Gordon Stalin Brown’s immediate priority is to restore stability and financial stability to the National Health Service, which is grappling with Tony Bliar’s market-based reforms. The underlying objective is to restore public trust in the health service and recover Labour’s poll lead over the Conservatives on health.

Patricia Hewitt, the outgoing health secretary, restored financial balance to the NHS as a whole. But there remain big problems in a minority of trusts and Ms Hewitt was criticised in private by colleagues for her poor communication skills and strained relations with the workforce.

Mr Johnson is seen as a conciliator rather than an innovator. His task is to improve relations with NHS staff and project an image of order and stability. If this means slowing reforms, such as extended choice of hospitals and payment by results, Mr Johnson is likely to do it.

The public-sector unions will remember the deal he struck preserving civil servants’ generous final salary schemes and they welcomed his appointment yesterday.

“He is someone we can do business with, and it presents staff, patients and government with a clear opportunity to make a fresh start,” said Dave Prentis, general secretary of Unison.

From:
http://www.ft.com/cms/s/4b662fac-25dd-11dc-b338-000b5df10621.html

After the reigns of John “not fit for purpose” Reid and then Patricia “best year ever” Hewitt the arrival of Alan Johnson the new Heath Secretary looks to be a positive move for the NHA staff.

One of his top priorities will be paying his staff- now that the NHS is in the black Labour can afford to pay the miserly annual pay awards in full and not staged as currently suggested.

Coroner John Pollard urged the NHS to consider the impact of reforms on staff as he recorded a suicide verdict.

He said: “I find it extremely sad that a young woman with such a lot going for her has been reduced to this state of despair. When people introduce these rules and systems, perhaps a bit more thought as to what effect they will have on people would be helpful.”

The inquest heard that Miss Wilson, who lived alone in Sale, Greater Manchester, found her position at work was made increasingly difficult by the Agenda for Change review, which was aimed at making NHS jobs and salaries fairer.

Her own job was reclassified two grades higher. But dieticians at Wythenshawe Hospital did not receive any improvement in their pay scale, although their colleagues at other hospitals in the area were promoted and received higher salaries.

Miss Wilson lobbied hospital chiefs on behalf of her staff but was told there was no money to improve their pay.

She was also upset because a failing student alleged that she had suffered discrimination at the hospital.

Neil Wilson, Morag’s father, visited her in December last year to hear her sing in a hospital choir in Manchester.

He said she felt unable to enjoy a tea break with her staff because they would stop talking as soon as she walked into the room.

Mr Wilson said: “They made her feel as if possibly she was to blame for them not being upgraded, they made her feel so bad she took her tea into her office.”

Mr Wilson, who lives with his wife Betty in Aberdeenshire, described how he found his daughter being sick because she was so worried about a meeting with the failing student and other work issues.

After the meeting she told her father that the student had been aggressive.

Mr Wilson heard his daughter moving about the house at 5am the next morning but went back to sleep.

He was woken again at 5.30am by a phone call but no one replied when he answered. Mr Wilson now believes it was his daughter calling before she committed suicide.

Minutes later, police found Miss Wilson’s car on the hard shoulder on the section of the M60 that crosses the Manchester Ship Canal near the Trafford Centre shopping complex.

Police found her handbag with a kitchen knife inside. Officers arrived at her home just as her father was filing a missing persons report.

Divers found her body in the canal four hours later. After finding stab wounds on her chest, detectives launched an investigation to find out if anyone else was involved in her death.

Two days later a pathologist confirmed that Miss Wilson had died from drowning.

Her family received more than 350 cards and letters after her death, many from her colleagues at the hospital.

It is understood that the complaint by the student has since been resolved.

A spokesman for Wythenshawe Hospital said: “Morag faced the challenges of any head of department, but had not raised any concerns about the demands.

“We cannot speculate on the motivation for Morag’s tragic actions but strongly believe she was appropriately supported by the trust. We would like to reiterate our sincere condolences and sympathy to Morag’s family.”

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/06/28/nsuicide128.xml

Health Direct would like to reiterate our sincere condolences and sympathy to Morag’s family, friends and colleagues.

Health Direct would also like to extend our sympathies to the family and friends of Dr David Kelly who also apparently committed suicide after also tangling with labour’s policies.

Against this background of apparent public discontent, doctors will today mount a full-scale attack on NHS reforms, accusing the government of “contemptuous disregard” for the views of the profession and of introducing changes “that are not fit for purpose and are damaging to medicine and healthcare in the UK”.

The Archdeacon of Totnes, John Rawlings, giving the sermon at the BMA’s traditional pre-conference service last night, said the debacle over jobs for junior doctors “has brought heartache of immeasurable proportions”. Earlier Sam Everington, acting chair of the BMA, said he thought the survey of public opinion gave “a very stark message, but I think it is very clear”.

The survey results run counter to most of those commissioned by the government and the official watchdog, the Healthcare Commission, which have traditionally found most patients are happy with their doctors and the treatment they receive on the NHS.

Vivienne Nathanson, head of science and ethics at the BMA, said the survey “reflects a big difference of opinion between the government, patients and doctors”.

The findings of the survey of around 1,000 members of the public in England, questioned on the street, generally reinforced the views of doctors – but there was divergence on the issue of charges in the NHS. The BMA is adamantly opposed to any charges, but 53% of the public thought there was a case for a small charge for some services where resources are limited.

“I wasn’t surprised, but our policy is clearly against it,” said Dr Everington. More work would be needed to find out exactly what sort of charges the public felt would be reasonable, he said.

The BMA has produced its own reform proposals for the NHS, the main one being that the NHS should be run by an independent board of governors. This won 60% support in the survey, but is not expected to find favour with government.

From:
http://politics.guardian.co.uk/publicservices/story/0,,2110593,00.html

The BMA’s critical view of Labour’s NHS policies have been long runing. On June 27 06 Health Direct posted: BMA reports that NHS does not provide choice says public

More than half the people in a general public survey on patient choice in the health service believe the NHS does not offer choice. The British Medical Association commissioned the survey and is publishing the findings on the eve of its annual meeting.

Mr James Johnson, chairman of the BMA, said: “Patient choice is on the lips of every politician and drives the NHS reform agenda. We wanted to find out what it means for ordinary people and how important it is to them. We found some surprising results which don’t seem to match government thinking. Most strikingly, the majority of people (55%) said the NHS did not offer choice”.

In the first ever High Court challenge of its kind, a judge was urged to force the National Institute for Health and Clinical Excellence (aka National Institite for Curbing Expenditure), to reconsider its block on the drugs for those newly diagnosed with the disease.

If successful, the case, brought by the drugs company Eisai and backed by the Alzheimer’s Society, could precipitate a flood of legal actions from patients refused other drugs on the NHS.

Nice decided last year that Aricept, Reminyl and Exelon – three inhibitors – should no longer be made available on the NHS.

At a cost of £2.50 a day, the drugs were too expensive when weighed against the benefits, it said.

But as the case began in London, Alzheimer’s sufferers and their carers protested outside the court, claiming the drugs had given them “a stay of execution”.

Inside the court, Mrs Justice Dobbs heard that Keith Turner, 68, a former chiropodist from Hastings, East Sussex, who was diagnosed in April 2004 and prescribed Aricept, said it had given him back his life.

His wife Lillian said it was “abhorrent and disgusting” that Nice was suggesting that carers such as her would be better off the sooner their sick relatives went into care, she said in a statement. “Even when Keith deteriorates – as we accept he ultimately will – each day we live together at home will be a day we cherish and value,” she said.

Eisai, the Japanese company that makes Aricept; Pfizer, which distributes it in Britain; and the Alzheimer’s Society are accusing Nice of making an “illegal” and “flawed” decision in deciding that those with mild Alzheimer’s be denied the drugs.

There are about 100,000 new cases diagnosed each year. They claim Nice has ignored the proven benefits of the drugs. They want Nice to be forced to reconsider its decision that the drugs be given only to moderate and severe Alzheimer’s sufferers.

David Pannick, QC, for Eisai, said: “One cannot over-emphasise the distress and damage caused to patients and their families by the disease, which progressively destroys the personality.”

Mr Pannick said Eisai and Pfizer recognised that Nice had a difficult job to perform, but it had to adopt a fair procedure, respect rights protected by the law and must not act in an irrational manner.

During the four-day hearing Nice will apparently argue that there was no unfairness.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/06/26/nelderly226.xml

It has taken 8 months for the legal bods to get to the courts. On 11 Oct 06 Health Direct posted: National Institute for Curbing Expenditure (NICE) blights thousands of Alzheimer sufferers

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.

Help the Aged said one in five people over 80 were affected by dementia and the number of people living with the disease was set to double in a decade.

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.”

Patients can rate trusts and comment on their experiences of secondary care, although references to individual clinicians or health professionals will be removed in classic Stalinist style.

They will also be able to compare hospitals on factors such as average length of stay for different treatments, readmission rates, patient survey results and infection levels.

Junior health minister Andy Burnham told HSJ: ‘Health is the second most researched topic on the internet. There’s lots of information out there but what is lacking is lots of validated, authoritative, relevant information. We will see criticism but I also feel people will log on to record thanks and appreciation.’

An electronic health library used by clinicians has been re-written in ‘ordinary language’ so patients can find out more about illnesses and treatments. The website will be able to create tailored individual and family health risk assessments based on age, sex and location.

Hospitals are being encouraged to add to the site by creating their own pages with localised information, governed by the same advertising guidelines used across the NHS. In time, the system is likely to be rolled out to primary care, although unsurprisingly this is still under develpment. Services provided through the independent sector on the NHS can also be rated.

The DoH has spent £3.6m on the website and plans to spend a further £10m a year to keep it going. It is run by Dr Foster Intelligence.

The DoH is also looking at making information available through mobile phones.

The health choices website is at: www.nhschoices.nhs.uk
From:
http://www.hsj.co.uk/healthservicejournal/pages/N1/p9/070621

Health Direct has just conducted a survey of 10 local dentists who are listed on the new nhs choices website. All are listed as
# NOT Currently Accepting New Fee Paying NHS Patients
# NOT Accepting New Charge Exempt Adults for NHS Treatment
# NOT Accepting New Children Aged 0-18 years for NHS Treatment
# DOES NOT Provide Urgent Dental Access Slots

Ergo Health Direct asks the Dept of Health what on earth is the point of your expensive website if patients can’t access the local services that the NHS is supposed to provide?

Voters want health services not yet more expensive spin. So nhschoices.nhs.uk becomes yet another example of labour wasting taxpayers’ money in the name of saving the NHS.

Speaking at the NHS Confederation’s annual conference in London, Mr Cameron promised legislation to outlaw such a policy in the future. He added that the Conservatives’ “first piece of health legislation” would commit the Tories to a comprehensive, universal health service funded out of taxation. But it would go further and “enshrine in law that NHS money should only be spent on NHS patients”, he said, ruling out the “patient passport” proposal.

In future there would be “no opt-outs” and “that’s a guarantee”, Mr Cameron told the conference of NHS managers and board members. “We are not going to use NHS money to help people get out of the NHS into private healthcare. NHS money will be spent on NHS patients and that will be written into the law.”

He underlined that he wanted there to be “no doubt whatsoever” the next Conservative government would uphold the principle of an NHS paid for out of general taxation.

Without naming specific sums, he said the Conservatives would “always support the NHS with the money it needs”.

Andrew Lansley, the party’s health spokesman, said that would mean “additional, growing, real-term resources” – reflecting the fact that as countries grew richer they spent a greater proportion of their total income on healthcare.

Meanwhile, David Nicholson, the NHS chief executive, without directly naming them, launched a strong attack on “the vested interests” of the British Medical Association and the Royal College of Nursing for wild claims that the NHS was “on its knees” or that the service’s financial performance was “a tragedy” or “a farce”.

Such claims “are not just factually incorrect”, said Mr Nicholson. “They are deeply damaging to the public confidence and staff morale”.

From:
http://www.ft.com/cms/s/2477045c-1f93-11dc-ac86-000b5df10621.html

On Jan 24 07 Health Direct posted- Conservative’s David Cameron would hand power back to GPs as many centralist targets for the National Health Service would be scrapped under a Conservative government as more purchasing power was handed to family doctors, David Cameron, the Tory leader said.

The policy would encompass a full-blooded return to GP fundholding – the practice of giving family doctors budgets to buy care on behalf of their patients, which Labour abolished but is now partially reinstating through practice based commissioning.

Health Direct also points out that government actions also loose elections.

Health Direct has frequently raised the issue of waste that labour’s blizzard of targets has created for the NHS. On Dec 18 06 in Labour’s mismanagement has led to NHS deficits according to Commons Health Select Commitee Mismanagement at all levels of the NHS in England has led to the current multimillion pound deficit, a committee of MPs has found.

The Commons health select committee said existing deficits were made worse by the cost of new staff pay deals and the expense of meeting NHS targets. Last year’s NHS deficit was £547m.

The committee said historic deficits, long hidden, were revealed when the government changed the rules so trusts could not underspend their capital budget to subsidise current spending.

But it said the government fuelled the problem by agreeing to new pay deals for doctors and nurses using estimates of the cost which were “hopelessly unrealistic”.

In addition, meeting national targets such as the requirement that no patient should wait more than four hours in A&E; had been costly.

Central government has made “some progress” in implementing previous recommendations made by the National Audit Office, the report says. These include increased use of framework agreements to cut the costs of buying in consultancy as well as involving qualified procurement staff.

However, the report states that “much more can be done” to improve value for money and identifies several areas where departments across government require “significant improvement”.

These areas include controls on awarding contracts by single tender, planning for and carrying out the transfer of skills from consultants to internal staff and better assessment of whether internal resources could be used instead of consultants.

The PAC praises the Ministry of Defence for using consultants to add “real value” to a government department and helping it make improvements it would not have otherwise achieved.

However, the report notes that departments across Whitehall and the Office of Government Commerce (OGC) do not routinely know how much money is spent on consultants.

The PAC says departments should have comprehensive data to help assess whether benefits obtained are justified by the costs and to judge if the best prices are secured when a consultant has considerable ongoing business.

It also calls for improved sharing across Whitehall and with the OGC on the performance of consultants to minimise the risk of departments being overcharged.

In a veiled challenge to Gordon Brown’s incoming premiership, Edward Leigh, the PAC’s Conservative chairman, said government needed to adopt a “much more intelligent approach” to the use of external consultants and become commercially “much sharper”.

“It is impossible to believe that the public is receiving anything like full value for money from this expenditure. In fact a good proportion of it looks like sheer profligacy,” Mr Leigh said.

Alan Downey, chief operating officer for KPMG Risk Advisory Services, which provides consultancy services to the public and private sector, said that although government expenditure on consultancy had increased over the last three years, more recently it had been declining.

From:
http://www.ft.com/cms/s/f6a2b6e2-1dd6-11dc-89f7-000b5df10621,dwp_uuid=34c8a8a6-2f7b-11da-8b51-00000e2511c8.html

Health Direct has long deplored labour’s waste of voter money- on Sept 12, 06 we posted:
NHS external manager bill soars to over £172m this year.

The NHS in England is set to spend £172m this year on external management consultants – a rise of 83% in two years – the Conservatives have claimed. The Tories warn spending on managers is detracting from clinical services.

Welwyn Hatfield MP Grant Shapps used the Freedom of Information Act to obtain figures from 76% of NHS trusts. The data shows a link between trusts with the biggest debts and most job cuts, the Tories said.

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

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

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

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

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

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

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

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

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

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

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

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

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

Four years after the original contracts were signed, the £20bn programme, to provide an electronic patient record and much else, is changing – although it is not yet entirely clear how.

Strategic health authorities are being given direct responsibility for improving implementation. A tender is being completed to bring on additional software and service suppliers.

And while key parts of the infrastructure are now in place, big questions remain about when new patient administration systems will go in to hospitals, along with the associated software needed to provide a shared, electronic patient record.

Fears about the future of iSoft, one of the two key software providers for the record, were markedly eased yesterday, as CSC, its parent contractor, took more responsibility for the software itself.

But hospitals are reluctant to take new administration systems until iSoft’s patient record software is available – the earliest installations are not due until next year – and until Cerner, the other record provider, has an accounts package adapted to the NHS.

It looks likely to be 2009 or 2010 before those will be being installed in large numbers nationwide. And some NHS trusts are seeking more variation than is so far theoretically permitted under the fierce standardisation that the programme has sought to date. That would vary existing contracts, as would bringing in more suppliers.

There remains room for fierce debate about where the blame lies for the delays – with the NHS or the suppliers. Mr Granger has paid suppliers only for systems that are working, keeping the programme on budget.

But six months ago, he warned publicly that his departure might lead to claims from key suppliers that their original contracts have been varied and they should be compensated. At the weekend, he described that risk as “significant”. And that appears to be one reason why he and ministers are talking about a “transition” from his full-time role, rather than an immediate departure.

There is also the question of who – given the size of the brickbats that have come to be associated with the job – will want to replace him.

From:
http://www.ft.com/cms/s/5e7e23f8-1e01-11dc-89f7-000b5df10621.html

There is also a question as to why Richard Grainger is leaving his post. Health Direct points out that successful IT projects need a champion to drive the strategic implementation through. With his departure that leadership is now lacking. And patients are having to wait even longer.

On Mon 5 Jun 06 Health Direct posted: £20bn NpfIT computer failures left NHS patients waiting longer as evidence that the Labour government’s troubled £20 billion National Health Service computer system has lengthened waiting times for patients has emerged for the first time.

It was hoped that a pilot scheme for the technology at the Nuffield Orthopaedic Centre NHS Trust in Oxford would show the benefits of the delayed system. Instead, when it went “live”, the computers crashed, data could not be found and some patients found that they were facing among the longest waits for operations in the country.

Staff who were instructed to sort out the problem could not even establish from the malfunctioning computers which patients had been waiting the longest and the numbers kept climbing.

Ross Anderson, a professor in security engineering at the University of Cambridge, warned that the new system was likely to cause “chaos and disaster” in the NHS. “They’re ripping out the old systems but they’re not replacing them with anything better,” he said.

Fewer hospitals and NHS trusts than last year can demonstrate that they are maintaining standards on cleanliness and infection control, despite the introduction of a strict “hygiene code” to eradicate illness caused by MRSA and Clostridium difficile.

Particular problems include failing to decontaminate reusable medical devices, to reduce healthcare-associated infections and to supply the latest recommended treatments for patients. There was also a slight decline in the number of trusts saying they met two standards on treating patients with dignity and respect.

The findings are based on 394 reports by the trusts themselves on their ability to meet the core standards. They show that 40 per cent believe that they met all the requirements in 2006-07, up from 34 per cent in 2005-06.

But 55 trusts (14 per cent) said that they had not met, or lacked evidence to say that they had met, the standard on reducing the risk from infections such as C. difficile, double the 7 per cent from last year.

A similar proportion also said that they had not met, or could not prove that they had met, the standard to disinfect medical equipment properly. In addition, 43 trusts (11 per cent) had failed adequately to keep wards clean and buildings in good order.

Overall, 99 trusts (25 per cent) had failed one or more aspects of a hygiene code, a set of 11 compulsory duties to prevent or cope with hospital superbugsthat was introduced in October 2006.

Inspectors are carrying out unannounced checks on infection control in 120 trusts, and hospitals have been told that they could be served improvement notices if they fail to tackle the bugs.

In April, statistics from the Health Protection Agency (HPA), the public health watchdog, showed that there were 55,681 cases of C. difficile in patients aged 65 and over in England in 2006. That figure was up by 8 per cent on 2005.

MRSA bloodstream infection figures revealed 1,542 cases in England between October and December 2006, down 7 per cent on the previous quarter. Despite this fall, the labour Government is expected to miss its target of halving MRSA rates before next April. Today’s report lists 15 trusts who know that they will get a “weak” rating in this year’s check by the Healthcare Commission. They have already said that they cannot meet 14 or more of the 24 requirements on care.

Four trusts did not meet any of the three standards relating to the hygiene code, the commission said. These were the Royal Cornwall Hospitals NHS Trust, Sheffield Primary Care Trust, Sutton and Merton Primary Care Trust and Wiltshire Primary Care Trust.

The Royal Cornwall was identified this month as being in financial difficulty when the Government published figures on NHS deficits.

A further one in ten trusts could not say that they conformed to guidelines regarding recommended new treatments and medicines.

The commission will now investigate one in five NHS trusts in England before publishing its final report in October.

Anna Walker, the commission’s chief executive, said that there were several possible reasons for the failures on hygiene, but the commission wanted to “applaud trusts that have put their hands up” and declared failures. “The first step to sorting out a problem is recognising you have one,” she said. “That is the action of an honest and responsible board that wants to make improvements and get these standards in place for patients.”

Opposition parties called the findings uanacceptable. Norman Lamb, the Lib Dem health spokesman, said: “There has to be a cultural change within hospitals. Three quarters are successfully implementing effective measures – there is no excuse for others not to follow.

“There has to be a zero-tolerance approach to tackling superbugs. It is shocking that, after countless government initiatives, the number of hospitals failing to protect patients from these infections has doubled.”

A Department of Health spokesman said: “It is encouraging that, for many standards, over 90 per cent of trusts were able to report compliance . . . Where there is evidence of a problem, it is important that individual organisations ensure that they have plans and processes in place to improve.

“The review process will help the trust to develop solutions with their SHA, and this is part of the declaration process.”

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article1945915.ece

The disgrace that is labour’s policy for the NHS once again shows it is the public that is paying the price for labour’s underfunding – with their lives.

On Fri 23 Feb 07 in MRSA and Clostridium difficile deaths up by half in year the Health Direct blog was partly set up in response to the preventable crisis that is killing thousands of patients in the UK. We calculated back in 2004 that fewer people being killed on UK roads than by superbugs. Since then Health Direct calculates that in 2005, there were nearly 70 per cent more deaths linked to MRSA and Clostridium difficile than were people killed in traffic accidents on all of the UK’s roads.

A spokeswoman for the Patients Association said: “Our worry is that these figures will continue to rise as other priorities take precedence “The labour 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.

The paper recommends reducing services at Queen Mary’s Hospital, Sidcup, rather than PFI hospitals in south east London, where a consultation on reconfiguration proposals is expected this autumn.

It adds that decisions should take into account many factors, not just finance. But with significant excess of beds expected and a £65m deficit some cuts seem inevitable. A spokesperson for the project board said hospitals were working to see where care would be best delivered but that all were likely to see significant change.

Reducing work at PFI hospitals at Bromley and Woolwich would achieve few savings as the NHS is committed to annual payments for the buildings, and often additional costs for some elements of facilities. The report says ‘whole hospital PFI sites’ have ‘less flexibility to reduce “hard” facilities managements costs in the event of an unplanned reduction in activity because of constraints in their PFI contracts’.

In contrast, excess land and facilities at non-PFI sites could be sold off to make significant savings.

The paper also warns that a new PFI site at Lewisham Hospital will need to achieve ‘high utilisation rates… if it is to avoid the increased pressures giving rise to a worsening of its income/expenditure and cash flow positions’.

Sharon Massey, cabinet member for health and adult social services at Bexley council, which covers Sidcup, said: ‘We are devastated that Queen Mary’s is coming out as the most vulnerable hospital. There is effectively a mortgage on other hospitals. Queen Mary’s does not have a mortgage so is easy to dispose of.’

The paper focuses on south east London but arguments would apply in other areas with a mix of PFI and non-PFI hospitals.

Imperial College London professor of health policy Nick Bosanquet also sent out a warning. He said: ‘There will be a temptation to say “we are stuck with these contracts, we will close down older hospitals which may in fact be lower cost”.’

From:
http://www.hsj.co.uk/healthservicejournal/pages/N2/p7/070614

On Jan 16, 07 Health Direct warned: Brown can’t cure this paralysed NHS, so he plans to privatise it

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 message of Robinson’s inquiry was devastating and explains the ostensibly terminal chaos enveloping the NHS under Patricia Hewitt. The central arm of government, the Treasury, has clearly given up on NHS reform. No government, Labour or Tory, has the guts to break the consultants’ restrictive practices, the GPs’ “lifestyle” demands or the healthcare unions.

The Treasury itself capitulated to the unions by rubber-stamping the ridiculously expensive 2004 NHS pay deal, depriving Britons for the first time of proper out-of-hours GP cover.

More alarming is that internal pricing and payment-per-treatment will leave these mastodons financially exposed through loss of business to the private sector. In an attempt to favour this sector, the Treasury and Hewitt are refusing to allow NHS hospitals to cut tariffs to compete. Small wonder James Johnson, the British Medical Association chairman, parodied Blair’s 1997 battle cry, “24 hours to save the NHS” by saying there was now “one year to save the NHS”.

Many hospital trusts are building up large deficits that they cannot possibly cover; 29 are contemplating some 60 “reconfigurations”, code for closures, at a time when Hewitt is also talking of somehow building 50 cottage hospitals. She must also now contend with 11 of her ministerial colleagues declared to be in open opposition.

Meanwhile manpower planning is in disarray, with hiring cuts or freezes almost everywhere and a reported surplus of 3,200 expensively trained NHS consultants by 2010.