Only 34 per cent said they would be happy to be treated, five per cent would be “very” happy with the prospect and 33 per cent could not decide.

The survey of 128,000 NHS staff in 326 trusts in England responded to the questionnaire from the Healthcare Commission, seeking information on how working conditions and the NHS could be improved.

Asked if their trusts put patients as the “top priority”, fewer than half agreed and more than a quarter (26 per cent) said patients were not the top priority.

The annual staff survey found the number of staff reporting injury or illness because of work fell from 22 per cent to 17 per cent between 2005 and 2006. Staff reporting mistakes of “near misses” that could affect patients’ safety fell from 49 per cent in 2003 to 38 per cent last year.

NHS employees reporting symptoms of stress caused by work fell from 39 per cent to 33 per cent over the year.

In the fight against hospital super bugs little changed over a year. Nearly a third, 31 per cent, said hot water, soap, hand towels or alcohol rub were not always available, compared with 32 per cent a year before.

Anna Walker, the chief executive of the Healthcare Commission, said: “The NHS is the fourth-largest employer in the world and this is believed to be the largest annual survey of staff in the world. It is vital that we hear loud and clear how staff are coping.

The organisation NHS Employers said staff had a “positive” view of working in the NHS but there were improvements to be made.

“There is clearly work that still needs to be done, particularly on tackling bullying and harassment and on the quality, effectiveness and frequency of appraisals. All staff should expect an annual, well-structured appraisal to help them achieve their full potential and over the coming year we will work with NHS organisations to ensure this happens,” he said.

A total of 59,695 physical assaults on NHS staff in England last year was down by 1,690 from 2004-05.

A spokesman for NHS Security Management Service said: “Although official figures suggest a downward trend in the amount of violence, a lot more work is still needed.”

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/03/30/nhs30.xml

Health Direct noted the dissillusionment of NHS staff to be treated in their own hospitals lat year on 28 Mar 06- Doctors opt to have private operations out of NHS

Hospital consultants are 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.

Dr Sarah Burnett, a consultant radiologist in London who worked in the NHS for 15 years, said she took out private medical insurance while she was employed in the state service because she was unimpressed with the level of care she witnessed first hand.

“NHS treatment is not a pleasant experience in any way — from the standard of the food, to ward cleanliness and the chance of catching MRSA,” she said. ]]> http://www.healthdirect.co.uk/2007/03/nhs-staff-wouldnt-be-treated-at-their-own-hospital.html/feed 0 http://www.healthdirect.co.uk/2007/03/hewitt-u-turn-as-hospital-trusts-to-be-free-of-rba-rule.html http://www.healthdirect.co.uk/2007/03/hewitt-u-turn-as-hospital-trusts-to-be-free-of-rba-rule.html#comments Thu, 29 Mar 2007 18:09:00 +0000 Dr Search- Principal Consultant at the Search Clinic http://healthdirect.clickinnovation.co.uk/?p=766 An accounting rule that has plunged more than two dozen hospital trusts into an irrecoverable financial position is to be ditched, Patricia Hewitt, the health secretary, announced yesterday. Now “absolutely confident” that the National Health Service would record a small surplus at the end of this financial year, Ms Hewitt said it could now use part of the £450m contingency reserve that strategic health authorities had built up to find the £179m needed to end a rule that the health department had long accepted was “unsustainable”.

Under resource accounting, a trust that overspends not only has to pay that money back the next year, but has to do so after the same amount is knocked off its budget.

The “double whammy” rule had affected 28 NHS trusts, “making it impossible for them, in some cases, to get out of debt”, Ms Hewitt said.

The accounting rule will still apply to primary care trusts as they are chiefly purchasers, not trading bodies like hospitals.

Some of the 28 trusts will now record a small surplus. Others, however, including Hinchingbrooke, the Queen Elizabeth in Woolwich, Whipps Cross and Mid-Yorkshire, will still be left with deficits not caused by the accounting rule that range from £12m to £21m. These will still have to be paid off over time.

Ms Hewitt told the Financial Times there remained “a small number” of hospitals – thought to be between 15 and 20 – with financial positions so serious that they were unlikely on their own to recover.

With the first takeover of an NHS hospital by a foundation trust expected to be formally approved this week, further foundation trust takeovers “may well be the solution in some cases”, she said, “but it won’t be the solution in every case.”

One surprise is that detailed work has shown the “double whammy” effect on hospitals – which has been inconsistently applied across the NHS – is smaller than original estimates that it would cost £500m to £600m to remove.

Ms Hewitt said the ending of the rule was the final part of a big set of financial reforms that would make the NHS finances “much more transparent” and “much fairer” in future.

They would end a trend that had seen healthier but overspending parts of the country being subsidised by other parts, chiefly in the north and Midlands, that had bigger health problems but which had, nonetheless, tended to break even or make surpluses, she said.

From:
http://www.ft.com/cms/s/26d60290-dcca-11db-a21d-000b5df10621.html

The inequity of Resource Accounting and Budgeting (RAB) was highlighted by Health Direct on Dec 14, 2006 in Unsustainable NHS resource account and budgeting (RAB) rules to stay- Hewitt insists when the health department postponed a decision to scrap a set of accounting rules- that have plunged some NHS trusts into potentially irrecoverable financial deficit.

The NHS Confederation, which represents health authorities and trusts, said yesterday that it was disappointed at the decision which came despite the health department accepting that the application of the rules to individual NHS trusts “will become increasingly unsustainable”.

Under resource accounting and budgeting, not only does an overspend have to be paid back but the same amount is knocked off the budget for the succeeding year. As a result a £10m overspend on a £100m budget has to be paid back from a budget that has been reduced to £90m.

The refusal of Hewitt to halt the Resource Account and Budgetting farce nails once and for all the lie that the NHS cutbacks are part of a process by Labour ministers to improve the NHS’s services.

These accounting cutbacks are the purely the result of Brown and Milburn’s incompetent stitch up in 2002 when they tried to agree a new funding process for the NHS.

As the inflated workforce had to be paid, hospitals and trusts plunged into deficit, the Commons Health Select Committee report says. Now posts are being left empty or lost, and a few NHS workers are being made compulsorily redundant. More than half of newly qualified physiotherapists have failed to find work in the NHS.

The MPs are scathing about the failure to maintain a link between staff numbers and the money available to pay them. Instead of raising productivity to meet targets, the NHS “threw new staff into the task rather than consider the most cost-effective way of doing the job”, the report says.

It calls the staff expansion “reckless and uncontrolled” and says that funding increases were often seen as a blank cheque for recruiting new staff.

There is also criticism of generous contracts. “Large pay increases were granted without adequate steps being taken to ensure increases in productivity in return,” it said.

The committee urged the Government to make workforce planning a priority, and for an end to constant health service reorganisation.

Stephen O’Brien, the Shadow Health Minister, said: “Top-down workforce targets imposed by Labour have created confusion amongst NHS staff. Patients are bewildered about where all the money has gone, and hard-working staff are losing confidence by the day in Labour’s stewardship of the NHS.”

The British Medical Association did not entirely endorse the report, however. Sam Everington, its deputy chairman, said: “While agreeing wholeheartedly that integrated workforce planning must be a priority… we do not agree that the expansion of the medical workforce was reckless
and uncontrolled and that pay increases for doctors have not seen a return in productivity.

“The UK is still critically short of doctors and the BMA has always believed that government goals to increase doctor numbers were too low.”

From:
http://www.timesonline.co.uk/tol/news/uk/health/article1555642.ece

Labour’s disasterous failure to properly manage NHS staffing levels was commented on 24 Nov 06- in NHS staff pay rises claim half of extra £5.5bn funding when almost half of last year’s £5.5bn increase in health spending in England went on higher pay, the latest figures from the Department of Health show.

This year, the department also expects to incur a redundancy bill of about £400m from shrinking the number of strategic health authorities and primary care trusts.

The redundancy bill, which excludes any redundancies from National Health Service trusts shedding jobs to balance their books, is four times the projected overspend for this year. In addition, the department spent a mighty £133m on external consultants last 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”.

NHS antenatal classes have been cut or suspended in at least 10 areas in England and Wales, according to the NCT.

These are Romsey in Hampshire; Worcestershire; Newham in London; Watford; Gwent in south Wales; south-west Kent; Nottinghamshire; Gloucestershire; Hemel Hempstead in Hertfordshire; and Wiltshire.

The NCT said it also understood that postnatal home visits have been stopped or are facing cuts in Wiltshire and in east and north Hertfordshire, which would mean new mothers have to travel to a clinic in order to receive after-birth care.

An NCT spokeswoman said: “These cuts in maternity services may reflect a more widespread pattern. The NCT is concerned that these short-term measures to ease financial deficits are having a negative effect on new parents and parents-to-be, preventing them from getting the information and support they need at this important stage in their lives.”

From:
http://www.guardian.co.uk/uk_news/story/0,,2043159,00.html

Health Direct points out that while the number of births rose from 563,744 in 2001 to 613,029 last year, the number of midwives dropped. In 2005 there were 24,808 midwives, 36 fewer than the previous year.

Midwife cuts
— Trusts are cutting budgets for midwifery training, in some cases by 75 per cent or completely
— Many midwifery units now depend on charitable donations to fund training
— Two thirds of midwifery managers say that their department is understaffed
— Thirty-eight per cent say that they have suffered budget cuts
— Twenty-seven per cent say that their Primary Care Trusts froze recruitment in 2005-06. A fifth say the freeze has not been lifted
— There were 24,808 midwives in NHS England, in 2005
— Since 2001, the annual number of births has risen by 49,285 to 613,029

On Jan 10, 2007 Health Direct posted that Maternity cash is cut amid boom in birthrate, say midwives as 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.

Dr Michael Williams, vice-president of the Royal College of Radiologists and co-author of the report, said that, in addition, some patients were not receiving enough radiotherapy.

Williams said: “One problem is delays in some areas of the country and the other is that, when patients are treated, they receive fewer fractions [doses] of radiation than they would receive elsewhere in Europe and America.”

It is understood that the report, co-authored by Mike Richards, the government’s “cancer czar”, also says that the NHS is administering only about half the amount of radiotherapy needed to treat British patients properly.

Williams has research showing that, in Britain, only 28,000 doses of radiation are given per million people compared with the recommended 54,000.

Williams accepts that the government has invested heavily in radiotherapy since 2000, but he says: “Restricted access to radiotherapy services means that some British cancer patients are dying.”

The government report has been subject to repeated delays. A draft was ready in August and the document has been with health ministers since February. Critics suspect the Department of Health (DoH) will suppress it until it is ready to announce a new plan to improve cancer services in the autumn.

Maidstone and Tunbridge Wells NHS Trust is investigating claims by consultants that three patients have suffered a return of their breast cancer during the long delay between their operation and the radiotherapy.

Peter Jones, a breast surgeon at Maidstone hospital, said: “We have examples of people who have actually developed recurrent cancers in the breast while they have been waiting for their radiotherapy. Over the last three years, we have been aware of this happening in three cases.”

Professor Karol Sikora, medical director of CancerPartners UK, a private company set up to treat NHS patients, added: “In some areas people are getting scarcely any radiotherapy. They are often old, poor, uneducated and forgotten about.”

A DoH spokesman said: “The government has already taken action to improve radiotherapy services. However, we do know there is more to do. The report has only recently been submitted to ministers.”

http://www.timesonline.co.uk/tol/life_and_style/health/article1563920.ece

As Health Direct pointed out on Friday, January 06, 2006 Labour ministers promises on ambitious 18 week maximum wait for surgery the 18 week process involves moving patients through three stages. From the initial visit to the GP, the patient has to go to a first outpatient appointment, then through any diagnostic tests that are needed and finally on to the operation itself once a decision to admit has been taken.

But an analysis of Department of Health data by the Financial Times shows that the government will miss its target without additional capacity and reform of the way the service operates.

Referring to the latest waiting times published in January 2006 “What these figures show,” according to Alan Maynard, professor of health economics at the University of York, “is that of the three elements needed to get to the overall 18-week target, one is falling far too slowly, one is unknown but may well rise before it falls, and the third – the time spent on the waiting list before an operation – is actually going in the wrong direction.

“Unless something changes radically, the government is going to miss its target”. 6 months on and with 17,000 NHS staff since having their jobs axed- Professor Maynard’s comments are as valid now as they were then.

Now it seems as though cancer patients- who are supposedly a high priority for Labour, are dying because of cash shortages in the key radiotherapy departments there appears to be little chance of achieveing the 18 week target when technological shortages remain the bottleneck.

Scientific evidence shows that heroin and cocaine are correctly ranked as class A drugs as they do cause the most harm. But LSD and ecstasy come close to bottom of the league in terms of harm caused, yet they are also labelled as class A.

Alcohol is legal and widely used but comes fifth in the “harm” table, ahead of amphetamines and cannabis, which are ranked as class B and class C respectively. Tobacco is also ranked as more harmful than cannabis.

The league table of 20 drugs drawn up by drugs specialists is intended to provide a scientifically based model for policy makers of the harm they cause. It shows that the dangers they pose bear little relationship to the official classification, on which the penalties for drug use are based. The eight drugs ranked as most dangerous include two that are unclassified while the eight judged least dangerous include two class A drugs.

The report comes a fortnight after an independent commission called for a radical overhaul of Britain’s drug laws which it said were driven by a “moral panic”. The commission, set up by the Royal Society of Arts, said the aim of public policy should be to reduce the harm drugs cause, not send people to jail. It proposed reclassifying drugs – legal and illegal – according to the harm they do.

Professor David Nutt, who works in addiction psychiatry at the University of Bristol and who led the latest research, said: “The current drug classification system is arbitrary in the way it assesses harms. It is not fit for purpose.

We have tried to come up with a better system by looking at the factors that contribute to drug use and the harms they cause. We should review the penalties for drug use in the light of the harms they cause and have a more proportionate response.”

Professor Colin Blakemore, chief executive of the Medical Research Council and co-author of the study, said: “The object was to bring a dispassionate approach to a very passionate issue. Some conclusions might appear to be liberal in stance, but that was not our starting position. We intended to reach conclusions that were evidence-based.”

“Alcohol and tobacco are way up there in the league table, not far behind heroin and cocaine and street methadone. Society has not only come to terms with alcohol and tobacco but is well aware of the harms associated with them so we felt it was useful to include them as calibration points for other drugs.”

All drugs were marked on the physical harm they caused to the individual user, their tendency to cause dependence and their social harm, including their effect on families, communities and society [such as crime and NHS costs]. Each was given an overall harm score by two separate groups of experts which yielded roughly similar results.

There was little evidence that ecstasy caused extensive harm, despite its widespread use by young people in clubs and pubs at weekends. Cannabis has been cited as a cause of schizophrenia but the authors said a causal relationship had not been established. If it were, evidence showed no more than 7 per cent of cases could be attributed to use of the drug.

Professor Leslie Iversen, of the University of Oxford, said there was a widespread myth that skunk, from the tips of the cannabis plant, was 20 to 30 times more powerful than that available 30 years ago. “It is simply not true,” he said. “The Advisory Council on the Misuse of Drugs looked at this carefully. Cannabis resin [hash] has changed little and is about 5 per cent tetrahydrocannabinol (THC). Skunk has 10-15 per cent THC. That makes it two to three times more powerful, not 20 to 30 times.”

The study, which took five years to complete, is published today in The Lancet. Professor Blakemore said: “We hope that policy makers will take note of the fact that the resulting ranking of drugs differs substantially from their classification in the Misuse of Drugs Act and that alcohol and tobacco are judged more harmful than many illegal substances.”

From:
http://news.independent.co.uk/uk/health_medical/article2383902.ece

Health Direct carried a series of posts last year by the scientific community on the risks of taking drugs compared to the “not fit for purpose” UK drugs laws.

Since then despite a number of high profile crimial offences being reported as being carried out under the influence of drugs and the pressure from the House of Commons Science and Technology committee- what has labour done about this? Absolutely ziltch.

Aug 02, 06. Risks of drugs scientifically compared- “Not fit for purpose” drugs laws criticised-
Risks of taking drugs compared- Scientific review of dangers of drug taking- Drugs, the real deal Health Direct reproduces the first ranking based upon scientific evidence of harm to both individuals and society of taking drugs. It was devised by government advisers- then ignored by Labour ministers because of its controversial findings.

The analysis was carried out by David Nutt, a senior member of the Advisory Council on the Misuse of Drugs, and Colin Blakemore, the chief executive of the Medical Research Council. Copies of the report have been submitted to the Home Office, which has failed to act on the conclusions.

Aug 01, 06- Drug classes have little link to the dangers Following on from yesterday’s post MPs demand changes to classification of illegal drugs by the Commons Science and Technology Committee, the Home Office has now been warned by its own senior advisers that alcohol and tobacco are more harmful to the nation’s health than the Class A drugs LSD and ecstasy.

Britain’s antiquated drugs laws stand accused of failing millions of people because they bear little or no relationship to the harm caused by everything from a hit of heroin to a seemingly harmless pint of lager.

On July 31, 06- MPs demand changes to classification of illegal d
rugs The ABC system of classifying illegal drugs should be replaced with a more scientifically based scale of harm, a committee of MPs will say today.

In a scathing report entitled Drug Classification: Making a Hash of It?, the Commons science and technology committee says there is no consistency in the way drugs are classified A, B or C and no evidence to support the official view that the classification has a deterrent effect. ]]> http://www.healthdirect.co.uk/2007/03/risks-of-drugs-tobacco-and-alcohol-are-more-dangerous-than-lsd.html/feed 0 http://www.healthdirect.co.uk/2007/03/mps-expose-lack-of-control-over-nhs-billions.html http://www.healthdirect.co.uk/2007/03/mps-expose-lack-of-control-over-nhs-billions.html#comments Thu, 22 Mar 2007 08:46:00 +0000 Dr Search- Principal Consultant at the Search Clinic http://healthdirect.clickinnovation.co.uk/?p=771 A devastating insight into financial mismanagement at all levels of the NHS- from Labour ministers down to hospital bureaucrats- is provided by a committee of MPs. The report by the all party Public Accounts Committee exposes how billions of pounds of taxpayers’ money is being poured into a health system with inadequate financial controls and low levels of accounting expertise. The MPs conclude that NHS structures are so inadequate that the Department of Health has no idea what the effect of last year’s total deficit of £570 million is having on patient care.

The deficit was recorded despite a massive rise in NHS spending from £69.7 billion in 2004-5 to £76.4 billion in 2005-6. In this financial year the amount being pumped in will soar again to £92.6 billion.

Edward Leigh, the chairman of the committee, said “weak control of finances” and “lack of interest” by doctors in the sums they were spending were to blame for many of the deficit problems.

In no less than one in three NHS organisations, auditors had raised concerns “about the financial management capabilities of general management”.

In one in four they were worried about the financial performance of non-executive directors.

The committee said that while the Department of Health had no “overall picture” of the effect of deficits on services to patients, it was clear they were adversely affecting the level and quality of care.

“Dealing with financial pressure diverts resources away from normal strategic operational priorities,” the report said.

“If a body’s management are concerned chiefly with recovering a deficit, they may be unable to give sufficient attention to issues such as clinical performance or current NHS restructuring.”

Andrew Lansley, the shadow health secretary, said the report showed ministers had ”no idea about the impact of their mismanagement on local NHS services” and exposed a “worrying lack of financial expertise in Whitehall”.

The committee said “errors” by the Department of Health in estimating the cost of three national pay initiatives for nurses, doctors and consultants were responsible for many of the problems, leaving the NHS having to fund a shortfall of £560 million.

Dr Peter Carter, the general secretary of the Royal College of Nurses, said it was very disturbing that the department had no clue about the effect of deficits on services and jobs. “It’s time for the Government to come clean. Ministers need their advisers to tell them just how damaging the deficits crisis has become and acknowledge the Government’s responsibility to work with front line staff to find a long-term solution.”

The Local Government Association said the deficits in some hospital trusts were having knock on effects on council services.

Sandy Bruce-Lockhart, the chairman of the LGA said: “Health and social care are two sides of the same coin and a financial crisis on one side is having an impact on the other.

“In the next three years alone, there will be over 400,000 more older people, many of whom will require social care. Without additional funding local government may potentially face a situation, by as early as 2009, where it cannot afford to provide support to the 370,000 elderly people with lower levels of need.”

Dr Gill Morgan, the chief executive of the NHS Confederation, said they were working “harder than ever” to achieve financial balance.

“It is important to remember that NHS deficits are concentrated in a relatively small number of organisations with over 50 per cent of the deficit in just six per cent of trusts,” she said.

A recent survey of NHS trust chief executives showed that three out of four trusts are already restricting patients’ access to treatment as they struggle to control deficits. The same survey found that half were delaying operations as they battled to save money.

Meanwhile, figures produced by the independent health think tank, the King’s Fund, showed that less than a third of the extra money spent on the NHS is actually going directly to improve health care and front-line services. Of the £19 billion spent by the Government on hospital and community health since 2003, £6.6 billion had gone on extra pay for clinical staff.

A further £2.2 billion went on the rising cost of drugs; £1.6 billion went on hiring more doctors to meet new EU employment laws on working hours; £1.1 billion went on new buildings and equipment; £1 billion went on equipment and £600 million on negligence law suits.

This left only £5.9 billion to spend on improving performance such as reducing waiting lists, the extension of day surgery and more nurses and consultants.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/03/20/nhs120.xml

The issue of Labour’s waste on the NHS finances continues to brew ominously for patients.

MPs only recently (30 Jan 07) in MPs want greater scrutiny of PFI hospitals to prevent more waste Health Direct posted that hospitals built under the Private Finance Initiative (PFI) must be subject to much “closer and sustained scrutiny” if millions more pounds are not to be wasted, the Public Accounts Committee said. Estimated capital costs for 17 PFI schemes approved by the end of 2005 have more than doubled – up by some £4bn to £13bn.

The figures, which emerged in a response to a Parliamentary Question tabled by Shadow Health Secretary Andrew Lansley, showed that the NHS would pay a total of £53bn to the private firms involved.

And last year (Fri 5 May) Health Direct highlighted the GPs’ out of hours opt out Out of hours GP shake up attacked as “shambolic” as £70 million is overspent when the shake-up of the out of hours health care system in England was “shambolic” and led to longer waits and higher costs, a committee of MPs has said.

New providers are spending 22% more but are not meeting key targets, the public accounts committee claimed. Fewer than 10% of primary care trusts met targets on assessing patients within 20 minutes of an urgent call the National Audit Office found. ]]> http://www.healthdirect.co.uk/2007/03/mps-expose-lack-of-control-over-nhs-billions.html/feed 0 http://www.healthdirect.co.uk/2007/03/warning-over-cuts-to-subsidies-on-drugs-advice.html http://www.healthdirect.co.uk/2007/03/warning-over-cuts-to-subsidies-on-drugs-advice.html#comments Wed, 21 Mar 2007 08:19:00 +0000 Dr Search- Principal Consultant at the Search Clinic http://healthdirect.clickinnovation.co.uk/?p=772 Looming cuts to funding for independent prescription advice for doctors could undermine the best use of medicines in the UK, a senior medical figure warned yesterday. Sir Charles George, director of the British Medical Association’s BMJ Group, which publishes a range of guides for doctors, said: “We’re worried that a number of sources of information about good prescribing have disappeared.”

His comments came against a backdrop of concern over a growing trend by the Department of Health to stop subsidising publications for prescribers that are designed to provide objective information free from -pharmaceutical companies’ influence.

He was speaking ahead of the launch this week of the latest edition of the twice-yearly British National Formulary, which is produced by the BMJ and which a new survey showed was the preferred medicines reference guide for GPs.

The BNF is distributed free of charge, thanks to government subsidies, to 185,000 prescribers in England alone. However, the DoH threatened at the end of last year to stop subsidising its distribution to medical students in England.

There was a last-minute reprieve after complaints, but Sir George said there had been no assurances that the subsidy to students would not be removed before the next issue of the BNF this autumn.

The threats to the BNF follow a pattern of reductions in government support in England in recent months for other independent assessments of medicines, at a time of growing demand internationally for such information.

The government last year removed the subsidy in England from the Drugs & Therapeutics Bulletin, a source of treatment information for GPs, which has led to subscriptions falling to one-sixth of their previous level.

From the start of this year, it also stopped funding Clinical Evidence, another regular guide produced by BMJ, and Best Treatments, a service that provided information on medicines to patients through the NHS Direct website.

From:
http://www.ft.com/cms/s/0d1c88e0-d5bf-11db-a5c6-000b5df10621.html

On June 13, 2006 Health Direct questioned the action of cutting the dissemination of best drugs practice as a means of costs savings in Doctors fight to save the Drug and Therapeutics Bulletin drug guidance from government axe

A highly respected and influential journal which gives doctors independent advice on the drugs they prescribe is set to close because the government is withdrawing its funding after 40 years.

The Drug and Therapeutics Bulletin is sent to every doctor in the country and offers what many describe as highly readable guidance on the value of sometimes heavily marketed pills. But the Department of Health has refused to renew its contract.

Senior doctors have signed a statement of protest, and more than 2,000 have written to ministers, including Patricia Hewitt, the health secretary.

DTB is “highly valued and trusted” to give independent and reliable information about drugs, the statement says. Its conclusions “are also widely regarded as a unique counterweight to the influence of the pharmaceutical industry”.

Health Direct notes that the closure of the trusted Drug and Therapeutics Bulletin is another sorry example of the Labour government’s short term NHS cost cuts. In comparison to the annual £1.4 m cost of the DTB, the NHS’s drugs bill is around £11 billion a year.

Even a cursory cost benefit analysis indicates that a 0.1% saving on the drugs bill will pay for the preservation of the DBT eight times over. ]]> http://www.healthdirect.co.uk/2007/03/warning-over-cuts-to-subsidies-on-drugs-advice.html/feed 0 http://www.healthdirect.co.uk/2007/03/the-cost-of-hospital-parking-95m.html http://www.healthdirect.co.uk/2007/03/the-cost-of-hospital-parking-95m.html#comments Tue, 20 Mar 2007 18:02:00 +0000 Dr Search- Principal Consultant at the Search Clinic http://healthdirect.clickinnovation.co.uk/?p=773 NHS hospitals were yesterday accused of exploiting the “most vulnerable” after they were found to have made more than £95 million in parking charges last year. Patients attending for treatment and relatives or friends visiting people in hospital were charged up to £3.50 an hour despite paying to build car parks through their taxes.

Last night, the cancer charity Macmillan, which obtained details through Freedom of Information, called for an end to the “shameful” charges. Two trusts each raised more than £2 million and a further 30 raised more than £1 million each from “outrageous charges on the weak and vulnerable”.

Southampton University Hospitals NHS Trust took £2,414,672 and Cambridge University Hospitals NHS Foundation Trust took £2,263,297.

Patients and visitors often have no choice but to use hospital parking, which used to be free. Some out-patients are too weak to walk further from their car and many of those who visit in-patients are themselves elderly or infirm.

The charity Macmillan Cancer Support Research raised the parking issue yesterday on behalf of cancer patients who have to make regular hospital visits. It said the £95 million total was shocking.

Judy Beard, Macmillan’s acting chief executive, said: “Cancer patients spend hundreds of pounds each year on hospital parking. Macmillan wants to see all cancer patients travelling regularly for treatment to be able to park free.

“It’s shameful that cancer patients are still paying to park at hospital. The Government should step in and introduce stronger regulations.”

Katherine Murphy, of the Patients’ Association, said: “It is disgraceful that the NHS should exploit the most vulnerable people. It is totally wrong to take money off people who have to attend hospital and those who visit them.

“We would like to know what happens to this money. Is it ploughed back into patient care or is it used to make car parks safer for staff?”

Patient watchdogs and MPs have called hospital parking fees a “tax on sickness”.

The £95 million does not tell the whole story because 74 trusts supplied no figures.

Hospitals have also started to charge for bedside telephones and television sets and many have replaced charity-run cafes with more expensive cafeterias.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/03/20/nhs20.xml

The issue of ad hoc NHS charges was raised on July 19, 2006 in Health Select Committee finds the system of NHS health charging is a mess as the House of Commons Health Select Committee in it’s report on health charges finds that the system of health charges in England is a mess.

Charges for prescriptions and dentistry have been in place for over 50 years and sight tests for almost 20 years. They have not been introduced following detailed analysis of their likely consequences; rather they have come about piecemeal, often in response to the need to raise money. There are no comprehensible underlying principles. The charges remain largely for ‘historical’ reasons.

In recent years, hospital patients and their visitors have also had to pay increasing sums for non-clinical services, such as car parking and bedside telecommunications. International research has shown that health charges have a negative effect on health, and that patients with long-term illnesses suffer particularly when charges are in place.

There is also some survey-based and anecdotal evidence which suggests that patients are less likely to visit their dentist or have prescriptions dispensed in full because of the costs.

The House of Commons Health Select Committee report also looked at other NHS charges and stated:

The recommendations will not address the fundamental problems in the current system of health charges. Little work has been done in this country on the costs or benefits of the different possible systems.

This work needs to be done urgently so that an alternative charging system, with consistent underlying principles, can be developed. The Government should undertake a major review to assess the costs and benefits of the following:
• abolishing all the existing health charges;
• abolishing only the prescription charge;
• abolishing only charges for initial consultation and diagnosis, such as dental check-ups and eye tests;
• establishing a system of reference pricing for medicines;
• completely revising the medical exemptions to the prescription charge;
• introducing a flat-rate prescription charge with no exemptions; and
• basing exemption to charges solely on income so that those who can afford to pay for their prescriptions, dental care and sight tests do so.

The review should also consider a system of charges appropriate for future challenges. In the future, the NHS may not be able to pay for every possible medical treatment in a country with an ageing population, demographic pressures, rising public expectations and increased possibilities of medical treatment and long-term therapies. ]]> http://www.healthdirect.co.uk/2007/03/the-cost-of-hospital-parking-95m.html/feed 0 http://www.healthdirect.co.uk/2007/03/junior-doctors-recruitment-this-is-a-fight-we-cannot-afford-to-lose.html http://www.healthdirect.co.uk/2007/03/junior-doctors-recruitment-this-is-a-fight-we-cannot-afford-to-lose.html#comments Mon, 19 Mar 2007 17:49:00 +0000 Dr Search- Principal Consultant at the Search Clinic http://healthdirect.clickinnovation.co.uk/?p=774 Some 12,000 people took part in Saturday’s march through central London. That represents more than one in three junior doctors in Britain. Consider that another one in three or four was working or asleep between nightshifts, and that most doctors have not been on a march before, and you will understand the scale of the anger.

The disastrous overhaul of the way in which junior doctors are selected and trained to become consultants is the most serious threat to the patient care and the health service that we have witnessed, and the ramifications are frightening in scope.

Junior medics and surgeons carried banners, chatted and caught up with old friends. Placards were heartfelt: “Our training, your health care, their mistake” and “Don’t dumb down doctors”.

I met people I hadn’t seen since medical school, doctors I had worked with in A&E;, and friends who have been locked away in hospitals all around the country. Everywhere, the stories were the same: no interviews offered, or one perhaps – in Wales.

One friend from university summed up her feelings after being informed, by a computer program, that she had not been successful. “You just think, all those years, all those degrees…”

The mood overall was one of determination: this is a fight that is too important – to us and to our patients – to contemplate losing.

We are protesting against an ill-conceived, centralised attack on the integrity and quality of the medical profession. As a leaked Department of Health memo revealed at the beginning of the year, medical unemployment is seen by the Government as useful to create a downward pressure on wages.

In the context of New Labour’s ideological commitment to introducing market principles and corporate provision into the NHS, this makes sense. In the context of providing safe, high quality health care to Britain’s patients, it does not.

Excellent physicians and surgeons are not readily replaceable. They have to be trained well, for a long time and to exacting requirements. I started at medical school in the year that Tony Bliar took office.

Ten years ago, my colleagues and I were among the brightest and most idealistic school leavers in the country; for the past four, we have worked tirelessly in dreadful conditions. For those of you unfortunate enough to have required our services, we are the doctors who treat you in casualty in the middle of the night, carry the crash bleeps, thrombolyse you when you have a heart attack, resuscitate you, and treat your life-threatening injuries after a car accident.

We routinely work for longer than our contracted hours because medicine is a vocation rather than a job and to leave on time would be dangerous.

This is the situation, with full medical employment.

A deliberate attempt to destabilise the profession, in the hope that it will lessen our power to insist on working to clinical priorities, rather than political and commercial ones, is what the Americans would call a deal-breaker.

As we walked toward Russell Square past the British Medical Association, I was reminded of the London bombs 18 months ago during which my friends and I worked treating the injured. How quickly people forget.

This labour government knows the price of everything and the value of nothing. A downgraded, under-trained, biddable medical workforce might be a cheaper way to meet flashy paper targets, but if we don’t put a stop to this, every one of us will know the true cost.

By Sarah McMahon, a junior doctor, in:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/03/19/ndocs319.xml

The plight of junior doctors is terrible, as the above shows. Health Direct have been watching this labour created fiasco and have recently posted a couple of posts in:

8 Mar 07- Climb down over junior doctor fiasco MMC MTAS IT system The Labour govt backed down yesterday and agreed to an immediate review of a flawed selection system that has left thousands of able young doctors without the prospect of a job and many threatening to leave the NHS. The independent review will start today and may recommend changes to the system before the current interview round has been completed.

7 Mar 07- Doctors who face the dole as MMC’s application IT system remains as fiasco given all the emphasis on investing in and improving the NHS, the idea of a wave of doctor unemployment seems a nonsense.

Alarmingly, however, it is very much a reality. Last week, the fears of thousands of junior doctors were realised when they failed to secure interviews for trainee consultant posts under a new fast-track system called Modernising Medical Careers. The doctors who missed out are left
wondering whether to try to retrain in another speciality, emigrate, or leave medicine altogether. ]]> http://www.healthdirect.co.uk/2007/03/junior-doctors-recruitment-this-is-a-fight-we-cannot-afford-to-lose.html/feed 0