only be cut by a third by then. It also reportedly recommended ways to handle the news in the media. Dr Mark Enright, from Imperial College, said the target was “unrealistic”.

Most had standing orders that said bills should be paid within 30 days, Mr Hodgkinson said. “But some are not paying for 60 or 90 days and even longer. They are in breach of their standing orders and for a lot of our members who are small businesses this is creating problems with cash flow. There is no doubt there is slow payment on a significant scale.”

With Patricia Hewitt, the health secretary, having said she would take “personal responsibility” for restoring the NHS to financial balance this year, Mr Hodgkinson said: “NHS chief executives are telling us that they must balance their books at all costs.”

Doris-Ann Williams, director-general of the British In-Vitro Diagnostics Association, whose members provide diagnostics supplies and tests, said: “We are starting to see invoices not being paid and orders not being closed until the start of the new financial year [in April].

“All sorts of measures are being taken to try not to spend money in this financial year.”

Having seen orders dry up and bills not paid this time last year as the NHS headed for a £500m-plus financial deficit, she added that this was “starting to seem like an annual event”.

She said: “We did a survey of our members in September and things had got much better than at this time last year. But the reports we are getting now is that the problem is recurring.”

John Wilkinson, director-general of the Association of British Healthcare Industries, whose members supply everything from latex gloves to high-technology life support machines, said they had seen the impact most in bigger items of capital spending.

“We traditionally get late payment around this time of year and we have had some reports of that recently but not an overwhelming crescendo. But capital spending on equipment seems to have dropped quite dramatically – it is really quite badly down.”

That was worrying when the NHS had a target to reduce the maximum wait from GP to surgery to 18 weeks and that goal would not be achieved by simply doing more faster but by reshaping the way services were delivered, Mr Wilkinson said. “Quite a lot of those changes will involve capital spending on equipment.”

One supplier who declined to be named said: “The instructions seem to be ‘spend absolutely nothing’ and we in common with our competitors have seen a marked drop in order levels. We’re expecting a flood of orders next month since payment will then fall in the next financial year.”

From:
http://www.ft.com/cms/s/e30c4d3c-bb07-11db-bbf3-0000779e2340.html

The cash crunch is also having a direct effect on patients. On March 07, 2006 Health Direct posted: NHS overspending increases waiting times for patients when early signs that a big overspend in the National Health Service in England is starting to affect patient care came with the waiting list figures for January. Although the total list rose by only 7,600 in the month, up 1 per cent, the number of patients waiting between three and five months for treatment has jumped by 36,600 – 25 per cent. In other words, while the number of patients waiting has only risen slightly, the wait has increased.

That appears to have resulted from hospitals putting off treatment until the new financial year, which starts in April, while still keeping to the government’s guarantee of a maximum six-month wait.

At the same time, some primary care trusts are telling hospitals that they must treat no more patients next financial year than this year, and in some cases fewer, to claw back an overspend that has been forecast to hit £790m by the end of this month.

Andrew Lansley, the Conservative health spokesman, said “[some] doctors are being told they cannot treat patients who are waiting in pain and discomfort until they reach the six months deadline. For a government that said it was going to put all this extra capacity into the NHS, and when the capacity becomes available then tells staff they cannot use it, it is the height of absurdity”.

Last year, on January 23, 2006 the same thing happened when NHS Hospitals shut wards as cash crisis bites. The spiralling cash crisis in the NHS has already forced two thirds of hospitals to close wards and will soon start directly affecting patient care, health chiefs warn. A survey of 117 chief executives of NHS trusts reveals the depth of concern among healthcare professionals about the destabilising impact of wide-ranging govt reforms.

Three quarters of them say that growing financial pressures brought on by primary and acute care restructuring will affect patient treatment.

Mrs Hewitt said she backed the increasing number of doctors who make decisions about whether it is appropriate and safe to operate on smokers, or patients who are significantly overweight.

“What I’ve been seeing. . . is more and more health centres and GP practices focussing on that kind of support,” she told The Sunday Times. “They will say to patients, you shouldn’t have this operation until you’ve lost a bit of weight and stopped smoking.”

However, she added that it would be “dreadful” to deny treatment on the basis that patients were to blame for their condition. Hip and knee replacements are among the operations likely to be denied to those who are overweight, while smokers could miss out on heart bypasses.

The Health Minister’s views on the issue, which mirror those of a growing number of medical experts, are based on what she describes as “best practice” – because operations are less likely to be successful when the patient is very fat or a heavy smoker.

However, some doctors have expressed concern that the stance could be used by some NHS trusts as a means of saving money, while others have questioned the criteria that will be used to judge an appropriate weight for surgery.

The two sides of the argument were outlined in a debate published last month in the British Medical Journal.

Prof Matthew Peters, the head of thoracic medicine at the Concord Repatriation General Hospital, Sydney, Australia, claimed that five non-smokers could be operated on for the cost of four smokers, and that their outcomes would be better.

However, Prof Leonard Glantz, of Boston University School of Public Health, in Massachusetts, said: “It is shameful for doctors to be willing to treat everybody but smokers in a society that is supposed to be pluralistic and tolerant.”

A policy of encouraging smokers to give up the habit before they are granted operations was put forward last year by hospital managers in Norfolk and Newcastle-under-Lyme, Staffordshire, where Health Service trusts are millions of pounds in debt.

The Norfolk trust explained the move by saying that smokers are at increased risk of complications and take more time to recover from surgery, meaning they have longer and more expensive stays in hospital.

Smokers, however, described the policy as blackmail, pointing out that they pay taxes along with non-smoking citizens.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/02/12/nsmoke12.xml
(If anyone is reading from the Times, your website update last week is painfully slow and content updates lost.)

The intrusion by the politically correct nanny Hewitt to find more ways of rationing NHS services had an unusual result last year.

Health Direct posted on Wed 30 Aug 06 in Call for IVF ban for obese, but young, smoking lesbians may win IVF postcode lottery when very obese women should be denied IVF fertility treatment, experts say. The British Fertility Society is recommending women with a body mass index of 36 and over should not be allowed access to fertility treatment.

Underweight women and those classed just as obese (BMI over 29) should be forced to address their weight before starting treatment, the society said. NHS guidelines say overweight women should be warned of the health risks, but do not impose any ban on treatment.

In some regions fewer than two thirds of units were able to offer one-to-one care, in which a woman is looked after by one midwife throughout pregnancy, the report claims.

There are fears that the situation could worsen further still after the Government last week outlined plans for maternity services that could see dozens of units shut down permanently and pregnant women forced to travel further to give birth.

Louise Silverton, the deputy general secretary of the Royal College of Midwives, said: “We have 25,000 midwives in the UK but 55 per cent of them work part time. We estimate that we need 10,000 more.

“As well as a rising birth rate, the Government is asking us to do much more, such as assess women for domestic violence. Yet instead of increasing numbers, we are finding that trusts are freezing posts, so newly qualified midwives can’t get jobs.”

A Department of Health spokesman said: “There are various factors that influence the decision to close a maternity unit for a period of time, including staff and bed availability and the number of women and complexity of care needed.

The minister in charge of maternity care sparked controversy last week when he failed to turn up at the launch of the review of the service. Ivan Lewis, who had already been accused of hypocrisy for campaigning against health cuts in his Bury constituency, said he had to attend another event in his role as minister for older people.

He denied that he should resign from the Government because he opposed plans to cut maternity services in his own constituency.

The Conservatives, who have claimed that 43 maternity units had closed or were under threat, said they had not seen any clinical evidence of the need to change the service.

Andrew Lansley, the shadow health secretary, said: “Government nationally seems to be saying that everything has to change, while locally Labour ministers say they don’t believe it and it’s not justified. There’s a hypocrisy in that.”

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/02/12/nbirth12.xml

The dire circumstances that faces the midwifery profession was highlighted by Health Direct on
Jan 10, 2007 when the RCM warned that Maternity cash is cut amid boom in the birthrate, say midwives.

The NHS is responding to a boom in the birthrate by cutting spending on maternity services, the Royal College of Midwives said after a survey of more than 100 heads of midwifery in hospital trusts across Britain. It found that two thirds of maternity units were understaffed and most were trying to save money by employing fewer qualified midwives and taking on maternity support workers instead.

Louise Silverton, the college’s deputy general secretary, said: “This is terrible news for a labour government that in its election manifesto pledged every woman would have a named individual midwife to care for her by 2009. The midwifery shortage is getting worse rather than better at a time when we are experiencing a significant increase in the number of births.”

The survey produced a “depressing picture” of cuts, job freezes, shortages and financial crises.

More than one in five heads of midwifery reported a cut in the number of midwives at their trust. Hospitals were also cutting budgets for the training and development of midwives, in some cases by 75% or even 100%. A few units have become totally dependent on charitable donations to fund midwifery training, the RCM added.

The survey found that midwifery units recruited an average of 6.3 newly qualified midwives last year, compared with 6.8 in 2005. The average unit had 21 maternity support workers last year, compared with 19 in 2005.

Ms Silverton said: “This is irrefutable proof that midwives are under enormous pressure and nothing is being done to alleviate the situation. Unless midwifery services are expanded there is no hope of the labour government’s manifesto commitments being achieved.”

Tony Blair tried to rally support for his embattled Health Secretary during yesterday’s meeting by hailing her proposals as the “biggest change in the NHS since its foundation”. He added that better care and value for money could go “hand-in-hand”.

But the Prime Minister’s spokesman admitted later that ministers were free to oppose proposals to close hospitals or cut services in their own constituencies. His comments came as research showed that frontline NHS trusts which run hospitals and GP clinics across England are on course to finish the year £1.05 billion in the red — only a fraction below last year’s record deficit.

The figure is drawn from a Conservative analysis of the deficits being forecast by each of England’s 10 strategic health authorities.

While front line trusts are deep in the red, the strategic health authorities themselves are on course to end the year with a huge £920 million surplus — almost twice last year’s figure. This allows ministers to say the overall deficit across the whole NHS is only £132 million.

However, the Tories claimed that health authorities have only been able to produce such a big surplus by slashing the amount they spend on crucial services, including training for doctors and nurses.

The figures were released as Miss Hewitt was accused of living on a “fantasy planet” after defending the proposals to overhaul services across the country.

She claimed the planned changes would allow more people to be treated closer to home by their family doctor or local health centre, rather than having to go into hospital.

“That will mean fewer emergency admissions, so you need fewer beds. Fewer beds are a sign of success — not a sign of failure,” she said in a newspaper interview.

Miss Hewitt took up the theme during yesterday’s presentation to the Cabinet. She argued that NHS reconfiguration was being driven by both patient demands and changing medical practices.

It was increasingly possible to treat more minor conditions in local health centres rather than the local hospital, she said. At the same time, specialist care for conditions such as heart disease were increasingly being concentrated in regional centres of excellence.

Andrew Lansley, the shadow health secretary, said Miss Hewitt’s remarks would be greeted with incredulity at a time when many trusts were struggling to cope with huge deficits.

“The Health Secretary is living on a fantasy planet, far removed from the reality of the front line cuts that are having a daily adverse impact on NHS staff and patients,” he said.

“Despite this year’s savage job losses, bed cuts and service closures, the NHS organisations providing front-line care are no less in the red than they were last year.”

The Patients Association said it did not see bed closures as a sign of success.

“What we hear about from patients is inappropriate discharges with patients being sent home too soon,” said Katherine Murphy, a spokesman for the association.

“We heard from one patients due to be discharged on a Wednesday who was away from her bed for 50 minutes, the night before to take a bath. When she went back to the ward someone was in her bed.

“Beds are being closed because of financial deficits. I would not call this a mark of success,” she said.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/02/09/nhs09.xml

A split and indecisive labour government looks in the offing. The first two blogs that Health Direct posted at the beginning of this year look to encapsulate Labour’s dilemmas.

On Wed 3 Jan 07- in NHS hospitals told to delay operations to ease health service’s debt underfunding Health Direct warned that the New Year has only just begun but it is clear that the next three months are not a good time to become ill as the NHS can not cope with Labour’s underfunding of the health services as patients in some parts of the National Health Service are for the first time facing minimum waits to be seen and treated as managers attempt to balance their books. Suffolk, Hertfordshire, North Yorkshire and Kingston are all imposing various forms of minimum wait, with some primary care trust chiefs saying their organisations may follow suit as the NHS battles to recover from last year’s £536m plus overspend.

On Tue 2 Jan 07 Health Direct noted that Labour leader defends hypocritical charges over NHS closures in her constituency – Cabinet minister Hazel Blears has defended her decision to take part in a protest over plans to close part of a hospital in her constituency. The proposals for Hope Hospital in Salford, Greater Manchester, are part of the controversial NHS shake up throughout the country.

Ms Blears, Labour chairwoman, said: “My first and foremost job is to represent Salford and the people of the area.” It is very damaging for a minister to directly oppose labour government policy.

Under the terms of the new contracts, dentists agree to provide a number of ‘units of dental activity’ (UDAs) for a certain price over the course of the year. Treatment is split into three categories. A dentist earns one ‘point’ for simple investigative work, three points for more complex work, such as fillings, and 12 points for treatment involving laboratory work, such as crowns and bridges.

A DoH memo sets out how PCTs should deal with patients of dentists who complete their contracted work before the end of the financial year – and will not be paid for any more NHS work.

The letter says PCTs must ‘ensure patients know how to access urgent care, and publicise any spare capacity in other dental practices locally’. It also tells PCTs to be ready to respond to media reports about the problem, saying they should have ‘clear lines ready in case of media interest’.

Bradford and Airedale Teaching PCT said 10 of its 73 dental practices were in danger of completing their contracted work too soon. The PCT aims to avoid NHS patients being refused treatment by introduce a pooling system, with other dentists with spare capacity taking on extra work.

British Dental Association chief executive Peter Ward said the dental contracts introduced last year had effectively introduced targets, which dentists would make sure they hit, rather than risk underperforming. This meant that some would finish their work earlier in the financial year than planned.

‘What was initially meant to be a performance measure translated into a target when contracts were drawn up,’ he said.

Mr Ward also said that the levels of contracted work often differed significantly from the historical levels of work dentists had performed.

A poll of BDA members, taken after the contracts were drawn up, revealed that 75 per cent of dentists thought the UDAs they were contracted to provide ‘were not relevant to their real level of work’.

Another problem with the NHS dental contract hit the headlines last month, when it was discovered that patients were being turned away from some dentists because of a shortfall in primary care trust dental budgets.

The problem has come about because many dentists are seeing more ‘exempt’ patients than predicted. Such patients, including children, make no contribution towards their treatment. The result is that PCTs around the country are reporting significant shortfalls in their expected patient income.

From:
http://www.hsj.co.uk/healthservicejournal/pages/np1/p7/070208

News of dental health rationing is nothing new to Health Direct blog readers. Only last week (Thu 1 Feb 07) we noted in Dental patients hit as dentists funding fails to add up as Dentists are turning away patients because miscalculations by the Department of Health have resulted in local health authorities running out of money in the dental budget. The problem has arisen because dentists have been treating more patients who are exempt from dental charges than had been anticipated under the new dental contract which came into force last April.

Again it is labour’s priority to try and spin the damaging news rather than actually fund a decent dental service.

The committee said it wanted to know “whether public confidence in the institute is waning, and if so why”, and said it would be looking at both Nice’s evaluation process and the appeal system.

At the same time it will compare the work of Nice with that of the body that is roughly its Scottish equivalent. In some cases the latter has approved treatments that Nice has rejected.

The pharmaceutical industry’s concerns that the NHS fails fully to implement Nice’s recommendations when it does back new treatments and procedures will also be addressed.

The committee said it wanted to look at “which guidance is acted on, which is not and the reasons for this”.

Nice is currently facing a judicial review backed by pharmaceutical companies and the Alzheimer’s Society over its decision on Alzheimer’s products.

The society said yesterday that the inquiry “should put a long-overdue spotlight on Nice’s methods” and the “glaring absence” of an independent appeals process.

http://www.ft.com/cms/s/659096bc-b32b-11db-99ca-0000779e2340.html

The Commons health committee’s whilst welcomed by Health Direct is long overdue.

On Fri 17 Nov 06 we noted that the Drugs watchdog faces legal review- NICE’s approach is irrational and flawed when a decision by the Labour government’s drugs watchdog to restrict the use by the NHS of Alzheimer’s medication is to be challenged in court. Two drug companies plan to apply for a judicial review of the way the National Institute for Health and Clinical Excellence reached its conclusion. NICE ruled NHS patients with newly diagnosed, mild Alzheimer’s disease should not be prescribed the drugs.

Neil Hunt, chief executive of the Alzheimer’s Society, said: “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 labour 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.”

The purchases would form a central part of a package of extra pandemic health preparation measures to be debated in the next comprehensive spending review this summer, which could cost more than £2bn.

The case for greater investment comes as the UK suffers its first significant outbreak in poultry of the H5N1 flu strain, which experts fear could form the basis for a mutation into a lethal human form.

Tamiflu, which the World Health Organisation has cited as a first line treatment for pandemic flu in spite of a still limited evidence base, is seen as pivotal to preparations, particularly since with current technology there are no effective vaccines that would be ready fast to protect against a pandemic flu strain.

Roche sells Tamiflu to governments for stockpiles at €15 (£9.90) per packet, so the additional purchases could be worth €700m-€1.1bn.

The larger stockpile would allow greater efforts to use the drug as a prophylactic, based on computer modelling conducted by Prof Neil Ferguson at Imperial College, London. This shows that there may be the possibility of diminishing the impact of a pandemic if those at risk of infection are treated before symptoms appear.

Currently, just 0.1 per cent of the 14.5m-strong stockpile is earmarked for such post-exposure prophylaxis.

Separately, purchases of more than £1bn have been proposed for face masks to limit the spread of infection, and antibiotics to treat the secondary infections likely to arise.

A year ago the government also paid £33m for sufficient “pre-pandemic” vaccine to protect 1.3m frontline health workers and key staff.

From
http://www.ft.com/cms/s/c6d178da-b586-11db-a5a5-0000779e2340.html

Health Direct has long warned that the govt’s efforts so far to protect the UK populace have been pathetic. On Nov 02, 2005 in The Chief Medical Officer labels N5H1 bird flu as ‘Public Enemy No1‘ when the Chief Medical Officer- Sir Liam Donaldson, called on NHS managers to ‘react as well’ to a flu pandemic as they did to the London bombings.

‘The NHS has got to take the pandemic seriously,’ he said. ‘We regard pandemic flu as public health enemy number one and we are on the march against it. The NHS needs to react as well to this pandemic as it did to the July bombings.’

He added: ‘I hope the urgency of the pandemic will make even the most uninterested managers make the move to develop a plan. With good planning and preparation we can reduce the impact of pandemic flu on the health of our population.’

Primary care trusts are being warned that they should expect to see at least 1,000 new flu patients a week during any pandemic and this figure could rise to over 5,000 at the virus’s peak.

Hospital admissions for acute respiratory and related conditions could increase by at least 50 per cent, with around 20,000 new patients a week at the height of the pandemic.

PCTs have been asked to draw up plans detailing how they would respond to a pandemic, which would be checked by the Department of Health to insure they were appropriate.

Sir Liam warned that the vaccine might not be available in time for the pandemic reaching the UK, but said the government was stockpiling 15 million anti-viral treatment courses to treat flu victims in the event of an outbreak.

Health Direct questioned what extra money was being allocated by the Labour govt to combat the flu epidemic when it does break- or is this yet another case of spin before truth?

The above was at least a better action that Labour’s “efforts” on Aug 19, 2005 when in Bird flu- Labour gives Doctors leaflets not vaccines it was announced that every doctor’s surgery in Britain will be sent official instructions on how to handle an outbreak of bird flu as ministers step up their preparations for a global pandemic that, if the worst fears are borne out, could kill up to 50m people.

The UK’s 10,465 surgeries will receive a package of information from the government to help tackle a flu pandemic, which scientists warn is now inevitable. Ministers and officials have privately expressed the view that a bird flu pandemic poses a greater threat than terrorism.

Each surgery will also be given 50 copies of a leaflet for patients. How very useful.

The Department of Health says up to 50m people could die worldwide, of whom between 50,000 and 650,000 would be in the UK.

Ministers are anxious to be able to demonstrate, if the virus strikes, that they have done everything possible to limit its impact.

Labour has been accused of failing to stockpile enough vaccines to combat the virus but officials say they cannot develop a jab until they know the exact strain.

Roche, the Swiss pharmaceutical group, is close to agreeing a donation of up to 3m doses of its antiviral drug, Tamiflu, to the World Health Organisation in an effort to limit the effects of a bird flu pandemic.

For a government obsessed with lies and spin over reality and improvement, this crass exercise is pathetic.

He was speaking at a recent conference with a wide range of interested parties at which concerns about the confidentiality and security of the system were aired, along with debates about how to get doctors, nurses and managers to own the programme, while speeding its implementation.

His conclusion that he had “seen no evidence” that a review was needed was greeted with disappointment by Martyn Thomas, a spokesman for 23 computer academics who have been calling for a review and who had earlier challenged Mr Nicholson to launch one.

The academics maintain that there remain questions about the technical architecture and security of the system while arguing that it is displaying many of the symptoms of past large scale IT failures.

Mr Nicholson said the programme did need to be reformed and needed to become more “self critical in a very open and public way”.

There were questions about whether it was trying to do “too much on too broad a front” and needed to be “focused down” on elements that could bring rapid benefits to patients, while the balance between national and local responsibilities needed to be resolved, he said.

Responsibility for implementation is being shifted away from Connecting for Health, the national programme, to strategic health authorities, with all NHS organisations now being told to produce and budget for an IT implementation plan.

However, the changes carry the risk that any significant slowing down of the project, or any big move away from national standardisation, could open up the NHS to claims for contract variation from the big suppliers – something both sides appear keen to avoid.

From:
http://www.ft.com/cms/s/29449c58-b263-11db-a79f-0000779e2340.html

When David Nicholson, the NHS chief executive, said nothing “has led me to believe that we are wildly off course” or that “a major review of the programme is required at this particular stage” he demonstrates either incompetence or deep ignorance.

Even the basic requirements for the Connected for Health IT system have yet to be decided:

Patients don’t like the proposals:
December 21, 2006
Patients win partial right to block medical records in U turn on CfH IT project
Labour Ministers have bowed to the complete distrust some patients have of the planned National Health Service electronic patient record by agreeing they will be able to place a total block on their records being uploaded to the system – rather than just a bar on them being shared. Precisely how they will be able to do that, however, has yet to be established ahead of pilot projects planned for the spring.

MPs don’t like the proposals
MPs will hold inquiry into £12bn (NPfIT) NHS IT plan
Wed 29 Nov 06- The House of Commons’ Health Committee has agreed to hold an inquiry into key facets of the £12.4bn NHS National Programme for IT (NPfIT) after some MPs expressed concerns that the scheme may be foundering. The decision reverses a resolution taken by the parliamentary committee only weeks ago not to hold an inquiry, and vindicates a campaign led by leading academics, Health Direct, Computer Weekly and MPs.

Doctors don’t like the proposals:
November 21, 2006
GPs revolt over patient files privacy on flagship IT system
About 50% of family doctors are threatening to defy government instructions to automatically put patient records on a new national database because of fears that they will not be safe, a Guardian poll reveals today. It shows that GPs are expressing grave doubts about access to the “Spine” – an electronic warehouse being built to store information on about 50 million patients – and how information on it could be vulnerable to hackers, bribery and blackmail.

Staff and users don’t like the proposals:
NHS and suppliers struggle with basics on CfH patient record system
Thu 2 Nov 06- The National Health Service and its suppliers are struggling to get in place the basic building blocks for the planned national electronic patient record (Connected for Health). The NHS financial deficit from last year and a shortage of resources to train staff appear to be compounding problems linking old systems with the new ones, as well as difficulties in migrating old data to the new systems.

Even the gravy train contractors don’t like the proposals:
Accenture drops out of NHS’s NPfIT IT project
Thu 28 Sep 06- US consultancy firm Computer Sciences Corporation has taken over as the largest regional contractor on the NHS’s troubled £6.2bn IT overhaul after rival group Accenture yesterday exited two 10-year contracts with the health service worth £2bn. CSC, already the lead contractor on a £973m contract in the north-west of England, is now charged with digitising the largely paper-based systems in GP surgeries, hospitals and other NHS trusts in the east and north-east of England.

So Mr Nicholson why continue with this “fundamentally flawed” IT project when you have the opportunity to review it’s purpose?

The primary care trust would retain a few core functions, including patient and public involvement, emergency planning and the handling of contracts.

The move would be a big step towards the government’s goal of turning the NHS primarily into a commissioning organisation. Provision in future will come from a mix of foundation hospitals, the private and voluntary sectors and social enterprise, but with the independent sector able to take part in the commissioning of care as well as its provision.

The trust yesterday insisted the proposal was only one of a number of options that would be put to the board in April. Anthony Sumara, Hillingdon PCT’s interim chief executive who was brought in to troubleshoot one of the NHS’s worst financial problems in London, was not available for comment yesterday. But he told the Health Service Journal that essentially, “I want to get rid of everything – outsource it”.

The trust would not be giving up responsibility because it would remain the statutory body, responsible for the outcome of the contracts. It would reduce staff numbers from about 300 to about 30, he said.

Hillingdon has an accumulated deficit of £54m on its £258m turnover and has been projecting a further £11m deficit this year. According to papers put to the board last week, “outsourcing the majority of commissioning functions . . . gives the greatest probability of success” in turning that round.

He acknowledges, however, that having to pay off £54m in debt will make it difficult to draw up a contract from which private companies could make a profit, and that Hillingdon on its own may be too small to attract private providers big enough to take financial risk on the deal.

The NHS is negotiating a framework contract with big UK and US health providers that would allow primary care trusts to access anything from help with number crunching to the sort of “end-to-end” commissioning service that Hillingdon is examining.

Nigel Edwards, director of policy for the NHS Confederation, said a number of PCTs were considering enlisting private sector help with commissioning. “But I am not aware of anywhere else considering anything remotely this radical.” With NHS commissioning in its infancy, drawing up such a contract would be “quite a challenge”, he warned.

From:
http://www.ft.com/cms/s/a9881978-b199-11db-b901-0000779e2340.html

On 27 Dec 06, Health Direct wrote in RIP NHS- the end of the National Health Service when the sad end to the National Health Service occurred when a private firm is awarded total control of NHS hospital in final erosion of National Health Service.

The first NHS hospital to be put under the total control of a private company was announced last week by the Department of Health. In a final erosion of the health service’s role as sole provider of healthcare for NHS patients, labour ministers have awarded a five year contract to manage the new Lymington New Forest Hospital in Hampshire to the Partnership Health Group, a partly owned subsidiary of Care UK. Doctors and nurses will be seconded from the NHS to work alongside staff employed directly by PHG.

Seems the NHS fragmentation is moving ever further.

Primary care trusts (PCTs) are seeing their budgets fall because too little money is being raised in dental charges. As a result the PCTs cannot pay the dentists and some are turning non paying patients away, the British Dental Association said yesterday.

Peter Ward, chief executive of the association said: “The BDA is aware that some PCTs are reporting anticipated shortfalls in the revenue they receive from NHS dental charges paid by patients.

“Our concern is that these PCTs are using money meant for dental care to plug these gaps in revenue, when there are patients in their area struggling to get NHS dental care and dentists ready and willing to provide it.”

Exempt patients include children and pregnant women, people on benefits, some war pensioners and some people on low incomes.

According to a memo seen by the BBC, the total amount of money from dental charges has been overestimated. It was anticipated that PCTs in England would get £630 million in charges, a quarter of the dental budget. But less money is coming in.

Jackie Sowerbutts, dental adviser to Surrey PCT, admitted that the trust had to say no to a number of requests from dentists for money.

“The labour government totally and utterly changed the system. It is not surprising the estimation [of patient charges] is turning out wrong. Many trusts are in this position,” she said.

Problems are being experienced in Surrey, Bradford, Sheffield, Norfolk, Coventry, London and Cambridgeshire, where a £2.2 million shortfall is expected, the BBC says.

In Coventry the shortfall is £600,000 and in Norfolk the budget is being cut by nearly £3 million. Sandra Gidley, health spokesman for the Liberal Democrats, said: “This is yet another botched NHS contract by a labour Government hell bent on driving through reforms with little understanding of the impact on patients and professionals.

“With many NHS Trusts deep in deficit, they simply cannot afford to bail dentists out of this latest labour Government-created problem. Their hands are tied.

“Rushed implementation of a system that was not tried and tested has led to the labour Government underestimating the number of exempt patients. The impact will be felt by all patients. It is simply unacceptable that patients seeking NHS dentistry are being encouraged to go private.”

A spokeswoman for the Department of Health said: “As this is the first year of the new system, it is taking time to build up an accurate picture of the amount of money being obtained.

“We will not know the final position until June, and we cannot yet predict with any confidence what the total charges collected over the year will be.

From:
http://www.telegraph.co.uk/news/main.jhtml;jsessionid=Q5CJX2WBYAY3FQFIQMGSFFWAVCBQWIV0?xml=/news/2007/02/01/ndocs101.xml

As the Dept of Health admit that they will not know for another 6 months what the true position for dentists will be- and that’s 3 months after this year’s financial allocation starts, then expect the same incompetence this time next year when the funds again run out.

On Oct 09, 06 Health Direct warned that Dentists abandon children on NHS when up to two-thirds of children in some areas of England are failing to get regular dental treatment as thousands of youngsters have been dropped by dentists no longer willing to provide free National Health Service care.

As more parents have been forced to pay for their children’s treatment, dental practices and health insurers have brought out special children’s policies to cover dental charges.

Derek Watson, chief executive of the Dental Practitioners Association, said: “Primary care trusts will say that, where children have been deregistered, other dentists who want to do more NHS work will be found for these children but, in practice, there are few dentists who want to do more NHS work.”

Thousands of dentists left the NHS at the end of March because they were unhappy with the new pay deal offered by the Department of Health. At that time, thousands of children were dropped by dentists who previously offered NHS care.

Health Direct warned on April 01, 2006 in D Day for Dentists- 1,000 dentists expected to quit NHS in contract row that an exodus of about 1,000 dentists from the NHS in England was predicted by the chief executives of primary care trusts, who take over untried and untested management of the service from today. The NHS Confederation provided the first hard evidence of how patients will be affected by a dentists’ contract that came into effect at midnight.

In the West Berkshire area more than 3,500 children have been dropped from NHS lists, while in Croydon it is more than 2,100, in Bromley 2,000 and in Sheffield 1,500. Across England just 45% of adults and 64% of children get regular treatment.

A recent study found that the proportion of 11-year-olds with tooth decay being treated has fallen by six percentage points in the past four years to only 42%, which researchers call a “disturbingly low” proportion.

Dentists believe access to the NHS will worsen because of labour government reforms to the way they are paid. A survey of local dental committees, carried out by the British Dental Association, showed 90% predict access to NHS dentistry will worsen.